【摘要】 目的 探討細菌性膠原酶對創口感染情況的影響。 方法 2006年11月-2006年12月，對28只新西蘭兔分為實驗組和對照組，分別予細菌性膠原酶溶液及生理鹽水浸潤創口并縫合。觀察創口感染及局部皮膚的炎性細胞浸潤情況。 結果 實驗組與對照組創口感染率差別無統計學意（Pgt;0.05），炎性細胞差別無統計學意義（Pgt;0.05）。 結論 細菌性膠原酶在創傷修復過程中不能直接降低感染率，對炎性細胞的遷移并無明顯的作用。 【Abstract】 Objective To assess the effects of bacterial collagenase on the wound infection. Methods A total of 28 New Zealand rabbits have chosen from November to December 2006, and were divided into a laboratorial group and a control group. We sutured the wounds and soaked them by the bacterial collagenase liquid or by the physiologic saline solution. The infection and the inflammatory cells of the skin around the wound were observed. Results The difference of the infection rates between the two groups was not statistically significant (P=0.62), nor the difference of inflammatory cells (P=0.84). Conclusions Bacterial collagenase can not decrease the rate of infection directly, and had no obvious effect on the transferring of inflammatory cells.
ObjectiveTo observe the accuracy of location and operation of traditional blind acupotomy lysis in the treatment of scapulohumeral periarthritis by using the high-frequency ultrasound.MethodsForty-two patients with scapulohumeral periarthritis diagnosed in the First Affiliated Hospital of Xinjiang Medical University and Urumqi Hospital of Traditional Chinese Medicine from February to April 2018 were selected. Four common sites of needle knife in the treatment of scapulohumeral periarthritis were operated blindly, and the process of the needle insertion points location and needle perform were both observed by high-frequency ultrasound.ResultsUsing high-frequency ultrasound to observe and confirm the bare-handed positioning point and needle-knife operating point, we found that the accuracy rate of bare-handed positioning needle-point was 100.0% (42/42). In the process of needling, the accuracies of needle insertion at the point of small tubercle of humerus and the point of bursa of deltoid muscle were high, which was 95.2% (40/42) and 100.0% (42/42), respectively. However, because of the deviation of the needle depth and direction, the accuracies of needle insertion at the coracoid point and the sulcus point between the humeral tubercles were low, which was 45.2% (19/42) and 4.8% (2/42), respectively.ConclusionsTraditional acupotomy lysis is a commonly used method of needle knife treatment. Using high-frequency ultrasound, it is found that even by experienced needle knife doctors, there may still be positioning deviation when using blind method to insert needles. Because the visualization of clinical needle knife is difficult to be carried out universally due to the limitations of time and technology, it is suggested that high-frequency ultrasound could be used as a visualization teaching tool in the training of needle knife operation to assist the training of blind needle knife operation technology, which may improve the accuracy of blind needle knife operation.
在GRADE方法中，若多數相關證據來自高偏倚風險的研究，則起初被定為高質量證據的隨機試驗和低質量證據的觀察性研究均有可能被降低質量等級。隨機試驗已確定的局限性包括：未進行分配隱藏、未實施盲法、未報告失訪情況及未恰當考慮意向性治療原則。最近提出的局限性包括：因明顯獲益而早期終止試驗和基于結果選擇性報告結局。觀察性研究的主要局限性包括使用不合適的對照及未能充分調整預后的不平衡。偏倚風險可因不同結果而異（如全死因死亡率的失訪遠少于生命質量的失訪），許多系統評價都容易忽略這一點。在決定是否因偏倚風險而降低質量等級時，不管是隨機試驗還是觀察性研究，作者不應采用對各個研究取平均值的方法。相反，對任何單個結果，當同時存在高、低偏倚風險的研究時，則應考慮只納入較低偏倚風險的研究。
The original meaning of “allocation concealment” is that the statistician and the trial designer who generated the random sequence and allocation sequence should not recruit and allocate the participants for the purpose of avoiding selection bias. In the process of generating allocation sequence, combined blinding measures are so called “setting blinding”, for instance, by using “double simulation”. We use a example to describe how to perform an adequate allocation and conceal the sequence, and setting blinding. Another example is used to describe how to report the methods of randomization, allocation concealment and the effect of blinding, etc.
Blinding is an effective measure to control and reduce the bias caused by the subjective factors of participants in a study. However, the failure of blinding results in more bias. Therefore, it is necessary to assess blinding quality in clinical trials involving blinding. The relevant international articles and methods of blinding assessment were summarized in this study. According to the present situation of blinding assessment, researchers don't pay enough attention to the assessment of blinding quality, relevant studies lack, comprehensive methods and tools for blinding quality, and researchers have discrepancy with time points in blinding quality. Therefore, it is necessary to conduct further studies in all aspects, and it is suggested that comprehensive blinding quality scales should be developed according to the key influencing factors of the implementation of blinding. Through the assessment of the implementation of key factors, the risk and degree of blinding should be confirmed in order to better interpret and assess researcher results.