五瓣法整复条蹼状瘢痕挛缩畸形

报告了一组应用五瓣法（５—Ｆｌａｐｔｅｃｈｎｉｑｕｅ）整复损伤和烧伤所致蹼状瘢痕挛缩畸形，获得良好治疗效果。并就手术设计、原理、操作方法及适应证进行了讨论。     

增殖性疤痕中表皮细胞增殖、血管新生与VEGF的表达

目的：研究增殖性疤痕中血管内皮细胞生长因子(VEGF)的表达，及其与疤痕表皮细胞增殖和血管新生的关系。方法：应用免疫组化和RT-PCR法，以正常皮肤、正常疤痕为对照，检测增殖性疤痕中VEGF表达，并研究VEGF与表皮细胞增殖、血管新生的相关关系。结果：增殖性疤痕内VEGF蛋白及VEGF mRNA表达明显升高，与正常疤痕、正常皮肤有显著差别。VEGF主要由疤痕表皮角朊细胞分泌，且VEGF蛋白和VEGF mRNA的表达与疤痕组织表皮细胞增殖、血管新生高度相关。结论：增殖性疤痕中VEGF蛋白和VEGF mRNA的表达与疤痕增殖密切相关。     

1090例高校新生卡介苗接种普及情况和PPD试验结果调查分析

为了解江西省卡介苗实施情况并为高校防治结核提供依据。本文调查江西财院九江分院１０９０名新生的卡痕和ＰＰＤ试验。结果：总卡痕率７２．９４％，城、乡间无显著性差异；ＰＰＤ试验阴性率６０．４６％，阳性率３９．５４％、其中强阳性率３．１２％，乡村生强阳率显著高于城市生；ＰＰＤ阳性率在城、乡之间以及有、无卡痕者均无显著性差异。有卡痕者ＰＰＤ阳性率４０．５０％，提示近６０％种卡后未阳转或又复转阴。作者认为高校新生入学时进行ＰＰＤ试验并对阴性和强阳性采取进一步防治措施是非常必要的。     

重组人酸性成纤维细胞生长因子促进创伤愈合的研究

目的：研究重组人酸性成纤维细胞生长因子（rh-aFGF)对兔创伤的促愈合作用。方法：采用兔背部刀割伤模型，将rh-aFGF溶液隔日一次滴注于创面，用创面照像、透明膜描记称量法记录伤后第4、8、12、16天创面面积，用注水法测量伤腔容积，伤后第8、16天取创面组织，观察创面的病理学变化，包括肉芽组织生长与再上皮化情况。结果：rh-aFGF可明显加速兔皮肤创伤的愈合，使创面面积明显缩小（P＜0．05），使伤腔容积明显减少（P＜0．05）。组织学检查：rh-aFGF组创面伤后8天成纤维细胞生长活跃、数量多，其毛细血管胚芽与成纤维细胞数量显著多于对照组；伤后16天，创面收缩与再上皮化明显，新生上皮向创面中心爬行较快。结论：rh-aFGF对兔背部刀伤创面有明显的促修复作用。     

纳洛酮治疗急性重型颅脑损伤

我院自2001年1月-2001年12月,共应用盐酸纳洛酮治疗急性中、重型颅脑损伤35例,取得一定的疗效,现报告如下.……     

Quantification of risk factors in Hospital infection at a surgical service

In this paper we have analyzed several risk factors for developing nosocomial infections at a Surgical Service of the Hospital Clinico Universitario San Cecilio 2>, based on a retrospective follow-up program designed specifically for this study. Of all patients admitted to the Service from January 1 to June 17, 1987, we examined the following variables: age, sex, cause of admission, emergency or non-emergency admission, operation and related variables. The overall rate of nosocomial infections was 16.46%. The most significant risk factors we found were operation , which had a linear correlation coefficient of '0.929 (p < 0.01) with hospital infection when stratified by its lenght, advanced age ( >60 years old), especially in non-operated patients, and chemoprophylaxis. Such risk factors were ascertained taking into account the confounding effect produced by the variables studied in this survey.Corresponding author.     

In vitro Virulenz wundinfizierender Staphylokokken-Isolate von schwerbrandverletzten Patienten

Zusammenfassung 30Staphylococcus aureus Stämme von drittgradig verbrannten Patienten wurden hinsichtlich ihrer Fähigkeit zur Hämolysingenerierung und ihres Vermögens zur Histaminfreisetzung aus Mastzellen (RPMC) untereinander verglichen. Die bakteriellen Kulturüberstande von 8 Stämmen aus Wundbiopsien zeigten signifikant niedrigere in vitro Aktivitäten als die übrigen Staphylokokken-Kulturüberstände. Bei dem Vergleich der in vitro Aktivitäten der gewaschenen Bakterienzellen ergab sich ein umgekehrtes Verhältnis. Diese Befunde zeigen, daß beiS. aureus Isolaten, welche zum Zeitpunkt einer invasiven Brandwundeninfektion isoliert werden können, die mikrobiellen Pathogenitätsfaktoren an die Bakterienzelle gebunden bleiben.

---

In vitro measurement of pathogenicity ofStaphylococcus aureus isolated from heavily burned patients

Summary The hemolysin and histamine releasing activity of 30S. aureus strains isolated from third degree burns of heavily burned patients was detected. The culture supernatants (cs) ofStaphylococcus aureus isolated during episodes of invasive burn wound infection displayed significantly lower amounts of hemolysin and histamine releasing activity as compared to cs of bacteria isolated when no sign of septicemia was present. In contrast, when washed bacterial cells were analysed, a reversed ratio could be observed. These data clearly indicate that in strains isolated during invasive burn wound infection pathogenicity factors remain attached to the bacterial surface of the staphylococci investigated.

Gefördert durch das Bundesamt für Zivilschutz (ZS 8-122-42)     

细胞松弛素B对内皮细胞损伤修复的影响

目的观察细胞松弛素B对内皮细胞损伤修复过程中微丝骨架系统的形态结构变化,研究阻断微丝功能对内皮细胞损伤修复的影响。方法以培养单层内皮细胞损伤模型,采用免疫荧光染色和3H-TdR掺入法,研究微丝功能对创面愈合及细胞增殖的影响。结果内皮细胞在损伤修复过程中伴随微丝特殊而有序的变化。用细胞松弛素B破坏微丝,可不同程度抑制创面的愈合及细胞增殖,并呈一定的时间-剂量依赖关系。结论微丝功能在促进内皮细胞修复过程中起重要作用,可通过直接或间接效应影响DNA合成,从而影响修复过程。     

Keratinocyte-derived growth factors play a role in the formation of hypertrophic scars

In predisposed individuals, wound healing can lead to hypertrophic scar or keloid formation, characterized by an overabundant extracellular matrix. It has recently been shown that hypertrophic scars are accompanied by abnormal keratinocyte differentiation and proliferation, and significantly increased acanthosis, compared with normal scars. This study addressed the question of whether the development of normal and hypertrophic scars is regulated by differences in the growth factor profiles of both the epidermis and the dermis. The presence of interleukin-1alpha (IL-1alpha), IL-1beta, tumour necrosis factor-alpha (TNF-alpha), platelet-derived growth factor (PDGF), transforming growth factor-beta1 (TGF-beta1), and basic fibroblast growth factor (bFGF) was investigated in biopsies taken from breast reduction scars at 3 and 12 months following surgery. The samples were analysed by immunohistological methods and categorized as scars that remained hypertrophic (HH), became normal (HN) or remained normal after 12 months (NN). The epidermal expression of IL-1alpha was significantly increased in NN scars compared with HN and HH scars 3 and 12 months following operation, whereas the dermal expression showed no difference. PDGF was significantly increased in the dermis of normal scars after 3 months and in both the epidermis and the dermis of hypertrophic scars after 12 months. IL-1beta, TNF-alpha, TGF-beta and bFGF showed no differences. It is hypothesized that impaired production of keratinocyte-derived growth factors, such as IL-1alpha, leads to a decrease in the catabolism of the dermal matrix, whereas augmented epidermal PDGF production leads to increased formation of the dermal matrix in hypertrophic scars. These observations support the possibility that the epidermis is involved in preventing the formation of hypertrophic scars.     

糖尿病大鼠创面愈合过程中成纤维细胞增殖及Ⅰ型胶原合成减少

目的：观察链脲佐菌素诱导的大鼠糖尿病复合创伤修复过程中成纤维细胞增殖与胶原合成的变化。 方法： 实验采用Wistar大鼠112只，随机分对照组和模型组。模型组大鼠腹腔注射链脲佐菌素（STZ）55 mg/kg，3周后各组动物复合背部2.04 cm²全厚皮切除形成伤口。观察创面愈合时间和愈合率；采用HE染色和免疫组化法观察成纤维细胞和增殖细胞核抗原(PCNA)表达水平；采用苦味酸-天狼星红染色和图像分析技术观察创面Ⅰ、Ⅲ型胶原含量及Ⅰ/Ⅲ型比值。 结果： STZ诱发的糖尿病大鼠复合创伤后创面的愈合时间为(27.13±1.81)d，明显长于对照组（15.25±1.67）d，P<0.01；模型组在创伤第3、7和15 d创面愈合率明显低于对照组，分别P<0.01；在3、5、7和9 d模型组创面成纤维细胞数量和PCNA表达也明显少于对照组，分别P<0.05和P<0.01。两组创面在不同时点上Ⅰ型胶原分布均呈递增趋势，但对照组明显多于模型组，分别P＜0.05；尽管对照组在创伤3、7 d Ⅲ型胶原含量高于模型组，但在创伤3、7和11 d模型组Ⅰ/Ⅲ胶原比值都明显低于对照组，分别P＜0.01。 结论： STZ可能通过影响创面细胞增殖和创面胶原合成，从而导致创面愈合迟缓。