重组人粒细胞巨噬细胞集落刺激因子在压疮护理中的应用

目的探讨重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)凝胶在Ⅱ~Ⅲ度压疮创面治疗和护理中的临床应用效果。方法将85例(98处)Ⅱ~Ⅲ度压疮患者分为两组,试验组创面应用重组人粒细胞巨噬细胞集落刺激因子凝胶治疗,对照组创面应用磺胺嘧啶银(SD-Ag)霜治疗,观察、对比两组患者治疗效果、创面细菌培养及PUSH评分结果。结果试验组平均愈合时间为16.75 d±1.22 d,有效率为96.49%,对照组平均愈合时间为21.73 d±4.55 d,有效率为78.05%。换药14 d后,试验组患者创面PUSH评分为5.76±2.59,对照组为8.59±3.23,各项指标对比,差异均具有统计学意义(P0.01)。结论重组人粒细胞巨噬细胞集落刺激因子凝胶能抑制Ⅱ~Ⅲ度压疮创面细菌繁殖,促进肉芽组织生成,显著缩短创面愈合时间。     

重组人表皮生长因子凝胶在Ⅲ期压疮护理中的应用研究

 目的 观察重组人表皮生长因子(recombinant human epidermal growth factor,rhEGF)凝胶在Ⅲ期压疮护理中的疗效.方法 38例Ⅲ期压疮入院患者随机分为治疗组和对照组.治疗组以rhEGF凝胶均匀涂布于创面;对照组仅以3%过氧化氢液冲洗.观察两组创面愈合率、组织学改变、创面羟脯氨酸(HYP)含量及Ⅰ型/Ⅲ型胶原比例.结果 治疗组的创面愈合速度较对照组明显加快,其Ⅲ期压疮平均愈合时间为(10±2.5)d,对照组为(35±8.7)d(P＜0.01).在治疗后第3、6、9天,治疗组可见创面肉芽组织灶明显增生,富含血管及细胞,同时创面中HYP含量增加,Ⅰ型/Ⅲ型胶原比例降低(P＜0.01).结论 rhEGF治疗Ⅲ期压疮可以缩短创面愈合时间,增加肉芽组织及HYP含量,降低Ⅰ/Ⅲ型胶原比例,明显促进压疮创面的修复.     

MEBO治疗老年Ⅲ期褥疮60例治疗体会

目的：观察外用湿润烧伤膏治疗老年Ⅲ期褥疮的临床效果。方法：本组60例老年Ⅲ期褥疮病人全部采用湿润浇伤膏（MEBO）湿性包扎法治疗。结果：本组60例，两月内痊愈47例，好转11例，死亡2例，治愈率78．3％，总有效率96．7％；半年内治愈58例，治愈率96．7％。结论：湿润烧伤膏可以促进老年Ⅲ期褥疮愈合。     

MEBO对深Ⅱ度烧伤胶原ⅠⅢ Ⅳ型变化的研究

目的：以ＭＥＢＯ治疗深Ⅱ度烧伤观察创面愈合前后Ⅰ,Ⅱ,Ⅳ型胶原变化。探讨ＭＥＢＯ与烧伤疤痕间关系。方法：设治疗组与传统干性治疗组各１５例并切取治疗前后活体组织用免疫组化ＳＰ染色法观察治疗前后胶原Ⅰ,Ⅲ,Ⅳ型变化。结果：ＭＥＢＯ治疗组Ⅰ型含量（＋）－（＋＋）１２／１５,（（＋＋＋）３／０,Ⅲ型（＋）－（＋＋）１５／６）,（＋＋＋）０／９,Ⅳ型（＋）－（＋＋）１５／３,（＋＋＋）０／１２。     

乏特氏壶腹周围憩室X线类型的临床意义

乏特氏壶腹周围憩室分为乳头旁（Ｉ）型、壶腹（Ⅱ）型、乳头异位（Ⅲ）型。Ｉ型最多，临床症状与其大小和是否伴有炎症有关，Ⅱ、Ⅲ型憩室虽少见，但与胆胰管疾患关系密切。憩室的大小、类型直接影响临床治疗效果。因此对壶腹周围憩室应采用多种检查，弄清憩室与十二指肠乳头的位置关系。     

MEBO治疗面部深度烧伤创面的临床体会

目的：观察MEBO对面部深Ⅱ度深型和浅Ⅲ度创面的治疗效果。方法：将采用MEBO治愈面部30例烧伤病人,选择深Ⅱ度15例,浅Ⅲ度15例,进一步观察创面感染,疼痛愈合时间及愈合瘢痕生成情况。结果：深Ⅱ型深型创面无瘢痕愈合,弹性尚好,有色素沉着,浅Ⅲ度创面愈合后有散在瘢痕形成,弹性欠佳,结论：MEBO有促进头部深度烧伤创面,再生、修复、融合漫延的作用,并有良好的止痕效果。     

骨髓基质细胞移植治疗骨缺损的实验研究

目的 探讨以Ⅰ型胶原海绵为载体的自体骨髓基质细胞移植治疗骨缺损的效果。方法 32只成年新西兰白兔随机分成Ⅰ、Ⅱ两组，分别自股骨大转子及胫骨结节抽取骨髓基质细胞进行培养，扩增后种植于Ⅰ型胶原海绵上，继续培养2周后植入1．5cm长桡骨缺损。Ⅰ组一侧桡骨缺损植入Ⅰ型胶原 自体骨髓基质细胞复合物(A处理)，对侧桡骨不做任何植入(B处理)。Ⅱ组一侧桡骨缺损做A处理，对侧桡骨缺损植入Ⅰ型胶原海绵(C处理)，分别于术后8周和12周取材，观察骨缺损的修复情况。结果 术后12周，A处理组全部骨性愈合，B处理组由纤维组织填充，C处理组有少量骨痂形成。结论 以Ⅰ型胶原海绵为载体的自体骨髓基质细胞移植能有效修复骨缺损。     

腰椎管狭窄症的CT分型

目的 探讨腰椎管狭窄症的ＣＴ分型。材料与方法 对７４５例腰椎管狭窄症的术前ＣＴ分型与手术结果进行对比分析。结果 ＣＴ分为３组,Ｉ型：中心椎管狭窄型;Ⅱ型：脊神经根管狭窄型;Ⅲ型：混合型（即Ｉ、Ⅱ型并存）。其中Ｉ型１０４例（１３．９６％）,Ⅱ型１５８例（２１．２１％）,Ⅲ型４８３例（６４．８３％）。ＣＴ分型与手术符合率为９２．２１％,不符多见于Ⅲ型。结论 ＣＴ分型对腰椎管狭窄的手术治疗具有指导意义,     

MEBT/MEBO联合紫外线照射治疗耳廓深度烧伤临床总结

目的：观察烧伤湿性医疗技术（MEBT／MEBO）紫外线照射治疗耳廓深Ⅱ度与Ⅲ度烧伤的疗效。方法：20例病人40只烧伤耳廓全程采用MEBT／MEBO治疗，同时对深Ⅱ度深型与Ⅲ度烧伤耳廓行早期耕耘疗法；于伤后3天－5天加用紫外线照射治疗。结果：37只烧伤耳廓达到良好愈合，Ⅰ期愈合率为92．5％；3只耳廓发生耳软骨炎（7．5％），最终为不同程度瘢痕愈合。结论：MEBT／MEBO可促进深度烧伤耳廓愈合，降低阼软骨炎发生率。     

肱骨髁间骨折的 CT 分型及其临床意义

目的建立一种基于CT的肱骨髁间骨折的分型,并评价其临床应用效果。方法 44例肱骨髁间骨折应用CT分型,其中6例Ⅰ型简单骨折1,6例Ⅱ型单柱复杂骨折,19例Ⅲ型双柱复杂骨折和3例Ⅳ型合并冠状面骨折。根据骨折分型选择手术内固定方式,术后随访评价临床效果。结果Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型骨折的平均手术时间分别是78.2、91.5、120.1、137.6min。44例中有39例获得随访（随访率为88.6%）,平均随访21.6个月（13～31个月）,平均骨折愈合时间为14.7周（12～21周）。术后12个月时的Mayo评分平均为82.4分（100～45分）。结论基于CT的肱骨髁间骨折的分型简洁易记,区分度好,具有高度的可靠性和可重复性,能指导治疗方法的选择,有助于判断预后。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.