COMPARATIVE OBSERVATION ON CURATIVE EFFECT OF POSTOPERATIVE SYMPTOMS OF THE CLOSED CRANIOCEREBRAL INJURY TREATED BY ACUPUNCTURE

Theincidenceofcraniocerebralinjuryisveryhighatpresent.Trafficaccident,violenceandindustrialinjuryarethemainreasonsofthedisease.Besidesthecorrespondingsymptomsofcontusionand1acerationofbrain,subduralhematoma,extraduralhematomaandintracere-bralhematomamayoccuratthesametime.Thepatientswilldieiftheyarenotoperatedintime.However,theexacerbationofcerebralfunctioncausedbyoperativemechanicalstimulationcannotbeavoided.Therefore,therehabilitationofcraniocerebralinjuryisverycomplicatedanddif-ficult,andne…     

儿童桡尺骨远端骨折背侧移位的损伤机制及治疗手法的探讨

总结了儿童桡尺骨远端骨折背侧移位９４例患者，利用回旋或折顶手法复位小夹板外固定，经８个月～５年的随访观察，效果满意。观察认为，扭转应力及成角应力皆可导致此类损伤，但不同创伤机制所导致的此类损伤的具体解剖不同，必须逆损伤机制，采取相应的手法复位才能获得满意的疗效。建议把儿童桡尺骨远端骨折背侧移位作为桡尺骨骨折的一种特殊类型独立出来，以引起重视，便于治疗     

吸入NO对体外循环术中肺缺血再灌注损伤的保护作用

目的 :探讨吸入一氧化氮 (NO)对体外循环手术中肺缺血再灌注损伤有无保护作用。方法 :将 2 0例风湿性心脏瓣膜疾病患者随机分为对照组和NO组 ,术中观察平均肺动脉压 (MPaP)、肺动脉阻力 (PVR)、气道峰压 (PAP)、动脉血氧分压 (PaO2 )、环磷酸鸟苷 (cGMP)、细胞间粘附分子 1(ICAM 1)、黄嘌呤氧化酶 (XOD)及丙二醛含量 (MDA) ,并记录术后应用人工呼吸时间。结果 :与NO组相比 ,对照组再灌注后PAP ,MPaP ,PVR明显升高 (P <0 .0 5 ) ;肺氧合功能明显受损 ,术后使用人工呼吸机时间显著延长 (P <0 .0 1) ;cGMP明显降低 (P <0 .0 1) ,而ICAM 1,XOD及MDA明显升高 (P <0 .0 5 )。结论 :说明体外循环术中存在明显的肺缺血再灌注损伤 ,再灌注后 11min吸入 2 0ppmNO连续 30min对该损伤有明显的保护作用 ,其机制与增加cMGP ,ICAM 1及XOD活性 ,降低及灭活 /减少氧自由基生成有关。     

Somatic growth and renal function after unilateral nephrectomy for Wilms' tumor

Solitary kidneys in renal donors and patients who have undergone unilateral nephrectomy for malignant disease have been reported to undergo hyperfiltration injury. This study was undertaken to evaluate the somatic growth and development of followed-up patient after Wilms' tumor to evaluate their renal function and identify any evidence of injury in the remaining kidney. The growth and development of all the children was found to be normal, as was DTPA clearance. Microalbuminuria in 24-h urinary collections was detected in 84% of the patients, indicating evidence of hyperfiltration injury. This study highlights the need for close monitoring of the renal function of long-term follow-up patients after Wilms' tumor in addition to the routine monitoring for tumor recurrence. Accepted: 26 May 1998     

Experimental Evidence of Cerebral Injury from Profound Hypothermia During Cardiopulmonary Bypass

Choreoathetosis, seizures, and impaired mental development continue to occur in children undergoing cardiopulmonary bypass (CPB) and profound hypothermia with or without circulatory arrest. Although there is some evidence that the hypothermia itself may be causing these neurologic problems, skepticism remains because of lack of evidence from experimental studies simulating the clinical setting. In this experimental study, we examined the effect of profound and moderate hypothermia on the brain while maintaining normal flow rates during CPB. Ten adult mongrel dogs equally divided into two groups were anesthetized and subjected to CPB and varying levels of hypothermia (group 1, ≤15°C; group 2, ≤32°C). Both groups were kept at the desired temperature for 1 hour prior to rewarming and discontinuation of CPB. The dogs were euthanized 4–6 weeks later and neuropathologic studies were performed. The mean CPB flow rates during cooling and at the desired rectal temperature were comparable in both groups: group 1, 108 ± 10 ml/kg/min versus 106 ± 7 ml/kg/min in group 2 (p= NS) and 95 ± 12 ml/kg/min in group 1 versus 101 ± 5 ml/kg/min in group 2 (p= NS). Because of the difference in temperature between the two groups, the mean cooling time (onset of CPB to desired rectal temperature) was longer in group 1 (70 ± 14 minutes) than in group 2 (28 ± 11 minutes, p= 0.007). Hence, the total mean CPB time was also longer in group 1 (198 ± 25 minutes) than in group 2 (143 ± 13 minutes, p= 0.002). The lowest mean blood and rectal temperature achieved in group 1 were 11 ± .9°C and 12 ± 1°C versus 29 ± .4°C (p < 0.001) and 30 ± .6°C (p= 0.001), respectively, in group 2 (p= 0.001). Neuronal loss and degeneration was noted in all dogs in group 1 ranging from 2 to 8 cells per 1000 cells counted compared to none in group 2 (p= 0.05). These lesions occurred in both the basal ganglia and the cortex, although they were more marked in the caudate when compared to the cortex and cerebellum. Both in the cortex and in the caudate, neuronal loss was more marked around the capillaries. We conclude that the use of profound hypothermia of ≤15°C and maintenance of normal flow rates during cooling at this temperature for 1 hour produces neuronal loss and degeneration in the brain. These lesions being more marked around capillaries points to the vulnerability of the neurons, probably because of their high lipid content to injury from the cold perfusate.     

舒心饮对豚鼠心脏再灌注冠脉流液前列腺素、心肌内皮素和脂质过氧化物的影响

目的:观察舒心饮对豚鼠心脏缺血再灌注的改善作用。方法:将豚鼠随机分为3组(对照组、缺血组、舒心饮组),观察舒心饮对豚鼠心脏缺血再灌注后冠脉流液中血栓素B2、6-酮-前列腺素 F_(1α)心肌组织内皮素和脂质过氧化物的影响。结果:对缺血后损伤的心肌, 于再灌注的同时给予舒心饮(1.6g/L),明显抑制血栓素 A_2的释放,促进前列环素I_2的产生,减少心肌内皮素的含量,加速清除氧自由基降低心肌组织脂质过氧化物的含量。结论:舒心饮具有抗心肌缺血的作用。     

健脾益气和胃法防治大鼠胃缺血再灌注损伤的实验研究

目的:探讨大鼠胃缺血后再灌注胃粘膜损伤与氧自由基脂质过氧化的相关性及以健脾益气和胃法防治其胃粘膜损伤的细胞保护作用机制。方法:采用腹腔动脉结扎法,造成胃缺血20min,解除结扎,再灌注60min 后,取出胃粘膜,观察正常对照组、病理模型组和用药各组中胃粘膜之氧自由基脂质过氧化物及清除酶系诸指标的变化。结果:大鼠胃缺血后再灌注,胃粘膜脂质过氧化物(LPO)含量比正常对照组明显增加,超氧化物歧化酶(SOD)、非蛋白巯基(NPSH)、谷胱甘肽过氧化物酶(GSH-Px)含量则明显降低(P<0.01);术前口服健脾益气和胃中药各组胃粘膜 LPO 含量明显低于病理组,SOD、NPSH、GSH-Px 水平则明显高于病理组(P<0.05,P<0.01);而过氧化氢酶(CAT)和前列腺素 E_2(PGE_2)在实验各组的比较无统计学意义(P>0.05)。结论:氧自由基脂质过氧化参与胃缺血再灌注的胃粘膜损伤过程,健脾益气和胃法的治疗对胃缺血再灌注损伤具有保护作用。此作用可能是通过抑制氧自由基过氧化损伤,提高胃粘膜 SOD、GSH-Px、NPSH 活性,增强其抗氧化能力而实现的。     

舒肝灵胶囊抑制肝损伤及影响免疫功能的实验研究

目的:观察舒肝灵胶囊对肝损伤动物的保护作用。方法:用脾指数、肝胶原蛋白含量、肝硬化形成率、ALT 值检测肝损伤程度。以炭粒廓清法,迟发型超敏反应法检测免疫功能。结果:舒肝灵胶囊能降低慢性肝损伤大鼠的脾指数、肝胶原蛋白含量及肝硬化形成率(P<0.05,P<0.01);降低急性肝损伤小鼠的 ALT 值(P<0.C15),提高小鼠对胶体炭粒的清除速度(P<0.05),增强二硝基氯苯(DNCB)引起的小鼠迟发型皮肤过敏反应强度。结论:舒肝灵胶囊能够抑制大鼠慢性肝损伤的发展,提高小鼠单核巨噬细胞的吞噬功能和 T 淋巴细胞的免疫功能。     

穿心草酮抗心肌缺血再灌注心律失常的保护作用及其机制

目的：观察３种穿心草酮（Ｘａｎ）对缺血再灌注模型心律失常的保护作用及其机制。方法：采用整体大鼠心肌缺血再灌注模型，于结扎前３ｍｉｎｉｖ３种Ｘａｎ１ｍｇ／ｋｇ。结果：３种Ｘａｎ可不同程度地降低缺血再灌注损伤引起的室性心律失常发性率，缩短持续时间；提高超氧化物歧化酶（ＳＯＤ）的活性，减少脂质过氧化反应代谢产物丙二醛的含量，减少心肌谷草转氨酶及乳酸脱氢酶的释放量；作用强度的顺序为：ＸａｎⅠ＞ＸａｎⅢ＞ＸａｎⅡ。结论：３种Ｘａｎ具有抗心肌缺血再灌注损伤的保护作用，作用机制可能是与其降低心肌脂质过氧化及增强ＳＯＤ的活性有关；Ｘａｎ的活性与其苯环上羟自由基及甲氧基的多少及其位置有关。     

柴蔻冲剂对慢性酒精性肝损伤大鼠抗脂质过氧化作用的实验研究

观察中药复方柴蔻冲剂（ＣＫＩ）对慢性酒精性肝损伤大鼠的防护作用。ＣＫＩ可显著提高红细胞和肝组织中超氧化物歧化酶（ＳＯＤ）活性，血与肝组织中过氧化氢酶（ＣＡＴ）、谷胱甘肽过氧化物酶（ＧＳＨ－ＰＸ）的活性。显著降低血浆与肝组织中脂质过氧化终产物丙二醛（ＭＤＡ）含量，抑制氧自由基的产生，提高组织抗氧化能力。并探讨了柴蔻冲剂的量效关系。