大张中厚头皮移植修复创伤性肉芽面的临床观察

创伤广泛性肉芽面，一般采用从大腿等部取中厚或簿皮移植修复，供皮区约需２～３周基本愈合，并留有取皮痕迹，相当部分病人有严重的疤痕增生；取皮较深或并发感染时，愈合期更长〔１〕。本文采用大张中厚头皮移植修复此种创伤，可完全避免上述缺点，并兼具诸多优点，取得...

湿润生肌膏对肛瘘术后创面肉芽组织中bFGF、TGF-β1细胞生长因子表达及肉芽生长情况的临床观察

目的：分析湿润生肌膏对肛瘘术后创面肉芽组织中b FGF、TGF-β1细胞生长因子表达及肉芽生长情况。方法：90例单纯性肛瘘患者,按数字法随机分为对照组和观察组,观察组用湿润生肌油纱,对照组用龙珠软膏制成的纱条。观察患者创面完全上皮化的天数,记录患者创面愈合天数;观察患者的治疗后7、14、21 d的肉芽组织生长情况、创面愈合率及不良反应情况。结果：治疗前,两组患者血清中b FGF和TGF-β1含量无明显差别;治疗后,血清中b FGF和TGF-β1含量明显升高,但观察组b FGF（30.28±3.16）、TGF-β1（0.94±0.15）明显高于对照组b FGF（26.74±2.93）、TGF-β1（0.81±0.17）（P〈0.05）。治疗后,观察组分泌物p H值（8.43±0.73）、分泌物浸透纱布总数（16.82±2.65）、愈合时间（25.28±5.24）及VAS评分（4.95±1.62）明显优于对照组分泌物p H值（6.24±0.69）、分泌物浸透纱布总数（27.81±2.85）、愈合时间（33.65±5.87）及VAS评分（7.18±1.43）（P〈0.05）。患者治疗7、14、21 d后,创面肉芽组织生长情况及创面愈合率均逐渐好转;但7、14、21 d相同的时间点,观察组的创面肉芽组织生长情况及创面愈合率明显优于对照组（P〈0.05）。观察组的二次感染率6.67%（3/45）明显高于对照组的二次感染率15.56%（7/45）（P〈0.05）。结论：湿润生肌膏辅助肛瘘患者的术后治疗,可提高血清中b FGF及TGF-β1的表达量,缩短创面愈合时间,减轻患者疼痛,为肛瘘患者的用药提供临床参考。

SPIROCHETES—— THE POSSIBLE ETIOLOGICAL FACTOR OF THE CHEILITIS GRANULOMATOSA

To detect spirochetes in sections and to study the therapeutic effect of penicillin in cheilitis granulomatosa (CG) and Melkersson- Rosenthal syndrome (MRS) and the relationship between the spirochetes infection and CG and MRS. Methods. Routine HE sections and Warthin- Starry special staining were carried out in 20 cases of CG and 6 cases of MRS. Meanwhile there were 9 cases of CG and 2 cases of MRS were treated by penicillin (12 000 000u,IV, per day) for two courses (14 days). Results. A kind of spirochete was discovered in the sections of all cases of the CG and MRS .The CG and MRS could be divided into two types histopathologically, that is granuloma type and interstitial inflammatory type (non- granuloma type), those morphological changes tallied with spirochetosis. After treatment by penicillin, the facial and labial swelling of the 11 cases of CG and MRS were abated. Conclusion. CG and MRS probably are infectious diseases caused by spirochetes.