For a long time, the monitoring of ventilator-associated pneumonia (VAP) has many drawbacks, such as complex diagnostic criteria, high subjectivity, low comparability, low attributable mortality, and difficulty in automated monitoring. The U.S. Center for Disease Control and Prevention proposed a new monitoring definition of ventilator-associated event (VAE) in January 2013 to address the existing problems of VAP. VAE monitoring can better predict the adverse prognosis of patients, adopt objective diagnostic criteria, and realize automatic monitoring. However, VAE surveillance also has some shortcomings: poor identification of VAP patients, lack of sufficient evidence of preventive strategies so far, inconclusive application in neonates and children groups, as easy to be interfered with as VAP. The applicability of VAE in China, its risk factors and preventive strategies need to be further studied.
Objective To introduce the effect of platelet-rich plasma (PRP) in the treatment of chronic tissue lesions. Methods The latest research papers concerning the relevant subject were reviewed and analyzed. Results In PRP, the platelets and cytokines, the interaction of them in the same proportion as they were in the body fluid, played promoting role in repairing the chronic damage of tissues. However, there was still way to go before PRP was appl ied for cl inical use in a widerrange. Conclusion PRP has quite a bright outlook in the treatment of chronic tissue lesions.
Objective Platelet-rich plasma (PRP) can promote the repair of soft tissue, wound, and bone defect. To investigate the effect of PRP on synovitis by establ ishing papain-induced osteoarthritis model of rabbit knee and interfering withPRP. Methods Twenty healthy 6-month-old rabbits (male or female, weighing 2.5-3.5 kg) were randomly divided into theexperimental group (n=10) and the control group (n=10). The whole blood (10 mL) was extracted from the central aural artery and PRP was prepared with the Landesberg’s method. Meanwhile, the platelet derived growth factor (PDGF), transforming growth factor (TGF), and vascular endothel ial growth factor (VEGF) concentrations in the circulating blood and PRP were measured. The 4% papain solution (0.3 mL) was injected into the knee joint cavity to establ ish the osteoarthritis model. After that, PRP (0.3 mL) was injected into the knee joints every week for 10 weeks in the experimental group, while normal sal ine of the same volume in the control group. At 2nd, 4th, 6th, 8th, and 10th weeks after the first injection, the erythrocyte sedimentation rate (ESR) and interleukin 1β (IL-1β) concentrations in the whole blood were tested, and the histological changes of the synovium were observed by HE staining and the Mankin scores were made. Results The blood cell counting showed that the platelet concentration of PRP was 6.8 times as that of the circulating blood. PDGF, TGF-β, and VEGF were 5, 8, and 7 times as those of the circulating blood, showing significant differences (P lt; 0.05). All animals survived to the end of experiment. There were significant differences in the ESR at 2nd, 6th, 8th, and 10th weeks and in the IL-1β at 4th, 6th, 8th, and 10th weeks between 2 groups (P lt; 0.05). In the control group, the synovium was edematous and thickened with fibrous effusion and pannus on surface; in the experimental group, the effusion of the synovium was decreased and less congestion and edema were observed at the 2nd week; the synovium was observed to be a bit thickened without obvious edema, with sl ight amount of yellowish joint fluid on surface and no conglutination at the 10th weeks. There were significant differences in the Mankin score at 4th, 6th, 8th,and 10th weeks (P lt; 0.05) between 2 groups. Conclusion PRP is beneficial to the alleviation of synovitis induced by papain according to restoring the damaged tissue and depressing the inflammatory factors.
目的 探討經轉化生長因子-β1 ( TGF-β1) 基因修飾的未成熟樹突狀細胞(imDC) 預處理大鼠小腸移植受體后的外周血及移植腸浸潤T 細胞的變化及意義。方法 選用近交系F344/ N 和BN 大鼠建立全小腸異位移植模型,實驗分4 組(每組24 只) : 同基因移植組(BN-BN 組) 、異基因移植組( F344/ N-BN 組) 、異基因移植+ TGF-β1 基因轉染imDC 組( F344/ N-BN + TGF2β1 組) 和異基因移植+ TGF-β1 基因轉染imDC + FK506 組( F344/ N-BN + TGF-β1 + FK506 組) 。各組大鼠分別于術后3 、5 、7 d 各處死6 只,獲取大鼠靜脈血和移植腸。應用免疫組化SABC 法檢測受體鼠外周血及移植腸CD4 + 、CD8 + 、CD25 + 細胞和IL-4 的表達。同時行移植腸組織病理學檢查并觀察大鼠生存情況。結果 TGF-β1 修飾的DC 細胞能顯著抑制外周血及移植腸浸潤淋巴細胞CD4 + 、CD8 + 及CD25 + 的表達,并提高IL-4 的表達; 顯著延長受體大鼠的生存時間,但移植腸仍有排斥反應的病理組織學征象。結論 TGF-β1 修飾的DC 通過影響受體外周血及移植腸浸潤T 細胞對大鼠小腸移植發揮免疫抑制作用。