Vascularization into a porous sponge by sustained release of basic fibroblast growth factor

Vascularization into a poly(vinyl alcohol) (PVA) sponge was investigated using basic fibroblast growth factor (bFGF). This growth factor was impregnated into biodegradable gelatin microspheres for its sustained release and then the bFGF-containing microspheres or free bFGF were incorporated into PVA sponges. Following subcutaneous implantation into the back of mice, the bFGF-containing gelatin microspheres induced vascularization in and around the sponge to a significantly greater extent than that of free bFGF from 3 days after implantation. Significant ingrowth of fibrous tissue into the sponge was also observed when bFGF-containing microspheres were added to the sponge in contrast to free bFGF. Tissue ingrowth occurred into the deeper portion of the sponge over time while it accompanied formation of new capillaries. Empty gelatin microspheres had no effect on vascularization and the level of fibrous tissue ingrowth into the sponge was similar to that of the control group. It was concluded that incorporation of gelatin microspheres containing bFGF into the PVA sponge was effective in prevascularization of the sponge pores.     

功能性鼻内镜鼻窦术后纳吸棉填塞止血对患者舒适度和术腔恢复效果的影响

目的:探讨功能性鼻内镜鼻窦术(functional endoscopic sinus surgery,FESS)后纳吸棉填塞止血对患者舒适度和术腔恢复效果的影响。方法:前瞻性选取2017年7月至2020年5月期间在皖北煤电集团总医院耳鼻咽喉科接受FESS的90例慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)患者,采用随机数表法分为纳吸棉组(n=45)和明胶海绵组(n=45);纳吸棉组FESS术后采用纳吸棉填塞术腔止血,明胶海绵组采用明胶海绵填塞术腔止血,术后随访3个月。观察两组止血和鼻腔症状缓解情况,采用视觉模拟疼痛量表(Visual Analogue Scale,VAS)评分评估患者舒适度,利用鼻内镜检查Lund-Kennedy评分和测量鼻腔气道阻力观察术腔恢复效果。结果:两组均充分止血,术腔术后未出现活动性出血,纳吸棉组术后4周鼻阻塞、鼻痛症状程度明显轻于明胶海绵组(P<0.05);纳吸棉组术后2、4周VAS评分显著低于明胶海绵组,术后4周、3个月鼻内镜Lund-Kennedy评分均低于明胶海绵组,差异均有统计学意义(P<0.05);纳吸棉组术后第1次鼻腔气道阻力显著低于明胶海绵组(P<0.05)。结论:纳吸棉是CRS患者FESS术后理想的鼻腔填塞止血材料,在缓解术腔相关症状、减轻疼痛、促进术腔恢复和改善鼻腔通气方面效果显著。     

First human experience of thermal arterial closure

Objectives: This study was designed to evaluate the efficacy and safety of the CardioDex arterial closure device, which is a novel femoral artery closure device used following percutaneous cardiac catheterization. Background: Current devices utilized to achieve hemostasis of the femoral artery following percutaneous cardiac catheterization include collagen plug and suture mediated devices, but are associated with significant vascular complications. The CardioDex closure device utilizes thermal energy to cause collagen shrinking and swelling and thereby, achieve hemostasis. Methods: The device was evaluated in a prospective nonrandomized single‐center trial with patients undergoing 6F invasive cardiac procedures. Femoral artery puncture closure was performed immediately at completion of the procedure, followed by 3–4 minutes of manual compression. Time to hemostasis (TTH), time to ambulation (TTA), and short‐term clinical follow‐up data were collected. Results: A total of 34 patients including 21 diagnostic and 13 interventional cases were evaluated. The median TTH was 3 min in diagnostic and 4 min in interventional cases. TTH was independent of activated clotting time (ACT). The median TTA was 2.75 hr and 3.37 hr in diagnostic and interventional groups, respectively. There were no major adverse events identified at 1 week and 30 day follow up. Conclusions: This first in human clinical experience with the CardioDex closure device demonstrates that in the small cohort studied, it is safe and effective in diagnostic cardiac catheterization and also in interventional cases on mild anticoagulation (mean ACT = 188 sec). It has the advantage of leaving no foreign material in the body following use. © 2013 Wiley Periodicals, Inc.     

鼻腔止血器用于鼻腔填塞止血的疗效分析

目的分析比较高分子止血海绵和鼻腔止血器在鼻内镜术后的止血效果。方法选取100例需要进行鼻腔、鼻窦手术患者,其中男性76例,女性24例;年龄18~60岁,中位年龄36岁。随机分为2组,试验组50例,对照组50例。在术后分别放置高分子止血海绵和鼻腔止血器,观察患者的疼痛反应和止血效果,并对比取出填塞物时的难易程度及出血量,进行对比分析。结果两者止血效果相当,试验组少量渗血36例,对照组29例;两组无出血病例;止血效果两组差异无统计学意义(P0.05)。试验组无痛、轻度疼痛各26、24例,对照组各3、44例。试验组填塞物容易取出46例,对照组21例。两组在鼻腔胀痛、头痛、抽出时难易程度、抽出时出血量方面的差异均有统计学意义(P0.05),均显示试验组的效果优于对照组。结论鼻腔止血器不良反应少,临床效果优于高分子止血海绵填塞,值得广泛推广。     

可吸收止血胶原海绵在心脏外科术中胸骨止血的应用体会

目的:总结斯泰可(stypro)可吸收止血胶原海绵在心脏外科手术中的使用体会。方法:回顾性分析我科心脏手术患者300例,以使用不同止血材料平均分为三组,每组各100例。骨蜡组以骨蜡完成胸骨断面止血;斯泰可组和明胶海绵组钝性去除填塞于胸骨骨髓腔中的骨蜡,代之以剪裁成适合宽度的斯泰可(stypro)可吸收止血胶原海绵或明胶海绵填充后关闭胸骨。分析比较三组术后24h纵膈引流量,术后胸骨哆开情况,伤口脂肪液化或感染情况,二次开胸止血以及骨蜡排异情况。结果:三组引流量斯泰可组明显少于其他两组[(153.5±50.5)vs.(250.5±102.5)vs.(332.5±105.5)mL,P0.05];术后拔除气管插管时间、术后平均住院天数、胸骨哆开、伤口脂肪液化或感染、二次开胸止血以及骨蜡排异例数,斯泰可组明显优于其他两组。结论:斯泰可(stypro)止血胶原海绵在心脏外科术中胸骨断面止血效果明确,应用简便,建议临床推广应用。     

胶原蛋白海绵用于下颌阻生牙拔除术的效果分析

目的:探讨在下颌阻生牙拔除术后应用胶原蛋白海绵的临床效果。方法:选取2016年11月—2017年11月在天津市口腔医院行下颌阻生牙拔除术的患者150例,随机分为常规组和胶原蛋白海绵组。胶原蛋白海绵组患者进行下颌阻生牙拔除术后在拔牙窝内填入胶原蛋白海绵,常规组患者则只进行常规拔牙处置,比较2组患者拔牙后的相关情况。采用SPSS 20.0软件包对数据进行统计学处理。结果:胶原蛋白海绵组患者拔牙后30 min内拔牙窝出血率显著低于常规组（P<0.05）,拔牙后第1天和第3天疼痛程度评分显著低于常规组（P<0.05）,拔牙后干槽症和其他并发症的发生率显著低于常规组（P<0.05）。结论:在下颌阻生牙拔除术后应用胶原蛋白海绵,不仅可以有效减少术后出血量,而且可以有效降低术后干槽症和其他并发症的发生率,值得推广应用。     

妇康宁颗粒的药效学研究

目的研究妇康宁颗粒剂的药效学。方法采用小鼠扭体法和热板法考察妇康宁颗粒的镇痛作用,采用小鼠耳肿胀法和大鼠纸片包埋法考察妇康宁颗粒的抗炎作用,采用小鼠凝血时间、出血时间试验考察妇康宁颗粒的止血作用,采用小鼠碳廓清试验考察妇康宁颗粒调节免疫作用。结果妇康宁颗粒对化学、物理刺激引发的疼痛具有良好的抑制作用。妇康宁颗粒剂对急性渗出性炎症和慢性增殖性炎症具有一定的抑制作用,具有剂量相关性。妇康宁颗粒剂具有一定的凝血和止血作用。妇康宁颗粒可以促进小鼠免疫器官的发育,增加小鼠单位时间清除血液异物的速度。结论妇康宁颗粒具有抗炎、止血、调节免疫作用,为临床应用提供了科学的依据。