烧伤研究与治疗进展

对近年来国外烧伤研究及治疗进展作一综述     

努力提高严重多发伤的基础研究和临床救治水平

目的:探讨提高严重多发伤的基础研究和临床救治水平。方法:结合我们的有关研究和参加抢救的临床救治体会,并引用国内外公开发表的相关论文及著作进行分析研究。结果:善于应用现有的先进科技手段,提高严重多发伤的基础研究和临床救治水平。降低伤残率和死亡率。结论:严重多发伤具有脏器损伤率高、出血性休克率高、感染率高、MODS发生率高、死亡率高等“五高”特点,所以其诊治的复杂性、紧迫性远远超过其他许多疾病。因此努力提高我国严重多发伤的基础研究及诊断和救治水平已是当务之急。     

藏药螃蟹甲中苯乙醇苷对模型大鼠急性高原脑水肿的改善作用

目的:研究藏药螃蟹甲中苯乙醇苷(PhGCs)对模型大鼠急性高原脑水肿的改善作用。方法:60只Wistar大鼠随机分为常氧空白(等容灭菌注射用水)组、缺氧模型(等容灭菌注射用水)组、地塞米松(4 mg/kg)组与PhGCs高、中、低剂量(400、200、50mg/kg)组。复制模型前6 d ig给药,ig给药第4 d起除常氧空白组外,其余各组大鼠均置于模拟海拔8 000 m的高原环境,连续缺氧暴露72 h以复制大鼠高原脑水肿模型。苏木精-伊红染色后光镜下观察大鼠脑组织病理改变;干湿质量法测定大鼠脑含水量;测定大鼠脑组织中丙二醛(MDA)含量与超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)活性;酶联免疫吸附(ELISA)法测定大鼠血清中与脑组织中白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)含量。结果:与常氧空白组比较,缺氧模型组大鼠脑组织出现明显水肿,细胞和血管周围腔隙增宽,可见炎性细胞浸润;大鼠脑含水量增加;大鼠脑组织MDA含量增加,SOD、GSH活性减弱;大鼠血清与脑组织IL-1β、TNF-α含量增加,差异均有统计学意义(P<0.01或P<0.05)。与缺氧模型组比较,PhGCs高、中、低剂量组大鼠脑组织炎症细胞浸润程度减轻,脑含水量减少;PhGCs高、中剂量组大鼠脑组织MDA含量减少,SOD、GSH活性增强,大鼠血清与脑组织IL-1β、TNF-α含量减少,差异均有统计学意义(P<0.01或P<0.05)。结论:PhGCs能明显减轻由急性缺氧所致大鼠急性脑损伤状态,对模型大鼠急性高原脑水肿有一定改善作用。     

Interleukin-10 promoter polymorphisms in rheumatoid arthritis and Felty's syndrome

OBJECTIVE: To examine whether promoter polymorphisms associated with variation in interleukin-10 (IL-10) production are relevant to the development of rheumatoid arthritis (RA) or Felty's syndrome (FS). METHODS: DNA was obtained from 44 FS patients, 117 RA patients and 295 controls. The promoter region between -533 and - 1120 was amplified by polymerase chain reaction, and polymorphisms detected by restriction enzyme digest or sequence-specific oligonucleotide probing. RESULTS: We found no significant difference in allele or haplotype frequencies between the groups. CONCLUSION: There is no association between FS or RA and these recently identified IL-10 promoter polymorphisms. Other genetic or environmental factors could explain the alterations in IL-10 levels seen in these conditions.      

Purging of acute myeloid leukemic cells by ether lipids and hyperthermia

Ether lipids (EL) and hyperthermia have been shown to possess a relatively selective cytotoxicity to leukemic cells. In this study, the combined effects of EL (ET-18-OCH3, ET-16-NHCOCH3, or BM 41.440) and hyperthermia on the growth of hematopoietic progenitors, myeloid leukemic cell lines, and leukemic cells obtained from patients with acute myeloid leukemia (AML) were examined to determine if this combination resulted in a greater selective killing of leukemic cells than that achieved by either EL or heat alone. When the cells were treated simultaneously with EL (50 micrograms/mL) and hyperthermia (42 degrees C) for one hour, the killing of leukemic cell line cells was enhanced considerably. Among the three EL, however, the combination of ET-18-OCH3 and heat seemed to be the most cytotoxic to leukemic cell line cells with no effect on the growth of hematopoietic progenitors. An increase in the duration of treatment with ET-18-OCH3 to four hours with heat added during the last hour resulted in a further reduction of leukemic cell line cells while sparing 50% of hematopoietic progenitors after cryopreservation. The combined treatment with ET-18-OCH3 and heat also inhibited the growth of leukemic progenitors obtained from AML patients by 97% to 100%. These data indicate that the combined treatment with EL and hyperthermia might offer an efficient means to eliminate myeloid leukemic cells in vitro.     

完全腹腔镜Roux—en—Y吻合术式应用于远端胃癌根治术20例

目的探讨完全腹腔镜Roux．en—Y吻合术式应用于远端胃癌根治术的安全性和可行性。方法回顾性分析福建省肿瘤医院腹部外科2012年8月至2013年3月对腹腔镜胃大部切除术后实施完全腹腔镜Roux．en—Y吻合术的20例胃癌患者的术中和术后临床资料。结果20例患者均成功实施完全腹腔镜远端胃癌根治术,无一例中转开腹或中转腹腔镜辅助手术。手术时间（190．8±53．6）min,术中出血量（122．4±57．7）ml,淋巴结清扫数（31．2±5．7）枚,术后病理切缘均为阴性。术后排气时间为（2．6±1．6）d,住院时间为（8．1±2．0）d。有1例术后出现肺部感染,但无吻合术相关并发症发生。结论完全腹腔镜Roux—en—Y吻合术式应用于远端胃癌根治术安全且可行。