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双语推荐：真皮

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背景：课题组以往研究证实，猪边腹部网状层真皮质地柔软，伸展性也较其他部位好，适合作为异种脱细胞真皮的制作材料，但将其与人网状层真皮和大鼠网状层真皮进行组织形态学和材料学表征的系统对比未见相关报道。目的：研究猪边腹部、大鼠背部与人网状层真皮在组织学、生物力学、分子结构和热稳定性等方面的差异。方法：取人、猪边腹部、Wistar大鼠背部网状层真皮标本并大体观察，石蜡切片后行苏木精-伊红染色、苦味酸-天狼星红染色，显微照相后用图像分析软件测量分析；样本真空干燥并复水后用电子拉伸机测量其力学性能并计算杨氏模量；真空干燥后的样品研碎后用傅里叶红外光谱仪及同步热分析仪分析测量。结果与结论：猪边腹部网状层真皮胶原纤维束直径与人网状层真皮无差异，大鼠背部胶原纤维束较人网状层真皮细(P 0.05)。3种网状层真皮杨氏模量差异无显著性意义。大鼠网状层真皮胶原蛋白分子有较多的氢键参与，人较少，猪介于两者之间；大鼠网状层真皮热稳定性较好，人和猪次之。
BACKGROUND:Previous studies of our research group have confirmed that the texture of porcine reticular dermis at lateral ventral part is softer and has more extensibility than other parts. Therefore, it may serve as the raw material of xenogenic aceluar dermal matrix. However, its comparison with human and rat reticular dermis has not been reported systematicaly in aspects of histomorphology and material characterization. OBJECTIVE:To compare the reticular dermis from the lateral region of porcine abdomen and rat dorsal part with the reticular dermis from human in histology, biomechanics, molecular structure, thermal stability and other properties. METHODS:The reticular dermis samples were taken from adult human, the lateral region of porcine abdomen, the back of rats, for gross observation. Paraffin sections were observed by hematoxylin and eosin staining andsirius red staining under a light microscopy. The relevant data of micrograph were measured by imagine analysis softwa

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目的 探讨小室移植法重建小鼠毛囊,观察细胞成分对毛囊再生的影响.方法 取0～2d的C57BL/6乳鼠背部皮肤,胰酶消化后分离表真皮,再分离出毛囊上皮细胞.实验分表皮细胞混合毛囊胚芽组、真皮细胞组、表皮细胞混合毛囊胚芽+真皮细胞组、毛囊上皮细胞+真皮细胞组.用小室移植法接种于裸鼠背部,并于移植后1、2、4、8周观察变化,HE染色观察毛囊组织学形态.结果 小鼠毛囊细胞移植1周时,背部小室开始脱落,伤口结痂;2周时除表皮细胞组外,另3组均长出了短小的毛发,镜下可见毛囊样结构;4周及8周时除表皮细胞组外,均长出了正常的毛发,表皮细胞与真皮细胞混合组及毛囊上皮细胞与真皮细胞混合组毛发生长情况良好,优于单独的真皮细胞组.结论 毛囊细胞小室移植后可形成新的毛囊,上皮细胞及真皮细胞在毛囊重建中具有重要的作用.
Objective To reconstitute hair follicles in mice using graft chambers,and to study the effect of different cell types on hair follicle regeneration.Methods Full-thickness skin was obtained from the back of C57BL/6 neonatal mice.Then,epidermal cell suspensions were prepared by shredding epidermis after trypsinization,hair follicles and dermal cells were collected by filtration,low-speed centrifugation and density gradient centrifugation,and hair follicle epithelial cells were obtained via trypsinization of hair follicles followed by filtration.Nude mice were classified into four groups to be transplanted with epidermal cells + follicular buds,dermal cells alone,epidermal cells + follicular buds + dermal cells,follicular epithelial cells + dermal cells,respectively.The cells were implanted into the dorsal skin of nude mice using fold chambers.After the grafting,the growth of skin and hairs was observed at the grafted sites on week 1,2,4 and 8,and skin specimens were obtained on week 2,4,

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目的探讨人工真皮复合自体刃厚皮片对全身关节处皮肤缺损创面的疗效及愈后。方法收集2008~2013年采用人工真皮复合自体刃厚皮片修复关节处皮肤缺损创面25例,其中创面覆盖膝关节10例,踝关节5例,肘关节4例,腕关节2例,指关节间3例,腋窝部1例。观察其手术后皮片存活情况,术后3个月瘢痕形成程度及功能恢复情况。结果在采用人工真皮复合自体刃厚皮片治疗方法的患者中,18例患者一期术后通过换药及时清除脓性分泌物,类真皮样肉芽组织形成良好,3例患者人工真皮下出现感染,通过清洁换药,引流脓液后,类真皮样肉芽组织可再次形成。2例患者因感染较重,通过再次手术彻底清创并更换人工真皮,获得同样疗效,二期植皮术后,皮片均贴附良好。2例患者创面面积小,揭除人工真皮薄膜后,创面通过周围正常上皮爬行覆盖,自行愈合。术后3个月随访患者关节功能恢复良好,无明显瘢痕增生级瘢痕挛缩形成。结论人工真皮复合自体刃厚皮片疗法不仅能提高创面自体皮片移植成活率,并可有效降低关节处瘢痕挛缩程度,为患者的远期关节功能恢复,提供有效的治疗方案。
Objective To investigate the efficacy and prognosis of artificial dermis combined with autologous skin graft in the body joints dermal wounds.Methods Twenty-five cases were collected from 2008 to 2013,who used artificial dermis combined with autologous skin graft repair articular wounds,including 10 cases of wound knee,5 cases of the ankle,4 cases of the elbow,2 cases of the wrist,3 cases of the knuckles,1 case of the axillary.Skin graft survival after surgery,the extent and functional recovery of scar formation after 3 months were observed.Results Among the patients,who underwent artificial dermis combined with autologous skin graft repair operations,dermal tissue of 1 8 cases formed well by timely removal of pus after phase one surgery.Three cases suffered artificial dermis infection,and the dermal tissue formed again after the clean dressing and drainage of pus.Two cases with severe infection underwent surgical debridement and replacement of artificial dermis,and the same

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目的观察人工真皮联合自体薄层皮片移植(简称复合皮移植)修复难愈性创面的疗效。方法选取住院的各种难愈性创面患者30例,均存在各种原因导致的不同程度和部位皮肤软组织缺损创面,部分病例伴有肌肉、肌腱、骨外露。一期清创后移植人工真皮,2~3周后局部肉芽组织生长良好,外露肌腱和骨组织被类真皮组织覆盖,二期移植自体薄层皮片。观察人工真皮和自体薄层皮片(复合皮)移植成活率、瘢痕增生、色素沉着和关节活动度等情况,综合评价人工真皮联合自体薄层皮片移植修复难愈性创面的临床效果。结果 30例患者人工真皮移植后成活25例,成活率为83.3%;5例溶解失活,原因为局部感染4例,局部固定不良1例。存活的25例人工真皮联合自体薄层皮片移植成活率达100.0%。25例出院后均随访2~6个月,复合皮生长良好,光滑有弹性,无明显瘢痕增生,少量皮肤色泽改变;供皮部位恢复良好,无瘢痕增生,部分患者有少量色素改变。结论人工真皮联合自体薄层皮片移植修复难愈性创面,复合皮移植成活率高,创面愈合质量好,成活后的复合皮部位和供皮区瘢痕增生轻微,关节功能恢复良好,方法简便,为难愈性创面的修复提供了新选择。
Objective To observe the effects of artificial dermis combined with autologous thin layer skin grafts(composite skin) in repairing the refractory wounds.Methods Thirty patients with refractory wounds were in-volved who had deep skin soft tissue defect , some cases complicated with exposure of muscles , tendons, bone.All of refractory wounds were repaired by the technology of combining artificial dermis with autologous thin skin transplanta -tion.The technology included 2 steps:firstly, artificial dermis were transplanted on all refractory wounds after the de-bridement , then autologous thin layer skin were transplanted on artificial dermis 2~3 weeks after debridement , at that time the dermal tissue growing well and covering exposed tendon , bone tissue .Then the survival rate of artificial dermis and composite skin , the degree of scar hyperplasia , pigmentation change and joint activity were observed to e-valuate the effects of composite skin repairing refractory wounds .Results In 2

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目的探讨应用异种（猪）脱细胞真皮基质包扎治疗门诊小面积烧伤患者的可行性。方法2006年11月至2012年11月门诊收治的63例小面积烧伤患者分别应用异种（猪）脱细胞真皮基质治疗和传统聚维酮碘乳膏纱布换药治疗，根据烧伤的深浅和处理方法的不同分成四组：真皮基质治疗浅Ⅱ°组（13例）、聚维酮碘乳膏治疗浅Ⅱ°组（17例）、真皮基质治疗深Ⅱ°组（19例）、聚维酮碘乳膏治疗深Ⅱ°组（14例）。观察创面愈合时间、换药次数、创面疼痛情况、患者依从性等。结果真皮基质治疗小面积浅Ⅱ°创面，创面平均愈合时间为（6．23±2．21）天，真皮基质治疗小面积深Ⅱ°创面，创面平均愈合时间为（12．46±3．57）天；聚维酮碘乳膏治疗小面积浅Ⅱ°创面，创面平均愈合时间为（8．37±4．39）天，聚维酮碘乳膏治疗小面积深Ⅱ°创面，创面平均愈合时间为（15．45±6．32）天。真皮基质治疗小面积浅Ⅱ°创面，平均换药次数为（3．34±1．45），真皮基质治疗小面积深Ⅱ°创面，平均换药次数为（3．69±2．48）；聚维酮碘乳膏治疗小面积浅Ⅱ°创面，平均换药次数为（6．67±3．72），聚维酮碘乳膏治疗小面积深Ⅱo创面，平均换药次数为（8．54±6．21）。结论真皮基质能够有效促进创面愈合，减少换药次数，适合门诊应用。
Objective To investigate the method and feasibility of acelluar heterologous (porcine) dermal matrix used in curing small size area burn of outpatients.Methods From November 2006 to November 2012 in the patients admitted in our hospital,the curing effects of the small area burn of outpatients using acelluar heterologous (porcine) dermal matrix and Betadine ointment were observed.The curing time and patients'' compliance were also studied.Results Wounds were healed satisfactorily after dressed with acelluar heterologous (porcine) dermal matrix comparing with dressed betadine ointment gauze.The healing time advanced and dressing change times reduced.The patients'' compliance was higher.Conclusion Acelluar heterologous (porcine) dermal matrix can be successfully used in curing small size area burn wounds of outpatients.Satisfactory clinical effect can be obtained if the burn wounds choice was suitable.

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目的探讨负压封闭引流联合人工真皮自体表皮移植修复外伤性创面的临床疗效。方法 25例外伤性创面均进行扩创并在负压封闭引流辅助下行人工真皮移植,平均3~5 d更换一次负压引流装置。平均在移植人工真皮后14 d行自体表皮移植修复创面。结果 24例创面应用该方法成功治愈。仅1例因患儿创面位于肛周,负压装置经常漏气,创面被粪便反复污染,最终导致创面感染,不得不将人工真皮移除。术后随访24例患者6~18个月,受访者均对效果满意。皮片色泽良好,质地柔软,耐磨,无挛缩,功能基本恢复,创面无复发。供区无或仅伴轻度色素沉着,无瘢痕增生。结论负压封闭引流联合人工真皮自体表皮移植是修复外伤性创面的有效手段,值得临床推广应用。
Objective To observe the clinical effects of traumatic wound therapy with vacuum-assisted closure over artificial dermis and subsequent epidermal skin graft. Methods All 25 patients underwent irrigation and debride-ment procedures. Following epidermal skin grafting, all patients were managed with VAC dressings, which were changed every 3 to 5 days, with subsequent epidermal skin grafting an average of 14 days later. Results The ther-apy was successful in 24 patients. The only failure occurred in a patient, in whom, negative pressure could not be maintained because of a lesion site susceptible to both dislodgement and infection (perianal region). Consequently, infection occurred, and artificial dermis had to be removed. 24 cases were followed up postoperatively for 6 to 18 months. All the 24 patients were satisfied with the results. The colour and texture of the reconstruction sites were very good without recurrence. All donor sites had no or light pigmentation and healed without scarri

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背景：近年来组织工程学取得巨大进展，皮肤组织工程尤为引人注目。人工真皮(PELNAC)相对应用较广泛，但报道以成人为主，缺乏修复儿童创面的报道。目的：探讨人工真皮作为儿童严重创伤创面真皮覆盖物的临床效果。方法：回顾性总结分析22例创面负压引流、人工真皮复合自体刃厚皮片或薄中厚皮片移植覆盖儿童严重创伤创面(实验组)的治疗效果，并与19例创面负压引流、创面肉芽培养、自体刃厚皮片或薄中厚皮片移植于同等创面(对照组)的治疗效果进行对比。分析评价指标包括人工真皮的存活率、创面完全覆盖所需的手术次数、植皮后创面完全愈合时间、随访创面移植区域的色泽、质地、皮下丰满度、瘢痕增生情况以及关节功能影响等。结果与结论：人工真皮移植后10-14 d存活率达90%以上。实验组2例第二次刃厚皮片移植，对照组8例第二次刃厚皮片移植，实验组创面植皮存活率优于对照组(P<0.05)。实验组植皮后创面完全愈合的平均时间为(13.86±3.09) d，对照组为(19.10±4.62) d，实验组平均植皮后创面完全愈合时间短于对照组(P<0.05)。经超过10个月随访，实验组的植皮区色泽、弹性优于对照组；实验组创面移植区域较对照组真皮部分皮下丰满度良好、瘢痕增生明显较轻；实验组关节功能受到不同程度影响5例，对照组关节功能受到影响10例，两组差异有显著性意义(P <0.05)。提示人工真皮抗感染力强、存活率高。将人工真皮应用于儿童严重创伤创面，与创面负压引流、培养肉芽及自体刃厚皮片或薄中厚皮片移植相比，能缩短创面植皮后愈合时间，提高愈合创面的质量，减少对关节功能的影响。
BACKGROUND:In recent years, tissue engineering has made great progress, and skin tissue engineering is especialy noteworthy. Artificial dermis (PELNAC) is relatively used widely, but there is a lack of relevant reports on wound repair in children. OBJECTIVE:To investigate the clinical efficacy of Pelnac? METHODS:In a retrospective study, 22 patients with the wound of severe trauma were treated with Pelnac as skin graft dressings on treatment of the wounds of severe trauma in children. ? graft, negative-pressure wound therapy and split-thickness skin graft as experimental group (Pelnac? group), and another 19 patients treated with granulation formation dressing and split-thickness skin graft as control group. We colected data including the graft livability, the required re-operative times and the epithelization time after the skin graft. During the folow-up, the skin color and texture of survival skin, subcutaneous fulness, scar hyperplasia and the joint function were also evaluated. RE

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目的探讨扁平苔藓(LP)皮损CD45RA、CD45RO及胞间黏附分子1(ICAM-1)的表达及意义。方法应用免疫组化方法检测35例LP皮损和20例正常皮肤组织中CD45RA、CD45RO及ICAM-1的表达水平。结果 LP皮损真皮内可见到CD45RO阳性表达,与正常对照组有统计学差异(P0.05);LP皮损表皮、真皮及真皮内小血管壁内皮细胞内均可见ICAM-1阳性表达,与正常对照组有统计学差异(均P0.05);两组均未见CD45RA阳性细胞表达。结论 LP皮损真皮内浸润细胞以记忆T细胞亚群为主,LP皮损角质形成细胞异常表达ICAM-1,推测ICAM-1参与了皮损角质形成细胞抗原呈递过程,从而促进记忆T细胞离开血管,向真皮及表皮浸润。
ObjectiveTo investigate the expression of CD45RA, CD45RO and ICAM-1 in the lesions of patients with lichen planus.Methods The expression levels of CD45RA and CD45RO and ICAM-1 were detected in 35 cases of LP lesion tissue and 20 cases of normal skin tissue by using immunohistochemical methods.Results CD45RO positive expression can be seen in the dermis of LP lesions, and had statistical difference compared with normal control group (P<0.05); the positive expression of ICAM-1 were visible within LP skin epidermis, dermis and small blood vessels endothelial cells in the dermis, and had statistical difference compared with the normal control group (allP<0.05); CD45RA positive cells expression were not found in both groups.Conclusion The dermal infiltrating cells are mainly memory T cells subset in the lesions of lichen planus, the significant expression of ICAM-1 in keratinocytes of LP patients suggest that ICAM-1 take part in the progress of the antigen-submit of keratinocytes, and promo

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采用组织学方法研究皖东黄牛颈部、背部和腹部皮肤的组织结构特点。显微观察结果显示，皖东黄牛皮肤由浅至深分为表皮、真皮和皮下组织三部分，其中颈部皮肤最厚、背部次之、腹部最薄；颈部和腹部皮肤真皮内胶原纤维分布不均匀，背部皮肤真皮内胶原纤维分布均匀、规律。皮肤表皮由内向外分为基底层、棘层、颗粒层和角质层四层，其中颈部皮肤表皮最厚，腹部其次，背部最薄。皮肤皮下组织腹部皮肤最为明显，颈部次之，背部皮下组织不明显。此外，皖东黄牛皮肤真皮内可见有皮脂腺、汗腺、毛根、毛囊、毛球、血管和神经等结构分布，其中背部皮肤内汗腺和皮脂腺较发达，腹部皮肤皮脂腺发达而汗腺不发达，颈部皮肤皮脂腺和汗腺均不发达。结果表明，皖东黄牛皮肤由表皮、真皮和皮下组织三部分组成；身体各部位皮肤厚度和组织结构存在差异，其中背部皮肤组织结构最适合皮革鞣制。
The purpose of this experiment was to illustrate the skin structure characteristics of neck,back and ab-dominal of Wandong Cattle in the histology method. The results showed that the skin of Wandong Cattle was con-tained in three parts(epidermis,dermis and subcutaneous tissue from outside - in,respectively). During these three positions,the skin of neck was the thickest and the skin of abdominal was the thinnest. Unlike the back derma,the distribution of collagenous fiber was in disorder in the neck and abdominal derma. Epidermis was di-vided into four layers from outside - in:lamina basalis,stratum spinosum,stratum granulosum and granular lay-er,respectively. Neck epidermis was the thickest among three positions. We found obviously subcutaneous tissue in abdominal and neck,however,it was hard to observe in back. Additionally,there were sebaceous glands, sweat glands,hair roots and hair follicle,ball top,muscle,blood vessels and nerves structures in the Wandong Cattle dermis.

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目的 探讨单纯持续牵引法和乳晕真皮瓣填充法两种矫正乳头内陷方法的优缺点及疗效.方法 单纯持续牵引法矫正32例60只内陷乳头,乳晕真皮瓣填充法矫正32例62只内陷乳头.术后平均随访12个月.对两组患者术后效果进行对比,并进行统计学分析.结果 单纯持续牵引组伤口愈合情况、乳头形态、血运及感觉情况、保留哺乳功能情况均优于真皮瓣填充组；乳头直径及高度、乳头回缩及复发率等,两组比较差异无统计学意义.结论 单纯持续牵引法优于真皮瓣填充法,两种方法对于治疗各种类型的乳头内陷安全有效,两组患者在症状和外形上均能得到改善.
Objective To investigate the difference between simple continued traction and areola dermal flap filling in inverted nipple correction surgery.Methods There were 60 nipples of 32 patients in simple continuous traction group and 62 nipples of 32 patients in dermal flap filling group.Follow-up was conducted for 12 months.The surgical results were compared with statistical analysis.Results Wound healing,nipple shape,blood supply,feeling and breast-feeding function in simple continuous traction group were better than those of the dermal flap filling group.There was no statistically significant difference in diameter and height of nipple,nipple retraction and relapse rate between the two groups.Conclusions Simple continuous traction is superior to dermal flap filling.Both methods are safe and effective for the treatment of various types of inverted nipple and two groups of patients have improved in symptoms and appearance.

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