五瓣法整复条蹼状瘢痕挛缩畸形

报告了一组应用五瓣法（５—Ｆｌａｐｔｅｃｈｎｉｑｕｅ）整复损伤和烧伤所致蹼状瘢痕挛缩畸形，获得良好治疗效果。并就手术设计、原理、操作方法及适应证进行了讨论。     

Intraparenchymal blood-fluid levels in traumatic intracerebral haematomas

Summary Blood-fluid levels within the cerebral parenchyma are observed more frequently on CT and MRI in traumatic intracerebral haematomas than in those of other aetiologies. The intraparenchymal blood-fluid interface can be formed without a fluid cavity. It is suggested that the blood-fluid levels represent layering of red blood cells within areas of contusion necrosis as well as extensive contusion oedema. The more extensive the damage to brain tissue, the more often blood-fluid levels formed. A poorer outcome can be therefore predicted when an intraparenchymal blood-fluid interface is seen.     

血乳酸浓度监测与组织氧合相关性的临床观察

目的　寻找能反映严重烧伤后组织氧合状况的简便易行、微创、有效的生化指标。方法　将收治的 34例大面积烧伤患者随机分为两组 ,A组 18例 ,采用改进后的抗休克复苏方案 ,使患者尿量维持在每小时 10 0ml左右 ;B组 16例 ,采用常规补液公式 ,使患者尿量维持在每小时 4 0ml左右。两组同时于复苏前、复苏后 1、8、16、2 4、4 8、72h监测血乳酸浓度 (BL)及常规监测指标 (尿量、血压、心率、神志 )。　结果　 (1)A组患者复苏后 2 4h内 ,血BL浓度平均为 (3.2± 0 .4 )mmol/L ,常规指标均处于正常范围 ;B组患者常规指标基本正常 ,血BL平均值为 (7.4± 1.6 )mmol/L ,持续时间可达 72h以上。 (2 )在常规监测指标指导下 ,B组复苏治疗效果不佳 ,病死率高 (31.2 % ) ;A组通过监测BL指导治疗 ,病死率仅为 5 .5 %。 (3)BL与尿量呈负相关 ,与心率呈正相关。　结论　 (1)严重烧伤休克时组织的乏氧代谢增强 ,监测血BL ,能基本达到快捷、灵敏、简单、有效、微创的要求 ,是反映全身组织器官氧合状况的良好指标。 (2 )建议烧伤抗休克的复苏时间应延长至 72h ,尿量保持在 10 0ml/h ,确保复苏的质量和效果。     

增殖性疤痕中表皮细胞增殖、血管新生与VEGF的表达

目的：研究增殖性疤痕中血管内皮细胞生长因子(VEGF)的表达，及其与疤痕表皮细胞增殖和血管新生的关系。方法：应用免疫组化和RT-PCR法，以正常皮肤、正常疤痕为对照，检测增殖性疤痕中VEGF表达，并研究VEGF与表皮细胞增殖、血管新生的相关关系。结果：增殖性疤痕内VEGF蛋白及VEGF mRNA表达明显升高，与正常疤痕、正常皮肤有显著差别。VEGF主要由疤痕表皮角朊细胞分泌，且VEGF蛋白和VEGF mRNA的表达与疤痕组织表皮细胞增殖、血管新生高度相关。结论：增殖性疤痕中VEGF蛋白和VEGF mRNA的表达与疤痕增殖密切相关。     

外伤性视神经病变的临床治疗分析

目的　探讨大剂量甲基强的松龙冲击疗法治疗外伤性视神经病变的疗效。方法　 2 0例 (2 0只眼 )外伤性视神经病变患者为治疗组 ,应用大剂量甲基强的松龙冲击治疗 ,另 2 0例 (2 0只眼 )外伤性视神经病变患者为对照组 ,使用常规剂量的地塞米松治疗。两组均同时使用高渗剂、血管扩张剂、神经营养剂及 B族维生素治疗 ,对两组病例药物治疗的结果进行总结分析。结果　治疗组经治疗后视力开始恢复的时间早于对照组 ,治疗组的总有效率为 80 % ,对照组的总有效率为 6 0 % ,治疗组的疗效优于对照组 ,且治疗越早疗效越好。两组比较具有显著的统计学差异 (P <0 .0 5 )。结论　大剂量甲基强的松龙冲击疗法治疗外伤性视神经病变疗效显著 ,治疗方便 ,是较理想的治疗方法     

1090例高校新生卡介苗接种普及情况和PPD试验结果调查分析

为了解江西省卡介苗实施情况并为高校防治结核提供依据。本文调查江西财院九江分院１０９０名新生的卡痕和ＰＰＤ试验。结果：总卡痕率７２．９４％，城、乡间无显著性差异；ＰＰＤ试验阴性率６０．４６％，阳性率３９．５４％、其中强阳性率３．１２％，乡村生强阳率显著高于城市生；ＰＰＤ阳性率在城、乡之间以及有、无卡痕者均无显著性差异。有卡痕者ＰＰＤ阳性率４０．５０％，提示近６０％种卡后未阳转或又复转阴。作者认为高校新生入学时进行ＰＰＤ试验并对阴性和强阳性采取进一步防治措施是非常必要的。     

Memory outcome at 5 years post-childhood traumatic brain injury

Primary objective: This study seeks to extend previous findings by documenting memory performance in a sample of 70 children at 5 years post-injury. It was anticipated that increasing injury severity would be associated with decreased performance on working and complex memory tasks. It was also expected that injury severity would significantly predict memory, but that the time from insult to subsequent testing would be associated with an increased relationship to non-injury factors.

Research design: Participants were assessed at 5 years post-injury, aged between 6-14 years, using measures of immediate, working and complex memory.

Methods and procedures: The sample comprised 18 children who had sustained a severe TBI, 24 with a moderate TBI, 11 with a mild TBI and 17 healthy controls, matched for age, gender and socio-economic-status.

Results: Results indicated that severe TBI was associated with decreased complex auditory-verbal memory performance, although children with TBI did not display impairment on immediate, working or complex visual-spatial memory. While injury severity significantly predicted complex memory outcome, non-injury factors failed to significantly predict either working or complex memory performance.

Conclusions: Future research should be engineered towards further clarifying what influences recovery from childhood TBI in the elongated post-injury period.     

μ,δ,κ阿片受体在创伤失血性休克大鼠心血管功能抑制中的作用

目的探讨μ，δ和κ阿片受体与创伤失血性休克大鼠心血管功能抑制的关系。方法用大鼠创伤失血性休克模型，观察创伤失血性休克后大鼠心脏和脑μ，δ和κ阿片受体变化及其与血流动力学指标的变化的关系；观察δ和κ阿片受体特异性拮抗剂对创伤失血性休克大鼠血流动力学指标的影响。结果创伤失血性休克后，大鼠心脏和脑δ和κ阿片受体数目明显升高，亲和力无明显变化，心脏和脑的δ和κ阿片受体数目升高与创伤失血性休克后大鼠血流动力学指标下降呈显著负相关。δ和κ阿片受体特异性拮抗剂可明显逆转创伤失血性休克大鼠血流动力学指标的下降。结论δ和κ阿片受体在创伤失血性休克心血管功能抑制中起重要作用，参与了创伤失血性休克的发病过程     

Keratinocyte-derived growth factors play a role in the formation of hypertrophic scars

In predisposed individuals, wound healing can lead to hypertrophic scar or keloid formation, characterized by an overabundant extracellular matrix. It has recently been shown that hypertrophic scars are accompanied by abnormal keratinocyte differentiation and proliferation, and significantly increased acanthosis, compared with normal scars. This study addressed the question of whether the development of normal and hypertrophic scars is regulated by differences in the growth factor profiles of both the epidermis and the dermis. The presence of interleukin-1alpha (IL-1alpha), IL-1beta, tumour necrosis factor-alpha (TNF-alpha), platelet-derived growth factor (PDGF), transforming growth factor-beta1 (TGF-beta1), and basic fibroblast growth factor (bFGF) was investigated in biopsies taken from breast reduction scars at 3 and 12 months following surgery. The samples were analysed by immunohistological methods and categorized as scars that remained hypertrophic (HH), became normal (HN) or remained normal after 12 months (NN). The epidermal expression of IL-1alpha was significantly increased in NN scars compared with HN and HH scars 3 and 12 months following operation, whereas the dermal expression showed no difference. PDGF was significantly increased in the dermis of normal scars after 3 months and in both the epidermis and the dermis of hypertrophic scars after 12 months. IL-1beta, TNF-alpha, TGF-beta and bFGF showed no differences. It is hypothesized that impaired production of keratinocyte-derived growth factors, such as IL-1alpha, leads to a decrease in the catabolism of the dermal matrix, whereas augmented epidermal PDGF production leads to increased formation of the dermal matrix in hypertrophic scars. These observations support the possibility that the epidermis is involved in preventing the formation of hypertrophic scars.     

Traumatic Memories: Empirical Foundations, Forensic and Clinical Implications

This article reviews empirical research on memories for negative personal experiences among adults. It examines basic concepts (including neural underpinnings), theoretical models of the affect-memory relationship, and data from three sources: victims or witnesses to crimes and atrocities, "flashbulb memories" for traumatic events, and laboratory simulations of shocking experiences. Evidence suggests that memories for traumatic experiences contain more central than peripheral detail, are reasonably accurate and well-retained for very long periods, but are not completely indelible. Assertions of eyewitness memory's vulnerability to change through suggestion have overstated the evidence. Forensic and clinical implications are discussed and a plea issued for more study of the memory phenomena that characterize posttraumatic stress disorder (PTSD) and are the focus of trauma survivors' treatment.