Seventeen cases involving 18 fingers of acute rupture of flexor tendon within the Zone Ⅱ were repaired by microsurgical technique for reconstructing the digital sheath with biological membrane since 1989. The excellent/good rate based on Eaton grading was 89%. The main procedure of the operation. the early postoperative rehabilitation and active excercises were described.
ObjectiveTo investigate biofilm formation on the surface of silica gel by breast surgery clinical specimens of Staphylococcus epidermidis and to analyze the relationship between biofilm formation and icaA, icaD, and accumulation-associated protein (aap) gene.
MethodsBetween December 2011 and January 2013, 44 strains of Staphylococcus epidermidis were isolated from the clinical specimens of the female patients who had no symptom of infection. The icaA, icaD, and aap genes were detected by PCR and 4 genotypic groups were divided:icaA+icaD+/aap+ group (group A), icaA+icaD+/aap- group (group B), icaA-icaD-/aap+ group (group C), and icaA-icaD-/aap- group (group D). Biofilms mass was semi-quantified by semi-quantitative adherence assay after 8, 12, 24, 30, and 36 hours of incubation. The thickness of biofilms was measured by confocal laser scanning microscope (CLSM) at 12 and 24 hours after incubation. The ultrastructure of biofilms was observed by scanning electron microscope (SEM) at 24 hours after incubation.
ResultsPCR test showed that 13 strains were icaA+icaD+/aap+(group A), 12 strains were icaA+icaD+/aap-(group B), 16 strains were icaA-icaD-/aap+(group C), and 3 strains were icaA-icaD-/aap-(group D). In 29 strains which had bacterial biofilm formation (65.9%), there were 13 strains in group A, 7 strains in group B, 9 strains in group C, and 0 in group D. The result of semi-quantitative adherence assay showed no significant difference in the absorbance (A) values among 4 groups at 8 hours (P>0.05). The A values of groups A, B, and C were significantly higher than that of group D at 12-36 hours, and group A was significantly higher than groups B and C (P<0.05), but there was no significant difference between groups B and C (P>0.05). The results of CLSM showed that the thickness of biofilm in groups A, B, and C was significantly larger than that in group D at 12 and 24 hours after incubation (P<0.05), and the thickness of biofilm in group A was significantly larger than that in groups B and C (P<0.05), but there was no significant difference between groups B and C (P>0.05). The result of SEM showed that the mature biofilm could be observed on the surface of silica gel in groups A, B, and C, and the ultrastructure of biofilms in group A were the most abundant and extensive among 3 groups. The ultrastructure of biofilm in group B was similar to that in group C. No obvious biofilms formed in group D.
ConclusionicaA, icaD, and aap genes all play key roles in the process for biofilm formation of Staphylococcus epidermidis. Futhermore, aap gene enhance the ability of biofilm-forming when aap and ica genes coexist, so the biofilm-forming ability of icaA+icaD+/aap+ is strongest.
Objective To summarize the effect of biofilm (BF) on the occurrence of prosthetic joint infection (PJI). Methods The domestic and abroad original l iterature in recent years about the relationship between BF and PJI was reviewed. Results Infection is a critical compl ication for prosthetic joint replacement. Basic research showes one of the reasons for PJI is BF. After adherence of the bacteria to the surface of prosthetic joint, BF forms through a series of regulation andcontrol system. And it lead to the occurrence of PJI. Recently a lot of progress have been made in the research fields of BF related PJI, which have covered aetiology, diagnosis, treatment, and prevention. Different studies show that BF has close relationship with PJI. Conclusion BF is proved to have close relationship with PJI. It is important on cl inical significances to diagnose, treat, and prevent PJI.
Objective The intercellular adhesion (ica) gene of Staphylococcus epidermidis (SE) is a key factor to bacterial aggregation, to analysis the genotype of iatrogenic SE and to explore the effect of iatrogenic SE ica operon on theformation of bacterial biofilm on the surface of polyvinyl chloride (PVC). Methods Fifty-six cl inical isolates of iatrogenic SEwere selected, and PCR and gene sequencing were used to detect the genes related with bacterial biofilm formation. The genes contained 16S rRNA, autolysin (atlE), fibrinogen binding protein (fbe), and icaADB. The bacteria suspension of 1 × 105 cfu/mL iatrogenic SE was prepared; according to the test results of target genes, the PVC material and the genotype of icaADB+, atlE+, fbe+ strains were co-cultivated as the ica positive group; the PVC material and the genotype of icaADB-, atlE+, fbe+ strains were co-cultivated as the ica negative group. The thickness of biofilm and bacterial community quantity unit area on PVC materials were measured by confocal laser scanning microscope, and the surface structure of biofilm formation was observed by scanning electron microscope (SEM) at 6, 12, 18, 24, and 30 hours. Results The positive rate of 16S rRNA of iatrogenic SE strains was 100% (56/56). The genotype of icaADB+, atlE+, and fbe+ strains accounted for 57.1% (32/56). The genotype of icaADB-, atlE+, and fbe+ strains accounted for 37.5% (21/56). The sequencing results showed that the product sequences of 16S rRNA, atlE, fbe, and icaADB were consistent with those in GenBank. With time, no significant bacterial biofilm formed on the surface of PVC in ica operon negative group. But in ica operon positive group, the number of bacterial community was gradually increased, and the volume of bacterial biofilms was gradually increased on the surface of PVC. At 24 hours, mature bacterial biofilm structure formed, and at 30 hours, the volume of bacterial biofilms was tending towards stabil ity. The thickness of biofilm (F=6 714.395, P=0.000) and the bacterial community quantity unit area on PVC materials (F=435.985, P=0.000) in ica operon positive groupwere significantly higher than those in ica operon negative group. Conclusion Iatrogenic SE can be divided into 2 types ofica operon negative and ica operon positive bacteria. The iatrogenic SE ica operon can strengthen bacterium biofilm formation capabil ity on PVC materials, bacterium community quantity, and thickness of biofilm, it plays an important role in bacterium biofilm formation on PVC materials.
Objective It is difficult to treat chronic osteomyel itis due to the formation of the Staphylococcus aureus biofilms. Liposomal gentamicin-impregnated allogeneic cortical bone can inhibit the formation of the Staphylococcus aureusbiofilms. To explore the treatment of chronic osteomyel itis of rabbit by l iposomal gentamicin-impregnated allogeneic cortical bone. Methods The l iposomal gentamicin, l iposomal gentamicin-impregnated allogeneic cortical bone and gentamicinimpregnated allogeneic cortical bone were produced. Then the chronic Staphylococcus aureus osteomyel itis models of rabbit were made in left lower l imbs of 40 6-month-old rabbits and the right lower l imbs were used as controls. After 2 weeks, the observations of gross and X-ray were done. Four rabbits died within 10 days after the models were made and other 36 rabbits were devided into 6 groups: group A (no antibiotics), group B (intravenous injection of gentamicin), group C (intravenous injection of l i posomal gentamicin), group D (implantation of gentamicin-impregnated allogeneic cortical bone), group E (implantation of l i posomal gentamicin-impregnated allogeneic cortical bone), and group F (implantation of allogeneic cortical bone). After 2 weeks of treatment, the bacterial culture, X-ray and HE staining were done. Results The chronic Staphylococcus aureus osteomyel itis model of rabbit was made successfully. The X-ray showed dissolution of bone and periosteal reaction in groups A, B, C, and F, and no obvious dissolution of bone and periosteal reaction in groups D and E. The Norden scores were (2.5 ± 0.3), (2.1 ± 0.2), (1.5 ± 0.3), (1.5 ± 0.2), (0.9 ± 0.3), and (2.7 ± 0.3) points in groups A-F, respectively; showing significant differences between group A and groups B-E (P lt; 0.05), between groups B, E, F and other groups (P lt; 0.05). The results of blood and marrow cultures for Staphylococcus aureus were positive in groups A and F, and negative in other 4 groups; the results of bone marrow culture for Staphylococcus aureus were positive in 6 rabbits of group B, 4 rabbits of group C and 3 rabitts of group D; and the results were negative in group E. HE staining showed: in groups A and F, abscess and dead bone formed, and no new bone formation were observed; in groups B and C, different degrees of neutrophil accumulation was seen; in group D, some neutrophil accumulation occurred, and osteoprogenitor cells and osteoclasts were seen around implanted bone; and in group E, no neutrophil accumulation was observed, a lot of granulation tissues formed, and osteoprogenitor cells and osteoclasts were seen around implanted bone. Conclusion Implantation of l iposomal gentamicin-impregnated allogeneic cortical bone has remarkly better effect in treating chronic osteomyel itis than intravenous injection of l iposomal gentamicin and implantation of gentamicin-impregnated allogeneic cortical bone.
Diabetic foot infection (DFI) is one of the main causes of hospitalized patients with diabetic foot. DFI should be diagnosed according to the clinical manifestations, and the severity of infection should be graded in time. Diabetic foot wounds are mostly chronic wounds, and there are many kinds of bacterial infections. The bacteria and antibiotics resistance will change with the progress of the disease. Bacterial biofilm is also one of the important causes of antibiotic resistance. Reasonable and timely surgical treatment combined with effective antibiotic treatment is an effective measure to deal with the challenge of DFI. On this basis, multidisciplinary cooperation will achieve the best clinical outcome.
Objective To investigate the effect of aureolysin （Aur） on staphylococcus aureus biofilm formation of dacron biomaterial surfaces under different Aur concentration. Methods Ninety dacron biomaterials were divided into 3 groups （group A, group IA, control group） with random number table （30 piece in each group）. Dacron biomaterials were put into vials contained staphylococcus aureus （105 CFU/ml） respectively; then Aur was added to make the concentration at 400ng/ml in group A, and group B at 80ng/ml. The thickness and number of staphylococcus aureus biofilm on the surfaces of dacron biomaterials of each group were evaluated by confocal laser microscopy and scanning electron microscopy after incubating 6h, 16h, 24h, 30h, and 48h. Results The thickness and number of staphylococcus aureus biofilm on dacron biomaterials surfaces increased significantly with time dependence in control group. The thickness and number of staphylococcus aureus biofilm in group A were less than those in group B and control group at each time points （P〈0. 05）. The thickness and number in group B were significantly decreased than those in control group （P 〈 0. 05）. Conclusion The study shows that Aur can effectively inhibit the formation of staphylococcus aureus biofilm on dacron biomaterials surfaces with dose dependence.
ObjectiveTo investigate the effect of accessory gene regulator C (agr C) specific binding peptides (named N1) on the biofilm formation of Staphylococcus epidermidis on the surface of polyvinyl chloride (PVC) materials in vitro.MethodsFirstly, the two strains (ATCC35984, ATCC12228) were cultured with N1 at concentrations of 100, 200, 400, 800, and 1 600 μg/mL, respectively. The control group was cultured with agrC specific binding unrelated peptides (named N0) at the same concentrations and the absorbance (A) value was measured after 24 hours to determine the optimal bacteriostatic concentration of N1. The two strains were cultured with N1 and N0 of the optimal concentration, respectively. The A values were measured at 6, 12, 18, 24, 30, and 48 hours to observe the effect of N1 on the biofilm formation ability of Staphylococcus epidermidis. On this basis, the surface structure of the biofilm on the surface of PVC material was observed by scanning electron microscopy after 6, 12, 18, 24, and 30 hours of incubation with PVC material sheet. The thickness of the biofilm was observed by laser confocal microscopy after 6, 12, 18, and 24 hours of incubation with ATCC35984 strain.ResultsThe optimal bacteriostatic concentration of N1 was 800 μg/mL. ATCC 12228 strain did not form obvious biofilm after being cultured with N1 and N0. When ATCC35984 strain was cultured with N1 and N0 for 12 hours, the difference in biofilm formation ability between groups N1 and N0 was statistically significant (P<0.05), but there was no significant difference at 6, 18, 24, 30, and 48 hours (P>0.05). Scanning electron microscopy examination showed that mature biofilm structure was observed in ATCC35984 strain and was not observed in ATCC12228 strain. Laser confocal microscopy observation showed that the number of bacteria in the group N1 was significantly lower than that in the group N0 at 12 hours, and the most of bacteria were dead bacteria. There was no significant difference in the number of bacteria at 6, 18, and 24 hours, and the most of them were live bacteria. The biofilm thickness of group N1 was significantly lower than that of group N0 at 12 and 18 hours (P<0.05).ConclusionThe intensity of N1 inhibiting the formation of Staphylococcus epidermidis biofilm is dose-dependent. During the aggregation period, N1 can inhibit the biofilm formation by hindering the bacterial growth and aggregation. The inhibition effect on mature biofilm is not obvious.
Objective To study the influence of brominated furanones on the biofilm formation of Escherichia coli on the polyvinyl chloride (PVC) material, and to provide new ideas for the research of surface modification of materials and cl inicaltreatment of biomaterial centered infection. Methods Three brominated furanones with representative chemical structurewere chosen and coated on the surface modification of PVC materials, respectively [furanone 1: 3, 4-dibromo-5-hydroxy-furanone; furanone 2: 4-bromo-5-(4-methoxyphenyl)-3-(methylamino)-furanone; furanone 3: 3, 4-dibromo-5, 5-bis (4-methylphenyl)- 2 (5H)-furanone]. All the modificated PVC materials and Escherichia coli were co-cultivated. The PVC material soaked with 75% ethanol for 5 minutes and Escherichia coli were co-cultivated together as the control group. The thickness of bacterial community and bacterial community quantity in the unit area on PVC materials were measured by confocal laser scanning microscope (CLSM), and the surface structure of biofilm formation was observed by scanning electron microscope (SEM). Results The CLSM showed that the thickness of bacterial community and the bacterial community quantity in the unit area of PVC materials was significantly less (P lt; 0.05) in furanone 3 group than in control group, but no significant difference (P gt; 0.05) was found between furanone 1, furanone 2 groups and control group. SEM showed that the quantity of bacterial community in the unit area of PVC materials surface in furanone 3 group was fewer than that in control group at 6 hours; the biofilm structure on PVC materials surface formed at 18 hours in control group, furanone 1 group, and furanone 2 group, but there was no mature biofilm structure on PVC materials surface in furanone 3 group at 18 hours. Conclusion The impact of different brominated furanones on Escherichia coli biofilm formation on the surface of PVC materials is different, 3, 4-dibromo-5, 5-bis (4-methylphenyl)-2 (5H)- furanone can inhibit Escherichia coli biofilm formation on the surface of PVC material.
Between 1988 and 1994, 78 cases (183 tendons) of flexor tendon injuries of the hand were repaired by microsurgical techique. The patients were followed up from4 to 6 months. The results were assessed according to the grading method of TAM. In 36 cases, 78 tendons were repaired by microsurgical suture and the excellentgood rate reached 76.2 per cent and the other 42 cases, 105 tendons were repaired with biological memberane wrapped arround the anastomotic site following microsurgical suture, in which, 32 cases, 77 tendons were followed up and the excellentgood rate was 89.5 per cent. The curative effect between the two groups hadsignificant difference statistically (Plt;0.05). Those cases with a bad results were mainly those injuries occurred in Zone II which had very poor soft tissue condition of the palm and thoes old cases having extensive scar tissue formation surrounding the tendon bed.
