创愈酊体内抗菌活性研究

为观察创愈酐体内抗菌活性，将２４０只小鼠尾部经７０℃水浴烫１３秒，致成Ⅱ°烫伤，创面涂绿脓杆菌或金葡菌１×１０＾９ＣＦＵ／ｍｌ。实验动物分为６组，治疗组创面分别涂２００％，１００％或５０％创愈酊；对照组创面分别涂赋形剂，生理盐水或磺胺嘧啶银溶液，观察一周后各组动物的存活率和愈合率，结果治疗组存活率和愈合率均高于对照组。研究表明创愈酊抗菌作用强，是一种较好的外用抗菌药物。     

中药消炎烧烫酊对烫伤家兔治疗作用的实验研究

目的:观察消炎烧烫酊对皮肤烫伤的作用。方法:采用家兔深Ⅱ度烫伤模型,18只家兔随机平均分成对照组、治疗1组、治疗2组共三组,每组6只。对照组创面涂抹75%酒精,4次/d;治疗1组创面涂抹消炎烧烫酊,2次/d;治疗2组涂抹消炎烧烫酊,4次/d。观察各组创面愈合过程;分别于治疗后48h、第6d取材,进行组织学检查。结果:治疗2组创面无感染,血液循环恢复快,上皮再生早。结论:消炎烧烫酊有抗感染,减少渗出和促进组织修复的作用,对Ⅱ度烫伤有明显疗效。     

七味烧伤酊的制备及临床应用

目的制备七味烧伤酊并观察其临床疗效。方法建立七味烧伤酊的制备方法和质控标准，将该药用于烧伤面积1％～20％Ⅱ度伤为主的烧伤患者120例，并与磺胺嘧啶银（SD-Ag）作对照，观察用药反应，如疼痛感、成痂时间、创面感染率、皮疹、肝肾功能、愈合时间。对照两组间性能价格比。结果七味烧伤酊组与SD—Ag组治疗Ⅱ度烧伤有效率均达100％，均未见肝肾功能损伤发生，在成痂时间、创面感染率、皮疹发生率、愈合时间上经统计学处理差异无统计学意义（P〉0．05），疼痛感发生率七味烧伤酊组明显高于对照组（P〈0．05），但仅发生于最初数次，且用药后数秒症状很快消失。每1％烧伤治疗面积七味烧伤酊组价格仅为对照组的50％。结论七味烧伤酊是一种价格低廉、副作用小、使用安全可靠、疗效确切的中药类烧伤创面外用药。     

壳聚糖宫颈抗菌膜在宫颈LEEP术后创面愈合的临床观察

目的 观察壳聚糖宫颈抗菌膜应用于宫颈环形电极切除术(LEEP术)后创面的愈合效果.方法 选择2010年2月～2012年2月宫颈疾病患者112例,均行LEEP刀手术,将112例患者随机分为两组,对照组56例给予常规药物,观察组56例在对照组基础上给予壳聚糖宫颈抗菌膜治疗,观察两组患者创面愈合情况.结果 观察组愈合56例,愈合率100%,对照组愈合51例,愈合率91.07%,两组差异有统计学意义,P＜0.05;观察组创面平均愈合时间(29.5±5.5)d,对照组创面平均愈合时间(42.5.5±4.5)d,两组差异有统计学意义,P＜0.05.结论 壳聚糖宫颈抗菌膜可缩短创面愈合时间,是LEEP术后防止感染的有效方法,可在临床推广.     

珠黄散联合新洁尔灭酊治疗Ⅲ期压疮疗效观察

目的:探讨珠黄散联合新洁尔灭酊治疗Ⅲ期压疮的疗效.方法:2015年1月至2016年6月我院收治的Ⅲ期压疮患者48例(压疮59处),按入院顺序编号,随机分入对照组24例(33处),观察组24例(26处).两组患者均用无菌生理盐水棉球擦洗压疮皮肤;对照组加用新洁尔灭酊消毒液擦洗伤口;观察组在加用新洁尔灭酊消毒液擦洗伤口后用珠黄散敷于疮面.结果:出院时观察组创面缩小率明显好于对照组,观察组创面平均愈合时间明显少于对照组(P<0.05),差异有统计学意义.治疗结束时,观察组临床治疗总有效率为87.50%明显高于对照组(P<0.05),差异有统计学意义.观察组患者换药次数明显低于对照组,观察组患者疼痛感受获得减轻的时间明显早于对照组(P<0.05),差异有统计学意义.结论:珠黄散与新洁尔灭酊联用治疗Ⅲ期压疮,能够促进创面愈合,改善临床症状,提高压疮临床治疗效果,值得临床推广.     

创愈酊体外抗菌活性研究

创愈酊体外抗菌活性研究结果表明：创愈酊对金黄色葡萄球菌，粪链球菌和表皮葡萄球菌有较强的抗菌作用，ＭＩＣ５０分别为１２．５％，３．１２５％和１．６％；对大肠杆菌也有较您的抑菌作用，ＭＬＣ５０为１２．５ｎ／ｕ：对沙雷氏菌的ＭＩＣ５０为６．２５％，对破伤风杆菌的ＭＩＣ５０为６．２５％。实验结果表明创愈酊具有广谱抗茵作用。     

两种修复方案治疗头面部深II度烧伤的疗效比较

目的探讨纳米银抗菌凝胶和亲水性纤维含银敷料对深Ⅱ度烧伤患者换药疼痛评分、创面愈合质量及血管内皮生长因子(VEGF)水平的影响。方法选取2016年1月至2017年6月江苏省人民医院溧阳分院收治的深Ⅱ度烧伤患者共86例,按照随机数字表法将患者分为对照组和观察组,每组各43例,观察组采用亲水性纤维含银敷料治疗,对照组采用纳米银抗菌凝胶治疗;比较两组患者创面愈合总有效率、创面愈合时间、换药疼痛视觉模拟(VAS)评分,随访12个月,比较两组患者瘢痕评分、色素沉着率及治疗前后VEGF水平。结果观察组创面愈合总有效率(90. 70%)高于对照组(72. 09%),差异有统计学意义(P <0. 05);观察组创面愈合时间、VAS评分、随访瘢痕评分及色素沉着率优于对照组,差异有统计学意义(P <0. 05);观察组治疗前后VEGF水平差值高于对照组,差异有统计学意义(P <0. 05)。结论相较于纳米银抗菌凝胶,亲水性纤维含银敷料治疗深Ⅱ度烧伤可有效促进创面愈合,减轻换药疼痛,降低瘢痕形成和色素沉着程度,并有助于上调VEGF表达水平。     

积雪苷霜联合负压封闭引流术在深度烧伤患者创面修复中的应用

目的 探讨分析积雪苷霜联合负压封闭引流术(VSD)在深度烧伤患者创面修复中的应用效果。方法 选取进行植皮治疗的90例深度烧伤患者,分为观察组和对照组,各45例。对照组患者给予VSD进行治疗,观察组患者在对照组的基础上联合积雪苷霜进行治疗,比较两组患者住院时间、创面愈合时间、首次植皮存活率、细菌培养阳性率、创面愈合率、并发症发生情况,负压引流后后炎性因子、疼痛介质、生活质量情况。结果 观察组住院时间、创面愈合时间均低于对照组(P<0.05)。观察组患者细菌培养阳性率低于对照组,而首次植皮存活率、创面愈合率均高于对照组(P<0.05)。创面换药1周后,两组患者IL-6、TNF-α、CRP炎性因子水平和NPY、5-HT、PGE2疼痛介质水平较负压引流后降低(P<0.05),观察组较对照组更低(P<0.01)。出院时两组患者生理功能、生理职能、活力、总体健康、躯体疼痛、情感职能、社会功能、精神健康生活质量评分较负压引流后升高(P<0.05),观察组较对照组更高(P<0.05或<0.01)。观察组并发症总发生率为6.67%,对照组并发症总发生率为22.2...     

早期手术与保守治疗在深度酸烧伤治疗中的应用

目的：观察早期手术与保守治疗在深度酸烧伤治疗中的临床应用效果。方法选取2010年4月至2013年6月于我院治疗的46例深度酸烧伤患者为研究对象,将其随机分为对照组和观察组,每组23例。对照组给予保守治疗,观察组则给予早期手术治疗,对治疗后两组患者的植皮存活率、创面愈合情况以及住院时间等进行比较。结果经治疗后,观察组的植皮存活率为（93.22±4.89）%,创面愈合时间为（42.26±12.11） d;对照组的植皮存活率为（73.87±10.92）%,创面愈合时间为（74.15±13.65） d,观察组的疗效优于对照组,差异具有统计学意义（P〈0.05）。结论深度酸烧伤患者进行早期手术治疗可有效促进创面愈合,提高患者的治疗效果和术后生存质量。     

烫疮油外涂治疗烧伤30例临床观察

目的 观察烫疮油外涂治疗Ⅰ度和浅Ⅱ度烧伤的临床疗效。方法 采用随机对照的方法，将60例患者随机分为两组，治疗组30例外涂烫疮油，对照组30例外涂美宝湿润烧伤膏。结果 治疗组总显效率93．3％，对照组总显效率96．7％。结论 烫疮油可迅速减轻烧伤后红斑、疼痛、肿胀、水疱、渗液等症状，加快创面的愈合，对治疗烧伤有较好疗效。     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.