郑州市4~6年级小学生视力不良及视力相关健康行为调查结果分析

目的 探讨郑州市小学生视力不良状况及视力相关健康行为的情况。方法 采用多阶段分层随机抽样方法抽取郑州市4~6年级小学生进行视力检查及视力相关健康行为情况调查,利用描述流行病学方法分析小学生的视力状况以及视力相关健康行为情况。采用单因素、多因素分析方法对学龄期儿童视力不良状况的影响因素进行分析。结果 共对2 415名郑州市4~6年级小学生进行视力检查及问卷调查,男童1 221人,女童1 194人,年龄10~13岁。视力不良检出共1 815例,占75.16%。轻度视力不良比例最高,共1 156例,占47.87%;其次是中度视力不良,488例,占20.21%;重度视力不良171例,占7.08%。多因素Logistic回归分析结果显示,性别（OR=0.517）、居住在城市（OR=5.888）、住校（OR=2.210）、读写姿势（OR=2.632,4.699）、参加课外辅导班（OR=5.501）、每日看电视时间（OR=1.440,1.881,2.389）、每日看手机或电脑时间（OR=2.307,2.704,3.747）、每日做作业时间（OR=1.736,1.887,2.234）、每日户外锻炼时间（OR=0.770,0.422,0.394）、家长不限制观看电子视频时间（OR=2.019）均为4~6年级小学生视力不良的影响因素。结论 郑州市4~6年级小学生视力不良状况较为严重,准确地识别视力不良的各类危险行为,给予个体针对性的矫正,才能达成防控学龄期儿童视力不良风险的目的。     

富血小板血浆在妇科疾病治疗中应用及其研究现状

富血小板血浆(PRP)是人自体全血经离心后获得的血小板浓缩物,含有大量生长因子及蛋白质。PRP因其有助于组织再生、伤口愈合、瘢痕修复等作用,在骨科、皮肤科、口腔颌面外科、整形美容科等领域应用广泛,而在妇科领域应用迄今相对较少。最新研究结果显示,PRP具有促进子宫内膜和卵泡生长作用,在治疗薄型子宫内膜(TE)、改善子宫内膜容受性(ER)、恢复卵巢功能等方面取得较大进展,并为多种妇科疾病治疗提供新的研究方向和手段。笔者拟就PRP的制备及分类、在妇科疾病治疗中的应用及其前景展望等最新研究现状进行阐述。     

羊水、胎皮与脐血对创伤愈合的影响

为促进伤口以完全再生的方式无瘢痕或较少瘢痕愈合 ,在实验羊背部脊椎两侧制做伤口模型 ,用羊水、胎皮、脐血等不同成分对伤口进行治疗 ,并于治疗后 1、3、7、1 4d取材 ,分别做HE、马宋三色染色 ,7d组做电镜切片 ,观察疗效。结果 :同期内羊水组、胎皮组及脐血组比云南白药组及生理盐水组炎症清除反应及肉芽、胶原生长好 ,但未发现有明显减少瘢痕愈合的作用。结果提示 :胎羊不同组分 (羊水、胎皮、脐血 )可促进伤口愈合 ,缩短愈合时间。     

逆向交锁髓内钉治疗股骨髁上骨折

目的探讨逆向交锁髓内钉在股骨髁上骨折中的应用价值.方法采用静力型交锁技术对16例股骨髁上骨折病例行经髁逆向交锁髓内钉治疗,其中陈旧性骨折6例,4例患者同期行植骨术.对伴有膝关节僵硬的病例,术中采用手法或(和)手术松解膝关节,术后辅以持续被动活动.结果随访8～36个月,骨折均愈合.愈合时间新鲜骨折2.5～5个月,平均3.5个月;陈旧性骨折7～11个月,平均8个月.结论逆向交锁髓内钉是治疗股骨髁上骨折的良好方法之一,其提供的力学固定有利于骨折愈合和膝关节功能的康复.     

肱骨干骨折的单侧多功能外固定支架治疗

目的探讨单侧多功能外固定支架治疗肱骨干骨折的临床疗效.方法自1993年6月～1999年12月间临床应用单侧多功能外固定支架治疗肱骨干骨折116例,并经随访观察.结果116例中有88例随访6个月～7年(平均随访3.8年),骨折愈合平均时间为43个月,愈合率94.32％,患肢功能恢复满复.结论单侧多功能外固定支架治疗肱骨干骨折符合生物学固定原则,既能减少骨折局部的创伤,保护血运,又能稳定固定骨折,可早期进行功能锻炼,特别是对软组织损伤严重的开放性骨折更具优越性.     

Investigating the effects of walnut ointment on non-healing burn wounds

Effective treatments for non-healing burn wounds are an unmet need for 95% of burn sufferers. Approaches currently available to treat non-healing burn wounds are not satisfactory due to undesirable side-effects or expense. The anti-oxidation and antibacterial activities of walnuts are recommended for treating chronic diseases. Walnut ointment has been developed and successfully applied to treat non-healing burn wounds in our hospital for decades. We report herein a detailed retrospective case review examining patients’ response to the walnut ointment. The walnut ointment has shortened healing time of non-healing burn wounds and improved clinical outcomes. In order to investigate the mechanism of action, walnut ointment has been applied on wounds of porcine full-thickness burn wound models. Histological and immunohistochemical analysis indicated our walnut ointment supports wound healing through promoting keratinocyte proliferation and differentiation. Taken together, we recommend the walnut ointment offers an effective and economical treatment for patients presenting with non-healing burn wounds.     

Selected conditions associated with an increased incidence of incisional hernia: A review of molecular biology

BackgroundIncisional hernias (IH) following a laparotomy, on average, occur in 10–20% of patients, however, little is known about its molecular basis. Thus, a better understanding of the molecular mechanisms could lead to the identification of key target(s) to intervene pre-and post-operatively.MethodsWe examined the current literature describing the molecular mechanisms of IH and overlap these factors with smoking, abdominal aortic aneurysm, obesity, diabetes mellitus, and diverticulitis.ResultsThe expression levels of collagen I and III, matrix metalloproteinases, and tissue inhibitors of metalloproteases are abnormal in the extracellular matrix (ECM) of IH patients and ECM disorganization has an overlap with these comorbid conditions.ConclusionUnderstanding the pathophysiology of IH development and associated risk factors will allow physicians to identify patients that may be at increased risk for IH and to possibly act preemptively to decrease the incidence of IH.     

负压封闭引流促进糖尿病足溃疡的愈合

目的分析负压封闭引流(vacuum sealing drainage,VSD)能否促进糖尿病足溃疡的愈合。方法回顾分析自2015年1月至2019年12月,北部战区总医院烧伤整形科收治的糖尿病足溃疡患者60例,并根据患者的治疗方式分为常规治疗组(30例)和VSD治疗组(30例)。统计对比分析两组患者的平均换药次数、平均愈合时间、疼痛程度及满意度。搜集治疗前和治疗14 d后的肉芽组织进行HE染色和VEGF免疫组化染色,分析创面愈合情况以及VEGF的表达情况。结果VSD治疗组换药次数[(5.40±0.28)次]显著少于常规治疗组[(31.41±1.11)次],组间比较P<0.05;VSD治疗组平均愈合时间(29.38±0.63)d显著短于常规治疗组(50.81±2.15)d,组间比较P<0.05;VSD治疗组患者的痛苦程度明显轻于常规治疗组,满意度显著优于常规治疗组,组间比较P<0.05。结论VSD治疗能够促进创面成纤维细胞的增殖、减少炎性细胞的浸润、促进VEGF的表达及创面的愈合。     

Professional project for wound healing clinicians

This article explores the professional project for an emergent subaltern specialist community of wound healing clinicians. Drawing on the literature on professions and boundary work, it examines how wound healing clinicians challenge the perception of their work as ‘dirty’ and seek its transformation into a specialism of ‘woundology’. The article is based on an ethnography of a UK multidisciplinary team of doctors and nurses with an interest and expertise in wound healing, who work as clinical academics and provide wound care services in outpatient clinics. It demonstrates that wound healing clinicians vindicate their professional status by seeking to enthral the medical community in ‘dirty wound care’ as a focused clinical specialty of ‘woundology’. Through training nurses to do medical wound care work, educating clinicians from other specialties about wounds and undertaking wound research, wound healing clinicians assert the professional boundaries of their specialism and its fit with mainstream medicine without embellishing the dirty aspects of their work.     

运动对骨骼－肌腱界面愈合组织的影响

利用纽西兰兔作体内实验，来分析手术后石膏固定，笼内活动，连续被动性活动三种不同的复健方法对肌腱－骨骼间界面愈合组织的影响。结果显示在术后第１５天愈合组织所能承受的最大张力，笼内活动组为０．８７５ｋｇ，石膏固定组为２．０１４ｋｇ，是笼内活动组的２３１．５２％，而连续被动性活动组为２．６３８ｋｇ，是笼内活动组的２６１．３５％。石膏固定组虽有很高的张力，但关节内粘连也较多。