目的 探讨甲型H1N1流感不同临床类型及不同阶段C反应蛋白（CRP）动态变化特征。 方法 回顾性分析2009年5月10日－2010年1月18日实验室确诊的271例甲型H1N1流感住院患者不同临床类型、疾病不同阶段CRP动态变化情况。 结果 甲型H1N1流感患者感染初期CRP较正常升高，且升高程度随着病情的加重而更明显；CRP在治疗第3天即明显下降或接近正常，其动态改变在不同疾病严重程度组间无明显差异；有脏器功能损害者CRP较无脏器功能损害者明显升高；多个脏器损害CRP较单一脏器损害组明显升高。 结论 甲型H1N1流感CRP升高程度可间接反映其疾病严重程度和脏器功能损害多少。
观察LASIK术后主视眼变化情况。方法：回顾性分析我院近来50例LASIK术后主视眼的变化。结果：49例近视眼获LASIK手术矫正后，主视眼无变化，1例主视眼发生变化。结论：LASIK手术后一般不会导致主视眼的变化。
【Abstract】ObjectiveTo investigate the effects of CO2 pneumoperitoneum on blood flow of carotid arteries in atherosclerosis rabbits.MethodsFifty Japan white rabbits were randomly divided into control group and three atherosclerosis groups. In atherosclerosis group, the rabbits were randomly subjected to CO2 pneumoperitoneum with an intraabdominal pressure of 0 mm Hg, 10 mm Hg or 15 mm Hg for 2 hours, after the model were created by feeding the rabbits with high fatty diet. The blood flow of the common carotid arteries were measured by electromagnetic blood flowmeter. Artery blood samples were collected for blood gas analysis at 30 minute intervals. ResultsHigher insufflation pressures and longer duration of CO2 pneumoperitoneum were associated with greater increase in blood flow of common carotid arteries. Compared with those in control group and atherosclerosis group with 0 mm Hg CO2 pneumoperitoneum, there were statistically significant increases in blood flow of the common carotid arteries during CO2 pneumoperitoneum in 10 mm Hg and 15 mm Hg pneumoperitoneum group, the changes in 15 mm Hg pneumoperitoneum group were more significant than those in 10 mm Hg pneumoperitoneum group (Plt;0.05). When compared with the blood flow before insufflation, those in 10 mm Hg and 15 mm Hg pneumoperitoneum group also increased significantly during CO2 pneumoperitoneum, even at 30 minute after desufflation (Plt;0.05). However, those in control group and 0 mm Hg pneumoperitoneum group did not change significantly (Pgt;0.05). There were significant decrease in pH and significant increase in PCO2 in both 10 mm Hg and 15 mm Hg groups, when compared with presufflation values or those in control group and 0 mm Hg pneumoperitoneum group(Plt;0.05). The changes in pH and PCO2, however, were no significant at any time point in control group and 0 mm Hg pneumoperitoneum group (Pgt;0.05). HCO3- did not change significantly in either group(Pgt;0.05).ConclusionUnder atherosclerosis conditions, CO2 pneumoperitoneum has an adverse influence on the blood flow of the common carotid arteries which may be associated with increased intrabdominal pressure,absorbed CO2 gas.
ObjectiveTo investigate the change of blood glucose and its clinical significance in patients with acute pancreatitis (AP). MethodsThe regularity of blood glucose change and the relation between the regularity and the prognosis were analyzed in 115 patients with AP and hyperglycemia.ResultsBlood glucose was increased with a median (M) of 8.7 mmol/L，18.45 mmol/L and 27.22 mmol/L, which gradually decreased to normal value within 3-17 days, 7-26 days and 24-46 days after treatment,respectively in patients with mild AP, type Ⅰ of severe acute pancreatitis (SAP) and type Ⅱ of SAP. There was marked statistical difference among the three groups. A smaller dose of regular insulin was used for 36 patients with mild AP; however, a larger dose of regular insulin was used for all 30 patients with SAP.ConclusionThe level of blood glucose, the dose of regular insulin and the duration of hyperglycemia increase with the severity of AP.
Objective To investigate whether the biomechanical effect of mushroom shaped surface prosthesis on femoral neck is in the scope of safety after the replacement. Methods Four donated fresh-adult specimens of upper femur under the age of 55 years old were used. The strains of detecting points A (lateral) and B (medial) on the narrow place of femoral neck in the standing position were simulated for three stages before or after the prosthesis replacement, namely the pre-replacement, the initial stage during which the interspace of the prosthesis was filled with cancellous bone, and laterstage during which the interspace of the prosthesis was filled with bone cement. Then they were compared by using l inear regression analysis in Excel and rel iabil ity analysis. Results The regression analysis showed that the values of correlation coefficient r were all more than 99% at the different stages, indicating the strain of femoral neck’s cortical bone was proportional to the load and there was no occurrence of the plastic deformation of the femoral neck. For point A, the slope of the trend l ine of strain was 0.671 9 at the pre-replacement stage. The value of the initial stage after replacement was 0.619 2 and its change rate was —7.8%; while corresponding value was 0.662 7 and —1.4% at the later stage after replacement. For point B, the slope of the trend l ine of strain was —1.056 1 at the pre-replacement stage. The value of the initial stage after replacement was — 1.129 2 and its change rate was 6.9%; while corresponding value was —1.085 1 and 2.7% at the later stage after replacement. Conclusion The mechanical strength of femoral neck is in the scope of safety after surface replacement of the femoral head. The change rate of strain at the later stage is smaller than the initial stage.
Objective To observe the epidermal width, the amount variation and distribution character of epidermal stem cells(ESCs) and the wound healing rate at different periods of diabetes mellitus(DM) rats after trauma, thento study the correlation of them. Methods Forty-eight Wistarrats were divided into DM group and normal control group randomly(n=24).TheDM rats were induced by streptozocin (STZ) and then made chronic healing wound by special perforex.At the 3rd, 4th, 7th,14th and 21st days after trauma, the healing rate was calculated, the wound edge and granulation tissue were obtained for haematoxylin-eosin (HE) staining and immunohistochemical staining of keratin 19(K19) and β1 integrin. Then the epidermal width, the area and the gradation value of positive unit(PU) were measured. Results At the 3rd, 7th,14th and 21st days after trauma, the wound healing rates of normal rats were 24.48%±3.37%, 50.46%±1.26%, 92.82%±2.12% and 99.41%±0.66% respectively, while those of DM rats were 2.43%±1.02%, 40.59%±1.65%, 80.77%±3.57% and 85.40%±0.94% respectively, showing significant differences (Plt;0.01). Before trauma, there was no significant difference in the epidermal width between normal rats and DM rats (Pgt;0.05). However, at the 3rd, 7th, 14th and 21st days after trauma, the epidermal widths of normal rats were 26.43±3.21, 33.29±3.52, 31.53±3.35 and 26.01±3.19 μm respectively, while those of DM rats were23.58±2.33, 31.02±3.38, 33.72±5.49 and 21.80±4.02 μm respectively,the epidermal widths in DM rats were significantly lower than those in normal rats(Plt;0.01). The average PU value of K19 in normal rats were 91.68%, 93.14%, 72.27% and 70.31% respectively, while those in DM rats were 40.29%, 40.79%, 29.94% and 10.37% respectively. The average PU value of β1 integrin in normal rats were 49.6%, 91.16%, 77.13% and 57.17% respectively, while those inDM rats were 38.94%, 24.16%, 61.36% and 38.83%. The results indicated that the average PU values of K19 and β1 integrin in DM rats were significantly lower than those in normal rats(Plt;0.05). Conclusion The amountand activity decrease of ESCs may be one of the important mechanisms of difficult recovering wounds of DM rats.
Objective To investigate the pathological changes in the neuromuscular junction during ischemiareperfusion(IR) in the skeletal muscle. Methods Forty-eight healthy adult Wistar rats (24 male, 24 female) were equally randomised into the following 6 groups: Group A (control group): no ischemiareperfusion; Group B: ischemia by clamping the blood vessels of the right hindlimb for 3 hours; Group C: ischemia by clamping for 4.5 hours;Group D: ischemia by the clamping for 4.5 hours followed by reperfusion for 1.5hours; Group E: ischemia for 4.5 hours followed by reperfusion for 24 hours; and Group F: ischemia for 4.5 hours followed by reperfusion for 2 weeks. Then, the medial head of the gastrocnemius muscle flap model was applied to the right hindlimb of each rat. The medial head of the gastrocnemius muscle was isolated completely,leaving only the major vascular pedicle, nerve and tendons intact.The proximal and distal ends (tendons) were ligated while the vessel pedicle was clamped. And then, Parameters of the muscle (performance,contraction index,colour,edema,bleeding) were observed. The muscle harvested was stained with gold chloride(AuCl3) and the enzymhistochemistry assay (succinate dehydrogenase combined with acetylcholine esterase) was performed. Morphology and configuration of the neuromuscular junction were observed during the ischemiareperfusion injury by means of the AuCl-3 staining. The result of the enzymhistochemical reactions was quantitatively analyzed with the computer imageanalysis system. And then, additional 5 rats were prepared for 3 different models identical with those in Groups A, C and E separately. The specimens were harvested from each rat and were stained with HE and AuCl-3, and they were examined under the light microscope. Results During the period of ischemia, the skeletal muscle of Group B showed the colour of purple and edema.The colour and edema became worse in Group ,while dysfunction of elasticity and contraction appeared obviously with plenty of dark red hemorrhagic effusion at the same time.After reperfusion,the color and edema of muscle in Group D became improved while the elasticity and function of contraction was not improved. Hemorrhagic effusion of Group D turned clearer and less than Group C.Group E was similar to Group D in these aspects of muscle except for much less hemorrhagic effusion. Skeletal muscle in Group F showed colour of red alternating with white, adhesion,contracture of muscle, exposure of necrotic yellow tissue and almost lost all its functions. The AuCl3 staining showed that during IR, necrosis of the myocytes was followed by degeneration of their neuromuscular junctions, and finally the nerve fibers attached to these neuromuscular junctions were disrupted like the withering of leaves. The enzymhistochemistry assay showed thatthere was no significant difference in the level of acetylcholine esterase between the ischemic group (Groups B and C) and the control group (Group A) (Pgt;0.05). However, the level of acetylcholine esterase in all the reperfused groups (Groups D, E and F) decreased significantly when compared with the control group（Group A）and the ischemic groups (Groups B and C) (Plt;0.01). Conclusion The distribution of the nerve fibers and the neuromuscular junctions in the mass of the muscles is almost like the shape of a tree. The neuromuscular junction seems to be more tolerant for ischemia than the myocyte. Survival ofthe neuromuscular junction depends on its myocytes alive. Therefore, an ischemiareperfusion injury will not be controlled unless an extensive debridement of the necrotic muscle is performed.
To investigate the influence of injury of nutrient artery on the blood supply of inner 2/3 of cortical and intramedullary tissue, the experiment was carried out on twenty-four rabbits. Four rabbits were killed and perfused with Chinese ink in femoral artery to survey the blood supply of intramedullary vessels. Others were received fracture on tibia and sacrificed respectively on the third, eighth, eighteenth, twenty-eighth, and forty-second days after fracture. Chinese ink was also perfused through femoral artery on those rabbits. The relative density of capillary vessels were determined. The results were as follows: when the nutrient artery was injured after fracture, blood supply to the intramedullary tissue and the inner 2/3 of cortical bone was interrupted. The intramedullary vessels were increared and dilated. During the whole course of healing of fraeture, the density of intramedullary capillary vessels were higher than normal. It was concluded that the anastomosis between the epiphysis and metaphysis was important in the reconstruction of collateral circulation in healing of fracture.
目的 了解近年四川省基层医疗卫生机构医疗服务的变化情况。 方法 对“四川省卫生统计数据采集与决策支持系统”收集的2002年－2011年年报数据进行分析。 结果 10年来，四川省基层医疗卫生机构医疗服务数量增加，效率提高，药费占医药费用的比例下降。 结论 10年卫生改革的有关政策特别是新医改的实施，对基层医疗卫生机构医疗服务起到较大的推动作用，四川省“保基本，强基层”的战略目标正在逐步实现。
目的:了解成都市集体儿童的健康状况及变化趋势,进一步做好托幼机构的卫生保健工作。方法:对1998-2007年成都市托幼机构集体儿童定期体检的资料进行分析、研究。结果:成都市集体儿童身高、体重达标率,身高、体重年增长合格率呈上升趋势;中、重度营养不良(体重低下、发育迟缓、消瘦)患病率逐年下降;单纯性肥胖发生率逐年升高;贫血的患病率呈下降趋势;视力不良患病率无明显下降;龋齿患病率呈下降趋势。结论:成都市集体儿童体格发育良好。儿童营养不良减少,肥胖明显增加,视力不良患病率无明显下降,今后托幼园所要将肥胖的预防和干预作为卫生保健工作的重点,并重视眼保健工作。