目的:研究分析深Ⅱ度烧伤创面肉芽组织和瘢痕组织中胰岛素样生长因子表达及相关性.方法:收集我院烧伤外科收治的29例深Ⅱ度烧伤患者作为研究对象,对其创面肉芽组织与增生性瘢痕、瘢痕疙瘩及其正常皮肤进行荧光定量-PCR(RT-PCR)检测,分析不同组织中胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、胰岛素样生长因子受体(insulin-like growth factor receptor-1R,IGF-1R)的表达.结果:RT-PCR示在瘢痕疙瘩及增生性瘢痕中IGF-1明显高于正常皮肤,差异有统计学意义(P<0.05);IGF-1R在增生性瘢痕中表达为弱阳性,与正常皮肤相比差异无统计学意义(P=0.894);而在瘢痕疙瘩IGF-1R明显高于瘢痕周围正常皮肤,差异具有统计学意义(P<0.027).深Ⅱ度烧伤肉芽组织与瘢痕组织都是细胞过度增殖形成的,与IGF-1关联密切,能够有效促进瘢痕组织和糖尿病的肉芽创面的成纤维细胞增生.结论:胰岛素样生长因子-1在深Ⅱ度烧伤创面肉芽组织以及瘢痕组织生长中起到非常重要的作用.能有效促进上皮组织生长抑制肉芽组织过度生长,进而有利于烧伤患者的创面愈合.

目的 探究术中体温干预对老年人经尿道前列腺电切术中低体温及术后寒颤发生率的影响.方法 选取2013年9月～2016年9月于我院行经尿道前列腺电切术治疗的100例良性前列腺增生患者,随机分为观察组和对照组各50.对照组采用常规保温护理,观察组在对照组基础上给予术中体温干预护理,比较两组患者各时段体温监测结果、平均动脉收缩压(SBP)、平均动脉舒张压(DBP)水平、心率(HR)变化以及术中低温(≤36.0℃)、术后寒颤发生情况.结果 观察组术中体温、术后体温均显著高于对照组,差异具有统计学意义(P<0.05);观察组术后SBP、DBP、HR水平均显著高于对照组,差异具有统计学意义(P<0.05);观察组术中低温发生率及术后寒颤发生率均显著低于对照组,差异具有统计学意义(P<0.05).结论 术中体温干预护理可以维持良性前列腺增生患者经尿道前列腺电切术中体温和其他生理指标的相对稳定,减少术中体温和术后寒颤的产生,值得推广.

Objective:To discuss the clinical effect of evidence-based nursing in the process of patients receiving treatment of nephrapostasis under laparoscope.Methods: Selected 82 patients with nephrapostasis receiving treatment in our hospital from January 2014 to October 2016 as the research objects,and all of them received surgical treatment under laparoscope,and they were equally divided into control group and test group,where routine nursing was given to the patients in the control group,and evidence-based nursing was given to the patients in the test group.Patients in both groups were compared in length of stay and occurring of adverse reaction.Results: The length of stay of patients in the test group was significantly shortened compared with that of patients in the control group;the adverse reaction incidence rate of patients in the test group was significantly lower than that of patients in the control group,and the difference was statistically significant(P<0.05).Conclusion: The evidence-based nursing could effectively improve the patients' clinical treatment effect,reduce the adverse reaction in the process of treatment,and was worth promoting and applying clinically.

目的 探讨重组人表皮生长因子辅助纳米银敷料治疗Ⅱ度烧伤的临床效果.方法 将111例Ⅱ度烧伤患者按随机数字表法分为2组:对照组55例(深Ⅱ度烧伤28例、浅Ⅱ度烧伤27例)采用纳米银敷料治疗;观察组56例(深Ⅱ度烧伤27例、浅Ⅱ度烧伤29例)采用重组人表皮生长因子辅助纳米银敷料治疗.2组治疗后7、14、28 d对烧伤创面分泌物进行细菌培养和鉴定,比较2组烧伤创面细菌检出率、不同时段愈合率及愈合时间.结果 观察组治疗后浅Ⅱ度烧伤创面菌检出率较对照组显著减少(P=0.041);深Ⅱ度烧伤创面治疗14、28 d后愈合率明显高于对照组(P=0.033、0.039),浅Ⅱ度烧伤创面治疗7 d后愈合率明显高于对照组(P=0.018);深Ⅱ度烧伤创面与浅Ⅱ度烧伤创面愈合时间均显著短于对照组(P=0.001、0.000).结论 重组人表皮生长因子辅助纳米银敷料治疗Ⅱ度烧伤可有效灭菌,控制感染;同时可促进成纤维细胞及上皮细胞增殖,促进新生肉芽形成,达到加速创面愈合的效果.

目的 探讨负压封闭引流技术(VSD)和植皮术联合修复深度烧伤创面的可行性.方法 选取接受治疗的深度烧伤患者60例,随机分为对照组和观察组各30例,对照组采用传统治疗,观察组采用负压封闭引流技术(VSD)和植皮术联合修复,比较两组的治疗效果.结果 观察组优20例(66.67%),良8例(26.67%),优良率为93.33%,对照组优12例(40%),良10例(33.33%),优良率为73.33%,差异具有统计学意义(P<0.05);观察组疼痛程度明显轻于对照组,差异具有统计学意义(P<0.05).结论 负压封闭引流技术(VSD)和植皮术联合修复深度烧伤创面效果良好,具有可行性.

Objective:To investigate in vivo expression of p120ctn and Her -2 in breast carcinoma with negative ER,PR and analyze its relationship with pathological characteristics.Methods:Immunohistochemical method was per-formed to detect expression of p120ctn and Her -2 in tissues from 87 cases of breast carcinoma with negative ER, PR,41 cases of paraneoplastic breast tissues and 33 cases of breast adenofibroma.Results:The rates of p120ctn aber-rant expression and Her -2 positive were 63.2% and 60.9%,respectively in 87 cases with negative ER and PR breast carcinoma,with 7.3% and 0% in 41 cases of paraneoplastic breast tissues and 9.1% and 0% in 33 cases of breast adenofibroma.The significant differences were seen among the aberrant expression of p120ctn and Her -2 posi-tive in ER and PR negative breast carcinoma compared with that of paraneoplastic breast tissues and breast adenofi-broma (P =0.000).Aberrent expression of p120ctn and Her -2 positive with ER,PR negative breast carcinoma were closely associated with histological grade and lymph node metastasis(P <0.05),but not related with the age,men-struation,tumor size and clinical stages(P >0.05).Furthermore,the aberrant expression of p120ctn was correlated with Her -2 positive in ER and PR negative breast carcinoma (r =0.952,P =0.000).Conclusion:The aberrant expression of p120ctn and Her -2 positive are likely to have synergistic or related effect in the genesis and progres-sion of ER and PR negative breast carcinoma.Combined detection of p120ctn and Her -2 may offer the initial evi-dence for predicting prognosis and gene targeting therapy of ER,PR negative breast carcinoma.