多济敷对面部磨削创面愈合的临床疗效观察

目的：本研究采用多济敷外用于面部皮损磨削术后创面,观察其对创面愈合时间、皮肤色素沉着等的变化。方法：采用区域神经阻滞或局部浸润麻醉,对不同类型的面部皮损34例进行皮肤磨削治疗,术后创面应用多济敷或凡士林纱布作为底层敷料包扎创面,术后换药一次,保留底层敷料。结果：2001年8月至2003年9月间,通过自身对照,34例面部磨削术后采用多济敷治疗组较凡士林纱布组创面愈合时间缩短(P＜0．05),经过6个月至2年的随访,皮肤色素沉着也有明显改善。结论：多济敷有利于缩短面部磨削术后创面愈合时间,改善面部色素沉着,外观满意。     

无名异接骨冲剂对骨痂局部骨形态发生蛋白含量的影响

为探讨无名异接骨冲剂加速骨折愈合的作用机理，选用５５只新西兰大白兔，随机选择５只作为正常组；另５０只在无菌条件下造成双桡骨标准骨折模型。将５０只骨折兔随机平均分为实验组和对照组，实验组用无名异接骨冲剂每天４ｇ／ｋｇ溶于２０ｍｌ蒸馏水中分早晚两次灌胃；对照组用２０ｍｌ蒸馏水灌胃。于骨折后第１，２，３，４及５周用断颈法每次每组处死５只兔，取骨痂进行抗骨形态发生蛋白（ＢＭＰ）单克隆抗体免疫组化染色，并用ＣＭＩＡＳ型图像分析仪对ＢＭＰ含量进行定量分析。结果发现：实验组骨折局部ＢＭＰ含量明显高于正常组（Ｐ＜０．０１）；第１，２周实验组明显高于对照组（Ｐ＜０．０１）；实验组ＢＭＰ高峰出现在第２周，而对照组出现在第３周。认为，无名异接骨冲剂能促进成骨细胞合成ＢＭＰ，使ＢＭＰ峰值提前，从而加速骨折愈合。     

Arterial response to excimer and argon laser irradiation in the atherosclerotic swine

Injury associated with laser-induced tissue ablation may be reduced by using pulsed energy delivery at low repetition rates, as opposed to using continuous wave energy delivery. This study was designed to examine the similarities and differences between these two systems as regards the healing process, and to examine whether one is superior to the other. In order to test this postulate, the healing response of normal and atherosclerotic aorta were examined after exposure in vivo to argon and excimer (XeCl 308 nm) laser radiation in hypercholesterolemic swine. Swine were fed hyperlipidemic diets for eight months following balloon denudation of the descending aorta. Following general anaesthetic, the descending aorta was isolated and laser burns were made on both normal and atherosclerotic intima using a continuous wave argon laser delivered through a 50 diameter quartz fibre, and a XeCl excimer laser carried through a 1 mm diameter fibre. Energy levels of 3 to 5 J were applied with the argon laser. The pulse duration for the excimer laser was 30 ns and craters were produced using 10 to 60 pulses at a repetition rate of 20 Hz and an energy density of 2 J cm^–2.Forty-eight hours after laser application, craters created by both lasers were filled with thrombus material. Argon burns were surrounded by thermal and acoustic injury which was not seen with excimer burns. Three weeks after laser application all crater surfaces were reconstituted. Unlike the excimer burns, argon craters demonstrated necrosis well beyond the crater margins and were characterized by multinucleate giant-cell reaction surrounding char debris. By nine weeks both excimer and argon laser burns were covered by fibrous tissue but could be distinguished by the fact that char debris and subjacent tissue injury arose with the argon burns.The results suggest that both lasers can be used to remove focal atherosclerotic plaque from arteries without inducing excessive thrombogenicity. Rapid healing is observed with both; however, damage to surrounding tissue is significantly greater with a continuous energy delivery laser as opposed to pulsed energy delivery.Work supported in part by: Heart and Stroke Foundation of Ontario, Grant-in-Aid No. 5-17     

膝关节韧带的生物力学研究进展

膝关节韧带的生物力学是近年来研究的热点之一,力学刺激对调控韧带功能、韧带组织愈合和重建有着重要的作用,作者从膝关节韧带的结构、力学与生化特点、愈合与重建、施加应力与制动对韧带的影响、应力对韧带细胞分化的影响和前交叉韧带与内侧副韧带的对比研究等方面综述了近年来的一些研究进展。     

Anastomotic false aneurysms with aortic Dacron graft after twenty-five years

One of the early diamond crimped knitted polyester (Dacron) grafts was surgically excised after implantation for 25 years in the aorto-billiac position because of false aneurysm formation at the three anastomotic sites. The sutures were no longer visible. While the areas around the false aneurysm were poorly incorporated, the graft limbs were well encapsulated with some endothelial-like cells on the luminal surface. The integrity of the graft was well preserved despite mild fraying and the disruption of one stitch.     

基于数据挖掘的刺络放血疗法治疗 外感发热的选穴规律研究

〔摘 要〕 目的：探究基于数据挖掘的刺络放血疗法治疗外感发热的选穴规律。 方法：2019 年 7 月至 2019 年 12 月采 用 Excel 2019 建立刺络放血数据仓库模型,随后下载、筛选已建数据库中刺络放血疗法治疗外感发热的文献资料,以及所 需信息的录入,借助建立的刺络放血数据库平台,对其进行数据挖掘。 结果：纳入刺络放血疗法治疗外感发热的文献共计 63 篇,其中刺络放血针具三棱针使用频次最高,刺络放血刺法使用频次最高的为点刺;刺络放血治疗未配合拔罐的研究 占比 80 %;采用刺络放血配合疗法的有 46 项,占比 73 %,其中以拔罐使用频次最高。 结论：刺络放血疗法治疗外感发热 以三棱针点刺治疗为主,且部分研究常配合其他疗法以明显提升治疗效果,但配合拔罐治疗临床应用较少。     

Squat and smile assessment in predicting healing of lower limb fractures fixed with a SIGN nail

BackgroundIrrespective of the treatment method, union is the ultimate goal of any fracture treatment. However, nowadays, rather than the physician-based clinico-radiological methods, the patient-reported outcome measurements assessing their quality of life and function are gaining much popularity. This is specifically true in the part of the world where the patient needs almost complete degree of hip/knee flexion – for social, cultural, religious or occupational reason(s). The ability to squat can assess the mobility and stability of joints and thus the quality of squatting is a proxy reflection of the functional outcome after fixation of lower limb fracture. Thus, we studied to determine the inter-observer and intra-observer reliability of Radiographic Union Score for Tibia (RUST) and Squat and Smile (S & S) test in clinical photograph. We further calculated the sensitivity and specificity of S & S test in predicting healing of lower limb fracture fixed by intramedullary interlocking nail considering RUST as the gold standard.MethodsThis was a retrospective study of prospectively collected data of solid Surgical Implant Generation Network (SIGN) intramedullary interlocking nailing from a single, university-based, high volume tertiary center where 56 consecutive adults with either tibial or femoral shaft fractures fixed with a SIGN nail within one year and not requiring any surgery till minimum of eighteen-month follow-up were included. Cases without either Anterior-Posterior (AP) view and/or Lateral (Lat.) view follow-up x-ray(s) or proper S & S clinical photograph (at least 1.5-year post fixation) were excluded. The x-rays (RUST criteria) and clinical photograph (S & S grading) were scored by two independent and blinded observers each and repeated after 1 month.ResultsThe overall intra-observer reliability was from 0.773 to 0.825 and inter-observer reliability from 0.635 to 0.757 for RUST scoring which was from 0.687 to 0.785 and from 0.301 to 0.650 respectively for S & S scoring. The sensitivity and specificity of S & S in predicting fracture healing were up to 82.22% and 63.64% respectively.ConclusionThe S & S test is reliable to predict the healing of lower limb fracture fixed with an intramedullary nail. The test is more useful to determine healed fractures than to determine non-healed ones. (sensitivity being higher than specificity)     

重组人表皮细胞生长因子对人皮肤细胞增殖作用的研究

目的：观察重组人表皮生长因子（recombinant human epidermal growth factor，rhEGF）对人表皮细胞增殖的变化。方法：运用包皮环切术后收集培养角质细胞，不同浓度的重组人表皮细胞生长因子处理细胞，MTT法测细胞生长率；流式细胞仪检测细胞周期以及蛋白的表达。结果：5～10ng·ml^-1重组人表皮细胞生长因子可促进人表皮细胞细胞生长。流式细胞仪检测10ng·ml^-1重组人表皮细胞生长因子处理后细胞增殖明显，S和G2／M期细胞数明显增加。结论：重组人表皮细胞生长因子可促进细胞生长以及切口愈合。     

综合医院疗愈花园设计思考——以北大国际医院疗愈花园为例

在本原健康理论的框架下,从自然、色彩、标识、声音、光线、艺术品、文化活动与社会支持8个方面,对北大国际医院住院部前花园的疗愈环境进行实地调研与分析,总结出了其设计所存在的问题与可借鉴的经验,为其他综合医院疗愈花园的设计提供参考。