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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.
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Objective The nerve-protective effect of Apoli-poprotein J ( ApoJ) in intracerebral hemorrhage ( ICH) is not yet clarified.This study aimed to explore the therapeutic effect of trans -plantation of bone marrow mesenchymal stem cells (BMSCs) carrying the ApoJ gene on intracerebral hemorrhage in rats and its possible ac -tion mechanism. Methods Rat BMSCs were isolated, cultured in vitro, and transfected with the recombinant plasmid pEGFP -N1-ApoJ mediated with lipofectamine.Ninety-six SD rats were randomly divided into groups A, B and C, and ICH models were established by two -step autologous intracranial blood injection .At 24 hours after model-ing, the rats in groups A, B, and C were transplanted with the same volume of ApoJ-transfected BMSC suspension, BMSC suspension and normal saline, respectively.At 1, 3, 5 and 7 days after transplantation, the neurofunction recovery of the rats were evaluated with modified Neurological Severity Scores (mNSS), the brain water content measured by the dry -wet weight method, and the expression level of complement component 3 (C3) in the brain tissue detected by Western blot . Results The mNSS exhibited no statistically significant differences among the three group of rats on the 1st day after transplantation (P>0.05), but was remarkably lower in group A than in B and C on the 3rd (8.13±0.99 vs 9.25±1.28 and 10.88±0.84, P<0.05), 5th (6.75±1.04 vs 8.50±1.41 and 9.75±0.89, P<0.05) and 7th day (5.63±0.52 vs 7.00±0.54 and 7.88±1.25, P<0.05), and markedly lower in group B than in C (P<0.05).The water content in the brain tissue was also significantly lower in group A than in B and C on the 1st (78.17±0.82 vs 78.83±0.56 and 80.38±0.35, P<0.05), 3rd (78.68±0.55 vs 79.12±0.26 and 81.47±0.26, P<0.05), 5th (77.00±0.58 vs 78.13±0.46 and 79.74± 0.41, P<0.05) and 7th day (75.89±0.46 vs 76.86±0.29 and 78.44±0.44, P<0.05), and remarkably lower in group B than in C (P<0.05).Western blot showed that the expression of the C 3 protein in the brain tissue was markedly decreased in group A as compared with B and C on the 1st (0.096±0.011 vs 0.212±0.014 and 0.440±0.006, P<0.05), 3rd (0.083±0.005 vs 0.164±0.013 and 0.604± 0.011, P<0.05), 5th (0.064±0.009 vs 0.105±0.010 and 0.333±0.010, P<0.05), 7th day (0.045±0.007 vs 0.091±0.004 and 0.141± 0.003, P<0.05), and significantly lower in group B than in C (P<0.05). Conclusion ApoJ can promote the recovery of the neuro-logical function of ICH rats by inhibiting complement activation -mediated secondary brain damage and alleviating cerebral edema .
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Objective The expressions of inflammatory factors and brain edema after traumatic brain injury (TBI) are the main factors for deterioration of the condition.TBI after drunkenness is even more difficult to be managed than simple TBI.This study was to discuss the effects of drunkenness on the inflammatory factors TNF-o and IL-6 and the aquaporin-4 (AQP-4) protein in rats after TBI.Methods Forty-eight male adult SD rats were randomly divided into a TBI and an ethanol (ETH) pretreatment group.TBI was induced using the Feeney's method after intraperitoneal injection of 3％ chloral hydrate at 30 mg/kg (the TBI group) or following gavage of ETH (the ETH group).At 1,3 and 5 days after modeling,modified neurological function scores (mNSS) were obtained,the expressions of TNF-α,IL-6 and AQP-4 protein determined by Western blot,and the levels of TNF-α.IL-6 and AOP-4 mRNA measured by RT-PCR at 6,24 and 72 hours.Results Compared with the TBI group,the ETH group showed significantly decreased mNSS at 1 day (9.00±0.63 vs 7.17±1.72,P＜0.05),3 days (7.00±1.10 vs 4.83±1.47,P＜0.05) and 5 days after modeling (5.50±1.05 vs 3.83± 0.75,P＜ 0.05),but remarkably up-regulated expressions of TNF-α (0.068± 0.008 vs 0.257 ± 0.008,P＜ 0.01),IL-6 (0.102 ±0.013 vs 0.320±0.016,P＜0.01) and APQ4 (0.054±0.007 vs 0.212±0.015,P＜0.01) at 6 hours,as well as at 24 and 72 hours (P＜0.01).Conclusion Drunkenness may increase the expressions of inflammatory factors and brain edema after traumatic brain injury and consequently aggravate secondary brain injury.
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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.