碘伏与湿润烧伤膏分阶段包扎疗法治疗Ⅱ度烧伤体会

目的:探讨湿润烧伤膏治疗烧伤的临床疗效.方法:碘伏与湿润烧伤膏分阶段包扎治疗47例Ⅱ度烧伤患者.结果:31例浅Ⅱ度烧伤患者创面全部实现皮肤再生愈合,16例深Ⅱ度烧伤患者90%以上达到皮肤再生愈合.结论:碘伏与湿润烧伤膏分阶断包扎疗法治疗烧伤,能够在发挥碘伏和湿润烧伤膏疗效的同时,减少治疗和护理的工作量,避免体位不当造成的影响,是治疗烧伤值得推荐的方法.     

烧伤原位再生复原技术的烧伤创面处理及终点标准规范

烧伤皮肤原位再生复原技术是我国生命科学家徐荣祥教授发明的一项全新的烧伤治疗技术, 现已被广泛应用, 成为治疗烧伤的主要手段。在烧伤创面处理上, 打破了现行的烧伤急救医疗模式, 建立了符合烧伤再生医疗系统的创面处理准则, 从而使深度烧伤创面能通过自身潜力再生愈合, 避免了深度烧伤创面需手术治疗及创面愈合后瘢痕增生等问题, 解决了深度烧伤创面难以愈合的历史医学难题。但该技术在临床应用过程中往往因为没有被规范应用, 尤其是在创面处理上, 没有被规范操作, 从而导致烧伤皮肤原位再生复原技术的自身原位再生复原特点没有被充分发挥, 使各种烧伤创面不能达到应有的效果。作者通过复习总结既往烧伤皮肤原位再生复原技术的临床应用成果和本人临床经验, 规范烧伤原位再生复原技术在烧伤创面的处理准则及终点标准, 展示皮肤原位再生复原技术的可靠疗效、较强实用性、科学性和先进性。     

MEBO治疗成人阴囊阴茎深度烧伤

目的 观察美宝湿润烧伤膏(MEBO)治疗成人阴囊阴茎深度烧伤的临床效果.方法 我科自2007年元月以来对9例成人阴囊阴茎深度烧伤创面全程应用皮肤原位再生医疗技术治疗.结果 9例患者创面全部治愈,其中仅1例阴囊前侧肉芽创面行自体皮片移植后治愈.愈后阴囊阴茎外观良好,功能恢复正常.结论 皮肤原位再生医疗技术方法简便,易操作,无痛苦,患者易于接受.MEBO是阴囊阴茎深度烧伤的首选外用药.     

烧伤再生医学理论与实践的巨著《烧伤治疗大全》出版

《烧伤治疗大全》是由徐荣祥教授著,中国科技出版社出版的第一部在国内面世的全面介绍烧伤再生医学理论与实践的著作。在烧伤医学已进入了组织器官再生阶段的今天.临床实践证实深度烧伤创面可以通过     

头面部烧伤合并外耳道烧伤临床治疗体会

目的:观察湿润烧伤膏药纱填塞治疗对外耳道烧伤创而的疗效.方法:对我科2005年3月至2009年12月住院的17例严重头面部烧伤合并外耳道烧伤的患者采用湿润烧伤膏药纱治疗后,定时检查外耳道、鼓膜的变化,并测试听力.结果:湿润烧伤膏药纱治疗严重头面部烧伤合并外耳道烧伤疗效好,愈后鼓膜与听力正常.结论:湿润烧伤膏药纱治疗严重头面部烧伤合并外耳道烧伤具有促进创面再生修复,较好地保持鼓膜完整和听力正常的良好效果.     

烧伤再生医学与疗法对大面积烧伤的治疗要点

目的总结烧伤再生疗法和传统治疗方法在大面积烧伤患者系统治疗中的不同。方法回顾性分析2例大面积烧伤患者经烧伤再生疗法的救治过程,总结大面积烧伤患者的治疗要点。结果经过分析客观详尽的临床数据,大面积烧伤患者在使用烧伤再生疗法治疗时,在补液量、多器官功能维护、防治感染、营养支持等方面均优于传统方法。结论烧伤再生疗法在大面积烧伤治疗中具有不可比拟的优势,但是需要系统掌握其在系统治疗中与传统疗法的不同之处,方能提高大面积烧伤患者的救治成功率。     

再生医疗技术治疗电烧伤的临床应用研究

目的 介绍各类电烧伤的临床特点、创面处理及治疗方法.方法 针对不同部位的电烧伤选择及时采用原位再生医疗技术的治疗方法,并重点强调临床治疗中的注意事项.结果 临床采用原位再生医疗技术治疗电烧伤能最大限度地保留机体间生态组织,各部位的电烧伤创面均能再生愈合.结论 再生医疗技术治疗电烧伤安全易行,操作简单,疗效可靠,残废率低.     

美宝湿润烧伤膏与磺胺嘧啶银霜治疗热镁渣烧伤的比较

目的:比较美宝湿润烧伤膏再生疗法与磺胺嘧啶银霜抗炎疗法治疗热镁渣烧伤的疗效.方法:选择36例热镁渣烧伤病人,随机分为两组,烧伤创面分别采用美宝湿润烧伤膏再生疗法(MEBO实验组)与磺胺嘧啶银霜抗炎疗法(SD-Ag对照组)治疗,观察两组病人不同深度烧伤创面的愈合时间、感染发生率、手术植皮例数及瘢痕发生率.结果:实验组创面愈合时间、感染率、手术植皮比例及瘢痕发生率均明显低于对照组(p<0.05).结论:在治疗热镁渣烧伤中,美宝湿润烧伤膏再生疗法疗效优于磺胺嘧啶银霜抗炎疗法.     

再论焦痂薄化术再生烧伤再生疗法中的应用前景

“烧伤再生疗法”的前身是“烧伤湿性医疗技术（ MEBT/MEBO）”,它由烧伤湿润暴露疗法（MEBT）和湿润烧伤膏（MEBO）组成,1991年被列入国家“十年百项”成果首批十项推广技术之一.为了加速创面坏死组织早期液化过程,附加了“耕耘疗法”等项技术,初步形成了具有中国特色的烧伤医疗体系.因为这种疗法能够激活自身成体细胞,使创面实现生理性愈合,又被称为“皮肤原位再生复原技术”,目前已成为我国治疗烧伤的主体技术.为了总结“烧伤再生疗法”治疗深度烧伤的临床经验,探讨加速创面坏死组织液化和缩短再生修复过程的有效方法,作者复习了与之有关的文献.结果发现,耕耘疗法能促进深Ⅱ度深型创面坏死组织液化,使这些创面实现原位再生修复;用其处理Ⅲ度创面,焦痂液化期偏长,从而也延长了烧伤皮肤再生愈合过程.Ⅲ度创面若附以“焦痂薄化术”处理,可有效地缩短液化期,在MEBT/MEBO培植的肉芽组织上移植自体皮肤很容易成活.同时观察到愈合后的皮肤形态近似于正常,组织病理学检查到具有类似于真皮组织的结构.据此认为,“焦痂薄化术”在“烧伤再生疗法”中应用前景十分广阔.     

湿润烧伤膏治疗小儿头面颈部Ⅱ度烧伤128例的临床体会

目的:观察湿润烧伤膏(MEBO)对小儿头面颈Ⅱ度烧伤的疗效.方法:对自2006年1月至2008年9月住院的128例头面颈部Ⅱ度烧伤患者采用美宝湿润烧伤膏治疗后,观察疗效及愈后3个月瘢痕形成情况,并对其进行临床总结分析.结果:美宝湿润烧伤膏治疗头面颈部烧伤创面愈合快,色素轻,无瘢痕形成.结论:美宝湿润烧伤膏治疗头面颈部Ⅱ度烧伤,具有促进创面再生修复,减轻疼痛,控制创面感染等治疗作用.     

Military tobacco policies: the good, the bad, and the ugly

The United States military has the legacy of a pro-tobacco culture and still has prevalence rates of tobacco use that are higher than their civilian counterparts. One tactic for decreasing use and the subsequent health problems is through effective tobacco control policies. We collected available tobacco control policies from all four branches of the military and, through qualitative analysis, identified policies that were unique either as providing more or less detail and restriction than peer group policies. Best and worst practice policies in the areas of enforcement, smoking cessation, smokeless tobacco use, environmental tobacco smoke, framing tobacco as non-normative, designated tobacco use areas, and monitoring of tobacco use are presented. Because policy making can be an effective tool for improving the health of military members, understanding what policy components are comparatively positive or negative is an important tool for health advocates both in the military and civilian settings.     

High tibial osteotomy for the treatment of unicompartmental knee osteoarthritis: a review of the literature, indications, and technique

In the past decades, there has been varying support for high tibial osteotomy. This surgical procedure was originally popularized by Mark B. Coventry, MD in the 1960s, but fell out of favor with orthopedic surgeons as knee arthroplasty became more commonplace. In the past 10 years, osteotomy has been rediscovered as an important adjunct to cartilage repair procedures that rely on a normalized biomechanical environment. Furthermore, there has been an increase in the number of patients presenting with unicompartmental disease (eg, after prior meniscectomy) who are at an age and functional level that is not ideally suited for joint arthroplasty. High tibial osteotomy allows 70% to 85% of patients to delay arthroplasty for ≥ 5 to 10 years and 50% to 60% for ≥ 15 years. This article provides an overview of the indications, technique, complications, and outcomes of high tibial osteotomy, specifically the more commonly used opening wedge technique.     

MR arthrography of the knee: how, why, when

MR arthrography combines the techniques of arthrography with MR imaging to benefit from the added imaging information afforded by intra-articular distention. This article reviews technical considerations for MR arthrography, potential complications, indications, pitfalls in imaging diagnosis, and commonly encountered pathology. It is an elegant study that can offer precise diagnostic information in the appropriate clinical setting.     

Amniotic fluid embolism with involvement of the brain,lungs, adrenal glands,and heart

The case of a healthy 31-year-old woman in the 40th week of second pregnancy is presented. During preparation for an emergency caesarean section, she developed an amniotic fluid embolism (AFE) with unusual and unique features. The acute onset of disease with cardiorespiratory failure with hypotension, tachycardia, cyanosis, respiratory disturbances and loss of consciousness, suggested at first a pulmonary thromboembolism, but the appearance of convulsions led to the diagnosis of AFE. The patient died after 5 days due to an untreatable brain edema. At autopsy, AFE with the usually associated disseminated intravascular coagulation was found in the lungs, brain, left adrenal gland, kidneys, liver and heart. Eosinophilic inflammatory infiltrates were found in the lungs, hepatic portal fields and especially in the heart, suggesting a specific hypersensitivity reaction to fetal antigens. Moreover, intravascular accumulation of macrophages in the lungs also favored a non-specific immune reaction to amniotic fluid constituents.     

Quantitative measurement of the pivot shift,reliability, and clinical applications

Static load–displacement measurement is unrelated to the dynamic knee function of anterior cruciate ligament (ACL) insufficiency. Performing an accurate, dynamic functional evaluation is necessary not only for the primary ACL injury, but also as an outcome measurement in ACL reconstruction. The pivot shift test is commonly used for assessing dynamic rotatory knee laxity in ACL-insufficient knees and is related to subjective knee function. Residual pivot shift after ACL reconstruction is a crucial factor related to poor clinical outcome. However, the pivot shift test is subjectively determined by the examiners’ hands. Not only 3-dimensional (3D) position displacement but also its 3D acceleration should be measured for quantitative evaluation of the pivot shift test and is currently feasible by using recent advanced technology, i.e., electromagnetic devices. We summarize the basic knowledge and current concepts of quantitative exploration of the dynamic knee movement during the pivot shift test.     

Ovarian cancer: the clinical role of US, CT, and MRI

This article presents an overview of ovarian cancer, which addresses the clinical roles of imaging studies, including US, CT, and MR imaging in the course of diagnosis and treatment of this important disease. US is the modality of choice in the evaluation of patients with suspected adnexal masses. Although its accuracy is not sufficient to avert surgery, morphological analysis of adnexal masses with US helps narrow the differential diagnosis, determining the degree of suspicion for malignancy, usually in concert with a serum CA-125 level. Combined morphological and vascular imaging obtained by US appear to further improve the preoperative assessment of adnexal masses. For uncertain or problematic cases, MR imaging helps to distinguish benign from malignant, with an overall accuracy for the diagnosis of malignancy of 93%. The accuracy of MR imaging in the confident diagnosis of mature cystic teratoma, endometrial cysts, and leiomayomas is very high. CT is not indicated for differential diagnosis of adnexal masses because of poor soft tissue discrimination, except for fatty tissue and for calcification, and the disadvantages of irradiation. In the staging of ovarian cancer, CT, US, and MR imaging all have a similarly high accuracy. Although it is difficult to suggest a simple algorithm for evaluating the state of women with adnexal masses, the correct preoperative diagnosis and staging of ovarian cancer with the use of any of these imaging studies will lead to an appropriate referral to a specialist in gynecologic oncology and offer a significant survival advantage for patients with ovarian cancer.     

Age, degraded viewing environments, and the speed of accommodation

Subjects were 35 males in an accommodation experiment which utilized a subjective laser optometer. Seven different age groups, from average age 22-52, were measured on the time to change accommodation from a near to an infinity target. During the experiment, room illumination, time duration of reading at a near distance, and the distance of a near-reading task were varied. Results indicated that the time to accommodate from a near to infinity target varied as a function of age, room illumination, and the distance of the near-reading task. During ideal conditions, older subjects could accommodate nearly as quickly as the younger subjects; however, during degraded viewing conditions, the accommodation time for older subjects increased as much as tenfold. Time to accommodate to a distant target also increased solely as a function of time spent reading at a near distance, regardless of age. In accordance with previous reviews of aging and military pilots, it is suggested that the time to accommodate may be used as an objective measure of degraded vision as it relates to age.     

Biopsy techniques in the investigation of diseases of the lung, mediastinum, and chest wall

Closed biopsy techniques are available for the investigation of diseases of the mediastinum, hilus, and chest wall as well as for pulmonary and pleural disease. Biopsy via the bronchoscope is of greatest value in the diagnosis of endobronchial lesions, especially those that are centrally sited, and of diffuse pulmonary disease including opportunistic infections. Fluoroscopically controlled fiberoptic bronchoscopy is beginning to replace the transcatheter biopsy technique. In general, the use of large needles for biopsy should be avoided. Percutaneous fine needle biopsy is an effective means of sampling lesions of the mediastinum, hilus, and chest wall. However, this mode of biopsy is most widely used as a safe and highly accurate means of diagnosing localized pulmonary disease.