化妆品皮肤损伤989例分析

目的 探讨化妆品皮肤损伤状况和病因及发生规律。方法 对989例化妆品皮肤损伤进行了临床观察，并用辨敏牌标准筛选斑贴试验试剂盒对患者做斑贴试验。结果 临床表现主要为接触性皮炎(70．58％)，其次是色素沉着(11．02％)、痤疮样损害(7．99％)、光感性皮炎(1．01％)、混合性皮损(9．40％)。可疑致病化妆品种类189种。989例患者中阳性者653例，阳性率66．03％。结论 斑贴试验对接触性皮炎、色素沉着类化妆品皮肤损伤有确定的指导、防治意义，化妆品皮肤损伤应进行斑贴试验。     

体积和剂量对斑试皮肤反应结果的影响

目的：探讨体积和剂量对斑贴试验皮肤反应结果的影响。方法：用不同浓度(1％和2％)和体积(10μl、15μl、20μl、25μl和30μl)的十二烷基磺酸钠(SLS)行斑贴试验，皮肤反应结果采用临床评估和经表皮失水率(TEWL)，皮肤色素仪a′值等非创检测相结合。结果：非创检测结果提示随试验物体积升高，皮肤反应程度有增强趋势；而临床评估剂量及体积之间的差异较小。结论：不同体积的SLS对斑试皮肤反应结果有影响。     

不同解剖部位皮肤斑贴试验结果比较和分析

目的：比较面部、前臂和背部三个部位同一产品局部封闭式斑贴试验结果的差异。方法：以2006年8月～2006年12月在北京空军总医院化妆品皮肤病专科门诊投诉化妆品过敏的患者为研究对象，判断标准采用甜匕妆品皮肤病诊断标准及处理原则总则》中的7项化妆品皮肤病诊断国家标准（GB17149．1～7-1997），统一登记表格记录化妆品皮肤病患者的病史资料及相关化妆品信息，分别在面部、前臂和背部进行同一产品的斑贴试验，对斑试结果进行统计学分析。结果：共112例患者完成了318个产品的斑贴试验，面部阳性反应例数最多，62例（占总患者的55．36％），84个产品（占总产品数的26．42％）；其次为前臂，39例（34．82％），59个产品（18．55％）；背部38例（33．93％），52个产品（16．35％）。面部和背部、面部和前臂斑试结果之间的差异有统计学意义，背部和前臂斑试结果之间的差异无统计学意义。结论：在进行化妆品的斑贴试验中，面部皮肤较前臂和背部敏感。     

沈阳地区89例湿疹皮炎斑贴试验临床分析

目的 了解沈阳地区湿疹皮炎患者接触性变应原的分布及其特点.方法 收集2008年3～11月诊断为湿疹皮炎患者,应用斑贴试验分析患者接触性变应原.结果 89例检测患者中,25例斑贴试验呈现阳性反应,阳性率为28.09％.对1种变应原致敏阳性者21例(占23.60％),对2种变应原致敏阳性者3例(占3.37％),对3种变应原阳性者0例(占0.00％),对4种及4种以上变应原阳性者1例(占1.12％),阴性者30例(占33.71％).列前4位的常见变应原致敏依次为:硫酸镍、对苯二胺、硫柳汞、芳香混合物.男女斑贴试验阳性率经统计学处理,差异无统计学意义(P＞0.05).男性患者中阳性率居前3位的变应原是硫酸镍、硫柳汞、甲醛.女性患者中列前3位分别为对苯二胺、硫酸镍、芳香混合物(后2者并列第2).男性患者中硫酸镍、硫柳汞的阳性检出率比女性明显增高,差异有统计学意义(P＜0.05).中青年组与中老年组阳性率差异无统计学意义(P＞0.05).结论 斑贴试验有助于明确湿疹皮炎患者的接触性变应原,为疾病的预防及治疗有一定的提示及参考意义.     

黏着斑激酶的高表达与人胃癌侵袭和转移的关系

目的 探讨胃癌侵袭和转移过程中黏着斑激酶（FAK）的表达与其生物学行为的关系。方法 用免疫组化SABC法检测10例行胃癌根治术所收集的癌组织、癌旁组织、正常胃黏膜组织和胃区域淋巴结标本中FAK的表达情况。结果FAK表达强阳性率在胃癌组织中（78．0％）明显高于正常胃黏膜组织（10．0％）及癌旁组织（20．0％），P〈0．01，正常胃黏膜组织与癌旁组织中的表达差异无统计学意义（P〉0．05）。FAK表达强阳性率在淋巴结有转移和无转移患者中分别是68．8％（22／32）和33．3％（6／18），前者明显高于后者（P〈0．05）；在有转移的淋巴结中和无转移的淋巴结中分别是87．2％（136／156）和40．9％（18／44），前者明显高于后者（P〈0．01）；FAK表达强阳性率与胃癌浸润深度和分化程度有关，浸润深度越深，细胞分化越低，表达强阳性率越高（P〈0．05）；与Borrmann分型、肿瘤部位及大小无关（P〉0．05）。结论 FAK表达与胃癌发生、发展有关，FAK表达增高是胃癌细胞浸润和转移的重要原因之一，检测癌组织中FAK表达水平，有助于进一步了解胃癌的生物学行为，有利于治疗与预后判断。     

人重复性损伤性斑贴试验评价化妆品安全性

目的:介绍人重复性损伤性斑贴试验(HRIPT,Human Repeated Insult Patch Test)在化妆品安全性评估中的作用,并用该方法对11种化妆品的安全性进行评价.方法:在53名志愿者中对11种化妆品进行人重复性损伤性斑贴试验,诱导期在后背部同一部位重复9次斑贴试验;之后休息2周,在非斑贴部位皮肤进行激发试验,斑贴24h、48h和72h后进行评分.试验结果判读参考国际接触性皮炎研究组ICDRG评分标准.根据化妆品的性质分别选择封闭或半封闭斑试器,0.3％～ 0.5％SLS作为阳性对照,凡士林和空白斑试器作为阴性对照.结果:11种受试化妆品中有7种显示出轻度的刺激性,1名受试者在试验前已对其中1种化妆品呈致敏状态,11种测试产品均未出现诱导过敏反应.结论:人重复性损伤性斑贴试验敏感性高,能够明确区分刺激性、已致敏性和潜在致敏性,可以作为化妆品安全性的确证试验.     

面部皮炎患者123例斑贴试验分析

目的：回顾分析笔者科室123例面部皮炎患者斑贴试验结果,以明确常见致敏化妆品成分及所致疾病种类.方法：对笔者科室门诊以“面部皮炎”为表现的患者进行化妆品系列变应原斑贴试验（49种变应原）,按国际接触性皮炎研究组推荐标准判读结果,并对结果进行统计分析.结果：共回顾分析123例面部皮炎患者斑贴试验结果,试验阳性患者79例,阳性率64.2％;排在前3位的致敏物质主要是乳化剂和防腐剂：山梨糖醇酐倍半油酸酯（13.82％）、卡松CG （8.94％）、阿莫醇（5.69％）;临床诊断中炎症性疾病,如：接触性皮炎、敏感皮肤、激素依赖性皮炎等斑贴试验阳性率80％,而色素异常性疾病,如：黑变病等阳性率约60％.结论：化妆品中山梨糖醇酐倍半油酸酯、卡松CG等是引起化妆品接触性皮炎的主要致敏成分,导致多种炎症性皮肤病和色素异常性皮肤病的发生.     

妇康宁治疗面部炎症性色素斑的临床观察

目的：探讨妇康宁对面部炎症性色素斑的疗效。方法：治疗组：面部炎症性色素斑108例，妇康宁3丸／次，日服三次。对照组：面部炎症性色素斑51例，维生素C 0．2g／次，日服三次。两组均外涂曲酸霜于色斑处，早晚各一次。两组疗程均一个月，连用三个疗程。结果：治疗组总有效率72．2％，对照组17．6％，两组比较有显著性差异(P＜0．01口。结论：妇康宁治疗面部炎症性色素斑疗效良好。     

欧洲标准变应原联合化妆品筛选变应原对女性面部皮炎患者的斑贴试验

目的采用欧洲标准变应原联合化妆品筛选变应原对女性面部皮炎患者进行斑贴试验,筛查主要致敏原。方法对门诊女性面部皮炎患者采用化妆品筛选变应原联合欧洲标准变应原进行斑贴试验,按国际接触性皮炎研究组推荐标准判读结果。结果41例女性患者进行了38种化妆品筛选变应原和26种欧洲标准变应原的斑贴试验。其中阳性率最高的化妆品筛选变应原计有乌洛托品（12．20％）、硫柳汞（9．76％）、双咪唑烷基脲（7．32％）及DMDM海因（7．32%）,阳性率最高的欧洲标准变应原计有硫酸镍（22．20％）、甲醛（14．63％）、对苯二胺（9．76％）及香料混合物（9．76％）。结论硫酸镍、甲醛、乌洛托品、硫柳汞、对苯二胺、香料混合物、双咪唑烷基脲、DMDM海因等是女性面部皮炎患者主要致敏原。     

粘着斑激酶在PDGF-BB诱导MHCC-97H细胞黏附侵袭中的作用

目的观察不同浓度血小板衍生生长因子（PDGF-BB）诱导MHCC-97H细胞中粘着斑激酶（focal adhesion kinase，FAK）mRNA的动态变化及FAK在细胞黏附、侵袭的作用。方法不同浓度（1，2．5，5，10，25ng／m1）PDGF-BB诱导MHCC-97H人肝癌细胞，Real-time PCR方法检测FAK及MMP-2的mRNA动态变化，黏附实验、侵袭实验分别检测诱导后MHCC-97H细胞的黏附、侵袭能力的变化。结果诱导后MHCC-97H细胞FAKmRNA水平上调，在10ng／ml浓度时达到最高，为对照组的112．6倍；MMP-2mRNA水平上调并与FAKmRNA水平上调呈一致性，在10ng／ml浓度时达到最高，为对照组的56．9倍。诱导后各组黏附率分别为（66±1．84）%、（69±1．41）％、（69±2．42）％、（71±1．37）%和（66±3．28）%，与对照组的（54±2．08）％比较均有统计学意义（P〈0．001）；诱导后5ng／ml和10ng／ml组侵袭细胞数分别为（26．63±4．5）、（28．75±4．2）个，与对照组（21．5±4．0）个比较有显著性差异（P〈0．05，P〈0．001）。诱导后黏附率与侵袭细胞数变化在10ng／ml浓度时都达到高峰。结论PDGF-BB上调MHCC-97H细胞中FAK表达，上调FAK促进MHCC-97H细胞的黏附和侵袭能力。     

冷冻保存人脐带血管细胞培育组织工程心血管补片

目的 探讨应用液氮冷冻保存的人脐带动脉壁肌成纤维细胞(HUAMs)制备组织工程心血管补片的可行性.方法 将液氮冷冻保存的人脐带动脉壁肌成纤维细胞种植在聚-4-羟基丁酸酯(P4HB)聚合材料构建的补片支架材料上,制备组织工程心血管补片.体外静态培育21 d,对补片组织进行组织学、扫描电镜检查.免疫组织化学分析组织样本中细胞外基质(胶原蛋白)的合成.结果 苏木素-伊红(HE)染色显示,肌成纤维细胞较好地黏附于聚合材料上,大部分细胞保持生长活力,并浸润生长入支架材料内部,形成组织.免疫组织化学显示补片材料中有胶原蛋白合成.结论 液氮冷冻保存的人类脐带肌成纤维细胞可作为种子细胞,用于制备人组织工程心血管补片.     

A retrospective review of an epidural blood patch database: the incidence of epidural blood patch associated with obstetric neuraxial anesthetic techniques and the effect of blood volume on efficacy

BackgroundThe optimal volume of blood required to treat post-dural puncture headache remains in question. In our institution a target volume of 30 mL is used for an epidural blood patch unless the patient experiences pain during injection.MethodsThe institutional database was retrospectively reviewed for epidural blood patch and delivery statistics over a 15-year period to determine if the volume of blood administered during the procedure directly correlated with the number of epidural blood patches administered. The primary endpoint was defined as the need for a repeat epidural blood patch.ResultsThere were 466 epidural blood patches performed on 394 patients, associated with 84 804 obstetric neuraxial procedures. Thirty-two percent (95% CI 28.3 to 34.9%) of patients who had an inadvertent dural puncture with an epidural needle received an epidural blood patch versus 0.19% (0.16% to 0.22%) of patients who received neuraxial anesthesia with no documented dural puncture with an epidural needle. All patients experienced relief of post-dural puncture headache, although 17% required two and 1.5% required three epidural blood patches. The mean ± SD volume of blood administered was 20.5 ± 5.4 mL and only 35 patients (8.9%) received 30 mL.ConclusionIncreasing blood volumes up to 30 mL did not reduce the need for repeat epidural blood patch. Although the optimal volume of blood to administer during epidural blood patch placement remains unknown, our institution will continue to administer up to 30 mL or until the patient experiences pain during epidural injection.     

Assessment of a tissue-engineered gastric wall patch in a rat model

Stenosis or deformity of the remaining stomach can occur after gastrectomy and result in stomach malfunction. The objective of this study is to demonstrate the feasibility of transplanting a tissue-engineered gastric wall patch in a rat model to alleviate the complications after resection of a large area of the gastric wall. Tissue-engineered gastric wall patches were created from gastric epithelial organoid units and biodegradable polymer scaffolds. In the first treatment group, gastric wall defects were created in recipient rats and covered with fresh tissue-engineered gastric wall patches (simultaneous transplantation). In the second treatment group, the tissue-engineered gastric wall patches were frozen for 12weeks, and then transplanted in recipient rats (metachronous transplantation). Tissue-engineered gastric wall patches were successfully used as a substitute of the resected native gastric wall in both simultaneous and metachronous transplantation groups. The defrosted wall patches showed almost the same cell viability as the fresh ones. Twenty-four weeks after transplantation, the defect in the gastric wall was well-covered with tissue-engineered gastric wall patch, and the repaired stomach showed no deformity macroscopically in both groups. Histology showed continuous mucosa and smooth muscle layers at the tissue-engineered stomach wall margin. The feasibility of transplanting a tissue-engineered patch to repair a defect in the native gastric wall has been successfully shown in a rat model, thereby taking one step closer toward the transplantation of an entire tissue-engineered stomach in the future.     

面部皮炎患者斑贴试验结果分析

目的:通过斑贴试验研究面部皮炎的病因与诊断。方法:对临床诊断为面部皮炎的41例患者进行问卷调查和斑贴试验(瑞典产标准接触变应原系列)。结果:两次判读结果阳性率分别为78.05%、68.29%,统计学显示有显著性差异(P<0.05)。阳性率居前的分别是硫酸镍(31.71%)、重铬酸钾(26.83%)、对苯类(19.51%)、芳香混合物(14.63%)、甲醛(12.20%)。出现强阳性反应最多的是硫酸镍(19.51%)。结论:面部皮炎患者应常规行斑贴试验,金属制品、化妆品、染料、建材等在引发面部皮炎中起重要作用。斑贴试验阴性者可能与刺激、光照、I型变态反应等有关,应综合分析。两次判读法可减少假阳性与假阴性的发生,值得推广。     

腹腔镜下哑铃状补片封堵治疗成人疝的临床研究(附30例报告)

目的 探讨应用腹腔镜下哑铃状补片封堵治疗成人疝的新方法.方法 我院2009年3月至2011年10月采用腹腔镜下哑铃状补片封堵治疗成人疝30例,其中右侧20例,左侧9例,双侧1例,均在腹腔镜下行内环口荷包缝合高位结扎及哑铃状补片封堵术.结果 手术时间单侧平均35 min,双侧60 min.术后平均4 d出院,无并发症.患者随访3个月至2年,无复发.结论 腹腔镜下行内环口荷包缝合高位结扎及哑铃状补片封堵术安全有效、创伤小、无瘢痕、恢复快、住院时间短,无肠粘连、肠梗阻、腹腔感染﹑阴囊感染、睾丸扭转及缺血坏死、切口感染、腹股沟区疼痛麻木等并发症,操作简便,无需特殊器械,疗效满意.     

EMLA patch for spinal puncture. A comparison of EMLA patch with lignocaine infiltration and placebo patch

We have prospectively assessed pain and anxiety of spinal puncture in 180 adult patients randomly allocated to one of three equal groups. On the morning of surgery group 1 had an EMLA patch, whereas group 2 and 3 had placebo patches. Group 2 also had infiltration analgesia with 2 ml lignocaine 2% with adrenaline, immediately before the block. Spinal anaesthesia was performed with 25 gauge sharp needles without introducer or 25,27 gauge blunt needles with 20,22 gauge introducers. Patients assessed the spinal puncture pain on a 10-cm visual analogue scale immediately after removal of the needle. Pain scores were significantly lower in group 1 (EMLA), median 0.75, than in group 2 (placebo, infiltration analgesia), median 1.75, and group 3 (placebo), median 1.80, p < 0.0001. Pain intensity was less than expected in more patients in the EMLA group than in the other two groups, p = 0.034. However, the decision to accept/reject spinal anaesthesia in the future was not influenced by the pain of lumbar puncture. We conclude that application of an EMLA patch is a simple and effective method to provide adequate analgesia for spinal puncture, which also helps to allay patients' fears of spinal anaesthesia.     

Epidural blood patch for management of postdural puncture headache in adolescents

BACKGROUND: In some patients spinal puncture (SP) is followed by postdural puncture headache (PDPH). When the symptoms of PDPH are severe and are not relieved within a few days an epidural blood patch (EBP) might be performed. The aim of this survey was to review requests for EBPs and to evaluate the effectiveness of EBP in patients aged 13-18 years during a 6.5 year period ending in June 2001. METHODS: The Information System Patient Measures Database was interrogated to identify patients who were referred for EBP. After identification, the patients' medical records were reviewed in detail for the characteristics of PDPH and other symptoms, and for the effectiveness of the EBP. RESULTS: Forty-two EBPs were performed after 40 SPs on 37 patients (24 girls, 13 boys). Epidural blood patches were performed twice in five patients. The reasons for repeating the procedure were repeat SP with new PDPH in three patients and an unsatisfactory effect in two patients. Twenty-eight of the 40 spinal punctures (70%) had been performed for diagnostic use and 10 (25%) for spinal anesthesia. Two patients (5%) developed PDPH after inadvertent dural puncture with an epidural needle. In 37 cases the criteria for PDPH were fulfilled, and one patient had a cerebrospinal fluid fistula headache. Two-thirds of the girls had associated symptoms of headache compared with one-third of the boys. Epidural blood patch was performed 1-22 days after SP with 0.2 ml/kg (mean) of autologous blood injected into the epidural space. The success rate of the first injection was 37 out of 40 EBP (93%), and the second injection was effective in both patients with recurred PDPH. CONCLUSION: Epidural blood patch seems to be an effective and safe procedure in adolescents for treating severe and persistent PDPH.     

Fibrin glue and bioabsorbable felt patch for intraoperative intractable air leaks

Objective: We worked to devise a new way to prevent postoperative persistent air leaks in high-risk pulmonary surgery patients. Methods: From November 1993 to June 2002, 60 patients with difficult to control intraoperative pulmonary air leakage were treated using bioabsorbable polyglycolide felt patches soaked in fibrin glue to cover the leakage site. Results: After application, the felt patch adhered tightly to the lung surface without peeling off, enabling good leakage closure with only 2 ml of fibrin glue used. Air leakage was controlled successfully in 52 (86.7%) of the 60. Four of the 8 patients in whom this method failed to stop air leakage also developed mild pyothorax, with 2 requiring a second operation by video-assisted thoracic surgery. Leakage was eventually controlled in all patients, with no postoperative deaths relating to air leakage. Conclusions: Fibrin-glue-soaked bioabsorbable felt patches effectively seal intraoperative intractable air leaks. Felt patch use may increase the risk of postoperative infection. It should be considered for use on patients with fistulas that cannot be controlled by direct closure or otherwise intraoperatively and who may potentially develop uncontrollable air leakage postoperatively.     

141例化妆品接触性皮炎患者斑贴试验结果分析

目的：检测分析化妆品接触性皮炎患者常见的致敏原种类,为其防治提供依据。方法：2009年10月～2011年2月,对临床诊断的141例化妆品接触性皮炎病例采用患者自用可疑化妆品和欧洲标准27种系列抗原进行斑贴测试;对测试数据进行统计学分析和比较。结果：患者对可疑化妆品斑贴阳性率48.22%（68/141）,阳性反应化妆品为45.69%（90/197）,导致患者阳性率高的化妆品依次是：香体喷雾（80,%44/55,）祛斑霜（56,%14/25）,水剂产品（38.89,%7/18）,清洁用品（31.58,%6/19）和护肤面霜（乳）（25.62,%31/121）。141例患者对欧洲标准27种系列抗原中至少1种过敏者123例,总阳性率87.2%;引起阳性率高的过敏源是：重铬酸钾（43.97%）、硫酸镍（43.26%）、氯化钴（36.17%）、对羟基苯甲酸类混合物（23.40%）、香料混合物（20.57%）、甲基二溴戊二腈（16.31%）、4-苯二胺碱基（15.60%）、苯唑卡因（14.90%）、甲醛（14.89%）、5-氯-2-甲基-4-异噻唑啉（13.48%）、芳香混合物Ⅱ（10.64%）。结论：化妆品原料中精炼不良带入的重金属、混合防腐剂、混和香料等是化妆品接触性皮炎的可能过敏源。     

生物型补片与聚丙烯补片修补家猪腹壁缺损的对比研究

目的通过比较观察生物型补片与聚丙烯补片修补家猪腹壁缺损后的组织病理学变化，进一步探讨此生物型补片在疝修补治疗中应用的可行性。方法分别于10只小猪的腹直肌左右侧腹壁制成-6cm×4cm的肌肉腱膜层缺损区。左侧缺损区用生物型补片进行手术修补，右侧用聚丙烯补片修补。分别于修补术后1、3、6、12个月取材行大体观察及组织病理学检查。结果小猪在修补术后均未发生腹壁切口疝。术后1年内，聚丙烯侧的补片结构不能被吸收而始终存在，局部的炎症反应较明显；生物补片侧在各期的局部炎症反应轻于聚丙烯侧，且补片成分变性吸收，逐步由结缔组织所替代。结论生物型补片的组织相容性较好，能诱导组织再生，实现对缺损的再生性修复，有可能成为一种比较理想的疝修补材料。