电损伤与烧伤皮肤上皮细胞极性化机理与形态学定量的研究
发布时间：2018-12-17 09:42
【摘要】： 目的:探讨电损伤与烧伤皮肤周边部基底层上皮细胞极性化形成机理;以及对极性化上皮细胞进行形态学观察及测量,为法医病理学诊断电损伤和烧伤提供客观量化指标。 方法:本实验共分六组,包括380V AC组、220V AC组、220V DC组、火焰烧伤组、金属灼伤组及正常对照组。每组标本均进行常规HE染色及免疫组化EGFR染色。光镜观察后,利用图像分析系统测定极性化上皮细胞核周长、长径、短径及长/短径比值,所有数据输入计算机SAS软件包进行分析。每组分别取四个标本进行TEM和SEM观察。 结果:1.损伤皮肤基底层及棘层上皮细胞核变长,其长径与基底膜近似垂直, 而颗粒层或透明层上皮细胞核固缩或核变长,部分上皮细胞核长径与皮肤表面平行。220V DC负极电流斑多数上皮细胞胞浆凝固，核空泡变或染色质溶解。 2.三组电损伤组上皮细胞核周长及长/短径比值两两比较无显著性差异(P0.05)； 二组烧伤组比较也无显著性差异(P0.05);而各电损 WP=5 伤组分别与各热烧伤组比较有显著(P0.05)。 3.TEM观察DC正极、AC电流斑与烧伤上皮细胞胞浆凝固，胞核变长，染色质边集，核仁消失； 220V DC负极电流斑上皮细胞核核溶解，染色均匀浅淡，染色质碎片散在分布于核浆中。SEM 观察电流斑底部有较多裂隙和小孔穴,小孔穴之间有一些组织细胞碎屑，烧伤皮肤底部较光滑,可见裂隙, 但无小孔穴。 4.损伤皮肤中央部位基底层与棘层极性化上皮细胞EGFR表达阴性, 正常皮肤与周边部皮肤基底层与棘层极性化上皮细胞EGFR表达阳性，且分布较均匀。 结论: 1.电损伤电流斑周边部上皮细胞极性化改变系电流热效应作用所致,而非电场直接作用所致。 2.通过计算机图像分析系统定量测定损伤皮肤周边部上皮细胞核周长及核长/短径比值,可推断该损伤系低压电损伤或烧伤。在低压电范围内,上述指标不能推断电压高低、是AC或DC损伤。 3.LM观察到DC负极电流斑上皮细胞胞浆凝固、核溶解呈空泡变，或核染色质固缩、伴周围透亮区；TEM观察到上皮细胞胞浆凝固，核溶解，染色质碎片散在分布于核浆中，可作为诊断直流电损伤的一个指标。SEM观察到电损伤电流斑皮损表面的小孔穴可作为区分电损伤与烧伤的指标之一。
[Abstract]:Objective: to investigate the mechanism of electrical injury and the formation of polarity of basal layer epithelial cells around burn skin, and to observe and measure the morphology of polar epithelial cells in order to provide an objective quantitative index for the diagnosis of electrical injury and burn injury by forensic pathology. Methods: this experiment was divided into six groups, including 380 V AC group, 220 V DC group, flame burn group, metal burn group and normal control group. Routine HE staining and immunohistochemical EGFR staining were performed in each group. The perimeter, length, short diameter and ratio of length to short diameter of the polar epithelium nucleus were measured by image analysis system. All the data were input into the computer SAS software package for analysis. Four specimens were taken from each group for TEM and SEM observation. Results: 1. The nuclei of the basal and spinous layers of the injured skin become longer, and their long diameter is approximately perpendicular to the basement membrane, while the nuclei of the granular or transparent layers become pyknotic or elongated. The long diameter of some epithelial nuclei was parallel to the skin surface. Most epithelial cells with 220 V DC negative current spots were coagulated in cytoplasm, vacuolated or chromatin dissolved. 2. There was no significant difference in the peripheral length and the ratio of length to short diameter of epithelial nucleus between the three groups (P0.05). There was no significant difference between the two groups (P0.05), while the electrical loss of WP=5 injury group was significantly higher than that of each thermal burn group (P0.05). 3.TEM was used to observe DC positive electrode, AC current spot and burn epithelial cell cytoplasm coagulation, the nucleus became longer, chromatin edge set, nucleolus disappeared; At 220 V DC negative current spot, the nucleus of the epithelium dissolved, the staining was even and shallow, and the chromatin fragments were scattered in the nucleus and cytoplasm. SEM observed that there were many cracks and holes at the bottom of the current spot, and some tissue and cell fragments were found between the holes. The base of burn skin is smooth, crack can be seen, but there is no small hole. 4. The expression of EGFR in the polar epithelial cells of the basal layer and the spinous layer in the central part of the injured skin was negative, and the expression of EGFR in the polar epithelium of the basal layer and the layer of the spinous layer in the normal skin and the peripheral part of the skin was positive, and the distribution was more uniform. Conclusion: 1. The polarity of the epithelial cells around the electric current spot was caused by the effect of current and heat, but not by the direct action of electric field. 2. The nuclear circumference and the ratio of nuclear length to short diameter of the epithelia around the injured skin were quantitatively measured by computer image analysis system. It was inferred that the injury was caused by low pressure electrical injury or burn. In the range of low voltage, the above indexes can not infer the voltage, it is AC or DC damage. 3.LM observed that the cytoplasm of DC negative current spot epithelial cells was coagulated, the nucleolysis was vacuolar, or the chromatin was pyknosis, with the surrounding bright area. TEM observed that the cytoplasm of epithelial cells was coagulated, nucleolysis and chromatin fragments scattered in the cytoplasm. SEM observed that the holes on the surface of electrical current spot could be used as an index to distinguish electrical injury from burn.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2002
【分类号】：D919
本文编号：2384035
[Abstract]:Objective: to investigate the mechanism of electrical injury and the formation of polarity of basal layer epithelial cells around burn skin, and to observe and measure the morphology of polar epithelial cells in order to provide an objective quantitative index for the diagnosis of electrical injury and burn injury by forensic pathology. Methods: this experiment was divided into six groups, including 380 V AC group, 220 V DC group, flame burn group, metal burn group and normal control group. Routine HE staining and immunohistochemical EGFR staining were performed in each group. The perimeter, length, short diameter and ratio of length to short diameter of the polar epithelium nucleus were measured by image analysis system. All the data were input into the computer SAS software package for analysis. Four specimens were taken from each group for TEM and SEM observation. Results: 1. The nuclei of the basal and spinous layers of the injured skin become longer, and their long diameter is approximately perpendicular to the basement membrane, while the nuclei of the granular or transparent layers become pyknotic or elongated. The long diameter of some epithelial nuclei was parallel to the skin surface. Most epithelial cells with 220 V DC negative current spots were coagulated in cytoplasm, vacuolated or chromatin dissolved. 2. There was no significant difference in the peripheral length and the ratio of length to short diameter of epithelial nucleus between the three groups (P0.05). There was no significant difference between the two groups (P0.05), while the electrical loss of WP=5 injury group was significantly higher than that of each thermal burn group (P0.05). 3.TEM was used to observe DC positive electrode, AC current spot and burn epithelial cell cytoplasm coagulation, the nucleus became longer, chromatin edge set, nucleolus disappeared; At 220 V DC negative current spot, the nucleus of the epithelium dissolved, the staining was even and shallow, and the chromatin fragments were scattered in the nucleus and cytoplasm. SEM observed that there were many cracks and holes at the bottom of the current spot, and some tissue and cell fragments were found between the holes. The base of burn skin is smooth, crack can be seen, but there is no small hole. 4. The expression of EGFR in the polar epithelial cells of the basal layer and the spinous layer in the central part of the injured skin was negative, and the expression of EGFR in the polar epithelium of the basal layer and the layer of the spinous layer in the normal skin and the peripheral part of the skin was positive, and the distribution was more uniform. Conclusion: 1. The polarity of the epithelial cells around the electric current spot was caused by the effect of current and heat, but not by the direct action of electric field. 2. The nuclear circumference and the ratio of nuclear length to short diameter of the epithelia around the injured skin were quantitatively measured by computer image analysis system. It was inferred that the injury was caused by low pressure electrical injury or burn. In the range of low voltage, the above indexes can not infer the voltage, it is AC or DC damage. 3.LM observed that the cytoplasm of DC negative current spot epithelial cells was coagulated, the nucleolysis was vacuolar, or the chromatin was pyknosis, with the surrounding bright area. TEM observed that the cytoplasm of epithelial cells was coagulated, nucleolysis and chromatin fragments scattered in the cytoplasm. SEM observed that the holes on the surface of electrical current spot could be used as an index to distinguish electrical injury from burn.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2002
【分类号】：D919
【参考文献】
相关期刊论文 前6条
1 廖志钢;吴家櫦;;电流斑的光镜和扫描电镜观察以及能谱测定[J];中国法医学杂志;1989年03期
2 万立华,马智华,张佐才;血管电损伤的实验研究[J];中国法医学杂志;2001年01期
3 马骥，王仁，孙长平，魏援，李继新，徐强，李宁和，陈怀芳;电警棍致皮肤损伤的实验研究[J];法医学杂志;1996年02期
4 肖红,谢挺,林亮,刘淑华,吴娟,方天人;17339例烧伤原因分析[J];中华流行病学杂志;2000年05期
5 钟敏华;赵崇华;;国内84家医院9695例电烧伤病人流行病学资料分析[J];中华整形烧伤外科杂志;1993年06期
6 竞花兰，，祝家镇;电损伤皮肤中金属导体元素含量的研究[J];中山医科大学学报;1995年01期
本文编号：2384035
本文链接：https://www.wllwen.com/shekelunwen/gongan/2384035.html
