摘要:目的:慢性难愈合创面是临床中常见的病种之一,但在治疗上缺乏有效的手段干预,越来越多的研究将慢性难愈合创面的治疗靶向转变为促进创面血管新生,探究MEBT/MEBO在促进血管新生过程的作用机制,为临床推广和应用MEBT/MEBO治疗慢性难愈合创面提供理论依据和参考价值;方法:应用付小兵及沈道修相结合的造模方法,分组为空白组、急性创面组、慢性难愈合创面组、贝复济组、MEBT/MEBO组,采用Image J软件、Western Blot、RT-PCR等方法,从宏观到微观观察PTEN-Akt-VEGF信号通路在各组中的动态变化;结果:MEBT/MEBO能够通过调控PTEN-Akt-VEGF信号通路,促进VEGF表达及其mRNA的转录,促进创面血管新生,提高创面愈合率。结论:(1)血管新生是创面修复的一个重要过程,上调VEGF的表达可加速血管新生,并以此促进创面愈合;(2)MEBT/MEBO在慢性难愈合创面的治疗中是安全、高效的治疗手段,可通过调控PTEN-Akt-VEGF信号通路,促进创面血管新生,达到创面愈合的效果。
摘要:烧伤湿性医疗技术(MEBT/MEBO)现已形成了较为系统的皮肤原位再生学术体系,由于PBL教学法强调培养学生分析问题和解决问题的能力,强调基础学科与临床医学的密切联系,通过尝试在七年制医学生外科学临床教学中引入PBL(Problem-based learning teaching method)教学法,以期达到提高学生的临床综合分析能力和临床操作技能之目的。作者从MEBT/MEBO教学目标、问题的设计及小组讨论方案各方面提出了具体需要解决的问题,对PBL应用于MEBT/MEBO教学就必要性、优越性、缺陷性及存在的问题等方面进行思考和分析,并提出了其发展展望。
摘要:Background The efficacy of pulsed dye laser combined (PDL) and UltraPulse fractional CO2 in treatment of hypertrophic scars is well documented. The present study investigates the efficacy of moist exposed burn ointment (MEBO)/moist exposed burn therapy (MEBT) in postlaser wound management. Methods Sixty-one patients with immature, red hypertrophic scars were enrolled in this clinical trial. Patients were randomly divided into two groups: (a) the MEBO treatment group (n = 30) and (b) the control group (n = 31) treated with chlortetracycline hydrochloride ointment. Demographic data such as age, gender, and cause of scars were recorded. A visual analogue score (VAS) was collected to measure pain at 1, 6, 24, 72 hours, and 7 days post-treatment. The Vancouver Scar Scale (VSS) was used to determine the response of the scars before and 3 months after the treatment. The wound healing time and pigmentation scores were also recorded. Results No significant differences were found in age, gender, and etiology of the scars in the two groups. The VAS scores in MEBO group were significantly lower than the control group within the first 3 days after treatment. The wound healing time of the MEBO group was significantly shorter than the control group. For both groups, VSS scores were significantly decreased and the scar markedly improved. However, the VSS scores were significantly lower in the MEBO group compared with the control group 3 months after treatment and pigmentation formation was dramatically lower in MEBO group compared with the control. Conclusion MEBT/MEBO treatment reduced the post-treatment pain, shortened the wound healing duration, promoted the overall scar condition, and reduced the incidence of pigmentation.
摘要:目的:总结分析MEBT/MEBO治疗面部烧伤的临床经验和方法。方法:对1988年1月至2001年12月应用MEBT/MEBO住院治疗的面部烧伤829例进行回顾性总结分析。结果:829例病人除6例治疗中自动出院外,其余823例全部临床治愈。无一例行外科植皮,随访半年无明显瘢痕形成及面容改变。结论:MEBT/MEBO是目前治疗面部烧伤的首选治疗方法。且有防止瘢痕形成和不影响面容等优点。