基于损伤韧带形态学的民间单方扭伤散配合纸夹板固定治疗急性踝关节扭伤临床观察

目的探讨基于损伤韧带形态学的民间单方扭伤散配合纸夹板固定治疗急性踝关节扭伤的临床疗效。方法选取江苏省宿迁市中西医结合医院联合苏州市中西医结合医院2022年1月至2023年7月收治的急性踝关节扭伤患者102例,按随机数字表法分为对照组和试验组,各51例。在常规康复训练基础上,对照组患者予纸夹板+金黄散治疗,试验组患者予纸夹板+扭伤散治疗,两组患者均持续治疗14 d。结果试验组的总有效率为82.35%,显著高于对照组的60.78%(P<0.05)。治疗后,两组患者的中医证候(疼痛肿胀、跛行步态、皮下瘀斑、关节活动受限)积分均显著降低(P<0.05),且试验组均显著低于对照组(P<0.05);两组患者的美国足踝外科功能评分量表(AOFAS)评分均显著升高(P<0.05),视觉模拟评分法(VAS)、肿胀评分量表的评分均显著降低(P<0.05),且试验组均显著优于对照组(P<0.05);两组患者的损伤韧带形态学指标(受伤韧带和健侧韧带的长度、宽度、厚度差值)均显著降低(P<0.05),且试验组均显著低于对照组(P<0.05);两组患者的炎性因子白细胞介素-6、肿瘤坏死因子-α、超敏C反应蛋白水平均显著降低(P<0.05),且试验组均显著低于对照组(P<0.05)。结论基于损伤韧带形态学的民间单方扭伤散配合纸夹板固定治疗急性踝关节扭伤的临床疗效良好,可恢复患者的关节功能与损伤韧带形态学,减轻疼痛程度,并改善炎性因子水平。

糖尿病雄性生殖损伤及其发生机制

糖尿病是由多种病因引起的代谢性疾病 ,其生殖损伤严重危害机体的健康。本文综述了糖尿病雄性生殖损伤病理生理改变及其发生机制 ,高血糖导致的氧化应激在糖尿病雄性生殖损伤中的重要作用 ,以及某些抗氧化剂可能成为有效治疗糖尿病生殖损伤的药物。

三七总皂苷对高血脂金黄地鼠脏器的影响

目的:研究三七总皂苷对高血脂金黄地鼠脏器的影响。方法:将金黄地鼠随机分为正常组、造模组,造模组饲喂高脂饲料4周造模成功后,将其分为三七总皂苷组、模型组,12周后,处死地鼠,取其肝脏进行VG染色,取心脏进行HE染色,取肾脏进行HE和Masson染色。结果:HE染色显示三七总皂苷组地鼠心脏的心肌细胞、肾脏的肾小球结构较模型组的损伤均有不同程度的改善;VG染色显示经三七总皂苷治疗后,肝脏小叶内的胶原纤维数量有所减少;Masson染色显示三七总皂苷组地鼠肾脏的纤维化程度与模型组相比有所减轻。结论:三七总皂苷可以适当改善高血脂模型组地鼠心脏、肝脏和肾脏的形态学损伤程度。

Single-strand DNA damages and its relationship with morphological change of neurons at early stage of rat cerebral ischemia/reperf usion

Objective：To discuss the DNA-strand breaks at early stage of middle cerebral artery occlusion/reperfusion (MCAO/R). Methods: Neurons number and morphologic change were observed by Nissl stain method, and DNA strand breaks were in situ detected by using DNA polymerase- I Klenow fragment-mediat-ed nick end-labelling method (Klenow method). Results: Six hours after reperfusion, a few neurons in dam-aged regions appeared morphologic changes while a few Klenow-positive cells were detected (P<0. 01). Twenty-four hours after reperfusion lots of neurons showed morphologic change while the number of Klenow-positive cells immediately and remarkably increased (P<0. 01). Seventy-two hours after reperfusion the number of neurons decreased significantly and the number of Klenow-positive cells was also less than that in 24 h (P<0. 05). Conclusion: ① 24 h after reperfusion when the number of Klenow-positive cells reached peak value, DNA single-strand breaks (SSBs) took place in many Klenow-positive cells, and presumed that DNA SSBs might be an important step in DNA-damage procession which might be induced by free radicals. ② At the same time when lots of DNA SSBs were produced, many neurons in the damaged regions showed morphological change, which indicated that lots of neurons had already progressed to irreversible damages when DNA SSBs took place.

STUDY OF MORPHOLOGICAL CHANGES OF HEART IN VIRAL MYOCARDITIS CAUSED BY REPETITIVE INFECTION OF CVB_3m

Objective To investigate the morphological changes of heart in viral myocarditis caused by repetitive infection of CVB3m. Methods 4-week-old mice were infected four times intraperitoneally with a timedependent dose and killed at the 10th, 30th and 60th day after the final infection respectively, then we examined the heart changes and collagen hyperplasia by HE, VG stain and 1HC. Results Heart damage appeared very serious at the tenth day, even there were small necrotic foci at the day of 30th, but we could not see any injury of heart 2 months later after final infection. Collagen turned up at the tenth day and there was much more collagen in heart and increased PCVA, CVF index at the sixtieth day. The 1HC of collagen demonstrated the collagen I hyperplasia was much obvious compared to collagen Ⅲ. Conclusion It strongly indicated that repetitive infection of CVB3m could lead to heart fibrosis and ventricular remodeling, which resulted in decreased systolic and diastolic function of heart.

Mechanisms of selective head cooling for resuscitating damaged neurons during post-ischemic reperfusion

Objective To evaluate the efficacy and the mechanism of application of selective head cooling on neuronal morphological damage during postischemic reperfusion in a rabbit model.Methods 168 New Zealand rabbits were randomized into three groups. Group Ⅰ [n=24, (38±0.5)℃, non-ischemic control]; Group Ⅱ [n=72, (38±0.5)℃, normothermic reperfusion]; Group Ⅲ [n=72, (28±0.5)℃, selective head cooling, initiated at the beginning of reperfusion). Animals in three subgroups (n=24, each) of Group Ⅱ and Group Ⅲ had reperfused lasting for 30, 180 and 360 min respectively. Using computerized image analysis technique on morphological changes of nucleus, the degree of neuronal damage in 12 regions were differentiated into type A (normal), type B (mild damaged), type C (severely damaged) and type D (necrotic). Fourteen biochemical parameters in brain tissues were measured.[KH*2/5D]Results As compared with Group Ⅰ, the counts of type A neuron decreased progressively, and those of type B, C and D increased significantly in Group Ⅱ during reperfusion (P【0.01). In Group Ⅱ, vasoactive intestinal peptide, b-endorphine, prostacyclin, T 3 and Na +, K +-ATPase were correlated with the changes of type A; b-endorphine and thromboxane with type B; glucose and vasopressin with type C; Na +, K +-ATPase, glutamic acid, T 3 and vasoactive intestinal peptide with type D (P【0.05). As compared with Group Ⅱ, the counts of type A increased, and those of type C and D significantly decreased in Group Ⅲ (P【0.01). In Group Ⅲ, Ca 2+ , Mg 2+ -ATPase were correlated with the changes of type A, C and D (P【0.01). Conclusion Selective head cooling for sex hours during postischemic reperfusion does improve neuronal morphological outcomes in terms of morphological changes.

Pathomorphological changes after liver impact injury in rabbits

Objective: To investigate the histopathological changes in the liver and other organs after impact injury. Methods: The rabbits were impacted with a BIM IV biological impacting machine at the xiphoid process. The severity of liver injury was graded and scored through gross anatomy. At the same time, the pathological changes in the liver, heart, and lung were observed by light and electron microscopes. Results: Light microscopy showed that the pathological changes in the liver were: 1) loss of normal structure, hemorrhage and distortion of hepatic lobules; 2) cloudy swelling, degeneration, vacuolation and necrosis of liver cells; 3) infiltration of neutrophils. The lungs were injured and there were liver cell emboli in the small pulmonary arteries. Electron microscopy showed that the ultrastructure of the liver cells was severely damaged and the cells had significant features of necrosis. Conclusions: The major pathomorphological changes in the liver after impact injury are hemorrhage and necrosis. They may be complicated by exfoliation of liver cells to hepatic sinusoids. These cells circulate with the blood to form emboli in the pulmonary blood vessels.

Establishment of a blunt impact-induced brain injury model in rabbits

Objective： To establish an animal model to replicate the blunt impact brain injury in forensic medicine. Methods： Twenty-four New Zealand white rabbits were randomly divided into control group （n=4）, minor injury group （n：10） and severe injury group （n=10）. Based on the BIM- II Horizontal Bio-impact Machine, self-designed iron bar was used to produce blunt brain injury. Two rabbits from each injury group were randomly selected to monitor the change ofintracranial pressure （ICP） during the impact- ing process by pressure microsensors. Six hours after injury, all the rabbits were dissected to observe the injury mor- phology and underwent routine pathological examination. Results： Varying degrees of nervous system positive signs were observed in all the injured rabbits. Within 6 hours, the mortality rate was 1/10 in the minor injury group and 6/10 in the severe injury group. Morphological changes con-sisted of different levels of scalp hematoma, skull fracture, epidural hematoma, subdural hematoma, subarachnoid hemo- rrhage and brain injury. At the moment of hitting, the ICP was greater in severe injury group than in mild injury group; and within the same group, the impact side showed positive pressure while the opposite side showed negative pressure. Conclusions： Under the rigidly-controlled experimental condition, this animal model has a good reproducibility and stable results. Meanwhile, it is able to simulate the morphology of iron strike-induced injury, thus can be used to study the mechanism of blunt head injury in forensic medicine.

Forensic medical study on morphology and formative mechanism of blunt head injury

Objective： To study the patterns and morphologic characteristics of blunt head injury and analyse its formative mechanism in attempt to provide references for medicolegal expertise. Methods： The statistical analysis was done in terms of gender, age, as well as the nature, pattern, location, and feature of the injuries. Results： Among the 202 cases of head injury-induced death, 124 were male and 78 female with the age ranging from 1-81 years. Death caused by homicide was dominant （106, 52.5%）, followed by suicide （49, 24.3%） and accident （44, 21.8%）. The majority of suicide-induced death were byfalling from height, and traffic crash was responsible for majority of unexpected death cases. The morphology and pathogenesis of the injuries varied according to differences on the mode, magnitude, and orientation of the outside force giving rise to blunt injury as well as the character of vulnerants. Conclusion： Studies on the morphology and its forma- tive rationale of blunt head injury will offer easy access to medicolegal expertise on the mode and character of the injury.