Abstract of JUC Clinical Indications

Abstract of JUC Clinical Indications Indications Current Treatments Limitations JUC Makes Up Limitations JUC Usage and Dosage JUC Precautions VVC Suppositories or oral antimicrobial agents are used in the vagina; antifungal and antibacterial ointments are used in the vulva.[1,2,3] Antimicrobial agents, especially their local application, may cause drug resistance more easily.[4] Colonization of pathogens on underpants or sanitary napkins causes recurrent ascending infections. Antifungal drugs can treat VVC, but cannot effectively prevent its recurrence.[5] Clinical trials prove that the local application of JUC in the vulva can achieve the equivalent effect of combined application of antibacterial and antifungal drugs, without causing drug resistance. JUC can also be sprayed on underwear, sanitary napkins and so on to eliminate infection sources, block infection routes and prevent ascending infections. 1. Before usage, clean the vagina with clean water and use suppositories in the vagina or receive oral administration; 2. Spray JUC:Spray 15cm from the skin, 3 times a day and 3 sprays each time until healing; 3. At the same time, spray JUC evenly on articles (underpants, sanitary napkins) touched by patients and let it dry. 4. When necessary, combine with antimicrobial agents for treatment. Clean the vulva before using JUC because it can only form a film on the body surface, and the effect could be affected by secretions. Condyloma Acuminatum (CA) Chemotherapy or surgery (cryotherapy, laser surgery, electrosurgery, etc.) are used for treatment.[7] There s no method to solve the problem of the high recurrence of CA in the world at present. [7-9] Clinical trials prove that JUC can effectively reduce CA recurrence after chemotherapy or surgery.[10-12]. 1. Before treatment, spray JUC:spray the area centered by the wart body, 10cm in diameter. Spray evenly 15cm from the skin; 2. After chemotherapy or surgery, spray JUC: spray the area centered by the lesion, 10cm in diameter. Spray 15cm from the skin, 3 times a day and 3 sprays each time until wound healing. 3. At the same time, spray JUC evenly on articles contacted with the lesion (clothing, towel, etc.) and let it dry. Once a day. Before laser treatment, the affected part and local mucosa are sprayed with JUC to prevent viruses from transferring and colonizing to other mucosas during laser treatment. After laser treatment, when sprayed on wounds,juc kills local viruses, preventing viruses from colonizing on wounds, preventing CA recurrence. Local application of JUC can prevent bacterial secondary infection, without causing drug resistance. 1

LEEP surgery LEEP surgery is a common method to treat CIN and various cervical lesions. There is no effective drug to treat local infection after LEEP surgery in the world at present. Clinical trials prove that the application of JUC after LEEP surgery can isolate the wound, prevent infections and promote wound healing. Auxiliary treatment of STD (gonorrhea, syphilis, and non-gonorrhea ) Antimicrobial agents are used to treat systemic infection of STD. There is no effective treatments for local symptoms. JUC can be used for local treatment of STD, which shortens course of treatment. Prevention of STD (gonorrhea, syphilis, and non-gonorrhea ) Condoms are often used to prevent STD at present. Condoms can t 100% prevent the infection; While there s no effective way to prevent transferring on articles touched by STD patients. Before intercourse, JUC is sprayed to form a protective film, preventing transferring of STD. JUC can also be used on articles touched by patients to effectively block infection routes and prevent the incidence of STD. Tinea pedis Antibacterial ointments, powders or gels are used for local treatment after debridement; For serious infections and recurrent patients, systemic application Antimicrobial agents, especially their local application, may cause drug resistance more easily.[4] Local application of antimicrobial agents has poor compliance. [13] Current Treatments don t JUC provides an overall treatment protocol, which achieves the equivalent effect of antifungal drugs in treating tinea pedis without causing drug resistance. It has good compliance and prevents secondary infection. JUC can 1. Debridement: When there are pustules or blisters, rupture the blister skin with aseptic forceps and rinse with normal saline; normal saline are also needed when there re discharges; 2. Spray JUC:Spray 15cm from the skin or article and cover the whole foot When there are pustules or blisters, it will cause more serious infection if not extracting blister liquids, removing crusts or debriding. This is because JUC can only form a film on the body surface and doesn't work on deep pathogens. JUC should be sprayed on 2

of Antimicrobial agents is needed. [13]. prevent external transmission, and fungus can colonize on shoes and socks easily, causing recurrence. also be used on shoes and socks to prevent recurrence. [14] evenly. Apply 3 times a day and 30 days. 3. At the same time, spray JUC evenly on articles contacted with the foot (shoes, socks, etc.) and let it dry. Once a day. 4. When necessary, combine with surrounding skin and articles touched by patients to prevent transmission. Only by spraying JUC for 30 continuous days, tinea pedis can be cured completely and recurrence can be prevented. Herpes Zoster Herpes Zoster is a self-healing disease. But for the older, children or immuno-deficient patients, it should be treated with antiviral drugs combined with analgesics and steroids [15,16]. Antiviral therapy is not quite effective; rashes around the lesion are susceptible to repeated bacterial infection; local application of analgesics and steroids may have side effects. [16] Local application of JUC on the lesion of herpes zoster can effectively shorten the course of disease and time of neuralgia; JUC can kill and isolate bacteria, preventing bacterial secondary infection and avoid drug resistance. JUC is a safe antiviral solution without side effects. [17] 1. Debridement: When the blister is large, extract blister liquid with aseptic syringe and gently remove blister skin with aseptic forceps, then rinse with normal saline; 2. Spray JUC: Spray the area centered by the lesion, 10cm in diameter. Spray 15cm from the skin, 3 times a day and 3 sprays each time until wound healing. 3. At the same time, spray JUC evenly on articles touched by the patient (clothing, towel, etc.) and let it dry. Once a day. 4. When necessary, combine with antiviral drugs and other dressings for treatment. If debridement is not performed, the local antiviral effect will not be desirable; because JUC can only form a film on the body surface and can not work on deep viruses. Spray JUC on the affected part, surrounding skin and articles to block infection routes and prevent secondary infection. Impetigo Debride locally, remove the crust, then apply antibiotics Antimicrobial agents, especially their local application, may cause drug JUC has the same efficacy as antimicrobial agents, without drug resistance. 1. Debridement: When the blister is large, extract blister liquid with aseptic syringe and gently remove If the impetigo is larger and not debrided, and the blister fluid is not extracted, the patients may have 3

or disinfectants locally; serious patients may be treated combined with oral antibiotics [18, 19]. resistance more easily. Local medication may have poor compliance. [4] Ruptured blister fluid may infect normal skin, causing the formation of new lesions; while contaminating touched articles like clothes and towels, generating new source of infection, and leading to the formation of new lesions. Local application of ointments may lead to low compliance and inconvenience in application, and clothes contamination. Spray JUC on the affected part, surrounding skin and touched articles to effectively block infection routes and prevent the formation of new lesions. JUC is convenient to use, and has high compliance [20]. blister skin with aseptic forceps, then rinse with normal saline; 2. Spray JUC: Spray the area centered by the lesion, 10cm in diameter. Spray 15cm from the skin, 3 times a day and 3 sprays each time until wound healing. 3. At the same time, spray JUC evenly on articles touched by the patient (clothing, towel, etc.) and let it dry. Once a day. 4. When necessary, combine with more serious infections; because JUC can only form a film on the body surface and can not work on deep bacteria. If not combined with spraying JUC on the affected part, surrounding skin and touched articles, it may easily lead to cross infection and secondary infection. Balanitis Balanitis is treated locally mainly with antimicrobial agents and steroids for external application in clinics [21, 22]. Antimicrobial agents, especially their local application, may cause drug resistance more easily.[4] Treatment with single antibiotics may have poor therapeutic effect. [22] Steroid hormone may have side effects. [23] Ointments are not convenient to use, and have poor compliance. JUC has the same efficacy as other antimicrobial agents, and does not cause drug resistance. JUC can kill microorganisms (bacteria, fungi, viruses), and have favorable effect on mixed infection. JUC is a safe antimicrobial solution with no side effect. JUC is convenient to use, and has good compliance. There is no need to smear.[24] 1. Before usage, clean the vagina with clean water. 2. Perform debridement if there s purulency; 3. Spray JUC: Spray 15cm from the skin or article, 3 times a day and 3 sprays each time until healing; 4. At the same time, spray JUC evenly on articles touched by the patient (shoes, socks, etc.) and let it dry. Once a day. 5. When necessary, combine with If debridement is not performed before spraying, it may easily cause more severe infection, because discharges may affect JUC forming a film. If overuse JUC every time, the mucosa may be red and swollen. We should reduce the dosage. Spray JUC on the articles like underpants to block infection routes and prevent cross infection. JUC should not be discontinued after 4

the disappearance of acute inflammation. Continue to use JUC for one month to prevent recurrence. Acute Wound At present, it is treated locally with antimicrobial agents and dressings for external application in clinics. [25] Antimicrobial agents, especially their local application, may cause drug resistance more easily.[4] Dressings have no explicit antibacterial effect, and can not prevent and treat infections. [26] antimicrobial film on the acute wounds to prevent and treat infections without causing drug resistance, and it functions as an invisible barrier dressing. [27-31] 1. Local debridement before usage: remove necrotic or contaminated tissues and remove blister skin if there re blisters. Rinse and disinfect with normal saline or disinfectants; 2. Spray JUC: Spray 15cm from the wound, 3 times a day and 3 sprays each time until wound healing. 3. When necessary, combine with JUC is only used for superficial, small, I and II degree wounds after debridement because discharges may affect film forming and efficacy. For large and deep wounds, JUC can be used combined with other treatments. Chronic wound (pressure ulcer or bed sore) Mainly for debridement clinically, and dressings, analgesics and local antimicrobial agents are used for treatment. [32] The nonhealing of chronic wounds is directly related to the bacterial biofilm formed on the wound surface. The efficacy is not obvious by using antimicrobial agents, and it is easy to cause drug resistance. [33] JUC can prevent the formation of bacterial biofilm on the wounds, changing the non-healing wounds into healable wounds. It will not cause drug resistance while removing wound odor and relieving the pain. It is convenient to use without smearing or bandaging. Therefore JUC has good patient compliance. [34-36] 1. Local debridement before usage: remove necrotic or contaminated tissues and remove blister skin if there re blisters. Rinse and disinfect with normal saline or disinfectants; 2. Spray JUC: Spray evenly 15cm from the wound on the wound and surrounding area, 2 times a day and 3 sprays each time until wound healing. 3. When necessary, combine with If debridement is not performed, JUC has less effect because JUC can only work on the wound surface without any penetration function. For small and superficial wounds, JUC can be used alone. JUC shall be applied in time within 5 days after the formation of wounds, or the wounds will become non-healing wounds because of the bacterial biofilm formed on the wound surface. For large and deep wounds, JUC can be used to prevent the formation of bacterial biofilm and change the 5

non-healing wounds into healable wounds. Then combine JUC with other treatments to promote wound healing. Catheter-associ ated urinary tract infection (CAUTI) Routine care. The bacterial biofilm formed on the surface of urinary catheter affects the action of antibiotics against bacteria, leading to high CAUTI incidence and difficulty for prevention and treatment. [37] Currently there are no effective methods to reduce CAUTI incidence internationally. antimicrobial film on the surface of the urinary catheter and effectively prevents the formation of bacterial biofilm, thus preventing the incidence of CAUTI. [38-41] 1. Treat the catheter with JUC before catheterization: Spray JUC on the catheter surface or soak the catheter in JUC solution for 2 minutes; 2. Care of indwelling catheter: clean the perineal tissue and the catheter, and spray JUC on the catheter and the urethral meatus 2 times a day and 3 sprays each time; At the same time, spray JUC on the junctions of collection bag 2 times a day and 3 sprays each time. If the urinary catheter is not treated before catheterization, it can not effectively prevent the formation of bacterial biofilm. If urethral meatus and other interfaces are not treated in the daily care, the bacterial ascending infection will be caused. Ventilator-asso ciated pneumonia (VAP) Routine care. The bacterial biofilm formed on the surface of tracheal catheter affects the action of antimicrobial agents, leading to the incidence of VAP. The hand hygiene of medical staff is poor. A risk factor for VAP is the potential pathogenic bacteria colonized in partes oralis. [42-44] antimicrobial film on the surface of the tracheal catheter and effectively prevents the formation of bacterial biofilm. One spray of JUC can provide the antimicrobial effects for 8 hours and effectively improve the hand hygiene of medical staff. In oral care, JUC can effectively prevent the formation of dental plaque and 1. Treat the tracheal catheter with JUC before mechanical ventilation: spray JUC on the surface of the tracheal catheter or soak the catheter in JUC solution for 2 minutes; 2. Routine care: spray JUC in the oral cavity 2 times a day and 3 sprays each time; At the same time, spray JUC on the junctions 2 times a day and 3 sprays each time. If the tracheal catheter is not treated before mechanical ventilation, it can not effectively prevent the formation of bacterial biofilm. In daily care, the interfaces shall be sprayed with JUC, or the bacterial ascending infection will be caused. 6

colonization of bacteria in oral cavity. [45] Intravenous catheter puncture site disinfection, regular dressing change, and avoiding the movement of intravenous catheter.[46] At present, besides the regular change of puncture sites, there is no explicit way to prevent infection internationally. One spray of JUC can provide the antimicrobial effects for 8 hours, therefore it can prevent the invasion of bacteria from puncture sites, reducing secondary infection and extending the indwelling time.[47] 1. Before catheter insertion, spray JUC on the puncture sites, surrounding skin and the surface puncture needle after disinfecting skin at puncture sites; 2. Care after catheter insertion: remove discharges and disinfect by normal treatment. Then spray JUC 15cm from the skin evenly on the puncture sites and surrounding skin, as well as catheter surface at the inlet and the outlet, 3 times a day and 3 sprays each time until tracheal extubation. The surface of intravenous needle/catheter must be sprayed with JUC before catheterization, so that a physical antimicrobial film will be formed on the surface to effectively prevent the bacterial ascending infection. Perineal incision Perineum cleaning, disinfectant sterilization, hip bath, wet compress, infrared radiation and so on. Preventive application of antibiotics has no effect on wound healing, pain and infection, yet causing drug resistance. The perineal wounds are not easy to bandage, therefore traditional dressing can't be used. [48-50] antimicrobial film, achieving therapeutic effect which antimicrobial drugs can't achieve, significantly reducing the growth of bacteria on incisions, relieving pain and promoting incision healing. In the management of perineal incisions, JUC forms an invisible antimicrobial film, thus isolating the wounds. [51,52] 1. Clean the incision with normal saline; 2. Spray JUC: 2 times a day, cover the perineal incision and surrounding tissue evenly until incision healing; 3. At the same time, spray on articles contacted with the incision and let it dry; 4. When necessary, combine with antimicrobial agents for treatment. Clean the incisions before spraying JUC. Discharges should be cleaned because JUC can only work on the surface, and has no penetration functions. 7

Care after laser surgery Local application of antimicrobial agents and dressing.[25] Local application of antimicrobial agents should be avoided as much as possible because it causes drug resistance more easily.[4] Dressings have no effect on preventing and treating infection.[26] antimicrobial film, killing and inhibiting the growth of pathogenic microorganisms, reducing secondary infection and shortening the time of wound healing. JUC prevents and treats infection without causing drug resistance. [53] 1. Local debridement before usage: remove scab skin or blister skin when there re scabs or blisters; 2. Spray JUC: Spray evenly 15cm from the wound on the wound and surrounding area, 3 times a day and 3 sprays each time until wound healing. 3. When necessary, combine with If wounds are not cleaned or debrided before usage, the effects of JUC will be affected and there may be more serious infections, for JUC has no penetration functions and can only work on wound surface. Acute radiodermatitis Reduce radiation as much as possible, keeping the irradiated site clean and reducing skin irritations. Local application of antibiotics and glucocorticoids are specific treatments.[54] Local application of antibiotics can cause drug resistance. [4]Hormone has side effects. There s no effective way to prevent grade 2 or above radiodermatitis in the world at present. [55] JUC physical antimicrobial method avoids drug resistance and has no side effects. antimicrobial film on wounds, controlling infections, and reducing the incidence of grade 2 or above radiodermatitis.[56]. 1. Local debridement before usage: Remove necrotic tissue, also remove scab skin or blister skin when there re scabs or blisters; Rinse and disinfect with normal saline or disinfectants; 2. Spray JUC: From day 1 of grade 1 radiodermatitis, spray evenly 15cm from the wound on the wound and surrounding area, in the morning, in the evening before sleeping and 30 minutes before radiation, and 3 sprays each time until wound healing. 3. When necessary, combine with If wounds are not cleaned or debrided before usage, the effects of JUC will be affected and there may be more serious infections, because JUC has no penetration functions and can only work on wound surface. Recurrent oral ulcer Systemic treatment combined with local treatment is used Application of antibiotics can cause drug resistance easily; [4] Application of JUC physical antimicrobial method avoids drug resistance; It promotes wound healing and 1. Debridement: Gargle with normal saline or cold boiled water; 2. Spray JUC evenly on oral mucosa, 3 Debride in time before usage because JUC only works on wound surface, has no effect on deep 8

clinically. Local or hormone causes side effects has no side effects on human times a day and 3 sprays each time pathogens. systemic application such as allergic reactions, body. JUC can be sprayed on until wound healing; of antibiotics is and hormone also causes the oral ulcer directly, and has 3. When necessary, combine with adopted to treat and local trichangiectasia, which obvious pain relieving actions. prevent infections; conceals local infection thus No need of professionals and local application of affecting wound healing; has good compliance. [59] hormone is adopted Application of local to inhibit anesthetic agent should be inflammation;local perfomed by professionals anesthesia is adopted and improper usage will to relieve pain. cause serious side effects. [57,58] [58] 1. Rein MF, Holmes KK: Nonspecific vaginitis, vulvovaginal candidiasis, and trichomoniasis. In Current Clinical Topics in Infectious Diseases, vol 4. Remington JS, Swartz MN, eds. New York: McGraw-Hill; 1983:281 315. 2. Hellberg D, Zdolsek B, Nilsson S, Mardh PA: Sexual behavior of women with repeated episodes of vulvovaginal candidiasis. Eur J Epidemiol 1995;11:575 579. 3. Nixon SA: Vulvovaginitis: the role of patient compliance in treatment success. Am J Obstet Gynecol 1991;165:1207 1209. 4. 中 华 人 民 共 和 国 卫 生 部, 抗 菌 药 物 临 床 应 用 指 导 原 则,2004,10 5. Sobel, J. D. 1988. Pathogenesis and epidemiology of vulvovaginal candidiasis. Ann. N. Y. Acad. Sci. 544:547 557. 6. 党 杰 明, 刘 春 敏, 王 雪 梅 等, 洁 悠 神 长 效 抗 菌 材 料 治 疗 外 阴 炎 临 床 试 验 报 告, 中 国 人 民 解 放 军 南 京 军 区 总 医 院 妇 产 科 7. Clinical Effectiveness Group (British Association for Sexual Health and HIV), United Kingdom National Guideline on the Management of Anogenital Warts, 2007 8. Kevin A. Ault,Epidemiology and Natural History of Human Papillomavirus Infections in the Female Genital Tract,Hindawi Publishing Corporation Infectious Diseases in Obstetrics and Gynecology Volume 2006, P1 5 9. lephania Jabionska,Traditional therapies for the treatment of condylomata aeuminata (genital warts),auslralasian Journal of Dermatology (1998) 39 (Suppl.), S2-S4 10. 卢 镜 洪, 何 柳 仙, 邓 贵 新 等, 洁 悠 神 " 预 防 尖 锐 湿 疣 激 光 术 后 复 发 临 床 观 察, 中 华 临 床 医 学 研 究 杂 志,2006,12(7): 890 11. 姜 文 华 韩 国 柱, 王 千 秋 等, 洁 悠 神 长 效 抗 菌 剂 辅 助 治 疗 有 关 性 病 的 疗 效 观 察, 中 国 医 学 科 学 院 皮 肤 病 研 究 所 12. 王 海 英, 战 春 雨, 王 海 军, 陈 碌, 洁 悠 神 长 效 抑 菌 剂 在 激 光 治 疗 尖 锐 湿 疣 创 面 的 临 床 应 用, 中 国 临 床 实 用 医 学,2008,10,2(10), 49-50 13 中 国 医 师 协 会 皮 肤 科 分 会 真 菌 学 组, 足 癣 诊 断 与 治 疗 指 南, 临 床 皮 肤 科 杂 志,2007,36(4), 270-271 更 新 版 本 (2009) 9

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