复杂胸部肿瘤切除胸壁重建术患者的康复护理

目的总结复杂胸部肿瘤切除胸壁重建患者的围手术期营养与康复护理经验。方法对10例复杂胸部肿瘤胸壁重建患者,实施饮食指导、康复锻炼、皮瓣观察、疼痛管理等围术期护理。结果 10例患者均顺利康复出院,术后出现胸腔积液3例,皮瓣危象、上肢淋巴水肿、自发性气胸、胸壁软化、心律失常各1例,经及时处理后均好转,伤口I期愈合。术后平均住院时间14.6d。结论胸壁重建是胸壁肿瘤尤其是复杂胸壁缺损的重要手术方法,围术期康复护理能促进患者术后恢复进程,改善预后。     

一起由两种血清型致病性大肠埃希菌引起的食物中毒调查

目的调查引起食物中毒的病原菌。方法采集食物中毒样品：患者肛拭17份、加工、销售人员肛拭5份、佐料4份、食物中毒患者吃剩的炒田螺3份、外环境涂抹标本6份,共35份样品。依照《食品卫生微生物学检验》GB/T4789-2003进行检测。结果在一份肛拭和一份田螺中检出致病性大肠埃希菌O26：K60（B6）,在一份肛拭和一份加工煲盖涂抹标本中检出致病性大肠埃希菌O128：K67（B12）。结论本次食物中毒是由两种血清型致病性大肠埃希菌引起。     

类风湿关节炎病人血清Th1/Th2细胞因子的水平及临床意义

目的：探讨类风湿关节炎（rheumatoid arthritis，RA）病人Th1／Th2平衡状态及血清中细胞因子的变化与RA发病机制及疾病发生发展的的关系。方法：采用酶联免疫吸附测定（ELISA）检测RA病人和正常人血清中Th1型细胞因子IFN-γ、Th2型细胞因子IL-4的水平变化。结果：（1）RA病人血清中IFN-γ水平明显升高，IL-4水平明显下降，与对照组比较差异具有统计学意义（P〈0．05）；（2）活动期RA病人血清中IFN-γ、IL-4水平变化与缓解期RA病人比较差异具有统计学意义（P〈0．05）；（3）缓解期与活动期RA病人比较，各临床参数均有明显改善。站论：在RA血清中Th1／Th2细胞分泌的细胞因子存在明显失衡，分泌模式朝Th1偏移，Th1／Th2平衡可能与RA的发病机制及疾病的发生发展密切相关。     

支气管哮喘缓解期从脾论治80例临床探讨

目的:从哮喘治脾的理论出发,观察对支气管哮喘病人的疗效。方法:随机选取患者,以化痰健脾中药为基础方对患者进行治疗。结果:总有效率81.2%,治疗前后有显著性差异。结论:哮喘治脾的理论对临床有重要指导意义。     

Biodegradable chitosan scaffolds containing microspheres as carriers for controlled transforming growth factor-β1 delivery for cartilage tissue engineering

Background Natural articular cartilage has a limited capacity for spontaneous regeneration. Controlled release of transforming growth factor-β(1) (TGF-β(1)) to cartilage defects can enhance chondrogenesis. In this study, we assessed the feasibility of using biodegradable chitosan microspheres as carriers for controlled TGF-β(1) delivery and the effect of released TGF-β(1) on the chondrogenic potential of chondrocytes.Methods Chitosan scaffolds and chitosan microspheres loaded with TGF-β(1) were prepared by the freeze-drying and the emulsion-crosslinking method respectively. In vitro drug release kinetics, as measured by enzyme-linked immunosorbent assay, was monitored for 7 days. Lysozyme degradation was performed for 4 weeks to detect in vitro degradability of the scaffolds and the microspheres. Rabbit chondrocytes were seeded on the scaffolds containing TGF-β(1) microspheres and incubated in vitro for 3 weeks. Histological examination and type II collagen immunohistochemical staining was performed to evaluate the effects of released TGF-β(1) on cell adhesivity, proliferation and synthesis of the extracellular matrix.Results TGF-β(1) was encapsulated into chitosan microspheres and the encapsulation efficiency of TGF-β(1) was high (90.1%). During 4 weeks of incubation in lysozyme solution for in vitro degradation, the mass of both the scaffolds and the microspheres decreased continuously and significant morphological changes was noticed. From the release experiments, it was found that TGF-β(1) could be released from the microspheres in a multiphasic fashion including an initial burst phase, a slow linear release phase and a plateau phase. The release amount of TGF-β(1) was 37.4%, 50.7%, 61.3%, and 63.5% for 1, 3, 5, and 7 days respectively. At 21 days after cultivation, type II collagen immunohistochemical staining was performed. The mean percentage of positive cells for collagen type II in control group (32.7%±10.4%) was significantly lower than that in the controlled TGF-β(1) release group (92.4%±4.8%, P<0.05). Both the proliferation rate and production of collagen type II in the transforming growth factor-β(1) microsphere incorporated scaffolds were significantly higher than those in the scaffolds without microspheres, indicating that the activity of TGF-β(1) was retained during microsphere fabrication and after growth factor release.Conclusion Chitosan microspheres can serve as delivery vehicles for controlled release of TGF-β(1), and the released growth factor can augment chondrocytes proliferation and synthesis of extracellular matrix. Chitosan scaffolds incorporated with chitosan microspheres loaded with TGF-β(1) possess a promising potential to be applied for controlled cytokine delivery and cartilage tissue engineering.     

Effect of NK cells on GVHD in H-2 haploidentical bone marrow transplantation in mice

Objective To study the effect of natural killer (NK) cells on graft-versus-host disease (GVHD) after H-2 haploidentical bone marrow transplantation (BMT) in mice. Methods Murine model of H-2 haploidentical BMT was established by using Balb/c (H-2d) mouse as recipient, and Balb/c(H-2d)×C57BL/6 (H-2b) (H-2d/b) mouse as donor. Lethally irradiated Balb/c (H-2d) mice were transplanted with the bone marrow cells from Balb/c(H-2d)×C57BL/6(H-2b) (H-2d/b) mice containing donor spleen cells and/or NK cells. GVHD and survival rates were studied by observation of clinical manifestations and pathological changes. ResultsIn the group of bone marrow spleen cells, GVHD was induced in 90% mice; but in the group plus with low amount of NK cells,GVHD was induced in 20% mice; and in the group transplanted with high amount of NK cells, GVHD was induced only in 10% mice. Compared to the group transplanted only with BM plus spleen cells, the incidences of GVHD in the latter two groups decreased significantly (P＜0.01) and the survival rates at different periods of 15, 30, 45 and 60 days increased obviously (P＜0.01 ). Conclusion In mouse H-2 haploidentical BMT, alloreactive NK cells can reduce the incidence of GVHD and increase the survival rate.     

带状疱疹后遗神经痛治疗体会

[目的]探讨带状疱疹后遗神经痛的最佳治疗方法。[方法]对带状疱疹后遗神经痛患者随机分组,采用中药外敷法和天灸法进行了治疗并观察对照。[结果]两组均获较高的近期疗效,但天灸组多数患者一次治愈而不复发,治疗一次后的疼痛缓解率非常高,治疗前后疼痛分值降低非常明显,与药敷组比较且具有统计学意义。[结论]天灸法将药物与灸疗巧妙结合,治疗带状疱疹后遗神经痛具有明显优势,值得推广应用。     

多媒体技术在外科手术学教学中的应用探索

外科手术学是联系基础医学和临床医学的重要桥梁，是一门实践性和技术性很强的学科；多媒体技术作为医学教学的辅助手段，应用于外科手术学教学具有许多优点。文章总结了外科手术学教学中应用多媒体技术的一些经验，并提出教学过程中应用多媒体时应注意的问题。     

Clinical Experience in TCM Differential Treatment of Fatty Liver

In recent years, with improvement of living standard, changes in dietary structure and technical progress in medical tests, the rate of detecting fatty liver has been rising, hence constant increase in its incidence. Based on the TCM principle for differentiating syndromes, the authors have achieved remarkable curative effects in treating fatty liver. TCM Conception on Fatty Liver There is no fatty liver in the terms of TCM. However, according to its clinical manifestations, the disease may belong to the categories of “abdominal mass”, “mass at hypochondria”, “hypochondriac pain”, “accumulation of phlegm with stasis”. Its etiology and pathogenesis mainly lie in uncontrolled diet or     

关木通对大鼠肾功能和组织病理学的影响

目的:观察大鼠关木通灌胃后肾功能及肾脏组织病理学改变。方法： 雄性Wistar大鼠随机分为对照组和模型组。模型组在给予关木通3、7和15 d时，采血并留取24 h尿液，分别检测血肌酐、尿素氮、24 h尿蛋白及尿视黄醇结合蛋白（RBP）；在上述时间点观察肾脏组织病理学改变，并与对照组对比。结果:①与对照组比较，模型组大鼠给予关木通后不同时间血肌酐、尿素氮及24 h尿蛋白排泄率无明显升高；与对照组比较，尿RBP含量给药后3 d即显著增加（P<0.01），并随着给药时间的延长持续升高。②模型组大鼠给药后3 d HE染色可见局部肾小管上皮细胞变性、坏死和崩解，并随给药时间的延长逐渐加重。结论：关木通致大鼠肾损伤的主要病理改变为肾小管上皮细胞变性、坏死。