β—七叶皂甙钠联合甘露醇治疗创伤性脑水肿的临床研究

目的 探讨β-七叶皂甙钠和甘露醇联合治疗创伤性脑水肿的疗效。方法 80例脑挫伤患者随机分为甘露醇＋地塞米松对照组35例,甘露醇＋β-七叶皂甙钠治疗组45例。结果 β-七叶皂甙钠＋甘露醇治疗组的总有效率高于甘露醇＋地塞米松对照组,结果用卡方检验统计,P＜0．05。结论 β-七叶皂甙钠治疗创伤性脑水肿有效,与甘露醇合用疗效更佳。     

11,12-环氧二十碳三烯酸对缺血前和再灌注前大鼠心肌钙调节蛋白的影响

目的观察11,12-环氧二十碳三烯酸(11,12-EET)预处理与后处理对缺血/再灌注(IR)大鼠心肌钙调节蛋白的影响,探讨11,12-EET心肌保护的作用及其机制。方法采用Langendorff离体灌流装置,通过停灌40min/复灌30min复制大鼠心肌IR损伤模型。将33只雄性Sprague-Dawley大鼠随机分为对照组、IR组、EET预处理组(Pre-EET)及EET后处理组(Post-EET)。采用BL-420生物信号采集系统监测心功能,比色法检测肌浆网Ca2 -ATPase变化,半定量RT-PCR方法检测钙泵(SERCA)、磷酸受纳蛋白(PLB)、兰尼碱受体2型(RyR2)及1,4,5-三磷酸肌醇受体2型(IP3R2)表达变化。结果Pre-EET及Post-EET组与IR组相比,心功能改善、Ca2 -ATPase活性增高(P<0.05,P<0.01);IP3R2表达增强,PLB表达降低(P<0.05,P<0.01);Pre-EET组SERCA表达增强(P<0.05)。Pre-EET与Post-EET组间差异无显著性;各组RyR2表达差异无显著性。结论11,12-EET预处理与后处理具有拮抗IR损伤的作用,这与其诱导肌浆网IP3R2表达上调,PLB表达下调以及改善Ca2 -ATPase的活性有关;同时,预处理肌浆网SERCA表达上调,也可能是其抗IR损伤机制之一。     

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&lt;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.     

群体创伤在基层医院急诊室的抢救护理

目的总结群体创伤在基层医院急诊室的抢救护理经验。方法对三起道路交通事故79例创伤病人的抢救护理进行回顾性分析。结果所有病例均在抵达急诊室15min～60min内完成初步的抢救或处理,然后分别送入手术室和病房进一步治疗,总抢救成功率96.2%。结论基层医院急诊室对群体创伤的抢救护理要达到高效、有序,就必须加强急诊室护士的培训,设置合理的抢救预案,建立完善的应急系统。     

浅谈如何发挥中职学校国书馆的德育职能

中职学校图书馆应当提高德育自觉性,立足本职,积极探索、创新,把图书馆真正建成学校的德育阵地.现探讨在当前形势下,中职学校图书馆在学校思想道德教育中的作用以及发挥中职学校图书馆德育职能的途径.     

缬沙坦对实验性兔动脉粥样硬化斑块形成的影响

目的 研究缬沙坦对实验性兔动脉粥样硬化血管壁过氧化物酶体增殖物激活受体γ(PPARγ)和单核细胞趋化蛋白-1(MCP-1)的影响.方法 24只新西兰白兔随机分为3组:正常对照组、动脉粥样硬化(AS)造模组、缬沙坦干预组,喂养12周.进行血脂测定、主动脉内膜/中膜比值测定,采用RT-PCR检测PPARγ和MCP-1 mRNA的表达.结果 缬沙坦组血管壁PPARγ mRNA的表达较AS组明显增加(P＜0.05), 缬沙坦组血管壁MCP-1mRNA的表达较AS组明显减少(P＜0.05).血清胆固醇、甘油三酯、低密度脂蛋白胆固醇缬沙坦组与AS组比较均无显著性差异 (P＞0.05), 但均高于对照组(P＜0.01).缬沙坦组内膜/中膜厚度比值较AS组明显减小(P＜0.05).结论 缬沙坦能够抑制血管壁细胞MCP-1的表达, 其具有抗炎作用, 抗炎作用可能与其改善PPARγ表达有关.     

椎弓根内固定系统治疗胸腰椎骨折的手术配合

目的介绍椎弓根内固定系统治疗胸腰椎骨折的手术配合体会。方法对本院2000年6月．2006年6月收治的68例胸腰椎骨折患者进行手术配合，包括术前探访、进入手术室后的进一步安慰、置府卧位于骨科手术床、C型臂X线透视下牵引复位、手术提供椎弓根内固定系统专用器械操作骨折复位内固定、全程相关功能监护等。结果68例手术配合顺利，术后骨折复位固定良好，无伤口感染、肺部感染、压疮、深静脉血栓形成，无内固定定松动、断裂，均未出现并发症。结论椎弓根内固定系统是一种治疗胸腰椎骨折的有效方法，手术配合亦不容忽视。     

雷公藤多甙抑制EM患者腹腔巨噬细胞及相应细胞模型分泌TNF-α的实验研究

目的观察雷公藤多甙(TWP)对子宫内膜异位症(EM)患者腹腔巨噬细胞和小鼠腹腔活化巨噬细胞释放TNF-α的影响,以探讨TWP用于临床治疗EM的机制并建立细胞模型,为后续研究做准备。方法收集16例经腹腔镜检查确诊为EM患者腹腔液分离纯化巨噬细胞,并给予不同剂量的TWP进行共同孵育;同时分离纯化小鼠腹腔巨噬细胞,用脂多糖(LPS)激活以获得细胞模型,同样予TWP进行共同孵育。分别以间接MTT法和RT-PCR法在蛋白质水平和基因水平检测该药物影响激活状态巨噬细胞分泌TNF-α含量的变化。结果 EM患者腹腔液中TNF-α含量显著高于非EM妇女,在4～24 h后TWP(6.25～100μg/L)显著抑制了TNF-α的分泌。结论 TWP在蛋白质和基因水平均能有效抑制激活巨噬细胞分泌TNF-α。     

Deletion of the activating NKG2C receptor and a functional polymorphism in its ligand HLA‐E in psoriasis susceptibility

Psoriasis is an inflammatory, immune‐mediated disease of the skin. Several studies have suggested that natural killer (NK) cells and their receptors may be important for its pathogenesis. Here, we examined whether deletion of the activating natural killer receptor gene NKG2C, which has a frequency of 20% in the European population, was associated with psoriasis susceptibility. The NKG2C deletion and a functional polymorphism in its ligand HLA‐E were genotyped in a Caucasian cohort of 611 psoriasis cases and 493 controls. We found that the NKG2C deletion was significantly increased in cases compared with controls [0.258 vs 0.200, P = 0.0012, OR = 1.43 (1.15–1.79)]. The low‐expressing HLA‐E*01:01 allele was associated with psoriasis (P = 0.0018), although this association was dependent on HLA‐C. Our findings support a potential immunoregulatory role for NK cells in psoriasis and suggest the importance of future studies to investigate the contribution of NK cells and their regulatory receptors to the pathogenesis of psoriasis.