Bloodletting Puncture at Hand Twelve Jing-Well Points Relieves Brain Edema after Severe Traumatic Brain Injury in Rats via Inhibiting MAPK Signaling Pathway

Objective:To investigate whether blood-brain barrier(BBB)served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points(HTWP)in traumatic brain injury(TBI)and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated(sham),TBI,and bloodletting puncture(bloodletting)groups(n=24 per group)using a randomized number table.The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days.The neurological function and cerebral edema were evaluated by modified neurological severity score(mNSS),cerebral water content,magnetic resonance imaging and hematoxylin and eosin staining.Cerebral blood flow was measured by laser speckles.The protein levels of aquaporin 4(AQP4),matrix metalloproteinases 9(MMP9)and mitogen-activated protein kinase pathway(MAPK)signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group,bloodletting puncture improved neurological function at 24 and 48 h,alleviated cerebral edema at 48 h,and reduced the permeability of BBB induced by TBI(all P<0.05).The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture(P<0.05 or P<0.01).In addition,the extracellular signal-regulated kinase(ERK)and p38 signaling pathways were inhibited by bloodletting puncture(P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways.Therefore,bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.     

如何学好药理学

药理学是研究药物与机体相互作用、作用机制及规律的科学,是连接基础医学与临床医学、医学与药学的一门重要课程.许多学生在初次学习药理学时,认为药理学不好学,内容复杂、抽象,药物种类较多,抓不住重点,难以记忆,不知道怎样学习药理学,现就这些问题谈谈学习药理学的方法.     

昆虫抗冻蛋白及其在医学领域中的应用

抗冻蛋白(antifreeze protein,AFP)是一类结构多样的蛋白质,具有热滞效应(thermal hysteresis,TH,降低冰点而不改变熔点)和重结晶抑制效应(recrystalization inhabition,RI).通过非共价吸附抑制机制吸附到冰核表面,限制冰晶生长和抑制冰晶重结晶,从而保护有机体免受结冰引起的伤害.由于抗冻蛋白具有阻止冰晶生长而不破坏细胞的特点,因而利用抗冻蛋白在低温中长期保存各种细胞、组织和器官,特别在器官移植中可能具有很好的应用前景.     

Sternal Reconstruction of Deep Sternal Wound Infections Following Median Sternotomy by Single-stage Muscle Flaps Transposition

Objective To assess clinical effectiveness of using bilateral pectoralis major or plus rectus abdominis muscle flaps in treating deep sternal wound infection （DSWI） following median sternotomy. Methods Between January 2009 and December 2013, 19 patients with DSWI after median sternotomy for cardiac surgery were admitted to our hospital, including 14 males （73.7%） and 5 females （26.3%）, aged 55±13 （18-78） years. According to the Pairolero classification of infected median sternotomies, 3 （15.8%） patients were type II, and the other 16 （84.2%） were type III. Surgical procedure consisted of adequate debridement of infected sternum, costal cartilage, granulation, steel wires, suture residues and other foreign substances. Sternal reconstruction used the bilateral pectoralis major or plus rectus abdominis muscle flaps to obliterate dead space. The drainage tubes were placed and connected to a negative pressure generator for adequate drainage. Results There were no intraoperative deaths. In 15 patients （78.9%）, bilateral pectoral muscle flaps were mobilized sufficiently to cover and stabilize the defect created by wound debridement. 4 patients （21.0%） needed bilateral pectoral muscle flaps plus rectus abdominis muscle flaps because their pectoralis major muscle flaps could not reach the lowest portion of the wound. 2 patients （10.5%） presented with subcutaneous infection, and 3 patients （15.8%） had hematoma. They recovered following local debridement and medication. 17 patients （89.5%） were examined at follow-up 12 months later, all healed and having stable sternum. No patients showed infection recurrence during the follow-up period over 12 months. Conclusion DSWI following median sternotomy may be effectively managed with adequate debridement of infected tissues and reconstruction with bilateral pectoralis major muscle or plus rectus abdominis muscle flap transposition.     

对症喝汤好处多

夏季多喝汤不仅能调节口味,补充体液,增强食欲,而且能防病抗病,对健康有益. 日常人们常喝的汤有荤、素两大类.荤汤有鸡汤、肉汤、骨头汤、鱼汤、蛋花汤等,素汤有海带汤、豆腐汤、紫菜汤、番茄汤、冬瓜汤和米汤等.无论是荤汤还是素汤,都应根据各人的喜好与口味来选料烹制,加之"对症喝汤",就可达到抗衰治病、清热解毒的"汤疗"效果.     

植皮区域局限性皮肤松弛症1例

病人,女,81岁.40年前在工作时双上肢不慎被火烧伤,当年在大连化工厂医院烧伤科给予取自体腹部皮肤行前臂植皮术,术后植皮区域皮肤成活修复良好.4年前无明显诱因双侧前臂植皮区域肤色逐渐变深,无意中发现皮肤明显松弛,无不适感.近3个月自觉植皮区域疼痛不适,局部无红肿等,轻微牵拉皮肤时疼痛明显.自发病起4年皮损未见扩大.患者既往体健,否认家族有类似病患者.     

POCT的信息管理

POCT是在医疗条件下,由非实验室的卫生保健人员,在实验室的质控指导下,于病人身边进行的检验。它广泛适用于医院(如外科,儿科)、监护病房、急救单位、保险公司、社区医疗、家庭保健网络等领域。当今,POCT在全球方兴未艾,据调查,现今已有10%的诊断实验是在POCT仪器上完成的,究其原因,无非是POCT兼具医学上的有效性及经济两个方面的优势。当然,随着POCT设备的投放不断增加,使用范围不断拓展,POCT的管理问题也日益凸现,本文将对POCT实施中的信息管理的若干问题进行初步探讨。     

第16届欧洲呼吸学会年会会议纪要

第16届欧洲呼吸学会年会(The European Respiratory Society 16th Annual Congress)于2006年9月1日～6日在德国慕尼黑市国际会议中心(ICM)召开,来自100多个国家和地区的16 888名代表参加了会议,大会共收到论文5277篇,接收论文4221篇,其中来自中国(包括香港、澳门和台湾)84篇(图1).现将会议内容扼要介绍如下.     

维生素B1和维生素B12肌注致过敏性休克1例报告

1 临床资料 患者,男,23岁,因左下肢疼痛20 d来医院就诊.询问病史:患者2 d前在上级医院诊断为坐骨神经痛.既往健康,无药物过敏史.门诊当日给予维生素B1 100 mg,维生素B12 250靏肌注,用药约5 min时患者感到头晕、胸闷、呼吸困难、寒战,面色苍白,脉搏105次·min-1,血压80/50 mmHg,考虑为药物所致过敏性休克,立即给予平卧,氧气吸入,肾上腺素1 mg肌注,地塞米松10 mg静注,5 min后患者恢复正常.     

Analytical Quality,Test Quality and Quality Costs

This paper discusses briefly analytical quality and its determinants design of quality assurance procedures on the basis of quality specifications and quality-cost models test quality and medical costs external quality assessment and harmonization of clinical chemical test results the potential role of computers, database and knowledge-based systems in achieving quality goals in decentralized analytical activities.     

品管圈管理在护理质量控制中的应用

目的探讨品管圈管理在护理质量控制中的应用效果,从而达到改进临床护理工作,提高护理工作质量的目的。方法以儿科为单位组圈,按品管圈管理的步骤实施各项活动,每月固定为一个品管圈周期,通过开展开题报告,中期评估和结果发表等形式进行过程评价和管理,对实施前后的结果进行比较。结果儿科在护理人员中共开展10个品管圈项目,护理人员对品管圈管理的知晓率达95%,参与率65%,项目完成7项,品管圈目标达标率70%,成果临床应用率60%。结论品管圈管理能有效提高护理人员参与管理意识和护理管理制度执行力,是提高护理人员解决问题能力的有效方式,在护理质量管理中取得了较好的效果。     

医用直线加速器的质量保证和质量控制

医用直线加速器为实行放射治疗的主要设备,结构复杂、精密度高、使用频率高,做好医用直线加速器的质量保证和质量控制工作是放射治疗能够精确安全进行的关键.本文对医用直线加速器常规性能指标的检测、日常保养和维护等内容做了介绍.     

如何正确理解骨质量

骨是人体内仅次于牙齿的坚硬组织,支撑人体,保护内脏并参与人体的代谢,具有十分重要的生理学价值。另一方面,骨组织又富有弹性,正常人轻度外伤后一般不会发生骨折,所有这一切都取决骨质量。因此,正确理解骨质量对于疾病的诊断和康复有着十分重要的意义。     

磁共振质量保证和质量控制若干问题的探讨

磁共振的质量管理和质量控制对保证磁共振设备安全有效的运转,提高诊断质量具有非常重要的意义.本文从磁共振日常工作的实际出发,探讨了磁共振质量保证和质量控制的内涵以及各个环节的具体内容,阐述了磁共振质量保证和质量控制不仅需要规范化、制度化,还需要领导重视全员参与,临床工程师在整个过程中发挥着不可替代的重要作用.     

PACS系统的质量保证与质量控制

以保证高质量影像图像以及控制受检者和放射从业人员辐射剂量为宗旨的QA、QC工作,将是医学信息界的一个重要课题.自动化、数字化可以减少一些问题,但可能引起新的问题的发生,探索出一套行之有效的查错、纠错及消除错误的方法及措施,是PACS质保/质控工作须完成的任务.     

放射治疗中的质量保证与质量控制

本文通过对内蒙地区24家放疗单位的调查,结合实际工作指出要做好放射治疗中的QA和QC2工作;首先要建立起完善的QA与QC保证体系,同时要完善设备配置,不断提高工作人员业务技能.     

护理专业素质与人文素养的有效结合评价

目的探讨护理专业素质与人文素养的有效结合评价。方法选取180例我院护士作为研究对象,分为常规组(90例和干预组(90例),常规组给予专业素质教育,干预组给予专业素质教育与人文素质教育,对比两组护理人员的认识评价与学习成绩,进行统计学分析。结果干预组护理人员的专业知识认识评分与人文素质认识评分均高于常规组,差异显著,具有统计学意义(P<0.05)。干预组护理人员的平时成绩、实验成绩、理论成绩、综合成绩,均高于常规组,差异显著,具有统计学意义(P<0.05)。结论在护理专业中融入护理专业素质教育与人文素质教育,提高了护理人员对专业知识与人文素质的认识,并且提高了学习成绩,护理质量明显改善。