大功率氦氖激光治疗增生性瘢痕的实验研究

Previousstudiesshowedthathigh－powerHe－Nelaserirradiationnotonlyinhibitgrowth犤１犦ofculturedcellsinhypertrophicscarbutinduceapoptosis犤２犦．Theobjectiveofthisstudywastoexploreroleofhigh－powerHe－Nelaserirradiationinbodyandprovidetheexperi－mentalbaseforclinicalapplicationthroughestablishinghypertrophicscaranimalmodel．１Materialandmethod１．１Material４Japanesewhiterabbitswithlargeearwerese－lectedasexperimentalanimalswithoutregardinggender．Therabbitsweightedbetween２．０～２．５kg，mea…     

非稳态噪声作业对油田压裂工人听力损伤的调查研究

１Subjectandmethod１．１Subject１４５６fracturingworkersofoilfieldwererandomlyselectedassubjects．Workerssufferingfromhearinglossduetononindustrialdamagewereexcludedfromthestudy．３５１workerswhodidnotworkedinfracturingplantwereselectedascontrolgroup．１．２MethodUsingfinesound－levelmeterND－２correctedbyChinaAcademic，weassessfieldnoiseofenvironmentwherefrac－turingworkersworkedaccordingtoEvaluationStandardsfornoiseofIndustryandEnterprise．Self－madequestionnairewasusedforas－sessmentofp…     

中国部分地区中老年人群骨质蔬松症流行病学研究

Theresearchisthelargesteffortonosteoporosisthathasbeenundertaken，andoneofthefewcountry－wideglobalefforts．TheresearchisespeciallyimportantwiththesuggestionthatChinesehavelowbonedensityingeneral，andtherapidagingoftheChinesepopulation犤１－２犦．１Materialsandmethods１．１SubjectsSubjectswereobtainedwithinformedconsentfrom５５９３HannationalityandregisteredinfiveareasofChinaincludingNorth，South－middle，East，South－westandNorth－eastbythestrati－fied－multi－steps－clustersamplingmethod…     

微波理疗对乳癌术后康复的作用

１SubjectandMethods１．１SubjectFromSeptember１９９４toSeptember１９９９４００pa－tientsofbreastcancerstagingfromstageItostageIIIaafterradicalormodifiedradicalmastectomyweredividedintotestandcontrolgroups．１．２Methods（１）Equipment：MultifunctionalmicrowavetreatingmachineforphysiotherapyofTianjinLY－IItypeused，withworkfre－quencyof２４５０MHzandcontinuousadjustablepowerbetween５～６０W．S＝１．２９whenradiatinginthemuscletissue．（２）Allthepatientswereadministrated５－Fuof０．７５…     

采用四股半腱肌肌腱和缝线钢板重建前十字韧带后的康复训练

FromMay１９９７toApril２００１，wereconstructedoldanteriorcruciateligament（ACL）injuryusingquadrupled－strandedsemi－tendinosustendonandsutureplateand１－yearrehabilitationexer－cise，andtherapeuticeffectwasfavorable．Hereisthereport．１Subjectandmethod１．１Subjects５１patients（２７malesand２４femalesaged１３～５７years，meanage：２４．７）enteredourstudy．Patientswithseverecompoundinjuriesofposteriorinnerandouterligamentswereex－cludedfromourstudy．AccordingtoLysholmkneescorescale犤１犦…     

Vocal rehabilitation by vocal tube after complete laryngectomy of phase I

VocaltubeBlom－Singerimplantationduringphaseofcompletelaryngectomycanavoiddistressassociatedwiththesecondsurgery．VocaltubeimplantationofphaseIunderbrightfieldissimplerandreliablecomparedwiththatofphaseII．１Subjectandmethod１．１SubjectFromOctober１９９８toOctober２００１，vocalrehabili－tationbyvocaltubeBlom－SingeraftercompletelaryngectomyofphaseIwasperformedon１３patients．Allpatientsweremenaged５６～６８yearsandsufferedfromsquamouscarcinomaprovedpathologically．１．２Method（１）Fis…     

混合性脑卒中患者血浆内皮素及一氧化氮变化对预后影响的研究

Inrecentyearsmanyresearchesshowedthatserumendothelins（ET）andNOplayedimportantfunctioninonsetprogressionofcerebralvesselsdiseases，manydatashowedthatserumETin－creasedandNOdecreasedinpatientswithhemorrhagicandis－chemiccerebralvesselsdiseases．ButthereportonETandNOchangeofmixedtypestrokepatientswasfew．Thisresearchin－vestigatethefunctionofETandNOinthisdiseasebytestingserumETandNOof３２mixedcerebralstrokepatientsandcom－paredthemwithcontrolgroup．１Subjectandmethod１．１SubjectObserv…     

曲美他嗪对陈旧性心肌梗死康复期运动耐量的影响

Persistentinsufficientflowofcoronaryarterywillleadtohi－bernationofpartialmyocardiumfollowingmyocardialinfarctionduetocoronaryheartdisease，andthusdecreasingheartfunction，ex－ercisetolerance，andqualityoflifeduringrehabilitationphase．TMZ，theinhibitorof３－KAT，playsthecardinalroleinen－ergymetabolismofmyocardium．Inpresentstudy，weobservedim－pactofTMZonexercisetoleranceofpatientswitholdmyocardialinfarction．１Subjectsandmethod１．１Subjects５８patientssufferedfromcoronaryscopyorclini－…     

脑卒中后癫痫的危险因素分析

Inthisstudy，etiologyofepilepsywasanalyzedusingmulti－variatenonconditionlogisticanalysistoprovidebasisforpreventionandrehabilitationofepilepsy．１Subjectandmethod１．１SubjectDuringNovember１９８７～May１９９６，１６２６sub－jectsunderwentfirstonsetofcerebrovasculardiseasewerere－cruitedfromintraneuralDepartment．１７９patientsexperiencedepilepsysecondarytostroke．AllprimarylesionswereprovedbyCTorlumbarspinepuncture．Nopatientshadhistoryofepilep－sy．Rheoencephalogramshowedepilepticchanges…     

细胞凋亡相关基因Bcl-2及Bax在骨肉瘤中的表达与自下而上质量的关系

Osteosarcomaisthemostcommonlyseentumorsinyoungadults，whichischaracterizedbypoorprognosis．Simplemorpho－logicalchangescannotbeusedtoevaluateprognosisofosteosarcomaexactly犤１犦．Inthisstudy，expressionofapoptosisrelatedgeneBcl－２andBaxinosteosarcomaof５１patientswithvariousclinicalap－pearanceswasinvestigatedtoexploretherelationshipbetweenapop－tosisandprognosis．１Subjectandmethod１．１Subject５１patientsunderwentsimilartreatmentofosteosar－comaduring１９８６～１９８８weredividedinto２grou…     

PPAR-γ激动剂15d-PGJ2对兔耳增生性瘢痕的影响

目的：观察过氧化物酶体增殖物激活受体-γ（peroxisome proliferator activated receptor-γ, PPAR-γ）的配体l5-脱氧-△12,14-前列腺素J2（15-deoxy-△12,14-prostagliandxin J2,15d-PGJ2）对兔耳增生性瘢痕CD34及转化生长因子-β1（transforming growth factor-β1,TGF-β1）的影响,探讨15d-PGJ2防治增生性瘢痕的机制和可行性。方法选取新西兰大白兔9只,在兔耳腹侧面制作2 cm＆#215;2 cm全层皮肤缺损创面,每耳2个,共计36个,建立兔耳增生性瘢痕动物模型,随机分为实验组和对照组,分别用15d-PGJ2及生理盐水行瘢痕内注射,1次/d,连续注射7 d。停止注射后第3、6、17天取材。应用免疫组织化学方法检测CD34和TGF-β1的表达。结果兔耳创面愈合后均出现不同程度类似人增生性瘢痕组织块,与对照组比较,实验组注射15d-PGJ2后瘢痕逐渐变平变软,颜色变浅,在各时间点CD34及TGF-β1的表达均较对照组低,差异有统计学意义（P＜0.05）。结论 PPAR-γ的配体15d-PGJ2可减少瘢痕内CD34、TGF-β1的含量,引起瘢痕萎缩,有一定的防治瘢痕增生的作用,为其治疗增生性瘢痕的临床应用提供了一定的理论依据。     

磷脂多不饱和脂肪酸抑制兔耳增生性瘢痕

背景：多不饱和脂肪酸有抑制细胞炎症反应及免疫功能的作用,增生性瘢痕的形成与炎症、细胞免疫、细胞因子有着密切关系,但目前尚无应用多不饱和脂肪酸防治增生性瘢痕的实验研究。目的：探讨磷脂多不饱和脂肪酸对兔耳增生性瘢痕的抑制作用。方法：在9只新西兰大白兔兔耳腹侧做直径1cm的圆形全层皮肤缺损创面,每侧6个,共108个,其中形成增生性瘢痕92个,瘢痕形成率为85%。实验分3组：每只兔耳靠前3个创面涂磷脂多不饱和脂肪酸霜,右耳靠后3个创面涂多磺酸黏多糖乳膏,创面上皮化后立即涂药,每日1次,左耳靠后3个创面自然愈合。分别在术后28,42,63,90d,观察创面的愈合情况;显微镜下观察瘢痕组织的厚度、胶原纤维和成纤维细胞密度;免疫组织化学染色检测胶原纤维的表达。结果与结论：涂抹磷脂多不饱和脂肪酸霜和多磺酸黏多糖乳膏可使增生性瘢痕体积缩小、厚度变薄、成纤维细胞密度减小、胶原纤维表达减少。尤以磷脂多不饱和脂肪酸霜的效果最为明显。说明磷脂多不饱和脂肪酸可抑制兔耳增生性瘢痕的形成,减轻瘢痕的增生程度。     

建立小鼠增生性瘢痕动物模型的研究

目的:应用小鼠建立自身产生的、与人类类似的增生性瘢痕动物模型。方法:在小鼠耳耳腹面形成边长约3mm的方形全层皮肤缺损创面,愈合后,用计数细胞层数的方法对增生块进行病理学观察,比较瘢痕增生程度。结果:小鼠耳腹面可产生类似于人类的增生性瘢痕。外观明显产生增生80%。结论:这一动物模型可能成为研究人类瘢痕的动物模型。     

一种兔耳中期增生性瘢痕动物模型的建立

目的建立兔耳中期瘢痕动物模型,寻找兔耳瘢痕形成的最佳位点。方法选用日本大耳白兔20只,在兔耳腹侧选定6个位点,作直径1cm直达软骨表面的皮肤全层及软组织缺损240个。创面暴露,于伤后7d去除软骨上面的肉芽及血浆痂壳一次。术后连续3个月观察创面自然愈合及瘢痕增生情况;用HE及苦味酸-天狼星红染色观察瘢痕形成及胶原分布情况;用计算机图像分析系统测定胶原含量。结果兔耳腹侧可制作类似人的增生性瘢痕模型,瘢痕的发生率42.5%～56.7%,瘢痕增生的高峰在造创后30～50d。不同位点瘢痕增生程度不同,胶原含量也不同。结论兔耳腹侧可建立中期瘢痕动物模型,兔耳腹侧的中分和耳尖外侧部分是制作兔耳增生性瘢痕的理想位点。     

红花对兔耳增生性瘢痕成纤维细胞及Ⅰ、Ⅲ型胶原的影响

背景：研究发现红花对体外培养的人增生性瘢痕成纤维细胞的增殖和胶原合成有抑制作用,但其具体作用机制与活体研究尚未进一步展开。目的：观察红花对兔耳增生性瘢痕成纤维细胞及Ⅰ、Ⅲ型胶原表达的影响。设计、时间、地点：随机对照动物实验,于2006-11/2008-03在重庆医科大学附属儿童医院动物实验中心及研究所完成。材料：新西兰大白兔27只,雌雄不限;50%红花注射液由山西太原华卫药业有限公司产品,批准文号：国药准字Z14020008。方法：兔耳腹侧建立增生性瘢痕模型,每耳2块。分为5组。术后第45天开始对增生性瘢痕行注射治疗。①正常皮肤组：为自身兔耳腹侧皮肤。②阳性对照组：右耳外侧增生性瘢痕,不予以任何处理。③生理盐水组右耳内侧增生性瘢痕,注射生理盐水。④低浓度红花组：左耳内侧增生性瘢痕,注射125 g/L红花液。⑤高浓度红花组：左耳外侧增生性瘢痕,注射500 g/L红花液。1次/周,连续注射4次。注射后第2,4,6周分别切取8只兔耳增生性瘢痕及皮肤待查。主要观察指标：瘢痕厚度,硬度;Mallory染色检测成纤维细胞密度胶原纤维排列及致密度。免疫组织化学方法检测每块组织Ⅰ、Ⅲ型胶原面密度,计算Ⅰ/Ⅲ型胶原比值。结果：注射后第4,6周,各组增生性瘢痕色泽均逐渐变浅,厚度及硬度均逐渐变小,尤以高浓度组明显,差异与其他增生性瘢痕组比较存在显著性意义（P 〈 0.05）。注射后第4,6周,高浓度红花组成纤维细胞密度较其他增生性瘢痕组低（P 〈 0.05）。注射后第4,6周,高、低浓度红花组I型胶原面密度值较阳性对照及生理盐水组低（P 〈 0.05）,且高浓度红花组低于低浓度红花组（P 〈 0.05）;各增生性瘢痕组Ⅰ/Ⅲ型胶原比值在注射后第2,4,6周均逐渐增高;同一时间段,高浓度红花组Ⅰ/Ⅲ型胶原比值为所有增生性瘢痕组中最低（P 〈 0.05）,低浓度红花组Ⅰ/Ⅲ型胶原比值与阳性对照及生理盐水组比较,差异有显著性意义。结论：高浓度红花液能促进兔耳增生性瘢痕的软化,组织顺应性增加。     

细菌纤维素减轻兔耳增生性瘢痕的作用

背景:国内外已有研究报道细菌纤维素对皮肤创伤愈合具有促进作用,但是其对增生性瘢痕是否有治疗作用尚不清楚。目的:观察细菌纤维素对兔耳增生性瘢痕的疗效。方法:建立兔耳腹侧增生性瘢痕模型,术后第21天创面上皮化后,对每只兔耳5个不同瘢痕面随机给予5种不同处理方式:持水性分别为1:5,1:6,1:8细菌纤维素组、阳性对照组(贴敷瘢痕贴)、阴性对照组(未贴任何敷料且瘢痕自然生长)。观察不同处理后第0,14,21,28,42,56天瘢痕面大体形态学及组织学变化。结果与结论:持水性1:5,1:6,1:8细菌纤维素组瘢痕增生厚度低于阴性对照组,但高于阳性对照组(P<0.01)。与阴性对照组比较,持水性1:5,1:6,1:8细菌纤维素组瘢痕组织中真皮层薄,成纤维细胞少,胶原纤维较细、排列较整齐;与阳性对照组组比较,持水性1:5,1:6,1:8细菌纤维素组成纤维细胞数稍多,胶原也稍粗、排列也稍不整齐。3种细菌纤维素组间瘢痕厚度及成纤维细胞数量为1:5细菌纤维素组>1:6细菌纤维素组>1:8细菌纤维素组(P<0.05)。说明细菌纤维素有效抑制了兔耳创面愈合后增生性瘢痕的形成,并且持水性越高,效果越好。     

细菌纤维素减轻兔耳增生性瘢痕的作用

背景：国内外已有研究报道细菌纤维素对皮肤创伤愈合具有促进作用,但是其对增生性瘢痕是否有治疗作用尚不清楚。目的：观察细菌纤维素对兔耳增生性瘢痕的疗效。方法：建立兔耳腹侧增生性瘢痕模型,术后第21天创面上皮化后,对每只兔耳5个不同瘢痕面随机给予5种不同处理方式：持水性分别为1：5,1：6,1：8细菌纤维素组、阳性对照组（贴敷瘢痕贴）、阴性对照组（未贴任何敷料且瘢痕自然生长）。观察不同处理后第0,14,21,28,42,56天瘢痕面大体形态学及组织学变化。结果与结论：持水性1：5,1：6,1：8细菌纤维素组瘢痕增生厚度低于阴性对照组,但高于阳性对照组（P〈0.01）。与阴性对照组比较,持水性1：5,1：6,1：8细菌纤维素组瘢痕组织中真皮层薄,成纤维细胞少,胶原纤维较细、排列较整齐;与阳性对照组组比较,持水性1：5,1：6,1：8细菌纤维素组成纤维细胞数稍多,胶原也稍粗、排列也稍不整齐。3种细菌纤维素组间瘢痕厚度及成纤维细胞数量为1：5细菌纤维素组〉1：6细菌纤维素组〉1：8细菌纤维素组（P〈0.05）。说明细菌纤维素有效抑制了兔耳创面愈合后增生性瘢痕的形成,并且持水性越高,效果越好。     

Analysis of gene expression patterns in human postburn hypertrophic scars

Hypertrophic scars cause cosmetic disfigurement and limited mobility in burn patients. To better understand the molecular pathophysiology of hypertrophic scar formation, microarray analyses were performed on normal skin and hypertrophic scars from four burn patients. Microarray analyses were determined in an effort to identify genes whose expression discriminated between normal skin and mature, hypertrophic scars. Surgical biopsies were obtained from two pediatric and two adult patients 6 to 15 months after burn injury. Total RNA was isolated from the samples and subjected to microarray analysis using the Affymetrix U95Av2 GeneChip. Results from this analysis revealed 31 probe sets representing genes that were consistently up-regulated at least two-fold in hypertrophic scar specimens from all four patients and four probe sets that were down-regulated. The significance analysis of microarrays algorithm also identified 35 probe sets whose increased expression resulted in the hierarchal clustering of the hypertrophic scar and normal tissue, seven of which were identical to the six genes identified by paired analyses. These six genes all displayed elevated levels of expression in the scar tissue. Proteins encoded by the genes identified included germline oligometric matrix protein, matrix metalloproteinase-16, collagen type 1alpha, pleiotrophin, and thrombospondin-4. Although the results presented here suggest that there may be unique patterns of gene expression in hypertrophic scars that may be important in the evaluation and treatment of hypertrophic scarring, the results must be confirmed with larger datasets.     

碱性成纤维细胞生长因子对增生性瘢痕与正常皮肤成纤维细胞胶原、纤维连接蛋白表达的影响

背景:碱性成纤维细胞生长因子能促进愈合伤口产生胶原蛋白、纤维连接蛋白和基质酶的基质成分.然而,细胞增殖、细胞外基质及新生血管的形成或伤口基质重塑过程失调,会导致瘢痕组织过度增殖.目的:观察碱性成纤维细胞生长因子在正常皮肤创面愈合和增生性瘢痕形成中的作用.方法:从5例进行瘢痕修复手术患者身上同时取正常皮肤和增生性瘢痕组织,分离培养正常人皮肤成纤维细胞和增生性瘢痕成纤维细胞.应用RT-PCR和酶联免疫吸附法检测两种成纤维细胞胶原、纤维连接蛋白基因表达和蛋白合成.采用JC-1染色和流式细胞术测定成纤维细胞线粒体膜电位改变,采用化学发光法检测细胞内ATP水平改变.观察碱性成纤维细胞生长因子对两种细胞的上述指标的影响.结果与结论:不同浓度碱性成纤维细胞生长因子可减慢增生性瘢痕成纤维细胞生长,抑制增生性瘢痕成纤维细胞Ⅰ型胶原表达和合成(P<0.05).碱性成纤维细胞生长因子对正常皮肤和增生性瘢痕成纤维细胞Ⅲ型胶原表达和合成均无影响.然而可上调正常皮肤成纤维细胞表达纤维连接蛋白(P<0.05).此外,10,100 μg/L碱性成纤维细胞生长因子处理后增生性瘢痕成纤维细胞线粒体膜电位呈去极化趋势,正常皮肤成纤维细胞中ATP水平显著增高(P<0.05).结果表明,碱性成纤维细胞生长因子在正常皮肤创面愈合和增生性瘢痕形成中可能有不同的作用和机制.