Gene expression of early hypertrophic scar tissue screened by means of cDNA microarrays

BACKGROUND: Hypertrophic scar is an excessive healing response that often follows thermal injury. The most outstanding morphologic change is the overdeposition of collagen, which is caused by imbalance between synthesis and metabolism of collagen. Previous studies also found that transforming growth factor-beta was the key factor controlling scar formation. However, neither anti-transforming growth factor-beta nor other methods could completely control scar formation and contraction. This fact suggests a multifactorial cause. Fortunately, cDNA microarray throws light on the general alteration at the gene level, and thus could allow us to find some new clues for understanding scar formation and contraction. METHODS: In this article, we report the results obtained from the scanning of gene expression of hypertrophic scar by means of cDNA microarray. Five cases of early human postburn hypertrophic scars were selected. Total tissue RNA was extracted from each hypertrophic scar sample and the corresponding uninjured region skin tissue; mRNA was further purified by Oligotex and then was reversely transcribed to cDNAs with the incorporation of fluorescent dUTP to prepare the hybridization probes. The mixed probes were hybridized to the cDNA microarray containing 4,096 genes on a type of chemical material-coated glass slide. After high-stringent washing, the hybridized slides were scanned for fluorescent signal detection. Then, the expression and distribution of cytoskeletal genes such as alpha-smooth muscle actin (alpha-SMA) gene; fibroblast tropomyosin TM30(pl) gene; vimentin gene; profilin gene; and BM40 gene of hypertrophic scar at 3, 6, 9, and 12 months age were further quantitatively studied by in situ hybridization or immunohistochemistry. RESULTS: Our data indicated that there were 94 genes overexpressed and 3 genes down-regulated in early postburn hypertrophic scar. These altered genes were related to proto-oncogenes, apoptosis, immune regulatory genes, cytoskeletal elements, metabolism, and so forth. We also found that the detected cytoskeletal gene expression was much more intense at all time points than the control group. Consistent with clinical observation, cytoskeletal genes reached a peak at an early stage and gradually decreased. CONCLUSION: Our study implied that multiple genes are involved in scar formation and contraction. Interferon is an autosecreted cytokine that might be responsible for self-control of overgrowth of cells in wounds. The early period of hypertrophic scar formation might be a good time for preventing overgrowth and contraction of hypertrophic scar by gene therapy.     

大鼠碱烧伤创面切痂植皮时机的选择

目的:通过动物实验探讨碱烧伤创面的切痂与植皮时机.方法: 90只成年Wistar 大鼠制作皮肤Ⅲ度烧伤模型并随机分为A、B 2组,每组45只,分别于伤后1 h、2 h、4 h、8 h、12 h、24 h、48 h、72 h、96 h切痂,每个时点5只.A组切痂后立即植皮,B组切痂后延迟48 h植皮,测定大鼠痂下组织pH值,观察创面损伤情况以及植皮成活系数.结果:A、B组间pH值差异无统计学意义(F=2.635, P＞0.05), 且各时点间差异亦无统计学意义(F=0.953, P＞0.05); A组术后1～8 h切痂立即植皮,植皮成活系数高于12～48 h切痂立即植皮,B组8 h后各时点切痂延迟植皮,植皮成活系数高于8 h前各时点.切痂和植皮时间存在交互效应(F交互= 85.580,P＜0.05).结论:碱烧伤后1～96 h, 切痂时间和植皮时机对大鼠痂下组织pH值无明显影响;碱烧伤大鼠8 h内切痂,立即植皮与8 h后切痂延迟48 h植皮植皮成活系数较高,切痂和植皮时间存在交互效应.     

小儿尿路感染病原菌分布及耐药性分析

目的探讨小儿尿路感染的常见病原菌并分析其耐药情况。方法回顾性分析2018年1月至12月我院收治的108例尿培养阳性的尿路感染患儿的临床资料,分析其病原菌及抗菌药物耐药情况,并将患儿分为单纯尿路感染组(29例)和复杂尿路感染组(79例),对比两组革兰阴性菌耐药情况。结果共检出116株细菌,其中革兰阴性菌90株(77.59%),革兰阳性菌26株(22.41%)。其中大肠埃希菌、肺炎克雷伯菌、屎肠球菌为主要病原菌。革兰阴性菌对阿米卡星、亚胺培南、哌拉西林/他唑巴坦耐药率最低,在10%左右;对呋喃妥因、喹诺酮类药物耐药率在20%左右;对三、四代头孢菌素及其含酶抑制剂耐药率在30%~40%;未发现对万古霉素、利奈唑胺耐药的革兰阳性菌。革兰阳性菌对链霉素、呋喃妥因耐药率在0~20%。单纯尿路感染组与复杂尿路感染组中的革兰阴性菌对常见抗生素耐药率比较差异无统计学意义(P>0.05)。结论革兰阴性菌是尿路感染的主要病原菌,随着耐药情况的改变,可能需要改变经验性抗感染药物,呋喃妥因可以作为轻症患儿经验性应用的推荐,既往可能低估了单纯尿路感染病原耐药情况,需进一步研究。     

霍乱弧菌及其他致病弧菌DNA多态性的研究

目的 探讨霍乱弧菌和其它致病弧菌分子遗传特征及相互关系。方法 用聚合酶链反应（ＰＣＲ）,ＤＮＡ序列分析,随机扩增多态性ＤＮＡ（ＲＡＰＤ）和平行链锁聚类分析,对３株Ｏ１群古典型,４株Ｅ１ Ｔｏｒ型,３株Ｏ１３９群霍乱弧菌和副溶血等３株致病菌进行检测。结果 Ｏ１３９群霍乱弧菌和Ｏ１群含有的霍乱肠毒素（ＣＴＸ）基因,核苷酸序列同源性为９６．９％－９８．７％。     

胸液胆固醇对胸膜腔积液渗漏性的鉴别诊断价值

目的探讨胸液胆固醇浓度（Pch）及胸液与血清中胆固醇浓度（Sch）的比值（P／Sch）对胸膜腔积液渗漏性的鉴别诊断价值。方法检测154例胸腔积液患者Pch、Sch、胸液乳酸脱氢酶（PLDH）、血清乳酸脱氢酶（SLDH）、胸液蛋白质（Pprot）、血清蛋白质（Sprot）；并计算出P／Sch、胸液与血清蛋白比值（P／Sprot）、胸液与血清乳酸脱氢酶比值（P／SLDH）。分别研究Pch和P／Sch对胸膜腔积液渗漏性诊断的敏感性和特异性，并与Light标准等进行比较。结果Pch和P／Sch对胸膜腔积液渗漏性诊断的敏感性分别为91.5％和96.1％，特异性分别为87.5％和95.8％。P／Sch对胸膜腔积液渗漏性诊断的敏感性高于PLDH和P／Sprot(P＜0.05)，特性性高于Light标准和P／Sprot（P＜0.05）。结论Pch及P／Sch对胸膜腔积液的渗漏性具有很高的鉴别诊断价值。     

症状性冷凝集素综合征二例

例1,女性,10岁.指端、鼻尖、耳轮等暴露皮肤发生紫绀,皮肤冰凉并有麻木,微痛感觉,咳嗽伴发热5d,以支气管肺炎收入院治疗.     

刮除并植骨治疗四肢骨巨细胞瘤50例

目的 探讨刮除植骨治疗四肢骨巨细胞瘤的疗效。方法 将50例Ⅰ-Ⅱ级四肢骨巨细胞瘤彻底刮除，用3%碘酒在病损腔内反复涂擦，蒸馏水反复冲洗，然后植入自体骨。结果 经2-13年随访，优良率88%，3例复发，无截肢病例。结论 Ⅰ-Ⅱ级四肢骨巨细胞瘤采用该方法可获得较为满意的疗效。     

口服核素胆囊显相剂~(131)Ⅰ—甲苯胺蓝在小鼠体内的动态观察

~(131)I—甲苯胺蓝是一种口服胆囊显相剂。本实验采用LKB—2250PWV大型整体半自动冷冻切片机进行连续切片,用整体放射自显影术研究该药在小鼠体内的分布情况。本品口服后能很快吸收,进入到胆囊,并维持较长时间,而在胃肠及肝内分布较少。实验提示了该药可能通过肝肠循环进行代谢在胆囊聚集并通过胃肠道及肾脏排泄。     

地塞米松对家兔急性实验性血清病的调节作用

本实验观察了不同时间及剂量的地塞米松(DX)对家兔急性实验性血清病(AESS)的调节作用。结果发现DX并不抑制AESS家兔特异性抗体的产生。相反,早期给药组动物抗体水平还有增高趋势,循环免疫复合物(CIC)水平显著高于晚期给药及阳性对照组。晚期给药各组特异性抗体,CIC水平及肾组织超氧化物歧化酶活力与阳性对照组无显著差别,但肾组织非特异性酯酶染色及病理学改变明显减轻,提示DX可能是通过减少单核细胞在肾小球内的聚集而减轻AESS的病理改变。氧自由基在AESS发病中的作用尚待进一步探讨。     

床边连续性静脉-静脉血液透析滤过治疗重症急性肾功能衰竭临床疗效研究

目的:比较床边连续性静脉-静脉血液透析滤过(CVVHDF)与间歇性血液透析(IHD)治疗重症急性肾功能衰竭疗效。方法:收集我院2008年1月-2010年1月重症急性肾功能衰竭病例56例,分成两组,各28例,一组行床边连续性静脉-静脉血液透析滤过治疗,另一组采用间歇性血液透析。结果:CVVHDF治疗后尿素氮、肌酐、尿酸、K+、Na+、pH值较治疗前有显著的改善(P<0.05),CVVHDF与IHD相比对血压的影响更小(P<0.05)。CVVHDF组有效率78.5%(22例)高于IHD组有效率53.6%(15例)(P<0.05)。结论:CVVHDF治疗的效果优于IHD,能改善重症急性肾功能衰竭的预后。