Logistic Regression Analysis and Nursing Interventions for High-risk Factors for Pressure Sores in Patients in a Surgical Intensive Care Unit

Objective： To investigate the risk factors related to the development of pressure sores in critically ill surgical patients and to establish a basis for the formulation of effective precautions. Methods： A questionnaire regarding the factors for pressure sores in critically ill surgical patients was created using a case control study with reference to the pertinent literature. After being exam- ined and validated by experts, the questionnaire was used to collect data about critically ill surgical patients in a grade A tertiary hospital. Among the 47 patients enrolled into the study, the 14 who developed nosocomial pressure sores were allocated to the pressure sore group, and the remaining 33 patients who met the inclusion criteria and did not exhibit pressure sores were allocated to the control group. Univariate and multivariate logistic regression analyses were employed to examine the differences in 22 indicators between the two groups in an attempt to identify the risk factors for pressure sores. Results： According to the univariate analyses, the maximum value of lactic acid in the arterial blood, the number of days of norepinephrine use, the number of days of mechanical ventilation, the number of days of blood purification, and the number of days of bowel incontinence were statistically greater in the pressure sore group than in the control group （P〈0.05）. The multivariate logistic regression analysis revealed that the number of days of norepinephrine use and the level of lactic acid in the arterial blood were high risk-factors for pressure sores （P〈0.05）. Conclusions： The best method for preventing and control pressure sores in surgical critically ill patients is to strongly emphasize the duration of the critical status and to give special attention to patients in a continuous state of shock. The adoption of measures specific to high-risk patient groups and risk factors, including the active control of primary diseases and the application of decompression measures during the treatment of the patients, are helpful for improving the quality of care in the prevention and control of pressure sores in critically ill patients.

Dynamic ModeⅡfracture behavior of rocks under hydrostatic pressure using the short core in compression(SCC)method

The shear failure of rocks under both a static triaxial stress and a dynamic disturbance is common in deep underground engineering and it is therefore essential for the design of underground engineering to quantitively estimate the dynamic ModeⅡfracture toughness KⅡCof rocks under a triaxial stress state.However,the method for determining the dynamic KⅡCof rocks under a triaxial stress has not been developed yet.With an optimal sample preparation,the short core in compression(SCC)method was designed and verified in this study to measure the dynamic KⅡCof Fangshan marble(FM)subjected to different hydrostatic pressures through a triaxial dynamic testing system.The formula for calculating the dynamic KⅡCof the rock SCC specimen under hydrostatic pressures was obtained by using the finite element method in combination with secondary cracks.The experimental results indicate that the failure mode of the rock SCC specimen under a hydrostatic pressure is the shear fracture and the KⅡCof FM increases as the loading rate.In addition,at a given loading rate the dynamic rock KⅡCis barely affected by hydrostatic pressures.Another important observation is that the dynamic fracture energy of FM enhances with loading rates and hydrostatic pressures.

Integrated Design of D.D.I., Filament Winding and Curing Processes for Manufacturing the High Pressure Vessel(Type Ⅱ)

As energy crisis and environment pollution all around the world threaten the widespread use of fossil fuels,compressed natural gas(CNG)vehicles are explored as an alternative to the conventional gasoline powered vehicles.Because of the limited space available for the car,the composite pressure vessel(TypeⅡ)has been applied to the CNG vehicles to reach large capacity and weight lightening vehicles.High pressure vessel(TypeⅡ)is composed of a composite layer and a metal liner.The metal liner is formed by the deep drawing and ironing(D.D.I.)process,which is a complex process of deep drawing and ironing.The cylinder part is reinforced by composite layer wrapped through the filament winding process and is bonded to the liner by the curing process.In this study,an integrated design method was presented by establishing the techniques for FE analysis of entire processes(D.D.I.,filament winding and curing processes)to manufacture the CNG composite pressure vessel(TypeⅡ).Dimensions of the dies and the punches of the 1 st(cup drawing),2 nd(redrawing-ironing 1-ironing 2)and 3 rd(redrawing-ironing)stages were calculated theoretically,and shape of tractrix die to be satisfied with the minimum forming load was suggested for life improvement and manufacturing costs in the D.D.I.process.Thickness of the composite material was determined in the filament winding process,finally,conditions of the curing process(number of heating stage,curing temperature,heating rate and time)were proposed to reinforce adhesive strength between the composite layers.

Effect of Qingguang'anⅡon expressions of OX42 protein and IL-1βmRNA of retinal microglia cells of rats with chronic high intraocular pressure

The study investigated the effects of Qingguang＇an Ⅱ（a Chinese medicinal preparation） on expressions of OX42 protein and interleukin-1β（IL-1β） mRNA of retinal microglia cells of rats with chronic high intraocular pressure（IOP）. SD rats were randomly divided into 6 groups, that were： A： blank group; B： model group; C： Qingguang＇an Ⅱ low dose group; D： Qingguang＇an Ⅱ medium dose group; E： Qingguang＇an Ⅱ high dose group; F： Yimaikang disket（a Chinese medicinal preparation） group. Experimental rats in B, C, D, E, F groups were established the model of chronic high IOP by cauterizing of superficial scleral vein. Tissues of eyes were obtained after intragastric administration for 2 and 4 wk. At the time-point of 2 wk, OX42 protein and IL-1β mRNA in group B were statistically expressed in higher level comparing with other groups（P〈0.05）. Moreover, at the time-point of 4 wk, OX42 protein and IL-1β mRNA in groups C, D and E were statistically expressed in lower level comparing with group F（P〈0.05）. Besides, OX42 protein and IL-1β mRNA in groups C and D were statistically expressed in higher level comparing with group E（P〈0.05）. OX42 protein and IL-1β mRNA in groups C and D were expressed in similar level（P〉0.05）. The study indicated that, in the protection of optic nerve of rats with chronic high IOP, the high dose of Qingguang＇an Ⅱ at the time-point of 4 wk was the better choice.

Synthesis of condensed polynuclear aromatic resin from furfural extract oil of reduced-pressure route Ⅱ

As an industrial byproduct of oil refining,furfural extract oil from reduced-pressure route Ⅱ with high aromatic content was used to prepare heat-resistant condensed polynuclear aromatic（COPNA） resin for the first time.The basic properties of furfural extract oil and the resultant COPNA resin were characterized by infrared spectroscopy（FT-IR）,nuclear magnetic resonance spectroscopy（1H-NMR）,thermogravimetric analysis（TGA） and elemental analysis（EA）.The result showed that heat treated furfural extract oil was successfully used for the synthesis of heat-resistant COPNA resin.The average structural parameters of raw materials and prepared resin were calculated by the improved Brown-Ladner method,and the averaged molecular structure of the resin was obtained.The reaction mechanism for the synthesis of COPNA resin was suggested as an acid-catalyzed positive ion type polymerization.

Changes in Plasma Angiotensin II and Circadian Rhythm of Blood Pressure in Hypertensive Patients with Sleep Apnea Syndrome Before and After Treatment

Objective To explore the changes in plasma angiotensin II （Ang Ⅱ） and circadian rhythm of blood pressure among hypertensive patients with sleep apnea syndrome （SAS） before and after continuous positive airway pressure （CPAP） or surgical treatment. Methods A total of 180 essential hypertension patients were enrolled in our study. The determination of plasma Ang Ⅱ concentration, ambulatory blood pressure （ABP）, and polysomnography （PSG） monitoring were performed before and 3 months after CPAP or surgical treatment. Results Patients were classified into three groups by their apnea-hypopnea index （AHI）： essential hypertension group （EH group, n=72; AHI〈5）, essential hypertension with mild SAS group （EH＋mild SAS group, n=60, 5≤AHI〈20）, and essential hypertension with moderate and severe SAS group （EH＋moderate-severe SAS group, n=48, AHI_〉20）. The concentrations of plasma AngⅡ in the above three groups were 13.42±3.27, 16.17±3.82, and 18.73±4.05 ng/mL respectively before treatment, and AngⅡ concentration in EH patients combined with SAS was significantly higher than that in EH group （all P〈0.05）. After treatment the values in the latter two groups significantly decreased to 14.67±2.56 and 15.03±3.41 ng/mL respectively （P〈0.05）. The incidence of non-dipper blood pressure curve in EH patients was 31.9%, and those in hypertensive patients with mild SAS and moderate-severe SAS were 51.7% and 58.3%, respectively before treatment. The incidence of non-dipper blood pressure curve in the EH patients with mild SAS was significantly higher than that of patients with EH alone （P〈0.05）. After CPAP treatment or surgery, the incidence of non-dipper blood pressure curve in the two SAS groups was significantly decreased to 38.3% and 39.6%, respectively （P〈0.05）. Conclusions Ang Ⅱ might play a role in blood pressure variability in patients with obstructive SAS. CPAP or surgical treatment can improve blood pressure disorder and decrease plasma Ang Ⅱ level in patients with obstructive SAS.

Effects of combination of irbesartan and perindopril on calcineurin expression and sarcoplasmic reticulum Ca^(2+)-ATPase activity in rat cardiac pressure-overload hypertrophy

Aim： To observe effects of angiotensin （Ang） II receptor antagonist （ATI） irbesartan and angiotensin-converting enzyme （ACE） inhibitor perindopril on rat myocardium calcineurin expression and sarcoplasmic reticulum Ca^2＋-ATPase activity in the model of pressure-overload cardiac hypertrophy. Methods： Forty male adult Sprague Dawley rats were divided into 5 groups One group was treated by sham operation; four groups were myocardium hypertrophy cases caused by banding aortic above renal artery. Drugs were given one week after operation. Group 1： sham group, rats （n=8） were gavaged with normal saline 2 ml/（kg·d） （ig）; Group 2： control group, rats （n=8） were treated with normal saline 2 ml/（kg·d） （ig）; Group 3： rats （n=8） were given perindopril 2 mg/（kg·d） （ig）; Group 4： rats （n=8） were treated with irbesartan 20 mg/（kg·d） （ig）; Group 5： rats （n=8） were given irbesartan 20 mg/（kg·d） plus perindopril 2 mg/（kg·d） （ig）. Morphometric determination, calcineurin expression and sarcoplasmic reticulum Ca^2＋-ATPase activity were done at the end of 6 week of drug intervention. Expression of calcineurin in myocardium was detected by immunohistochemistry. Results： Left ventricular mass index （LVMI）, transverse diameter of myocardial cell （TDM）, calcineurin activity were remarkably decreased after drug intervention and this decrease was most remarkable in the combination drug therapy group. Sarcoplasmic reticulum Ca^2＋-ATPase activity was increased after drug intervention, especially in the combined drug therapy group. Calcineurin expression in myocardium was remarkably decreased after drug intervention. LVMI was positively correlated with TDM and calcineurin, negatively correlated with sarcoplasmic reticulum Ca^2＋-ATPase. Conclusion： These data suggest that irbesartan and perindopril inhibit cardiac hypertrophy through the increased activity of sarcoplasmic reticulum Ca^2＋-ATPase and decreased expression of calcineurin. Their combination had better effects on regressing of ventricular hypertrophy.

Co-oxidation of arsenic(Ⅲ) and iron(Ⅱ) ions by pressurized oxygen in acidic solutions

The co-oxidation of As(Ⅲ) and Fe(Ⅱ) in acidic solutions by pressured oxygen was studied under an oxygen pressure between 0.5 and 2.0 MPa at a temperature of 150℃. It was confirmed that without Fe(Ⅱ) ions, As(Ⅲ) ions in the solutions are virtually non-oxidizable by pressured oxygen even at a temperature as high as 200℃ and an oxygen pressure up to 2.0 MPa. Fe(Ⅱ) ions in the solutions did have a catalysis effect on the oxidation of As(Ⅲ), possibly attributable to the production of such strong oxidants as hydroxyl free radicals (OH ) and Fe(Ⅳ) in the oxidation process of Fe(Ⅱ). The effects of such factors as the initial molar ratio of Fe(Ⅱ)/As(Ⅲ), initial pH value of the solution, oxygen pressure, and the addition of radical scavengers on the oxidation efficiencies of As(Ⅲ) and Fe(Ⅱ) were studied. It was found that the oxidation of As(Ⅲ) was limited in the co-oxidation process due to the accumulation of the As(Ⅲ) oxidation product, As(Ⅴ), in the solutions.

The effects of long-term low-dose hormone replacement therapy on blood pressure and vasoactive factors in postmenopausal women

Objective:To investigate the effects of long-term low-dose hormone replacement therapy(HRT)on blood pressure,the plasma renin activity(PRA),plasma angiotensin Ⅱ(AngⅡ)leveland serum nitric oxide(NO)concentration in postmenopausal women.Methods:A total of 140 postmenopausal women were selected from the medical staff of thePeking Union Medical College Hospital.Of these,63 subjects who had been treated with low-dose sex hormone for over 5(5-32)years were set up as HRT group,and 77 age-matched sub-jects who had never received HRT were designed as control group.The levels of serum estradiol(E_2),follicle stimulating hormone(FSH)and nitric oxide(NO),the concentration of plasma an-giotensin Ⅱ(AngⅡ),plasma rennin activity(PRA)and the blood pressure were evaluated inthese two groups.Results:The serum level of estradiol in HRT group was significantly higher than that in con-trol group(median,interquartile range;124.0 pmol/L,113.4 vs.78.2 pmol/L,121.8)(P<0.05)and systolic blood pressure in HRT groups was significantly lower than that in control group[(126.7±14.4)mmHg vs.(132.4+19.8)mmHg](P<0.05).Diastolic blood pressure[(79.7±7.9)mmHg vs.(79.6±10.4)mmHg],the serum level of FSH[(54.4±18.9)IU/L vs.(60.4±24.4)IU/L],the plasma level of PRA(median,interquartile range;0.14 pg/L/hr,0.11vs.0.12 pg/L/hr,0.10),AngⅡ(median,interquartile range;46.0,31.1 pg/ml vs.44.4,33.0pg/ml)and serum level of NO(median,interquartile range;63.8 μmol/L,58.9 vs.56.0 μmol/L,94.8)showed no significant difference between HRT and control groups(P>0.05).Conclusions:Long-term low-dose HRT decreased the systolic blood pressure,but showed noeffects on the diastolic blood pressure,plasma level of AngⅡ,PRA,and serum level of NO inpostmenopausal women.

Validation of LPD Scale for the Assessment of Pressure Ulcer at Home

Objectives: This study was designed to test and validate the new LPD scale in a home care setting. The specific objectives are to validate the LPD scale for subjects cared for at home;and to compare LPD to the Braden scale for internal validity. Method: This multicenter, cross-sectional study was conducted in the domestic environment of subjects cared for Home Care services from North to South of Italy. Data collection lasted 8 months, between June 2018 and September 2020, and consisted of the simultaneous compilation of the new LPD, and the Braden scale. Home Care Expert nurses could interface with the recruited subjects and/or caregivers. The parameters considered to validate the new scale were sensitivity (Se), specificity (Sp), positive predictive values (PPV), odds ratio (OR), and the area under the receiver operating characteristic (ROC) curve. Results: Of the 679 recruited subjects, 63.2% were women, and more than 50% did not have a pressure ulcer. 48.2% of the sample aged over 85 years old;69% was affected by multiple disease, and 76.6% took a lot of drugs. 91.6% of the subjects were affected by a partial or total functional dependency. Around 50% of subjects presented double incontinence, and 43% were conscious and collaborated. 85.4% of subjects lived in a healthy environment. The predictive validity parameters showed: Se 77.25%, Sp 84.04%, PPV 91.37%, and the area under the curve (AUC) 0.88% with a confidence interval (CI) 95%. These values mean a moderately accuracy of the test. Conclusions: The new LPD scale has demonstrated a good capacity for identifying the subjects at risk of pressure ulcer and had a better discriminatory power rather than Braden scale.

Evaluation of the versatility of perforators-enhanced rhomboid flap technique for ischial sores reconstruction

Background: Prolonged pressure on the skin known as pressure sores, can cause frequent injuries to the skin and underlying tissues. However, several prevention approaches, including non-surgical and surgical management,are available. In flap surgery for pressure sores, a variety of flap types may be used;each offers certain benefits and some incidences of complications and recurrence. This study evaluated the versatility of the perforatorenhanced rhomboid flap technique for ischial sore construction.Methods: This prospective study was conducted in the Plastic Surgery Department of Fayoum University Hospital.The perforator-enhanced rhomboid flap technique was employed in 20 patients with ischial pressure sores who failed to respond to conservative treatment. A proper history was obtained and a preoperative arterial duplex was performed to determine the site of the prominent perforators for their preservation at the base of the flap.Postoperative follow-ups and evaluations were performed.Results: The mean age of the study group was 43.7 ± 13.1, ranging from 19 to 65 years. Moreover, 80% of the participants were males while 20% were female. The main etiology of the sores was paraplegia in 45% of cases.The mean surface area of sores was 24.8 ± 6.3 cm2. In 75% of cases, the color match of the flap was rated as excellent. Similarly, 70% of the patients rated flap thickness as excellent. In 55% of the cases, the scar appearance was deemed excellent. Overall satisfaction was reported as excellent by 40% of the patients, while only 5% reported poor satisfaction. Approximately, 10% of the cases were identified with seroma, and 30% had wound dehiscence of a mean size of 1.33 ± 0.98 cm and required around 6.8 ± 1.9 weeks to heal.Conclusion: The perforator-enhanced rhomboid flap technique is a versatile method for reconstructing ischial pressure sores owing to its technical ease, short operative time, reliable vascularity, aesthetic outcome, matching skin color, and short recovery time. The main limitations include large defects with large surface areas, lack of a nearby donor site for a rhomboid flap, and scarring from prior procedures around the sore.

应用动态血压监测仪及人体成分分析仪观察氨氯地平贝那普利片(Ⅱ)对原发性高血压患者的疗效

目的 评价动态血压监测仪及人体成分分析仪在氨氯地平贝那普利片(Ⅱ)治疗原发性高血压患者疗效中的作用。方法 110例原发性高血压患者,入组前停用既往所有降压药,洗脱期间,饮食方式不变。2周之后接受氨氯地平贝那普利片(Ⅱ)治疗,监测并比较患者治疗前后动态血压参数(白天、夜间、24 h的收缩压和舒张压)、平滑指数、人体成分[骨骼肌质量、脂肪含量、骨骼肌质量指数(SMI)]。结果 治疗后,白天、夜间、24 h的收缩压分别为(132.58±11.22)、(120.23±12.83)、(126.10±8.11)mm Hg(1 mm Hg=0.133 kPa),均低于治疗前的(148.36±10.42)、(133.11±12.91)、(142.26±10.15)mm Hg,舒张压分别为(75.65±11.96)、(68.31±9.10)、(71.40±8.70)mm Hg,均低于治疗前的(85.03±10.98)、(77.85±10.84)、(83.92±9.89)mm Hg,治疗后的平滑指数(2.00±0.23)高于治疗前的(1.21±0.26),差异具有统计学意义(P<0.01)。患者治疗后的骨骼肌质量(35.75±6.84)kg、SMI(8.38±0.51)kg/m2均高于治疗前的(25.15±6.58)kg、(7.95±0.44)kg/m2,脂肪含量(18.83±4.15)kg低于治疗前的(23.12±4.51)kg,差异具有统计学意义(P<0.01)。结论 氨氯地平贝那普利片(Ⅱ)能有效平稳地降低原发性高血压患者的动态血压,且增加骨骼肌质量、降低脂肪含量,优化人体成分,值得临床推广。

基于改进NSGA-Ⅱ算法的RV减速器参数多目标优化研究

旋转矢量(RV)减速器是工业机器人核心部件,对于机器人的性能起到关键作用。针对提升RV减速器综合性能的问题,从优化传动压力角的相关参数出发,对其结构参数(摆线轮齿数、短幅系数、针径系数、摆线轮宽度等)的多目标优化设计进行了研究。首先,研究了摆线轮平均压力角、传动效率和传动机构体积三者的相关参数之间的关系;然后,以此为优化目标,在摆线轮标准齿廓方程的基础上建立了多目标优化数学模型(该模型采用了基于非支配占优排序遗传学算法(NSGA-Ⅱ)改进了交叉算子系数生成的改进NSGA-Ⅱ算法);通过模型求解得到了帕累托最优解集,根据模糊集合理论的相关方法选取了最优解;最后,以某公司220-BX型RV减速器为例,进行了优化设计,建立了3D模型后进行了有限元分析,并加工出实验样机,进行了传动效率对比实验。实验结果表明:摆线轮平均压力角减小了7.19%,体积减小了11.1%,传动效率提高了4.9%。研究结果表明:该模型交互性强,能提高设计效率并节省设计开销,可为实际RV减速器工程优化设计提供参考。

多磺酸粘多糖乳膏联合京万红软膏治疗Ⅰ、Ⅱ期压疮的效果观察

目的探讨多磺酸粘多糖乳膏联合京万红软膏在治疗Ⅰ、Ⅱ期压疮的效果。方法选择2022年4月至2023年9月在本院骨科收治的带入Ⅰ、Ⅱ期压疮患者60例参与研究,按照随机数字表法分为试验组与对照组,每组30例,对照组使用传统换药治疗,试验组采用多磺酸粘多糖乳膏联合京万红软膏治疗。对比两组治疗后的临床疗效、临床指标、治疗舒适度、治疗前后创面恢复及生活质量的差异性。结果对照组治疗有效率为63.33%(19/30),试验组的治疗有效率为86.67%(26/30),试验组的治疗有效率高于对照组,差异具有统计意义(P<0.05);试验组在水泡吸收时间、创面结痂时间、压疮愈合时间、换药次数均低于对照组,差异具有统计意义(P<0.05);对照组治疗舒适度为66.67%(20/30),试验组的治疗舒适度为90.00%(27/30),试验组的治疗舒适度高于对照组(P<0.05);两组在治疗前,PUSH评分和WHOQOL—Bref评分差异无统计学意义(P>0.05);治疗后,两组PUSH评分均比治疗前有所降低,WHOQOL—Bref评分有所升高,且试验组PUSH评分低于对照组,WHOQOL—Bref评分高于对照组(P<0.05)。结论多磺酸粘多糖乳膏联合京万红软膏治疗Ⅰ、Ⅱ期压疮中发挥良好的功效,能提高临床的治疗效果,促进伤口愈合,提高患者治疗的舒适感和生活质量。

基于NSGA-Ⅱ的盾构机土压力自动控制技术研究

针对传统盾构机土压力控制方法存在的不足,提出一种基于非支配排序遗传算法Ⅱ(Non-dominated Sorting Genetic AlgorithmsⅡ,NSGA-Ⅱ)的多目标优化控制策略。该策略综合考虑了土压力跟踪性能、刀盘扭矩波动等多个目标,通过自适应遗传算法实现了参数的在线优化,同时集成了智能感知、实时调控等功能模块,构建了一个高度智能化的自动控制系统。仿真实验结果表明,所提出的控制策略能够有效提高土压力控制精度、抑制扭矩波动等,为实现盾构施工智能化提供了新的解决方案。

活力碘治疗Ⅱ期压疮的效果观察

目的探讨活力碘治疗Ⅱ期压疮的效果。方法2007年1月-2009年2月对28例(37处)Ⅱ期压疮患者随机分为两组,观察组给予涂擦活力碘,每2h涂1次,对照组给予涂抹湿润烧伤膏,每天2次,观察两组患者治疗第5d、第7d的治疗效果。结果活力碘治疗Ⅱ期压疮效果优于湿润烧伤膏,两组比较,P<0.001,差异具有统计学意义。结论活力碘治疗Ⅱ期压疮比湿润烧伤膏治疗效果好,值得临床推广应用。

黄连膏配合艾条灸治疗Ⅱ期前压疮的临床疗效观察

目的观察黄连膏外敷配合艾条灸熏烤治疗可疑深部组织损伤、Ⅰ期、Ⅱ期压疮的疗效。方法选取2011年11月-2012年4月入院的可疑深部组织损伤、Ⅰ期、Ⅱ期压疮患者35例(共计42处),随机分为治疗组和对照组,对照组采用每日基础护理支持,治疗组在基础护理之外,每日实施艾灸熏烤10～15 min,行雀啄灸,并每日黄连膏涂抹患处。从压疮大小、创面情况、24 h渗液量、周边皮肤的情况四个方面进行评价和观察。通过对患者初始压疮情况进行评分,治疗10 d后再进行评分,然后对两组两次分数的差值进行比较。结果两组压疮大小、创面情况、周边皮肤的情况比较,差异有统计学意义(P<0.05)。两组24 h渗液量比较,差异无统计学意义(P>0.05)。治疗组总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论采用黄连膏配合艾条灸治疗可疑深部组织损伤、Ⅰ期、Ⅱ期压疮效果明显,值得推广。

贝复济联合泡沫敷料治疗Ⅱ～Ⅲ期压疮临床疗效观察

目的探讨贝复济联合泡沫敷料用于治疗Ⅱ、Ⅲ期压疮的疗效及护理要点。方法将90例患者分别采用硬币法分成治疗1组、治疗2组与对照组。3组都用生理盐水冲洗创面;治疗1组用生理盐水冲洗创面后,用贝复济喷剂喷于创面,再用康惠尔泡沫敷料覆盖创面;治疗2组用生理盐水冲洗创面后,先用贝复济喷创伤面,再在创面上盖上无菌纱布;对照组用生理盐水冲洗后,用康惠尔泡沫敷料覆盖创面。结果治疗组治愈率和总有效率高于对照组及观察组,而在治愈时间比较上,治疗组明显优于对照组及观察组。结论贝复济联合泡沫敷料能提高压疮治愈率,缩短愈合时间。

针刺仿真手法对高血压大鼠血压及心肌血管紧张素Ⅱ的影响

目的:通过针刺手法仿真系统,以不同刺激量参数的捻转手法刺激自发性高血压大鼠(SHR),比较其降压效应及对心肌血管紧张素(Ang)Ⅱ含量的影响,为针灸治疗高血压临床研究探索最佳针刺刺激参数,同时为针刺手法量化和规范化研究提供思路。方法:33只SHR随机分为轻刺激组(n=8)、中刺激组(n=8)、重刺激组(n=8)、模型组(n=9),另设8只正常动物组。采用PowerLab无创尾动脉血压测定分析系统对大鼠进行血压测定,并应用放射免疫法检测各组大鼠心肌组织AngⅡ含量的变化。轻、中、重3种刺激参数旋转角度和频率分别为:144°、75次/min,255°、111次/min,360°、140次/min。结果:轻刺激量捻转手法与中刺激量捻转手法均有显著抑制血压上升的作用(P<0.01),而重刺激量捻转手法抑制血压上升的效果不明显(P>0.05),SHR模型组的血压3周后显著升高(P<0.01)。同时发现,各治疗组大鼠心肌组织中的AngⅡ水平仍高于正常组(P<0.05),与模型组的差异无显著性意义(P>0.05)。结论:不同量化参数的捻转手法的针刺效应具有差异性,针刺治疗的效果与手法参数的量化有密切的关系;本研究同时提示针刺治疗高血压可能与AngⅡ无明显相关性,其机制有待于进一步研究。

马应龙痔疮软膏治疗中风病后Ⅰ、Ⅱ期压疮的临床观察

目的探讨马应龙痔疮软膏治疗中风病后Ⅰ、Ⅱ期压疮的临床疗效。方法选取2013年3月—2018年2月期间北京中医药大学东直门医院脑病科收治的中风病后Ⅰ、Ⅱ期压疮患者84例,根据随机数字表法分为干预组与对照组,每组各42例。干预组消毒或清创后予马应龙痔疮软膏治疗,对照组予利凡诺治疗。两组患者均连续治疗14 d后,以临床疗效中治愈率为主要疗效指标,以压疮愈合评价量表(Pressure ulcer scale for healing,PUSH)、压疮愈合时间和治疗满意度为次要疗效指标评价治疗前后两组患者的疗效及满意度。结果治疗后干预组治愈率为77.78%,对照组治愈率为52.83%,干预组优于对照组,两组比较,差异有统计学意义(P<0.05)。治疗后两组中风后压疮患者PUSH量表评分均较治疗前明显降低,差异有统计学意义(P<0.01);且干预组治疗后PUSH量表评分明显低于对照组,两组比较,差异有统计学意义(P<0.01)。治疗后干预组压疮创面愈合时间优于对照组,两组比较,差异有统计学意义(P<0.01)。治疗后干预组满意率为97.62%,对照组满意率88.10%,干预组满意度明显高于对照组,两组比较,差异有统计学意义(P<0.01)。结论马应龙痔疮软膏在治疗中风后Ⅰ、Ⅱ期压疮的疗效确切,患者依从性与满意度良好,适宜临床推广应用。