[Effects of comprehensive treatment of infected wounds in patients with iatrogenic Cushing's syndrome].

Objective: To investigate the characteristics and comprehensive treatment of infected wounds in patients with iatrogenic Cushing's syndrome. Methods: A retrospective observational study was conducted. From May 2012 to December 2021, the data of 19 patients with iatrogenic Cushing's syndrome discharged from the Department of Burns and Plastic Surgery of the First Affiliated Hospital of Guangxi Medical University were collected, including 8 males and 11 females, aged 28-71 (56±11) years, with 12 cases of infected acute wounds and 7 cases of infected chronic wounds. The lesions were located in the limbs, perianal, and sacrococcygeal regions, with original infection ranging from 9 cm×5 cm to 85 cm×45 cm. After admission, the patients were performed with multidisciplinary assisted diagnosis and treatment, and the wounds were treated with debridement and vacuum sealing drainage, according to the size, severity of infection, suture tension, and bone and tendon tissue exposure of wounds, direct suture or autologous skin and/or artificial dermis and/or autologous tissue flap transplantation was selected for wound repair. The levels of cortisol and adrenocorticotropic hormone (ACTH) of patients at 8:00, 16:00, and 24:00 within 24 h after admission were counted. After admission, the number of operations, wound repair methods, and wound and skin/flap donor site healing of patients were recorded. During follow-up, the wounds were observed for recurrent infection. Results: The cortisol levels of 16 patients at 8:00, 16:00, and 24:00 within 24 h after admission were (130±54), (80±16), and (109±39) nmol/L, respectively, and ACTH levels were (7.2±2.8), (4.1±1.8), and (6.0±3.0) pg/mL, respectively; and the other 3 patients had no such statistical results. After admission, the number of surgical operation for patients was 3.4±0.9. The following methods were used for wound repair, including direct suturing in 4 cases and autologous skin and/or artificial dermis grafting in 9 cases, of which 2 cases underwent stage Ⅱ autologous skin grafting after artificial dermis grafting in stage Ⅰ, and 6 cases had pedicled retrograde island flap+autologous skin grafting. The wound healing was observed, showing that all directly sutured wounds healed well; the wounds in 6 cases of autologous skin and/or artificial dermis grafting healed well, and the wounds in 3 cases also healed well after the secondary skin grafting; the flaps in 4 cases survived well with the wounds in 2 cases with distal perforators flap arteries circumfluence obstacle of posterior leg healed after stage Ⅱ debridement and autologous skin grafting. The healing status of skin/flap donor sites was followed showing that the donor sites of medium-thickness skin grafts in the thigh of 4 cases were well healed after transplanted with autologous split-thickness grafts from scalp; the donor sites of medium-thickness skin grafts in 3 cases did not undergo split-thickness skin grafting, of which 2 cases had poor healing but healed well after secondary skin grafting 2 weeks after surgery; the donor sites of split-thickness skin grafts in the head of 2 patients healed well; and all donor sites of flaps healed well after autologous skin grafting. During follow-up of more than half a year, 3 gout patients were hospitalized again for surgical treatment due to gout stone rupture, 4 patients were hospitalized again for surgical treatment due to infection, and no recurrent infection was found in the rest of patients. Conclusions: The infected wounds in patients with iatrogenic Cushing's syndrome have poor ability to regenerate and are prone to repeated infection. Local wound treatment together with multidisciplinary comprehensive treatment should be performed to control infection and close wounds in a timely manner, so as to maximize the benefits of patients.

Patensin, a saponin from Pulsatilla patens var. multifida.

Patensin, a new triterpenoid glycoside, was isolated from the ethanolic extraction of the roots of Pulsatilla patens var. multifida. Its structure was established as hederagenin 3-O-beta-D-galactopyranosyl-(1-->2)-beta-D- glucopyranoside on the basis of hydrolysis and spectral evidence including 1D and 2D NMR techniques.

[Experimental study on selenium preventing nasopharyngeal carcinoma].

In this study, we observed the effect of selenium (Se) on nasopharyngeal carcinoma (NPC) induced by dinitrosopi erazine (DNP) in rats through adding sodium selenite into drinking water. One hundred and sixty Wistar rats were divided into five groups: (1) blank control group (BG), no treatment; (2) Se control group (SG), given 50.7 mumol/L Se in drinking water for the first 3 weeks and then 31.7 mumol/L until the end of the experiment; (3) DNP control group (DG), injected subcutaneously 15mg/kg DNP twice a week from the 4th week to the 35th week; (4) Se prevention group (PG), given Se as done in SG and injected DNP as done in DG; (5) Se therapy group (TG), injected DNP as done in DG and given 50.7 mumol/L Se in drinking water from the 36th week to the end of the experiment. The experimental duration was one year. The result showed that there was no NPC in BG and SG and that the incidence of NPC in PG was reduced by 54.3% as compared with that in DG, which was significantly different (P < 0.01). In addition, the incidences of precancerous lesions of nasopharynx were significantly different between the two groups. But the incidences of NPC were not significantly different between TG and DG. In the process of carcinogenesis, the blood Se concentration of DG decreased. The blood Se concentration of rats could be elevated by supplementing Se in drinking water. Our result suggested that elevating the level of Se in rats can prevent the NPC.

An improved method for the analysis of sister-chromatid exchange in vivo.

A single injection method of halogenated nucleosides for analysis in vivo of SCE is reported. Halogenated nucleosides were suspended in plant oils, such as peanut oil, and injected into mice subcutaneously. When the dosage of halogenated nucleosides reached 500 mg/kg, satisfactory differential sister chromatid staining of bone marrow cells was obtained. This technique was simple, neither special equipment nor surgical procedure was needed, and the dosage of halogenated nucleosides was relatively low.