Exudate Volume Research Articles

Multifunctional Janus nanofibrous membrane with unidirectional water transport and pH-responsive color-changing for wound dressing

Chronic wounds often produce a significant volume of exudate, posing a substantial obstacle to healing. Consequently, there is a pressing demand for a versatile dressing capable of effectively managing exudate in chronic wounds. In this context, a Janus smart dressing is proposed, featuring unidirectional water transport and a pH-responsive color-changing for exudate management and wound monitoring. The dressing’s mechanisms for unidirectional water transport and color changing are elucidated. The Janus dressing consists of a polyacrylonitrile (PAN)/sodium polyacrylate (SPA)/anthocyanin (An) hydrophilic layer with antioxidant and pH-sensitive functions and a poly (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) hydrophobic layer, enabling unidirectional exudate drainage without reverse osmosis. Studies indicate that the Janus dressing exhibits excellent air permeability, moisture permeability, mechanical properties, cytocompatibility, and antioxidant performance while promptly responding to color variations in solutions of varying pH levels. In vivo studies demonstrated the excellent wound healing ability of Janus PHBV-PAN/SPA/An membrane. Consequently, this study provides a promising solution to develop wound dressings that can effectively manage excessive wound exudate and dressing changes.

Effectiveness of silver and iodine dressings on wound healing: a systematic review and meta-analysis

ObjectiveTo evaluate the effects of silver and iodine dressings on healing time, healing rate, exudate amount, pain and anti-infective efficacy.DesignSystematic review and meta-analysis.Data sourcesDatabases including PubMed, Cochrane Library, Embase, Web...

Clinical Observation of Wound Fluid Extravasation after Shoulder Arthroscopy

Fluid leakage to the outside of the wound after shoulder arthroscopy can present a risk of complications such as wound infection and delayed wound healing. Most relevant studies dealt with fluid leakage to the internal environment and did not focus on fluid leakage outside the body and its effect on the wound. We, therefore, focused on and investigated the significance of wound fluid leakage to the body surface after shoulder arthroscopy. Methods: Observational and analyzed patient data from 15 cases of shoulder arthroscopy were used to calculate the amount of fluid exudation by recording the operation time, the amount of intraoperative fluid perfusion, the surgical incisions, and weighing the surgical dressings on the first day of the postoperative period. The statistical method of Pearson's correlation coefficient was used to evaluate the correlation between the patients' postoperative fluid exudate volume and the operation time, intraoperative fluid infusion volume, and surgical incision. Results: All patients had no incision infections or other postoperative complications. The duration of surgery and the amount of postoperative wound exudate were correlated in 15 patients (R=.547, p<.05), the amount of perfusion and the amount of postoperative wound exudate were statistically significant (R=.569, p<.05), and the incisions and the amount of postoperative wound exudate were statistically significant (R=.702, p<.05). Conclusion: There is a correlation between postoperative fluid exudation after shoulder arthroscopy and operative time, intraoperative perfusion, and surgical incisions. When the operator performs shoulder arthroscopy, he or she should try to shorten the operative time and reduce intraoperative fluid perfusion and surgical incisions.

A Case Report Intravitreal Anti VEGF Bevacizumab on Patient with Hypertension Retinopathy and Exudative Retinal Detachment

Introduction : To present a case of intravitreal anti VEGF bevacizumab function on patient with hypertension retinopathy and exudative retinal detachment.
 Case Illustration : A 29 years old man presented with chief complaint blurry vision with visual acuity 1/60 on both eyes. History of hypertension sinced one year ago and already got hemodialisa treatment twice a week sinced 6 months ago. Ophthalmic examination showed decreased vision on both eyes and posterior segment both eyes we can find macular star and papil edema. Patient had diagnosed with hypertension retinopathy scheie 4 and exudative retinal detachment both eyes.
 Discussion : Hypertension will cause blood vessels to become damage in the form of sclerosis, thickening of blood vessel walls, and plasma leakage. Hypertension retinopathy acts as predictor of systemic morbidity and mortality due to organ target damage. Regulating systemic disease like blood pressure to become normal will improve clinical signs of hypertension retinopathy. Administration of anti-VEGF intravitreal injection therapy like bevacizumab can improve permeability of blood vessels in retina and decreased volume of exudate in retina. Visual acuity for this patient will improve to become 4/60 for both eyes.
 Conclusion : Uncontrolled hypertension can lead to organ target damage, which one of that was eyes. Hypertension retinopathy can make complications like exudative retinal detachment if the blood pressure still uncontrolled. Management of exudative retinal detachment caused by hypertension retinopathy was giving intravitreal anti VEGF injection in eyes to repair breakdown of blood retinal barrier, and the blood pressure must be well controlled to maintain permeability of blood retinal barrier.

Anti-Inflammatory Potential of Pteropodine in Rodents.

Pteropodine (PT) is a component of some plants with potentially useful pharmacological activities for humans. This compound has biomedical properties related to the modulation of the immune system, nervous system, and inflammatory processes. This study addresses the anti-inflammatory and antioxidant capacity of pteropodin in a murine model of arthritis and induced edema of the mouse ear. To evaluate the anti-inflammatory activity, we used the reversed passive Arthus reaction (RPAR), which includes the rat paw edema test, the rat pleurisy test, and a mouse ear edema model. The antioxidant effect of PT was evaluated by determining the myeloperoxidase enzyme activity. PT showed an anti-inflammatory effect in the different specific and non-specific tests. We found a 51, 66 and 70% inhibitory effect of 10, 20 and 40 mg/kg of PT, respectively, in the rat paw edema test. In the pleurisy assay, 40 mg/kg of PT induced a low neutrophil count (up to 36%) when compared to the negative control group, and 20 mg/kg of PT increased the content of lymphocytes by up to 28% and the pleural exudate volume decreased by 52% when compared to the negative control group, respectively. We also found an 81.4% inflammatory inhibition of the edema ear with 0.04 mg/ear of PT, and a significant myeloperoxidase enzyme inhibition by the three doses of PT tested. We conclude that PT exerted a potent anti-inflammatory effect in the acute inflammation model in rodents.

Anthocleista vogelii (Planch) stem bark ethanol extract prevents inflammatory and pain phenotypes in experimental rodent models by modulating oxido-inflammatory mediators

Ethnopharmacological relevanceThe Anthocleista species are used to treat pain, inflammation, and stomach disorders, but the mechanism by which Anthocleista vogelii Planch stem bark ethanol extract (AVSBE) elicits its anti-pain activity is not fully understood. AimThis study elucidates the phytochemical signatures of AVSBE along with its anti-nociceptive, anti-inflammatory, and antioxidant activities in animal models of pain and inflammation. MethodsThe Gas Chromatography and Mass Spectrometry (GC-MS) and Lorke's methods were used for the phytochemical characterization and LD50 determination of AVSBE. Male and female Wistar rats and Swiss mice were given oral pre-treatment of AVSBE (100, 200, and 400 mg/kg), indomethacin (10 mg/kg), morphine (10 mg/kg), and vehicle (10 mL/kg). Subsequently, various models were employed to evaluate AVSBE's anti-nociceptive and anti-inflammatory effects. Specifically, the acetic acid-induced mice writhing, formalin-induced paw licking, and hot plate models were used to assess AVSBE's anti-nociceptive activity, while the carrageenan-induced paw edema and air pouch models were used to evaluate AVSBE's anti-inflammatory activity. ResultsAVSBE (100, 200, and 400 mg/kg) reduced writhes, paw licking, and pain reaction time. It also decreased rat paw size and inflammatory exudate volume. AVSBE (200 and 400 mg/kg) lowered oxido-nitrosative stress, inflammatory mediators, and leukocyte counts in the exudate fluid. Animals administered with AVSBE showed no stomach ulceration. The LD50 of AVSBE is over 5000 mg/kg, p.o. GC-MS analysis revealed 19 phytochemical compounds in AVSBE, including eicosanoic, octadecatrienoic, linoleic, palmitoleic, and 9,12-octadecanoic acids, phytol, among others. ConclusionThese findings suggest that AVSBE demonstrated activities that can reduce inflammation and alleviate pain by inhibiting oxido-nitrosative stress and inflammatory mediators, contributing validity to the ethnomedicinal benefit of AVSBE in managing inflammatory and pain-related crisis.

Pemanfaatan Gel Ekstrak Kulit Buah Mangga Arumanis (Mangifera indica L.) Sebagai Antiinflamasi Dengan Metode Kantong Granuloma Secara In-Vivo

In previous research, mango rind extract has been studied as an antioxidant, antihypertensive, and antidiabetic, because it contains flavonoids and 17% mangiferin compounds. In this research, the effect of arumanis mango rind extract gel (Mangifera indica L.) as an anti-inflammatory was tested in male white mice induced by carrageenan using the granuloma pouch method. This experimental study used experimental white male mice which were grouped into 5 groups: the control group, the group with 2% mango rinf extract, the group with 4% mango rind extract, the group with 8% mango rind extract, and the comparison group. The parameters that were analyzed were exudate volume, total leukocytes, and type of leukocytes on days 3, 5, 7. The results showed that mango arumanis (Mangifera indica L.) rind extract had anti-inflammatory effectiveness topically as indicated by a decrease in the average exudate volume, total leukocytes, and leukocyte cell types (segmented neutrophil cells and lymphocyte cells) in each concentration group of mango rind extract, based on two-way ANOVA test and Duncan's test showed significant differences with respect to concentration and time (p<0.05). It can be concluded that all gel concentrations of arumanis mango rind extract (Mangifera indica L.) 2%, 4%, and 8% have anti-inflammatory effects.

Comparative study of the antioxidant and anti-inflammatory effects of the natural coumarins 1,2-benzopyrone, umbelliferone and esculetin: in silico, in vitro and in vivo analyses.

The aim of this work was to compare the anti-inflammatory and antioxidant effects of three natural coumarins: 1,2-benzopyrone, umbelliferone and esculetin. The antioxidant capacity of coumarins was evaluated using both chemical and biological in vitro assays. Chemical assays included DPPH and ABTS∙+ radical scavenging as well as ferric ion reducing ability power (FRAP) assay. Inhibition of mitochondrial ROS generation and lipid peroxidation in brain homogenates were used as biological in vitro assays. The experimental method of carrageenan-induced pleurisy in rats was used for the in vivo investigation of the anti-inflammatory activity. In silico molecular docking analysis was undertaken to predict the affinity of COX-2 to the coumarins. Considering the antioxidant capacity, esculetin was the most efficient one as revealed by all employed assays. Particularly, the mitochondrial ROS generation was totally abolished by the compound at low concentrations (IC50 = 0.57μM). As for the anti-inflammatory effects, the COX-2 enzyme presented good affinities to the three coumarins, as revealed by the molecular docking analyses. However, considering the in vivo anti-inflammatory effects, 1,2-benzopyrone was the most efficient one in counteracting pleural inflammation and it potentiated the anti-inflammatory actions of dexamethasone. Umbelliferone and esculetin treatments failed to reduce the volume of pleural exudate. Overall, therefore, our results support the notion that this class of plant secondary metabolites displays promising effects in the prevention and/or treatment of inflammation and other diseases associated with oxidative stress, although the singularities regarding the type of the inflammatory process and pharmacokinetics must be taken into account.

Analgesic and anti-inflammatory investigation of 1,2,4- triazole derivatives in rats

Pain and inflammation are the major devastating health problems commonly treated with NSAIDs. NSAIDs are regularly employed to relieve pain and inflammation. However, the 1,2,4-triazole derivatives have been scientifically evaluated for their use in relieving pain and inflammation. The current research plan is to explore the analgesic and anti-inflammatory properties of 1,2,4-triazole derivatives. 1,2,4-triazoles was tested for their anti-inflammatory properties using carrageenan and formalin-induced paw oedema, acetic acid-induced writhing investigation, while its peripheral and central analgesic actions were assessed using the hot plate method and Carrageenan induced Air Pouch model respectively. The test compounds were administrated at dose of 55 mg/Kg. The standard Diclofenac drug was administrated at dose of 10 mg/Kg for Acetic acid induced writhing investigation, Anti-inflammatory activity and 10 mg/Kg dose of pentazocine was administrated for hot plate method. Rats given with distilled water (10 mL/kg) were designated as the negative controls. Oral administration of all treatments was used. Evaluation of the analgesic and anti-inflammatory investigation showed that the second compound (5-(4-nitrophenyl)-1-phenyl-1H-1,2,4-triazole-3-(2H)–one declines the number of abdominal cramps caused by 1�etic acid and increases the time of response in hot plate method and decreased the edema induced by carrageenan, formalin also decreased volume of exudates in air pouch model. The results of the research indicate that compound 5-(4-nitrophenyl)-1-phenyl-1H-1,2,4-triazole-3-(2H)-one has shown more effective analgesic and Anti-inflammatory properties than the other two compounds.

Anti-inflammatory and antinociceptive activities of Daniellia oliveri (Fabaceace) stem bark extract.

Daniellia oliveri (Rolfe) Hutch. & Dalziel (Fabaceae) is used for the treatment of inflammatory diseases and pains (chest pain, toothache and lumbago) and rheumatism. The study investigates the anti-inflammatory and antinociceptive properties of D. oliveri and possible mechanism of antiinflammatory action. Acute toxicity of the extract was evaluated in mice using the limit test. The anti-inflammatory activity was assessed in xylene-induced paw oedema and carrageenan-induced air-pouch models at doses of 50, 100 and 200mg/kg, p.o. Volume of exudate, total protein, leukocyte counts, myeloperoxidase (MPO) and concentration of cytokines (TNF-α and IL-6) were measured in the exudate of rats in the carrageenan-induced air-pouch model. Other parameters include lipid peroxidation (LPO), nitric oxide (NO) and antioxidant indices (SOD, CAT and GSH). Histopathology of the air pouch tissue was also carried out. The antinociceptive effect was assessed using acetic acid-induced writhing, tail flick and formalin tests. Locomotor activity was done in the open field test. The extract was analysed with HPLC-DAD-UV technique. The extract showed significant anti-inflammatory effect (73.68 and 75.79%, inhibition) in xylene-induced ear oedema test at the dose of 100 and 200mg/kg, respectively. In carrageenan air pouch model, the extract significantly reduced exudate volume, protein concentration, the migration of leukocytes and MPO production in the exudate. The concentrations of cytokines TNF-α (12.25±1.80pg/mL) and IL-6 (21.12pg/mL) in the exudate at the dose of 200mg/kg were reduced compared to carrageenan alone group (48.15±4.50pg/mL; 82.62pg/mL) respectively. The extract showed significant increase in the activities of CAT and SOD and GSH concentration. The histopathological assessment of the pouch lining revealed reduction of immuno-inflammatory cell influx. Nociception was significantly inhibited by the extract in acetic acid-induced writhing model and the second phase of formalin test indicating a peripheral mechanism of action. The open field test showed that D. oliveri did not alter locomotor activity. The acute toxicity study did not cause mortality or signs of toxicity at 2000mg/kg, p.o. We identified and quantified caffeic acid, p-coumaric acid, ferulic acid, rutin, apigenin-7-glucoside, quercetin and kaempferol in the extract. The results of our study showed that the stem bark extract of D. oliveri possesses anti-inflammatory and antinociceptive activities thereby supporting its traditional use in the treatment of some inflammatory and painful disorders.

Poly(vinyl alcohol)-gelatin crosslinked by silane-functionalized guanidyl-hydroxyurethane oligomer as contact-killing non-leaching antibacterial wound dressings

The present work aims to prepare efficient wound dressing with noncytotoxicity, proper mechanical strength, and the ability to preserve a hygienic environment over wounded skin tissue. To fulfill this goal, the synthesis of a novel silane crosslinking agent with antibacterial guanidinium chloride functional group is considered. The resulting reagent was applied to make a series of film-type stable crosslinked networks composed of poly(vinyl alcohol) and gelatin. The potential protection of wounds from external forces was confirmed, as these films had a very good tensile strength (16–31 MPa) and good elongation (54%–101%) under dry conditions. The good dimensional strength of dressings was preserved after hydration with simulated wound exudates. Based on the calculated fluid handling capacity of the prepared dressings (2.43–3.54 g 10−1 cm−2 d−1), they were suitable for treating wounds with ‘light’ to ‘moderate’ exudate volume. All the prepared dressings showed very good biocompatibility, as determined by the high viability of fibroblast cells directly contacted with dressing (over 80%) or leachates extracted from them (over 90%). In addition, dressings functionalized with guanidinium groups could effectively kill representative gram-positive and gram-negative bacterial strains.

The clinical application effects of artificial dermis scaffold and autologous split-thickness skin composite grafts combined with vacuum-assisted closure in refractory wounds.

To investigate the clinical application effects of artificial dermis scaffold and autologous split-thickness skin composite grafts combined with vacuum-assisted closure (V.A.C) in refractory wounds. A retrospective analysis was performed on 70 patients with refractory wounds admitted to the First Affiliated Hospital of Soochow University from June 2019 to December 2021 (44 males and 25 females, with an average age of 49.3 ± 21.4 years). There were 26 patients with chronic ulcers; 3 patients with cancerous wounds; 16 patients with hot crush injuries; and 25 patients with traumatic wounds, including 21 cases of hands, 33 cases of feet, 6 cases of upper limbs, and 10 cases of lower limbs. The patients were divided into an artificial dermis scaffold group (35 patients, including 21 males and 14 females, aged 49.5 ± 21.3 years) and a skin graft group (35 patients, including 23 males and 11 females, aged 49.1 ± 21.5 years). In the artificial dermis scaffold group, after debridement, the artificial dermis scaffold was transplanted for approximately 2 weeks until the wound surface was well vascularized, after which the autologous split-thick skin graft was transplanted. Negative pressure wound therapy was performed throughout the treatment. In the skin grafting group, after debridement, the autologous split-thickness skin graft (aSTSG) was transplanted, and negative pressure wound therapy was performed continuously. The wound healing rate; skin graft survival rate; postoperative wound infection; exudative fluid volume; subcutaneous haematoma; hospitalisation time; hospitalisation cost; Vancouver Scar Scale (VSS) score, used to evaluate the scar of the recipient area at 6months after the operation; and the sensory disorder grading method, used to evaluate the sensory recovery of the recipient area, were compared between the two groups. All 70 refractory wounds healed. In the artificial dermis scaffold group, the skin graft survival rate was 90% (86%-95%), the hospitalisation time was 38 (29-45) days, the hospitalisation cost was 148 102 (118242-192327) yuan, and the VSS score was 1.9 ± 1.3. There were significant differences in skin graft survival rate (70% [60%-80%]), length of hospital stay (21 [14-28] days), hospitalisation cost (76 201 [39228-135 919] yuan) and VSS score [6.1 ± 3.6] between the skin graft group and the artificial dermis scaffold group (P < .05). The skin graft survival rate, scar hyperplasia and sensory recovery of the recipient area in the artificial dermis scaffold group were better than those in the skin graft group, but the hospitalisation time was relatively longer, and the hospitalisation cost was relatively higher. Wound healing rate, postoperative wound infection, exudate volume, and subcutaneous haematoma of patients in the two groups were similar, and there were no significant differences (P > .05). The artificial dermis scaffold and composite transplantation of autologous aSTSG with V.A.C can promote painless wound healing and improve the skin survival rate, skin colour and lustre, and flexible smooth texture and is conducive to less scar hyperplasia and postoperative functional exercise and recovery. This method provides a reasonable and effective scheme for the treatment of clinical refractory wounds.

Isolation of a Flavone Apigenin and a Steroids Squalene from Peronema canescens Jack Leaves with Anti-Inflammatory Activities

The leaves of the P. canescens are ethnobotanically used by the community as a remedy for bruises and fever. This study aims to isolate both of ethanol and n-hexane fractions of P. canescens Jack leaves. Isolate then characterized and determined their anti-inflammatory activity with male white mice. Anti- Inflammatory was determined by the volume of exudate and % inflammation inhibition. The isolates with good anti-inflammatory activity were characterized using UV-Vis and IR spectrophotometry. Our findings showed that the ethanolic (F1) and n-hexane (F2) fractions of P. canescens extract had a good anti-inflammatory activity with percent inhibition values of 58.12% and 56.59%, respectively. The characterization results showed that isolate F1 was a flavonoid group, Apigenin compound, while isolate F2 was a steroid group, Squalene compound.

Anti-Inflammatory Effect of Dendrobium Huoshanense Polysaccharides on Carrageenan-Induced Air Pouch Synovitis in Mice

Objective: The purpose was to observe the anti-inflammatory effects of Dendrobium huoshanense polysaccharides (DHPs) on carrageenan-induced sterile air pouch synovitis. Materials and Methods: A total of 30 Institute of Cancer Research (ICR) mice were randomly and equally assigned to the control, carrageenan-induced air pouch synovitis model (model), and carrageenan-induced air pouch synovitis model + DHP (200 mg/kg of body weight) (model + DHP) groups. Mice in the model + DHP group were intragastrically administered 200 mg/kg BW of DHP solution daily for 10 days. Mice in the control and model groups were intragastrically administered the same amount of distilled water. Two hours after intragastric administration on day 10, 1 mL of a 1% carrageenan solution in a sterile 0.9% saline solution was injected into the air pouch of mice in the model and model + DHP groups. Six hours later, the mice were sacrificed and 4 mL of ice-cold sterile 0.9% saline solution was injected into the air pouch to fully wash its inner wall. The lavage fluid was collected to observe the color and turbidity of the lavage fluid, as well as the appearance of the backside of the air pouch. The exudate volume, total number of leukocytes, protein content, levels of malondialdehyde (MDA), interleukin-1b (IL-1β), and tumor necrosis factor-alpha (TNF-α), and total superoxide dismutase (T-SOD) activity of the lavage fluid were analyzed. Results: The results showed that pretreatment with DHPs reduced the carrageenan-induced exudate volume (P &lt; 0.01), total leukocytes (P &lt; 0.05), and protein content (P &lt; 0.01) in the air pouch lavage fluid. Furthermore, mice in the model + DHP group had significantly higher (P &lt; 0.01) T-SOD activity and lower MDA content (P &lt; 0.05), IL-1β (P &lt; 0.05), and TNF-α (P &lt; 0.01) levels in the air pouch lavage fluid compared with the model group. Conclusion: It is concluded that DHPs partially alleviated carrageenan-induced sterile inflammation, and its mechanism may be related to reducing exudation and scavenging oxygen-free radicals, inhibiting lipid peroxidation, and reducing the level of the proinflammatory factors, such as IL-1β and TNF-α.

The role of ipsilateral mediastinal lymph node dissection in treatment of patients with non-small-cell lung cancer

Background. Lung cancer occupies the leading place in the structure of cancer incidence and death rate. Treatment results are still not satisfactory. Five-year postsurgical survival rate is 24–30%. Patients die in different periods of time from local recurrences and distant metastases. To this day, there is no unambiguous attitude towards ipsilateral mediastinal lymph node dissection in surgical treatment of patients with lung cancer. Despite the oncologic relevance of the abovementioned lymph node dissection, there are still concerns on worsening of recovery conditions of bronchial stump, increase in the amount of lymphorrhea and additional injury rate of the surgery. There is also an opinion that the risk of development of postsurgical complications, and, as a result, the increase in lethality rate, outweigh the positive impact of ipsilateral mediastinal lymph node dissection on radicality and long-term treatment results.&#x0D; Purpose – to study the impact of ipsilateral mediastinal lymph node dissection on the course of postsurgical period in patients with lung cancer, clarifying diagnostics of spread of tumor process and survival rate of the patients.&#x0D; Materials and methods. Treatment results of 187 patients with non-small-cell lung cancer with different clinical stages from T1-3N0 M0 to T1-2N1 M0 were analyzed. The patients were divided into two groups: the first group (comparison group) consisted of 72 patients, who underwent radical operations with selective lymph node dissection. The patients of the second group, the study group (115 patients), obligatorily underwent ipsilateral mediastinal lymph node dissection. The number of removed lymph nodes in one patient ranged from 5 to 10 in the first group and from 18 to 25 in the second one. In the cases when no cancer cells were found in lymph nodes, they were managed with monoclonal antibodies to cytokeratins, expressed with cancer cells, with further microscopic evaluation. During the postsurgical period the following values were studied: duration of the surgery, the volume of intraoperative blood loss, the amount and duration of exudation, frequency and character of postsurgical complications. Comparison of survival rates of the patients was performed with the test of statistical significance of differences by χ2 criterion. Methods of non-parametric statistical estimate were used for statistical analysis of the results by the means of Statistica 6.0, SPSS 17.0 software.&#x0D; Results. Adding ipsilateral mediastinal lymph node dissection to surgical interference increased its duration by 30 minutes on average. An increase in the volume of exudate by 136,2 ± 18,4 ml was observed in early postsurgical period. Structure and frequency of postsurgical complications in both groups was similar. In most cases heart rhythm disorder, namely ciliary arrhythmia, was observed in the first days after the surgery. Postsurgical lethality rate in both groups was caused by various factors and equaled 1,4% in the first, and 0,8% in the second one. Additional usage of immunohistochemicalanalysis of lymph nodes with monoclonal antibodies to tumoral cytokeratins in patients after performing ipsilateral mediastinal lymph node dissection led to their lesion being found more frequently. Indeed, metastases were detected in 21% of 19 patients, in which N0 status was previously established in light microscopy. Also, a significant increase in three-year survival rate by 15,3% (p=0,042) was observed in patients with lung cancer, who underwent ipsilateral mediastinal lymph node dissection and had no signs of mediastinal lymph nodes lesion, and 23,2% (p=0,014) in patients with the signs of the lesion.&#x0D; Conclusions. Performing ipsilateral mediastinal lymph node dissection in patients with lung cancer during surgical interference does not have an impact on postsurgical lethality rate and frequency and structure of complications. During the study of lymph nodes, which, according to light microscopy, were considered unaffected by cancer, additional lymphogland metastases were found in 20,7% of the patients by the means of monoclonal antibodies to cytokeratins. It allows the stage of the disease to be more accurately determined and optimal type of adjuvant therapy to be chosen. Detection rate of metastases in regional lymph nodes significantly increases from 51,4% to 67,8% in patients with lung cancer after radical operations with additional ipsilateral mediastinal lymph node dissection. Obligatory ipsilateral mediastinal lymph node dissection in surgeries for lung cancer increases overall three-year survival rate, especially in patients with affected lymph nodes by 16,3%.

Clinical application of traditional Chinese medicine powder in the treatment of acute and chronic wounds.

This study aimed to explore the clinical application and efficacy of traditional Chinese medicine (TCM) powder in the treatment of acute and chronic wounds. Eighty patients with a wound infection were randomly and equally divided into a control group and an observation group. Gauze padding containing furacilin was used to dress the infected wounds of the control group. TCM powder was used to treat the wounds of the observation group. The total response rate of the observation group was significantly higher than the control group (P= .017). The colour and exudate volume scores in the observation group were lower than the control group, and the differences between the two groups were statistically significant (P< .05). The time to the appearance of new epithelium and time to the wound healing of the burns in the observation group were shorter than the control group, and the differences were statistically significant (P< .05). The TCM powder absorbed a large amount of necrotic tissue and exudate from the wound surface, cleared heat and toxins, and activated blood circulation. It also resolved blood stasis, eliminated pus, and allowed for new skin growth, as well as regenerating muscle.

Health-related quality of life predictors in people with chronic wounds

ObjectiveTo assess health-related quality of life and its predictors among people with chronic wounds. Material and methodsA cross-sectional, analytical study was conducted with 85 people with chronic wounds, from July to September 2019, at a university hospital in the state of Paraíba, Brazil. Data were collected using forms and the Cardiff Wound Impact Schedule (CWIS). For data analysis, multiple linear regression was performed. ResultsThe mean quality of life score according to the CWIS was 45.57. The variables gender, marital status, comorbidities, duration of injury and appearance of exudate were negatively associated with the well-being domain. Injury duration, tissue depth, tissue type, and exudate volume were variables negatively associated with physical symptoms and mastery of daily living. Religion, wound origin, duration, lesion size, and tissue depth were negatively associated with the social life domain. ConclusionSociodemographic characteristics and wound-related aspects need to be considered when assessing and caring for patients with chronic wounds to ensure a better quality of life.

A novel gedunin-2-hydroxypropyl-β-cyclodextrin inclusion complex improves anti-nociceptive and anti-inflammatory activities of gedunin in rodents.

Gedunin is a bioactive compound, obtained from Entandrophragma angolense (EA), which has limited therapeutic usefulness due to poor aqueous solubility and first-pass effects. Cyclodextrins are cyclic oligosaccharides that form complexes with poorly soluble compounds, thus enhancing their pharmacological activity. In this article, we evaluated the pharmacological activities of gedunin-2-hydroxypropyl-β-cyclodextrin complex (GCD) in rodents. The antinociceptive activity of GCD (50, 100, 200 mg/kg) and Gedunin (50mg/kg) was tested in acetic acid-induced writhing and formalin-induced paw licking in mice. The anti-inflammatory activity was investigated in carrageenan-induced paw oedema and air pouch inflammation models in rats. Leucocytes counts, Tumour Necrosis Factor-alpha (TNF-α) level, nitric oxide, malondialdehyde, reduced glutathione, and myeloperoxidase enzyme activities were assessed in the air pouch exudate. The GCD (200mg/kg) significantly decreased writhing response, reduced licking duration and decreased oedema compared with gedunin and control. Exudate volume and leucocyte count were significantly reduced by GCD (200 mg/kg), it decreased myeloperoxidase activity and inhibited TNF-α release. The carrageenan-induced GSH depletion, increased malondialdehyde and nitrite levels were significantly reversed by GCD (200 mg/kg) relative to gedunin and control. The GCD complex demonstrated significant antinociceptive and anti-inflammatory activities relative to gedunin alone via mechanisms associated with inhibition of oxidative stress and inflammation in rodents.

Efficacy of Freeze-Dried Amnion Grafts on Cytokines in Uterine Exudates Following Hysteroscopic Adhesiolysis of Severe Intrauterine Adhesions.

BackgroundIntrauterine adhesions (IUAs) are a benign uterine disorder that results in intrauterine adhesions and scarring. This study was conducted to assess the effects of freeze-dried amnion grafts on the concentrations of adhesion-related cytokines in uterine exudates following hysteroscopic adhesiolysis of IUAs.Materials and MethodsThis study was a prospective randomized controlled trial. Thirty patients who underwent hysteroscopic adhesiolysis for severe IUAs were enrolled. They were randomly divided into a study group (with freeze-dried amnion graft treatment after surgery, N = 15) and a control group (without a graft, N = 15). After complete separation of adhesions, a Foley balloon containing a freeze-dried amnion graft was inserted into the uterine cavity in the study group, while a Foley balloon with no graft was placed in the control group. Enzyme-linked immunosorbent assays were performed to test adhesion-related cytokine concentrations in uterine exudates, including IL-1β, TNF-α, and VEGF, at different time intervals after surgery. Second-look hysteroscopy was conducted three months after the surgery. On the basis of the American Fertility Society (AFS) scoring system, the level of adhesions was evaluated during hysteroscopy.ResultsThe postoperative volume of the uterine exudates in the study group was significantly lower than that of the control group (P < 0.05). The adhesion-related cytokine concentrations of TNF-α, VEGF, and IL-1β significantly increased after surgery in both groups. Their concentrations were significantly lower in the study group than in the control group (P < 0.05). Moreover, IL-1β exhibited a long-lasting effect in the study group. AFS scores and readhesion rates were significantly lower in the study group than in the control group after hysteroscopic adhesiolysis of severe IUAs.ConclusionThe application of freeze-dried amnion grafts is beneficial to the postoperative recovery of patients with severe IUAs and may reduce the readhesion rate after hysteroscopic adhesiolysis by lowering adhesion-related cytokines, including TNF-α, VEGF, and IL-1β.

The effect of fibrin glue on the quantity of drainage after thyroidectomy: a randomized controlled pilot trial.

PurposeA seroma is a collection of exudates after surgical trauma in wound healing. Fibrin glue is used to prevent seroma by reducing the generation of exudate. However, the impact of fibrin glue on the prevention of seroma remains debatable. Therefore, we conducted a randomized controlled pilot trial to investigate the effect of the amount of fibrin glue used on the generation of exudate after thyroidectomy and the sample size of future definitive trials.MethodsBetween February and December 2020, 41 patients were enrolled; 21 patients in the low fibrin group and 20 in the high fibrin group. Stratified randomization was performed based on sex, body mass index, and thyroiditis. All patients underwent total thyroidectomy and bilateral central compartment dissection. In the low and high fibrin groups, 2 mL and 6 mL of fibrin glue were applied to patients, respectively.ResultsBoth the total drain volume and flow rate during the first 12 hours were lower in the high fibrin group than in the low fibrin group (65.0 mL vs. 47.6 mL, P = 0.008 and 2.7 mL/hr vs. 1.8 mL/hr, P = 0.002, respectively). The calculated sample size for future randomized controlled trial was 32 patients (α = 0.05, power = 0.8), and the power of this trial was 0.91 with µ1 = 2.7, µ2 = 1.8, σ = 0.9, and α = 0.05 (µ = mean, σ = standard deviation).ConclusionSix milliliters of fibrin glue could reduce total drain volume and flow rate of exudate after thyroidectomy. Therefore, applying an appropriate amount of fibrin glue after thyroidectomy may reduce postoperative seroma.