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。     

Hyaluronic acid dressing (Healoderm) in the treatment of diabetic foot ulcer: A prospective,randomized, placebo‐controlled,single‐center study

Fast and complete healing of a diabetic foot ulcer (DFU) is challenging due to the hostile wound healing environment of the diabetic patients. As a part of a multimodal treatment approach, advanced dressing material using hyaluronic acid (HA) has been found to be effective. However, previous studies have used HA with additional biologics, which interferes in determining the true clinical effect of HA in DFU. To examine the sole effectiveness of HA in DFU treatment, a prospective, randomized, placebo‐controlled, single‐center study was conducted using an HA dressing without additional substances. Thus, 34 patients who met the inclusion criteria were randomized into two groups (the study group: HA dressing material; the control group: conventional dressing material). During the 12‐week study period, complete ulcer healing rate was evaluated as a primary endpoint. Additionally, healing velocity and the mean duration for achieving a 50% ulcer size reduction was compared between the two groups as a secondary endpoint. At the end of the study, the study group presented a significantly higher complete healing rate as compared to that in the control group [84.6% (11/13), 41.6% (5/12), respectively, P = 0.041]. Additionally, faster ulcer healing velocity and shorter mean duration for achieving a 50% ulcer size reduction were observed in the study group (P = 0.022 and 0.004, respectively). The Kaplan‐Meier survival analysis for the median time for 50% ulcer healing rate also showed a significantly shorter duration in the study group (21 days vs. 39 days, P = 0.0127). Finally, there were no adverse events related to the dressing materials used in the study. As a major component of the extracellular matrix, this study supports the safety and efficacy of a pure HA dressing without additional substances in treating DFU.     

CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕疗效观察

目的：探讨CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕的疗效。方法选取我院2014年1月至2015年5月收治的面部痤疮凹陷性瘢痕患者84例,采用随机数字表法分为观察组和对照组,每组42例。所有患者均接受CO2点阵激光治疗,观察组外用胶原贴敷料,对照组不作处理。CO2点阵激光治疗结束冰袋冷敷20 min后,进行急性炎症反应的半定量评分;治疗结束后进行疗效评价;治疗结束后6个月记录不良反应等。结果观察组急性炎症反应的半定量评分[(1.52±0.38)分]、误工期[(7.60±2.80) d]、痂皮脱落时间[(6.35±1.50) d]明显低于对照组的[急性炎症反应的半定量评分(2.10±0.52)分、误工期(10.50±3.45) d、痂皮脱落时间(8.25±2.15) d, P<0.05];观察组和对照组的总有效率分别为92.86%和76.19%,两组比较差异有统计学意义(P<0.05);观察组色素沉着发生率为19.05%、持久性潮红发生率为0,感染性脓疱发生率为2.38%,显著低于对照组的30.95%、4.76%、7.14%(P<0.05);两组均未发生瘢痕增生。结论 CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕疗效显著,其具有不良反应低、结痂时间和误工期短的优点,值得临床推荐使用。     

PVA-PEG physically cross-linked hydrogel film as a wound dressing: experimental design and optimization

The development of hydrogel films as wound healing dressings is of a great interest owing to their biological tissue-like nature. Polyvinyl alcohol/polyethylene glycol (PVA/PEG) hydrogels loaded with asiaticoside, a standardized rich fraction of Centella asiatica, were successfully developed using the freeze–thaw method. Response surface methodology with Box–Behnken experimental design was employed to optimize the hydrogels. The hydrogels were characterized and optimized by gel fraction, swelling behavior, water vapor transmission rate and mechanical strength. The formulation with 8% PVA, 5% PEG 400 and five consecutive freeze–thaw cycles was selected as the optimized formulation and was further characterized by its drug release, rheological study, morphology, cytotoxicity and microbial studies. The optimized formulation showed more than 90% drug release at 12?hours. The rheological properties exhibited that the formulation has viscoelastic behavior and remains stable upon storage. Cell culture studies confirmed the biocompatible nature of the optimized hydrogel formulation. In the microbial limit tests, the optimized hydrogel showed no microbial growth. The developed optimized PVA/PEG hydrogel using freeze–thaw method was swellable, elastic, safe, and it can be considered as a promising new wound dressing formulation.     

Comparison of platelet‐rich plasma gel in the care of the pressure ulcers with the dressing with serum physiology in terms of healing process and dressing costs

This research was carried out with the aim of comparing the effects of platelet‐rich plasma (PRP) gel and gas dressing with serum physiologic applied to stage II pressure ulcer in coccyx of patients for 2 months on healing process and dressing costs. This prospective randomised controlled experimental study was conducted with 60 patients hospitalised in the palliative care unit after surgery. The experimental group (n = 30) was dressed with platelet‐rich plasma gel. The control group (n = 30) was treated with serum physiologic dressing. At the end of the 20th observation of the patients in the experimental group, it was found that the mean scores of area, exudate, and tissue type in pressure sores decreased statistically (P < .001). In the control group, no significant difference was found between the mean PUSH score at the end of the 20th observation (P > .05). The study showed that PRP gel had a positive effect on healing of stage II pressure ulcers with platelet‐rich plasma gel dressings. In addition, when evaluated in the long term, it was concluded that platelet‐rich plasma gel is easily accessible and less costly than serum physiological dressing.     

Aquacel Ag dressing versus Acticoat™ dressing in partial thickness burns: A prospective,randomized, controlled study in 100 patients. Part 1: Burn wound healing

Introduction

Studies comparing contemporary silver dressings in burns are scarce.

Methods

In a prospective, randomized, controlled study, counting 50 patients/research group, we compared two frequently used silver dressings, Acticoat™ and Aquacel^® Ag, in the management of partial thickness burns with a predicted healing time between 7 and 21 days as assessed by laser Doppler imaging between 48 and 72 h after burn. Variables investigated were related to baseline research group characteristics, wound healing, bacteriology, economics, nurse, and patient experience.

Results

Both research groups were comparably composed taking into account gender, age and burn characteristics. Similar results were obtained as to healing time and bacterial control with both silver dressings. A statistically significant difference in favor of the Aquacel^® Ag dressing was found for average ease of use (p < 0.001), average ease of application (p = 0.001), patient pain (p < 0.001), patient comfort with the dressing (p = 0.017), silver staining (p < 0.001), and cost effectiveness (p < 0.001).

Conclusion

Both silver dressings resulted in comparable healing times and bacterial control but the Aquacel^® Ag dressing significantly increased comfort for patients as well as nurses and was significantly more cost-effective than the Acticoat™ dressing for the given indication.     

人体生物敷料在腹腔开放治疗中的临床疗效

目的 探讨人体生物敷料（灭活的同种异体皮肤）作为腹腔开放临时覆盖物的临床疗效.方法 回顾性分析2011年1月至2014年1月南京军区南京总医院收治的44例因外伤行腹腔开放治疗患者的临床资料.所有患者腹腔开放后以改良三明治法作为临时关腹技术.2011年1月至2012年12月共33例行腹腔开放治疗患者采用凡士林纱布为腹腔临时覆盖物,设为凡士林纱布组（33例）;2013年1月至2014年1月共11例行腹腔开放治疗患者采用人体生物敷料为腹腔临时覆盖物,设为人体生物敷料组（11例）.采用门诊和电话随访,随访时间截至2014年10月.比较两组患者肠道空气瘘发生率、植皮时间、术前和术后2周内血液感染学指标（WBC、中性粒细胞所占比例、降钙素原及C反应蛋白）,住院时间、住院费用以及总体预后.计量资料比较采用独立样本t检验和重复测量方差分析;率或构成比的比较采用Fisher确切概率法.结果 凡士林纱布组患者中,肠道空气瘘发生率为42.4％（14/33）,人体生物敷料组患者中无一例出现肠道空气瘘,两组比较,差异有统计学意义（P＜0.05）.凡士林纱布组植皮时间为（15±6）d,人体生物敷料组为（11±3）d,两组比较,差异有统计学意义（t =2.10,P＜0.05）.凡士林纱布组患者术前、术后第1、3、7、14天降钙素原分别为（1.20±0.60） μg/L、（2.50±0.90） μg/L、（1.70±0.30） μg/L,（1.90±0.40） μg/L、（2.70±0.60）μg/L,显著高于人体生物敷料组的（0.90 ±0.30） μg/L、（1.80±0.60） μg/L、（1.30 ±0.50） μg/L、（0.60±0.20） μg/L、（0.30±0.07） μg/L,两组比较,差异有统计学意义（F=8.50,P＜0.05）;两组患者WBC、中性粒细胞所占比例和C反应蛋白分别由术前的（13.8±2.4）×10^9/L和（12.9±2.1）×10^9/L、0.90±0.09和0.88 ±0.06、（81±19） mg/L和（136±28） mg/L变化为术后第14天的（16.2±3.3）×10^9/L和（7.9±3.0）×10^9/L?