Identification of Bacterial Isolates and Their Antimicrobial Susceptibility Pattern from Wound/Pus Sample in a Tertiary Care Hospital, Gwalior, India

Objective: The goal of this investigation was to look at the frequency and dispersal of bacteria isolated from pus/wound, as well as their susceptibility patterns. Materials and Methods?A study was conducted on 175 patients who provided pus and/or wound discharge samples in different wards (outpatient department or inpatient department). MacConkey agar and blood agar plates were immediately inoculated with samples and incubated at 37°C for 24?hours. The Gram stain and biochemical tests were used to identify all isolates after incubation. Kirby–Bauer's disc diffusion method was used to perform sensitivity tests on Mueller–Hinton agar plates. Results?This study covered 175 patients, with a bacterial isolation rate of 102 (58.28%). Males outnumbered females in the samples (M:F?=?1.8:1), with a median age of 45 years as majority were in the age group of 40 to 60 years which was 41 (40.20%). Total 90.1% samples showed monomicrobial infection, whereas 9.8% showed polymicrobial infection, and total 112 bacterial strains were isolated. Conclusion?Escherichia coli was the most prevalent isolate in present investigation, followed by Pseudomonas aeruginosa. Chloramphenicol is the only antibiotic which is effective for both gram-negative bacilli and gram-positive cocci. This report's susceptibility statistic may be worth considering for developing empiric treatment regimens for pyogenic infections.

Clinical Observation on Wagner 2-3 Diabetic Foot Ulcer Treated by TCM External Treatment Scheme for Euriching Pus for Tissue Growth / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and safety of traditional Chinese medicine （TCM） external therapeutic protocol of enriching pus for tissue growth （EPTG） in the treatment of Wagner 2-3 diabetic foot ulcer. MethodThe randomized controlled trial （RCT） design was adopted. Patients receiving basic treatment were divided into the EPTG group and the control group （debridement and change of nano-silver medical antibacterial dressing）. Ulcer healing rate， ulcer area， ulcer depth， TCM symptom score， visual analogue scale（VAS）， transcutaneous partial pressure of oxygen， wound blood flow， inflammatory factors ［C-reactive protein （CRP）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α）］， growth factors ［vascular endothelial growth factor （VEGF）， transforming growth factor-β1 （TGF-β1）， and fibroblast growth factor-β （FGF-β）］， adverse events， and outcome events of the two groups before and after treatment were observed. ResultCompared with the conditions before treatment， the ulcer healing rate， ulcer area， ulcer depth， TCM symptom score， VAS score， transcutaneous partial pressure of oxygen， wound blood flow， CRP， IL-6， TNF-α， VEGF， TGF-β1， and FGF-β were significantly improved （P<0.01）. In terms of the improvement in the ulcer healing rate， ulcer area， ulcer depth， VAS score， transcutaneous partial pressure of oxygen， wound blood flow， CRP， IL-6， TNF-α， VEGF， TGF-β1， and FGF-β， the EPTG group was superior to the control group （P<0.01）. There were no statistically significant differences in adverse events and outcome events between the two groups. ConclusionThe TCM external therapeutic protocol of EPTG is safe and effective in the treatment of Wagner 2-3 diabetic foot ulcer. It can greatly reduce the area and depth of diabetic foot ulcer， improve the ulcer healing rate and TCM symptom score， relieve the pain of patients， and improve the microcirculatory blood supply in the local ulcer. Its mechanism of action may be related to the reduction of the local inflammatory response of the wound and the improvement of the proliferation of fibroblasts and vascular endothelial cells.

TREATMENT DIFFICULTIES WITH LIVER ABSCESS IN PREGNANCY A RARE CASE REPORTTREATMENT DIFFICULTIES WITH LIVER ABSCESS IN PREGNANCY A RARE CASE REPORT

Liver abscess in pregnancy is a rare entity and can be a life threatening condition. Here we present A case of amoebic liver abscess in 25 years old lady in of pregnancy, with highlights on treatmentthird trimester difficulties which we had faced in the management and timely intervention leads to good fetomaternal outcome

Bacteriological Profile of Wound Swab and Pus Samples Using Conventional Media and Chromogenic Medium.

Background: Wound infections continue to be a causeof concern as they can delay healing and cause woundbreakdown. Their effective treatment demands quickisolation and identification of causative organisms withappropriate antibiotic sensitivity pattern. Material andMethods: Wound swab and pus samples received frominpatient as well as outpatient department of all agegroups and both genders were processed usingconventional media as well as chromogenic medium(HiCrome UTI) and results of both were compared.Antibiotic sensitivity testing was done on Vitek 2Compact automated system. Results: Among 342samples, 77% showed growth. Fifty eight percentagewere Gram negative and 42% were Gram positiveorganisms. Polymicrobial growth was seen in 11% ofsamples. HiCrome UTI isolated all organisms inculture. Colony characteristics and colour of all isolateson HiCrome UTI were comparable to theiridentification on Vitek 2 Compact. Among the Grampositive organisms, commonest was MethicillinSensitive Staphylococcus aureus (MSSA 42%)followed by Methicillin Resistant Staphylococcusaureus (MRSA 33%), Enterococcus faecalis (10%),Staphylococcus epidermidis (8%), Staphylococcushaemolyticus (3%), Streptococcus pyogenes (2%) andStreptococcus agalactiae (2%). Most of the Grampositive organisms were sensitive to vancomycin,teicoplanin, linezolid and clindamycin The commonGram negative organisms were E. coli (36%),Klebsiella pneumoniae (20%), Pseudomonasaeruginosa (18%), Proteus mirabilis (7%),Enterobacter cloacae (6%) and Acinetobacterbaumannii (4%). Most of the Gram negative organismswere sensitive to cefepime, beta lactams-betalactamase inhibitors, aminoglycosides and fluoroquinolones. Conclusion: Gram-negative organismspredominated in our study. HiCrome UTI agar can beused as a cost-effective approach for rapid isolation ofall organisms. It gives definite identification ofcommon organisms and thus reduces turn-around-timefor the same. It provides presumptive identification ofinfrequent organisms which can be further confirmedby simple biochemical tests. Hence these properties ofHiCrome UTI agar help serve the purpose especiallyfrom mixed cultures and in resource constraint settings

Analysis of urine as an indicator of specific body conditions in pregnant women in rural mountainous region

Background:Urinalysis is a procedure for examining physical properties, particulate matter, cells, casts, crystals, organisms and solutes. Urinalysis is a routine screening and diagnostic tool used to identify infections including renal, urological, liver disease, diabetes mellitus and urinary tract infection (UTI). Urinalysis can be used to screen, glucose, leucocytes, nitrite and blood. Although urinalysis is an effective screening tool it should not be used in isolation to guide treatment because false positives, for example, nitrites, and false negatives, for example, glucose, can occur if the sample is contaminated or left to stand for too long. UTI is among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Aim of this study is to identify the markers of urinary tract infection by urine routine microscopic analysis in pregnant women.Methods:This was a two months prospective study from June 1st 2019 to July 31st 2019. Urine samples of 72 pregnant women coming routinely to OPD of GMC,Doda were examined by physicaland biochemical analysisby microscopy methods.Results:Majority of samples were pale yellow with turbid appearance. Protein was present in most of the samples whereas glucose was present in a minor number of samples. Microscopy revealed increase in pus and epithelial cells count in most of the samples while bacteria were present in almost half of the samples.Conclusions:To conclude from the present study that appearance, presence of protein, pus cells, epithelial cell and bacteria, all taken together can serve as a strong indicator of UTI.

Microbial Profile and Antibiogram of Pus Isolate in a Tertiary Care Hospital of Western Odisha.

Pus sample is one of the major samples received in Microbiology laboratory. Overall incidence of wound sepsis in India is 10-33%. A predictable microbial profile in wound infection is very much important for clinician to start empirical therapy and also to combat drug resistance. We wanted to assess the microbial profile and antibiogram in pus isolates causing wound infection in a tertiary care centre of Western Odisha.METHODSThis is a cross-sectional descriptive study. 287 pus samples in total received from different departments of Hitech Medical College, Rourkela, from June 2019 to Dec. 2019 were processed using standard microbial culture methods and antibiotic sensitivity was done as per CLSI guideline.RESULTSAmong 287 samples, 187 (65%) showed positive growth. Among 187 positive samples, 64% were from male population. Middle age group (21-40 and 41-60) was most affected age group (36% and 37.4% respectively). Most commonly isolated bacteria were Staphylococcus aureus (38%) followed by Pseudomonas species (17.10%). Least common bacteria were Streptococcus pyogenes (0.5%). Most of the gram-negative bacilli showed high sensitivity towards imipenem (53-93%), meropenem (80-100%), piperacillin tazobactam (67-100%) and amikacin (67-88%) but lower sensitivity to 3rd generation cephalosporins (36-73%), cotrimoxazole (60-80%), amoxiclav (20-75%) and fluoroquinolones (42-73%). Staphylococcus aureus showed high sensitivity to linezolid (92%), aminoglycoside (84%), clindamycin (88%) and cotrimoxazole (72%) but lower sensitivity to erythromycin (25%), amoxiclav (40%) and fluoroquinolones (44%).CONCLUSIONSStaphylococcus aureus and Pseudomonas species were the most common bacteria isolated in our study with variable antibiogram. Pus aspirate was better sample than pus swab. A continuous inspection should be carried out to monitor the antibiogram of wound isolate to formulate and implement antibiotic policy in our hospital.

Comparative Study of Bacteriological Profile of Cellulitis in Diabetic versus Non-Diabetic Patient

Introduction: Comparative study of bacteriological profile of cellulitis - in diabetic versus non diabetic patient.Materials and Methods: During a period of June 2018–May 2019 in Sanjay Gandhi Memorial Hospital surgical wards,approximately 100 cases including both diabetic and non-diabetic getting admitted through surgery out patient department,casualty, or transferred from other departments diagnosed as cellulitis based on clinical suspicion. Samples were collectedfrom the deeper portion of the ulcers, among these samples, one swab was used for Gram staining and the other was usedfor culture. A direct Gram stained smear of the specimen was examined. The organisms were identified on the basis of theirGram staining properties, their biochemical reactions, and the culture identified.Results: According to pus culture sensitivity is was found that among Gram-negative isolates, Pseudomonas aeruginosa(25.19% in D and 28.06 in ND) is most common in both diabetic and non-diabetic followed by Escherichia coli (16.12% in Dand 17.39% in ND) and Klebsiella pneumoniae (12.9% in D and 8.6% in ND). Among Gram-positive isolates, Staphylococcusaureus is most commonly isolated followed by Enterococcus in diabetics, as in non-diabetics, S. aureus (32. 25% in D and30.43% in ND) is most commonly isolated followed by Enterococcus (9.6% in D and 4.3% in ND) and methicillin-sensitive S.aureus (1.6% in D and 2.17% in ND) (D – diabetics and ND – non-diabetics).Conclusion: Microbiological evaluation of the ulcers revealed that the prevalence of Gram-negative organisms 47 (57.75%)was found to be more than Gram-positive organisms 14 (17.5%), Candida albicans 3 (3.75%), and polymicrobial species17 (21.25%). Among Gram-negative isolates, P. aeruginosa is most common in both diabetic and non-diabetic followed by E.coli and K. pneumoniae. Among Gram-positive isolates, S. aureus is most commonly isolated followed by Enterococcus indiabetics, as in non-diabetics, S. aureus is most commonly isolated followed by Enterococcus and methicillin-sensitive S. aureus.

Multifocal hepatic abscesses in immunocompetent patient due to Bartonella henselae: Case report with review of literature

To the best of our knowledge, this is the first case of multifocal hepatic abscesses in a young immunocompetent adult from India, which was successfully treated with hepatectomy and short course of oral antibiotic regimen. Publishing further such case reports will provide more clarity regarding the clinical significance of the disease, including associated risk factors and appropriate treatment.

Incidence of urinary tract infection in febrile children

Background: Urinary tract infection is diagnosed by the growth of many organisms of a single specimen in the urine with presence of many symptoms. bacteriuria is defined as growth with a colony of >105/ml of a single species in a midstream clean catch urine sample.Methods: A cross sectional study was undertaken in febrile children with urinary tract infection attending Department of Paediatrics, tertiary care hospital, Bangalore during the period January 2017 to December 2017.Results: Out of the 200 children studied, 93 children belonged to the age group of 6 year to 12 year and 57 children belong to 1 year to 6-year age group and 50 children belongs to 12 year to 18-year age group. 97 children showed significant pyuria in centrifuged urine sample of which 49 were males and 48 were females. Majority 45 children were belonging to age group of 6 year to 12 year. Out of 97 children showed significant pyuria in centrifuged urine sample of which 46 children 5-10 cells/HPF and 27 children showed > 10 cells/HPF and 24 cases showed < 5cells / HPF. Out of 200 children, in 29 cases urine culture showed E. coli growth and 51 cases showed no growth.Conclusions: Urinary tract infections are common in childhood. Nearly all UTIs are caused by bacteria that enter the opening of the urethra and move upward to the urinary bladder and sometimes the kidneys.

Aerobic Bacterial Profile Of Aspirated Pus Samples At A Tertiary Care Hospital, Patna, Bihar

Abscess is an accumulation of pus in tissue and it is caused by suppuration deep within a tissue, an organ or confined space. Though the bacterial profile from pus samples remains almost similar in various studies, the irrational use of antibiotics has lead to the emergence of various drug resistant pathogens. In this retrospective study we have taken 290 aspirated pus samples for aerobic culture and sensitivity and found 23 different aerobic bacterial isolates. Most common isolate was Escherichia coli (n-12) followed by Staphylococcus aureus (n-8) and one each was Acinetobacter spp., Klebsiella pneumoniae and Streptococcus spp. Sensitivity of E coli was found to be low for ciprofloxacin, amoxycillin+clavulanic acid, ceftazidime, cefepime and aztreonam; while sensitivity was high for amikacin, imipenem, colistin and tigecycline. Staphylococcus aureus was highly sensitive to most of the antibiotics that had been put for sensitivity testing. A continuous inspection should be carried out to monitor the antimicrobial susceptibility of bacterial isolates from aspirated pus samples to choose appropriate antibiotics for prophylaxis and treatment of infections.

Staphylococcus aureus in breast abscess-major culprit besides others

OBJECTIVE:Breast abscess is a significant cause of morbidity especially in young women of childbearing age. These abscesses are associated with physical, psychological disturbance, and long-term cosmetic consequences.MATERIALS AND METHODS:This was a prospective study that involved seventy cases of breast abscesses to identify etiological agents and their susceptibility patterns.RESULTS:Lactation was a risk factor in almost two-third of all cases. Others were diabetes mellitus, extremes of age, immunocompromised conditions, and tuberculosis. The most common bacterial isolate was Staphylococcus aureus (83.3%), almost half being methicillin-resistant S. aureus (MRSA). Others included coagulase-negative Staphylococcus, Enterococcus spp., Streptococcus spp., Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Candida spp., and acid-fast bacilli.CONCLUSIONS:The treatment of all such microorganisms is different, signifying that microbial diagnosis plays a pivotal role in management of such abscesses.

A Study of Aerobic Bacterial Isolates and their Antibiotic Susceptibility Pattern from Pus Samples in a Tertiary Care Hospital, Rajasthan

Background: Aerobic bacteria are the major cause of pyogenic infections characterized by local and systemic inflammation and pus formation. Different studies show that bacterial profile of pus samples and their antimicrobial sensitivity pattern shows many variations. Emergence of antimicrobial drug resistance has made the treatment of pyogenic infections difficult. Pus culture and sensitivity testing done prior to start antibiotic therapy help in right approach towards selection of antibiotic and treatment. Methods: A study was conducted in Department of Microbiology of a private tertiary care hospital in Udaipur, Rajasthan from August 2017 to January 2018. Total of 240 pus samples were analyzed for aerobic culture and sensitivity. Processing and identification was done as per standard guidelines. Antibiotic sensitivity testing was performed by Kirby Baur disc diffusion method. Results: In our study, out of 240 pus samples sent from various departments, 160 (66.6%) were positive for bacterial growth. Commonest isolate was Staphylococcus aureus, followed by Pseudomonas species, E. coli, Klebsiella species, Enterococcus species, either alone or in mixed growth. All Staphylococcus aureus were sensitive to Vancomycin and Linezolid. For Pseudomonas species, effective drugs were piperacillin-tazobactem and polymyxin B; for enterobacteriacae, most effective drug was meropenem. Conclusion: It is of utmost importance for a clinician to send the pus sample for microbiological analysis and antibiotic sensitivity testing before starting antibiotic therapy to minimize the emergence of drug resistance.

Surgical Management Of Residual Cyst: A Case Report

Inflammatory odontogenic cysts are benign osteolytic asymptomatic lesions and can destroy the surrounding bone and let it infected. The term residual cyst is used most often for retained radicular cyst from teeth that has been removed. Residual cysts are among most common cysts of the jaws. It can be concluded that early detection and accurate diagnosis are essential for the proper treatment of the residual cysts. This case report reveals some of the technical considerations in managing huge maxillary midline residual cyst surgically.

Research advances of material basis of multi-effect Astragali Radix / 中草药

Astragali Radix is a classic Chinese materia medica with multiple effects including replenishing qi, consolidating exterior, promoting pus and discharge tissue regeneration, inducing diuresis to alleviate edema and other effects. Modern scientific researches have confirmed that different forms of Astragali Radix (single drug and compound) exhibit various pharmacodynamic effects on different pathological diseases, and their material basis are not the same. This review summarized the researches on the material basis of multi-effect Astragali Radix and provided new ideas for the related studies of material basis of Astragali Radix and its formula.

Comparative study of microflora between birth canal and new born oral cavity

Background: New-born acquires mother’s microbiome from the birth canal during the delivery process and these bacteria then colonize in the gut. Studying the oral microbiome of infants offer a good perspective for us to understand the gut microbiome disruption caused by C-section. A previous study of three-month-old infants reported a higher amount of bacterial taxa of the oral microbiota in vaginally delivered infants than the ones with another birth mode. Aim: Comparison of microflora between the birth canal and the oral cavity of a newborn in Caesarean delivery. Materials and methods: 30 pregnant women selected for the study. Parturient canal samples obtained prior to delivery and infant’s oral cavity oral samples obtained immediately after birth. Samples transported to the lab for microbiological assays and data tabulated and statistically analyzed using Chi-Square Test. Results: E.coli was observed in 21.1% (N=7) in the vaginal swab whereas its occurrence in buccal smear was 10.3% (N=3). The chi-square test of independence was statistically insignificant (p> 0.05). The staphylococcus was observed in 44.8 (N= 13) of vaginal swab and 37.9% (N=11) of buccal smear and again the difference was statistically insignificant. The presence of pus cells was 31% (N=9) in vaginal swab and 10.3% (N=3) in the buccal smear. Conclusion: A significant number of mother-child pairs showed the presence of Staphylococcus aureus, Klebsiella, and E.coli. However, Klebsiella and pus cells were occasionally found.

Effect of ASX on chronic alcoholism induced memory impairment and expressions of NF-κB p65,iNOS,TNF-αin mice / 中国药理学通报

Aim To investigate the effect of ASX (trans-astaxanthin)on the expressions of NF-κB p65 , iNOS and TNF-αin the hippocampus and the prefron-tal cortex of chronic alcohol mice.Methods 40 mice were randomly divided into control group,7 d,14 d, 21 d,28 d alcohol-treated group,the mice were given alcohol preference testing on day of 6,13,20,27. Mice were subjected to alcohol withdrawal for one day after testing.In order to determine the exact time point of cognitive memory impairment in mice after alcohol consumption,they were given morris water maze test after alcohol preference testing. The other 40 mice were randomly divided into control group, alcohol group and ASX group (20,40,80 mg·kg-1 ).After chronic ASX administration, mice were given one probe trial of 60 s in which the platform was removed from the pool to evaluate escape latency,the number of times the animal crossed the previous location of the platform,time spent in the target quadrant,and swim-ming speed.The expressions of NF-κB p65 ,iNOS and TNF-αwere detected by western blotting after behav-ioral testing.Results The mice showed an obvious al-cohol-related phenomenon on 2 1 and 28 days after al-cohol treatment,and escape latency significantly in-creased,entries in target quadrant and duration in tar-get quadrant significantly decreased with increasing drinking days and withdrawal times.The results also suggested that 2 1 days chronic ASX treatment reversed this learning deficit.Moreover,the expression of NF-κB p65 ,iNOS and TNF-αin the hippocampus were significantly increased after 2 1 d alcohol treatment (P<0.001),and pretreatment with ASX (40,80 mg· kg-1 ) could obviously inhibit these changes (P <0.001);Parallel to these changes in the hippocam-pus,the level of NF-κB p65 ,iNOS and TNF-αwere also increased in the prefrontal cortex (P<0.001 ), however,only ASX (80 mg · kg-1 ) administration could inhibit the increase (P<0.05 ).Conclusion These results indicate that ASX pretreatment can pro-tect against alcohol-induced memory impairment via the inhibition of NF- κB p65 ,iNOS and TNF-αexpres-sions in hippocampus and prefrontal cortex.

Impact of adherence of pus moss on the efficacy of different surgical procedures for perforated peptic ulcers / 实用医学杂志

Objective To study the effects of intraperitoneal adherence of pus mosses on the efficacy of open repair(OR)and laparoscopic repair(LR)for perforated peptic ulcers(PPUs). Methods Intraperitonealad-herence of pus mosses was divided into the first,second and third stage,respectively. Surgical duration,volume of peritoneal drainage ,rate of abnormal wound healing ,number of intensive care unit transfer ,recovery time of bowel function ,ambulation time ,length of hospital stay ,and postoperative treatment abandonment rate were compared. Results There were 78 ,46 ,and 29 patients for the three stages in OR group ,and 71 ,39 ,and 15 patients in LR group,respectively. There were significant differences insurgical duration,volume of peritoneal drainage,rate of abnormalwound healing,number of ICU transfer,recovery time of bowel function,ambulation time,length of hospital stay about the first stage between the two surgical methods(P values were 0.000,0.000, 0.015,0.000,0.000,0.000,and 0.043 respectively)except for treatment abandonment rate(P value was 0.209). There were significant differences in volume of peritoneal drainage ,rate of abnormal wound healing ,number of ICU transfer,recovery time of bowel function,ambulation time,and length of hospital stay(P values were 0.000, 0.033,0.000,0.000,0.001,and 0.028 respectively)for the second stage except surgical duration and treatment abandonment rate(P values were 0.196 and 0.358 respectively) between the two procedures. The differences were significant in surgical duration ,volume of peritoneal drainage ,and length of hospital stay between the two methods (P values were 0.039 ,0.003 ,0.024 ,and 0.002 respectively) for the third stage but there were no significant differencesin rate of abnormal wound healing , number of ICU transfer , recovery time of bowel function ,ambulation time ,and treatment abandonment rate (P values were 0.175 ,0.173 ,0.766 ,and 0.757 respectively). Conclusions LR is superior to OR under the first stage of pus moss and still has advantages under the second stage. However,LR may be inferior to OR under the third stage.

Effects of Therapy of Wound Pus Promoting Granulation Tissue Growth on Related Factors of Granulation Tissue in Rat Chronic Skin Ulcers Based on Drug-wound Interaction / 广州中医药大学学报

Objective To observe the effects of therapy of wound-pus promoting granulation tissue growth guided by drug-wound interaction theory on the related factors in granulation tissue during the healing of chronic skin ulcer in rats based on drug-wound interaction. Methods Twenty-four rats were randomly divided into normal group, model group, control group, and treatment group, 6 rats in each group. The rats in the normal group had no skin ulcer and was given normal feeding,and the rats with chronic skin ulcer in the other 3 groups were induced by compound factors-overlapped method of hormone intervention-skin defect-bacterial infection. After modeling,the model group was given external use of saline gauze dressing,the control group given external use of vaseline gauze dressing,and the treatment group given external use of Shengji Xiangpi Ointment,changing fresh dressing for wound daily,the treatment lasting for 14 days. Wound sample was taken from the left back of rats, and therapeutic effect was evaluated according to the changes in the wound surface of the rat right back. After intervention for 3,7,and 14 d,the secreta and granulation tissue in the wound surface of rats were observed, the expression levels of vascular endothelial growth factor (VEGF), inducible nitric oxide synthase(iNOS), arginine-1 (Arg-1), and Notch1 in granulation tissue of rat ulcer wound were measured by enzyme-linked immunosorbent assay (ELISA). Results The wound in the treatment group has been healed after treatment for 14 days (P < 0.05 or P < 0.01 as compared with the diameter of the ulcer in the model group and the control group) . At the early stage of wound repairing (3 d),the expression levels of VEGF and Arg-1 in the treatment group were increased, and Notch1 expression level was decreased, the difference being statistically significant as compared with those of the model group and the control group (P < 0.05). At the late stage of wound repairing (14 d),the expression level of iNOS in the treatment group was increased,and the difference was statistically significant as compared with that of the model group(P < 0.05). Conclusion The therapy of wound-pus promoting granulation tissue growth guided by drug-wound interaction theory can promote the healing of chronic skin ulcerative wound in rats and improve the general condition of rats. The therapeutic mechanism may be associated with firstly inhibiting the expression of iNOS induced by M1 type macrophage at early stage and then promoting M2 type macrophage phenotype index Arg-1 expression,and regulating the expression of VEGF and Notch1 in the granulation tissue.

Mujer joven con nefritis lúpica y dengue / Young woman with lupus nephritis and dengue

Se reporta caso clínico de una mujer de 21 años con lupus eritematoso sistémico (LES) de diagnóstico reciente complicada con nefritis lúpica (NL) tratada en nuestro centro, con evolución favorable con inmunosupresores. Pero reingresa por dengue con signos de alarma del cual se recupera satisfactoriamente.

Clinical case of a 21 year old woman with complicated systemic lupus erythem atosus (SLE) recently diagnosed with lupus nephritis (LN) treated at our center, with favorable evolution immunosuppression reported. But readmitted because dengue of with warning signs, at present he is recovering satisfactorily

Effect of long-time mechanical ventilation on early postoperative inflammatory responses in hipp-ocampi of mice / 中华麻醉学杂志

Objective To evaluate the effect of long?time mechanical ventilation on early postoper?ative inflammatory responses in the hippocampi of mice. Methods Forty?eight healthy male C57BL∕6 mice, aged 8-10 weeks, weighing 20-25 g, were divided into 3 groups ( n=16 each) using a random number table: control group ( group C) , operation group ( group O) and long?time mechanical ventilation after operation group ( group MV) . Open reduction and internal fixation was performed after tibial fracture was induced in O and MV groups. Group O inhaled isoflurane for 6 h after operation. The mice were me?chanically ventilated for 6 h under isoflurane anesthesia in group MV. On 1 and 3 days after the end of ven?tilation, 8 mice were randomly selected, and contextual fear conditioning test was carried out to assess the cognitive function. The rate of time spent freezing was calculated. Then venous blood samples were collected and hippocampi removed for determination of the levels of interleukin?6 ( IL?6) , tumor necrosis factor?al?pha ( TNF?α) and IL?1β in plasma and hippocampal tissues by enzyme?linked immunosorbent assay. Re?sults Compared with group C, the rate of time spent freezing was significantly decreased, and the levels of IL?6, TNF?α and IL?1β in plasma and hippocampal tissues were significantly increased after the end of ventilation in group O ( P<0.01) . Compared with group O, the rate of time spent freezing was significantly decreased, and the levels of IL?6, TNF?α and IL?1β in plasma and hippocampal tissues were significantly increased after the end of ventilation in group MV ( P<0.01) . Conclusion The mechanism by which long?time mechanical ventilation leads to early postoperative cognitive dysfunction is related to induction of in?flammatory responses in the hippocampi of mice.