Relationship Between Fibril Length and Tissue Ingrowth in the Healing of Expanded Polytetrafluoroethylene Grafts

Purpose To determine whether fibril length is correlated with graft healing as well as cellular and capillary ingrowth in a canine carotid implantation model.Methods Expanded polytetrafluoroethylene (ePTFE) vascular grafts with three different fibril lengths (30, 60, and 90µm) were implanted into the carotid artery in dogs. They were retrieved 4 weeks later, and subjected to histomorphometric analysis.Results Endothelial healing was best in the 60-µm grafts. Not only cellular ingrowth but also capillary ingrowth was most evident in the 60-µm grafts, followed by the 90-µm grafts and then the 30-µm grafts.Conclusion Better endothelial healing of ePTFE vascular grafts is correlated with more cellular and capillary ingrowth, but more cellular and capillary ingrowth is not correlated with longer fibril length or higher air porosity.     

Intestinal Anastomoses from Diabetic Rats Contain Supranormal Levels of Gelatinase Activity

PURPOSE: Early postoperative strength in intestinal anastomoses is reduced in diabetic rats, whereas collagen deposition is essentially unchanged, suggesting that increased matrix degradation may be the cause of diminished wound strength. The aim of this study was to investigate whether (gelatin-degrading) matrix metalloproteinase activity is enhanced in intestinal anastomoses from diabetic rats. METHODS: Sixty male young adult Wistar rats underwent resection and anastomosis of both ileum and colon. In half the animals diabetes was induced seven days before operation by streptozotocin injection (50 mg/kg intravenously). Gelatinase activities in extracts from uninjured intestine and anastomoses at one, three, or seven days after surgery were measured by quantitative gelatin zymography. RESULTS: After surgery, profound changes were observed with time for gelatinase activities with molecular weights of 50 and 60 kDa, thought to represent matrix metalloproteinase-2, and of 66, 80, 105, 140, 220, and 260 kDa, thought to represent various forms of matrix metalloproteinase-9. In many cases, specific activities were significantly (P < 0.05) higher in the anastomotic extracts from diabetic rats. Total anastomotic activities present at Day 7 were strongly elevated for most matrix metalloproteinase forms in ileum and colon from diabetic animals. CONCLUSION: Experimental diabetes leads to a sustained and elevated presence of gelatinase activity in intestinal anastomoses. Increased local matrix degradation may contribute significantly to impaired anastomotic strength in the intestine observed under this condition.     

采用聚类分析和对应相关方法研究1069例冠心病心绞痛证候应证组合规律

目的:研究聚类分析和对应相关方法对1 069例冠心病心绞痛的69个症状进行分类研究和证候要素组合规律。方法:在五家医院多中心、大样本收集1 069例经冠脉造影证实的冠心病心绞痛患者,记录中医四诊信息,运用聚类分析和对应相关方法进行分类研究和证候要素组合规律研究。结果:运用聚类的方法把1069例冠心病心绞痛的69个症状聚成6类,经中医专家辨证第1类心肾阴阳俱虚、第2类气虚血瘀、第3类肝气郁结、第4类脾气虚弱、第5类痰瘀互阻、第6类气虚。应用对应相关分析方法得出血瘀和痰浊之间的关系最为密切,其次依次为气虚和血瘀,气虚和痰浊,气虚和肝虚,气虚和阴虚等关系较紧密。从图表可知气虚、血瘀和痰浊位于所有症状和证候的中心,初步推断气虚、血瘀和痰浊是冠心病心绞痛的核心病机。结论:气虚、血瘀和痰浊是冠心病心绞痛的主要病机,此外再兼加阴虚、肝虚可以覆盖85%以上的病人。     

脑血管病患者的康复护理

脑血管病是一组突然起病的脑血液循环障碍性疾病，具有发病率、致残率、病死率高的特点，存活患者中大约3／4有肢体及语言功能障碍，严重影响患者的生存质量，给家庭和社会带来巨大负担。我科对2006年1月至2007年12月收治的262例脑血管病患者在进行积极治疗预防并发症的同时，及早进行康复护理，对减少致残、最大限度地发挥患者的残存功能、提高生存质量方面收到了较好效果，现报告如下。     

教学重演律在探索性药理学实验中的应用

探讨"教学重演律"在探索性药理学实验中的应用,为形成一种新的药理学实验教学模式提供理论基础。     

生理湿润环境对急慢性损伤愈合的临床观察

目的:探讨生理湿润环境对急慢性损伤愈合作用的临床效果.方法:采用多中心协作研究的方法,对59例住院或门诊急慢性损伤患者的创面采用美宝创面速愈贴创造生理湿润环境的方法处理,观察其减轻疼痛、预防控制感染、促进创面愈合和减少瘢痕的作用.结果:进入本次研究的病例59例,其中急性损伤28例,创面愈合时间5d~21d;慢性损伤31例,创面愈合时间7d～45d.收到了较好的止血、止痛、控制感染、促进愈合和减少瘢痕的效果,治愈率100%.结论:生理湿润环境不仅能够促进各种急慢性损伤的愈合,同时具有良好的止痛、止血、预防控制感染和减少搬痕的作用,值得临床推广应用.     

Evaluation of the healing activity of hydrocotyle tincture in the treatment of wounds

The object of this study was to evaluate the healing activity of Cothyline^TM, a new formulation comprising asiaticoside as the main ingredient in combination with antiseptic adjuvants. The study has two parts: (1) a clinical phase involving the observation of patients afflicted with soiled wounds and chronic or recurrent atony which was resistant to the usual treatment, and (2) an experimental phase in which the healing action of Cothyline was evaluated by light and electron microscopic observation of the morphological changes that occurred in scarified guinea pig skin. Treatment of patients with Cothyline completely healed (64%) or improved (16%) the lesions under study. In the animal study, it was shown that changes occurred in the shape and size of the keratohyaline granules, a phenomenon observed during accelerated healing. To the best of our knowledge, this is the first time that the healing action of Cothyline has been demonstrated in an objective and controlled manner. Cothyline has the unique advantage of simultaneously acting as an antiseptic and a cicatrizant; moreover, it affects all four phases of healing. This drug constitutes a new and advantageous approach in the treatment of wounds.     

Does focal destruction of the thoracic aorta wall by Staphylococcus aureus lead to the development of infected aneurysms? An experimental study.

Objective: The infrequency of infected aneurysms suggests that either infection of segments of the aortic wall is uncommon, or that infections do not always lead top infected aneurysm formation. The purpose of the study was to determine whether focal Staphylococcus aureus infection of aortic wall segments leads consistently to the development of infected aneurysms and to evaluate the segments in which infection did not lead to the infected aneurysm formation. Methods: Twenty pigs were inoculated with 0.1 ml of a Staphylococcus aureus inoculum in three segments of the thoracic aorta wall (study group). In another 10 pigs, 0.1 ml of saline solution was injected in three segments of the thoracic aorta wall (control group). Study group: histological abnormalities and bacterial culture of the inoculation sites were evaluated at 10 days (n=5 pigs), 30 days (n=5 pigs), and 90 days (n=10 pigs). Control group: histological abnormalities were evaluated at 10 days (n=5 pigs) and 90 days (n=5 pigs). Results: Study group: infected aneurysms developed in only two animals killed at 30 days. At 90 days, destruction of the elastic tissue, scar tissue and neointima formation were found in all the aortic segments studied. Control group: no significant changes were found in any of the segments evaluated. Conclusion: In our experimental model, acute local infection by S. aureus caused the development of infected aortic aneurysm in only 10% of the animals. In the remaining 90%, healing of the site of infection followed resolution of the infection.     

Prediction of bacterial meningitis in children with meningeal signs: reduction of lumbar punctures

Physicians often have to perform a lumbar puncture to ascertain the diagnosis in patients with meningeal signs, because of the serious consequences of missing bacterial meningitis The aim of this study was to derive and validate a clinical rule to predict bacterial meningitis in children with meningeal signs, to guide decisions on the performance of lumbar punctures. Information was collected from records of patients (aged 1 mo to 15 y) consulting the emergency department of the Sophia Children's Hospital between 1988 and 1998 with meningeal signs. Bacterial meningitis was defined as cerebrospinal fluid (CSF) leucocyte count >5 cells μl^?1 with a positive bacterial culture of CSF or blood. The diagnostic value of predictors was judged using multivariate logistic modelling and area under the receiver operating characteristic curves (ROC area). In the derivation set (286 patients, years 1988–1995) the duration of the main complaint, vomiting, meningeal irritation, cyanosis, petechiae and disturbed consciousness were independent clinical predictors of bacterial meningitis. The ROC area of this model was 0.92. The only independent predictor from subsequent laboratory tests was the serum C‐reactive protein concentration, increasing the ROC area to 0.95. Without missing a single case, this final model identified 99 patients (35%) without bacterial meningitis. Validation on 74 consecutive patients in 3 subsequent years (1996–1998) yielded similar results. Conclusion: This prediction rule identifies about 35% of the patients with meningeal signs in whom a lumbar puncture can be withheld without missing a single case of bacterial meningitis. For the individual patient this prediction rule is valuable in deciding whether or not to perform a lumbar puncture.