复方壳多糖真皮替代物体外抗菌作用的研究

目的 研究复方壳多糖真皮替代物对金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌、白念珠菌的体外抑菌作用。方法 制备复方壳多糖真皮替代物和复方胶原凝胶真皮,分别为实验组和对照组,各取50μL滴加在涂满细菌或真菌的平板,每种菌实验组和对照组样本各6个,孵育24h后观察抑菌环。结果 复方壳多糖真皮替代物对金黄色葡萄球菌、大肠埃希菌、铜绿假单胞菌具有抑菌作用,抑菌环均大于复方胶原凝胶真皮替代物,差异有统计学意义。两组对白念珠菌无抑菌作用。结论 复方壳多糖真皮替代物是有体外抗细菌作用的组织工程产品。     

Is dermis fat arthroplasty better than plain gap arthroplasty? A prospective randomised controlled trial

The aim of the study was to compare interpositional arthroplasty using a dermis fat graft with gap arthroplasty in the management of ankylosis of the temporomandibular joint (TMJ). We organised a prospective randomised study of 22 patients who presented with ankylosis of the TMJ. They were randomised to be treated with either plain gap arthroplasty or dermis fat arthroplasty, and the predictor variable was the method of treatment. The primary outcome variables were mouth opening and pain on jaw exercises. Pain and interincisal opening were measured on day 5, day 14, at the end of one month, and at six months, one year, two years, and three years. There was a significant difference between the two groups on two occasions: postoperative day 5 (p = 0.013) and at one year (p = 0.018). The mean (SD) scores for mouth-opening were higher in the dermis fat group at all times (41.20 (4.69) mm compared with 39.50 (2.46) mm in gap arthroplasty at two years, and 41.40 (3.60) mm compared with 38.9 (2.02) mm at three years). The visual analogue pain scores were also lower in the dermis fat graft group. The groups showed similar results at the end of three years follow up, with no significant difference in mouth opening. We conclude therefore that the two techniques have similar outcomes in the management of ankylosis of the TMJ.     

异种脱细胞真皮基质抗原性的实验研究

目的　观察不同方法制备的异种脱细胞真皮基质 (Xeno -ADM )埋植物的抗原性差异。　方法　将猪断层中厚皮片采用胰蛋白酶 +tritonX 10 0等处理 ,制成Xeno -ADM ,分为戊二醛交联的Xeno ADM1组、网状交联的Xeno ADM2 组、未交联的Xeno ADM3 组、动物先用Xeno ADM蛋白致敏后再移植交联的Xeno ADM4组和未交联的异体兔Allo ADM对照组。分别将移植物埋植于 5组共计 2 5只日本白兔的耳部和背部皮下 ,术后 2～ 32周检测兔血清抗ADMs抗体效价 ,并观察移植物大体和组织学变化。　结果　Xeno ADM4埋植物组血清抗Xeno ADM蛋白抗体效价最高 ;排除致敏因素的影响 ,Xeno ADM各组血清抗体滴度依次为 :Xeno ADM3 组 >Xeno ADM2 组 >Xeno ADM1组 (P<0 .0 5～ 0 .0 0 1) ;在Allo ADM组中 ,有 4 0 %的血清样本呈现出抗Allo ADM蛋白抗体阳性。组织学上 ,Xeno ADM移植部位有激烈而持久的炎症反应 ,明显强于Allo ADM异体埋植对照组 ;ADM被降解吸收的程度依次为 :Xeno ADM3 >Xeno ADM2 >Xeno ADM4>Xeno ADM1>Allo ADM (P <0 .0 5～ 0 .0 0 1) ,在交联型ADM组易产生异物巨细胞反应。　结论　Xeno ADM的免疫原性强于Allo ADM ,诱导宿主产生IgG限制的免疫反应 ;大张变性的ADM埋植物能降低抗原 抗体反应 ,减缓炎症免疫反应导致的ADM     

不同厚度真皮组织缺损与增生性瘢痕形成的关系

目的探讨损伤后不同厚度真皮组织缺损与增生性瘢痕发生之间的关系。方法选择四肢部位供皮区共32处作为研究创面，分为刃厚皮供皮区(A组)、中厚皮供皮区(B组)，再根据是否移植具有一定厚度的自体皮片，将A组分为A1组(刃厚皮不植皮组)、A2组(刃厚皮植皮组)；将B组分为B1组(中厚皮不植皮组)、B2组(中厚皮植刃厚皮组)、B3组(中厚皮植中厚皮组)。留取所取皮片及移植皮片标本，计算机测量所取皮片及移植皮片的真皮厚度；术后6个月，应用温哥华瘢痕评估量表评估上述供皮区瘢痕形成及增生程度。结果A组缺损真皮厚度在0．146～0．163mm之间，B组缺损真皮厚度在0．456—0．656mm之间；随着真皮缺损的增加，愈合后瘢痕温哥华评分值也相应增加；缺失真皮的创面回植自体皮片后，其术后瘢痕评分值会相应减少，并与移植皮片厚度成反比。结论真皮组织缺损厚度与瘢痕增生的程度成正比，真皮组织的回植可减轻瘢痕增生。     

巢蛋白在人真皮成纤维细胞中的表达

目的探讨巢蛋白(nestin)在人皮肤真皮组织成纤维细胞(adu lt hum an derm is fibrob lasts,HDF)中的表达。方法采用体外培养、免疫组织/细胞化学技术检测巢蛋白在6例成人皮肤真皮组织及体外培养3、5、7、10、12代龄皮肤真皮成纤维细胞中的表达,计数分析人皮肤真皮组织成纤维细胞中巢蛋白+成纤维细胞数量,权重法分析体外培养成纤维细胞各代间巢蛋白的表达差异。结果人皮肤真皮组织中,巢蛋白+成纤维细胞表达数量占成纤维细胞总数(9.5±3.0)%,其数量为(103.3±67.4)个/mm2。与人皮肤真皮组织巢蛋白+成纤维细胞的表达数量相比,体外培养的真皮成纤维细胞中巢蛋白+成纤维细胞数量明显升高,并出现代龄之间的差异(P<0.05),其中第7、10代细胞表达量高于第5、12代细胞,第3代细胞最少(P<0.05)。结论在人皮肤真皮组织成纤维细胞中存在着巢蛋白+成纤维细胞。体外培养条件下,人皮肤真皮巢蛋白+成纤维细胞数量增加,提示体外培养作为刺激因子可能使成纤维细胞反分化为其前体细胞,作为干细胞标志物的巢蛋白有可能成为用于成纤维前体细胞鉴定的标志物之一。     

Dermal pharmacokinetics of pyrazinamide determined by microdialysis sampling in rats

Studies have demonstrated the efficacy of pyrazinamide (PZA) against stages of the Leishmania parasite that causes cutaneous leishmaniasis. Although PZA is widely distributed in most body fluids and tissues, the amount of drug reaching the skin is unknown. This study aimed to investigate the pharmacokinetics of PZA in rat dermal tissue by dermal microdialysis. Skin pharmacokinetics was assessed by implanting a linear microdialysis probe in the dermis of ten rats. In addition, blood samples were collected to assess plasma pharmacokinetics. Unbound microdialysate (N?=?280) and plasma (N?=?120) concentrations following single intravenous doses of 25?mg/kg or 50?mg/kg PZA were quantified by a validated HPLC method. Probe calibration was performed by retrodialysis. Non-compartmental analysis and non-linear mixed-effects modelling were performed using WinNonlin and NONMEM v.7.3. PZA rapidly permeated into the dermis and reached high levels, with mean maximum concentrations (C_max) of 22.4?±?7.1?µg/mL and 48.6?±?17.3?µg/mL for the two doses studied. PZA showed significant distribution to the skin (fAUC_dermal/fAUC_plasma?=?0.82?±?0.31 and 0.84?±?0.25 for 25?mg/kg and 50?mg/kg doses, respectively). Active unbound concentrations in dermal tissue reached lower levels than free plasma concentrations, indicating that free PZA levels in plasma were in equilibrium with tissue levels. These results showed equivalent unbound drug tissue concentrations and corresponding unbound plasma levels. This study shows that PZA distributes rapidly into dermal interstitial fluid space in rats and therefore may be a potential agent in the treatment of cutaneous leishmaniasis.     

Elastolyse der mittleren Dermis und anuläres elastolytisches Riesenzellgranulom: Unterschiedliche Stadien im klinischen Spektrum der dermalen Elastolyse? Fallbericht und Literaturübersicht

Zusammenfassung In den letzten Jahren fanden die Erkrankungen mit Elastolyse im Bereich der Dermis vermehrt Beachtung. Die Elastolyse der mittleren Dermis ist eine seltene Erkrankung bislang ungekl?rter ?tiologie, die histologisch durch einen umschriebenen Verlust der elastischen Fasern im Bereich der mittleren Dermis gekennzeichnet ist. Es wurden fl?chige und papul?se, inflammatorische und nicht entzündliche Formen beschrieben. Wir berichten über eine 70j?hrige Patientin, bei der die klinischen und histologischen Befunde im Zentrum der anul?ren Herde dem Bild einer nicht entzündlichen Elastolyse der mittleren Dermis entsprachen, w?hrend der ger?tete, leicht erhabene Randwall der Hautver?nderungen Züge eines anul?ren elastolytischen Riesenzellgranuloms aufwiesen. Anhand unseres Fallberichtes und einer Literaturübersicht diskutieren wir die Differentialdiagnose der Hautver?nderungen mit dermaler Elastolyse und postulieren, da? die Hautver?nderungen mit beschriebener Elastolyse in der mittleren Dermis unterschiedliche Stadien einer Erkrankung darstellen, die überlappen oder ineinander übergehen k?nnen. Eingegangen am 4. Oktober 1995, Angenommen am 31. Januar 1996