By reviewing the current status of chronic pain and combining with the new definition of pain revised by the International Association for the Study of Pain in 2020, firstly a prevention-based approach, self-management of pain, and multidisciplinary collaboration based on the integration of bio-psycho-social-environmental factors is proposed. The medical mode will greatly improve the treatment effect of chronic pain and the quality of life of patients. Secondly, the importance of strengthening humanistic care and paying attention to health education, as well as improving medical staff’s awareness of chronic pain and the level of diagnosis and treatment are pointed out. Finally, it is clarified that innovative non-drug treatments and the establishment of digital pain management platforms are the future of chronic pain.
Evidence-based medicine emphasizes that treatment must be based on the following elements ： the latest and best evidence, clinicians＇ expertise and patients＇ preference. Evidence-based medicine embodies the ethos both to explore medical science and to respect patients＇ values. Evidence-based medicine is an integration of the scientific and the humanistic spirit.
摘要:目的: 探讨联合LCT和高危型HPV检测对CIN宫颈治疗后的随访意义。 方法 :对200例LCT异常,高危型HPV阳性,阴道镜活检证实为CIN1~3的患者行LEEP治疗或宫颈冷刀锥切,治疗后进行严格随访,包括LCT和高危型HPV检测,阳性病例行组织学检查。 结果 :(1)所有病例经治疗后均无病变残留,其治愈率为100%。(2)从治疗后3个月起,CIN1组高危型HPV转阴率为100%。在随访的第3个月和6个月,CIN2~3组高危型HPV转阴率分别为7317%和9085%,显著低于CIN1组,差异有统计学意义(〖WTBX〗P ＜005)。(3)从随访12个月起,一直有2例病例持续HPV阳性,均为CIN3患者,但LCT和阴道镜检查未发现细胞学异常,继续随访。 结论 :CIN治疗后高危型HPV的转阴时间及转阴率与CIN的级别有关;高危型HPV持续阳性,但LCT和阴道镜检查无异常者可继续严格随访;LCT联合高危型HPV检测是CIN治疗后临床追踪随访的有效手段。Abstract: Objective: To investigate the Significance of LCT joint highrisk HPV testing for followup after CIN treatment. Methods : 200 cases that highrisk HPV infection were tested by realtime PCR and CIN1~3 were confirmed with LCT and colposcopy biopsy were considered. The patients were treated with LEEP treatment or cold knife conization. After treatment, all cases were strictly followed up with LCT and HPV test, and the patients with positive results were examined by histology. Results : 1) After treatment, there was no residual disease in all cases, the cure rate was 100%. 2) From 3 months after treatment, highrisk HPV negative rate was 100% in CIN1 cases. While at 3rd and 6th month after treatment, highrisk HPV negative rate in CIN2~3 cases were 7317% and 9085%, which were significantly lower than those in CIN1 cases,the difference was statistically significant. 3) From the 12th monthafter treatment, there are still two cases of sustained highrisk HPV positive but normal with LCT and colposcopy biopsy. All cases are still strictly followedup. Conclusion : After treatment, the negative rate and time of highrisk HPV concerned with the grade of the CIN; the patients with persistent positive highrisk HPV, but without abnormalities detected by LCT and colposcopy biopsy could continue to strictly follow up; LCT joint highrisk HPV detection is an effective clinical means for followup after CIN treatment.
OBJECTIVE: To investigate the efficiency of recombinant human epidermal growth factor (rhEGF) on burn wound healing and to explore the effective density of the ointments. METHODS: A total of 120 cases of burn in superficial II degree and profound II degree were randomly divided into 2 groups. In the first group of 15 cases of superficial II degree, the wounds were treated by rhEGF ointments of different density, 0.5 microgram/g, 10 micrograms/g and 50 micrograms/g, to screen out the effective density. And in the other 105 cases of the second group, optimal density of the ointments based on the result of the first group were employed to treat the burn wound in superficial II degree and profound II degree, with the self-corresponding wounds of the same degree as control, to study the efficiency of rhEGF on wound healing, according to the wound healing time, and adverse reaction of the ointment. RESULTS: In the first group, the average healing time of superficial II wound treated by ointments of 10 micrograms/g and 50 micrograms/g significantly shortened when compared with that treated by ointments of 0.5 microgram/g(P lt; 0.01), but there was no obvious difference between the cases treated by ointments of 10 micrograms/g and 50 micrograms/g. In the second group, the healing time of superficial II wound treated by ointments of 10 micrograms/g was (8.39 +/- 2.25) days, (9.52 +/- 2.56) days in the control (P lt; 0.01); and healing time of profound II burn treated by ointments of 10 micrograms/g was (16.80 +/- 2.99) days, (18.27 +/- 3.17) days in the control (P lt; 0.01). And healing rates of burn wound at different periods were higher than those of the control. CONCLUSION: The above results indicate that rhEGF ointments can enhance burn wound healing significantly, and the ointment of 10 micrograms/g is a good choice for clinical application.
Objective To investigate the effect of ultra-filtration on reducing the matrix effects of the immersionof recombination human acellular dermal matrix (rhADM) on detecting residual bovine serum albumin (BSA) by ELISA.Methods Preparation of rhADM immersion: rhADM were rinsed, and then rhADM immersion were prepared. Physiologicalsal ine was used as immersion medium. Presaturation and ultra-filtration: marked the ultra-filtration tubes as PR1 (presaturation protocol 1), PR2 (presaturation protocol 2) and rhADM, respectively, added 2 mL of 1 mg/mL and 10 μg/mL BSA solution into PR1 and PR2 respectively, and added 2 mL of rhADM immersion into rhADM tubes (rhADM1 and rhADM2). The tubes were then centrifuged at 1 500 × g for 20 minutes. The above steps were repeated for 3 times. Take the inner-tube of ultrafiltration into unused centrifuge tube. Added 4 mL of 10 μg/mL BSA solution in PR1 and PR2 tubes, 4 mL of rhADM immersion in rhADM tubes, centrifuged at 1 500 × g for 20 minutes, and then the filtration was colleted. Detecting BSA concentration: the BSA concentrations of all samples were detected by using the quantitative measure of residual BSA ELISA kit. The recoveries of 10 μg/ mL BSA solution treated by presaturation protocol 1 and 2 were calculated (untreated 10 μg/mL BSA solution was as the basic sample, marked R10 and R20 respectively). The correlation coefficient between the logarithm of the filtrate dilution and the absorbance (A) value was calculated and compared with that of water exact without ultra-filtration. Results The BSA concentration of PR1 and R10 was (23.80 ± 1.58) μg/ mL and (9.04 ± 0.24) μg/mL, respectively. The BSA concentration of PR2 and R20 was (8.64 ± 0.24) μg/mL and (8.12 ± 1.01) μg/ mL, respectively. The average recovery of 10 μg/mL BSA was 263.4% ± 16.9% and 106.5% ± 3.0% when the ultra-filtration tubes were presaturaed by PR1 and PR2 (P lt; 0.01), respectively. The BSA recovery of PR2 met the detecting demand. The correlations between A value and sample dilution were increased, the correlationcoefficient was raised from — 0.727 to — 0.960 after rhADM immersion were treated by ultra-filtration. Conclusion Theresults show that the matrix effects can be reduced effectively by ultra-filtration, indicating that an acceptable recovery of BSA can be acquired when ultra-filtration tube is presaturated by sample water extract.
OBJECTIVE: To explore an optimal method of recombinant human epidermal growth factor(rhEGF) application on the burn wounds of superficial II degree and profound II degree for accelerating its healing. METHODS: There were 180 burn wounds in 60 patients with the self-corresponding wound of the same degree as controls. The wounds of all patients were divided three regions(A, B, C). The wounds were treated once a day with 1% SD-Ag in region A as controls, with rhEGF(40 U/cm2) in region B, and with a combination of rhEGF(40 U/cm2) and Su Yu Ping (5 g) in region C. The wound healing time was recorded and compared. RESULTS: In regions A, B and C, the healing time of superficial II degree wound was (13.20 +/- 2.40) days, (10.20 +/- 2.20) days and (8.72 +/- 2.31) days (P lt; 0.01); that of profound II degree wound was (20.10 +/- 3.40) days, (17.20 +/- 3.12) days and (15.10 +/- 3.81) days respectively (P lt; 0.01, P lt; 0.05). The healed wound of profound II degree was elastic and tough in regions B and C, while that was not elastic and tough, and congestive in region A. CONCLUSION: The above results indicate that rhEGF can enhance burn wound healing markedly and that a combination rhEGF and Su Yu Ping has more significant effect than rhEGF alone and is recommended for clinical application.
Objective To investigate a new grafting material of bone xenograft with b bone inductive and conductive capacity. Methods Based on successful clinical application of the reconstituted bone xenograft (RBX), a new xenograft was made by combining recombinant human bone morphogenetic protein-2 (rhBMP-2) with antigen-free bovine cancellous bone (BCB). Sixty male BALB/C mice aged 4 weeks were divided into study group of 30 and control group of 30 randomly. rhBMP-2 / BCB was implanted in the left thigh muscle pouch in the study group andBCB in the control group. The mice were sacrificed at 7 d, 14d and 21d after implantation. Inductivity of rhBMP-2/BCB was detected by histological observation and biochemical determination of the samples. Results Histological examinationshowed that rhBMP-2/BCB induced chondrogenesis on the 7th day, with woven boneformed on the 14th day, and lamellar bone and marrow on the 21st day, while BCBfailed to induce chondrogenesis or osteogenesis on the 7th, 14th and 21st days. The alkaline phosphatase activities and calcium content in study group were higher than those in control group with significant difference (P＜0.01). Conclusion rhBMP-2/BCB is an ideal grafting material with b bone inductive and conductive capacity without evoking immune reaction.
【Abstract】 Objective To study a new method of alveolar cleft bone graft repair. Methods From April 2005to August 2006, 26 cases (30 sides) of alveolar cleft were treated with trabecular substance of self-il ium combined with the decalcified dentinal matrix of human (DDM). There were 16 males and 10 females, aged 6-12 years. Unilateral alveolar cleft was involved in 22 cases, bilateral alveolar cleft in 4 cases. All cases were accompanied by nasal wing collapse, 5 by deciduous tooth retention, 3 by malposed teeth and 1 by tooth deformity. Anterior occlusal radiographs and panoramic oral radiographs were taken to observe union and bone absorption before and after operation. Results Twenty-three patients achieved heal ing by first intention, oronasal fistulas were closed successfully. Infection occurred in one bilateral alveolar cleft case and bone tissue exposure in 2 cases. Wound healed by rinse or dressing change and inunction with MEBO. The X-ray films after operation showed bone bridge formation in the alveolar cleft. The stabil ity and continuity of body of maxilla were resumed. Four cases (6-9years old) were observed 6.5 months, 22 cases (9-12 years old ) were observed 8.6 months. According to Bergland for evaluation,the X-ray films after 3 months of operation showed 16 cases (16 sides) in class I (53.3%), 7 cases (8 sides) in class II (26.7%),2 cases (4 sides) in class III (13.3%), and 1 case(2 sides) in class IV (6.7%). The overall survival ratio of alveolar bone grafting was 93.3%, and the cl inical success ratio was 80%. Conclusion The DDM is good in alveolar cleft bone graft repair. It is better than using self-il ium only cl inically.
A new type of testing system used for antithrombotic pressure circulatory equipment has been developed, which realized a new method for the calibration of pressure sensor. Multi-path control and acquisition functions are achieved by this method based on human-computer interaction testing system. The precision of pressure sensor is obtained by polynomial fitting for each test point using linear interpolation method. The result showed that the precision test of pressure sensor could be realized easily and efficiently, using the developed testing system, and the parameters of pressure sensor could be calibrated effectively, so that it could be accurately used in the antithrombotic pressure circulatory equipment. The developed testing system has a prosperous future in the aspects of promotion and application.
OBJECTIVE To improve the osteoinduction of coral and provide a perfect bone graft substitute for clinical bone defects. METHODS By combining coral with collagen and recombinant human bone morphogenetic protein-2(rhBMP-2), coral/collagen/rhBMP-2 composite was obtained. The composite was implanted into the back muscle pouches of mice, and coral/collagen or coral/rhBMP-2 were implanted as control. The osteoinduction of the composite was assessed by histology and image analysis system. RESULTS The chondrocyte differentiation and matrix formation were observed in local sites after one week, lamellar bone with bone marrow were formed after 4 weeks, and coral were absorbed partially. The quantity of osteoinduction was time-related and rhBMP-2 dose-related(P lt; 0.01). Coral/collagen and coral/rhBMP-2 implants did not show any bone or cartilage formation. CONCLUSION The coral/collagen/rhBMP-2 composite possesses a superior osteoinduction and will be a new type of bone substitute to be used in orthopedic and maxillofacial surgery.