烫伤大鼠垂体前叶P物质和降钙素基因相关肽神经的变化

目的　观察烫伤早期大鼠垂体前叶P物质 (SP)与降钙素基因相关肽 (CGRP)神经的形态分布变化。　方法　采用大鼠 30 %TBSAⅢ度烫伤模型 ,于伤后 1、2、6、10、12、2 4、72h 7个时相点 ,对垂体前叶SP和CGRP两种肽能神经行免疫组织化学染色观察 ;经图像分析测定 ,比较两种神经覆盖面积的变化。　结果　两种肽能神经的形态变化明显 ;伤后 1hSP、CGRP神经数目与对照相比分别增加 85 .7%和 6 0 .5 % ,神经纤维的膨体、分枝等明显增多 ;2h后减少 ,2 4h后趋于恢复。图像分析显示 :两种肽能神经的覆盖面积呈正相关变化 ,其基本变化趋势为伤后 1h升高 ,随后降低 ,伤后 12h降至最低点 ,然后回升。　结论　烫伤后早期大鼠垂体前叶的SP与CGRP神经形态分布发生明显变化 ,可能参与了全身应激反应的功能调节     

MR淋巴显像技术显示乳糜池和胸导管的研究

目的探讨非造影性MR淋巴显像技术对正常乳糜池和胸导管的显示情况以及它们的形态特点。方法对112例接受胸部和上腹部MR检查的病例加作MR水成像序列即呼吸门控快速自旋回波(TSE)3DT2W序列以显示乳糜池和胸导管,扫描序列包括:①呼吸门控半傅立叶单次激发快速自旋回波(HASTE)T2W序列;②屏气快速小角度激发(FLASH)T1W序列;③呼吸门控TSE3DT2W(MR水成像)冠状位扫描。将其中满足纳入标准的100例作为研究对象,观察乳糜池和胸导管的显示情况、位置和形态。结果在TSE3DT2W图像上:①乳糜池显示率为71.0%(71/100),其中单管型占43.7%(31/71),分支型(2～3支淋巴管汇合)占23.9%(17/71),网状型占32.4%(23/71);乳糜池平均长度4.5cm。②胸导管下段显示率为57.0%(57/100),平均直径0.23cm。③胸导管上段显示率为31.0%(31/100)。结论作为一种无创性方法,TSE3DT2W序列能较好地显示乳糜池和胸导管下段,结合横断面HASTE和FLASH序列,可以确定这些较大淋巴管结构的位置和解剖形态。     

小鼠胚胎生殖细胞体外培养

目的：研究胚胎生殖细胞的体外生长条件和分化潜能，探索从胚胎生殖细胞获得皮肤细胞的可能性。方法：在解剖显微镜下分离取出10天龄的胎鼠生殖嵴，消化法得到原生殖细胞，接种在胎鼠的成纤维细胞饲养层上，培养基使用α-MEM添加药用级的bFGF，或者添加成纤维细胞的上清液，配制成条件培养基。培养的细胞用形态学观察法，碱性磷酸酶染色法和诱导分化的方法来鉴定。结果：初步摸索出胚胎生殖细胞体外培养的简单方法，验证了它的分化潜力，观察到了神经细胞、心肌细胞、和表此样细胞。结论：本试验为简易条件下的胚胎生殖细胞的研究做出了有益的探索，为大规模获得表皮细胞提供了一个新的思路。     

平台髌骨角测量膝关节表面置换术髌骨高度的变化

目的研究平台髌骨角对于膝关节表面置换手术前后髌骨高度的准确性、可重现性,特点及不足,以及手术影响髌骨高度的变化因素。 方法选取吉林大学中日联谊医院骨科2015年1月到2016年1月资料完整的100例全膝关节置换术的患者作为研究样本,所有患者均为骨关节炎和类风湿性关节炎的病人,选取患者术前术后的膝关节侧位片,膝关节屈曲角度为30°。测量所选患者的术前术后膝关节侧位片平台髌骨角的。运用广泛使用的3种测定髌骨高度方法进行54例全膝关节置换患者手术前后侧位片的测量。3种方法为改良Black-burne-Peel指数,改良Caton-Desehamps指数和改良Insall-Salvati指数。由2名观察者使用标准的方法,独立的方式进行了524个数据的测量。对这2名观察者测量的数据进行组内相关系数(ICC)和95%可信区间的统计,对改良Black-burne-Peel指数,改良Caton-Desehamps指数、改良Insall-Salvati指数和平台髌骨角的术前术后数据进行配对t检验。 结果改良Insall-Salvati指数(术前ICC＝0.75;术后ICC＝0.87)、改良Black-burne-Peel指数(术前ICC＝0.65;术后ICC＝0.88)、改良Caton-Desehamps指数(术前ICC＝0.72;术后ICC＝0.88)和平台髌骨角(术前ICC＝0.86;术后ICC＝0.93)均具有更高的术后组内相关系数。其中,平台髌骨角的组内相关系数是最高的,患者术后的髌骨高度出现了降低。4种方法的术前术后数据比较显示,除了改良Insall-Salvati指数之外,改良Caton-Desehamps(t＝3.69)、改良Black-burne-Peel指数(t＝3.50)和平台髌骨角(t＝7.55)的测量均提示患者手术前后的髌骨高度差异具有统计学意义(均P<0.01)。 结论平台髌骨角在反应膝关节表面置换术的髌骨高度变化具有准确性、可重现性、直观、简洁、快速的优点,可以有效地评估膝关节表面置换术后患者髌骨高度的变化。     

Effects of WNK3 kinase on regulation of large-conductance calcium-activated potassium channels and its mechanisms

Objective To investigate the effects of WNK3 kinase on the regulation of large-conductance calcium-activated potassium channels (Maxi K channels) on African green monkey kidney fibroblast-like cells (Cos-7 cells) and its mechanisms. Methods (1) Cos-7 cells were transfected with 0, 0.6, 1.2, 1.8 μg WNK3 plasmid+0.5 μg Maxi K plasmid. The total protein expression of Maxi K channel and the phosphorylation of mitogen-activated protein kinase (MAPK) extracellular regulated kinase-1 and-2 (ERK1/2) were detected by Western blotting. (2) Cos-7 cells were divided into the control group (2.5 μg Maxi K plasmid) and the experimental group (2.5 μg WNK3 plasmid+2.5 μg Maxi K plasmid). Cell surface biotinylation was used to investigate the cell surface protein expression of Maxi K channel in Cos-7 cells. Immunoprecipitation and Western blotting were used to detect the ubiquitination of Maxi K channel protein. (3) WNK3 kinase was knocked down by WNK3 siRNA. The lysosomal degradation pathway was blocked by the proton pump inhibitor (Baf-A1). Cos-7 cells were divided into Maxi K+negative control siRNA group, Maxi K+WNK3 siRNA group and Maxi K+WNK3 siRNA+Baf-A1 group. The protein expression of Maxi K channel protein was detected by Western blotting. Results (1) Compared with those in 0 μg WNK3 plasmid groups, in 0.6, 1.2, 1.8 μg WNK3 plasmid groups the total protein expression of the Maxi K channel increased and the phosphorylation level of MAPK ERK1/2 reduced on a dose-dependent manner (all P＜0.01). (2) Compared with those in the control group, the total protein expression and cell surface membrane protein expression of the Maxi K channel increased in the experimental group (P＜0.01), while the ubiquitination of the Maxi K channel protein reduced (P＜0.01). (3) Compared with the Maxi K+negative control siRNA group, the expression of Maxi K protein reduced in the Maxi K+WNK3 siRNA group (P＜0.01), but did not change in the Maxi K+WNK3 siRNA+Baf-A1 group (P＞0.05). The expression of Maxi K protein in Maxi K+WNK3 siRNA+Baf-A1 group was higher than that in Maxi K+WNK3 siRNA group (P＜0.01). Conclusions WNK3 kinase inhibits the lysosomal degradation pathway of Maxi K channel protein by reducing the ubiquitination of Maxi K channel, and promotes the expression of Maxi K channel protein in cells and on cell membrane. These effects may be achieved by suppressing MAPK ERK1/2 signal transduction pathway.     

重组融合饰胶蛋白拮抗转化生长因子β1刺激增生性瘢痕成纤维细胞增殖的作用

目的　观察重组谷胱甘肽S -转移酶与饰胶蛋白的融合蛋白 (GST -Decorin)对转化生长因子 β1 刺激增生性瘢痕成纤维细胞的作用 ,探索瘢痕治疗的新方法。　方法　采用RT -PCR技术克隆饰胶蛋白 (Decorin)cDNA并连接到pGEX - 4T - 1载体上 ,大肠杆菌内表达GST -Decorin ;体外分离培养增生性瘢痕成纤维细胞 ,加入 1∶6 .2 5 ,1∶12 .5 0 ,1∶2 5 .0 0 ,1∶5 0 .0 0 ,1∶10 0 .0 0稀释度的GST -Decorin ,经四唑盐 (MTT)比色法测定细胞增殖速度 ;进一步将 2mg L的TGF - β1 或同时与 1∶12 .5 0的GST -Decorin加入培养基内 ,比较细胞增殖速度的变化 ,并应用原位杂交及图像分析观察细胞Ⅰ、Ⅲ型前胶原mRNA的表达。　结果　稀释度为 1∶6 .2 5～ 1∶2 5的GST -Decorin可有效地抑制瘢痕成纤维细胞的增殖速度 (P <0 .0 1或P <0 .0 5 ) ;1∶12 .5 0的GST -Decorin能完全拮抗 2mg L的TGF - β1 刺激细胞增殖及Ⅰ、Ⅲ型前胶原的mRNA表达。　结论　GST -Decorin可抑制体外培养的增生性瘢痕成纤维细胞增殖并拮抗TGF - β1 ,提示其具有潜在的治疗瘢痕增生的作用     

参附注射液对实验性急性坏死性胰腺炎肠道细菌移位的影响

目的：研究参附注射液对实验性急性坏死性胰腺炎（ANP）时肠道细菌移位的影响。方法：ANP大鼠制模方法采用胰腺被膜下注射牛磺胆酸钠。假手术组、对照组经皮下注射生理盐水，实验组同法给予等量参附注射液。取标本（下腔静脉血、腹水、肠系膜淋巴结及大肠内容物）进行细菌培养，计数菌落数及鉴定细菌种类。结果：标本中生长的细菌与大肠内容物培养细菌种类相同，实验组标本的菌落数少于对照组（P〈0.01）。结论：实验性ANP大鼠合并感染的细菌来源于肠道，参附注射液可以减少肠道细菌移位。     

Paradigm shift in gastrointestinal surgery − combating sarcopenia with prehabilitation: Multimodal review of clinical and scientific data

A growing body of evidence has demonstrated the prognostic significance of sarcopenia in surgical patients as an independent predictor of postoperative complications and outcomes. These included an increased risk of total complications, major complications, re-admissions, infections, severe infections, 30 d mortality, longer hospital stay and increased hospitalization expenditures. A program to enhance recovery after surgery was meant to address these complications; however, compliance to the program since its introduction has been less than ideal. Over the last decade, the concept of prehabilitation, or “pre-surgery rehabilitation”, has been discussed. The presurgical period represents a window of opportunity to boost and optimize the health of an individual, providing a compensatory “buffer” for the imminent reduction in physiological reserve post-surgery. Initial results have been promising. We review the literature to critically review the utility of prehabilitation, not just in the clinical realm, but also in the scientific realm, with a resource management point-of-view.     

Focal injection of vancomycin combined with surgical debridement–dermatoplasty in the treatment of pseudo-epitheliomatous granuloma

Background

Pseudo-epitheliomatous granuloma (PEG) can occur in some small skin wounds with secondary infections resulting from improper treatments. It is difficult to heal and can easily relapse.

Objectives

This study explores the clinical and pathological characteristics of PEG and effective treatments.

Patients and methods

Tissue specimens of PEG obtained from 11 patients (age range: 2–67 years) were sent for microbial examination and histological observation. The local lesions were treated by focal injection of vancomycin combined with surgical debridement–dermatoplasty.

Results

The diagnosis of PEG was based on histological examination, which revealed long epithelial peduncle encapsulated granulation tissue-like honeycomb in which more vessels, macrophages, lymphocytes and mast cells and less extracellular matrix were distributed. Bacteria such as Staphylococcus aureus, Bacillus pyocyaneus, ethylene-type Streptococcus, stool Streptococcus and F-citric acid Bacillus were found in the microbial culture of the specimens. They were tolerant to celbenin but sensitive to vancomycin. PEG could be cured by focal application of vancomycin combined with free skin or skin flap after thorough debridement. The relapse of PEG could be prevented by the therapy.

Conclusion

Focal injection of vancomycin combined with surgical debridement–dermatoplasty is an effective therapy for PEG.     

复合药物局部注射治疗瘢痕疙瘩临床观察

目的：观察得宝松联合5-氟尿嘧啶局部注射治疗增生性瘢痕和瘢痕疙瘩的疗效。方法：对37例增生性瘢痕和瘢痕疙瘩患者采用得宝松和5-氟尿嘧啶皮损内注射。结果：37例患者，临床治愈15例，显效21例，无效1例，总有效率为97．3％。结论：得宝松联合5-氟尿嘧啶治疗增生性瘢痕和瘢痕疙瘩疗效显著。