海水浸泡踝、膝关节开放损伤的治疗

目的探讨海水浸泡踝、膝关节开放损伤的治疗。方法自1986年2月至2003年1月，海水浸泡踝、膝关节开放损伤共41例47个关节均于彻底清创后关节内骨折复位内固定，一期闭合创面，一期行局部皮瓣或肌皮瓣转移修复关节周围软组织明显缺损。结果皮瓣或肌皮瓣全部存活。创部Ⅱ／甲愈合25个关节(占51．2％)，Ⅱ／乙愈合18个关节(占38．3％)，仅4个关节出现感染征象(占8．5％)。随访6个月至16年10个月，关节内骨折均愈合，踝、膝关节功能恢复满意，膝关节功能优6例，良4例，可1例；踝关节功能优14例，良8例，可1例，差1例。但是，伤后5～7a以上者均出现不同程度的关节退变表现。结论海水浸泡时间不超过2h、伤后时间在6～8h以内的踝、膝关节开放损伤均可于彻底清创后一期处理关节内骨折和闭合创面，局部皮瓣或肌皮瓣转移修复软组织缺损是可行的。     

玻璃纤维增强聚氯乙烯界面结构优化及性能研究

以两种硅烷偶联剂及成膜剂组成的浸润剂处理玻璃纤维，研究其增强聚氯乙烯复合材料的形态结构和软科学性能。经ＳＥＭ和ＦＴ－ＩＲ的研究结果表明：在浸润剂中添加了成膜剂后，复合材料的界面可以达到良好的结合状态，材料的力学性能也有明显提高。     

海水环境创伤弧菌感染的病理学研究

目的观察总结海水环境中感染创伤弧菌（vibrio vulnificus，Vv）后局部组织和器官的病理学特点，为临床Vv感染的诊治提供一定的实验依据。方法128只SPF级昆明小鼠，随机分成4组，每组32只，分别为海水Vv菌液浸泡组（A组）、等渗盐水Vv菌液浸泡组（B组）、单纯无菌海水浸泡组（c组）以及单纯无菌致伤组（D组）。每组又随机分成0，6，12，24h4个不同时间组，每组8只。D组小鼠仅无菌致伤，A、B、C组小鼠在无菌致伤后按分组设计均浸泡于相应液体中45～60min。于不同时段对各组局部肌组织及主要脏器组织进行取材、制片、HE染色和观察；采鼠尾血进行Vv的分离培养。结果A组创伤组织的损伤最为严重：0h时，可见肌纤维变性、溶解和断裂，但炎症反应不明显；12h时肌组织溶解坏死更加明显，肌间隙增宽，渗出及出血明显，并伴有大量中性粒细胞浸润；24h时，肌组织大片溶解坏死，微脓肿形成。总体来讲，Vv感染的A、B两组要比未感染的c、D两组病变严重，而组织修复过程也要缓慢。海水菌液浸泡组脱离浸泡后24h时仍无好转趋势，并且该组部分小鼠Vv血培养结果为阳性。Vv血培养阳性的小鼠其主要脏器也出现不同程度的损伤，以肺和肾脏的广泛出血性损伤为主。结论在海水环境中Vv经由皮肤伤口侵入后，其伤口往往表现为感染早、发展快且病变严重的特点。感染组织病理学特点为组织大片的溶解坏死和大量中性粒细胞浸润并伴有脓腔形成；Vv可经伤口人血，引发败血症，并导致小鼠肺、肾等多脏器的损伤。     

Fine structural deformation of the dermal capillary following immersion fixation procedure

The possibility of fine structural deformation related to skin biopsy and the subsequent immersion fixation procedure were investigated, because little attention has yet been focused on artifacts of the dermal microvasculature. Contraction of the material following biopsy removal was marked in skin regions with thin epidermis and resulted in capillary collapse. As the collapse of the vessels increased, lining cells became thicker and more rugged, endothelial fenestrations disappeared, and 10 nm filaments aggregated. Simultaneously, perivascular connective tissue material was separated from the dermal element in which the vessels were embedded and appeared as a homogenous areola around the endothelial tube. Basal lamina appeared folded and partially multilaminated around the vascular circumference, particularly in the venous segment of the microvasculature; these are considered to be the definite characteristics of dermal capillaries. In contrast to the skin regions with thin epidermis, the vessels in “well developed” dermal papillae did not collapse and bore close similarities to the perfused ones. The present study indicates that most of the so-called characteristics of dermal capillaries in biopsy skin is attributable to artifacts following the removal of the skin before fixation.     

Cold-induced vasodilatation in the foot is not homogenous or trainable over repeated cold exposure

Cold-induced vasodilatation (CIVD) is proposed to be a protective response to preserve tissue integrity in the extremities during cold exposure, but little research exists on either the trainability or the spatial pattern of CIVD response in the foot. We investigated the thermal response across the foot with repeated cold exposure. Ten healthy subjects immersed their left foot to the ankle in 8°C water for 30 min 5 days/week for 3 weeks. Skin temperature was recorded on the medial side of the nail bed of the 5 toes and the dorsum of the foot. The presence of CIVD, defined as an increase of 1°C at any time during cooling, was rare with our protocol. While a CIVD response was observed at least once in 8 of the 10 subjects, only 122 instances of CIVD were observed out of a total of 900 possible observations (10 subjects × 6 sites × 15 trials). Furthermore, thermal habituation was not evident, with toe temperatures at the end of each immersion (8–11°C) remaining near water temperature throughout the 15 sessions. Even within the two subjects exhibiting the most incidence of CIVD, high variability existed in the occurrence, magnitude, and/or onset times. Synchronicity was often observed where more than one toe exhibited CIVD, though the magnitude varied greatly (range 1–9°C). We conclude that, under realistic conditions of whole-foot immersion in cold water, CIVD is not a common or trainable response.     

腹腔开放伤大鼠海水浸泡后肝肾功能变化与胃黏膜损伤的关系

目的探讨腹腔海水浸泡对腹腔开放伤大鼠肝肾功能改变与胃黏膜损伤的关系。方法56只SD大鼠随机分为正常组、单纯腹部开放伤组及腹腔海水浸泡组,后两组又分为1h、2h、3h组,监测血清丙氨酸氨基转移酶(ALT)、尿素(Ure)、肌酐(Cr)及胃黏膜溃疡指数(UI)的变化。结果随着海水浸泡时间的延长,腹腔海水浸泡组大鼠胃黏膜UI与ALT、Ure、Cr均明显增高(P<0.05);且与UI存在正相关。结论腹腔海水浸泡可导致大鼠肝肾功能损伤,并与胃黏膜损伤密切相关。     

Enhanced osteointegration on tantalum-implanted polyetheretherketone surface with bone-like elastic modulus

Polyetheretherketone (PEEK) possesses a similar elastic modulus as bones but yet suffers from bio-inertness and poor osteogenesis. In this work, tantalum ions are implanted energetically into PEEK by plasma immersion ion implantation (PIII) to form Ta₂O₅ nanoparticles in the near surface. Nanoindentation reveals that the surface elastic modulus of the Ta ion implanted PEEK is closer to that of human cortical bones. In vitro cell adhesion, alkaline phosphatase activity, collagen secretion, extracellular matrix mineralization, and real-time PCR analyses disclose enhanced adhesion, proliferation, and osteogenic differentiation of rat bone mesenchymal stem cells (bMSCs) on the Ta-PIII modified PEEK. In vivo evaluation of the cortico-cancellous rat femur model by means of micro-CT, sequential fluorescent labeling, and histological analysis after 8 weeks confirms significantly improved osteointegration. The bone-like elastic modulus and modified surface topography of the Ta-PIII modified PEEK synergistically induce osteogenic differentiation of bMSCs and the surface-modified materials have large potential in dental and orthopedic implants.     

冷水束缚应激对大鼠脊髓背根神经节、胃组织内TRPV1 mRNA 及血清 SOD、MDA 的影响

目的：探讨不同时间的冷水束缚应激（ WIRS）对大鼠脊髓背根神经节（ DRG）和胃内瞬时受体电位香草酸亚型1（TRPV1） mRNA及血清超氧化物歧化酶（SOD）、丙二醛（MDA）的影响。方法选取40只雄性Wistar大鼠,随机分成4组：正常组（NC组,n＝10）、WIRS 2 h组（n＝10）、WIRS 4 h组（n＝10）和WIRS 6 h组（n＝10）,NC组不造模;WIRS 2 h组、WIRS 4 h组、WIRS 6 h组均用WIRS法复制急性胃黏膜病变模型,大鼠WIRS时间分别为2、4、6 h。于不同作用时间观察大体胃黏膜损伤变化,评定胃黏膜损伤指数;HE染色观察胃黏膜的损伤程度;实时荧光定量PCR法检测各组大鼠胸段DRG和胃内的TRPV1 mRNA的表达情况;测定各组大鼠血清中SOD、MDA的活力。结果 WIRS各组大鼠胃黏膜损伤明显,溃疡指数明显升高（ P＜0.05）。与NC组比较,WIRS各组胃组织内TRPV1 mRNA的表达均降低（ P＜0.05）;胸段DRG内TRPV1 mRNA在WIRS 6 h组的表达明显降低（ P＜0.05）。血清SOD活力先增高后降低,4 h时达到高峰;MDA随应激时间延长呈增高趋势,但在应激4 h时出现一下降过程。结论 TRPV1参与了急性胃黏膜病变的发生机制;血清中SOD、MDA的活力变化较好地反映出应激时机体氧化和抗氧化能力,有望在发现和评估应激性溃疡的发生中起重要作用。