Iodoform gauze removes necrotic tissue from pressure ulcer wounds by fibrinolytic activity

Iodoform gauze is used in clinical practice for treatment of infected wounds. However, effectiveness and action mechanism of iodoform gauze for removal of necrotic tissue are unknown. We therefore employed case control and biochemical studies in order to clarify the pharmacological activity of iodoform gauze. A clinical study demonstrated that treatment with iodoform gauze removed necrotic tissue more effectively than treatment with conventional ointments. More than 60% of iodoform gauze-treated wounds were completely debrided within 2 weeks. Consistent with the clinical observation, biochemical analyses revealed clear differences in wound fluid proteins after treatment with iodoform gauze or conventional gauze. The amount of macroaggregates of type I collagen from wounds were remarkably decreased in iodoform gauze. Moreover, iodoform gauze and iodoform itself released non-aggregative type I collagen from necrotic debris in vitro. Taken together, we conclude that iodoform gauze efficiently removes necrotic tissue by its lytic activity for collagen fibers.     

对比盐酸米诺环素软膏和碘仿纱条填塞拔牙窝治疗干槽症的效果

目的对比干槽症患者采用盐酸米诺环素软膏与碘仿纱条填塞拔牙窝的临床疗效。方法 90例干槽症患者,随机分为A组及B组,每组45例。A组采用碘仿纱条填塞拔牙窝, B组采用盐酸米诺环素软膏填塞拔牙窝。对比两组患者的治疗效果,治疗前后视觉模拟评分法(VAS)评分。结果治疗后,两组的总有效率对比,差异无统计学意义(P>0.05);但B组的显效率73.33%高于A组的53.33%,差异具有统计学意义(P<0.05)。治疗后, B组的VAS评分(1.19±0.24)分低于A组的(1.34±0.15)分,差异具有统计学意义(P<0.05)。结论干槽症患者采用盐酸米诺环素软膏与碘仿纱条填塞拔牙窝均可以取得良好的疗效,但盐酸米诺环素软膏的治疗显效率更高,疼痛更轻,且操作更加简单,患者的依从性更高,临床推广价值更高。     

碘仿纱条填塞治疗产后出血患者的效果观察

目的：分析碘仿纱条填塞治疗产后出血患者的效果。方法选取78例产后出血患者,随机分为观察组和对照组,每组39例,对照组给予临床药物保守治疗,观察组给予碘仿纱条填塞治疗,比较两组患者的疗效。结果对照组的有效率为82.1%,观察组的有效率为92.3%,观察组的有效率显著高于对照组,差异有统计学意义（P＜0.05）。结论不同分娩方式引起的出血量不同,采用碘仿纱条填塞治疗产后出血具有明显疗效。     

碘仿纱布联合美宝湿润烧伤膏治疗骨科创面感染46例

目的:探讨碘仿纱布联合美宝湿润烧伤膏治疗骨科创面感染的临床效果。方法:将2019年1月至2019年12月兴国县人民医院收治的92例骨科创面感染患者按随机数字表法分为观察组和对照组,各46例。观察组给予碘仿纱布联合美宝湿润烧伤膏治疗,对照组给予常规清创、换药等处理。比较两组患者的临床疗效、创面感染相关临床指标及治疗前后白细胞计数(WBC)、C反应蛋白(CRP)、创面细菌计数。结果:观察组总有效率明显高于对照组(P<0.05);观察组肉芽覆盖时间、肉芽痊愈时间、创面愈合时间、住院时间均明显低于对照组(P<0.05);观察组治疗后5 d、10 d的WBC、CRP、创面细菌计数均明显低于对照组(P<0.05)。结论:碘仿纱布联合美宝湿润烧伤膏治疗骨科创面感染临床效果显著,能有效控制感染,促进创面愈合和康复进程。     

两种不同根管充填材料的临床效果观察

目的观察比较Cortisomol和碘仿氧化锌丁香油根充材料在根管充填术后1周的反应情况。方法将162例患者的218颗患牙随机分为两组,实验组（Cortisom01）84例,110颗患牙;对照组（碘仿氧化锌丁香油）78例,108颗患牙。经常规根管预备及消毒后,分别用Cortisomol永久性根充材料和碘仿氧化锌丁香油根充材料作为糊剂充填根管。结果用Cortisomol根充材料治疗,有反应的患牙8颗,占7．3％;碘仿氧化锌丁香油根充材料治疗,有反应的患牙21颗,占19．4％,两种材料差异有统计学意义（P〈0．05）。结论Cortisomol可减少根管充填术后的反应,是比较好的根管充填材料。．     

老年前期和老年期顽固性鼻出血的治疗

目的：探讨老年前期和老年期顽固性鼻出血的临床治疗步骤和方法。方法：回顾性分析76例老年前期和老年期顽固性鼻出血的治疗资料。结果：76例顽固性鼻出血患者全部治愈，其中包括凡士林纱条和碘仿纱条填塞术、鼻内镜下微波治疗术和数字减影血管造影栓塞术。结论：顽固性鼻出血治疗的关键是准确找到出血部位及明确出血原因，并根据患者实际情况采取有效止血措施。     

拔牙导致上颌窦瘘的临床治疗

目的:探讨拔牙导致上颌窦瘘处理方法.方法:收集1996-2005年间我院拔牙导致点颌窦瘘病例42例,采用保守及手术进行处理.结果:在32例上颌窦无感染病例中,有23例上颌窦内无残留牙根,经保守治疗1周后拆除碘仿纱条,伤口愈合;9例有牙根残留者有8例经保守治疗愈合,1例多次换药后不愈合,行双层瓦合瓣修复.10例上颌窦有炎症者经上颌窦根治术而治愈.结论:无感染病例可用保守治疗,感染病例应手术治疗.     

比较两种根充糊剂对替牙期乳牙牙根吸收的影响

目的:探讨氢氧化钙碘仿糊剂和氧化锌碘仿糊剂对替牙期乳牙根管充填后的临床疗效及对乳牙根的影响.方法:对2008年4月～2010年4月在本院口腔科就诊的患儿50例,年龄10～13岁,在1～2年内即将替换的乳牙60颗随机分成两组,分别进行氢氧化钙碘仿糊剂和氧化锌碘仿糊剂充填,观察两组患牙的临床反应,患牙牙根和糊剂的吸收情况,并进行统计分析.结果:用氧化锌碘仿糊剂做根管充填有短暂的炎性反应,而且糊剂吸收迟缓于乳牙的吸收.结论:对乳牙根管的充填氢氧化钙碘彷糊剂优于氧化锌碘仿糊剂.     

Vitapex在乳牙根尖周炎中的临床效果分析

目的探讨Vitapex治疗乳牙根尖周炎的临床应用效果。方法回顾性分析2010年1月—2011年10月在该院口腔科就诊的110例患儿136颗患牙,随机分为实验组(Vitapex糊剂充填治疗)和对照组(氧化锌碘仿糊剂充填治疗),观察比较两组的治疗效果。结果实验组的治疗效果明显优于对照组,差异具有统计学意义(P0.05)。结论 Vitapex糊剂治疗乳牙根尖周炎的临床操作简单快捷,不仅可以防止根尖周炎的产生,而且还可以促进根尖周病变的愈合,术后并发症少,易于儿童接受,其临床效果优于氧化锌碘仿糊剂,值得临床应用和推广。     

鼻窦内窥镜手术后对漂移中鼻甲的处理探讨

目的 探讨鼻窦内窥镜手术后对漂移中鼻甲的处理方法。方法对6例鼻窦内窥镜手术后发生漂移中鼻甲进行内移固定术,即在鼻窦内窥镜下于中鼻甲前半部内侧面及鼻中隔相对应处分别造成一小创面,中鼻道用碘仿纱条填压,使其两处创面充分接触、粘连愈合,中鼻甲被固定于鼻中隔上。结果 经术后观察1年,6例病人中鼻甲位置均处于正常,中鼻道开放良好,鼻窦引流通畅,嗅觉正常,无头痛及其他不适。结论 对鼻窦内窥镜手术后发生漂移的中鼻甲采取的内移固定术,效果良好、简单易行,是解决中鼻甲漂移的有效方法。     

Agitated delirium associated with therapeutic doses of sustained-release bupropion

CASE DESCRIPTION: We report a case of a patient initiated on therapeutic doses of sustained-release bupropion for the management of major depressive disorder who subsequently developed acute agitated delirium that required ICU level care. This patient's history was significant for alcohol and cannabis abuse but he was currently detoxified and beyond the withdrawal period. Throughout the course of treatment, all maintenance medications, including bupropion, were discontinued and the patient required escalating doses of benzodiazepines and typical antipsychotics to resolve symptoms. The patient's delirium subsided after approximately 5 days. CONCLUSION: Dopamine is thought to play a role in the pathophysiology of delirium and given the mechanism of action of this drug and the presence of delirium risk factors in our patient, we are faced with a likely causative factor of this acute delirious episode.     

不同充填剂治疗乳牙根尖周炎的疗效对比研究

目的 探讨不同充填剂治疗乳牙根尖周炎的近远期临床疗效.方法 我院诊治的120颗患尖周炎的乳牙,随机将其分为A(使用干髓糊剂进行充填)、B(使用氢氧化钙碘仿糊剂进行充填)、C(使用抗生素糊剂进行根管充填)三个治疗组,治疗3个月、6个月、1年后,比较各组患牙的治疗成功率.结果 于治疗3个月、6个月和1年,与A组相比,B组和C组的成功率都明显升高,P<0.05,差异具有统计学意义;与B组相比,C组的成功率没有明显差异,P>0.05.近期失败的主要临床表现为存在不同程度的咬合痛、叩击痛,窦道没有消失;远期的主要临床表现为牙齿折断、充填物脱落、继发龋齿.结论 氢氧化钙碘仿糊剂和抗生素糊剂根管充填是目前治疗乳牙根尖周炎的相对比较有效方法,值得临床推广应用.     

Psychosis and delirium following metabolife use

Weight gain is a well-known complication of antipsychotic therapy, especially when using newer atypical antipsychotic agents. In addition to the risk of medical comorbidities associated with weight gain, such as diabetes mellitus and cardiovascular disease, a further risk of antipsychotic-induced weight gain is that patients may resort to over-the-counter preparations to aid in weight loss. We report on a case in which a patient with schizophrenia began using Metabolife, an herbal preparation containing ephedra, for weight reduction and subsequently developed an exacerbation of his psychosis with superimposed delirium. We mention several relatively safe alternatives to herbal supplements for weight loss, as well as emphasize the need for clinicians to educate their patients regarding the potential risks of over-the-counter weight loss agents.     

Current practice and opinions of hospital pharmacists regarding their role in the screening,prevention and treatment of delirium

Background An interdisciplinary approach is fundamental for effective prevention and treatment of delirium. Pharmacists could play a role in identifying and resolving medication-related delirium. However, little is known about their role in delirium care. Objective The main purpose of this survey was to assess the current practice and opinions of pharmacists concerning their involvement in screening, prevention and treatment of delirium. Setting Pharmacists in public and private hospitals in Australia. Method A cross-sectional survey was conducted using a pilot tested web-based questionnaire which was distributed primarily via a link in the electronic newsletter of the Society of Hospital Pharmacists of Australia. Main outcome measure Number and proportion of respondents answering questions related to the practice and perceptions of pharmacists in delirium management. Results Responses from 106 pharmacists were included in the analysis. Most respondents believed that pharmacists could play a role in prevention (92%) and screening (62%) of patients for delirium. However, in practice only 8% of pharmacists reported that they had ever screened a patient for delirium using a validated tool and 79% indicated that pharmacists were never or rarely involved in delirium treatment. When pharmacists did make recommendations half of the respondents said that pharmacists’ recommendations were frequently or always accepted by the delirium treating teams. Conclusion Hospital pharmacists are underutilised in the prevention and management of delirium. Strategies to increase their involvement in the prevention and management of delirium should be implemented.     

牙体牙髓病综合治疗分析与病因探讨

目的 对牙体牙髓病病因与治疗进行分析探讨.方法 选择2007年10月至2010年11月我科门诊收治的牙体牙髓病患者100例;将其随机分为治疗组与对照组,每组患者50例.对照组患者应用甲醛甲酚(FC)或者樟脑酚(CP)作暂封,再以干髓剂或者根管充填剂作为填塞剂,进行永久性的充填.治疗组50例患者应用替硝唑与碘仿以及地塞米松的合剂,再以CP棉捻或者棉球进行暂封,待患者症状消除后应用替硝唑与丁香油、碘仿与地塞米松的合剂以及少许丁香油粘固粉调制成糊状后,进行根管充填,并要求充填到其根尖,垫底则应用磷酸锌的粘固粉,最后做永久性的充填.对两组暂封成功率与永久充填成功率进行对比分析.结果 治疗组50例患者,暂封成功43例,失败7例,暂封成功率为86.0％;永久充填成功43例,失败7例,永久充填成功率为86.0％.对照组50例患者,暂封成功29例,失败21例,暂封成功率为58.0％;永久充填成功26例,失败24例,永久充填成功率为52.0％.对两组暂封成功率与永久充填成功率分别进行对比,差异均具有统计学意义(P＜ 0.01).结论 牙体牙髓病,根据患者病史与临床症状以及检查分析,多数能够明确诊断;及时予以综合性治疗,能够达到比较满意的疗效.     

头孢他啶预防胆脂瘤型中耳炎术后复发的作用分析

目的：探索头孢他啶预防胆脂瘤型中耳炎患者术后复发的作用。方法选取胆脂瘤型中耳炎患者共81例,随机分为观察组（n＝41）与对照组（n＝40）,在内窥镜下结合鼓膜穿孔和后鼓室对病变采取完全清理,存留外耳道后壁,施行“完壁式”中耳乳突根治术或内置法鼓膜修补术。术后用明胶海绵及碘纺纱条填塞中耳乳突术腔,缝合切口。对照组与观察组患者术后外耳道填塞明胶海绵与纱条14 d,对照组患者术后给予常规抗生素治疗,观察组患者局部滴注头孢他啶治疗,每日2次,2.0 g/次,持续治疗7 d。结果观察组患者治疗有效率为97.56%,对照组患者治疗有效率为90%,两组患者治疗有效率相比差异无统计学意义（χ2＝1.998,P＜0.05）。术后随访1年,观察组患者外耳道形态好,平滑、完整、干燥,大小接近正常,无外耳道狭窄。随访期内有1例患者出现胆脂瘤复发,但无面瘫和眩晕发生;对照组患者有7例出现复发,其中3例鼓膜再穿孔,4例鼓膜疤痕内陷,两组患者复发率比较,差异具有统计学意义（χ2＝24.95,P＜0.05）。结论头孢他啶用于临床胆脂瘤型中耳炎术后抗生素的治疗,不仅可以减轻广谱抗生素不合理使用造成的细菌耐药,还可以保证胆脂瘤型中耳炎手术治疗的效果,预防胆脂瘤型中耳炎术后复发。     

不同填充材料在一次性根管治疗中的应用分析

目的对比口腔内科3种不同的根管填充材料在一次性根管治疗中的临床效果。方法 2010年1月～2011年1月于笔者所在门诊收治的各类牙髓炎、根尖周炎需进行根管治疗的患者共213例,330颗牙。随机分为3组,分别采用Vitapex糊剂(A组)、Cortisomol糊剂(B组)以及碘仿氧化锌丁香油糊剂(C组)进行根管填充,比较3组根管填充治疗1周后患者疼痛情况及术后1年的治愈率。结果根管治疗1周后,A组疼痛发生率为13.6%,B组为16.4%,C组为28.2%,C组疼痛发生率明显高于A、B组(P<0.05);C组疼痛评分明显高于A、B组(P<0.05);1年后A组治愈率为91.2%,B组为90.0%,C组为79.1%,C组明显低于A、B组(P<0.05);A、B组比较,差异无统计学意义(P>0.05)。结论在同等的操作条件下Vitapex糊剂、Cortisomol糊剂比碘仿氧化锌丁香油糊剂有更好的疗效,是较为理想的根充材料。     

两种根充剂在乳牙根管治疗中的临床疗效观察

目的观察对比Vitapex糊剂和氧化锌碘仿糊剂在乳牙根管治疗中的疗效。方法选择门诊就诊患儿120例,226颗牙,随机分为两组,A组用Vitapex糊剂充填根管,B组用氧化锌碘仿糊剂充填根管。结果根管充填后6个月、1年、2年随访,两组疗效良好,无显著差异（P〉0.05）。Vitapex糊剂吸收早于牙根吸收;氧化锌碘仿糊剂迟于牙根吸收,易发生乳牙滞留。结论两组糊剂均适于乳牙根管充填,可根据乳牙发育情况选择应用。     

应用纤维桩改进式根管充填对根尖微渗漏的影响

目的：通过离体牙试验,探讨高强度玻璃纤维增强树脂复合材料（FRC）桩钉改进式根管充填对根尖微渗漏的影响。方法：选60例离体前牙,采用碘仿氧化锌糊剂及牙胶尖做侧压充填,然后实验组在已充填的根管内加压插入FRC桩,对照组不再做处理,对两组做根尖染色渗漏试验。结果：实验组根尖微渗漏较对照组小,两者比较,差异有统计学意义。结论：常规根管充填后,采用FRC桩加固充实根管,能提高根充的充实度,有效减少根充后根尖微渗漏的产生。     

Postoperative delirium

Delirium is a global impairment of upper brain functions caused by an organic substrate. It is frequently observed in the postoperative period, particularly in elderly people. Vascular and orthopedic surgery and long-duration surgery are associated with a higher incidence of postoperative delirium. When it occurs, postoperative delirium makes patient management much more difficult, increases costs, and, above all, causes severe discomfort to the patient. Delirium is also associated with higher postoperative mortality and morbidity, and with delayed functional recovery, but it is still unclear whether worse prognosis is directly caused by delirium or results from the neurological damage of which delirium is simply a symptom. Drug therapy should be part of a complex approach to prevent and treat this complication. Neuroleptics like haloperidol and droperidol, and benzodiazepines are usually employed in order to control symptoms like agitation, restlessness, and altered perceptions. Atypical neuroleptics, like risperidone, have not yet been studied in postoperative delirium, although some case reports in which they were successfully used have been published. Physiostigmine is effective in delirium caused by anticholinergic syndrome; vitamins may be useful in alcoholics; melatonin use has been suggested in order to prevent and treat delirium by normalizing sleep-wake cycle alterations. Environmental interventions are often costless and may be very useful to prevent and treat postoperative delirium in patients at risk.