Clinical study of Maggot therapy for Fournier's gangrene

Fournier''s Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier''s gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier''s gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture‐directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.     

许昌市市区垃圾容器垃圾残留物蝇蛆（蛹）侵害情况调查及其防治措施

目的了解现代城市中各类垃圾容器中垃圾残留物的蝇蛆（蛹）侵害情况,探索控制蝇蛆（蛹）的有效措施。方法采取目测法,观察各类垃圾容器中蝇蛆（蛹）存活情况及数量,统计阳性侵害桶数及阳性只数。结果经调查,公共场所垃圾容器阳性侵害率为7．25％,平均阳性个数为1．97只／个;单位、社区垃圾容器,阳性侵害率为13．75％,平均阳性个数为2．24只／个;市场垃圾容器阳性侵害数为25．63％,平均阳性个数为2．61只/个;垃圾中转站的垃圾中转箱阳性侵害率为20．00％,平均阳性个数为4．19只／个。结论公共场所垃圾容器中蝇蛆（蛹）侵害牢低,平均阳性个数低。定期清理垃圾容器内的垃圾残留物,设置密闭垃圾容器,清理垃圾箱槽底部积存的污物污水,加大对蝇密度较高的区域的消杀力度,可以明显减轻现代城市中各类垃圾容器中垃圾残留物的蝇蛆（蛹）侵害。     

4种二氯炔戊菊酯异构体对蚊蝇蜚蠊的毒效观察

目的测定药物分别为5.0mg*ai/m2的4种二氯炔戊菊酯异构体在油漆三合板面上对蚊、蝇和蜚蠊的毒杀效果.方法强迫接触法.结果顺式二氯炔戊菊酯对蚊、蝇的KT50为9.50和9.22min,反式二氯炔戊菊酯为6.82和8.72min,右旋反式二氯炔戊菊酯为8.06和10.89min,左旋反式二氯炔戊菊酯为5.75和10.44min;除顺式二氯炔戊菊酯外,其余接触面所试蚊、蝇的24h死亡率均达92%～100%.4种二氯炔戊菊酯异构体对德国小蠊的毒杀效果均不理想,72h死亡率均未超过80%.结论4种二氯炔戊菊酯异构体对蚊、蝇均具有较好的毒杀效果,但不同异构体对蚊、蝇的毒杀效果存在差异;对德国小蠊的毒杀效果均不理想.     

Dietary restriction and lifespan: Lessons from invertebrate models

Dietary restriction (DR) is the most robust environmental manipulation known to increase active and healthy lifespan in many species. Despite differences in the protocols and the way DR is carried out in different organisms, conserved relationships are emerging among multiple species. Elegant studies from numerous model organisms are further defining the importance of various nutrient-signaling pathways including mTOR (mechanistic target of rapamycin), insulin/IGF-1-like signaling and sirtuins in mediating the effects of DR. We here review current advances in our understanding of the molecular mechanisms altered by DR to promote lifespan in three major invertebrate models, the budding yeast Saccharomyces cerevisiae, the nematode Caenorhabditis elegans, and the fruit fly Drosophila melanogaster.     

A gene chip study suggests that miR-17-3p is associated with diabetic foot ulcers

Background of the Study Diabetic foot ulcers (DFUs) are severe effect of diabetes. This research aimed to discover the role of micro-ribonucleic acid (miRNA) in treating DFUs involved in maggot debridement therapy (MDT) via a miRNA chip study. A miRNA chip approach was adopted. Patients with diabetes (type 1 or 2) who had at least one-foot ulcer (current or previous) were enrolled in the study. The alterations of miRNA expressions in the granulation tissue during treatment with MDT were measured. Following MDT, the increased expression of miR17-92 was verified in vivo. The miR-17-3p expression increased, and Flk-1 (vascular endothelial growth factor) expression was significantly reduced in patients with DFUs who received MDT (P < 0.01). Results from human umbilical vein endothelial cells that excrete or secrete showed consistency with in vitro findings (P < 0.001, P < 0.05). The overexpression of miR-17-3p demonstrated inhibitory activity on tube formation (P < 0.05). When DFUs were treated with MDT, it revealed that miR-17-3p had a negative regulatory effect on Flk-1.     

LS7综合干预对急性脑梗死预后的影响

目的探讨简单7步骤生活指南(LS7)综合干预对急性脑梗死预后的影响。方法将68例急性脑梗死患者均分为对照组和LS7组。对照组予常规治疗、康复训练及其相关疾病治疗,LS7组在对照组基础上进行LS7综合干预。观察两组患者治疗前后LS7评分、BI评分及Morisky服药依从性量表评分、卒中量表评分(NIHSS)、改良Rankin量表评分(mRS)、汉密尔顿焦虑量表评分(HAMA)、汉密尔顿抑郁量表评分(HAMD)。观察两组治疗后的复发情况。结果两组患者治疗后LS7、BI及Morisky服药依从性量表评分较治疗前均明显增高(P＜0.05),且LS7组评分高于对照组(P＜0.05)。两组患者治疗后NIHSS、mRS、HAMA、HAMD评分较治疗前均明显降低(P＜0.05),且LS7组评分均低于对照组(P＜0.05)。两组患者复发率比较,差异无统计学意义。结论LS7综合干预可有效降低脑梗死神经功能缺损程度、提高患者服药依从性、降低卒中后焦虑抑郁发生,从而提高患者生存质量。     

肇庆市连续两年蝇类季节消长调查结果分析

对肇庆市端州区1994年～1995年两个年度蝇类季节消长调查结果进行了分析:笼捕蝇23363只,计有5科23属35种;常见蝇种、优势种群、季节消长曲线结构基本一致;而年收捕总量、总密度、蝇类品种均有变化,这种差别可能是城市卫生设施改善的结果。     

长白山有瓣蝇类调查报告

目的为深入了解中朝边境我省境内一侧有瓣蝇类种群分布,为今后开展蝇类防制及边境防病工作的需要提供科学依据。方法以网扑为主、笼诱为辅,定期或不定期进行调查。结果初步报告长白山有瓣蝇类6科239种,其中花蝇科67种,厕蝇科18种,麻蝇科33种,丽蝇科27种,蝇科93种,粪蝇科仅1种。结论本调查报告为吉林省山区城乡蝇类防治工作提供了科学依据。     

Maggot debridement therapy in the tropics – Preliminary outcomes from a tertiary hospital

This paper aimed to describe the clinical outcomes and patients’ acceptance of Maggot debridement therapy (MDT) at a tertiary hospital in Singapore. Patients with non-viable tissue (NVT) covering at least 25% of wound bed on lower limbs and/or unable to tolerate sharp debridement at the bedside were recruited between January and August 2021. Sterile medical-grade maggots of Lucilla Cuprina were used. Wound specialist nurses assessed the size and wound to determine the type of MDT, either Baggots or free-range larvae (FRL), and the number of maggots required prior to commencement of therapy. Wound sites were measured and photographed at multiple time points: before the start of MDT therapy, during the wound review at 48 or 72 h after each cycle of MDT and completion of therapy. Three patients received Baggot therapy, while the remaining 11 received FRL therapy. The mean age for patients receiving Baggot and FRL were 78.3 (SD = 10.6) and 63.6 (11.4), respectively. Each patient received three cycles of MDT treatment on average. The most common type of wound was ray amputated toe wounds (n = 8), while the most common wound aetiology was arterial ulcerations (n = 12). A reduction of NVT was observed in 11 out of 14 patients, and ten of these 11 patients achieved successful debridement (at least 25% reduction in NVT). Five out of 14 patients had to undergo amputation within the same admission due to poor wound healing, and 60% of these five patients failed to achieve successful debridement. MDT was quite well-accepted by the patients, and they felt some improvement in their wounds. MDT can facilitate wound healing through successful debridement and potentially reduce the need for amputation. Further research needs to be done regarding the type of MDT that is optimal to use in tropical countries with high humidity.