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2016 Vol. 32, No. 6

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Expert Forum
Pay more attention to the precise assessment of extraordinary agent wounds
Jia Chiyu
2016, 32(6): 321-322. doi: 10.3760/cma.j.issn.1009-2587.2016.06.001
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Although the extraordinary agent wound is not common, the difficulties of its diagnosis, treatment, and the high medical risk as well as the indeterminacy of its prognosis bring great challenges to the clinicians. It is mainly attributed to the complexities of extraordinary agent wounds and the deficiency in the assessment technic of wound. Therefore, it is necessary and important to establish a precise assessment method to benefit the surgical planning, pre-estimation of peri-operative risk, and the doctor-patient communication. Based on the relative scientific research and our recent clinical research data, we bring forth our opinions on the current status and the development trend of the assessment of extraordinary agent wounds in this article.
Expert Comment
Precise management of extraordinary agent wound by establishment of a multidisciplinary cooperation mechanism
Liu Yi
2016, 32(6): 323-325. doi: 10.3760/cma.j.issn.1009-2587.2016.06.002
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With the development of social economy, people′s lifestyle has changed accompanied with the problem of population aging. The spectrum of disease also varied accordingly, thus led to complicated and varied wound aetiology, along with the formation of innumerably changed acute and chronic wounds. Therefore, it is hard to meet the requirement of multidisciplinary knowledge and technique in the diagnosis and treatment of some extraordinary agent wound with a single discipline. The extraordinary agent wound is caused by some uncommon or rare etiological factors, the specialty of which lays on the unique mechanism of wound formation, and a lot of disciplines were involved in the diagnosis and management of the wound. A unification of multiple disciplines is needed to integrate the relevant theory and technique to care the wound by giving consideration of the symptom and the aetiology. The primary diseases which induced the uncommon agent wound should be targeted and treated effectively; meanwhile, a comprehensive treatment combined with multiple new wound management techniques should be carried out to realize the objective of precise treatment.
2016, 32(6): 325-325. doi: 10.3760/cma.j.issn.1009-2587.2016.06.101
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2016, 32(6): 325-325. doi: 10.3760/cma.j.issn.1009-2587.2016.06.102
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Clinical application of surgical intervention model for repairing tuberculosis wound with sinus tract
Jia Chiyu, Li Pengcheng, Cheng Lin, Zheng Mengli, Jin Wenbo, Wu Yujia, Chang Chunjuan, Zhang Yuanyuan, Shu Bin, Yin Bin
2016, 32(6): 326-330. doi: 10.3760/cma.j.issn.1009-2587.2016.06.003
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Objective To retrospectively explore the effectiveness of surgical intervention model for repairing the tuberculosis wound with sinus tract. Methods Forty-three patients with tuberculosis wound with sinus tract who met the inclusion criteria were admitted to the 309th Hospital of PLA from January 2010 to October 2015. These patients were divided into test group (n=38) and control group (n=5) according to the different treatment and patient′s consent. Patients in test group were treated as follows. Firstly, antituberculosis drugs were taken orally for at least 3 weeks, and the wounds were accurately assessed using magnetic resonance imaging combined with 3-dimensional reconstruction software. Then sinus tract and its surrounding devitalized tissue were completely excised, and vacuum sealing drainage (VSD) treatment with negative pressure value of -26.6 kPa was performed for 1 to 2 weeks (dressing change was performed per 7 days). Lastly, the wounds were covered through direct suture or grafting skin or flap. Patients in control group were firstly given antituberculosis drugs orally for at least 3 weeks, and then they were treated with routine dressing change in outpatient service every 3 days. After the former therapy, patients in both groups were given antituberculosis drugs by oral administration for at least 6 months and were followed up for 6 to 36 months. Detection of Bacillus tuberculosis, Acid-fast bacilli, and tuberculosis granuloma, wound healing time, and relapse of tuberculosis wound in patients of both groups were recorded. The rates of single sinus tract, two sinus tracts, and more than or equal to 3 sinus tracts of patients in test group were recorded. Data were processed with Fisher′s exact test and Wilcoxon rank-sum test. Results Bacillus tuberculosis was respectively detected in wounds of 5 patients in test group and 2 patients in control group. Acid-fast bacilli were positively expressed in wounds of 8 patients in test group and 3 patients in control group. A typical tuberculosis granuloma phenomenon was observed in the wounds of 27 patients in test group and 4 patients in control group. These differences in above-mentioned 3 indexes between two groups were not statistically significant (with P values respectively 0.238 4, 0.154 4, 1.000 0). The median of wound healing time of patients in test group was 19.6 d, which was significantly shorter than that in control group (94.4 d, χ2=12.986 0, P=0.000 3). There were 2 and 1 patients with recurrent tuberculosis wound in test group and control group respectively, without statistically significant difference (P=0.363 0). Among patients in test group, the rate of single sinus tract was 23.7%(9/38), the rate of two sinus tracts was 28.9%(11/38), and the rate of more than or equal to 3 sinus tracts was 47.4% (18/38). Conclusions Repairing the tuberculosis wound with sinus tract in surgical intervention model of antituberculosis therapy+ accurate wound assessment+ debridement+ VSD treatment+ surgical repair is beneficial to making the optimal operation plan under the premise of knowing location of sinus tract, which can reduce surgical risk.
2016, 32(6): 330-330. doi: 10.3760/cma.j.issn.1009-2587.2016.06.103
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Curative effects of platelet-rich plasma combined with negative-pressure wound therapy on sternal osteomyelitis and sinus tract after thoracotomy
Hao Daifeng, Feng Guang, Li Tao, Chu Wanli, Chen Zequn, Li Shanyou, Zhang Xinjian, Zhao Jingfeng, Zhao Fan
2016, 32(6): 331-335. doi: 10.3760/cma.j.issn.1009-2587.2016.06.004
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Objective To observe the curative effects of platelet-rich plasma (PRP) combined with negative-pressure wound therapy (NPWT) on patients with sternal osteomyelitis and sinus tract after thoracotomy. Methods Sixty-two patients with sternal osteomyelitis and sinus tract after thoracotomy, hospitalized from March 2011 to June 2015, were retrospectively analyzed. Based on whether receiving PRP or not, patients were divided into two groups, group NPWT ( 22 patients hospitalized from March 2011 to December 2012) and combination treatment group (CT, 40 patients hospitalized from January 2013 to June 2015). After debridement, patients in group NPWT were treated with continuous NPWT (negative pressure values from -15.96 to -13.30 kPa), while those in group CT were treated with PRP gel (blood platelet counts in PRP ranged from 1 450×109/L to 1 800×109/L, with 10-15 mL in each dosage) made on the surgery day to fill the sinus tract and wound, followed by NPWT. Negative pressure materials were changed every 5 days until 20 days after surgery in patients of both groups. PRP gel was replenished before changing of negative pressure materials in patients of group CT. The sinus tract sealing time, wound healing time, number of patients who had secondary repair surgery, number of patients who had recurrence of sinus tract within three months after wound healing, and length of hospital stay were recorded. Data were processed with t test, Fisher′s exact test, and chi-square test. Results The sinus tract sealing time, wound healing time, and length of hospital stay in patients of group CT were (16±8), (27±13), and (43±13) d respectively, which were all significantly shorter than those in group NPWT [(29±14), (41±17), and (60±20) d, with t values from 3.88 to 4.67, P values below 0.01]. The number of patients who had secondary repair surgery in group CT was less than that in group NPWT (P<0.01). There was no statistically significant difference in the number of patients who had recurrence of sinus tract between two groups (P>0.05). Conclusions Compared with NPWT only, PRP combined with NPWT has great curative effects on patients with sternal osteomyelitis and sinus tract after thoracotomy, for it shortens sinus tract sealing time, wound healing time, and length of hospital stay, and avoids the secondary repair surgery. This method is simple and safe with little injury.
2016, 32(6): 336-337. doi: 10.3760/cma.j.issn.1009-2587.2016.06.005
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2016, 32(6): 338-339. doi: 10.3760/cma.j.issn.1009-2587.2016.06.006
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2016, 32(6): 340-340. doi: 10.3760/cma.j.issn.1009-2587.2016.06.007
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Advancement in the diagnosis and management of toxic epidermal necrolysis
Sun Wei, Min Dinghong, Guo Guanghua
2016, 32(6): 341-344. doi: 10.3760/cma.j.issn.1009-2587.2016.06.008
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Toxic epidermal necrolysis (TEN) is a potentially life-threatening condition usually attributed to severe adverse drug reactions. The evolvement of TEN, including extensive epidermal sloughing, fluid and electrolyte imbalances, hypermetabolism, immune dysfunction, sepsis and organs failure, are very similar to that of extensive burn. There is no unified therapeutic regimen for TEN due to its unclear pathogenesis.This article reviews the recent progress in regard to TEN in etiology, pathogenesis, diagnosis, differential diagnosis, treatment, new standard diagnostic approach, primary care, and supportive treatment.
2016, 32(6): 376-377. doi: 10.3760/cma.j.issn.1009-2587.2016.06.014
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2016, 32(6): 378-380. doi: 10.3760/cma.j.issn.1009-2587.2016.06.015
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2016, 32(6): 380-381. doi: 10.3760/cma.j.issn.1009-2587.2016.06.016
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Original Article
Effects of ulinastatin on immune function of patients with severe burn injury
Li Juncong, Hu Chao, Yang Hongming, Yao Yongming
2016, 32(6): 345-350. doi: 10.3760/cma.j.issn.1009-2587.2016.06.009
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Objective To primarily evaluate the effects of ulinastatin on immune function of patients with severe burn injury. Methods Forty patients with severe burn admitted to our ward from March 2013 to October 2015, conforming to the study criteria, were divided into conventional treatment group (CT, n=20) and ulinastatin treatment group (UT, n=20) according to the random number table and patient′s consent. After admission, patients in group CT received antishock treatment, antibiotic treatment, debridement, skin grafting, and nutrition support, etc. On the basis of the above-mentioned treatment, patients in group UT received intravenous drip of ulinastatin from first day after admission twice a day, with a dosage of 8×105 U every time, for 7 days in addition. Peripheral venous blood samples were collected from patients in groups CT and UT on post treatment day (PTD) 1, 3, 5 and 7, respectively. Twenty healthy volunteer were selected as health control group (HC), and peripheral venous blood samples were collected on the first day of the study. Percentage of CD4+ CD25+ regulatory T lymphocytes (Tregs) was determined by flow cytometer. The proliferative activity of T lymphocytes was detected by microplate reader (denoted as absorbance value). Content of interleukin 2 (IL-2) in culture supernatant of T lymphocytes, and content of IL-4 and γ interferon (IFN-γ) in serum were detected by enzyme-linked immunosorbent assay. Expression of human leukocyte antigen-DR (HLA-DR) on CD14+ monocytes was determined by flow cytometer. Data were processed with analysis of variance for repeated measurement, chi-square test, and LSD-t test. Results (1) Compared with that of volunteer in group HC, the percentage of CD4+ CD25+ Tregs of patients in group CT was significantly increased from PTD 1 to 7 (with t values from 13.303 to 26.043, P values below 0.01). Compared with that in group CT, the percentage of CD4+ CD25+ Tregs of patients in group UT was significantly decreased on PTD 5 and 7 (with t values respectively 8.317 and 15.071, P values below 0.01). (2) The proliferative activity of T lymphocytes of patients in group CT on PTD 1, 3, 5, and 7 was respectively 0.71±0.11, 0.61±0.15, 0.54±0.12, and 0.67±0.17, which was significantly lower than that in group HC (1.21±0.22, with t values from 8.686 to 11.957, P values below 0.01). The proliferative activity of T lymphocytes of patients in group UT on PTD 3, 5, and 7 were respectively 0.81±0.11, 0.85±0.14, and 1.08±0.13, which was significantly higher than that in group CT (with t values from 4.808 to 8.568, P values below 0.01). (3) Compared with those of volunteer in group HC, content of IL-2 in culture supernatant of T lymphocytes of patients in group CT was significantly decreased from PTD 1 to 7 (with t values from 8.073 to 9.288, P values below 0.01), content of IL-4 in serum of patients in group CT was significantly increased from PTD 1 to 7 (with t values from 18.926 to 41.451, P values below 0.01), and content of IFN-γ in serum of patients in group CT was significantly decreased from PTD 1 to 7 (with t values from 4.543 to 27.659, P values below 0.01). Compared with those in group CT, content of IL-2 in culture supernatant of T lymphocytes of patients in group UT was significantly increased from PTD 3 to 7 (with t values from 6.507 to 8.869, P values below 0.01), content of IL-4 in serum of patients in group UT was significantly decreased from PTD 3 to 7 (with t values from 6.922 to 8.843, P values below 0.01), and content of IFN-γ in serum of patients in group UT was significantly increased on PTD 5 and 7 (with t values respectively 5.369 and 13.521, P values below 0.01). (4) The percentages of CD14+ monocytes with positive expression of HLA-DR of patients in group CT on PTD 1, 3, 5, and 7 were respectively (28±6)%, (25±7)%, (25±7)%, and (39±10)%, which were significantly lower than the percentage of volunteer in group HC [(87±8)%, with t values from 16.323 to 25.645, P values below 0.01]. The percentages of CD14+ monocytes with positive expression of HLA-DR of patients in group UT on PTD 3, 5, and 7 were respectively (40±6)%, (42±9)%, and (49±10)%, which were significantly higher than those in group CT (with t values from 3.071 to 7.324, P values below 0.01). Conclusions On the basis of CT, additional ulinastatin intervention can decrease CD4+ CD25+ Tregs percentage, improve the immune function of T lymphocytes and T helper cells, and increase expression of HLA-DR on CD14+ monocytes of patients with severe burn injury, thus improve the immune function of patients.
Epidemiological investigation of hospitalized children with burn injuries in a hospital of Fuzhou
Li Lin, Lin Renqin, Xu Le, Pan Qiong, Dai Jiaxi, Jiang Meiyun, Chen Zhaohong
2016, 32(6): 351-355. doi: 10.3760/cma.j.issn.1009-2587.2016.06.010
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Objective To analyze the epidemiological characteristics of hospitalized children with burn injuries in Fujian Medical University Union Hospital, so as to provide evidence to complete an adequate, timely, and effective prevention and treatment system of children with burn injuries. Methods Medical records of children with burn injuries, aged 14 and under, hospitalized in the Department of Burns from July 2012 to June 2015 were collected. Data of gender and age, location and cause of injury, time of injury, state of injury, admission time after injury, first aid, length of hospital stay, and treatment and so on were recorded. They were divided into 4 age brackets: less than or equal to 1 year old, more than 1 year old and less than or equal to 3 years old, more than 3 years old and less than or equal to 7 years old, more than 7 years old and less than or equal to 14 years old, then gender and cause of injury of children in the 4 age brackets were analyzed. Admission months of the children were divided into spring (March to May), summer (June to August), autumn (September to November) and winter (December to February of the following year), and then the cause of injury of children in each season was analyzed. Severities of male and female children, length of hospital stay of children with different causes of injury were analyzed. Data were processed with chi-square test, Wilcoxon rank-sum test. Results Out of 2 608 inpatients with burn injuries, 1 407 children with burn injuries, aged 14 and under, accounting for 53.9%, were admitted in the recent 3 years. The ratio of male to female was 1.6 ∶1.0. Children more than 1 year old and less than or equal to 3 years old ranked the largest number (68.3%, 961/1 407) in the 4 age brackets. There was statistically significant difference in constituent ratios of gender of children among the 4 age brackets (χ2=11.00, P=0.012). One thousand three hundred and seventy-two children were burned indoors (97.5%), while 35 children were burned outdoors (2.5%). Scalding with hot fluids was the most common cause of burn (95.0%, 1 337/1 407). There was statistically significant difference in constituent ratios of injury cause of children among the 4 age brackets (χ2=107.23, P<0.01). There was statistically significant difference in constituent ratios of injury cause of children more than 7 years old and less than or equal to 14 years old compared with those of the other 3 age brackets (with χ2 values from 12.88 to 119.85, P values below 0.01). Most burn accidents occurred between 17: 00-20: 59 (33.5%, 472/1 407). Burns were more likely to happen in April to October. July (10.4%, 146/1 407) and August (10.5%, 148/1 407) were the crest-time. Most of the children were burned in summer (35.3%, 496/1 407). There was statistically significant difference in the injury cause of children among each season (χ2=14.61, P=0.024). The burn degrees of male and female children were mainly mild or moderate, and there was no statistically significant difference in the severity (Z=-0.39, P>0.05). The trunk was the most involved anatomic site (61.1%, 859/1 407). Most of children were admitted to hospital within 2 hours post burn (79.7%, 1 121/1 407). Majority of children were taken off clothes as first aid on spot or did not receive any treatment. Most of the children were discharged within 2 weeks after admission (80.0%, 1 126/1 407). There was statistically significant difference in length of hospital stay of children with causes of hot liquid scald, flame burn, electric burn, high temperature solid burn, chemical burn (χ2 =17.33, P=0.002). Most of the children were treated with non-surgical methods, and the majority of the children got better condition or totally recovered and then discharged. Conclusions The majority of hospitalized children with burn injuries in our unit are young boys in preschool period, who were burnt by hot fluid at the time of dinner and bathing at home during summer. So we should make more effort on popularization of prevention about burn.
Clinical efficacy of negative-pressure wound therapy combined with porcine acellular dermal matrix for repairing deep burn wounds in limbs
Liu Wei, Li Feng, Chen Xin, Pan Qing
2016, 32(6): 356-362. doi: 10.3760/cma.j.issn.1009-2587.2016.06.011
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Objective To observe the clinical efficacy of negative pressure wound therapy (NPWT) in combination with porcine acellular dermal matrix (ADM) dressing for repairing deep burn wounds in limbs of patients with non-surgical treatment. Methods Thirty-two patients with deep partial-thickness burn to full-thickness burn on the limbs admitted to our ward from June 2012 to December 2015, conforming to the inclusion criteria, were divided into group NPWT (n=10, treated with interval negative pressure drainage at -16.6 kPa), group ADM (n=7, treated with porcine ADM dressing), and group NPWT+ ADM (n=15, treated with interval negative pressure drainage and porcine ADM dressing as above) according to the random number table and patient′s consent. After being treated for 21 d, residual wounds were cured by routine dressing change using sulfadiazine silver. On post treatment day (PTD) 7, 14, and 21, wound gross observation was conducted, wound drainage fluid volume was recorded, and wound healing rate was calculated. Wound secretion was collected for bacterial culture before treatment and on PTD 21, and bacterial clearance effect was recorded. The wound healing time was also recorded. Measurement data were processed with analysis of variance for repeated measurement, one-way analysis of variance, and LSD test. Eenumeration data were processed with chi-square test or Fisher′s exact test. Results (1) On PTD 7, the wounds of patients in group NPWT and group NPWT+ ADM were significantly shrinked as compared with those before treatment. Skin paddle scattered on the wounds of patients in group NPWT+ ADM on PTD 7. The wounds of patients in group ADM were slightly shrinked on PTD 7 as compared with those before treatment. On PTD 14, the wounds of patients in group NPWT were slightly shrinked as compared with those on PTD 7, while those in group NPWT+ ADM were significantly shrinked as compared with those on PTD 7. Skin paddle on the wounds of patients in group NPWT+ ADM on PTD 14 were increased and fused. The wounds of patients in group ADM were significantly shrinked on PTD 14 as compared with those on PTD 7. On PTD 21, partial wounds of patients in group NPWT were healed, while the wounds of patients in group ADM were slightly shrinked in comparison with those on PTD 14 and most of wounds were not healed. Most of wounds of patients in group NPWT+ ADM were healed. (2) On PTD 7, the wound drainage fluid volumes of patients in group NPWT and group NPWT+ ADM were obviously more than the wound drainage fluid volume of patients in group ADM (with P values below 0.01). On PTD 14, the wound drainage fluid volume of patients in group NPWT was significantly more than that in group ADM (P<0.01); while that between group ADM and group NPWT+ ADM was close (P>0.05). On PTD 21, the wound drainage fluid volume of patients in group NPWT and group NPWT+ ADM was significantly less than that in group ADM (with P values below 0.01). From PTD 7 to 21, the wound drainage fluid volumes of patients in group NPWT+ ADM were significantly reduced as compared with those in group NPWT (with P values below 0.01). (3) On PTD 7, the wound healing rates of patients in group ADM and group NPWT+ ADM were significantly lower than the wound healing rate of patients in group NPWT (P<0.05 or P<0.01), and the wound healing rate of patients in group NPWT+ ADM was significantly higher than that in group ADM (P<0.01). On PTD 14 and 21, the wound healing rates of patients in group NPWT+ ADM were significantly higher than those in group NPWT and group ADM (with P values below 0.01), and the wound healing rates of patients in group NPWT were significantly higher than those in group ADM (with P values below 0.01). (4) Before treatment, the bacteria were respectively detected in 18, 11, and 23 wounds of patients in group NPWT, group ADM, and group NPWT+ ADM. On PTD 21, the bacteria were respectively detected in 2, 8, and 2 wounds of patients in group NPWT, group ADM, and group NPWT+ ADM. The bacterial clearance of wounds of patients in group NPWT and group NPWT+ ADM was significantly better than that of patients in group ADM (with P values below 0.01). The bacterial clearance of wounds of patients in group NPWT+ ADM was close to that in group NPWT (P=1.00). (5) The wound healing time of patients in group NPWT+ ADM was (18.7±1.2) d, which was significantly shorter than that in group NPWT [(23.9±1.5) d] and group ADM [(28.4±1.8) d], with P values below 0.01. The wound healing time of patients in group NPWT was significantly shorter than that in group ADM (P<0.01). Conclusions NPWT combined with porcine ADM dressing can effectively remove wound bacteria, reduce wound exudation, and promote wound healing in repairing deep partial-thickness burn wounds and full-thickness burn wounds. Its clinical effect is better than NPWT or porcine ADM dressing alone, and this method may be suitable for patients with non-surgical treatment.
Changes in the expression of large-conductance calcium-activated potassium channels in dorsal root ganglion neurons after electrical injury in rats′ sciatic nerves and its influence on sensory conduction function
Wang Guangning, Li Xueyong, Xu Xiaoli, Ren Pan
2016, 32(6): 363-369. doi: 10.3760/cma.j.issn.1009-2587.2016.06.012
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Objective To study the changes in the expression of large-conductance calcium-activated potassium (BKCa) channels in dorsal root ganglion (DRG) neurons after electrical injury in rats′ sciatic nerves and its influence on sensory conduction function. Methods One-hundred and thirty-six adult SD rats were divided into normal control group, sham electrical injury group, and 75, 100, 125 V electrical injury groups according to the random number table, with 8 rats in normal control group and 32 rats in each of the rest 4 groups. Rats in normal control group were routinely fed without any treatment. Blunt dissection of the sciatic nerves of left hind leg of rats was performed in sham electrical injury group, while sciatic nerves of left hind leg of rats in electrical injury groups were electrically injured with corresponding voltage. Eight rats of normal control group fed for one week, and 8 rats from each of the rest four groups on post injury day (PID) 3 and in post injury week (PIW) 1, 2, 3 respectively were collected to detect the paw withdrawal mechanical threshold (PWMT). In addition, rats of 100 V electrical injury group in PIW 1 were collected and intrathecally injected with NS1619 after former PWMT detection, and PWMT was detected per 30 minutes within three hours post injection. The rats in each group at each time point were sacrificed after PWMT detection. The DRG of L4 to L6 segments of spinal cord was sampled to observe the BKCa channels distribution with immunohistochemical staining and to detect the protein and mRNA expressions of BKCa channels with Western blotting and reverse transcription-polymerase chain reaction respectively. Data were processed with one-way analysis of variance, analysis of variance of factorial design, and SNK test. Results (1) The PWMT values of rats in 75 and 100 V electrical injury groups on PID 3 and in PIW 1, 2, 3 were (5.8±0.6), (5.0±0.8), (4.2±0.3), (5.9±1.1) g; (5.3±1.3), (5.9±2.0), (4.5±2.7), (4.3±1.3) g, respectively, which were significantly lower than the value (s) in normal control group [(11.2±2.0) g] and sham electrical injury group [respectively (11.3±2.1), (12.0±2.0), (11.1±1.6), (10.3±2.1) g, with P values below 0.05]. The PWMT values of rats in 125 V electrical injury group decreased obviously on PID 3 and in PIW 1 [(6.1±1.6) and (5.7±1.7) g] as compared with the value (s) in normal control group and sham electrical injury group, and they were obviously increased in PIW 2 and 3 [(26.7±3.3) and (21.7±3.4) g] as compared with the value (s) of the rest 4 groups (with P values below 0.05). The PWMT of 100 V electrical injury group in PIW 1 firstly increased and then decreased within three hours post injection, which increased significantly at post injection minutes 30, 60, 90, 120 as compared with that before intervention [respectively (8.5±0.8), (9.7±1.2), (11.0±1.5), (8.6±0.8) g, with P values below 0.05]. (2) The positive expression of BKCa channels in large amount was observed in the cytoplasm and cytomembrane of neurons on the DRG of rats in normal control group and sham electrical injury group at each time point. The positive expression of BKCa channels in the cytoplasm and cytomembrane of neurons on the DRG of rats decreased over time in electrical injury groups, which was most obvious in 125 V electrical injury group. (3) There were no statistically significant differences in the protein expression of BKCa channels in DRG of rats among the five groups on PID 3 (with P values above 0.05). Compared with those in normal control group (0.477±0.027, 0.521±0.034, 0.475±0.022) and sham electrical injury group (0.511±0.025, 0.489±0.025, 0.483±0.032) in PIW 1, 2, 3, the protein expressions of BKCa channels in DRG of rats in 75, 100, 125 V electrical injury groups were decreased significantly (0.274±0.026, 0.202±0.019, 0.285±0.033; 0.253±0.022, 0.233±0.024, 0.203±0.017; 0.092±0.017, 0.095±0.021, 0.087±0.016, with P values below 0.05). The protein expressions of BKCa channels in DRG of rats in 125 V electrical injury group in PIW 1, 2, 3 were obviously lower than those in 75 and 100 V electrical injury groups (with P values below 0.05). (4) The mRNA expression levels of BKCa channels in DRG of rats in 75, 100, 125 V electrical injury groups on PID 3 and in PIW 1, 2, 3 were 0.326±0.021, 0.238±0.019, 0.291±0.022, 0.364±0.018; 0.264±0.020, 0.293±0.017, 0.243±0.023, 0.295±0.021; 0.134±0.023, 0.089±0.017, 0.074±0.018, 0.087±0.020, respectively, significantly decreased as compared with the level (s) in normal control group (0.581±0.051) and sham electrical injury group (0.603±0.045, 0.586±0.032, 0.614±0.045, 0.572±0.038), with P values below 0.05. The mRNA expression levels of BKCa channels in DRG of rats in 125 V electrical injury group at each time point were lower than those in 75 and 100 V electrical injury groups (with P values below 0.05). Conclusions The electrical injury in sciatic nerves results in reduction of the BKCa channels expression in rat′s DRG of corresponding spinal segments, which plays a role in the pathological process of sensory conduction dysfunction.
Effects of culture supernatant of human amnion mesenchymal stem cells on biological characteristics of human fibroblasts
Wu Qi′er, Lyu Lu, Xin Haiming, Luo Liang, Tong Yalin, Mo Yongliang, Yue Yigang
2016, 32(6): 370-375. doi: 10.3760/cma.j.issn.1009-2587.2016.06.013
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Objective To investigate the effects of culture supernatant of human amnion mesenchymal stem cells (hAMSCs-CS) on biological characteristics of human fibroblasts. Methods (1) hAMSCs were isolated from deprecated human fresh amnion tissue of placenta and then sub-cultured. The morphology of hAMSCs on culture day 3 and hAMSCs of the third passage were observed with inverted phase contrast microscope. (2) Two batches of hAMSCs of the third passage were obtained, then the expression of vimentin of cells was observed with immunofluorescence method, and the expression of cell surface marker CD90, CD73, CD105, and CD45 was detected by flow cytometer. (3) hAMSCs-CS of the third passage at culture hour 72 were collected, and the content of insulin-like growth factor Ⅰ (IGF-Ⅰ), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and basic fibroblast growth factor (bFGF) were detected by enzyme-linked immunosorbent assay. (4) Human fibroblasts were isolated from deprecated human fresh prepuce tissue of circumcision and then sub-cultured. Human fibroblasts of the third passage were used in the following experiments. Cells were divided into blank control group and 10%, 30%, 50%, and 70% hAMSCs-CS groups according to the random number table (the same grouping method below), with 48 wells in each group. Cells in blank control group were cultured with DMEM/F12 medium containing 2% fetal bovine serum (FBS), while cells in the latter 4 groups were cultured with DMEM/F12 medium containing corresponding volume fraction of hAMSCs-CS and 2% FBS. The proliferation activity of cells was detected by cell counting kit 8 and microplate reader at culture hour 12, 24, 48, and 72, respectively, and corresponding volume fraction of hAMSCs-CS which causing the best proliferation activity of human fibroblasts was used in the following experiments. (5) Human fibroblasts were divided into blank control group and 50% hAMSCs-CS group and treated as in (4), with 4 wells in each group, at post scratch hour (PSH) 0 (immediately after scratch), 12, 24, 48, and 72, the migration distance of cells was observed and measured with inverted phase contrast microscope. (6) Human fibroblasts were grouped and treated as in (5), with 3 battles in each group, and apoptosis rate of cells was detected by flow cytometer. Data were processed with analysis of variance of factorial design, analysis of variance for repeated measurement, one-way analysis of variance, LSD test, and t test. Results (1) On culture day 3, most hAMSCs were in large form, and spindle-shaped with much prominences like fibroblasts or in flat polygonal shape. hAMSCs of the third passage were spindle-shaped. The expression of vimentin of hAMSCs of the third passage was strongly positive, and the expressions of surface markers CD90, CD73, and CD105 of the cells were positive, while the expression of CD45 of the cells was negative. (2) The content of IGF-Ⅰ, VEGF, EGF, and bFGF in hAMSCs-CS were respectively (11.7±1.0), (316±68), (6.1±0.4), and (1.49±0.05) pg/mL. (3) At culture hour 12-72, the proliferation activity of human fibroblasts in each hAMSCs-CS group was significantly higher than that in blank control group (with P values below 0.01), and the proliferation activity of human fibroblasts in 50% hAMSCs-CS group was the highest. (4) The width of scratch in two groups was nearly the same at PSH 0. The migration distance of cells in 50% hAMSCs-CS group was significantly longer than that in blank control group at PSH 12-72 (with P values below 0.01). (5) The apoptosis rate of human fibroblasts in blank control group was (16.2±2.4)%, which was significantly higher than that in 50% hAMSCs-CS group [(7.4±3.6)%, t=6.710, P<0.01]. Conclusions hAMSCs-CS can promote proliferation and migration of human fibroblasts and inhibit the apoptosis of human fibroblasts.
Review
Advances in the progress of anti-bacterial biofilms properties of acetic acid
Gao Xinxin, Jin Zhenghua, Chen Xinxin, Yu Jia′ao
2016, 32(6): 382-384. doi: 10.3760/cma.j.issn.1009-2587.2016.06.017
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Abstract:
Bacterial biofilms are considered to be the hindrance in the treatment of chronic wound, because of their tolerance toward antibiotics and other antimicrobial agents. They also have strong ability to escape from the host immune attack. Acetic acid, as a kind of organic weak acid, can disturb the biofilms by freely diffusing through the bacterial biofilms and bacterial cell membrane structure. Then the acid dissociates to release the hydrogen ions, leading to the disorder of the acid-base imbalance, change of protein conformation, and the degradation of the DNA within the membranes. This paper reviews the literature on the characteristics and treatment strategies of the bacterial biofilms and the acetic acid intervention on them, so as to demonstrate the roles acetic acid may play in the treatment of chronic wound, and thus provide a convincing treatment strategy for this kind of disease.

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