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Combination of ablative fractional carbon dioxide laser and platelet-rich plasma treatment to improve hypertrophic scars:a retrospective clinical observational study

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Burns & trauma 2021年第1期9卷 364-371页

作者： Zhanzhan Dai Xiaozhen Lou Tuo Shen Yu Sun Yongqiang Xiao Xingfeng Zheng Xuexin Wang Yu Peng Yukun Guo Yibin Guo Jiannan Wen He Fang Bing Ma Zhaofan Xia Department of Burn Surgery the First Affiliated Hospital of Naval Medical UniversityBurn Institute of PLA168 Changhai RoadYangpu DistrictShanghai 200433China Research Unit of key techniques for treatment of burns and combined burns and trauma injury Chinese Academy of Medical Sciences168 Changhai RoadYangpu DistrictShanghai 200433China Department of Burn and Plastic Surgery the 970th Hospital of People’s Liberation Army7 Zhichunan RoadZhifu DistrictYantaiShandong264000China Department of Health Statistics the Naval Medical University800 Xiangyin RoadYangpu DistrictShanghai 200433China First Resident Outpatient Department of Northern Theater General Hospital 22 Beiwu RoadHeping DistrictShenyangLiaoning Province110001China

Background:Hypertrophic scars are one of the main complications that affect the quality of life of patients after *** methods have been shown to be effective in the treatment of hypertrophic scars,such as ablative fractional CO_(2) laser(AFCL)and platelet-rich plasma(PRP).However,there are few studies on the effect of the combined application of these *** purpose of this study was to explore the therapeutic effect of AFCL combined with PRP on hypertrophic burn ***:A retrospective clinical observation study was conducted on 50 patients with hypertrophic burn *** AFCL+PRP group included 31 patients who received AFCL combined with PRP treatment;the AFCL group included 19 patients who received AFCL treatment *** University of North Carolina 4P Scar Scale(UNC4P)and the Vancouver Scar Scale(VSS)scores that were collected before each treatment were used as indicators of the effectiveness of the previous *** scores recorded at the second,fourth and seventh months were ***:The demographic data of the 2 groups were not significantly *** treatment,therewas no difference in the UNC4P and VSS scores between the 2 *** a significant decline in the UNC4P and VSS total scores over 6 months in both groups(p<0.05)and scores in the 2 groups were comparable after 3 and 6 months(p<0.05).UNC4P scores in the AFCL+PRP group decreased from a mean of 8.26 to 2.61(p<0.05)with a concomitant drop in VSS scores from a mean of 11.74 to 6.06(p<0.01).In the AFCL group UNC4P and VSS scores decreased from 7.68 to 4.63(p<0.05)and from 10.89 to 8.16(p<0.05),*** sub-items of these 2 assessments were analysed and the results suggest that AFCL combined with PRP can comprehensively improve ***:This study shows that PRP is an effective adjunct for AFCL in the treatment of hypertrophic burn scars and that the combination of PRP and AFCL proved to be more useful than AFCL *** combination ma

关键词： Ablative fractional carbon dioxide laser Platelet-rich plasma Hypertrophic scars

Valuable prognostic indicators for severe burn sepsis with inhalation lesion:age, platelet count, and procalcitonin

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Burns & trauma 2018年第4期6卷 255-261页

作者： Yichao Xu Xinyuan Jin Xiaonan Shao Feng Zheng Hong Zhou Department of Burns Fujian Medical University Union HospitalFuzhou 350000China Department of Burn Plastic Surgery The Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhou 215008China Department of Nuclear Medicine The Third Affiliated Hospital of Soochow UniversityChangzhou 213003China Department of Critical care Medicine The Third Affiliated Hospital of Soochow UniversityChangzhou 213003China Department of Plastic Surgery and Burns The Third Affiliated Hospital of Soochow UniversityChangzhou 213003China

Background:Severe burn sepsis can lead to high mortality. We explored the valuable prognostic indicators for severe burn sepsis with inhalation lesion. Methods:Thirty-eight severe burn patients with sepsis who were admitted to the Third Affiliated Hospital of Soochow University from August 2014 to December 2017 were retrospectively analyzed. Among them, 22 patients were assigned to the death group and 16 patients to the survival group. Their general information, vital signs, and blood index including serum procalcitonin (PCT) and C-reactive protein (CRP) levels at admission, diagnosis of sepsis, and 1-week post-diagnosis of sepsis were compared. Results:Patients in the death group were older and had lower platelet count (PLT) at diagnosis of sepsis and 1-week post-diagnosis as well as higher PCT level at 1-week post-diagnosis than patients in the survival group (all p<0.05). According to receiver operating characteristic (ROC) curves, the above four indicators could be used to predict the prognosis, and the area under the curve (AUC) of PLT at diagnosis and 1-week post-diagnosis was larger (0.888 and 0.911), and PLT at diagnosis had the highest sensitivity and specificity (0.842 and 0.937). In addition, these patients were divided into two groups by the optimal cutoff age of 38 years. According to multivariate logistic regression analysis and COX regression analysis, only age group and PLT at diagnosis were statistically significant (all p<0.05). The risk of death in the older group was 28 times higher than that in the younger group, and the risk of death increased by 3%for each unit reduction in PLT at diagnosis. Moreover, age group was an independent factor affecting the patients' survival (β=?1.370, p=0.026). Considering the survival time after sepsis, the mortality risk was lower for patients in the older group than for patients in the younger group (hazard ratio (HR)=0.254, 95%confidence interval (CI) 0.076–0.851). Conclusion:Age, PLT at diagnosis of sepsis, an

关键词： Burns Sepsis Age Platelet count Procalcitonin

Prediction of median survival time in sepsis patients by the SOFA score combined with different predictors

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Burns & trauma 2020年第1期8卷 475-484页

作者： Wen Li Meiping Wang Bo Zhu Yibing Zhu Xiuming Xi Department of Critical care Medicine Fuxing HospitalCapital Medical University.20A Fuxingmenwai StreetXicheng DistrictBeijing 100038China Department of Epidemiology and Health Statistics School of Public HealthCapital Medical University.10 XitoutiaoYouanmenwaiFengtai DistrictBeijing 100069China Department of Statistics Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Background:Sepsis is the leading cause of intensive care unit(ICU)*** purpose of this study was to explore the prognostic value of the Sequential Organ Failure Assessment(SOFA)score,the Acute Physiological and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,and procalcitonin(PCT),albumin(ALB),and lactate(LAC)levels in patients with ***:Consecutive adult patients with suspected or documented sepsis at ICU admission were *** basic vital signs and related auxiliary examinations to determine their PCT and ALB levels and APACHE Ⅱ score were recorded at ICU admission,and their LAC levels and SOFA scores were recorded for one week after *** influence of these variables on hospital mortality was *** regression was used to derive the Sepsis Hospital Mortality Score(SHMS),a prediction equation describing the relationship between predictors and hospital *** median survival time was calculated by the Kaplan–Meier *** the validation group,the kappa value was calculated to evaluate the stability of the derived ***:This study included 894 sepsis patients admitted to 18 ICUs in 16 tertiary *** were randomly assigned to an experimental group(626 cases)and validation group(258 cases).In addition,a nonsurvival group(248 patients)of the experimental group was established according to the outcome at the time of *** hospital mortality rate in the experimental group was 39.6%(248/626).Univariate and multivariate regression analyses revealed that the APACHE Ⅱ score(odds ratio[OR]=1.178),△SOFA(OR=1.186),△LAC(OR=1.157),and SOFA mean score(OR=1.086)were independently associated with hospital *** SHMS was calculated as logit(p)=4.715–(0.164×APACHE Ⅱ)–(0.171×△SOFA)–(0.145×△LAC)–(0.082×SOFA mean).A receiver operating characteristic curve was constructed to further investigate the accuracy of the SHMS,with an area under the curve of 0.851(95%confidence interval[CI]0.821–0.882;p<0.00

关键词： Sepsis SOFA APACHEⅡ Lactate Mortality Sequential Organ Failure Assessment Acute Physiological and Chronic Health EvaluationⅡ

富血小板血浆通过促进再上皮化加速皮肤创面愈合

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中华烧伤杂志 2021年第1期37卷 452-452页

作者：宋菲(编译) 董叫云(审校) Xu PC Wu YG Zhou LN Department of Burn and Plastic Surgery General Hospital of Southern Theater Command PLA Guangzhou China Department of Dermatology Southwest Hospital Third Military Medical University (Army Medical University) Chongqing China Department of Endocrinology Southwest Hospital Third Military Medical University (Army Medical University) Chongqing China State Key Laboratory of trauma Burn and Combined Injury Institute of Burn Research Southwest Hospital Third Military Medical University (Army Medical University) Chongqing 400038 China Chongqing Key Laboratory for Disease Proteomics Chongqing 400038 China

自体富血小板血浆(PRP)已被证明对创面愈合有效,然而有证据显示PRP在伴急慢性创面患者中的使用是不足的。本研究目的是深人研究PRP对急性皮肤创面修复的有效性和协同作用,并探讨其可能的机制。在C57/BL6小鼠背部制作全层皮肤缺损创面,... 详细信息

自体富血小板血浆(PRP)已被证明对创面愈合有效,然而有证据显示PRP在伴急慢性创面患者中的使用是不足的。本研究目的是深人研究PRP对急性皮肤创面修复的有效性和协同作用,并探讨其可能的机制。在C57/BL6小鼠背部制作全层皮肤缺损创面,分别将PRP或生理盐水作用至创面区域。在伤后第3、5、7、14天观测创面愈合率及局部炎症、血管生成、再上皮形成和胶原沉积情况。在体内外研究中进一步探讨表皮干细胞(ESC)的生物特点,其具备促进表皮再上皮化的能力。

关键词：局部炎症上皮形成再上皮化富血小板血浆表皮干细胞胶原沉积 C57/BL6小鼠全层皮肤缺损

Emergency medicine providers＇ opioid prescribing practices stratified by gender, age, and years in practice

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World Journal of Emergency Medicine 2016年第2期7卷 106-110页

作者： Shawn M. Varney Vikhyat S. Bebarta Lisa M. Mannina Rosemarie G. Ramos Victoria J. Ganem Katherine R. carey Department of Emergency Medicine University of Texas Health Science Center San Antonio 78229 USA Department of Emergency Medicine University of Colorado School of Medicine Aurora 80045 USA Department of Emergency Medicine Mike O'Callaghan Federal Medical Center Nellis 89191 USA Air Force Enroute care Research Center Fort Sam Houston 78208 USA The Geneva Foundation Tacoma 98402 USA

BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing ***: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square ***: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused ***: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.

关键词： Prescription opioid misuse Emergency medicine provider Prescribing practices

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合理的影像学检查——急性膝关节损伤的检查

英国医学杂志中文版 2012年第5期15卷 314-316页

作者： James Teh Gregoris Kambouroglou Julia Newton 王英民(译) Radiology Department Orthopaedic Nuffield Centre Oxford University Hospitals NHS Trust Oxford OX3 7LD UK trauma Service John Radcliffe Hospital Oxford University Hospitals NHS Trust Oxford OX3 9DU Oxsport Nuffield Orthopaedic Centre Oxford University Hospitals NHS Trust Oxford OX3 7LD 北京医院骨科

普通x线片对于膝关节损伤的评估可能是不适当的；可能还需要其他的影像学技术，特别是核磁共振。

关键词：急性膝关节损伤影像学检查普通x线片影像学技术核磁共振

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眼球穿通伤的一种前摄疗法

世界核心医学期刊文摘（眼科学分册） 2005年第2期1卷 43-43页

作者： Kuhn F. Mester V. Morris R. 肖颖 American Society of Ocular trauma 1 201 11th Avenue South Birmingham AL 35205 United States Dr.

Background: Perforating injuries continue to have a poor prognosis with less t han two-thirds of eyes having at least ambulatory final vision, due to prolifer ation originating from the exit wound. Materials and Methods: We developed a new , proactive treatment method, which is applicable in most eyes with perforating trauma. The strategy involves limited, indirect ophthalmoscopic vitrectomy durin g the primary repair; heavy topical corticosteroid therapy postoperatively; and complete vitrectomyon day 3, including prophylactic retinectomy around the exit wound, evacuation of subretinal blood, laser retinopexy, and silicone oil implan tation. Results: In the five consecutive eyes in which the proactive treatment a pproach was used, no"enscarceration" of the retina into the exit wound, prolife rative vitreoretinopathy, retinal detachment, or retinal folding has occurred. T he median visual acuity improved from count fingers to 0.6 in the three eyes wit hout macular involvement. Conclusions: Far-reaching conclusions must not be mad e based on such a small series, but the proactive treatment approach appears pro mising in preventing proliferation-related complications such as fractional ret inal detachment or retinal fold development. A similar approach should be consid ered for eyes with deep impact trauma from intraocular foreign bodies and in eye s with incarcerated retina in the rupture wound.

关键词：眼球穿通伤视网膜下出血玻璃体切割术视网膜脱离间接检眼镜激光光凝术平均视力眼内异物硅油填充术破裂口

Life-saving therapy for complete traumatic hemipelvectomy:a case report

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Chinese Medical Journal 2021年第11期134卷 1376-1378页

作者： Jing-Hong Zheng Hong-Jiang Chen Xiao-Hui Lu Di Zhao Shao-Wei Luo You-Bin Chen Jian-Kun Xu Wen Chen Yong-Ming Zeng Lin-Xi Huang Si Chen Wei-Qi Ke Jun Hu Department of traumatology First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China Department of Joint Surgery First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China Department of Spinal Surgery First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China Department of Burns and Plastic First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China Department of General Surgery First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China Department of Intensive care Unit First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China Department of Urinary Surgery First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China Department of Anesthesiology First Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515041China.

To the Editor:traumatic hemipelvectomy(THP),which was first described by Turnbull in 1978,is an unstable ligamentous or osseous hemipelvic injury that involves rupture of the pelvic neurovascular bundle(either open or closed integuments).[1]THP is a rare and catastrophic injury that is usually caused by high-energy trauma,as in a traffic,motorcycle,and machinery-related accident,and is accompanied by pelvic fractures.[2]THP usually leads to other associated injuries.[3]The mortality associated with open pelvic fracture is approximately 40%,while the mortality associated with THP may reach as high as 100%.[4]However,few studies describe a standardized approach for handling this fatal trauma.

关键词： mortality injuries unstable

Assessing keloid recurrence following surgical excision and radiation

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Burns & trauma 2020年第1期8卷 34-40页

作者： Michael H.Gold Mark S.Nestor Brian Berman David Goldberg Gold Skin care Center 2000 Richard Jones RoadSuite 220NashvilleTN 37215 Center for Clinical and Cosmetic Research 2925 NE 199th StSuite 205AventuraFL 33180 Department of Dermatology and Cutaneous Surgery University of Miami Miller School of MedicineMiamiFL Skin Laser&Surgery Specialists of NY/NJ 110 E.55th Street13th floorNew YorkNY 10022

Keloids are a fibroproliferative disorder that can result from a cutaneous injury to the reticular *** rates as high as 100%have been reported following surgical excision ***,a variety of post-surgical techniques have been employed to prevent keloid recurrence,including the use of *** numerous studies have shown post-excisional X-rays,electron beam,lasers and brachytherapy can reduce the rate of keloid recurrence,numerous inconsistencies,including a wide range of definitions for keloid recurrence,make it difficult to compare study *** review aims to examine the various means for defining keloid recurrence in clinical trials involving the use of radiation *** of the Cochrane Library and PubMed were performed to identify the available information for post-surgical keloid recurrence following radiation *** identified study was reviewed for patient followup and criteria used to define keloid *** search results included clinical studies with external beam radiation,brachytherapy and superficial radiation *** studies did not include a definition of keloid recurrence,or defined recurrence only as the return of scar *** studies defined keloid recurrence based on patient self-assessment questionnaires,symptoms and scar elevation and changes in Kyoto Scar Scale,Japan Scar Workshop Scale and Vancouver Scar Scale *** results of this review indicate keloidectomy followed by radiation therapy provide satisfactory recurrence rates;however,clinical studies evaluating these treatments do not describe treatment outcomes or use different definitions of keloid ***,recurrence rates vary widely,making comparisons across studies *** recurrence should be clearly defined using both objective and subjective measures.

关键词： Keloid Keloid scar Recurrence External beam radiation Brachytherapy Superficial radiation therapy