纳米银敷料在糖尿病足患者护理中的效果观察

目的：观察纳米银敷料在糖尿病足患者护理中的效果。方法将80例糖尿病足患者随机均分为纳米银敷料组和对照组（n=40）。纳米银敷料组患者使用纳米银敷料保护创面。对照组患者使用普通无菌纱布保护创面。记录2组患者创面愈合情况和创面细菌培养阳性例数。结果纳米银敷料组治愈率52.5%高于对照组27.5%（χ2=4.22,P<0.05）,无效率12.5%低于对照组（χ2=10.06,P<0.05）。纳米银敷料组细菌培养阳性的患者（13例）明显低于对照组（23例）（χ2=4.09,P<0.05）。结论纳米银敷料用于糖尿病足患者的护理效果更好。     

新型敷料纳米银在犬咬伤伤口应用的疗效观察

目的 探讨纳米银敷料治疗犬咬伤创面的临床疗效.方法 将60例86处犬咬伤创面患者,随机分为观察组和对照组.观察组用纳米银敷料换药,对照组采用盐水纱条换药.结果 两组相比,观察组总有效率为100%,对照组总有效率为80%,观察组在换药次数、愈合时间（d）、换药费用（元）及创面愈合百分率在治疗后的第2周、第4周均明显好于对照组（ P＜0.01）;观察组犬咬伤创面的平均痊愈时间（29±4.82）d明显短于对照组（37±6.32）d,经统计学分析,差异有统计学意义（P＜0.001）.结论 纳米银敷料能较快控制犬咬伤创面感染及创周炎症反应,缩短炎症期,促进伤口愈合,从而缩短愈合时间.     

两种方法治疗烧伤创面的临床疗效对比

目的比较纳米银敷料与磺胺嘧啶银霜两种方法治疗烧伤创面的临床效果。方法将124例烧伤患者随机均分为纳米银敷料组和磺胺嘧啶银霜组,通过两组患者的细菌感染率、创面愈合时间、手术植皮率、瘢痕发生率和毒副反应发生率比较两组临床疗效差异。结果两组患者细菌感染率和毒副反应发生率比较无显著差异;纳米银敷料组患者创面愈合时间为（89±1．5）d,明显短于磺胺嘧啶银霜组的（13．2±1．2）d（P〈0.05）;纳米银敷料组患者手术植皮率和瘢痕发生率分别为6．5％和24.2％,均显著少于磺胺嘧啶银霜组的41.9％和54.8％（P〈0．05）。结论纳米银敷料治疗烧伤创面效果明显优于磺胺嘧啶银霜,能缩短创面愈合时间,提高创面愈合率,值得临床广泛推广使用。     

泡沫敷料治疗骨科压疮18例效果观察

目的：探讨泡沫敷料治疗骨科压疮的效果.方法：将36例骨科压疮患者按住院先后顺序随机分为对照组和观察组各18例.对照组创面用传统的压疮护理方法;观察组创面清洗消毒后,Ⅰ、Ⅱ期压疮用泡沫敷料覆盖,Ⅲ期压疮根据伤口情况选择内敷料后用泡沫敷料覆盖.从初诊至治疗结束,2组患者均全程给予减压措施、营养支持、活动和皮肤护理等全身干预.结果：观察组17例治愈,1例好转;对照组8例治愈,6例好转,4例无效.观察组治疗效果明显优于对照组（P＜0.01）.结论：与传统敷料相比,泡沫敷料可减轻患者身心痛苦,促进伤口愈合,缩短疗程,提高压疮患者的生活质量,值得在临床上进一步推广.     

液体敷料治疗永久性膀胱造瘘术后刺激性皮炎的疗效观察

目的 观察液体敷料治疗永久性膀胱造瘘术后刺激性皮炎的效果.方法 将2011年7月～2013年12月南昌大学第二附属医院泌尿外科收治的27例永久性膀胱造瘘术后并发刺激性皮炎患者随机分为实验组14例和对照组13例,分别采用赛肤润和氧化锌软膏进行皮肤护理,比较两组患者皮炎创面治疗有效率及愈合时间.结果 实验组14例患者中,显效9例,有效5例,无效0例,有效率为100.0％;对照组13例患者中,显效6例,有效3例,无效4例,有效率为69.2％,两组比较,差异有统计学意义（P＜0.05）.实验组和对照组患者的治愈时间分别为（4.07±0.71）d、（5.38±1.24）d,差异有统计学意义（P＜0.05）.结论 将液体敷料用于永久性膀胱造瘘口周围刺激性皮炎的治疗,可显著促进刺激性皮炎创面愈合,缩短愈合时间.     

康惠尔水胶体敷料治疗Ⅰ期和Ⅱ期压疮疗效观察及护理心得

目的：探讨康惠尔水胶体敷料治疗Ⅰ期和Ⅱ期压疮的疗效。方法50例压疮患者随机分为观察组（康惠尔组）和对照组各25例。对照组患者清创后用无菌敷料覆盖创面,治疗组患者外贴康惠尔水敷料贴。结果疼痛消失时间,观察组（5.4±1.7）d、对照组（7.3±2.6）d,两组差异有统计学意义（P＜0.05）;治愈时间,观察组（11.5±3.4）d、对照组（18.7±4.5）d,两组差异有统计学意义（P＜0.05）。结论康惠尔水胶体敷料贴在压疮创面愈合时间上较常规纱布敷料短,且其粘合力强、不易脱落,明显减少换药次数,减轻护士的工作量和患者换药时的痛苦,值得临床广泛应用。     

金因肽联合纳米银医用敷料在Ⅱ度烧伤创面治疗中的临床观察

目的：观察金因肽联合纳米银医用敷料在治疗Ⅱ度烧伤创面的疗效。方法：Ⅱ度烧伤创面患者78例,随机分为治疗组40例,应用金因肽联合纳米银医用敷料换药;对照组38例,应用0.5%碘伏纱布,观察两组创面愈合情况和抑（杀）菌效果。结果：与对照组比较,治疗组创面愈合时间明显缩短,差异有统计学意义（P〈0.05）,抑（杀）菌效果显著。结论：金因肽联合纳米银医用敷料能有效抑制或杀灭烧伤创面病原菌,明显缩短烧伤创面愈合时间。     

纳米银敷料联合人表皮生长外溶因子凝胶制剂在深Ⅱ度烧伤创面治疗中的应用效果

目的：探讨纳米银敷料联合人表皮生长外溶因子凝胶制剂在深Ⅱ度烧伤创面治疗中的应用效果。方法：选取汕头市第二人民医院收治的74例深Ⅱ度烧伤患者作为研究对象,以随机数表法分为对照组与观察组,每组各37例。全部患者均实施彻底清创,对照组在清创后采用人表皮生长外溶因子凝胶制剂治疗,观察组在对照组基础上加用纳米银敷料治疗,比较两组患者治疗效果。结果：相较于对照组,观察组治疗后视觉模拟评分法（VAS）评分与创面细菌阳性率更低,差异有统计学意义（P<0.05）;观察组治疗1周与2周后的创面溶痂率更高,差异有统计学意义（t=11.501、10.102,P<0.05）;观察组完全溶痂时间与创面愈合时间更短,差异有统计学意义（t=7.481、5.990,P<0.05）;观察组治疗2周后的降钙素原（PCT）与高敏C反应蛋白（hs-CRP）均低于对照组,差异有统计学意义（t=6.259、12.689,P<0.05）。结论：纳米银敷料联合人表皮生长外溶因子凝胶制剂在深Ⅱ度烧伤创面治疗中的应用效果确切,可缩短创面愈合时间。     

碳纤维敷料与纳米银创伤贴在褥疮中的联合应用

目的观察碳纤维敷料与纳米银创伤贴在褥疮中联合应用的疗效。方法将18例45处褥疮患者随机分成2组,观察组9例24处褥疮,对照组9例21处褥疮。观察组按常规清创消毒后创面贴碳纤维敷料片,换药3d～4d后,改用纳米银创伤贴,根据伤口情况1d～2d换药1次。对照组按常规清创消毒后创面盖上无菌纱块,根据伤口情况1d换药1～2次。14d后对2组患者的褥疮进行疗效观察。结果本试验观察组治愈率达100%,对照组治愈率达到66.7%。结论观察组治疗褥疮优于传统方法。     

磺胺嘧啶银联合氧疗用于护理和治疗压疮的临床效果观察

目的：观察使用磺胺嘧啶银敷料联合氧疗用于护理二期以上压疮的临床治疗效果。方法选取56例二期以上压疮患者作为研究对象,随机均分为观察组和对照组（n=28）。观察组采用磺胺嘧啶银联合氧疗进行治疗与护理,在常规清理疮面后使用氧气吹干再贴上磺胺嘧啶银敷料,在用无菌纱布覆盖并包扎,松紧适宜,每班更换1次;对照组使用常规的清理方法,用络合碘消毒生理盐水清洗后擦干,在疮面敷上水胶体敷料（溃疡贴）。每2～3天更换1次或每4～7天更换1次,具体需根据渗液吸收的饱和程度调整敷料更换时间。观察对比2组的治疗时间及治疗效果。结果对照组痊愈9例,平均治愈时间为(12.1±1.3)d,好转12例,无效7例;观察痊愈19例,平均治愈时间为(7.9±1.0)d,好转8例,仅1例无效。观察组疗效显著优于对照组(P<0.01),平均治愈时间显著短于对照组(P<0.01)。结论应用磺胺嘧啶银联合氧疗护理二期以上压疮患者,能使压疮溃疡面坏死组织呈进行性减退,肉芽组织新鲜,生长迅速,创面愈合率提高,缩短疗程,且操作简单,值得临床推广应用。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…