Effects of recombinant human granulocyte macrophage colony stimulating factor gel on treatment of full-thickness frostbite wounds on foot and hand / 中华烧伤杂志

Objective@#To explore the effects of recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) gel on treatment of thefull-thickness frostbite wounds on foot and hand.@*Methods@#From November 2013 to April 2017, a total of 45 patients of 71 full-thickness frostbite wounds on foot and hand meeting the inclusion criteria were admitted to the First Hospital of Jilin University and the prospective randomized controlled study was done. The patients were divided into rhGM-CSF group of 24 patients with 35 wounds and control group of 21 patients with 36 wounds according to the random number table. There were 20 males and 4 females, aged (38±13) years among patients in rhGM-CSF group, and there were 19 males and 2 females, aged (36±14) years among patients in control group. Patients in 2 groups were performed with the same systemic treatment of rewarming, anti-inflammation, pain relief, anti-infection, anti-coagulation, and thrombolysis. Wounds of patients in rhGM-CSF group and control group were respectively treated with rhGM-CSF gel and aloe vera gel for external usage with 10 mg for every square centimeter and dressing change once every 24 hours, until wounds healed completely. The wound inflammatory response was scored on treatment day (TD) 1, 3, 7, 14, wound secretion was collected for bacteria culture and positive bacteria detection rate was calculated before treatment and on TD 6 and 12, adverse drug reaction after drug use was observed, and the complete wound healing time was recorded. Data were processed with Fisher′s exact probability test, analysis of variance for repeated measurement, t test, and Bonferroni correction.@*Results@#The scores of wound inflammatory response of patients in 2 groups on TD 1 and 3 were close (t=0.37, 2.93, P>0.05). The scores of wound inflammatory response of patients on TD 7 and 14 in rhGM-CSF group were significantly higher than those in control group (t=5.77, 5.83, P<0.01). The results of bacteria culture of wound secretion of patients in 2 groups before treatment were negative. The positive bacteria detection rates of wound secretion of patients in rhGM-CSF group on TD 6 and 12 were 5.71% (2/35) and 22.86% (8/35), which were slightly lower than 13.89% (5/36) and 30.56%(11/36) in control group respectively, but there was no significantly statistical difference (P>0.05). No adverse drug response occurred in patients in rhGM-CSF group, while 1 patient in control group had adverse drug response, with symptoms of redness and swelling of wounds and patchy erythema on skin around wounds, which were alleviated by irrigating with normal saline. The complete wound healing time of patients in rhGM-CSF was (12.3±0.5) d, which was significantly shorter than (16.5±0.8) d in control group (t=24.89, P<0.05).@*Conclusions@#The topical rhGM-CSF gel has effects of shortening time of wound healing and reducing inflammatory response of wound on treatment of full-thickness frostbite wounds on foot and hand, which is safe in clinical application.

Minor similarities and major differences between cold injury and burn injury / 中华烧伤杂志

Cold injury is very damaging. This article summarizes the mechanism, types, and rehabilitation of cold injury, focusing on the degree and clinical treatment of frostbite. Frostbite can mainly cause damage of microcirculation and capillary structure, while burn injury can mainly cause damage of cutaneous tissues. Based on this, the key point of management of frostbite is to improve microcirculation and appropriate rewarming, while that of burn injury is wound repair. Up to date, the rate of amputation caused by frostbite is still high, and the rehabilitation for sequela caused by frostbite remains a big challenge in modern medicine. It is worth paying more attention to.

Clinical strategy on repair of pressure injury on ischial tuberosity based on the histopathological type / 中华烧伤杂志

Objective@#To investigate effects of clinical strategy on repair of pressure injury on ischial tuberosity based on the histopathological type.@*Methods@#From January 2014 to January 2018, 33 patients with 33 pressure injuries on ischial tuberosity were admitted to our department. There were 25 males and 8 females aged 35 to 87 years. Pressure injuries on ischial tuberosity were repaired with different methods according to pathological types of denatured tissue on basal parts of wounds and tissue defect volumes. Areas of wounds after thorough debridement ranged from 2.0 cm×1.0 cm to 14.0 cm×12.0 cm. Pressure injuries of necrosis type with tissue defect volumes of 6.5-9.5 cm3 were sutured directly after debridement at the first stage. Tissue defect volumes of 3 patients with pressure injuries of granulation type ranged from 56.0 to 102.5 cm3. According to situation around wounds, the above mentioned 3 patients were respectively repaired with posterior femoral Z-shaped reconstruction, posterior femoral advanced V-Y flap, and posterior femoral propeller flap. Tissue defect volumes of 5 patients with pressure injuries of infection type ranged from 67.5 to 111.0 cm3. Among the patients, 2 patients were repaired with posterior femoral propeller flaps, 2 patients were repaired with posterior femoral advanced V-Y flaps, and 1 patient was repaired with posterior femoral Z-shaped reconstruction. Among patients with pressure injuries of synovium type, wounds of 14 patients with tissue defect volumes 6.4-9.5 cm3 were sutured directly after debridement, and tissue defect volumes of another 8 patients were 97.0-862.5 cm3. Among the 8 patients, 7 patients were repaired with gluteus maximus myocutaneous flaps and continued vacuum sealing drainage was performed for 7 to 14 days according to volume of drainage, and 1 patient was repaired with posterior femoral propeller flap. Areas of flaps or myocutaneous flaps ranged from 3.5 cm× 2.5 cm to 14.0 cm×12.0 cm. The donor sites of flaps were sutured directly. Operative areas after operation and healing of wounds during follow-up were observed.@*Results@#The sutured sites of 33 patients connected tightly, with normal skin temperature, color, and reflux. During follow-up of 12 months, wounds of 25 patients healed well with no local ulceration, and 8 patients were admitted to our department again due to recurrence of pressure injuries on or near the primary sites. Pathological types of pressure injuries of the 8 patients were synovium types. After complete debridement, the tissue defect volumes were 336.8-969.5 cm3, wounds with areas ranged from 8.0 cm×7.0 cm to 14.0 cm×12.0 cm were repaired with gluteus maximus myocutaneous flaps or posterior femoral propeller flaps which ranged from 8.0 cm×7.0 cm to 14.0 cm×12.0 cm. Eight patients were discharged after wound healing completely. During follow-up of 12 months, operative sites of the patients healed well, with no recurrence.@*Conclusions@#Appropriate and targeted methods should be chosen to repair pressure injuries on ischial tuberosity based on the pathological types. Direct suture after debridement is the first choice to repair pressure injury of necrosis type. Pressure injuries of granulation type and infection type can be repaired with posterior femoral propeller flap, Z-shaped reconstruction, or advanced V-Y flap according to situation around wounds. Gluteus maximus myocutaneous flap is the first choice to repair pressure injury of synovium type. In addition, recurrence-prone characteristics of pressure injury of synovium type should be taken into consideration, plan should be made previously, and resources should be reserved.

Bacterial biofilm and chronic wound infection / 中华烧伤杂志

Bacteria usually colonize, reproduce, and grow aggressively on chronic wounds in the form of biofilm. Different from free bacteria, bacteria in biofilm exhibit unique mechanism in epigenetics and biological behavior, especially in resistance to antibiotics and host immunity. In this article, we introduce the composition and structural function of bacterial biofilm, expound the drug-resistance mechanism of bacterial biofilm, discuss the clinical characteristics of bacterial biofilm infection wound and the diagnosis method of biofilm, and analyze the treatment strategy for bacterial biofilm. It is suggested that clinicians should pay more attention to bacterial biofilm infection and advocate in-depth study of bacterial biofilm in order to improve the quality of managing chronic wounds.

Current Status and Progress of Peroral Endoscopic Myotomy in Treatment of Achalasia of Cardia / 胃肠病学

Achalasia of cardia caused by neuromuscular dysfunction at esophagus-stomach junction is a functional disease of esophageal dynamic dysfunction. It is characterized by absence of peristalsis of esophageal body and failure of the lower esophageal sphincter to relax. The methods of therapy include botulinum toxin injection, stent placement, laparoscopic Heller myotomy and balloon dilatation. However,these methods have some shortages,such as easy to recur, causing larger trauma,etc. . With the development of technology of endoscopy,a new method peroral endoscopic myotomy ( POEM)is widely used in clinical practice,and it can used in some special patients such asⅢ type achalasia,pediatric and elderly patients,as well as sigmoid-type achalasia. This article reviewed the current status and progress of POEM in treatment of achalasia of cardia.

Research progress and prospect of acupuncture for low-risk mild hypertension / 中国针灸

The low-risk mild hypertension constitutes a considerable proportion in hypertension. Through searching CNKI, Wanfang database, VIP database and PubMed database, literature during the last 10 years was collected and reviewed. It was indicated that excessive diagnosis, insufficient evidence of drug treatment, and poor drug adherence existed in low-risk mild hypertension, however, acupuncture at Renying (ST 9) and other therapies had remarkable effects. This paper mainly expounded the diagnosis and treatment status of low-risk mild hypertension as well as the research summary of acupuncture for low-risk mild hypertension.

Acupuncture method of "Huoxue Sanfeng, Shugan Jianpi" for morning blood pressure in patients with cerebral infraction combined with essential hypertension: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical effects of acupuncture method of "Huoxue Sanfeng, Shugan Jianpi" (activating blood and eliminating wind, soothing liver and strengthening spleen) on morning blood pressure in patients with cerebral infraction combined with essential hypertension.</p><p><b>METHODS</b>Sixty-eight patients were randomly divided into an observation group and a control group, 34 cases in each one. The patients in the two groups were treated with acupuncture method of "Xingnao Kaiqiao" (consciousness-restoring resuscitation) and oral administration of nifedipine. In addition, patients in the observation group were treated with acupuncture method of "Huoxue Sanfeng, Shugan Jianpi" that met the criteria of standard manipulation, in which bilateral Renying (ST 9), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3) were selected. The treatment was given once a day, five times a week, for totally six weeks. The improvement and control rate of morning blood pressure in the two groups were observed.</p><p><b>RESULTS</b>(1) After treatment, the morning blood pressures were decreased significantly in the two groups (all P < 0.05); after 15 treatments, the reduction of systolic pressure and diastolic pressure in the observation group was superior to that in the control group, but the difference was not significant (both P > 0.05); after 30 treatments, the reduction of systolic pressure and diastolic pressure in the observation group was significantly superior to that in the control group (both P < 0.05). (2) After 30 treatments, the control rate of morning blood pressure in the observation group was significantly higher than that in the control group [82.4% (28/34) vs 58.8% (20/34), P < 0.05].</p><p><b>CONCLUSION</b>Acupuncture method of "Huoxue Sanfeng, Shugan Jianpi", characterized with standard manipulation criteria, can effectively control morning blood pressure in patients with cerebral infraction combined with essential hypertension.</p>

Advances in the progress of anti-bacterial biofilms properties of acetic acid / 中华烧伤杂志

Bacterial biofilms are considered to be the hindrance in the treatment of chronic wound, because of their tolerance toward antibiotics and other antimicrobial agents. They also have strong ability to escape from the host immune attack. Acetic acid, as a kind of organic weak acid, can disturb the biofilms by freely diffusing through the bacterial biofilms and bacterial cell membrane structure. Then the acid dissociates to release the hydrogen ions, leading to the disorder of the acid-base imbalance, change of protein conformation, and the degradation of the DNA within the membranes. This paper reviews the literature on the characteristics and treatment strategies of the bacterial biofilms and the acetic acid intervention on them, so as to demonstrate the roles acetic acid may play in the treatment of chronic wound, and thus provide a convincing treatment strategy for this kind of disease.

Study on anti-cataract effect of gigantol combined with syringic acid and their mechanism / 中国中药杂志

<p><b>OBJECTIVE</b>To study the anti-cataract effect of gigantol combined with syringic acid and their action mechanism.</p><p><b>METHOD</b>H202-induced lens oxidative injury in vitro rat model was establish to observe the impact of gigantol combined with syringic acid on lens transparency under a dissecting microscope. D-galactose-induced cataract rat model was established to observe the impact of gigantol combined with syringic acid on lens transparency under a slit-lamp. UV spectrophotometry was adopted to detect the inhibitory activity of gigantol combined with syringic acid against AR. Molecular docking method was used to detect binding sites, binding types and pharmacophores of gigantol combined with syringic acid in prohibiting aldose reductase.</p><p><b>RESULT</b>Both in vitro and in vivo experiments showed a good anti-sugar cataract activity in the combination of gigantol and syringic acid and a better collaborative effect than single component-gigantol and syringic acid and positive control drug Catalin. Molecular docking and dynamic simulation showed their collaborative AR-inhibiting amino acid residue was Asn160 and the major acting force was Van der Waals' force, which formed common pharmacophores.</p><p><b>CONCLUSION</b>Gigantol combined with syringic acid shows good anti-cataract, their action mechanism is reflected in their good collaborative inhibitory effect on AR.</p>

Extraction and Isolation of Different Polar Alkaloids from Herba Dendrobii and Their Influences on Human Lens Epithelial Cells Proliferation / 广州中医药大学学报

Objective To observe the protection of human lens epithelial cells(HLEC) by different polar alkaloids extracted from Herba Dendrobii(HD).Methods We extacted the Herba Dendrobii powder with ethanol,and then treated the extract with falling-film concentration,acidification,salting out,chloroform extraction,and washing with water.Different polar alkaloids were extracted from HD after the above treatment.The protective effect of HD alkaloids was observed on HLEC,which were cultured with DMEM medium containing 10% fetal calf serum.Ten groups were set up for the experiment: normal control group,model group,high-and low-dose water-soluble alkaloids groups,high-and low-dose fat-soluble alkaloids groups,high-and low-dose low-polar alkaloids group,and high-and low-dose weak-polar alkaloids groups.The high-dose dosage of the alkaloids was 25.0 ?g/L and low-dose dosage was 12.5 ?g/L.Methyl thiazolyl tetrazolium(MTT) assay was used to evaluate the proliferation of HLEC under the different conditions of interventions.Results The single-factor experiments showed that the highest extracting rate of HD alkaloids was obtained under the conditions of extracting the powder with 80% ethanol for 3 times and for 3 hours.The results of protective experiment showed that the proliferation of HLEC in the model group was inhibited by hydrogen peroxide(H2O2),and the inhibitive rate was lower in low-dose fat-soluble alkaloids group than that in the model group(P