选择性脱细胞猪皮研制及早期临床应用

目的介绍选择性脱细胞猪皮覆盖大面积烧伤早期创面的研制方法及临床应用效果. 方法 2001年1月～2002年5月,对1例深Ⅱ度15%、Ⅲ度25%烧伤患者的右前臂和右小腿,行选择性脱细胞中厚猪皮早期覆盖.戊二醛交联后表皮面黏贴于容器,边缘包埋.在含0.25%胰酶的PBS液中37℃消化2小时,去污剂处理24小时后,漂洗备用.将处理后猪皮应用于1例切削痂自体微粒植皮创面覆盖约2%,大体和光镜观察其功能和外观恢复情况. 结果组织学观察见表皮层基本完整,真皮内无细胞.初步临床观察显示,选择性脱细胞猪皮的真皮可在创基成活,失活表皮可被宿主自体表皮替代. 结论选择性脱细胞猪皮有望替代现有材料用于大面积烧伤切削痂创面的早期覆盖.     

中国仓鼠肺成纤维细胞和HeLa细胞DNA氧化损伤的自身修复能力与比较

目的:研究不同氧化相关因素对中国仓鼠肺成纤维细胞(CHL)和HeLa细胞DNA损伤的自身修复情况.方法:将CHL细胞和HeLa细胞用不同氧化相关因素处理一定时间[CHL细胞:过氧化氢(H2O2)25 min,重铬酸钾(K2Cr2O7)105 min,阿霉素(Dox)75 min;HeLa细胞:H2O2 25 min,K2Cr2O7 105 min],随后立即去毒培养0、0.5、1、2、3 h,以碱性单细胞凝胶电泳技术检测DNA链断裂情况.结果:①CHL细胞经H2O2、K2Cr2O7、Dox作用后引起DNA链断裂,去毒培养1 h链断裂修复明显(P<0.01);去毒培养2～3 h,前两毒剂的损伤组完全修复,而Dox组链断裂仍高于未损伤组;②HeLa细胞经H2O2、K2Cr2O7作用后引起DNA链断裂,去毒培养0.5 h链断裂明显修复(P<0.01),去毒培养1 h则完全修复;③CHL细胞和HeLa细胞损伤后修复的拖尾率与修复时间的回归系数显著不同(P<0.05).结论:两种细胞在氧化性DNA损伤后均迅速启动自身修复,但HeLa细胞比CHL细胞有更快的修复能力;同时这两种细胞由Dox所致损伤修复能力均较H2O2、K2Cr2O7所致的差.     

实验性腹主动脉瘤瘤体外径与iNOS相关性分析及分期研究

Objective To construct new model of experimental abdominal aortic aneurysm (AAA) and detect the AAA outer diameter and the change of induce nitric oxide synthase(iNOS) in the abdominal aor-tic aneurysm in different period,and analysis the correlation between experimental AAA and iNOS.Methods During the operation of the experiment group,the vascular prosthesis of PTFE was implanted to the rabbit abdominal aorta to form an aneurysm,while sham operation was done in the control group.The tissue of ab-dominal aortic aneurysm was harvested in 1 d,7d,14d,and 28d after operation,respectively.The tissue bo-mogenate concentration of iNOS in the abdominal aortic aneurysm were detected by enzyme linked immu-nosorbent assay (ELISA).Results In experimental group,mean concentration of the tissue bomogenate concentration of iNOS in the abdominal aortic aneurysm in 1 d,7 d,14 d,28 d were (22.129 ±2.518)μ/mL,(27.337±5.321) μ/mL,(36.047±4.584)μ/mL,(44.756±1.799)μ/mL,respectively;In control group,that was (12.499±1.807)μ/mL.The concentration of iNOS in experimental group was significantly higher than that of control group (P < 0.01).The difference during the experimental group all had statisti-cal significance (P < 0.05).Conclusion It is possible that iNOS has some biological function during the formation and progression of the abdominal aortic aneurysm.     

DNA双链断裂残留损伤与癌细胞辐射敏感性研究

目的 了解不同组织来源癌细胞株和人体肿瘤组织原代细胞的DNA双链断裂损伤修复的个体差异性,探寻预测癌细胞辐射敏感性的生物指标。方法 ⁶⁰Co γ射线照射诱发DNA损伤,脉冲电场凝胶电泳检测DNA双链断裂损伤修复,细胞克隆形成能力法检测细胞辐射敏感性。结果 8个不同组织来源癌细胞株的辐射敏感性有较大的差异(D₀为0.65~2.15 Gy),不同细胞株20 Gy γ射线照射诱发产生的DNA双链断裂原初损伤有一定的差别,但与细胞辐射抗性无相关性。辐射敏感细胞SX-10的DNA双链断裂修复缺陷发生在早期快速修复相,而A2780细胞的修复缺陷是发生在晚期慢速修复相。20 Gy照射修复2 h后DNA双链断裂残留量与细胞辐射敏感性指标D₀或SF₂值有显著的相关性。不同个体患者脑肿瘤组织原代细胞之间,辐射诱发DNA双链断裂的修复反应存在明显差异,修复2 h后残留损伤的个体差异性分布类似于癌细胞株。结论 DNA双链断裂残留损伤与癌细胞辐射抗性有显著相关性,可作生物指标预测肿瘤组织细胞对放射治疗的反应性。     

快速富集骨髓干细胞复合羟基磷灰石三钙在胸腰椎骨折中的应用

胸腰椎骨折在临床上是脊柱骨折的好发部位,后路手术多采用椎弓根钉系统复位固定加椎板间或横突间植骨融合。后外侧融合是降低内固定失败、减少纠正丢失等并发症的有效措施。传统植骨采用自体髂骨,也有运用同种异体骨,但有一定并发症发生率。近年来有单纯运用骨髓移植治疗骨缺损     

Hernia repair in elderly patients under unmonitored local anaesthesia is feasible

Background: There is a growing interest in the use of local anaesthesia for inguinal hernia repair. It certainly seems to be an acceptable alternative for the elderly. Supporting intravenous sedation, however, still requires monitoring, anaesthetic personnel and some preparations for the patient. Therefore we set up a feasibility study of hernia repair under local anaesthesia without intravenous sedation or monitoring in elderly patients. Method: A total of 62 patients (aged 65 years or more) with unilateral inguinal hernia received a Mesh Plug Repair. Prospectively collected data included procedure-related complications and information on pain and quality of life as measured by Short Form 36. Results: No procedure-related complications were noted. Comparing the preoperative scores, the SF-36 on day 14 (n=61) did not differ significantly. After a median follow-up of ten months (n=54), significantly higher scores were found for scales of physical and emotional role and pain (all p<0.05). Twenty-two patients reported some form of pain (40.7%). 94.4% of the patients would recommend the procedure when asked. Conclusion: The results of this study indicated that Mesh Plug Repair performed under unmonitored local anaesthesia with no intravenous sedation is a feasible alternative for elderly patients. It has advantages for the medical organization without disadvantages for the patient.     

Use of an aortic connector system for vein grafting

OBJECTIVE: The aortic connector system was used to minimize cerebrovascular complications when performing the proximal anastomosis of vein grafts during coronary artery bypass grafting (CABG). The goal of this study was to investigate the intermediate outcomes of patients undergoing CABG with the aortic connector system. METHODS: The aortic connector was used on nine patients undergoing CABG between November 2002 and July 2003. Intermediate outcomes of the patients were examined, and the results of coronary angiography, which were performed before patient discharge and at least 6 months after discharge, were evaluated. RESULTS: There were no operative deaths or cerebrovascular accidents. One patient died 9 months after discharge, one patient had angina, and the remaining seven patients were asymptomatic. When evaluating the results of angiography performed before patient discharge, two of the 21 distal vein graft anastomoses were occluded (patency rate, 90.5%), but there was no stenosis or occlusion at the proximal anastomoses sites that were performed using the aortic connector. When evaluating the results of the second angiography performed after patient discharge, four of the eight proximal anastomoses were patent, one was completely occluded, two had 90% stenosis and one had 75% stenosis. Further, four of the 18 distal anastomoses were occluded (patency rate, 77.8%). There was no significant difference in graft flow or device size when comparing patients with patent vein grafts and those with stenotic or occluded vein grafts. CONCLUSION: Intermediate outcomes of vein grafting using the aortic connector were suboptimal. Long-term outcome data are forthcoming.