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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.
ABSTRACT
Objective To observe the effect of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on the prevention and treatment of oral mucositis induced by concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma. Methods A total of 64 patients with locally advanced nasopharyngeal carcinoma from April 2015 to April 2017 in the Second Affiliated Hospital of Xi'an Jiaotong University were enrolled. The patients were randomly divided into the observation group (32 cases) and the control group (32 cases) according to the random number table method. Both groups were treated with intensity modulated radiotherapy (IMRT) and synchronized with TP regimen (docetaxel + cisplatin) chemotherapy for 2 cycles. Both groups were treated with mouthwash at the beginning of radiotherapy to prevent oral mucositis. The observation group was given rhGM-CSF mouthwash, and the control group was given compound borax mouthwash. The oral mucositis and the oral pain during the treatment and the end of the treatment were evaluated by using American Radiation Oncology Group (RTOG) grading criteria and visual analogue scoring method(VAS) grading criteria. The time of onset of oral mucositis and the total time of radiotherapy in both groups was also recorded. Results All the patients were treated with concurrent chemoradiotherapy. The total radiotherapy time in the observation group was less than that in the control group [(46.4±1.6) vs. (48.2±3.2) d, t= -2.720, P= 0.009]. The clinical total effective rate was 93.8 %(30/32) in the observation group and 96.9 %(31/32) in the control group respectively (χ2= 0.35, P =0.554).The occurrence of grade 1,2 and 3 oral mucositis in the observation group was(20.9±2.5), (29.3±2.4), and (34.5±1.8) d respectively, which was latter than that in the control group [(16.3 ±2.0), (24.2 ±2.2) and (31.0 ±2.2) d] respectively (t= 8.125, P= 0.000; t= 8.840, P= 0.000; t= 6.944, P= 0.001). During concurrent chemoradiotherapy,the incidence of grade 3 oral mucositis in the observation group was lower than that in the control group[31.2 %(10/32)vs.56.2 %(18/32);Z=-2.197,P=0.028].At the end of concurrent chemoradiotherapy, the total incidence of grade 2 and grade 3 oral mucositis in the observation group was lower than that in the control group [53.1 % (17/32) vs. 81.2 % (26/32); Z= -2.708, P= 0.007]. The incidence of moderate and severe oral pain caused by oral mucositis in the observation group was lower than that in the control group[46.9 %(15/32)and 6.2 %(2/32)vs.59.4 %(19/32)and 15.6 %(5/32),respectively;Z= -2.009, P= 0.045]. Conclusion rhGM-CSF mouthwash can delay the occurrence of oral mucositis, reduce the incidence of oral mucositis and oral pain to effectively prevent and treat oral mucositis induced by concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma, which is worthy of clinical application.
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BACKGROUND:There are less reports about the external use of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) hydrogel to repair thick skin graft donor sites. By now, relevant self-control studies have not been retrieved. OBJECTIVE:To observe the effect of rhGM-CSF on the repair of thick skin graft donor sites. METHODS:Sixty patients with burns and scar hyperplasia undergoing autologous thick skin grafting were enroled, 47 males and 13 females, aged 18-65 years. The thigh was selected as donor sites. According to the depth of donor sites, the patients were divided into 0.4 mm and 0.55 mm groups, with 30 cases in each group. Wounds on the symmetric areas with equal area and same depth were selected or wounds with same depth were selected and divided equaly. The wounds were randomly assigned into treatment group and control group. The treatment group was treated with rhGM-CSF hydrogel externaly; the control group was only given vaseline dressing. At postoperative 3, 7, 10, 14 days, the fresh dressing was changed. Then, the wound appearance, healing time, healing rate and adverse effects were observed in the two groups. RESULTS AND CONCLUSION:At 14 days after operation, the wound surface was smoother and the pigmentation was relatively less in the treatment group compared with the control group; the degree of wound pain was less in the treatment group than the control group during dressing change (P < 0.05). At 10 and 14 days after operation, the healing rate and healing time were better in the treatment group than the control group (P < 0.05). No general malaise or hypersensitivity cases were reported, and local issue hyperplasia was also not found. Al the above indicate that the external use of the rhGM-CSF hydrogel can evidently shorten the healing time and improve the healing condition when it is applied in the thick skin graft donor sites.
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Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is characterized by fever, neutrophilia, erythematous and tender skin lesions that typically show a diffuse infiltrate of neutrophils in the upper dermis. This disorder has been associated with myeloproliferative syndromes. We report the case of a 53-year-old woman with an acute myeloid leukemia, presenting a Sweet's syndrome. A worsening of cutaneous lesions injuries was observed when granulocyte colony stimulating factor was added to treatment.
Subject(s)
Female , Humans , Middle Aged , Granulocyte Colony-Stimulating Factor/adverse effects , Leukemia, Myeloid, Acute/complications , Sweet Syndrome/etiology , Diagnosis, Differential , Fatal Outcome , Leukemia, Myeloid, Acute/drug therapy , Sweet Syndrome/pathologyABSTRACT
Objective: To observe the impact of transfection of human granulocyte macrophage colony stimulating factor (hGMCSF) mediated by hydroxyapatite(HA) nanoparticles on the growth of HepG2 cells in order to lay the foundation for further studying gene-modified tumor vaccines of hepatoma in clinic. Methods: The proliferation of HepG2 cells was measured by MTT assay. The plasmids containing hGM-CSF gene were transfected into HepG2 cells mediated by HA nanoparticles. Subsequently, resistant cells were selected by G418 screening. The monoclonal cells were selected by limiting dilution method. RT-PCR was used to identify the integration of hGM-CSF into HepG2 cells and transcription of hGM-CSF. ELISA was performed to detect the level of secreted hGM-CSF in cultured medium and the lasting time. The effect of hGM-CSF on cell cycle and apoptosis were assessed by flow cytometry (FCM) analysis. Results: MTT assay demonstrated that Nano-HA suspension liquid had no significant effects on the growth of HepG2 cells at the concentration below 80 μg/mL. RT-PCR demonstrated the hGM-CSF gene was successfully integrated and steadily expressed in the transfected HepG2 cells. ELISA indicated stable secretion of hGM-CSF from the stable transfected HepG2 cells [mean (216.22 ± 45.78) ng/106 cells per 24 h]. FCM analysis showed that hGM-CSF had no significant effects on the cell cycle and apoptosis of HepG2 cells. Conclusion: hGM-CSF gene could be safely transfected and stably expressed in HepG2 cells mediated by HA nanoparticles. Transfection of hGM-CSF gene mediated by HA nanoparticles has no effects on the growth of HepG2 cells. This study may lay a foundation for the further study of gene-modified hepatoma vaccines.