Recombinant human granulocyte-macrophage colony-stimulating factor hydrogel promotes healing of deep partial thickness burn wounds

Objective

To assess the effects of recombinant human granulocyte/macrophage colony-stimulating factor (rhGM-CSF) hydrogel on the healing of deep partial thickness burn wounds.

Methods

Ninety three wounds of 65 burn patients who suffered from a deep partial thickness burn of <5% TBSA and could not heal over 3 weeks were included in this study. The patients were randomly assigned to use rhGM-CSF hydrogel (GC group, n = 32) or hydrogel without rhGM-CSF (control group, n = 33). rhGM-CSF hydrogel or hydrogel without rhGM-CSF was topically applied to the wounds, the dressing was changed once a day. Wound healing time and percentage, wound discharge, periwound inflammation, the positive wound swabs culture count, and adverse drug reactions were observed and compared between two groups.

Results

Healing time was 12.2 ± 5.0 days after the application of rhGM-CSF hydrogel. This was significantly shorter than that of control wounds (15.5 ± 4.7 days). Healing percentage at 14 days in the rhGM-CSF-treated wounds was 97.5 ± 7.7%, which was markedly higher than the control (85.9 ± 6.8%). At 3, 6, 12, 14 day, the GC group was significantly superior to the control group with respect to the score of periwound inflammation, wound purulence and discharge. The positive wound swabs culture count of the GC group on the 7th and 14th day post-treatment was 14 and 4, respectively, which was significantly lower than the control.

Conclusion

rhGM-CSF hydrogel promotes the healing process of deep partial thickness burns effectively. No adverse reaction of the drug was observed during the study.     

The effect of adipose derived stromal vascular fraction on stasis zone in an experimental burn model

Background

Stasis zone is the surrounding area of the coagulation zone which is an important part determining the extent of the necrosis in burn patients. In our study we aim to salvage the stasis zone by injecting adipose derived stromal vascular fraction (ADSVF).

The effect of stromal vascular fraction in an experimental frostbite injury model

BackgroundDespite current treatment modalities, frostbite remains an injury with a poor prognosis which may cause functional morbidities. Several experimental and clinical studies have demonstrated that stromal vascular fraction is an autologous mixture, which can improve wound healing and vasculogenesis. The aim of this study was to show the beneficial effects of stromal vascular fraction on experimental frostbite healing.Material and methodsStromal vascular fraction (SVF) was harvested from 5 rats after excision of the inguinal fat pads. Another 20 rats were separated into 2 groups of 10 as the SVF group and the control group. A frostbite injury was created on each rat using a cryoprobe frozen with liquid nitrogen (?196 °C). SVF was applied to the SVF group and phosphate-buffered saline to the control group. All injections were performed subcutaneously within the frostbite injury area. Biopsies were performed on days 5 and 14 for histopathological and immunochemical evaluations. The tissue perfusion rates of both groups were assessed on day 14 using indocyanine green angiography (SPY system).ResultsThe increase in mean tissue perfusion was 373.3% ( ± 32.1) in the SVF group and 123.8% ( ± 16.3) in the control group (p < 0.001). The macroscopic wound reduction rates of the SVF and control groups were 25.5% ( ± 19.1) and 18.0% ( ± 5.9), respectively on day 5%, and 78.2% ( ± 9.2) and 57.3% ( ± 16.7) on day 14 (p = 0.007; p = 0.003). Acute inflammation and the fibrosis gradient were significantly decreased in the SVF group compared to the control group (p = 0.004, p = 0.054 respectively on day 14). Granulation tissue amount, re-epithelialization score and neovascularization were significantly increased in the SVF group (p = 0.006, p = 0.010 and p = 0.021, respectively on day 14).ConclusionsThe study results demonstrated that SVF increases frostbite wound healing by increasing tissue perfusion rate, neovascularization and re-epithelialization, and modulating acute inflammation and fibrosis.     

巴曲酶对深Ⅱ度烫伤创面微循环血流变化及愈合的影响

目的　探讨巴曲酶对大鼠烫伤早期创面淤滞带微循环血流变化及愈合过程的影响。　方法　Wistar雄性大鼠 2 0只 ,随机分为烫伤对照组及巴曲酶治疗组 ,在各组动物背部均造成 4cm× 4cm大小深Ⅱ度烫伤。分别于伤前、伤后 0 .5、2、4、6、12、2 4、72h测定创面局部皮肤血流量 ;于伤后立即、伤后 14、18d测定烫伤面积及残留创面面积 ;于伤后 30d将大鼠处死取材行组织学观察及毛囊计数。　结果　大鼠伤后 2 72h皮肤血流量进行性减少 ;与对照组相比 ,给予巴曲酶后皮肤血流量得到明显改善 ,创面愈合速度明显加快 ,愈合后皮肤附件明显增多。　结论　巴曲酶能逆转烧伤后创面淤滞带循环 ,加快创面愈合速度和提高皮肤愈合质量     

重组人粒细胞巨噬细胞集落刺激因子凝胶剂对深Ⅱ度烧伤创面溶痂及愈合影响的临床研究

目的通过临床对比研究,探讨重组人粒细胞巨噬细胞集落刺激因子(recombinant human granulocyte-macrophage colony-stimulating factor,rhGMCSF)凝胶剂对深Ⅱ度烧伤创面溶痂及愈合的作用及其机制。方法以2008年12月-2010年12月收治的符合选择标准的58例深Ⅱ度烧伤患者作为试验对象。男36例,女22例;年龄12～67岁,平均32.4岁。热液烫伤38例,火焰烧伤20例。受伤至治疗时间为1～3d,平均2.1d。采用随机双盲、自身对照方法,分为给予rhGMCSF凝胶剂治疗组(试验组)及不含rhGMCSF的凝胶剂基质治疗组(对照组)。两组用药面积比较差异无统计学意义(P>0.05),具有可比性。用药后观察创面情况,于2、6、10、14、18d计算创面溶痂率,记录完全溶痂时间及创面愈合时间。结果与对照组相比,试验组用药4d后黄白色坏死组织或痂皮逐渐变软;6d后坏死组织易浮动而脱落或痂皮边缘翘起,基底红白相间,深层肉芽组织增长迅速;8d时痂皮基本溶解。用药2d后试验组创面溶痂率即高于对照组,除用药后18d,其余各时间点两组创面溶痂率比较差异均有统计学意义(P<0.05)。试验组完全溶痂时间为(7.71±2.76)d,较对照组(14.71±3.63)d明显缩短(t=13.726,P=0.000);创面愈合时间为(18.41±2.47)d,亦较对照组(23.58±3.35)d明显缩短(t=15.763,P=0.000)。结论 rhGMCSF凝胶剂与单纯凝胶剂基质相比能促进深Ⅱ度烧伤创面坏死组织脱落,加快创面愈合。     

血管基质片段细胞携血管内皮生长因子对移植颗粒脂肪血管化的影响

目的 探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)复合血管基质片段细胞( stromal vascular fraction cells,SVFs)细胞疗法对移植颗粒脂肪组织血管化的影响,寻找一种安全、有效、简单的细胞辅助脂肪移植术式.方法 取患者植皮术后废弃的皮下脂肪,提取SVFs.用DiI染色观察SVFs染色标记情况,锥虫蓝染色观察SVFs活性.将0.3 ml待移植的脂肪颗粒分别与0.2 ml下列细胞混合:①复合有VEGF的SVFs(A组);②SVFs(B组);③DMEM完全培养基(C组).按照随机化原则将3组脂肪组织混合物分别注射移植于裸鼠背部皮下,每只裸鼠背上注射3个点(共12只).观察移植物外形、成活情况、湿重、直径,HE染色及CD31染色镜下观察并计数毛细血管密度.使用SPSS 16.0进行方差分析检验.结果 新鲜提取的SVFs可被DiI标记染色,加用VEGF仍能保持较好的细胞活性,移植术后2个月3组移植脂肪的湿重为:A组(191.90 ±9.81)mg、B组( 177.01±10.50)mg、C组(92.05±8.30)mg,A组＞B组＞C组(P＜0.01).移植物直径为:A组(0.49±0.24)cm、B组(0.40±0.26) cm、C组(0.32±0.28) cm,A组＞B组＞C组(P＜0.01).CD31染色镜下,每高倍镜视野微血管密度:A组(14.58±2.06)个、B组(11.55±2.18)个、C组(7.87±1.55)个,与B组和C组比较,A组较少见纤维结缔组织增生及坏死凋亡细胞.结论 结合VEGF因子的SVFs辅助脂肪移植是一种临床可操作性强、简便可行的较理想的细胞疗法,比单纯SVFs更能有效地促进移植脂肪血管化.     

Adipose-derived stromal vascular fraction improves tendon healing in rabbits

Objective:To evaluate the potential effects of uncultured adipose-derived stromal vascular fraction on tendon healing.Methods:Twenty five adult male New Zealand white rabbits weighing 2.5-3.0 kg were used.Five rabbits were used as donors of adipose tissue and the rest were divided into control and treatment groups.The injury model was completed by unilateral tenotomy through the middle one third of deep digital flexor tendon.Immediately after suture repair,either fresh stromal vascular fraction from enzymatic digestion of adipose tissue or placebo was intratendinously injected at tendon stumps in treatment and control groups,respectively.Immobilization with cast was continued for two weeks after surgery.Animals were sacrificed at eight weeks after surgery and tendons underwent histological,immunohistochemical,and mechanical evaluations.Statistical analyses of quantitative and qualitative data were assessed using one-way analysis of variance and MannWhitney U-test,respectively.Results:Histological evaluations demonstrated superior fibrillar linearity and continuity,and decreased vascularity in treatment group indicated improved organization and remodeling of neotendons.Immunohistochemistry demonstrated a significant increase in collagen I expression in treatment group.Ultimate load and energy absorption capacity were both significantly increased in cell-treated repairs compared with controls.Conclusion: The present study shows that intratendinous injection of uncultured adipose-derived stromal vascular fraction results in improved structural and mechanical properties of tendon repairs and it could be an effective modality for treating tendon injury.     

Early intervention by Captopril does not improve wound healing of partial thickness burn wounds in a rat model

The Renin Angiotensin System is involved in fibrotic pathologies in various organs such as heart, kidney and liver. Inhibition of this system by angiotensin converting enzyme antagonists, such as Captopril, has been shown beneficial effects on these pathologies. Captopril reduced the inflammatory reaction but also directly influenced the fibrotic process.Prolonged and excessive inflammatory response is a major cause of hypertrophic scar formation in burns. We therefore evaluated the effect of Captopril on the healing of partial thickness burn wounds in a rat model.Partial thickness contact burns were inflicted on the dorsum of the rats. The rats received either systemic or local treatment with Captopril. The inflammatory reaction and wound healing (scar) parameters were investigated and compared to control animals.In this study we could not detect positive effects of either administration route with Captopril on the inflammatory reaction, nor on wound healing parameters. The local treatment showed reduced wound closure in comparison to the systemic treatment and the control group.Early Captopril treatment of burn wounds did not show the beneficial effects that were reported for fibrotic disorders in other tissues. To influence the fibrotic response Captopril treatment at a later time point, e.g. during the remodeling phase, might still have beneficial effects.     

Application of multiple deep learning models for automatic burn wound assessment

PurposeAccurate assessment of the percentage of total body surface area (%TBSA) burned is crucial in managing burn injuries. It is difficult to estimate the size of an irregular shape by inspection. Many articles reported the discrepancy of estimating %TBSA burned by different doctors. We set up a system with multiple deep learning (DL) models for %TBSA estimation, as well as the segmentation of possibly poor-perfused deep burn regions from the entire wound.MethodsWe proposed boundary-based labeling for datasets of total burn wound and palm, whereas region-based labeling for the dataset of deep burn wound. Several powerful DL models (U-Net, PSPNet, DeeplabV3+, Mask R-CNN) with encoders ResNet101 had been trained and tested from the above datasets. With the subject distances, the %TBSA burned could be calculated by the segmentation of total burn wound area with respect to the palm size. The percentage of deep burn area could be obtained from the segmentation of deep burn area from the entire wound.ResultsA total of 4991 images of early burn wounds and 1050 images of palms were boundary-based labeled. 1565 out of 4994 images with deep burn were preprocessed with superpixel segmentation into small regions before labeling. DeeplabV3+ had slightly better performance in three tasks with precision: 0.90767, recall: 0.90065 for total burn wound segmentation; precision: 0.98987, recall: 0.99036 for palm segmentation; and precision: 0.90152, recall: 0.90219 for deep burn segmentation.ConclusionCombining the segmentation results and clinical data, %TBSA burned, the volume of fluid for resuscitation, and the percentage of deep burn area can be automatically diagnosed by DL models with a pixel-to-pixel method. Artificial intelligence provides consistent, accurate and rapid assessments of burn wounds.     

不同敷料对深度烧伤创面植皮后愈合情况的影响对比

目的:对比分析不同敷料对深度烧伤创面植皮后愈合情况的影响。方法:选取我院于2011年5月～2012年5月收治的69例深度烧伤并接受创面植皮的患者,选择患者身上2处大小为1%的邻近创面,将创面内层覆盖物为聚酰胺薄纱的所有创面作为实验组,内层覆盖物为凡士林油纱的创面作为对照组。对比分析两组术后的创面蒸发量、不同时间点的创面愈合率、创面愈合时间及换药时的疼痛情况。结果:术后5天,实验组内层敷料表面的蒸发量要明显少于对照组[(25.3±6.1)ml.h-.1m-2vs(35.8±4.9)ml.h-.1m-2t=11.147 P<0.05],所有患者内层敷料表面的蒸发量要显著少于裸露创面(P<0.05),但高于正常皮肤表面(P<0.05);实验组术后10天,15天及20天的创面愈合率均高于对照组[(81.2±19.5,95.3±9.4,99.8±0.4)%vs(72.4±7.6,84.6±10.4,97.2±2.3)%t=3.493,6.340,9.251 P<0.05],且创面完全愈合时间要显著短于对照组[(14.1±2.0)天vs(17.2±2.5)天t=8.043 P<0.05];实验组术后5天换药及揭除内层敷料时的VAS评分要明显低于对照组[(3.3±0.7,5.0±0.6)vs(4.9±0.4,7.9±0.5),t=16.485,30.843 P<0.05]。结论:相比与传统的凡士林油纱,聚酰胺薄纱更有利于深度烧伤创面植皮后的愈合,且减轻了患者换药时的疼痛,值得推广。     

Acute and chronic wound fluids inversely influence adipose‐derived stem cell function: molecular insights into impaired wound healing

Wound healing is a complex biological process that requires a well‐orchestrated interaction of mediators as well as resident and infiltrating cells. In this context, mesenchymal stem cells play a crucial role as they are attracted to the wound site and influence tissue regeneration by various mechanisms. In chronic wounds, these processes are disturbed. In a comparative approach, adipose‐derived stem cells (ASC) were treated with acute and chronic wound fluids (AWF and CWF, respectively). Proliferation and migration were investigated using 3‐(4,5‐Dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) test and transwell migration assay. Gene expression changes were analysed using quantitative real time–polymerase chain reaction. AWF had a significantly stronger chemotactic impact on ASC than CWF (77·5% versus 59·8% migrated cells). While proliferation was stimulated by AWF up to 136·3%, CWF had a negative effect on proliferation over time (80·3%). Expression of b‐FGF, vascular endothelial growth factor (VEGF) and matrix metalloproteinase‐9 was strongly induced by CWF compared with a mild induction by AWF. These results give an insight into impaired ASC function in chronic wounds. The detected effect of CWF on proliferation and migration of ASC might be one reason for an insufficient healing process in chronic wounds.     

The effect of adipose stromal vascular fraction on transverse rectus abdominis musculocutaneous flap: an experimental study

Background: Transverse rectus abdominis musculocutaneous (TRAM) flap is one of the options in reconstruction after breast cancer surgery for breast reconstruction. Tissue necrosis often occurs in the third and fourth perfusion zones of the flap. A study was planned to find out the effects of adipose stromal vascular fraction (SVF) cells on viability of TRAM flap and the experimental model was designed to be applicable in clinical practice. Methods: Right inferior epigastric artery pedicled, 5?×?2.5?cm sized TRAM flap was used as a flap model in 30 rats in three groups (group 1: sham; group 2: phosphate-buffered saline (PBS); group 3: SVF cell injected). The viability of the flaps were assessed on the postoperative 7th day with photographs and software for the calculations. Results: The mean viable flap percentage to total flap area was recorded as 51.8%?±?11.19, 49.5%?±?10.30, 82.3%?±?9.56, in group 1, group 2, and group 3, respectively (p?<?0.05). The mean capillary density was noted as 5.15?±?0.56, 4.37?±?0.58, and 12.40?±?1.17 in groups 1, 2, and 3, respectively (p?<?0.05). The fibrosis gradient indicated no difference between the groups (p?>?0.05). The in-vivo differentiation of SVF cells to endothelial cells was noted. The blood VEGF levels showed a marked increase in the experimental group (p?<?0.05). Conclusion: The adipose SVF cells were found out to improve the TRAM flap viability and decrease necrosis, especially in zone 3 and 4.     

烧伤后24 h内削痂防治深Ⅱ度创面进行性加深的组织学观察

目的　探讨烧伤后 2 4h内行削痂手术 ,对深Ⅱ度烧伤创面进行性加深的防治作用。方法　选择 12例深Ⅱ度烧伤患者 ,在伤后 2 4h内进行创面削痂手术。分别从手术前、手术后 (伤后 5～7d)和未手术创面 (伤后 5～ 7d)获取标本。采用HE染色、Masson′s染色和免疫组化技术标记Vi mentin抗原阳性细胞的方法 ,对创面组织标本进行组织学观察。　结果　随病程演进 ,未手术创面炎性反应程度明显加重 ,组织坏死范围扩大 ,原来残存的皮肤附件因炎症加重而消失 ;Masson′s染色棕红色范围扩大 ,亮绿色范围缩小 ;Vimentin抗原阳性细胞数量明显减少。伤后 2 4h内削痂创面局部炎症反应较未削痂创面明显减轻 ,可见新鲜肉芽形成和部分上皮修复 ,组织坏死范围未见进一步扩大 ,与未手术区比较差异有显著性意义 (P <0 .0 5 ) ;Masson′s染色亮绿色范围无明显缩小 ;Vimentin抗原阳性细胞数量明显多于未手术区 (P <0 .0 5 )。　结论　烧伤后 2 4h内削痂 ,能适时去除创面坏死组织、阻断组织变质性损害的加剧 ,从而有效改善深Ⅱ度创面的进行性加深现象 ,对创面愈合具有促进作用。     

表皮生长因子对大鼠深Ⅱ度烧伤创面愈合的影响

目的　进一步观察重组人表皮生长因子 (rhEGF)对深Ⅱ度烧伤创面愈合的促进作用。方法　采用大鼠深Ⅱ度烫伤模型 (以下称烧伤 ) ,创面分别外用rhEGF、肝素加rhEGF及等渗盐水。比较不同方式处理创面后的愈合时间 ,测定创面愈合率、创面含水量、羟脯氨酸 (OHP)含量及Ⅰ /Ⅲ型胶原比例 ,进行细胞DNA周期分析和组织学检查。　结果　外用rhEGF可使烧伤创面愈合时间缩短 2d,增加创面OHP含量 (P <0.0 5),降低Ⅰ /Ⅲ型胶原比例 (P <0.0 5),促进肉芽组织形成 ,加速细胞DNA复制 (P <0.0 5 )。加用肝素后可使创面愈合时间进一步缩短 2d,促进肉芽组织生长。伤后第 7天用药各组间比较 ,差异无显著性意义 (P >0.0 5)。　结论　外用rhEGF能明显促进深Ⅱ度烧伤创面愈合 ,加用肝素后效果更加显著 ,但早期使用rhEGF效果不明显     

Evaluations of bacterial contaminated full thickness burn wound healing in Sprague Dawley rats Treated with Tualang honey

Aim:

The effect of Tualang honey on wound healing in bacterial contaminated full-thickness burn wounds was evaluated in 36 male Sprague Dawley rats.

Materials and Methods:

The rats were randomly divided into three groups (n = 12/group). Three full-thickness burn wounds were created on each rat. Each group of rats was inoculated with a different organism in the burn wounds: Group A was inoculated with Pseudomonas aeruginosa, Group B was inoculated with Klebsiella pneumoniae and Group C was inoculated with Acinetobacter baumannii. One wound on each rat was dressed with either Tualang honey, Chitosan gel or Hydrofibre silver. Each wound size was measured on day 3, 6, 9, 12, 15, 18 and 21 of the study.

Results:

The mean wound size of the Tualang honey-treated wounds was not statistically different than that of the Chitosan gel or Hydrofibre silver-treated wounds when the wounds were compared throughout the entire experiment (P > 0.05). However, comparing the mean wound size on day 21 alone revealed that the Tualang honey-treated wounds were smaller in comparison to that of the Chitosan gel and Hydrofibre silver-treated groups.

Conclusions:

This study shows that topical application of Tualang honey on burn wounds contaminated with P. aeruginosa and A. baumannii gave the fastest rate of healing compared with other treatments.     

重组人粒细胞巨噬细胞集落刺激因子对深Ⅱ度烧伤创面的治疗作用

目的 了解重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)凝胶剂治疗深Ⅱ度烧伤创面的有效性和安全性. 方法采用多中心、随机、双盲、安慰剂平行对照的研究方法,将深Ⅱ度烧伤创面作为目标创面,把321例烧伤患者(实际完成302例)分为用药组200例,创面涂rhGM-CSF凝胶;对照组102例,创面涂安慰剂.观察用药后两组患者的全身情况和不良反应,以及不同时相点创面愈合时间、愈合率、总有效率. 结果用药后两组患者生命体征,血、尿常规及肝、肾功能,创面分泌物、创缘反应比较,差异均无统计学意义(P>0.05),无不良反应.用药组创面愈合时间的中位数为17 d,低于对照组(20 d,P<0.01).用药第8、14、20、28天,用药组平均创面愈合率分别为24.5%、70.5%、95.3%、99.6%,均高于对照组(15.1%、51.4%、84.6%、97.1%,P<0.01).用药8、14、20 d用药组的总有效率显著高于对照组(P<0.01). 结论 rhGM-CSF凝胶剂能促进深Ⅱ度烧伤创面愈合,并且有一定的安全性.     

烧伤后24小时内削痂对深Ⅱ度创面局部炎症反应的影响

目的探讨烧伤后24h内行削痂手术对深Ⅱ度创面局部炎症反应以及组织损害的影响。方法选择12例烧伤患者,伤后24h内对深Ⅱ度创面行削痂手术,将患者同一创面分为3个标本采集区,即手术前、手术后和未手术区。手术前标本取自削痂术前创面,手术后和未手术区创面标本于伤后5—7d获取。采用组织培养和比色法测定创面组织释放白细胞介素(IL)8、髓过氧化物酶(MPO)和丙二醛(MDA)的水平,通过HE和Masson染色对创面组织坏死程度进行形态学观察。结果削痂手术后,患者创面组织局部释放IL8、MPO、MDA的水平分别为(6.83±1.85)μg/L、(4.07±0.87)U/g、(8.94±5.66)μmol/g,与未手术创面比较明显降低(P<0.01)。形态学观察显示,手术前创面有凝固性坏死灶;未手术创面炎症反应明显,坏死组织范围扩大;削痂手术后创面局部的炎症反应得到改善,未见坏死组织范围扩大。结论伤后24h内行削痂手术,可以改善深Ⅱ度烧伤创面局部的炎症反应,防止创面进行性加深,有利于创面及早愈合。     

Comparison of Laser Doppler Imaging (LDI) and clinical assessment in differentiating between superficial and deep partial thickness burn wounds

Purpose of presentation/study

To compare the accuracy of Laser Doppler Imaging (LDI) and clinical assessment in differentiating between superficial and deep partial thickness burns to decide whether early tangential excision and grafting or conservative management should be employed to optimize burn and patient management.

Inverse relationship between the apoptotic rate and the time elapsed from thermal injuries in deep partial thickness burns

BACKGROUND: The purpose of this article was to further describe apoptotic behaviour in deep partial thickness burns, correlating the apoptotic rate of these lesions with the time elapsed from injury. METHODS: We used TUNEL and Fas immunohistochemistry in serial biopsies of deep partial thickness burns harvested from 1 to 23 days following injury. The apoptotic rate was defined as the number of apoptotic cells out of the total number of nucleated cells. RESULTS: We recruited 25 subjects. Apoptosis was present in all biopsies and showed an inverse relationship with the time elapsed from thermal injury, higher during the first days and lower in the third week (r=-0.518; p=0.008). No significant correlations were demonstrated with age, total burn surface area, deep partial thickness burns area, Baux UBS index. CONCLUSIONS: Our study demonstrates that apoptosis persists in deep partial thickness burns throughout the first 3 weeks and shows an inverse relationship with the time elapsed from injury. It provides, in our opinion, the basis for future investigations regarding correlation with local vascularity and perfusion status and with clinical outcomes of deep partial thickness burns.     

微管失稳剂oncoprotein18/stathmin基因在深Ⅱ度烧伤愈合前创面及增生性瘢痕中的表达

目的观察深Ⅱ度烧伤创面愈合前及愈合后增生性瘢痕组织中微管失稳剂oncoprotein18/stathmin(Op18)基因的表达. 方法提取临床深Ⅱ度烧伤愈合前与愈合后不同时期增生性瘢痕中的总RNA,以GADPH基因表达为内参照,采用逆转录酶-多聚酶链式反应(RT-PCR)方法,半定量检测上述基因表达水平. 结果与正常组织比较,伤口愈合前Op18基因表达显著降低(P<0.05),愈合后表达迅速增高(P<0.05),在4～32个月增生性瘢痕中Op18基因稳定高表达. 结论在伤后早期Op18基因的表达水平降低与细胞增殖、组织修复的需要相适应,在增生性瘢痕组织中通过Op18基因高表达来抑制瘢痕增生.