磺胺嘧啶银混悬液联合银锌霜分阶段疗法在大面积烧伤中的应用

目的：观察2008年1月至2010年12月期间98例TBSA大于35%的烧伤病人创面联合应用磺胺嘧啶银混悬液联合银锌霜的疗效。方法：以同期76例应用碘伏的病人作为对照,两组病人的平均年龄、烧伤面积、Ⅲ度面积无显著差别,用药方式均以半暴露为主。结果：磺胺嘧啶银混悬液联合银锌霜组能显著增加细菌转阴率,减少抗生素应用时间及植皮手术次数,缩短愈合时间。结论：磺胺嘧啶银混悬液联合银锌霜较碘伏能显著增加抗感染能力,有利于肉芽创面形成,为自行愈合或再次手术打下良好基础,值得应用。     

新型抗菌凝胶敷料治疗深II度烧伤创面的疗效评价

目的:评价新型抗菌凝胶敷料普朗特联合磺胺嘧啶银霜治疗深Ⅱ度烧伤创面的临床疗效和安全性。方法:采用前瞻性随机对照的方法将2015年3月至2016年5月来我科初次就诊的深Ⅱ度烧伤患者74例分为两组:试验组38例采用新型抗菌凝胶敷料普朗特联合磺胺嘧啶银霜治疗,对照组36例采用磺胺嘧啶银霜治疗。两组均采用规定的标准化创面处理方式,其余治疗均按常规进行。分别统计和比较两组的创面愈合时间、愈合率、创面细菌培养阳性率、换药时的疼痛程度,同时定期监测患者在用药期间有无实验室指标异常及不良反应的发生。结果:试验组创面愈合时间(21.11 3.13)d,明显短于对照组(25.28 4.50)d(P0.01)。治疗后7 d、14 d、21 d,试验组创面愈合率分别为(26.63 5.21)%、(63.32 5.32)%、(92.66 4.19)%,均显著高于对照组(P0.05)。治疗后7 d、14 d,试验组分别有5例(13.16%)和1例(2.63%)创面细菌培养阳性,明显低于对照组的12例(33.33%)和8例(22.22%)(P0.05)。治疗后7 d、14 d、21 d,试验组换药时的疼痛评分均明显低于对照组(P0.05)。两组治疗期间实验室检查指标均无异常波动,均未见明显不良反应。结论:新型抗菌凝胶敷料普朗特联合磺胺嘧啶银霜治疗深Ⅱ度烧伤创面能缩短愈合时间,提高愈合率,减少创面感染发生,减轻患者痛苦。     

几种药物用于烧伤大鼠局部抗感染作用的观察

在烧伤大鼠创面接种绿脓杆菌（１０９ＣＦＵ／ｍｌ,）使用银锌霜、磺胺嘧啶银霜,生态霜及空白霜膏抗感染实验,结果发现：生态霜作用与磺胺嘧啶银、银锌霜效果相当,既能拮抗绿脓杆菌感染,又对创面有保护作用,如先使用生态霜效果更好。     

枯草芽胞杆菌喷雾剂对家兔皮肤创伤愈合的影响

目的 :观察枯草芽胞杆菌喷雾剂对家兔皮肤创伤愈合的影响。方法 :采用家兔皮肤创伤为模型 ,连续给药 6 d,第 11天测定创面面积 ,并于第 17天记录创面愈合数。结果 :枯草芽胞杆菌喷雾剂高剂量组和磺胺嘧啶银组创面面积显著小于空白对照组 ( P<0 .0 5 ) ;枯草杆菌喷雾剂的愈合率显著高于空白对照组( P<0 .0 5 )。结论 :枯草芽胞杆菌喷雾剂能够缩小家兔创面愈合 ,增加创面愈合率     

两种湿敷护理法对眼镜蛇咬伤致局部溃疡的疗效比较

目的 探讨中华眼镜蛇咬伤致局部软组织肿胀坏死的有效护理方法.方法 收集2010年1月~2012年12月我科收治的60例中华眼镜蛇咬伤中毒患者的临床资料,按护理方法不同随机分为观察组和对照组各30例.观察组采取磺胺嘧啶银霜配合使用重组人表皮生长因子外用溶液(Ⅰ),对照组采取常规的护理措施即单纯使用40%硫酸镁甘油湿敷肿胀坏死处,观察比较两组病例开始消肿时间与完全消肿时间及止痛效果.结果 观察组患者肿胀开始消退和完全消退时间分别为(25.4±22.3)h、(98.1±20.5)h,止痛有效率为90%;对照组患者肿胀开始消退及完全消退时间分别为(45.6±32.1)h、(132.2±73.4)h,止痛有效率为60%.两组患者肿胀开始消退时间和完全消退时间比较,观察组明显短于对照组(P＜0.05),止痛有效率高于对照组.结论 磺胺嘧啶银霜配合使用重组人表皮生长因子外用溶液(Ⅰ)能有效促进中华眼镜蛇咬伤中毒致坏死皮肤的愈合.     

新洁尔灭浸泡联合碘伏湿敷用于骨科感染伤口换药效果观察

目的:分析碘伏湿敷联合新洁尔灭浸泡针对骨科感染伤口换药的效果。方法:收集2013年8月至2015年8月,本院骨科收治伤口感染病人66例,并将这部分人员随机划分成实验组与对照组,每组33例病人。对照组33例病人采用传统外科换药的方法,实验组33例病人采用碘伏湿敷联合新洁尔灭浸泡的治疗方法。并对两组病人治疗伤口愈合的时间、换药次数及疼痛反应进行对比。结果:实验组采取碘伏湿敷联合新洁尔灭浸泡的方法,在伤口愈合的时间、换药次数及疼痛反应等方面实验组效果均明显好于对照组,其差异性具有统计学意义(P0.05)。结论:对骨科伤口感染患者应用碘伏湿敷联合新洁尔灭浸泡的方法,收效良好,效果明显好于传统骨科换药手段,临床中应当得到大力推广与使用。     

红光促进难治性创面愈合的研究

目的:探讨红光照射对难治性创面的创缘组织中血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)的表达及治疗难治性创面的临床效果。方法:收集2008年6月-2010年12月因难治性创面入住笔者单位治疗的40例患者,按治疗方法分为红光照射治疗组20例和常规治疗组20例。常规治疗组患者创面以0.5%碘伏与水胶体敷料换药。治疗组在常规治疗的基础上加用红光照射。于治疗后第7天、14天、21天切取创缘组织,研究红光照射对创缘组织中VEGF的影响,并比较两组患者的创面愈合率和愈合时间。结果:临床实验中,治疗组创缘组织中的VEGF含量明显高于对照组(P<0.01);治疗组创面愈合率明显高于对照组(P<0.01);治疗组的愈合时间低于对照组(P<0.05)。结论:红光照射能显著提高创缘组织中VEGF含量,减少创面愈合时间,促进愈合。     

磺胺嘧啶锌过敏1例报告

磺胺嘧啶锌是一种常用的烧伤外用药,适用于预防及治疗Ⅱ°、Ⅲ°烧烫伤继发创面感染,具有抗菌消炎、收敛之功效.但由于个体差异,有些患者涂抹后有不同程度的过敏症状,现将我院磺胺嘧啶锌过敏1例资料报告如下.     

抑菌生防治大鼠烫伤创面大肠杆菌感染的实验研究

本实验将大白鼠背部烫伤后,用大肠杆菌涂抹创面,分别用BS_(224)菌(抑菌生)及AG—SD(磺胺嘧啶银霜)处理创面,以观察抑菌生对动物烫伤感染的防治效果。结果表明:抑菌生对有一定耐药性(但对AG—SD不耐药)的大肠杆菌引起的烫伤局部感染具有较强的防治功效,其作用和疗效优于AG—SD。     

红光促进难治性创面愈合的研究

目的：探讨红光照射对难治性创面的创缘组织中血管内皮细胞生长因子（vascular endothelial growth factor,VEGF）的表达及治疗难治性创面的临床效果。方法：收集2008年6月-2010年12月因难治性创面入住笔者单位治疗的40例患者,按治疗方法分为红光照射治疗组20例和常规治疗组20例。常规治疗组患者创面以0.5%碘伏与水胶体敷料换药。治疗组在常规治疗的基础上加用红光照射。于治疗后第7天、14天、21天切取创缘组织,研究红光照射对创缘组织中VEGF的影响,并比较两组患者的创面愈合率和愈合时间。结果：临床实验中,治疗组创缘组织中的VEGF含量明显高于对照组（P〈0.01）;治疗组创面愈合率明显高于对照组（P〈0.01）;治疗组的愈合时间低于对照组（P〈0.05）。结论：红光照射能显著提高创缘组织中VEGF含量,减少创面愈合时间,促进愈合。     

Comparison of silver sulfadiazine and gentamicin for topical prophylaxis against burn wound sepsis.

Daily prophylactic application of either 1.0% silver sulfadiazine cream or 0.1% gentamicin cream was compared for effectiveness in preventing bacterial colonization of burn wounds and sepsis. Pseudomonas aeruginosa colonized the wounds of 37% of the 38 patients treated with silver sulfadiazine and 30% of the 33 patients treated with gentamicin; gentamicin-resistant P. aeruginosa colonized the wounds of 21% of the patients treated with gentamicin. Staphylococcus aureus colonization occurred in 55% of the patients treated with silver sulfadiazine, whereas colonization with Candida species occurred in 58% of the patients treated with gentamicin. Although gentamicin-resistant organisms caused no deaths their repeated appearance resulted in discontinuation of prophylaxiz with gentamicin cream. The next year P. aeruginosa strains resistant to gentamicin were isolated from burn wounds of only two patients who had not previously received parenteral therapy with gentamicin or tobramycin. Gentamicin cream should be reserved for treating patients with wounds infected by gentamicin-sensitive P. aeruginosa and those allergic to sulfa drugs. For most patients with burn wounds silver sulfadiazine is safe and effective as an antibacterial agent for topical prophylaxis.     

氧化锌软膏联合1%联苯苄唑乳膏对改善外阴阴道假丝酵母菌病患者外阴不适症状的疗效观察

目的:观察氧化锌软膏联合1%联苯苄唑乳膏局部外涂对改善外阴阴道假丝酵母菌病(VVC)患者外阴不适症状的疗效。方法:选择2017年1月至6月在本院妇科门诊就诊的VVC患者148例,根据外阴不适的轻、中、重程度随机分为研究组和对照组,每组各74例。两组患者均阴道内给予克霉唑阴道片1片(睡前),研究组在此基础上于外阴不适处联合外涂氧化锌软膏及1%联苯苄唑乳膏,早晚交替各1次;对照组仅每晚外涂1%联苯苄唑乳膏1次。3天后,比较两组的临床应用效果。结果:研究组和对照组有效率分别为87.84%(65/74)和71.62%(53/74),研究组显著高于对照组(P0.05);两组轻度外阴不适患者治疗后总有效率分别为97.14%(34/35)和94.59%(35/37),差异无统计学意义(P0.05);中度外阴不适患者总有效率分别为82.61%(19/23)和54.55%(12/22),研究组显著高于对照组(P0.05);重度外阴不适患者总有效率分别为75.00%(12/16)和40.00%(6/15),研究组显著高于对照组(P0.05)。结论:氧化锌软膏联合1%联苯苄唑乳膏局部交替外涂用于治疗伴中、重度外阴不适症状的VVC患者的临床疗效显著优于单用1%联苯苄唑乳膏局部外涂。     

Effects of fire on landscape heterogeneity in Yellowstone National Park,Wyoming

Abstract. A map of burn severity resulting from the 1988 fires that occurred in Yellowstone National Park (YNP) was derived from Landsat Thematic Mapper (TM) imagery and used to assess the isolation of burned areas, the heterogeneity that resulted from fires burning under moderate and severe burning conditions, and the relationship between heterogeneity and fire size. The majority of severely burned areas were within close proximity (50 to 200 m) to unburned or lightly burned areas, suggesting that few burned sites are very far from potential sources of propagules for plant reestablishment. Fires that occurred under moderate burning conditions early during the 1988 fire season resulted in a lower proportion of crown fire than fires that occurred under severe burning conditions later in the season. Increased dominance and contagion of burn severity classes and a decrease in the edge: area ratio for later fires indicated a slightly more aggregated burn pattern compared to early fires. The proportion of burned area in different burn severity classes varied as a function of daily fire size. When daily area burned was relatively low, the proportion of burned area in each burn severity class varied widely. When daily burned area exceeded 1250 ha, the burned area contained about 50 % crown fire, 30 % severe surface burn, and 20 % light surface burn. Understanding the effect of fire on landscape heterogeneity is important because the kinds, amounts, and spatial distribution of burned and unburned areas may influence the reestablishment of plant species on burned sites.     

抗内毒素Fab’对严重烧伤早期肠源性内毒素血症小鼠NO、MDA与iNOS的影响及意义

目的：观察抗内毒素Fab’对严重烧伤早期肠源性内毒素血症小鼠肠组织中NO、iNOS、MDA水平的影响,探索防治烧伤脓毒症的新措施。方法：采用严重烧伤早期肠源性内毒素血症小鼠模型,分为烧伤组、治疗组及对照组,分别于6、12、24、48h4个时相点测定肠组织中NO、iNOS、MDA的浓度：结果：烧伤后肠组织中NO、iNOS、MDA水平均比正常对照组显著增高;治疗组肠组织中NO、iNOS、MDA水平较烧伤组显著降低。结论：抗内毒素Fab’能减轻内毒素对机体的损害,从而起到对严重烧伤早期肠源性脓毒症的防治作用。     

Early evolution of selenium status and oxidative stress parameters in rat models of thermal injury

The objective of the present study was to measure the relationship between selenium status and oxidative stress in two rat models of thermal injury. A non-lethal third-degree burn injury involving 20% (experiment 1) or 40% (experiment 2) of total body surface area (TBSA) was applied to male Wistar rats. Selenium level, glutathione peroxidase (GPx) activity in plasma, red blood cells (RBC) and tissues (liver, kidney, muscle, and brain), and plasma selenoalbumin (Se-alb) were measured in control rats and in burned rats respectively 6 hours after injury and daily from day 1 to day 5. In parallel, lipid and protein oxidative damages, monitored by plasma and tissue thiobarbituric acid reactive species (TBARs) levels and plasma total thiol groups were assessed.

We observed a decrease of plasma Se and Se-albumin 6 hours after burn injury. In parallel, plasma GPx activity rapidly decreased and remained significantly lower than in control rats. These alterations were enhanced by the burn injury severity. Plasma TBARs followed the same pattern as that of plasma cholesterol, with an initial decrease and an increase at day 3 in 40% TBSA burned rats. Plasma thiol groups decreased in the two experiments indicating plasma protein oxidation.

These results confirm an early oxidative stress in burn injury, and suggest an early selenium mobilization, which might counteract this oxidative stress. These data underline the crucial need of a restored selenium status in burned patients immediately after the burn injury.     

复方黄柏液联合夫西地酸软膏及西替利嗪 治疗面部糖皮质激素依赖性皮炎疗效观察

目的观察复方黄柏液联合夫西地酸软膏及西替利嗪治疗面部糖皮质激素依赖性皮炎（以下简称为面部激素性皮炎）的疗效。方法采用随机对照观察方法对108例面部激素性皮炎患者分成治疗组和对照组。治疗组使用复方黄柏液（湿敷）联合夫西地酸软膏（外用）,对照组用3%的硼酸溶液湿敷及维生素B6软膏外用;两组均口服西替利嗪片。2周为1个疗程,治疗2个疗程。结果治疗组有效率为80.77%;对照组有效率为56.86%。两组有效率比较差异有统计学意义（χ^2=7.16,P〈0.05）。结论复方黄柏液联合夫西地酸软膏及西替利嗪治疗面部激素性皮炎疗效好,无明显不良反应。     

Synergistic interactions between leaf beetle herbivory and fire enhance tamarisk (Tamarix spp.) mortality

The combined effects of herbivory and fire on plant mortality were investigated using prescribed burns of tamarisk (Tamarix ramosissima Lebed) exposed to herbivory by the saltcedar leaf beetle (Chrysomelidae: Diorhabda carinulata Desbrocher). Tamarix stands in the Humboldt Sink (NV, USA) were divided into three treatments: summer burn (August 2006), fall burn (October 2006) and control (unburned), and litter depth was manipulated to vary fire intensity within burn seasons. A gradient of existing herbivory impact was described with three plant condition metrics prior to fire: reduced proportions of green canopy, percent root crown starch sampled at the height of the growing season (August 2006), and percent root crown starch measured during dormancy (December 2006). August root crown starch concentration and proportion green canopy were strongly correlated, although the proportion green canopy predicted mortality better than August root crown starch. December root crown starch concentration was more depleted in unburned trees and in trees burned during the summer than in fall burn trees. Mortality in summer burned trees was higher than fall burned trees due to higher fire intensity, but December root crown starch available for resprouting in the spring was also lower in summer burned trees. The greatest mortality was observed in trees with the lowest December root crown starch concentration which were exposed to high fire intensity. Disproportionate changes in the slope and curvature of prediction traces as fire intensity and December starch reach reciprocal maximum and minimum levels indicate that beetle herbivory and fire intensity are synergistic.     

Morph identification in natural populations of alate female bird cherry aphids, Rhopalosiphum padi L., by multivariate methods

The effects of six burning treatments combined with two insecticide treatments of alfalfa (Medicago sativa L.) stubble on alfalfa plant bug, Adelphocoris lineolatus (Goeze) and Lygus spp. populations were evaluated over an 8-yr period (1982–1989). The burn treatments were: burning every spring and autumn, burning in alternate springs, burning at 50–100 mm and 150–200 mm of spring growth, and an unburned control. Alfalfa plant bug, which overwinters in the egg stage in alfalfa stems, were reduced by the spring burns. First generation populations of Lygus spp., were enhanced by the burn treatments before spring growth appeared, but were reduced when alfalfa was burned over 50 mm of spring growth. Counts of the minute pirate bug, Onus tristicolor White, were enhanced in 1983 by all burn treatments, and in 1985 by some of the burn treatments. Of all the predators, only spiders were significantly reduced and only in 1986 by the burned every autumn and spring treatments.     

湖南省长株潭地区儿童烧伤流行病学调查研究

目的：总结分析湖南省长株潭地区儿童烧伤的流行病学特征。方法：采用分层随机抽样法抽取湖南省长株潭地区3所医院,收集其2010年1月至2010年12月间收治的0—14岁烧伤患儿病历资料,并对烧伤患儿或其家长进行问卷调查。、结果：各年龄段患儿烧伤构成比依次为0-3岁（62．1％）、4-6岁（24．2％）以及7—14岁（13．6％）。致伤原因构成比依次为热液烧伤（56．1％）、火焰烧伤（31．8％）、其他原因烧伤（12．1％）。83．3％的烧伤发生在室内,客厅为最主要的烧伤发生场所占47．3％。75．8％的患儿烧伤发生在白天（6：00-18：00）。62．5％的患儿烧伤发生在夏、秋两季（6月-11月）。结论：在长株潭地区,婴幼儿时期（0-3岁）为儿童烧伤的易发年龄段;热液／热蒸汽造成的烧烫伤是儿童烧伤最常见的类型;室内特别是客厅为儿童烧伤最容易发生的地点。白天和夏、秋两季为儿童烧伤的好发时段和季节。