猪皮生物敷料对大鼠烧伤的促愈作用

目的考察我室研制的软膏剂猪皮生物敷料对大鼠深二度烧伤创面的愈合作用。方法利用SPF级SD大鼠制备深二度烧伤动物模型,以灭菌油纱布敷料为对照组,观察利用软膏剂猪皮生物敷料对创面愈合作用的影响。结果实验组创面覆盖后渗出明显减少,愈合时间平均为213d,愈合时间较对照组提前了59d。实验组伤后7、9、12、15、18及21d的创面愈合率较烧伤对照组高(P<001)。结论软膏剂猪皮生物敷料促进烧伤创面愈合,对于临床上需要包扎的创面,这种膏剂猪皮敷料是一种很好的选择。     

硅胶敷料促进猪深Ⅱ度烧伤创面愈合的实验研究

目的:研究硅胶敷料对猪深Ⅱ度烧伤创面愈合的影响。方法:采用猪深Ⅱ度烫伤模型(以下称烧伤),分成实验组和对照组,创面分别外用硅胶敷料及生理盐水纱布,观察两组创面愈合时间;伤后7、10、14天分别取创面组织进行羟脯氨酸(OHP)含量、细胞DNA周期分析及组织学检查。结果:动物实验显示,应用硅胶敷料可使深Ⅱ度烧伤创面愈合时间缩短3天左右,创面OHP含量增加(P<0.05),促进肉芽组织形成,加速细胞DNA复制(P<0.05)。结论:外用硅胶敷料能促进烧伤深Ⅱ度创面愈合。     

伤安素治疗Ⅱ°烧伤的临床观察及护理

目的:观察伤安素治疗Ⅱ°烧伤的疗效及副作用及创面换药的护理方法.方法:将38例Ⅱ°烧伤病人等分实验组(伤安素组)和对照组(烧烫宁软膏组).实验组根据创面大小剪合适大小的伤安素贴于创面,对照组采用烧烫宁软膏纱布覆盖创面.隔日换药1次.无菌操作,并观察病人对疼痛的反应,观察创面敷料渗血渗液及肢端血液循环情况.结果:实验组治愈率89%,止痛率79%,致敏率0,优于对照组,P＜0.05.结论:伤安素治疗Ⅱ°烧伤,可减少瘢痕形成,疗效显著.     

沙棘油治疗烧伤创面的临床观察

目的效果观察沙棘油的治疗烧伤创面。方法将沙棘油与纱布制成沙棘油纱布作为内层敷料贴缚于创面,然后以无菌纱布覆盖包扎．隔日更换1次直至创面愈合。结果151例烧伤病人创面用药组和对照组用凡士林油治疗创面结果显示。沙棘油具有减少创面渗出、缓解疼痛、促进上皮和肉芽组织生长、加速创面愈合作甩。统计学分析两组具有显著性差异（P〈0．01）。结论沙棘油是医学上有广泛用途的珍贵药用油,作为一种治疗烧伤创面的外用药,具有肯定的疗效。     

Clinical observation of carbon fiber wound dressing Shangansu on large area deep burn wounds covered with xenoskin after microskin graft

目的 观察伤安素碳纤维敷料对大面积深度烧伤切痂微粒皮移植异种皮覆盖的治疗作用.方法 选择50%TBSA以上深度烧伤患者76例,分为对照组(碘伏纱布,棉垫包扎)和治疗组(伤安素碳纤维敷料,棉垫包扎),创面深度均为Ⅲ度切痂创面,观察面积为30%～51%[(31±4.6)%];创面处理时间:手术部位24 h内0.5%碘伏包扎,每日换药1次.手术切痂时间:治疗组伤后5～7 d[(5.80±0.14)d],对照组伤后5～7 d[(5.71±0.21)d],非手术部位全部用SD-Ag暴露和烤架促进成痂,观察渗出情况、异种皮排异时间、残余创面炎症反应、创面愈合时间、创面愈合质量.结果治疗组吸收容量大,异种皮排异时间较对照组平均延长4.76 d,残余创面炎症反应轻,创面愈合时间较对照组平均缩短5.80 d.结论 伤安素碳纤维敷料具有吸水性强、可抑制细菌生长、延长异种皮排异时间、促进创面愈合、减少瘢痕形成等优点.     

伤安素(OUR)在大面积烧伤微粒皮移植异种皮覆盖的临床观察

目的观察伤安素碳纤维敷料对大面积深度烧伤切痂微粒皮移植异种皮覆盖的治疗作用。方法选择50%TBSA以上深度烧伤患者76例,分为对照组(碘伏纱布,棉垫包扎)和治疗组(伤安素碳纤维敷料,棉垫包扎),创面深度均为Ⅲ度切痂创面,观察面积为30%～51%[(31±4.6)%];创面处理时间:手术部位24 h内0.5%碘伏包扎,每日换药1次。手术切痂时间:治疗组伤后5～7 d[(5.80±0.14)d],对照组伤后5～7 d[(5.71±0.21)d],非手术部位全部用SD-Ag暴露和烤架促进成痂,观察渗出情况、异种皮排异时间、残余创面炎症反应、创面愈合时间、创面愈合质量。结果治疗组吸收容量大,异种皮排异时间较对照组平均延长4.76 d,残余创面炎症反应轻,创面愈合时间较对照组平均缩短5.80 d。结论伤安素碳纤维敷料具有吸水性强、可抑制细菌生长、延长异种皮排异时间、促进创面愈合、减少瘢痕形成等优点。     

异种脱细胞真皮基质敷料在小儿烧伤中的应用观察

目的:探讨异种脱细胞真皮基质敷料在小儿烧伤创面的治疗效果。方法:将310例小儿烧伤患儿随机分为观察组和对照组,观察组165例采取异种脱细胞真皮基质敷料治疗的烧伤创面,对照组145例仅接受常规治疗,比较两组患儿创面愈合情况及换药次数等。结果:观察组患儿创面愈合时间为18.30±3.10d、瘢痕发生率为6.24%(12/165)、患儿创面植皮8例,占4.85%;均显著低于对照组[创面愈合时间25.10±5.53d、瘢痕发生率为25.80%(40/145)、患儿创面植皮21例,占13.55%]。两组比较均有显著性差异(P<0.05)。结论:异种脱细胞真皮基质敷料在小儿烧伤治疗中能有效减轻创面愈合时间、瘢痕发生率、患儿创面植皮例数及创面换药的频次。     

蝶形胶布和美宝创疡贴用于手术治疗拇趾双侧嵌甲的效果及护理

目的：探讨蝶形胶布和美宝创疡贴用于手术治疗拇趾双侧嵌甲的效果及护理。方法：采用随机对照试验,将40例拇趾双侧嵌甲病例按病人就诊先后顺序分为实验组和对照组各20例：对照组采用全拔甲＋患趾双侧部分甲母质切除、甲沟成形术十1号丝线缝合切口＋美宝创疡贴敷料＋加压包扎;实验组：采用患趾双侧部分趾甲、甲母质切除、甲沟成形术＋蝶形胶布（4-5条）拉拢固定切口＋美宝创疡贴敷料＋加压包扎。结果：经过1年的临床随访及电话回访;实验组：满意率为90%;对照组：满意率为60%,两组术后满意率比较差异有显著性（P〈0.05）。结论：患趾双侧部分趾甲、甲母质切除、甲沟成形术＋蝶形胶布拉拢固定切口＋美宝创疡贴治疗拇趾双侧嵌甲无需拔甲和缝针,术后趾甲甲床无创伤,无疼痛,趾甲表面光滑、无畸形,效果优。     

几种常用烧伤敷料的物理特性实验研究

目的探讨几种烧伤敷料的物理特性,为烧伤创面外用材料的选择提供依据。方法分别对非脱脂纱布、脱脂纱布及人造皮膜等几种材料的通透性、对外界污染的屏障隔离作用、对烧伤创面的保护作用、敷料的黏性进行实验。结果在抵抗外界污染方面,非脱脂纱布的抵抗力是脱脂纱布的2倍;在隔离保护烧伤创面方面,15屈脱脂纱布已能有效保护创面从而防止渗液外漏;人造皮膜的通透性是刃厚皮片的3．8倍;人造皮膜与创面的黏附力是脱脂纱布的1／2。结论以非脱脂纱布作为外层敷料优于脱脂纱布。5层非脱脂纱布即可达到隔离外界污染的作用;以15层脱脂纱布作为包扎烧伤创面的敷料,可达到有效保护创面的作用;人造皮膜作为内层敷料。有利于维持创面组织细胞复苏的内环境;人造皮膜与创面的黏性较小,有利于敷料的更换。     

丝蛋白敷料对大鼠浅二度创面的疗效研究

目的:观察大鼠二度烫伤创面应用丝蛋白创面敷料覆盖后的疗效?方法:SPF级雄性大鼠20只,体重230~250 g,随机分成对照组和实验组?76℃热水烫伤10 s,形成8 cm × 5 cm浅二度烫伤创面?腹腔注射平衡液5 ml抗休克处理?对照组创面覆盖消毒凡士林纱布,实验组创面覆盖丝蛋白创面敷料,外用无菌纱布包扎固定?手术后3 d行创面取材,组织培养后测定其释放表皮细胞生长因子(EGF)?碱性成纤维细胞生长因子(bFGF)?血小板衍生生长因子-AB(PDGF-AB)及白细胞介素-8(IL-8)的水平,并通过HE和Masson染色对创面组织坏死程度进行形态学观察?结果:实验组与对照组创面组织EGF?bFGF?PDGF-AB及IL-8的表达水平有明显差异(P均 < 0.01)?结论:丝蛋白创面敷料覆盖大鼠浅二度烧伤创面能促进局部生长因子的释放,抑制炎性因子的表达,有效抑制创面炎症反应并且对大鼠浅二度烫伤创面的愈合有促进作用?     

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.