Biocompatibility of silk-tropoelastin protein polymers

Blended polymers are used extensively in many critical medical conditions as components of permanently implanted devices. Hybrid protein polymers containing recombinant human tropoelastin and silk fibroin have favorable characteristics as implantable scaffolds in terms of mechanical and biological properties. A firefly luciferase transgenic mouse model was used to monitor real-time IL-1β production localized to the site of biomaterial implantation, to observe the acute immune response (up to 5 days) to these materials. Significantly reduced levels of IL-1β were observed in silk/tropoelastin implants compared to control silk only implants at 1, 2 and 3 days post-surgery. Subsequently, mice (n = 9) were euthanized at 10 days (10D) and 3 weeks (3W) post-surgery to assess inflammatory cell infiltration and collagen deposition, using histopathology and immunohistochemistry. Compared to control silk only implants, fewer total inflammatory cells were found in silk/tropoelastin (∼29% at 10D and ∼47% at 3W). Also fewer ingrowth cells (∼42% at 10D and ∼63% at 3W) were observed within the silk/tropoelastin implants compared to silk only. Lower IL-6 (∼52%) and MMP-2 (∼84%) (pro-inflammatory) were also detected for silk/tropoelastin at 10 days. After 3 weeks implantation, reduced neovascularization (vWF ∼43%), fewer proliferating cells (Ki67 ∼58% and PCNA ∼41%), macrophages (F4/80 ∼64%), lower IL-10 (∼47%) and MMP-9 (∼55%) were also observed in silk/tropoelastin materials compared to silk only. Together, these results suggest that incorporation of tropoelastin improves on the established biocompatibility of silk fibroin, uniquely measured here as a reduced foreign body inflammatory response.     

胰岛素自我注射者皮下脂肪增生现状与危险因素的调查分析

目的探讨自我注射胰岛素患者皮下脂肪增生现状与危险因素。方法选择我院2017年6月至2018年6月门诊自我注射胰岛素发生皮下脂肪增生患者100例作为研究对象,选择同期100例未发生皮下脂肪增生的自我胰岛素注射患者作为对照,确定皮下脂肪增生发生的危险因素。结果多因素logistic回归分析显示,年龄>60岁、胰岛素注射不规范、糖尿病病程>10年、胰岛素应用时间≥3年、同一针头应用次数>10次,胰岛素注射用量均是皮下脂肪增生发生的独立危险因素(P<0.05)。结论胰岛素自我注射者皮下脂肪增生发生与其年龄、病程以及胰岛素自我注射规范性密切相关,可给予针对性干预措施,以减少皮下脂肪增生的发生率。     

A型肉毒毒素注射治疗眉间纹的高频超声研究

【摘要】 目的 研究A型肉毒毒素治疗眉间纹引起的皮肤及其下肌层的厚度改变。方法 收集北京协和医院2017年8月至2018年2月注射A型肉毒毒素治疗的26例中重度眉间纹受试者,于注射前及注射后4周、16周,采用50 MHz高频超声检测注射部位皮肤的真皮层厚度,20 MHz高频超声检测皮肤全层和肌层厚度。采用单组重复测量资料的方差分析、配对t检验及Bonferroni法比较受试者注射治疗前后3个时间点超声检测的组织厚度。结果 注射前,真皮层、皮肤全层和肌层厚度分别为（2.01 ± 0.48）、（4.32 ± 0.73）、（4.51 ± 0.67） mm。注射前、注射后4及16周真皮层厚度差异无统计学意义（F = 1.94,P = 0.199）,而皮肤全层厚度、肌层厚度差异均有统计学意义（F = 6.28、24.19,P = 0.020、 < 0.001）。与注射前相比,注射后4周皮肤全层厚度显著增加（4.88 ± 0.93 mm,t = 3.72,P = 0.004）,而肌层厚度显著降低（3.82 ± 0.79 mm,t = 4.65,P = 0.001）。与注射前和注射后4周相比,注射后16周时皮肤全层厚度（4.61 ± 0.73 mm）和肌层厚度（4.38 ± 0.90 mm）差异均无统计学意义（均P > 0.0167）。结论 注射A型肉毒毒素可改变皮下组织和肌层厚度,高频超声可用于A型肉毒毒素注射治疗眉间纹的疗效评价及随访。     

揿针围刺治疗急性期带状疱疹患者的疗效观察及护理

目的 观察揿针围刺疗法治疗急性期带状疱疹的临床疗效。 方法 收集2017年2月至2018年2月就诊于我院疼痛科及皮肤科门诊的急性期带状疱疹患者60例,将其随机分为观察组(30例)和对照组(30例),对照组给予常规护理,观察组则在对照组基础上运用揿针围刺疗法,比较2组止疱时间、结痂时间、脱痂时间及疼痛评分。 结果 观察组止疱时间、结痂时间、脱痂时间均早于对照组(P<0.05);而VAS评分低于对照组(t=2.269,P=0.027)。 结论 揿针围刺疗法联合常规护理是治疗急性期带状疱疹的有效方法,可控制急性炎症,提高日常生存质量。     

Intra- and interindividual variation in gene expression in human adipose tissue

Adipose tissue is a highly plastic tissue with an important endocrine and metabolic function. To understand its role in human health and disease, it is necessary to understand the extent of variation and the specific differences within and between different depots and subjects. We employed cDNA microarray analysis to investigate this in human subjects ranging from lean to mildly obese. We observe (1) high similarity between different samples of one adipose depot, (2) only small differences between the subcutaneous and visceral adipose tissue depot and (3) larger differences in gene expression between different individuals (per depot). The major variation within adipose depots can be attributed to differences in the non-adipocyte component of adipose tissue. Using only non-obese subjects, we identified genes that were consistently differentially expressed between subcutaneous and omental adipose tissue, despite the variation in gene expression between these subjects. Using quantitative real time polymerase chain reaction (PCR), fatty acid binding protein 4 (FABP4), vimentin (Vim), four and a half LIMs domains (FHL1), CD36 (all higher in subcutaneous adipose tissue) and Matrix Gla protein (MGP; lower in subcutaneous adipose tissue) were confirmed to be significantly differentially expressed between depots.     

可吸收多糖微球的制备及生物相容性研究

采用淀粉为主要原料经乳化交联制备一种具有微孔结构的新型可降解止血材料。并根据GB/T16886医疗器械生物学评价标准规定的皮内反应试验、致敏试验、全身急性毒性试验和植入试验方法评价可吸收多糖微球的生物相容性,同时与进口微球作对比,以验证其安全性。试验结果显示无皮内反应、无致敏、无全身急性毒性、肌肉植入2周后未见固形物,无明显组织反应。可吸收多糖微球具有良好的生物相容性,符合临床使用要求。     

Combining desloratadine and pseudoephedrine in the treatment of seasonal allergic rhinitis

Nonsedating antihistamines are a first-line therapy in the management of allergic rhinitis. They relieve the majority of the histamine-mediated symptoms of the condition, including rhinorrhea, sneezing, and pruritus. The nonsedating antihistamine desloratadine is effective in alleviating the symptoms of both seasonal and perennial allergic rhinitis. It may also have some decongestant properties, and thus help to alleviate nasal congestion. Administering desloratadine in combination with the decongestant pseudoephedrine may offer allergic rhinitis patients with moderate-to-severe nasal congestion the benefits of desloratadine’s effectiveness for alleviating histamine-mediated symptoms plus pseudoephedrine’s relief from nasal congestion. This drug profile reviews a combination therapy containing desloratadine and pseudoephedrine, approved in the USA for the relief of the symptoms of seasonal allergic rhinitis, including nasal congestion.     

骨膜去细胞生物支架的制备和鉴定

目的 制备兔骨膜去细胞生物支架,为骨缺损、骨不愈的组织工程研究提供天然的生物支架材料。 方法 取健康新西兰大白兔,游离双侧胫骨近端内侧骨膜,通过物理冻融（-80℃,24h）、去污剂洗脱（triton-X 100、SDS）和酶消化（DNA酶、RNA酶）获取骨膜去细胞生物支架。通过HE染色、DAPI染色、琼脂糖电泳和基因组DNA定量分析(n=5)测定细胞结构及DNA成分残留;Masson染色和羟脯氨酸测定法(n=6)定性定量检测骨膜细胞外基质的主要成分（胶原）的保留情况;扫描电子显微镜下观察骨膜去细胞生物支架的表面微结构;CCK8法检测支架浸提液毒性;皮下包埋实验(n=4)观察该支架的免疫排斥反应。 结果 HE染色和4’,6-二脒基-2-苯基吲哚（DAPI）染色表明去细胞支架无残留细胞;琼脂糖电泳未见明显DNA条带;DNA定量检测显示组织去细胞率达95%以上;Masson染色及羟脯氨酸测定表明去细胞支架胶原成分被保留;扫描电子显微镜下细胞外基质呈现三维网状疏松结构;不同体积分数的浸提液对骨膜细胞的增殖与对照组（普通培养基）比较无明显抑制作用（P＞0.05）;异体皮下包埋实验显示,该去细胞支架免疫排斥反应不明显。 结论 运用物理冻融、去污剂洗脱和酶消化等方法所获取的骨膜去细胞生物支架细胞去除彻底,细胞外基质的结构及主要成分保留完好,生物相容性良好。     

早期持续壁负压吸引对乳腺癌术后皮下积液预防作用的临床评价

目的 通过对乳腺癌改良根治术后患者的临床病例资料统计对比分析,探讨术毕即刻持续壁负压吸引对乳腺癌患者术后皮下积液发生率的影响.方法 回顾性分析2011年6月至2012年9月改良根治术治疗的120例乳腺癌患者临床病例资料,将其随机分为三组：试验A组40例患者双管引流,术毕即刻外接壁负压持续吸引,24h后改为每2 h一次（q2 h）间断壁负压吸引;试验B组40例患者双管引流,术毕24h后外接壁负压q2h间断吸引;对照C组40例患者双管引流,术毕外接普通负压鼓引流,比较三组对术后皮下积液发生的影响.结果 三种不同术后引流方式对皮下积液发生率（x2=12.834,P＜0.05）、置管天数（x2=14.064,P＜0.05）及皮下积液累及范围（x2=12.468,P＜0.05）的影响均具有统计学差异.术毕即刻持续壁负压吸引组（A组）与对照组（C组）比较,积液发生率降低（x2=12.624,P＜0.05）,置管天数缩短（x2=11.665,P＜0.05）,积液累及范围减小（x2=11.25,P＜0.05）;与间断壁负压吸引组（B组）比较,积液发生率降低（x2 =4.114,P＜0.05）,置管天数（x2=1.127,P＞0.05）及积液累及范围（x2=2.222,P＞0.05）统计学差异不明显.结论 术毕即刻持续壁负压吸引较间断壁负压吸引及传统吸引方式更好的预防皮下积液的发生,临床统计数据具有统计学意义.