粒-巨噬细胞集落刺激因子对外周血T细胞和NK细胞的作用

为观察粒巨噬细胞集落刺激因子（ＧＭＣＳＦ）对淋巴细胞及ＮＫ细胞的影响,我们对化疗后应用ＧＭＣＳＦ的患者外周血淋巴细胞及ＮＫ细胞的变化进行了观察。病例和方法１　病例选择　４３例患者均为肿瘤化疗后病例,Ｋａｎｏｆｓｋｙ评分＞７０分。ＧＭＣＳＦ组２２例,中位年龄４９．２岁,男１２例,女１０例。对照组２１例,中位年龄４７．５岁,男１２例,女９例;其中有３例因粒细胞缺乏合并感染使用了粒细胞集落刺激因子而予去除,剩余１８例进行比较。２　方法　ＧＭＣＳＦ（升白能,美国先灵葆雅公司产品）３００μｇ／ｄ…     

重组人粒细胞集落刺激因子对药物性皮肤溃疡愈合的影响

背景：粒细胞集落刺激因子对成纤维细胞、角质细胞、皮肤黏膜细胞均有不同程度的刺激作用。 目的：观察粒细胞集落刺激因子对药物性外渗所致皮肤溃疡的愈合作用。 设计：随机对照动物实验。 单位：解放军第四军医大学西京医院呼吸内科。 材料：实验于2004—06／2004—11在解放军第四军医大学西京医院呼吸内科实验室完成。取雄性昆明种小白鼠20只，体质量18～24g。 方法：将制备好的皮肤溃疡动物模型随机分为对照组和治疗组，每组10只。对照组给予酚妥拉明1mg，利多卡因20mg，地塞米松1mg，用生理盐水稀释至0．5mL，封闭，1次／d，共7d；治疗组在溃疡周围注射粒细胞集落刺激因子25μg，用生理盐水稀释至0．5mL，隔日给药1次，共7d。观察溃疡处皮肤组织的愈合时间和组织学变化。 主要观察指标：观察粒细胞集落刺激因子对药物性外渗所致皮肤溃疡、糜烂的愈合时间和组织学变化。 结果：20只小白鼠均进入结果分析。①愈合时间：对照组糜烂、溃疡的愈合时间明显长于治疗组[（20-24，8～12）d，t=2．264，P=0．01]；②组织学观察：对照组治疗7d后肉芽组织增生不明显；治疗组治疗7d后肉芽组织增生，新生血管丰富。 结论：粒细胞集落刺激因子能促进药物性糜烂、溃疡的创伤愈合。     

外源性粒-巨噬细胞集落刺激因子对脓毒症树突状细胞的生物效应

目的 探讨粒-巨噬细胞集落刺激因子(GM-CSF)用于重度脓毒症治疗对于脾脏树突状细胞(DCs)的生物学效应及对预后影响.方法 选取160只雄性昆明鼠,随机(随机数字法)分为4组:健康对照组(n=50,不予特殊处理,正常喂养),CLP组(n=42,盲肠结扎穿孔),常规治疗组(n=34,CLP术后12、24、36、48、60、72、84h腹腔注射头孢曲松5 mg/kg),GM-CSF治疗组(n=34,CLP术后除常规治疗外另于12、36、60、84h皮下注射GM-CSF 20 μg/kg).于CLP术后0、12、24、48、72 h分批处死,用流式细胞仪测定各组脾脏DCs数量及凋亡率,用ELISA法检测各组血清IL-12质量浓度.并观察96h生存预后.结果 重度脓毒症时所有时间点脾脏DCs凋亡增加、数量明显减少(P＜0.05),IL-12血清浓度单向曲线型增高(P＜0.05);头孢曲松治疗可以加剧DCs的丢失(P＜0.05),而对IL-12质量浓度无影响(P＞0.05).GM-CSF治疗可增加DCs的数量(P＜0.05),降低IL-12质量浓度(P＜0.05).Logistic回归分析GM-CSF的OR值为0.079.结论 GM-CSF治疗重度脓毒症可以增加脾脏DCs数量,降低血清IL-12质量浓度,改善预后.     

重组人粒细胞集落刺激因子干预后自体骨髓移植对骨折愈合的影响

背景:自体骨髓经皮移植促进骨折愈合已经成为临床一种治疗手段,其中骨髓问充质干细胞在局部微环境下所起到的作用已经得到共识.但是如何提高其在移植骨髓中的含量仍是目前面临的难题.已经有研究报道重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimulating factor,rhG-CSF)可动员外周骨髓间充质干细胞快速增殖.目的:探讨rhG-CSF干预的自体骨髓移植对兔桡骨骨折愈合的促进作用.方法:制备桡骨中J段3 mm宽骨折模型白兔56只,随机分为4组,每组14只.术后1h,rhG-CSF组,自体骨髓组与PBS对照组均在白兔背部皮下注射rhG-CSF,1次/d,连续5d.模型组皮下注射相应体积的生理盐水.术后5 d,自体骨髓组抽取自体骨髓经皮回植骨折部位,PBS对照组在骨折处注射相应体积的生理盐水.术后14,28 d取材进行影像学、组织学、组织形态计量学检测与分析.结果与结论:rhG-CSF,自体骨髓,PBS对照组新生血管、骨小梁形成、4种骨痂记分、外骨痂厚度均优于模型组,尤以自体骨髓组效果最显著(P<0.01或P<0.05).说明rhG-CSF干预能够促进骨折愈合,结合自体骨髓移植促进骨折愈合的效果更佳.     

重组人粒细胞集落刺激因子对药物性皮肤溃疡愈合的影响

背景:粒细胞集落刺激因子对成纤维细胞、角质细胞、皮肤黏膜细胞均有不同程度的刺激作用。目的:观察粒细胞集落刺激因子对药物性外渗所致皮肤溃疡的愈合作用。设计:随机对照动物实验。单位:解放军第四军医大学西京医院呼吸内科。材料:实验于2004-06/2004-11在解放军第四军医大学西京医院呼吸内科实验室完成。取雄性昆明种小白鼠20只,体质量18～24g。方法:将制备好的皮肤溃疡动物模型随机分为对照组和治疗组,每组10只。对照组给予酚妥拉明1mg,利多卡因20mg,地塞米松1mg,用生理盐水稀释至0.5mL,封闭,1次/d,共7d;治疗组在溃疡周围注射粒细胞集落刺激因子25μg,用生理盐水稀释至0.5mL,隔日给药1次,共7d。观察溃疡处皮肤组织的愈合时间和组织学变化。主要观察指标:观察粒细胞集落刺激因子对药物性外渗所致皮肤溃疡、糜烂的愈合时间和组织学变化。结果:20只小白鼠均进入结果分析。①愈合时间:对照组糜烂、溃疡的愈合时间明显长于治疗组[(20～24,8～12)d,t=2.264,P=0.01];②组织学观察:对照组治疗7d后肉芽组织增生不明显;治疗组治疗7d后肉芽组织增生,新生血管丰富。结论:粒细胞集落刺激因子能促进药物性糜烂、溃疡的创伤愈合。     

大枣多糖对气血双虚模型小鼠全血细胞和血清粒-巨噬细胞集落刺激因子水平的影响

目的：观察大枣多糖对气血双虚小鼠全血细胞、血清粒-巨噬细胞集落刺激因子水平的影响，分析丈枣补血作用的可能途径。 方法：实验于2002—02／06在河南中医学院动物实验中心完成。①选用昆明种小鼠60只，体质量20-22g，雄性，6周龄。随机选用50只造成气血双虚模型：每鼠尾部放血0．025mL／g，分别于第2A，6，8天，腹腔注射环磷酰胺80，40，40，40mg／kg（给环磷酰胺前禁食不禁水12h）；其余10只小鼠为空白对照组（仅注射同体积生理盐水）。将50只气血双虚模型小鼠随机分为5组：大、中、小剂量大枣多糖组[分别灌胃400，200，100mg/kg剂量的大枣多糖（由河南中医学院药物化学学科提供。本品为鼠李科植物枣Ziziphus jujuba Mill．干燥成熟果实经乙醇回流脱脂、水提取、浓缩、醇沉、除蛋白、透析、醇沉、真空干燥等程序提取的精制物）水溶液，灌胃体积0.02mL／g]，当归补血口服液组[灌胃6．6mL／kg当归补血口服液（郑州市协和制药厂生产，批号010301，10mL／支），原药液稀释3倍1及模型组（灌胃等体积生理盐水）。空白对照组仅灌同体积生理盐水。1次／d，连续给药10d。（爹于末次给药后2h，各组动物均尾部取血，采用库尔特细胞全自动分析仪测血液中红细胞、白细胞、血红蛋白和血小板数；然后，每组各取5只小鼠，眼眶取血，采用由解放军总医院科技开发中心提供（批号020126）的粒-巨噬细胞集落刺激因子试剂盒测血清粒-巨噬细胞集落刺激因子水平。组问计量资料差异比较采用t检验。 结果：小鼠60只均进人结果分析。①空白对照组、各剂量大枣多糖组、归补血口服液组小鼠血红细胞计数、白细胞计数、血小板计数明显高于模型组（P〈0．01）；空白对照组，大、中剂量大枣多糖组、归补血口服液组小鼠血红蛋白含量高于模型组（P〈0．01），小剂量大枣多糖组血红蛋白含量与模型组相近。②模型组小鼠血清粒-巨噬细胞集落刺激因子水平明显低于空白对照组、当归补血口服液组、各剂量大枣多糖组（P〈0．01）。 结论：大枣多糖可通过升高气血双虚小鼠血清粒-巨噬细胞集落刺激因子水平，改善全血细胞检测结果，起到补血作用。     

大枣多糖对气血双虚模型小鼠全血细胞和血清粒-巨噬细胞集落刺激因子水平的影响

目的:观察大枣多糖对气血双虚小鼠全血细胞、血清粒-巨噬细胞集落刺激因子水平的影响,分析大枣补血作用的可能途径。方法:实验于2002-02/06在河南中医学院动物实验中心完成。①选用昆明种小鼠60只,体质量20～22g,雄性,6周龄。随机选用50只造成气血双虚模型:每鼠尾部放血0.025mL/g,分别于第2,4,6,8天,腹腔注射环磷酰胺80,40,40,40mg/kg(给环磷酰胺前禁食不禁水12h);其余10只小鼠为空白对照组(仅注射同体积生理盐水)。将50只气血双虚模型小鼠随机分为5组:大、中、小剂量大枣多糖组[分别灌胃400,200,100mg/kg剂量的大枣多糖(由河南中医学院药物化学学科提供。本品为鼠李科植物枣ZiziphusjujubaMill.干燥成熟果实经乙醇回流脱脂、水提取、浓缩、醇沉、除蛋白、透析、醇沉、真空干燥等程序提取的精制物)水溶液,灌胃体积0.02mL/g],当归补血口服液组[灌胃6.6mL/kg当归补血口服液(郑州市协和制药厂生产,批号010301,10mL/支),原药液稀释3倍]及模型组(灌胃等体积生理盐水)。空白对照组仅灌同体积生理盐水。1次/d,连续给药10d。②于末次给药后2h,各组动物均尾部取血,采用库尔特细胞全自动分析仪测血液中红细胞、白细胞、血红蛋白和血小板数;然后,每组各取5只小鼠,眼眶取血,采用由解放军总医院科技开发中心提供(批号020126)的粒-巨噬细胞集落刺激因子试剂盒测血清粒-巨噬细胞集落刺激因子水平。组间计量资料差异比较采用t检验。结果:小鼠60只均进入结果分析。①空白对照组、各剂量大枣多糖组、归补血口服液组小鼠血红细胞计数、白细胞计数、血小板计数明显高于模型组(P<0.01);空白对照组,大、中剂量大枣多糖组、归补血口服液组小鼠血红蛋白含量高于模型组(P<0.01),小剂量大枣多糖组血红蛋白含量与模型组相近。②模型组小鼠血清粒-巨噬细胞集落刺激因子水平明显低于空白对照组、当归补血口服液组、各剂量大枣多糖组(P<0.01)。结论:大枣多糖可通过升高气血双虚小鼠血清粒-巨噬细胞集落刺激因子水平,改善全血细胞检测结果,起到补血作用。     

熟地黄多糖对气血双虚小鼠全血细胞及血清粒-巨噬细胞集落刺激因子水平的影响

背景：熟地黄为生地黄的炮制加工品．现代研究多集中在熟地黄粗品的止血、补缸、抗氧化、抗衰老、抗炎、益智、降糖等方面，也有对机体免疫功能的影响，但缺少熟地黄活性部位对气血双虚模型动物的影响报道。目的：观察熟地黄多糖对气血双虚小鼠全虹细胞及血清粒-巨噬细胞集落刺徽因予水平的影响。设计、时间及地点：随机对照，动物血液学分子水平检测，于2002—02／06在河南中医学院动物实验中心完成。材料：清洁级昆明种6周龄雄性小鼠60只，由河南省医学实验动物中心提供。地黄购于河南武陟县药材公司，由本院化学室按药典方法经脱脂、水提、醇沉、除蛋白、透析、洗脱、真空干燥等工艺制得熟地黄多糖。当归补血口服液为郑州市协和制药厂产品。环磷酰胺为上海华联制药有限公司产品。方法：取50只小鼠，每只尾部放血0．5mL，分别于第2，4，6，8天腹腔注射环磷酰胺80，40，40，40mg／kg建立气血双虚模型，随机分为5组，高、中、低剂量熟地黄多糖组分别灌胃400，200，100mg／kg熟地黄多糖水溶液，当归补血口服液组灌胃6．6mL／kg当归补血口服液，模型组仅灌胃同体积生理盐水，1次，d，连续给药10d。剩余10小鼠作为空白对照组，仅腹腔注射同体积生理盐水，尾部不放血。主要观察指标：尾部取血检测全血细胞及血清粒-巨噬细胞集落刺激因子水平的变化。结果：60只小鼠均进入结果分析。与空臼对照组比较，模型组全血细胞水平显著降低（t=2．838～13．429，P〈0．01），血清粒-巨噬细胞集落刺激因子含量明显降低（t=-3．266，P〈0．05），表明骨髓造血功能受到抑制，造模成功。与模型组比较，高、中剂量熟地黄多糖组和当归补血口服液组均能显著升高红细胞、白细胞、血小板和血红蛋白水平（t=2．998-12．83,P〈0．01）；低剂量熟地黄多糖组能明显升高红细胞、白细胞、血小板水平（t=-2．779-4．653，P〈0．01或0．05）。与模型组比较，高、中剂量熟地黄多糖组和当归补血口服液组可显著提高血清粒-巨噬细胞集落刺激因子含量（t=-3．740-6．588，P〈0．01）；低剂量熟地黄多糖组可明显提高血清粒-巨噬细胞集落刺激因子含量（t=-2．662，P〈0．05）。结论：熟地黄多糖可促进机体的造血机能，给予高、中剂量时对气血双虚小鼠外周血血细胞状况和血清粒-巨噬细胞集落刺激因子水平均有显著改善作用，以中剂量提升作用最强。     

粒-巨噬细胞集落刺激因子对实体瘤化疗患者网织红细胞、血红蛋白和红细胞比积的影响

粒-巨噬细胞集落刺激因子(GM-CSF)可用于防治化疗后白细胞减少。在体外培养中它还具有促进红系细胞生成的作用,但对接受细胞毒药物化疗的恶性肿瘤患者体内红系细胞作用的报道尚不多见。本文通过测定实体瘤化疗患者应用GM-CSF后网织红细胞、血红蛋白(Hb)和红细胞比积(HCT)的变化,提示GM-CSF对体内红系生成具有一定的促进作用。 34名可供研究的患者随机分为两组,其中实验组在每个化疗周期第8天和第15天给予GM-CSF,300u/d,以预防白细胞减少,对照组则未接受GM-CSF。实体瘤共有非小细胞型肺癌(6例)、小细胞型肺癌(6例)、卵     

Impaired healing of cutaneous wounds and colonic anastomoses in mice lacking thrombin-activatable fibrinolysis inhibitor

Summary.  Plasmin and other components of the plasminogen activation system play an important role in tissue repair by regulating extracellular matrix remodeling, including fibrin degradation. Thrombin-activatable fibrinolysis inhibitor (TAFI) is a procarboxypeptidase that, after activation, can attenuate plasmin-mediated fibrin degradation by removing the C-terminal lysine residues from fibrin, which play a role in the binding and activation of plasminogen. To test the hypothesis that TAFI is an important determinant in the control of tissue repair, we investigated the effect of TAFI deficiency on the healing of cutaneous wounds and colonic anastomoses. Histological examination revealed inappropriate organization of skin wound closure in the TAFI knockout mice, including an altered pattern of epithelial migration. The time required to completley heal the cutaneous wounds was slightly delayed in TAFI-deficient mice. Healing of colonic anastomoses was also impaired, as reflected by decreased strength of the tissue at the site of the suture, and by bleeding complications in 3 of 14 animals. Together, these abnormalities resulted in increased mortality in TAFI-deficient mice after colonic anastomoses. Although our study shows that tissue repair, including re-epithelialization and scar formation, occurs in TAFI-deficient mice, TAFI appears to be important for appropriate organization of the healing process.     

The effect of antioxidant therapy on colonic inflammation in the rat

Under normal physiological conditions, chemical and antioxidant defenses protect tissues from the damaging effects of reactive oxygen metabolites (ROM). It has been proposed that ROMs are involved in the development of tissue injury in many inflammatory diseases and also in patients with colitis. In the present study we aimed to investigate the effects of antioxidant therapy on the extent of colonic inflammation and ROM levels in the injured tissues in a trinitrobenzene sulfonic acid-induced colitis model in the rat. Sprague-Dawley rats were pretreated with the antioxidants superoxide dismutase (30,000 U/kg s.c.) or catalase (400,000 U/kg s.c.) prior to induction of colitis and they were decapitated 24 h (acute group) or 6 days (chronic group) after the induction of colitis (each group consists of eight to ten rats). Pretreatment with the antioxidants reduced the macroscopic damage score significantly in both acute and chronic groups compared with untreated colitis groups, whereas they reduced the microscopic damage score and colonic wet weight only in the chronic group. The chemiluminescence assay - a technique to assess the presence of reactive oxygen species in the tissues - values of the groups pretreated with the antioxidants showed a tendency to decrease compared with the untreated colitis group, but they were not statistically significant. Based on these findings, pretreatment with the antioxidants superoxide dismutase or catalase has beneficial effects on the extent of colonic inflammation, particularly in the chronic period, and this may support the importance of antioxidant therapy to reduce the severity of inflammatory bowel disease in humans.     

左半结肠癌致急性肠梗阻一期切除手术治疗体会

结肠癌致急性肠梗阻是常见的外科急腹症之一,由于该起病隐匿,进展缓慢,常被误诊,及时处理直接关系到患者的预后。我院2008—05—2011-08收治左半结肠癌致急性肠梗阻16例,均行急诊手术,疗效满意,现报告如下。     

The effect of relative bowel rest on collagen in the colonic wall

In previous studies it was shown that diminished colonic content pre- and postoperatively, obtained by feeding rats low residue diet, results in less marked postoperative disturbances in collagen metabolism than in animals fed standard laboratory diet. In the present investigation the effect of relative bowel rest on collagen content and collagen concentration in the intact colonic wall was studied by feeding unoperated rats low residue diet. It was found that the colonic and cecal contents were reduced significantly and that this primarily affected the non-collagenous substances in the colon with a marked decrease, while the collagen content was unchanged. In the cecum, both the collagen and the non-collagenous contents were significantly increased. Thus, the pattern of change in biochemical response varied in different parts of the large intestine after institution of bowel rest. Further, the present data imply that collagen concentration can be misleading as a measure of the actual collagen amount.     

Histological effects of He:Ne laser on the healing of experimental colon anastomoses in the rat

Despite technical advances, the incidence of anastomotic leaks in elective colorectal surgery remains around 14%. Recent studies suggest that the use of low-energy lasers may enhance wound healing in different tissues in a selective, nondestructive manner. Based on these findings we have attempted to provide experimental background on the histological effects of He:Ne laser during the early stages of healing in 70 colonic anastomoses performed on rats. The irradiation of the anastomoses by two doses of 3.6 J/cm2 produces an increase in the populations of round cells and fibroblasts of the scar tissue, an increase in new vessel formation, and a significant improvement in epithelialization. This suggests that the irradiation of colonic wounds with He:Ne lasers can result in an enhancement of healing.     

丙酮酸钠液腹腔复苏对失血性休克大鼠肠黏膜屏障的保护作用

目的 探讨丙酮酸钠液腹腔复苏对失血性休克大鼠肠黏膜屏障的保护作用.方法 健康清洁级雄性SD大鼠,40只随机(随机数字法)分为4组:假手术组(Ⅰ组)、失血性休克模型组(Ⅱ组),复方氯化钠静脉复苏+ PD-2液腹腔复苏组(Ⅲ组),复方氯化钠静脉复苏+丙酮酸钠腹腔复苏组(Ⅳ组),每组10只.采用Wiggers改良法制备失血性休克模型.Ⅱ组行右颈总动脉、右股静脉、左股动脉插管及全身肝素化.Ⅲ组、Ⅳ组行静脉复苏的同时,分别向腹腔内注入2.5％ PD-2液20 mL和2.5％丙酮酸钠液20 mL.2h后取动脉血测血气(pH、PaCO2、PaO2)和D-乳酸含量,光镜下观察各组大鼠小肠黏膜组织形态变化.结果 血气分析:Ⅲ组、Ⅳ组较Ⅱ组pH水平及PaO2含量明显升高(P＜0.01);与Ⅲ组比较,Ⅳ组pH水平及PO2水平升高更为明显(P＜0.05).D-LA含量:Ⅲ组、Ⅳ组较Ⅱ组明显降低(P＜0.01);与Ⅲ组比较,Ⅳ组D-LA降低更明显(P＜0.05).光镜下Ⅱ组大鼠小肠黏膜层绒毛高度水肿,黏膜下血管塌陷,大片黏膜绒毛坏死、脱落,缺损;Ⅲ组和Ⅳ组小肠黏膜破坏较Ⅱ组明显减轻;Ⅳ组大鼠小肠黏膜绒毛水肿、倒伏及坏死程度均轻于Ⅲ组.小肠上皮损伤指数评分:Ⅳ组高于Ⅱ组及Ⅲ组(P＜0.01 orP＜ 0.05).结论 静脉复苏加腹腔复苏可降低失血性休克大鼠血浆D-LA含量、纠正酸中毒,提高氧分压;并且对于肠黏膜屏障的保护作用,丙酮酸钠液作用优于PD-2液.     

人性化护理对乳腺癌根治术患者恢复期心理状态的影响

目的:探讨人性化护理对于改善乳腺癌根治术患者心理状态的临床效果。方法:将193例乳腺癌根治术患者术后随机分为实验组(n=97)和对照组(n=96),对照组给予常规护理,实验组在对照组基础上给予人性化护理。结果:实验组患者心理状态评分均显著优于对照组(P<0.05)。结论:人性化护理模式应用于乳腺癌根治手术患者的康复,对于改善患者心理状态是非常有意义的,值得在临床上应用和推广。     

The influence of tissue oxygen and perfusion on wound healing

The availability of oxygen (O2) to cells in the wound area and the presence of adequate blood flow are important factors to the healing process. Oxygen plays a critical role in the formation of collagen, the growth of new capillaries, and the control of infection. Perfusion and delivery of O2 to tissue are closely related. Although an adequate blood flow does not guarantee a sufficient supply of O2, without it the provision of O2 to healing tissues will be impaired. Basic scientific studies have clarified how O2 and blood flow influence healing. Recent research has focused on clinical populations and begins to provide direction for additional clinical studies and interventions to support the healing process. Based on existing research, clinical interventions aimed to maintain perfusion and supply of O2 include fluid volume assessments, pulmonary hygiene regimens, postoperative position changes, and ambulation.