几丁糖预防髌骨骨折术后膝关节粘连的临床观察

目的　观察几丁糖对髌骨骨折术后发生膝关节功能障碍的影响。方法　选择 1999年 3月～ 1999年10月收治的 4 0例髌骨骨折行内固定治疗者 ,随机选择 2 4例术中关节腔内涂布 2 %几丁糖 4 ml作为几丁糖组 ;另 16例常规手术不作任何处理作为对照组。双盲法观察术后 1个月和 1年时膝关节的伸屈活动度。结果　 4 0例均获随访 ,术后 1个月时膝关节活动度 ,几丁糖组伸屈 10 4°± 2 3°,对照组伸屈 72°± 16°,具有统计学意义 (P<0 .0 1) ;术后 1年 ,几丁糖组伸屈 16 5°± 38°,对照组 110°± 31°,具有统计学意义 (P<0 .0 5 )。结论　医用几丁糖能有效预防髌骨骨折术后膝关节粘连的发生。     

几丁糖预防肘关节粘附的临床研究

OBJECTIVE: To study the clinical effect of chitosan on prevention of elbow adhesion after elbow arthrolysis. METHODS: Twenty six patients with elbow ankylosis were performed elbow arthrolysis, which divided into two groups, in chitosan group, 12 patients were injected 2% chitosan into the elbow joint cavity, and no chitosan used in the other 14 patients as control group. The average range of extension and flexion of elbow joint was detected to evaluate the clinical results. RESULTS: All patients were followed up 8 to 51 months, averaged 24 months. In the chitosan group, the average range of extension and flexion of elbow joint was restored to 92.9 degrees +/- 20.9 degrees, with an average increase of 55.0 degrees +/- 15.9 degrees compared with preoperation. In the control group, the average range of extension and flexion of elbow joint was restored to 75.4 degrees +/- 17.5 degrees, with an average increase of 38.2 degrees +/- 11.9 degrees. The outcome showed significant difference between the chitosan group and the control group (P < 0.01). CONCLUSION: Chitosan can prevent or reduce elbow adhesion after elbow arthrolysis.     

An experimental study evaluating the effect of Mitomycin C on the prevention of postoperative intraabdominal adhesions

BACKGROUND: Fibroblast proliferation is one of the well-known mechanisms for postoperative intraabdominal adhesion formation. Inhibition of fibroblast proliferation is an attractive field of investigation in the prevention of adhesions. Mitomycin C (MMC) is a cytotoxic agent that alkylates and crosslinks DNA and also inhibits fibroblast proliferation up to a few weeks. We aimed to determine the effect of MMC on the prevention of adhesions. MATERIALS AND METHODS: Generation of adhesions in rats by brushing a 1-cm(2) area of the cecum and the peritoneum on the right side of the abdominal wall was followed by intraperitoneal administration of saline, 1 mg/kg MMC, and 0.5 mg/kg MMC in saline. After 45 days, formation of adhesions was graded. RESULTS: The average adhesion scores of the control, and MMC (1 mg/kg), MMC (0.5 mg/kg) groups were 3.2 +/- 0.7, 0.8 +/- 0.6, and 0.7 +/- 0.8, respectively. Adhesion scores of the two MMC-treated groups were significantly lower than that of the control group (P < 0.001). There was no difference between the two MMC groups (P > 0.05). No side effect of MMC was observed. CONCLUSION: MMC was found to be very effective in the prevention of postoperative intraabdominal adhesions.     

医用隔离材料防止肌腱粘连的实验研究

目的 通过动物实验比较目前较成熟的几种防肌腱粘连的材料,为临床提供依据.方法 雄性新西兰大白兔40只,随机分为4组,每组lO只,分别取左后肢第二、三趾为组内配对.在实验动物第二趾近节将屈肌腱切断后,用改良Kessler法缝合;对照组(A1)直接闭合切口,实验组分别在缝合口周围涂抹透明质酸钠(B1)、几丁糖(c1)、生物蛋白胶(D1)后闭合切口;各组第三趾缝合肌腱后加用聚乳酸可吸收膜包绕吻合口(A2、B2、C2及D2组).6周后对肌腱行大体、组织学观察及生物力学测试.结果 大体及光镜观察显示各实验组粘连程度均低于对照组A1,其中B1和C2组粘连程度最低.肌腱拉出距离及总活动度比值各组与对照组比较差异均有统计学意义(P＜0.05).各组最大拉力数值差异无统计学意义(P＞0.05).结论 聚乳酸可吸收医用膜、生物蛋白胶、透明质酸钠、几丁糖及其配对组合均有助于减少肌腱粘连,并且不影响肌腱愈合强度.其中,透明质酸钠组和几丁糖+医用膜组粘连程度最低,疗效显著.     

Comparison of PTFE,pericardium bovine and fascia lata for repair of incisional hernia in rat model,experimental study

Incisional hernia is a frequent complication of abdominal surgery developing in 11–20 % of patients undergoing an abdominal operation. Regarding morbidity and loss of manpower, incisional hernias continue to be a fundamental problem for surgeons. In this experimental study, three commonly used mesh materials (Goretex PTFE; Tutoplast Fascia lata; Tutopatch Pericardium bovine) were compared according to effectiveness, strength, adhesion formation, histological changes, and early complications. Three groups, each consisting of 14 rats, have been formed as group A: polytetrafluoroethylene (PTFE), group B: pericardium bovine and group C: fascia lata. Evaluations were achieved at the end of the first and second postoperative week, respectively. Adhesion formation, wound maturation, bursting pressure, and tensile strength were evaluated. No statistically significant difference regarding adhesion formation was observed between groups although adhesion formation was less significant in PTFE and pericardium bovine groups than in the fascia lata group. Bursting pressure and tensile strength values were significantly higher in PTFE group than in the fascia lata group (P <0.05). No statistically significant difference was observed between groups regarding wound maturation. In this experimental model, PTFE and pericardium bovine were found to be superior to fascia lata in abdominal wall repair. Electronic Publication     

Active vitamin D reduces macrophage infiltration by TREM-1 in renal tissue of diabetic nephropathy rats

Objective To investigate the effects of active vitamin D (VD) on the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in renal tissue of diabetic nephropathies (DN) rats and to explore the impact of TREM-1 on adhesion and migration capacity of macrophage. Methods DN rat models were established by streptozotocin. Rats were randomly distributed into four groups: control (NC) group, VD group, DN group and DN+VD group (DN rats with 0.1 μg?kg-1?d-1 calcitriol by gavages). Rats were sacrificed respectively at 8 weeks and 12 weeks after treatment. Pathological changes in kidney tissue were detected and the expressions of CD68 and TREM-1 were acquired by immunohistochemistry stain and Western blotting. In vitro, RAW264.7 cells were divided into NC group, VD group, high glucose (HG) group and HG+VD group. In HG+VD group rats were treated by high glucose with 10-8 mol/L 1,25(OH)2D3. TREM-1 expression was measured by immunohistochemistry stain and Western blotting, and the ability of macrophage in migration and adhesion was evaluated by Transwell migration assay and adhesion assay. TREM-1 siRNA was transferred to silence TREM-1 expression, while plasmid of TREM-1 was transferred for high expression. Their ability of adhesion and migration in macrophage and the effect of 1,25(OH)2D3 were examined. Results (1) Compared with the NC group, the expressions of CD68 and TREM-1 were increased in DN group (P＜0.05), whereas markedly decreased in DN+VD group (P＜0.05). (2) The number of adhesion and migration cells, and the expression of TREM-1 protein in macrophage were obviously increased in HG group as compared with those in NC group (all P＜0.05); whereas above changes were markedly decreased in HG+VD group than those in HG group (P＜0.05). (3) The number of adhesion and migrated macrophage was reduced after TREM-1 siRNA intervention (all P＜0.05). VD could significantly decrease the effect of high glucose on adhesion and migrated macrophages after TREM-1 siRNA (all P＜0.05). (4) Adhesion and migration of macrophage were increased via TREM-1 overexpression (all P＜0.05), but the effects of VD on high glucose-induced adhesion and migration of macrophage were disappeared. Conclusions VD can suppress the adhesion and migration of macrophage via reducing the expression of TREM-1, and inhibit infiltration of macrophage in renal tissue of DN rats.     

Reduction of Abdominal Adhesions with Elecrospun Fiber Membranes in Rat Models

Purpose: The aim of this study was to assess the effects three electrospun fiber membranes on postoperative adhesion formation in rat surgical models. Materials and Methods: The PEG-PHBV (polyethylene glycol and poly-β-hydroxybutyrate valerate), PLA(Polylactic acid) and CS-PEG(chitosan and polyethylene glycol) were used for submicrometric membranes fabrication by electrospinning. A total of 64 SD male rats were randomly divided into 4 groups, one control group and 3 treatment groups, each consisting of 16 rats. The rats were underwent median laparotomy and standardized abrasion of the cecum. The indicated membranes were applied intraperitoneally at the end of the surgical procedure in the treatment groups, while the controls left without treatment. Two and four weeks after surgery respectively, a relaparotomy was made for adhesion grading and histopathological examination, Hydroxyproline (Hyp) levels at the adhesion sites in each group were measured. Results: The electrospun submicrometric membranes significantly reduced not only the incidence of adhesion but also the adhesion grading scales (p < 0.05 compared to the control group) at both two weeks and four weeks after the initial operation. Furthermore, the fibrosis grades were also higher in control groups as compared with the submicrometric membrane groups. Hyp levels in the control group was significant higher than the three experiment groups at both 2 and 4 weeks time points (p < 0.05). There were no statistical differences between the different treatment groups at either time points. Conclusions: Three electrospun submicrometric membranes were soft, flexible, easy to handle, and effectively reduced adhesion formation in rat modes.     

改性壳聚糖防粘连膜防止心肌梗死模型兔心脏与周围组织粘连

目的 观察改性壳聚糖防粘连膜对心肌梗死兔心脏与周围组织粘连程度的影响.方法 25只日本长耳白兔,开胸结扎冠状动脉制备心肌梗死模型,随机分为对照组(A组)和改性壳聚糖防粘连膜组(B组),A组正常关胸,B组关胸前在心脏和胸壁间置入改性壳聚糖防粘连膜.每组造模型成功各11只.术后3个月A组存活8只、B组存活9只.分别行在体磁共振电影和二次开胸,分级评价粘连程度.采用Wilcoxon秩和检验.结果 磁共振电影评价粘连程度,A组轻度粘连、中度粘连、重度粘连分别为2只、2只、4只;B组分别为7只、2只、0只.差异有统计学意义(P<0.05).开胸评价粘连程度,A组无粘连、轻度粘连、中度粘连、重度粘连分别为1、1、2、4只;B组分别为3、4、2、0只.差异有统计学意义(P<0.05).结论 改性壳聚糖防粘连膜可以减轻心肌梗死模型兔心脏与周围组织粘连.     

Fibrin gel limits intra-abdominal adhesion formation.

Autologous fibrin gel (FG) has recently been reported efficacious in hepatic injury; the effects of fibrin compounds on intra-abdominal adhesion formation is controversial. This study evaluated intra-abdominal adhesion formation in a rabbit devascularization model. Seventeen New Zealand rabbits were anesthetized and laparotomy was done. The uterine horns were abraded to punctate bleeding followed by bilateral uterine devascularization. Treatment consisted of 10 cc saline control (c) or FG applied to the uterine horns. Peritoneal lavage was done at 15 minutes for red blood cell (RBC) analysis. Autopsy was performed at 1 week. Adhesions were graded from grade 0 (no adhesions) to grade III (dense adhesions). Adhesion grading revealed no difference in average adhesion grade between FG and C with small bowel (1.0 +/- 1.3 vs 0.5 +/- 1.0); bladder (2.1 +/- 1.1 vs 2.4 +/- 1.2); or uterus (1.2 +/- vs 2.0 +/- 1.2). Adhesion grade was significantly less in FG compared to C for the colon and the abdominal incision (0.4 +/- 0.5 vs 1.7 +/- 1.1 and 1.2 +/- 1.1 vs 3.0 +/- 1.2; P less than 0.05 by t-test). There were no differences in lavage RBC count between FG and C (13.1 x 106 +/- 4.1 x 10(6) vs 8.7 x 106 +/- 3.2 x 10(6)). Fibrin gel significantly decreased incisional and colonic adhesions and reduced other abdominal adhesion formation by a nonhemostatic dependent mechanism.     

改性壳聚糖防粘连膜防止心肌梗死模型兔心脏与周围组织粘连

目的 观察改性壳聚糖防粘连膜对心肌梗死兔心脏与周围组织粘连程度的影响.方法 25只日本长耳白兔,开胸结扎冠状动脉制备心肌梗死模型,随机分为对照组(A组)和改性壳聚糖防粘连膜组(B组),A组正常关胸,B组关胸前在心脏和胸壁间置入改性壳聚糖防粘连膜.每组造模型成功各11只.术后3个月A组存活8只、B组存活9只.分别行在体磁共振电影和二次开胸,分级评价粘连程度.采用Wilcoxon秩和检验.结果 磁共振电影评价粘连程度,A组轻度粘连、中度粘连、重度粘连分别为2只、2只、4只;B组分别为7只、2只、0只.差异有统计学意义(P<0.05).开胸评价粘连程度,A组无粘连、轻度粘连、中度粘连、重度粘连分别为1、1、2、4只;B组分别为3、4、2、0只.差异有统计学意义(P<0.05).结论 改性壳聚糖防粘连膜可以减轻心肌梗死模型兔心脏与周围组织粘连.     

The effect of a chitosan coating on the adhesive potential and tensile strength of polypropylene meshes

Purpose

The polypropylene mesh used for the repair of abdominal wall hernia can cause intraabdominal adhesions. In this study, the effect of chitosan coating of the polypropylene meshes on the adhesion and tensile strength of the meshes was investigated.

Method

After coating polypropylene meshes with 2?% chitosan, 5?×?3 cm patches were prepared. Under general anesthesia, sterile laparotomy was performed in 96 Wistar albino female rats that were equally allocated to 6 groups. In the first group, only laparotomy was performed. In the second group, chitosan was applied to the peritoneal cavity, and the laparotomy was closed. In the third group, polypropylene (prolene) patches were used to close the abdomen; in the fourth group, polypropylene polyglecaprone 25 (ultrapro) mesh patches were used to close the abdomen. In the fifth and sixth groups, chitosan-coated versions of the meshes used in the third and fourth groups, respectively, were applied. All skin incisions were closed in all groups. On the 7th and 21st?days, eight randomly selected rats from each group were killed. The abdomen was opened, and the adhesions were evaluated using the diamond score. The tensile strength of the meshes was measured by an Instron 4301 device. The histopathological evaluation of the inflammatory response was performed according to the Ehrlich and Hunt classification.

Results

The adhesion score was comparable among mesh groups but higher when mesh groups were compared with the control and chitosan groups (p<0.001). The tensile strength of meshes did not differ among mesh groups. Histopathologically, meshes with or without chitosan were similar in terms of inflammatory findings.

Conclusions

The chitosan coating did not affect the adhesion potential, the tensile strength, or the inflammatory response of the polypropylene meshes.     

The effect of suture technique on adhesion formation after flexor tendon repair for partial lacerations in a canine model.

BACKGROUND: Adhesion formation is a serious problem after flexor tendon repair. Many repair techniques have been developed to increase the suture strength after tendon repair surgery. The purpose of this study was to assess adhesion formation with different suture techniques in an in vivo canine model. METHODS: Sixty flexor digitorum profundus tendons were partially lacerated (80%) and repaired with either a modified Kessler (MK) or Becker (MGH) suture technique and supplemented with a simple running suture. The dogs were sacrificed at 1 week, 3 weeks, or 6 weeks after surgery and the repaired tendons were evaluated for adhesion breaking strength. RESULTS: At 1 week there was no significant difference between the two repair groups (p > 0.05). At 3 and 6 weeks, the adhesion breaking strength in the MK suture group was significantly less than that of the MGH suture group (p < 0.05). CONCLUSION: High friction suture techniques may cause more adhesion formation than the lower friction suture techniques under passive postoperative therapy.     

Phosphate depletion in the rat: effect of bisphosphonates and the calcemic response to PTH

BACKGROUND: The removal of phosphate from the diet of the growing rat rapidly produces hypercalcemia, hypophosphatemia, hypercalciuria, and hypophosphaturia. Increased calcium efflux from bone has been shown to be the important cause of the hypercalcemia and hypercalciuria. It has been proposed that the increased calcium efflux from bone is osteoclast mediated. Because bisphosphonates have been shown to inhibit osteoclast-mediated bone resorption, this study was performed to determine whether bisphosphonate-induced inhibition of osteoclast function changed the biochemical and bone effects induced by phosphate depletion. METHODS: Four groups of pair-fed rats were studied: (a) low-phosphate diet (LPD; phosphate less than 0.05%), (b) LPD plus the administration of the bisphosphonate Pamidronate (APD; LPD + APD), (c) normal diet (ND, 0.6% phosphate), and (d) ND + APD. All diets contained 0.6% calcium. A high dose of APD was administered subcutaneously (0.8 mg/kg) two days before the start of the study diet and on days 2, 6, and 9 during the 11 days of the study diet. On day 10, a 24-hour urine was collected, and on day 11, rats were either sacrificed or received an additional APD dose before a 48-hour parathyroid hormone (PTH) infusion (0.066 microgram/100 g/hr) via a subcutaneously implanted miniosmotic pump. RESULTS: Serum and urinary calcium were greater in the LPD and LPD + APD groups than in the ND and ND + APD groups [serum, 11.12 +/- 0.34 and 11.57 +/- 0.45 vs. 9.49 +/- 0.17 and 9.48 +/- 0.15 mg/dl (mean +/- SE), P < 0.05; and urine, 8.78 +/- 2.74 and 16.30 +/- 4.68 vs. 0.32 +/- 0.09 and 0.67 +/- 0.28 mg/24 hr, P < 0.05]. Serum PTH and serum and urinary phosphorus were less in the LPD and LPD + APD than in the ND and ND + APD groups (P < 0.05). The calcemic response to PTH was less (P < 0.05) in the LPD and LPD + APD groups than in the ND group and was less (P = 0.05) in the LPD + APD than in the ND + APD group. Bone histology showed that phosphate depletion increased the osteoblast and osteoclast surface, and treatment with APD reduced the osteoblast surface (LPD vs. LPD + APD, 38 +/- 4 vs. 4 +/- 2%, P < 0.05, and ND vs. ND + APD, 20 +/- 2 vs. 5 +/- 2%, P < 0.05) and markedly altered osteoclast morphology by inducing cytoplasmic vacuoles. CONCLUSIONS: (a) Phosphate depletion induced hypercalcemia and hypercalciuria that were not reduced by APD administration. (b) The calcemic response to PTH was reduced in phosphate-depleted rats and was unaffected by APD administration in normal and phosphate-depleted rats, and (c) APD administration markedly changed bone histology without affecting the biochemical changes induced by phosphate depletion.     

Arterial wall strength after endovascular photodynamic therapy

BACKGROUND AND OBJECTIVES: Vascular photodynamic therapy (PDT) inhibits intimal hyperplasia (IH) induced by angioplasty in rat iliac arteries by eradicating the proliferating smooth muscle cells. This process may jeopardise the structure and strength of the arterial wall, reflected by a decreased bursting pressure. STUDY DESIGN/MATERIALS AND METHODS: Thirty male Wistar rats of 250-300 g were subdivided into 3 groups (n = 10). In all groups, IH was induced by balloon injury (BI). One experimental group received PDT at 50 J/cm diffuser length, the other group at 100 J/cm diffuser length. The third group served as control group and received no PDT. In half of each group the bursting pressure was analyzed after 2 hours (n = 5), in the other half after 1 year. RESULTS: Two hours after the procedure the bursting pressure was 3.37 +/- 0.58 (+/-SEM) bar in the BI + PDT 50 and 3.96 +/- 0.43 bar in the BI + PDT 100 group, compared to 2.20 +/- 0.27 bar in the BI group (P < 0.05). After 1 year these values were 3.18 +/- 0.87 bar in the BI + PDT 50 (P < 0.05) and 2.02 +/- 0.31 bar in the BI + PDT 100 group, compared to 2.10 +/- 0.30 bar in the BI group (NS). In the BI + PDT 100 group, 3 out of 5 rats appeared to have aneurysmal dilatation after 1 year. CONCLUSIONS: Endovascular PDT increases the arterial wall strength as measured by the bursting pressure at short-term. After 1 year, wall strength is not diminished as measured by bursting pressure, but aneurysmal dilatation nevertheless developed with 100 J/cm. dl. This may limit the use of high energy PDT.     

烫伤及内毒素/脂多糖对豚鼠胃肠动力的影响

目的探讨烫伤及内毒素/脂多糖(LPS)对豚鼠胃肠动力障碍发生的机制。方法将30只健康豚鼠随机分为烫伤组(造成30%TBSA深Ⅱ度烫伤)、LPS组(腹腔注射LPS)及对照组(腹腔注射等渗盐水),每组10只。3组豚鼠处理后30min予碳素墨水灌胃,然后测定其胃肠道碳素墨水推进距离;并取肠道组织匀浆检测其降钙素基因相关肽(CGRP)、Na -K -腺苷三磷酸(ATP)酶、Mg2 -ATP酶、Ca2 -ATP酶、Ca2 -Mg2 -ATP酶活性及结肠袋平滑肌细胞线粒体膜电位(△ψm).结果烫伤组及LPS组豚鼠肠道碳素墨水推进距离[(53±9)、(91±10)cm]较对照组[(142±11)cm]明显缩短(P<0·01);烫伤组与LPS组比较,肠道推进距离更短(P<0·01).烫伤组及LPS组豚鼠肠道组织中CGRP的含量为(52.0±39.0)、(20.0±23.0)μg/L,均高于对照组(0.8±2.0)μg/L(P<0.05或0·01)。而烫伤组与LPS组比较,其增高幅度更大(P<0.05).烫伤组、LPS组大鼠Na -K -ATP酶、Mg2 -ATP酶、Ca2 -ATP酶、Ca2 -Mg2 -ATP酶活性和线粒体膜电位与对照组比较呈不同程度降低(P<0·05),但烫伤组与LPS组各种ATP酶和线粒体膜电位改变程度比较,差异无统计学意义(P>0·05).结论烫伤及LPS对豚鼠肠道动力功能有明显抑制作用,尤以烫伤明显;重度烫伤时,引起肠道平滑肌细胞线粒体膜电位改变的主要因素可能是肠道LPS.     

外源性碱性成纤维细胞生长因子对鞘内肌腱愈合和粘连的影响

目的 探讨外源性碱性成纤维细胞生长因子（basic fibroblast growth factor，bFGF）对鞘内肌腱愈合和粘连形成的作用。方法 成年雄性来亨鸡90只随机平均分成3组，每组30只，制备右爪第3趾趾深屈肌腱横断模型。A组肌腱横行切断后原位缝合；B组肌腱断端应用纤维蛋白封闭剂（fibrin sealant，FS）0．6μl后，原位缝合修复横断肌腱；C组则在断端使用bFGF和FS混合物0．6μl（内含bFGF500ng）后，原位缝合修复横断肌腱。术后1、2、4、8周，每组各取6只鸡第3趾行大体及组织学观测，术后8周每组再取6只鸡第3趾行生物力学测定。结果大体观察：术后8周各组肌腱粘连程度分级差异均无统计学意义（P〉0．05）。组织学观测：术后1、2、4、8周成纤维细胞计数及术后4、8周胶原纤维含量，A、B两组间差异均无统计学意义（P〉0．05）；C组与A、B两组比较，术后1、2、4周成纤维细胞数及术后4、8周胶原纤维含量差异均有统计学意义（P〈0．05）。生物力学测定：术后8周，A、B、c组肌腱滑动距离分别为3．44±0．43、3．51±0．56和2．84±0．42mm，屈曲功分别为14．87±1．72、14．08±1．85和20．62±3．52Nmm，最大抗拉力分别为10．34±1．45、11．26±1．83和15．02±2．20N，A、B两组间差异均无统计学意义（P〉0．05），但C组与A、B两组比较，各指标差异均有统计学意义（P〈0．05）。结论 在肌腱断端使用外源性bFGF能促进鞘内肌腱的愈合，但也加重了肌腱的粘连。     

Thermotolerance protects against endotoxin-mediated microvascular injury

An early event in endotoxin-induced tissue injury is adhesion and migration of leukocytes through the endothelium. This is a three-stage process, initially low-grade selectin-mediated adhesion, seen as a decrease in rolling velocity, followed by integrin-mediated adhesion and transmigration. Thermotolerance has been shown to reduce tissue injury and mortality induced by endotoxin. The aim of this study was to investigate the effect of thermotolerance on leukocyte-endothelial interactions. Intravital video microscopy was used to examine hemodynamic parameters, leukocyte rolling, adhesion, and migration in rat mesenteric postcapillary venules. Sprague-Dawley rats were randomized into control, lipopolysaccharide (LPS), and thermotolerance + LPS groups. Thermotolerance was induced 18 h prior to administration of LPS by elevating core body temperature to 41 + 0.5 degrees C for 15 min. LPS (055:B5 15 mg/kg) was administered via the jugular vein after baseline recording. Leukocyte rolling velocity and the number of adherent and migrated leukocytes were measured by intravital microscopy at baseline 0 min and 10, 30, 60, and 90 min after LPS administration. Heat shock protein 72 (HSP72) expression in tissues was determined by Western immunoblotting. The results indicated that LPS administration significantly decreased leukocyte rolling velocity during endotoxemia and increased leukocyte adhesion (10.3 +/- 1.67, 13.2 +/- 1.40, and 10.0 +/- 1.57/100 microm) and migration (5.7 +/- 1.02 and 8.3 +/- 1.76/field) at 30, 60, and 90 min after LPS injection (P < 0.01 vs baseline and control group). Thermotolerance maintained leukocyte rolling velocity and significantly reduced leukocyte adhesion (5.7 +/- 0.88 and 4.0 +/- 0.68/100 microm) and migration (2.8 +/- 0.32 and 3.0 +/- 0.68/field) at 30 and 60 min after LPS administration (P < 0.01 and 0.05 vs LPS group). Expression of HSP72 was induced in mesentery, gut, and lung by thermotolerance. This study indicates that thermotolerance attenuated LPS-induced microvascular injury by decreasing leukocyte-endothelial adhesion and migration.     

壳聚糖纳米粒子携带反义增殖细胞核抗原寡核苷酸抑制血管移植后内膜增殖的实验研究

目的探讨壳聚糖纳米粒子携带反义基因在血管外科领域中的应用。方法雄性SPF级SD大白鼠54只,体重450～600g,随机分为实验组和对照组(n=27)。实验组取右侧颈静脉、颈动脉吻合口段灌注携带增殖细胞核抗原(proliferation cell nuclear antigen,PCNA)的反义寡核苷酸(antisens oligo deoxy nucleotides,ASODN)粒子后,移植至同侧颈动脉;对照组用同样方法灌注生理盐水。取造模后血管通畅的48只大白鼠(n=24)分别于第1、2、3、4周超声多普勒监测血流动力学,取标本行免疫组织化学染色、Western blot蛋白印迹检测、血管壁组织病理变化检测等。结果两组的血栓形成率差异无统计学意义(P>0.05)。在4周的观察期内,代表增殖的PCNA蛋白印迹条带显示:实验组移植静脉、吻合口的浓度较对照组低。术后1、2、3及4周,实验组移植静脉PCNA阳性细胞指数分别为0.13%±0.11%,0.79%±0.28%,0.45%±0.29%,0.43%±0.25%,吻合口分别为1.90%±0.84%,2.11%±0.98%,2.48%±0.77%,2.17%±0.36%,较对照组明显减少(P<0.05);实验组移植静脉及吻合口的空腔面积分别为88.71±16.96、95.98±21.44、88.48±32.81、97.86±34.11μm2和41.49±3.34、45.15±11.65、46.27±8.90、51.62±8.85μm2,均较对照组大(P<0.05),实验组移植静脉、吻合口的内膜面积/中膜面积分别为22.73%±3.11%、32.40%±4.55%、45.14%±3.19%、45.70%±5.01%和41.49%±3.34%、45.15%±11.65%、46.27%±8.90%、51.62%±8.85%,均较对照组小(P<0.05)。最大血流速度比较,两组在第1周血流最大速度相似,后3周出现不同变化。对照组静脉移植段和吻合口的最大流速逐渐增加,在第3周达到最高,至第4周时降低;实验组静脉移植段和吻合口最大流速逐渐降低,在第3周达到最低,至第4周时升高。第4周实验组和对照组移植静脉段和吻合口最大流速均接近。各时间点两组内比较差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05)。结论壳聚糖纳米粒子携带PCNA-ASODN能有效抑制血管移植后内膜细胞增殖,从而抑制新生内膜过度增厚。     

医用几丁糖预防宫腔再粘连的临床分析

目的 探讨医用几丁糖在宫腔粘连分离术后预防宫腔再粘连的临床效果.方法 2011年3月-2013年4月宫腔镜下宫腔粘连分离术112例,根据术后防粘连的方法不同分为研究组和对照组：研究组61例,术后宫腔内放置医用几丁糖2.5 ml及元宫环1枚,术后联合人工周期治疗（戊酸雌二醇3 mg每12 h口服1次,共21 d,最后10 d加用安宫黄体酮6 mg,1次/d,口服）;对照组51例,术后宫腔内放置元宫环1枚,术后用药同研究组.比较2组术后再粘连发生率.结果 2组轻度粘连患者术后均未见宫腔粘连复发.中度宫腔粘连患者分离术后复发率研究组13.9%（5/36）显著低于对照组36.7%（11/30）（Z=-2.134,P=0.033）.重度宫腔粘连患者分离术后复发率研究组66.7%（6/9）与对照组88.9%（8/9）无统计学差异（Z=-1.102,P=0.270）.重度粘连患者二次宫腔镜下粘连分离术后宫腔镜检查,研究组2例存在粘连,对照组7例,有统计学差异（Z=-2.017,P=0.044）.结论医用几丁糖能有效预防中、重度宫腔粘连患者的术后复发.     

增精颗粒对大鼠附睾精子质量的影响

目的 :观察中药增精颗粒 (ZJG)对不育大鼠附睾精子质量的影响 ,探讨ZJG改善附睾精子质量的机制。　方法 :将 4 0只雷公藤多甙 (GTW )实验性SD雄性大鼠不育模型随机分成 4组 ,每组 10只 ,包括不育组 [GTW 2mg/(ml·10 0g) ]和ZJG高、中、低剂量组 [高 :ZJG0 .6 7g/(ml·10 0g) +GTW 2mg/(ml·10 0 g) ,中 :ZJG0 .33g/(ml·10 0g) +GTW 2mg/(ml·10 0 g) ,低 :ZJG0 .17g/(ml·10 0 g) +GTW 2mg/(ml·10 0g) ],另设正常组 (对照 ) 10只(等量的 1%羧甲基纤维素钠溶液 )。整个实验周期 6周 ,由 3周造模期和 3周用药期组成。ZJG各组按指定的剂量用药 3周 (实验第 4 3d)观察大鼠附睾精子质量、附睾腺管壁厚度及主要性腺器官系数的变化。　结果 :ZJG高、中、低剂量组附睾精子密度分别为 (5 9.6± 3.72 )、(6 3.3± 5 .70 )、(6 9.7± 6 .91)× 10 6/ml,精子活率分别为 (6 5 .4±6 .33) %、(6 9.3± 10 .96 ) %和 (72 .6± 9.6 1) % ,畸形率分别为 (5 2 .3± 7.4 7) %、(4 6 .2± 7.73) %和 (33.2± 7.97) % ,与不育组 [精子密度 (13.1± 6 .81)× 10 6/ml,精子活率 (7.6± 5 .87) % ,畸形率 (77.2± 8.75 ) % ]相比 ,ZJG各组差异均有显著性 (P <0 .0 5 ) ,与正常组 [精子密度 (75 .6± 10 .82 )× 10 6/ml,精子?