手烧伤晚期功能重建

目的：探讨一种科学的方法对手烧伤晚期畸形进行功能重建。方法：采用了手术与非手术相结合的方法，对62例病人，80只手烧伤晚期功能障碍进行重建。结果：局部改形31例，大张全厚或中厚植皮27例，皮瓣移植4例，手术均成功，术后注重康复治疗，畸形改善，功能得到最大限度恢复。结论：手烧伤晚期功能重建如何，烧伤早期正确处理是基础，整形手术是关键，康复治疗是保障。     

重度失水所致应激性高血糖症

本文报道2例肠梗阻和1例有机磷农药中毒患者出现暂时性高血糖症。该3例患者均无糖尿病史,因有重度失水,经大量补液纠正失水后血糖迅速恢复正常。口服葡萄糖耐量试验正常。作者认为非糖尿病患者可因重度失水而致应激性高血糖症。     

A protease inhibitor attenuates gastric erosions and microcirculatory disturbance in the early period after thermal injury in rats

The effects of camostat mesilate, a synthetic serine protease inhibitor on gastric microcirculation and active oxygen species generated by leucocytes from the gastric and jugular veins in the early period after thermal injury were assessed. Male Wistar rats were anaesthetized and a 30% full skin-thickness dorsal burn was inflicted. Camostat mesilate (100 mg/kg) was dissolved in distilled water and administered orally to rats 40 min before thermal injury (the camostat group). The control animals (the vehicle group) were administered distilled water orally. Rolling leucocytes as well as Monastral blue B deposits in venules were observed using in vivo microscopy. Active oxygen species were measured by chemiluminescence. Camostat mesilate decreased the total length of gastric erosion, venular deposits of Monastral blue B, and rolling of leucocytes in venules, and relatively increased luminol-dependent chemiluminescence activity generated by zymosan-stimulated leucocytes 15 min after thermal injury. These results suggest that serine proteases are involved in the formation of gastric erosions and gastric microcirculatory disturbance in the early period after thermal injury.     

Crystalloids, colloids and kids: a review of paediatric burns in intensive care

This is a retrospective review of all burns patients admitted to a paediatric intensive care unit (PICU) over a 7 year period. Resuscitation fluid therapy and clinical course are presented. Ninety-eight new burns victims were admitted with a mortality rate of 10.2%, all in burns of greater than 25% body surface area (BSA). The incidence of ARDS was 20%, with an 18% mortality rate. Of 85 patients with burns greater than 5% BSA, 33 received the hospital-recommended colloid-based resuscitation formula, 46 received a combination of crystalloids and colloids and in 6 patients the resuscitation regimen was not able to be determined. The aetiology, age distribution, sex ratio, severity of burns and length of stay in hospital did not alter significantly over the study period. The number of burns admissions to PICU increased, as did their duration of intubation and ICU stay. The hospital-recommended resuscitation formula consistently underestimated the fluid volume required for adequate resuscitation. No statistically significant difference in adverse effects was found between the resuscitation groups. This study is unable to recommend a definitive approach to the fluid resuscitation of burns shock in paediatrics and the best approach is one of meticulous fluid resuscitation titrated on clinical effect.     

SARS冠状病毒N蛋白单克隆抗体的制备及鉴定

目的 制备SARS冠状病毒(SARS-CoV)N蛋白特异性单克隆抗体(McAb)，为SARS的快速诊断及致病机制的研究提供实验材料。方法 用纯化的重组SARS-CoVN蛋白免疫BALB/c小鼠，经细胞融合和亚克隆后获得分泌针对N蛋白的杂交瘤细胞株，用Western blot和间接免疫荧光法检测这些细胞株分泌的单克隆抗体特异性，并将N蛋白分3段表达初步定位单克隆抗体识别表位所在区域。结果 通过细胞融合和3轮克隆化，筛选出分泌抗N蛋白的6个杂交瘤细胞株。Western blot及免疫荧光显示，获得的McAb可与SARS-CoVN蛋白及SARS-CoV发生特异性反应，有4个细胞株分泌的抗体的识别位点位于N蛋白N端，2个位于C端。结论 获得了SARS-CoV特异性单克隆抗体并进行了初步定位，可用于SARS的早期诊断及致病机制研究。     

抗SARS病毒N蛋白单克隆抗体的制备和初步应用

目的 制备抗SARS病毒N蛋白的单克隆抗体并研究其初步应用。方法 用基因重组N蛋白免疫小鼠，取免疫后的鼠脾细胞与骨髓瘤细胞融合，筛选分泌抗SAPS病毒N蛋白单克隆抗体细胞株。将阳性细胞株接种小鼠腹腔制备单克隆抗体腹水并对抗体进行纯化，分析纯化抗体的相对亲和力。选择亲和力较高的抗体制备检测SARS病毒抗原的酶联免疫诊断试剂，并对其敏感性和特异性进行分析。结果 共获得11株单克隆抗体细胞株，其中3株单抗与N蛋白具有较高的亲和力，4株纯化单抗与N蛋白反应很弱，其余4株单抗介于两者之间。用亲和力较高的单抗制备检测SARS病毒抗原的诊断试剂，其敏感性可达31PFU／ml，而且与其他呼吸道病毒无交叉反应。结论 该试剂特异性较好，可用于SARS病毒抗原的检测，其敏感性仍需用临床急性期样品进行评价。     

小儿重症哮喘多因素回归分析

应用电脑对111例儿童哮喘50项指标进行多因素逐步回归分析,把发作时喘憋严重,平时也有不同程度的喘息症状患儿列入小儿重症哮喘,与非重症哮喘比较,结果显示夜间喘、急性发作持续天数、非特异性刺激诱发、间歇期症状、发绀、呼吸困难、入院后激素治疗、中性粒细胞、IgA、pH、哮喘持续状态等11个因素入选重症哮喘回归方程,表明这些因素与小儿重症哮喘相关,提出儿童哮喘危险信号的临床指标。     

SARS病毒S蛋白受体结合区DNA疫苗及免疫效果研究

目的 研究SARS冠状病毒(SARS-CoV)靶细胞受体结合区所构建之DNA疫苗的免疫效果,为进一步的SARS-CoV免疫机理研究及疫苗研制奠定基础.方法 选取SARS-CoV S基因包含靶细胞受体结合区和S1亚单位C端2个基因片段作为目的基因,构建真核表达质粒pVAX-RBD(receptor binding domain)、pVAX-S1C作为DNA疫苗免疫BALB/c小鼠,检测其特异性体液免疫及细胞免疫情况.结果 体液免疫方面,以SARS全病毒裂解产物和原核表达的RBD蛋白作为诊断抗原,用ELISA均可检测到高滴度的小鼠血清抗体IgG的产生.而且,血清中和试验显示pVAX-RBD质粒激发了小鼠保护性中和抗体的产生.通过流式细胞分析和酶联免疫斑点实验(ELISPOT)检测,pVAX-RBD和pVAX-S1C两组质粒均诱导免疫小鼠产生了特异性细胞免疫反应.结论 证明SARS-CoV S蛋白受体结合区上中和表位的存在;体液免疫在抗SARS-CoV感染方面起到重要作用.     

Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19

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