细菌生物膜形成与慢性难愈性创面相关性的研究进展

感染是影响慢性难愈性创面愈合最常见的原因,由于多种细菌混合感染、耐药性产生、生物膜的形成使其治疗成为难题.其中,细菌生物膜形成是导致创面的难以愈合的重要因素之一.本文就慢性难愈合创面中细菌生物膜的形成机制、特征、生态学、对伤口愈合的影响以及可能的治疗对策等作一综述.     

生长激素在创面愈合中的应用

软组织损伤创面在合并糖尿病、放射治疗等情况下,常常延迟愈合、不愈、或反复发作,转变为慢性难愈性创面,成为长期困扰,临床治疗的一大难题。通常采用的皮肤移植疗法,无论自体还是异体皮都受到供体来源少的限制,异体皮和人工合成皮还存在免疫排斥等问题。生长激素在慢性创面愈合中的作用受到广泛关注,为慢性难愈创面的治疗提供了新的途径,有望带来突破性的治疗效果。     

基因治疗在慢性难愈创面的应用进展

众多疾病和创伤都会带来损伤创面的难愈问题,慢性难愈创面的长期存在不仅增加了局部感染的机会,而且大大影响了局部组织的结构和功能。基因治疗作为一种新的生物治疗方法,其相关理论和技术近来日臻完善,为慢性难愈创面的治疗提供了新的技术途径,有望带来突破性的治疗效果。     

负压封闭引流治疗厌氧菌感染创面的临床观察

目的:观察负压封闭引流联合双氧水冲洗治疗厌氧菌感染创面的临床治疗效果。方法:收集我院收治的创面厌氧菌感染患者60例,随机分为两组。其中,对照组(30例)患者采用常规换药治疗创面厌氧菌感染,VSD组(30例)患者给予负压封闭引流并辅以双氧水冲洗治疗。观察并比较两组患者厌氧菌清除率,以及创面愈合情况。结果:VSD组创面厌氧菌感染率明显低于对照组,创面愈合效果优于对照组,差异有统计学意义(P0.01)。结论:负压封闭引流不仅能够有效控制感染创面厌氧菌生长,而且可以有效促进创面愈合,对临床具有指导意义。     

负压创面治疗技术对水通道蛋白4表达变化的研究

目的：研究爆炸伤后肌肉组织中AQP4蛋白表达变化的规律,以及应用创面负压吸引技术后AQP4蛋白表达的变化影响,探讨创面负压吸引技术的可能作用机制。方法：在猪软组织爆炸伤模型基础上将10只家猪的双侧臀部随机分为实验组和对照组,爆炸致伤造成的创面分别应用传统纱布爆炸治疗及负压创面治疗。应用Western-Blot技术和RT-PCR技术检测创面组织中AQP4蛋白和AQP4 mRNA的表达水平,并对两者的相关性进行分析。结果：致伤3天后对照组和实验组创面组织AQP4蛋白和AQP4 mRNA表达均达到峰值,随后逐渐降低,对照组创面AQP4蛋白和AQP4 mRNA水平显著高于实验组（P〈0.05）。实验组及对照组AQP4 mRNA与AQP4蛋白表达呈正相关。结论：负压创面治疗技术可减低创面组织AQP4蛋白表达。AQP4蛋白表达变化可能是负压创面治疗技术促进创面愈合的机制之一。     

红光促进难治性创面愈合的研究

目的：探讨红光照射对难治性创面的创缘组织中血管内皮细胞生长因子（vascular endothelial growth factor,VEGF）的表达及治疗难治性创面的临床效果。方法：收集2008年6月-2010年12月因难治性创面入住笔者单位治疗的40例患者,按治疗方法分为红光照射治疗组20例和常规治疗组20例。常规治疗组患者创面以0.5%碘伏与水胶体敷料换药。治疗组在常规治疗的基础上加用红光照射。于治疗后第7天、14天、21天切取创缘组织,研究红光照射对创缘组织中VEGF的影响,并比较两组患者的创面愈合率和愈合时间。结果：临床实验中,治疗组创缘组织中的VEGF含量明显高于对照组（P〈0.01）;治疗组创面愈合率明显高于对照组（P〈0.01）;治疗组的愈合时间低于对照组（P〈0.05）。结论：红光照射能显著提高创缘组织中VEGF含量,减少创面愈合时间,促进愈合。     

红光促进难治性创面愈合的研究

目的:探讨红光照射对难治性创面的创缘组织中血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)的表达及治疗难治性创面的临床效果。方法:收集2008年6月-2010年12月因难治性创面入住笔者单位治疗的40例患者,按治疗方法分为红光照射治疗组20例和常规治疗组20例。常规治疗组患者创面以0.5%碘伏与水胶体敷料换药。治疗组在常规治疗的基础上加用红光照射。于治疗后第7天、14天、21天切取创缘组织,研究红光照射对创缘组织中VEGF的影响,并比较两组患者的创面愈合率和愈合时间。结果:临床实验中,治疗组创缘组织中的VEGF含量明显高于对照组(P<0.01);治疗组创面愈合率明显高于对照组(P<0.01);治疗组的愈合时间低于对照组(P<0.05)。结论:红光照射能显著提高创缘组织中VEGF含量,减少创面愈合时间,促进愈合。     

壳聚糖抗菌生物医用膜在烧伤创面中的临床应用

目的总结水溶性壳聚糖抗菌生物医用膜凝胶剂(商品名:凯舒林)对人体II度烧伤创面的治疗作用和安全性,并探索后期创面色素沉着、瘢痕增殖的机制。方法选择II度烧伤患者60例,用药前均用生理盐水清洁创面、去腐皮,于创面上均匀涂壳聚糖抗菌生物医用膜治疗,观察记录创面成痂、止痛、感染及痂下愈合时间,追踪随访6个月后创面色素沉着及瘢痕增殖程度。结果本组60例使用壳聚糖抗菌生物医用膜治疗的烧伤患者,创面全部自行愈合。治愈时间:浅Ⅱ度患者平均8.5 d;深Ⅱ度患者平均19 d。创面愈合后随访6个月,浅Ⅱ度创面患者3个月内有轻度色素改变,3个月后逐步恢复正常;深Ⅱ度创面患者3个月后部分患者有散在的点样色素脱失改变;部分患者有散在的扁平瘢痕。随访6个月,创面色素沉着和瘢痕增生程度明显减轻,功能明显改善,未见瘢痕疙瘩增殖。结论壳聚糖抗菌生物医用膜用于烧伤创面具有良好的组织相容性,止痛效果好,创面成痂快,兼有控制创面感染,促进愈合,减轻瘢痕增殖的作用,无明显不良反应,安全性好。     

VSD联合金因肽治疗手足外科难愈性伤口的临床研究

目的:观察封闭式负压引流技术(VSD)联合金因肽治疗手足外科难愈性伤口的临床疗效,为临床联合运用提供依据。方法:86例手足外科难愈性伤口患者随机分为治疗组和对照组各43例,治疗组采用VSD联合金因肽治疗,对照组采用常规换药治疗,观察两组临床疗效和上皮化时间、愈合时间、创面愈合率、换药次数、伤口疼痛评分、住院费用差异。结果:治疗组总有效率90.70%;对照组总有效率72.09%;两组比较,有显著性差异(P0.05);治疗组上皮化时间、愈合时间、创面愈合率、换药次数、伤口疼痛评分、住院费用较对照组相比明显缩短,差异有统计学意义(P0.05)。结论:VSD联合金因肽治疗手足外科难愈性伤口疗效确切,能更好促进损伤组织的修复,加速创面愈合,值得临床推广应用。     

烧伤病房难愈性创面病原菌分布及耐药性分析

目的 分析烧伤病房难愈性创面病原菌分布及耐药性,为临床合理选用抗生素提供依据.方法 对2006年1月至2012年6月间中国人民解放军第八五医院烧伤病房收治的难愈性创面患者创面分离出的病原菌,采用K-B纸片扩散法进行药物敏感试验,分析病原菌耐药性.结果 分离出病原菌154株,革兰阳性菌62株,占40.26％;革兰阴性菌92株,占59.74％.常见病原菌为金黄色葡萄球菌、铜绿假单胞菌和鲍曼不动杆菌.烧伤难愈性创面中金黄色葡萄球菌最多见,压迫性溃疡创面中常见铜绿假单胞菌和鲍曼不动杆菌,其他难愈性创面中铜绿假单胞菌最常见.创面革兰阳性菌对利奈唑烷和呋喃妥因的耐药率较低,革兰阴性菌对头孢哌酮/舒巴坦、阿米卡星、亚胺培南、氨曲南和头孢西丁的耐药率较低,无万古霉素耐药菌.常见病原菌中金黄色葡萄球菌和鲍曼不动杆菌的耐药率较高,铜绿假单胞菌的耐药率较低.结论 不同病因的难愈性创面病原菌分布不同,引起难愈性创面的病原菌主要为多重耐药金黄色葡萄球菌和鲍曼不动杆菌.     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.