[Objective]To observe the effect of vacuum sealing drainage(VSD) on bacteria and microcirculation of acute explosion wounds in pigs.[Method]Twelve blast wounds,created by explosion of a specific type of electric detonations which were fixed at 1 cm over the skin of the hips of six Lanzhou healthy pigs(30-40 kg),were divided into two matched groups.Debridement was performed at 6 hours after injury.Group A was treated with conventional dressing change,and group B was treated with VSD under the pressure of-20kPa.Tissue specimens collected from different sites of the wound bed before and at 12,24,48,72 hours after treatment,and experienced bacteria counting.The microcirculation of the blast wounds was examined by color B-mode ultrasonic diagnostic equipment before and 72hours after treatment.[Result]The difference of wound bacteria loads between group A and group B was statistically signficant at different time points.Bacteria loads in group B were increased to 105cfu/g at 48 h after treatment,compared with group A at 24 h.No signal of blood flow in blast wound was found before treatment.In contract,the blast wound had plenty of signals of blood flow in group B.[Conclusion]VSD could reduce the bacteria loads,and delay the time of infection.Meanwhile it improved the microcirculation of the acute blast wound.

Objective To analyze the clinical effects of bronchoscope combined with hot and cold ablation in treatment of benign and malignant tumors in primary tracheal and bronchial. Methods From January 2013 to November 2015, 30 cases of pathological types of primary tracheal / bronchial benign and malignant tumors patients include: 8 cases of hamartoma, 1 case of lipoma, 4 cases of granuloma, 1case of clear cell carcinoma, 7 cases of small cell lung cancer, 9 cases of squamous cell carcinoma, were treated by using carbon dioxide cryotherapy combined hot ablation under bronchoscope. Then investigated the outcomes. Results 30 patients, 22 males, 8 females, suffered from 1 month to 2 years, underwent surgery bronchoscope interventional treatment under local anesthesia combined with intravenous anesthesia, are taking joint cold ablation technique. All patients airway is completely opened, the lifting of the airway obstruction. Including 19 cases of disposable surgical removal of the lesion; 8 cases of lesions due to wide distribution, 2 times surgery; three cases three times surgery, no serious complications, follow-up without recurrence, blood gas analysis and dyspnea index were significantly improved. Conclusion Bronchoscope cold joint ablation techniques in the treatment of primary tracheal, bronchial benign and malignant tumors is effective, simple, minimally invasive and safe.

Periodontitis is a critical risk factor for the occurrence and development of diabetes.Porphyromonas gingivalis may participate in insulin resistance(IR)caused by periodontal inflammation,but the functional role and specific mechanisms of P.gingivalis in IR remain unclear.In the present study,clinical samples were analysed to determine the statistical correlation between P.gingivalis and IR occurrence.Through culturing of hepatocytes,myocytes,and adipocytes,and feeding mice P.gingivalis orally,the functional correlation between P.gingivalis and IR occurrence was further studied both in vitro and in vivo.Clinical data suggested that the amount of P.gingivalis isolated was correlated with the Homeostatic Model Assessment for IR score.In vitro studies suggested that coculture with P.gingivalis decreased glucose uptake and insulin receptor(INSR)protein expression in hepatocytes,myocytes,and adipocytes.Mice fed P.gingivalis tended to undergo IR.P.gingivalis was detectable in the liver,skeletal muscle,and adipose tissue of experimental mice.The distribution sites of gingipain coincided with the downregulation of INSR.Gingipain proteolysed the functional insulin-binding region of INSR.Coculture with P.gingivalis significantly decreased the INSR-insulin binding ability.Knocking out gingipain from P.gingivalis alleviated the negative effects of P.gingivalis on IR in vivo.Taken together,these findings indicate that distantly migrated P.gingivalis may directly proteolytically degrade INSR through gingipain,thereby leading to IR.The results provide a new strategy for preventing diabetes by targeting periodontal pathogens and provide new ideas for exploring novel mechanisms by which periodontal inflammation affects the systemic metabolic state.