外用重组牛碱性成纤维细胞生长因子对于糖尿病足的观察和护理

目的探讨复方黄柏液及重组牛碱性成纤维细胞生长因子对糖尿病足溃疡的作用及临床护理策略。方法将60例入院的糖尿病足患者,按入院的先后顺序,随机分为30例治疗组,30例对照组。两组患者除常规治疗外,治疗组患者应用复方黄柏液及重组牛碱性成纤维细胞生长因子隔日换药,对照组常规清创后予以应用藻酸盐敷料,观察5周,比较两组患者糖尿病足的恢复情况。结果治疗组在促进创面愈合方面,明显优于对照组,差异有统计学意义(P<0.05)。结论在综合治疗基础上,糖尿病足创口换药时应用复方黄柏液及重组牛碱性成纤维细胞生长因子,能明显提高糖尿病足的愈合率。     

外用重组牛碱性成纤维细胞生长因子结合中药沐足治疗糖尿病足难愈创口临床研究

目的探讨外用重组牛碱性成纤维细胞生长因子结合中药沐足治疗糖尿病足难愈创口的临床疗效。方法选取2012年8月~2014年1月我院糖尿病足部溃疡患者60例,随机分为观察组和对照组,各30例。观察组给予中药沐足、l%Ag-SD霜联合重组牛碱性成纤维细胞生长因子局部外用,而对照组仅局部外用l%Ag-SD霜。观察及比较两组患者治疗后临床疗效、创面愈合时间、住院时间及不良反应情况。结果观察组患者总有效率明显高于对照组,创面愈合时间和住院时间明显短于对照组(P0.05),且两组均未见不良反应。结论外用重组牛碱性成纤维细胞生长因子联合中药沐足治疗糖尿病足难愈创口患者疗效安全、有效,能促进创面愈合,缩短住院时间。     

重组碱性成纤维细胞生长因子及复方四黄液创面敷料用于污染创面处理的随机对照研究

目的观察重组碱性成纤维细胞生长因子及复方四黄液创面敷料联合应用于污染创面处理的临床疗效。方法 160例急诊开放性骨折创面污染的手术患者应用随机数字表分为观察组和对照组,每组各80例,观察组采用重组碱性成纤维细胞生长因子喷雾剂及复方四黄液创面敷料进行创面处理,对照组采用常规方法进行创面处理;观察和比较两组创面愈合、换药次数及感染情况。结果观察组平均愈合时间、换药次数、甲级愈合率及创面感染率等指标均优于对照组,其差异均有统计学意义(均P<0.05)。结论重组碱性成纤维细胞生长因子联合复方四黄液创面敷料用于污染创面的处理,可有效地预防创面感染,促进创面愈合。     

生肌玉红膏对慢性皮肤溃疡患者创面中VEGF和FGF-2水平及疼痛、愈合的影响

目的:探讨生肌玉红膏对慢性皮肤溃疡患者创面中血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子2(FGF-2)水平及疼痛、愈合的影响.方法:选取某院确诊的慢性难愈性皮肤溃疡患者96例,采用随机数字表法分为观察组和对照组,每组48例.对照组患者采用常规清创联合药物治疗,观察组采用常规清创联合生肌玉红膏换药治疗,均持续治疗3周.记录2组患者创面愈合时间,评估2组患者治疗前后创面疼痛程度、溃疡面积和创面分泌物中VEGF和FGF-2水平,记录治疗期间不良反应发生率.结果:观察组患者溃疡面愈合时间明显低于对照组(P<0.05);治疗后2、3周2组患者创面疼痛程度(VAS)评分均较治疗前降低,且观察组低于对照组(P<0.05);治疗后,观察组患者溃疡面积少于对照组,创面分泌物中VEGF及FGF-2水平明显高于对照组(P值均<0.05);2组患者治疗期间不良反应发生率比较差异无统计学意义(P>0.05).结论:常规清创联合生肌玉红膏治疗皮肤溃疡可明显提高创面分泌物中VEGF和FGF-2水平,减轻创面疼痛及溃疡面积,促进创面愈合.     

外用重组牛碱性成纤维细胞生长因子和磺胺嘧啶银治疗烧伤创面的对比分析

目的对比外用重组牛碱性成纤维细胞生长因子和磺胺嘧啶银治疗烧伤创面的临床效果,为临床提供更好的治疗方法。方法收集我院烧伤科2016年1月至2017年1月治疗的烧伤患者198例,按照数字表法随机分为治疗组和对照组,每组各99例,对照组采用磺胺嘧啶银进行治疗,治疗组采用外用重组牛碱性成纤维细胞生长因子进行治疗,对比两组患者的愈合时间和愈合情况。结果两组患者经过治疗后,创面具有显著改善,治疗组在浅Ⅱ°和深Ⅱ°创面的愈合时间上明显短于对照组,差异具有统计学意义(P<0.05)。在创面愈合情况上,治疗组浅Ⅱ°和深Ⅱ°创面的恢复情况明显好于对照组,差异具有统计学意义(P<0.05)。结论采用外用重组牛碱性成纤维细胞生长因子(贝复济)治疗烧伤创面,对浅Ⅱ°及深Ⅱ°创面都能够起到缩短愈合时间,加速创面愈合的作用,临床疗效确切,值得推广使用。     

研究纳米银敷料与重组人表皮生长因子联合治疗Ⅱ度烧伤的疗效

目的观察分析银离子抗菌功能性敷料联合重组人表皮生长因子治疗Ⅱ度烧伤的临床疗效。方法收集2016年5月至2017年5月来我院接受诊治的98例Ⅱ度烧伤患者作为研究对象,回顾性分析根据不同用药将病例分为研究组、对照组各49例,对照组单纯银离子抗菌功能性敷料换药,研究组在此基础上联合重组人表皮生长因子换药治疗,观察对比两组患者治疗20d后的愈合率和平均愈合时间。结果研究组患者伤口愈合时间明显短于对照组(P<0.05);治疗20d后研究组治愈率100%明显高于对照组的87.7%(χ~2=6.391,P=0.011)。结论银离子抗菌功能性敷料与重组人表皮生长因子联合治疗Ⅱ度烧伤,患者伤口愈合快,疗效好值得推广。     

利拉鲁肽治疗糖尿病足的临床疗效及对血管生成因子的影响

目的 探讨胰高血糖素样肽-1受体激动剂(利拉鲁肽)治疗糖尿病足的临床疗效及对血管生成因子的影响.方法 研究纳入80例糖尿病足患者,随机分为对照组和观察组.对照组给予降血糖、局部创面处理、抗感染等常规治疗;观察组在常规治疗的基础上予以利拉鲁肽治疗.观察治疗后患者临床疗效及血管生成因子水平(血管内皮生长因子、碱性成纤维细胞生长因子、色素上皮衍生因子)、血液流变学的变化.结果 与对照组相比,观察组治愈率和有效率(P=0.003)更高,血液流变学得到改善(P<0.01);利拉鲁肽治疗后患者血清血管内皮生长因子、碱性成纤维细胞生长因子水平均升高及色素上皮衍生因子水平降低(P<0.01),与对照组比较,观察组血清血管内皮生长因子、碱性成纤维细胞生长因子水平均升高更明显及色素上皮衍生因子水平降低更明显(P<0.01).结论 利拉鲁肽可能通过调节血管生成因子表达、改善血液流变学,进而有利于糖尿病足患者创面愈合.     

康复新液与重组牛碱性成纤维细胞生长因子对早期糖尿病足的疗效观察

目的探讨外用康复新液、重组牛碱性成纤维细胞生长因子（rb-bFGF）对早期糖尿病足的临床疗效。方法将45例早期糖尿病足患者随机分为3组,每组15例。对照组创面换药局部单纯外用凡士林纱布;康复新组、rb-bFGF组创面换药局部分别外用康复新液、rb-bFGF湿敷。治疗期间观察记录每周创面收缩率、肉芽组织生长情况、渗液情况。结果康复新组、rb-bFGF组从治疗2周开始,疗效均优于对照组,差异有统计学意义（P〈0.05）;康复新组和rb-bFGF组疗效差异无统计学意义（P〉0.05）。结论康复新和重组牛碱性成纤维细胞生长因子均可促进早期糖尿病足创面愈合。     

外用重组人碱性成纤维细胞生长因子治疗外伤缺损性创面的疗效观察

目的 观察重组人碱性成纤维细胞生长因子(rh-b FGF)治疗外伤后体表组织缺损性创面的疗效。方法 80例外伤后皮肤软组织缺损创面形成患者,随机分为治疗组(外用重组人碱性成纤维细胞生长因子组)和对照组(普通外科换药组),每组40例。观察两组治疗效果。结果 两组愈合时间、甲级愈合率、不良反应发生率比较,治疗组均优于对照组,差异具有统计学意义(P<0.05)。结论 外用重组人碱性成纤维细胞生长因子能够加快外伤后缺损性创面愈合,提高伤口甲级愈合率,不良反应少,疗效显著。     

观察负压封闭引流术联合银离子藻酸盐敷料在治疗压疮的效果

目的研究讨论压疮患者接受负压封闭引流术联合银离子藻酸盐敷料治疗的临床效果及症状改善情况。方法参与本实验的压疮患者共70例,其中应用负压封闭引流术,拆除引流后给予二期植皮6例,未接受二期植皮的64例。将未接受二期植皮的64例患者分成研究组32例和对照组32例。本实验对照组患者应用负压封闭引流术加常规创面换药治疗,研究组在负压封闭引流术的基础上联合应用阴离子藻酸盐抗菌敷料治疗。结果相比于对照组,研究组患者临床治疗总有效率更高,患者换药次数、新鲜肉芽生长时间和创面愈合时间均更短,差异有统计学意义(P<0.05)。结论压疮患者在临床治疗中应用负压封闭引流术联合银离子藻酸盐敷料方法效果更好,能够缩短患者的创伤愈合时间,促进其身体恢复的同时能够减少家庭经济负担,具有较大临床应用价值。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Alcohol and Substance Use and Abuse in Women and Children

No abstract available for this article.     

Degraded and undegraded carrageenans and experimental gastric and duodenal ulceration

The prevention of histamine-induced gastric and duodenal ulceration in the guinea-pig has been examined using a series of undegraded and degraded carrageenans. Undegraded carrageenans were active at lower doses than degraded carrageenans. The high viscosity of the undegraded carrageenans in solution prevented their use in larger doses. Degradation of carrageenan without serious loss of sulphate, gives a product which allows the dose to be increased to an extent that its effect more than offsets the slight loss in activity caused by the degradation. No single feature of carrageenan structure can be related to anti-ulcer activity although degradation, and hence reduction of molecular size, generally reduces activity. Sulphate contents over 30% have little apparent effect on activity; κ-carrageenans were not consistently different in anti-ulcer activity from Λ-carrageenans. This contrasts with the antipeptic activity of carrageenans where κ-carrageenans are less active than their Λ-counter-parts. As with antipeptic activity, the degree of anti-ulcer activity is probably determined by a combination of structural features which includes molecular size and polyanionic properties.     

Excretion and biotransformation of alfentanil and sufentanil in rats and dogs

The excretion and biotransformation of alfentanil (ALF) and sufentanil (SUF), two recent analogues of the synthetic opioid fentanyl, were studied after single iv administration of the tritium-labeled drugs in male rats and dogs. The drugs were almost completely metabolized in the two species, which resulted in a large number of metabolites. The excretion of the metabolites was rapid and exceeded 95% within 4 days, except for that of ALF metabolites in dogs (about 85%). For ALF, excretion of the radioactivity with the urine (73% in rats, about 76% in dogs) exceeded that with the feces. For SUF, excretion of the radioactivity with the urine amounted to 38 and 60% and that with the feces to 62 and 40%, in rats and dogs, respectively. Bile-cannulated rats excreted 68% with the bile within 24 hr after SUF dosing, and about 22% of this biliary radioactivity was subjected to enterohepatic circulation. After an ALF dose, the biliary excretion amounted to 24%, and the enterohepatic circulation was minimal. The main metabolic pathways of the two drugs were the oxidative N-dealkylation at the piperidine nitrogen and at the amide nitrogen, oxidative O-demethylation, aromatic hydroxylation, and the formation of ether glucuronides. N-[4-(Hydroxymethyl)-4-piperidinyl]-N-phenylpropanamide (M6) was the main metabolite of both ALF and SUF in rats. In dogs, the glucuronide of N-(4-hydroxyphenyl)propanamide (M5) was the main metabolite of ALF. After SUF dosing in dogs, N-[4-(methoxymethyl)-4-piperidinyl]-N-phenylpropanamide was more abundant than M5.