目的:探讨在瘢痕切除术中应用深部埋置环形褥式缝合技术(the Looped,Broad and Deep Buried suturing technique,LBD减张缝合技术)缝合切口的临床效果,观察其减轻后期切口瘢痕形成的效果。方法:2017年6月-2018年1月对68例行瘢痕切除术...目的:探讨在瘢痕切除术中应用深部埋置环形褥式缝合技术(the Looped,Broad and Deep Buried suturing technique,LBD减张缝合技术)缝合切口的临床效果,观察其减轻后期切口瘢痕形成的效果。方法:2017年6月-2018年1月对68例行瘢痕切除术的患者应用LBD减张缝合技术缝合切口,观察术后12个月时的恢复情况。结果:所有68例患者,术后12个月,除1例颈部、1例腹部、1例前臂、1例鼻头、2例面部瘢痕稍明显外,其余62例恢复满意,部分甚至达到“社交距离无痕”。结论:LBD减张缝合技术效果稳定可靠,操作简单,可显著减轻术后切口瘢痕,适用于所有有张力的切口缝合,值得临床推广。展开更多
目的:观察整形外科手术方法在手部深度烧伤后瘢痕预防及功能恢复中的应用效果。方法:选取笔者医院(2017年-2018年)收治的84例手部深度烧伤患者,依据入院顺序单双号分为两组,各42例。两组均接受常规治疗,对照组在其基础上给予肉芽组织清...目的:观察整形外科手术方法在手部深度烧伤后瘢痕预防及功能恢复中的应用效果。方法:选取笔者医院(2017年-2018年)收治的84例手部深度烧伤患者,依据入院顺序单双号分为两组,各42例。两组均接受常规治疗,对照组在其基础上给予肉芽组织清创联合植小皮片治疗;观察组于常规治疗基础上应用整形外科手术方法。比较两组治疗后温哥华瘢痕量表(Vancouver scar scale,VSS)评分、密歇根手功能量表(Michigan hand outcomes questionnaire,MHQ)评分、日常生活活动能力(Activity of daily living scale,ADL)恢复情况,并以手指关节总活动度(Total active movement,TAM)评估两组组疗效。结果:观察组手指关节活度恢复优良率92.86%,明显高于对照组的73.81%,差异有统计学意义(P<0.05)。治疗3个月后,观察组色泽、柔软度、血管分布以及厚度评分显著低于对照组,差异有统计学意义(P<0.05)。观察组手部总体功能、工作能力、日常生活能力、外观以及对手的满意度评分明显高于对照组,差异有统计学意义(P<0.05);疼痛评分明显低于对照组,差异有统计学意义(P<0.05)。ADL量表中,两组穿鞋评分比较差异无统计学意义(P>0.05);观察组进食、洗脸、刷牙、梳头、穿衣及剪指甲评分明显高于对照组(P<0.05)。结论:对手部深度烧伤患者采取整形外科手术方法,能有效改善瘢痕形成情况,促进手功能与日常生活能力的恢复。展开更多
AIM:To investigate the efficacy and safety of Honghua preserved amniotic membrane(AM)for preventing scar formation of the filtering bleb in a rabbit model of glaucoma trabeculectomy surgery.METHODS:Totally 36 rabbits(...AIM:To investigate the efficacy and safety of Honghua preserved amniotic membrane(AM)for preventing scar formation of the filtering bleb in a rabbit model of glaucoma trabeculectomy surgery.METHODS:Totally 36 rabbits(36 eyes)were randomly divided into 3 groups:the experimental group(ocular trabeculectomy in combination with Honghua preserved AM transplantation),the control group(ocular trabeculectomy surgery in combination with AM implantation),and the blank group(single trabeculectomy).Clinical observations[including intraocular pressure(IOP),filtering blebs and complications],MassonTrichrome staining,real-time quantitative reverse transcription-polymerase chain reaction(real-time PCR),Western blot were performed on different time points(D1,D7,D14,D21 and D56)after the surgery.RESULTS:After operated for 14d,there were statistically significant differences in the filtering blebs compared to the situation before operation(P【0.05),whereas no statistically difference on that among three groups(P】0.05).After 21d,the IOP of experimental group was lowest(P【0.05).There was significant difference between control group and blank group(P【0.05).On postoperative D14,the mean number of fibroblasts in the experimental group was significantlylower(40.6±10.2)compared to those in the control group(54.4±10.8)and blank group(68.2±11.6)(P【0.05,respectively).The mean numbers of the macrophage in the experimental and control groups were respcitively significantly lower versus the blank group(P【0.05,P【0.05,respectively).Compared to that in blank group,the level of transforming growth factor-β(TGF-β1)expression in sclera and conjunctival areas was reduced in the experimental and control groups on protein and mRNA level(P【0.05),but not significant difference between these two groups(P】0.05).CONCLUSION:The trabeculectory surgery with Honghua preserved AM can control IOP,sustain the functional filtration bleb,inhibit the proliferation of fibroblasts and open the filtrating pathway on the rabbit glaucoma mode展开更多
Reactive astrogliosis occurs after central nervous system（CNS） injuries whereby resident astrocytes form rapid responses along a graded continuum. Following CNS lesions, na？ve astrocytes are converted into reactive...Reactive astrogliosis occurs after central nervous system（CNS） injuries whereby resident astrocytes form rapid responses along a graded continuum. Following CNS lesions, na？ve astrocytes are converted into reactive astrocytes and eventually into scar-forming astrocytes that block axon regeneration and neural repair. It has been known for decades that scarring development and its related extracellular matrix molecules interfere with regeneration of injured axons after CNS injury, but the cellular and molecular mechanisms for controlling astrocytic scar formation and maintenance are not well known. Recent use of various genetic tools has made tremendous progress in better understanding genesis of reactive astrogliosis. Especially, the latest experiments demonstrate environment-dependent plasticity of reactive astrogliosis because reactive astrocytes isolated from injured spinal cord form scarring astrocytes when transplanted into injured spinal cord, but revert in retrograde to naive astrocytes when transplanted into naive spinal cord. The interactions between upregulated type I collagen and its receptor integrin β1 and the N-cadherin-mediated cell adhesion appear to play major roles for local astrogliosis around the lesion. This review centers on the environment-dependent plasticity of reactive astrogliosis after spinal cord injury and its potential as a therapeutic target.展开更多
目的:探讨早期治疗与康复一体化护理模式对深Ⅱ度烧伤创面愈合效果的影响。方法:选择笔者医院2017年1月-2018年12月收治的106例深Ⅱ度烧伤患者作为研究对象,根据入院先后顺序,采用随机数字表法分为观察组和对照组,各53例。对照组沿用常...目的:探讨早期治疗与康复一体化护理模式对深Ⅱ度烧伤创面愈合效果的影响。方法:选择笔者医院2017年1月-2018年12月收治的106例深Ⅱ度烧伤患者作为研究对象,根据入院先后顺序,采用随机数字表法分为观察组和对照组,各53例。对照组沿用常规康复护理模式,观察组实施早期治疗与康复一体化护理模式。随访3个月,记录伤后14d视觉模拟评分法(Visual analogue scoring,VAS)评分、创面上皮覆盖比例和创面完全愈合时间,观察创面愈合后瘢痕增生情况,并采用温哥华瘢痕量表(Vancouver scar scale,VSS)评估瘢痕增生程度,采用简明烧伤健康量表(Burn specific health scale,BSHS-A)评估生存质量。结果:观察组伤后14d VAS评分低于对照组,创面上皮覆盖比例高于对照组,创面完全愈合时间短于对照组,差异均有统计学意义(P<0.05)。两组患者均获得随访,观察组出院时及出院3个月VSS评分均明显低于对照组,差异均有统计学意义(P<0.05)。在治疗前BSHS-A评分上两组差异无统计学意义(P>0.05)。出院时及出院3个月,观察组BSHS-A评分均明显高于对照组,差异均有统计学意义(P<0.05)。结论:实施早期治疗与康复一体化护理模式能加快深Ⅱ度烧伤创面愈合,在减轻疼痛程度、延续愈合后瘢痕增生上较常规康复护理模式具有显著优势,值得临床推广应用。展开更多
文摘目的:探讨在瘢痕切除术中应用深部埋置环形褥式缝合技术(the Looped,Broad and Deep Buried suturing technique,LBD减张缝合技术)缝合切口的临床效果,观察其减轻后期切口瘢痕形成的效果。方法:2017年6月-2018年1月对68例行瘢痕切除术的患者应用LBD减张缝合技术缝合切口,观察术后12个月时的恢复情况。结果:所有68例患者,术后12个月,除1例颈部、1例腹部、1例前臂、1例鼻头、2例面部瘢痕稍明显外,其余62例恢复满意,部分甚至达到“社交距离无痕”。结论:LBD减张缝合技术效果稳定可靠,操作简单,可显著减轻术后切口瘢痕,适用于所有有张力的切口缝合,值得临床推广。
文摘目的:观察整形外科手术方法在手部深度烧伤后瘢痕预防及功能恢复中的应用效果。方法:选取笔者医院(2017年-2018年)收治的84例手部深度烧伤患者,依据入院顺序单双号分为两组,各42例。两组均接受常规治疗,对照组在其基础上给予肉芽组织清创联合植小皮片治疗;观察组于常规治疗基础上应用整形外科手术方法。比较两组治疗后温哥华瘢痕量表(Vancouver scar scale,VSS)评分、密歇根手功能量表(Michigan hand outcomes questionnaire,MHQ)评分、日常生活活动能力(Activity of daily living scale,ADL)恢复情况,并以手指关节总活动度(Total active movement,TAM)评估两组组疗效。结果:观察组手指关节活度恢复优良率92.86%,明显高于对照组的73.81%,差异有统计学意义(P<0.05)。治疗3个月后,观察组色泽、柔软度、血管分布以及厚度评分显著低于对照组,差异有统计学意义(P<0.05)。观察组手部总体功能、工作能力、日常生活能力、外观以及对手的满意度评分明显高于对照组,差异有统计学意义(P<0.05);疼痛评分明显低于对照组,差异有统计学意义(P<0.05)。ADL量表中,两组穿鞋评分比较差异无统计学意义(P>0.05);观察组进食、洗脸、刷牙、梳头、穿衣及剪指甲评分明显高于对照组(P<0.05)。结论:对手部深度烧伤患者采取整形外科手术方法,能有效改善瘢痕形成情况,促进手功能与日常生活能力的恢复。
基金Supported by the National Natural Science Foundation of China(No.81160118)Clinical Medicine Research Special-purpose Foundation of China(No.L2012052)+3 种基金Science and Technology Foundation of Jiangxi Province(No.20111BBG70026-2)Jiangxi Province Youth Science Foundation(No.20114BAB215036)Science and Technology Platform Construction Project of Jiangxi Province(No.2013-116)Health Department Tradition Chinese Medicine Science and Technology Foundation(No.2012A087)
文摘AIM:To investigate the efficacy and safety of Honghua preserved amniotic membrane(AM)for preventing scar formation of the filtering bleb in a rabbit model of glaucoma trabeculectomy surgery.METHODS:Totally 36 rabbits(36 eyes)were randomly divided into 3 groups:the experimental group(ocular trabeculectomy in combination with Honghua preserved AM transplantation),the control group(ocular trabeculectomy surgery in combination with AM implantation),and the blank group(single trabeculectomy).Clinical observations[including intraocular pressure(IOP),filtering blebs and complications],MassonTrichrome staining,real-time quantitative reverse transcription-polymerase chain reaction(real-time PCR),Western blot were performed on different time points(D1,D7,D14,D21 and D56)after the surgery.RESULTS:After operated for 14d,there were statistically significant differences in the filtering blebs compared to the situation before operation(P【0.05),whereas no statistically difference on that among three groups(P】0.05).After 21d,the IOP of experimental group was lowest(P【0.05).There was significant difference between control group and blank group(P【0.05).On postoperative D14,the mean number of fibroblasts in the experimental group was significantlylower(40.6±10.2)compared to those in the control group(54.4±10.8)and blank group(68.2±11.6)(P【0.05,respectively).The mean numbers of the macrophage in the experimental and control groups were respcitively significantly lower versus the blank group(P【0.05,P【0.05,respectively).Compared to that in blank group,the level of transforming growth factor-β(TGF-β1)expression in sclera and conjunctival areas was reduced in the experimental and control groups on protein and mRNA level(P【0.05),but not significant difference between these two groups(P】0.05).CONCLUSION:The trabeculectory surgery with Honghua preserved AM can control IOP,sustain the functional filtration bleb,inhibit the proliferation of fibroblasts and open the filtrating pathway on the rabbit glaucoma mode
基金supported by research grants to SL from NIH(1R01NS079432 and 1R01EY024575)Shriners Research Foundation(SHC-86300-PHI,SHC-86200-PHI-16 and SHC-85100)
文摘Reactive astrogliosis occurs after central nervous system（CNS） injuries whereby resident astrocytes form rapid responses along a graded continuum. Following CNS lesions, na？ve astrocytes are converted into reactive astrocytes and eventually into scar-forming astrocytes that block axon regeneration and neural repair. It has been known for decades that scarring development and its related extracellular matrix molecules interfere with regeneration of injured axons after CNS injury, but the cellular and molecular mechanisms for controlling astrocytic scar formation and maintenance are not well known. Recent use of various genetic tools has made tremendous progress in better understanding genesis of reactive astrogliosis. Especially, the latest experiments demonstrate environment-dependent plasticity of reactive astrogliosis because reactive astrocytes isolated from injured spinal cord form scarring astrocytes when transplanted into injured spinal cord, but revert in retrograde to naive astrocytes when transplanted into naive spinal cord. The interactions between upregulated type I collagen and its receptor integrin β1 and the N-cadherin-mediated cell adhesion appear to play major roles for local astrogliosis around the lesion. This review centers on the environment-dependent plasticity of reactive astrogliosis after spinal cord injury and its potential as a therapeutic target.
文摘目的:探讨早期治疗与康复一体化护理模式对深Ⅱ度烧伤创面愈合效果的影响。方法:选择笔者医院2017年1月-2018年12月收治的106例深Ⅱ度烧伤患者作为研究对象,根据入院先后顺序,采用随机数字表法分为观察组和对照组,各53例。对照组沿用常规康复护理模式,观察组实施早期治疗与康复一体化护理模式。随访3个月,记录伤后14d视觉模拟评分法(Visual analogue scoring,VAS)评分、创面上皮覆盖比例和创面完全愈合时间,观察创面愈合后瘢痕增生情况,并采用温哥华瘢痕量表(Vancouver scar scale,VSS)评估瘢痕增生程度,采用简明烧伤健康量表(Burn specific health scale,BSHS-A)评估生存质量。结果:观察组伤后14d VAS评分低于对照组,创面上皮覆盖比例高于对照组,创面完全愈合时间短于对照组,差异均有统计学意义(P<0.05)。两组患者均获得随访,观察组出院时及出院3个月VSS评分均明显低于对照组,差异均有统计学意义(P<0.05)。在治疗前BSHS-A评分上两组差异无统计学意义(P>0.05)。出院时及出院3个月,观察组BSHS-A评分均明显高于对照组,差异均有统计学意义(P<0.05)。结论:实施早期治疗与康复一体化护理模式能加快深Ⅱ度烧伤创面愈合,在减轻疼痛程度、延续愈合后瘢痕增生上较常规康复护理模式具有显著优势,值得临床推广应用。
