In-situ electrochemical study on the eff ects of Fe(Ⅲ)on kinetics of pyrite acidic pressure oxidation

Fe(Ⅲ)has been proved to be a more eff ective oxidant than dissolved oxygen at ambient temperature,however,the role of Fe(Ⅲ)in pyrite acidic pressure oxidation was rarely discussed so far.In this paper,in-situ electrochemical investigation was performed using a flow-through autoclave system in acidic pressure oxidation environment.The results illustrated that increasing Fe(Ⅲ)concentrations led to raising in redox potential of the solution,and decreased passivation of pyrite caused by deposition of elemental sulfur.Reduction of Fe(Ⅲ)at pyrite surface was a fast reaction with low activation energy,it was only slightly promoted by rising temperatures.While,the oxidation rate of pyrite at all investigated Fe(Ⅲ)concentrations increased obviously with rising temperatures,the anodic reaction was the rate-limiting step in the overall reaction.Activation energy of pyrite oxidation decreased from 47.74 to 28.79 kJ/mol when Fe(Ⅲ)concentration was increased from 0.05 to 0.50 g/L,showing that the reaction kinetics were limited by the rate of electrochemical reaction at low Fe(Ⅲ)concentrations,while,it gradually turned to be diffusion control with increasing Fe(Ⅲ)concentrations.

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.

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.

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.

马应龙麝香痔疮膏对老年Ⅱ~Ⅲ期压疮患者炎症反应及创面愈合情况的影响

目的探讨马应龙麝香痔疮膏对老年Ⅱ~Ⅲ期压疮患者炎症反应及创面愈合情况的影响。方法按随机数字表法分配原则将2020年1月—2022年6月医院收治的68例老年Ⅱ~Ⅲ期压疮患者分为对照组(34例)和治疗组(34例)。两组均进行常规消毒清创,对照组在常规消毒清创基础上给予利凡诺创伤膏纱条外敷,治疗组在常规消毒清创基础上给予马应龙麝香痔疮膏纱条外敷,两组均连续治疗2周。比较两组治疗2周后的疗效,临床症状改善情况,治疗前、治疗2周后的创面愈合情况、疼痛程度、炎症指标及血管内皮功能指标。结果与对照组比较,治疗组治疗2周后的总有效率较高[85.29%(29/34)vs 55.88%(19/34),P<0.05]。与对照组比较,治疗组渗液消失时间、新生肉芽组织生长时间及压疮愈合时间均较短(P<0.05)。与治疗前比较,治疗2周后,两组创面面积、创面组织类型、渗液量、视觉模拟评分法(visual analogue scale,VAS)评分及血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1β(interleukin-1β,IL-1β)、C反应蛋白(C-reactive protein,CRP)水平均降低,治疗组低于对照组(P<0.05);两组血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)、表皮细胞生长因子(epidermal growth factor,EGF)水平均升高,治疗组高于对照组(P<0.05)。结论马应龙麝香痔疮膏可明显减轻老年Ⅱ~Ⅲ期压疮患者炎症反应,改善血管内皮功能,缓解创面疼痛,进而有助于改善患者临床症状,促进创面愈合,疗效显著。

Pressure from the lips and the tongue in children with class III malocclusion

Objective： To discuss possible relationships between class In malocclusion and perioral forces by measuring the pressure from the lips and the tongue of children with class nI malocclusion. Methods： Thirty-one children with class In malocclusion were investigated and their perioral forces were measured at rest and during swallowing under natural head position by a custom-made miniperioral force computer measuring system. Results： The resting pressures exerted on the labial side and palatine side of the upper lett incisor, as well as the labial side and lingual side of the lower lett incisor, were 0 g/cm^2, 0 g/cm^2, 0.57 g/cm^2 and 0.23 g/cm^2, respectively. Correspondingly, the swallowing forces were 2.87 g/cm^2, 5.97 g/cm^2, 4.09 g/cm^2 and 7.89 g/cm^2, respectively. No statistical difference between muscular pressure and gender existed. During swallowing, the lingual forces were significantly higher than the labial forces （P〈0.01）, however, at rest there was no significantly different force between these two sides. Compared to the normal occlusion patients, children with class Ⅲ malocclusion had lower pedoral forces. The upper labial resting forces （P〈0.01）, the lower labial resting forces （P〈0.05） and all the swallowing pressures from the lips and the tongue （P〈0.01） showed statistical differences between the two different occlusion conditions. Meanwhile, no significant difference was found for the resting pressure from the tongue between class Ⅲ malocclusion and normal occlusion. Conclusion： Patients with class Ⅲ malocclusion have lower perioral forces and this muscle hypofunction may be secondary to the spatial relations of the jaws. The findings support the spatial matrix hypothesis.

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.

记忆海绵垫对神经外科手术患者压疮预防的效果研究

目的探讨记忆海绵垫在神经外科手术患者压疮预防中的效果,为临床应用提供依据。方法将2022年6月1日至2023年12月30日在我院实施神经外科手术治疗的100例患者纳入临床研究,基于随机乱数表法分成研究组和对照组,均为50例;两组均实施系统围手术期护理,在术中研究组应用记忆海绵垫,对照组应用普通海绵垫。观察并记录两组术后压疮发生率,掌握受压部位疼痛发生情况,评估两组术后舒适度和患者护理总满意度。结果研究组术后当天、术后3 d压疮发生率均低于对照组(均P<0.05)。手术后,研究组的肩颈痛、腰背疼痛以及肢体麻木部位的发生率均低于对照组(均P<0.05)。术后3 d评测,研究组的生理、心理精神、社会文化、环境状态及总评分等舒适度评分,护理总满意度均高于对照组(均P<0.05)。结论在神经外科手术中应用记忆海绵垫,可有效预防和减少压疮发生,改善患者舒适度,提高护理满意度。

敛疮膏治疗热毒壅滞型褥疮验案评析

文章列举自拟敛疮膏治疗热毒壅滞型褥疮验案两则,阐述热毒炽盛、气血壅滞是褥疮形成的重要病理变化。自拟敛疮膏方能清热凉血、解毒化瘀、敛疮生肌,是治疗热毒壅滞型褥疮的良方,其治疗热毒壅滞型褥疮的脉证特点为口干、发热、局部红肿热痛、皮肤破溃、舌红苔少或苔黄、脉数或滑。文章详述自拟敛疮膏治疗热毒壅滞型褥疮的内在机制并附验案两则,供同仁参考。同时,着重讨论了大黄在该方中的应用,提出大黄外用能清热解毒、活血通经、调和气血,药力平和而非寒凉过度,可以解毒、活血而不留瘀,即使是治疗高龄、体虚老人,只要用之合宜,亦能取得良效。

腹腔镜结直肠手术中气管导管套囊压力控制对术中血流动力学及术后咽喉痛的影响

目的:探讨腹腔镜结直肠手术中气管导管套囊压力控制对术中血流动力学及术后咽喉痛的影响。方法:选择行腹腔镜结直肠癌根治手术的患者94例。采用随机数字表将患者随机分为H组(导管套囊压力控制组,n=48)和L组(指感法组,n=46)。H组患者套囊压力控制在25~30 cmH2O,L组患者仅监测套囊压力。所有患者监测并记录麻醉诱导前(T0)、气管插管后(T1)、建立气腹前(T2)、建立气腹后(T3)、头低足高位后(T4)、气管拔管前(T5)、气管拔管后(T6)时间点的心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP),以及T1~T5时间点的套囊压力和气道压力。同时调查患者术后2 h、12 h及24 h的咽痛、声嘶情况。结果:L组的HR、MAP、套囊压力在T1~T5均明显高于H组(P<0.05)。两组患者T3时的气道压力均明显上升(P<0.05),T4时均进一步升高(P<0.05),但两组间差异无统计学意义。H组术后2 h、12 h咽痛发生率低于L组(P<0.05)。两组患者术后声嘶发生率及严重程度差异无统计学意义(P>0.05)。结论:腹腔镜手术中,控制气管导管套囊压力可以降低术后咽痛的发生率,并保持术中血流动力学的相对稳定。

两种评分系统评估急性脑梗死患者卧床期间压疮发生的研究

目的对比Braden量表、急性生理与慢性健康评分-Ⅱ(APACHE-Ⅱ)评估急性脑梗死患者卧床期间压疮风险的价值。方法选取70例急性脑梗死患者,患者清醒时,采用Braden量表、APACHE-Ⅱ量表评估患者卧床期间压疮发生风险,统计患者的一般资料和压疮发生情况,对比上述两种量表评估急性脑梗死患者压疮发生价值。结果70例急性脑梗死卧床期间发生压疮13例,占比18.57%,未发生压疮57例,占比81.43%;发生组Braden评分低于未发生组,APACHE-Ⅱ评分高于未发生组(P<0.05);绘制ROC曲线图结果显示,Braden量表和APACHE-Ⅱ量表评估急性脑梗死患者卧床期间压疮发生风险的AUC分别为0.814、0.832,评估价值较理想,且APACHE-Ⅱ量表的AUC大于Braden量表。结论相较于Braden量表,在急性脑梗死患者中应用APACHE-Ⅱ评估卧床期间压疮风险的价值更高。

吹氧联合疮面换药治疗Ⅲ期压疮的临床分析

目的观察吹氧联合疮面换药治疗Ⅲ期压疮的疗效。方法选择Ⅲ期压疮病人72例,随机分为观察组(37例)和对照组(35例),观察组用吹氧联合清创胶、减压贴换药;对照组不吹氧,其它步骤同观察组,观察两组疮面3 d显效率及压疮愈合时间。结果观察组和对照组3 d显效为78.04%和52.63%(P=0.000);平均愈合时间为12.89 d和20.21 d(P=0.045),差异有显著意义。结论吹氧联合疮面换药是治疗Ⅲ期压疮病人的有效方法。

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。

红光照射联合湿敷护理治疗慢性阻塞性肺疾病并Ⅲ期压疮的疗效观察

评价红光照射联合药物湿敷护理治疗慢性阻塞性肺疾病(COPD)并Ⅲ期压疮的临床疗效。将66例COPD并Ⅲ期压疮患者分为对照组和观察组,各33例。对照组采用传统方法治疗,观察组采取红光照射联合药物湿敷护理治疗,观察两组VAS疼痛评分情况、压疮的治愈时间及治疗效果。观察组患者VAS评分低于对照组,观察组总有效率显著高于对照组,观察组患者压疮愈合时间为(17.31±1.35)d明显短于对照组的(26.21±2.13)d,差异均有统计学意义(P<0.05,P<0.01,P<0.01))。红光照射联合药物湿敷护理治疗能有效促进COPD并Ⅲ期压疮创面的愈合,缩短其治愈时间,是Ⅲ期压疮的有效治疗方法。

重组人表皮生长因子凝胶在Ⅲ期压疮护理中的应用研究

目的观察重组人表皮生长因子(recombinant human epidermal growth factor,rhEGF)凝胶在Ⅲ期压疮护理中的疗效。方法 38例Ⅲ期压疮入院患者随机分为治疗组和对照组。治疗组以rhEGF凝胶均匀涂布于创面;对照组仅以3%过氧化氢液冲洗。观察两组创面愈合率、组织学改变、创面羟脯氨酸(HYP)含量及Ⅰ型/Ⅲ型胶原比例。结果治疗组的创面愈合速度较对照组明显加快,其Ⅲ期压疮平均愈合时间为(10±2.5)d,对照组为(35±8.7)d(P<0.01)。在治疗后第3、6、9天,治疗组可见创面肉芽组织灶明显增生,富含血管及细胞,同时创面中HYP含量增加,Ⅰ型/Ⅲ型胶原比例降低(P<0.01)。结论 rhEGF治疗Ⅲ期压疮可以缩短创面愈合时间,增加肉芽组织及HYP含量,降低Ⅰ/Ⅲ型胶原比例,明显促进压疮创面的修复。

骶尾部Ⅲ期、Ⅳ期压疮的围手术期护理

目的:通过对骶尾部Ⅲ期、Ⅳ期压疮患者进行围手术期的护理,促进患者术后康复,提高术后满意度。方法:对42例并发骶尾部Ⅲ期、Ⅳ期压疮患者从全身支持治疗、心理护理、术区准备、术后对皮瓣和全身情况的观察、术后体位护理等方面总结围手术期护理对提高皮瓣成活率,减少术后并发症的重要性。结果:42例患者骶尾部皮瓣全部成活,术后恢复良好,出院随访均6个月以上,无复发。结论:加强术前全身支持治疗和护理,做好患者、家属的心理护理,做好术区准备,术后伤口连续灌洗与负压吸引,对皮瓣和全身情况的密切观察,术后合理应用翻身床是骶尾部Ⅲ期、Ⅳ期压疮患者围手术期护理的关键。

重组人表皮生长因子用于大鼠Ⅲ期压疮模型的实验研究

[目的]观察重组人表皮生长因子(rhEGF)用于治疗大鼠Ⅲ期压疮溃疡创面的疗效。[方法]采用SD大鼠制备Ⅲ期压疮动物模型,实验组16只用rhEGF喷洒创面,对照组16只用生理盐水溶液湿敷创面,治疗后的第3天、第7天、第10天、第14天取创伤组织制成组织切片,观察其病理学变化;动态观察rhEGF和生理盐水对溃疡愈合时间及愈合率的影响。[结果]两组溃疡创面愈合时间及动态愈合率比较差异有统计学意义(P<0.05)。[结论]重组人表皮生长因子可以促进大鼠Ⅲ期压疮溃疡创面的愈合。

安普贴在Ⅲ期压疮治疗中的应用

[目的]观察新型敷料安普贴在Ⅲ期压疮治疗中的疗效。[方法]将15例43处Ⅲ期压疮病人随机分为2组;安普贴组8例23处压疮,对照组7例20处压疮。安普贴组按常规清创消毒后创面贴安普贴,伤口根据情况1d或7d换药1次;对照组按常规清创消毒后创面盖上无菌纱块,根据伤口情况1d^2d换药1次。14d后对2组病人的压疮进行疗效观察。[结果]本实验安普贴组治愈率达100%,对照组治愈率达65%。[结论]安普贴治疗Ⅲ期压疮优于传统方法。

复合疗法治疗Ⅲ期压疮的疗效观察

目的探讨"复合疗法"治疗Ⅲ期压疮的临床效果。方法选取2010年1月至2014年10月冀中能源邢台矿业集团有限责任公司总医院收治的62例Ⅲ期压疮患者,按随机数字表法将患者分为观察组和对照组,各31例。两组在治疗进展中均加进行基础干预的加强。对照组采用常规换药措施,观察组在此基础上采用"复合疗法"(氧疗+药物+自制水袋)治疗创面。比较两组治疗效果。结果观察组痊愈24例,显效6例,无效1例;对照组痊愈15例,显效9例,无效7例;观察组疗效优于对照组(P<0.05)。观察组感染控制时间,形成肉芽组织所需时间显著短于对照组[(3.7±1.1)d比(7.1±0.9)d,(4.5±1.1)d比(11.9±2.7)d],差异有统计学意义(P<0.01),观察组创面水肿消退时间、创面恢复时间显著短于对照组,换药次数显著低于对照组[(3.1±0.2)d比(5.3±0.3)d,(9.4±0.4)d比(13.1±0.3)d,(6.8±0.6)次比(11.7±0.5)次],差异有统计学意义(P<0.01)。结论在常规压疮的干预措施基础上使用复合疗法治疗Ⅲ期压疮,可以对创面的恢复起到很好的促进作用,并且使患者创面的恢复时间大大地减少。

局部注射胰岛素联合湿性敷料对糖尿病患者Ⅲ期压疮治疗的影响

目的：探讨胰岛素局部注射联合湿性敷料对糖尿病患者Ⅲ期压疮疗效的影响。方法：将入院时有Ⅲ期压疮的32例糖尿病患者随机均分为观察组和对照组，对照组在常规护理和饮食控制基础上，压疮部位仅给予湿性敷料换药；观察组在常规护理和饮食控制的基础上压疮部位给予胰岛素局部注射联合湿性敷料应用。连续观察21 d后比较2组的临床疗效。结果：观察组压疮愈合时间较对照组明显缩短（P〈0.01），不同时间段压疮创面愈合率均优于对照组（P〈0.05~P〈0.01）；压疮局部行胰岛素注射治疗对糖尿病患者全身血糖无明显影响。结论：胰岛素局部注射联合湿性敷料治疗糖尿病患者压疮可缩短创面愈合时间，且经济安全无不良反应。