Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

实报实销与管理性医疗的老年糖尿病患者需眼部治疗的比较研究

目的:比较网络型医疗保险+选择的医疗受益者(M C)与实报实销健康保险者(FFC)需要眼部治疗的发生率。方法:对洛山矶地区社区居住的年龄>65岁的糖尿病患者中的M C和FFS人群进行横断面随机抽样调查。眼科医师在未知患者健康保险类型的情况下,对患者行常规散瞳检查,并判断在近6个月内是否需要眼部治疗。为了评价保险类型与需要治疗之间的联系,采用经社会人口统计与临床特征调整后的Logistic回归分析。结果:311例M C和107例FFS受试者眼部就诊率和已患有眼部疾病的发生率相近。然而,通过本临床检查,M C受试者较FFS更易发生糖尿病视网膜病…     

多粘菌素B琼脂糖层析柱清除体液中内毒素

用多粘菌素B琼脂糖亲和层析法清除内毒素,结果表明:5ml多粘菌素B层析柱的总吸附内毒素能力为450 μg,用此法可完全清除体液或各种液体中的内毒素,对血清及腹水中的内毒素也有明显的吸附作用,而其他各种主要成分(除内毒素外)经过处理后无明显改变。去氧胆酸是一种强有力的去污剂,可使已饱和的柱子复活,复活率达85％左右。该方法有简便,可靠,吸附能力大,柱子的复活率高等优点。本方法的建立为内毒素血症的治疗展示了新的前景。     

An Analysis of Chromosome on Sterility Caused by Azoospermia or Oligospermia

ＡｎＡｎａｌｙｓｉｓｏｆＣｈｒｏｍｏｓｏｍｅｏｎＳｔｅｒｉｌｉｔｙＣａｕｓｅｄｂｙＡｚｏｏｓｐｅｒｍｉａｏｒＯｌｉｇｏｓｐｅｒｍｉａ￥ＷｕＭｅｉｈｅｎｇ；ＴａｎｇＷｉｎｇｎｕｏ．（ＡＣＴＡＡＣＡＤＥＭＩＡＥＭＥＤＩＣＩＮＡＥＮＡＮＪＩＮＧ，１９９５（...     

A study on various symptoms of chronic hepatitis treated with radix astragali and its regulative effect to levels of serum hormone

Sixty-seven cases of chronic hepatitis were treated with Radix Astragali. After treatment (2-month course), the clinical improvement rate in 38 cases of the Stagnation of the Liver-Qi and Deficiency of the Spleen type was 92.1%, and in 26 cases of the Deficiency of Liver Yin and Kidney Yin type was 88.5%, more effective than in the control group (P<0.05). The regulative effect to the levels of serum hormone was observed in the patients of the Stagnation of the Liver-Qi and Deficiency of the Spleen type treated with this medicine. The results showed that the levels of serum triiodothyronine, estradiol (female) and testosterone (male) were increased after treatment (1.40±1.38 ng/dl, 129.30±1.23 pg/ml and 496.24±1.47 ng/dl). Pre-treatment levels were 1.22±1.49 ng/dl, 104.60±1.45 pg/ml and 398. 17±1.55 ng/dl respectively (P<0.05); however, the level of serum prolactin (2.75±4.46 ng/ml) was lower after treatment than before treatment (3.20±3.82 ng/ml,P<0.05). No obvious changes were observed in the levels of serum follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, thyroxine, triiodothyronine uptake ratio and cortisol after treatment.     

PHAGAQUOSONOGRAM (PASG) DIAGNOSIS FOR CANCER OF GASTRIC CARDIA A PRELIMINARY STUDY OF 223 PATIENTS

Phagaquosonographies (PASG) of 100 normal subjects and 223 patients with cardiac cancer (CC) were analyzed. The apparatus was self-designed and self-manufactured. The wave patterns and the pre-ejection period and other 8 quantitative indices in PASG were compared and patients with CC were found to have abnormal levels (P less than 0.01). The phagaquosonograms in 82 patients with esophageal, gastric or cardias (non-cancer) diseases served as controls. The PASG showed positive results in 97.3%, suspicious in 2.3% and negative in 0.4% of CC cases and 100% negative in the normal subjects. It was 1.2% positive, 8.5% suspicious and 90.3% negative in the esophageal, cardiac or gastric non-cancer diseases. PASG has high sensitivity (97.3%), and typical characteristics (98.8%). It is shown that this method can be used in screening, diagnosis, differential diagnosis and prediction of prognosis of cardiac cancer.     

115例狼疮性肾炎的临床和病理观察

<正> 对象和方法至1986年,华山医院对115例狼疮性肾炎(LN)作了肾穿刺活检,占同期肾活检病例的17.2%,在继发性肾脏疾病中占首位。其中有完整临床和病理资料者108例。男性19例,