Control of Surface Wound Infection: Skin Versus Synthetic Grafts

Auto-, iso-, or xenografts of skin and synthetics placed on surface wounds freshly contaminated with Pseudomonas aeruginosa stabilizes the wound bacterial population in rats over a 24-h period. When these wounds contained a bacterial contamination established for 24 h prior to grafting, only skin and the synthetic polyhydroxyethylmethacrylate were effective in lowering the initial bacterial concentration. Polyurethane foam and nylon velour were not effective in the established infection model. Skin placed on a contaminated wound for 2 h or longer appeared to equilibrate with the underlying muscle so that the bacterial count per milligram of skin was similar to that of the muscle. It was suggested that this preparation would be useful to obtain an estimate of surface contamination without biopsy of the infected muscle. Skin grafts in place for 2 h significantly lowered the bacterial count in a wound with an established infection. A second decrease occurred between 4 and 24 h after grafting. Histological studies of contaminated and exposed panniculus muscle showed that leukocytes tend to migrate from the muscle surface to its base. Skin grafts and polyhydroxyethylmethacrylate appear to reverse the white cell migration so that the cells move toward the surface of the muscle with preservation of normal staining characteristics in the muscle. It is suggested that this alteration in cell movement after graft application might modify the white cell function and result in a greater bactericidal activity. Apparently, grafts lower bacterial levels in an established infection by modifying the host response to the surface contamination.     

壳聚糖护创敷料用于烧伤创面的治疗效果和安全性研究

目的:探讨壳聚糖护创敷料用于烧伤创面的治疗效果和安全性。方法:采用回顾性方法分析,选取中国人民解放军空降兵军医院烧伤科(本院)自2014年1月-2018年9月就诊的80例烧伤患者的临床资料,根据治疗方法分为对照组(40例,给予单纯紫草油覆盖创面)与研究组(40例,给予壳聚糖护创敷料覆盖创面),比较两组创面愈合时间、疼痛度、瘢痕生长及不同时期分泌物细菌培养阳性率。结果:研究组的创面愈合时间(18.45±4.64)及瘢痕生长评分(3.23±1.12)均低于对照组(22.45±5.23、5.34±1.23),均有显著差异(P0.05)。治疗后7 d、14 d、21 d研究组的创面疼痛度低于对照组(P0.05)。治疗后3 d、7 d、14 d研究组的细菌培养阳性率低于对照组(P0.05)。两组治疗期间均没有出现不良事件和严重不良事件的发生。结论:壳聚糖护创敷料用于烧伤创面患者治疗中,可缩短创面愈合时间,抑菌,减少创面愈合后的瘢痕增生,从而减轻患者疼痛,安全性高,值得临床推广应用。     

抑菌生的研究总结报告

本文报告一种由枯草杆菌制成的生态制剂,并命名为抑菌生(Subtilobiogen)。该制剂对创、烧伤感染有治疗作用。经过安全试验、急性毒性试验、Ames试验和微核试验证明,该制剂是一种无害、无毒和有致突变作用的活菌制剂。抑菌生有膏剂、乳剂及粉剂3种剂型。抑菌生在试管和体内对金黄色葡萄球菌、绿脓杆菌和大肠杆菌均具有抑菌作用。临床观察证明,将抑菌生喷洒在创面上,对浅Ⅱ°度、深Ⅱ°度及混合型烧伤感染均具有明显疗效。实验组(181例)与对照组(174例)相比较,在统计学上具有显著性差异。抑菌生的作用机制,经过初步试验证明,与营养争夺和占位性保护有关,因为枯草杆菌的生长速度超过金黄色葡萄球菌、绿脓杆菌和大肠杆菌的生长速度。     

湿润烧伤膏对肛瘘术后造模大鼠创面修复的影响

摘要 目的：探究湿润烧伤膏（MEBO）对肛瘘术后造模大鼠创面修复的影响。方法：将45只SPF级SD大鼠随机分为模型组（Model组）、MEBO组、易孚组,每组15只。建立全层皮肤缺损开放感染模型。观察肛瘘创面组织一般情况。分别在给药第3、7、14天测定并计算创面愈合率。苏木精-伊红（HE）染色观察大鼠创面组织病理学变化。酶联免疫吸附实验（ELISA）检测各组大鼠创面肉芽组织中炎症因子指标[肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）]水平。采用碱性磷酸酶（SAP）免疫组化法对创面肉芽组织进行染色,观察表皮生长因子（EGF）、基质金属蛋白酶-2（MMP-2）水平。蛋白质印迹（Western Blot）法检测各组大鼠创面肉芽组织B细胞淋巴瘤/白血病-xL基因（Bcl-xl）、B细胞淋巴瘤/白血病-2基因拮抗剂（Bak）蛋白表达水平,计算Bcl-xl/Bak比值。结果：与Model组相比,MEBO组大鼠创面愈合率（干预7、14 d后）、创面肉芽组织中EGF、MMP-2水平、Bcl-xl、Bak蛋白表达水平均显著升高（P＜0.05）,创面分泌物和水肿评分、创面肉芽组织生长评分、创面肉芽组织中TNF-α、IL-6水平、Bcl-xl/Bak比值均显著降低（P＜0.05）。大鼠创面组织出血减少、细胞间渗出液减少,血管扩张减轻,炎性细胞浸润减轻,可见大量的新生毛细血管和成纤维细胞。结论：MEBO可能通过抑制炎症反应,改善创面微循环和促进组织再生对肛瘘术后大鼠创面修复。     

Effects of Silver Nanoparticles on Burn Wound Healing in a Mouse Model

Biological Trace Element Research - Healing of injuries caused by exposure to heat has been discussed in many studies, although a few drugs have been shown to produce satisfactory results. In this...     

大鼠心肌梗死后螺内酯与氯沙坦干预对其心肌胶原变化的影响

目的:观察大鼠急性心肌梗死(acmemyocardial infarction,AMI)后左心室心肌重构分析和非梗死区Ⅰ、Ⅲ型胶原含量的变化,分别使用螺内酯和氯沙坦以及将两药合用对AMI模型进行干预,探索醛固酮受体拮抗剂和血管紧张素受体阻断剂对AMI后心室重构和胶原增生的影响.方法:将50只雌性SD大鼠随机分为AMI组、螺内酯组、氯沙坦组、联合用药组和假手术组,每组10只,结扎大鼠左前降支建立急性心肌梗死模型.术后8周进行血流动力学测定、病理分析和非梗死区Ⅰ、Ⅲ型胶原含量的测定.结果:AMI组与假手术组相比,左心室舒张末压(LVEDP)、容积、重量和非梗死区Ⅰ、Ⅲ型胶原含量均显著增加(P<0.05);左心室球形指数、左心室内压最大上升和下降速率(±dp/dt/LVSP)均显著降低(P<0.05).螺内酯组与AMI组相比,左心室非梗死区Ⅰ、Ⅲ型胶原含量显著减少(P<0.05),其余各指标差异无统计学意义(P>0.05).氯沙坦组和联合用药组与AMI组相比,LVEDP、左心室实际重量显著降低(P<0.05);左心室容积仅联合用药组有显著降低(P<0.05);而两组的±dp/dt/LVSP显著增加(P<0.05).螺内酯、氯沙坦和联合用药3组与AMI组相比,左心室非梗死区Ⅰ、Ⅲ型胶原含量均显著减少(P<0.05);且3组之间差异无统计学意义(P>0.05).结论:螺内酯能有效抑制AMI左心室非梗死区Ⅰ、Ⅲ型胶原的增生,提示螺内酯可能有改善左心室重构的潜在作用.氯沙坦与螺内酯合用可更有效防治AMI后左心室重构,改善左心室舒张功能.     

Effect of Sub-deficient Zinc Status on Insulin Sensitivity after Burn Injury in Rats

Although zinc status is an important parameter in insulin sensitivity, data concerning its implication in noxious burn-induced insulin resistance are scarce. The present study was designed to evaluate the impact of zinc status before burn on the recovery of injury with focus on plasma insulin and glucose levels. The experiment was performed in male adult Wistar rats fed from weaning with a zinc normal diet (80 ppm) or a depleted zinc diet (10 ppm) for 8 weeks and burned to third degree on 20% of their total body surface area. Blood and tissue samples were collected 3, 6, and 24 h after injury in order to study biochemical parameters and the glucose/insulin response in relation with the zinc status. After burn, zinc-depleted rats presented an exacerbated decrease in plasma zinc level. In addition, the burn-induced insulin resistance, leading to protein catabolism, was emphasized, with higher plasma insulin, glucose, and leptin levels in zinc-deficient animals versus normal-fed rats. Our experimental results underlined the interest to early control the zinc status in order to limit the deleterious effects of oxidative stress and insulin resistance in burned patients.     

Studies on the Prevalence and Effect of Trypanosoma Lewisi Infection in Finnish Rats

It is fully justified to call rats a menace to public health owing to their role as carriers of various infective agents. Investigations concerning the named role of this species have also contributed in shedding more light onto the apathogenic or only slightly pathogenic parasites in the rat populations.     

高乳清蛋白的肠内营养对大鼠伤口愈合的影响

探讨高乳清蛋白的肠内营养对大鼠创伤皮肤的促愈合作用.将36只SD大鼠随机分为3组,每组12只,即高乳清蛋白肠内营养组(A)、普通肠内营养组(B)、空白对照组(C),建立大鼠皮肤创伤模型后进行肠内营养支持,肠内营养用量为每天731.5kJ·kg-1,以灌胃的方式提供,分别于术后第7、14天测定血清蛋白、血红蛋白含量并计算创面愈合率.结果显示,术后第7、14天A组的血清蛋白、血红蛋白及伤口皮肤平均愈合率显著高于B、C组,差异具有统计学意义(p＜0.05).表明高乳清蛋白肠内营养具有较好的促进伤口愈合的作用.     

联合应用NGF 和胰岛素对糖尿病大鼠烫伤创面表皮干细胞的影响

目的:通过局部联合应用神经生长因子和胰岛素对糖尿病大鼠深II度烫伤创面表皮干细胞标记物β1整合素和角蛋白19(K19)表达的影响,探讨神经生长因子和胰岛素联合应用于糖尿病烫伤创面治疗后对创面愈合的影响。方法:雄性wistar大鼠腹腔注射链脲佐菌素(STZ)建立糖尿病模型60只,1月后在大鼠背部造成深II度烫伤。将大鼠随机分为糖尿病对照组(B)、胰岛素治疗组(C)、神经生长因子治疗组(D)、神经生长因子联合胰岛素治疗组(E),每组15只。另取15只正常雄性wistar大鼠作为正常对照组(A)。观察伤后3、7、11、15、21 d各组创面愈合情况,检测创面β1整合素和角蛋白19(K19)的表达并计算创面愈合率。结果:E组创面愈合率自第7天起较A、B、C、D组增加,为[(25.33±2.32)%,(P<0.05)];A、C、D组创面愈合率较B组增加分别为[(22.51±1.78)%,(16.68±1.95)%,(18.29±1.70)%,(P<0.05)]。E组整合素β1和角蛋白19(K19)表达自伤后第7至21天各时相点显著增加,(P<0.05)。结论:糖尿病大鼠深II度烫伤创面局部联合应用神经生长因子和胰岛素可促进表皮干细胞的增殖与分化从而加速创面的愈合。     

Mechanical Properties of Collagen Biomimetic Films Formed in the Presence of Calcium,Silica and Chitosan

Using eucollagen solutions from ox hide, we cast collagen films to assess the influence of calcium and silica on the reconstitution of the fibrous structure of collagen. The tensile strength and the breaking elongation of the reconstituted collagen films were measured and analysed. Significant differences were observed between reconstituted collagen films with and without calcium and silica. The breaking elongation of the films obtained in the presence of silica was significantly greater, and the degradation was lower than other films of reconstituted collagen. Collagen and chitosan do not exist together as blends in nature, but the specific properties of each may be used to produce in biomimetic way man-made blends with biomedical applications, that confer unique structural, mechanical （detail） and in vivo properties.     

烧伤膏对小鼠皮肤烫伤创面愈合的修复作用研究

目的:探讨烧伤膏对烫伤小鼠皮肤创面修复的可能作用机制。方法:将50只小鼠随机分为5组:正常组、模型组,烧伤膏高、中、低剂量组。除正常组和模型组外,烧伤膏实验组小鼠每天外涂烧伤膏治疗,连用15天。治疗结束后,采用Masson染色技术检测各组小鼠皮肤厚度及细胞病理形态;采用生化法检测皮肤中羟脯氨酸(Hyp)含量;采用ELISA技术检测皮肤中的TNF-α,IL-1β、Collagen I、EGF和TGF-β1的含量。结果:与正常组相比,模型组小鼠皮肤烫伤创面可见表皮细胞脱落,结构模糊,细胞变性坏死,表皮和真皮厚度明显减少,胶原纤维变薄,排列紊乱无序,呈断裂状;烧伤后创面局部组织中Hyp、TNF-α、IL-1β的含量显著升高(P0.01,P0.01,P0.01),而EGF、TGF-β1和Collagen I含量均明显减少(P0.01,P0.01,P0.01),而应用烧伤膏治疗15天后,上述各项实验指标明显得到改善。结论:烧伤膏抑制创面早期感染,减少胶原蛋白的分解和促进后期创面修复的作用可能与抑制炎性细胞因子和增加皮肤相关生长因子表达的作用机制有关。     

梅花鹿茸胶原酶解物对去势大鼠骨质疏松症防治作用的实验研究(英文)

观察梅花鹿茸胶原酶解物(CSDV)对去势大鼠骨质疏松症防治作用的实验研究。通过对模型组、给药组和假手术组在形态计量学指标,生物力学指标和血清生化指标的评价,考察鹿茸胶原酶解物的作用。结果表明CSDV能够明显提高去势骨质疏松症大鼠骨密度,调节血清碱性磷酸酶水平和骨钙素水平。说明鹿茸胶原酶解物在防治去势大鼠骨质疏松症方面具有明显作用。     

蓝科肤宁联合胶原贴敷料治疗颜面再发性皮炎的临床观察

目的:探讨蓝科肤宁联合胶原贴敷料治疗颜面再发性皮炎的疗效和安全性。方法:将90例入选的颜面再发性皮炎的患者随机分成治疗组、对照1组和对照2组,每组各30例。治疗组给予蓝科肤宁湿敷,早晚各一次,同时给予胶原贴敷料每晚1次,连用4周;对照1组外用蓝科肤宁湿敷;对照2组外用胶原贴敷料每晚1次,连用4周。治疗结束后4周,观察和比较各组患者的主观症状感觉、皮损情况及不良反应的发生情况。结果:所有患者均按要求完成整个疗程。治疗4周后,三组患者的症状评分均显著低于治疗前,且治疗组的症状评分显著低于对照2组(P0.001),而与对照1组比较差异无统计学意义(P0.05)。治疗组、对照1组和对照2组的临床有效率分别为93%、90%、63%,治疗组、对照1组均显著高于对照2组(P0.05),而治疗组和对照1组之间比较差异无统计学意义(P0.05)。三组不良反应的发生率比较均无统计学差异(P0.05)。结论:蓝科肤宁联合胶原贴敷料治疗颜面再发性皮炎的疗效更好,安全性高。     

The Effect of Mesenchymal Stem Cells and Chitosan Gel on Full Thickness Skin Wound Healing in Albino Rats: Histological,Immunohistochemical and Fluorescent Study

Background

Wound healing involves the integration of complex biological processes. Several studies examined numerous approaches to enhance wound healing and to minimize its related morbidity. Both chitosan and mesenchymal stem cells (MSCs) were used in treating skin wounds. The aim of the current work was to compare MSCs versus chitosan in wound healing, evaluate the most efficient route of administration of MSCs, either intradermal or systemic injection, and elicit the mechanisms inducing epidermal and dermal cell regeneration using histological, immunohistochemical and fluorescent techniques.

Material and Methods

Forty adult male Sprague Dawley albino rats were divided into four equal groups (ten rats in each group): control group (Group I); full thickness surgical skin wound model, Group II: Wound and chitosan gel. Group III: Wound treated with systemic injection of MSCs and Group IV: Wound treated with intradermal injection of MSCs. The healing ulcer was examined on day 3, 5, 10 and 15 for gross morphological evaluation and on day 10 and 15 for histological, immunohistochemical and fluorescent studies.

Results

Chitosan was proved to promote wound healing more than the control group but none of their wound reached complete closure. Better and faster healing of wounds in MSCs treated groups were manifested more than the control or chitosan treated groups. It was found that the intradermal route of administration of stem cells enhanced the rate of healing of skin wounds better than the systemic administration to the extent that, by the end of the fifteenth day of the experiment, the wounds were completely healed in all rats of this group. Histologically, the wound areas of group IV were hardly demarcated from the adjacent normal skin and showed complete regeneration of the epidermis, dermis, hypodermis and underlying muscle fibers. Collagen fibers were arranged in many directions, with significant increase in their area percent, surrounding fully regenerated hair follicles and sebaceous glands in the dermis of the healed areas more than in other groups.

Conclusion

MSCs enhanced the healing process of wound closure more than chitosan gel treatment. Furthermore, MSCs injected intradermally, were more efficient in accelerating wound healing than any other mode of treatment.     

流感病毒影响大鼠胚胎心脏发育机制的初步探究

先天性心脏病(先心病)是新生儿第一大出生缺陷,其中主因素有遗传因素、环境因素,但更多的是两者的相互作用。诱发先心病发生的环境因素复杂多样,但是具体的致病机制还有待阐明。研究表明孕母体早期感染流感病毒后,胎儿出现心血管畸形的概率显著增加,但其分子机制尚不明确。为了揭示流感病毒宫内感染和先天性心脏缺陷之间的关系,本实验利用F344大鼠建立了流感病毒宫内感染的动物模型,观察了感染流感病毒后孕鼠胚胎的发育,并利用荧光定量PCR检测了调控大鼠胚胎心脏发育的关键基因的表达。结果表明,流感病毒感染孕鼠后延迟鼠的胚胎发育,导致胚胎心脏发育异常。同时,胚胎心脏发育的关键基因骨形成蛋白4 (bone morphogenetic protein 4, BMP4)、成纤维细胞生长因子12 (fibroblast growth factor 12, FGF12)、包含氧化还原酶的WW域(WW domain-containing oxidoreductase, WWOX)、盘状结构域受体2 (discoidin domain-containing receptor 2, DDR2)和乙型肾上腺素受体3 (Ephrin type-B receptor 3, EPHB3)的表达下调,且均具有统计学差异。本研究初步证明流感病毒可能通过抑制胚胎心脏发育相关基因的表达,影响胚胎心脏发育过程,致使先心病的发生。     

新型抗菌凝胶敷料治疗深II度烧伤创面的疗效评价

目的:评价新型抗菌凝胶敷料普朗特联合磺胺嘧啶银霜治疗深Ⅱ度烧伤创面的临床疗效和安全性。方法:采用前瞻性随机对照的方法将2015年3月至2016年5月来我科初次就诊的深Ⅱ度烧伤患者74例分为两组:试验组38例采用新型抗菌凝胶敷料普朗特联合磺胺嘧啶银霜治疗,对照组36例采用磺胺嘧啶银霜治疗。两组均采用规定的标准化创面处理方式,其余治疗均按常规进行。分别统计和比较两组的创面愈合时间、愈合率、创面细菌培养阳性率、换药时的疼痛程度,同时定期监测患者在用药期间有无实验室指标异常及不良反应的发生。结果:试验组创面愈合时间(21.11 3.13)d,明显短于对照组(25.28 4.50)d(P0.01)。治疗后7 d、14 d、21 d,试验组创面愈合率分别为(26.63 5.21)%、(63.32 5.32)%、(92.66 4.19)%,均显著高于对照组(P0.05)。治疗后7 d、14 d,试验组分别有5例(13.16%)和1例(2.63%)创面细菌培养阳性,明显低于对照组的12例(33.33%)和8例(22.22%)(P0.05)。治疗后7 d、14 d、21 d,试验组换药时的疼痛评分均明显低于对照组(P0.05)。两组治疗期间实验室检查指标均无异常波动,均未见明显不良反应。结论:新型抗菌凝胶敷料普朗特联合磺胺嘧啶银霜治疗深Ⅱ度烧伤创面能缩短愈合时间,提高愈合率,减少创面感染发生,减轻患者痛苦。     

Characterization of a Phospholipid Adduct Formed in Sprague Dawley Rats by Chloroform Metabolism: NMR Studies

The formation of a covalent adduct to a single phospholipid by the oxidative chloroform metabolite, phosgene, is demonstrated in liver mitochondria of phenobarbital-pretreated Sprague Dawley (SD) rats treated with CHCl₃. The densitometric analysis of the phosphorus stained extracted phospholipids showed that the formation of this adduct in liver mitochondria is accompanied by a decrease of phosphatidylethanolamine and cardiolipin. The characterization of this adduct was performed with a multinuclear NMR approach by comparison with the decreased phospholipids. Treatment of rats with [¹³C]chloroform resulted in an intense ¹³C NMR peak from either an esteric or amidic carbonyl. Very strong similarities in fatty acid composition were found between phosphatidylethanolamine and the phosgene-modified PL, using ¹³C and ¹H NMR spectroscopy. A multiplet at 3.91 ppm coupled to a signal at 3.41 ppm was shown by two-dimensional ¹H NMR in the adduct spectrum. This cross peak was interpreted as arising from the shifted resonances of the two PE head group methylene groups, due to the binding with phosgene. ³¹P spectrum of the adduct was identical to that of phosphatidylethanolamine. We concluded that the chloroform adduct is a modified phosphatidylethanolamine, with the phosgene-derived carbonyl bound to the amine of the head group. © 1997 John Wiley & Sons, Inc. J Biochem Toxicol 12: 93–102, 1998     

The Effect of Infection Control Nurses on the Occurrence of Pseudomonas aeruginosa Healthcare-Acquired Infection and Multidrug-Resistant Strains in Critically-Ill Children

Background

Healthcare-acquired Pseudomonas aeruginosa (P. aeruginosa) infections in the Pediatric Intensive Care Unit (PICU), which have a high incidence, increase treatment costs and mortality, and seriously threaten the safety of critically ill children. It is essential to seek convenient and effective methods to control and prevent healthcare-acquired infections (HAIs). This research was conducted to study the effect of infection control nurses on the occurrence of P. aeruginosa HAIs and multi-drug resistance (MDR) strains in PICU.

Methods

The clinical data was divided into two groups, with the age ranging from 1 month to 14 years. One group of the critically ill patients(N = 3,722) was admitted to PICU from 2007 to 2010, without the management of infection control nurses. The other group of the critically ill patients (N = 3,943) was admitted to PICU from 2011 to 2013, with the management of infection control nurses. Compare the mortality, morbidity and the incidence of acquired P. aeruginosa infections to evaluate the effect of infection control nurses.

Results

After implementation of the post of infection control nurses, the patient''s overall mortality fell from 4.81% to 3.73%. Among the patients with endotracheal intubation more than 48 hours, the incidence of endotracheal intubation-related pneumonia decreased from 44.6% to 34.32%. The mortality of patients with endotracheal intubation decreased from 16.96% to 10.17%, and the morbidity of HAIs with P. aeruginosa decreased from 1.89% to 1.07%. The mutual different rate (MDR) dropped from 67.95% to 44.23%. There were remarkable differences in these rates between the two groups (p<0.05).

Conclusion

Implementing the post of infection control nurses is associated with effectively reducing the HAI rate, especially the incidence and morbidity of P. aeruginosa HAIs, reducing PICU mortality, improving P. aeruginosa drug resistance.