Change in granulation tissue coverage and bacteriological load using Low Cost Negative Pressure Wound Therapy in acute musculoskeletal wounds

BackgroundLow cost Negative Pressure Wound Therapy (NPWT) dressings have been considered as an alternative to traditional daily dressings. There is scanty literature evaluating the change in the percentage area of wound covered by granulation tissue following application of low-cost NPWT. The change in the bacteriological flora following application of low-cost NPWT devices has also not been evaluated.MethodsPatients above the age of 18 years with acute musculoskeletal injuries of <3 weeks duration which underwent a surgical debridement and required subsequent wound coverage were included in the study. Area of the wound and the area covered by the granulation tissue as well as the bacteriological count were measured before and after application of NPWT. A low cost NPWT using wall mounted vacuum device was put on the patient giving a constant negative pressure of 125 mm of Hg for 2 days. The findings before and after application of NPWT were compared and analyzed using Wilcoxin Signed-rank test.Results21 patients with mean age of 35.52±15.075 were included. The pre-NPWT granulation tissue area ranged from 122 mm² to 8483 mm² with a mean of 1648.38 mm² (SD = 1933.866). The post-NPWT granulation tissue area ranged from 234 mm² to 7847 mm² with a mean of 2364.48 mm² (SD = 1857.716). The mean increase in granulation tissue was 716.1 mm².The pre-NPWT wound area ranged from 422 mm² to 10847 mm² with a mean of 4009.62 mm² (SD = 3026.209). The post-NPWT wound area ranged from 326 mm² to 9143 mm² with a mean of 3410.33 mm² (SD = 2636.206). The mean reduction in wound size was 599.29 mm².The pre-NPWT bacteriological count ranged from 3000/ml to 130000000/ml with a mean of 12616761.90/ml (SD = 29664589.37). The post-NPWT bacteriological count ranged from 1000/ml to 380000000/ml with a mean of 26401523.81/ml. The mean increase in bacteriological count was 13784761.91/ml.ConclusionThere was a statistically significant decrease in wound size (p = 0.001) and statistically significant increase in percentage area of granulation tissue coverage (p = 0.000) following low cost NPWT application. However there was no statistically significant increase in bacteriological clearance in these patients.     

三阴性乳腺癌细胞脂肪非典型钙黏蛋白4表达下调的生物学作用及机制

背景与目的 三阴性乳腺癌（TNBC）容易发生侵袭转移,恶性程度极高。笔者团队前期研究发现脂肪非典型钙黏蛋白4（FAT4）在TNBC组织中呈低表达且与预后相关,进而本研究进一步探讨FAT4对TNBC细胞生物学行为的影响,及其相关机制。方法 用qRT-PCR及Western blot检测正常人乳腺上皮细胞系（MCF-10A）及不同TNBC细胞系（BT-549、MDA-MB-231、MDA-MB-468、MDA-MB-436）中FAT4的表达水平。选择其中合适的TNBC细胞系,分别转染FAT4-shRNA（FAT4敲低组）、阴性对照序列（阴性对照组）,以未处理的TNBC细胞为空白对照组,分别采用CCK-8实验、流式细胞术、Transwell小室实验检测细胞增殖能力、凋亡率、侵袭与转移能力的变化,并用Western blot检细胞中Hippo信号通路下游靶点YAP及上皮间质转化（EMT）相关蛋白的变化。结果 与正常人乳腺上皮细胞比较,各TNBC细胞系中FAT4的mRNA与蛋白表达量均不同程度的降低（均P<0.05）。功能实验选用BT-549细胞和MDA-MB-436细胞。无论在BT-549细胞或MDA-MB-436细胞中,与空白对照组比较,FAT4敲低组在转染后24、48、72 h的增殖能力均明显升高、凋亡率明显降低、侵袭与转移能力明显增强（均P<0.05）;YAP蛋白表达量无明显变化（P>0.05）,但磷酸化YAP（p-YAP）表达量明显降低,上皮标志物E-cadherin水平明显降低,而间质标志物N-cadherin水平明显升高（均P<0.05）;阴性对照组与空白对照组间以上指标差异均无统计学意义（均P>0.05）。结论 FAT4表达水平在TNBC细胞中普遍降低,FAT4表达的降低能增强TNBC细胞增殖和侵袭迁移能力、减少TNBC细胞凋亡,其机制可能与FAT4降低后Hippo信号通路下游的YAP蛋白磷酸化减少,从而促进EMT进程有关。     

甲醇-二硫化碳解吸-气相色谱法测定工作场所空气中1,2-二氯乙烯

目的建立甲醇-二硫化碳解吸-气相色谱法测定工作场所空气中1,2-二氯乙烯的方法。方法空气中1,2-二氯乙烯用活性炭管采集,经甲醇-二硫化碳溶剂解吸,DB-FFAP毛细管色谱柱(30 m×0.25 mm,0.25μm)分离,火焰离子化检测器检测,保留时间定性,峰高或峰面积定量。结果顺-1,2-二氯乙烯、反-1,2-二氯乙烯的检出限分别为0.35μg/ml、0.81μg/ml;定量下限分别为1.16μg/ml、2.67μg/ml(相应的最低检出浓度分别为0.23 mg/m³、0.54 mg/m³)。批内相对标准偏差分别为0.32%~0.60%、0.50%~0.79%,批间相对标准偏差分别为0.60%~0.95%、0.78%~0.90%;平均解吸效率分别为97.6%~101%、96.0%~98.0%;在2.5μg/ml~500μg/ml内线性关系良好,相关系数分别为0.999 8、0.999 6。结论本方法灵敏度高、准确度和精密度好,解吸效率高,可用于工作场所空气中1,2-二氯乙烯的检测。     

树突状细胞和胸腺阴性选择

胸腺内阴性选择的发生过程也就是中枢免疫耐受的形成过程,即自身反应性胸腺细胞被克隆清除或处于免疫 无能状态的过程。胸腺树突状细胞作为胸腺内功能强大的抗原呈递细胞,在阴性选择中必定发挥着不可忽视的作用。     

Exposure to formaldehyde and phenol during an anatomy dissecting course: sensitizing potency of formaldehyde in medical students

BACKGROUND: The sensitizing potency of formaldehyde and phenol during anatomy dissecting was investigated. The objective was to determine whether exposure induces specific IgE or IgG against formaldehyde-albumin or phenol-albumin. METHODS: In 27 medical students, specific IgE against formaldehyde-albumin by RAST plus ELISA and specific IgE against phenol-albumin by ELISA were assessed. In addition, specific IgG against formaldehyde-albumin was assessed in 23 students. Symptoms before and during dissecting were assessed, and indoor formaldehyde and phenol were measured. RESULTS: Mean indoor formaldehyde was 0.265 +/- 0.07 mg/m3, and mean indoor phenol was 4.65 +/- 2.96 mg/m3. Specific IgE/IgG against formaldehyde-albumin was not found at the beginning. Four students developed specific IgE against formaldehyde-albumin (RAST classes of > or =2.0), and all four also had specific IgE in the ELISA, but IgG against formaldehyde-albumin was not found. Specific IgE against phenol-albumin was not seen. Itch and paresthesia of the hands (P<0.00001), dizziness (P<0.008), burning eyes (P<0.01), headache, sneezing, epistaxis, gingival bleeding, oral or pharyngeal itch, and shortness of breath were experienced. CONCLUSIONS: Formaldehyde exposure during dissecting may induce specific IgE, but not IgG, against formaldehyde-albumin. Sensitization did not correlate with symptoms.     

Blood styrene concentrations in a “normal” population and in exposed workers 16 hours after the end of the workshift

Summary Blood styrene was measured by a gas chromatography-mass spectrometry method in 81 normal people and in 76 workers exposed to styrene. In the normal subjects, styrene was also tested in alveolar and environmental air. Styrene was found in nearly all (95%) blood samples. Average styrene levels in the normal subjects were 221 ng/1 in blood (Cb), 3 ng/1 in alveolar air (Ca) and 6 ng/1 in environmental air (Ci). Styrene levels did not differ significantly between smokers and non-smokers, 95% of values being below 512 ng/1 in Cb, 7 ng/1 in Ca and 15 ng/l in Ci. In workers with an average exposure to styrene of 204 g/l, at the end of the workshift, mean blood styrene concentration was 1211 g/l. In blood samples collected at the end of the Thursday shift, styrene levels were significantly higher (1590 g/1) than those found at the end of the Monday shift (1068 g/l. A similar difference was found in samples taken the morning after exposure (60 and 119 g/l, respectively). Significant correlations between blood and environmental styrene were found both at the end of the shift and the morning after exposure (r=0.61 and 0.41, respectively). In workers occupationally exposed to styrene, 16 h after the end of the workshift, blood styrene (94 g/l) was significantly higher than that found in the normal subjects (0.22 g/l). The half-life of blood styrene was 3.9 h.     

降低隧道施工机械尾气污染的几项措施

目的　研究降低无轨运输方式施工隧道中空气污染的措施。方法　采用燃油添加剂 ,定期对施工机械进行维修和保养 ,减少发动机空档排气 ,将压入式通风口设置于距掌子面 8～ 10m处 ,保持通风管道密闭通畅致使有效送风。结果　隧道中有害气体CO、NOx及黑烟浓度至少降低 4 6 % ,55%和 4 2 %。结论　采取以上措施能明显改善施工环境的污染状况并减轻对施工人员身体健康的危害     

影响精神分裂症患者阴、阳性症状疗效的因素分析

目的 :探讨抗精神病药物及临床常见因素对精神分裂症患者阴、阳性症状疗效的影响。方法 :采用前瞻性设计的方法 ,对连续入院的 12 9例精神分裂症病人 ,分别在 6周的单一抗精神病药物治疗前后使用BPRS ,SANS ,SAPS及自编问卷进行调查和评估。并应用t检验和多逐步回归进行统计学分析。结果 :各量表总分治疗前后差异有显著意义 (P <0 .0 0 1) ,但SANS与SAPS各自治疗前后差值之间无显著差异 (P >0 .0 5 )。阴、阳性症状的疗效与性别和家族史的关系特别密切 (P <0 .0 5 )。结论 :性别和家族史对于精神分裂症阴、阳性症状的疗效有显著影响而抗精神病药物似乎不存在明显的优劣之分。有关发现值得进一步探讨研究。     

利培酮治疗精神分裂症阴性症状临床对照研究

目的 :评价利培酮治疗精神分裂症阴性症状的疗效及安全性。方法 :采用病例随机对照的研究方法。结果 :利培酮对阴性症状有明显疗效 (P<0 .0 1) ,且对兴趣社交缺乏、注意障碍改善显著 (P<0 .0 5 ) ,副反应少而轻微。结论 :利培酮是治疗精神分裂症阴性症状的有效药物 ,且副反应少而轻微 ,对以阴性症状尤其是兴趣社交缺乏、注意障碍突出的精神分裂症效果显著 ,值得临床推广应用     

北京市一些高级办公大楼室内空气质量问题探讨

我们调查了北京一些高档的空调建筑,包括商业和政府机构办公大楼,测试了主要的室内污染和室内气象参数,如温度、湿度、风速等。测试结果指出,在这些建筑中存在着严重的室内空气质量问题。而且,引起不良室内空气质量的原因不是单一的而是多方面的。因此如何提高室内空气质量,为人们提供健康而舒适的室内环境,是空调设计者的迫切任务。