PDGF-AB对人正常皮肤和增生性瘢痕成纤维细胞-胶原网收缩影响的差异

目的：研究血小板衍生生长因子(PDGF)—AB对人正常皮肤和增生性瘢痕成纤维细胞一胶原网(FPLC)收缩影响的差异,探讨PDGF—AB促进伤口愈合的作用机制及其在瘢痕增生中的作用．方法：取体外培养的人正常皮肤(NsFb)及增生性瘢痕成纤维细胞(HTsFb),建立成纤维细胞—胶原网模型,比较PDGF—AB对两种成纤维细胞—胶原网收缩影响的差异．结果：PDGF—AB对两种成纤维细胞—胶原网收缩均有明显促进作用,且均呈剂量依赖性关系,但作用有差异．结论：PDGF—AB可能通过刺激伤口收缩促进创面愈合,同时可能在瘢痕挛缩性疾病中起重要作用。     

继往开来创新发展——空军军医大学第一附属医院(西京医院)烧伤与皮肤外科发展历程

空军军医大学第一附属医院(西京医院)烧伤与皮肤外科由著名医学家汪良能教授于1955年创建,当时为烧伤整形外科,是全国最早成立的烧伤整形专业科室之一.成立初期,科室仅有床位7张,面积不足200 m2.岁月如梭,66个春秋记载着几代创业者的光辉奋斗历程,披荆克难、笃志求学,敬业善守、救死扶伤,科室在不断前行中发展、壮大,为...     

炎症反应在增生性瘢痕和瘢痕疙瘩形成中的作用及其机制研究进展

增生性瘢痕与瘢痕疙瘩是创面愈合后常见的后遗症,发生率高,严重影响患者生活质量,而目前仍缺少有效的预防和治疗方法,主要原因在于瘢痕发生机制尚不明确。目前研究认为,炎症反应在瘢痕形成过程中发挥重要作用,通过对其作用机制的研究,有望寻找预防和治疗增生性瘢痕和瘢痕疙瘩的新的药物靶点。本文主要就炎症因子、炎症细胞在增生性瘢痕与瘢...     

白细胞介素17的信号转导调控及白细胞介素17在脓毒症中作用的研究进展

脓毒症依然是危重症患者的主要死亡原因之一,而过度的炎症反应和长期的免疫抑制均可导致脓毒症患者死亡。白细胞介素17（IL-17）作为关键的促炎性细胞因子,在机体的炎症反应和免疫系统中发挥着重要的作用。信号转导是IL-17在维持机体健康及参与脓毒症疾病发生发展中的关键环节。本文重点归纳讨论IL-17的信号转导调控,及IL-...     

烧伤科进修生教学应用PBL教学法结合多媒体

目的将PBL教学法与多媒体结合教学应用于烧伤科进修医生的临床教学中,对其应用效果进行探讨分析。方法将本院60名烧伤科进修医生,经随机数字分2组,实验组、对照组,各30名,对照组采用传统的教学方式;实验组运用PBL教学法结合多媒体教学,分析教学后改善疗效、满意度。结果与对照组相比,实验组进修医生在掌握临床知识、操作能力方面取得较高成绩,组间成绩比差异具有统计学意义(P 0.05)。与对照组比,实验组对患者满意度较高,差异具有统计学意义(P 0.05)。结论 PBL教学法结合多媒体教学法在烧伤科进修医生教学中应用效果明显,比传统常规教学式临床效果更明显。     

人脂肪间充质干细胞的分离培养及生物学特性研究

目的：探索高效分离和扩增人脂肪间充质干细胞（adipose derived mesenchymal stem cells,ADSCs）的方法,观察其生物学特性,并通过形态学、免疫表型及多向分化能力进行鉴定。方法：以手术中剩余的人皮下脂肪组织为材料来源,利用胶原酶消化法分离ADSCs,体外扩增后传代,倒置显微镜观察,MTT比色法测定细胞生长曲线,流式细胞仪检测细胞表面标记CD29、CD31、CD34、CD45、CD90、CD105的表达。在DMEM及胎牛血清培养基、地塞米松、IBMX、吲哚美辛的诱导下向脂肪细胞定向分化;在DMEM及胎牛血清培养基、地塞米松、抗坏血酸、β-磷酸甘油、胰岛素的诱导下向成骨细胞定向分化。结果：原代和传代细胞呈梭形外观,生长增殖能力良好。细胞传代后2天内处于潜伏期,第3天进入生长期,5天后进入平台期。流式细胞仪检测CD29、CD31、CD34、CD45、CD90、CD105阳性率分别为73.4%、3.6%、4.5%、2.0%、97.3%、80.4%。经定向诱导分化后,细胞分别呈现脂肪细胞、骨细胞的表型特征。结论：酶消化法能有效分离纯化人ADSCs,细胞生长稳定,增殖能力活跃,具有ADSCs的一般生物学特性,为其成为组织工程理想的种子细胞提供了进一步的支持。     

离体角质形成细胞热损伤模型建立及细胞凋亡观察

Objective To reproduce a model of heat injured KC in vitro and explore its apoptosis rate of KC due to heat injury at different temperature. Methods Human KCs were cultured in vitro, and they were incubated at 37, 41, 43,45, 48, and 51 ℃ respectively for 10 mins in water bath. Trypan blue staining and Hoechst 33258 fluorescence staining were used respectively to determine necrosis and apoptosis of KC. Rates of apoptosis and necrosis of KC were analyzed quantitatively by flow cytometer. The prolifera-tion activity of KC after heat injury was detected by MTT test. Results The results of trypan blue stai-ning, Hoechst 33258 fluorescence staining, and flow cytometer demonstrated that number of apoptotic and necrotic KC increased gradually along with a rise of water bath temperature. The rates of apoptosis and necro-sis of KCwererespectively(12.3±3.2)% and (14.1±1.6)% at 45℃, (27.7±5.1)% and (58.0± 4.2)% at 48 ℃. Rate of KC necrosis reached up to (83.0±5.3)% at 51℃. Inhibition of KC growth reached a stationary phase when the injurious temperature reached 45 ℃ as observed with MTT test. Con-clusions Heat injury can induce apoptosis and growth inhibition of KC in vitro. Incubating KC at 45 ℃ for 10 mins is a good condition to reproduce a model of heat injured KC in vitro. This model may be used to study the biological character and apoptosis of KC after burn injury.     

胰岛素对脂肪干细胞生长因子分泌功能的影响

Objective To study the effect of insulin in different concentrations on secretion function of growth factors of adipose-derived stem cells (ADSCs). Methods ADSCs were isolated from human ab-dominal adipose tissue and cultured. The immunophenotype and adipose induced-differenciation were identi-fied, and the third generation cells were collected. The collected cells were assigned to 1 × 10-8, 1 × 10-7, 1 × 10-6 mol/L insulin groups according to the concentration of added insulin. When cells grew into 70% confluence in conventional medium, ADSCs were cultured further in serum-free DMEM containing insulin in different concentrations for 3 days. ADSCs cultured in medium without insulin were used as control group. Secretion amount of vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) of ADSCs were determined by enzyme-linked immunosorbent assay. The effects of the supernatant fluid of ADSCs' nutrient solution on the proliferation and collagen synthesis of the cultured fibroblast were detected by MTT chromatometry and hydroxyproline chromatometry. Results The secretion amounts of VEGF and HGF of ADSCs in 1 × 10-8 and 1 × 10-7 mol/L insulin groups [ (471±41, 762±66 ng/L), (643±64, 930±67 ng/L) , respectively ] were significantly higher as compared with those in control group (286±47, 577±84 ng/L) ( P <0.05 orP <0.01). No change occurred in the secretion amount of VEGF and HGF of ADSCs in 1±10-6 mol/L insulin group ( P >0.05 ). The supernatant fluid of ADSCs' nutrient medium of 1 ± 10-8 ,1 ± 10-7 mol/L insulin groups showed obvious stimulative effect on the proliferation and collagen synthesis of fibroblasts, and it was most obvious in the 1 ± 10-7 mol/L group ( P < 0.05 or P < 0. 01 ). Conclusions Insulin in the concentrations of 1 ± 10-8 and 1 ± 10-7 mol/L can notably promote ADSCs' function of secreting VEGF and HGF.     

持续负压灌洗引流在糖尿病足合并足底脓肿清创术中的应用

目的 了解早期清创结合持续负压灌洗引流在糖尿病足合并足底脓肿患者保肢手术中应用的可行性.方法 糖尿病足合并足底脓肿患者10例共10只患足,实施手术清创后留置胃管进行持续负压灌洗引流7～14 d,停止灌洗后维持负压吸引3～5 d,拔除引流管,术后3周左右拆线.观察创面愈合情况. 结果经上述处理,患者局部炎性反应明显减轻,创面愈合,足部功能恢复良好,外形不受影响. 结论清创术结合局部持续负压灌洗引流,有利于糖尿病足合并足底脓肿的治疗,可保留患肢原始长度.     

重度烧伤大鼠血清对巨噬细胞Notch1的激活及分泌功能的影响

目的研究重度烧伤大鼠血清刺激后巨噬细胞Notch1蛋白表达变化,及其细胞分泌因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平变化。方法选取成年雄性SD大鼠24只,随机分为假伤组、烧伤24 h组和烧伤7 d组,每组8只。烧伤组SD大鼠造成约30%总体表面积(TBSA)Ⅲ度烧伤,分别于伤后24 h、7 d收集血清;假伤组大鼠用37℃水浴,水浴后24 h取其血清作为对照。用上述各组血清制成20%培养液,刺激小鼠源巨噬细胞系RAW264.7,分别于加入血清刺激后即刻和刺激4、8、12、24、48 h后收取细胞及其上清液。另外用含20%假伤血清+脂多糖(100 ng/m L)培养液刺激巨噬细胞,于相同时间点收样。Western Blot检测各时间点巨噬细胞中Notch1蛋白表达变化,酶联免疫吸咐试验检测刺激24 h后培养上清液中IL-6及TNF-α的含量变化。结果 (1)假伤组血清刺激后即刻和刺激4、8、12、24、48 h后,Notch1蛋白表达无明显变化;(2)烧伤24 h组血清刺激后,Notch1蛋白表达明显升高,并随时间延长而达高峰;(3)烧伤7 d组血清刺激后,Notch1蛋白表达无明显变化,与假伤组血清刺激结果类似;(4)假伤组血清+脂多糖混合刺激后,Notch1蛋白表达明显增加;(5)烧伤24 h组血清及假伤组血清+脂多糖,上清液中IL-6和TNF-α含量均明显高于假伤组血清及烧伤7 d组血清。结论烧伤血清刺激下的巨噬细胞Notch1信号被激活,IL-6及TNF-α分泌能力增强,且这种激活可被脂多糖刺激所模拟。