目的探讨和研究结构化皮肤护理方案应用于大便失禁患者预防失禁性皮炎(incontinence-associated dermatitis,IAD)的效果,为制订标准护理流程提供依据。方法选取ICU 80例大便失禁患者,根据随机数字表分为实验组(n=40)和对照组(n=40)。实...目的探讨和研究结构化皮肤护理方案应用于大便失禁患者预防失禁性皮炎(incontinence-associated dermatitis,IAD)的效果,为制订标准护理流程提供依据。方法选取ICU 80例大便失禁患者,根据随机数字表分为实验组(n=40)和对照组(n=40)。实验组应用结构化管理模式,制订并实施结构化的皮肤护理方案;对照组按大便失禁患者护理常规进行护理。护士经过相关培训后进行数据收集,确定患者是否存在IAD以及IAD的严重程度(Incontinence-Associated Dermatitis and its Severity Instrument,IADS),评价患者肛周及骶尾部的皮肤情况。结果实验组患者IADS得分明显低于对照组(P<0.01),压疮的发生率也低于对照组(P<0.01)。结论结构化及皮肤护理方案能减少患者皮肤暴露于粪便的频率,可降低压疮发展的可能性,减轻患者痛苦,同时降低临床护理负担。展开更多
Objective: SHR-1210 is a new and promising anti-PD-1 agent for solid tumors. During the phase I study of SHR-1210, we encountered a novel but prevalent immune-related dermatologic toxicity: reactive capillary hemangio...Objective: SHR-1210 is a new and promising anti-PD-1 agent for solid tumors. During the phase I study of SHR-1210, we encountered a novel but prevalent immune-related dermatologic toxicity: reactive capillary hemangiomas(RCHs). Thus we tried to summarize the features of RCHs and estimate their relationship with tumor response.Methods: This prospective observational study systematically enrolled 98 patients with advanced solid tumors from April 27th,2016 to June 8th, 2017 in the context of the phase I clinical study of SHR-1210. This report focused on the skin toxicities. Patients underwent entire skin inspection every two weeks while taking medication. The clinical course of RCHs was recorded and their association with tumor response was estimated. The data cut-off date was November 15th, 2017.Results: After a median follow-up of 242(range, 29–567) days, RCHs were observed in 85.7%(84/98) of patients on cutaneous/mucosal surfaces; 84.5%(71/84) of the RCHs were evaluated as grade 1 adverse events. No grade 3 or 4 RCHs were observed. The time of onset of RCHs was dose dependent and shortest in the 400 mg-dose cohort(P < 0.001). Spontaneous and complete regression of RCHs was observed both during and after treatment. The objective response rate of tumors for patients with RCHs was 28.9%(24/83). However, no responders were observed among the patients without RCHs.Conclusions: RCHs were prevalent but manageable during treatment with SHR-1210. It might add to the expanding literature regarding immune-related dermatologic adverse events.展开更多
Objective: To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage (VSD) in treating large-area skin defects. Methods: Totally 18 patients with skin defects, treated with artific...Objective: To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage (VSD) in treating large-area skin defects. Methods: Totally 18 patients with skin defects, treated with artificial skin combined with VSD from September 2008 to May 2009 in our hospital, were retrospectively analyzed in this study. There were 15 males and 3 females, aged 7-66 years, 34.3 years on average. Among them, 10 cases had skin laceration caused by traffic accidents (7 with open fractures), 1 mangled injury, 1 blast injury, 1 stump infection combined with skin defects after amputation and 5 heel ulcers. Results: All skin grafts in 16 cases survived afterbeing controlled by VSD for one time. For the rest 2 patients, one with skin avulsion on the left foot was given median thickness skin grafts after three times of VSD, the other with open fractures in the left tibia and fibula caused by a traffic accident was given free flap transplantation. Skin grafts of both patients survived, with normal color and rich blood supply. Conclusion: Skin grafting in conjunction with artificial skin and VSD is much more effective than traditional dress- ing treatment and worth wide application in clinic.展开更多
OBJECTIVE: To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. METHODS: Twenty-eight patients with thirty...OBJECTIVE: To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. METHODS: Twenty-eight patients with thirty-three chronic cutaneous wounds resulting from trauma, diabetes mellitus, pressure sore and radiation injuries were enrolled in this prospective, open-label crossover trial. Prior to treatment with rbFGF, all wounds failed to heal with conventional therapies within 4 weeks. All wounds were locally treated with rbFGF at a dose of 150 AU/cm(2). Healing time and the quality of wounds were used to evaluate the efficacy of the treatment. RESULTS: Healing of all chronic wounds was expedited. During the study, eighteen wounds completely healed within 2 weeks, four healed within 3 weeks, and another eight completely healed within 4 weeks. Only three wounds failed to heal within 4 weeks, but healed at 30, 40 and 42 days after treatment with rbFGF. Thus, compared with conventional therapies, the effective rate of rbFGF treatment within 4 weeks was 90.9%. Histological assessment showed more abundant capillary sprouts or tubes and that fibroblasts were differentiated in wounds treated with rbFGF. No adverse side effects related to basic fibroblast growth factor were observed. CONCLUSIONS: Our results indicate that rbFGF could be used to accelerate healing in chronic wounds. It is our belief that this may be a more effective method of chronic wound management.展开更多
OBJECTIVE: To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds. METHODS: Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopat...OBJECTIVE: To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds. METHODS: Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn. RESULTS: In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P展开更多
文摘目的探讨和研究结构化皮肤护理方案应用于大便失禁患者预防失禁性皮炎(incontinence-associated dermatitis,IAD)的效果,为制订标准护理流程提供依据。方法选取ICU 80例大便失禁患者,根据随机数字表分为实验组(n=40)和对照组(n=40)。实验组应用结构化管理模式,制订并实施结构化的皮肤护理方案;对照组按大便失禁患者护理常规进行护理。护士经过相关培训后进行数据收集,确定患者是否存在IAD以及IAD的严重程度(Incontinence-Associated Dermatitis and its Severity Instrument,IADS),评价患者肛周及骶尾部的皮肤情况。结果实验组患者IADS得分明显低于对照组(P<0.01),压疮的发生率也低于对照组(P<0.01)。结论结构化及皮肤护理方案能减少患者皮肤暴露于粪便的频率,可降低压疮发展的可能性,减轻患者痛苦,同时降低临床护理负担。
基金supported by a grant from CAMS Initiative for Innovative Medicine (Grant No. CAMS-12M-1-010)
文摘Objective: SHR-1210 is a new and promising anti-PD-1 agent for solid tumors. During the phase I study of SHR-1210, we encountered a novel but prevalent immune-related dermatologic toxicity: reactive capillary hemangiomas(RCHs). Thus we tried to summarize the features of RCHs and estimate their relationship with tumor response.Methods: This prospective observational study systematically enrolled 98 patients with advanced solid tumors from April 27th,2016 to June 8th, 2017 in the context of the phase I clinical study of SHR-1210. This report focused on the skin toxicities. Patients underwent entire skin inspection every two weeks while taking medication. The clinical course of RCHs was recorded and their association with tumor response was estimated. The data cut-off date was November 15th, 2017.Results: After a median follow-up of 242(range, 29–567) days, RCHs were observed in 85.7%(84/98) of patients on cutaneous/mucosal surfaces; 84.5%(71/84) of the RCHs were evaluated as grade 1 adverse events. No grade 3 or 4 RCHs were observed. The time of onset of RCHs was dose dependent and shortest in the 400 mg-dose cohort(P < 0.001). Spontaneous and complete regression of RCHs was observed both during and after treatment. The objective response rate of tumors for patients with RCHs was 28.9%(24/83). However, no responders were observed among the patients without RCHs.Conclusions: RCHs were prevalent but manageable during treatment with SHR-1210. It might add to the expanding literature regarding immune-related dermatologic adverse events.
文摘Objective: To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage (VSD) in treating large-area skin defects. Methods: Totally 18 patients with skin defects, treated with artificial skin combined with VSD from September 2008 to May 2009 in our hospital, were retrospectively analyzed in this study. There were 15 males and 3 females, aged 7-66 years, 34.3 years on average. Among them, 10 cases had skin laceration caused by traffic accidents (7 with open fractures), 1 mangled injury, 1 blast injury, 1 stump infection combined with skin defects after amputation and 5 heel ulcers. Results: All skin grafts in 16 cases survived afterbeing controlled by VSD for one time. For the rest 2 patients, one with skin avulsion on the left foot was given median thickness skin grafts after three times of VSD, the other with open fractures in the left tibia and fibula caused by a traffic accident was given free flap transplantation. Skin grafts of both patients survived, with normal color and rich blood supply. Conclusion: Skin grafting in conjunction with artificial skin and VSD is much more effective than traditional dress- ing treatment and worth wide application in clinic.
基金supported partially by the National Grant for Outstanding Young Researchers (No.39525024) the Major State Basic Development Program (No.G1999054204).
文摘OBJECTIVE: To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. METHODS: Twenty-eight patients with thirty-three chronic cutaneous wounds resulting from trauma, diabetes mellitus, pressure sore and radiation injuries were enrolled in this prospective, open-label crossover trial. Prior to treatment with rbFGF, all wounds failed to heal with conventional therapies within 4 weeks. All wounds were locally treated with rbFGF at a dose of 150 AU/cm(2). Healing time and the quality of wounds were used to evaluate the efficacy of the treatment. RESULTS: Healing of all chronic wounds was expedited. During the study, eighteen wounds completely healed within 2 weeks, four healed within 3 weeks, and another eight completely healed within 4 weeks. Only three wounds failed to heal within 4 weeks, but healed at 30, 40 and 42 days after treatment with rbFGF. Thus, compared with conventional therapies, the effective rate of rbFGF treatment within 4 weeks was 90.9%. Histological assessment showed more abundant capillary sprouts or tubes and that fibroblasts were differentiated in wounds treated with rbFGF. No adverse side effects related to basic fibroblast growth factor were observed. CONCLUSIONS: Our results indicate that rbFGF could be used to accelerate healing in chronic wounds. It is our belief that this may be a more effective method of chronic wound management.
基金supported by the Major State Basic Research Development Program of China(No.Gl999054205).
文摘OBJECTIVE: To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds. METHODS: Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn. RESULTS: In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P