Detection of hyphal fusion in filamentous fungi using differently fluorescence-labeled histones

Cell fusion occurs regularly during the vegetative and sexual phases of the life cycle in filamentous fungi. Here, we present a simple and efficient method that can detect even rare hyphal fusion events. Using the homothallic ascomycete Sordaria macrospora as an experimental system, we developed a histone-assisted merged fluorescence (HAMF) assay for the investigation of hyphal fusion between vegetative mycelia. For this purpose, two reporter vectors were constructed encoding the histone proteins HH2B or HH2A fused at their C terminus either with the cyan or yellow fluorescent protein, respectively. The chimeric proteins generate fluorescently labeled nuclei and thus enable the distinction between different strains in a mycelial mixture. For example, hyphae with nuclei that show both cyan as well as yellow fluorescence indicate the formation of a heterokaryon as a result of hyphal fusion. To test the applicability of our HAMF assay, we used two S. macrospora developmental mutants that are supposed to have reduced hyphal fusion rates. The simple and efficient HAMF assay described here could detect even rare fusion events and should be applicable to a broad range of diverse fungal species including those lacking male or female reproductive structures or asexual spores. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. Christine Rech and Ines Engh contributed equally to this work.     

脊椎植骨术中人工骨对软组织的反应

背景：脊椎后路植骨融合是常见的脊椎术式,人工骨可以很好地辅助植骨融合,但是由于软组织可能对人工骨存在一定的反应,人工骨目前很少应用于脊椎后路植骨中。 目的：拟通过兔的脊椎后路植骨实验,探讨如何降低脊椎手术中软组织对人工骨反应。 方法：36只成年公兔随机分为可吸收止血纱布组和对照组,于L2-3去皮质的椎板表面上,植入β-磷酸三钙人工骨,以可吸收止血纱布隔离背侧软组织为可吸收止血纱布组,无隔离物为对照组。检测植骨后不同时间点,兔血液中的C-反应蛋白表达,记录植骨后1周和12周皮肤愈合和皮下组织愈合情况以及局部炎症反应,CT检查记录植骨后不同时间点的人工骨爬行替代情况。 结果与结论：1周时,可吸收止血纱布组所有兔的背侧筋膜愈合完整;对照组9只中7只筋膜愈合完整,2只背侧筋膜愈合欠佳。12周时,可吸收止血纱布组9只中8只背侧筋膜愈合良好,1只愈合欠佳;对照组9只中6只愈合良好,2只愈合欠佳,1只轻度感染。1周时两组肌肉组织都存在一定充血,部分炎性细胞浸润,可吸收止血纱布组炎性细胞浸润较少,局部充血相对较少。12周时两组肌肉组织都存在一定的肉芽组织增生,可吸收止血纱布组炎性细胞浸润略少,对照组部分动物可见较明显的坏死组织。植骨后即刻,植骨后1周,4周时血液中的C-反应蛋白表达在两组间差异无显著性意义。植骨后12周时,CT检查显示靠近骨面的人工骨吸收明显,靠近软组织的人工骨无明显吸收,人工骨吸收情况在两组间无明显区别。结果提示,人工骨放置应尽量与植骨面多接触,这可促进人工骨尽早吸收,并降低软组织反应。减少人工骨和软组织接触,可以降低软组织对人工骨的反应。可吸收止血纱布的早期生物隔离和组织修复作用能一定程度减少组织对人工骨的反应。     

湿润烧伤膏并二氧化碳激光治疗血栓性外痔80例

目的：运用湿润烧伤膏(MEBO)纱布条与常规凡士林纱条填塞换药治疗，二氧化碳激光血栓性外痔手术后作对照，观察其促进创面愈合的作用。方法：分别将(MEBO)纱布条和凡士林纱布条填塞创面，外层用无菌纱布包扎，每日换药2次。结果：血栓性外痔激光手术后用湿润烧伤膏纱布条填塞可加速创面局部粘膜组织修复，无感染。创面愈合天数进行比较，明显少于凡士林对照组。结论：湿润烧伤膏具有抗炎减轻粘膜水肿，促进创面愈合疗效显著。     

Throat pain and pharyngeal packing: a controlled randomized double-blind comparison between gauze and tampons

In order to determine whether patients having pharyngeal packing experience more or less post-operative throat pain when tampons were used, 80 patients were randomized into two groups to receive either gauze or tampon pharyngeal packing. A third control group of 40 patients were intubated but did not have any throat packs. Post-operative throat pain was subjectively rated at both 6 hours and at 24 hours by an independent observer. Thirty-eight per cent of patients had moderate or severe throat pain in the gauze group, whilst in the tampon and control groups these amounted to only 15% and 1% respectively. A significantly higher proportion of patients also had a moderate or severe sore throat at 24 hours in the former group. Intubation alone resulted in a sore throat post-operatively in 50% of patients, but 85% of those had a mild sore throat only. No differences in pain ratings in any group could be shown between men or women or between age groupings. Endotracheal intubation often causes post-operative throat pain which is exacerbated by the use of pharyngeal packing. The results presented suggest that tampons are a safe, effective alternative to gauze and result in less severe post-operative throat pain.     

Intra-abdominal packing with laparotomy pads and QuikClot™ during damage control laparotomy: A safety analysis

BackgroundIntra-abdominal packing with laparotomy pads (LP) is a common and rapid method for hemorrhage control in critically injured patients. Combat Gauze™ and Trauma Pads™ ([QC] Z-Medica QuikClot^®) are kaolin impregnated hemostatic agents, that in addition to LP, may improve hemorrhage control. While QC packing has been effective in a swine liver injury model, QC remains unstudied for human intra-abdominal use. We hypothesized QC packing during damage control laparotomy (DCL) better controls hemorrhage than standard packing and is safe for intracorporeal use.MethodsA retrospective review (2011–2014) at a Level-I Trauma Center reviewed all patients who underwent DCL with intentionally retained packing. Clinical characteristics, intraoperative and postoperative parameters, and outcomes were compared with respect to packing (LP vs. LP + QC). All complications occurring within the patients’ hospital stays were reviewed. A p ≤ 0.05 was considered significant.Results68 patients underwent DCL with packing; (LP n = 40; LP + QC n = 28). No difference in age, BMI, injury mechanism, ISS, or GCS was detected (Table 1, all p > 0.05). LP + QC patients had a lower systolic blood pressure upon ED presentation and greater blood loss during index laparotomy than LP patients. LP + QC patients received more packed red blood cell and fresh frozen plasma resuscitation during index laparotomy (both p < 0.05). Despite greater physiologic derangement in the LP + QC group, there was no difference in total blood products required after index laparotomy until abdominal closure (LP vs LP + QC; p > 0.05). After a median of 2 days until abdominal closure in both groups, no difference in complications rates attributable to intra-abdominal packing (LP vs LP + QC) was detected.ConclusionWhile the addition of QC to LP packing did not confer additional benefit to standard packing, there was no additional morbidity identified with its use. The surgeons at our institution now select augmented packing with QC for sicker patients, as we believe this may have additional advantage over standard LP packing. A randomized controlled trial is warranted to further evaluate the intra-abdominal use of advanced hemostatic agents, like QC, for both hemostasis and associated morbidity.     

Use of controlled fascial tension and an adhesion preventing barrier to achieve delayed primary fascial closure in patients managed with an open abdomen

Open management of the abdomen has become an accepted technique for both the treatment and the prevention of abdominal compartment syndrome. It has also gained popularity as a treatment option in situations requiring multiple laparotomies such as uncontrolled intra-abdominal infections and severe abdominal injury necessitating damage control surgery. A significant number of patients managed with the open abdomen technique are unable to undergo complete abdominal wall closure and consequently develop large, complex anterior abdominal wall hernias. We report the use of a controlled fascial tensioning device, the Wittmann Patch (Starsurgical, Inc, Burlington, WI), in combination with an adhesion preventing barrier to allow for unhindered sequential medial advancement of the fascia toward the midline. The use of these 2 devices together may lead to a higher incidence of fascia-to-fascia abdominal wall closure than the use of fascial tension alone.     

扶正生肌油纱条对肛瘘术后创面愈合的影响

目的:观察扶正生肌油纱条对肛瘘术后患者创面愈合的影响。方法:选择 2019年 1月—2021年 1月于南京中医药大学徐州附属医院治疗的 160例行肛瘘手术的低位单纯肛瘘患者 160例,按随机数字表法分为两组,每组 80例,对照组术后给予凡士林纱条治疗,研究组术后给予扶正生肌油纱条治疗,治疗后检测两组患者表皮生长因子( EGF)、血管内皮生长因子( VEGF)、炎症指标、免疫球蛋白指指标,给予视觉模拟评分( VAS)评价,记录两组患者创面愈合时间,比较两组患者临床疗效。结果:研究组 IgG水平高于对照组 [(10.12±3.14)g/L vs (7.52±2.19)g/L],研究组 IgA水平低于对照组 [(1.01±0.30)g/L vs (1.45±0.41)g/L,(P<0.05)],研究组 EGF、VEGF水平 [(7.61±2.18)μg/L、(139.02± 36.32)ng/L vs(5.93±1.26)μg/L、(121.84±33.25)ng/L]高于对照组,差异有统计学意义( P<0.05),研究组 IL-1β水平低于对照组 [(23.66±6.94)ng/L VS (31.31±10.13)ng/L,P<0.05],研究组 IL-10水平高于对照组 [(65.19± 16.06)pg/mL vs(56.61±15.52)pg/mL,P<0.05],研究组患者 VAS评分低于对照组 [(2.73±0.81)分 vs(4.18±1.13)分, P<0.05],研究组患者创面愈合时间低于对照组 [(22.78±6.32)d vs(29.45±8.33)d,P<0.05],研究组患者总有效率( 97%)高于对照组( 76%),差异有统计学意义( P<0.05)。结论:扶正生肌油纱条治疗肛瘘术后患者,可提升患者 EGF、VEGF水平,调控免疫球蛋白分泌,抑制患者炎症,缓解患者疼痛,促进创面愈合,提升临床疗效。     

MEBO纱条脓腔引流治疗肛旁脓肿

目的：观察湿润烧伤膏（MEBO）油纱条引流肛旁脓肿的临床效果。方法：28例肛旁脓肿棱形放射状切口切开术后行MEBO油纱条填塞脓腔治疗,合并肛门瘘管者同时实行挂线治疗。结果：78．57％患者经3－4次换药治疗愈合。结论：MEBO纱条引流治疗肛旁脓肿效果显著。     

湿润烧伤膏纱条肛周脓肿引流治疗的临床体会

目的：观察自制湿润烧伤膏（MEBO）纱条引流肛周脓肿的临床疗效。方法：自制湿润烧伤膏纱条,高压消毒,经肛周脓肿切口填塞脓腔,隔日换药。结果：90％以上的病例经2－5次换药引流后愈合。结论：肛周脓肿经湿润烧伤膏纱条换药后,可缩短病程,减少工作量,治疗效果显著。     

宫腔纱布填塞治疗产后出血的方法改进

目的探讨治疗产后出血的安全有效方法。方法采用长100 cm、宽4 cm、厚4层的无菌纱条,以生理盐水浸湿、挤干,用卵圆钳夹住纱条一端,从阴道置入子宫腔,自子宫底起来回折叠,将整个子宫腔填紧塞满,不留空隙;剖宫产者在切口处充分估计拟填充子宫下段所需纱条长度,剪去多余纱条,先将尾端放置宫颈口附近,然后将剩余纱条充分填塞子宫下段,直视下缝合子宫切口。结果 16例产后出血患者均取得满意的止血效果,有效率达100%。产后42 d来院随访13例,子宫复旧良好,无产褥期出血及盆腔感染。结论改良的宫腔纱布填塞技术是治疗产后出血的简便、安全、有效的方法。