MEBO治疗烧伤后残余创面疗效观察(附32例分析)

为探索治疗烧伤后残余创面的理想方法，本组将MEBO试用于治疗烧伤后残余创面，并与SD－Ag霜进行对照比较，结果显示。MEBO组效果优于SD－Ag组。MEBO组平均每日缩小面积为0．199±0．038cm2，对照组（SD－Ag霜）为0．037±0．015cm2，两者差异显著P＜0．01，且愈合后前者疤痕较后者轻。表明，MEBO是治疗烧伤后残余创面的理想药物，能明显加快创面愈合，减轻疤痕。     

湿润烧伤膏在乳房手术中的临床应用

目的：总结美宝湿润烧伤膏（MEBO）治疗各种乳房手术后皮肤创面的临床疗效。方法：对2001年10月-2007年10月实施乳房手术后的病历资料进行回顾性调查，主要调查指标为手术后创面的处理方法、愈合时间、局部并发症；调查分为MEBO治疗组（MEBO组）与非MEBO处理组（对照组）。结果：MEBO治疗组共计169例，对照组252例，MEBO治疗组的愈合时间与局部并发症明显低于对照组，组间均有非常显著性意义（P〈0．01）。结论：美宝湿润烧伤膏可促进乳房手术后创面的愈合，降低局部并发症。     

湿润烧伤膏治疗宫颈环形电切术后创面疗效观察

目的观察湿润烧伤膏（MEBO）治疗宫颈环形电切术后创面的疗效。方法将200例宫颈疾病患者行宫颈环形电切术后随机分为治疗组（100例）,对照组（100例）。治疗组术后创面外涂MEBO治疗,对照组术后创面用明胶海绵填塞治疗,观察两组患者术后创面愈合情况。结果治疗组术后阴道出血持续时间、阴道流液时间、术后创面愈合时间均比对照组明显缩短（P〈0．005）,治疗组术后宫颈黏膜外翻及宫颈息肉样增生程度明显低于对照组（P〈0．叭）。结论宫颈环形电切术后创面应用MEBO治疗,能减轻宫颈环形电切术后的不良反应,缩短创面愈合时间,且无瘢痕形成,效果满意,值得临床推广运用。     

美宝湿润烧伤膏(MEBO)对皮肤溃疡修复作用的实验研究

目的：初步探讨MEBO对体表皮肤溃疡创面修复作用的机制。方法：将54只SD雄性大鼠随机分为MEBO治疗组、四环素对照组和凡士林对照组，每组18只，参照文献制成SD大鼠体表溃疡模型，次日开始用药治疗，并观察用药后各组溃疡创面愈合情况、肉芽组织生长情况，记录创面愈合时间；在造模后第7、14d及创面愈合时每组各处死大鼠6只，取创面中心肉芽组织及愈合区中心组织，采用光镜观察成纤维细胞与新生毛细血管的数量与形态。结果：MEBO组大鼠的创面愈合情况明显好于四环素与凡士林对照组，创面愈合时间明显短于四环素组及凡士林组（P〈0．05；P〈0．01）；组织病理学检测MEBO组治疗的创面，术后第7d成纤维细胞数及新生毛细血管数均明显多于四环素组及凡士林组（P〈0．05；P〈0．01）；术后第14d，MEBO组成纤纬细胞数、新生毛细血管数明显减少，与凡士林组比较，有显著性差异（P〈0．05）。结论：MEBO能明显的缩短实验性SD雄性大鼠体表皮肤溃疡模型创面修复愈合时间，具有促进创面愈合的作用，并且对于创面修复过程肉芽组织中新生毛细血管和成纤维细胞数量与形态具有良好的调节作用。     

MEBT/MEBO治疗急性放射性皮炎临床观察

急性放射性皮炎,是肿瘤放疗中常见的损伤。传统上多采用外科换药治疗,且疗程偏长,疼痛、搔痒症状多不能缓解,有些病人还可发生局部感染。自1994年4月～1998年5月,我们采用MEBT／MEBO技术治疗该病人106例,并同94例外科换药疗法组进行对此。结果,治疗组创面平均愈合时间为5．6天（3～16天）;对照组为15天（6～30天）。治疗组用药10分钟到0．5小时,疼痛与搔痒症状减轻或消失,愈合后皮肤红嫩柔软,有弹性,无疤痕遗留;对照组愈合后皮肤质地僵硬,弹性差,44例留有疤痕增生。作者认为,MEBT／MEBO在急性放射性皮炎创面上,可产生止痛、止痒、抗感染、促进创面愈合,预防疤痕增生等作用。     

MEBO结合纳米银敷料治疗烧伤后期残余创面的临床观察

目的：观察MEBO与纳米银敷料对烧伤后期残余创面的治疗作用。方法：选择烧伤后期残余创面40例，随机分为对照组20例（用钠米银敷料换药）和治疗组20例（用MEBO结合含纳米银敷料换药），观察创面炎症反应，创面愈合时间及创面愈合后的瘢痕情况。结果：与对照组比较，MEBO组创面炎症的反应轻，引流通畅，创面愈合时间明显缩短，预后瘢痕轻。结论：MEBO结合纳米银敷料治疗烧伤后期残余创面能有效防治感染，加速残余创面愈合，能有效减轻后期瘢痕挛缩。     

MEBO对烧伤患者的免疫学影响

本文从局部及全身免疫方面对120例烧伤患者进行了研究，尤其对60例MEBO治疗患者，局部及全身IgA、IgG、IgM产生细胞和C3的变化进行了检测。结果显示：①烧伤区免疫因子染色强度均明显高于正常人及非烧伤区（P<0.01）。②烧伤深度及面积与局部免疫因子染色强度呈正相关，烧伤越深及面积越大，患者局部免疫因于染色越强，免疫力则高（P＜0．05）。③MEBO治疗，不同程度烧伤患者的痊愈时间明显较对照组缩短（P＜0．01），MEBO有明显促进烧伤创面愈合作用。④MEBO治疗后患者局部免疫因子染色强度明显高于治疗前及对照组（P<0．05），MEBO有明显提高烧伤患者局部免疫功能作用。⑤MEBO治疗后患者周围血和血清免疫球蛋白明显高于治疗前及对照组（P<0．05），MEBO有明显提高烧伤患者全身免疫功能作用。⑥MEBO治疗局部感染率明显低于对照组（P<0．05），MEBO有明显抗感染作用。并研究探讨了MEBO治疗中疗程与局部免疫、烧伤深度与局部及全身免疫、烧伤面积与局部及全身免疫间的关系。证实，MEBO可通过提高患者机体免疫力，对抗细菌、病毒及毒素对烧伤创面的侵袭，起到控制烧伤创面感染作用，且通过提高机体免疫力，促进创面愈合，缩短疗程     

MEBO与SD-Ag霜对比治疗烧伤70例临床体会

目的；比较MEBO（湿润烧伤膏）与SD－Ag（磺胺密啶银）霜治疗不同烧伤创面的疗效。方法：随机选择70例烧伤病例，35例烧伤创面采用MEBO治疗（治疗组）；35例采用SD－Ag霜治疗（对照组），观察两组不同深度烧伤创面的愈合时间、感染发生率及瘢痕发生率。结果：治疗组创面愈合时间、感染率及瘢痕出现率均明显低于对照组。结论：在烧伤治疗中，MEBO作用明显优于SD－Ag霜。     

MEBO与EGF在自体微粒皮种植修复肉芽创面中的临床疗效比较

目的 比较湿润烧伤膏（MEBO）、表皮细胞生长因子（EGF）对自体微粒皮种植修复肉芽创面的临床疗效.方法 选取中老年糖尿病、瘫痪、严重全身营养不良的38例患者,其肉芽创面面积大于5 cm2,按取皮面积：创面面积=1：20-30的比例种植自体微粒皮,将38例患者随机分为两组,治疗组15例（MEBO组）,对照组23例（EGF组）,分别用MEBO和EGF换药治疗至创面愈合,观察创面皮岛修复情况及愈合时间.结果 肉芽创面经自体微粒皮种植术治疗后,应用MEBO和EGF治疗都能使其愈合,但治疗组（MEBO组）的创面愈台率高于对照组（EGF组）;MEBO组创面生长出皮岛以及愈合所需时间较EGF组明显缩短（P＜0.01）.结论 肉芽创面经自体微粒皮种植术治疗后,应用MEBO治疗较EGF更能有效地促进创面修复.     

褥疮的临床治疗

目的：比较湿润烧伤膏（MEBO）和生肌散治疗褥疮的临床疗效。方法：将2003年1月～2007年6月接诊的褥疮病例随机分为MEBO治疗组和生肌散治疗组，MEBO组30例，创面外敷MEBO治疗；生肌散组28例，创面外敷生肌散治疗。结果：MEBO治疗组的治愈率明显高于生肌散治疗组（P〈0．001）。结论：湿润烧伤膏治疗褥疮临床疗效优于生肌散。     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Die rechtsmedizinische Identifizierung — Bedeutung und Beweiswert —

Zusammenfassung Bei der rechtsmedizinischen Identifizierung kann die Identität im strengen Sinn allenfalls bei lebenden Personen festgestellt werden; sonst läßt sich nur von Teilen auf das Ganze (vom Untersuchungsobjekt auf die Person) schließen, wobei die verschiedenen Merkmale des Untersuchungsobjektes entsprechend der Hdufigkeit ihres Vorkommens eine unterschiedliche Beweiskraft haben. Bei der Schädelidentifizierung mit Hilfe moderner photographischer oder elektronischer Superprojektionsverfahren ergeben sich unter Berücksichtigung der Weichteildicken so viele (fiktive) Vergleichspunkte, daß bei geeignetem Vergleichsmaterial (Photographien) Identität wegen der Vielzahl übereinstimmender Bezugspunkte in den meisten Fällen evident ist.     

Imaging of abdominal nodal spread in malignant disease

This is a review of the role of imaging procedures for the assessment of abdominal and pelvic lymph nodes. The diagnosis of malignant lymphatic spread is rarely the sole purpose of imaging, because it is usually part of a general abdominal examination, most frequently with CT or US, or increasingly with MRI. These studies are often requested in order to obtain information about the situation to be encountered during surgery, or to alert the surgeon to irresectability or to unexpected metastases outside the initially planned area of exploration. In most surgically treated tumours the role of imaging for preoperative staging is limited, due either to its insufficient sensitivity or because the initial treatment is independent of the lymph node stage. Imaging is commonly used to verify treatment response to chemo- or radiotherapy and for follow-up.Correspondence to: S. Delorme     

改进的定位技术在胸部肿瘤穿刺活检中的应用

目的：探索CT-SIM三维定位系统、体模固定技术和PET-CT融合影像导引定位技术在胸部肿瘤经皮穿刺活检中的应用价值。方法：对380例胸部肿瘤患者行改进的CT定位技术下的经皮穿刺活检术。根据肿瘤的大小、深度、毗邻关系、活动度以及患者的心肺功能状态,综合运用CT-SIM系统、体模固定技术和PET-CT融合影像导引技术,为患者进行穿刺前定位。统计穿刺定位时间长度、成功率、确诊率、并发症发生情况,并与210例采用传统铅栅定位下胸部肿瘤穿刺活检的相应资料进行比较。结果：采用改进的CT定位技术的380例患者穿刺定位精确,平均定位时间（9.5 min）较传统方法（16.8 min）缩短7.3 min,活检成功率和确诊率分别是98.7%和95.3%,高于传统定位方法的93.3%和83.3%,两者差异均具有统计学意义（P〈0.05）。穿刺并发症发生率相似,气胸发生率分别为2.8%和2.9%,咯血发生率分别为11%和12.8%。结论：根据患者状态及肿瘤特点,在CT-SIM系统快速精确定位技术的基础上,综合运用体模固定技术和PET-CT融合影像导引技术,能显著缩短经皮穿刺活检的定位时间,提高活检成功率。