I-methylene blue kuphando lwamanxeba: izigqubuthelo, ukukhanya, neziphumo zokuphola

Ibhandeji edyojwe ngombala oluhlaza okwesibhakabhaka nebhotile enesixhobo sokuthontsiza ulwelo olulo mbala zibonakala ngathi ziyindlela enye yokungenelela. Kuphando lwamanxeba azinjalo. Enye sisigqubuthelo esenziwe kumzi-mveliso esinomthamo wedayi ongaguqukiyo, esivavanywa njengesixhobo esigqityiweyo. Enye sisisombululo esithanjiswa ngesandla, apho uxinaniso, umthamo wolwelo, nexesha lokudibana nenxeba ziguquka qho xa sisetyenziswa. Izifundo zezi zimbini ziphendula imibuzo eyahlukileyo, yaye neziphumo ezizilinganisayo ziyahluka ngokufanelekileyo.

Olu phononongo luzigcina zahlukene. Luchaza oko abaphandi bakusebenzisileyo, apho bakusebenzise khona, noko bakulinganisileyo: ubungakanani bendawo yenxeba, isantya sokuvaleka, amanani eebhaktheriya, okanye umlinganiselo waselabhoratri omele ukuphola, njengokuvaleka kwesikroba esenziwe kwisitya sokukhulisa iiseli.

Iimeko ezintathu, zichazwe ngokucacileyo

Uphando lwamanxeba nge-methylene blue lwenzeka kwiimeko ezintathu. Nganye inengqiqo yayo malunga noko kwenziwa yidayi.

Eyokuqala, izigqubuthelo zogwebu ezinedayi. Iimveliso ezifana nogwebu lwepolyvinyl alcohol olufakwe i-methylene blue negentian violet (oluthengiswa njengeHydrofera Blue antibacterial foam) zithwala iidayi ezibotshelelwe kwisakhiwo esixhasayo sesigqubuthelo. Indlela yokusebenza echaziweyo kukusebenza ngokuchasene neebhaktheriya okunxulumene nesigqubuthelo, ngenjongo yokunceda ukulawula umthwalo weebhaktheriya kwindawo yenxeba ngoxa ugwebu lulawula ulwelo oluphuma enxebeni. Izigqibo zonyango ngemveliso enjalo zezengcali yezonyango ekhetha isigqubuthelo senxeba elithile; imiyalelo yokusebenzisa isigqubuthelo ichaza ixesha lokusigcina enxebeni nobuninzi bamaxesha okusitshintsha, hayi indlela eqhelekileyo yokulungiselela idayi eluhlaza okwesibhakabhaka.

Eyesibini, unyango lwefotodayinamiki nge-methylene blue. Apha isisombululo se-methylene blue sisetyenziswa njengento eyenza indawo ichaphazeleke kukukhanya, kuze kukhanyiswe kuso, ngokuqhelekileyo ngokukhanya okubomvu okukufutshane nencopho yokufunxwa kokukhanya yidayi. Ukukhanya neoksijini zithatha inxaxheba ekudaleni izinto ezisebenza ngokukhawuleza ngokwekhemikhali ezonakalisa iintsholongwane. Le yikhemistri eyahlukileyo kwingqiqo yokuchasana nokonakaliswa yioksijini esetyenziswa kwintengiso yokhathalelo lolusu, umahluko ochazwa nakwisikhokelo sethu se-methylene blue kukhathalelo lolusu. Ungenelelo yindibaniselwano yedayi, umthamo wokukhanya, neoksijini, yaye ukutshintsha nayiphi na kwezi zintathu kutshintsha ungenelelo.

Eyesithathu, i-methylene blue ngaphandle kokukhanya kwiiseli nakwizilwanyana. Ezi mvavanyo zibuza ukuba ingaba idayi ngokwayo iyayitshintsha na indlela eziziphatha ngayo iiseli zefibroblast, iiproteni zesakhiwo esixhasayo, okanye ukuvaleka kwamanxeba ovavanyo. Zizifundo zendlela yokusebenza, hayi iimvavanyo zezigqubuthelo.

Imephu yeemodeli zezifundo: yintoni eyavavanywayo, yavavanywa entwenini, yaye yintoni eyatshintshayo

Sebenzisa le theyibhile njengemephu yeli nqaku. Funda umqolo ngamnye ukusuka ekhohlo ukuya ekunene: into esetyenzisiweyo, imodeli, nesiphumo esinokuxhaswa nguloo mqolo. Akukho mqolo oboleka isiphumo somnye.

Izigqubuthelo: isixhobo esigqityiweyo, hayi indlela yokulungiselela idayi

Izigqubuthelo zogwebu ezifundwayo kukhathalelo lwamanxeba zizixhobo ezenziwe kumzi-mveliso. Uluhlu lweHydrofera Blue oluchazwe kwiphepha lemveliso lomenzi ludibanisa iidayi ezimbini kugwebu olungenazintsholongwane: uhlobo lweCLASSIC lwepolyvinyl alcohol luthwala ubuninzi be-0.00025 g yedayi nganye kwigram nganye yogwebu, kanti uhlobo lweREADY lwepolyurethane luthwala ubuninzi be-0.00035 g kwigram nganye. Ngenxa yokuba iidayi zifakwa ngexesha lokwenziwa, isigqubuthelo ngasinye sithwala umthamo owaziwayo, yaye iingxelo zezonyango zichaza imveliso ngegama, ixesha lokusigcina enxebeni, neshedyuli yokusitshintsha.

Ezi zizixhobo zonyango ezivunyelwe ukuba zithengiswe, hayi amayeza aphunyeziweyo. Isigqubuthelo sokuqala sinemvume yeFDA enguK013462 yango2002, uhlobo lwepolyurethane lweHydrofera Blue lunemvume enguK130670 yango2014, yaye uhlobo lweREADY olunomphetho lunemvume enguK190268 yango2019. Imvume ngendlela ye510(k) iqinisekisa ukufana okukhulu nesixhobo esandulelayo; ayisosigunyaziso sokusebenza konyango. Amabango okuchasana neentsholongwane kumaxwebhu esixhobo axhomekeke kakhulu ekusebenzeni ngaphakathi kwesigqubuthelo nakuvavanyo lwaselabhoratri, nto leyo engafanele iguqulelwe kwibango lokuba isigqubuthelo sisusa zonke iintsholongwane kwizicubu ezosulelekileyo ngonciphiso oluchaziweyo ngokomlinganiselo welog.

Amava ezonyango apapashiweyo ubukhulu becala aquka uthotho oluncinci lwamatyala angenamaqela othelekiso. Kwisifundo sikaWoo noHeil sokulandelela amanxeba angapheliyo angama-29, apho iHydrofera Blue Classic yayitshintshwa kathathu ngeveki kangangeeveki ezine, umndilili wobungakanani bendawo yenxeba wehla ukusuka ku-21.4 ukuya ku-12.3 cm² (unciphiso lwe-42.5%) yaye amanqaku ePUSH ehla ukusuka ku-13.3 ukuya ku-10.7. Uthotho lwamatyala lwamanxeba angama-15 emilenzeni olwenziwa nguCoutts, uRyan noSibbald lwafumanisa ukuncipha kobungakanani benxeba kwiiveki ezine kumanxeba asi-8 kwali-14 awayenokuhlolwa, kunye nokuncipha kweentlungu kwezinye izigulana, ingakumbi ezo zinezilonda zeenyawo ezinxulumene nesifo seswekile. Uphononongo lukaLullove lweqela lamanxeba angama-53 kusetyenziswa iingxelo ezidlulileyo lwadibanisa ugwebu nesakhiwo esixhasayo sekholajeni evela ezimgusheni, ngoko unciphiso lomndilili wobungakanani bendawo lwe-91.3% kwiiveki ezilishumi elinambini alunakubalelwa kugwebu lodwa. Uhlalutyo olukhulu lukaHurd lwenkqubo kusetyenziswa iingxelo ezidlulileyo lwaxela ukuphola okukhawulezayo apho izigqubuthelo zazisetyenziswa ngaphakathi kwendibaniselwano yokhathalelo enomgangatho omiselweyo, nto leyo iphinda ivavanye indibaniselwano kunedayi.

Umda omnye ukhona kuzo zonke ezi zifundo: umthwalo weebhaktheriya uboniswa ngamanqaku osulelo kuvavanyo lwezonyango okanye ngeesampulu ezithathwa ngokuswayipha ezibonisa umthamo oqikelelweyo, hayi ngeenkcubeko zeesampulu zezicubu ezilinganisa umthamo ezithathwa ngokulandelelana. Isishwankathelo esinyanisekileyo kukuba izifundo zogwebu oluneedayi ezimbini zixela ukuncipha kobungakanani bendawo, ukuphucuka kwamanqaku omandlalo wenxeba, yaye ngamanye amaxesha iintlungu ezincinci, ngaphandle kokuqinisekisa unxulumano phakathi komthamo nesiphumo olungqamene ne-methylene blue okanye izinga elilinganisiweyo lokubulawa kweebhaktheriya kwizicubu. Kwaye akukho nto kwizifundo zezigqubuthelo eqinisekisa ukuba ukufunxa igauze kwisisombululo sebhotile yokuthontsiza kuyafana. Uxinaniso, ukusasazeka, isantya sokukhutshwa kwedayi, ukungabikho kweentsholongwane, nexesha lokusigcina enxebeni konke kuyahluka.

Ukukhanya nedayi: izifundo zamanxeba ngefotodayinamiki

Uphando lwamanxeba ngefotodayinamiki longeza ukukhanyiswa kwinkqubo yovavanyo. Uxinaniso kwizifundo zabantu ngokuqhelekileyo luphakathi kwe-0.01% ne-1% ye-methylene blue, ngokukhanya okubomvu okukufutshane ne-635 ukuya kwi-660 nm, nemithamo yamandla okukhanya esuka kwiijoules ezimbalwa kwisentimitha nganye yesikwere ukuya ngaphezu kwekhulu. Amaqela othelekiso ayahluka: ezinye izifundo zithelekisa nokhathalelo oluqhelekileyo, ezinye zixela amanani eebhaktheriya ngaphambi nasemva konyango kumanxeba afanayo.

Imiqondiso engaguquguqukiyo kakhulu ebantwini iphathelele imeko yenxeba nobungakanani bendawo kunamanani eebhaktheriya. Kwisifundo esineqela lothelekiso sezilonda ezili-12 zesifo seswekile esenziwa nguCarrinho noogxa bakhe, i-0.01% ye-methylene blue ngokukhanya kwe-660 nm kumthamo we-6 J/cm², kathathu ngeveki kangangeeseshoni ezilishumi, yavelisa unciphiso lobungakanani bendawo olwalukhulu ngakumbi ngokobalo kunonyango lweqela lothelekiso. Uthotho lwamatyala lwamanxeba amahlanu osulelekileyo olwenziwa nguShen noogxa bakhe lwaxela ukuphola okupheleleyo emva komndilili weeseshoni ezine zedayi eyi-1% ngokukhanya kwe-635 nm, ngaphandle kweziphumo ezilinganisa amanani eebhaktheriya. Olona vavanyo lukhulu olwenziwe ukuza kuthi ga ngoku olwabela abantu kumaqela ngokungakhethiyo, uvavanyo lukaChagas noogxa bakhe lwezilonda zeenyawo zesifo seswekile olunabathathi-nxaxheba abangama-94 apho abathathi-nxaxheba nabavavanyi babengazi ukuba ngubani okweliphi iqela, lwafumanisa amanqaku enxeba eBates-Jensen ephucuka ukusuka kwiseshoni yesithathu ukuya kuhlolo olulandelayo emva kweentsuku ezingamashumi amathathu ngokusebenzisa idayi eyi-1% nelaser ye-660 nm, ngaphandle kweziganeko ezingathandekiyo ezinxulumene nonyango, kodwa kwakhona ngaphandle kwesiphumo esilinganisa umthwalo weebhaktheriya.

Izilumkiso ezimbini zigcina olu phando lunyanisekile. Okokuqala, isiphumo esimangalisayo ngokuphathelele ukunqunyulwa kwelungu esikhe sicatshulwe kuTardivo noogxa bakhe sasebenzisa i-methylene blue idityaniswe netoluidine blue, ngoko asinakubalelwa kwi-methylene blue yodwa. Okwesibini, ukuphola emva kweseshoni yokukhanya akunakubalelwa ngokuzenzekelayo kwikhemistri eqhutywa kukukhanya echasene neentsholongwane, kuba ukukhanya okubomvu ngokwako kunokutshintsha ukulungiswa kwezicubu. Kuvavanyo lwamanxeba eempuku olwenziwa nguSperandio noogxa bakhe olunamaqela edayi yodwa, ukukhanya kuphela, indibaniselwano, neqela lothelekiso, imeko yelaser yodwa yachaphazela ukuphola ngokwayo. Ukubalela isiphumo ekubulaweni kweebhaktheriya kufuna iimvavanyo zeentsholongwane kunye namaqela othelekiso afanelekileyo. Umsebenzi wezilwanyana ucace ngakumbi kulo mba: kwimodeli yenxeba elosulelekileyo lempuku encinci eyenziwa nguPérez noogxa bakhe, unyango lwefotodayinamiki lwavelisa esona siphumo sokuphola sibonakalayo silungileyo ngoxa imupirocin yavelisa olona nciphiso lukhulu lweebhaktheriya, yahlula ngokucacileyo ezi ziphumo zimbini. Isishwankathelo sethu sobungqina be-methylene blue nokukhanya okubomvu sibeka ezi nkqubo zamanxeba ecaleni kweemeko zokukhanya ezingezizo ezamanxeba ukuze ikhemistri yokukhanya efanayo ingaphazanyiswa nesiseko esifanayo sokusetyenziswa kunyango.

Iiseli neemodeli zolusu: apho umqondiso wokuphola uqala khona

Imvelaphi yaselabhoratri yebango lokuphola kwamanxeba sisifundo sango2017 sikaXiong noogxa bakhe kwiiseli zefibroblast zomaleko wesikhumba sabantu nolusu olwakhiwe ngokutsha. Iiseli zefibroblast ezivela kubanikeli ababini, ezazifumene i-100 nM ye-methylene blue ngaphambi kovavanyo, zaphinda zagcwalisa isikroba esenziwe ngokukrwela ngokukhawuleza ngakumbi ngokobalo kuneeseli ezinganyangwanga kwiiyure ezingama-24. Kulusu olwakhiwe ngokutsha olunobungqingqwa obupheleleyo, ukuvezwa ixesha elide kwandisa ukufuma nobungqingqwa bomaleko wesikhumba obulinganisiweyo, kunye nokwanda kokuveliswa kwe-elastin neCOL2A1 phakathi kweenguqu kwisakhiwo esixhasayo.

Ezi ziziphumo zokwenene ezinxulumene namanxeba, yaye zezazo iimodeli. Uvavanyo lokukrwela lulinganisa ukuhamba kweeseli ngokudibeneyo ukuwela isikroba kwisitya. Aluqulathanga mpendulo yamajoni omzimba, ukuhlala nokwanda kweebhaktheriya, ulwelo oluphuma enxebeni, okanye isigqubuthelo. Ulusu olwakhiwe ngokutsha longeza ulwakhiwo lwezicubu kodwa lusaswele ukujikeleza kwegazi nolandelelwano olupheleleyo lweenkqubo zokuphola. Akukho nanye kwezi modeli evavanya isigqubuthelo sogwebu okanye inkqubo yefotodayinamiki, yaye akukho nanye enika uxinaniso lokusetyenziswa ekhaya.

I-methylene blue ekwimixube elungiselelweyo ikwavavanyiwe kumanxeba ezilwanyana eziziimpuku. Ijeli ye-0.005% ekwiiniosome eyafundwa nguFarmoudeh noogxa bakhe yakhawulezisa ukuvaleka kwangoko kwamanxeba eempuku enziwe ngokusikwa nokususwa kwezicubu xa ithelekiswa nedayi engafakwanga kwezo zakhiwo kunye nesiseko sejeli esingenadayi, kunye neziphumo ezingcono zohlolo lwezicubu ngemikroskopu nemilinganiselo yoxinzelelo lokonakaliswa yioksijini. Inanoemulsion ye-0.1 mg/mL eyafundwa nguGao noogxa bakhe kwiimpuku ezincinci ezinesifo seswekile yakhawulezisa ukuvaleka kunye nokwanda kweziphawuli zokwakheka kwemithambo yegazi emitsha nokuncipha kwemiqondiso yokonakaliswa yioksijini nokufa kweeseli okucwangcisiweyo. Indlela umxube olungiselelwe ngayo ibalulekile kuzo zombini ezi meko; akukho siphumo kwezi esidlulela ngokuzenzekelayo kwidayi nje enyibilikiswe emanzini.

Kwaye icala lesiphumo alifani kuzo zonke iimeko. Kuvavanyo lukaDinc noogxa bakhe lokudibanisa amathumbu eempuku, i-methylene blue eyi-1% efakwe ngaphakathi esiswini yanciphisa uxinzelelo olufunekayo ukuze indawo yokudibanisa igqabhuke kunye nehydroxyproline ngosuku lwesithathu, ibonisa ukuncipha kwamandla okuphola kwangoko kuloo mthamo nakuloo ndlela yokufakwa. Uxinaniso, izicubu, indlela umxube olungiselelwe ngayo, nendlela yokufakwa zimisela isiphumo.

Yintoni omele uyibuze ngalo naliphi na ibango lamanxeba

Lonke ibango nge-methylene blue eliphathelele amanxeba kufuneka likwazi ukumelana nemibuzo emine. Okokuqala, yintoni kanye eyasetyenziswayo: isigqubuthelo esenziwe kumzi-mveliso esinegama, inkqubo echaziweyo yento eyenza indawo ichaphazeleke kukukhanya kunye nokukhanya, okanye isisombululo esingachazwanga? Okwesibini, yasetyenziswa entwenini: kwiiseli, kwinxeba lesilwanyana, okanye kumanxeba abantu odidi oluchaziweyo? Okwesithathu, yathelekiswa nantoni, kangangexesha elingakanani? Okwesine, ngesiphi isiphumo esilinganisiweyo: utshintsho kubungakanani bendawo, ukuvaleka, amanani eebhaktheriya, okanye umlinganiselo waselabhoratri omele ukuphola?

Amabango angawucacisiyo umbuzo wokuqala yeyona ngxaki ixhaphakileyo. Isiphumo esifunyenwe ngogwebu olufakwe idayi asikuqinisekisi ukuthambisa inxeba lide libe luhlaza okwesibhakabhaka, yaye umqondiso wokuchasana neentsholongwane emva kweseshoni yefotodayinamiki awukuqinisekisi ukuthambisa kancinane isisombululo ngaphandle kokukhanya. Isikhokelo esiza kupapashwa sokufunda amabango e-methylene blue ngamanxeba siza kunika olu luhlu lokuhlola indawo esisigxina enemizekelo echaziweyo; de kube ngoko, le theyibhile ingentla isebenza njengemephu.

Amanxeba anzulu, asasazekayo, anevumba elibi, ahamba nomkhuhlane, okanye angaphucukiyo afuna ukuhlolwa yingcali yezonyango kunedayi. Uphando oluphononongwe apha lufanele ukulandelwa kanye ngenxa yokuba lucacisa izinto ezisetyenzisiweyo, iimodeli, nemilinganiselo. Gcina ezi zintathu ziqhagamshelene nebango ngalinye ukuze eli candelo lophando liqondakale ngokucacileyo.