金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

保留变性真皮并移植大张自体皮修复手部深度烧伤的远期疗效观察

目的观察保留变性真皮并移植大张自体皮修复手部深度烧伤的远期疗效。方法对86例患者的152只深度烧伤手经削刮痂保留变性真皮后,行大张自体皮移植术。术后观察疗效并作随访,时间为3个月—3年,对手部皮肤的颜色、弹性、挛缩程度及功能进行评级。结果152只手中外观及功能优良者141只,占92.8%。结论保留变性真皮并移植大张自体皮修复手部深度烧伤,术后外观及功能恢复较好,是修复手部深度烧伤创面的较佳选择。     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

金黄色葡萄球菌侵袭烫伤家兔致淋巴细胞蛋白质组的变化

Objective To study the proteomic change in Iymphocytes of rabbits with scald injury and Staphylococcus aureus (SA) invasion. Methods Twenty-four rabbits were divided into four groups as follows: control group, scald group, scald with SA invasion 2 hs group, and scald with SA invasion 6 hs group, according to random number table, with 6 rabbits in each group. Except for rabbits in control group (sham scald at 37 ℃ ) , rabbits in the other 3 groups were subjected to 30% TBSA full-thickness scald. Rabbits in SA invasion 2 and 6 hs groups were injected with 2 mL (1.0×108 CFU/mL) SA suspension, which was in the log growth phase, via auricle vein 18 hs and 22 hs after injury. Whole blood samples were collected from carotid artery of rabbits in 4 groups 24 hs after scald. Lymphocytes were isolated and its ex-tracted proteins were analyzed by two-dimensional gel electrophoresis coupled with mass spectroscopy. Re-suits About 1030 protein spots of lymphocytes were detected in each group. Compared with that of control group, 19 protein spots were found to be differentially expressed in the other 3 groups, and 11 spots (10 pro-teins) were identified. Expression levels of cofilin, cyclophilin A, ubiquitin, nucleoside diphosphate ki-nase, glutamate dehydrogenase and annexin 1 were down-regulated, but expression level of peroxiredoxin was up-regulated obviously. Conclusions There is obvious proteornic change in lymphocytes of scalded rabbits or of scalded rabbits invaded by SA, and it may relate to immune suppression and sepsis after injury.     

延迟复苏对特重烧伤患者预后的影响

【目的】探讨延迟复苏对特重烧伤患者预后的影响,认识早期及时有效的复苏对特重烧伤患者预后的重要意义。【方法】回顾性分析198例特重烧伤患者的治疗情况,并根据烧伤后开始复苏时间的早晚将患者分为A(0～6h)、B(6h以上)两组,比较两组患者在早期休克发生率、休克期平均复苏补液量、后期严重并发症发生率、病死率及治愈平均疗程等方面有何不同。【结果】A、B两组患者在平均年龄、平均烧伤面积、平均Ⅲ度面积等方面无明显差异的情况下,通过比较发现A、B两组患者在早期休克发生率、休克期平均复苏补液量、后期严重并发症发生率、病死率及治愈平均疗程等方面均具有显著差异(P<0.01)。【结论】延迟复苏可以使特重烧伤患者早期休克发生率增高、休克期复苏补液量增加、后期严重并发症发生率、死亡率增高,疗程延长。     

头皮恶性肿瘤切除后创面的皮瓣修复

目的探讨利用皮瓣转移修复头皮恶性肿瘤切除后创面的疗效。方法对38例头皮恶性肿瘤患者（鳞状细胞癌25例、基底细胞癌9例、黑色素瘤2例、疣状癌2例）实施肿瘤扩大切除术（切口距肿瘤边缘3～5cm,其中17例切除局部颅骨,10例切除局部硬脑膜,5例行同侧颈部淋巴清扫）。肿瘤切除后创面采用皮瓣转移修复（24例采用一个单蒂头皮瓣,6例采用多个单蒂头皮瓣,3例采用双蒂头皮瓣,3例采用下斜方肌皮瓣,2例采用背阔肌皮瓣）。硬脑膜缺损采用阔筋膜修补,颅骨缺损暂不修补。供瓣区直接缝合或中厚植皮修复结果其中31例患者皮瓣血运完全正常,另7例患者共8个皮瓣出现皮瓣远端静脉回流障碍,经高压氧治疗后皮瓣最终存活。所有患者供瓣区愈合好或植皮全部存活。患者对疗效均感满意。术后随访6个月～3年,未见肿瘤复发。结论利用皮瓣转移修复头皮恶性肿瘤切除后创面的疗效基本满意。     

游离肩胛皮瓣修复足部皮肤软组织缺损疗效评价

目的通过对62例肩胛皮瓣修复的患足观察测量,评价疗效,为此术式的临床应用及改正提供数据.方法于术后、皮瓣修薄术后、修薄术后三月后分别观察皮瓣成活率、磨损情况、感觉、患足周长、外形,并评价.结果肩胛皮瓣修复足部软组织缺损成功率为98%,16例三月后回访者无磨损破溃,无感觉,美学评价优良率于皮瓣修薄术后出院前为48%,术后三月后为56%,患足与对侧足皮瓣处周经比较有统计学差异.结论肩胛皮瓣修复足部皮肤软组织缺损安全可靠,能很好地满足患足功能上的需要,外观上经超薄皮瓣修薄术后仍有一定程度的臃肿,有待改正.但肩胛皮瓣仍是足部大面积软组织缺损的首选修复皮瓣之一.     

累及鼻窦的面部复杂缺损创面的修复方法及其临床效果

目的探讨累及鼻窦的面部复杂缺损创面的修复方法与临床效果。方法采用回顾性观察性研究方法。2020年1月—2022年5月, 中南大学湘雅医院烧伤整形外科收治5例、郴州市第一人民医院烧伤整形科收治4例符合入选标准的累及鼻窦的面部复杂缺损创面患者, 其中男6例、女3例, 年龄35～69岁, 包括4例钛网外露伴鼻窦损伤患者及5例肿瘤累及鼻窦患者。多学科团队合作充分评估损伤情况后, 对钛网外露患者行钛网去除、鼻窦清创、鼻窦黏膜去除, 对肿瘤患者行肿瘤根治性切除, 术后皮肤软组织缺损面积为5.0 cm×2.5 cm～18.0 cm×7.0 cm、鼻窦前壁缺损/缺如面积为3 cm×2 cm～6 cm×4 cm、窦腔深1～4 cm。根据旋股外侧动脉降支的穿支走行情况, 移植股前外侧嵌合皮瓣或股前外侧肌皮瓣(皮瓣面积9 cm×4 cm～19 cm×8 cm、肌肉大小5 cm×3 cm×3 cm～11 cm×6 cm×3 cm)修复缺损, 将供区创面直接缝合。观察术中移植组织瓣类型、受区血管、血管吻合方式以及术后供受区恢复情况、并发症发生情况, 随访受区外观与血运以及溃疡、肿瘤复发情况。结果对6例患者行股前...     

胶合软骨支架行外耳再造术

目的 报道外耳再造软骨支架成形固定的一种新方法。方法 临床应用11例，I期行传统耳后组织扩张器置入，预制耳后薄皮瓣，解剖层次为颞浅筋膜浅层。Ⅱ期取自体胁软骨为支架材料，根据健侧模样雕切成耳轮、对耳轮支架条，用医用胶粘合、拼接、点补、固定。通过接矫正耳轮上角及延长耳轮脚，点补形成耳轮结节、对耳屏及修整欠缺处，然后，耳轮与对耳轮支架进行粘合，形成胶合软骨支架。结果 除第1例取第8，9两肋软骨外，其余10例均取单根肋软骨。胶合的软骨支架系统稳固。外观逼真，立体感强，愈后无排异，轮廓清晰，随访1-3年，支架稳定，针塌陷。结论 医用胶行软骨支架固定方便、牢固、节省材料，无毒副作用，塑形逼真，是一种可行方法。