应用带血管蒂皮瓣、肌（皮）瓣治疗下肢皮肤软组织缺损26例分析

目的:探讨采用带血管蒂皮瓣、肌(皮)瓣修复下肢皮肤软组织缺损、重建功能、再造器官和改善外形的效果。方法:采用带血管蒂皮瓣、肌(皮)瓣,通过局部转移或移位,进行血管、神经吻合,覆盖因创伤造成的下肢软组织缺损。结果:本组共26例患者,一期治愈23例,治愈率88.5%;二期治愈3例,治愈率11.5%,总治愈率100%。结论:由于不同于传统的随意皮瓣,切取范围不受长宽比例限制,手术一次完成。极大可能的修复缺损的皮肤及软组织,保持患肢的长度及功能。     

组织工程在软骨损伤修复方面的研究现状及应用前景

创伤和各种疾病引起软骨缺损在临床上十分常见。由于关节软骨几乎没有自身修复的能力,因此关节软骨的损伤修复已成为近年来骨科临床基础研究的一个重要课题,也是骨科界的难题之一,许多学者进行了相关研究。近二十年,随着细胞生物学和生物材料科学的发展,诞生了一门新的学科——组织工程学。利用组织工程学原理和方法能够再生软骨组织,为软骨缺损的修复提供了一种新的思路和方法。尤其是近几年来,三维立体生物可降解材料的研制成功及细胞培养技术的不断提高,为软骨缺损组织工程学修复的临床应用展示了广阔的前景。     

Screening for significant atherosclerotic renal artery stenosis with a regression model in patients undergoing transradial coronary angiography/intervention

Objective: Early detection of atherosclerotic renal artery stenosis (ARAS) is clinically important with respect to blood pressure control, prevention of renal insufficiency, and even improving survival. We investigated whether the presence of significant ARAS (luminal diameter narrowing ≥70%) could be predicted using a logistic regression model before coronary angiography/intervention. Methods: Initially, we developed a logistic regression model for detecting significant ARAS based upon clinical and angiographic features and biochemical measurements in a cohort of 1 813 patients undergoing transfemoral coronary and renal angiography. This model was then prospectively applied to an additional 495 patients who received transradial renal angiography to ascertain its predictive accuracy for the presence of significant ARAS. Results: Multivariate regression analysis revealed that older age (≥65 years), resistant hypertension, type 2 diabetes, creatinine clearance (Ccr) ≤60 ml/min, and multivessel coronary disease were independent predictors for significant ARAS. A logistic regression model for detecting ARAS by incorporating conventional risk factors and multivessel coronary disease was generated as: P/(1−P)=exp(−2.618+1.112[age≥65 years]+1.891[resistant hypertension]+0.453[type 2 diabetes]+0.587[Ccr≤60 ml/min]+2.254[multivessel coronary disease]). When this regression model was prospectively applied to the additional 495 patients undergoing transradial coronary and renal angiography, significant ARAS could be detected with a sensitivity of 81.2%, specificity of 88.9%, and positive and negative predictive accuracies of 53.8% and 96.7%, respectively. Conclusions: The logistic regression model generated in this study may be useful for screening for significant ARAS in patients undergoing transradial coronary angiography/intervention.     

复方金银花、茵陈五苓注射液对家兔内毒素性肾衰组织结构影响

目的:研究复方金银花和茵陈五苓两种注射液对内毒素所致家兔肾衰中肾脏组织结构的保护作用。方法:将重量2.5±0.25kg的健康雄性家兔32只,随机分为对照组、模型组、复方金银花组和茵陈五苓组,每组8只。模型组、复方金银花组、茵陈五苓组家兔一次性静脉注射大肠杆菌O111B4内毒素生理盐水,剂量为100ug/kg。两保护组家兔注射内毒素24h后静脉注射剂量为100ug/kg的中药注射液。模型组家兔静脉注射同容积的生理盐水。对照组家兔静脉注射与内毒素溶液和中药注射剂等体积的生理盐水。静脉注射内毒素及生理盐水后第7h处死。取肾组织标本,Bouns液固定,石蜡切片,HE染色,显微观察并摄影。结果:模型组肾脏肾小体血管球肿胀,有血栓形成,肾小囊壁层内皮细胞脱落,肾小囊腔变小,肾小管内皮细胞脱落。复方金银花组、茵陈五苓组肾脏的肾小体血管球略有肿胀,肾小囊的内皮细胞较完整,肾小囊腔较对照组稍变小。结论:复方金银花与茵陈五苓对家兔因内毒素所致肾衰中肾脏组织结构有确实的保护作用。     

中国樱桃离体快速繁殖的研究

以中国樱桃春季刚萌发的顶芽和腋芽为外植体,研究了不同种类和不同浓度生长调节物质对中国樱桃初代培养、增殖和生根的影响。结果表明,中国樱桃的最佳初代培养基为MS+6-BA1.0 mg/L+IBA0.2 mg/L;MS培养基中加入1.0mg/L6-BA和0.2 mg/L NAA,增殖效果最好,增殖系数达11.73;组培苗在1/2 MS+IBA0.5 mg/L+NAA0.1 mg/L培养基上根诱导效果最好,生根率可达91.1%。     

低温锻炼对蝴蝶兰组培苗抗寒性的影响

在模拟冷害条件下,研究了低温锻炼对蝴蝶兰组培苗生理作用的影响,并对低温锻炼的最适温度进行筛选。结果表明,低温胁迫会造成蝴蝶兰组培苗存活率下降,可溶性糖含量、脯氨酸含量、超氧化物歧化酶活力、过氧化氢酶活力上升,丙二醛含量上升。低温锻炼可以提高蝴蝶兰组培苗的存活率,提高蝴蝶兰组培苗渗透性物质含量、抗氧化酶水平、降低丙二醛含量,从而增强了蝴蝶兰组培苗的抗寒能力。其中,17℃/12℃昼夜低温锻炼对模拟冷害具有最为显著的缓解作用。     

Tissue-engineered graft constructed by self-derived cells and heterogeneous acellular matrix

Background： Endothelial and smooth muscle cells were used as seeding cells and heterogeneous acellularized matrix was used as scaffold to construct the tissue-engineered graft. Methods： A 2 weeks piglet was selected as a donor of seeding cells. Two-centimetre length of common carotid artery was dissected. Endothelial cells and smooth muscle cells were harvested by trypsin and collagenase digestion respectively. The isolated cells were cultured and expanded using routine cell culture technique. An adult sheep was used as a donor of acellularized matrix. The thoracic aorta was harvested and processed by a multi-step decellularizing technique to remove the original cells and preserve the elastic and collagen fibers. The cultured smooth muscle cells and endothelial cells were then seeded to the acellularized matrix and incubated in vitro for another 2 weeks. The cell seeded graft was then transplanted to the cell-donated piglet to substitute part of the native pulmonary artery. Results： The cultured cells from piglet were characterized as endothelial cells by the presence of specific antigens vWF and CD31, and smooth muscle cells by the presence of specific antigen a-actin on the cell surface respectively with immunohistochemical technique. After decellularizing processing for the thoracic aorta from sheep, all the cellular components were extracted and elastic and collagen fibers kept their original morphology and structure. The maximal load of acellular matrix was decreased and 20% lower than that of untreated thoracic aorta, but the maximal tensions between them were not different statistically and they had similar load-tension curves. Three months after transplantation, the animal was sacrificed and the graft was removed for observation. The results showed that the inner surfaces of the graft were smooth, without thrombosis and calcification. Under microscopy, a great number of growing cells could be seen and elastic and collagen fibers were abundant. Conclusion： Cultured self-derived endothelial and smooth muscle cells could be used as seeding cells and heterogeneous acellularized matrix could be used as scaffold in constructing tissue-engineered graft.     

Relationships between serum lipid, lipoprotein, triglyceride-rich lipoprotein, and high-density lipoprotein particle concentrations in post-renal transplant patients

Objective:Disturbances in lipid and lipoprotein profiles in patients after kidney transplantation (Tx) are still not understood. Methods:Serum levels of lipids,lipoprotein,triglyceride-rich lipoproteins (TRLs),and high-density lipoprotein (HDL) particles were determined,lipid and lipoprotein ratios were calculated,and their relationships in Tx patients with hypertriglyceridemia (HTG) and lower apolipoprotein AI (apoAI) concentration were examined. Serum lipid and lipoprotein levels were measured in 109 Tx p...     

急性力竭运动对大鼠肾脏TXA_2/PGI_2代谢平衡的影响

目的:探讨急性力竭运动及恢复期过程中肾脏TXA2/PGI2代谢平衡调节的生物学效应及自由基代谢的介导作用。方法:SD大鼠随机分为安静对照组、运动后即刻组、运动后1 h组、3 h组和24 h组,各运动组采用递增负荷跑台运动至力竭方案,测定肾组织中TXB2、6-keto-F1α和MDA含量和SOD活性。结果:运动后即刻肾脏TXB2含量和TXB2/6-keto-F1α比值均显著下降,恢复期TXB2含量和TXB2/6-keto-F1α比值均显著低于安静水平。运动及恢复期肾组织SOD活性、MDA含量与TXB2、6-keto-F1α含量均呈显著负相关。结论:力竭运动及恢复期肾脏TXA2/PGI2平衡均下调,运动中有利于维持肾脏局部基本的血液供应,可能与运动性肾脏缺血激发局部代偿机制有关,恢复期则促进肾脏血液再灌注和恢复血供。肾脏抗自由基能力提高可能主要通过抑制肾脏TXA2合成下调TXA2/PGI2平衡。