人纤维蛋白胶对供皮区创面的疗效观察

目的:探讨局部应用人纤维蛋白胶(FS)对中厚供皮区创面的止血和修复作用.方法:选择30例90个中厚供皮区创面为研究对象,分FS止血组、自然止血组以及凝血酶止血组,均选择自体相应部位及相似深度创面进行对照.分别观察各组间创面的止血时间和术后创面完全愈合时间.结果:FS止血组的平均止血时间比自然止血组与凝血酶止血组分别缩短36秒和13秒(P＜0.01);创面完全愈合时间,FS止血组为(12.10±2.32)天,自然止血组和凝血酶止血组分别为(19.80±3.86)天和(19.20±3.65)天,FS止血组明显提前(P＜0.01).结论:FS对中厚供皮区创面有明显的止血作用,并能促进创面提前愈合和预防创面感染.     

液超妥与痊愈妥复合敷料应用于供皮区创面疗效观察

目的探讨液超妥与痊愈妥复合敷料对供皮区创面的止血和修复作用。方法对20例全身烧伤面积在50%以下的烧伤患者的刃厚皮和中厚皮供皮区创面进行随机同体自身对照研究。研究组使用液超妥与痊愈妥复合敷料覆盖创面,对照组使用无菌凡士林纱布覆盖创面,对比两组创面的愈合效果和愈合时间。结果研究组17例显效,显效率85%,对照组6例显效,显效率30%,两组差异有统计学意义(P<0.01)。研究组刃厚皮创面与中厚皮创面愈合时间均较对照组提前,其伤后不同时间创面愈合率亦较对照组明显提高,差异均有统计学意义(P<0.01)。结论液超妥与痊愈妥复合敷料应用于供皮区创面能起到良好的止血效果,并可加快创面愈合,减少创面感染,限制瘢痕形成。     

安普贴治疗供皮区创面的临床分析

目的探讨安普贴治疗烧伤植皮供皮区创面的临床疗效。方法选择2009年4月～2012年4月笔者所在科室收治的烧伤需植皮的患者30例,随机分为安普贴治疗组和凡士林油纱组,观察两种不同敷料供皮区创面的愈合时间。结果供皮区创面平均愈合时间:凡士林油纱组为(13.23±2.03)d,安普贴组为(11.01±1.52)d,差异有统计学意义(P<0.05)。结论应用安普贴治疗烧伤植皮供皮区创面,可以减轻患者痛苦,缩短创面愈合时间,值得临床推广。     

依济复与贝复济应用在供皮创面的比较

目的为了比较依济复与贝复济促进供皮区愈合的治疗效果。方法采用自身对照分组比较方法,观察供皮愈合时间,有无刺激性,所得数据用平均数(x±s)表示并χ2检验。结果对照组比较依济复及贝复济均能促进供皮区创面的愈合(P<0.01),依济复与贝复济比较其创面愈合时间无明显差异(P>0.05),两种药物共同使用在创面上与单独应用一种药物效果差异不大(P>0.05)。依济复与贝复济对创面都有轻度的刺激性。结论尽管作用对靶细胞有所不同,两种药物均能加速供皮创面的愈合,但两种药物对供皮区(取刃厚皮及中厚皮)的作用效果无明显差别。     

液超妥与痊愈妥复合敷料应用于供皮区创面疗效观察

目的探讨液超妥与痊愈妥复合敷料对供皮区创面的止血和修复作用。方法对20例全身烧伤面积在50％以下的烧伤患者的刃厚皮和中厚皮供皮区创面进行随机同体自身对照研究。研究组使用液超妥与痊愈妥复合敷料覆盖创面,对照组使用无菌凡士林纱布覆盖创面,对比两组创面的愈合效果和愈合时间。结果研究组17例显效,显效率85％,对照组6例显效,显效率30％,两组差异有统计学意义（P〈0．01）。研究组刃厚皮创面与中厚皮创面愈合时间均较对照组提前,其伤后不同时间创面愈合率亦较对照组明显提高,差异均有统计学意义（P〈0．01）。结论液超妥与痊愈妥复合敷料应用于供皮区创面能起到良好的止血效果,并可加快创面愈合,减少创面感染,限制瘢痕形成.     

人纤维蛋白胶对大鼠肝损伤的止血护创作用

目的探讨局部应用人纤维蛋白胶 (FS)对实验性肝损伤的止血和护创作用。方法采用大鼠肝表面裂伤 (Ⅰ型 )和部分肝切除断面伤 (Ⅱ型 )模型 ,以自然止血法为阴性对照 ,缝合止血法和凝血酶止血法为阳性对照 ,比较各组间创面止血时间和术后d 1、4、7、14及 5 0光镜下创面愈合情况。结果与自然止血组相比 ,FS组对Ⅰ型肝损伤模型止血时间平均缩短 86 .0 % (P <0 .0 1) ,对Ⅱ型肝损伤模型缩短 79.0 % (P <0 .0 1) ;与凝血酶止血法相比 ,FS组止血时间分别缩短 45 .0 %和 84.0 % (P <0 .0 1和P <0 .0 5 )。肉眼和镜下观察 ,FS组创面愈合较快 ,局部组织损伤较轻 ,术后 5 0d腹腔粘连基本消失。结论FS对大鼠肝损伤有明显止血作用 ,并能促进创伤的愈合。     

血凝酶在皮肤移植术中对供皮区的止血效果

目的:观察注射用血凝酶对皮肤移植术中供皮区创面出、渗血的止血的效果与安全性。方法:切瘢植皮病人 60例,随机分为 2组,进行前瞻对照研究。血凝酶组病人术前 30min肌内注射血凝酶 1单位,术中于取皮前 15min静脉注射血凝酶 1单位,术后每日静脉注射血凝酶 1单位,连续 3d。空白对照组不用任何止血药。观察 2组术中出血、渗血量,检测停药后d3凝血功能。结果:血凝酶组供皮区创面出、渗血量为 (0. 20±s0. 09)g·cm-2,空白对照组为(0. 37± 0. 14)g·cm-2,P<0. 01。2组凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原相比较差异无显著意义 (P>0. 05)。结论: 血凝酶能够有效减少供皮区创面的出、渗血量,是一种安全的止血药。     

重组人表皮生长因子对各种创面的治疗作用

目的　观察重组人表皮生长因子 (rhEGF)对临床各种常见创面的治疗作用和副作用。方法　选择浅Ⅱ°、深Ⅱ°烧伤创面、慢性溃疡创面和中厚供皮区创面共 43例患者为研究对象 ,所有病例均行自身对照 ,选择自身相应部位、相似深度创面作对照 ,慢性溃疡创面以治疗前的病情作对照。结果　治疗组浅Ⅱ°、深Ⅱ°烧伤创面、中厚供皮区创面愈合速度加快 ,同期愈合率提高 ,愈合时间缩短。对慢性溃疡创面也有疗效。未观察到与使用rhEGF有关的全身系统异常变化和不良反应。结论　重组人表皮生长因子是对临床各种常见创面有效、安全的治疗药物     

胶原蛋白海绵复合bFGF促进兔胫骨外露创面愈合的实验研究

目的研究胶原蛋白海绵复合bFGF对骨外露创面愈合的影响。方法 30只日本大耳白兔,随机分为A、B、C三组,每组10只。于胫骨上段前内侧作一1cm×1.5cm创面,暴露胫骨。A组创面喷洒bFGF后,胶原蛋白海绵覆盖,纱布包扎。B组覆盖胶原蛋白海绵扎。C组喷洒生理盐水。术后观察各组创面完全愈合的时间,测量并计算术后各时期创面收缩率。创面愈合后,取材,HE染色,显微镜下观察组织结构。结果大体观察:A、B、C组创面愈合时间分别为(25.12±1.46)d、(30.50±1.69)d、(33.38±1.77)d。A组较B、C组愈合时间提前,差异有统计学意义(P<0.01)。组织学观察:A组创面愈合质量优于B、C组。结论胶原蛋白海绵复合bFGF对兔胫骨外露创面愈合具有促进作用,提高创面愈合质量,减少瘢痕组织。     

异种脱细胞真皮基质在供皮区创面的应用观察

目的探讨供皮区创面应用异种（猪）脱细胞真皮基质修复的临床效果。方法应用异种（猪）脱细胞真皮基质治疗48处供皮区创面（治疗组）,与同期应用凡士林油纱布治疗的48处供皮区创面（对照组）比较,观察供皮区创面愈合时间和愈合质量。结果异种（猪）脱细胞真皮基质治疗供皮区创面愈合时间[（10．5±3．1）d]较对照组[（17．2±5．2）d]平均提前3．8 d（P＜0．01）。结论异种（猪）脱细胞真皮基质可加快供皮区创面愈合。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.