The effect of different ultrasound debridement method on epiphytic bacteria of diabetic foot ulcer wound / 中国实用护理杂志

Objective:To investigate the effect of ultrasonic debridement mediated by 0.9% sodium chloride solution and 0.5% iodophor volt combined with eddy current washing and high pressure pulse washing on the removal of colonized bacteria on the wound surface of diabetic foot and wound healing.Methods:From March to November 2020, a total of 60 patients using ultrasonic therapy for debridement were divided into control group, experimental group 1, experimental group 2 and experimental group 3 by random digit table in the fourth People′s Hospital of Dalian. The final effective data collected was 15 cases in each group. The control group was given ultrasonic debridement mediated by 0.9% sodium chloride solution and eddy current washing.Experimental group 1 was given ultrasonic debridement mediated by 0.9% sodium chloride solution and high pressure pulse washing. Experimental group 2 received 0.5% iodophor mediated ultrasonic debridement and eddy current washing. Experimental group 3 0.5% iodophor mediated ultrasonic debridement and high pressure pulse washing. The size of the wound was measured, sampled and bacterial cultured before and after the first, fifth and 10th intervention. The wound bacterial clearance rate and wound area reduction rate were calculated and compared.Results:Before and after 3 interventions, the bacterial clearance rate and the total reduction of wound surface in 4 groups were increased ( P<0.01), the total bacterial clearance rate of experimental group 3 was the highest, which was (93.85 ± 9.87)%.The total reduction rate of wound in experimental group 2 was the highest, which was (20.831 4 ± 9.379 8)%. Conclusions:0.5% iodophor mediated ultrasonic debridement combined with high pressure pulse washing is the most effective way in the removal of diabetic foot wounds, and 0.5% iodophor solution mediated ultrasonic debridement combined with eddy current washing is the most effective in reducing diabetic foot wounds.

Clinical characteristics of chronic myeloid leukemia with T315I mutation and the efficacy of ponatinib / 南方医科大学学报

OBJECTIVE@#To analyze the clinical features of chronic myeloid leukemia (CML) with T315 I mutation (CML-T315I) and compare the effectiveness of different treatments.@*METHODS@#We retrospectively analyzed the clinical data and outcomes of 19 patients with CML-T315I receiving different treatments. The T315 I mutations in these patients were detected by examination of BCR-ABL kinase domain (KD) mutation by RTQ-PCR and Sanger sequencing. The relapse following the treatments, defined as hematological, cytogenetic and molecular biological recurrences, were analyzed in these patients.@*RESULTS@#Of the 19 patients with CML-T315I, 14 (73.7%) were in CML-CP stage at the initial diagnosis, and 13 (81.2%) were high-risk patients based on the Sokal scores. All the 19 patients were treated with TKI after the initial diagnosis, and during the treatment, 15 (78.9%) patients were found to have additional chromosomal aberrations, and 10 (52.6%) had multiple mutations; 13 (68.4%) of the patients experienced disease progression (accelerated phase/blast crisis) before the detection of T315I mutation, with a median time of 40 months (5-120 months) from the initial diagnosis to the mutation detection. After detection of the mutation, 12 patients were treated with ponatinib and 7 were managed with the conventional chemotherapy regimen, and their overall survival rates at 3 years were 83.3% and 14.2%, respectively ( < 0.001).@*CONCLUSIONS@#CML patients resistant to TKI are more likely to have T315I mutations, whose detection rate is significantly higher in the progressive phase than in the chronic phase. These patients often have additional chromosomal aberrations and multiple gene mutations with poor prognoses and a high recurrence rate even after hematopoietic stem cell transplantation. Long-term maintenance therapy with ponatinib may improve the prognosis and prolong the survival time of the patients.

Influence of high quality nursing mode on the quality of life in endoscopic retrograde cholangiopancreatography patients / 中国实用护理杂志

Objective To study the influence of high quality nursing mode on the quality of life in endoscopic retrograde cholangiopancreatography (ERCP) patients. Methods A total of 292 patients with ERCP were randomly divided into control group and observation group with 146 cases in each group by the randomized block design method. The control group was given the conventional nursing care. The observation group was given the high quality nursing care based on the conventional nursing care. The score of Quality of Life of the World Health Organization (WHOQOL- 100), Quality of Life Index of Gastrointestinal Tract (GIQLI), Hamilton Anxiety Scale (HAMA), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale(VAS) before and after nursing care were observed and compared. The difference impact of two kinds of nursing mode on nursing quality between two groups was evaluated. Results WHOQOL-100 score in the observation group after treatment, including physiology and psychology and environment and social relations state such as grading, was respectively (59.3 ± 6.0), (61.8 ± 7.2), (60.3 ± 6.2), (62.8 ± 7.3) points and GIQLI index included self-conscious symptom and body physiological status and daily and social activities,such as state of emotional and psychological and the overall score, was respectively (79.8±4.9), (19.8±1.8), (14.7±1.9), (19.2±2.8), (105.7±6.6) points, which was (50.9±6.3), (52.5±6.7), (51.4±5.6), (53.4±7.1), (67.2±4.8), (15.6±1.9), (10.2±1.8), (16.3±2.3), (94.4 ± 6.2) points in control group, the difference between two groups was statistically significantly(t=1.876-2.327, P<0.05). HAMA score and SAS scores and SDS score and VAS score in the observation group after nursing was respectively (24.28 ± 4.78), (29.48 ± 6.54), (30.55 ± 7.32), (4.55 ± 1.18) points and respectively (36.68 ± 5.39), (41.72 ± 6.03), (42.65 ± 7.21), (6.07 ± 1.17) points in the control group, the difference between two groups was statistically significantly(t=2.876-4.012, P<0.05). Conclusions High quality nursing mode of ERCP in patients with perioperative patients of psychological and physiological all have different degrees of improvement and is suitable for popularization and application in clinic.

Relationship between helper T cell 17/regulatory T cells balance and acute graft versus host disease after allogeneic hematopoieticstem cell transplantation / 中华器官移植杂志

Objective To investigate the relationship between the helper T cell 17 (TH 17)/ Regulatory T cells (Treg cells) balance in peripheral blood with acute graft-versus-host reaction (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT),as well as the impact of anti-thymocyte immunoglobulin (ATG) on helper T cells in peripheral blood.Method Seventyeight hematologic patients underwent allo-HSCT,conditioning with or without ATG.Ten healthy volunteers severed as a control group.The helper T and regulatory T cells in peripheral blood were detected by flow cytometry.Enzyme-linked irnmunosorbent assay (ELISA) was used to detect serum concentrations of interleukin(IL)-17,IL-21,IL22,IL23,γ interferon (IFN-γ),and transforming growth factor β1 (TGF-β1).Result The percentage of Treg cells,TH17 cells and ratio of TH17/Treg cells in patients without aGVHD showed no significant difference from the healthy controls (P＞ 0.05).As compared with control group and non aGVHD group,the ratio of Treg cells was increased,the percentage of TH 17 cells,and TH 17/Treg cells were significantly increased in 1-2-degree aGVHD group (P＜0.01).With increased degree of aGVHD,the difference as above was more significant in 3-4-degree aGVHD recipients (P＜0.01).In aGVHD group,the IL-17,IL-23,IL-21 and IFN-γ concentrations were higher than the healthy group (P＜0.01) and non-aGVHD group (P＜0.05).Serum TGF-β1 level in aGVHD group was significantly decreased as compared with healthy group and non-GVHD group (P＜0.05),while IL-22 concentrations showed no statistically significant difference among three groups (P＞0.05).In anti-thymocyte immunoglobulin (ATG) pretreatment group,the absolute count of peripheral blood lymphocytes was less than in healthy control group (P＜0.01).In ATG group,the absolute counts of TH1 cells,TH17 cells,CD3+ CD4+ cells and non-TH1/17 cells were less than in non-ATG group (P =0.0000),while the absolute counts of lymphocytes,CD3+ CD4-cells,and TH 1/17 cells were less than in non-ATG group,but there was significant difference (P＞0.05).Conclusion The balance of TH 17/Treg cells and related cytokines were closely associated with aGVHD after allo-HSCT,and ATG influences the reconstruction of TH 17 and Th1 cells at early stage.

Effect of histone deacetylase inhibitor LBH589 on proliferation, apoptosis and drug resistance of acute myeloid leukemia cell line HL60/ADM / 白血病·淋巴瘤

Objective To investigate the effect of histone deacetylase inhibitor LBH589 on proliferation,apoptosis and drug resistance of chemoresistant acute myeloid leukemia cells HL60/ADM.Methods HL60/ADM cells were treated with LBH589.Proliferation,apoptosis and adriamycin IC50 were evaluated by MTT assay and AnnexinV-FITC/PI stain.The change in MRP1 expression and intercellular adriamycin accumulatiom were analyzed by flow cytometry.Results Effective proliferative inhibition and apoptotic induction in HL60/ADM cells were observed after treatment with 10-80 nmol/L LBH589 with maximal effect detected after treatment with 70 nmol/L LBH589 for 60 hours.However,inhibition ratio remain unchanged with the further increase of drug dose and incubation time (P ＞ 0.05).Downregulation of MRP1 [(93.90±4.20) ％ vs (76.19±6.53) ％],upregulation of adriamycin accumulation [(8.53±0.68) ％ vs (25.67±1.34) ％] and decrease in adriamycin IC50 [(6.833±0.319) μg/ml vs (1.382±0.104) μg/ml] were induced by the treatment with 20 nmol/L LBH589 (P ＜ 0.01),whose reversal fold was 4.9.The expression of acetylated histone 3 after treatment with LBH589 was higher than that before treatment (P ＜ 0.01).However,relative p-Akt levels after treatment for 24 h and 48 h were 1.07±0.09 and 0.59±0.01,respectively,which were lower than that before treatment (2.03±0.12) (P ＜ 0.01).Meanwhile,expression levels of p53 were 0.57±0.04 and 1.31±0.09,respectively,which were higher than that before treatment (0.21 ±0.02) (P ＜ 0.01).Conclusion Treatment with LBH589 has the capability of inhibiting proliferation and inducing apoptosis,as well as increasing intercellular adriamycin accumulation and sensitivity through downregulation of MRP1 expression and inhibition of PI3K-Akt signaling pathway in HL60/ADM cells.

Impact of rhG-CSF mobilization on TH17/Treg cells in donors' peripheral blood / 中华器官移植杂志

Objective To explore the effect of recombinant human granulocyte colony stimulating factor (rhG-CSF) mobilization on TH17/Treg cells and its impact on suppressor of cytokine signaling-3 (SOCS3) gene expression in CD4+ T cells in donors' peripheral blood.Method Sixteen donors were injected subcutaneously with rhG-CSF 5 μg/kg every day for 5 consecutive days for peripheral blood stem cells mobilization.At the first 0,3,5 day,the mononuclear cclls (MNCs) in peripheral blood or graft and serum specimens were taken.The CD4 + T cells in MNCs were sorted using immuno-magnetic beads.The ratio of TH 17 and Treg cells in MNCs,cytokines concentrations of IL-17A,IL-21,ID23 and TGFβ1 in serum,and SODC3 gene expression in CD4+ T cells were detected by using flow cytometry,ELISA,and reverse transcription real-time quantitative PCR (RT-qPCR),respectively.Results (1)The ratio of Th17 cells (CD3+ CD8 CD17+) and Treg cells (CD4+ CD25+ Foxp3+) in MNCs in peripheral blood and graft at the first 0,3 and 5 days after mobilization was (2.69 ± 0.81) ％,(0.91 ± 0.33) ％,(0.35 ± 0.12) ％,(0.21 ± 0.05) ％,and (0.56 ± 0.24) ％,(0.72 ± 0.22％),(1.59 ± 0.54) ％,(3.38 ± 0.52) ％,respectively,showing a significant declining and increasing trend respectively (P＜0.05); (2)The cytokine concentrations in serum at the first 0,3 and 5 days after mobilization were 7.33 ± 0.89,5.78 ± 1.03 and 3.32 ± 0.84 μg/L for IL-17A; 124.56 ± 15.18,117.12 ± 14.45 and 64.94 ± 11.25 μg/L for IL-21 ; 183.52 ± 59.35,280.49 ± 69.75 and 393.62 ± 57.25μg/L for TGF-β1 (P＜0.01) ; and 45.89 ± 6.95,46.25 ± 7.44 and 47.45 ± 10.75 μg/L for IL-23,respectively.The IL-17A and IL-21 concentrations showed significant declining trend,contrarily TGF-β1 with an increasing trend,while IL-23 concentration had no change.After rhG-CSF mobilization,the SOCS3 gene expression in CD4 + T cells of peripheral blood and graft at the first 0,3,5 days was gradually increased.Conclusion rhG-CSF suppresses Th17 cells and promotes regulatory T cells generation,meanwhile decreases IL-17A and IL-21 and elevates serum TGF-β1 concentrations,and contributes to CD4 + T cells differentiation to Tregs,probably by elevating SOSC3 gene expression in CD4+ T cells.