负压封闭引流联合银黄洗剂冲洗治疗下肢静脉性溃疡的效果观察

目的:观察负压封闭引流联合银黄洗剂冲洗治疗下肢静脉性溃疡的临床疗效。方法:将52例下肢静脉性溃疡患者随机分为对照组和治疗组各26例,对照组给予负压封闭引流联合生理盐水冲洗治疗,治疗组给予负压封闭引流联合银黄洗剂冲洗治疗,疗程均为28 d。比较两组患者创面的面积及状态评分(气味、肉芽形态及疼痛的评分)、相关炎性指标(白细胞计数及超敏C反应蛋白值)的变化情况及总有效率。结果:治疗组的总有效率为88.46%,高于对照组的61.54%,差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后创面的面积及状态评分明显改善,白细胞计数及超敏C反应蛋白值明显降低(P<0.05),且治疗组较对照组改善更明显,差异均有统计学意义(P<0.05)。结论:负压封闭引流联合银黄洗剂冲洗治疗下肢静脉性溃疡可有效促进肉芽组织生长、改善创面状态并降低炎性反应,明显提高创面愈合率。     

Effect of irrigation of the nose with isotonic salt solution on adult patients with chronic paranasal sinus disease

In a prospective, randomized, controlled, double-blind trial we compared the effectiveness of endonasal irrigations with Ems salt solution to that with sodium chloride solution in the treatment of adult patients with chronic paranasal sinus disease. Subjects (n = 40) were randomly allocated to treatment either with isotonic Ems salt solution or with isotonic sodium chloride solution. The treatment consisted of endonasal irrigation twice daily and additional nasal spray as required. Nasal endoscopy, plain radiography of the paranasal sinuses, olfactometry, anterior rhinomanometry, and a saccharin-clearance test were carried out on days 1 and 7. Patients recorded rating scales of general discomfort, nasal airway obstruction, agreeableness of the irrigation, duration of improved nasal resistance after each irrigation, and the amount of additional nasal spray in a diary. Nasal air flow was not improved significantly. Subjective complaints, endonasal endoscopy, and radiography results revealed a significant improvement in both groups (P = 0.0001). In comparison, the two groups were not significantly different in outcome. Endonasal irrigations with salt solutions are effective in the treatment of chronic sinusitis, and a significant difference between Ems salt and sodium chloride was not observed. Received: 18 January 2000 / Accepted: 20 July 2000     

Acceptance and effects of nasal lavage in volunteer woodworkers

Wood dust is an irritant and is carcinogenic to the nasal mucosa. It inhibits its own clearance from the nose. It therefore makes sense to lavage retained wood dust from the nose following exposure. To our knowledge this is the second study conducted to determine whether the procedure of nasal lavage reduces nasal symptoms in woodworkers. Forty-six woodworkers from 150 approached volunteered to trial nasal lavage using gravity fed, home-made unbuffered isotonic saline for 2 months in a crossover trial and then be followed-up a year later. The group reported significantly decreased nasal symptoms and over half continued to use nasal lavage voluntarily after 1 year. Results support the findings of the previous study that nasal lavage improves nasal symptoms and supplements those findings with data indicating patterns of voluntary usage following the study's conclusion. It is concluded that nasal lavage is an acceptable, effective and inexpensive option with minimal side effects for woodworkers who experience nasal symptoms and who wish to try the procedure.     

经尿道膀胱肿瘤电汽化切割加膀胱灌注化疗

目的总结经尿道汽化切割(TUVBT)加膀胱灌注化疗治疗膀胱肿瘤的疗效。方法对31例施行经尿道膀胱肿瘤电汽化切割加术后膀胱灌注化疗患者的临床资料进行回顾性分析。结果31例患者康复顺利,住院时间短,无明显合并症。随访3个月￣4年,复发1例,再次电汽化治疗后随访13个月无异常。结论经尿道膀胱肿瘤电汽化切割加膀胱灌注化疗治疗浅表性膀胱肿瘤,安全,微创,疗效可靠,是值得首选的方法。     

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??Objective    To study the effect of different irrigation regimens and methods of activation on smear layer removal in root canals. Methods    Thirty-two mandibular premolar roots were divided into 4 groups??with 8 teeth in each . In group A??the teeth were instrumented and irrigated by lateral opening syringe. In group B??irrigation was done using passive ultrasonic irrigation??PUI?? system. In group C RinsEndo root canal irrigation system was used and in group D??Vibringe sonic irrigation system. Scanning electron microscope evaluation was done for assessment of smear layer removal in the coronal??middle??and apical thirds. Results    In each group??there was a smear layer covering the dentinal tubule in apical thirds??and the score was higher than that in the coronal and middle ??P??0.05??. The scores of B??C and D groups were lower than those in group A??P??0.05??. Among A??B??C??D groups in the area of the root canal wall??difference of smear layer score was not statistically significant. Conclusion    Better removal of smear layer of the middle and apical thirds of root canal can be achieved by using RinsEndo??Vibringe and PUI system than by lateral opening syringe.     

Comparison of the flow characteristics of irrigants with standard and Max‐i‐Probe needles

The objectives of this study were to determine the direction and pattern of flow of irrigating solutions inside simulated root canals with different irrigation needles; and to determine whether different needle designs increase the likelihood of irrigating solution passing through the apical foramen. Two types of needles were compared: a standard needle with a bevel and an open end, and a needle with a side opening and closed rounded tip. Observations of irrigant flow within the canals indicated that the side‐venting needle can be dangerous if the needle gauge is small and it reaches the full length of the canal, since this allowed irrigants to flow into the periapical area. With the standard needle, the fluid did not go beyond the tip of the needle when minimal irrigating pressure was employed. As the size of canal increased, the fluid did not extrude beyond the tip of both needles. However, if the needles bound in the canals, then the fluid was forced away from the needle tip, and the pressure applied to the syringe was directly proportional to the distance the fluid flowed away from the needle tip. Both side‐venting and standard needles can be used for irrigation safely and effectively if a dynamic irrigation technique (moving the needle up and down inside the canals while irrigating) is employed.     

上颌窦穿刺冲洗治疗儿童急慢性鼻窦炎的效果分析

目的分析上颌窦穿刺冲洗治疗儿童急慢性鼻窦炎的临床疗效。方法将320例儿童(7~12岁)急慢性鼻窦炎患者采用随机平行试验设计,分为实验组160例和对照组160例,两组均服用鼻窦炎口服液1次10 m l,每日3次,实验组在鼻腔黏膜麻醉下行上颌窦穿刺,用0.9%氯化钠溶液加甲硝唑注射液反复冲洗后,窦腔内注入地塞米松5mg,每周一次;鼻腔内滴1%呋喃西林麻黄素液,3次/d,15 d为一个疗程。对照组口服广谱抗生素+鼻腔内滴1%呋喃西林麻黄素液,3次/d,15 d为一个疗程。治疗结束后每月复查1次,6个月后进行疗效评定。结果实验组的治愈率84.38%,总有效率98.75%,均显著高于对照组,两组间比较有显著性差异(P<0.01)。结论上颌窦穿刺冲洗结合鼻窦炎口服液治疗儿童急、慢性鼻窦炎疗效可靠,穿刺前充分评估患儿病情,实施健康教育,加强心理护理是上颌窦穿刺治疗顺利进行的基础,也是上颌窦穿刺成功的重要保证。     

Evaluation of smear layer removal by bicarbonate soda,ethylenediamine tetraacetic acid with cetrimide and sodium hypochlorite with a new model

Various methods are used to evaluate irrigants. The primary aim was to develop a model for preliminary testing of potential irrigants. The second aim was to investigate the effect of bicarbonate soda on smear layer by comparing it with ethylenediamine tetraacetic acid with cetrimide (EDTAC) and sodium hypochlorite (NaOCl). Extracted human single‐canal teeth were halved, and a uniform filing method was used to create smear layer. The following solutions were then applied – distilled water (control), 1% NaOCl, 17% EDTAC and bicarbonate soda at concentrations of 1%, 5%, 10% and 15%. Some samples had multiple solutions in different sequences. Samples were examined by scanning electron microscopy. Representative images were scored based on the degree of smear layer remaining. Results were analysed with the SAS system, using the GENMOD procedure. Complete smear layer was found in samples treated with all solutions except EDTAC used alone. There were no significant differences between the sequences, EDTAC/NaOCl/EDTAC and NaOCl/EDTAC/NaOCl. There were no significant differences between groups with and without bicarbonate soda. In conclusion, the model was effective for testing chemical effects on solutions on smear layer. Bicarbonate soda did not remove smear layer and provided no additional cleaning effects after EDTAC and NaOCl.