電損傷與燒傷皮膚上皮細胞極性化機理與形態(tài)學定量的研究
發(fā)布時間：2018-12-17 09:42
【摘要】： 目的:探討電損傷與燒傷皮膚周邊部基底層上皮細胞極性化形成機理;以及對極性化上皮細胞進行形態(tài)學觀察及測量,為法醫(yī)病理學診斷電損傷和燒傷提供客觀量化指標。 方法:本實驗共分六組,包括380V AC組、220V AC組、220V DC組、火焰燒傷組、金屬灼傷組及正常對照組。每組標本均進行常規(guī)HE染色及免疫組化EGFR染色。光鏡觀察后,利用圖像分析系統(tǒng)測定極性化上皮細胞核周長、長徑、短徑及長/短徑比值,所有數(shù)據(jù)輸入計算機SAS軟件包進行分析。每組分別取四個標本進行TEM和SEM觀察。 結(jié)果:1.損傷皮膚基底層及棘層上皮細胞核變長,其長徑與基底膜近似垂直, 而顆粒層或透明層上皮細胞核固縮或核變長,部分上皮細胞核長徑與皮膚表面平行。220V DC負極電流斑多數(shù)上皮細胞胞漿凝固，核空泡變或染色質(zhì)溶解。 2.三組電損傷組上皮細胞核周長及長/短徑比值兩兩比較無顯著性差異(P0.05)； 二組燒傷組比較也無顯著性差異(P0.05);而各電損 WP=5 傷組分別與各熱燒傷組比較有顯著(P0.05)。 3.TEM觀察DC正極、AC電流斑與燒傷上皮細胞胞漿凝固，胞核變長，染色質(zhì)邊集，核仁消失； 220V DC負極電流斑上皮細胞核核溶解，染色均勻淺淡，染色質(zhì)碎片散在分布于核漿中。SEM 觀察電流斑底部有較多裂隙和小孔穴,小孔穴之間有一些組織細胞碎屑，燒傷皮膚底部較光滑,可見裂隙, 但無小孔穴。 4.損傷皮膚中央部位基底層與棘層極性化上皮細胞EGFR表達陰性, 正常皮膚與周邊部皮膚基底層與棘層極性化上皮細胞EGFR表達陽性，且分布較均勻。 結(jié)論: 1.電損傷電流斑周邊部上皮細胞極性化改變系電流熱效應作用所致,而非電場直接作用所致。 2.通過計算機圖像分析系統(tǒng)定量測定損傷皮膚周邊部上皮細胞核周長及核長/短徑比值,可推斷該損傷系低壓電損傷或燒傷。在低壓電范圍內(nèi),上述指標不能推斷電壓高低、是AC或DC損傷。 3.LM觀察到DC負極電流斑上皮細胞胞漿凝固、核溶解呈空泡變，或核染色質(zhì)固縮、伴周圍透亮區(qū)；TEM觀察到上皮細胞胞漿凝固，核溶解，染色質(zhì)碎片散在分布于核漿中，可作為診斷直流電損傷的一個指標。SEM觀察到電損傷電流斑皮損表面的小孔穴可作為區(qū)分電損傷與燒傷的指標之一。
[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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2002
【分類號】：D919
本文編號：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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2002
【分類號】：D919
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