康复新液联合远红外线照射治疗糖尿病足的临床研究

目的:观察康复新液联合远红外线照射治疗糖尿病足的临床疗效,为治疗糖尿病足提供指导。方法:糖尿病足病人30例,随机分为2组,试验组15例,溃疡共18处,在内科治疗的基础上,用康复新液外敷联合远红外线局部照射治疗,对照组15例,溃疡共19处,在内科治疗的基础上,用康复新液外用湿敷。每天一次,一周为一疗程,两组均观察两个疗程,根据溃疡面积的变化以及症状改善的程度制定疗效标准,根据该标准,对两组的临床疗效,治疗前后溃疡面积的变化进行比较。结果:两组临床疗效比较,治疗组显效1例,有效17例,无效0例,总有效率100%。对照组显效0例,有效13例,无效6例,总有效率68.42%。两组比较,差异有显著性意义(P<0.05),两组患者治疗前后溃疡面积差值的比较,差异有显著性意义(P<0.05)。结论:①两种治疗方法均取得了一定的疗效;②康复新液联合远红外线局部照射治疗糖尿病操作简便,疗效肯定;③康复新液联合远红外线局部照射治疗糖尿病足的疗效优于单独用康复新液治疗。     

三种方法护理化疗性口腔炎的效果比较

目的 比较复方氯己定、海藻生物胶和思密达用于化疗性口腔炎的护理效果,探讨化疗性口腔炎的有效护理方法。 方法 将264例化疗性口腔炎患者随机分为对照组、观察1组、观察2组各88例。对照组常规应用复方氯己定含漱液进行护理,观察1组应用思密达进行护理,观察2组应用海藻生物胶进行护理,护理5 d后比较三组疗效。 结果 护理后对照组、观察1组、观察2组有效率分别为44.32%、78.41%、93.18%,三组比较,差异有统计学意义（P＜0.01）。 结论 复方氯己定、海藻生物胶和思密达护理化疗性口腔炎均有效,但复方氯己定疗效欠佳,思密达次之,海藻生物胶能够更有效地改善与减轻化疗所致口腔炎。     

复方氯己定含漱预防腭裂整复创面感染的效果观察

目的探讨复方氯己定含漱液对腭裂整复创面感染的影响。方法分别用复方氯己定含漱液 (观察组 )和复方硼砂漱口液 (对照组 )对腭裂整复术后病人进行含漱 ,观察两组病人整复术后创面愈合率、平均住院时间。结果创面愈合时间观察组为 (8 5± 1 0 )d ,对照组 (14 0± 1 0 )d ;创面糜烂和愈合不良的发生率观察组为 0 ,对照组为 12 5 % ;平均住院时间分别为 (9 5± 2 0 )d和 (11 5± 3 0 )d ,观察组明显优于对照组 (P <0 0 5或P <0 0 1)。结论用复方氯己定含漱液漱口可有效降低腭裂整复创面感染率。     

西吡氯铵含片与复方氯己定治疗重型口疮的疗效对比

目的:观察西吡氯氨含片和复方氯已定治疗复发性重型口疮的临床疗效对比;方法:选取35例重型口疮患者随机分成2组,对照组18例,治疗组17例,对照组局部给予复方氯己定漱口水,治疗组局部选用西吡氯铵含片,分别7天后9天后观察口疮愈合情况;结果:西吡氯铵含片局部运用治疗重型口疮与复方氯己定组治疗效果无显著性差异(P＞0.05);结论:使用西吡氯铵含片作为口腔局部抗菌药治疗重型口疮具有疗效确实,不良反应少,副作用小,对粘膜刺激小,安全等优点,值得在临床推广.     

康复新液联合维生素C及贝复济治疗口腔溃疡的临床效果

目的 探究康复新液配合维生素C及贝复济用于口腔溃疡患者的效果。 方法 选取2021年 8月-2022年8月安顺市人民医院收治的60例口腔溃疡患者，随机分为常规组（给予康复新液， n=30）与 研究组（给予康复新液配合维生素C及贝复济， n=30），比较两组溃疡面愈合、临床疗效、疼痛缓解时 间及VAS评分。 结果 研究组溃疡面愈合时间短于常规组（P＜0.05）；研究组治疗总有效率为96.67%，高 于常规组的70.00%（P＜0.05）；研究组疼痛缓解时间短于常规组（P＜0.05）；研究组治疗后VAS评分低 于常规组（P＜0.05）。 结论 针对口腔溃疡患者，相较于单独使用康复新液，使用康复新液配合维生素C 及贝复济治疗的效果更为理想，可有效缩短溃疡面愈合、疼痛缓解时间，缓解患者疼痛。     

复方氯己定含漱液对种植义齿后种植体周围龈沟液中骨桥蛋白和碱性磷酸酶水平的影响

目的：探讨种植义齿后复方氯己定含漱液含漱对种植体周围龈沟液中骨桥蛋白（OPN）和碱性磷酸酶（ALP）水平的影响。方法：20例种植义齿患者随机分为A、B两组,每组10例,每位患者种植义齿1颗。A组患者义齿种植术后应用0.12%复方氯己定含漱液漱口,每次15 ml,早晚刷牙后含漱。B组患者只于早晚刷牙后清水漱口。两组均在种植术前2h及种植术后1.5个月采集种植体龈沟液1次,采用Western-boltting法检测OPN的表达,酶联免疫吸附法（ELISA）检测ALP水平。结果：两组患者种植义齿前OPN和ALP的表达差异无显著性（P〉0.05）,种植术后A组OPN和ALP的水平明显低于B组术后,差异有统计学意义（P〈0.05）。结论：种植义齿术后用复方氯己定含漱液含漱能够明显降低种植体周围龈沟液中OPN及ALP表达,有利于种植牙的成功种植。     

中西医结合治疗复发性阿弗他溃疡的临床观察

目的:现察中药"溃疡灵"和胸腺素注射浪联合治疗复发性阿弗他口腔溃疡疗效,并探讨患者对免疫反应的影响.方法:将我科门诊80例复发性阿弗他口腔溃疡患者随机分成治疗组及对照组,每组40例.对照组采用肌注胸腺素注射液.治疗组采用对照组治疗基础上加用中药"溃疡灵".现察两组患者的疗效,并检测两组患者治疗前后外周血T淋巴细胞亚群值.结果:治疗组比对照组疗效好,差异性显著(p<0.05).结论:中西医结合治疗RAU明显减少溃疡复发频率及程度,缩短溃疡愈合时间,疗效可靠,可广泛应用于临床.     

淋巴细胞、细胞因子与复发性阿弗他溃疡

复发性阿弗他溃疡(recurrent aphthous ulcer RAU)又称为复发性口腔溃疡(recurrent oral ulcer ROU)、复发性阿弗他口炎(recurrent aphthous stomatitis RAS),是指疼痛而原因不明的溃疡.这种溃疡为不连续、疼痛、浅在、复发性溃疡,并且被灰黄色伪膜覆盖、红晕包围[1].RAU主要发生于唇、颊、舌缘粘膜,但在角化完全的附着龈、硬腭少见.复发性阿弗他溃疡可以分为三型:轻型阿弗他溃疡(minor aphthous ulcer,MiAU)、重型阿弗他溃疡(major aphthous ulcer,MjAU)、疱疹样阿弗他溃疡(herpetiform ulcer,HU).MiAU 约占RAU的80%.直径2～4mm MjAU溃疡大而深,直径10～30mm深达粘膜下层直至肌层.     

多维元素胶囊(金维康)与碘甘油联合治疗口腔溃疡

目的:观察多维元素(金维康)与碘甘油联合治疗口腔溃疡的疗效。方法:202例口腔溃疡患者随机分为治疗组及对照组,每组各101例。治疗组口服多维元素,局部外涂碘甘油。对照组用洗必泰含漱液漱口,局部撒敷冰硼砂。观察疼痛缓解及溃疡愈合时间。结果:治疗组溃疡愈合时间比对照组缩短(P<0.01),其中疼痛缓解率,总有效率高于对照组(P<0.01)。结论:多维元素胶囊与碘甘油联合治疗口腔溃疡可促进组织修复。     

中西医结合治疗复发性口腔溃疡120例疗效观察

目的:观察中西医结合治疗复发性口腔溃疡的临床疗效.方法:对120例患者以贝复济无菌喷雾剂喷涂口腔溃疡面,并口服金施尔康片、中药治疗,观察记录临床疗效.结果:治愈43例,显效32例,有效24例,无效3例,总有效率为97.06%.结论:本方法疗效明显,可缩短疗程,减少复发机会,是治疗复发性口腔溃疡的有效且重要手段.     

Oral chlorhexidine and microbial contamination during endoscopy: possible implications for transgastric surgery. A randomized, clinical trial

Background

One of the biggest concerns associated with transgastric surgery is contamination and risk of intra-abdominal infection with microbes introduced from the access route. The purpose of this study was to evaluate the effect of oral decontamination with chlorhexidine on microbial contamination of the endoscope.

Methods

In a prospective, randomized, single-blinded, clinical trial the effect of chlorhexidine mouth rinse was evaluated. As a surrogate for the risk of intra-abdominal contamination during transgastric surgery, microbial contamination of the endoscope during upper endoscopy was examined. Patients referred to upper endoscopy were assessed for eligibility and randomized to either chlorhexidine or no mouth rinse. Culture samples were collected from gastric aspirates and endoscopes. The primary outcome measure was colony forming units (CFU) in the endoscope samples. Secondary outcome measures were species specific effect of chlorhexidine on micro-organisms with abscess forming capabilities and the effect of proton pump inhibitor (PPI) treatment on CFU.

Results

Chlorhexidine mouth rinse resulted in a significant reduction of CFU in the endoscope samples (p = 0.001). There was no species specific effect and micro-organisms with abscess forming capabilities were equally present. PPI treatment was associated with significantly higher CFU counts in both the gastric (p = 0.004) and endoscope samples (p = 0.049).

Conclusions

Chlorhexidine mouth rinse was effective in reducing microbial contamination of the endoscope, but micro-organisms with abscess forming capabilities were still present. PPI treatment significantly increased CFU and should be discontinued before transgastric surgery.     

Management of open fractures with sterilization of large, contaminated, extruded cortical fragments

The literature provides surprisingly little guidance for the management of Grade III open fractures with large extruded segments of long bones. A 10-cm segment of femoral diaphysis was reimplanted successfully in a 24-year-old man with a comminuted segmental open fracture. For basic information, laboratory studies were performed to determine the relative efficacies of various methods of sterilization of contaminated bovine metatarsals. Bovine bone segments were given one of the following treatments: (1) saline rinse; (2) povidone-iodine scrub/saline rinse; (3) povidone-iodine scrub/autoclaving; (4) povidone-iodine scrub/thimerosal immersion; (5) povidone-iodine scrub/povidone-iodine immersion; or (6) chlorhexidine gluconate scrub antibiotic solution immersion. The segments were then cultured. Only the povidone-iodine/autoclave and chlorhexidine gluconate/orthopedic antibiotic solution treatments were 100% effective in eliminating bacterial growth. Contaminated extruded segments of long bones can be adequately sterilized for reimplantation by surgical cleansing with chlorhexidine gluconate followed by brief soaking in antibiotic solution.     

The Influence of Serial Carbohydrate Mouth Rinsing on Power Output during a Cycle Sprint

The objective of the study was to investigate the influence of serial administration of a carbohydrate (CHO) mouth rinse on performance, metabolic and perceptual responses during a cycle sprint. Twelve physically active males (mean (± SD) age: 23.1 (3.0) years, height: 1.83 (0.07) m, body mass (BM): 86.3 (13.5) kg) completed the following mouth rinse trials in a randomized, counterbalanced, double-blind fashion; 1. 8 x 5 second rinses with a 25 ml CHO (6% w/v maltodextrin) solution, 2. 8 x 5 second rinses with a 25 ml placebo (PLA) solution. Following mouth rinse administration, participants completed a 30 second sprint on a cycle ergometer against a 0.075 g·kg^-1 BM resistance. Eight participants achieved a greater peak power output (PPO) in the CHO trial, resulting in a significantly greater PPO compared with PLA (13.51 ± 2.19 vs. 13.20 ± 2.14 W·kg^-1, p < 0.05). Magnitude inference analysis reported a likely benefit (81% likelihood) of the CHO mouth rinse on PPO. In the CHO trial, mean power output (MPO) showed a trend for being greater in the first 5 seconds of the sprint and lower for the remainder of the sprint compared with the PLA trial (p > 0.05). No significant between-trials difference was reported for fatigue index, perceived exertion, arousal and nausea levels, or blood lactate and glucose concentrations. Serial administration of a CHO mouth rinse may significantly improve PPO during a cycle sprint. This improvement appears confined to the first 5 seconds of the sprint, and may come at a greater relative cost for the remainder of the sprint.

Key points

• The paper demonstrates that repeated administration of a carbohydrate mouth rinse can significantly improve peak power output during a single 30 second cycle sprint.
• The ergogenic effect of the carbohydrate mouth rinse may relate to the duration of exposure of the oral cavity to the mouth rinse, and associated greater stimulation of oral carbohydrate receptors.
• The significant increase in peak power output with the carbohydrate mouth rinse may come at a relative cost for the remainder of the sprint, evidenced by non-significantly lower mean power output and a greater fatigue index in the carbohydrate vs. placebo trial.
• Serial administration of a carbohydrate mouth rinse may be beneficial for sprint athletes as a method of performance enhancement that minimizes the risk of performance decrement through body mass increase and gastrointestinal disturbances associated with ingesting carbohydrate solutions.

Key words: Anaerobic, exercise performance, exercise physiology, nutrition, physical performance     

正颌术后患者口腔冲洗方法的改进

目的提高口腔冲洗效果。方法将47例牙颌面畸形正颌术后患者随机分为两组,观察组24例采用改良法行口腔冲洗,即将吸唾管放置口角低位处,用1.5%过氧化氢溶液和生理盐水进行口腔冲洗,同时用棉签按先上后下、由后向前擦拭牙面及口腔黏膜。对照组23例行常规口腔冲洗。结果观察组冲洗后牙菌斑指数显著少于对照组(P<0.01)。结论对正颌术后患者采用改良口腔冲洗法护理效果显著优于常规方法。     

术前漱口预防全麻术后呼吸道感染的临床研究

目的探讨全麻插管患者术后呼吸道感染的预防方法。方法将 2 4 0例普外科行全麻插管手术患者随机分为对照组和观察组 ,各 12 0例。观察组术前 2d开始用漱口液在三餐前后及睡前漱口 ,7次 /d ;术后第 1天用漱口液行口腔护理 ;对照组术前不予漱口液漱口 ,术后第 1天常规用生理盐水棉球行口腔护理。两组于漱口前及术后第 1天分别行咽拭子培养。结果对照组与观察组术后咽试子培养结果比较 ,差异有显著性意义 (均P <0 .0 5 )。呼吸道感染、咳嗽咳痰发生率及其症状持续时间 ,观察组明显低于对照组 (均P <0 .0 1)。结论全麻患者术前采用漱口液漱口 ,可起到局部抑菌杀菌的作用 ,减少呼吸道感染的机会。     

In vitro assessment of the immediate and prolonged antimicrobial action of chlorhexidine gel as an endodontic irrigant against Enterococcus faecalis.

OBJECTIVE: The aim of this study was to assess in vitro the antimicrobial activity of 2% chlorhexidine gel against Enterococcus faecalis , comparing it to other endodontic irrigants (2% chlorhexidine liquid and 5.25% sodium hypochlorite). STUDY DESIGN: Eighty roots of human mandibular premolars were prepared by serial instrumentation technique, autoclaved, and contaminated for 7 days with E faecalis monocultures. The roots were then divided into 5 groups according to the irrigant substance used during the standardized biomechanical preparation. In order to evaluate the antimicrobial action of the irrigant substances, 3 microbial samples were taken: initial (before the biomechanical preparation); post-treatment (immediately after the biomechanical preparation), and final (7 days after the biomechanical preparation). The microbiological samples were plated to count the colony-forming units (CFU). RESULTS: The 2% chlorhexidine gel and 2% chlorhexidine liquid significantly reduced the E faecalis CFU in the post-treatment and final microbiological samples. The 5.25% sodium hypochlorite also reduced the E faecalis CFU immediately after the root canal instrumentation, but it was not able to keep the root canal free of detectable E faecalis in the final sample. CONCLUSIONS: The 2% chlorhexidine gluconate (gel and liquid) antimicrobial ability was more effective than 5.25% sodium hypochlorite in keeping low CFU of E faecalis for 7 days after the biomechanical preparation.     

单侧膝关节多发韧带损伤手术治疗后患者满意度调查

目的调查单侧膝关节多发韧带损伤术后满意度情况及影响因素。方法收集本院自2010-01—2015-02单侧膝关节多发韧带损伤行手术治疗的113例患者,术后1年给113例患者邮寄一份由笔者设计的单侧膝关节多发韧带损伤的满意度量表,其中包含对手术疗效的总体满意度、对具体功能和症状缓解程度的13个单项满意度以及可能的影响因素。收集患者作答后的满意度量表并统计分析。结果 84例寄回了量表,总体满意度78.57%,13个单项满意度分别为平地行走89.26%、住院期间医护人员的服务态度84.52%、经治医生术前谈话签字内容与过程83.33%、消除关节僵硬感80.95%、疼痛缓解79.76%、恢复家务73.80%、术后改善跛行72.62%、术后住院天数70.24%、关节活动度66.67%、快走或慢跑64.29%、下楼梯59.52%、上楼梯57.14%、下蹲53.57%。其中参加运动的频率、术前伴发疾病、是否按照医师要求康复锻炼、术后并发症、术后最大活动量为满意度的影响因素。结论单侧膝关节多发韧带损伤行手术治疗患者总体满意度较高,单项满意度中平地行走最高,下蹲最低。     

常规刷牙预防呼吸机相关性肺炎的效果观察

目的探讨常规刷牙在预防呼吸机相关性肺炎(VAP)中的作用,为寻找更为有效的口腔护理方法提供依据。方法将98例经口气管插管机械通气患者随机分为两组,对照组(48例)应用传统擦拭法进行口腔护理,观察组(50例)采用常规刷牙方法进行口腔护理;两组口腔护理后均给予口腔冲洗和咽部深吸引。比较两组机械通气1周后VAP发生率、机械通气时间及ICU住院时间。结果观察组机械通气1周后VAP发生率显著低于对照组(P<0.05),机械通气时间及ICU住院时间显著短于对照组(均P<0.01)。结论常规刷牙配合口腔冲洗及咽部深吸引能显著降低VAP的发生率,缩短机械通气及ICU住院的时间。     

经皮骶髂关节空心螺钉内固定联合支架外固定治疗骨盆骨折的临床效果分析

目的:探讨经皮骶髂关节空心螺钉内固定联合支架外固定在骨盆骨折中的临床疗效.方法:选取2015年1月-2017年1月佳木斯大学附属第一医院骨外二科收治的经皮骶髂关节空心螺钉内固定联合支架外固定治疗的40例患者(内外固定组),同期收治的采用开放手术治疗的40例骨盆骨折患者(开放手术组)作对照.术后,观察分析两组患者的手术相关指标、Majeed功能评分、临床疗效以及术后并发症发生情况.结果:内外固定组患者的手术时间、术后下床时间均显著短于开放手术组,术中出血量显著少于开放手术组,Majeed功能评分显著高于开放手术组,差异均有统计学意义(P＜0.05).内外固定组患者的治疗总有效率为90.0％(36/40例),显著高于开放手术组的65.0％(26/40例),差异有统计学意义(P＜0.05).内外固定组患者的术后并发症发生率为7.5％(3/40例),显著低于开放手术组的20.0％(8/40例),差异有统计学意义(P＜0.05),术后并发症主要有感染、骨关节炎、下肢深静脉血栓.结论:经皮骶髂关节空心螺钉内固定联合支架外固定相较于开放手术,能够有效缩短手术时间、减少术中出血量、提高治疗优良率及降低术后并发症发生率,值得在临床上推广应用.