Diagnosis and treatment of painful leg ulcers / 中华皮肤科杂志

Painful leg ulcers are very common in clinic,including arterial ulcers,venous ulcers,autoimmune diseases-related ulcers,gangrenous pyoderma,necrobiosis lipoidica and hypertensive ulcers.At present,few painful leg ulcer-related researches have been conducted in China,and pain is only treated as a concomitant symptom of leg ulcers.However,a series of painful leg ulcer-related researches have been carried out in other countries.This review comprehensively expounds the definition,epidemiological characteristics,etiology and management of,as well as pain mechanism and assessment in painful leg ulcers.

Effect Observation and Preliminery Mechanism Exploration of Shengji Corium Elephatis Mastic in Treating Chronic Refractory Skin Ulcer / 中国中医药信息杂志

Objective To observe the effect of Shengji corium elephatis mastic in treating chronic refractory skin ulcer, and analyze its preliminary mechanism. Methods Totally 62 patients with chronic refractory skin ulcer in granulation stage were randomly divided into two groups, 32 cases of treatment group were treated with Shengji corium elephatis mastic, and 30 cases of control group were treated with Vaseline gauze. All patients were treated for 4 weeks. The rate of wound healing, wound reduction ratio and wound secretion level of VEGF were observed. Results The cure rate and the total effective rate between the two groups had significant difference (P<0.05). After 2 weeks treatment, the mean wound reduction area of treatment group and control group was 82.31%and 66.32%respectively. After 4 weeks treatment, the mean wound reduction area of treatment group and control group was 90.35%and 78.7%respectively, the difference was statistically significant (P<0.05). After 1, 2 and 3 weeks treatment, the treatment group had significant difference with the control group in wound secretion VEGF level (P<0.05). Conclusion Shengji corium elephatis mastic can promote wound healing of chronic refractory skin ulcer. The possible mechanism is that Shengji corium elephatis mastic promotes the generation of VEGF in wound thus promotes wound repair.

Decompression via posterior-anterior approach and anterior fixation in treatment of fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation / 中华骨科杂志

Objective To evaluate the surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation. Methods This study retrospectively reviewed 37 cases of lower cervical spine fracture with bilateral joints dislocation. There were 21 males and 16 females with an average age of 42 years (19-58). Distraction-flexion stage 3(DFS 3) were found in 24 cases and DFS 4 in 13 cases. All the cases were diagnosed by X-ray, CT and MRI and confirmed during the surgery. Decompression via posterior-anterior approach and anterior fixation had been adapted as the surgical strategy. The NASCIS and IMSOP standard were applied to definite the level of cervical spinal cord injury. The ASIA grading was used for evaluation the spinal cord function and the recovery rate. The X-ray and CT were used to observe reduction and bone fusion. Results The mean operative time was (4.5:±0.5) h, and the mean amount of blood loss was 360 ml (200-500 ml). All the incision healed. The two segments fixation was used in 23 cases, 3 segments fixation in 13 cases, and 4 segments fixation in 1 case. The mean follow-up period was 32 months (16-45 months).Postoperative X-ray and CT showed that bone fusion was achieved in all patients within 4-8 months, without graft displacement, or failure of implants. Spinal cord function did not aggravate, and sensory recovery ranged from 7 to 20 levels (averaged, 12.7). The ASIA grade were improved with an average of one grade. Conclusion To treat fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation, the posterlor-anterior approach and anterior fixation/fusion was benefit to preservation the cervical spinal cord function and reconstruction biomechanical stability of the cervical spine.

Fibroblast seeded on the thoroughly acellular human amniotic membrane with three-dimensional adhesion in vitro / 中华骨科杂志

Objective Three-dimension (3D) cell matrix adhesion in vivo is fundamentally important for a wide variety of cellular physiological and pathological phenomena, however, the cell-matrix 3D adhesion is hardly observed in vitro. We present the human foreskin fibroblasts (HFF) formed 3D adhesion complexes on the thoroughly acellular human amniotic matrix (TAHAM). Methods TAHAM were produced by suspending digestion with trypsin. The HFF were seeded on 6 well plate, matrigel and TAHAM individually.The light microscope, scanning electronic microscope, immunohistochemistry and immunofluorescence were used to observe the micro-structures and detect the type Ⅰ , Ⅲ, Ⅳ, Ⅵ collagen, laminin, fibronectin, TGF-β1, TGF-β2, FGF of the TAHAM. Phase contrast microscope was engaged to observe the morphology of HFF. The time-lapse CCD and the trace analysis software were employed to prescribe the cell migration. The 3D adhesion foci were identified by the laser confocal microscope. The strain of the TAHAM was tested by the universal mechanical testing instrument. Results The fibers of the TAHAM were intact, type Ⅰ , Ⅲ,Ⅳ, Ⅵ collagen, laminin, fibronectin were positive, TGF-β1, TGF-β2, FGF were negative. HFF had a bipolar extension to form multilayer cell clusters networks and grew into the matrix. All of the seeded cells survived three weeks under regular culture without transfer. On TAHAM, HFF moved in a straight line with a speed of 12 μm/h. α5 integrin (green), paxillin (red) and fibronectin (blue) co localized to form 3D adhesion complexes (white). Conclusion The main molecular components and biomechanical properties is preserved in TAHAM. HFF forms 3D adhesion complexes on TAHAM. Cell morphology and migration of HFF on TAHAM correspond to that under 3D adhesion behavior.

Survey of the knowledge about metabolic syndrome and their demand situation in community / 中国实用护理杂志

Objective To investigate the status of the knowledge of metabolic syndrome and their demand situation among community nurses and discuss the community nursing intervention on metabolic syndrome. Methods A survey about the knowledge and its needs of metabolic syndrome was conducted in community nurses of the practice bases of the nursing school of Zhejiang Traditional Chinese Medical University by selfdesigned questionnaires. Results 58.8% of the communities had carried out the prevention of metabolic syndrome, and standard administration had been applied in 43.3% among them. 40.8% and 42.9% nurses were not clear about the diagnosis and prevention of metabolic syndrome respectively. 100.0% nurses agreed that corresponding training was necessary for them. Conclusions The education and training of the knowledge about metabolic syndrome must be enhanced for community nurses, and the intervention measures should be reinforced to improve the rate of diagnosis , cognition rate, control rate in order to improve the people's health and reduce the social and personal burden.