VSD引流术结合重组人碱性成纤维细胞生长因子及液体敷料对糖尿病足溃疡的临床疗效及疼痛影响观察

目的:探讨负压封闭引流术(VSD)结合重组人碱性成纤维细胞生长因子及液体敷料对糖尿病足溃疡的临床疗效及疼痛影响观察.方法:选取2019年5月～2021年5月期间某院收治的98例糖尿病足溃疡患者作为研究对象,随机将所有患者分为研究组和对照组各49例,研究组采用VSD引流术结合重组人碱性成纤维细胞生长因子及液体敷料进行治疗,给予对照组普通换药治疗方式,并对比两组患者临床疗效及对患者疼痛程度的影响.结果:研究组临床总有效率为95.92％,明显高于对照组的73.47％(P<0.05);治疗7d及治疗14d后,研究组目前疼痛状况(PPI)、视觉模拟评定法(VAS)、疼痛评级指数(PRI)评分均明显低于对照组(P<0.05);研究组换药次数明显少于对照组,创面愈合时间、抗生素使用时间及住院时间均明显短于对照组(P<0.05).结论:针对糖尿病足溃疡患者,采用VSD引流术结合重组人碱性成纤维细胞生长因子及液体敷料对其进行治疗,可有效促进创面愈合、减轻患者疼痛程度,能够减少患者换药次数与抗生素使用时间,缩短患者创面愈合时间与住院时间,临床疗效较好,值得应用.     

Principles of environmentally-sustainable anaesthesia: a global consensus statement from the World Federation of Societies of Anaesthesiologists

The Earth’s mean surface temperature is already approximately 1.1°C higher than pre-industrial levels. Exceeding a mean 1.5°C rise by 2050 will make global adaptation to the consequences of climate change less possible. To protect public health, anaesthesia providers need to reduce the contribution their practice makes to global warming. We convened a Working Group of 45 anaesthesia providers with a recognised interest in sustainability, and used a three-stage modified Delphi consensus process to agree on principles of environmentally sustainable anaesthesia that are achievable worldwide. The Working Group agreed on the following three important underlying statements: patient safety should not be compromised by sustainable anaesthetic practices; high-, middle- and low-income countries should support each other appropriately in delivering sustainable healthcare (including anaesthesia); and healthcare systems should be mandated to reduce their contribution to global warming. We set out seven fundamental principles to guide anaesthesia providers in the move to environmentally sustainable practice, including: choice of medications and equipment; minimising waste and overuse of resources; and addressing environmental sustainability in anaesthetists’ education, research, quality improvement and local healthcare leadership activities. These changes are achievable with minimal material resource and financial investment, and should undergo re-evaluation and updates as better evidence is published. This paper discusses each principle individually, and directs readers towards further important references.     

Diffusion-weighted magnetic resonance imaging in rat kidney using two-dimensional navigated,interleaved echo-planar imaging at 7.0 T

The purpose of this study was to investigate the feasibility of two-dimensional (2D) navigated, interleaved multishot echo-planar imaging (EPI) to enhance kidney diffusion-weighted imaging (DWI) in rats at 7.0 T. Fully sampled interleaved four-shot EPI with 2D navigators was tailored for kidney DWI (Sprague–Dawley rats, n = 7) on a 7.0-T small bore preclinical scanner. The image quality of four-shot EPI was compared with T₂-weighted rapid acquisition with relaxation enhancement (RARE) (reference) and single-shot EPI (ss-EPI) without and with parallel imaging (PI). The contrast-to-noise ratio (CNR) was examined to assess the image quality for the EPI approaches. The Dice similarity coefficient and the Hausdorff distance were used for evaluation of image distortion. Mean diffusivity (MD) and fractional anisotropy (FA) were calculated for renal cortex and medulla for all DWI approaches. The corticomedullary difference of MD and FA were assessed by Wilcoxon signed-rank test. Four-shot EPI showed the highest CNR among the three EPI variants and lowest geometric distortion versus T₂-weighted RARE (mean Dice: 0.77 for ss-EPI without PI, 0.88 for ss-EPI with twofold undersampling, and 0.92 for four-shot EPI). The FA map derived from four-shot EPI clearly identified a highly anisotropic region corresponding to the inner stripe of the outer medulla. Four-shot EPI successfully discerned differences in both MD and FA between renal cortex and medulla. In conclusion, 2D navigated, interleaved multishot EPI facilitates high-quality rat kidney DWI with clearly depicted intralayer and interlayer structure and substantially reduced image distortion. This approach enables the anatomic integrity of DWI-MRI in small rodents and has the potential to benefit the characterization of renal microstructure in preclinical studies.     

发达国家医学生器官捐献意愿研究现状的范围综述

目的了解发达国家医学生器官捐献意愿研究的目的、结果、障碍因素和解决对策。 方法以主题词和自由词联合的方式对PubMed、Web of Science、Ovid MEDLINE、Ovid EMBASE(Excerpta Medica)、EBSCOhost Complete和Cochrane Library等已发表文献数据库，以及灰色文献数据库York Centre for Reviews and Dissemination、Open Grey、ProQuest Dissertation and Theses和Mednar进行系统、全面地检索，并采用Arksey和O′Malley提出的范围综述框架进行文献资料整合。 结果共纳入17项发达国家医学生器官捐献意愿研究。研究背景主要为医学生未来对于公众器官捐献有着重要影响。研究结果表明，大多数医学生器官捐献意愿性良好，但不同亚组的研究结果不一；其最主要的障碍因素为医学生器官捐献相关知识的缺乏；解决对策主要为施予系统化、结构化和可评价的教育课程。 结论21世纪以来发达国家医学生器官捐献意愿研究方兴未艾，其研究的多层面、多角度以及揭示的问题、寻求的解决对策，可对我国现阶段医学生器官捐献的研究提供一定参考。     

Effects of Wenyang Zhenshuai Granules on the Expression of Key Mitochondrial Autophagy Proteins in the Doxorubicin-Induced Model of H9c2 Cardiomyocyte Injury

Bulletin of Experimental Biology and Medicine - This study aimed to explore the effects of Wenyang Zhenshuai granules (WZG) on the morphology of cardiomyocytes, cell viability, and the expression...