Patterns of membrane potentials and distributions of the medullary respiratory neurons in the decerebrate rat

We analyzed the membrane potential of 161 respiratory neurons in the medulla of decerebrate rats which were paralyzed and ventilated. Three types of inspiratory (I) neurons were observed: those displaying progressive depolarization in inspiration (augmenting I neurons), those which gradually repolarized after maximal depolarization at the onset of inspiration (decrementing I neurons) and those exhibiting a plateau or bell-shaped membrane potential trajectory throughout inspiration (I-all neurons). Three types of expiratory (E) neurons were also encountered: those in which the membrane potential progressively depolarized (augmenting E neurons), those in which the membrane potential repolarized during the interval between phrenic bursts (decrementing E or post-I neurons) and those exhibiting a plateau or bell-shaped membrane potential trajectory throughout expiration (E-all neurons). Axonal projections of these medullary neurons were identified in the cranial nerves (n = 34), or in the spinal cord (n = 19) as revealed by antidromic stimulation and/or by reconstruction following horseradish peroxidase (HRP) labeling. The other 108 neurons were not antidromically activated (NAA) by the stimulations tested, or had their axons terminating inside the medulla as revealed by HRP labeling. All these respiratory neurons, except for 3 which were hypoglossal motoneurons, had their somata within the ventrolateral medulla, in the region of the nucleus ambiguus, homologous to the ventral respiratory group (VRG) of the cat. No dorsal respiratory group (DRG) was detected within the medulla of the rats. Due to this absence of a DRG, it is concluded that the neural organization of respiratory centers is quite different in cats and rats.     

干扰素治疗小儿呼吸道感染的研究

目的观察干扰素治疗小儿呼吸道感染的疗效。方法将90例呼吸道感染的小儿随机分成3组,在对症治疗基础上,A组静脉点滴利巴韦林10mg/(kg·d),B组肌注干扰素10μg,1次/d,C组空气压缩泵雾化吸入干扰素10μg,1次/d,观察3组的病情变化。结果C组咳嗽、发热、喘憋及肺部体征好转时间均较A组明显缩短(P<0.01),B组与C组疗效无显著性差异。结论干扰素治疗小儿呼吸道感染疗效确切,值得推广。     

Vertebral body replacement system Synex in unstable burst fractures of the thoracic and lumbar spine

A prospective longitudinal study was performed to evaluate the vertebral body replacement system Synex associated with posterior fixation in unstable burst fractures of the lumbar and thoracic spine. Within 24 months, we treated 28 patients (average age, 41 years; range, 22–64 years; 14 women, 14 men) with acute unstable burst fractures without osteoporosis of the thoracolumbar region (n=16) and the thoracic (n=3) as well as the lumbar (n=9) spine in two stages (primary dorsal transpedicular stabilization and secondary vertebral body replacement). The complications were analyzed and the postoperative follow-up result was evaluated regarding stability, bone fusion, correction loss, pain and neurological status. One patient showed a transient irritation of the lumbosacral plexus and one patient had a superficial wound infection (complication rate, 7.1%). At the follow-up examination (mean follow-up, 13 months) only in two cases a minimal loss of correction (<5°) was measured. Radiologically, 27 patients showed secure bone fusions and all patients had stability of the osteosynthesis. Most of the patients stated no or just slight pain at follow-up. Only two patients with pain to a medium degree had to take painkillers. The vertebral body replacement system Synex seems to be a good alternative for vertebral body replacement in unstable burst fractures of the thoracic and lumbar spine since at present follow-up it shows a high rate of bone fusion and minimal loss of correction.     

SARS患者白细胞形态学观察

目的：观察不同病程的严重急性呼吸综合征(SARS)患者白细胞形态的变化。方法：对不同病程SARS患者的血涂片进行形态观察和分析。结果：SARS患者发病期间，其粒细胞比例明显升高，淋巴细胞明显减少，而且出现核仁及多核仁现象，随病程进展，粒细胞、淋巴细胞的比例逐渐恢复至正常范围，有核仁的淋巴细胞也随之减少至消失，均为正常成熟的淋巴细胞。结论：SARS患者发病期间，外周血涂片白细胞分类中，中性粒细胞(分叶核)比例升高，淋巴细胞比例明显减少，随病程进展出现的核仁淋巴细胞减少，血细胞比例、形态恢复正常。     

鱼腥草注射液佐治下呼吸道感染的疗效观察

目的观察鱼腥草注射液佐治下呼吸道感染的疗效及安全性.方法将76例急性下呼吸道感染患者随机分为治疗组和对照组,两组均予内科常规治疗,治疗组则另予鱼腥草注射液治疗.结果治疗组的总有效率为94.7%,显著优于对照组的73.7%(x2=6.33,P＜0.05),且未见明显副作用.结论鱼腥草注射液佐治急性下呼吸道感染安全、有效,值得推广.     

95例SARS患者T细胞及其亚群动态变化的观察

对 95例SARS患者的T淋巴细胞亚群动态变化进行分析。其中 85例痊愈 ,1 0例死亡。 85例痊愈患者 ,病程第 7天平均CD4 + ( 3 2 5± 1 90 )个 /μL ,CD8+ ( 3 1 9± 3 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 5± 0 .71 ,与我国正常人相比〔平均CD4 + ( 72 7± 2 5 5 )个 /μL、CD8+ ( 5 3 9± 1 3 4)个 /μL ,CD4 + /CD8+ 1 .49〕 ,T淋巴细胞亚群明显下降 (P =0 .0 0 1 )。病程第1 4天左右免疫功能逐渐恢复 ,平均CD4 + ( 5 61± 5 2 2 )个 /μL ,CD8+ ( 3 70± 2 71 )个 /μL ,CD4 + /CD8+ 1 .68± 1 .1 1。 2 1d后免疫功能基本恢复正常 ,平均CD4 + ( 675± 448)个 /μL ,CD8+ ( 4 67± 2 41 )个 /μL ,CD4 + /CD8+ 1 .48± 0 .68。 1 0例死亡患者的T细胞亚群在入院后逐渐出现下降趋势 ,病程第 7天CD4 + ( 2 48± 82 )个 /μL ,CD8+ ( 2 3 3± 1 1 5 )个 /μL ,CD4 + /CD8+ 1 .2 1± 0 .40 ,第 1 4天T淋巴细胞继续下降 ,平均CD4 + ( 1 81± 1 2 8)个 /μL ,CD8+ ( 1 73± 1 0 9)个 /μL ,CD4 + /CD8+ 1 .1 7± 0 .45 ,2 1d后CD4 + 细胞继续下降 ,平均CD4 + ( 1 2 5± 46)个 /μL ,CD8+ ( 94± 3 8)个 /μL ,CD4 + /CD8+ 1 .44±0 .5 9。结果提示 :SARS患者早期可能存在异常的免疫反应 ,这种异常免疫反应可能是导?     

连续性静脉-静脉血液滤过联合机械通气治疗ARDS的临床观察

目的　观察连续性静脉 -静脉血液滤过 (CVVH)联合机械通气治疗ARDS患者的临床疗效。方法　选择入住ICU符合ARDS诊断标准的患者 4 0例 ,随机分为 2组 :A组 2 1例 ,采用常规治疗 +机械通气 ;B组 1 9例 ,采用常规治疗 +机械通气 +CVVH。分别观察 2组患者在使用呼吸机时间、氧合指数、吸入氧浓度、动脉血氧分压、PEEP水平、心率、血压及病死率等方面的差别。结果　A、B两组患者在病因、年龄、性别、APACHEⅡ评分及平均脏器功能障碍数等方面相似 ,B组患者加用CVVH后 ,各项指标经统计学处理显示 :病死率 ,B组与A组比较 ,差异有显著性意义 (P <0 0 5 ) :其他指标与A组比较 ,差异均有高度显著性意义 (P <0 0 1 )。结论　CVVH疗法可有效清除ARDS患者血管外肺水和各种应激激素、致炎介质 ,明显改善了ARDS患者肺部氧合功能及血流动力学指标 ,提高了抢救成功率