应用自制咽鼓管导管治疗分泌性中耳炎

分泌性中耳炎以耳阻塞感、耳鸣、听力下降、中耳腔内(昨)化脓性积液等为特征,治疗多采用咽鼓管吹张,鼓膜穿(测)或鼓膜切开置管等.通常经咽鼓管导管吹张,只能给气,为经该导管同时给药、方便治疗,我们对导管作了一些改进,2005年2月～2007年10月应用此改进导管治疗分泌性中耳炎66例(73耳),效果较好,报告如下.     

Transduced monocyte/macrophages targeted to murine skin by UV light

We have selectively targeted monocyte/macrophages overexpressing an immunomodulatory molecule, latency-associated peptide (LAP), a naturally occurring antagonist for transforming growth factor-beta1, to murine skin utilizing UV light to produce a cutaneous influx of transduced monocyte/macrophages. Bone marrow (BM) cells from BALB/c mice were transduced in vitro with a retroviral construct containing green fluorescent protein (GFP) for detection and human LAP (hLAP) as a test molecule. The transduced BM cells were then cultured in vitro with granulocyte-macrophage colony-stimulating factor (GM-CSF) to produce differentiation to monocyte/macrophages. More than 80% of transduced BM cells were CD11b-positive and MOMA-positive by fluorescence-activated cell-sorter analysis and secreted LAP by ELISA after 10 days of culture in granulocyte-macrophage colony-stimulating factor (GM-CSF). Transduced monocyte/macrophages containing either GFP or hLAP-GFP were then injected intravenously into BALB/c mice. One-half of recipients in each group were exposed to UVB (72 mJ) to induce monocyte/macrophage infiltration into skin. Recipients were sacrificed 60 h after UV irradiation. We found transduced cutaneous macrophages expressing GFP by examining with fluorescence microscopy frozen skin sections of recipient mice immunostained with antibodies to GFP and to macrophage marker F4/80. We identified hLAP sequences by polymerase chain reaction (PCR) of total DNA in recipient blood and UV-irradiated skin but not in unirradiated skin. LAP sequences were also detected at much lower levels in other organs (lung, spleen, and liver) by PCR. Therefore, we have shown that genetically altered monocytic cells can be injected intravenously and targeted to mouse skin by UV exposure. This macrophage-based gene-transfer method may be a potentially useful immunotherapeutic approach for delivering monocyte/macrophage-derived products to skin.     

IL-1β及其受体在机械性脑损伤大鼠大脑皮质及海马中的表达

 目的通过复制Marmarou大鼠机械性脑损伤模型,研究脑损伤后白细胞介素1β(interlukin-1β,IL-1β)及其受体IL-1RI在大脑皮质和海马中表达的时序性特点及二者之间的相互关系.方法将60只清洁级雄性SD大鼠随机分为正常对照组、手术对照组及损伤后1h组、2 h组、4 h组、8 h组、12 h组、24h组、2 d组、3 d组、5 d组.采用组织芯片及免疫组化技术检测大脑皮质和海马中IL-1β、IL-1RI的表达情况.结果对照组大脑皮质、海马部位均表达少量IL-1β及IL-1RI.与对照组相比,损伤组皮质和海马中IL-1β的表达在损伤后30 min～12 h组显著升高(P＜0.01),并在2 h达高峰,然后逐渐降低,损伤后24 h降至正常水平,而皮质和海马中IL-1RI的表达在损伤后1～12 h组显著升高(P＜0.01),并在4 h达高峰,然后逐渐降低,损伤后72 h降至正常水平.结论IL-1β及IL-1RI的表达在闭合性脑损伤早期即显著升高,后期逐渐恢复正常,两者在损伤后表达的时序性变化特点基本一致,共同参与脑损伤的病理生理过程.     

MEBO包扎治疗150例Ⅱ度烧伤疗效观察

目的 :为探讨MEBO烧伤膏包扎治疗效果。方法 :选择同期住院Ⅱ度烧伤患者进行包扎治疗。结果 :浅Ⅱ度～深Ⅱ度烧伤患者 1 50例 ,创面全部愈合 ,无疤痕增生。结论 :MEBO烧伤膏包扎治疗Ⅱ度烧伤创面 ,方法简单 ,疗效可靠 ,便于推广应用     

伸肘位手法复位形石膏夹板固定治疗小儿肱骨髁上伸直型骨折

目的　介绍伸肘位手法复位－Ｕ 形石膏夹板固定治疗小儿肱骨髁上伸直型骨折。　方法　在伸肘位肘关节伸屈肌均处于无张力状态,因而也是肱骨髁上骨折复位与固定的最佳位置。局部血肿内麻醉下,由助手对抗牵引,令肘关节伸直,前臂旋后位,矫正骨折移位。应用－Ｕ 形石膏夹板绷带固定,肘关节外翻２０°～３０°,确使折端桡侧皮质嵌紧,直至骨质愈合。３ ～４ 周后去石膏,恢复屈肘活动。　结果　临床应用４８ 例,骨折手法复位成功率为１００ ．０ ％ 。经６ 个月～２ 年（平均１ 年２ 个月） 的随访,肘关节伸屈功能均恢复正常,无肘内翻畸形等并发症发生。　结论　伸肘位手法复位－Ｕ 形石膏夹板固定治疗小儿肱骨髁上伸直型骨折,能达到理想的复位和维持稳定的固定效果,可有效地遏制肘内翻畸形。     

Differential Fos expression in the paraventricular nucleus of the hypothalamus, sacral parasympathetic nucleus and colonic motor response to water avoidance stress in Fischer and Lewis rats

The responsiveness of hypothalamic CRF to various stressors is reduced in the young female Lewis relative to the histocompatible Fischer rat. Whether such a difference impacts the brain-gut response to water avoidance stress was investigated by monitoring Fos immunoreactivity in the brain and sacral spinal cord and fecal pellet output. Exposure for 60 min to water avoidance stress increased the number of Fos positive cells in the paraventricular nucleus of the hypothalamus (PVN), nucleus tractus solitarius (NTS), and the parasympathetic nucleus of the lumbo-sacral spinal cord (L6-S1) in both Lewis and Fischer rats compared with non stress groups. The Fos response was lower by 32.0% in the PVN, and 63% in sacral parasympathetic nucleus in Lewis compared with Fischer rats while similar Fos expression was observed in the NTS. Stress-induced defecation was reduced by 52% in Lewis compared with Fischer rats while colonic motor response to CRF injected intracisternally resulted in a similar pattern and magnitude of defecation in both strains. The CRF receptor antagonist [ -Phe12,Nle^21,38C^aMeLeu³⁷]-CRF_12–41 injected intracisternally antagonized partly the defecation response in Lewis and Fischer rats. These data indicate that a lower activation of PVN and sacral parasympathetic nuclei in Lewis compared with Fisher rats may contribute to the differential colonic motor response and that the blunted CRF hypothalamic response to stress, unlike responsiveness to central CRF plays a role.     

明胶微球乙肝疫苗动物免疫效果研究

目的 研究并优化微球乙型肝炎疫苗的配方,观察微球乙肝疫苗对温度的稳定性。方法 用明胶包裹ＨＢｓ制备微球,设计不同配方及不同粒径微球乙肝疫苗、冻干微球乙肝疫苗于不同温度放置一定时间,免疫动物观察免疫效果。结果 微球疫苗ＨＢｓ包裹率〉９０％,微球疫苗的免疫效果受佐剂配方及制备程序等因素影响,〈１０μｍ的微球（５．６μｍ）免疫效果明显优于〉１０μｍ的微球（２５．４μｍ）（Ｐ〈０．０２）及铝佐剂组（Ｐ〈０     

应用绞股蓝预防豚鼠胆囊胆固醇结石形成的实验研究

目的 探讨胆固醇结石的预防。方法 采用豚鼠为实验对象,随机分为三组,设置了空白组、对照组、预防组。结果 药物预防组较对照组成石率显著降低(P<0.05),药物预防组胆汁中胆固醇含量较对照组显著降低(P<0.05),胆汁酸含量较对照组显著升高(P<0.05)。结论 绞股蓝能改善肝细胞功能,降低胆汁中胆固醇含量,提高胆汁酸含量,达到预防胆固醇结石形成。     

刺突截骨椎管成形术治疗退行性腰椎管狭窄症

目的：介绍刺突截骨椎管成形术及其应用,方法：采用该术式治疗37例退行性腰椎管狭窄症患者,术后进行疗效评分（Oswestry问卷）和腰椎管直径测量。方法：术后1年腰腿痛平均改善76％,术后4年平均改善74％,疗效下降不显著（P＞0．05）。术后CT显示腰椎管直径平均增加20％,刺突原位愈合率87％。结论：该术式操作简单,神经减压充分,手术并发症少,其治疗退行性腰椎管狭窄症术手近、中期疗效和影像学评估均满意。     

他克莫司治疗肾移植术后耐激素性排斥反应的临床观察

目的观察用他克莫司(FK506)替换环孢素A(CsA)治疗肾移植术后耐激素性排斥反应的效果.方法26例肾移植患者应用CsA后出现排斥反应,经用甲泼尼龙(MP)0.5g/d×3d冲击治疗效果不佳,改用FK506治疗,FK506的浓度维持在8～12μg/L左右,临床症状减轻,免疫及生化指标逐渐好转,为治疗有效.治疗无效者主要改用单克隆抗CD3抗体(OKT3)治疗.结果本组26例耐激素性排斥经改用FK506后,23例分别在8～15d逆转,肾功能恢复正常,治愈率88.46%(23/26).3例治疗效果不佳,使用血浆置换治疗和OKT35mg/d×5d后排斥逆转.26例肾功能全部恢复正常,但有3例出现高血糖.结论FK506治疗耐激素性排斥反应效果好,副作用小.治疗时应掌握诊断标准,注意监测血糖及生化指标.对于PRA高于30%的患者行血浆置换治疗,加用OKT3冲击治疗,可取得满意的效果.经上述治疗效果不佳者应及早切除移植肾,以保证患者的生命安全.