1.Magnesium sulfate use in adult patients with tetanus at Mariano Marcos Memorial Hospital & Medical Center
Stephen A. Ujano ; Guillermo L. Manalo III
Philippine Journal of Internal Medicine 2025;63(3):122-126
OBJECTIVE
This study aimed to determine whether adjunctive therapy with magnesium sulfate is more effective than diazepam alone in reducing mortality and morbidity rates among adult patients with tetanus admitted to Mariano Marcos Memorial Hospital and Medical Center (MMMH & MC) from January 1, 2012, to January 1, 2022.
METHODSRetrospective cohort study using chart review and descriptive statistics. included patients admitted at East Avenue Medical Center for DFU. The primary endpoint was major amputation of the lower extremities. Data were analyzed using Receiver Operating Characteristic (ROC) analysis and logistic regression.
RESULTSA total of 51 patients were included in the study, with 17 patients in the adjunct magnesium sulfate group and 34 patients in the diazepam group. Based on the results of this study, at a 95% confidence interval, ICU stay was significantly longer in the magnesium sulfate group compared to the diazepam group, along with an increased average hospital stay. There was no significant difference in patient mortality in terms of treatment, age, severity, ICU stay, or duration of mechanical ventilation.
CONCLUSIONThe use of magnesium sulfate as an adjunct treatment for tetanus is not superior to standard stand-alone diazepam, regardless of severity. Magnesium sulfate use is associated with a longer overall hospital stay. Lastly, hospital-acquired pneumonia and aspiration pneumonia significantly increase the risk of mortality among patients with tetanus, regardless of age, treatment, or severity.
Human ; Tetanus ; Magnesium Sulfate ; Diazepam
2.Short-term effectiveness of transverse antecubital incision for failed closed reduction of Gartland type Ⅲ supracondylar humerus fractures in children.
Yinshuan DENG ; Jing BAI ; Rui LIU ; Zhaoming DA ; Weishun YAN ; Zhen CHEN ; Shuo LI ; Tao QU ; Weimin NIU ; Binbin GUO ; Zhiyun YANG ; Guohai LI ; Guoxin NAN
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(5):566-571
OBJECTIVE:
To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children.
METHODS:
Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria.
RESULTS:
All incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up ( P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up ( P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up ( P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%.
CONCLUSION
The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.
Male
;
Female
;
Humans
;
Child
;
Child, Preschool
;
Calcium Sulfate
;
Humerus
;
Humeral Fractures/surgery*
;
Plastic Surgery Procedures
;
Fracture Fixation, Internal/methods*
;
Bone Wires
;
Fracture Healing
;
Treatment Outcome
;
Range of Motion, Articular
3.Effect of acrylic bone cement mixed with calcium sulfate combined with percutaneous kyphoplasty in the treatment of osteoporotic fractures.
Yang FU ; Ying-Chao YAN ; Xuan-Liang RU ; Hang-Bo QU
China Journal of Orthopaedics and Traumatology 2023;36(9):896-900
OBJECTIVE:
To investigate the clinical efficacy of acrylic cement (PMMA) mixed with calcium sulfate combined with percutaneous kyphoplasty (PKP) in the treatment of osteoporotic fracture (OVCF).
METHODS:
The clinical data of 191 patients with OVCF treated with PKP from January 2020 to March 2021 were retrospectively analyzed. Among them, 82 patients with 94 vertebral bodies were treated with PMMA mixed with calcium sulfate as the observation group, and 109 patients with 125 vertebral bodies were treated with pure PMMA as the control group. Among the 82 patients in the observation group, there were 16 males and 66 females, with a mean age of (75.35±11.22) years old, including 36 thoracic vertebrae and 58 lumbar vertebrae. In the control group, there were 109 patients, 22 males and 87 females, with an average age of (74.51±9.21) years old, including 63 thoracic vertebrae and 62 lumbar vertebrae. The visual analog scale (VAS) before operation and 1 day, 3 months and 1 year after operation were calculated. The Oswestry disability index (ODI), Cobb's angle, vertebral body height and the probability of postoperative bone cement leakage were used to analyze the efficacy of the two groups.
RESULTS:
All the patients were followed up for more than one year. Compared with the control group, there was no significant difference in operation time, bleeding volume and bone cement injection volume between the two groups(P>0.05), while the leakage rate of bone cement was significantly lower in the observation group (P<0.05). In addition, there was no significant difference in VAS, ODI, Cobb angle, and vertebral body height between the two groups before operation, and 1 day, 3 months, and 1 year after operation (P>0.05), but each index was improved compared with that before operation (P<0.05).
CONCLUSION
PMMA mixed with calcium sulfate has equivalent efficacy in treating OVCF than PMMA alone, but can effectively reduce the probability of cement leakage.
Female
;
Male
;
Humans
;
Aged
;
Aged, 80 and over
;
Middle Aged
;
Polymethyl Methacrylate
;
Calcium Sulfate/therapeutic use*
;
Osteoporotic Fractures/surgery*
;
Bone Cements/therapeutic use*
;
Kyphoplasty
;
Retrospective Studies
;
Lumbar Vertebrae/surgery*
4.Fucoidan sulfate from Sargassum fusiforme regulates the SARS-CoV-2 receptor AXL expression in human embryonic lung diploid fibroblast cells.
Xuqiang ZHOU ; Weihua JIN ; Di JIANG ; Yipeng XU ; Sanying WANG ; Xinna WU ; Yunchuang CHANG ; Huili SU ; Tianjun ZHU ; Xiaogang XU ; Genxiang MAO
Journal of Zhejiang University. Science. B 2023;24(11):1047-1052
新冠病毒感染疫情严重威胁着世界各国人民的生命健康。目前,对病毒感染的防治研究主要集中在抑制病毒与分子受体的结合上。AXL作为新发现的严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)受体,在协助病毒感染人体呼吸系统中发挥着重要作用,是未来临床干预的潜在靶点。本研究对已发表的单细胞测序数据进行整理和分析,发现AXL在年轻人肺细胞中的表达水平明显高于老年人。人胚肺二倍体成纤维细胞(2BS)是衰老研究的公认细胞株。本文采用2BS细胞构建复制性细胞衰老模型,发现年轻细胞中AXL的蛋白水平明显高于衰老细胞,据此推测年轻人感染的风险可能更高,需要注意防护。我们发现一种羊栖菜褐藻多糖硫酸酯组分(SFW-3)可显著下调年轻2BS细胞中AXL的表达水平,表明SFW-3具有一定的抗SARS-CoV-2感染的研究价值,同时表明2BS细胞株也可作为潜在的SARS-CoV-2体外感染模型。
Humans
;
SARS-CoV-2
;
Sargassum/metabolism*
;
Diploidy
;
Sulfates/metabolism*
;
COVID-19
;
Polysaccharides/pharmacology*
;
Lung
5.Montanide ISA-720 and Naloxone in HBsAg Vaccine Formulation: Cytokine Profiling and Monitoring of Long-Lasting Humoral Immune Responses.
Mina MIRZAEE ; Setareh HAGHIGHAT ; Bahareh GOLKARAN ; Fatemeh ASGARHALVAEI ; Rayhaneh MIRZAEE ; Morteza TAGHIZADEH ; Mohammad Ali SAVOJI ; Behzad ESFANDIARI ; Mehdi MAHDAVI
Biomedical and Environmental Sciences 2022;35(9):792-803
OBJECTIVE:
This study aimed to investigate the effects of Montanide ISA-720 and Naloxone (NLX) in Hepatitis B surface antigen (HBsAg) vaccine formulation on cytokine and long-lasting antibody responses.
METHODS:
First, the HBsAg was formulated in Montanide ISA-720 adjuvant and Naloxone at 5 and 10 mg/kg. The experimental mice were immunized three times at a 2-week interval, and then IL-4, IL-2, TNF-α, and IFN-γ cytokines; long-lasting IgG antibody responses 220 days after the last shot; and IgG1/IgG2a isotypes were assessed by ELISA.
RESULTS:
The HBsAg-Alum group exhibited the highest IL-4 cytokine response among the experimental groups, whereas NLX in HBsAg-MON720 vaccine formulation did not affect cytokine responses. In addition, NLX in Alum-based vaccine suppressed IL-4 cytokine response and increased the IL-2/IL-4 cytokine ratio. Moreover, HBsAg-MON720 was more potent than HBsAg-Alum in the induction of antibody responses, and NLX in Alum- and MON720-based vaccines induced long-lasting antibody responses.
CONCLUSION
NLX in Alum-based vaccine decreased IL-4 cytokine response, increased IL-2/IL-4 cytokine ratio, and improved long-lasting humoral immune responses in both vaccine formulations. Therefore, the adjuvant activity of NLX in the vaccine formulation depends on the type of adjuvant and the nature of the antigen in the vaccine formulation.
Adjuvants, Immunologic/pharmacology*
;
Alum Compounds
;
Animals
;
Cytokines
;
Hepatitis B Surface Antigens
;
Hepatitis B Vaccines
;
Immunity, Humoral
;
Immunoglobulin G
;
Interleukin-2
;
Interleukin-4
;
Mice
;
Mice, Inbred BALB C
;
Mineral Oil
;
Naloxone/pharmacology*
;
Tumor Necrosis Factor-alpha
6.Medication law and mechanism of traditional Chinese medicine in prevention and treatment of epidemic diseases: based on traditional Chinese medicine theory of cold pestilence.
Ze-Yu LI ; Er-Wei HAO ; Rui CAO ; Si LIN ; Shu-Ying CHEN ; Xian-Ting HUANG ; Wan-Ru XU ; Xiao-Tao HOU ; Jia-Gang DENG
China Journal of Chinese Materia Medica 2022;47(17):4765-4777
Epidemic diseases have caused huge harm to the society. Traditional Chinese medicine(TCM) has made great contributions to the prevention and treatment of them. It is of great reference value for fighting diseases and developing drugs to explore the medication law and mechanism of TCM under TCM theory. In this study, the relationship between the TCM theory of cold pestilence and modern epidemic diseases was investigated. Particularly, the the relationship of coronavirus disease 2019(COVID-19), severe acute respiratory syndrome(SARS), and influenza A(H1 N1) with the cold pestilence was identified and analyzed. The roles of TCM theory of cold pestilence in preventing and treating modern epidemic diseases were discussed. Then, through data mining and textual research, prescriptions for the treatment of cold pestilence were collected from major databases and relevant ancient books, and their medication laws were examined through analysis of high-frequency medicinals and medicinal pairs, association rules analysis, and cluster analysis. For example, the prescriptions with high confidence levels were identified: "Glycyrrhizae Radix et Rhizoma-Bupleuri Radix-Paeoniae Radix Alba" "Glycyrrhizae Radix et Rhizoma-Pinelliae Rhizoma-Bupleuri Radix", and TCM treatment methods with them were analyzed by clustering analysis to yield the medicinal combinations: "Zingiberis Rhizoma-Aconiti Lateralis Radix Praeparata-Ginseng Radix et Rhizoma" "Poria-Atractylodis Macrocephalae Rhizoma" "Cinnamomi Ramulus-Asari Radix et Rhizoma" "Citri Reticulatae Pericarpium-Perillae Folium" "Pinelliae Rhizoma-Magnoliae Officinalis Cortex-Atractylodis Rhizoma" "Paeoniae Radix Alba-Angelicae Sinensis Radix-Glycyrrhizae Radix et Rhizoma-Bupleuri Radix-Scutellariae Radix-Rhizoma Zingiberis Recens" "Ephedrae Herba-Armeniacae Semen Amarum-Gypsum Fibrosum" "Chuanxiong Rhizoma-Notopterygii Rhizoma et Radix-Angelicae Dahuricae Radix-Platycodonis Radix-Saposhnikoviae Radix". Then, according to the medication law for cold pestilence, the antiviral active components of medium-frequency and high-frequency medicinals were retrieved. It was found that these components exerted the antiviral effect by inhibiting virus replication, regulating virus proteins and antiviral signals, and suppressing protease activity. Based on network pharmacology, the mechanisms of the medicinals against severe acute respiratory syndrome coronavirus(SARS-CoV), 2019 novel coronavirus(2019-nCoV), and H1 N1 virus were explored. It was determined that the key targets were tumor necrosis factor(TNF), endothelial growth factor A(VEGFA), serum creatinine(SRC), epidermal growth factor receptor(EGFR), matrix metalloproteinase 9(MMP9), mitogen-activated protein kinase 14(MAPK14), and prostaglandin-endoperoxide synthase 2(PTGS2), which were involved the mitogen-activated protein kinase(MAPK) pathway, advanced glycation end-products(AGE)-receptor for AGE(RAGE) pathway, COVID-19 pathway, and mTOR pathway. This paper elucidated the medication law and mechanism of TCM for the prevention and treatment of epidemic diseases under the guidance of TCM theory of cold pestilence, in order to build a bridge between the theory and modern epidemic diseases and provide reference TCM methods for the prevention and treatment of modern epidemic diseases and ideas for the application of data mining to TCM treatment of modern diseases.
Aconitum
;
Antiviral Agents
;
COVID-19/epidemiology*
;
Calcium Sulfate
;
Communicable Disease Control
;
Communicable Diseases/virology*
;
Creatinine
;
Cyclooxygenase 2
;
Drugs, Chinese Herbal/therapeutic use*
;
Endothelial Growth Factors
;
Epidemics/prevention & control*
;
ErbB Receptors
;
Humans
;
Matrix Metalloproteinase 9
;
Medicine, Chinese Traditional
;
Mitogen-Activated Protein Kinase 14
;
Pinellia
;
SARS-CoV-2
;
TOR Serine-Threonine Kinases
;
Tumor Necrosis Factors
;
COVID-19 Drug Treatment
7.Detection of chondroitin sulfate in Cervi Cornu Pantotrichum and Cervi Cornu of different specifications and its application in quality evaluation.
Yu-Shun LU ; Yan-Ting ZHANG ; Zhi-Man LI ; Jian-Bo CHEN ; Xiao-Hui HUO ; Di QU ; Yin-Shi SUN
China Journal of Chinese Materia Medica 2022;47(19):5203-5208
The present study comprehensively compared the content of chondroitin sulfate in Cervi Cornu Pantotrichum(CCP) and Cervi Cornu(CC) of different specifications and explored the feasibility of chondroitin sulfate as an indicator to distinguish between CCP and CC. Twenty-two batches of CCP of different specifications(two-branched velvet antler and three-branched velvet antler) from 15 habitats, CC from 6 habitats, and 60 batches of CCP slices prepared from different parts(wax slices, powder slices, gauze slices, and bone slices) were collected. High-performance liquid chromatography(HPLC) was used to determine chondroitin sulfate content in CCP and CC of different specifications. Cluster analysis was used to classify CCP slices of different specifications. The results showed that CCP contained abundant chondroitin sulfate. The average content of chondroitin sulfate was 2.35 mg·g~(-1) in two-branched velvet antler and 1.79 mg·g~(-1) in three-branched velvet antler, significantly higher than 0.11 mg·g~(-1) in CC. Chondroitin sulfate content in wax slices, powder slices, gauze slices, and bone slices were 7.81, 8.39, 1.33, and 0.54 mg·g~(-1), respectively. Cluster analysis showed that gauze slices and bone slices could be clustered into one category and distinguished from wax slices and powder slices. CCP slices prepared from different parts could be separated well through chondroitin sulfate content. Based on the five principles of Q-marker selection, chondroitin sulfate can be used as a potential Q-marker for the identification of CCP and CC, as well as a potential quality indicator for CCP slices of different specifications(wax slices, powder slices, gauze slices, and bone slices). This research provides data support for CCP quality evaluation.
Animals
;
Cornus
;
Chondroitin Sulfates
;
Deer
;
Powders
;
Antlers
;
Gastropoda
8.Application evaluation of prefabricated rigid connecting bar in implants immediate impression preparation of edentulous jaw.
Juan WANG ; Hua Jie YU ; Jing De SUN ; Li Xin QIU
Journal of Peking University(Health Sciences) 2022;54(1):187-192
OBJECTIVE:
To compare the operation complexity and accuracy of traditional splint impression technique and impression technique with prefabricated rigid connecting bar system for full-arch implants-supported fixed protheses in vitro.
METHODS:
Standard mandibular edentulous model with six implant analogs was prepared. The implants were placed at the bone level and multiunit abutments screwed into the implants. Two impression techniques were performed: the traditional splint impression technique was used in the control group, and the rigid connecting bar system was used in the test group. In the control group, impression copings were screwed into the multiunit abutments and connected with autopolymerizing acrylic resin. Open tray impression was fabricated with custom tray and polyether. In the test group, cylinders were screwed into the multiunit abutments. Prefabricated rigid bars with suitable length were selected and connected to the cylinders with small amount of autopolymerizing acrylic resin, and open tray impression was obtained. Impression procedures were repeated 6 times in each group. The working time of the two impression methods were recorded and compared. Analogs were screws into the impressions and gypsum casts were poured. The gypsum casts and the standard model were transferred to stereolithography (STL) files with model scanner. Comparative analysis of the STL files of the gypsum casts and the standard model was carried out and the root mean square (RMS) error value of the gypsum casts of the control and test groups compared with the standard model was recorded. The trueness of the two impression techniques was compared.
RESULTS:
The work time in the test group was significantly lower than that in the control group and the difference was statistically significant [(984.5±63.3) s vs. (1 478.3±156.2) s, P < 0.05]. Compared with the standard model, the RMS error value of the implant abutments in the test group was (16.9±5.5) μm. The RMS value in the control group was (20.2±8.0) μm. The difference between the two groups was not significant (P>0.05).
CONCLUSION
The prefabricated rigid connecting bar can save the chair-side work time in implants immediate loading of edentulous jaw and simplify the impression process. The impression accuracy is not significantly different from the traditional impression technology. The impression technique with prefabricated rigid connecting bar system is worthy of clinical application.
Acrylic Resins
;
Calcium Sulfate
;
Dental Implants
;
Dental Impression Materials
;
Dental Impression Technique
;
Humans
;
Jaw, Edentulous
;
Models, Dental
;
Mouth, Edentulous
9.Chemical characterization of a new sulfated polysaccharide from Gracilaria chouae and its activation effects on RAW264.7 macrophages.
Feifei LI ; Kehai LIU ; Kewu LIU
Journal of Zhejiang University. Science. B 2022;23(1):84-88
This study aimed to characterize the chemical composition of a new sulfated polysaccharide from the red alga Gracilaria chouae and evaluate its activation effects on RAW264.7 macrophages. It showed that the obtained G. chouae polysaccharide (GCP-3A) was a sulfated acidic polysaccharide with a molecular weight of 11.87 kDa. GCP-3A was composed of xylose, galactose, glucose, and mannose with a molar ratio of 3.00:29.28:0.63:0.45, and it contained α,β-glycosidic linkages. Scanning electron microscopy (SEM) and a Congo red test showed that it was a heterogeneous polysaccharide with irregular interwoven sheets and rods, and did not have a triple-helix conformation. Furthermore, GCP-3A significantly promoted the proliferation of RAW264.7 macrophages and the secretion of nitric oxide (NO) in tests of 3-(4,5-dimethylthiahiazo-2-yl)-2,5-diphenytetrazoliumromide(MTT) and NO.
Gracilaria/chemistry*
;
Macrophages
;
Molecular Weight
;
Polysaccharides/pharmacology*
;
Sulfates/pharmacology*
10.Effect of calcium sulfate on promoting natural healing of docking sites during bone transport.
Xue-de GUO ; Hong-Ya MENG ; Ci-Shan WANG ; De-Yu WAN ; Lei-Zi CHAI
China Journal of Orthopaedics and Traumatology 2022;35(1):85-89
OBJECTIVE:
To observe clinical effect of calcium sulfate on promoting natural healing of docking sites during bone transport.
METHODS:
A retrospective study was performed on the patients with posttraumatic chronic osteomyelitis treated by bone transport and calcium sulfate implantation from January 2013 to January 2018. There were 23 males and 4 females, aged from 20 to 61 years old with an average of (44.30±10.00) years, the courses of disease ranged from 3 to 86 months with an average of(13.26±16.47) months. Sixteen patients with posttraumatic chronic osteomyelitis were caused by internal fixation of closed fractures, and 11 patients were caused by open fractures. The length of bone defects after debridement ranged from 4 to 14 cm with an average of(9.11±2.57) cm. Postoperative complications, natural healing rate of the docking sites, external fixation index were observed, Checketts & Otterburn pin-tract infection classification was used to evaluate pin-tract infection, and Paley evaluation criteria was used to evaluate bone and function results.
RESULTS:
Twenty-seven patients were followed up from 26 to 41 months with an average of (31.32±3.37) months. It did not happened skin embedded between bone stumps in all patients. All patients obtained bone union at (17.78±5.43) months after operation.Among them, 25 patients healed naturally in the docking sites, 2 patients with poor compliance healed after debridement and bone grafting in the docking sites. One patient occurred equines deformity, and no re-fracture or recurrence of infection occurred. According to Checketts & Otterburn pin tract infection classification, 22 patients (41 pin tracts)occurred pin-tract infection with varying degrees. The average external fixation index was (2.02±0.24) months/cm(ranged from 1.6 to 2.4 months/cm). According to Paley evaluation criteria, bony results showed 21 patients obtained excellent results, 5 good, and 1 moderate;functional results showed 19 patients got excellent results, 7 good, and 1 moderate.
CONCLUSION
During bone transport, the implantation of calcium sulfate on the bone defect areas could prevent skin embedding between the bone stumps, benefit for the natural healing of the docking sites, and could avoid the second-stage debridement and bone grafting for most patients. However, it should be noted that compliance needs to be increased.
Animals
;
Bone Transplantation
;
Calcium Sulfate
;
Child
;
Child, Preschool
;
Female
;
Fracture Fixation
;
Horses
;
Humans
;
Infant
;
Male
;
Osteomyelitis/surgery*
;
Retrospective Studies
;
Tibial Fractures
;
Treatment Outcome


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