普通敷料与湿性敷料在脓肿切开引流术后伤口护理中的临床效果比较

目的 探讨并观察普通辅料与湿性敷料在行脓肿切开引流术后患者护理中的临床效果,并对其效果做出评价。方法将本科行脓肿切开引流术的122例患者随机分为对照组和治疗组,术后分别使用普通敷料与湿性敷料,比较二者在伤口愈合时间、换药次数等方面的差异。结果与对照组比较,治疗组在行脓肿切开引流术后患者护理中伤口愈合时间、换药次数、疼痛评分方面有明显优势,差异有统计学意义（P〈0．05）。结论使用湿性敷料用于脓肿切开引流术后的护理可减少伤口愈合时间,减轻患者痛苦,临床效果优于传统干性敷料。     

伤口湿性愈合理论在门诊换药护理中的应用价值分析

<正>门诊换药包括处理患者伤口、及时更换敷料、观察情况愈合情况、清除分泌物、清除坏死组织等,确保伤口引流通畅、创面清洁,防止感染,加快切口愈合。传统干性换药中所用敷料价格低廉,可较好的将渗液吸收,保护创面,但极易渗漏、粘连,容易形成结痂,再次换药时极易对切口造成二次伤害[1]。临床有研究显示:伤口湿性愈合理论中所用到的湿性敷料,可为切口提供一个潮湿的愈合环境,加快上皮细胞组织     

难愈伤口治疗的新方法-德湿威交互式湿润治疗

Winter研究表明，湿润环境能促使创面再上皮化能力提高。保湿敷料已被证实为加速愈合和促进组织生长的理想敷料。对于难愈性伤口(溃疡、褥疮以及糖尿病坏疽等)的治疗，出现了众多油膏制剂、糊剂以及水凝胶制剂等湿润性治疗方法。德湿威伤口湿疗敷料具有新的伤口治疗理念：交互式湿润治疗。我院2001年11月～2002年4月应用德湿敷料治疗27例住院病患者，取得了显著疗效，现报告如下。     

浆细胞性乳腺炎急性期切开引流术疗效及术后切口愈合影响因素分析

目的：探究浆细胞性乳腺炎急性期切开引流的疗效并分析影响切口愈合的因素。方法选取收治的浆细胞性乳腺炎急性期患者60例，所有患者行切开引流术并使用银离子敷料引流及抗感染治疗。根据切口愈合情况将患者分为A组（Ⅰ期愈合）和B组（非Ⅰ期愈合），归纳影响切口愈合的相关因素。结果术后患者平均红肿消退时间（6．3±1．3）d，换药2周后取切口分泌物细菌培养均为阴性，63．3％（38／60）的患者出现窦道或瘘管，所有患者治愈后乳腺形成硬结。患者切口Ⅰ期愈合率为56．7％（34／60），A组年龄≥50岁、术前未使用抗生素、病程≥6个月、既往行切开引流术及术前合并瘘管或窦道的比例明显低于B组，差异均有统计学意义（ P ＜0．05）。抗生素使用的3个亚组间切口I期愈合率差异无统计学意义（ P ＞0．05）。2组患者婚姻状况和手术切口方式差异无统计学意义（ P ＞0．05）。 Logistic多因素回归分析显示，患者年龄、术前抗生素使用情况、病程、既往史及合并瘘管或窦道均为影响浆细胞性乳腺炎急性期切开引流术后切口愈合的因素。结论浆细胞性乳腺炎急性期切开引流联合银离子敷料可有效控制感染，加速切口愈合。     

湿性敷料治疗1例幼儿葡萄糖酸钙外渗引起组织坏死的护理

在现实治疗中幼儿葡萄糖酸钙渗漏时有发生,葡萄糖酸钙外渗引起组织坏死的伤口治疗由以前的干性愈合发展到现在的湿性愈合。本文阐述了一个2个月大的幼儿由于葡萄糖酸钙渗漏引起组织坏死,运用湿性愈合理论,同时根据患者的具体情况,选择合适的湿性敷料或改良的湿性敷料,创造接近生理状态的湿性愈合环境,促使伤口加速愈合。通过52天的治疗成功愈合的案例为类似的患者的治疗提供相应的实践经验。     

银离子藻酸盐抗菌敷料在1例糖尿病足底溃疡合并严重感染伤口中的应用

目的:通过应用银离子藻酸盐抗菌敷料,认识伤口护理的进展过程,进一步了解湿性敷料在有效控制糖尿病足底溃疡中的作用。方法:将银离子藻酸盐抗菌敷料应用于1例糖尿病足底溃疡合并严重感染伤口的老年患者。在控制血糖、营养神经、消除足底压力、抗感染及改善周边血液循环等基础治疗的同时,进行健康宣教、心理疏导等护理,伤口床配合应用银离子藻酸盐抗菌敷料换药。结果:溃疡面完全愈合。结论:糖尿病患者出现足溃疡的概率呈上升趋势,足溃疡又是糖尿病患者下肢截肢致残的主要原因。除提供全面有效的治疗外,应用合适的湿性敷料也尤为重要。银离子藻酸盐抗菌敷料用于治疗糖尿病足溃疡操作简单,换药次数减少,可有效促进溃疡面的愈合。     

贝复济联合康惠尔伤口敷料在外伤伤口中应用

目的 探讨湿性愈合敷料对外伤伤口的疗效.方法 将42例外伤伤口患者随机分为观察组22例和对照组20例,观察组采用湿性敷料治疗予贝复济联合康惠尔伤口敷料,对照组采用传统换药方法.比较两组患者的治愈率、愈合时间、换药次数、换药所花的时间和费用.结果 观察组的治愈率明显高于对照组(P＜0.05),平均愈合时间、换药次数、换药...     

藻酸盐敷料治疗顽固性窦道伤口的疗效观察

目的探讨藻酸盐敷料治疗顽固性窦道伤口的疗效。方法将32例顽固性窦道伤口患者根据随机分为观察组和实验组,各16例,观察组使用传统碘仿敷料条填充治疗,实验组使用藻酸盐敷料填充条治疗,两组从愈合时间、疼痛和治疗费用方面比较治疗效果。结果实验组藻酸盐敷料较观察组碘仿敷料可明显提高治愈率,在伤口愈合时间28天之内实验组有12例,而观察组仅6例。实验组较观察组可有效地减轻换药时的疼痛程度,实验组0、1、2、3级疼痛者分别为2、14、0、0例,而观察组分别为1、2、13、0例。实验组患者平均医疗费用为356元,而观察组为468元。经统计学分析,差异均有统计学意义（P〈0．05）。结论藻酸盐敷料治疗顽固性窦道伤口不仅可缩短治愈时间,减轻患者疼痛,同时还能减少患者的费用,具有临床应用价值。     

负压封闭引流技术治疗糖尿病足湿性坏疽的疗效观察

目的探讨负压封闭引流技术（VSD）治疗糖尿病足湿性坏疽的临床疗效。方法对42例糖尿病足湿性坏疽患者进行随机分组,对照组患者进行调控血糖、全身营养支持、抗感染、局部清创换药。治疗组患者在此基础上进行负压封闭引流治疗,至伤口愈合。结果治疗组患者创面肉芽组织新鲜,无渗出及感染,创面平均愈合时间为79.6d,明显优于对照组。结论 VSD治疗糖尿病足湿性坏疽可改善其局部血运,减轻水肿,促进创面肉芽组织生长,缩短创面愈合时间。     

新型敷料应用于慢性伤口的疗效观察

目的：总结新型敷料应用于慢性伤口的应用效果。方法：对本院2008年7月～2009年12月在神经内科、神经外科、骨科、内分泌科、肿瘤科、ICU、门诊的29例患者,33处慢性伤口采用Coloplast的康惠尔伤口湿性敷料代替原来的普通敷料进行治疗。结果：伤口Ⅰ期愈合显效23处,Ⅱ期愈合有效8处,无效2例。结论：采用新型敷料换药,能缩短伤口愈合时间,提高伤口愈合速度,减轻患者痛苦。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.