外用冻干重组人表皮生长因子促进创面愈合的疗效观察

目的 :观察外用冻干重组人表皮生长因子 (rh EGF)促进创面愈合的临床疗效。方法 :应用 rh EGF治疗烧伤创面及中厚皮片取皮后供皮区创面 (以下简称供皮区 )共 33例 ,采用相同部位作自身配对对照。结果 :rh EGF治疗浅 度烧伤创面的平均愈合时间为 (7.86± 2 .35 ) d,与对照组比较有非常显著性差异 (P <0 .0 1) ;供皮区平均愈合时间为 (9.18± 2 .14 ) d,与对照组比较有显著性差异 (P <0 .0 5 ) ;而深 度创面愈合时间为 (10 .88± 3.31) d,与对照组比较无差异 (P >0 .0 5 )。结论 :rh EGF对浅 度烧伤创面及供皮区创面有促进愈合的作用     

应用重组人表皮细胞生长因子（rhEGF）治疗烧伤残余创面36例

从 2 0 0 0年 4月至 2 0 0 1年 4月使用重组的人类表皮生长因子 ( rh EGF)治疗大面积烧伤残余创面36例 ,rh EGF有促进烧伤残余创面愈合、加快创面上皮化和缩短治疗时间的作用 ,具体如下。1　临床资料1 . 1　一般资料 :男 2 1例 ,女 1 5例 ,合计 36例 ,年龄 3～ 76岁 (平均 2 7.7岁 ) ,烧伤总面积 2 1 %～86% ,平均 33. 2 % ,烧伤深度浅 II～ III度 ,当创面经非手术治疗或手术植皮大部分愈合后 ,由于各种原因残余的少部分创面不再进行手术治疗时 ,使用 rh EGF湿敷或喷涂创面 ,残余创面最大面积达体表面积的 3%左右 ,其中最大连续面积达…     

重组人表皮细胞生长因子作用于创面的阴性观察

目的考察和评估rhEGF确切的临床效果,指导合理用药.方法入选病例95例,采用随机自身对照试验,治疗区在对照区基础上用rhEGF局部均匀喷湿创面,每日换药,观察创面愈合,以创面愈合为标准,判断创面愈合时间.结果用rhEGF治疗刃厚供皮区、中厚供皮区、烧伤浅Ⅱ°、深Ⅱ°创面,平均愈合时间分别为(7.10±3.20)d、(15.8±3.30)d、(11.0±2.10)d、(21.7±3.84)d,治疗区愈合时间较对照区无明显差异.结论 rhEGF用于治疗各类烧伤创面无明显效果.     

莫匹罗星和重组人表皮生长因子治疗烧伤残余肉芽创面的疗效分析

目的 :探讨应用莫匹罗星和国产重组人表皮生长因子 ( rh EGF)对大面积深度烧伤后残余肉芽创面 (简称残余创面 )的疗效。方法 :对 32例大面积烧伤患者后期残余创面分二组进行自身观察对照治疗 :治疗组 ( 32例 )应用莫匹罗星和重组人表皮生长因子 ( rh EGF)治疗 ,对照组 ( 2 4例 )选择紫花烧伤膏作自身对照治疗 ,观察和比较两组残余创面细菌转阴率和创面愈合情况。结果 :治疗组细菌总转阴率为 73% ,对照组为 2 2 % ,P <0 .0 1,两组差异有非常显著性意义 ;治疗组创面平均愈合时间为 ( 17.36± 4.98)天 ,而对照组为 ( 2 9.6± 8.72 )天 ,治疗组创面较对照组平均提前约 12天愈合 ,P <0 .0 5 ,两组差异有显著性意义。结论 :应用莫匹罗星和国产 rh EGF治疗烧伤残余创面 ,能有效地清除残余创面感染的主要细菌 (金黄色葡萄球菌和 MRSA) ,可明显加速烧伤残余创面的愈合     

重组人碱性成纤维细胞生长因子在烧伤创面中的应用

目的 :观察重组人碱性成纤维细胞牛长因子 (rh -bFGF)对烧伤创面愈合的影响。方法 :2 0 0 0年 2月～2 0 0 1年 12月局部清创后随机对 80例Ⅱ°烧伤创面和 8例烧伤后残余肉芽创面作为治疗组 ,用rh -bFGF喷雾剂以 15 0AU/cm进行局部喷涂 ,无菌敷料覆盖包扎。 80例早期烧伤创面采用自身对照法行常规治疗 ,观察同一深度、面积相近的创面的愈合时间 ,同期随机另选择 8例烧伤后残余肉芽创面者行常规治疗作为对照 ,观察创面愈合时间、创面局部及全身反应情况。结果 :治疗组创面愈合时间明显提前 ,经统计学处理 ,有显著性差异 (P <0 .0 5 )。结论 :rh -bFGF有明显促进烧伤创面愈合的作用。     

重组人碱性成纤维细胞生长因子在烧伤及皮肤损伤创面中的应用

目的　观察重组人碱性成纤维细胞生长因子 (rh -bFGF)对烧伤及损伤创面愈合的影响。方法　用rh -bFGF喷雾剂 ( 1 5 0AU/cm)进行局部喷涂 ,无菌敷料覆盖包扎。 80例早期烧伤创面采用自身对照法行常规治疗 ,观察同一深度、面积相近的创面的愈合时间 ,同期随机另选择 1 6例损伤后残余肉芽创面者行常规治疗作为对照。结果　治疗组创面愈合时间明显提前 ,经统计学处理 ,有显著性差异 (p <0 .0 1 )。结论　rh -bFGF有明显促进烧伤及皮肤损伤创面愈合的作用     

异种（猪）脱细胞真皮基质覆盖供皮区创面止痛疗效观察

目的：探讨应用脱细胞真皮基质覆盖供皮区创面止痛效果观察。方法40例烧伤总面积（total body surface area,TBSA）1%～80%病例,随机均分为A组和B组（n=20）。A组供皮区覆盖脱细胞真皮基质,B组供皮区覆盖凡士林,观察供皮区创面愈合时间及疼痛程度。结果 A组中途不需换药,创面愈合时间缩短,平均（10.0±2.6）d供皮区创面无疼痛;B组创面隔天换药,创面愈合时间较长（18.2±3.8）天,第2～3天开始疼痛,直至供皮区伤口愈合,组间差异有统计学意义（P＜0.05）结论异种(猪)脱细胞真皮基质覆盖供皮区后能加快皮肤创面愈合,改善愈合后的瘢痕及色素沉着,减轻患者治疗过程的换药痛苦,止痛效果明显,减少患者费用,缩短住院时间。     

磺胺嘧啶银霜联合重组人表皮生长因子治疗儿童烧伤创面的疗效观察

目的 :探讨 1%磺胺嘧啶银 (SD- AG)霜联合重组人表皮生长因子 (rh EGH)治疗儿童 度烧伤创面的疗效。方法 :对 97例烧伤患儿分两组进行治疗 :实验组 5 1例 (浅 度 30例 ,深 度 2 1例 ) ,创面外用 1% SD- AG霜及 rh EGH治疗。对照组 4 6例(浅 度 2 6例 ,深 度 2 0例 ) ,仅外用 1% SD- AG治疗。两组创面外用药均覆盖消毒纱布包扎 ,每日或隔日换药一次 ,直至创面愈合。对比观察两组患儿创面愈合时间。结果 :实验组浅 度愈合时间为 (8.5 3± 1.4 1) d,比对照组愈合时间 [(11.5 8± 2 .6 1)d]短 (P <0 .0 5 ) ;实验组深 度创面愈合时间为 (18.30± 4 .5 4 ) d,比对照组愈合时间 [(2 2 .86± 3.5 7) d]短 (P <0 .0 1)。结论 :1% SD- AG霜与 rh EGH联用治疗儿童 度烧伤能促进创面的愈合     

重组人表皮生长因子对Ⅱ度烧伤创面愈合的影响

目的观察重组人表皮生长因子(rhEGF)对烧伤患者烧伤Ⅱ度创面愈合的治疗效果。方法在常规治疗基础上,应用rhEGF对A组56例浅Ⅱ度和深Ⅱ度创面的烧伤患者及B组35例深Ⅱ度创面的患者进行治疗对照观察。结果A组试验组(A1)浅Ⅱ度、深Ⅱ度创面平均愈合时间分别为(10·10±2·20)d、(17·25±3·40)d,对照组(A2)平均愈合时间分别为(13·20±3·35)d、(21·68±4·50)d。两组患者创面平均愈合时间差异均有显著意义(P<0·01)。B组试验组(B1)深Ⅱ度创面平均愈合时间为(17·68±3·10)d;对照组(B2)平均愈合时间为(17·45±3·50)d,两组患者创面平均愈合时间差异无显著意义(P>0·05)。结论外用rhEGF能明显促进烧伤患者Ⅱ度创面的愈合,但对于深Ⅱ度创面,宜于烧伤后第6天使用rhEGF进行治疗。     

大面积烧伤病人应用重组生长激素后血浆蛋白的变化及对创面愈合的影响

目的：探讨重组人生长激素对大面积烧伤病人血浆蛋白的影响及其对烧伤创面愈合的作用。方法：选择14例烧伤面积大于50％，Ⅲ度面积大于20％的成年烧伤患者，随机分为重组人生长激素组(rhGH)和对照组。常规行补液、抗感染及支持治疗。伤后5d内行创面切削痂、自体皮移植。rhGH组从术后第1天起每天按0．3IU／kg给予rhGH治疗共10d，对照组按相同方法给2ml生理盐水作安慰剂对照。伤后当天、14、21d取外周血检测血浆蛋白、转铁蛋白，记录供皮区、深Ⅱ度创面完全愈合时间。结果：rhGH组血浆蛋白水平、供皮区、深Ⅱ度创面愈合时间明显优于对照组(P＜0．05或＜0．01)。结论：严重烧伤病人早期应用rhGh，能有效促进蛋白合成，加快创面愈合，减少感染，缩短住院时间。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.