Team:SZPT-CHINA/Human Practices

Integrated Human Practices

Background:the Problem

Experimental Design

Product Design


Fire is one of the main disasters among various kinds of disasters that most frequently and universally endangers the safety of the people and property. Almost all fires are accompanied by personal burns. The physical and psychological damage caused by burns is very huge and the treatment process is long and easy to cause infection. Therefore, our team decided to carry out our project for burn treatment this year. By consulting doctors, experts, firefighters, enterprises and pharmacies, we understood the background, designed the experiment and product, evaluated and improved them. And focusing on the feedback, improvement and feedback closed-loop mode, we finally completed our project.
● Background:the Problem
Figure 1. Background overview
Interviews with Firefighters
The first thing that comes to mind is the fire retrograde-firefighters when we talk about fire. Our team came to the fire station in Xili Street, Nanshan District, Shenzhen and interviewed the firefighters (Figure 2). We have learned that there are two main reasons for fires: the hidden dangers in residential area fire protection improper use of flammable products (batteries, sundries, alcohol disinfection products, etc.). During the interview, firefighters pointed out that in addition to urban fires in factories, household fires are more likely to occur in urban villages.
Figure 2. Interviewed with Xili Fire Station on April 7, 2021
We learned that firefighters have been rescuing the same person on different occasions. Most burn victims rescued from a fire later tried to end their lives because of incurable scars or high medical expenses which shocked our team and motivated us greatly.
Interviews with Psychological Doctors
After interviewing with firefighters, we learned that burn could have a serious psychological impact on patients. We contacted psychological doctors and wanted to understand how burns affect patients. We realized that the main psychological problems of burn patients are: self-sealing, woebegone, inferiority, worry, fear and even suicide. This made us wondered, how should we help them?
Interviews with Burn Doctors
We mainly consulted doctors online in the early stage due to the epidemic. We mainly consulted doctors online in the early stage due to the epidemic. The following doctors were interviewed online from March 28, 2021 to May 28, 2021, 2020.
Figure 3. Interviewed with Xili Fire Station on April 7, 2021
Since our team members are not medical majors and do not know much about burn and treatment, we must consult professionals about medicine. Therefore, we interviewed and consulted three burn doctors offline (Figure 4, 5). We consulted the basic knowledge and the treatment of burns. After the doctor's introduction, we found that the treatment of Pseudomonas aeruginosa infection in burn wounds is very essential. After brainstorming, our team finally decided to carry out our project targeting Pseudomonas aeruginosa infection. (Interview content)
Summary of the interview with burn doctors
Question1: Nowadays, how to treat burns?
Answer: Superficial Ⅱ degree burns and small area burns below superficial Ⅱ degree burns are mainly covered by healthy skin growth around the burn wound and skin grafting are not required. However, for deep Ⅱ degree burns or large area burns, because the subcutaneous tissue or skin layer is totally destroyed, the original skin tissue can no longer grow or heal, then grafting or flap transplantation is needed.

Question2: What are the advantages and disadvantages of skin grafting?
Answer: In addition to the high cost, skin grafting is the most advanced technology.

Question3: As we learned in the early interview, scars will cause serious psychological harm to patients. The burn wound has been repaired and treated, why did it still have scars? Can't the current restoration technology solve the aesthetic problem?
Answer:Although severity of the scar is associated with restoration technology, it's mainly related to the degree of burn infection.

Question4: Why does is get infected? What are the main infectious bacteria?
Answer: There are so many possibilities of surgical infection, debridement , hygiene, environment, wound conditions, etc. The main infectious bacteria were Acinetobacter Baumannii, Staphylococcus aureus and Pseudomonas aeruginosa. Pseudomonas aeruginosa has super intrinsic drug resistance and the ability to produce drug resistance, which makes the treatment effect of many antibiotics for burn patients infected with Pseudomonas aeruginosa worse and worse. Therefore, patients with Pseudomonas Aeruginosa need higher treatment cost, longer treatment cycles, and even lead to death.

Question5: Do you have any recommendations for the treatment of Pseudomonas Aeruginosa?
Answer: In the face of the emergence of more and more multi-resistant Pseudomonas aeruginosa, we need a lot of time and economic cost to develop new antibiotics. Therefore, it is very necessary to replace antibiotics with new drugs. The first expectation of new drugs is that they are effective and have few side effects.
Figure 4. Dr. Bai Zheng ( the fifth ) , Dr. Ding Weijia ( the third ), Department of Burn, Longgang Central Hospital, Shenzhen on April 10, 2021
Figure 5. Interviewed with Dr. Sun Dongyuan , Department of Burn, Shekou People's Hospital, Shenzhen on May 19, 2021
Interviews with Doctors in Other Departments
During the interview, we found that in chronic wounds Pseudomonas aeruginosa infection may appear. Then we visited the doctor of Chronic Wounds Department (Figure 6), who said Pseudomonas aeruginosa is mainly common and difficult to deal with in burns, but rarely in chronic wounds, which can be treated with ordinary dressing.
Figure 6. Interviewed with Dr. He Taofang, Department of Chronic Wound, Affiliated Hospital of Southern University of Science and Technology, Shenzhen on April 29, 2021
According to the same thinking, team members believe that major orthopedic surgery is easy to cause infection. We also contacted Dr. Zhu Jinyu, Department of Bone and Joint Surgery, Affiliated Hospital of Southern University of Science and Technology, Shenzhen (Figure 3) and Dr. Liu Jaquan, Osteomyelitis Department of Orthopaedic Hospital, Henan (Figure 4). Both of them said orthopedic surgery are less likely to cause infection. During the operation, doctors will make sure that the wound is not infected as much as possible, and the environment and surgical tools will be disinfected. During the interview, doctors told us that Pseudomonas aeruginosa is mainly found in burns. In order to get more accurate and reliable information, we searched online to contact regional hospital doctors (Figure 8, 9, 10, 11), accidentally found that burn infection with Pseudomonas aeruginosa was related to the geographic location. Pseudomonas aeruginosa is more susceptible to cause infection in humid climates. Therefore, in humid climates (Shenzhen is a hot and humid climate), burn infection with Pseudomonas aeruginosa are more common.
● Experimental Design
Figure 7. Experimental design overview
Engineering Bacteria
Our team completed the preliminary design of the experiment under the guidance of our instructors. We contacted Dr. Tang Mingxing, Institute of Advanced Technology, Chinese Academy of Sciences (Figure 8). We expressed our ideas to Dr. Tang and he was very optimistic about our design and asked us a question: What is the carrier of our antibacterial protein? The best option is to find a carrier that can help heal the wound.
Figure 8. Had a meeting with Dr. Tang at SZPT on June 9, 2021
After interviewing with firefighters and psychologists, our team always wanted to have a deeper understanding of wound repair. Inspired by Dr. Tang, we found bacterial cellulose after researching literatures consulting our instructors. In order to understand the usage of biological dressing on the market, our team paid a return visit to Dr. Ding Weijia (Figure 9). We asked him about the feasibility of bacterial cellulose and the use of existing dressing, and received a positive response. At the same time, the doctor also showed us many cases, and taught us about burn grade judgment and burn treatment. We benefited a lot from the interview and got help in education. In the end, we decided to use Gluconacetobacter hansenii ATCC 53582 as the chassis and the bacterial cellulose produced by it as the carrier of antibacterial protein, so as to achieve the purpose of antibiosis and repair.
Figure 9. Return visited to Dr. Ding Weijia, Department of Burn, Longgang Central Hospital, Shenzhen on June 14, 2021
Near Infrared Light (NIR)
Because the bacteria cellulose production is very low, we have to find ways to speed. In the literature, we found that the visible light is widely used in medical field, so we thought of genetics of the light. We found Processor Jin Fan (Figure 10). Jin Fan introduced genetic knowledge, led us to analyze the production principle of bacteria cellulose. Finally, he suggested that we could add NIR light control module to improve the production of bacterial cellulose, in order to achieve the regulation of NIR light, we finally added a degradation module to control it not to produce bacteria cellulose in dark condition. However, we don't know whether NIR light has an effect on burned skin. We also ask question when learning about the infection of Pseudomonas aeruginosa. After getting doctors' approval did, we officially confirmed and started the experiment, and finally we made it.
Figure 10. Communicated with Professor Jin on April 14, 2021
At the beginning of the experiment of regulating bacterial cellulose by NIR light, we found that the production of bacterial cellulose did not increase significantly under NIR light, so we consulted Dr. Ye Haifeng, an expert in Optogenetics (Figure 11), who suggested optimizing the parameters such as the light distance and the composition of the culture medium. According to the above suggestions, we found through a series of experiments that bacterial cellulose can be generated quickly under NIR light.(For more details, please click results).
Figure 11. Connected with Dr. Ye Haifeng, East China Normal University on June 21, 2021
Safety and Drug Release Module (Blue Light)
Since the antibacterial protein is synthesized in the body of Gluconacetobacter hansenii ATCC 53582, it is necessary to find ways to release the drug protein to make it play a role. In addition, considering safety issues, we need to add lysis module for Gluconacetobacter hansenii ATCC 53582. Our team paid a return visit to Professor Jin Fan who recommended the pDawn promoter. We used NIR light to control the production of bacterial cellulose. If we also use light to lysate bacterial, it will be more convenient and save medical consumption, which should be our best choice.
● Product Design
Figure 12. Product design overview
Source of Inspiration
In the process of the experiment, we began to imagine the form of our product. In the literature, we found the spray of Bacillus subtilis, which is suitable for the prevention and treatment of small area second degree burn wound infection we were inspired to use our product in the form of live bacteria.

Pharmacy interview: visit pharmacies to gain information about products. We visited each pharmacy (11 pharmacies) near school and learned about the existing burn treatment products and the forms of live bacteria products.Content of interview
Figure 13, 14. Interviewed with pharmacies on August 18, 2021
Question1: What are the main types of treatment burn products on the market today?
Answer: Most of them are ointment types, such as MEBO, which is the most convenient, most consumers prefer to buy them.

Question2: What are the types of live bacteria products?
Answer: Capsule, tablet, infusion and ointment.

Question3: What are the live bacteria in the current live bacteria products?
Answer: Probiotics and Bifidobacterium.

Question4: What kind of diseases are these live bacteria products mainly used to treat?
Answer: Stomach.

Question5: Do you have any suggestions or expectations for our project?
Answer: The first point of live bacteria products is the safety issue, the second is the good effect, and the last is the price.
Interviews with Burn Doctors
In order to determine the product form, we once again consulted Dr. Ding Weijia, from the Burn Department (Figure 7), about his views on live bacterial dressings. Dr. Ding asked us questions, can we ensure the safety of live bacteria? Is the secretion of live bacteria harmful to the human body? What is the patient's acceptance of live bacteria? In response to safety issues, we introduced our safety and drug release module to Dr. Ding. Dr, Ding said that the idea was fabulous. In terms of treatment and use, live bacteria dressing products have good feasibility, but we still need to consider safety issues, such as for the blue light lysis bacteria.
Questionnaire survey
Reminded from Dr. Ding, we considered our stakeholders (the public). Based on the content of the project, we published a questionnaire to investigate public's understanding and acceptance of live bacteria products, as well as their recommendations and needs for burn drugs.

According to the statistics, the public's understanding of live bacteria is mainly from food, and they are willing to try live bacteria drugs. The main suggestions are products should be convenient to use and effective. survey data
Interviews with Biological Security Expert
During the investigation, we have been asked many times about the safety of live bacteria. We found Dr. Xiong Yan, a biological security expert, to assess whether the bacteria we were using was dangerous. Dr. Xiong told us that the strains we were using had high safety performance, and there was a suicide module, which would not have much impact on the safety of human body. And the coconut we usually eat was cultivated by Gluconacetobacter hansenii, so its safety is relatively high. These results allowed us to move towards the direction of viable bacteria.
Artificial Leather Enterprises
We visited Shenzhen Lando Biomaterials Co.,Ltd., Lando artificial leather is the first leather regeneration and repair technology in China. We had a conversation with the technical director of Lando, who introduced the company and their product technology. Later, our team visited the company's laboratory and various equipment in the laboratory. We gained advice. Technical director suggested that we should first determine our product type, whether to simply make dressings or tissue scaffolds. Dressing is relatively simple. However, if it is a tissue scaffold, the degradation of the material and the pore size should be considered, which determines whether the new cells or blood vessels can penetrate and regenerate.
Figure 15. Communicated with a technical director in Lando on August 11, 2021
After the communication with the technical director of Lando, we also visited the laboratory and production workshop. At the same time, we had an in-depth communication with the technical personnel involved in the research and development of artificial leather project, and learned about the material, production process and use mode of artificial leather.
Figure 16. Communicated with technicians from Lando on August 11, 2021
live bacteria enterprises
In our cooperation and communication with NWU-China-A team, we also helped each other to find enterprises we need. NWU-China-A found a live bacteria enterprise for us (Xi'an Donghai Live Bacteria Brand Promotion Co., LTD.). Due to epidemic prevention and control, we online consulted the manager of the enterprise about live bacteria products. The manager of the enterprise introduced to us that the main types of live bacteria products on the market are tablets, capsules and ointment, and the existing live bacteria products are mainly used in clinical, health care products, food, medical beauty and additives. It is not recommended to make tablet viable products because of the high cost of tablet technology. Instead of just live bacteria, experts suggested we make our own live by-products.

Then we also visited a Biotechnology company, Shenzhen Agrecoe Bio-technology Co.,Ltd, . After learning that there were microbial agents in the products produced by the enterprise, we first visited the workshop of Shenzhen Agrecoe Bio-technology Co.,Ltd, and consulted technical personnel for problems we encountered when making our products. We also met with the president of the board and introduced our project as well as our ideas on product design to him. The president talked about his experience and told us that the company's sales volume of bactericide was relatively good, and the market feedback of bactericide was better than that of bactericide powder. The production process of the two products were the same, but the final form was different.
Figure 17, 18. Communicated with Shezhen Agrecoe Bio-technology Co.,Ltd on August 23, 2021
The president's sharing inspired us. We wanted to make our live bacteria into cream form, which could also follow the results of our previous pharmacy surveys. Most consumers choose the ointment type drugs.
The design of devices
Since our products need to be illuminated when in use, we need to design a lighting device. During the early interview with the firefighters, firefighters mentioned that what they needed most for the product was portable. In the early interview, we also sought advice from a doctor, who thought that our product needed two different kinds of light illumination, and the device could consider a dual-light type to reduce consumables. Therefore, our team discussed and designed a portable light device with dual light control (as shown in the Figure 26), which can be used with our live bacteria product. However, this portable device is only suitable for small area burns, and for large area burns, we need a larger device. And finally, we designed another device with LED arrangement (as shown in the Figure 27).
Figure 19. Portable light control device for small area burns.
Figure 20. The apparatus with an array of LEDs for treatment of large area burns
● Meetings
Central China Regional Meeting
Due to the strict prevention and control of the epidemic, this year's Central China Regional Meeting was held online on May 29th. For the project introduction of each team, our team found that the experimental design of FAFU-China was similar to ours. After the meeting, we got in touch with them and confirmed our long-term cooperation.
Figure 21. Central China Regional Meeting on May 29, 2021
Southern China Regional Meeting
On August 6th, the South China Regional Meeting was held online by SZU-China. More than 20 teams from South China introduced the project respectively. After watching the project introduction of other teams, the instructor found our team's shortcomings in project summary and English speech. Then we made timely adjustments and improvements after the meeting.
From August 27 to 29, 2021, 79 teams from China were having an online and offline exchange, which was organized by Fudan University. During the conference, we actively communicated with other teams (NWU-China-A, Jiangnan-China, NUDT-CHINA). While making suggestions, we also received many valuable opinions and finally won the Active Participation Awards. We discussed the comments from experts immediately after the project.
Figure 22. CCiC announced the winning teams on August 29, 2021