Te metilēna kikorangi i te rangahau patunga: ngā takai, te rama, me ngā putanga whakaora

Ki te titiro atu, he rite tonu pea te takai kua poke ki te kikorangi me te pounamu whai pūturuturu e mau ana i te wai kikorangi hei wawaotanga. I te rangahau patunga, he rerekē ēnei. Ko tētahi he takai kua hangaia me te rahinga waikano pūmau, ā, kua whakamātauria hei pūrere kua oti te hanga. Ko tērā atu he wairewa ka pania ā-ringa, ā, ka rerekē te kukūtanga, te rōrahi, me te roa o te pānga i ia paninga. He rerekē ngā pātai ka whakautua e ngā rangahau o ēnei mea e rua, ā, ka rerekē hoki ā rātou paearu putanga.

Ka wehewehea ēnei mea e rua i tēnei arotake. Ka whakarārangitia ngā mea i whakamahia e ngā kairangahau, ngā mea i whakamahia ai, me ngā mea i inea: te horahanga patunga, te tere kati, ngā tatauranga huakita, tētahi inenga whakakapi taiwhanga rānei, pēnei i te kati o tētahi āputa raraku i roto i te rīhi.

Ngā horopaki e toru, kua whakamāramatia māriretia

E toru ngā horopaki o te rangahau patunga e whakamahi ana i te metilēna kikorangi. He ariā motuhake tō ia horopaki mō te mahi a te waikano.

Tuatahi, ko ngā takai pahuka whai waikano. Ka mau ngā waikano ki roto i te hanganga o te takai i ngā hua pēnei i te pahuka waipiro polyvinyl kua whakakīia ki te metilēna kikorangi me te waiporoporo gentian, e hokona ana hei pahuka ārai-huakita Hydrofera Blue. Ko te tikanga mahi e kīia ana, ko te mahi ārai-huakita e pā ana ki te takai, hei āwhina ki te whakahaere i te nui o ngā huakita i te taiao o te patunga, i te wā e whakahaere ana te pahuka i te wai ka puta i te patunga. Mā te mātanga haumanu e kōwhiri ana i tētahi takai mō tētahi patunga motuhake ngā whakatau maimoatanga mō taua hua. Mā ngā tohutohu whakamahi o te takai e whakatau te roa o te mau me te auau o te whakakapi, ehara mā tētahi tohutaka whānui mō te waikano kikorangi.

Tuarua, ko te haumanu matū whakahohe-rama me te metilēna kikorangi. I konei, ka whakamahia he wairewa metilēna kikorangi hei matū tairongo ki te rama, kātahi ka whitingia ki te rama, ko te tikanga he rama whero e tata ana ki te tihi ngongo-rama o te waikano. Ka whai wāhi te rama me te hāora ki te whakaputa i ngā momo matū tauhohe e tūkino ana i ngā moroiti. He matū rerekē tēnei i te take ārai-hāora e whakamahia ana i te whakatairanga hua tiaki kiri, ā, ka whakamārama hoki tā mātou aratohu mō te metilēna kikorangi i te tiaki kiri i taua rerekētanga. Ko te wawaotanga ko te huinga o te waikano, te horopeta rama, me te hāora. Ki te whakarerekētia tētahi o aua mea e toru, ka rerekē te wawaotanga.

Tuatoru, ko te metilēna kikorangi kāore he rama i roto i ngā pūtau me ngā kararehe. Ka pātai ēnei whakamātau mēnā ka whakarerekē te waikano tonu i te whanonga o ngā pūtau fibroblast, i ngā pūmua o te hanganga tautoko, i te kati rānei o ngā patunga whakamātau. He rangahau ēnei mō te tikanga mahi, ehara i te whakamātautau takai.

Te mahere tauira rangahau: he aha i whakamātauria, ki runga i te aha, ā, he aha i rerekē

Whakamahia tēnei ripanga hei mahere mō te tuhinga. Pānuitia ia haupae mai i te taha mauī ki te taha matau: te rauemi, te tauira, me te paearu putanga e taea ana e taua haupae te tautoko. Kāore tētahi haupae e tango i te paearu putanga o tētahi atu.

Ngā takai: he pūrere kua oti te hanga, ehara i te tohutaka waikano

Ko ngā takai pahuka i rangahaua i te tiaki patunga he pūrere kua hangaia. Ko te whānuitanga Hydrofera Blue e whakaahuatia ana i te whārangi hua a te kaihanga ka whakakotahi i ngā waikano e rua ki roto i te pahuka kore moroiti: kei te momo waipiro polyvinyl CLASSIC te mōrahi 0.00025 g o ia waikano mō ia karamu pahuka, ā, kei te momo polyurethane READY te mōrahi 0.00035 g mō ia karamu. Nā te mea ka utaina ngā waikano i te wā e hangaia ana, he rahinga mōhiotia tō ia takai. Ka whakaahua ngā pūrongo haumanu i te hua mā tōna ingoa, te roa o te mau, me te hōtaka whakakapi.

He pūrere hauora ēnei kua whiwhi whakawātea, ehara i te rongoā kua whakaaetia. Kei te takai taketake te whakawātea FDA K013462 nō 2002, kei te momo polyurethane Hydrofera Blue te whakawātea K130670 nō 2014, ā, kei te momo READY whai taitapa te whakawātea K190268 nō 2019. Mā te whakawātea i raro i te ara 510(k) e whakatau he ōritenga nui tō te pūrere ki tētahi pūrere o mua; ehara tēnei i te whakaaetanga mō tōna whaihua. Ko ngā kerēme ārai-moroiti i roto i ngā tuhinga pūrere e whakawhirinaki nui ana ki te mahi i roto i te takai me ngā whakamātautau taiwhanga. Kaua e tahuri aua kerēme hei kī ka whakakore te takai i ngā moroiti katoa o te kiko kua whakapoketia mā tētahi hekenga taupū kua tohua.

Ko te nuinga o ngā wheako haumanu kua whakaputaina he raupapa iti kāore he rōpū whakatairite. I tētahi rangahau anga whakamua o ngā patunga mauroa 29 nā Woo rāua ko Heil, i whakakapihia te Hydrofera Blue Classic e toru ngā wā ia wiki mō ngā wiki e whā. I heke te horahanga patunga toharite mai i te 21.4 ki te 12.3 cm² (he hekenga 42.5%), ā, i heke ngā kaute PUSH mai i te 13.3 ki te 10.7. I kitea e tētahi raupapa kēhi o ngā patunga waewae 15 nā Coutts, Ryan rāua ko Sibbald te iti haere o te rahi patunga i te whā wiki i roto i te 8 o ngā patunga 14 i taea te aromātai, me te whakaitinga mamae i ētahi tūroro, otirā te hunga whai whewhe waewae nā te mate huka. I whakakotahitia e tētahi rōpū rangahau titiro whakamuri o ngā patunga 53 i pūrongotia e Lullove te pahuka me tētahi hanganga tautoko collagen hipi. Nō reira, kāore e taea te kī nā te pahuka anake te hekenga horahanga toharite 91.3% i te tekau mā rua wiki. I pūrongotia e tētahi tātaritanga nui titiro whakamuri o tētahi hōtaka nā Hurd te tere ake o te whakaora i ngā wāhi i whakamahia ai ngā takai i roto i tētahi huinga tiaki kua whakaritea kia ōrite. Ka whakamātauria anō i konei te huinga tiaki, ehara i te waikano.

Kotahi te herenga e kitea ana puta noa i ēnei rangahau: ka whakaatuhia te nui o ngā huakita hei kaute haumanu whakapokenga, hei paninga kohikohi tauira āhua ine-rahinga rānei, kāore hei whakatipu tauira kiko ine-rahinga e mahia ana i ngā wā raupapa. Ko te whakarāpopototanga pono, ka pūrongo ngā rangahau pahuka whai waikano e rua i te hekenga horahanga, te pai ake o ngā kaute takotoranga patunga, ā, i ētahi wā, te iti ake o te mamae. Kāore rā e whakaū ana i tētahi hononga horopeta me te urupare e hāngai motuhake ana ki te metilēna kikorangi, i tētahi tere patu huakita rānei kua inea i roto i te kiko. Waihoki, kāore tētahi mea i ngā rangahau takai e whakamana ana he ōrite te rumaki whāriki takai ki te wairewa pūturuturu. He rerekē katoa te kukūtanga, te tohatoha, te tere tuku, te kore moroiti, me te roa o te mau.

Te rama me te waikano: ngā rangahau patunga mā te tauhohenga matū whakahohe-rama

Ka tāpiri te rangahau patunga mā te tauhohenga matū whakahohe-rama i te whitinga rama ki te kawa. Ko ngā kukūtanga i ngā rangahau tangata kei waenganui i te 0.01% me te 1% metilēna kikorangi i te nuinga o te wā, me te rama whero e tata ana ki te 635 ki te 660 nm, ā, ko te pūngao rama mō ia horahanga mai i ētahi joule ruarua mō ia henemita pūrua ki te neke atu i te kotahi rau. He rerekē ngā rōpū whakatairite: ka whakatairite ētahi rangahau ki te tiaki paerewa, ā, ka pūrongo ētahi atu i ngā tatauranga huakita i mua, i muri hoki, i roto i ngā patunga kotahi.

Ko ngā tohu tangata e tino kitea tonutia ana e pā ana ki te āhua me te horahanga o te patunga, kaua ki ngā tatauranga huakita. I tētahi rangahau whai rōpū whakatairite o ngā whewhe 12 nā te mate huka, nā Carrinho me ōna hoa, i whakamahia te 0.01% metilēna kikorangi me te rama 660 nm i te 6 J/cm², e toru ngā wā ia wiki mō ngā wā maimoatanga tekau. I puta he hekenga horahanga tino nui ake i tērā o te maimoatanga whakatairite. I pūrongotia e tētahi raupapa kēhi o ngā patunga whakapoke e rima nā Shen me ōna hoa te whakaora katoa i muri i te toharite o ngā wā maimoatanga e whā ki te waikano 1% me te rama 635 nm, kāore he paearu putanga huakita ine-rahinga. Ko te whakamātautau matapōkere nui rawa tae noa mai ki tēnei wā, he whakamātautau matapōrua whai kaiuru 94 mō ngā whewhe waewae nā te mate huka, nā Chagas me ōna hoa, i kite i te pai haere o ngā kaute patunga Bates-Jensen mai i te wā maimoatanga tuatoru tae atu ki te aroturuki i te toru tekau rā, mā te waikano 1% me te taiaho 660 nm. Kāore he pānga kino e pā ana ki te maimoatanga, engari kāore anō he paearu putanga ine-rahinga mō te nui o ngā huakita.

E rua ngā kōrero tūpato hei pupuri i te pono o ēnei tuhinga rangahau. Tuatahi, ko te putanga nui mō te tapahi peka e whakahuatia ana i ētahi wā mai i a Tardivo me ōna hoa i whakamahi i te metilēna kikorangi i whakakotahitia ki te toluidine kikorangi. Nō reira, kāore e taea te kī nā te metilēna kikorangi anake taua putanga. Tuarua, kāore e tika kia kī aunoa nā te tauhohenga matū whakahohe-rama ārai-moroiti te whakaora i muri i tētahi wā maimoatanga rama, nā te mea ka taea e te rama whero tonu te whakarerekē i te whakatikatika kiko. I tētahi whakamātau patunga kiore nā Sperandio me ōna hoa me ngā rōpū waikano anake, rama anake, huinga, me te rōpū whakatairite, i whai pānga motuhake te taiaho anake ki te whakaora. Hei whakaū nā te patunga huakita tētahi putanga, me whai inenga mātai moroiti me ngā rōpū whakatairite tika. He mārama ake ngā rangahau kararehe mō taua take: i tētahi tauira patunga whakapoke kiore iti nā Pérez me ōna hoa, i puta te putanga whakaora ā-kite pai rawa i te haumanu matū whakahohe-rama, engari i puta te hekenga huakita nui rawa i te mupirocin, ka mārama te wehe o aua paearu putanga e rua. Ka whakatakotoria e tā mātou tirohanga whānui ki ngā taunakitanga mō te metilēna kikorangi me te rama whero ēnei kawa patunga ki te taha o ngā horopaki rama kāore e pā ana ki te patunga, kia kore ai e pōhēhētia he ōrite ngā take whakamahi haumanu nā te ōritenga o te tauhohenga matū whakahohe-rama.

Ngā pūtau me ngā tauira kiri: te tīmatanga o te tohu whakaora

Ko te pūtake taiwhanga o te kerēme whakaora patunga he rangahau nō 2017 nā Xiong me ōna hoa mō ngā pūtau fibroblast o te kiri whakaroto tangata me te kiri kua hangaia anō. Ko ngā pūtau fibroblast nō ngā kaituku e rua, i whakamātauria i mua ki te 100 nM metilēna kikorangi, i whakakī anō i tētahi āputa raraku kia tino tere ake i ngā pūtau kāore i whakamātauria, i te 24 hāora. I te kiri kua hangaia anō me te mātotoru katoa, i piki te whāinu me te mātotoru o te kiri whakaroto i inea i te roanga ake o te pānga. Ko te pikinga o te whakaputanga elastin me COL2A1 ētahi o ngā panoni ki te hanganga tautoko.

He paearu putanga tūturu ēnei e hāngai ana ki te patunga, ā, me here tonu ki ō rātou tauira. Ka ine te whakamātau āputa raraku i te neke ngātahi o ngā pūtau puta noa i tētahi āputa i roto i te rīhi. Kāore he urupare ārai mate, he whakatūnga huakita, he wai ka puta i te patunga, he takai rānei. Ka tāpiri te kiri kua hangaia anō i te hanganga kiko, engari kāore tonu he rere toto, he raupapa whakaora katoa rānei. Kāore tētahi o aua tauira e whakamātau i te takai pahuka, i te kawa matū whakahohe-rama rānei, ā, kāore tētahi e tuku i te kukūtanga mō te whakamahi ki te kāinga.

Kua whakamātauria hoki te metilēna kikorangi kua whakaritea hei ranunga i ngā patunga o ngā kararehe ngau. I tere ake ai te kati tōmua o ngā patunga kiore i hangaia mā te tango kiko, i tētahi rā niosome 0.005% i rangahaua e Farmoudeh me ōna hoa, ina whakatairitea ki te waikano herekore me te matū kawe. I pai ake hoki ngā kitenga mātai kiko me ngā inenga ahotea hāora. I tere ake ai te kati i tētahi whakaehunga mitanano 0.1 mg/mL i rangahaua e Gao me ōna hoa i ngā kiore iti mate huka, me te pikinga o ngā tohu hanga ia-toto me te hekenga o ngā tohu hāoratanga me te mate pūtau kua hōtakatia. He mea nui te hanganga ranunga i ngā kēhi e rua; kāore tētahi o aua putanga e hāngai aunoa ki te waikano noa kua rewa ki te wai.

Waihoki, kāore te pānga e ahu ki te huarahi kotahi i ngā horopaki katoa. I tētahi whakamātau hononga whēkau kiore nā Dinc me ōna hoa, i whakaitihia e te metilēna kikorangi 1% i whakatakotoria ki roto i te kōpū te pēhanga pakaru o te hononga me te hydroxyproline i te rā tuatoru. I whakaatu tēnei i te ngoikore o te kaha whakaora tōmua i taua horopeta me taua ara tuku. Mā te kukūtanga, te kiko, te hanganga ranunga, me te ara tuku e whakatau te putanga.

Ngā pātai mō ia kerēme patunga

Me taea e ia kerēme patunga mō te metilēna kikorangi te whakautu i ngā pātai e whā. Tuatahi, he aha rawa i whakamahia: he takai kua hangaia me tōna ingoa, he kawa kua tautuhia mō te matū tairongo ki te rama me te rama, he wairewa kāore i tautuhia rānei? Tuarua, ki runga i te aha: he pūtau, he patunga kararehe, he patunga tangata rānei nō tētahi momo kua tohua? Tuatoru, he aha te mea whakatairite, ā, he pēhea te roa? Tuawhā, he aha te paearu putanga i inea: te panoni horahanga, te kati, ngā tatauranga huakita, he inenga whakakapi taiwhanga rānei?

Ko ngā kerēme e whakapōuri ana i te pātai tuatahi te hapa tino noa. Kāore tētahi putanga i whiwhi mā te pahuka kua utaina ki te waikano e whakamana ana i te pani i tētahi patunga kia kikorangi. Kāore hoki tētahi tohu ārai-moroiti i muri i tētahi wā maimoatanga matū whakahohe-rama e whakamana ana i te pani tapatapa i tētahi wairewa kāore he rama. Ka whai wāhi pūmau tēnei rārangi arowhai, me ngā tauira kua whakamāramatia, ki te aratohu ka puta ā muri ake nei mō te pānui kerēme patunga metilēna kikorangi. Kia tae rā anō ki taua wā, ko te ripanga o runga te mahere.

Ko ngā patunga hōhonu, e horapa ana, e haunga kino ana, e haere tahi ana me te kirikā, kāore rānei e pai haere ana, me whai aromatawai haumanu, kaua he waikano. He take pai kia whai tonu i ngā rangahau kua arotakengia i konei, nā tō rātou tino tautuhi i ngā rauemi, ngā tauira, me ngā inenga. Me here tonu aua mea e toru ki ia kerēme kia mārama ai te pānui i tēnei ao rangahau.