纤维蛋白胶存在的问题与相应的解决方法

分析了纤维蛋白胶存在的问题,如蛋白胶不同供体来源、成份来源、应用的简易性与有效性、止血功效局限、机械强度与纤溶抑制剂的选择等,并提出相应的解决方案。     

医用生物蛋白胶应用于甲状腺次全切除术的意义

目的:探讨医用生物蛋白胶在甲状腺次全切除手术治疗中的作用。方法:2003年10月至2005年12月甲状腺次全切手术治疗的186例患者分成两组,其中98例应用生物蛋白胶,不放引流物,另一组组88例放置胶管或胶片引流。两组进行引流量、拆线时间等多项指标对比。结果:第Ⅰ组多指标优于或等于第Ⅱ组。结论:在甲状腺次全切除术应用医用生物蛋白胶后渗血渗液明显减少,可不放引流物,引流物引起的并发症减少。     

生物蛋白胶封堵合并宫颈环扎术治疗胎膜早破的疗效观察

目的:观察生物蛋白胶封堵合并宫颈环扎术治疗胎膜早破,对孕妇、胎儿及新生儿的影响,明确该技术治疗胎膜早破的疗效。方法:我院产科共收治妊娠<30周胎膜早破患者48例,采用生物蛋白胶封堵合并宫颈环扎术治疗胎膜早破,观察治疗后孕妇羊水指数,胎儿双顶径,新生儿出生时体重,及孕妇的副反应。结果:在本次封堵治疗过程中均一次封堵成功,没有不良反应发生,所有孕妇术后阴道流水情况均明显改善,其中有2例孕妇术后1周阴道流水停止。所有孕妇术后羊水漏出量均明显减少,B超检查显示羊水指数均在(6±2)cm,胎儿每周双顶径增长均达到(0.15±0.02)cm,延长孕周最短(5±2)w,10例早产,38例继续妊娠至37 w。新生儿出生时体重为(2000±260)g,无1例发生NRDS。同期没有进行宫颈内封堵仅行药物保胎治疗的10例孕妇,胎龄延长最长达到10 d,最短者24 h内出现早产分娩,早产儿平均体重1400 g,均发生NRDS,有2例放弃治疗,4例在NICU行治疗,最终因各种并发症死亡。48例行封堵治疗孕妇未发生过敏反应,无阴道出血及产后出血和感染等。结论:应用生物蛋白胶结合宫颈环扎术治疗胎膜早破,手术操作简单,可延长了孕周,提高了新生儿成活率,无不良反应,具有广泛的应用前景。     

Prophylaxis of local vascular graft infection with levofloxacin incorporated into albumin-sealed dacron graft (LVFX-ALB Graft).

An animal model was used to assess the efficacy of levofloxacin (LVFX) incorporated into albumin (ALB)-sealed Dacron (LVFX-ALB) graft for the prevention of vascular graft infections caused by Staphylococcus aureus. Under general anesthetic, an interposition graft was placed into dog carotid artery. On completion of the operation, 0.1 ml of normal saline containing 10(7) colony-forming units (CFU) of a slime-producing S. aureus was inoculated directly onto the graft. After 1 day, the samples were sterilely harvested. The antibacterial activity of LVFX into the LVFX-ALB graft was evaluated by colony counting in bacterial cultures and by the fluorescent antibody method staining bacteria adhesion to the grafts. LVFX-ALB grafts had a lower infection rate than the control grafts (1/4, 10(2) CFU vs 4/4, 1.50 x 10(5)+/-1.38 x 10(5)CFU (mean+/-SE)). In an immunostaining study, LVFX-ALB grafts had small fluorescent areas showing S. aureus adhesion, while fluorescence was observed over the entire surface of the control grafts. Therefore, LVFX-ALB presumably had a bactericidal action and adhesive prevention against inoculated S. aureus. LVFX-ALB may be useful in preventing graft infections during and immediately after vascular reconstruction.     

纤维蛋白单体D区与E区聚合后E区结构的变化

应用纤维蛋白单克隆抗体IF 5 3,观察当纤维蛋白的“A”位点与另一纤维蛋白D区域的“a”位点结合后纤维蛋白E区的变化 .纤维蛋白原Aα链经赖氨酰肽链内切酶消化后 ,应用反相HPLC分离纯化 ;通过ELISA法检测单克隆抗体IF 5 3与纤维蛋白原及其衍生物的反应情况 ;应用放射免疫法检测RGD合成肽抑制纤维蛋白单体与IF 5 3反应的情况 .发现IF 5 3能与纤维蛋白原Aα链的一个片段反应 ,该片段经氨基酸序列分析显示为纤维蛋白原Aα链氨基末端 (1～ 2 9) .该抗体能与酸溶解的纤维蛋白单体和可溶性纤维蛋白及XDP反应 ,但不能与酸化纤维蛋白原或GPRP反应 ,因此IF 5 3的抗原决定簇在Aα 2 0～ 2 9,与凝血酶作用于纤维蛋白肽A ,暴露出的聚合位点“A”(Aα17～19)紧邻 .当GPRP存在于纤维蛋白原溶液时 ,经凝血酶作用产生这种纤维蛋白单体不能与IF 5 3反应 .Aα(93～ 99) (ILRGDFS)合成肽部分抑制纤维蛋白单体与IF 5 3的反应 .实验结果提示 ,当纤维蛋白单体相互聚合 ,或纤维蛋白单体与纤维蛋白原聚合时 ,纤维蛋白单体结构会发生变化 ,其中Aα2 0～ 2 9片段成为新抗原暴露于E区表面 ,并且Aα2 0～ 2 9与纤维蛋白原细胞粘附区域RGD1片段邻近     

纤维蛋白对尿激酶原激活纤溶酶原反应动力学的影响

反应体系中存在的纤维蛋白（fibrin）对尿激酶（UK）、scu-PA以及组织型纤溶酶原激活剂（t-PA）激活纤溶酶原（plasminogen）的反应有不同的作用：UK、t-PA激活plasminogen的反应可被反应体系中存在的fibrin所加强;fibrin对scu-PA激活plasminogen反应的动力学常数无明显影响;但对小分子质量scu-PA与单链抗体的嵌合分子激活plasminogen的反应起明显的抑制作用.为确定反应体系中存在的fibrin对scu-PA的K区插入突变体-InB激活plasminogen反应的影响,测定了在反应体系中存在fibrin的情况下的InB激活plasminogen反应的K_m^fibrin以及k_cat^fibrin.K_m^fibrin＝4.2 μmol·L^-1,远远大于无fibrin时的K_m＝0.379 μmol·L^-1,说明有fibrin存在时突变体InB与天然底物plasminogen的亲和性降低了.k_cat^fibrin＝0.107 s^-1,也远远大于无fibrin时k_cat＝0.0165 s^-1,说明有fibrin存在时突变体InB对plasminogen的反应活性增强了.原因可能是：与fibrin结合的plasminogen的构象发生了有利于被纤溶酶原激活剂水解的变化.     

利用脱细胞血管基质体外构建小口径组织工程血管

目的探讨利用犬的间充质干细胞诱导分化种子细胞,以异种脱细胞血管基质为基础体外构建小口径血管移植物。方法采用密度梯度离心和贴壁培养的方法从犬骨髓中分离出间充质干细胞并体外培养,诱导分化成内皮样细胞和平滑肌样细胞;采用非离子型去垢剂和胰蛋白酶去除猪颈动脉血管壁结构细胞,对脱细胞基质进行组织学、力学检测及孔隙率评估。在生物反应器内采用旋转种植的方法将犬骨髓间充质干细胞诱导的内皮样细胞种植到脱细胞基质上,体外构建小口径组织工程血管。结果犬的骨髓间充质干细胞体外能够定向诱导分化为平滑肌样细胞和内皮样细胞,可以作为血管组织工程的种子细胞。经过脱细胞处理后,光镜和电镜观察证实血管壁的细胞成分完全去除。具有良好的孔径和孔隙率。支架在生物力学、孔隙率等方面符合构建组织工程血管支架的要求。在生物反应器内剪切力条件下可以初步构建出组织工程血管。结论小口径血管移植物可以将间充质干细胞诱导种子细胞,以异种脱细胞血管支架作为基质,在搏动性生物反应器内培养的方法进行构建。     

Enhancement of tendon-bone healing with the use of bone morphogenetic protein-2 inserted into the suture anchor hole in a rabbit patellar tendon model

Background aimsSuture anchor fixation failure has been reported as a result of anchor loosening and migration during the tendon-bone repair. The aim of this study was to evaluate the effects of bone morphogenetic protein-2 (BMP-2) inserted into the suture anchor hole on bone formation and the tendon-bone healing.MethodsBoth back legs of 24 New Zealand White rabbits (n = 48) were used in this study. A metal suture anchor was then placed 5 mm below the cortex. In the control group, the space over the eyelet of the anchor (suture anchor hole) was not filled. In the experimental group, the suture anchor hole was filled with 0.1 mL of fibrin glue (group 2) or collagen gel (group 3) with 1 μg BMP-2. Histologic analysis, real-time-polymerase chain reaction, bone density and failure load measurement were performed, and differences were analyzed at 4 and 8 weeks.ResultsHistologic analysis revealed more abundant new bone, mature bone and organized fibrocartilage at the tendon-bone interface at 4 and 8 weeks in groups in which BMP-2 was applied. At 8 weeks, the failure load of groups 1, 2 and 3 was significantly different among the three groups (P = 0.01). After post hoc Tukey test, the failure load of group 2 was significantly higher than that of group 1 (P = 0.01).ConclusionsBMP-2, administrated as described in this study, improved tendon-bone healing and bone formation, resulting in improved biomechanical strength of the tendon-bone junction.     

兔颈动、静脉移植桥血管狭窄模型的建立及其电镜观察

目的：建立兔颈动、静脉移植血管桥动物模型,观察移植桥血管内膜增生和狭窄的电镜下表现。方法：通过兔双侧颈动脉进行动脉桥和静脉桥的移植,形成双侧移植血管桥再狭窄动物模型。在第8周施行血管桥移植手术的同时留取右侧颈动静脉标本作为对照血管,再分别于第12周、16周和第20周分别处死模型兔,采集移植桥血管标本,在光镜下测量其内膜厚度、面积、狭窄度,并进行电镜观察。结果：颈动脉和颈静脉桥移植后,随着时间的延长,桥血管的出现平滑肌迁移,脂质沉积,内膜增生,血管狭窄等改变,且以静脉桥血管的病理改变更为明显。结论：在兔形成动脉粥样硬化病变基础上,进行双侧颈动脉血管桥的移植,建立兔双侧颈动脉移植血管桥再狭窄动物模型,有利于设立自身对照,研究术后动静脉桥再狭窄差异机制;建立动、静脉桥后,位于血管中膜的平滑肌细胞出现向血管内膜迁移现象,说明中膜平滑肌细胞迁移进入内膜导致新内膜形成是血管再狭窄的重要环节。     

兔颈动、静脉移植桥血管狭窄模型的建立及其电镜观察

目的:建立兔颈动、静脉移植血管桥动物模型,观察移植桥血管内膜增生和狭窄的电镜下表现。方法:通过兔双侧颈动脉进行动脉桥和静脉桥的移植,形成双侧移植血管桥再狭窄动物模型。在第8周施行血管桥移植手术的同时留取右侧颈动静脉标本作为对照血管,再分别于第12周、16周和第20周分别处死模型兔,采集移植桥血管标本,在光镜下测量其内膜厚度、面积、狭窄度,并进行电镜观察。结果:颈动脉和颈静脉桥移植后,随着时间的延长,桥血管的出现平滑肌迁移,脂质沉积,内膜增生,血管狭窄等改变,且以静脉桥血管的病理改变更为明显。结论:在兔形成动脉粥样硬化病变基础上,进行双侧颈动脉血管桥的移植,建立兔双侧颈动脉移植血管桥再狭窄动物模型,有利于设立自身对照,研究术后动静脉桥再狭窄差异机制;建立动、静脉桥后,位于血管中膜的平滑肌细胞出现向血管内膜迁移现象,说明中膜平滑肌细胞迁移进入内膜导致新内膜形成是血管再狭窄的重要环节。     

大鼠颈部自体静脉移植模型两种吻合方法的比较

目的比较间断吻合和连续吻合法建立静脉桥狭窄动物模型的优劣。方法SD大鼠20只,分成两组（间断吻合组和连续吻合组）,取颈外静脉与颈总动脉行端端吻合。术后4周取下静脉桥,观察桥管通畅性,分析新生内膜与中膜的厚度、面积比。结果连续组与间断组相比手术时间更短,出血更少,但桥管通畅率低,两组内膜增生程度没有显著差异。结论连续吻合用时短,出血少,对术者要求更高,较易形成吻合口狭窄。两者造模效果一样。     

腓骨柱植骨支撑固定防治股骨颈骨折术后股骨头坏死的机理和临床疗效

目的:探讨腓骨柱植骨支撑固定防治股骨颈骨折术后股骨头坏死机理研究和临床疗效。方法:随访符合标准的56例患者,记录骨折的Garden分型、内固定的全程稳定性、股骨头坏死的发生和演变等指标,并采用SPSS18.0进行统计分析。结果:56例患者均恢复解剖复位,在术后3-6月骨折愈合,平均4个月,愈合率为100%;Harris功能评分51-100分,平均分为84.6分,其中优者(≥90.0分)37髋,良者(80.0~89.9分)14髋,中者(70.0~79.9分)者1髋,差者(70.0分)4髋,Harris功能评分优良率为91.10%,没有发生内固定失效和骨折不愈合;22例根据MRI表现出股骨头坏死症状,坏死率39.30%,其中17例影像学坏死能够在随访期内维持为ARCOⅠ-Ⅱ期或者完全修复。其余的5例进展为临床坏死;晚期出现塌陷4例(7.15%)。Garden Ⅰ、Ⅱ级和GardenⅢ、Ⅳ级相比较,两组股骨头坏死率有统计学差异(P0.05),且两组的晚期塌陷率比较也有统计学差异(P0.05)。结论:空心加压螺钉与腓骨柱的所具有的生物力学稳定效能,能提供全程可靠的抗挤压、抗拉伸及抗旋转三维度稳定性,可以提供强大的机械稳定性;同时腓骨柱具有较强的生物学修复能力,为股骨头骨头血运重建和坏死区修复持续稳定的血供及持续有效的生物学修复能力。生物学愈合后腓骨柱在软骨下形成一个较大接触面积的支撑效果,可以预防股骨头坏死后塌陷。     

Structural Basis and Kinetic Pathway of RBM39 Recruitment to DCAF15 by a Sulfonamide Molecular Glue E7820

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卵磷脂促进小菜蛾颗粒体病毒感染的研究

采用有机溶剂从鸡蛋中提取卵磷脂,与小菜蛾颗粒体病毒混合添食感染2—3龄小菜蛾幼虫,所得数据经统计学方法处理,得到三组死亡率与时间的回归直线方程为y=18.1x-59.8(GV对照)、y=27.23x-99.85(GV+30mg卵磷脂/ml)、y=13.6x-18(GV+70mg卵磷脂/ml)。GV+70mg卵磷脂/ml与GV对照组比较,感染性提高了17％,LT_(50)提前了1.066天。结果表明,卵磷脂对小菜蛾颗粒体病毒感染具有促进作用。     

Conditions for Infection of Apple by Phytophthora syringae

The processes leading to Phytophthora fruit rot were divided into two main stages for the purposes of investigating the effects of temperature and duration of wet periods on pathogen development: oospore germination and infection of fruit by zoospores. It was found that the first stage was markedly affected by temperature over the range 10–20°C and required a wet period of 4–7 days. At 18 and 20°C, activation was low regardless of the length of the wet period. Once oospore germination (first stage) had occurred, free water was necessary for only a few hours for fruit infection (second stage) to occur, but the incidence of infection rose rapidly over the first 48 h, regardless of temperature over the range 10–20°C. From the data obtained, mathematical models were produced relating the incidence of Phytophthora fruit rot to the two weather variables. These models can be used to develop a weather‐based risk assessment system for the disease.     

Infection of Spathoglottis plicata (Orchidaceae) seeds by mycorrhizal fungus

Spathoglottis plicata seeds were encapsulated in 4-mm-diameter capsules of alginate-chitosan or alginate-gelatin and infected with the mycorrhizal fungus Rhizoctonia AM9. The encapsulated seeds were placed directly on Rhizoctonia culture. About 66% of the seeds encapsulated in sucrose-free chitosan-alginate established a symbiotic relationship with the mycorrhizal fungus after co-culturing for 2 weeks. The highest percentage of infection observed was about 84%. Addition of sucrose or using gelatin-alginate for encapsulation reduced the percentage of infection by about half. The growth of Rhizoctonia AM9 in sucrose-free alginate, chitosan and gelatin was found to be minimal. The advantages of germinating orchid seeds, encapsulated in sucrose-free polymers, through mycorrhizal infection is discussed. Received: 19 February 1998 / Revision received: 8 May 1998 / Accepted: 20 May 1998     

鼠伤寒沙门氏菌诱导昆明小鼠肠道感染模型的建立

目的:建立鼠伤寒沙门氏菌诱导昆明小鼠肠道感染模型。方法:先用5 mg/mL链霉素预处理2 d,提高小鼠对鼠伤寒沙门氏菌的敏感性,然后正常饲养1 d,攻毒前禁水禁食4 h,再分别以不同剂量灌胃攻毒2次,间隔24 h。观察小鼠临床症状,并通过组织病理切片、透射电镜和免疫组织化学的方法,分别观察小鼠肠道组织病理变化、小肠上皮细胞超微结构变化及肠道淋巴细胞增殖状况。结果:攻毒后昆明小鼠会出现昏睡、食欲不振、寒颤,甚至死亡的现象,解剖后发现小鼠肠道充血膨胀。组织病理切片显示小鼠肠粘膜受损,小肠绒毛肿胀,排列杂乱,炎性细胞浸润;透射电镜观察超微结构显示小肠上皮细胞线粒体空泡化,嵴和膜发生融合消失,粗面内质网发生扩张;免疫组织化学的方法显示肠道感染后,淋巴结肿大,T淋巴细胞大量增殖。结论:该模型对探索鼠伤寒沙门氏菌引发肠炎的发病机制、病理生理、免疫等方面作用具有重要意义,并为特异性卵黄抗体被动免疫保护效果的后续评价奠定基础。     

Infection of Subterranean Clover (Trifolium subterraneum) by Kabatiella caulivora

Kabatiella caulivora is a serious pathogen of clover ( Trifolium ) spp. Subterranean clover ( T. subterraneum ) cv. Woogenellup was inoculated with K. caulivora , to study the attachment and germination of conidia, germ-tube penetration of the plant surface, and histochemistry and ultrastructure of changes in the host associated with lesion development. The foliar architecture caused the conidia to concentrate at the base of leaflets and on the petiolules (between the leaflets and petioles). Epidermal cells immediately beneath conidia and, occasionally, also adjacent cells developed a yellow-brown discoloration 1 day post-inoculation. Penetration appeared to be directly through the cuticle, characterized by constricted hyphae at the point of entry. No appressoria were observed. In leaves, invasion was restricted to the area proximal to the petiolule and leaf mid-rib. In petioles and petiolules, the hyphae initially remained between the epidermal cells and first layer of mesophyll cells before moving intercellularly through the mesophyll tissue towards phloem tissues. The cuticle was occasionally degraded in petiole and petiolule infections, the loss of epidermal and mesophyll cell wall components was detected, and chloroplasts and starch grains were disrupted. Plants developed macroscopic symptoms 10–11 days post-inoculation with necrotic lesions occurring on leaves, petioles and petiolules. Sporulation occurred approximately 15–18 days post-inoculation when affected plants collapsed. This information may be useful for breeding programmes aimed at selecting varieties with improved resistance to the clover scorch disease.     

HCMV感染的抗氧化治疗与洁罗维注射液临床预防与治疗应用

人巨细胞病毒(HCMV)是疱疹病毒中最大也是最常见的一种,HCMV感染危害性大,亚洲与非洲地区的人群感染率高,目前临床仍缺乏专属性强的治疗药物。在其治疗过程中,抗病毒药物长期应用导致耐药问题存在,而机体免疫功能抑制与病毒耐药发生率关系密切,因此HCMV防治过程中,抗病毒抗氧化协同治疗势在必行。洁罗维注射液(阿昔洛韦氯化钠注射液Ⅱ)是一种"抗病毒+抗氧化+营养支持"三重作用机制的新型复方抗病毒输液,可提高机体免疫功能,降低病毒耐药性,有利于临床诸多科室HCMV感染的预防与治疗,具有极高的临床推广价值。