组织块培养法和酶消化法分离髌韧带细胞的比较*******◆

背景：调动和激活韧带与肌腱细胞群是有效修复损伤韧带与肌腱的关键，通过对韧带与肌腱细胞可能存在的不同群进行分离，对韧带与肌腱组织正常结构的维护及损伤修复具有重要意义。 目的：比较经组织块培养法和酶消化法分离出来的髌韧带细胞的形态、增殖，细胞复制性衰老与表面标记物表达。 方法：分别用组织块培养法和酶消化法对成年SD大鼠的髌韧带细胞进行分离培养，比较该两种方法得到的髌韧带细胞的形态，生长曲线，表面标记物的表达，细胞复制性衰老等情况。 结果与结论：经两种分离方法分离所得的髌韧带细胞的形态、增殖能力、表面标记物及复制性衰老均存在差异。提示髌韧带细胞可能存在不同群，且不同群的髌韧带细胞可能在髌韧带正常功能与修复中发挥不同的作用。 关键词：韧带；肌腱；损伤；修复；韧带细胞     

剖宫产术后使用硬膜外持续自控镇痛泵对产妇的影响

目的观察剖宫产术后应用镇痛泵对产妇镇痛效果、术后肠功能的恢复及早期泌乳的影响。方法随机将120例需行剖宫产孕妇根据自愿选择术后镇痛方式分为两组,观察组术后采用硬膜外自控镇痛泵,对照组术后不使用镇痛泵,观察两组产妇切口疼痛程度、肠蠕动恢复的时间、乳汁分泌情况。结果观察组镇痛效果明显,肠蠕动恢复快及初乳时间早于对照组(P<0.01)。结论镇痛泵可有效地为剖宫产产妇解决切口疼痛问题,肠蠕动恢复快,促进早泌乳。     

幽门螺杆菌感染与十二指肠球部溃疡相关性的临床研究

目的研究根除幽门螺杆菌（Hp）治疗对Hp阳性的十二指肠球部溃疡愈合率、愈合质量及复发的影响。方法将78例Hp阳性的十二指肠球部溃疡患者随机分为除菌组和非除菌组，除菌组给予泮托拉唑40mg＋克拉霉素0．5g＋呋喃唑酮0．1g口眼，2次／d，1周后泮托拉唑改为40mg，1次，d，共治疗6周。非除菌组单独给予泮托拉唑，剂赶方法同上。分别于6周及1年后复查胃镜。结果除菌组和非除菌组比较，6周后溃疡愈合率差异无统计学意义（分别为97．6％和91．7％，P〉0．05）。6周后溃疡愈合质量比较差异有统计学意义。1年后两组溃疡复发率比较，除菌组低于非除菌组，差异有统计学意义（分别为6．7％和59．3％，P〈0．01），Hp根除率除菌组高于非除菌组，差异有统计学意义（分别为86．7％和3．7％，P〈0．01）。结论Hp感染与十二指肠球部溃疡存在相关性，根除Hp治疗不仅可以提高溃疡的愈合质量，而且还可以减少溃疡的复发。     

角膜内皮细胞的损伤及促进其修复的因素

角膜内皮创伤愈合早在19世纪就受到人们的重视,近年来对角膜内皮损伤的病理、愈合的过程、修复机制均有了更深刻的认识。很多学者对角膜内皮愈合过程中各种因子的促进作用进行了系统的研究。其中各种生长因子和纤维连接蛋白对角膜内皮的愈合有促进作用,层粘连蛋白、高糖、柔红霉素对角膜内皮细胞有损害作用。     

两种狂犬病疫苗联合人狂犬病免疫球蛋白的效果分析

目的 了解高州市犬伤重伤暴露人群注射冻干和液体人用狂犬病疫苗及联合注射人狂犬病免疫球蛋白的效果。方法 调查对象为2005年8月1日～2006年11月30日到高州市疾控中心就诊的犬伤重伤者（全为Ⅲ级伤）。狂苗用7针法（0、3、7、14、28d，第一第二针次加注1支）和5针法联合注射人狂犬病免疫球蛋白，全程免疫后第30d用酶联免疫法检测血清抗体水平，联合使用武汉生物制药研究所生产的人狂犬免疫球蛋白（批号20050702-1，生产日期20050501，有效期20080817），剂量为20IU／Kg体重，治疗中观察副反应。结果 狂苗免疫抗体阳性率达到99．13％（574／579），不同程度的反应率为3．45％（20／579），579人中注射冻干狂苗7针法361人，抗体阳性率（360／361）99．72％，副反应为（5／361）1．38％，注射液体狂苗7针法59人，抗体阳性率（59／59）100％，副反应为（7／59）11．86％，注射液体狂苗5针法159人，抗体阳性率（155／159）97．48％，副反应为（12／159）7．5％，无中强反应发生。人狂犬病免疫球蛋白对伤口有抗感染、促进结痂、愈合作用。经设对照组比较，实验组平均结痂时间较对照组早2．43d，愈合时间早0．94d。结论 冻干人用狂犬病疫苗7针法及联合应用人狂犬病免疫球蛋白治疗安全，副作用少，保护率高；狂犬病免疫球蛋白对伤口有促进伤口结痂、愈合作用。     

高频电刀对腹部切口愈合影响的实验和临床研究

目的　探讨高频电刀对腹部切口愈合的影响。方法　将 2 4 0只大鼠平均分成实验组和对照组 2组 ,分别用电刀和普通手术刀制成腹部手术的动物模型 ,用生理盐水 (10°) ,以及 10 2 、10 5和10 8浓度的大肠埃希氏杆菌、金黄色葡萄球菌和铜绿假单胞菌的定量混合液 0 .2ml分别注入皮下 ,以观察电刀和冷刀在不同浓度细菌存在的条件下对切口感染的影响。在动物实验的基础上 ,随机将2 2 0例腹部Ⅱ类以上手术的患者分为电刀组 (93例 )、电凝组 (5 5例 )、对照组 (72例 )。其中 ,电刀组剖腹时用高频电刀切割组织 ,并用电凝止血。电凝组用普通手术刀剖腹 ,用电凝止血。对照组用普通手术刀剖腹 ,用丝线打结止血。观察 3组患者术后切口愈合的情况。结果　实验显示除 10 0 组外 ,其他各组使用电刀的切口感染率明显高于对照组。经统计学处理 ,10 2 组、10 5组和 10 8组的差异均有显著意义 (P <0 .0 5 ) ,10 0 组的差异无显著意义 (P >0 .0 5 )。临床观察发现 ,电刀组有 16例 (17.2 0 % ) ,电凝组有 9例 (16 .36 % ) ,而对照组 2例 (2 .86 % )切口愈合延迟。电刀组与对照组的差异有非常显著意义(χ2 =8.5 7,P <0 .0 1) ,电凝组与对照组的差异有显著意义 (χ2 =5 .6 6 ,P <0 .0 5 ) ,电刀和电凝组的差异无显著意义 (χ2 =0     

术前术中静脉化疗对小肠吻合口愈合影响的实验研究

选用３０只家兔，分成２组，实验组术前１天和术中静脉化疗，分别于术后第３天、第７天、第１４天处死，研究对小肠吻合口愈合的影响。结果表明，术后第３天实验组与对照组相比无差异（Ｐ＞０．０５），术后第７天、第１４天实验组动物小肠吻合口虽无渗漏，但显微镜下的组织学观察及羟脯氨酸含量测定，与对照组相比均有显著差异（Ｐ＜０．０１），提示术前术中静脉化疗对小肠吻合口的愈合有一定影响。     

Bacterial cellulose graft versus fat graft in closure of tympanic membrane perforation

Object

To compare between results of bacterial cellulose graft myringoplasty and fat graft myingoplasty in patients had mild or moderate size safe perforation.

Evaluation of healing by gentle touch

OBJECTIVES: To evaluate the effectiveness and safety of healing by gentle touch in clients attending The Centre for Complementary Care (CCC) in Eskdale, Cumbria. STUDY DESIGN: An evaluation of data collected by questionnaire over 6 years. METHODS: All clients attending the CCC between 1995 and 2001 were invited to participate in this study, and data were collected from 300 subjects with a wide range of ailments who received four treatment sessions within 6 weeks. Exclusion criteria were: recent treatment at the CCC; failure to complete four treatment sessions; and age under 16 years. Outcome measures included comparison of pre- and post-treatment levels of physical (pain, disability, immobility, sleep disturbances, reliance upon medication, daily activities) and psychological (stress, panic, fear, anger, relaxation, coping, depression/anxiety) functioning; these were assessed using a questionnaire with visual analogue scales for subjective rating of symptoms and the EuroQoL (EQ-5D), a generic state-of-health measure. RESULTS: Wilcoxon signed ranks tests showed statistically significant improvements in both psychological and physical functioning, particularly in stress reduction (median stress levels fell by four points), pain relief (median pain ratings fell by two points), increased ability to cope (median improvement of three points) and increased general health ratings (median improvement of 20 points) between study entry and end of treatment (P < 0.0004 for all these symptoms). The most substantial improvements were seen in those with the most severe symptoms at study entry. No adverse effects of treatment were documented. CONCLUSIONS: This audit of treatment outcomes provides evidence consistent with the hypothesis that healing, as provided at the CCC, was associated with improved psychological and physical functioning in the majority of subjects, and is worthy of further evaluation.     

Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial

BACKGROUND & AIMS: Nutrients putatively implicated in pressure ulcer healing were evaluated in a clinical setting. METHODS: Sixteen inpatients with a stage 2, 3 or 4 pressure ulcer randomised to receive daily a standard hospital diet; a standard diet plus two high-protein/energy supplements; or a standard diet plus two high-protein/energy supplements containing additional arginine (9 g), vitamin C (500 mg) and zinc (30 mg). Nutritional status measurements (dietary, anthropometric and biochemical) and pressure ulcer size and severity (by PUSH tool; Pressure Ulcer Scale for Healing; 0=completely healed, 17=greatest severity) were measured weekly for 3 weeks. RESULTS: Patients' age and BMI ranges were 37-92 years and 16.4-28.1 k g/m2) respectively. Baseline PUSH scores were similar between groups (8.7+/-0.5). Only patients receiving additional arginine, vitamin C and zinc demonstrated a clinically significant improvement in pressure ulcer healing (9.4+/-1.2 vs. 2.6+/-0.6; baseline and week 3, respectively; P<0.01). All patient groups presented with low serum albumin and zinc and elevated C-reactive protein. There were no significant changes in biochemical markers, oral dietary intake or weight in any group. CONCLUSIONS: In this small set of patients, supplementary arginine, vitamin C and zinc significantly improved the rate of pressure ulcer healing. The results need to be confirmed in a larger study.