Fas系统参与介导烧伤后心肌细胞凋亡及牛磺酸的影响

目的观察Fas系统在烧伤后心肌细胞凋亡中的作用及牛磺酸的影响。方法选健康Wistar大鼠,随机分成对照组(Sham)、烧伤组(造成40%TBSAⅢ度烧伤)和牛磺酸保护组(烫伤后即刻腹腔注射牛磺酸400 mg/kg)。用原位末端标记(TUNEL)法检测凋亡细胞,RT-PCR检测Fas mRNA表达,免疫组化检测Fas/FasL和Caspase-8/3蛋白表达和荧光法分析Caspase-3活性。结果烧伤组大鼠伤后6 h和24 h心肌细胞凋亡指数分别为8.96±2.10和18.67±2.48,较对照组(0.92±0.34)有显著性升高,Fas蛋白阳性表达指数分别为13.51±1.56和14.55±1.89,也显著性高于对照组(2.46±0.75);Caspase-3活性分别为1.38±0.16和1.96±0.71,较对照组(0.35±0.06)有显著性差异。烧伤组凋亡指数与Fas表达之间有良好的相关性(r=0.86)。牛磺酸保护组细胞凋亡指数为2.14±0.68,Fas蛋白表达为3.71±0.82,Fas mRNA表达为0.17±0.03,Caspase-3活性为0.88±0.16,较烧伤组均有显著性降低。结论Fas系统参与了介导烧伤后心肌细胞凋亡,牛磺酸对烧伤后心肌细胞Fas表达及其信号转导有较好的拮抗作用。     

烧伤兔血清对培养内皮细胞的影响

本实验采用血管内皮细胞培养模型，动态观察了家兔烧伤（３０％Ⅲ度）早期烧伤表对内皮细胞结构和功能的影响，通过相差显微动态观察、台盘菜染色、ＨＥ染色光镜检查及扫描电镜观察。同时检测孵育不同时相点增减液中ＬＤＨ、６－ｋｅｔｏ－ＰＧＥ１α、ｔＰＡ及内皮细胞抗上板粘附能力变化。结果显示：（１）烧伤血清对内皮细胞有明显的损伤作用功能改变早于结构损害，而结构损害又以细胞间连接及其表达结构改变为早；（２）烧伤血     

大白鼠皮肤Ⅱ度、Ⅲ度碱烧伤模型复制

目的 根据大白鼠皮肤碱烧伤创面早期病理组织学观察复制Ⅱ、Ⅲ度碱烧伤模型,研究碱烧伤的临床治疗.方法 Wistar纯种健康大白鼠20只,以不同浓度2mol/l、2.5mol/l、5mol/lNaOH,作用时间分别为30秒、45秒、60秒、75秒,涂抹于脱毛后的表皮.结果 2mol/L(60s)、2.5mol/L(45s),5mol/L(30s)即可直接造成Ⅱ度～深Ⅱ度烧伤;2mol/L(75s)、2.5mol/L(60s)、5 mol/L(45s)即可造成Ⅲ度烧伤,其烧伤深度与NaOH溶液浓度和作用时间呈正比.结论 Ⅱ度、Ⅲ度碱烧伤均为渐进性烧伤,与文献中介绍的潜拙样损伤似乎不同.另外,不同浓度NaOH溶液在相同时间对皮肤组织的损伤及同一浓度NaOH溶液在不同时间对大白鼠皮肤的损伤病理学变化均有差异.     

应用和推广烧伤皮肤再生医疗技术的体会(二)

目的：通过临床实践总结、分析、认识干细胞与再生医学理论在烧伤创疡中的作用与效果；方法：应用MEBT／MEBO观察烧伤创疡创面的再生修复变化。结果：MEBT／MEBO治疗77种创疡疾病冶愈率达92％以上，有效率达100％。结论：MEBT／MEN)治疗慢性体表性溃疡及皮肤病性皮肤损伤、感染性溃疡效果满意。     

52例电烧伤的治疗分析

目的：总结电烧伤的治疗方法。方法：对52例资料齐全的电烧伤病人的治疗方法及疗效进行回顾性分析。结果：单纯电火花烧伤的治疗和一般烧伤相同，电击伤多为早期清创，植皮覆盖创面。结论：电烧伤创面根据情况可有多种治疗方法：包括单纯换药，湿润烧伤膏，中厚皮片移植，皮瓣移植等。     

胶原酶在治疗烧、创伤创面中应用的临床观察

目的　探讨胶原酶制剂治疗烧、创伤创面的临床疗效。方法　创面常规清创后涂胶原酶制剂外敷凡士林纱布或无菌纱布包扎 ,每日或隔日换药。结果　本组 2 2 0例 ,其中 4 4例浅Ⅱ度烧伤创面用药后 8～ 11d基本愈合 ,83例深Ⅱ度创面 12～ 18d愈合 ,4 2例Ⅲ度创面用药 7～ 10d基本达到植皮条件 ,5 1例创伤所致肌腱、韧带、骨骼等外露创面用药 12～ 19d基本具备植皮条件。结论　胶原酶治疗烧、创伤创面 ,具有加速坏死组织液化、促进损伤部位残留表皮细胞生长、利于创面修复和减轻瘢痕的作用     

三种氨基酸对兔血浆皮质酮浓度的影响

侧脑室注射甘氨酸使健康家兔和烧伤家兔血浆皮质酮浓度降低;注射L—谷氨酸和L—天冬氨酸使健康家兔血浆皮质酮浓度升高,但不能使烧伤后升高的血浆皮质酮浓度发生改变。提示这三种氨基酸作为神经递质参与下丘脑—垂体—肾上腺皮质轴的调控。烧伤刺激通过下丘脑引起内分泌紊乱,这种紊乱与L—谷氨酸和L—天冬氨酸失控有关。     

Effects of granulocyte colony-stimulating factor on bacterial translocation due to burn wound sepsis

The presence of certain defects in both cellular and humoral immunity after thermal injury has been established. Likewise, the translocation of enteric bacteria to the mesenteric lymph nodes and to distant organs has also been observed following serious thermal injury. The effects of granulocyte colony-stimulating factor (G-CSF) on bacterial translocation, the small bowel mucosa, and cecal bacterial content were investigated in a rat model of burn wound sepsis in which albino Wistar rats were scalded over 30% of their bodies, after which the lesions were infected by 1×10⁸ colony-forming units (cfu)Pseudomonas aeruginosa. The control group was treated with 5% dextrose solution subcutaneously starting 2 days preburn, while the treatment group received 100μg/kg human G-CSF subcutaneously. On the 4th day post burn all animals were killed to examine the bowel and culture of the mesenteric lymph nodes (MLN), livers, and spleens. No significant differences were observed between the groups regarding the cecal bacterial content and small bowel; however, a difference was seen in the ratio of translocation in the MLN liver and spleen and quantitative MLN cultures. Based on these findings, G-CSF was thus found to be significantly effective in reducing bacterial translocation due to burn wound sepsis.     

The last 10 years in a burn centre in Ankara, Turkey: an analysis of 5264 cases

This is a retrospective study analysing 5264 patients treated in the burn centre at Gülhane Military Medical Academy from 1 January 1986 to 31 December 1995. Our burn centre is not only the firs, but one of the best established and supported in Turkey. Our present study has the largest patient group of other previously published studies from Turkey. Of the total patients studied, 4464 patients had minor burns and were treated on an outpatient basis and 800 patients had moderate to major burns. Although our centre is in a military area in Ankara, only 1047 (20 per cent) patients were military personnel and the military-related burn causes comprised only 6 per cent of the total. The remaining 4217 (80 per cent of the total patients) were civilians. Flame injuries were also more frequent in military patients than civilians. Minor burns were most common in the age group 0–10 years old (40 per cent) and moderate to major burns in the age group 21–30 years (54 per cent). Scalds were the main cause of paediatric burns. Male patients were dominant. The overall mortality among inpatients was 18.2 per cent and mean total body surface area (TBSA) was 57.6 per cent in patients who died. 134 patients demonstrated inhalation injury and 82 per cent of these patients died. The epidemiological pattern of our patients is similar to that in other studies from developed countries, although some ethnic causative factors could be found. Our study indicates that emergency measures should be taken to prevent flame injuries at military barracks and industrial workplaces and scalding accidents to children at home and throughout the country.     

Blood platelets in severely injured burned patients

Unbelievable decrease of blood-platelet in the severely burned patients during the treatment of skingrafting caused two patients to unexpected death. From the records of changes of platelet number, a certain ‘platelet curve’ was made. By observing the curve, our treatments of skingrafting were carried out during the stable period and from then on we had no death cases.