Combined application of moist exposed burn ointment and maggot therapy in wound healing.

OBJECTIVE: Hard-to-heal wounds are a global health challenge, and effective treatments are still lacking. Moist exposed burn ointment (MEBO) and maggots are traditional treatments for promoting wound healing. This study was a preliminary exploration of combined maggot therapy and MEBO in the treatment of hard-to-heal wounds. METHOD: A coexistence experiment was conducted to determine the survival rates of maggots in MEBO. The maggots were placed in two different existence conditions: one set in MEBO (MEBO group), and another set as the control group (no MEBO) to compare survival rates. Case reports describe the use of the combined application of MEBO and maggots in the treatment of patients with hard-to-heal wounds. RESULTS: The coexistence experiment indicated that maggots in the MEBO group had a higher survival rate. From the therapeutic effect of the clinical cases (n=7), the combined application was safe and effective, with all the reported wounds eventually healing. CONCLUSION: Based on the findings of this study, we believe the combined application of MEBO and maggots is a promising way of promoting wound healing. Further studies and clinical trials are needed to elucidate the mechanism of the combined application in promoting wound healing and to more persuasively clarify the therapeutic effect.

Malleolar fracture in pregnancy and lactation-associated osteoporosis: a case report and literature review.

OBJECTIVE: The incidence of fractures in pregnancy and lactation-associated osteoporosis (PLO) is very low. Some fracture cases of PLO are associated with vertebral compression fractures, while malleolar fractures in patients with PLO are rarely reported before. CASE REPORT: A 31-year-old Han Chinese patient presented with a malleolar fracture 3 months after delivery, while she was still breastfeeding. Temporary closed reduction and plaster external fixation were performed in the emergency room. Then the patient was admitted to the orthopedic trauma ward for surgery and diagnosed as PLO by dual-energy X-ray absorptiometry (DEXA). After preoperative evaluation, the patient underwent open reduction and internal fixation. With the diagnosis of PLO, the patient was treated with weaning, bisphosphonate, and supplementation of calcium carbonate and vitamin D. During the 12-month follow-up period, the results of DEXA and laboratory examination improved gradually, and the internal fixation was removed 12 months after surgery. CONCLUSION: Orthopedic doctors should not ignore the possibility of PLO to avoid misdiagnosis of perinatal women with fractures. Improvement of functional recovery of fractures can be achieved with accurate diagnosis and individual treatment.

Barton Fracture of the Distal Radius in Pregnancy and Lactation-Associated Osteoporosis: A Case Report and Literature Review.

OBJECTIVE: Pregnancy and lactation-associated osteoporosis (PLO) is very rare, which typically occurs during the third trimester or during lactation. Many cases of PLO are associated with vertebral compression fractures or hip fractures, while distal radius fractures in patients with PLO are rarely reported. CASE REPORT: A 36-year-old patient presented with Barton fracture at 37 weeks of gestation. Temporary closed reduction and plaster external fixation were performed in emergency room. At 38 weeks of gestation, she gave birth to a healthy boy and began breastfeeding after delivery. Three days after delivery, the patient was admitted to the orthopedic ward for surgery and was diagnosed as PLO. The patient underwent open reduction and internal fixation and treated with weaning and supplementation of calcium carbonate and vitamin D. During the 1-year follow-up period, the results of laboratory tests and bone mineral density gradually returned to normal. CONCLUSION: Clinicians should be alert to the possibility of PLO to avoid missed diagnosis. Accurate diagnosis and individualized treatment are of great significance for relieving pain and functional recovery of patients.

Evaluation of liver function and electroacupuncture efficacy of animals with alcoholic liver injury by the novel imaging methods.

Imaging methods to evaluate hepatic microcirculation (HM) and liver function (LF) by directly monitoring overall liver tissue remain lacking. This study establish imaging methods for LF that combines Laser speckle perfusion imaging (LSPI) and in vivo optical imaging (IVOI) technologies to investigate changes of hepatic microcirculation and reserve function in the animals gavaged with 50% ethanol (15 ml/kg·bw) for a model of acute alcoholic liver injury (ALI), and for evaluation of electroacupuncture (EA) effect. The liver blood perfusion and indocyanine green (ICG) distribution were observe by LSPI and IVOI separately. After EA, the livers were collected to measure the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), thromboxane A (TXA2), prostacyclin (PGI2) and endothelin (ET). The acquisitions of newly established LSPI of liver and ICG in vivo fluorescence imaging (ICG-IVFI), combining the results of other indexes showed: hepatic microcirculation perfusion (HMP) significantly reduced, ICG metabolism reduced, and ALT/AST increased in animal model with acute ALI. EA can reverse these changes. The use of LSPI of liver and ICG-IVFI, which was novel imaging methods for LF established in this study, could display the LF characteristics of ALI and the EA efficacy.

A low ratio of n-6/n-3 polyunsaturated fatty acids suppresses matrix metalloproteinase 13 expression and reduces adjuvant-induced arthritis in rats.

Increased expression of matrix metalloproteinase 13 (MMP13) in chondrocytes contributes to the development of osteoarthritis. The hypothesis of this study was that diet with a low ratio of n-6/n-3 polyunsaturated fatty acids (PUFAs) is associated with reduced MMP13 expression in inflammatory chondrocytes in vitro and in vivo. Human chondrocytes were cultured with different ratios of linoleic acid (LA, n-6 PUFA) to α-linolenic acid (n-3 PUFA) from 1:1 to 10:1. Proliferation of chondrocytes, MMP13 protein and mRNA levels were detected, respectively. Sprague-Dawley rats (n=30) were fed diets containing different ratios of n-6/n-3 PUFA. Freund's complete adjuvant was injected to make the model of arthritis. Paw swelling rate was measured and all rats were euthanized after 6 weeks of treatment. Serum MMP13 and IL-1 were measured by enzyme-linked immunosorbent assay. Joint histological sections were stained with safranin-O Fast Green to evaluate cartilage damage. Low ratio of LA/α-linolenic acid decreased the mRNA and protein levels of MMP13 but did not affect chondrocytes proliferation. Ratios of PUFA such as 1:1 and 2:1 significantly reduced paw swelling rate, and serum MMP13 and IL-1 levels in a rat model. Histological staining showed that ratios of 1:1 and 2:1 PUFA significantly alleviated cartilage damage in adjuvant-induced arthritis. A ratio of n-6/n-3 PUFA of 1:1 showed the strongest inhibitory effect on MMP13. Our results indicate that a low ratio of n-6/n-3 PUFA at 1:1 significantly suppressed MMP13 expression both in vitro and in vivo and reduced adjuvant-induced arthritis in rats could be a means to control and reduce the symptoms of osteoarthritis.

A pilot study on effects of acupuncture and moxibustion by hyperspectral imaging technique.

This study was to observe the effects of acupuncture and moxibustion on spectrum features of acupoint using hyperspectral imaging (HSI) technique. HSI of the Neiguan (PC6) in the acupuncture groups, moxibustion groups, and control groups was scanned by the hyperspectral imager to analyze the spectrum features and the variations within the wavelength of 400-1000 nm and explore the relationship between the spectral characteristics and effects of acupuncture and moxibustion. The light absorption intensity was slightly reduced within the wave band of 540-590 nm after acupuncture. The absorption intensity of PC6 before moxibustion was significantly higher than that after moxibustion, and the maximum reduction was found at the wavelength of 580 nm with 20.5% reduction, P < 0.05. There was no significant change of the spectrum of palm and PC6 and the spectrum curves of the acupoint were basically identical in control group. The light absorption intensity of PC6 of human body was weakened after Acu-mox. Specific wavelengths were all exhibited at 580 nm and the effect of moxibustion was more significant. HSI technique can be used to measure the spectral characteristics of the acupoint areas. This first time research would be significant and beneficial for study on the effect of acupuncture and moxibustion.

[Influence of electroacupuncture on indocyanine green metabolism in liver: display of in vivo fluorescence imaging].

OBJECTIVE: To observe the influence of electroacupuncture (EA) on indocyanine green (ICG) metabolism in the liver and the action mechanism of acupuncture for hepatic regulation. METHODS: Forty Kunming mice were randomly divided into an EA group and a control group, 20 cases in each one. Combined with classical hepatic metabolism test of ICG, after tail vein injection of ICG, twenty mice were treated with EA at "Zusanli" (ST 36) for 20 min. The ICG fluorescence intensity and distribution in the liver were observed with animal in vivo fluorescence imaging apparatus during 20 min of EA and 60 min of needle withdrawal. Twenty mice, taken as control group, were treated with ICG injection and no EA. The differences of fluorescence intensity and distribution in both groups were compared. RESULTS: (1) There was blocking and gathered fluorescent sign in both groups when ICG was injected immediately. With the extension of observation time, the fluorescence brightness and area were increased until 30 min of injection. This was in accordance with known metabolism activities of ICG in the liver. (2) At 10 min and 20 min of EA and after needle withdrawal, compared with the control group, the fluorescence intensity in the liver of the EA group was weaker and the distribution area was smaller. (3) According to quantitative statistics of fluorescence intensity, at each time point of treatment, the value in the control group was higher than that in the EA group, which appeared regularly all along. As for the total mean difference of ICG fluorescence intensity at all time points, there was statistical difference between the two groups (P < 0.05). CONCLUSION: EA could reduce fluorescence intensity and lasting time of ICG, indicating that EA accelerates metabolic process of ICG in the liver. Also it is feasible to apply animal in vivo fluorescence imaging technology to the principle research of acupuncture effect.