高频双向喷射通气和常规机械通气对蒸气吸入性损伤犬治…

目的：观察高频双向喷射通气（ＨＦＴＪＶ）和常规机械通气（ＣＭＶ）对蒸气吸扩性损伤犬的呼吸循环动力学参数、肺容量及血气的影响。方法：通过服气吸入致伤，复制了犬重度蒸气吸入性损伤模型。结果：①两种通气下呼吸系统总阻力（Ｒｒｓ）、肺阻力（ＰＬ）均显著高于对照值（Ｐ〈０．０１），呼吸系统总顺应性（Ｃｒｓ）、肺顺应性（ＣＬ）均显著低于对照值（Ｐ均〈０．０５），但两者之间比较，Ｒｒｓ、ＲＬ和Ｃｒｓ、ＣＬ的变化     

高频双向喷射通气对组胺犬气体交换及呼吸力学的影响

本实验比较了不同通气频率时高频双向喷射通气（ＨＦＴＪＶ）与高频喷射通气（ＨＦＪＶ）对组胺致肺损伤犬气体交换、氧运输功能、呼吸力学及血流动力学的影响。结果表明，在组胺持续滴注时，当通气频率分别为６０及１００次／ｍｉｎ时，ＨＦＴＪＶ时的ＰａＣＯ＿２较ＨＦＪＶ时均显著降低（Ｐ＜０．０、１），ｐＨ均显著升高（Ｐ＜０．０１），而ＰａＣＯ＿２、氧耗量、氧运输量、心输出量、肺动脉压、气道压、肺及时吸系统阻力、顺应性等均无明显改变。提示：ＨＦＴＪＶ能够显著增强组胺致肺损伤大的ＣＯ＿２排除，而对氧运输功能、呼吸力学及血流动力学均无明显影响。     

c-Met癌基因在胃癌中的角色探讨

胃癌是世界范围内高发的恶性肿瘤．正常胃黏膜在外源及内源性致病因素共同作用下发生恶变，而肿瘤的发生、发展、浸润、转移对人类身心健康造成严重影响。蛋白酪氨酸激酶（protein tyrosine kinase，PTK）是一类备受关注的效应蛋白，研究发现PTK参与了人类多种肿瘤的发生及发展过程，部分能作为肿瘤预后评估指标。c-Met癌基因编码的蛋白产物属于受体型蛋白酪氨酸激酶家族，我们尝试回顾其在人类胃腺癌中相关研究，分析Met蛋白酪氨酸激酶在胃癌发生、发展中所扮演的角色及对临床治疗的意义。     

79例新生儿肺炎肺部影像分析

目的 通过分析79例新生儿肺炎肺部影像表现,提高对其认识及诊断水平.方法 回顾性总结我院新生儿科2009年9月-2010年9月住院且资料完整的79例新生儿肺炎病例资料,分析其肺部影像表现.结果 新生儿肺炎主要影像表现:双肺纹理增粗,肺野透亮度减低,肺气肿,沿支气管分布小斑点,小斑片状影,融合性斑片状影及支气管充气征.结论 肺部X线检查是诊断新生儿肺炎的必要手段,对指导其诊疗具有重要意义.     

兔烟雾吸入性损伤模型的改进和建立

目的 改进并建立一种兔烟雾吸入性损伤模型 方法 参照以往兔烟雾吸入性损伤模型制作方法,采用自制烟雾吸入性损伤致伤仪致伤,改进模型制作方法：以干燥的松木屑及煤油为发烟材料,在密闭环境使兔自行吸入烟雾10min,间隔2min再次致伤10min。伤后观察兔临床表现、各时点血气及伤后24h肺组织切片观察。 结果 (1)伤后兔呼吸频率明显加快,呼吸困难明显,肺部可及干啰音,24h后呼吸症状改善。(2) 血气示PaO2由伤前90.20±18.44mmHg分别降至伤后10min 63.48±12.90mmHg、伤后2h 56.96±10.23mmHg及伤后4h 65.76±12.55mmHg,与伤前比较差异有显著性(P<0.05)。至伤后24h基本恢复正常;PaCO2由伤前32.10±5.48mmHg分别升至伤后10min 41.72±6.33mmHg、伤后2h 43.12±5.42mmHg及伤后4h 39.11±6.91mmHg与伤前比较差异有显著性(P<0.05)。至伤后24h基本恢复正常。(3)肺组织切片：伤肺有血管内充血、肺泡水肿和出血、间质水肿及炎性细胞浸润等肺损伤改变。致伤过程无动物死亡。结论 本文推荐的兔烟雾吸入性损伤模型是一种简便、实用、稳定、经济、可重复的烟雾吸入性损伤模型,适于烟雾吸入性损伤的研究。     

早期肠内免疫营养对烫伤小鼠肠道免疫功能的影响

目的 了解早期免疫强化肠内营养对烫伤小鼠肠道免疫功能的影响.方法 选择24只雄性BALB/c小鼠制作20%TBSAⅢ度烫伤模型,采用简单随机法分成2组.每组12只.普通营养组:于伤后2 h开始经口灌喂普通肠内营养剂;免疫营养组:方法同前,在普通营养剂基础上加入谷氨酰胺和精氨酸.2组营养剂糖、脂肪、蛋白质供热比均为82:3:15,热量与氮之比为150:1.每只小鼠营养摄入按732.2 kJ·kg-1·d-1计算,第1天摄入标准量的1/3,第2天摄入标准量的1/2,第3天起摄入全量,每天的计划量分4～6次喂完.2组营养摄入为等氮、等热量、等体积.小鼠连续灌喂7d后处死,取全段小肠.另取10只同品系小鼠作为健康对照组,同法取材.记录肠集合淋巴结细胞总数,通过流式细胞仪检测淋巴结中CD3+、CD4+、CD19+及凋亡细胞变化,双抗体夹心酶联免疫吸附测定法检测肠IgA变化.结果 健康对照组、普通营养组、免疫营养组小鼠肠道淋巴结细胞总数分别为(4.5±0.6)×106、(2.3±0.4)×106、(3.8±0.5)×106个,与健康对照组比较,后2组细胞数明显减少(P＜0.05).但免疫营养组高于普通营养组(P＜0.05);3组小鼠肠道淋巴结CD3+、CD4+、CD19+细胞数比较情况类似于淋巴结细胞总数.健康对照组、普通营养组、免疫营养组淋巴细胞凋亡率分别为(4.8±2.1)%、(12.7±2.4)%、(8.0±1.7)%,与健康对照组比较,后2组小鼠细胞凋亡率明显增加(P＜0.05),但免疫营养组低于普通营养组(P＜0.05).健康对照组、普通营养组、免疫营养组肠IgA水平分别为(42±7)、(35±6)、(38±6)μg/cm,与健康对照组相比,后2组水平明显减低(P＜0.05),但免疫营养组高于普通营养组(P＜0.05).结论 用强化免疫营养剂进行早期肠内营养,可以改善烫伤小鼠肠道免疫功能.     

人血管内皮生长因子165基因转染人骨髓间充质干细胞的实验研究

Objective To establish an effective method of transfecting human marrow mesenchymal stem cells (MSC) with human vascular endothelial growth factor 165 ( VEGF 165) gene. Methods MSCs isolated and cultured in vitro were divided into transfection group (pShuttle-CMV/VEGF 165 plasmid was transfected into MSCs through liposome-mediating method), empty plasmid group (pShuttle-CMV vehi-cle was transfected into MSCs as control), liposome group (liposome was transfected into MSCs as control) and control group(normal culture). Expressions of Mrna and protein of MSCs were determined by RT-PCR, enzyme-linked immunosorbent assay and Western Blot. Sensitivity to MSCs on VEGF plasmid transfec-tion was detected by MTT test. Results Expression level of VEGF 165 gene Mrna in transfection group, empty plasmid group, liposome group, and control group was respectively 0.89 ± 0.03, 0. 34 ± 0.04, 0.40 ± 0.03, and 0.30 ± 0.03, and the difference between transfection group and the other three groups was statistically significant ( P <0. 01 ). Content of VEGF protein in transfection group, empty plasmid group, liposome group, and control group was respectively (778 ± 35 ), (543 ± 24), (561 ± 28), (571 ± 23) pg/Ml, and the difference between transfection group and the other three groups was statistically significant ( P <0.01 ). In the transfection group, expression level of VEGF protein peaked on 7th day after transfec-tion, which was decreased gradually later. In transfection group, expression level of V EGF 165 protein was obviously higher than that of the other three groups ( P <0. 01 ), and no inhibitory effect of VEGF plasmid transfection on MSCs proliferation was found. Conclusions The method for transfecting human VEGF 165 gene into MSCs is established in this research, through which target gene and protein can express effectively.     

强化精氨酸肠内营养对烧伤患者营养状况和细胞免疫的影响

Objective To investigate the effects of arginine enriched enteral nutrition (EN) on nu-tritional status and cellular immunity of severely burned patients. Methods Randomized, single blind, parallel and positive control investigation was employed in the study. Thirty severely burned patients were di-vided into enteral immune nutrition (EIN) group and EN group. Sixteen patients in EIN group received en-teral nutrition enriched with arginine, while the other 14 patients in EN group received standard enteral nu-trition. Nutritional support was continued for 14 days. Gastrointestinal reaction of patients in 2 groups was observed. Fasting venous blood was drawn from patients of both groups before receiving nutrition treatment and on the morning of 7th, 14th day of treatment. Level of serum protein, hepatic function parameters, renal function parameters, fasting-blood glucose, and subpopulations of T lymphocytes in peripheral blood were determined. Results (1) Incidence of gastrointestinal side effect in EIN group (25.0%) was close to that of EN group (21.4% , P>0.05). (2) Compared with pre-treatment days, levels of prealbumin and transferrin in serum of patients in 2 groups on 7th and 14th post-treatment days were significantly increased (P<0.05 or P<0.01), but there was no significant difference between 2 groups. The level of total serum protein on 14th day of treatment of patients was significantly increased in both groups, and that of EIN group (66±7 g/L)was significantly higher compared with that in EN group (64 ± 11 g/L, P<0.05). The level of serum albumin (29±5, 32±5 g/L, respectively) of patients in EIN group on 7th and 14th day of treat-ment were significantly higher than that (26±4 g/L, P <0.05) in pre-treatment days, however there was no significant difference in EN group. (3) There was no significant difference in respect of hepatic function, renal function, and fasting-blood glucose between pre-treatment and post-treatment periods in both groups (P>0.05). (4) The ratio of CD4+ , CD8+ on 14th day of treatment in EIN group was close to that of pre-treatment level. In EN group, cell percentage of CD4+ significantly decreased, while that of CD8+ significantly increased (P<0.05), and CD4+ was significantly higher [(56±8) %] in EIN group than that in EN group [(55±12) % , P <0.05]. In both groups, cell percentage of CD3+ was significantly higher than that in pre-treatment days (P<0.05), while there was no obvious change in CD4+/CD8+. Conclusions Arginine enriched enteral nutrition can effectively improve nutritional status and cellular immune function of burn patients.     

人骨髓间充质干细胞的分离培养鉴定及BrdU标记的实验研究

背景：骨髓间充质干细胞具有多向分化能力,是目前极具潜力的细胞及基因治疗的靶细胞。 目的：拟在体外建立一种分离纯化、培养扩增、标记骨髓间充质干细胞的方法。 设计、时间和地点：开放性实验,于2008-03/05在南昌大学第一附属医院烧伤研究所完成。 材料：人骨髓间充质干细胞取自临床骨髓穿刺检查正常的住院患者,无血液系统疾病和家族遗传病史,由南昌大学第一附属医院提供。 方法：密度梯度离心和贴壁培养相结合,分离纯化骨髓间充质干细胞,并用BrdU标记。 主要观察指标：相差显微镜下观察人骨髓间充质干细胞的形态变化;流式细胞仪检测人骨髓间充质干细胞的表面标记以及细胞周期;绘制人骨髓间充质干细胞生长曲线;透射电镜观察人骨髓间充质干细胞的超微结构。 结果：密度梯度离心结合贴壁法能分离培养出纯度较高的人骨髓间充质干细胞。流式细胞仪检测人骨髓间充质干细胞CD90,CD29,CD44,CD34,CD45阳性细胞表达分别为98.48%,98.74%,97.41%,0.36%,0.64%。人骨髓间充质干细胞的生长曲线呈S形。透射电镜可见人骨髓间充质干细胞胞质丰富,粗面内质网发达,大量蛋白分泌物。免疫组织化学检测BrdU标记48 h后人骨髓间充质干细胞标记率> 80%。 结论：采用淋巴细胞分离液密度梯度离心和贴壁培养相结合,以获得纯度较高和活性骨髓间充质干细胞,是简便可行的方法;BrdU是一种简单、有效的标记骨髓间充质干细胞的方法。     

早期药膳饮食对烫伤大鼠肠黏膜Peyer’s结T淋巴细胞及亚群的影响

背景：肠相关淋巴组织的组成部分Peyer’s 结是肠黏膜免疫系统的重要诱导部位,含有参与免疫应答的各种免疫细胞,如CD4 +T 细胞、CD8 +T细胞、B细胞等。 目的：观察早期药膳饮食对烫伤大鼠肠道肠黏膜Peyer’s结T淋巴细胞及其亚群的影响。 设计、时间及地点：随机对照动物实验,于2006-04/2007-03在南昌大学一附属医院完成。 材料：Wistar大鼠100只,随机分成药膳喂养组(n=30)、肉汤喂养组(n=30)、常规喂养组(n=30)、正常对照组(n=10)。药膳成分：党参20 g、白术25 g、茯苓25 g、炙甘草15 g、黄芪20 g、薏苡仁20 g、瘦猪肉200 g。 方法：药膳喂养组、肉汤喂养组、常规喂养组实施背部30%体表面积Ⅲ度烫伤,伤后早期分别给予药膳、肉汤和生理盐水,2 mL/次,2次/d。正常对照组实施37 ℃假伤。 主要观察指标：伤后3,7,14 d检测大鼠肠黏膜Peyer’s结T淋巴细胞及亚群。 结果：伤后3,7 d,药膳喂养组、肉汤喂养组、常规喂养组Peyer’s结淋巴细胞总数、CD3+淋巴细胞的百分比及总数、CD4+百分比及总数、CD8+细胞的百分比及总数较正常对照组明显减少 (P < 0.05,P < 0.01),至14 d,药膳喂养组与正常对照组相比差异不显著。伤后3,7,14 d药膳喂养组CD3+淋巴细胞的百分比及总数、CD4+百分比及总数较肉汤喂养组、常规喂养组明显升高(P < 0.05)。伤后3,7 d药膳喂养组Peyer’s结CD8+细胞的百分比及总数较肉汤喂养组、常规喂养组明显下降(P < 0.05)。 结论：早期药膳饮食有利于肠道Peyer’s结淋巴细胞的增生,并改善Peyer’s结T淋巴细胞亚群的比例,从而改善烫伤大鼠肠道免疫功能。