Enhanced healing efficacy of an optimized gabapentin-melittin nanoconjugate gel-loaded formulation in excised wounds of diabetic rats

The present study aimed to design and optimize, a nanoconjugate of gabapentin (GPN)-melittin (MLT) and to evaluate its healing activity in rat diabetic wounds. To explore the wound healing potency of GPN-MLT nanoconjugate, an in vivo study was carried out. Diabetic rats were subjected to excision wounds and received daily topical treatment with conventional formulations of GPN, MLT, GPN-MLT nanoconjugate and a marketed formula. The outcome of the in vivo study showed an expedited wound contraction in GPN-MLT-treated animals. This was confirmed histologically. The nanoconjugate formula exhibited antioxidant activities as evidenced by preventing malondialdehyde (MDA) accumulation and superoxide dismutase (SOD) and glutathione peroxidase (GPx) enzymatic exhaustion. Further, the nanoconjugate showed superior anti-inflammatory activity as it inhibited the expression of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). This is in addition to enhancement of proliferation as indicated by increased expression of transforming growth factor-β (TGF- β), vascular endothelial growth factor-A (VEGF-A) and platelet-derived growth factor receptor-β (PDGFRB). Also, nanoconjugate enhanced hydroxyproline concentration and mRNA expression of collagen type 1 alpha 1 (Col 1A1). In conclusion, a GPN-MLT nanoconjugate was optimized with respect to particle size. Analysis of pharmacokinetic attributes showed the mean particle size of optimized nanoconjugate as 156.9 nm. The nanoconjugate exhibited potent wound healing activities in diabetic rats. This, at least partly, involve enhanced antioxidant, anti-inflammatory, proliferative and pro-collagen activities. This may help to develop novel formulae that could accelerate wound healing in diabetes.     

Feasibility of open chest management with modified negative pressure wound therapy immediately after cardiac surgery

OBJECTIVESTo evaluate the feasibility of open chest management with our modified negative pressure wound therapy immediately after cardiac surgery as a therapy for atypical tamponade.METHODSOpen chest with modified negative pressure wound therapy was performed immediately after cardiac surgery. The surface of the heart and the vessels were covered with non-adherent siliconized gauze. The sternal halves were stented using edge-cut disposable syringes to maintain a larger mediastinal cavity. Approximately 45 mm of distance was kept between the sternal edges. A trimmed sterile polyvinyl foam sponge was inserted into the mediastinum, the entire wound was sealed and negative pressure (−50 to −75 mmHg) was applied using a suction generator. Delayed chest closure was performed in a standard manner once the haemodynamic status was stabilizsed.RESULTSThe mortality rate was 3/15 (20%) patients. Deep sternal wound infection occurred in 1/15 (6.7%) patients. Five patients were extubated during the open chest management. Sternal closure was delayed for median of 3 days after the initial surgery. There was no incidence of bleeding complications or need for additional haemostatic procedures.CONCLUSIONSNegative pressure wound therapy performed immediately after cardiac surgery was feasible in our small number of patients.Clinical registration numberStudy ID: 2020-149.     

严重烧伤后合并真菌感染的临床分析

目的探讨严重烧伤并发真菌感染的诊疗经验和体会。方法回顾分析2001年～2007年24例严重烧伤并发真菌感染病例的临床资料。结果真菌感染的好发时间为伤后6天～34天,平均15天;常见部位:创面、静脉导管、呼吸道、口腔等;常见菌种:白色念珠菌、光滑球拟假丝酵母菌、曲霉菌、热带念珠菌、近平滑念珠菌等;主要诱因:(1)长时间使用高效广谱抗生素;(2)机体免疫力下降,防御机能严重受损;(3)糖皮质激素的较长时间使用;(4)炎热、潮湿的环境因素;(5)静脉导管长时间留置。24例中,治愈15例,治愈率为62.5%;死亡9例,病死率为37.5%。结论严重烧伤容易发生真菌感染,常与细菌感染并存,窄谱敏感抗生素加氟康唑(大扶康)、积极的创面处理、持续热风干燥治疗及定期翻身是治疗真菌感染的有效方法。     

Some Aspects of the Burning Process of Antimony and Potassium Manganate(VII) Compositions

Antimony and potassium manganate(VII) compositions are widely used in time delay elements of detonators. Despite the existing literature on such systems, there is no complete information on the burning process of Sb/KMnO₄ compositions in closed systems. There are also no data on the heat of their combustion in conditions of increased pressure without the access of oxygen from the air and on the composition of solid combustion products. These issues are the subject of the presented work.     

烧伤合并毒败血症的手术切削痂效果分析

目的　探讨烧伤合并毒败血症的治疗方法。方法　对 13 4例烧伤合并毒败血症患者进行烧伤创面切削痂植皮 ,以消除细菌来源、减少烧伤毒素、促进创面修复、促进病情恢复。结果　治愈 115例、死亡 19例。结论　对于烧伤合并毒败血症 ,及时采用手术治疗 ,不仅利于症状的控制、也是保证患者最终康复的重要手段。一旦烧伤病人出现毒败血症 ,应尽早进行烧伤创面切削痂植皮术修复深度创面     

烧伤小鼠IFIT1表达的初步观察

目的 观察烧伤小鼠干扰素诱导表达蛋白IFIT1的表达变化,初步探究其表达变化的原因.方法 实验小鼠致TBSA 15%Ⅱ度烧伤,1 d及7 d后处死,取肝、肺及脾组织.脂多糖掺入小鼠腹腔巨噬细胞株RAW264.7的培养基中,至终浓度0.1～1.0μg/ml,作用6 h.提取组织及细胞RNA,进行半定量逆转录-聚合酶链式反应,提取组织及细胞裂解上清,进行免疫印迹检测.结果 小鼠肝、肺、脾组织IFIT1的转录在烧伤后1 d升高,伤后7 d恢复至伤前水平;肝、肺、脾IFIT1的蛋白水平在伤后1 d一致升高,伤后7 d仍能检出升高.体外实验,细菌脂多糖显著激活RAW264.7细胞的IF-IT1转录及蛋白表达.结论 烧伤小鼠伤后早期IFIT1表达迅速升高,此变化与同期的内毒素血症引起的细胞应激有关.     

难愈性创面的中西医研究进展

创面愈合是目前临床研究的热点及难点问题之一,随着人们对创面愈合机制认识的不断进步,促创药物的研究及开发必将成为现代医学和传统医学研究的焦点。     

肝细胞生长因子促进培养的兔胃粘膜细胞损伤的修复

分离家兔胃粘膜细胞，培养48h细胞融合成片后，造成约2mm2的无细胞区，作为损伤修复模型进行实验。结果：空白对照组约48h完全修复，而肝细胞生长因子（HGF，50μg／L）组24h就修复完毕。其中对照组损伤周边的胃粘膜细胞游走速度为（16．62±0．38）μm／h，而HGF组达（23．90±0．68）μm／L（P＜0．01）；模型制作后12～24h五溴脱氧尿核苷标识率，HGF组（7．6％）约是对照组（0．5％）的15倍。表明HGF有显著促进胃粘膜细胞游走与增殖的功能。提示HGF在胃炎、胃溃疡等疾病的修复过程中可能起着重要作用。     

灼伤病人外周血IL—6、TNF的水平与休克相互关系的研究 

采用Ｂ９细胞增殖的ＭＴＴ法及Ｌ９２９细胞结晶紫比法，对１０例Ⅱ度以上的灼伤病人检测４个不同时期外周血ＩＬ—６、ＴＮＦ含量。结果表明，正常人血清中ＩＬ—６、ＴＮＦ含量＜１０ｋＵ／Ｌ（１２例），与灼伤病人区别明显（Ｐ＜０．０１）。灼伤病人外周血ＩＬ—６、ＴＮＦ的水平与灼伤的面积、严重程度、临床分型以及休克发生发展有密切的相关性，而ＩＬ—６、ＴＮＦ含量变化早于休克的发生，其变化有良好的规律性．提示外周血ＩＬ—６、ＴＮＦ含量变化可作为判断灼伤休克的一个指标。     

两种冲洗液对于负压封闭引流技术治疗效果的影响

目的：比较应用两种冲洗液对于负压封闭引流技术（vacuum sealing drainage,VSD）治疗效果的影响。方法对40例外院治疗手部创面感染后皮肤缺损患者,应用 VSD 技术治疗并分别给予苯扎氯铵溶液和0．9％盐水进行术后冲洗引流,对创面细菌培养结果,引流管堵塞发生情况,薄膜漏气发生情况,术后皮瓣感染发生情况,进行分析比较。结果创面细菌培养阳性观察组为1例,对照组为6例;引流管堵塞观察组3例,对照组7例;薄膜漏气观察组2例,对照组3例;术后皮瓣感染观察组1例,对照组6例。结论应用苯扎氯铵溶液冲洗负压引流装置的效果较应用生理盐水的效果好,在临床上值得推广应用。