308nm准分子激光治疗白癜风发生水疱的原因与防治措施

目的探讨308 nm准分子激光治疗白癜风发生水疱的原因与防治措施。方法回顾我科2005年1月—2014年2月308 nm准分子激光治疗白癜风3152例中发生水疱181例的临床资料,分析水疱发生原因及防治措施。结果本组水疱的总发生率为5.74%。头面部治疗水疱发生率为5.07%,口角及唇部治疗水疱发生率14.01%,颈部治疗水疱发生率5.80%,躯干部治疗水疱发生率2.92%,四肢部治疗水疱发生率5.56%。本组发生水疱后均立即停止308 nm准分子激光局部照射,给予局部对症处理,水疱恢复正常时间平均为7.36 d。结论 308 nm准分子激光治疗白癜风时,治疗剂量应从最小红斑量开始,逐渐递增剂量,根据红斑反应调整治疗剂量,避免单次照射剂量过大或在光敏性患者身上照射,以减少或避免水疱的发生。     

大疱性类天疱疮患者疱液中趋化因子受体5和可诱导共刺激分子的检测

目的：检测C?X?C趋化因子受体5（CXCR5）和可诱导共刺激分子（ICOS）在大疱性类天疱疮（BP）患者疱液中的水平，探讨其在BP发病机制中的意义。方法收集15例BP患者疱液为实验组，15例Ⅱ度烧伤患者疱液为对照组，采用酶联免疫吸附测定（ELISA）方法分别检测CXCR5及ICOS在两组疱液中的水平。结果实验组及对照组疱液中CXCR5水平分别为（219±145.31）、（147±23.83）ng/L，差异有统计学意义（t=4.577，P<0.05），但疱液中ICOS水平差异无统计学意义[（30.18±14.86）比（21.43±5.32）ng/L，t=1.628，P>0.05]。结论 CXCR5的表达可能与BP发病有一定关系，而ICOS与BP发病的关系尚需进一步研究。     

Transcapillary Forces and the Development of Oedema in the Lower Limb of Patients with Chronic Critical Limb Ischaemia (CLI)

OBJECTIVE: factors regulating transcapillary fluid transport were investigated to elucidate the causes of oedema in CLI. MATERIAL: sixteen patients, 6 men and 10 women (mean age of 79+/-10.3 years) with unilateral CLI and peripheral pitting oedema. METHODS: measurements were performed in both limbs. Interstitial fluid was collected by applying blister suction cups on the dorsolateral part of the foot and colloid osmotic pressure of this fluid (COP if) was measured in a colloid oncometer. Plasma colloid osmotic pressure (COP pl) was obtained from venous blood. Interstitial fluid pressure (P if) was measured by wick-in-needle technique. RESULTS: mean COP if in the limbs with CLI was 2.3 S.D. 0.5 mmHg, significantly lower than in the limbs without CLI (3.1 S.D. 0.7 mmHg, p<0.0001). Mean COP pl was 21.1 S.D. 1.8 mmHg, which was lower than in healthy controls. Mean plasma albumin concentration was 30 S.D. 6 g/l which was lower than the reference values. Mean P if in the limbs with CLI was 0.7 S.D. 1.6 mmHg, significantly higher than in the limbs without CLI (-1.4 S.D. 1.4 mmHg, p<0.0001). The calculated mean reabsorption pressure (P r) in the limbs with CLI was 19.6 S.D. 1.7 mmHg, significantly higher than in the contralateral limbs (16.7 S.D. 2.1 mmHg, p<0.001). CONCLUSION: a low plasma albumin concentration in patients with CLI agrees with the reduction in COP pl but cannot explain the oedema formation, since it is unilateral. The high P r may cause a high transcapillary filtration pressure, resulting in a relatively great net filtration and subsequent oedema formation.     

Increased serum IL-6, TNF-alpha and IL-10 levels in patients with bullous pemphigoid: relationships with disease activity

AIM: The present report analyzes the serum levels of three cytokines, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) in 15 patients with bullous pemphigoid (BP) (compared with 20 healthy controls) to evaluate a possible involvement of these biological modulators in the clinical expression of this disease. BACKGROUND: BP is a rare bullous disease of autoimmune origin with evidence of inflammatory processes that cause skin lesions with local increase of various pro-inflammatory mediators. METHODS: Determination of cytokine concentrations were obtained employing commercially available ELISA kits. RESULTS: The sera of BP patients showed increased levels of these three cytokines (P < 0.01). When the number of skin lesions (blisters and/or erosion) of each patient, employed as a marker of disease activity, was correlated with the serum levels of IL-6 and TNF-alpha, significant correlations were found (IL-6: P < 0.01 and TNF-alpha: P < 0.01, respectively), suggesting a possible role of these mediators in the development of BP blisters. The serum levels of IL-6 also correlated (P = 0.01 with those of serum C reactive protein (CRP), an acute-phase protein induced by IL-6 in hepatocytes. In addition, serum TNF-alpha and sE-selectin (an adhesion molecule previously reported to be increased by this cytokine) levels were also correlated (P < 0.05). CONCLUSIONS: On the basis of these data, it may be indicated that at least IL-6 and TNF-alpha are associated with the clinical expression of BP and that the endothelial activation (possibly induced by the TNF-alpha activity), seems to be an important phase of this dermatosis.     

烧伤创面水疱液对人骨髓间充质干细胞体外培养及表型转化的影响

目的 了解烧伤水疱液对人骨髓间充质于细胞(MSC)体外培养及表型转化的影响.方法 体外分离、培养、扩增、鉴定人骨髓MSC,收集烧伤患者伤后12、24、48 h水疱液,分别加入MSC培养液中.分为水疱液1组:MSC培养液中加入伤后12 h水疱液;水疱液2组:MSC培养液中加入伤后24 h水疱液;水疱液3组:MSC培养液中加入伤后48 h水疱液;对照组:常规培养.各组所加水疱液体积分数均为20%.观察水疱液微生物生长情况及各组MSC生长情况.流式细胞仪检测培养8 d时各组MSC中CD44、细胞角蛋白7(CK7)阳性表达率.结果 15个水疱液标本细菌、真菌培养均为阴性;各组MSC细胞形态无明显变化,但各水疱液组细胞数量均少于对照组,水疱液3组细胞数量下降最明显.水疱液1、2、3组CD44阳性表达率分别为(83.0±3.1)%、(77.2±2.9)%、(65.1±2.3)%,均低于对照组[(89.5±3.2)%,P<0.01];水疱液1、2、3组CK7阳性表达率分别为(24.06±0.11)%、(16.41±0.09)%、(4.48±0.07)%,明显高于对照组[(3.87±0.04)%,P<0.01].结论 烧伤创面水疱液对MSC体外培养有明显的抑制作用,并具有一定的促进MSC表型转化作用.     

水蛭、斑蝥对鸡胚绒毛尿囊膜(CAM)血管生成的影响

目的研究中药水蛭、斑蝥对鸡胚绒毛尿囊膜(CAM)血管生成的影响。方法将12只Wistar大鼠随机分为水蛭组(高低剂量组)、斑蝥组(高低剂量组)、血清组和空白组,中药水蛭、斑蝥各制成水煎液,灌胃7d,采血清备用。建立6d鸡胚绒毛尿囊膜血管模型,观察各组血清对鸡胚绒毛尿囊膜(CAM)血管生成的影响。结果水蛭高剂量组有明显地抑制新生血管数量的作用,与空白组比较,差异有统计学意义(P0.05);斑蝥高、低剂量组与空白组比较,亦能较强地抑制新生血管数(P0.05);水蛭、斑蝥高低剂量组有抑制血管生成面积的趋势,但差异无统计学意义(P0.05)。结论虫类中药水蛭、斑蝥对CAM血管生成有一定的抑制作用。