The Effects of Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor Gel on Third-Degree Frostbite Wounds in Northeastern China: A Randomized Controlled Trial.

The aim of the study was to investigate the effects of the rhGM-CSF gel on third-degree frostbite wounds. Sixty-two patients who had suffered third-degree frostbite on their hand or foot (91 wounds in total) were selected using a convenience sampling method and randomly allocated to two groups: the rhGM-CSF group(31patients,45 frostbite wounds) received the rhGM-CSF gel when wound dressing change daily; however, the control group (31patients, 46 frostbite wounds) received aloe glue. The wound healing time, the score of inflammation about the wound and the positive bacterial culture of wound secretions were used to measure outcomes, respectively. Data were analyzed using SPSS (25.0), Student's t test or Mann-Whitney U test and chi-square test or Fisher exact test were selected, as appropriate. The healing time of the rhGM-CSF group was (12.2 ± 5.0) days, which was significantly shorter than that of the control group (15.5 ± 4.7) days (P < .0001). The rhGM-CSF group's wound inflammation scores on the 7th and 14th day of treatment were (0.96 ± 0.21) and (1.88 ± 0.29), respectively, which were better than those of the control group (1.12 ± 0.24) and (1.38 ± 0.15) (both P < .0001). The positive bacterial culture of wound secretions in the rhGM-CSF group was also better than that in the control group on the 3rd, 7th, and 14th day after treatment (P = .027, .004, .030, respectively). According to the results, using rhGM-CSF gel considerably increases the speed of frostbite wounds healing, and have an effect on protecting third-degree frostbite wounds regarding the positive effects. Trial Registration: This trial was registered in the Chinese Clinical Trial Register, ChiCTR1900021299.

The effectiveness of silver-containing hydrofiber dressing compared with topical silver sulfadiazine cream in pediatric patients with deep partial-thickness burns: a retrospective review.

BACKGROUND: Deep partial-thickness (DPT) burns are a common pediatric burn injury and involve the limbs and trunk. Initial management of a pediatric burn is conservative and consists of wound dressings and creams to optimize the environment for reepithelialization. Silver-containing Hydrofiber dressings (SHDs) and silver sulfadiazine (SS) cream are used widely to treat burn wounds. However, the effectiveness of the 2 methods when applied to pediatric DPT burn wounds is unclear. PURPOSE: This study was performed to compare the effectiveness of SHD versus SS cream in pediatric patients with DPT burns. METHODS: The authors conducted a retrospective review of data collected from 92 pediatric patients (mean age, 51.44 months; range, 2 months to 18 years) with DPT burns to the limbs and trunk involving 5% to 10% of total body surface area who were admitted to a burn center from January 2018 through January 2020; more than 75% of these burns were scald injuries. Of the patients included in this analysis, 40 were treated with topical SS cream, whereas SHDs were used in 52 patients. Outcomes included time to complete healing, number of dressing changes, nursing care time, hospitalization expenses, complications, and patient primary caregiver satisfaction score using a 4-point Likert scale. RESULTS: The complete healing time was significantly shorter in the SHD group compared with the SS group (18.98 ± 2.21 days vs 22.45 ± 2.25 days, respectively; P < .05). There were fewer dressing changes in the SHD group than in the SS group (4 ± 0.74 vs 11.55 ± 0.88, P < .05). Overall, caregivers of patients in the SHD group reported better satisfaction than caregivers in the SS group. CONCLUSION: When compared with SS cream, the use of SHD was found to be a safe, effective, and economical therapeutic method for treating DPT burns in the pediatric patients included in this study..

A specially designed medical screen for children suffering from burns: A randomized trial of a distraction-type therapy.

OBJECTIVE: To evaluate the impact of the specially designed medical dressing screen during wound dressing changes of children who suffered burns to their hand or foot. DESIGN: Randomized controlled trial. SETTING: Burns and Plastic Reconstruction Unit. PARTICIPANTS: Children (N=120) with burns on up to 1-5% of the total body surface area. INTERVENTIONS: The patients were selected and randomly allocated to 3 equal-sized groups as follows: control group (N=40): the children received only regular dressing changes; computer group (N=40): a touch-screen computer was used for children during dressing changes; medical screen group (N=40): a medical screen combined with the touch-screen computer were used for children during dressing changes. All patients underwent a dressing change once per day for four days. Data were distributed four times: immediately after the initial dressing change (T1); and immediately after each times at next three consecutive days (T2-T4). MAIN OUTCOME MEASURES: The Pain level of the children evaluated by medical staffs was the primary outcome, the Pain level of the children evaluated by children's parents and the satisfaction of wound therapist were used as second outcomes. RESULTS: The mean scores related to pain level at the medical screen group displayed significantly better results than those of control group and those of the computer group. Additionally, the results of the pain evaluated by parents and satisfaction score of the wound therapist at the medical screen group was also better than other groups. CONCLUSIONS: This study demonstrated "that the" application of the medical screen for burns can relieve the pain of 1-3 years old children suffering from a burns during dressing changes. Additionally, the application of the medical screen also increased the satisfaction of the parents and the wound therapist performing the dressing changes.

The complete chloroplast genome of Aloe vera from China as a Chinese herb.

Aloe vera has been used as a Chinese herb and an ingredient in many cosmetic products in China. In this study, the complete chloroplast genome of A. vera was determined for more genetic data information. The chloroplast genome was 152,875 bp length as a typical quadripartite structure that contained a large single-copy region (LSC) of 83,505 bp, a small single-copy region (SSC) of 16,178 bp and a pair of inverted-repeat regions (IRs) of 26,596 bp. The overall nucleotide composition of chloroplast genome is: 47,185 bp A (30.8%), 48,123 bp T (31.5%), 29,326 bp C (19.2%), 28,241 bp G (18.5%) and the total G + C content of 37.7%. Then, 131 genes were found that included 85 protein-coding genes (PCGs), 38 transfer RNA (tRNAs) and 8 ribosome RNA (rRNAs). The phylogenetic analysis showed that A. vera closely related to A. maculata in the phylogenetic relationship of the family Asphodelaceae by the Maximum-Likelihood (ML) method.

Complicated Posterior Cervical Skin and Soft Tissue Infections at a Single Referral Center.

BACKGROUND: Although the incidence and mortality of complicated skin and soft tissue infections have decreased, this infection is still relatively frequent and can be associated with lethal complications. In this study, the authors present our clinical experience of patients with complicated posterior cervical skin and soft tissue infections (CPCSSTIs) diagnosed and treated in a reconstructive unit in northeastern China. METHODS: A retrospective chart review of patients diagnosed with CPCSSTIs from January 2009 to December 2018 was performed. To make the results objective and convincing, a data analysis was performed relating to demographic characteristics, clinical presentation, predisposing factor, bacterial culture, laboratory and radiographic evaluations, diagnostic clues, management, and complications as well as the clinical course and outcome. RESULTS: During the ten-year period, there were 174 consecutive patients admitted to our reconstructive center with final diagnosis of CPCSSTIs included. All the patients were adults, and the majority were male (67.2%). The patient's mean age was 51.3 years (range, 15-88 years). There were 114 patients (65.5%) that had associated systemic diseases, with diabetes mellitus (40.2%) as the most common predisposing factor. Common presented clinical symptoms were pain (90.8%), swelling (85.1%), and erythema (77%) of the neck. Surgical treatment was performed in all the patients, and most of them (83.9%) received the first surgery within 24 h. The most commonly isolated pathogen was Staphylococcus aureus (30%). Vancomycin (21.3%) was the most commonly used antibiotics, followed by cefepime (18.4%). All the patients survived and were discharged with a mean duration of hospitalization of 28.7 days. Those patients with predisposing factors (31.4 ± 12.35 days) or complications (41.0 ± 12.5 days) tended to have a longer hospital stay. The mean total costs of admission per patient were 47 644 RMB. CONCLUSION: This study highlights the high cost burden of CPCSSTI patients. Those patients with predisposing factors or complications tended to have a longer hospital stay.

Deep frostbite: Clinical characteristics and outcomes in northeastern China.

OBJECTIVE: To investigate the clinical characteristics and treatment outcomes in patients with severe frostbite in a single institution in northeastern China. METHODS: The clinical records of patients with severe frostbite of the extremities who were hospitalized at the authors' institution between January 2009 and April 2019 were retrospectively reviewed. Demographic data, predisposing factors, clinical presentation, duration of signs and symptoms, number of surgical interventions, and length of hospital stay were extracted and analyzed. RESULTS: A total of 156 consecutive inpatients were treated for severe frostbite with the mean age was 43.7 ± 14.15 years. Hands were the most common site involved (38.5%). The most prevalent predisposing factor for frostbite included alcohol abuse (41.67%), smoking habits (37.18%) and psychiatric illness (14.11%). Mean duration of signs and symptoms was 3.6 days. Most of patients (37.8%) sustained frostbite injury in January. All patients survived, and the mean length of hospital stay was 45.6 days (range, 29-62). Amputations of limbs were performed in 40.4% of patients. CONCLUSION: The incidence of deep frostbite in Jilin province correlates with the environmental temperature and is often associated with alcohol abuse, smoking and other psychosocial factors. Delayed presentation would increase the risk of amputation. These findings should guide clinical decisions about the treatment of individual patients with deep frostbite.

A randomized trial of a distraction-type intervention to assist in managing dressing changes for children experienced burns.

AIM: To evaluate the impact of the specially designed medical dressing screen during wound dressing changes for children aged 1-3 who experienced a burn on their hand or foot. DESIGN: Randomized controlled trial. METHODS: The study was performed, between January 2019 - April 2019, at a Burn Outpatient Ward. A total of 52 outpatient children who had suffered burns were included in the clinical trial. The burn area of these participants accounted for 1-5% of the total body surface area. The children were randomly divided into two equal-sized groups, each receiving a different treatment. In the medical screen group (N = 26), a medical screen was used for children during the dressing changes. In the control group (N = 26), the children received only regular dressing changes. Pain level of the children during dressing change was the primary outcome, the satisfaction of children's parents and wound therapist were used as second outcomes. The Bonferroni method was used to perform pairwise comparisons of repeatedly measured data at different measurement times in two groups. RESULTS: The results showed that the medical screen group had better outcomes with respect to pain management during dressing changes; in addition, the satisfaction score of the wound therapist and children's parents presented also better outcomes compared with the control group. CONCLUSION: This study demonstrated application of the medical screen for burns can relieve the pain of 1 - 3-year old children experienced a burn during dressing changes. In addition, the application of the medical screen also increased the satisfaction of the child's parents and wound therapist. Registration NO: 1,900,020,953. IMPACT: Compared with conventional dressing methods, the medical screen can be used as a novel way to decrease the negative experience of burn patients ages 1-3 who require dressing changes.

Impact of orally administered tramadol combined with self-selected music on adult outpatients with burns undergoing dressing change: A randomized controlled trial.

OBJECTIVE: To investigate the effects of music and/or tramadol on pain and anxiety in burn outpatients undergoing dressing changes. DESIGN: Randomized controlled trial. SETTING: Burns and Plastic Reconstruction Unit. PARTICIPANTS: Patients (N=180) with burns on up to 10%-30% of the total body surface area (TBSA). INTERVENTIONS: The patients were randomly allocated to 4 equal-sized groups as follows: (1) tramadol group (TG), patients received 100mg of tramadol orally 20min before the dressing change; (2) music group (MG), patients listened to self-selected music during the dressing change; (3) music-plus-tramadol group (MTG), patients received tramadol and listened to self-selected music; and (4) control group (CG), patients received a routine dressing change only. All patients underwent the interventions once per day for 2days. MAIN OUTCOME MEASURES: McGill Pain Questionnaire Short Form (MPQ-SF) (primary outcome), McGill Pain Persian version of Burn Specific Pain Anxiety Scale (BSPAS) (primary outcome), and heart rate (HR) and overall patient satisfaction (secondary outcomes). RESULTS: The results showed that music-plus-tramadol group (MTG) had better outcomes with respect to pain and anxiety management during dressing changes. CONCLUSIONS: In comparison with music or tramadol alone, the integration of music and tramadol offers a secure and favorable treatment choice to relieve pain and anxiety, ultimately improving the satisfaction levels of burn outpatients during dressing changes.

Characterisation of the complete chloroplast genome of an endemic herb plant species, Rheum palmatum (Polygonaceae) in China.

Rheum palmatum has a long history in medicine, which is one of the main export medicinal herb in China. The complete chloroplast genome of R. palmatum was assembled and reported in this study. The R. palmatum chloroplast genome was 161,541 bp in length as the circular and consisted a large single-copy (LSC) region of 86,519 bp, a small single-copy (SSC) region of 13,112 bp and a pair of inverted-repeat (IR) regions of 30,955 bp. The nucleotide composition was asymmetric 31.2% A (Adenine), 31.5% T (Thymine), 19.0% C (Cytosine), and 18.3% G (Guanine) with an overall G + C content of 37.3%. It encoded 131 genes, including 86 protein-coding genes (76 PCG species), 37 transfer RNA genes (26 tRNAs species), and eight ribosomal RNA genes (four rRNAs species). The Phylogenetic relationships used neighbour-joining (NJ) method and the result showed that R. palmatum and Rheum officinale are phylogenetically related to each other in the family Polygonaceae. This study will be very important for Chinese medicinal herb research value and clinical drug development for future in China.