重组人血小板源生长因子促进糖尿病大鼠创面愈合机制的初步研究

目的:研究重组人血小板源生长因子(rhPDGF)对糖尿病大鼠全层皮肤缺损创面的修复作用及其可能机制。方法:在26只糖尿病大鼠背部制备4个全层皮肤缺损创面,创面随机分成3组,rhPDGF治疗组,凝胶剂基质组,空白组。观察伤后3,7和14d组织肉芽形成、胶原沉积、再上皮化速率,以及炎症细胞的浸润情况,并采用免疫组织化学方法观察创周和创基修复细胞增殖状况。结果:伤后7d,组织学检查显示,经rhPDGF治疗的创面伤后7d肉芽组织生长活跃,其毛细血管胚芽与成纤维细胞数量显著多于其他组,大量的炎症细胞浸润和胶原沉积,rhPDGF治疗组伤腔容积减小至(0.03±0.03)mL,明显低于凝胶剂基质对照组(0.06±0.03)mL(P<0.05)和空白对照组(0.07±0.05)mL(P<0.05)。伤后7d,rh-PDGF治疗组的创面收缩明显,再上皮化速率达到46.1%,明显高于凝胶剂基质对照组(23.2%)和空白对照组(25.6%)。伤后14d,rhPDGF治疗组再上皮化速率达到99.9%,明显高于凝胶剂基质对照组(91.7%)和空白对照组(91.3%)。同时伤后组织中各类修复细胞PCNA的表达有显著差异。结论:rhPDGF对糖尿病大鼠创面有促修复作用,其对炎症细胞的趋化和修复细胞的增殖影响扮演重要角色。     

重组人血小板源生长因子促进糖尿病大鼠创面愈合机制的初步研究

目的：研究重组人血小板源生长因子(rhPDGF)对糖尿病大鼠全层皮肤缺损创面的修复作用及其可能机制。方法：在26只糖尿病大鼠背部制备4个全层皮肤缺损创面，创面随机分成3组，rhPDGF治疗组，凝胶剂基质组，空白组。观察伤后3，7和14d组织肉芽形成、胶原沉积、再上皮化速率，以及炎症细胞的浸润情况，并采用免疫组织化学方法观察创周和创基修复细胞增殖状况。结果：伤后7d，组织学检查显示，经rhPDGF。治疗的创面伤后7d肉芽组织生长活跃，其毛细血管胚芽与成纤维细胞数量显著多于其他组，大量的炎症细胞浸润和胶原沉积，rhPDGF治疗组伤腔容积减小至(0．03&;#177;0．03)mL，明显低于凝胶剂基质对照组(0．06&;#177;0．03)mL(P&;lt;0．05)和空白对照组(0．07&;#177;0．05)mL(P&;lt;0．05)。伤后7d,rh-PDGF治疗组的创面收缩明显，再上皮化速率达到46．1％，明显高于凝胶剂基质对照组(23．2％)和空白对照组(25．6％)。伤后14d，rhPDGF治疗组再上皮化速率达到99．9％，明显高于凝胶剂基质对照组(91．7％)和空白对照组(91．30％)。同时伤后组织中各类修复细胞PCNA的表达有显著差异。结论：rhPDGF对糖尿病大鼠创面有促修复作用，其对炎症细胞的趋化和修复细胞的增殖影响扮演重要角色。     

防疤烧伤膏对烫伤创面的促愈合效应(英文)

目的在观察防疤烧伤膏疗效基础上,进一步研究该药对烫伤创面的促愈合作用,并探讨其可能机制。方法4只小型猪背部各制备9个面积为2.54cm2的深II度烫伤创面,并将创面随机分为3组(每组12个创面),即防疤烧伤膏治疗组,凡士林治疗组,空白对照组。以创面面积、创面组织增殖细胞核抗原(PCNA)检测及组织学检查评价各级治疗效果。结果伤后11d防疤烧伤膏治疗组创面面积缩小为(0.10±0.03)cm2,明显小于凡士林组犤(0.81±0.54)cm2t=-3.22,P<0.05犦和空白对照组犤(0.70±0.21)cm2,t=-6.93,P<0.05犦;PCNA检测显示伤后7,11d各组创面组织均为强阳性表达;组织学检查表明伤后7d防疤烧伤膏治疗组的创面纤维组织生长多于凡士林组和空白组,伤后11d防疤烧伤膏治疗组创面已基本愈合,而凡士林组和空白对照组仍残留部分创面。结论防疤烧伤膏促进烫伤创面愈合的作用表现为溶解创面痂皮,促进纤维组织和表皮生长。     

防疤烧伤膏与京万红促进烫伤创面愈合作用的比较研究

目的比较防疤烧伤膏和京万红对烫伤创面愈合的作用。方法于小型猪背部制备小面积深Ⅱ°烫伤创面,并将创面分为防疤烧伤膏治疗、京万红治疗和空白对照3组。以创面面积及创面组织学检查评价各组治疗效果。结果伤后11d防疤烧伤膏和京万红治疗组创面面积分别缩小到(0.06±0.10)cm2,(0.03±0.03)cm2,两组间差异无显著性意义(P>0.05),都明显优于空白对照组(0.71±0.23)cm2,(P<0.01);伤后11d组织学检查见京万红治疗组创面均已被新生表皮覆盖,表皮生长略好于防疤烧伤膏组,而空白对照组仍残留部分创面。结论防疤烧伤膏和京万红对烫伤创面愈合均有促进作用,且两者的效果相近。     

封闭负压引流技术修复猪皮肤软组织爆炸伤创面的促愈合作用

目的:封闭负压引流技术是一种创面治疗新技术,观察不同负压封闭负压引流技术对猪皮肤软组织爆炸伤后创面愈合的修复作用。方法:实验于2003-04/05在唐都医院组织工程实验室完成。用电雷管在10只15～20kg的小白家猪双侧肩胛及双侧臀部造成40个爆炸伤创面,按随机数分为5组:对照组、-10kPa治疗组、-15kPa治疗组、-20Pa治疗组和-25kPa治疗组。各组创面伤后前3d不做任何治疗,以造成创面感染。伤后第3天,对照组常规换药,各治疗组分别用相应负压的封闭负压引流技术治疗。于治疗前和治疗后不同时间点测量创面面积、创面深度,并取创面中心的活组织进行细菌计数。结果:对照组,-10,-15,-20,-25kPa治疗组创面平均愈合时间分别为(32.8±1.6),(27.1±1.5),(25.8±1.0),(26.4±1.1),(27.8±1.4)d,各组间差异有显著性意义(P<0.01)。对照组在治疗前创面面积为(10.76±0.42)cm2,治疗3d后扩大至(13.30±0.43)cm2,随后面积逐渐缩小;各治疗组从治疗后第1天(伤后第4天)起创面面积维持不变或略缩小,其后创面面积逐渐缩小。对照组创面在伤后3～6d,创面深度由(1.65±0.25)cm加深至(2.43±0.25)cm,治疗后19d,肉芽组织长满伤口。各治疗组封闭负压引流技术治疗后深度就开始变浅;-15kPa治疗组伤后第9天肉芽组织已长平伤口,其他治疗组肉     

电针足三里对大鼠氧自由基和前列腺素的影响

目的　观察电针对应激大鼠血浆超氧化物歧化酶 ( SOD)、丙二醛 ( MDA)和前列腺素 E2 ( PGE2 )的影响 ,以探讨电针对胃黏膜保护作用的机理。方法　将 72只大鼠平均分为空白对照组、应激组和电针组 ,每组再按实验时间 1 ,3,5 d平均分为 3小组 (每小组 8只 )。利用生化比色法和放免分析法测定各组大鼠血浆 SOD、MDA和 PGE2 含量并计算各组溃疡指数 ( UI)。结果　应激组较空白对照组大鼠血浆 SOD明显下降 ( 1 7.0± 2 .9) N.L-1→ ( 1 1 .9± 3.4) N.L-1;MDA明显上升 ( 4 .85± 2 .38) N.L-1→ ( 7.5 6± 2 .48)N.L-1;PGE2 明显下降 ( 2 .74± 0 .77) ng.L-1→ ( 1 .5 4± 0 .2 5 ) ng.L-1,P<0 .0 5。 UI明显上升 ( 1 .1± 0 .4)→ ( 2 8.0± 4.1 ) ,P<0 .0 1。电针组较应激组血浆 SOD明显上升 ( 1 1 .9± 3.4) N.L-1→ ( 1 7.7± 4.8) N.L-1;MDA明显下降 ( 7.5 6± 2 .48) N.L-1→ ( 4 .1 4± 1 .78) N.L-1;PGE2 明显上升 ( 1 .5 4± 0 .2 5 ) ng.L-1→( 3.2 1± 0 .38) ng.L-1,UI明显下降 ( 2 8.0± 4.1 )→ ( 1 9.0± 2 .3) ;P<0 .0 1。电针组 PGE2 实验 5 d组较实验 1 d组明显上升 ( 3.2 1± 0 .38) ng.L-1→ ( 4 .5 2± 1 .0 6) ng.L-1,P<0 .0 5。结论　电针对胃黏膜的损伤具有保护作用 ,其机制与其影     

重组人表皮生长因子对剖官产腹壁感染切口愈合的促进作用

目的　观察重组人表皮生长因子 (rh EGF,商品名金因肽 )对剖宫产腹壁感染切口的治疗作用。方法　 37例剖宫产腹壁切口感染患者 ,在抗感染、清创的基础上 ,治疗组 2 1例用金因肽溶液喷洒切口 ,对照组 16例用 5 %碘伏液涂抹。观察切口自用药至愈合的时间。结果　治疗组切口平均愈合时间为 (12 .5 3± 3.0 1) d,而对照组为 (2 0 .33± 2 .75 )d,治疗组切口较对照组平均提前 7.8d愈合 (P<0 .0 1) ,两组间具有显著性差异。结论　 rh EGF具有促进剖宫产腹壁感染切口愈合的作用。     

佛甲草抗疲劳作用的动物实验

目的观察佛甲草提取液对小鼠综合体能及其小鼠血清、肝组织丙二醛、超氧化物歧化酶的影响,从而探讨该提取液的抗疲劳作用。方法①实验于2005-04/05在赣南医学院机能实验室完成。选用昆明种小鼠100只,雌雄不拘,体质量(20±2)g。②观察佛甲草提取液(由佛甲草提取所得)对小鼠耐寒能力的影响取雄性小鼠20只,随机分成2组空白对照组和佛甲草实验组,每组10只。空白对照组腹腔注射生理盐水10m L/kg;佛甲草组腹腔注射佛甲草提取液5g/kg。给药后1h,将小鼠置于-20°C低温冰箱中,记录小鼠存活时间。③观察佛甲草提取液对小鼠耐热能力的影响取雌性小鼠20只,随机分为2组,每组10只。空白对照组腹腔注射空白对照10m L/kg;佛甲草组腹腔注射佛甲草提取液5g/kg。给药后1h,将小鼠置于50℃恒温箱中,记录小鼠存活时间。④观察佛甲草提取液对小鼠负重游泳时间的影响取雄性小鼠20只,随机分为2组空白对照组和佛甲草组,每组10只。空白对照组腹腔注射空白对照10m L/kg;佛甲草组腹腔注射佛甲草提取液5g/kg。给药后1h,小鼠按体质量的5%尾根铜丝负重,置25℃恒温水箱中,记录小鼠从入水至沉入水中不再浮出水面为止所需时间,即为小鼠游泳时间。⑤观察佛甲草提取液对小鼠血清、肝组织丙二醛含量和超氧化物歧化酶活性的影响将其余40只小鼠随机分为4组空白对照对照组、维生素E对照组,佛甲草低剂量组和佛甲草高剂量组,每组10只。空白对照组小鼠灌胃空白对照10m L/(kg·d);维生素E对照组灌胃维生素E2.5g/(kg·d);佛甲草低剂量组灌胃佛甲草提取液5g/(kg·d);佛甲草高剂量组灌胃佛甲草提取液10g/(kg·d),连续14d。末次给药后2h,将各组小鼠断头取血,1500r/m in,离心5m in,取血清;取适量肝组织,用冰冷空白对照在冰浴中制成10%组织匀浆,4℃,3500r/m in,离心10min,取上清液。均采用硫代巴比妥酸比色法和黄嘌呤氧化酶法分别测定血清、肝组织丙二醛含量和超氧化物歧化酶的活性。⑥组间计量资料差异比较采用双侧t检验。结果小鼠100只均进入结果分析。①耐寒存活时间佛甲草组明显长于空白对照组[(58.30±6.88),(48.40±7.93)m in,t=2.9819,P<0.01]。②耐热存活时间佛甲草组明显长于空白对照组[(35.60±6.38),(22.80±6.30)m in,t=4.507,P<0.01]。③负重游泳时间佛甲草组明显长于空白对照组[(74.10±15.47),(43.60±13.62)m in,t=4.6779,P<0.01]。④血清、肝组织丙二醛含量佛甲草提取液低剂量和高剂量组明显低于空白对照组[血清(8.41±1.45),(7.65±1.32),(10.05±1.59)μm ol/L;肝组织(334.12±58.48),(315.13±55.65),(407.82±60.29)nm ol/g,t=2.41,3.6923,2.7748,3.5719,P<0.05～0.01];与维生素E的作用效果基本一致。⑤血清、肝组织超氧化物歧化酶活性佛甲草提取液低剂量和高剂量组明显高于空白对照组[血清(287.63±23.33),(300.86±26.35),(262.52±29.47)kNU/L;肝组织(783.59±27.07),(810.30±38.72),(741.04±45.92)kNU/g,t=2.112,3.0672,2.5237,3.6472,P<0.05～0.01];与维生素E的作用效果基本一致。结论佛甲草提取液具有增强机体活力和适应能力及对抗机体疲劳的作用。     

多发伤早期血小板计数变化及其对预后的影响

目的 :探讨多发伤后早期外周血小板计数的变化规律及其临床意义。方法 :选择伤后 4 8h内的 90例多发伤者 ,连续观察入院后即刻、2 4、72、12 0和 16 8h的生命体征各指标及血小板、白细胞等变化 ,记录伤后器官功能变化、并发症及创伤严重等级评分 (ISS)和急性生理学与慢性健康状况 (APACHE )等评分。结果 :伤后患者血小板计数总体呈下降趋势 ,72 h为低谷 ,12 0 h基本恢复正常。血小板降低组较血小板正常组伤情重〔 ISS评分为 (2 9.6 0± 9.80 )分比 (2 2 .30± 12 .0 0 )分 ,P<0 .0 5 ;APACHE 评分为 (4 4 .5 0± 15 .30 )分比(30 .6 0± 10 .6 0 )分 ,P<0 .0 5〕、器官功能不全发生率高 (83.9%比 6 2 .7% ,P<0 .0 5 ) ;血小板降低并死亡组血小板下降时间早〔(30 .1± 10 .3) h比 (5 1.3± 14 .8) h,P <0 .0 5〕,持续低值时间长〔(6 3.7± 11.0 ) h比 (5 4 .2±13.4 ) h,P<0 .0 5〕。结论 :多发伤后血小板呈消耗性降低 ,血小板快速下降和持续低值者提示预后不佳。     

竹荪托盖液对辐射损伤大鼠免疫功能的修复作用

目的:竹荪是含有锌、铜、铁、硒等具有免疫增强作用的微量元素的菌体,探讨竹荪托盖液对辐射损伤大鼠免疫功能的修复作用,并观察剂效关系。方法:实验于2003-09/11在泸州医学院附属医院传染与免疫实验室完成。选择雄性健康SD大鼠60只,随机分为5组,竹荪托盖液大剂量组12只、竹荪托盖液中剂量组12只、竹荪托盖液小剂量组12只、贞芪口服液组12只、空白对照组12只,以60Co-γ射线300cGy(55cGy/min366s)一次性全身照射造成大鼠辐射损伤。照射后第2天开始对辐射损伤大鼠进行灌喂试验(竹荪托盖液大剂量组8g,1mL/d,竹荪托盖液中剂量组4g,0.5mL/d,竹荪托盖液小剂量组2g,0.25mL/d,贞芪口服液组15g,1mL/d),30d后断颈处死实验大鼠,采血作免疫指标检测。解剖取胸腺、脾脏作指数测定。结果:5组60只动物均进入结果分析。①胸腺指数、脾脏指数计量分析结果:竹荪托盖液各组胸腺、脾脏明显增大(竹荪托盖液大剂量组、竹荪托盖液中剂量组、竹荪托盖液小剂量组胸腺指数分别为0.009±0.065,0.008±0.079,0.008±0.053;脾脏指数分别为0.027±0.032,0.024±0.051,0.024±0.042)呈现剂量效应关系,胸腺指数、脾脏指数竹荪托盖液大剂量组与空白对照组(0.008±0.027,0.023±0.039)比较差异显著(χ2=9.95×10-4,P<0.01),竹荪托盖液大剂量组与贞芪口服液组(0.008±0.061,0.024±0.042)比较差异显著(χ2=8.60×10-4,P<0.01)。②各组免疫指标分析结果:竹荪托盖液大剂量组免疫球蛋白IgG,IgA,IgM分别为(2.18±0.19),(0.33±0.13),(0.77±0.18)g/L,竹荪托盖液大剂量组与贞芪口服液组犤(2.48±0.17),(0.26±0.04),(0.47±0.16)g/L犦比较差异显著(P<0.05,P<0.01),竹荪托盖液大剂量组与空白对照组犤(2.56±0.33),(0.25±0.02),(0.40±0.10)g/L犦比较差异显著(P<0.05,P<0.01)。竹荪托盖液大剂量组CD4+,CD8+分别为(43.48±1.33)%,(27.2±0.42)%,竹荪托盖液大剂量组与贞芪口服液组犤(40.27±2.85)%,(31.33±1.01)%犦比较差异显著(P<0.05),竹荪托盖液大剂量组与空白对照组犤(39.97±2.95)%,(29.08±1.80)%犦比较差异显著(P<0.05)。各组间比较P<0.05,白细胞介素2竹荪托盖液大剂量组为(33.14±2.23)ng/L,竹荪托盖液大剂量组与贞芪口服液组犤(30.14±2.21)ng/L犦比较差异显著(P<0.05),竹荪托盖液大剂量组与空白对照组犤(29.73±1.45)ng/L犦比较差异显著(P<0.01)。自然杀伤细胞明显表现竹荪托盖液大剂量组CD16,CD57最高,分别为(23.00±2.04)%,(21.42±3.60)%,竹荪托盖液大剂量组与贞芪口服液组犤(17.33±2.02)%,(17.33±2.77)%犦比差异显著(P<0.01,P<0.05),竹荪托盖液大剂量组与空白对照组犤(13.67±4.14)%,(14.00±1.41)%犦比差异显著(P<0.01)。结论:①竹荪托盖液能增加辐射损伤大鼠胸腺指数、脾脏指数,且呈剂量效应关系。②改善血清体液免疫及细胞免疫指标,提高T细胞生长因子的指数,其胸腺、脾脏指数增加与免疫功能增强有关。③竹荪托盖液大剂量组各项指标表现出的作用均为最佳,优于贞芪口服液组和空白对照组。     

重组人酸性成纤维细胞生长因子促进皮肤缺损创面愈合的量效关系

目的观察外用重组人酸性成纤维细胞生长因子(rhaFGF)对全层皮肤缺损创面愈合的作用.方法将6只小型猪背部的60个创面分成5组,分别采用3种不同浓度的rhaFGF、碱性成纤维细胞生长因子(bFGF)及注射用水治疗.结果经rhaFGF治疗后创面面积、伤腔容积均比注射用水组明显缩小(P     

Management of skin tears and stage II skin ulcers with two topical regimens: a study of cost minimization

A health-economic study of newly formed skin tears and stage II ulcers used an unblinded, comparative, parallel-group design to evaluate two topical regimens as to time required for complete healing and assessment of cost minimization. Thirty-six elderly patients, at risk for developing indolent wounds of the skin and underlying tissues, were assigned to receive either a saline spray and a topical antibiotic ointment (TAM, n = 14) or Dermagran Spray and Dermagran Ointment (DSO, n = 22). The 76 wounds that appeared in these patients had comparable pretreatment surface areas of 3.73 +/- 0.96 cm2 in the DSO group versus 5.57 +/- 1.13 cm2 in the TAM group (P = NS). All wounds were treated twice daily, starting within 24 hours of their appearance, until complete healing. The 19 wounds in the TAM group healed within 48.0 +/- 25.3 days versus 15.4 +/- 1.9 days for the 57 wounds in the DSO group (P < .05). The cost of wound management for a given patient was calculated by adding the costs of nursing labor and the amount of product consumed to effect complete healing. To this end, the cost of the TAM regimen was $323.23 +/- 171.70 versus $104.75 +/- 12.92 for the DSO regimen (P < .05). Results are presented in light of the increasing pressure on long-term care facilities to provide effective and affordable treatment.     

两种皮肤保护方法在负压治疗慢性伤口中的应用研究

目的 探索两种皮肤保护方法对预防负压伤口治疗相关的潮湿相关性皮肤损伤的效果。方法 纳入具有负压伤口治疗适应证的慢性伤口患者132例,随机分为两组,每组各66例。试验组采用防漏膏封堵伤口周围皮肤保护法,对照组采用多聚合物无痛皮肤保护膜涂抹法,两组均干预14 d后,使用标准的湿性治疗随访至愈合或3个月。评价指标：负压治疗期间伤口周围皮肤潮湿相关性皮肤损伤发生率为主要结局指标,负压治疗过程中的漏气报警和皮肤浸渍频次、伤口面积、深度缩小率及随访3个月末的伤口治愈率与愈合时间为次要结局指标。结果 共脱落6例,试验组在负压治疗期间潮湿相关性皮肤损伤发生率、漏气报警和皮肤浸渍频次均少于对照组（均P<0.05）。试验组负压治疗14 d的伤口面积缩小率大于对照组（P<0.05）,深度缩小率两组接近（P>0.05）。随访期末试验组治愈率高于对照组（P<0.05）,两组愈合时间接近（P>0.05）。结论 两种皮肤保护法对预防潮湿相关性皮肤损伤均有一定效果,防漏膏保护法效果更优,在确保负压治疗顺利进行,改善伤口治疗效果,促进伤口愈合中发挥重要作用,适用于不同类型、不同部位的慢性伤口患者。     

The effect of colloidal fluid replacement on wound healing in an experimental sublethal hemorrhagic shock model.

OBJECTIVE: The aim of the study was to evaluate the effects of different resuscitation solutions on wound healing in an animal model of sublethal hemorrhagic shock. METHODS: Sublethal hemorrhagic shock was established by blood withdrawal until the mean arterial pressure fell to 40 mmHg within 15 min. Animals were resuscitated with four different solutions: group I (n=19) 0.9% NaCl, group II (n=20) 10% dextran 40, group III (n=20) 6% hydroxyethyl starch, group IV (n=18) 4% modified fluid gelatin. Following inhalation anesthesia, a full thickness skin incision of 2 cm in length was made on the abdominal wall and sutured primarily. The incision wound on the abdominal wall was excised on the fifth day. The breaking strength of the incision and hydroxyproline content of dry tissue were evaluated. RESULTS: Differences in breaking strength values were observed between groups I-III and I-IV (P<0.05). Hydroxyproline values were significantly lower in group IV (58.47 microg/ml) and group II (69.17 microg/ml) (P<0.05). The gelatin-resuscitated group had lower breaking strength and hydroxyproline values than the other groups. CONCLUSION: It can be concluded that resuscitation with modified fluid gelatin may have detrimental effects on wound healing in an experimental model of sublethal hemorrhagic shock.     

Pharmacokinetics of Enrofloxacin and Danofloxacin in Plasma, Inflammatory Exudate, and Bronchial Secretions of Calves following Subcutaneous Administration

Enrofloxacin (2.5 mg/kg of body weight) and danofloxacin (1.25 mg/kg) were administered subcutaneously to ruminating calves (n = 8) fitted with subcutaneous tissue cages. Concentrations of enrofloxacin, its metabolite ciprofloxacin, and danofloxacin in blood (plasma), tissue cage exudate (following intracaveal injection of 0.3 ml of 1% [vol/wt] carrageenan), and bronchial secretions were measured by high-performance liquid chromatography (HPLC) and microbiological assay (enrofloxacin plus ciprofloxacin and danofloxacin). Mean maximum concentrations (C(max)) +/- standard deviations of enrofloxacin (0.24 +/- 0.08 microg/ml), ciprofloxacin (0.11 +/- 0.03 [total, 0.34 +/- 0.10] microg/ml), and danofloxacin (0.23 +/- 0.05 microg/ml) were detected in the plasma of calves by HPLC. The C(max) were 0.49 +/- 0.17 microg/ml (enrofloxacin equivalents) and 0.24 +/- 0.03 microg/ml (danofloxacin) when they were measured by microbiological assay. Mean C(max) in exudate (HPLC) were 0.18 +/- 0.07 microg/ml (enrofloxacin), 0.10 +/- 0.04 microg/ml (ciprofloxacin), 0.27 +/- 0.09 microg/ml (enrofloxacin plus ciprofloxacin), and 0.19 +/- 0.05 microg/ml (danofloxacin), and concentrations in exudate exceeded those in plasma from 8 h (enrofloxacin and ciprofloxacin) or 6 h (danofloxacin) after drug administration. The C(max) were 0.34 +/- 0.09 microg/ml (enrofloxacin equivalents) and 0.22 +/- 0.04 microg/ml (danofloxacin) in exudate when they were measured by the microbiological assay. The maximum mean concentration achieved in bronchial secretions (HPLC) were 0.07 +/- 0.04 microg/ml (enrofloxacin), 0.04 +/- 0.07 microg/ml (ciprofloxacin), 0.10 +/- 0. 05 microg/ml (enrofloxacin plus ciprofloxacin), and 0.12 +/- 0.09 microg/ml (danofloxacin). The maximum mean concentration in bronchial secretions from a limited number of animals from which samples were available for microbiological assay were 0.27 +/- 0.11 microg/ml (n = 4 [enrofloxacin equivalents]) and 0.14 +/- 0.02 microg/ml (n = 3 [danofloxacin]). With predictive models of efficacy (C(max)/MIC and area under the concentration-time curve/MIC ratios in plasma) for Pasteurella multocida (MIC of enrofloxacin, 0.06 microg/ml [24]; MIC of danofloxacin, 0.06 microg/ml [6]), enrofloxacin produced scores of 8.17 and 52.00, respectively, compared to those of danofloxacin, which were 4.02 and 23.05, respectively. With the dosing rates recommended in some markets by manufacturers, enrofloxacin and danofloxacin achieved concentrations above the MICs for important pathogenic organisms in plasma, tissue cage exudate, and bronchial secretion. Since fluoroquinolones display concentration-dependent activities, C(max)/MIC ratios may be critical to efficacy. In the United States enrofloxacin is currently the only fluoroquinolone licensed for food animals and dosages for acute respiratory disease are 2.5 to 5 mg/kg for 3 days or 7.5 to 12. 5 mg/kg once. The higher dosages on a single occasion are likely to confer C(max)/MIC ratios that are associated with greater clinical efficacy.     

四黄生肌汤治疗肛周脓肿的有效性及对血清炎症因子的影响

目的探讨四黄生肌汤治疗肛周脓肿的临床效果及其对血清炎症因子的影响。方法选取2017年5月至2019年3月该院收治的102例肛周脓肿患者作为研究对象,随机分为对照组和观察组,每组各51例。对照组患者给予保留括约肌手术治疗,观察组患者在对照组的基础上联合四黄生肌汤治疗,治疗10 d后对两组患者疗效进行评估,比较两组患者创面愈合、症候评分、炎症因子水平及并发症发生率。结果观察组患者创面愈合、创面腐肉脱落时间短于对照组,创面缩小率高于对照组,差异均有统计学意义(P<0.05);两组患者治疗10 d后分泌物、肉芽形态、红肿及创面疼痛评分均低于治疗前,且观察组患者治疗10 d后分泌物、肉芽形态、红肿及创面疼痛评分均低于对照组,差异均有统计学意义(P<0.05);两组患者治疗10 d后激活素A(ACTA)、白细胞介素(IL)-6及C反应蛋白(CRP)水平均低于治疗前,且观察组患者治疗10 d后ACTA、IL-6及CRP水平均低于对照组,差异均有统计学意义(P<0.05);两组患者治疗后肛瘘、排便困难、肛门失禁、创面延迟愈合及肛门缺损发生率比较,差异均无统计学意义(P>0.05)。结论四黄生肌汤用于肛周脓肿患者治疗,能促进创面愈合,改善中医症候积分,降低炎症因子水平,且不增加治疗后并发症发生率,值得临床推广应用。     

Glycosaminoglycan hydrogels as supplemental wound dressings for donor sites

Chemically crosslinked glycosaminoglycan (GAG) hydrogel films were evaluated as biointeractive dressings in a porcine model for donor-site autograft wounds. Multiple 5 x 5 x 0.03 cm wounds were created on the dorsum of pigs. Half of the wounds were treated with a GAG film plus an occlusive dressing (Tegaderm), whereas the other half were treated with Tegaderm alone. At 3, 5, or 7 days after surgery, the partially healed wounds were excised and evaluated histologically for three animals at each time point. By day 3, epithelial cells had proliferated and migrated from wound edges and from epithelial islands associated with residual hair follicles to begin to cover the wound bed. A statistically significant increase in coverage was observed for GAG + Tegaderm-dressed wounds than for those with Tegaderm alone at day 3 and day 5 post-surgery. By day 7, all treatment groups were completely healed. Thus, GAG hydrogels accelerated wound healing by enhancing re-epithelialization.     

Effects of granulocyte-colony stimulating factor on wound healing in a mouse model of burn trauma

The effects of burn trauma and granulocyte-colony stimulating factor (G-CSF) treatment on wound healing in a surgical incision model were studied. Sixty adult male mice were used in this study. Under general anesthesia hot water at 97 degrees C was applied for 3 sec to the dorsum of the mice in order to achieve 20% burn wound. After burn trauma, full thickness midline skin incision 2 cm in length was performed on the abdominal wall and then were sutured primarily with 4/0 polypropylene. In Group I only skin incision was performed, group II had skin incision and burn, in group III G-CSF (0.03 BU/30 g) was applied intraperitoneally after burn and skin incision. Breaking strength and 5-hydroxyproline (5-HP) levels of the wounds were calculated 5 and 10 days after the procedure. 5-HP levels and breaking strength values showed statistical difference between groups II-III and I-II (p<0.05). 5-HP levels were lowest in incision and burn group (41.80 microg/mg). Breaking strength levels were also lowest in the same group (0.12 kg) (p<0.05). These results suggest that third degree burn causes a significant impairment on incisional wound healing and G-CSF ameliorates this impairment.     

持续负压封闭引流在急诊四肢Ⅱ类手术创面中的临床应用研究

目的探讨负压封闭引流技术(vacuum sealing drainage,VSD)在急诊四肢Ⅱ类手术创面中的临床应用。方法回顾性分析VSD组38例,采用VSD治疗,对照组34例,采用常规手术及引流方法治疗。观察患者伤口分泌物细菌培养阳性率、脓毒症发生率、行植皮或皮瓣转移手术率、换药次数、伤口愈合时间、伤口愈合等级(甲级/乙级/丙级)比率、住院天数以及治疗总费用(不含内置物)等。结果两组患者换药次数、伤口愈合时间、住院天数以及不含内置物的治疗总费用四个计量指标在VSD组均明显低于未应用VSD的对照组(P<0.05),患者伤口分泌物细菌培养阳性率、脓毒症发生率在VSD组均明显低于未应用VSD的对照组(P<0.05),伤口愈合等级(甲级/乙级/丙级)比率VSD组也明显优于未应用VSD的对照组(P<0.05)。结论在处理四肢Ⅱ类手术创面时,早期、急诊应用VSD具有吸附坏死组织和创面渗出物、持续创面主动引流和预防感染等作用,可有效降低患者术后脓毒症的发生率,缩短住院时间,减轻经济负担。