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find Author "岑瑛" 108 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
  • 深化医护一体化,提高创面治疗水平

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  • 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
  • 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

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  • 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
  • TRANSFORMING GROWTH FACTOR β1/Smad3 SIGNAL TRANSDUCTION PATHWAY AND POST-TRAUMATIC SCAR FORMATION

    【Abstract】 Objective To summarize the recent progress in related research on transforming growth factor β1 (TGF-β1)/Smad3 signal transduction pathway and post-traumatic scar formation. Methods Recent related literature at home and abroad on TGF-β1/Smad3 signal transduction pathway and post-traumatic scar formation was reviewed and summarized. Results TGF-β1 is an important influence factor of fibrotic diseases, and it plays biological effects by TGF-β1/Smad3 signal transduction pathway. The pathway is regulated by many factors and has crosstalk with other signal pathways at cellular and molecular levels. The pathway is involved in the early post-traumatic inflammatory response, wound healing, and late pathological scar formation. Intervening the transduction pathway at the molecular level can influence the process of fibrosis and extracellular matrix deposition. Conclusion TGF-β1/Smad3 signal transduction pathway is an important way to affect post-traumatic scar formation and extracellular matrix deposition. The further study on the pathway will provide a theoretical basis for promotion of wound healing, as well as prevention and treatment of pathological scar formation.

    Release date:2016-08-31 04:22 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
  • 精氨酸对创伤后机体影响的研究进展

    Release date:2016-09-01 11:08 Export PDF Favorites Scan
  • 韧带样型纤维瘤病的诊治进展

    韧带样型纤维瘤病是具有向病灶周围局部组织和(或)器官侵袭性生长、但无转移性潜力特性的一类肿瘤性疾病,组织学分类包括肌纤维母细胞性肿瘤、成纤维细胞性肿瘤和两者混合型肿瘤。该病发病率较低,且相对散在,因其临床表现及该病的检验方法和影像学检查不具有明显特征性,目前诊断多依据术后病理检查结果。这不仅局限了临床上对此病的研究,同时也加大了临床诊治的难度。很多研究报道所含患者例数少,其结论尚无定论,甚至出现互相矛盾的结果。现就其近期诊治等方面的进展进行综述。

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
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