动物瘢痕模型的相关研究进展

皮肤损伤后的异常愈合会导致病理性瘢痕的产生。病理性瘢痕的出现不仅影响美观,严重时还会造成心理和生理功能障碍。病理性瘢痕的机制研究对于瘢痕治疗有极为重要的意义。其中,动物瘢痕模型是目前研究病理性瘢痕的重要模型手段之一。理想的动物瘢痕模型应该在组织学、细胞学等层面尽可能接近于人类的病理性瘢痕。该文分别从传统技术动物瘢痕中的啮齿类动物模型、兔耳模型和猪模型,以及新技术动物瘢痕模型这两个方面,结合近年来在瘢痕领域应用较多的研究,进行了相应系统的阐述。     

经鼻高流量氧气湿化治疗老年慢性阻塞性肺疾病急性加重合并呼吸衰竭的可行性研究

ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO₂), arterial partial pressure of carbon dioxide (PaCO₂), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ² test was used for their comparisons. ResultsThe SPO₂ values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO₂ before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P＞0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P＞0.05). There was no significant difference in PaCO2 between the two groups (P＞0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P＜0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P＞0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV.     

注射用肉毒毒素制剂及其研发进展

肉毒毒素(Botulinum Toxin,BoNT)已成为现代医学最具多用途的治疗药物之一。通过将肉毒毒素注射到特定过度活动的肌肉中,可以阻断神经和肌肉之间的信号传导,引起肌肉的松弛性麻痹,从而达到治疗的功效。从业者应熟悉各类产品的特性,以实现安全有效地使用。除了已经上市的众多肉毒毒素产品外,目前还在开发其他新型制剂,这些产品将会进一步扩大肉毒毒素的适用范围,以及给患者提供更多的选择。     

改良"箭头"皮瓣法乳头乳晕再造术

目的 介绍改良"箭头"皮瓣法乳头乳晕再造术的应用经验.方法 将"箭头"皮瓣法乳头乳晕再造术的设计经过凋整改进,为曾使用自体组织行乳房再造的患者再造乳头乳晕12例,其中2例采用改良"箭头"皮瓣法+薄中厚皮片移植乳头乳晕再造,4例采用改良"箭头"皮瓣法+自体肋软骨埋置+乳晕文身的乳头乳晕再造,6例采用"箭头"皮瓣法+乳晕文身的乳头乳晕再造.结果 再造乳头全部成活,其中2例术后1个月时再造乳头回缩完全变平,其余10例术后3个月时再造乳头回缩率约50%,跟踪随访6个月至1年,再造乳头大小稳定,与对侧基本对称.结论 本手术方法设计合理、操作简单,且无需另选供区,远期乳头突度维持也良好.     

Rat posterior parietal cortex: topography of corticocortical and thalamic connections

Anatomical and functional findings support the contention that there is a distinct posterior parietal cortical area (PPC) in the rat, situated between the rostrally adjacent hindlimb sensorimotor area and the caudally adjacent secondary visual areas. The PPC is distinguished from these areas by receiving thalamic afferents from the lateral dorsal (LD), lateral posterior (LP), and posterior (Po) nuclei, in the absence of input from the ventrobasal complex (VB) or dorsal lateral geniculate (DLG) nuclei. Behavioral studies have demonstrated that PPC is involved in spatial orientation and directed attention. In the present study we used fluorescent retrograde axonal tracers primarily to investigate the cortical connections of PPC, in order to determine the organization of the circuitry by which PPC is likely to participate in these functions, and also to determine how the topography of its thalamic connections differs from that of neighboring cortical areas. The cortical connections of PPC involve the ventrolateral (VLO) and medial (MO) orbital areas, medial agranular cortex (area Fr2), portions of somatic sensory areas Par1 and Par2, secondary visual areas Oc2M and Oc2L, auditory area Tel, and retrosplenial cortex. The secondary visual areas Oc2L and Oc2M have cortical connections which are similar to those of PPC, but are restricted within orbital cortex to area VLO, and within area Fr2 to its caudal portion, and do not involve auditory area Te1. The cortical connections of hindlimb cortex are largely restricted to somatic sensory and motor areas. Retrosplenial cortex, which is medially adjacent to PPC, has cortical connections that are prominent with visual cortex, do not involve somatic sensory or auditory cortex, and include the presubiculum. We conclude that PPC is distinguished by its pattern of cortical connections with the somatic sensory, auditory and visual areas, and with areas Fr2, and VLO/MO, in addition to its exclusive thalamic connectivity with LD, LP and Po. Because recent behavioral studies indicate that PPC, Fr2 and VLO are involved in directed attention and spatial learning, we suggest that the interconnections among these three cortical areas represent a major component of the circuitry for these functions in rats.     

不同烧结温度对双相钙磷陶瓷颗粒材料介孔结构及其成骨性能的影响

目的通过体内外实验检测不同烧结温度下制备的不同介孔直径双相钙磷陶瓷（biphasic calcium phosphate，BCP）颗粒材料成骨能力差异，为筛选具备更好临床应用参数的 BCP 材料提供依据。方法将羟基磷灰石（hydroxyapatite，HA）及 β-磷酸三钙（β-tricalcium phosphate，β-TCP）以 8∶2 比例混合后，分别在 1 050、1 150 及 1 250℃ 下烧制 3 h 制备 3 种 BCP 材料（分别设为材料1、2、3），比表面积测试法（Brunauer-Emmett-Teller test，BET）测量材料的颗粒内部孔隙率及介孔直径、体积、面积，X 线衍射（X-ray diffraction，XRD）评估材料组成成份，扫描电镜观察材料微观表面形态。体外将第 3 代 SD 大鼠 BMSCs 与各材料共培养 7 d（分别设为 A、B、C 组），扫描电镜观察细胞黏附情况，鬼笔环肽染色观察 BMSCs 贴附于材料表面后的形态，细胞计数试剂盒 8 法检测细胞增殖活性。体内建立比格犬异位成骨模型：取 9 只比格犬，于每只犬双侧竖脊肌内制作 9 个肌袋，将肌袋随机分为 3 组（每组 3 个/只），A、B、C 组分别置入材料 1、2、3。术后 1、2、3 个月分别麻醉 3 只比格犬取材行 HE、Masson 及番红固绿染色，计算 BCP 间隙中的成骨面积比；行实时荧光定量 PCR（real-time fluorescence quantitative PCR，qRT-PCR）检测成骨相关基因 ALP、骨桥蛋白（osteopontin，OPN）、骨钙素（osteocalcin，OC）的表达。结果BET 检测示随烧结温度增加，颗粒内部孔隙率无明显变化，但介孔直径、体积及面积逐渐减小；XRD 检测示 3 种材料均可见 HA 及 β-TCP 两种 X 线衍射波；扫描电镜观察示 3 种材料表面有广泛分布的微孔，孔间有空隙相连。体外实验示 BMSCs 在 3 种材料表面黏附、增殖，B、C 组材料的细胞生物相容性优于 A 组。体内实验结果示，术后 2 个月开始 3 种材料颗粒孔隙内即可见明显的骨样组织沉积。各组成骨面积比随时间延长均增加，术后 2、3 个月 A 组成骨面积比显著高于 B、C 组，1 个月时显著高于 B 组（P<0.05）。qRT-PCR 检测示，A 组成骨相关基因表达在 2 个月时出现峰值，B、C 组各成骨相关基因表达随时间延长逐渐增加。术后 1 个月 A 组 ALP 和 OPN mRNA 相对表达量显著高于 B、C 组，术后 2 个月 A 组 OC mRNA 相对表达量显著高于 B、C 组，术后 3 个月 B、C 组 ALP mRNA 相对表达量及 B 组 OPN mRNA 相对表达量显著高于 A 组（P<0.05）；其余各时间点各组间比较各基因 mRNA 相对表达量差异均无统计学意义（P>0.05）。 结论不同烧结温度下制备的 BCP 材料，其介孔直径随温度增加而减小。不同介孔直径的 BCP 材料异位成骨能力存在差异，其中直径为 12.57 nm 的 BCP 材料能更早激活成骨基因，具备更强的成骨能力。介孔直径可作为一个优化 BCP 材料成骨能力的指标。     

双相生物钙磷陶瓷生物相容性及异位骨诱导的实验研究

目的检测运用羟基磷灰石及β-磷酸三钙制备的双相钙磷陶瓷的生物相容性及其异位骨诱导效率。方法采用化学共沉淀法及过氧化氢发泡法,将羟基磷灰石及β-磷酸三钙以6∶4的比例在1 100 ℃条件下烧结3 h获得双相钙磷陶瓷,利用X线衍射评估材料组成成分。分离SD大鼠骨髓间充质干细胞,接种于双相钙磷陶瓷,通过扫描电镜、鬼笔环肽及DAPI染色观察细胞的黏附,CCK8法评估细胞增殖,碱性磷酸酶测定法评估骨髓间充质干细胞的碱性磷酸酶表达活性。将不含骨髓间充质干细胞的双相钙磷陶瓷置入比格犬竖脊肌内,于4、8、12周对样本行大体检测、组织染色,测算新骨生成率,从而评估双相钙磷陶瓷的异位骨诱导效率。结果成功制备双相钙磷陶瓷,X线衍射分析可见羟基磷灰石及β-磷酸三钙特异性的衍射峰。扫描电镜可见双相钙磷陶瓷表面广泛分布大孔及连通孔,孔壁粗糙不平,孔内可见均匀分布的微孔。鬼笔环肽及DAPI染色显示,骨髓充质干细胞在材料表面伸展黏附,共培养后逐渐从不规则形转变为均一的长梭形。CCK8法提示共培养后第1天,细胞活力降低,而第3、4、5、7天,细胞增殖活力逐渐增加。碱性磷酸酶活性检测提示,与对照组相比,共培养后第1、7天,双相钙磷陶瓷组的骨髓间充质干细胞可分泌更多的碱性磷酸酶。双相钙磷陶瓷顺利置入比格犬竖脊肌内,术后8周材料孔隙内可见骨样组织沉积,术后12周大孔成骨比例为0.77±0.11,孔内成骨面积比例为0.71±0.14。结论双相钙磷陶瓷具有良好的生物相容性及异位骨诱导效率。