美宝创疡贴治疗糖尿病足的疗效体会

目的总结、探讨创疡贴治疗早期糖尿病足溃疡创面的临床疗效。方法2009年1月至2013年5月收治的21例早期糖尿病足患者,除给予调控血糖、控制感染、营养支持等全身治疗外,创面采用创疡贴包扎治疗,每日换药1~2次,观察创面愈合时间和愈合效果。结果21例早划糖尿病足患者创面全部愈合,愈合时间为6~22 d,愈后均无明显瘢痕增生。结论创疡贴治疗早期糖尿病足溃疡创面,可缓解疼痛,预防感染,促进创面愈合,值得临床推广应用。     

湿润烧伤膏联合创疡贴治疗失禁相关性皮炎的疗效分析

目的探讨湿润烧伤膏联合创疡贴治疗失禁相关性皮炎的临床疗效。方法将2013年10月至2014年8月收治的34例失禁相关性皮炎患者随机分为两组,试验组(17例)采用湿润烧伤膏联合创疡贴治疗,对照组(17例)采用紫草油护理皮肤,观察两组患者皮炎创面的愈合效果及愈合时间。结果试验组治愈14例、好转3例、无效0例,对照组治愈7例、好转5例、无效5例,两组对比,差异具有统计学意义(P0.05);试验组创面平均愈合时间为轻度3.7 d±1.4 d、中度5.9 d±1.5 d、重度7.2 d±0.9 d,对照组创面平均愈合时间为轻度5.9 d±1.2 d、中度8.2 d±1.3 d、重度11.3 d±0.7 d,两组对比,差异具有统计学意义(P0.05)。结论湿润烧伤膏联合创疡贴治疗失禁相关性皮炎疗效显著,愈合时间明显短于紫草油治疗者,值得临床推广。     

A Self-Healing Hierarchical Fiber Hydrogel That Mimics ECM Structure

Although there have been many studies on using hydrogels as substitutes for natural extracellular matrices (ECMs), hydrogels that mimic the structure and properties of ECM remain a contentious topic in current research. Herein, a hierarchical biomimetic fiber hydrogel was prepared using a simple strategy, with a structure highly similar to that of the ECM. Cell viability experiments showed that the hydrogel not only has good biocompatibility but also promotes cell proliferation and growth. It was also observed that cells adhere to the fibers in the hydrogel, mimicking the state of cells in the ECM. Lastly, through a rat skin wound repair experiment, we demonstrated that this hydrogel has a good effect on promoting rat skin healing. Its high structural similarity to the ECM and good biocompatibility make this hydrogel a good candidate for prospective applications in the field of tissue engineering.     

Development of polyurethane foam dressing containing silver and asiaticoside for healing of dermal wound

 Polyurethane foam dressings for dermal wounds were formulated with natural polyols in order to improve the foam characteristics and the release of 2 active agents, silver and asiaticoside (AS) as an antimicrobial agent and an herbal wound healing agent, respectively. The foam was instantly formed by interaction of polyols and diisocyanate. Hydroxypropyl methylcellulose, chitosan and sodium alginate were individually mixed with the main polyols, polypropylene glycol, in the formulation while the active components were impregnated into the obtained foam dressing sheets. Although the type and amount of the natural polyols slightly affected the pore size, water sorption-desorption profile and compression strength of the obtained foam sheets, a prominent effect was found in the release of both active components. Among natural polyols formulations, foam sheets with alginate showed the highest silver and AS release. Non-cytotoxicity of these foam sheets to human fibroblast cells was confirmed. Antimicrobial testing on four bacteria strains showed that 1 mg/cm2 silver in formulations with 6% of natural polyols and without natural polyols had sufficient content of the silver release with comparable inhibition zone and significantly larger zone than other formulations. In pig study, the foam dressing with 6% alginate, 1 mg/cm2 silver and 5% AS could improve wound healing in both the percentage of the wound closure and histological parameters of the dermal wound without any dermatologic reactions. In conclusion, this innovative foam dressing had potential to be a good candidate for wound treatment.     

Periodontal dressing may influence the clinical outcome of non-surgical periodontal treatment: a split-mouth study

To cite this article:
Int J Dent Hygiene 10 , 2012; 284–289
DOI: 10.1111/j.1601‐5037.2010.00493.x Genovesi AM, Ricci M, Marchisio O, Covani U.Periodontal dressing may influence the clinical outcome of non surgical periodontal treatment: a split‐mouth study. Abstract: Introduction: After scaling and root planning (SRP), healing induces the formation of a junctional long epithelium rather than a new connective attachment. We hypothesize that the placement of a periodontal dressing will be able to prevent detachment of coagulum inducing proper healing and improving periodontal parameters. Materials and methods: This split‐mouth study included 30 patients with periodontitis with ages ranging from 35 to 70 years. Probing pocket depth (PD), probing attachment level (PAL), bleeding on probing index (BoP) and plaque index (PI) were assessed before and after therapy. The group of patients received SRP in a span of 24 h. Then, a periodontal dressing was applied on the test side and it was removed after 1 week. Results: Control group: The difference between PD values at baseline and after therapy was 1.6 ± 0.6 mm. The difference in PAL (ΔPAL) measurement was 1.4 ± 0.4. Test group: there was a greater PD reduction, this being 2.4 ± 0.6 mm on average. The difference in PAL was 2.5 ± 0.4 mm. Conclusions: Our results clearly suggest that the use of a periodontal dressing improves the periodontal parameters after an SRP procedure. This is probably due to clot stabilization and prevention of bacterial colonization during wound healing.     

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目的评价自制洗必泰凝胶对粪肠球菌的抑菌效果。方法于2011年9月至2012年3月在辽宁省疾病控制中心微生物实验室采用纸片扩散法药敏实验测定生理盐水（A组）、Vitepex（B组）、2％洗必泰溶液（c组）和洗必泰凝胶（D组）对粪肠球菌形成的抑菌环直径并进行统计学分析。结果C组和D组的抑菌环直径明显大于B组,差异有统计学意义（p〈0．01）;C组和D组抑菌环直径的差异无统计学意义（P〉0．05）;4组组内各时间点抑菌环直径差异均无统计学意义（P〉0．05）。结论洗必泰凝胶是根管再治疗的理想消毒药物。     

Assessment of the Thrombogenic Effect of Fibrin Sealant Dressing in a Vascular Surgery Model in Rabbits

This study's objective was to investigate the potential thrombogenic effects of thrombin-containing fibrin sealant dressings (FSD) in a vascular repair model. Oval-shaped pieces of the rabbit abdominal aorta and vena cava were excised, the injuries were repaired with FSD, and animals were allowed to recover. Thrombus formation was examined by (1) an infusion of indium-labeled platelets into the rabbits following FSD application and estimation of total number of platelets attached to the wounds at 2, 4, and 6 h later (short-term effect, n = 12); and by (2) morphological and histological examinations of the vessels and dressings on days 1, 3, and 7 after repair operation in another group of rabbits (long-term effect, n = 12). Application of FSD sealed the vascular injures and produced immediate hemostasis that was stable up to 1 week. The highest numbers of platelets (both native and labeled) adhered to the arterial and venous repair sites were 6.5 × 10⁶ and 4.4 × 10⁷, respectively, 6 h after operation. The adhered platelets, however, did not form a visible and clinically significant thrombus. In long-term experiments, no evidence of thrombus was found in the lumens of the repaired vessels or on the dressings, and no microthrombi were detected histologically in other tissues at any time point. Although vena caval injuries showed signs of healing at day 7 postoperatively, the aortic wounds expanded progressively (pseudoaneurysm) and were prone to rupture at later times. Thus, direct exposure of FSD does not cause intravascular thrombosis or thrombotic events in rabbits. The dressing appears to be safe and effective for short-term repair of vascular injuries. It may also allow healing of minor venous defects, but cannot replace conventional surgical techniques (suturing) for permanent repair of arterial damages.     

不同年龄和营养水平下驴肥育性能测定

选择断奶佳米驴、1.5岁驴及当地成年退役驴70头,用传统饲料或全价料加不同粗料肥育,分7个小群,饲喂63 d或113 d。结果表明,63 d日增重1.5岁驴（444.44～560.16）g,成年退役驴（611.11～670.15）g,断奶驴为（185.17～292.86）g;83 d日增重,1.5岁驴（423.42～566.08）g,成年退役驴（493.75～562.00）g。1.5岁驴日增重,以A2全价料加部分苜蓿效果好,与传统料A1群差异极显著（P<0.01）,与全价料不加部分苜蓿而加青贮A3群差异显著（P<0.05）。优质肉比例,饲养63 d断奶驹平均为57.03%,饲养113 d,1.5岁佳米驴平均为57.52%,成年退役驴平均为61.92%。1.5岁驴和成年退役驴,屠宰率分别为,43.37%～50.94%,46.64%～50.63%;净肉率分别为34.85%～38.32%,36.03%～36.14%;骨肉比3.19%～4.02%,4.00%～5.45%;脂肉比20.70%～22.65%,4.09%～8.01%。皮厚和皮重,饲养63 d断奶驴分别为（0.60～0.75）cm,（8.27～9.00）kg;肥育113 d 1.5岁佳米驴分别为（0.79～0.99）cm,（9.50～10.33）kg,退役成年驴分别为（0.85～1.04）cm,（10.00～11.60）kg,呈现皮厚随年龄增厚,皮重随年龄营养增重趋势。试驴内脏重量随年龄增大而增加,同龄不同营养群间内脏重量互有高低。试验认为,断奶驴不宜肥育肉用;成年退役驴以63 d强度肥育较好;1.5岁驴可短期（63 d,83 d）强度肥育生产优质驴肉,或肥育数月生产高中档驴肉。     

敷料预防无创正压通气鼻面部压疮效果的网状Meta分析

目的采用网状Meta分析方法评价7种常用敷料预防无创正压通气(NIPPV)患者鼻面部压疮的效果。方法以压疮、正压通气、positive pressure pespiration、pressure ulcer等检索词检索PubMed、EMbase、Cochrane Library、Web of Science、CINAHL、中国生物医学文献数据库(CBM)、中国知网(CNKI)及万方数据库等中外文数据库,检索时间截止2015年7月,纳入对比敷料预防NIPPV患者鼻面部压疮的随机对照试验(RCT)。由2名研究者独立进行数据提取和质量评价,采用WinBugs、Stata软件分析数据。结果最终纳入27个RCT,共2 797例患者。网状Meta分析结果显示,7种敷料预防NIPPV患者鼻面部压疮效果均优于常规护理措施(均P0.05)。根据累积排序概率曲线下面积(SUCRA)排序结果,凝胶敷料、泡沫敷料是预防NIPPV患者鼻面部压疮的较优方案。结论基于网状Meta分析结果和SUCRA排序结果,凝胶敷料和泡沫敷料预防NIPPV患者鼻面部压疮效果优于其他敷料。未来研究应关注不同种类敷料间效果的直接比较及成本效果评价。     

水胶体透明敷料预防神经外科中心静脉导管细菌定植和细菌感染的研究

目的比较透明薄膜敷料与水胶体透明敷料预防神经外科中心静脉导管细菌定植和细菌感染的效果,为合理选择中心静脉导管固定敷料提供依据。方法按照随机数字表法将神经外科行中心静脉置管患者470例分为对照组(230例)和观察组(240例),中心静脉置管后对照组采用透明薄膜敷料固定导管,观察组采用水胶体透明敷料固定导管。比较两组导管病原菌定植、导管相关性感染和导管相关性血源性感染、皮肤病原菌定植情况。结果观察组导管病原菌定植、导管相关性感染、导管相关性血源性感染以及皮肤病原菌定植的发生率显著低于对照组,导管感染发生时间显著延长(均P0.05)。结论水胶体透明敷料可以有效预防神经外科患者中心静脉导管细菌定植和细菌感染,具有良好的皮肤安全性。