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1.
Artigo em Inglês | MEDLINE | ID: mdl-31685465

RESUMO

Treating chronic hepatitis E virus (HEV) infections with ribavirin (RBV) is a recommended option (1).….

2.
Scand J Gastroenterol ; : 1-6, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31687871

RESUMO

Background: Brain metastasis (BM) from colorectal cancer (CRC) seriously affects the survival and quality of life of patients. However, this disease is not fully understood. It is not clear when follow-up monitoring should be conducted to achieve early diagnosis. Furthermore, the reported prognostic factors have varied among different studies. Our study aims to determine the clinicopathological, survival and prognostic factors, as well as the timing of BM occurrence.Methods: We retrospectively studied the patients with BM from CRC between January 2000 and July 2017. The clinicopathologic features were assessed, and the time from primary tumor surgery and extracranial metastases (lung, liver and bone) to the occurrence of BM was calculated, respectively. Survival time after BM was statistically analyzed. Multivariate Cox analysis was carried out to determine the independent factors that affected survival.Results: 52 patients were analyzed. Most of the patients (86.5%) had combined extracranial metastases when BM was diagnosed, and lung was the commonest extracranial metastasis location. The median time interval from CRC surgery to the diagnosis of BM was 20.5 months, and the median time interval from lung, liver and bone metastases to BM was 7, 5 and 2 months, respectively. After diagnosis of BM, the median survival was 9 months. Extracranial metastases (p =.012) and Karnofsky performance status (p =.025) were independent prognostic factors based on multivariate analysis.Conclusion: BM from colorectal cancer often occur in the late stage, and has an extremely poor prognosis. Identifying the timing of brain metastasis can help to detect this disease early.

3.
Artigo em Inglês | MEDLINE | ID: mdl-31678080

RESUMO

BACKGROUND: Studies assessing ibrutinib's economic burden versus chemoimmunotherapy (CIT) focused on pharmacy costs but not medical costs. This study compared time to next treatment (TTNT), health care resource utilization (HRU), and total direct costs among patients with chronic lymphocytic leukemia (CLL) initiating front-line ibrutinib single agent (Ibr) or CIT. MATERIALS AND METHODS: Optum Clinformatics Extended DataMart De-Identified Databases were used to identify adults with ≥ 2 claims with a CLL diagnosis initiating front-line Ibr or CIT from February 12, 2014 to June 30, 2017. Inverse probability of treatment weighting was used to control for potential differences in baseline characteristics between the Ibr and CIT cohorts. Two periods were considered: entire front-line therapy (until initiation of second-line therapy) and first 6 months of front-line therapy. Comparisons with a subgroup of CIT patients initiating bendamustine/rituximab (BR) were also conducted. RESULTS: TTNT was significantly longer for Ibr (N = 322) relative to CIT (N = 839; hazard ratio, 0.54; P = .0163; Kaplan-Meier rates [24 months]: Ibr = 88.6%, CIT = 75.9%) and the subset of CIT patients treated with BR (N = 455; hazard ratio, 0.54; P = .0208; Kaplan-Meier rates [24 months]: Ibr = 89.0%, BR = 79.0%). During the entire front-line therapy, Ibr patients had significantly fewer monthly days with outpatient visits (rate ratio = 0.75; P = .0200). Ibrutinib's higher pharmacy costs (mean monthly cost difference [MMCD] = $6,849; P < .0001) were offset by lower medical costs (MMCD = -$10,615; P < .0001), yielding net savings (MMCD = -$3,766; P < .0001) versus CIT. Ibr was associated with net savings (MMCD = -$5,569; P < .0001) versus BR. Cost savings and reductions in HRU were more pronounced during the first 6 months of front-line therapy. CONCLUSION: During front-line CLL treatment, Ibr was associated with longer TTNT, fewer monthly days with outpatient visits, and net monthly total cost reduction versus CIT and BR.

4.
Artigo em Inglês | MEDLINE | ID: mdl-31689183

RESUMO

Just like many other topics in computer vision, image classification has achieved significant progress recently by using deep learning neural networks, especially the Convolutional Neural Networks (CNNs). Most of the existing works focused on classifying very clear natural images, evidenced by the widely used image databases such as Caltech-256, PASCAL VOCs and ImageNet. However, in many real applications, the acquired images may contain certain degradations that lead to various kinds of blurring, noise, and distortions. One important and interesting problem is the effect of such degradations to the performance of CNN-based image classification and whether degradation removal helps CNN-based image classification. More specifically, we wonder whether image classification performance drops with each kind of degradation, whether this drop can be avoided by including degraded images into training, and whether existing computer vision algorithms that attempt to remove such degradations can help improve the image classification performance. In this paper, we empirically study those problems for nine kinds of degraded images - hazy images, motion-blurred images, fish-eye images, underwater images, low resolution images, salt-and-peppered images, images with white Gaussian noise, Gaussian-blurred images and out-of-focus images. We expect this work can draw more interests from the community to study the classification of degraded images.

5.
Chemistry ; 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31670429

RESUMO

Polymorphism, the intrinsic character of one chemical compound with at least two distinct phase arrangements, plays a very key role in the photophysical properties. In this contribution, four 'T'-shaped molecules bearing the 2,1,3-benzothiadiazole (BTD) skeleton, named 5 a-5 d, were prepared and characterized. All compounds exhibited excellent thermal stability and polymorphism in the solid state, evident from thermogravimetric analysis, differential scanning calorimetry, and polarized optical microscopy results. Intense emissions with high photoluminescent quantum yields were achieved both in solution (56-97 %) and neat films (33-98 %). All compounds possessed clearly pH-dependent luminescence properties in solution. Additionally, compound 5 d showed useful mechanochromic luminescence owing to the transformation between the crystal and amorphous state. Employing compounds 5 a-5 d as the dopant, solution-processable organic light-emitting diodes (OLEDs) were fabricated and presented a highest external quantum efficiency of 6.15 %, which is higher than the theoretical value of fluorescence-based OLEDs (∼5 %). This research provided a novel strategy for designing high-efficiency BTD-based polymorphic luminescent materials.

6.
Int J Infect Dis ; 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31672657

RESUMO

BACKGROUND: Despite the considerable disease burden caused by the disease, rotavirus vaccine has not been introduced into routine national immunization schedule, and norovirus vaccines are being developed without a comprehensive understanding of gastroenteritis epidemiology. To bridge this knowledge gap, we investigated the disease burden of viral gastroenteritis in rural China. METHODS: Between October 2011 and December 2013, population-based surveillance was conducted in Zhengding and Sanjiang counties in China. Stool samples were collected from children <5 years of age with diarrhea. All specimens were tested for rotaviruses, noroviruses, sapoviruses, enteric adenoviruses, and astroviruses. RESULTS: The most common pathogen causing diarrhea was rotavirus (54.7 vs 45.6 cases/1,000 children/year in Zhengding and Sanjiang, respectively), followed by norovirus (28.4 vs 19.3 cases/1,000 children/year in Zhengding and Sanjiang, respectively). The highest incidence of these viruses was observed in children 6-18 months of age. Among the 5 viral pathogens, rotaviruses caused the most severe illness, followed by noroviruses. CONCLUSION: Rotavirus and norovirus are the 2 most important viral pathogens causing childhood diarrhea in both northern and southern China; they should be the major targets for viral gastroenteritis prevention strategies among children in China.

8.
Artigo em Inglês | MEDLINE | ID: mdl-31641900

RESUMO

Psychological resilience refers to the ability to adapt effectively in the face of adversity, which is closely related to an individual's psychological and physical health and well-being. Although previous behavioural studies have shown sex differences in psychological resilience, little is known about the neural basis of sex differences in psychological resilience. Here, we measured amplitude of low-frequency fluctuations (ALFF) via resting-state functional magnetic resonance imaging to investigate the sex-linked neurofunctional basis of psychological resilience in 231 healthy adolescents. At the behavioural level, we replicated previous findings indicating that males are more resilient than females. At the neural level, we found sex differences in the relationship between psychological resilience and ALFF in the right orbitofrontal cortex (OFC). Specifically, males showed a positive correlation between psychological resilience and ALFF in the right OFC, while females showed a negative correlation in this region. The sex-specific association between psychological resilience and spontaneous brain activity might be dependent on differences in hormonal systems and brain development between male and female adolescents. Taken together, the results of our study might provide the first evidence of sex-specific neurofunctional substrates of psychological resilience in adolescents, emphasizing the vital role of sex effects in future psychological resilience-related studies.

9.
Urology ; 2019 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-31605682

RESUMO

Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) of the kidney in children younger than 10 years of age is extremely rare. We describe here the case of a 7 year old female patient who was diagnosed with ES/PNET. The timeframe for this case spanned from 8 months prior to diagnosis until 8 months post surgical removal of the tumor. In addition, we summarized the cases of PNET in children younger than 10 years of age in the last decade.

10.
J Clin Ultrasound ; 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31609458

RESUMO

OBJECTIVES: To summarize the contrast-enhanced ultrasound (CEUS) features of mediastinal lymphomas and thymic epithelial tumors (including thymomas and thymic carcinomas) and to explore the value of CEUS in the differential diagnosis of lymphomas and thymic epithelial tumors. METHODS: Sixty-nine patients with 69 mediastinal lesions who underwent CEUS and had disease confirmed by histopathology were enrolled in the study. There were 33 cases of lymphoma, 19 cases of thymic carcinoma, and 17 cases of thymoma. CEUS features, including the enhancement pattern, enhancement distribution, enhancement time, inner necrosis status, wash out pattern, and vascular morphology, were evaluated in each group. RESULTS: Thymomas often presented with homogeneous (88.2%, 15/17) and late (88.2%, 15/17) enhancement and a low rate of inner necrosis (17.6%, 3/17). Late (73.7%, 14/19), heterogeneous (68.4%, 13/19), and centripetal (63.2%, 12/19) enhancement were more often observed in thymic carcinoma, as was a high rate of inner necrosis (78.9%, 15/19). Lymphomas showed a homogeneous enhancement rate of 57.6% (19/33) and a late enhancement rate of 54.5% (18/33). The rate of inner necrosis for lymphomas was 45.5% (15/33). The diagnostic accuracy of this finding for distinguishing thymic epithelial tumors from lymphomas was 63.8%, the sensitivity was 80.6%, and the specificity was 45.5%. Enlarged blood vessels were a feature specific to lymphomas, while small vessels arranged in a comb shape was a feature specific to thymic epithelial tumors. CONCLUSION: This study describes the CEUS features of common mediastinal tumors and may stimulate further studies in this field.

11.
Artigo em Inglês | MEDLINE | ID: mdl-31652978

RESUMO

This study aimed to explore the relationship between physical exercise (PE) and mobile phone dependence (MPD) in Chinese university students and verify the potential role of self-control (SC) in mediating the decrease of MPD by PE. Through the quota sampling, 608 students that complied with the requirements were surveyed from 10 universities in China. PE, MPD, and SC were assessed using standard scales. For data analysis, t-tests, correlation analysis, hierarchical regression, and regression analysis were carried out in turn. The results showed significant gender differences in PE, MPD, and SC. For male students, the level of PE and score of SC were higher than those in females, yet the MPD score was lower. PE and SC were negatively related to MPD (r = -0.124, p < 0.01; r = -0.563, p < 0.001), so both could remarkably predict MPD (ß = -1.00, p < 0.05; ß = -0.552, p < 0.001). Gender was also a significant predictor for MPD (ß = 0.089, p < 0.05). PE could, to some extent, decrease MPD, in which SC played a significant mediating role-its mediating effect accounted for nearly 71% of the total effect. The present study shows that PE is negatively correlated with MPD, and SC mediates the decrease of MPD by PE for university students in China. This indicates that the improvement of SC by PE could be a highly trustworthy and practicable way to effectively address the issue of MPD in university students or other young people across the world.

12.
Medicine (Baltimore) ; 98(38): e17275, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31568008

RESUMO

Single nucleotide polymorphisms (SNPs) of the interleukin 28B (IL28B) gene has proven to be associated with the clinical outcome of patients with chronic hepatitis virus B or C (HBV or HCV) infections. However, whether IL28B SNPs have an influence on the risk of hepatocellular carcinoma (HCC) among patients with HBV or HCV infection remains controversial. Therefore, this study aims to determine the association between IL28B polymorphisms and the risk of HCC in individuals with HBV or HCV infection.PubMed, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) databases were used to identify studies meeting the selection requirements using the terms "interleukin 28B", "IFN-lambda-3", "IFNL3", "single nucleotide polymorphisms", "SNPs", "hepatocellular carcinoma", "HCC", "liver cancer".A total of 24 eligible original studies (1 cohort study and 23 case-control studies) involved 20238 individuals (HCC group = 8725 vs control group = 11,513) were included. Both IL28B rs12979860 CC and rs8099917 TT genotypes were significantly associated with a decreased risk of HCC among patients with HBV or HCV infection (OR = 0.71, 95% CI = 0.57-0.88; OR = 0.82, 95% CI = 0.72-0.94, respectively). Egger test and Begg test revealed no' publication bias (P > .05). Sensitivity analyses suggested the robustness of the results in this meta-analysis.Both IL28B rs12979860 CC and rs8099917 TT genotypes are protective factors for the development of HCC among patients with HBV or HCV infection. Future prospective studies examining the impact of IL28B polymorphisms on the risk of HCC and investigating the underlying mechanism for the protective role of IL28B polymorphisms in HCC development are warranted.


Assuntos
Carcinoma Hepatocelular/genética , Predisposição Genética para Doença/genética , Hepatite B/complicações , Hepatite C/complicações , Interferons/genética , Neoplasias Hepáticas/genética , Polimorfismo de Nucleotídeo Único/genética , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/virologia , Hepacivirus , Hepatite B/genética , Vírus da Hepatite B , Hepatite C/genética , Humanos , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/virologia
13.
Int J Mol Sci ; 20(20)2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31623059

RESUMO

Long noncoding RNAs (lncRNAs) are involved in a diversity of biological processes. It is known that differential expression of thousands of lncRNAs occurs in host during influenza A virus (IAV) infection. However, only few of them have been well characterized. Here, we identified a lncRNA, named as interferon (IFN)-stimulated lncRNA (ISR), which can be significantly upregulated in response to IAV infection in a mouse model. A sequence alignment revealed that lncRNA ISR is present in mice and human beings, and indeed, we found that it was expressed in several human and mouse cell lines and tissues. Silencing lncRNA ISR in A549 cells resulted in a significant increase in IAV replication, whereas ectopic expression of lncRNA ISR reduced the viral replication. Interestingly, interferon-ß (IFN-ß) treatment was able to induce lncRNA ISR expression, and induction of lncRNA ISR by viral infection was nearly abolished in host deficient of IFNAR1, a type I IFN receptor. Furthermore, the level of IAV-induced lncRNA ISR expression was decreased either in retinoic acid-inducible gene I (RIG-I) knockout A549 cells and mice or by nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) inhibitor treatment. Together, these data elucidate that lncRNA ISR is regulated by RIG-I-dependent signaling that governs IFN-ß production during IAV infection, and has an inhibitory capacity in viral replication.

14.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(9): 1083-1086, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31657329

RESUMO

OBJECTIVE: To discuss the clinical significance of antibacterial peptide LL-37 in the early diagnosis of patients with sepsis in emergency department. METHODS: Forty patients diagnosed with sepsis in the emergency department of the Affiliated Hospital of Zunyi Medical College from December 2017 to March 2018 were enrolled as sepsis group. Twenty healthy volunteers were enrolled contemporaneously in our hospital at medical center as healthy control group. Peripheral blood was collected immediately after diagnosis in sepsis group or during physical examination in healthy control group. The expression of antibacterial peptide LL-37 was determined by enzyme-linked immunosorbent assay (ELISA). Meanwhile, serum procalcitonin (PCT) and C-reactive protein (CRP) levels were determined. The differences in antibacterial peptide LL-37, PCT and CRP levels between the two groups were compared. Pearson correlation method was used to analyze the correlation between antibacterial peptide LL-37, PCT and CRP. Receiver operating characteristic (ROC) curve was drawn, and the early individually or jointly diagnostic value of each detected index for sepsis was analyzed. RESULTS: The levels of antimicrobial peptide LL-37, PCT and CRP in peripheral blood of sepsis group were significantly higher than those of healthy control group [LL-37 (µg/L): 1.34±0.69 vs. 0.10±0.06, PCT (µg/L): 46.67±39.51 vs. 0.03±0.02, CRP (mg/L): 129.68±49.83 vs. 3.16±2.85], with statistically significant differences (all P < 0.05). Pearson correlation analysis showed that the expression of antimicrobial peptide LL-37 was positively correlated with PCT and CRP levels (r1 = 0.835, r2 = 0.932, both P < 0.01). ROC curve analysis showed that the area under ROC curve (AUC) of LL-37, PCT and CRP for early diagnosis of sepsis was 0.885, 0.963 and 0.983, respectively, and the AUC of combined diagnosis of the three parameters was as high as 0.994, indicating that the value of combined diagnosis of sepsis was greater than that of single diagnosis; when the combined prediction probability of the three parameters was 0.92, the sensitivity was 97.5%, and the specificity was 95.0%. CONCLUSIONS: Antibacterial peptide LL-37 has certain clinical value in early diagnosis of patients with sepsis, which can be used as early routine monitoring indicators for patients with early sepsis when combined with PCT and CRP.


Assuntos
Peptídeos Catiônicos Antimicrobianos/metabolismo , Calcitonina , Sepse/diagnóstico , Proteína C-Reativa , Peptídeo Relacionado com Gene de Calcitonina , Diagnóstico Precoce , Serviço Hospitalar de Emergência , Humanos , Precursores de Proteínas , Curva ROC , Sepse/metabolismo
16.
BMJ Open ; 9(8): e027702, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31471434

RESUMO

OBJECTIVE: Mounting data now support a strong link between the presence of non-alcoholic fatty liver disease (NAFLD) and an increased risk of urolithiasis. However, little is known on the association between hepatic fibrosis and the risk of urolithiasis among NAFLD patients. Therefore, this study aimed to investigate the prevalence of urolithiasis among NAFLD patients and determine whether the Fibrosis-4 (FIB-4) score, a surrogate marker of hepatic fibrosis, is associated with urolithiasis among NAFLD patients. DESIGN: Cross-sectional studies. SETTING: China. METHODS: A total of 2058 adult patients with NAFLD were included in this study. Logistic regression analysis was used to detect the association between FIB-4 score and urolithiasis. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic value of FIB-4 score for the detection of urolithiasis among NAFLD patients. RESULTS: 200 (9.7%) individuals had ultrasonography-diagnosed urolithiasis among 2058 NAFLD patients. FIB-4 score (OR=1.58; 95% CI 1.06 to 2.31), age (OR=1.11; 95% CI 1.08 to 1.13), obesity (OR=3.16; 95% CI 2.29 to 4.39) and hyperuricemia (OR=3.79; 95% CI 2.67 to 5.36) were independent factors associated with urolithiasis among NAFLD patients. Moreover, a novel algorithm including multiple variables (FIB-4 score, age, obesity and hyperuricemia) showed an area under a ROC curve of 0.813 (95% CI 0.795 to 0.829) for identifying urolithiasis among NAFLD patients. The optimal cut-off value of > -2.23 for the multivariate model provides a sensitivity of 76% and a specificity of 74% for predicting urolithiasis among NAFLD patients. CONCLUSION: Urolithiasis among NAFLD patients is associated with FIB-4 score. Further, a novel algorithm based on FIB-4 score could serve as a useful tool for identifying individuals with a higher risk of urolithiasis among NAFLD patients, although prospective cohort studies are still needed in the future.

17.
Virol Sin ; 2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31552609

RESUMO

Beak and feather disease virus (BFDV) is an infectious agent responsible for feather degeneration and beak deformation in birds. In March 2017, an epidemic of psittacine beak and feather disease (PBFD) struck a farm in Fuzhou in the Fujian Province of southeast China, resulting in the death of 51 parrots. In this study, the disease was diagnosed and the pathogen was identified by PCR and whole genome sequencing. A distinct BFDV strain was identified and named as the FZ strain. This BFDV strain caused severe disease symptoms and pathological changes characteristic of typical PBFD in parrots, for example, loss of feathers and deformities of the beak and claws, and severe pathological changes in multiple organs of the infected birds. Phylogenetic analysis showed that the FZ strain was more closely related to the strain circulating in New Caledonia than the strains previously reported in China. Nucleotide homology between the FZ strain and other 43 strains of BFDV ranged from 80.0% to 92.0%. Blind passage experiment showed that this strain had limited replication capability in SPF Chicken Embryos and DF-1 Cells. Furthermore, the capsid (Cap) gene of this FZ strain was cloned into the pGEX-4T-1 expression vector to prepare the polyclonal anti-Cap antibody. Western blotting analysis using the anti-Cap antibody further confirmed that the diseased parrots were infected with BFDV. In this study, a PBFD and its pathogen was identified for the first time in Fujian Province of China, suggesting that future surveillance of BFDV should be performed.

18.
Spectrochim Acta A Mol Biomol Spectrosc ; 225: 117511, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31513979

RESUMO

This paper proposes a fluorescent aptasensor for the detection of carbendazim (CBZ) in aqueous solution using CBZ-specific aptamer as sensing probe, gold nanoparticles (AuNPs) and Rhodamine B (RhoB) as indicator, respectively. In the absence of CBZ, CBZ aptamer could wrap AuNPs and maintained it dispersed in NaCl solution basically. Contrarily, the aptamer could specifically combine with CBZ and form a stable aptamer-CBZ complex, leaving AuNPs exposed to be aggregated by NaCl solution. The dispersed AuNPs could efficiently quench the fluorescence of RhoB, but those aggregated AuNPs have poor capability to impair the fluorescent indicator. Thus, the concentration of CBZ could be detected quantitatively through the distinction of the fluorescence intensity. This convenient fluorescent assay for CBZ had a wide linear range from 2.33 to 800 nM and a 2.33 nM limit of detection (LOD). Furthermore, it had high selectivity over pesticides, antibiotics, metal ions and other disrupting chemicals. As for application, the method could determine CBZ in water samples with recoveries in the range of 96.3-111.2%. This fluorescent aptasensor possessed great potential application for CBZ detection in actual aquatic environment.

19.
Biomed Pharmacother ; 120: 109385, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31542613

RESUMO

Long non-coding RNA (lncRNA) linc00152 has been recognized as an oncogenic lncRNA in various cancers. This study attempts to investigate the roles of linc00152 in the metastasis-related traits of infantile hemangioma (IH). Linc00152 was overexpressed in the proliferating-phase hemangioma tissues when compared with that in involuting-phase. Downregulation of linc00152 strikingly suppressed the cell viability, migration and invasion of hemangioma cells. Furthermore, silence of linc00152 repressed the growth and lung metastasis of hemangioma cell in vivo. Subsequent analysis revealed that linc00152 bound with miR-139-5p and linc00152 expression was inversely correlated with the level of miR-139-5p in IH. Same effects of miR-139-5p transfection on HemECs cells were observed as downregulation of linc00152. Moreover, tumor protein D52 (TPD52) was confirmed to be the target of miR-139-5p. Besides, the anti-tumor effect of linc00152 silence on hemangioma cell was reversed by rexpression of TPD52. This study demonstrates that downregulatuon of linc00152 restrains the aggressiveness of hemangioma cell in vitro and in vivo via interacting with miR-139-5p and further modulates the level of TPD52.

20.
Int Wound J ; 16(5): 1214-1221, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31483575

RESUMO

The use of negative-pressure wound therapy (NPWT) has displayed significant clinical benefits in the healing of infected wounds. However, the effects of NPWT on bacterial colonisation and infection of traumatic wounds has been controversial. The aim of this study is to evaluate the impact of NPWT treatment in rabbits with a contaminated full-thickness wound on bacterial behaviour, including colony morphology, spatial distribution, fissional proliferation, and bacterial bioburden. Full-thickness wounds were created on the back of rabbits, and were inoculated with bioluminescent Staphylococcus aureus. The wounds were treated with sterile gauze dressings and NPWT with continuous negative pressure (-125 mm Hg). Wound samples were harvested on days 0 (6 hours after bacterial inoculation), 2, 4, 6, and 8 at the centre of wound beds before irrigation. Scanning electron microscopy and transmission electron microscopy (TEM) analyses were performed to determine the characteristic bacteriology. Laser scanning confocal microscopy was performed to obtain bioluminescent images, which were used to observe spatial distribution of the GFP-labelled S. aureus within the tissue and quantify the bacterial bioburden. NPWT resulted in sparse amounts of scattered bacteria on the wound surface or as sparsely spaced single colonies within the tissue. Wound bioburden on day 8 in the NPWT and gauze groups was 34.6 ± 5.5% and 141.9 ± 15.4% of the baseline values (N = 6), respectively (P < .0001). TEM showed a lack of S. aureus active fission within NPWT-treated tissue. NPWT can impact S. aureus colony morphology and spatial distribution both on the surface and within wound tissue, and reduce S. aureus as early as 48 hours after therapy initiation. Additionally, NPWT inhibits bacterial fissional proliferation in microcolonies.

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