负压引流联合重组人酸性成纤维细胞生长因子治疗难愈性创面的临床随机对照研究

目的：观察负压引流系统联合重组人酸性成纤维细胞生长因子(rh-aFGF,recombinant human acid-ic fibroblast growth factor)治疗难愈性创面的有效性及安全性。方法入选3个研究中心194例深Ⅱ度烧伤、Ⅲ度烧伤、糖尿病足溃疡、血管性慢性溃疡患者,根据随机数列表、多中心分层随机方法分为两组,治疗组98例,对照组96例。治疗组采用创面封闭式负压引流技术同时引流前,引流中给予rh-aFGF冲洗治疗。对照组采用VSD治疗,同时围引流期给予生理盐水水冲洗。连续治疗15 d,观察创面愈合情况。结果联合VSD治疗,rh-aFGF干预后肉芽组织生长评分显著高于对照组[(2.6±1.5)分vs (1.9±1.4)分,P=0.027],此外治疗组完全愈合时间[(14..6±5.2) d]比对照组[(19.5±7.9) d]短,治疗组住院时间[(13.4±4.7) d]明显短于对照组[(16.4±5.2) d],引流后残余创面面积明显[(15.4±1.9) cm2]明显小于对照组[(19.3±2.1) cm2],两组比较差异具有显著统计学意义。此外远期随访显示,rh-aFGF有利于降低愈合后创面感觉异常发生率,两组比较差异具有统计学意义(χ2=25.16,P=0.000)。结论负压引流与rh-aFGF联合治疗可显著促进肉芽组织生长,两者联合治疗可作为难愈性创面重要的治疗方案。     

持续冲洗rh-aFGF合并负压引流对难愈性创面愈合过程的修复效应

目的探讨持续冲洗重组酸性成纤维细胞生长因子(rh-aFGF)合并负压引流对难愈性创面愈合过程的修复效应。方法以入院病例号为编号,根据随机数字表,将80名难愈性创面患者随机分成2组,每组40例。治疗过程中,观察组患者予以5支rh-aFGF配成冲洗液,冲洗创面,并合并负压引流;对照组患者给予生理盐水配成冲洗液,同观察组冲洗方法进行冲洗。观察创面愈合情况以及深部组织外露面积。结果肉眼观察,观察组患者创面肉芽组织生长良好,优于对照组肉芽生长情况;引流10d后,观察组和对照组创面愈合率分别为(64.2±3.2)%和(27.6±2.6)%,前者优于后者(P<0.05);观察组和对照组伤腔容积减少值分别为(16.4±2.2)mL和(5.9±2.6)mL,前者优于后者(P<0.05)。结论 Rh-aFGF持续冲洗创面能够营养创面周围神经,可促进皮肤修复过程,优化难愈性创面修复效果。     

超脉冲CO2点阵激光联合重组牛碱性表皮生长因子凝胶治疗面部术后凹陷性瘢痕的效果及安全性

目的探讨超脉冲CO2点阵激光联合重组牛碱性表皮生长因子凝胶治疗面部术后凹陷性瘢痕的效果及安全性。 方法选取面部术后凹陷性瘢痕患者100例,根据就诊病例号分为观察组和对照组。对照组给予超脉冲CO2点阵激光治疗,2个月治疗1次,5次为1个疗程;观察组在对照组基础上联合重组牛碱性表皮生长因子凝胶治疗,每次激光治疗后应用重组牛碱性成纤维细胞生长因子凝胶20 d,2次/d。1个疗程结束后比较2组疗效、创面结痂时间、红斑持续时间、创面疼痛时间、皮肤干燥紧绷感情况、患者满意度及治疗期间感染、水肿、新生瘢痕等不良反应发生情况。 结果2组治疗总有效率差异无统计学意义（P＞0.05）;观察组结痂时间、红斑持续时间及疼痛时间均短于对照组,皮肤干燥紧绷感发生率低于对照组,患者满意度高于对照组,治疗期间总不良反应发生率低于对照组,差异有统计学意义（P＜0.05）。 结论超脉冲CO2点阵激光联合重组牛碱性表皮生长因子凝胶治疗面部术后凹陷性瘢痕,虽然未能提高疗效,但能加速创面修复,减轻创面疼痛、皮肤干燥紧绷等不适感,提高患者满意度,减少治疗期间不良反应发生率。     

重组牛碱性成纤维细胞生长因子凝胶治疗小儿轻中度深Ⅱ度烧伤效果探讨

目的：研究重组牛碱性成纤维细胞生长因子(rb-bFGF)凝胶在小儿轻中度深Ⅱ度烧伤治疗中的临床效果。方法选择该科2009年9月-2014年9月的120例四肢皮肤深Ⅱ度烧伤的小儿患者,按创面处理方法随机分为两组,重组牛碱性成纤维细胞生长因子凝胶组（观察组）与凡士林油纱组（对照组）各60例。两组病例均每日治疗1次,直到创面封闭。对两组创面的愈合时间及愈合后瘢痕形成等情况进行比较。结果治疗组创面平均愈合时间为（16.64±2.58）d,有5例瘢痕形成。对照组创面平均愈合时间为（19.82±2.23）d,有17例出现瘢痕增生,两组比较差异有统计学意义（P<0.05)。结论重组牛碱性成纤维细胞生长因子凝胶治疗小儿轻中度深Ⅱ度烧伤创面疗效满意,容易被患儿及家属接受,易于推广。     

重组牛碱性成纤维细胞生长因子治疗浅度烧伤创面的疗效观察

目的观察重组牛碱性成纤维细胞生长因子应用于治疗浅Ⅱ度烧伤创面的临床效果。方法选取90例小面积浅Ⅱ度烧伤患者,随机平均分为2组:应用重组牛碱性成纤维细胞生长因子治疗的患者为治疗组,使用碘伏油纱治疗的患者为对照组,观察创面愈合时间、患者疼痛程度及远期色素沉着、瘢痕增生几率情况。结果重组牛碱性成纤维细胞生长因子治疗组效果优于对照组,治疗组创面愈合时间(8.56±2.51)d短于对照组(12.42±2.13)d(P﹤0.05),平均愈合时间较提前3~5 d;患者疼痛度减轻[VAS评分分别是:(1.66±0.05)和(3.25±0.12),P﹤0.05];部分患者一年后随访发现治疗组远期色素沉着较轻,疤痕增生几率低。结论应用重组牛碱性成纤维细胞生长因子治疗小面积浅度烧伤能够缩短创面愈合时间,在有效促进烧伤创面愈合同时,可减轻换药时疼痛,减轻远期色素沉着,降低瘢痕增生率。     

重组人酸性成纤维细胞生长因子促进创伤愈合的研究

目的：研究重组人酸性成纤维细胞生长因子（rh-aFGF)对兔创伤的促愈合作用。方法：采用兔背部刀割伤模型，将rh-aFGF溶液隔日一次滴注于创面，用创面照像、透明膜描记称量法记录伤后第4、8、12、16天创面面积，用注水法测量伤腔容积，伤后第8、16天取创面组织，观察创面的病理学变化，包括肉芽组织生长与再上皮化情况。结果：rh-aFGF可明显加速兔皮肤创伤的愈合，使创面面积明显缩小（P＜0．05），使伤腔容积明显减少（P＜0．05）。组织学检查：rh-aFGF组创面伤后8天成纤维细胞生长活跃、数量多，其毛细血管胚芽与成纤维细胞数量显著多于对照组；伤后16天，创面收缩与再上皮化明显，新生上皮向创面中心爬行较快。结论：rh-aFGF对兔背部刀伤创面有明显的促修复作用。     

rh-aFGF治疗DM合并胆管结石的疗效及发生感染的logistics分析

目的 研究重组人酸性成纤维细胞生长因子(rh-aFGF)治疗对糖尿病(DM)合并胆管结石的疗效.方法 选取2016年5月至2019年6月该院收治的120例DM合并胆管结石患者为研究对象,分为对照组及观察组,两组均行腹腔镜下经胆囊管开口微切开胆管并一期缝合胆管术(LTCBDE)术,观察组联合使用rh-aFGF治疗.比较两组临床疗效、创面愈合时间和愈合率,统计分析感染发生情况,并采用logistics分析发生感染的影响因素.结果 观察组创面愈合时间、感染发生率明显低于对照组,而各时间点的创面愈合率明显高于对照组(P<0.05).logistics分析显示术中出血量、手术时间、术前空腹血糖、术前糖化血红蛋白是术后感染的危险因素(P<0.05).结论 rh-aFGF治疗DM合并胆管结石可明显降低感染发生率.     

重组酸性成纤维细胞生长因子持续冲洗合并负压引流治疗难愈性创面

目的研究重组人酸性成纤维细胞生长因子联合负压引流在难愈性创面治疗中的作用。方法收集2010年1月-2012年12月难愈性创面患者54例,按照交替法分为两组。试验组29例,使用酸性成纤维细胞生长因子持续冲洗（冲洗液中加入5支rh-aFGF）合并负压引流进行治疗;对照组25例,除冲洗液加生理盐水外,操作同试验组。记录治疗前后的创面及深部组织外露面积,并计算创面愈合率和伤腔容积减少值。结果试验组可见创面肉芽生长良好,骨肌腱外露面积缩小,伤腔容积减少值、创面愈合率均好于对照组（P〈0.05）,试验组创面经过短期换药后愈合或经植皮修复满意,对照组创面需要经过皮瓣移植或长时间换药才能完全愈合。结论本研究通过外源性持续补充aFGF,达到替代治疗的目的。     

重组人酸性成纤维细胞生长因子促进慢性溃疡性创面愈合的临床研究

目的观察重组人酸性成纤维细胞生长因子（rh-aFGF）促进慢性溃疡性创面（静脉曲张性溃疡、压疮、糖尿病足溃疡）愈合作用及安全性。方法选择2012年8月～2013年8月于石家庄市中医医院、石家庄市第二医院、唐山协和医院三家医院收治的253例慢性溃疡患者,分为三组,试验组（90例）采用rh-aFGF冻干粉均匀外敷后喷雾治疗（3～4喷/cm2）,对照组1（91例）则仅给予rh-aFGF喷雾治疗（3～4喷/cm2）,对照组2（72例）采用湿润烧伤膏外敷后生理盐水喷雾治疗。观察三组的愈合时间、肉芽生长情况、瘢痕形成情况。结果试验组与对照组1和对照组2比较,患者创面渗出更少,肉芽生长状况更佳,差异均有统计学意义（P〈0.05）。试验组患者完全愈合时间、20 d累积愈合率、延迟愈合率均低于对照组1和对照组2,差异均有统计学意义（P〈0.05）。远期随访显示试验组瘢痕面积小于对照组1和对照组2,差异有统计学意义（P〈0.05）。结论 rh-aFGF促进愈合作用强于湿润烧伤膏,另外冻干粉直接外敷效果较喷雾的促进愈合效果更佳。     

逆行岛状筋膜蒂指背皮瓣修复同指指端缺损的临床分析

目的：对应用同指逆行岛状筋膜蒂指背皮瓣修复技术对患有指端缺损疾病的患者实施治疗的临床效果进行研究。方法选择在该院2012年8月—2014年8月就诊的患有指端缺损疾病的患者90例，随机分为对照组和治疗组，平均每组45例。采用腹部带蒂皮瓣技术对对照组患者实施治疗；采用同指逆行岛状筋膜蒂指背皮瓣修复技术对治疗组患者实施治疗。结果治疗组患者手部功能恢复正常时间(50.24±7.68)d和缺损修复治疗计划实施总时间(12.25±3.44)d明显短于对照组(74.92±10.64)、(17.59±4.51)d；指端缺损疾病治疗效果(总有效率93.4%)明显优于对照组（总有效率75.6%)；在手术修复治疗的围术期出现不良反应的人数（1例）明显少于对照组（8例）。结论应用同指逆行岛状筋膜蒂指背皮瓣修复技术对患有指端缺损疾病的患者实施治疗的临床效果非常明显。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.