灵芝壳聚糖的特性及其在生物医学材料领域中的应用

灵芝壳聚糖是带有正电荷的天然多糖,具有良好的生物相容性与降解性,还具有抗炎、抗氧化、 抗菌、促进伤口愈合等作用。灵芝壳聚糖作为灵芝的有效成分之一,在理化性能等方面区别于下虾蟹壳 中的壳聚糖,具有独特的优势。目前商品化的壳聚糖多数来源于虾蟹壳等,以灵芝为来源的壳聚糖商品较 少。本文综述了灵芝壳聚糖的特性以及在生物医学材料行业中的应用优势,以期为灵芝壳聚糖的开发与生 物医学应用提供参考。     

基于生物材料构建人工真皮支架的研究进展

在创面修复领域中, 无瘢痕愈合以及完整重建皮肤功能是临床及基础研究面临的重大挑战。目前, 已有多种人工真皮支架被用于临床创面修复, 以解决组织缺损导致的皮肤结构失调等问题。皮肤组织工程研究中用于制作人工真皮支架的生物材料主要包括天然生物材料、生物合成材料以及有机高分子材料这3类。该文综述了生物材料的生物相容性、生物活性、可降解性及生物材料对创面愈合的作用, 并概述了基于生物材料、创面愈合细胞及相关细胞因子的人工真皮支架构建策略。     

壳聚糖及其复合物在治疗下肢慢性溃疡中的研究进展

下肢慢性溃疡(CLU)是一种常见的外科疾病。在人群中发病率为0.12%～1.1%,其中60岁以上发病率为0.5%～3%,80岁以上则高达5%。根据溃疡病因,可将其分为血管源性溃疡、糖尿病足溃疡、压力性溃疡、创伤性溃疡、神经营养性溃疡、恶性溃疡等。伤口的愈合包括炎症反应期、增生期和修复期,适当的微环境能促进细胞的增殖和迁移,有利于早期伤口愈合,防止炎症和疤痕产生。溃疡创面的处理对愈合过程有着至关重要的作用。目前针对CLU的治疗主要包括清创、植皮、负压封闭引流、抗感染、局部活性因子、干细胞移植及敷料覆盖等。选择合适的伤口敷料对促进CLU创面的愈合起至关重要的作用,这类敷料除具有良好的吸收伤口渗液能力外,还应保持伤口的适宜的微环境、抑菌、止血、镇痛等能力和促进伤口愈合能力。壳聚糖化是甲壳素经强碱作用脱去部分乙酰基的产物。其具有抗感染、止血、免疫调节、诱导组织修复和细胞增殖,以及良好的生物相容性和生物降解性。同时壳聚糖对白细胞和巨噬细胞具有趋化作用,增强巨噬细胞吞噬作用,其可刺激中性粒细胞及巨噬细胞分泌白细胞介素和肿瘤坏死因子,进而促进创面进行"自净"。壳聚糖在治疗CLU中的良好前景。     

医用壳聚糖创面修复膜凝胶在面部外伤患者中的应用效果

目的 分析医用壳聚糖创面修复膜凝胶在面部外伤患者临床治疗中的应用效果。方法 选择2020年 1月-2022年12月我院收治的50例面部外伤患者为研究对象，采用随机数字表法分为对照组和试验组，每组 25例。对照组给予面部伤口常规处理，试验组在对照组基础上给予医用壳聚糖创面修复膜凝胶，比较两组 面部伤口愈合情况、临床疗效、面部伤口细菌情况。结果 试验组面部伤口愈合率为100.00%，高于对照组 的84.00%，差异有统计学意义（P＜0.05）；试验组治疗总有效率为100.00%，高于对照组的84.00%，差异有 统计学意义（P＜0.05）；试验组治疗第3、5天伤口细菌数量＜1 cfu/cm2占比高于对照组，1 cfu/cm2＜伤口 细菌数量＜10 cfu/cm2占比低于对照组，差异有统计学意义（P ＜0.05）。结论 医用壳聚糖创面修复膜凝胶 在面部外伤患者中的应用效果确切，能够有效促进面部伤口愈合，抑制细菌生长，避免伤口感染、开裂迹 象，值得临床应用。     

医用伤口修复液对肛瘘术后创面修复的临床疗效

目的观察医用伤口修复液对肛瘘患者术后创面修复的临床疗效。方法将78例行手术治疗的肛瘘患者随机分为2组,试验组39例,予以医用伤口修复液纱条换药,1次/d,至创面愈合;对照组39例,予以无菌凡士林纱布换药,1次/d,至创面愈合。比较2组患者的创面渗液明显减少时间、出血情况,换药时创面疼痛评分及创面愈合时间。结果试验组的创面疼痛评分、创面渗液明显减少时间、创面愈合时间及发生创面出血的比例均短于或低于对照组,其差异均具有统计学意义（P〈0.05）。所有患者均未发生不良反应。结论医用伤口修复液对肛瘘患者术后创面修复具有较好的临床疗效。     

可注射性胶原的基础研究及在面部整形美容的应用

胶原是由特异性动物细胞合成的一种高分子蛋白质,广泛存在于所有哺乳动物的皮肤、骨骼、肌腱和韧带中,是动物的主要结缔组织蛋白。胶原材料就是从这些组织中提取出来的一种天然生物材料,可以是同种的或异种的,临床上应用较多的是异种胶原生物材料。异种胶原生物材料在医学上的应用甚广,可用于止血,促进伤口愈合,作为烧伤创面敷料,骨移植替代材料,组织再生诱导物等;还可制成可注射性胶原溶液,用于治疗尿失禁,声门及腭咽功能不全的修复;在整形美容外科的应用更为广泛,在国     

天然生物材料促进创面修复的研究进展

急慢性创面严重威胁患者的生命健康和生活质量, 因此创面修复是近年来国内外学者研究的热点问题。随着材料学与组织工程的发展, 越来越多由天然成分制备的生物材料被用于创面修复的基础研究和临床治疗, 此类材料可作为创面组织再生的模板, 诱导自体细胞黏附、迁移, 促进细胞外基质沉积, 具有广阔的临床应用前景。该文对创面修复领域中目前研究热门的天然生物材料的特点及其应用进展作一综述, 旨在为新型创面敷料及组织工程皮肤研发提供思路。     

成纤维细胞在成人、胎儿皮肤伤口愈合中差异的研究进展

创伤修复是医学领域中最古老的问题之一,近年国内外学者十分重视创伤修复的基础研究与临床治疗.随着分子生物学和组织工程等高新技术的进步和发展,以及它们在这一领域的应用,使创伤修复成为了集医学、生物化学以及生物材料学等诸多专业与学科为一体的边缘性学科.成纤维细胞(fibroblast,FB)是参与创伤修复的主要细胞,Lekic[1]等称FB为创伤修复的工程师、建筑者和管理员.了解与控制FB的生物学行为是促进伤口愈合、预防和/或减少瘢痕形成的基础和关键,已成为诸多学者的共识.胎儿的创面为无瘢痕愈合,而成年创面愈合有瘢痕,甚至形成瘢痕疙瘩,该现象引起了学者的关注.随着分子生物学技术的发展,研究认为这种愈合差异与FB有关.本文将近年来有关FB在成年和胎儿创面愈合差异的研究综述如下.     

胶原注射美容技术

1　概述医用美容注射胶原是一种新型的医学生物材料 ,是高度纯化的人或动物胶原蛋白。所谓胶原注射美容技术就是采用注射性胶原整复人体软组织的缺损或畸形以达到整形美容的目的。胶原是由特异性动物细胞合成的一种高分子蛋白质 ,广泛存在于所有哺乳动物的皮肤 ,骨骼、肌腱和韧带中 ,是动物的主要结缔组织蛋白。胶原材料就是从这些组织中提取出来的一种天然生物材料 ,可以是同种的或异种的 ,主要来源于人和牛 ,目前临床上应用较多的是异种胶原生物材料。异种胶原生物材料在医学上应用很广 ,可用于止血 ,促进伤口愈合、诱导组织再生等 ,并可…     

新型冠状病毒肺炎疫情下医疗美容机构安全防控专家共识

新型冠状病毒肺炎疫情复杂严峻,针对医疗美容机构的实际情况及医疗特点,本学会组织医疗美容行业专家针对疫情期间医美机构安全防控的总体原则、诊疗流程、清洁消毒、防护工作等提出专家共识,以指导各地医美机构复工后安全、有序地开展医疗工作。     

Schwierige Weichteilverhältnisse

Patients with impaired wound healing and problematic soft tissue conditions after traumatic injury or following surgery present a daily challenge to the attending trauma surgeon. The repair process in wound healing is affected by a variety of local and systemic factors. For the surgeon it is very important to know about these factors and their effects on the process of wound healing to promote unimpaired tissue repair. With a steadily increasing number of elder patients, comorbidities play an essential role in the healing process. This article gives a review of the most important factors affecting tissue repair and the relevant literature.     

Analysis of the effects of chitosan on inflammation, angiogenesis, fibroplasia, and collagen deposition in polyvinyl alcohol sponge implants in rat wounds

Chitosan is a large molecular weight, positively charged polysaccharide extracted and purified from the chitin of crab shells. This compound has been shown to have hemostatic activity and has been suggested for use as a topical agent in tissue repair. The objective of this study was to analyze the effect of chitosan on the wound healing response to a standardized injury in the rat. The polyvinyl alcohol sponge implant model was used as a means to deliver either chitosan or its vehicle to a standardized subcutaneous wound on the backs of Sprague-Dawley rats. On days 8 and 14, the chitosan-treated implants contained primarily polymorphonuclear leukocytes compared with the vehicle controls which contained mainly macrophages, fibroblasts, collagen, and new blood vessels. High-performance liquid chromatography analysis for hydroxy-L-proline deposited in the sponge implants showed significantly lower amounts on both days 8 and 14 in the chitosan treatment group. These histologic and biochemical studies suggest that chitosan modulates wound healing by first reducing the influx of activated tissue macrophages, which in turn reduces the subsequent events of angiogenesis, fibroplasia, and connective tissue deposition.     

Effect of aging on wound healing: current concepts.

The population is aging, and advanced age is commonly identified as a risk factor for delayed wound healing. Therefore, it is important for WOC nurses to be knowledgeable about how aging affects the wound healing and repair process, and strategies they can use to promote healing in the elderly population. Impaired wound healing in the aged is due partly to comorbidities common among the elderly, but evidence also suggests that inherent differences in cellular structure and function may impair tissue repair and regeneration as well. This article will address the effect of aging on wound healing, with a particular focus on processes of cellular senescence and related factors hypothesized to result in slowed or impaired wound healing in the elderly.     

PRF促进急性创面愈合的研究进展

伤口愈合很大程度上依赖于机体自身的修复能力,而组织损伤会激活多种细胞分泌生长因子参 与炎症反应过程,调节蛋白质和其他细胞成分的合成、分解,从而促进细胞增殖、基质形成、血管再生 及肉芽形成,达到创面修复的目的。富血小板纤维蛋白（PRF）是第二代血小板浓缩物,与富血小板血 浆（PRP）不同,PRF制备时未加入抗凝剂和其他化学成分,有效避免了过敏反应。PRF富含生长因子, 可持续释放生长因子至少1周以上,同时具有良好的立体纤维蛋白空间结构,可为创面提供理想的细胞支 架,能有效促使细胞迁移和增殖,从而达到促进创面愈合的作用。本文为探究PRF促进急性创面愈合的研 究进展,现就伤口愈合过程、PRF应用于急性伤口愈合时的作用机制作一综述。     

Production of VEGF and b-FGF in drainage fluid from patients undergoing incisional hernia repair

Wound healing is a complex process involving interaction between different cell types, such as growth factors. Among these, vascular endothelial growth factors (VEGF) and basic fibroblast growth factors (b-FGF) are the most important. The aim of this study was to assess the production of VEGF and b-FGF in wound drainage fluid from patients undergoing incisional abdominal hernia repair. Ten female patients with abdominal midline incisional hernia undergoing surgical repair were included in this study. In all cases a closed suction drain was placed in the wound below the fascia and removed on postoperative day 4. Wound fluid was collected on the I, II, III and IV day and its amount at each time was recorded. VEGF and b-FGF production were evaluated as the quantity produced in 24 hours. In all patients the amount of drainage fluid from the surgical wound was highest on the I day after surgery, after which there was a significant reduction. VEGF production increased progressively after the operation proving significantly higher only on the IV day. The amount of b-FGF, in contrast, was higher on the I day, decreasing thereafter on the following postoperative days. Analysis of the production of growth factors in the drainage fluid has enabled us to better assess the events that occur following surgical wounds and has confirmed the physiology of the healing process and the possible use of these factors in modulating positive healing.     

Improvement of wound tissue repair by chitosan films containing (–)‐borneol,a bicyclic monoterpene alcohol,in rats

The aim of this study was to investigate the wound‐healing activity of (–)‐borneol (BOR) incorporated in chitosan film on healing protocol in rodents. To assess the BOR wound‐healing potential, male Wistar rats were subjected to a full‐thickness excisional wound. The animals were divided into three groups: dressed with chitosan‐based film (QUIN); dressed with chitosan‐based film containing 0·5% BOR (QUIBO05); or dressed with chitosan‐based film containing 1% BOR (QUIBO1). Dressing the wound areas and histological analysis were performed on the 3rd, 7th, 14th, and 21st days. The myeloperoxidase (MPO) activity was assessed on the third and seventh days after surgical procedures. Wounds dressed with chitosan‐based film containing BOR reduced significantly the MPO activity (P < 0·001), showed significantly larger wound retraction rates (7 days, P < 0·05), improved the granulation reaction, and also provided better collagenisation density and arrangement during wound healing. It is suggested that BOR modulates the wound‐healing process and is a promising compound to be used in wound care. This product may be quite useful in improving wound healing and could be a new biotechnological product with healing properties and clinical application. Further ongoing studies will enable us to understand the precise mechanisms whereby BOR improves the wound‐healing process.     

Wound repair and regeneration

The skin is the biggest organ of the human being and has many functions. Therefore, the healing of a skin wound displays an extraordinary mechanism of cascading cellular functions which is unique in nature. As healing and regeneration processes take place in all parts of the human body, this review focuses on the healing processes of the skin and highlights the classical wound healing phases. While regeneration describes the specific substitution of the tissue, i.e. the superficial epidermis, mucosa or fetal skin, skin repair displays an unspecific form of healing in which the wound heals by fibrosis and scar formation. The first stage of acute wound healing is dedicated to hemostasis and the formation of a provisional wound matrix, which occurs immediately after injury and is completed after some hours. Furthermore, this phase initiates the inflammatory process. The inflammatory phase of the wound healing cascade gets activated during the coagulation phase and can roughly be divided into an early phase with neutrophil recruitment and a late phase with the appearance and transformation of monocytes. In the phase of proliferation the main focus of the healing process lies in the recovering of the wound surface, the formation of granulation tissue and the restoration of the vascular network. Therefore, next to the immigration of local fibroblasts along the fibrin network and the beginning of reepithelialization from the wound edges, neovascularization and angiogenesis get activated by capillary sprouting. The formation of granulation tissue stops through apoptosis of the cells, characterizing a mature wound as avascular as well as acellular. During the maturation of the wound the components of the extracellular matrix undergo certain changes. The physiological endpoint of mammalian wound repair displays the formation of a scar, which is directly linked to the extent of the inflammatory process throughout wound healing.