大鼠烫伤创面愈合过程中皮肤基底膜层黏连蛋白的变化

目的：研究烫伤愈合过程中层黏连蛋白(LN)的表达。方法：采用免疫组化方法在大鼠浅Ⅱ度烫伤（伤后1,3,5,7,10,14d组）、Ⅲ度烫伤切痂混合移植模型（大张异体皮移植3,5,7,14,21,28d组）上研究了愈合过程中LN的变化。结果：正常皮肤基底膜中含有LN，而创伤后表皮细胞迁移缘LN消失，愈合后表皮下LN又出现。混合移植后7d出现异体皮排异反应，表现为异体表皮细胞铲除，而异体表皮下仍可见LN阳性表达。异体皮移植后10d，从自体皮迁移来的表皮细胞下有零星LN，而异体表皮细胞被完全铲除，异体皮基底膜处LN仍基本保持完整。异体皮移植后21d，自体表皮已基本覆盖异体皮区，此时LN表达已基本完整。结论：烫伤愈合过程中LN的变化有助于创面愈合。     

局部纤维连接蛋白对大鼠Ⅲ度烫伤创面愈合作用的研究

目的 研究混合皮肤移植对促进Ⅲ度烫伤皮肤愈合的机制。方法 在大鼠Ⅲ度烫伤及烫伤后切痂移植异体皮打洞嵌植自体皮片（混合移植）的模型上比较单纯Ⅲ度烫伤创面与混合移植后３,５,６,１７,２１和２８天自体皮区、异体皮区皮肤（包括部分皮下组织）中纤维连接蛋白（ＦＮ）含量的变化。结果 单纯Ⅲ度烫伤大鼠创面炎性反应明显,伤后２８天仍未愈合,混合移植异体皮出现排异现象;自体皮生长良好,植皮后２８天自体表皮相连。相     

自体表皮细胞培养与异体真皮组合应用研究

严重烧伤病人皮肤修复中主要未解决的问题是真皮的替代。动物实验结果表明，异体皮移植后５天，用自体培养表皮细胞膜片覆盖真皮床，１４天后复合皮成活率是８４．６％±２．４％。组织学检查证实表皮已形成了复层结构，可见基底层、颗粒层和角质层。临床应用中，异体皮移植后１０天，去除异体表皮覆盖病人的自体培养表皮，３５天后未见排斥征象，异体真皮促进了培养表皮的分层、成熟和完整，组织学检查证实表皮细胞的边缘清楚，已分化形成颗粒层和角质层，真皮多细胞，已血管化，但表皮嵴缺乏。     

局部纤维连接蛋白对大鼠III度烫伤创面愈合作用的研究

目的　研究混合皮肤移植对促进Ⅲ度烫伤皮肤愈合的机制。方法　在大鼠Ⅲ度烫伤及烫伤后切痂移植异体皮打洞嵌植自体皮片 (混合移植 )的模型上比较单纯Ⅲ度烫伤创面与混合移植后 3 ,5 ,7,14 ,2 1和 2 8天自体皮区、异体皮区皮肤 (包括部分皮下组织 )中纤维连接蛋白 (FN)含量的变化。结果　单纯Ⅲ度烫伤大鼠创面炎性反应明显 ,伤后 2 8天仍未愈合 ,混合移植异体皮出现排异现象 ;自体皮生长良好 ,植皮后 2 8天自体表皮相连。相应的未进行切痂混合移植的大鼠烫伤创面FN在烫伤后 17天才达到最高峰 ,混合移植异体皮区的FN在植皮后 3天即升高 ,第 7天为最高 ,第 14天降低 ,而自体皮区FN在移植后 2天即已达到最高峰。混合移植早期 ,自体皮区FN含量均高于异体皮区和烧伤创面。结论　自体皮片比异体皮片更易与创面粘连 ,建立血供 ,上皮更易扩展 ,从而有利于创面愈合。     

脱细胞异体真皮与自体刃厚皮移植矫正瘢痕畸形

目的 评估脱细胞异体真皮在烧伤后期瘢痕畸形矫正中的应用价值。方法 对60例烧伤后期瘢痕畸形病人矫形后继发创面行脱细胞异体真皮与自体刃厚皮复合移植。结果 所有病人皮片全部成活，复合皮片外观平整，颜色与邻近正常皮肤近似，无明显收缩，柔软耐磨，富有弹性。结论 脱细胞异体真皮是烧伤后期瘢痕畸形矫形中较理想的材料。     

混合表皮细胞与脱细胞真皮基质构建复合皮的移植和转归研究

探讨混合表皮细胞与脱细胞真皮体外构建的复合皮作创面移植后的转归。将BALB／c小鼠的表皮细胞和人表皮细胞按一定比例混合，种植于脱细胞真皮基质表面，经体外培养后形成复合皮，然后移植于BALB／c小鼠全层皮肤缺损创面，观察人表皮细胞的转归。结果显示，复合皮移植后可封闭创面，人表皮细胞多位于新生表皮上层，随时间延长，数量逐渐减少并最终被小鼠自体表皮细胞替代。提示两种不同的表皮细胞按一定比例混合培养构建复合皮可封闭全层皮肤缺损创面，可望节省自体皮源，缩短体外培养时间。     

瘢痕畸形应用脱细胞异体真皮复合移植的疗效观察

目的评价脱细胞异体真皮在烧伤后期瘢痕畸形整形中的应用价值。方法对24例烧伤后期瘢痕畸形病人整形后继发创面进行脱细胞异体真皮与自体刃厚皮片复合移植。结果24例病人复合移植皮片成活率为95％。成活的复合移植皮片具有外观平整,颜色与邻近正常皮肤相近似,无明显收缩,触之柔软,耐磨,弹性好等特点。结论脱细胞异体真皮是烧伤后期瘢痕畸形整形中比较理想的材料。     

异种无细胞真皮动物移植实验研究

目的研究巴马香猪无细胞真皮（acellular dermal matrix,ADM）结合自体刃厚皮移植于皮肤全层缺损大鼠后的免疫排斥反应、移植皮片存活率及创面收缩率。方法将巴马香猪ADM、人ADM及异体大鼠ADM结合自体刃厚皮移植于皮肤全层缺损大鼠背部,与大鼠自体全厚皮片移植组、单纯自体刃厚皮移植组比较,观察移植第1、2、4、8w时免疫排斥反应发生及炎症细胞浸润情况,计算不同时间点移植皮片存活率及创面收缩率。结果巴马香猪ADM和人ADM结合自体皮片移植到大鼠创面后,未引起明显免疫排斥反应,移植皮片存活率及创面收缩率无明显差异;与异体大鼠ADM组移植皮片存活率及创面收缩率之间差异不显著;移植皮片存活率明显低于自体全厚皮片移植组,但显著高于单纯自体刃厚皮移植组,创面收缩率显著低于自体刃厚皮移植组。结论巴马香猪ADM与人ADM具有相似的安全性和有效性,可提高自体皮片存活率,降低创面收缩率,完全可能替代人ADM应用于创伤修复领域。     

异体真皮在大面积烧伤后期功能整形的应用

目的观察异体真皮在烧伤后瘢痕整形手术中的临床应用效果。方法8例烧伤后瘢痕整形手术中,异体真皮组创面应用异体真皮＋自体刃厚皮片复合移植覆盖,对照组创面应用自体刃厚皮片移植覆盖,随访1年,比较术后两组功能和收缩情况。结果烧伤瘢痕切除术后半年及1年随访观察,发现采用异体真皮组创面应用异体真皮＋自体刃厚皮片复合移植术较对照组愈合后皮肤收缩少,表面更光滑柔软。结论异体真皮＋自体刃厚皮片复合移植较单纯自体刃厚皮片移植后期功能和外观佳,是烧伤后瘢痕整形良好的覆盖材料。     

培养的人表皮细胞片同种移植于烧伤创面

利用培养的人表皮细胞片同种移植于烧伤创面,最长随访至半年未见明显排异。为究其原因,对表皮内与排异密切相关的DR抗原的Langerhans细胞在培养过程中的变化进行了观察。证明新生的表皮细胞片内不显示有Langerhans细胞,在体外和异体淋巴细胞混合培养也不具有刺激转化的现象。提示培养的表皮细胞片同种移植,有可能延长存活期。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.