摘要:目的：評價圍手術期預防性應用抗菌藥物現狀及合理性。方法：采用回顧性調查的方法，隨機抽查2009年度Ⅰ類切口手術圍手術期病案500份，設計外科圍手術期預防性應用抗生素調查表，對預防用藥的適應證、用藥種類、聯合用藥、給藥時機及持續時間進行統計分析。結果：未使用抗生素5例，預防性使用抗生素495例，其中不合理80例（16.00％）。預防性使用抗生素總品規數為540，其中頭孢菌素類453例（83.89%），青霉素類（包括加酶抑制劑）26例（4.81%），喹諾酮類44例（8.15%）。選用頭孢唑啉鈉178例（32.96%）居第一位，頭孢替唑鈉第二，151例（2796%）。結論：Ⅰ類切口手術患者圍手術期預防性使用抗菌藥物較為合理，但仍存在用藥指征把握不嚴，抗菌藥物的選擇、抗菌藥物使用時間較長等問題，有待進一步規范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
The objective of the study is to analyze the biological characteristics and stability of the linear derivative Bac2a from bactenecin, compared with the control peptide melittin. The secondary structure, antibacterial activity, hemolytic activity, cell toxicity and stability of the Bac2a were determined by circular dichroism spectroscopy, broth micro-dilution method and MTT assay. The results showed that Bac2a was a nonregular curl in aqueous solution, however, it was an α-helix structure in the hydrophobic environment. The minimal inhibitory concentration (MIC) of Bac2a ranged from 2 to 32 μmol/L, so the bacteriostatic activity of Bac2a was strong. The hemolytic rate was only 14.81% when the concentration of Bac2a was 64 μmol/L, which showed that the hemolytic rate of Bac2a was low. The therapy index of Bac2a was 3.26, and the cytotoxicity was relatively low, thus the cell selectivity was relatively high. In addition, with the heating treatment of 100℃ for 1 h, Bac2a still possessed rather a high antibacterial activity and showed a good heating stability. In a word, Bac2a has good application prospects in food, medicine and other fields, and is expected as a substitute for traditional antibiotics.
ObjectiveTo review the related studies on the application of nanomaterials in the treatment of osteomyelitis, and to provide new ideas for the research and clinical treatment of osteomyelitis.MethodsThe literature about the treatment of osteomyelitis with nanomaterials at home and abroad in recent years was reviewed and analyzed.ResultsAt present, surgical treatment and antibiotic application are the main treatment options for osteomyelitis. But there are many defects such as antibiotic resistance, residual bone defect, and low effective concentration of local drugs. The application of nanomaterials can make up for the above defects. In recent years, nanomaterials play an important role in the treatment of osteomyelitis by filling bone defects, establishing local drug delivery system, and self-antibacterial properties.ConclusionIt will provide a new idea and an important research direction for the treatment of osteomyelitis to fully study the related characteristics of nanomaterials and select beneficial materials to make drug delivery system or substitute drugs.
ObjectiveTo investigate the effects of micro/nano-structure and antimicrobial peptides (AMPs) on antibacterial properties of titanium (Ti) metallic surface.MethodsTi disks were treated via sandblasted large-grit acid-etched (SLA) and alkali-heat treatment (AHT) to build the micro/nano-structure, on which AMPs were spin-coated with a certain amount (10, 30, 50, 70, and 90 μg). Scanning electron microscope (SEM) and energy dispersive spectroscopy (EDS) were used to observe the surface structure and characterize the surface elements (i.e. contents of C, N, O, and Ti). Ti disks loaded with AMPs of difference amounts were co-cultured with Staphylococcus aureus (S. aureus) for 24 hours. After that, the formation and dimension of antibacterial circle were measured. Furthermore, the Ti disks treated with different approaches (untreated, SLA treatment, SLA+THA treatment, and 90 μg AMPs-loaded samples) were co-cultured with S. aureus and Escherichia coli (E.coli) for 3 hours, bacterial adhesion on the disks were evaluated by using SEM. The antibacterial performances in solution were quantitatively evaluated by immersing the Ti disks in bacterial solutions and measuring the absorbance (A) values.ResultsIt was found that the nanoporous structure could be easily constructed by SLA+AHT approach. After spin-coating AMPs, the nanopores with the diameter less than 200 nm were almost covered. According to the element analysis, with the increase of AMPs, the C content gradually increased; the N content was not detected until AMPs amount reached 70 μg on the disks. The diameter of antibacterial circle clearly depended on the AMPs amount. The Ti disks loaded with 90 μg AMPs had significantly larger antibacterial circles than the other Ti disks (P<0.05). Based on the SEM observation, the Ti disks loaded with 90 μg AMPs has the least bacterial attachment compared with the other Ti disks (P<0.05). TheA value of bacterial solution immersed with the Ti disks loaded with 90 μg AMPs was much lower than the other Ti disks (P<0.05).ConclusionThe approach of micro/nano-structure and AMPs can improve the antibacterial properties of Ti metallic surface.
ObjectiveThe antibacterial properties of porous medical implant materials were reviewed to provide guidance for further improvement of new medical implant materials.MethodsThe literature related to the antibacterial properties of porous medical implant materials in recent years was consulted, and the classification, characteristics and applications, and antibacterial methods of porous medical implant materials were reviewed.ResultsPorous medical implant materials can be classified according to surface pore size, preparation process, degree of degradation in vivo, and material source. It is widely used in the medical field due to its good biocompatibility and biomechanical properties. Nevertheless, the antibacterial properties of porous medical implant materials themselves are not obvious, and their antibacterial properties need to be improved through structural modification, overall modification, and coating modification.ConclusionAt present, coating modification as the mainstream modification method for improving the antibacterial properties of porous medical materials is still a research hotspot. The introduction of new antibacterial substances provides a new perspective for the development of new coated porous medical implant materials, so that the porous medical implant materials have a more reliable antibacterial effect while taking into account biocompatibility.
In order to solve the problem of high cytotoxicity in vitro of nano-silver antibacterial gel, and the problem of large nano-silver particle size and size distribution, this study prepared nano-silver antibacterial gel with better biocompatibility and good antibacterial effect by using physical cross-linking method and using poloxamer as dispersant when prepared nano-silver. In this study, nano-silver was prepared by photo-initiator method and by adding poloxamer as a dispersant, and then UV-visible absorption spectrum test and scanning electron microscopy (SEM) test were carried out using prepared nano-silver mixture and particles after drying respectively. The gel was prepared through adjusting its pH value by using sodium bicarbonate, and then pH value test, SEM test for cross-section of gel, swelling ratio test, viscosity test, inhibition zone test and in vitro cytotoxicity test were carried out. The test results showed that the maximum absorption wavelength of prepared nano-silver, using poloxamer as dispersant and ultra-pure water as solvent, was 414 nm, and the average nano-silver size was about 60 nm. The prepared nano-silver using poloxamer as dispersant had smaller particle diameter and narrower particle size distribution than those using PVP as dispersant. Similarly, the prepared nano-silver using ultra-pure water as solvent also had smaller particle diameter and narrower particle size distribution than those using distilled water as solvent. The pH value of the prepared gel was between 5.8~6.1. The dried gel section had many holes. The water absorption of gel was fine and the viscosity of gel was fit to coat on the gauze. In addition, the prepared gel with nano-silver had greater ability to inhibit Escherichia coli and Staphyloccocus aureus at the concentrations of 24, 18 and 12 μg/mL. And the biocompatibility of the prepared gel with nano-silver was good when the concentration below 24 μg/mL. Based on the above features, the nano-silver antibacterial gel could be used in the treatment of burn or other wounds.
Objective To review the research progress of new antibacterial hydrogels in the treatment of infected wounds in the field of biomedicine, in order to provide new methods and ideas for clinical treatment of infected wounds. Methods The research literature on antibacterial hydrogels at home and abroad was extensively reviewed in recent years, and the antibacterial hydrogels for the treatment of infected wounds were classified and summarized. Results Antibacterial hydrogels can be divided into three categories: inherent antibacterial hydrogels, antibacterial agent release hydrogels, and environmental response antibacterial hydrogels. The advantages and disadvantages of antibacterial materials, antibacterial mechanism, antibacterial ability, and biocompatibility were discussed respectively. Inherent antibacterial hydrogels have the characteristics of wide source, low cost, and simple preparation, but their antibacterial ability is relatively weak. New antimicrobial substances are added to antibacterial agent release hydrogels, such as antimicrobial peptides, metal ions, graphene materials, etc., providing a new therapeutic strategy for alternative antibiotic therapy. On the basis of the antibacterial material, environmental promoting factors such as photothermal effect, pH value, and magnetic force are added to the environmental response antibacterial hydrogels, which synergically enhances the antibacterial ability of the hydrogel, improves the precise regulation function and bionic effect of the hydrogel. ConclusionThe selection of a variety of materials, the addition of a variety of antibacterial agents, and the effect of various promoting factors make composite hydrogels show multiple characteristics. The development of antibacterial hydrogels that can effectively address practical clinical applications remains a significant challenge. In the future, expanding the application range of antibacterial hydrogels, constructing drug-loaded hydrogels, and developing intelligent hydrogels are still new areas that need to be explored and studied.
The poor mechanical property and vulnerability to bacterial infections are the main problems in clinic for dental restoration resins. Based on this problem, the purpose of this study is to synthesize silver-titanium dioxide (Ag-TiO2) nanoparticles with good photocatalytic properties, and add them to the composite resin to improve the mechanical properties and photocatalytic antibacterial capability of the resin. The microstructure and chemical composition of Ag-TiO2 nanoparticles and composite resins were characterized. The results indicated that Ag existed in both metallic and silver oxide state in the Ag-TiO2, and Ag-TiO2 nanoparticles were uniformly dispersed in the resins. The results of mechanical experiments suggested that the mechanical properties of the composite resin were significantly improved due to the incorporation of Ag-TiO2 nanoparticles. The antibacterial results indicated that the Ag-TiO2 nanoparticle-filled composite resins exhibited excellent antibacterial activities under 660 nm light irradiation for 10 min due to the photocatalysis, and the Ag-TiO2 nanoparticle-filled composite resins could also exhibit excellent antibacterial activities after contact with bacteria for 24 h without light irradiation because of the release of Ag ions. In summary, this study provides a new antibacterial idea for the field of dental composite resins.
Objective
To systematically review the efficacy of long-acting antibacterial material in the prevention of secondary urinary infection.
Methods
PubMed, The Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of long-acting antibacterial material in the prevention of secondary urinary infection from inception to November, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.
Results
A total of 16 RCTs were included. The results of meta-analysis showed that: the long-acting antibacterial material group was superior to the general intervention group in morbidity of secondary urinary infection (Peto OR=0.17, 95%CI 0.13 to 0.23, P<0.000 01), and bacterial positive rate of secondary urinary infection (Peto OR=0.15, 95%CI 0.08 to 0.27,P<0.000 01).
Conclusion
Current evidence shows that long-acting antibacterial material can effectively reduce the infection rates of secondary urinary infection. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To design and construct a graphene oxide (GO)/silver nitrate (Ag3PO4)/chitosan (CS) composite coating for rapidly killing bacteria and preventing postoperative infection in implant surgery. Methods GO/Ag3PO4 composites were prepared by ion exchange method, and CS and GO/Ag3PO4 composites were deposited on medical titanium (Ti) sheets successively. The morphology, physical image, photothermal and photocatalytic ability, antibacterial ability, and adhesion to the matrix of the materials were characterized. Results The GO/Ag3PO4 composites were successfully prepared by ion exchange method and the heterogeneous structure of GO/Ag3PO4 was proved by morphology phase test. The heterogeneous structure formed by Ag3PO4 and GO reduced the band gap from 1.79 eV to 1.39 eV which could be excited by 808 nm near-infrared light. The photothermal and photocatalytic experiments proved that the GO/Ag3PO4/CS coating had excellent photothermal and photodynamic properties. In vitro antibacterial experiments showed that the antibacterial rate of the GO/Ag3PO4/CS composite coating against Staphylococcus aureus reached 99.81% after 20 minutes irradiation with 808 nm near-infrared light. At the same time, the composite coating had excellent light stability, which could provide stable and sustained antibacterial effect. ConclusionGO/Ag3PO4/CS coating can be excited by 808 nm near infrared light to produce reactive oxygen species, which has excellent antibacterial activity under light.
