west china medical publishers
Author
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Author "岑瑛" 109 results
  • 重视烧伤感染,提高烧伤患者救治率

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
  • 与时俱进不断创新,提高我省创面治疗的医疗水平

    创面及创面治疗是外科领域永恒的主题。一个多世纪以来,围绕创面的处理,特别是难愈性创面的治疗,众多的研究和方法源源不断地问世,但其中绝大多数是大同小异,治疗效果无明显差别。  在上个世纪90年代,一种创面治疗的新方法——负压封闭引流技术(vacuum sealing drainage,VSD)问世,该方法堪称创面治疗的一次革命,一次飞跃。该方法变开放式创面治疗为封闭式,既减少了换药的痛苦,为创面制造了一个封闭的符合组织修复需要的环境,同时负压吸引也有利于创面分泌物的引流,适当的负压对创面组织及血管的再生起到了促进作用。通过此方法,复杂的难治性创面的治疗取得了很大的进展,特别对糖尿病性溃疡、烧伤创面、起搏器植入术创面、植皮术后、电击伤扩创后创面等。2008年“5?12”汶川大地震发生后,该项技术由以色列友人托马士引入我省,在我省整形烧伤学界同仁的努力学习下,经不断研讨摸索、总结与交流,这一革命性的技术迅速被推广和应用。德阳市中心医院李永忠主任和成都医学院马兵主任,分别举办了多期VSD学习班,对该项技术在我省的全面推广起到了很大的促进作用。  通过对VSD临床应用、经验总结,针对不同病种、不同情况的使用得到了不断改进,如VSD对传统的褥疮、糖尿病创面、电击伤创面的常规治疗,以及对植皮后或皮瓣转移后创面的改进治疗,均取得了良好的效果。川北医学院的向小燕应用VSD对15例患者共19处褥疮进行治疗,总结出扩创后应用VSD 5~18 d后创面即可准备充分,可进一步手术,并能极大提高手术成功率。配合VSD的临床应用,马红等从护理角度探讨了该方法的治疗体会,认识到应用该法时,从体位、皮肤清洁、功能锻炼、冲洗及观察、消毒、心理、营养等方面的护理对治疗的成功也十分关键。而马兵等则对VSD的研究进展作了较详尽的综述,对VSD的作用机制、适应证、禁忌证、影响因素及发展方向分别进行了探讨,罗江蓉则从动物实验角度对VSD应用于全厚皮移植术的加压固定作了较深入的研究,从其所做动物实验结果,观察到应用VSD后,可提高所植皮片的成活率。  总之,VSD对各种创面的处理治疗是非常简便、有效、省时,减少患者痛苦,减轻医护人员工作量的一个好方法。  四川省整形烧伤学界的同仁们,长江后浪推前浪,一浪更比一浪高,愿我们大家不断努力,不断学习,与时俱进,不断创新,为进一步提高我省创面治疗的医疗水平共同努力。                                                              二〇一一年九月五日

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • 深化医护一体化,提高创面治疗水平

    Release date: Export PDF Favorites Scan
  • 不断努力进一步提高我省创面处理的水平

      创面的处理,是外科大夫永恒的工作主题之一,对于难以覆盖或修复的创面处理,更成为了摆在所有整形外科医师面前的一道难题。  通过不断努力,我省的整形烧伤外科医疗队伍在创面处理方面有了长足的进步。目前对于创面的处理,从基础研究到生物组织工程材料的应用,从新技术应用于创面到各种组织瓣覆盖创面,以及护理队伍对创面护理体会的总结等,无不显示了我省烧伤整形医务工作者在这个领域取得的喜人成绩。  创面的基础研究,应立足于解决临床难题方面。但要做到贴近临床,并将基础研究的成果应用于临床,必须具备丰富的临床经验并有扎实的科研素质才能得以实现。在这方面,成都医学院的李晨阳医师及四川大学华西医院的于蓉医师均作了可喜的尝试,他们在创面愈合后的瘢痕或瘢痕疙瘩形成的机制研究方面做了初步的有效的工作;将生物材料作为组织修复的替代物或填充物,运用先进的科学技术和方法实现组织材料的“工厂化”,是科技应用于人类的一大福音;四川大学制革系的林海等人跨学科结合自身的优势在脱细胞真皮基质的研究方面取得了可喜的成绩,他们研究成功的医用生物皮片现已能作为填充材料应用临床实验;对于创面或难以覆盖的创面的处理,我省的同行们在这方面也作出了显著的成绩。将生长因子用于创面促进创面愈合;使用各种组织瓣覆盖创面;运用封闭式负压引流装置治疗皮肤缺损,均取得了良好的治疗效果。同时,护理人员也对各种创面加强了护理,并总结出了一些有实际指导经验的护理体会,通过医护之间的良好合作,共同提高对创面患者的诊治水平。  总之,在创面的处理方面,我省各级医院的医务工作者均做了大量的工作,取得了可喜的成绩,省市级重点医院,在这方面起到了引领和带头人的作用。但与其他兄弟省市相比,无论是基础研究还是临床实际均还存在一定差距,还需不断努力,进一步提高我省创面处理的水平,造福于四川的父老乡亲。二○一○年一月十三日

    Release date: Export PDF Favorites Scan
  • DETECTION OF EXPRESSION OF HEAT SHOCK PROTEIN 47 mRNA IN PATHOLOGICAL SCAR TISSUE BY USING REAL-TIME FLUORESCENT QUANTITATIVE RT-PCR

    Objective To detect the expression of heat shock protein 47 mRNA in pathological scar tissue by using real-time fluorescent quantitative reversetranscription-polymerase chain reaction (RT-PCR). Methods The tissues of normal skin(n=6), hypertrophic scar(n=6) and keloid(n=6) were adopted, which were diagnosised by Pathology Department. Based on fluorescent TaqMan methodology, the real-time fluorescent quantitative RT-PCR were adopted to detect the expression ofheat shock protein 47 mRNA. Results Compared with normal skin tissue(0.019±0.021)×105, the expressions of heat shock protein47 cDNA of hypertrophic scar tissue(1.233±1.039)×105 and keloid tissue(1.222±0.707)×105 were higher, being significant differences(Plt;0.05). Conclusion A fluorescent quantitative method was successfully applied to detecting the expression of heat shock protein 47 mRNA. Heat shock protein 47 may play an important role in promoting the formation of pathological scar tissue.

    Release date:2016-09-01 09:30 Export PDF Favorites Scan
  • EFFECT OF γ INTERFERON ON THE FIBROBLASTS IN HYPERTROPHIC SCARS

    OBJECTIVE To study the influence and mechanism of gamma-IFN on fibroblasts in hypertrophic scars(HTS). METHODS The cultured fibroblastic cells were isolated from the hypertrophic scars of 10 patients. The fibroblasts were divided into two groups, one group was treated with gamma-IFN (100 U/ml, 5 days) and the other without gamma-IFN as control. The proliferative activity in both groups was investigated and compared by blood cytometer, the proportion of myofibroblast (MFB) and the ratio of apoptosis were examined and analysed between two groups by flow cytometry using alpha-smooth muscle actin (alpha-SMA) as marker. RESULTS The proliferative activity was downregulated with gamma-IFN. In gamma-IFN treated group, the differentiation of MFB were reduced and the decreasing ratio was 3.2% at the 2nd day and up to 10.5% at the 8th day, then it reduced gradually. The apoptosic ratio is 17.7% in gamma-IFN treated group, and is 10.9% in control group. The difference was statistically significant. CONCLUSION gamma-IFN could downregulate the proliferation of fibroblasts, decrease the differentiation of MFB and induce the apoptosis. It has beneficial effect in the treatment of hypertrophic scars(HTS).

    Release date:2016-09-01 11:05 Export PDF Favorites Scan
  • Progress in clinical application of V-Y advancement flaps

    Based on skin elasticity and mobility, V-Y advancement flaps are designed to repair wounds. Traditional V-Y flaps have been limited due to short advancing distance. With the development of perforator flaps and the application of microsurgical techniques, V-Y advancement flaps are gradually transiting from traditional random flaps to axial flaps containing well-known vessels or perforator arteries. The advancing distance of V-Y advancement flaps is significantly increased, and the design forms are gradually flexible and diversified. V-Y advancement flaps are widely used in clinical practice and can be used to repair wounds in almost all parts of the body. This article reviews the clinical application progress of V-Y advancement flaps to further promote its clinical application.

    Release date:2019-08-15 01:20 Export PDF Favorites Scan
  • 胚胎皮肤无瘢痕愈合的研究进展

    早期胚胎皮肤的创伤愈合时间短,伤后无瘢痕遗留,探索其愈合机制对临床防治瘢痕具有重要意义。尽管无瘢痕愈合的发生机制仍不明确,但近年来随着研究的深入,成体与胚胎皮肤创伤愈合过程中所表现出的差异逐渐被发现。现就胚胎成长环境、炎症、细胞因子、细胞外基质、基因表达等方面对胚胎无瘢痕愈合的可能机制作出阐述。

    Release date: Export PDF Favorites Scan
  • The Effect of Shenfu Injection on the Wound Healing of Deep Partial-thickness Burn in Rats

    【摘要】 目的 探讨中成药参附注射液对大鼠深Ⅱ度烧伤创面愈合的影响。 方法 选用16只Sprague-Dawley(SD)大鼠,随机分为实验组、对照组,每组各8只,建立20%体表面积深Ⅱ度烫伤模型。烫伤后即刻及此后每天,实验组大鼠以参附注射液20 mL/kg腹腔注射给药,1次/d,连续给药5 d;对照组给予注射等剂量的生理盐水。分别于致伤后的7、14 d取创面组织块,光学显微镜观察成纤维细胞及胶原纤维生长情况,电子显微镜观察致伤后14 d成纤维细胞细胞器情况,分别计算烧伤后第7、14天两组的创面愈合率,并观察比较两组创面愈合的时间。 结果 所有选入实验的SD大鼠均存活至实验结束。实验组、对照组术后第7天创面愈合率分别为(36.34±2.55)%及(33.13±2.62)%,两组差异有统计学意义(t=2.486,P=0.027);实验组、对照组术后第14天创面愈合率分别为(75.71±2.29)%及(72.36±2.85)%,两组差异有统计学意义(t=2.590,P=0.022);实验组、对照组创面愈合时间分别为(20.88±1.36)、(22.94±2.16) d,两组差异有统计学意义(t=-2.286,P=0.0395)。伤后7、14 d创面组织块切片光学显微镜观察发现,实验组肉芽组织及胶原纤维较多,排列更有序,表皮基底细胞增殖活跃,炎症反应较轻;伤后14 d时电子显微镜观察发现,实验组成纤维细胞的细胞器更丰富,分泌胶原更多,实验组创面愈合情况优于对照组。 结论 腹腔注射参附注射液可以促进烧伤创面的愈合,其可能的机制为清除氧自由基,抗脂质过氧化。【Abstract】 Objective To explore the effect of Shenfu injection on promoting healing of deep partial-thickness burn wound in rats.  Methods Sixteen Sprague-Dawley (SD) rats were randomly selected, and deep partial-thickness burn with 20% of the body surface was inflicted. The rats were randomly divided into experimental group and control group with eight in each group. Rats in the experimental group were treated with abdominal injection of Shenfu injection at a dose of 20 mL/(kg•d) for five days continually, and rats in the control group were treated with the same dose of 0.9% saline solution. The growth of granulation tissue and collagen fibers were evaluated under light microscope at the seventh and the fourteenth day. The growth of fibroblast was observed under transmission electron microscope at the fourteenth day. The cure rate of both groups of rats at the seventh and fourteenth day was calculated. Then we compared their healing time and the cure rate of the traumatic wound respectively. Results All rats had survived until wound healing. The cure rate at the seventh day for the experimental group and the control group was (36.34±2.55)% and (33.13±2.62)%, and their difference was statistical (t=2.486, P=0.027); At the fourteenth day, the cure rate was respectively (75.71±2.29)% and (72.36±2.85)% with a significant difference between each other (t=2.590, P=0.022). The healing time of the experimental group (20.88±1.36) was significantly shorter than that of the control group (22.9±2.16) (t=-2.286, P=0.040). At the seventh and fourteenth day, light microscope observation showed that the growth of granulation tissue and collagen fibers for rats in the experimental group were much more than that in the control group, the basale cell proliferation was more active, and inflammation was slighter. Through transmission electron microscope, we observed more fibroblast and collagen in the experimental group, which showed a better cure than the control group. Conclusion Shenfu injection can significantly promote wound healing of deep partial-thickness burn. It may possibly get this effect through anti-oxidation.

    Release date:2016-09-08 09:25 Export PDF Favorites Scan
  • EFFECTIVENESS OF PERICHONDRIAL CUTANEOUS GRAFT OF DORSAL AURICLE FOR REPAIRING FACIAL MELANOCYTIC NEVUS EXCISION DEFECT

    Objective To investigate and compare the effectiveness of perichondrial cutaneous graft (PCCG) of dorsal auricle for repairing defect after excision of melanocytic nevus in different parts of the face. Methods Between February 2008 and October 2012, 29 cases of facial melanocytic nevus were admitted. There were 11 males and 18 females, aged 3-25 years (median, 11 years). The locations were the upper eyelid in 5 cases, the nose in 15 cases, and the buccal region in 9 cases. The size of the nevi ranged from 1.2 cm × 1.0 cm to 4.0 cm × 2.2 cm. Defects after excision of nevi were repaired by PCCG of the dorsal auricle, which size ranged from 1.5 cm × 1.5 cm to 4.2 cm × 2.5 cm. The postoperative effectiveness was scored by patients according to color match, scar formation, and flatness of the reception site. The satisfaction evaluations were compared by the score among different parts. Results All the PCCG survived. All the patients were followed up 7-15 months (mean, 10 months). All the reception site had good color match and acceptable scar formation. The nasal part had good flatness, and the upper eyelid had poor flatness. Score comparison showed no significant difference in color match between 3 parts (P gt; 0.05). Nasal part had significantly less scar formation than buccal region and upper eyelid (P lt; 0.05), but no significant difference between buccal region and upper eyelid (P gt; 0.05). Nasal part and buccal region both had significantly better flatness than upper eyelid (P lt; 0.05), but no significant difference between nasal part and buccal region (P gt; 0.05). The overall evaluation score of nasal part and buccal region was significantly higher than that of the upper eyelid group (P lt; 0.05), and the score of the nasal part was significantly higher than that of the buccal region (P lt; 0.05). Conclusion PCCG of dorsal auricle has a good color match in repair of facial defect, especially in repair of nasal defect with good flatness and no obvious scar formation.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
11 pages Previous 1 2 3 ... 11 Next

Format

Content