ABSTRACT
Objective To investigate the effect of platelet-rich plasma (PRP) combined with negative pressure wound therapy (NPWT) on orthopedic refractory wound.Methods A total of 84 patients with chronic refractory wound were selected from January 2014 to December 2016 in Department of Osteology,Jizhong Energy Xingtai Mining Group General Hospital.The patients were divided into control group and observation group according to the admission time,42 cases in each group.The patients in the control group were treated with NPWT,and the patients in the observation group were treated with PRP and NPWT.The power of hydrogen (pH) of wound exudate,wound temperature and wound pressure ulcer scale for healing (PUSH) were compared between the two groups before and after treatment.The bacterial cuhure result was compared between the two groups after two weeks of treatment.The change of serum erythropoietin (EPO) level were observed before and four weeks after treatment,and the suitable skingrafting time,wound healing time and cure rate were observed in the two groups.Results After two weeks of treatment,the positive rate of bacterial culture in the observation group was significantly lower than that in the control group (x2 =4.850,P ＜ 0.05).The pH value of wound exudate and the wound PUSH score in the observation group were significantly lower than those in the control group(P ＜0.05),but the wound temperature in the observation group was higher than that in the control group after two weeks of treatment (P ＜ 0.05).The results of intra group comparison showed that the serum EPO level showed an upward trend within four weeks of treatment,and the difference was statistically significant at different time points in the two groups (F =7.356,8.264;P ＜ 0.05).The level of serum EPO in the observation group was significantly higher than that in the control group at the treatment of 1,2,3 and 4 weeks (P ＜ 0.05).Compared with the control group,the suitable skingrafting time was early (P ＜ 0.05),the wound healing was fast (P ＜ 0.05),and the cure rate was high in the observation group (x2 =4.720,P ＜ 0.05).Conclusion The combination of PRP and NPWT has good antibacterial effect,and can promote the EPO level and wound healing.
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Objective To investigate the clinical effect of platelet-rich plasma combined with flap transplantation in treatment of refractory wounds.Methods Sixty patients of refractory wounds who were admitted into our hospital from April 2016 to February 2017 were enrolled in the observation group,and another sixty patients with refractory wounds who had been discharged from the hospital before April 2016 were trea-ted as the control group.All the patients accepted debridement and disinfection.Then the observation group were managed with PRP and flap transplantation,while the control group were treated with flap transplantation directly without PRP.Observed the frequency of dressing changes, rate of wound infection,healing time and recovering rate of the two groups.Measurement data were analyzed with t inspection and analysis of va-riance,and count data were compared by χ2test,and repeat data was analyzed with repeat data variance analysis.Results After one weeks' treatment,the number of wet gauze layers were(20.5 ±1.6)in the observation group,which was less than(23.3 ±6.1)in the control group with statistically significant difference(t=-3.439,P=0.001).The healing time of the observation group was(25 ±2)d,which was shorter than(43 ±5)d in the control group(t=-25.891,P=0.000).The frequency of dressing changes was(7.1 ±1.0)times in observation group, which was less than(9.3 ±1.4)times in the control group(t=-9.905,P=0.000).There were 5 cases of inflammation reaction in the obser-vation group,which was less than 18 cases in the control group(χ2=9.090,P=0.003).The cases of the skin flap survival in the observation group was 55,which was more than 41 cases in the control group,and the difference of the two groups was statistically significant(χ2=10.208, P=0.001).The average healing rate of the two groups both increased at different time points.And the average healing rate of the observation group was higher than that in the control group at different time points,and the difference was statistically significant(P<0.05).Conclusion Platelet-rich plasma can remarkably shorten the healing time,improve healing rate,reduce frequency of dressing change and promote wound healing for refractory wound.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the role of HIV-1 tat gene variations in AIDS dementia complex (ADC) pathogenesis.</p><p><b>METHODS</b>HIV-1 tat genes derived from peripheral spleen and central basal ganglia of an AIDS patient with ADC and an AIDS patient without ADC were cloned for sequence analysis. HIV-1 tat gene sequence alignment was performed by using CLUSTAL W and the phylogentic analysis was conducted by using Neighbor-joining with MEGA4 software. All tat genes were used to construct recombinant retroviral expressing vector MSCV-IRES-GFP/tat. The MSCV-IRES-GFP/tat was cotransfected into 293T cells with pCMV-VSV-G and pUMVC vectors to assemble the recombinant retrovirus. After infection of gliomas U87 cells with equal amount of the recombinant retrovirus, TNF-α, and IL-1β concentrations in the supernatant of U87 cells were determined with ELISA.</p><p><b>RESULTS</b>HIV-1 tat genes derived from peripheral spleen and central basal ganglia of the AIDS patient with ADC and the other one without ADC exhibited genetic variations. Tat variations and amino acid mutation sites existed mainly at Tat protein core functional area (38-47aa). All Tat proteins could induce U87 cells to produce TNF-α and IL-1β, but the level of IL-1β production was different among Tat proteins derived from the ADC patient's spleen, basal ganglia, and the non-ADC patient's spleen. The level of Tat proteins derived from the ADC patient's spleen, basal ganglia, and the non-ADC patient's spleen were obviously higher than that from the non-ADC patient's basal ganglia.</p><p><b>CONCLUSION</b>Tat protein core functional area (38-47aa) may serve as the key area of enhancing the secretion of IL-1β. This may be related with the neurotoxicity of HIV-1 Tat.</p>