Objective To develop a diclofenac sodium-loaded gelatin scaffold with anti-inflammatory activity and provide a new avenue for alleviating the inflammatory response and enhancing cartilage regeneration in vivo. Methods Diclofenac sodium was homogeneously mixed with gelatin to prepare a diclofenac sodium-loaded porous gelatin scaffold by freeze-drying method as the experimental group, and a pristine porous gelatin scaffold was served as a control group. The general morphology of the scaffold was observed, the pore size of the scaffold was measured by scanning electron microscopy, the porosity of the scaffold was calculated by drainage method, the loading of diclofenac sodium into the gelatin scaffold was detected by fourier transform infrared spectrometer and X-ray diffraction examinations, and the release kinetics of diclofenac sodium from gelatin scaffold was tested using an in vitro release assay. The two scaffolds were co-cultured with lipopolysaccharide-predisposed RAW264.7 in vitro, and the expressions of interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) were detected by reverse transcription polymerase chain reaction (RT-PCR), enzyme-linked immuno sorbent assay, and Western blot, to detect the in vitro anti-inflammatory effect of the drug-loaded scaffold. Thereafter, the second generation chondrocytes of New Zealand white rabbits were inoculated on the two groups of scaffolds for in vitro culture, and the cytocompatibility of the scaffold was tested by live/dead staining and cell counting kit 8 assay, the feasibility of in vitro cartilage regeneration of the scaffold was evaluated via gross observation, HE staining, Safranin-O staining, and immunohistochemical collagen type Ⅱ staining, as well as biochemical quantitative analyses. Finally, the two groups of chondrocyte-scaffolds were implanted subcutaneously into New Zealand white rabbits, and after 4 weeks, the general observation, HE staining, safranin O staining, immunohistochemical collagen type Ⅱ staining, and biochemical quantitative analyses were performed to verify the cartilage regeneration in vivo, and the expression of inflammation-related genes CD3 and CD68 was detected by RT-PCR to comprehensively evaluate the anti-inflammatory performance of the scaffolds in vivo. Results The two scaffolds exhibited similar gross, microporous structure, pore size, and porosity, showing no significant difference (P>0.05). Diclofenac sodium was successfully loaded into gelatin scaffold. Data from in vitro anti-inflammatory assay suggested that diclofenac sodium-loaded gelatin scaffold showed alleviated gene and protein expressions of IL-1β and TNF-α when compared with gelatin scaffold (P<0.05). The evaluation of cartilage regeneration in vitro showed that the number of living cells increased significantly with the extension of culture time, and there was no significant difference between the two groups at each time point (P>0.05). White cartilage-like tissue was regenerated from the scaffolds in both groups, histological observation showed typical cartilage lacuna structure and specific cartilage extracellular matrix secretion. There was no significant difference in the content of cartilage-specific glycosaminoglycan (GAG) and collagen type Ⅱ between the two groups (P>0.05). In vivo experiments showed that the samples in the experimental group had porcelain white cartilage like morphology, histologic staining showed obvious cartilage lacuna structure and cartilage specific extracellular matrix, the contents of GAG and collagen type Ⅱ were significantly higher than those in the control group, and the protein and mRNA expressions of CD3 and CD68 were significantly lower than those in the control group, with significant differences (P<0.05). ConclusionThe diclofenac sodium-loaded gelatin scaffold presents suitable pore size, porosity, and cytocompatibility, as well as exhibited satisfactory anti-inflammatory ability, providing a reliable scheme for alleviating the inflammatory reaction of regenerated cartilage tissue after in vivo implantation and promoting cartilage regeneration in vivo.
OBJECTIVE Influence of irradiation and phenytoin sodium on modulatory activities of wound fluid on proliferation of fibroblasts and collagen synthesis was studied. METHODS The male Wistar rats were used in this study. The rats were divided into irradiated and non-irradiated groups, and in each of them it was subdivided into phenytoin group and control. A 7 cm long incisional wound was made on the back of each rat, in which a polyvinyl alcohol sponge (PVAS) with a size of 1.0 cm x 0.4 cm was implanted into the wound and the wound was sutured up. The PVAS was prepared by rinsing in running water over night and then was boiled for 30 minutes. Before implantation, the sponge was immersed in phenytoin sodium solution (10 mg/l ml) or normal saline (as control). From each wound the wound fluid and fibroblasts were collected. The methods of incorporation of 3H were adopted to assess the proliferation of fibroblasts and synthesis of collagen. RESULTS It was shown that proliferation of fibroblasts and collagen synthesis were stimulated by wound fluid remarkably on 5 to 8 days after wounding, and that 6 Gy to total-body irradiation wound decrease this effect. It was also noted that topical phenytoin sodium increased the modulatory activity of wound fluid irrespective of being irradiated or not. CONCLUSION It could be drawn that, after total-body irradiation, stimulation of hyperplasia of fibroblasts and collagen synthesis by wound fluid was markedly lowered indicating the total-body irradiation resulted in changes of local conditions of the wound which was unbenefitted to repair of tissue cells, while phenytoin sodium could enhance the stimulating action of wound fluid on proliferation of fibroblasts and synthesis of collagen which was beneficial to wound healing.
ObjectiveTo establish a more accurately method to detect the residue of 1,4-butanediol diglycidyl-ether (BDDE) in the cross-linked sodium hyaluronic gel so as to provide a scientific testing method for the quality control. MethodsThe gas chromatography was used to explore the thermal stability of BDDE, and the residues of BDDE in sodium hyaluronic gel was detected by fluorescence spectrophotometry. The hyaluronidase was added to the BDDE standard solution and the improved fluorescence spectrophotometer was used to detect the BDDE residues in the cross-linked hyaluronic sodium gel. ResultsA good linearity was obtained as y=14.102x+1.103 (R2=0.999 8) for BDDE. BDDE was unstable under high temperature and long storage time. The relevant fluorescence intensity was detected with hyaluronidase solution. After adding hyaluronidase into the BDDE standard solutions, the advanced linearity was obtained as y=14.027x+7.062 (R2=0.999 9). ConclusionFluorescent spectrophotometry is a simple, rapid, and accurate method to analyze BDDE residue of cross-linked sodium hyaluronic gel. Due to the poor thermal stability, all the factors related to temperature must be excluded during the process, including the temperature control of every step. Furthermore, the adding of hyaluronidase in the pre-preparation of cross-linked sodium hyaluronic gel can bring interference. So when using fluorescent spectrophotometry, adjustment must be taken before the calibration curve is preparation.
Objective To study the clinical efficacy of topiramate combined with carbamazepine combined with phenytoin in elderly seizures. Methods A total of 105 elderly patients with epilepsy were enrolled in this study from August 2014 to July 2016 in Fuzhou Chinese and Western Medicine Hospital. The patients were aged 61 to 80 years. There were 42 males and 63 females with epilepsy. The course were 1 to 5 years; 55 cases were partial onset, 50 cases were systemic attack. According to the different treatment methods, the patients were divided into A, B, C three groups, each group were 35 patients. Group A was daily treated with 4 to 8 mg/kg topiramate; Group B was treated with 0.3 g carbamazepine combined with 250 to 300 mg phenytoin per day. Group C was daily treated with 4 to 8 mg/kg topiramate and 0.3 g carbamazepine combined with 250 to 300 mg phenytoin. The total effective rate, the incidence of adverse reactions, the number of seizures before and after treatment were compared among the three groups. Results The total effective rate of group C was higher than that of group A and B, and the difference was statistically significant (P<0.05). There were no significant differences in the number of epileptic seizures between the three groups before treatment (P>0.05). The number of seizures in group C was significantly lower than that in group A and B (P<0.05). Conclusions The treatment of topical epilepsy patients with topiramate and carbamazepine combined with phenytoin can significantly improve the total effective rate of treatment, protect the safety of medication, reduce the number of patients with epilepsy, so that patients can quickly return to normal life. It would be worthy for clinical promotion and use.
Objective To systematically evaluate the effectiveness and safety of disodium cantharidinate and vitamin B6 injection plus chemotherapy compared with chemotherapy alone, in the treatment of non-small cell lung cancer (NSCLC). Methods The Cochrane Library (Issue 1, 2011), MEDLINE (1966 to November 2011), EMbase (1984 to November 2011), CBM (1978 to November 2011), CNKI (1995 to November 2011) and VIP (1989 to November 2011) were searched electronically, and the randomized controlled trials (RCTs) about disodium cantharidinate and vitamin B6 injection plus chemotherapy for NSCLC were included. The quality of the included studies was assessed and crosschecked by two reviewers independently, and meta-analyses were performed for homogeneous studies by using Cochrane Collaboration’s RevMan 5.1 software. Results Eight RCTs involving 539 patients met inclusion criteria were included in meta-analyses. The quality of all studies was in Grade B. The results of meta-analyses showed that disodium cantharidinate and vitamin B6 injection plus chemotherapy, compared with chemotherapy alone, could increase effective rate (RR=1.32, 95%CI 1.07 to 1.62) and clinical benefit rate (RR=1.24, 95%CI 1.12 to 1.37), improve quality of life (RR=2.23, 95%CI 1.55 to 3.19) and clinical symptoms (RR=1.55, 95%CI 1.24 to 1.95), increase body weight (RR=2.72, 95%CI 1.74 to 4.25), and decrease bone marrow suppression (leucocyte reduction rate) (RR=0.36, 95%CI 0.21 to 0.61). Conclusion The evidence available indicates that the treatment regimen of disodium cantharidinate and vitamin B6 injection plus chemotherapy is superior to chemotherapy alone in increasing effects and decreasing toxicity for the patients with NSCLC. More high-quality and multi-center RCTs with larger sample and longer follow-up are proposed.
Objective To investigate the effect of vitamin K1 in the function of blood coagulation state, intraopera- tive blood loss, and hemoglobin content of liquid in postoperative drainage in patients with cirrhosis combined with portal hypertension before and after splenectomy combined with the hydrodynamic vein cut-out surgery. Methods In total of 143 cases of cirrhosis combined with portal hypertension who treated in our hospital from January 2010 to October 2015 were prospectively collected, and randomly divided into 3 group, including 51 cases of vitamin K1 group, 45 cases of carbazochrome sodium sulfonate group, and 47 cases of control group. Drug was used form 1 week before surgery to 5 days after surgery (vitamin K1 group: vitamin K1, 0.03 g, intravenous drip; card collaterals sodium sulfonic group: card collaterals sulfonic sodium, 80 mg, intravenous drip; control group: normal saline, 250 mL, intravenous drip). Prothrombin time of patients in 3 groups was detected at 1 week before surgery, 3 days before surgery, 1 day before surgery, 1 day after surgery, 3 days after surgery, and 5 days after surgery; hemoglobin content of liquid in postoperative drainage was detected on 1, 3, and 5 days after surgery. Results In terms of prothrombin time, there was no significant difference at 1 week before surgery and 5 days after surgery (P>0.05); prothrombin time of vitamin K1 group was lower than those of carbazochrome sodium sulfonate group and control group on 3 days and 1 day before surgery (P＜0.05), but there was no significant difference between carbazochrome sodium sulfonate group and control group on 3 days and 1 day before surgery (P>0.05); prothrombin time of vitamin K1 group and carbazochrome sodium sulfonate group was both lower than that of control group on 1 day and 3 days after surgery (P＜0.05), but there was no significant difference between carbazochrome sodium sulfonate group and vitamin K1 group on 1 day and 3 days after surgery (P>0.05). In terms of intraoperative blood loss, intraoperative blood loss of vitamin K1 group was lower than those of carbazochrome sodium sulfonate group and control group (P＜0.05), but there was no significant difference between carbazochrome sodium sulfonate group and control group (P>0.05). In terms of hemoglobin content of liquid in postoperative drainage, it was lower in vitamin K1 group and carbazochrome sodium sulfonate group than that of control group on 1 day and 3 days after surgery (P＜0.05), but there was no significant difference among 3 groups on 5 days after surgery (P>0.05). Conclusion Vitamin K1 is helpful to improve function state of blood coagulation before and after surgery in patients with cirrhosis combined with portal hypertension (from 1 week before surgery to 3 days after surgery), and reduce the intraoperative blood loss; carbazochrome sodium sulfonate can improve function status of postoperative blood coagulation to 3 days after surgery and postoperative blood loss, but has no obvious improvement in the function status of preoperative blood coagulation and introperative blood loss.
Hypernatremia is one of the commonly syndromes in critically ill patients. Severe hypernatremia has a low incidence (0.6%–1.0%) but with a very high mortality (58%–87%). Conventional treatments include the limitation of sodium intake and the supplement of sodium free liquid according to the assessed water lost. The reduction rates of conventional treatments are commonly not effective enough to decrease the serum sodium concentration in severe euvolemic or hypervolemic hypernatremia patients. Continuous renal replacement therapy (CRRT) has been reported to be effective on the reduction of sodium level in severe hypernatremia patients. However, the evidences on the use of CRRT for hypernatremia are limited. Our present review summarizes the current evidences on the prevalence of hypernatremia, the outcome of hypernatremia patients, the conventional treatment of hypernatremia, and the advantages and indications of CRRT for the management of hypernatremia. Additionally, we introduce our experiences on the management of hypernatremia using CRRT as well.
ObjectiveTo investigate the effect of post-conditioning with fospropofol disodium on hepatic ischemiareperfusion (I/R) and its possible mechanism in rats. MethodsForty-eight Sprague-Dawley rats were randomly divided into four groups, including sham group (S), control group (C), propofol group (P) and fospropofol disodium group (F). According to the different periods after reperfusion, each group was further divided into 2-hour and 4-hour reperfusion subgroups respectively (n=6 in each subgroup), named S2h, C2h, P2h, and F2h subgroups and S4h, C4h, P4h, and F4h subgroups. The livers of rats were reperfused after hepatic ischemia for one hour. In the beginning of reperfusion, normal saline was infused intravenously in group S and group C continuously, propofol was infused intravenously in group P continuously, fospropofol disodium was infused continuously in group F. The blood was sampled at the end of ischemia and reperfusion for assay of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The bcl-2 and bax protein contents in liver tissue were detected by immunohistochemical analysis, and liver samples were stained with hematoxylin-eosine for histological observation and damage degree evaluation by counting the proportion of necrosis cells. ResultsThe activity of ALT and AST, the rate of necrosis cells and the amount of bcl-2 and bax protein after reperfusion in group C, group P and group F were higher than those in group S at matched reperfusion time points (P<0.05). The activity of ALT and AST, the proportion of necrosis cells and bax protein contents decreased in group P and group F, compared with group C at the same reperfusion time points, while the contents of bcl-2 protein were significantly increased (P<0.05). ConclusionFospropofol disodium can alleviate hepatic injury induced by ischemia-reperfusion in rats, in which the bcl-2 and bax protein may play important roles.
ObjectiveTo compare the effect of bromfenac sodium hydrate ophthalmic solution and fluorometholone following sub-bowmans keratomileusis (SBK) from the aspects of subjective visual perception, ophthalmic signs and intraocular pressure. MethodsFifty myopic patients (94 eyes) who underwent SBK from April to May 2013 were divided into two groups according to the different postoperative drug treatment. Patients in group A were treated with bromfenac sodium hydrate (51 eyes), and patients in group B were treated with fluorometholone (43 eyes). To compare the effects of two kinds of drugs after SBK, results of the routine examination were recorded including uncorrected visual acuity (UCVA), refractive status, visual symptoms and signs, intraocular pressure (IOP) and Haze under Corneal Epithelium (HAZE) on pre-operational and postoperative day 1, 7, and 30. ResultsOn the 30th day, IOP in group A and group B were (9.88±2.34) mm Hg (1 mm Hg=0.133 kPa) and (11.00±2.27) mm Hg, respectively, and the difference between the two groups was statistically significant (P<0.05), but there were no statistically significant differences at other time points. There was no statistically significant difference in UCVA, refractive status, visual symptoms and signs, and corneal epithelial staining between the two groups (on day 1, 7, and 30). ConclusionBromfenac sodium and fluorometholone have the same effect in the control of postoperative visual acuity and ophthalmic inflammation. Bromfenac sodium has greater advantages in IOP control. Therefore, bromfenac sodium can substitute fluorometholone in resisting inflammation after SBK.
ObjectiveTo explore the application of 10% sodium chloride for stage-Ⅲ pressure ulcer debridement. MethodsAccording to the standard, 68 stage-Ⅲ pressure ulcer cases were selected from January 2011 to December 2014. All the patients had yellow surface and positive bacterium cultivation suggesting wound infection. They were randomly divided into control group and trial group. The control group used traditional treatment for debridement, while the trial group used 10% sodium chloride, until the end of debridement where the granulation became fresh and bacterium cultivation negative. Then we compared these two groups in terms of debridement time, wound drainage, wound smell, granulation growth, pain score and cost. ResultsThe control group debridement time was 18-32 days, averaging (22.4±10.8) days, and the trial group debridement time was 5-13 days, averaging (11.6±4.0) days (P<0.05). The control group wound drainage ratings score was 6.70±2.87, while the trial group wound drainage ratings score was 3.65±1.23 (P<0.05). In terms of the wound smell, the control group had a score of 2.74±1.62, and the score for the experimental group was 1.26±0.51 (P<0.05). The average cost of the control group was (975.00±10.29) yuan, while the experimental group was (626.00±8.18) yuan (P<0.05). ConclusionThe application of 10% sodium chloride for stage-Ⅲ pressure ulcer debridement can shorten debridement time, promote the growth of granulation and reduce the economic burden, which is worth clinical promotion.