自体富血小板凝胶治疗难治性糖尿病足溃疡的疗效观察

糖尿病由于长期血糖控制不理想,容易导致急慢性并发症的发生。特别是足部溃疡的发生,增加了病人的经济及生活负担。目前新开展的自体富血小板凝胶治疗技术能够明显加速溃疡生长,促进溃疡愈合。     

自体富血小板凝胶在治疗糖尿病足和糖尿病皮肤慢性溃疡中的临床疗效观察

目的：探讨自体富血小板凝胶在治疗糖尿病足和糖尿病皮肤慢性溃疡中的临床疗效。方法选取在本院进行治疗的62例糖尿病足和糖尿病皮肤慢性溃疡患者随机分为观察组和对照组,分别行APG治疗和常规治疗,对比两组患者的治疗效果和痊愈时间、治疗费用情况。结果APG观察组的患者治疗总有效率（93.55%）显著高于对照组（70.97%）,观察组患者的愈合时间均显著短于对照组,治疗总费用观察组各分级患者均显著低于对照组（P〈0.05）。结论 APG计数治疗糖尿病足和糖尿病慢性溃疡效果显著优于常规治疗方法,可以加快患者的治疗时间,减少患者治疗费用,值得进行临床推广。     

自体富血小板凝胶治疗糖尿病足和糖尿病皮肤慢性溃疡的临床疗效

目的浅析自体富血小板凝胶应用于糖尿病足与糖尿病皮肤慢性溃疡的治疗效果。方法抽选2014年8月至2016年3月于本院治疗的54例糖尿病足与糖尿病皮肤慢性溃疡患者为观察对象,将其随机划分成研究组以及参照组,每组各27例。为参照组患者行常规治疗,研究组行自体富血小板凝胶治疗,观察两组患者的临床疗效。结果在为患者治疗后,研究组患者的治疗总有效率明显优于参照组,从两组患者的愈合时间上对比,研究组的愈合时间要短于参照组,对比差异具有统计学意义(P<0.05)。结论自体富血小板凝胶应用于糖尿病足与糖尿病皮肤慢性溃疡的治疗效果,明显优于行常规治疗的参照组,能够促进患者快速愈合,最大限度的降低患者的治疗费用,值得在临床上推广。     

自体富血小板凝胶联合负压辅助闭合技术治疗糖尿病足溃疡的效果

目的 观察自体富血小板凝胶联合负压辅助闭合技术治疗糖尿病足溃疡的效果.方法 选取2019年9月-2020年3月邵阳学院附属第二医院收治的糖尿病足溃疡患者110例作为研究对象,采用随机数字表法分为观察组55例和对照组55例,对照组患者应用负压辅助闭合技术,观察组患者在对照组基础上联合自体富血小板凝胶治疗.比较2组患者治疗...     

智能负压联合自体富血小板凝胶在糖尿病足Wagner 3～4级中的应用效果

目的 探讨智能负压联合自体富血小板凝胶在糖尿病足Wagner 3～4级中的应用效果.方法 选取2020年2月至2021年5月钦州市第一人民医院住院的80例糖尿病足Wagner 3～4级患者作为研究对象,采用随机数字表法将其分为试验组和对照组,每组各40例.对照组患者采用智能创伤负压综合治疗法,试验组患者采用智能创伤负压...     

糖尿病足溃疡患者经自体富血小板凝胶联合VSD技术治疗的疗效评价

目的 分析经自体富血小板凝胶(APG)联合负压引流(VSD)技术治疗糖尿病足溃疡的价值.方法 选取糖尿病足溃疡患者107例,其中53例行常规治疗为对照组,另54例在对照组基础上结合APG联合VSD技术为观察组,比较2组治疗效果、创面愈合时间及住院时间、治疗前后血糖控制效果[餐后2 h血糖(2hPG)、空腹血糖(FPG)...     

自体富血小板凝胶治疗老年糖尿病足溃疡合并下肢动脉粥样硬化性疾病的效果与安全性

目的 探讨自体富血小板凝胶治疗老年糖尿病足溃疡合并下肢动脉粥样硬化性疾病的效果与安全性.方法 选取2015年11月～2020年9月重庆市中医院收治的120例老年糖尿病足溃疡合并下肢动脉粥样硬化性疾病患者作为研究对象,采用随机数字表法分为实验组(61例)与对照组(59例).对照组采用常规方法进行治疗,实验组在常规方法治疗...     

不同治疗周期下自体富血小板凝胶对糖尿病足溃疡的治疗效果观察

目的观察自体富血小板凝胶对糖尿病足溃疡不同治疗周期的临床疗效。方法纳入2016年8月～2018年4月我院糖尿病足溃疡患者80例,随机将其分为对照组(n=40)和观察组(n=40),对照组实施常规方法治疗,观察组实施自体富血小板凝胶治疗,对比两组患者疗效情况、住院用度、住院时间、患者满意度及相关知识了解度。结果观察组临床疗效、住院用度、住院时间、患者满意度及相关知识了解度明显优于对照组,差异有统计学意义(P 0.05)。结论自体富血小板凝胶的诊断和治疗对糖尿病足溃疡患者功能恢复有着较好的疗效,缩短观察时间,降低了平均费用,使患者满意度明显提高,临床具有广泛使用意义。     

自体血清治疗单纯疱疹病毒性角膜炎的疗效观察

目的 观察自体血清滴眼治疗单纯疱疹病毒性角膜炎（herpes simplex keratitis,HSK）的临床效果.方法 把68例76眼随机分成两组,对照组按照常规HSK给予抗病毒类药物治疗,治疗组在对照组基础上加用自体血清滴眼治疗.结果 所有的HSK患者中,治疗组治愈率80.0％,有效率为100.0％;对照组治愈率50.0％,有效率为97.2％,两组比较治疗组治愈率高于对照组（x^2 =8.462,P =0.015）.治疗前后比较显示,治疗组经治疗后疗效变化有统计学差异（P＜0.01）,对照组变化无统计学差异（P＞0.05）;经治疗,治疗组和对照组视力分布有统计学差异（x^2 =6.043,P =0.049）.结论 自体血清滴眼治疗HSK是明显有效的.     

The safety and efficacy of Diphoterine for ocular and cutaneous burns in humans

Context: Diphoterine, developed by the French company Prevor, is a polyvalent, chelating, amphoteric and slightly hypertonic solution used in the management of chemical cutaneous and ocular burns. While used extensively in Europe and Canada, it is has not been approved by the United States Occupational Safety and Health Administration (OSHA) as an alternative to the water-rinse method due to a lack of evidence of its safety and efficacy on human subjects. An unbiased and extensive systematic review was undertaken in order to better understand Diphoterine’s safety and efficaciousness on humans.

Objective: Review the safety and efficacy of Diphoterine for treating chemical burns of the skin and eyes in humans.

Methods: Data sources: Information sources included Pubmed, the National Library of Medicine’s Medline Database and the “Publications” sections of the Prevor website. Search terms included Diphoterine, chemical burn, ocular burn and cutaneous burn. Study selection: Any study type published through a peer-reviewed journal up to May 2016 was considered eligible. Published data must have included Diphoterine in the treatment of chemical burns on the skin or eyes as well as meet other specified criteria. Acceptable studies had to use either a quantitative (e.g. number of work days lost) or qualitative (e.g. level of erythema) approach when measuring cutaneous or ocular lesion outcomes. Data extraction: Independent assessment of article inclusion by two authors using predefined criteria.

Results and Conclusion: Diphoterine is safe and highly effective in improving healing time, healing sequelae and pain management of chemical burns on the skin and eyes of humans. Outcomes are significantly improved when compared to water or a physiologic solution equivalent. We recommend that this product be readily available to emergency responders and companies that expose their employees to hazardous chemical substances in order to improve healing sequelae, pain management and lost work days from these types of burns.     

Nanoparticles laden in situ gel of levofloxacin for enhanced ocular retention

Abstract

Availability of proper concentration of medicament on to the corneal surface is a challenging task. Many novel formulations, i.e. hydrogels, nanoparticles, ocuserts, etc. had been tested to improve ocular bioavailability, out of which our group found, in situ gel and polymeric nanoparticle are the most interesting approach to achieve ocular retention. We found that in situ gel stay only for 12?h and poly(lactic-co-glycolic acid (PLGA) nanoparticles are non mucoadhesive in nature so we try to combine both these formulations and termed it as “Nanoparticle laden in situ gel”. Here we prepare nanoparticle laden in situ gel containing levofloxacin encapsulated PLGA nanoparticle, incorporated in chitosan in situ gel and evaluated its ocular retention by gamma scintigraphy in rabbits. The observations of acquired gamma camera images showed good retention over the entire precorneal area. From static and dynamic gamma scintigraphy evaluation, we can be interpret that developed nanoparticle laden in situ gel formulation cleared at a very slow rate and remained at corneal surface for longer duration than marketed formulation, in situ gel and nanosuspension alone.     

新型硅凝胶烧伤创面气雾剂研制及临床应用

目的：寻求新型气雾剂应用于烧伤创面。方法：用医用级硅酮加上无毒、无刺激性溶剂溶解，配有助溶剂及抗菌止痛剂等，制成均匀的抗菌硅酮溶液。结果：临床应用II度烧伤创面126例，疗效满意。结论：硅凝胶烧伤创面气雾剂成膜迅速，同时创新的加入止痛和抗菌制剂，能保证成膜后有一定的抗菌能力。     

Intractable ocular diseases and treatment progress

传统眼用制剂在眼部的生物利用度较低,对眼部疾病难以达到满意的治疗效果,这主要是由于传统眼用制剂难以透过眼部众多的生理屏障、在眼部滞留时间较短所致。为了提高药物的眼部生物利用度,减轻药物对眼组织的不良反应,纳米粒、微球、原位凝胶等新型给药系统已被应用于眼用制剂,并且受到研究者的广泛关注。鉴于多种眼部给药系统的快速发展,本文对眼部给药系统的最新研究进展进行综述。首先,本文介绍了眼部结构及限制药物进入眼部的生理屏障;其次,对新型眼部给药系统分别进行介绍,主要包括纳米粒、脂质体、脂质纳米粒、微球、原位凝胶等;最后,着重讨论了眼部给药系统在临床治疗中的应用前景和亟待解决的问题。

     

盐酸川芎嗪眼用原位温敏凝胶的制备及体外释药特性研究

目的：制备盐酸川芎嗪眼用原位温敏凝胶并对其体外释药特性进行考察。方法采用泊洛沙姆407和泊洛沙姆188为温敏基质制备眼用温敏凝胶,采用无膜溶出模型,研究药物在某一时间的累积释放百分率与时间的变化,对曲线进行拟合分析,研究川芎嗪的体外释放特性。结果所制得凝胶为均匀稍带黏性的澄清溶液,该制剂的体外释放行为遵循零级动力学方程（r ＝0．9887）,由 Ritger －Peppas 方程拟合的 n 值为0．7533。结论盐酸川芎嗪眼用温敏凝胶体外释药是由药物扩散和凝胶溶蚀双重机制控制。     

羊膜移植术联合高浓度自体血清治疗早期严重眼化学伤的临床观察

目的分析探讨羊膜移植术联合高浓度自体血清治疗早期严重眼化学伤的的临床疗效。方法选取2013年6月~2016年2月期间我院收治的98例早期严重眼化学伤患者,共109只患眼。采用随机数字表法分为观察组45例(53眼)和对照组45例(56眼)。对照组患者采用高浓度自体血清治疗,观察组患者采用羊膜移植术联合高浓度自体血清治疗。分析比较两组患者的植片存活情况、临床疗效、术后并发症及术后1年的视力情况。结果观察组患者植片存活率大于对照组,差异有统计学意义(P<0.05);观察组患者植片存活保持透明的患眼占比大于对照组,差异有统计学意义(P<0.05);两组患者植片存活保持半透明和植片存活但混浊的患眼占比比较无统计学意义(P>0.05);观察组患者的治疗有效率大于对照组,差异有统计学意义(P<0.05);Mann-Whitney检验结果显示,试验组治疗后临床效果优于对照组(P<0.05);观察组患者术后并发症比例小于对照组,差异有统计学意义(P<0.05);术后1年,两组患者视力≥0.30、0.10~0.23、0.01~0.10的患者比例比较无统计学意义(P>0.05);观察组患者视力在指数以下的患者比例小于对照组,差异有统计学意义(P<0.05)。结论羊膜移植术联合高浓度自体血清治疗早期严重眼化学伤,能显著提高患者的植片存活率,改善患者术后视力恢复。联合治疗安全有效,值得临床推广应用。     

清得佳凝胶在烧伤创面中的临床应用

目的观察清得佳凝胶对烧伤创面的疗效。方法在浅Ⅱ及深Ⅱ烧伤创面上均匀涂上一层约1～2mm厚度的清得佳凝胶,采用暴露疗法,每天换药1次,并相应设立对照组,创面外用皮维碘行暴露疗法,作疗效观察。结果治疗组的创面愈合时间比对照组浅Ⅱ创面提前2d左右,深Ⅱ提前5d左右(P<001),且创面湿润,干净,不形成痂皮。结论清得佳凝胶这种外用药是一种湿润疗法,对创面无刺激,能去除创面坏死组织,加快创面残余上皮细胞增生速度,促进创面愈合。     

Development of loteprednol etabonate-loaded cationic nanoemulsified in-situ ophthalmic gel for sustained delivery and enhanced ocular bioavailability

A novel cationic nanoemulsified in-situ ophthalmic gel of loteprednol etabonate (LE) was developed to improve the permeability and retention time of formulations for overall improvement of drug’s ocular bioavability. Capryol 90 (oil phase), tween 80 (surfactant) and transcutol P (cosurfactant) was selected as formulation excipients to construct pseudoternary phase diagrams and nanoemulsion region was recognized from diagrams. Spontaneous emulsification method was used to manufacture LE nanoemulsion and it was optimized using 3² factorial design by considering the amount of oil and the ratio of surfactant to cosurfactant (S_mix) as independent variables and evaluated for various physicochemical properties. Optimized NE was dispersed in Poloxamer 407 and 188 solution to form nanoemulsified sols that were predictable to transform into in-situ gels at corneal temperature. Drug pharmacokinetics of sterilized optimized in situ NE gel, NE-ISG2 [0.69% w/w Capryol 90, 0.99%w/w S_mix (3:1), 13% Poloxamer 407, 4% w/w Poloxamer 188] and marketed formulation were assessed in rabbit aqueous humor. The in-situ gels were clear, shear thinning in nature and displayed zero-order drug release kinetics. NE-ISG2 showed the minimum ocular irritation potential and significantly (p?<?0.01) higher C_max and AUC_(0–10?h), delayed T_max, extended mean residence time and improved (2.54-fold times) bioavailability compared to marketed formulation.     

卡波姆宫颈凝胶对慢性宫颈炎的临床疗效分析

目的 分析卡波姆宫颈凝胶对慢性宫颈炎的临床治疗效果.方法 随机抽取本院2014年9月至2015年9月采用卡波姆宫颈凝胶治疗的慢性宫颈炎患者36例作为研究组;选取同期采用治糜灵栓治疗的慢性宫颈炎患者36例作为对照组,分析对比两组患者的临床治疗效果.结果 研究组在生理、心理、总体健康和活力等方面的评分与对照组相比具有明显优势,差异有统计学意义(P＜0.05);研究组临床有效率为94.44％,明显优于对照组的66.67％,差异有统计学意义(P＜0.05).结论 卡波姆宫颈凝胶在治疗慢性宫颈炎方面效果较为良好,是改善患者生活质量的重要手段,值得在临床上推广.