ABSTRACT
BACKGROUND: Photodynamic antimicrobial chemotherapy holds broad-spectrum antibacterial ability, fast onset of action and non-resistance, which has been extensively applied in the treatment of superficial localized infection. OBJECTIVE: To explore the efficacy of photodynamic antimicrobial chemotherapy for treating osteomyelitis. METHODS: Thirty-six New Zealand white rabbits (provided by Laboratory Animal Center of Academy of Military Medical Sciences) were selected, and a left tibia osteomyelitis model was established. At 28 days after modeling, rabbit models were randomly divided into three groups: Blank group (tibia debridement only), control group (vancomycin/polymethylmethacrylate bone cement was filled into the intramedullary cavity of the infectious tibia after debridement), and experimental group (intramedullary treatment of photodynamic antimicrobial chemotherapy after debridement). The gross observation, imaging examination and bacterial culture were performed at 4, 8, and 12 weeks after surgery. The study was approved by the Ethical Committee of Affiliated Hospital of Logistics College of CAPF, with the approval No. (2015)-0002. RESULTS AND CONCLUSION: (1) Appearance of the skin: Purulent secretion was observed in the blank group, but disappeared in the control and experimental groups where the skin healed well. (2) X-ray examination: With time going, the osteomyelitis aggravated in the blank group. The bone destruction was reduced gradually in the control and experimental groups, and the bone defects healed gradually. There was no significant difference between control and experimental groups at different time points after surgery. (3) Bacterial culture: With time increasing, the bacterial positive rate showed no significant change in the blank group. The bacterial positive rate in the control and experimental groups was on a decline, which showed no significant difference between control and experimental groups at different time points after surgery (P > 0.05). (4) These results indicate that photodynamic antimicrobial chemotherapy is a new treatment for osteomyelitis to effectively control infection, providing experimental basis in clinical practice.
ABSTRACT
BACKGROUND:In foreign animal experiments and clinical reports, microporous polysaccharide hemospheres are characterized as good hemostatic effect, no delayed bleeding, good biocompatibility, and no adverse reactions in the body. OBJECTIVE:To assess the efficacy and safety of microporous polysaccharide hemospheres on reducing blood loss after unilateral total hip arthroplasty. METHODS:Totaly 98 patients who received unilateral total hip arthroplasty due to femoral neck fractures, 39 males and 59 females, aged 61-77 years, were randomly divided into two groups: test group, treated with 1g microporous polysaccharide hemospheres before suture of wound; control group, treated with electric coagulation hemostasis before suturing. Drainage tubes were placed in the two groups. Hemoglobin, blood loss, alogeneic transfusion rate, drainage volume, coagulation index and incidence of deep venous thrombosis of the lower limbs were compared. RESULTS AND CONCLUSION:The total blood loss, drainage volume, and transfusion rate in the test group were significantly lower than those in the control group (P < 0.01), but there were no differences in D-dimer, platelet count, activated partial thromboplastin time and international normalized ratio between the two groups. One case of each group developed deep venous thrombosis of the lower limbs, and no significant difference was in the incidence of deep venous thrombosis between the two groups. No infection occurred. These findings indicate that microporous polysaccharide hemospheres that are safe, effective and convenient can reduce the visible and hidden blood loss after unilateral total hip arthroplasty.