慢性束缚应激对小鼠认知功能及海马不同亚区星形胶质细胞的影响

目的 探讨慢性束缚应激(CRS)对小鼠认知功能的影响,观察海马不同亚区(CA1、CA3和DG区)星形胶质细胞(AS)的激活情况,明确慢性应激对海马的损伤是否存在特异性靶点.方法 雄性KM小鼠24只按体质量随机分为对照组和应激组,每组各12只.采用慢性束缚方法建立小鼠CRS模型,利用新异物体识别实验(NORT)和Morris水迷宫(MWM)评测其认知功能,HE染色观察细胞的形态结构变化,免疫组织化学染色法对海马CA1、CA3和DG区AS标志物胶质纤维酸性蛋白(GFAP)进行染色,采用显微镜和图像分析软件对海马上述亚区AS进行计数并分析GFAP的表达.结果 与对照组相比,应激组小鼠NORT及MWM实验的成绩均显著下降(P＜0.05),海马神经元形态结构损伤,CA1和CA3区AS细胞数及GFAP表达均显著增加(P＜0.05),DG区两者均无显著变化(P＞0.05).结论 CRS能够导致小鼠认知功能障碍,海马CA1、CA3区AS的活化可能是其机制之一.     

近发际缘内头皮冠状切口径路在耳鼻咽喉头颈外科手术中应用的临床意义

目的探讨近发际缘内头皮冠状切口手术径路在耳鼻咽喉头颈外科手术中的临床意义。方法采用经近发际缘内头皮冠状切口入路,行颧骨复合体骨折切开复位内固定术20例;额窦巨大囊肿4例;额窦骨瘤2例;额部良性肿块2例,分析、观察总结此切口的优缺点。结果28例疗效满意,所有切口均I期愈合,无面部切口瘢痕遗留、术后面神经瘫痪、脑膜撕裂脑脊液漏出现。结论近发际缘内头皮冠状切口手术入路,在颅脑及颌面外科经常使用。在耳鼻咽喉头颈外科手术中应用此切口,术野显露充分,对比颜面部中上份一些传统入路难以操作的手术更方便,更能提高手术质量。直视下的手术能避免在该区域手术操作中的面神经损伤脑膜损伤脑脊液鼻漏的并发症,同时也隐藏了颜面部的手术切口瘢痕达到术后面部美观之功效。该切口是面中上份手术切口径路的理想选择,值得在耳鼻咽喉头颈外科手术中应用推广。     

曲安奈德抑制兔耳瘢痕增生与氧自由基作用的初步研究

目的 了解曲安奈德局部注射对兔耳增生性瘢痕组织中丙二醛含量的影响,并探讨曲安奈德抑制兔耳增生性瘢痕的作用与氧自由基的关系. 方法 新西兰兔共18只,随机选取其中的14只制作兔耳增生性瘢痕模型,4只作为正常兔耳皮肤组织标本,共8例;兔耳增生性瘢痕组织标本28例,随机分为曲安奈德组(10例)、生理盐水组(10例)、空白对照组(8例).制模术后6周予曲安奈德原液(1 ml:40 mg)分点注射于瘢痕样组织内,每处2～3点,总量0.3～0.4 ml,每周1次,3次为一疗程.制模术后9周取材,显微镜下记数成纤维细胞,并用测微尺测量瘢痕的相对增生厚度,以计算瘢痕增生指数,采用分光光度法测定丙二醛含量变化. 结果 ①大体形态学变化:曲安奈德局部治疗3周后,瘢痕颜色接近兔耳的正常肤色,略高出皮面,表面平整,触之质软.②组织学变化:与空白对照组、生理盐水组比较,曲安奈德组胶原纤维多为平行排列,数量减少.③成纤维细胞密度与瘢痕增生指数变化:与正常皮肤组比较,空白对照组以及生理盐水组成纤维细胞密度增高(P＜0.05),而曲安奈德组则无显著性差异(P＞0.05);生理盐水组与空白对照组间成纤维细胞密度及瘢痕增生指数比较差异无统计学意义(P＞0.05),与此两组比较,曲安奈德组则显著降低(P＜0.05).④丙二醛含量变化:与空白对照组、生理盐水组、正常皮肤组比较,曲安奈德组丙二醛含量明显增高(P＜0.05);生理盐水组与空白对照组间比较差异无统计学意义(P＞0.05);与正常皮肤组比较,空白对照组和生理盐水组丙二醛含量增高(P＜0.05). 结论 曲安奈德局部注射引起兔耳增生性瘢痕组织中氧自由基水平进一步升高.     

A型肉毒毒素对增生性瘢痕成纤维细胞增殖、凋亡及对ERK/MAPK信号通路的影响

目的 探讨A型肉毒毒素对体外培养的人增生性瘢痕成纤维细胞增殖、凋亡及对ERK/MAPK信号通路的影响。方法 采用组织块法将人增生性瘢痕成纤维细胞分离并培养。将其分为对照组及A型肉毒毒素组。A型肉毒毒素组则给予含有0.4U/L A型肉毒毒素的DMEM培养基进行培养。对照组采用单纯DMEM培养基培养。在第1、3、5、7天时采用CCK8试剂盒检测细胞增殖并比较。采用流式细胞术对对照组和A型肉毒毒素干预的成纤维细胞行凋亡检测。Western blot法检测对照组、A型肉毒毒素组及U0126干预组成纤维细胞Ⅰ型胶原蛋白（collagen Ⅰ）, p-ERK1/2及总ERK蛋白相对表达量。结果 A型肉毒毒素能够显著抑制成纤维细胞增殖活性,干预7天时,细胞数量仅为对照组的68.9%。A型肉毒毒素组成纤维细胞的凋亡比率为35.9%,显著高于对照组。三组成纤维细胞的总ERK1/2蛋白相对表达量比较差异无统计学意义（P>0.05）,而p-ERK1/2在对照组则仍显著高表达,但A型肉毒毒素组和U0126组的p-EKR1/2则显著受抑制,且低表达。Ⅰ型胶原蛋白则在对照组中高表达,显著高于A型肉毒毒素组和U0126组（P<0.05）。结论 A型肉毒毒素能够通过抑制ERK/MAPK信号通路而使得成纤维细胞凋亡增加,增殖活性减弱,Ⅰ型胶原蛋白分泌减少。     

剖宫产切口瘢痕缺损诊治的几个问题

剖宫产切口瘢痕缺损(cesarean scar defect,CSD)属于剖宫产远期并发症,是剖宫产切口瘢痕处的肌层愈合不良形成的凹陷结构[1].进行性升高的剖宫产率已成为严重的全球性公共卫生问题,我国的剖宫产率在2008年至2014年期间已经从28.8％上升到34.9％,二孩政策全面放开后会进一步增高.CSD可引发各...     

Glial Fibrillary Acidic Protein and Vimentin Expression Is Regulated by Glucocorticoids and Neurotrophic Factors in Primary Rat Astroglial Cultures

The neurotrophic factors epidermal growth factor (EGF), basic fibroblast growth factor, (bFGF), insulin‐like growth factor I (IGF‐I) and insulin (INS) regulate neural and astroglial cell functions. Glucocorticoids may influence the metabolism of astroglial compartment and are key hormones in neurodegenerative events. This study was designed to assess the interactions between growth factors and dexamethasone (DEX) on cytoskeletal proteins (GFAP and vimentin) expression in 25 days in vitro (DIV) astrocyte cultures. An increase in GFAP and vimentin expression was observed after 12 h pretreatment with bFGF and subsequent treatment for 60 h with DEX. GFAP immunoreactivity was decreased after 24 h progression growth factors (EGF, IGF‐I and INS) addition, when compared to control 36 h DEX and bFGF‐pretreated cultures for the last 12 h. Vimentin immunoreactivity was decreased after 12 h bFGF pretreatment and subsequent 60 h DEX addition in astrocyte cultures compared to 12 h bFGF‐pretreated ones. Pretreatment for 36 h with DEX plus bFGF in the last 12 h and subsequent treatment for 24 h with DMEM (Dulbecco's modified Eagle medium; DMEM) + BSA (bovine serum albumine) (harvesting), or with progression growth factors (EGF, IGF‐I or INS) alone or two of them together, stimulated GFAP expression, compared to untreated controls. Immunochemical analysis of the mitogen‐activated protein kinase ERK2 suggests an involvement of this enzyme in the control of GFAP expression. The above findings support the view of an interactive and complex dialogue between growth factors and glucocorticoids during astroglial cell proliferation and maturation in culture. This may have implications in therapeutic approach of neurologic disorders associated with astrogliosis, including cerebrovascular disease.     

Comparison of efficacy and safety of intralesional triamcinolone and combination of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: Randomised control trial

The treatment of keloid and hypertrophic scar is challenging with no universally accepted mode for permanent ablation. Conventional therapies yield unpredictable results, significant complications and require elaborate hardware.

髙频超声技术对乳腺癌和乳腺术后放射样瘢痕对比研究

目的 :研究乳腺术后放射状瘢痕与乳腺癌超声表现的鉴别诊断。方法 :回顾分析我院自2010年8月至2013年8月以来,于我科实施乳腺局部切除经复查超声示放射样癒痕的70例患者临床资料(研究组),及70例乳腺癌患者临床资料(对照组),两组均予高频超声检查,观察对比两组超声提示的生长方式、边缘、形状、后方回声、、回声特点、腋窝淋巴结血供情况和肿大特点,测量研究组放射状瘢痕手术前后的THC(血红蛋白总浓度)。结果 :研究组形状不规则70例(100.0%),对照组61例(87.1%),不具差异;研究组晕环征0例(0.0%),对照组56例(80.0%),差异显著;研究组肿块横切面宽度/厚度>2共60例(85.7%),对照组0例(0.0%),差异显著。结论 :乳腺术后放射状瘢痕与乳腺癌通过高频超声下敏感性指标对比,可以给临床提供诊断的可靠依据,并且能够降低重复活检,减轻患者痛苦,应予推广。     

Treatment of heterotopic caesarean scar pregnancy complicated with post termination increase in size of residual mass and morbidly adherent placenta

We report a case of a secundipara with heterotopic cesarean scar pregnancy (HCSP) treated with potassium chloride injection into the ectopic embryo followed by sac aspiration. The remaining “mass” increased in size threefold and was surrounded by a rich vascular network. An arteriovenous malformation was suspected; however, appropriate treatment was precluded because of the viability of the ectopic gestation. Sonographic examination revealed a morbidly adherent placenta, and attempt to resect the mass laparoscopically was complicated by bleeding that required hysterectomy. This case illustrates a complication of the intervention performed to preserve the intrauterine gestation in case of HCSP. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46 :227–230, 2018