We investigated the delivery of drugs to the posterior segment of the eye by non-invasive topical instillation using submicron-sized poly(D,L-lactide-co-glycolide)(PLGA) nanoparticles(NPs). Surface-modified PLGA NPs w...We investigated the delivery of drugs to the posterior segment of the eye by non-invasive topical instillation using submicron-sized poly(D,L-lactide-co-glycolide)(PLGA) nanoparticles(NPs). Surface-modified PLGA NPs were developed to improve the drug delivery efficiency to the retina and were administered as topical eye drops to mice. Chitosan(CS) and glycol chitosan(GCS), which are mucoadhesive polymers, and polysorbate 80(P80) were used as surface modifiers, and have been reported to increase the association of NPs with cells.Coumarin-6 was used as a model drug and fluorescent marker, and after ocular administration of PLGA NP eye drops, the fluorescence intensity of coumarin-6 was observed in the retina. The fluorescence image analysis indicated that there are several possible routes to the retina and fates of PLGA NPs in ocular tissue, and that these pathways involved the corneal,non-corneal, or uveal routes. Delivery to the mouse retina segments after topical administration was increased by surface modification with CS, GCS, or P80. Surface-modified PLGA NPs are a promising method for retinal drug delivery via topical instillation.展开更多
Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Fi...Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Five female patients (40 - 71 years old) diagnosed as interstitial cystitis by cystoscopic findings and a 68 year-old bladder pain syndrome patient were enrolled. All patients, having interstitial cystitis, had undergone hydrodistention therapy previously and had not improved their symptoms by empirical therapies. Daily or weekly (upon their severity of symptoms) intravesical instillation of 20 ml of 4% non-alkalinized (pH 6.0 - 7.0) lidocaine solution was performed for several times, and patients were asked to keep them in the bladder as long as two hours each time. Previous medications such as anti-cholinergic drugs and analgesics were continued according to patient's requirements and symptoms. The treatment effect was evaluated comparing O'Leary-Sant Symptom Index for interstitial cystitis patients and visual analog pain scale before and after the series of lidocaine therapies. Results: Instillation was made 6 to 16 times. Patients with interstitial cystitis improved their symptoms from O'Leary-Sant Symptom Index 17.5 to 10, Problem Index from 14.8 to 6 in an average. Crouching pain disappeared in all these patients after the instillation therapy. Severe interstitial cystitis findings on cystoscopy disappeared completely in one patient after the therapy. One patient having bladder pain syndrome reduced her analgesics use, and bladder-filling pain decreased from 7 to 3 as a visual analog scale score. One patient complained palpitation at 11th instillation and abandoned treatment thereafter, otherwise, none of these patients showed side effect concerning lidocaine toxicity. Conclusions: Intravesical non-alkalinized lidocaine instillation therapy for interstitial cystitis/bladder pain syndrome patients were an easy, safe and effective treatment.展开更多
In order to study bladder intravesical instillation methods in pure line LEW rats and nude mice, female LEW rats and nude mice aged 2 to 4 weeks were sacrificed. Their urethra and bladder were observed under anatomica...In order to study bladder intravesical instillation methods in pure line LEW rats and nude mice, female LEW rats and nude mice aged 2 to 4 weeks were sacrificed. Their urethra and bladder were observed under anatomical microscopy. A trochar was prepared according to the outline and an- gle of the urethra. Ink was poured into female rats and nude mice bladder though urethra. Filling and staining of bladder were observed and evaluated under anatomical microscopy. Status and urethral injury of rats and mice were observed. The results showed that urethra anatomic structure of rats and nude mice was different from that of human urethra. When bladder was filled with ink and became blue, liquid was not seen to leak out. The success rate of intubation was high (100%). Living activi- ties of animals weren’t influenced by intravesical instillation. It was concluded that bladder irrigation might be a kind of valid and utilizable method in pure line rat and nude mouse empirical study. The model may be a more effective tool for study of bladder tumor.展开更多
Background: Uncontrolled acute postoperative pain is considered a risk factor for the development of chronic pain afterward. Objectives: To explore the most effective dose of ketamine instillation (1 of 3 doses: 1, 2,...Background: Uncontrolled acute postoperative pain is considered a risk factor for the development of chronic pain afterward. Objectives: To explore the most effective dose of ketamine instillation (1 of 3 doses: 1, 2, or 3 mg/kg) for acute and chronic post mastectomy pain (PMP). Methods: Ninety female patients with cancer breast, aged (18 - 60 yrs), weighted (50 - 90 kg), scheduled for modified radical mastectomy, randomly allocated into 3 groups to receive ketamine instillation after surgical homeostasis before wound closure (1 of 3 doses;1, 2, or 3 mg/kg as A, B or C groups respectively) patients were followed up for 48 h for acute pain (total morphine consumption, the first request of analgesia and visual analog scale at rest and movement (VASR/M), chronic pain by Leeds assessment of neuropathic signs and symptoms (LANSS) for six-months, hemodynamics, and side effects. Results: Median total dose of morphine consumption was 8 mg (5 - 10) versus 6 mg (6 - 7) in A and B groups respectively in the first 48 h postoperatively. Lowest VASR/M was recorded in C then B and lastly A group (P = 0.037). No patients in the C group requested analgesia versus thirty (100%) and nine (30%) patients in the A and B groups respectively with the first request of analgesia was 12 h (5 - 36) in the A group versus 30 h (12 - 36) in the B group respectively (P Conclusion: Ketamine instillation effectively controlled acute post mastectomy pain (PMP) in a dose-dependent manner and reduced the incidence and severity of chronic pain in patients who undergoing a modified radical mastectomy.展开更多
Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients wit...Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but展开更多
Oral health is often impaired in people living in residential care.In older people,poor oral health is associated with functional deficits,multiple sclerosis,and memory disorders.Keeping one’s teeth healthy throughou...Oral health is often impaired in people living in residential care.In older people,poor oral health is associated with functional deficits,multiple sclerosis,and memory disorders.Keeping one’s teeth healthy throughout life would promote both oral health and general health.Biting and swallowing problems in older people are also linked to oral health,limiting eating activities and requiring diet changes to softer foods that are easy to chew and swallow.This may limit dietary diversity and adequate nutrient intake.Although eating-related chewing and swallowing problems are common in institutionalized residents,they are often addressed too late,when the resident is already malnourished.Nutrition in nursing and retirement homes has been the subject of various studies since the 2000s.However,studies on swallowing and chewing difficulties are scarce and their link to adequate nutrient intake has received lesser attention[6,7].展开更多
Europium doped Gd_2 O_3 nanotubes(Gd_2 O_3:Eu^(3+) NTs) were synthesized and characterized. Then,the neurotoxicity and brain localization of Gd_2 O_3:Eu^(3+) NTs were evaluated. All experimental rats were administered...Europium doped Gd_2 O_3 nanotubes(Gd_2 O_3:Eu^(3+) NTs) were synthesized and characterized. Then,the neurotoxicity and brain localization of Gd_2 O_3:Eu^(3+) NTs were evaluated. All experimental rats were administered by intranasal instillation with 30 μL Gd_2 O_3:Eu^(3+) NTs suspension 3.0 and 15.0 mg/mL respectively every other day for 35 consecutive days, and the rats of control group were administered with an equal volume of physiological saline. The Morris water maze was used to assess the rats' spatial learning and memory ability. The oxidative stress-related biomarkers and the activity of AChE in striatum and hippocampus were analyzed, and the histopathology of hippocampus and striatum was observed.The brain localization of gadolinium(Gd) was measured. The results showed that the escape latency of the rats in high-dose group prolonged significantly compared with that of control group after treatment of six weeks(p < 0.05), and the swimming time in D quadrant of high-dose group shortened significantly compared with the control group(p < 0.01). In addition, high-dose Gd_2 O_3:Eu^(3+) NTs could decrease the activity of GSH-Px and CAT in hippocampus and the activity of SOD in striatum(p < 0.05). MDA content in hippocampus and striatum of high-dose group increased(p < 0.05). High dose Gd_2 O_3:Eu^(3+) NTs could increase the activity of AChE in hippocampus(p < 0.05) and in striatum(p < 0.001). But there were no significant differences between the low-dose group and control group(p > 0.05). The results of Gd localization in brain showed that the ranking of Gd levels was olfactory bulb > striatum > hippocampus> cerebellum > brain stem > frontal cortex. The pathology results indicated that high dose Gd_2 O_3:Eu^(3+)NTs resulted in degeneration necrosis, nucleus pycnosis, and axons disappearance of the nerve cells at CA1, CA3 and DG area of hippocampus. Therefore, the results implied that Gd_2 O_3:Eu^(3+) NTs have the potential neurotoxicity and a possible danger in causing neurodegenerative disorders after intranasal instillation.展开更多
Aim: The use of negative pressure wound therapy (NPWT) is well established in the treatment of chronic wounds. NPWT with instillation (NPWTi) combines traditional NPWT with the application of a topical irrigation solu...Aim: The use of negative pressure wound therapy (NPWT) is well established in the treatment of chronic wounds. NPWT with instillation (NPWTi) combines traditional NPWT with the application of a topical irrigation solution (in this case octenidine based octenilin? wound irrigation solution) within the wound bed. The purpose of the study was to investigate the impact of NPWTi on pressure ulcers (PUs). Methods: In total 13 patients with PUs in different locations were treated with negative pressure therapy combined with ocitenidine based instillation fluid after first surgical debridement. After 6 days the dressing was removed and wound closure using different local flaps was performed. Results: Normal wound healing without irritation was found 30 days post-debridement and after 90 days the wounds showed complete healing. No adverse incidents occurred and no toxic tissue reactions were documented. During the follow up period, there was no recurrence of the PU in any of the treated patients. Conclusion: It is generally recognised that for chronic wounds to heal, optimum wound bed preparation is of paramount importance. This helps prepare for secondary healing, skin grafting or coverage with flaps. Tests were performed in vitro simulating real clinical conditions using PU vacuum exudates. These tests quantified the antiseptic efficacy of octenilin? wound irrigation solution in the eradication of microorganisms. Further research is needed to establish the role of NPWTi with octenilin? in the management of category 4 PUs, but these initial results on 13 patients lead in the direction of developing an enhanced protocol for the treatment of chronic wounds.展开更多
Utilization of negative pressure wound therapy with instillation (NPWTi) for sternal dehiscence wounds secondary to sternal wound infection after surgery has become an accepted therapy. NPWTi accelerates wound healing...Utilization of negative pressure wound therapy with instillation (NPWTi) for sternal dehiscence wounds secondary to sternal wound infection after surgery has become an accepted therapy. NPWTi accelerates wound healing through macrostrain, microstrain, and cyclic fluid instillation. Wounds benefit from additional superficial infection control with the removal of microorganisms, the release of proinflammatory mediators, stimulation of angiogenesis, as well as mechanical debridement. However, very few cases of utilizing NPWTi in the treatment of sternal wound infections have been reported in the literature. This case study describes the use of NPWTi with hypochlorous acid for the treatment of a sternal wound infection.展开更多
目的:探讨肝素/碱化利多卡因(利多卡因与碳酸氢钠混合)协同膀胱内灌注联合水扩张及经尿道电灼治疗女性间质性膀胱炎(interstitial cystitis,IC)的有效性和安全性。方法:选择2012年1月至2020年12月于中国医科大学附属第一医院泌尿外科就...目的:探讨肝素/碱化利多卡因(利多卡因与碳酸氢钠混合)协同膀胱内灌注联合水扩张及经尿道电灼治疗女性间质性膀胱炎(interstitial cystitis,IC)的有效性和安全性。方法:选择2012年1月至2020年12月于中国医科大学附属第一医院泌尿外科就诊,符合美国泌尿外科协会指南的诊断标准,新诊断为IC的女性患者的病例资料进行回顾性分析,诊断时对可疑病变进行膀胱镜检查和活检。所有患者均接受持续12个月的2%(质量分数)利多卡因10 mL+5%(质量分数)碳酸氢钠5 mL+肝素25000 IU的膀胱内灌注治疗,根据患者的意愿,选择接受或不接受水扩张及经尿道电灼治疗,将患者分为水扩张和经尿道电灼(hydrodistension and transurethral fulguration,HD/TF)组和非HD/TF组,记录患者治疗前和治疗后1、6、12个月O’Leary-Sant间质性膀胱炎症状指标评分(interstitial cystitis patient symptom index scores,ICSI)、问题指标评分(interstitial cystitis patient problem index scores,ICPI)、耻骨上疼痛视觉模拟评分(visual analog scale,VAS)、功能性膀胱容量(functional bladder capacity,FBC)等。结果:共收集到患者79例,其中有4例(5.1%)患者因病理诊断为癌或治疗失败而行膀胱切除术被剔除,其余患者均在治疗后1、6、12个月成功随访。重复测量方差分析显示:治疗后ICPI、ICSI和VAS较治疗前均显著降低(P<0.05),FBC显著增加(P<0.05)。治疗后1、6、12个月随访期间FBC持续下降,差异有统计学意义(P<0.05);在治疗后1个月和6个月随访时ICSI持续降低,差异有统计学意义(P<0.05),而治疗后的6个月与治疗后12个月的ICSI差异无统计学意义(P>0.05)。HD/TF组在治疗后1个月和6个月随访时ICPI持续降低,差异有统计学意义(P<0.05),而治疗后6个月与12个月的ICPI差异无统计学意义(P>0.05)。治疗后1、6、12个月其余各项指标之间比较,差异均无统计学意义(P>0.05)。与非HD/TF组相比,HD/TF组的ICPI、ICSI、VAS和FBC改善更早,且VAS和FBC的变化更显著(P<0.05)。结论:肝素/碱化利多卡因协同膀胱内灌注加水扩张和经尿道电灼治疗IC是一种有效的治疗选择。膀胱内肝素/碱化利多卡因协同灌注可能成为首选治疗方法,可显著减轻患者和医保系统的经济负担,如果患者能接受,可考虑经尿道电灼联合水扩张的治疗方法。展开更多
目的系统评价负压治疗联合滴注冲洗对感染性伤口的治疗效果。方法检索国内外各数据库2022年5月前发表的有关负压治疗联合滴注冲洗对感染性伤口治疗效果的研究,使用RevMan 5.4以及R Studio 4.2.1软件对纳入文献进行系统评价。结果最终纳...目的系统评价负压治疗联合滴注冲洗对感染性伤口的治疗效果。方法检索国内外各数据库2022年5月前发表的有关负压治疗联合滴注冲洗对感染性伤口治疗效果的研究,使用RevMan 5.4以及R Studio 4.2.1软件对纳入文献进行系统评价。结果最终纳入15篇文献,共涉及996例研究对象。与传统负压伤口治疗相比,负压治疗联合滴注冲洗能有效降低引流管的堵管率[OR=0.11,95%CI(0.05,0.28),P<0.001],提高伤口闭合率[OR=1.99,95%CI(1.38,2.87),P<0.001]和细菌清除率[OR=18.04,95%CI(16.77,19.31),P<0.001],缩短感染性伤口的闭合时间[MD=-3.15,95%CI(-3.15,-2.34),P<0.001]。而对于滴注冲洗液的选择,生理盐水与抗菌溶液两个亚组的伤口闭合率和伤口闭合时间的合并效应量差异均无统计学意义(P=0.226,P=0.568)。结论负压治疗联合滴注冲洗能促进感染性伤口的闭合,抑制局部感染与细菌繁殖,提高感染性伤口负压治疗的效果,且负压吸引联合生理盐水滴注冲洗与抗菌溶液冲洗的疗效相当。展开更多
基金supported by JSPS KAKENHI Grant Number JP16K18948
文摘We investigated the delivery of drugs to the posterior segment of the eye by non-invasive topical instillation using submicron-sized poly(D,L-lactide-co-glycolide)(PLGA) nanoparticles(NPs). Surface-modified PLGA NPs were developed to improve the drug delivery efficiency to the retina and were administered as topical eye drops to mice. Chitosan(CS) and glycol chitosan(GCS), which are mucoadhesive polymers, and polysorbate 80(P80) were used as surface modifiers, and have been reported to increase the association of NPs with cells.Coumarin-6 was used as a model drug and fluorescent marker, and after ocular administration of PLGA NP eye drops, the fluorescence intensity of coumarin-6 was observed in the retina. The fluorescence image analysis indicated that there are several possible routes to the retina and fates of PLGA NPs in ocular tissue, and that these pathways involved the corneal,non-corneal, or uveal routes. Delivery to the mouse retina segments after topical administration was increased by surface modification with CS, GCS, or P80. Surface-modified PLGA NPs are a promising method for retinal drug delivery via topical instillation.
文摘Purpose: The effectiveness of daily or weekly instillation of non-alkalinized lidocaine for patients suffering interstitial cystitis and/or bladder pain syndrome was evaluated retrospectively. Patients and methods: Five female patients (40 - 71 years old) diagnosed as interstitial cystitis by cystoscopic findings and a 68 year-old bladder pain syndrome patient were enrolled. All patients, having interstitial cystitis, had undergone hydrodistention therapy previously and had not improved their symptoms by empirical therapies. Daily or weekly (upon their severity of symptoms) intravesical instillation of 20 ml of 4% non-alkalinized (pH 6.0 - 7.0) lidocaine solution was performed for several times, and patients were asked to keep them in the bladder as long as two hours each time. Previous medications such as anti-cholinergic drugs and analgesics were continued according to patient's requirements and symptoms. The treatment effect was evaluated comparing O'Leary-Sant Symptom Index for interstitial cystitis patients and visual analog pain scale before and after the series of lidocaine therapies. Results: Instillation was made 6 to 16 times. Patients with interstitial cystitis improved their symptoms from O'Leary-Sant Symptom Index 17.5 to 10, Problem Index from 14.8 to 6 in an average. Crouching pain disappeared in all these patients after the instillation therapy. Severe interstitial cystitis findings on cystoscopy disappeared completely in one patient after the therapy. One patient having bladder pain syndrome reduced her analgesics use, and bladder-filling pain decreased from 7 to 3 as a visual analog scale score. One patient complained palpitation at 11th instillation and abandoned treatment thereafter, otherwise, none of these patients showed side effect concerning lidocaine toxicity. Conclusions: Intravesical non-alkalinized lidocaine instillation therapy for interstitial cystitis/bladder pain syndrome patients were an easy, safe and effective treatment.
基金a grant from National Youth Natural Sciences Foundation of China (No. 30200284)
文摘In order to study bladder intravesical instillation methods in pure line LEW rats and nude mice, female LEW rats and nude mice aged 2 to 4 weeks were sacrificed. Their urethra and bladder were observed under anatomical microscopy. A trochar was prepared according to the outline and an- gle of the urethra. Ink was poured into female rats and nude mice bladder though urethra. Filling and staining of bladder were observed and evaluated under anatomical microscopy. Status and urethral injury of rats and mice were observed. The results showed that urethra anatomic structure of rats and nude mice was different from that of human urethra. When bladder was filled with ink and became blue, liquid was not seen to leak out. The success rate of intubation was high (100%). Living activi- ties of animals weren’t influenced by intravesical instillation. It was concluded that bladder irrigation might be a kind of valid and utilizable method in pure line rat and nude mouse empirical study. The model may be a more effective tool for study of bladder tumor.
文摘Background: Uncontrolled acute postoperative pain is considered a risk factor for the development of chronic pain afterward. Objectives: To explore the most effective dose of ketamine instillation (1 of 3 doses: 1, 2, or 3 mg/kg) for acute and chronic post mastectomy pain (PMP). Methods: Ninety female patients with cancer breast, aged (18 - 60 yrs), weighted (50 - 90 kg), scheduled for modified radical mastectomy, randomly allocated into 3 groups to receive ketamine instillation after surgical homeostasis before wound closure (1 of 3 doses;1, 2, or 3 mg/kg as A, B or C groups respectively) patients were followed up for 48 h for acute pain (total morphine consumption, the first request of analgesia and visual analog scale at rest and movement (VASR/M), chronic pain by Leeds assessment of neuropathic signs and symptoms (LANSS) for six-months, hemodynamics, and side effects. Results: Median total dose of morphine consumption was 8 mg (5 - 10) versus 6 mg (6 - 7) in A and B groups respectively in the first 48 h postoperatively. Lowest VASR/M was recorded in C then B and lastly A group (P = 0.037). No patients in the C group requested analgesia versus thirty (100%) and nine (30%) patients in the A and B groups respectively with the first request of analgesia was 12 h (5 - 36) in the A group versus 30 h (12 - 36) in the B group respectively (P Conclusion: Ketamine instillation effectively controlled acute post mastectomy pain (PMP) in a dose-dependent manner and reduced the incidence and severity of chronic pain in patients who undergoing a modified radical mastectomy.
文摘Objective To study the therapeutic efficacy of combined interventional chemotherapy and intravesical instillation of mitomycin on preventing bladder cancers from recurring after local ablation. Methods 28 patients with superficial bladder cancers were randomized into combined interventional chemotherapy and intravesical instillation of mitomycin or intravesical instillation of mitomycin alone for preventing recurrence after local ablation. The result was assessed by x2 test. Results The patients have been followed up for 12-26 months (mean 21 months). 1 case has had tumor recurrence in the combined modality therapy group and 4 in the intravesical instillation alone group, the tumor recurrence rate being 7% (1/14) and 29% (4/14) respectively (P【0.05). Conclusion Combined use of interventional chemotherapy and intravesical instillation of mitomycin is effective in preventing superficial bladder cancer from recurring after local ablation with fewer adverse effects. The ragimen is not only reliable but
文摘Oral health is often impaired in people living in residential care.In older people,poor oral health is associated with functional deficits,multiple sclerosis,and memory disorders.Keeping one’s teeth healthy throughout life would promote both oral health and general health.Biting and swallowing problems in older people are also linked to oral health,limiting eating activities and requiring diet changes to softer foods that are easy to chew and swallow.This may limit dietary diversity and adequate nutrient intake.Although eating-related chewing and swallowing problems are common in institutionalized residents,they are often addressed too late,when the resident is already malnourished.Nutrition in nursing and retirement homes has been the subject of various studies since the 2000s.However,studies on swallowing and chewing difficulties are scarce and their link to adequate nutrient intake has received lesser attention[6,7].
基金Project supported by Chinese Natural Science Foundation Project(21271059)A Province and a School Special Project of Hebei University(20170026)
文摘Europium doped Gd_2 O_3 nanotubes(Gd_2 O_3:Eu^(3+) NTs) were synthesized and characterized. Then,the neurotoxicity and brain localization of Gd_2 O_3:Eu^(3+) NTs were evaluated. All experimental rats were administered by intranasal instillation with 30 μL Gd_2 O_3:Eu^(3+) NTs suspension 3.0 and 15.0 mg/mL respectively every other day for 35 consecutive days, and the rats of control group were administered with an equal volume of physiological saline. The Morris water maze was used to assess the rats' spatial learning and memory ability. The oxidative stress-related biomarkers and the activity of AChE in striatum and hippocampus were analyzed, and the histopathology of hippocampus and striatum was observed.The brain localization of gadolinium(Gd) was measured. The results showed that the escape latency of the rats in high-dose group prolonged significantly compared with that of control group after treatment of six weeks(p < 0.05), and the swimming time in D quadrant of high-dose group shortened significantly compared with the control group(p < 0.01). In addition, high-dose Gd_2 O_3:Eu^(3+) NTs could decrease the activity of GSH-Px and CAT in hippocampus and the activity of SOD in striatum(p < 0.05). MDA content in hippocampus and striatum of high-dose group increased(p < 0.05). High dose Gd_2 O_3:Eu^(3+) NTs could increase the activity of AChE in hippocampus(p < 0.05) and in striatum(p < 0.001). But there were no significant differences between the low-dose group and control group(p > 0.05). The results of Gd localization in brain showed that the ranking of Gd levels was olfactory bulb > striatum > hippocampus> cerebellum > brain stem > frontal cortex. The pathology results indicated that high dose Gd_2 O_3:Eu^(3+)NTs resulted in degeneration necrosis, nucleus pycnosis, and axons disappearance of the nerve cells at CA1, CA3 and DG area of hippocampus. Therefore, the results implied that Gd_2 O_3:Eu^(3+) NTs have the potential neurotoxicity and a possible danger in causing neurodegenerative disorders after intranasal instillation.
文摘Aim: The use of negative pressure wound therapy (NPWT) is well established in the treatment of chronic wounds. NPWT with instillation (NPWTi) combines traditional NPWT with the application of a topical irrigation solution (in this case octenidine based octenilin? wound irrigation solution) within the wound bed. The purpose of the study was to investigate the impact of NPWTi on pressure ulcers (PUs). Methods: In total 13 patients with PUs in different locations were treated with negative pressure therapy combined with ocitenidine based instillation fluid after first surgical debridement. After 6 days the dressing was removed and wound closure using different local flaps was performed. Results: Normal wound healing without irritation was found 30 days post-debridement and after 90 days the wounds showed complete healing. No adverse incidents occurred and no toxic tissue reactions were documented. During the follow up period, there was no recurrence of the PU in any of the treated patients. Conclusion: It is generally recognised that for chronic wounds to heal, optimum wound bed preparation is of paramount importance. This helps prepare for secondary healing, skin grafting or coverage with flaps. Tests were performed in vitro simulating real clinical conditions using PU vacuum exudates. These tests quantified the antiseptic efficacy of octenilin? wound irrigation solution in the eradication of microorganisms. Further research is needed to establish the role of NPWTi with octenilin? in the management of category 4 PUs, but these initial results on 13 patients lead in the direction of developing an enhanced protocol for the treatment of chronic wounds.
文摘Utilization of negative pressure wound therapy with instillation (NPWTi) for sternal dehiscence wounds secondary to sternal wound infection after surgery has become an accepted therapy. NPWTi accelerates wound healing through macrostrain, microstrain, and cyclic fluid instillation. Wounds benefit from additional superficial infection control with the removal of microorganisms, the release of proinflammatory mediators, stimulation of angiogenesis, as well as mechanical debridement. However, very few cases of utilizing NPWTi in the treatment of sternal wound infections have been reported in the literature. This case study describes the use of NPWTi with hypochlorous acid for the treatment of a sternal wound infection.
文摘目的:探讨肝素/碱化利多卡因(利多卡因与碳酸氢钠混合)协同膀胱内灌注联合水扩张及经尿道电灼治疗女性间质性膀胱炎(interstitial cystitis,IC)的有效性和安全性。方法:选择2012年1月至2020年12月于中国医科大学附属第一医院泌尿外科就诊,符合美国泌尿外科协会指南的诊断标准,新诊断为IC的女性患者的病例资料进行回顾性分析,诊断时对可疑病变进行膀胱镜检查和活检。所有患者均接受持续12个月的2%(质量分数)利多卡因10 mL+5%(质量分数)碳酸氢钠5 mL+肝素25000 IU的膀胱内灌注治疗,根据患者的意愿,选择接受或不接受水扩张及经尿道电灼治疗,将患者分为水扩张和经尿道电灼(hydrodistension and transurethral fulguration,HD/TF)组和非HD/TF组,记录患者治疗前和治疗后1、6、12个月O’Leary-Sant间质性膀胱炎症状指标评分(interstitial cystitis patient symptom index scores,ICSI)、问题指标评分(interstitial cystitis patient problem index scores,ICPI)、耻骨上疼痛视觉模拟评分(visual analog scale,VAS)、功能性膀胱容量(functional bladder capacity,FBC)等。结果:共收集到患者79例,其中有4例(5.1%)患者因病理诊断为癌或治疗失败而行膀胱切除术被剔除,其余患者均在治疗后1、6、12个月成功随访。重复测量方差分析显示:治疗后ICPI、ICSI和VAS较治疗前均显著降低(P<0.05),FBC显著增加(P<0.05)。治疗后1、6、12个月随访期间FBC持续下降,差异有统计学意义(P<0.05);在治疗后1个月和6个月随访时ICSI持续降低,差异有统计学意义(P<0.05),而治疗后的6个月与治疗后12个月的ICSI差异无统计学意义(P>0.05)。HD/TF组在治疗后1个月和6个月随访时ICPI持续降低,差异有统计学意义(P<0.05),而治疗后6个月与12个月的ICPI差异无统计学意义(P>0.05)。治疗后1、6、12个月其余各项指标之间比较,差异均无统计学意义(P>0.05)。与非HD/TF组相比,HD/TF组的ICPI、ICSI、VAS和FBC改善更早,且VAS和FBC的变化更显著(P<0.05)。结论:肝素/碱化利多卡因协同膀胱内灌注加水扩张和经尿道电灼治疗IC是一种有效的治疗选择。膀胱内肝素/碱化利多卡因协同灌注可能成为首选治疗方法,可显著减轻患者和医保系统的经济负担,如果患者能接受,可考虑经尿道电灼联合水扩张的治疗方法。
文摘目的系统评价负压治疗联合滴注冲洗对感染性伤口的治疗效果。方法检索国内外各数据库2022年5月前发表的有关负压治疗联合滴注冲洗对感染性伤口治疗效果的研究,使用RevMan 5.4以及R Studio 4.2.1软件对纳入文献进行系统评价。结果最终纳入15篇文献,共涉及996例研究对象。与传统负压伤口治疗相比,负压治疗联合滴注冲洗能有效降低引流管的堵管率[OR=0.11,95%CI(0.05,0.28),P<0.001],提高伤口闭合率[OR=1.99,95%CI(1.38,2.87),P<0.001]和细菌清除率[OR=18.04,95%CI(16.77,19.31),P<0.001],缩短感染性伤口的闭合时间[MD=-3.15,95%CI(-3.15,-2.34),P<0.001]。而对于滴注冲洗液的选择,生理盐水与抗菌溶液两个亚组的伤口闭合率和伤口闭合时间的合并效应量差异均无统计学意义(P=0.226,P=0.568)。结论负压治疗联合滴注冲洗能促进感染性伤口的闭合,抑制局部感染与细菌繁殖,提高感染性伤口负压治疗的效果,且负压吸引联合生理盐水滴注冲洗与抗菌溶液冲洗的疗效相当。
