胡椒碱对过氧化氢损伤大鼠心肌线粒体的保护作用及机制研究

目的研究胡椒碱抗心肌抗缺血、增强耐缺氧能力及心肌保护作用的机制。方法采用过氧化氢损伤大鼠心肌线粒体模型，观察胡椒碱对心肌线粒体中谷胱甘肽（GSH）、丙二醛（MDA）、ATP酶和门冬氨基转移酶（AST）的影响。结果过氧化氢损伤后，大鼠心肌线粒体中MDA水平升高，GSH含量降低，Na^＋K^＋-ATP酶和Ca^2＋-ATP酶活性降低，AST活性升高，而胡椒碱可以抑制MDA生成、增加AST活性，提高GSH含量并增强Na^＋K^＋-ATP酶和Ca^2＋-ATP酶活性。结论胡椒碱可能是通过升高心肌线粒体GSH，降低MDA及增加Na^＋K^＋-ATP酶和Ca^2＋-ATP酶活性来实现其心肌保护作用。     

三康胶囊对减压缺氧环境下大鼠生化指标的影响

目的观察三康胶囊（San—Kang capsule，SK）在减压缺氧环境时对大鼠生化指标的影响。方法分别在常压与减压环境下，测定大鼠的血糖及血乳酸、心、肝及股四头肌的糖原、心肌及股四头肌的乳酸（LD）、心肌组织中的乳酸脱氢酶（LDH）和心、脑、肝及股四头肌的Na^＋K^＋-ATP酶的含量或活性。结果与常压比较，减压条件下SK可使大鼠血糖升高，心肌和肝组织糖原含量降低，心肌LDH活性升高，与NS组比较，无论是常压还是减压环境，都可使组织中的LD减少；以及使心肌和脑组织的Na^＋K^＋-ATP酶活性增加。结论三康胶囊在减压缺氧条件下，有升高血糖、增加Na^＋K^＋-ATP酶活性等作用。     

海水浸泡对失血性休克大鼠心肌和肝细胞线粒体功能的影响

目的：研究海水浸泡对失血性休克大鼠心肌和肝细胞线粒体功能的影响。方法：采用雄性Wistar大鼠24只,分为正常对照组,平原休克组和海水休克组,每组8只。测定血液动力学及心肌和肝细胞线粒H^ -ATP酶、琥珀酸脱氢酶（SDH）,Ca^2 -Mg^2 -ATP酶,质子转运及线粒体总钙的变化。结果：海水浸泡失血性休克大鼠血液动力学,心肌和肝细胞线粒体H^ -ATP酶,SDH,Ca^2 -Mg^2 -ATP酶活性均显著低于正常对照组和平原休克组,线粒体总钙含量显著高于平均体克组,海水浸泡失血性休克亚线粒体质子跨膜转运能力与平原休克组比较,差异无显著性意义。结论：海水浸泡失血性休克大鼠心肌和肝细胞线粒体酶活性显著下降,线粒体钙含量升高,伤情显著加重。     

海水浸泡对腹部开放伤大鼠TGF-β1、VEGF蛋白及mRNA表达的影响

目的 观察海水浸泡对腹部开放伤大鼠转化生长因子β1(TGF-β1)和血管内皮生长因子(VEGF)蛋白及mRNA表达的影响.方法 成年健康Wistar大鼠60只,随机分为2组,其中腹部开放伤合并海水浸泡组40只,腹部开放伤对照组20只.腹部开放伤合并海水浸泡后0.5、1、2、3、4h应用免疫组织化学、核酸原位杂交和图像分析技术检测大鼠肺和肾组织TGF-β1和VEGF蛋白及mRNA表达水平的变化.结果 对照组在致伤后1h开始出现TGF-β1蛋白阳性表达,2、3和4h表达逐渐增强.海水浸泡组0.5h开始出现阳性表达,此后表达逐渐增强,4h时阳性表达量最高.TGF-β1 mRNA表达滞后于蛋白表达.两组均于致伤后2h开始出现VEGF蛋白阳性表达,3、4h表达逐渐增强.VEGF mRNA与蛋白表达同步且一致.结论 TGF-β1和VEGF蛋白及mRNA的高表达与损伤关系密切,可作为海水浸泡伤预后判断的指标.     

大鼠腹部开放伤合并海水浸泡后内毒素、TNF-α、IL-6、IL-8的变化

目的：观察大鼠腹部开放伤合并海水浸泡后不同时段血浆内毒素（LPS）、肿瘤坏死因子-α（TNF-α）、IL-6和IL-8的变化。方法：成年健康Wistar大鼠116只,随机分为2组,其中腹部开放伤合并海水浸泡组96只,腹部开放伤对照组20只。应用微生物快速检测仪和γ测量仪检测大鼠腹部开放伤合并海水浸泡后0.5,1,2,3和4h血浆LPS、TNF-α、IL-6和IL-8水平。结果：腹部开放伤合并海水浸泡2～4h后,血浆中LPS水平明显上升,与对照组比较具有显著性差异。海水浸泡4h后血浆中TNF-α浓度上升明显,具有显著性差异。海水浸泡3～4h后血浆中IL-6浓度明显升高,具有显著性差异。海水浸泡后不同时间血浆中IL-8浓度与对照组比较无明显变化。结论：血浆中LPS、TNF-α和IL-6浓度明显升高与损伤关系密切,是引发中毒性休克导致机体死亡的主要原因之一。     

bFGF对慢性酒精中毒大鼠肝组织ATP酶活力的影响

目的观察碱性成纤维细胞生长因子（bFGF）对慢性酒精中毒大鼠肝组织Na^＋-K^＋-ATP酶活力和Ca^2＋-Mg^2＋-ATP酶活力的影响,探讨bFGF对慢性酒精中毒所致的肝损伤的保护作用。方法选择成年Wistar雄性大鼠,采用白酒灌胃建立慢性酒精中毒模型,慢性酒精中毒模型建立成功的大鼠随机抽签法分为酒精中毒对照组、生理盐水（NS）对照组和bFGF治疗组。另10只不灌白酒作为正常对照组。bFGF治疗组大鼠白酒灌胃的同时,1h后按12μg/kg剂量肌肉注射,共14d。各组大鼠到相对应的时间点取出肝组织制成匀浆,测定肝组织匀浆中Na^＋-K^＋-ATP酶活力和Ca^2＋-Mg^2＋-ATP酶活力。结果与正常对照组相比,慢性酒精中毒后大鼠肝组织中Na^＋-K^＋-ATP酶活力及Ca^2＋-Mg^2＋-ATP酶活力均明显降低（P〈0.05）;经bFGF治疗后肝组织中Na^＋-K^＋-ATP酶活力和Ca^2＋-Mg^2＋-ATP酶活力均明显高于酒精中毒对照组及NS对照组（P〈0.05）。结论 bFGF能提高慢性酒精中毒肝组织中Na^＋-K^＋-ATP酶活力及Ca^2＋-Mg^2＋-ATP酶活力,提示bFGF对慢性酒精中毒所致的肝损伤具有保护作用。     

亚低温治疗对脑创伤后三磷酸腺苷酶的影响

目的 观察亚低温治疗对大鼠脑外伤后脑组织Na^ -K^ -ATP酶、Mg^2 -ATP酶以及Ca^ -ATP酶的影响。方法 75只大鼠随机分为常温对照组（33只）、常温受伤组（22只）和亚低温治疗组（20只）,后两组用自由落体方法致大鼠左侧脑外伤,亚低温治疗组受伤后用冰袋全身降温至脑温30℃后维持1h,然后加热复温至37℃。每组大鼠在伤后3h,1,3,5和7d取大脑组织,测定组织匀浆液中ATP酶的活性。结果 （1）Na^ -K^ -ATP酶;常温受伤组和亚低温治疗组在3h明显高于对照组,而后明显下降。亚代温治疗组在第3天明显高于常温受伤组;（2)Mg^2 -ATP酶;常温受伤组和亚低温治疗组在1d后才开始明显下降,但亚低温治疗组在1d和3d中较常温组睛降速度明显变慢;（3）Ca^2 -ATP酶：常温受伤组第1天就较常温对照组明显下降,而亚低温治疗组3h和第1天保持正常,有3天才明显下降,但仍然显著高于常温受伤组。结论（1）脑外伤大鼠脑细胞Na^2 -K^ -ATP酶早期对脑外伤有应激反应,亚低温治疗对细胞钠通道的作用不明显;（2）亚低温对钙泵有明显的调节作用,较常温受伤组显著提高脑细胞Ca^2 -Mg^2 -ATP酶的活性;（3）亚低温治疗能延缓脑细胞钙通道的损伤时间,且在7d内脑细胞的钠通道和钙通道在低水平保持相对稳定,从而减少Ca^2 的内流,减轻脑水肿。     

海水浸泡对失血性休克并腹部开放伤实验大鼠肿瘤坏死因子α及肠道热休克蛋白HSP-70的影响

目的探讨海水浸泡失血性休克并腹部开放伤对实验大鼠血浆肿瘤坏死因子α(TNFα-)和肠道热休克蛋白HSP-70水平变化的影响。方法建立失血并腹腔海水浸泡伤动物模型。实验大鼠随机分为对照组(n=6)、失血创伤组(n=14)、失血创伤海水浸泡组(n=14),失血创伤组为单纯失血性休克并腹部开放伤,失血创伤海水浸泡组将动物致伤后置入人工配置的海水中,于伤前和浸泡后30m in及1,1.5,3 h取血测定TNFα的变化,取肠道组织测定HSP-70的表达。结果失血创伤海水浸泡组血中TNFα较失血创伤组伤后明显升高并且高峰出现时间明显提前,肠道损伤病理变化明显重于失血创伤组,肠道组织中HSP-70含量在创伤早期显著升高,后又明显降低。结论TNFα-的过度表达在失血性休克并腹部开放伤后海水浸泡的病理生理变化中起重要作用,肠道组织细胞中HSP-70的异常表达在肠道组织细胞的应激反应机制中,可能有重要的意义。     

钠、钾离子对肌质网囊泡NADH氧化酶和伴生超氧自由基的调控

目的 探讨Na^＋、K^＋浓度对骨骼肌肌质网囊泡氧化还原系统的调控作用及对Ca^2＋释放通道的影响。方法提取肌质网囊泡，分别检测其在不同Na^＋、K^＋浓度下还原型辅酶Ⅰ（nicotinamide adenine dinucleotide，NADH）氧化初速率、超氧产率、[^3H]-ryanodine结合率和Ca^2＋释放速率的变化。结果 高浓度的Na^＋、K^＋对肌质网NADH的氧化初速率和伴生的超氧自由基产率均有抑制作用；在[^3H]-ryanodine结合实验中，高浓度的Na^＋、K^＋也压抑了NADH诱导的受配体结合的升高；同样，在Ca^2＋释放动力学实验中，不同浓度的K^＋调控了由NADH诱导的Ca^2＋释放初速率。结论 骨骼肌肌质网膜上可能存在具有对Na^＋、K^＋浓度敏感并中介超氧自由基产生的NADH氧化还原系统，其参与调节Ca^2＋释放通道的活性。     

兔肢体火器伤受海水浸泡后伤道周围骨骼肌Na ＋ / -K ＋ / -ATP酶活性变化

目的观察兔肢体火器伤合并海水浸泡时伤道周围骨骼肌组织Ｎａ＋－Ｋ＋－ＡＴＰ酶（Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ）活性变化及其影响因素,为防治继发损伤提供依据。方法以高速钢珠射击兔后肢,伤后将实验兔随机分为海水浸泡和单致伤组。将浸泡组（１４只）兔浸泡于人工配制的海水中３０分钟,于伤前及伤后３,６,１２,２４小时分别切取距伤道壁０．５ｃｍ（Ａ区）、１．５ｃｍ（Ｂ区）、２．５ｃｍ（Ｃ区）处组织,测定Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ和超氧化物歧化酶（ＳＯＤ）活性、ＡＴＰ和丙二醛（ＭＤＡ）含量。单致伤组（１０只）除不浸泡外,处理同海水浸泡组。结果海水浸泡组各区骨骼肌组织Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性、ＡＴＰ含量均呈伤后３小时较伤前明显下降（Ｐ＜０．０１）,６～１２小时回升,２４小时再次下降的趋势,下降幅度为Ａ区＞Ｂ区＞Ｃ区。ＭＤＡ含量与Ｎａ＋－Ｋ＋－ＡＴＰａｓｅ活性变化呈负相关（ｒ＝－０．７７Ｐ＜０．０１）。单致伤组上述指标变化趋势同海水浸泡组,但变化幅度小。结论肢体火器伤合并海水浸泡时,可加剧伤道周围骨骼肌组织过氧化脂质反应,抑制抗氧化物酶活性,从而导致能量代谢障碍和细胞膜酶活性下降,加剧继发损伤。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.