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Formic and acetic acids are the most abundant gaseous organic acids and play the key role in the atmospheric chemistry. In iodine-adduct chemical ionization mass spectrometry (CIMS), the low utilization efficiency of methyl iodide and humidity interference are two major issues of the vacuum ultraviolet (VUV) lamp initiated CIMS for on-line gaseous formic and acetic acids analysis. In this work, we present a new CIMS based on VUV lamp, and the ion-molecular reactor is separated into photoionization and chemical ionization zones by a reducer electrode. Acetone was added to the photoionization zone, and the VUV photoionization acetone provided low-energy electrons for methyl iodide to generate I-, and the addition of acetone reduced the amount of methyl iodide by 2/3. In the chemical ionization zone, a headspace vial containing ultrapure water was added for humidity calibration, and the vial changes the sensitivity as a function of humidity from ambiguity to well linear correlation (R2 > 0.95). With humidity calibration, the CIMS can quantitatively measure formic and acetic acids in the humidity range of 0%-88% RH. In this mode, limits of detection of 10 and 50 pptv are obtained for formic and acetic acids, respectively. And the relative standard deviation (RSD) of quantitation stability for 6 days were less than 10.5%. This CIMS was successfully used to determine the formic and acetic acids in the underground parking and ambient environment of the Shandong University campus (Qingdao, China). In addition, we developed a simple model based formic acid concentration to assess vehicular emissions.

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High ammonia-nitrogen digestate has become a key bottleneck limiting the anaerobic digestion of organic solid waste. Vacuum ammonia stripping can simultaneously remove and recover ammonia nitrogen, which has attracted a lot of attention in recent years. To investigate the parameter effects on the efficiency and mass transfer, five combination conditions (53 °C 15 kPa, 60 °C 20 kPa, 65 °C 25 kPa, 72 °C 35 kPa, and 81 °C 50 kPa) were conducted for ammonia stripping of sludge digestate. The results showed that 80% of ammonia nitrogen was stripped in 45 min for all experimental groups, but the ammonia transfer coefficient varied under different conditions, which increased with the rising of boiling point temperature, and reached the maximum value (39.0 mm/hr) at 81 °C 50 kPa. The ammonia nitrogen removal efficiency was more than 80% for 30 min vacuum stripping after adjusting the initial pH to above 9.5, and adjustment of the initial alkalinity also affects the pH value of liquid digestate. It was found that pH and alkalinity are the key factors influencing the ammonia nitrogen dissociation and removal efficiency, while temperature and vacuum mainly affect the ammonia nitrogen mass transfer and removal velocity. In terms of the mechanism of vacuum ammonia stripping, it underwent alkalinity destruction, pH enhancement, ammonia nitrogen dissociation, and free ammonia removal. In this study, two-stage experiments of alkalinity destruction and ammonia removal were also carried out, which showed that the two-stage configuration was beneficial for ammonia removal. It provides a theoretical basis and practical technology for the vacuum ammonia stripping from liquid digestate of organic solid waste.

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El síndrome compartimental agudo requiere de la descompresión quirúrgica, mediante fasciotomía, esta técnica debe ser urgente y será clave para evitar la instauración de graves secuelas. El posterior abordaje de estas heridas de difícil y lenta cicatrización suponen un reto para los profesionales de la salud y un problema para la salud pública debido a los altos costes y elevada morbilidad. La terapia de presión negativa (TPN) o cura por vacío (VAC, "vacuum assisted closure") es un tratamiento no invasivo que consigue la curación de las heridas favoreciendo la vascularización, la aparición del tejido de granulación y eliminación del exceso de exudado[AU]

Acute compartment syndrome requires surgical decompression by fasciotomy, this technique must be urgent and will be key to avoid the establishment of serious sequels. The subsequent approach to these wounds, which are difficult and slow to heal, is a challenge for health professionals and a problem for public health due to high costs and high morbidity. Negative pressure therapy (NPWT) or vacuum assisted closure (VAC) is a non-invasive treatment that achieves wound healing by promoting vascularization, the appearance of granulation tissue and elimination of excess exudate[AU]

A síndrome compartimental aguda requer descompressão cirúrgica, por fasciotomia, esta técnica deve ser urgente e será fundamental para evitar o estabelecimento de sequelas graves. O tratamento subsequente destas feridas difíceis e de cicatrização lenta é um desafio para os profissionais de saúde e um problema desaúde pública devido aos elevados custos e à elevada morbilidade. A terapia por pressão negativa (NPWT) ou o encerramento assistido por vácuo (VAC) é um tratamento não invasivo que permite a cicatrização de feridas através da promoção da vascularização, do aparecimento de tecido de granulação e da remoção do excesso de exsudado[AU]

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OBJECTIVES: The vacuum erection device (VED) is a second-line treatment tool recommended in erectile dysfunction (ED) guidelines but has long been unavailable in Japan. A new VED, Vigor 2020® (A & HB Company Limited, Tokyo, Japan), has now been manufactured and received medical approval from the Pharmaceuticals and Medical Devices Agency in Japan. We conducted a retrospective observational study of ED patients who used Vigor 2020 in clinical practice. METHODS: We analyzed male ED patients aged ≥20 years treated with Vigor 2020 in our outpatient clinics. The primary endpoint was improvement of erection as evaluated by an Erection Hardness Score (EHS) of ≥1 point. Secondary endpoints were improvement of sexual function and adverse events as evaluated by the International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire for assessing ejaculatory dysfunction (MSHQ-EjD). RESULTS: Thirty-three patients (mean age, 57.21 [27-86] years) could be evaluated before and after using Vigor 2020. Among the 16 patients with baseline EHS ≤2, 14 (93.33%) improved by ≥1 point, and 10 of these 16 patients (62.50%) improved to EHS ≥3 and could insert vaginally. Significant improvement was observed for IIEF total score and for the MSHQ-EjD in patients with an EHS of ≥3 after use of Vigor 2020. No patient experienced significant adverse events. CONCLUSIONS: The Vigor 2020 may be an efficacious treatment tool for ED. Patients with significant ED experienced not only significant improvement of erection but also improvement of ejaculation with its use.

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The substantial deformation exhibited by hyperelastic cylindrical shells under pressurization makes them an ideal platform for programmable inflatable structures. If negative pressure is applied, the cylindrical shell will buckle, leading to a sequence of rich deformation modes, all of which are fully recoverable due to the hyperelastic material choice. While the initial buckling event under vacuum is well understood, here, the post-buckling regime is explored and a region in the design space is identified in which a coupled twisting-contraction deformation mode occurs; by carefully controlling the geometry of our homogeneous shells, the proportion of contraction versus twist can be controlled. Additionally, bending as a post-buckling deformation mode can be unlocked by varying the thickness of our shells across the circumference. Since these soft shells can fully recover from substantial deformations caused by buckling, then these instability-driven deformations are harnessed to build soft machines capable of a programmable sequence of movements with a single actuation input.

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BACKGROUND AND AIMS: Esophageal stricture (ES) is a severe adverse event following wide-field endoscopic submucosal dissection (ESD) of superficial esophageal carcinoma. This study evaluated the efficacy and safety of combining endoscopic vacuum therapy (EVT) and budesonide orodispersible tablet (BOT) in preventing post-ESD strictures. METHODS: This prospective case series included patients with superficial esophageal squamous cell carcinoma and adenocarcinoma who had wide-field ESD (≥75% circumference, resection length ≥50 mm). After ESD, EVT was applied immediately, followed by 8 weeks of BOT. The main outcome measurement was the incidence of post-ESD stricture. RESULTS: Eleven patients underwent ESD. Of these, 81.8% had 75-99% circumference resected, and 18.2% had a circumferential resection. EVT remained in situ for a mean of 3.5 days. No esophageal strictures were observed by the final follow-up. There were no major adverse events related to EVT or BOT. CONCLUSIONS: The prophylactic combination of EVT and BOT is a novel and promising strategy for reducing post-ESD strictures.

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The storage duration of fresh meat products is a contributing factor leading to increased waste and loss at the retail counter. Losses of fresh pork can be linked to packaging methods that do not protect the attributes of color, taste, and odors consumers use in determining wholesome meat. Boneless pork loins (N = 63) were fabricated into 2.54-cm-thick chops and assigned to one of three vacuum treatments (VacA, VacB, VacC) or a fourth polyvinyl chloride overwrap (PVC) treatment to assess objective fresh color, cook loss, Warner-Bratzler shear force (WBSF), and lipid oxidation. Pork chops (n = 882) were evaluated at 5-day intervals (D 0, 5, 10, 15) in a randomized complete block design. Pork chop surface color was lighter (L*; p < 0.0001) when stored in a vacuum compared to PVC-packaged loin chops, regardless of storage duration. Redness (a*) values were greater (p < 0.0001) for loin chops stored in PVC than all other vacuum packaging treatments throughout the entire 15-day display period. Relative values for chroma on PVC-packaged loin chops were greater (p < 0.0001) throughout the simulated retail display period. An interaction of day and packaging treatment (p < 0.0343) occurred for WBSF. Lipid oxidation for pork chops packaged using PVC was significantly greater (p < 0.0001) from Day 10 through the completion of the storage period. Results indicate that vacuum packaging limits the deterioration of fresh pork loin chops, whereas traditional overwrapping expedites the color and lipid oxidation during refrigerated storage.

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The freshness of Atlantic salmon is influenced mainly by tissue metabolism, which in turn is affected by storage time and conditions. The alterations in taste profiles and nutritional values of salmon when packaged using vacuum methods have not been fully understood, and the factors contributing to these changes require further research. In this work, the extraction method for flavor nutrients from salmon was optimized via the Plackett-Burman (PB) test. A sensitive and rapid targeted metabolomics method for the simultaneous determination of 34 nutrients was successfully established via ultra-performance liquid chromatography-triple quadrupole/linear ion trap composite mass spectrometry (UHPLC-QTRAP/MS), and various nutritional compositions during storage at 0 °C under different vacuum conditions (0 kPa or -90 kPa) for 4 and 8 days were analyzed. Results showed that storage time had a significant effect on salmon metabolism. The total amino acids decreased by 62.95% and 65.89% at 0 kPa and -90 kPa, respectively. Notably, a marked reduction in histidine after 8 days at -90 kPa may have diminished bitterness, while decreased levels of umami-tasting amino acids like glutamine and aspartic acid affected the overall flavor profile. Overall, the packaging conditions at 0 °C and 0 kPa were more suitable for the preservation of most nutrients in salmon. Pathway enrichment analysis revealed that the reduction in substances was mainly related to the alanine, aspartate, and glutamate metabolism pathways. Alanine, inosine, and histidine, whose levels changed significantly, can bind to the typical umami taste receptor TIR1/TIR3 and can be biomarkers to monitor and determine the freshness or spoilage of salmon after 4-8 days of storage. This study revealed the changes in small-molecule nutrients in salmon during storage under different packaging conditions, which provides a reference for the packaging preservation technology of fresh salmon and new ideas for the evaluation of salmon quality and determination of freshness.

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Storing ground beef at frozen temperatures prior to refrigerated display when using thermoforming vacuum packaging is not a common manufacturing practice. However, limited data on thermoforming packaging film and its interaction with meat quality suggests that more information is needed. The current study aimed to identify the influences of thermoforming packaging on the surface color and lipid oxidation of ground beef. Ground beef was portioned into 454 g bricks and packaged into one of three thermoforming films: T1 (150 µ polyethylene/EVOH/polyethylene coextrusion), T2 (175 µ polyethylene /EVOH/polyethylene coextrusion), and T3 (200 µ polyethylene/EVOH/polyethylene coextrusion), stored for 21 days at -20.83 °C (±1.50 °C), and displayed for 42 days at 3.0 °C ± 1.5 °C. There were no statistical differences for the packaging treatment of lipid oxidation (p = 0.0744), but oxidation increased throughout storage day (p < 0.0001). The main effects of treatment and day resulted in altered (p < 0.05) surface lightness (L*), redness (a*), yellowness, hue angle (°), red-to-brown (RTB), and relative myoglobin for met-myoglobin (MET), deoxymyoglobin (DMB), and oxymyoglobin (OMB). Surprisingly, there was an interaction between treatment and day for the calculated relative values of chroma (p = 0.0321), Delta E (p = 0.0155), and the ratio of a*:b* (p < 0.0001). These results indicate that thermoforming vacuum packaging can reduce the rate of deterioration that occurs to ground beef color and the rate of oxidation.

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The effect of different methods of drying celery root enriched with beet juice by vacuum impregnation (VI) was studied. The process of convection drying, vacuum drying and freeze drying was carried out. Compared to dried indigenous celery, dry impregnated tissue was characterized by lower values of dry matter, L* and b* color parameters, as well as higher values of water activity, density and a* color parameter. In addition, VI reduced the drying time. Forty Volatile Organic Compounds (VOCs) were found in celery, while fifty-one VOCs were found in the profile of celery with beetroot juice. The innovative method of vacuum impregnation made it possible to produce a new type of product with changed properties and a variable VOCs profile. The best fit of the drying process kinetics was achieved by using the logistic model. Increasing the temperature during convection drying resulted in shorter drying time, increased values of dry matter, reduced the water activity value and altered VOCs.

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Using sous-vide technology in combination with essential oils offers the potential to extend the preservation of food items while preserving their original quality. This method aligns with the growing consumer demand for safer and healthier food production practices. This study aimed to assess the suitability of minimal processing of game meat and the effectiveness of vacuum packaging in combination with Piper nigrum essential oil (PNEO) treatment to preserve red deer meat samples inoculated with Listeria monocytogenes. Microbial analyses, including total viable count (TVC) for 48 h at 30 °C, coliform bacteria (CB) for 24 h at 37 °C, and L. monocytogenes count for 24 h at 37 °C, were conducted. The cooking temperature of the sous-vide was from 50 to 65 °C and the cooking time from 5 to 20 min. Additionally, the study monitored the representation of microorganism species identified through mass spectrometry. The microbiological quality of red deer meat processed using the sous-vide method was monitored over 14 days of storage at 4 °C. The results indicated that the TVC, CB, and L. monocytogenes counts decreased with the temperature and processing time of the sous-vide method. The lowest counts of individual microorganism groups were observed in samples treated with 1% PNEO. The analysis revealed that PNEO, in combination with the sous-vide method, effectively reduced L. monocytogenes counts and extended the shelf life of red deer meat. Kocuria salsicia, Pseudomonas taetrolens, and Pseudomonas fragi were the most frequently isolated microorganism species during the 14-day period of red deer meat storage prepared using the sous-vide method.

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BACKGROUND: Anastomotic leaks post-ileoanal pouch-anal anastomosis (IPAA) significantly compromise patient outcomes and increase healthcare resource utilization. The aim of this study was to evaluate outcomes of Endoluminal Vacuum Therapy (EndoVac) for pouch leaks. We hypothesized that EndoVac for early compared with late leaks was associated with a higher pouch survival rate. METHODS: We retrospectively reviewed consecutive pouch anastomotic leaks treated with EndoVac therapy at our institution between 2013-2023. Patients were stratified into early (≤30 days) and late (>30 days) leaks. Anastomotic healing was defined as complete closure of the leak site and resolution of symptoms. Pouch failure was defined as a permanent ileostomy or pouch excision. The probability of pouch survival was estimated using the Kaplan-Meier method. RESULTS: A total of 14 IPAA patients were included: median age 34 years, 71% were male, and median body mass index 23.46kg/m2. DIAGNOSES: ulcerative colitis (n=12) and familial adenomatous polyposis (n=2). The median (IQR) time from pouch construction to leak was 44.5 (12-192) days; of these, 6 (43%) early and 8 (57%) late. All (100%) leaks were at the anastomosis; all (100%) were diverted at the time of EndoVac therapy: 10 (71%) still diverted and 4 (29%) re-diverted. Patients underwent a median of 5.5 EndoVac changes (3-7) over a duration of 13.5 (6-21) days from initiation of treatment to cessation of therapy. After EndoVac therapy, healing was observed in 10 (71%) patients, 2 of whom required a minor handsewn anastomotic revision but healed completely, and 4 did not heal: 3 had pouch excision and 1 underwent redo pouch surgery. Anastomotic healing (66.7% vs. 75%, p=0.7) and pouch survival (83.3% vs. 75%, p=0.73) were not significantly different between the early and late leak groups. The overall pouch salvage rate was 78.5%. CONCLUSIONS: EndoVac therapy was effective in achieving high rates of pouch salvage and anastomotic healing in patients with ileoanal pouch leaks, irrespective of the timing of intervention postoperatively. This supports the use of EndoVac as a viable treatment option for both early and late anastomotic leaks.

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INTRODUCTION: Cervical laceration is an obstetric injury associated with severe postpartum hemorrhage and subsequent spontaneous preterm birth. While operative vaginal delivery is a known risk factor for cervical laceration, it is unclear whether forceps and vacuum deliveries incur the same risk. The aim of this systematic review was to compare the risk of cervical laceration between operative instruments (forceps vs vacuum). MATERIAL AND METHODS: Medline, Embase, Global Health, CENTRAL, Emcare, and Web of Science were searched from inception until August 2024 with terms related to operative vaginal delivery and cervical laceration. Studies comparing the risk of cervical laceration in individuals undergoing forceps or vacuum delivery were included. Two authors conducted screening, data extraction, and quality assessment of all studies. Random-effects models were used to pool risk ratios across studies and certainty of evidence was assessed using Cochrane methods and the GRADE approach. PROSPERO Registration Number CRD42023421890. RESULTS: Thirteen studies were eligible for inclusion, 3 randomized controlled trials (RCTs) and 10 observational studies. The overall rate of cervical laceration was 0.35% (990/284218 births) where 1.04% of forceps deliveries (456/43817) were complicated by cervical laceration compared to 0.22% of vacuum deliveries (534/240401). The risk of cervical laceration was 2-5 fold greater in forceps deliveries than in vacuum deliveries: pooled unadjusted risk ratio [RR] 4.83, 95% confidence interval [CI] 1.56-14.98 among RCTs and pooled unadjusted RR 1.89, 95% CI 1.59-2.24 among observational studies. The overall quality of evidence was low to moderate mainly due to the lack of attention to confounding in the included literature. The GRADE assessment indicated that the certainty of evidence was very low for observational studies and moderate for RCTs. CONCLUSIONS: Low certainty of evidence indicates that forceps deliveries may be associated with an increased risk of cervical laceration compared to vacuum deliveries.

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Two-dimensional semiconducting materials such as MoS2have gained significant attention for potential applications in electronic components due to their reduced dimensionality and exceptional electrical and optoelectronic properties. However, when reporting the performance of such 2D-based devices, one needs to consider the effect of the environment in which the characterization is carried out. Air exposure has a non-negligible impact on the electronic performance and vacuum thermal annealing is an established method to decrease the effects of adsorbates. Nevertheless, when measurements are performed in ambient conditions these effects arise again. In this work, we study the changes in the electrical and optoelectronic properties of single-layer MoS2-based devices at air exposure after thermal annealing treatment. Measurements are carried out in anin-situvacuum thermal annealing system, enabling the recording of electrical performance degradation over time. Moreover, this work shows how hexagonal boron nitride (hBN) capping improves device performance, both in vacuum and after venting, as well as stability, by decreasing the degradation speed by around six times. The results suggest that vacuum thermal annealing and hBN capping are methods to mitigate the effects of air environment on these devices.

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Vacuum collected toilet wastewater (VCTW) contains high and fluctuating contents of organics and nitrogen, which exerts technological challenges to biological treatment processes. A partial nitrification-denitrification and anammox (PND-AMX) process was developed in sequencing batch reactor (SBR) and moving bed biofilm reactor (MBBR) to achieve effective nitrogen removal in VCTW at low ambient temperature. Stable PND was achieved, and nitrogen removal efficiency in SBR could be manipulated by adjusting influent COD/N ratios. As temperature ≥18 °C, 91.0% nitrogen was removed in PND-AMX process. In spite of the decreased anammox activity at 13-18 °C, more than 90% nitrogen removal could be obtained by adjusting SBR influent COD/N to 2.43 ± 0.32 with methanol. In MBBR reactor, Candidatus Kuenenia was the dominant anammox bacteria and contributed to more than 90% nitrogen removal capacity. Co-existing anammox and denitrifying bacteria synergistically contributed to the removal of ammonium, nitrite, nitrate, and COD in MBBR.

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The complex relationships within desert ecosystems and their environmental conditions are reflected in patterns of plant water use. Thus, understanding the sources of water used by plants in these areas is crucial for effective resource management. In this study, we investigated the water use pattern of Haloxylon ammodendron in Semnan province, in the central plateau of Iran, using the stable isotope analysis. We employed a simple, homemade cryogenic vacuum distillation (CVD) system to directly extract water from soil samples and different plant components for subsequent analysis by mass spectrometer. The contribution of each possible water source to the plant xylem water was estimated using the IsoSource mixing model. The pattern of δ 18O values in the xylem water of H. ammodendron indicated its reliance on groundwater as a primary water resource during the wet season. Additionally, the correlation of sand particles with both δ2H and δ18O was found to be 0.32. Moreover, the δ 18O values of H. ammodendron xylem water were mainly similar to those of groundwater, suggesting the species' dominant use of groundwater. The findings of this study provide valuable insights for strategically planting H. ammodendron to mitigate impacts on groundwater resources and ensure long-term sustainability in arid and semi-arid regions.

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To fully leverage the advantages of both hot air drying and radio frequency vacuum drying, a segmented combination drying technique was applied to post-harvest Cistanche. This new drying method involves using hot air drying in the initial stage to remove the majority of free water, followed by radio frequency vacuum drying in the later stage to remove the remaining small amount of free water and bound water. During the radio frequency vacuum drying (RFV) phase, the effects of temperature (45, 55, and 65 °C), vacuum pressure (0.020, 0.030, and 0.040 MPa), plate spacing (65, 75, and 85 mm), and slice thickness (4, 5, and 6 mm) on the drying characteristics, quality, and microstructure of Cistanche slices were investigated. Additionally, infrared thermal imaging technology was used to examine the surface temperature distribution of the material during the drying process. The results showed that compared to radio frequency vacuum drying alone, the hot air-radio frequency combined drying significantly shortened the drying time. Under conditions of lower vacuum pressure (0.020 MPa), plate spacing (65 mm), and higher temperature (65 °C), the drying time was reduced and the drying rate increased. Infrared thermal imaging revealed that in the early stages of hot air-radio frequency vacuum combined drying, the center temperature of Cistanche was higher than the edge temperature. As drying progressed, the internal moisture of the material diffused from the inside out, resulting in higher edge temperatures compared to the center and the formation of overheating zones. Compared to natural air drying, the hot air-radio frequency vacuum combined drying effectively preserved the content of active components such as polysaccharides (275.56 mg/g), total phenols (38.62 mg/g), total flavonoids (70.35 mg/g), phenylethanoid glycosides, and iridoids. Scanning electron microscopy observed that this combined drying method reduced surface collapse and cracking of the material. This study provides theoretical references for future drying processes of Cistanche.

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OBJECTIVE: To evaluate the frequency and factors associated with clip migration in MRI-guided breast biopsies. METHODS: This study was approved by our Institutional Review Board and was compliant with HIPAA. We retrospectively evaluated all MRI-guided biopsies performed between January 2013 and December 2020 in our institution for clip migration. Only patients with follow-up breast MRI showing the clip were included in the study. Migration was defined as movement of the clip of 10 mm or more from the target lesion. Migration frequency and directions were recorded. Factors associated with clip migration were analyzed using statistical tests as appropriate. RESULTS: A total of 291 biopsies in 268 women were included in the study with 31 migration events recorded (11%; 95% CI, 7%-15%). All migrations occurred along the biopsy tract; 97% (30/31) of them displaced distal to the needle entry site. More than 50% regional fat (around the target lesion) was the strongest factor associated with migration, seen in 21/141 women (15%), compared to 10/150 (7%) with 50% or less local fat (P = .023). Global fatty breast was more loosely associated with migration, showing borderline significance (P = .06). Other factors did not correlate with clip migration, including lesion size, depth, or location; pathology result; breast thickness; or biopsy approach. CONCLUSION: Although clip migration after breast MRI-guided biopsy is an uncommon event, it occurs more often when the target lesion is surrounded by fat, with the clip usually displaced away from the needle entry site.

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OBJECTIVE: To investigate the effectiveness of antibiotic bone cement combined with the vacuum sealing drainage (VSD) technique for repairing sacrococcygeal pressure ulcer wounds. METHODS: A retrospective analysis was conducted on data from 136 patients treated at Yantai Affiliated Hospital of Binzhou Medical College between May 2020 and June 2022. The cases were devided into a control group and a study group according to their treatment regimen. Indicators of postoperative recovery including blood routine recovery time, hospital stay, antibiotic application time, and healing time were compared between the two groups. Before the procedure and 6, 12, 24, and 48 hours following the operation, the pain levels of patients in both groups were examined using a visual analogue scale (VAS). On the 3rd, 7th, 14th, 21st, and 28th days of treatment, the pressure ulcer scale for healing (PUSH) was used to measure the pressure ulcer area between the two groups. On the 7th, 14th, 21st, and 28th days following treatment, the capillary density values were compared between the two groups, along with the levels of interleukin-1ß (IL-1ß), interleukin-12 (IL-12), and c-reactive protein (CRP). The proportions of immunoglobulin M (IgM) and immunoglobulin G (IgG) levels, CD3+, CD4+, and CD8+ T cell subsets, as well as CD4+/CD8+ ratio, were compared between the two groups. RESULTS: The blood routine recovery time, hospital stays, antibiotic usage duration, and healing time were all significantly shorter in the study group compared to those in the control group (all P<0.05). At 6 h, 12 h, 24 h, and 48 h following surgery, the VAS score in study group was significantly lower than that of the control group (P<0.05). The study group also showed a greater reduction in pressure ulcer area, with lower PUSH scores observed on days 14, 21, and 28 (P<0.05). Post-treatment levels of IL-1ß, IL-12, and CRP decreased in both groups, with significantly lower levels in the study group (P<0.05). Following therapy, both groups demonstrated significantly increased levels of CD3+, CD4+, CD4+/CD8+, IgM and IgG and reduced level of CD8+. These improvements were more pronounced in the study group (all P<0.05). CONCLUSION: The combination of antibiotic bone cement and VSD is effective in enhancing recovery, reducing pain and inflammation, and improving immune response in the treatment of sacrococcygeal pressure ulcers.

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Background: For decades, open surgical repair was the only available method to treat pectus excavatum (PE). In 1998 Donald Nuss described first time a minimally invasive repair of pectus excavatum (MIRPE), and today MIRPE is performed with increasing frequency worldwide. However, despite its minimally invasive approach, with the widespread use of MIRPE the character and number of complications have increased. 20 years ago, non-surgical measures such as vacuum bell therapy (VBT) were introduced as a useful complement for specific treatment of PE patients. However, until today there are no existing validated guidelines concerning VBT. Methods: The study includes the results of an online survey submitted to the members of Chest Wall International Group (CWIG), a selective review of the English spoken current literature with focus on VBT and an analysis of our own previous studies concerning VBT. Results: Seventy-two percent of the CWIG members practicing in 47 different institutions confirmed to use VBT for PE patients. Furthermore, within the last 10 to 15 years an increasing number of studies were identified reporting on successful use of VBT for PE. However, a recently published study stated that the effect of VBT is predominantly because of thickening of the chest wall by increasing pre-sternal adipose tissue. There was one study comparing VBT to MIRPE but no randomized and/or prospective studies comparing conservative treatment vs. surgical repair or conservative treatment vs. no specific therapy. Variables predictive of an excellent outcome could be identified. Especially in younger PE patients, VBT is reported with increasing frequency in the survey as well as in the literature. However, validated guidelines concerning VBT are still not available. Conclusions: Non-operative treatment of PE with VBT proved to be safe and a potential alternative to surgical repair in carefully selected PE patients. Patient's age at diagnosis and severity of the PE represents relevant variables to decide which kind of therapy might be successful to correct PE. Especially in PE patients under the age of 10 years, VBT seems to represent the first step of specific therapy.