负压封闭引流技术对大鼠急性创面愈合过程中Ⅰ/Ⅲ型胶原比例变化的影响

文题释义：负压封闭引流技术：是一种用来处理各种急慢性复杂伤口的技术。这种技术主要通过亲水材料聚乙烯醇和疏水材料聚氨酯以及引流管来完成,安全无毒的聚乙烯醇覆盖在皮肤缺损或者软组织损伤部位,在它上面覆盖一层疏水材料聚氨酯,两者之间置入引流管后连接负压吸引装置,设置负压值,医用贴膜封闭由此形成密闭空间,促进创面愈合。 Ⅰ/Ⅲ型胶原比例：皮肤组织中最丰富的物质是胶原蛋白,而Ⅰ/Ⅲ型胶原的量占总胶原的90%以上,Ⅰ型胶原纤维较粗壮,呈条束状,决定着皮层的抗拉伸强度;Ⅲ型胶原纤维较细微,呈疏松网状结构,决定着皮肤的韧性及弹性,所以Ⅰ/Ⅲ型胶原比例决定着皮肤的愈合质量。背景：负压封闭引流技术可以促进各种急慢性创面的愈合。Ⅰ/Ⅲ型胶原比例在维持皮肤组织稳态及皮肤损伤后的修复过程中发挥着重要的作用,但是在负压封闭引流技术促进创面愈合过程中Ⅰ/Ⅲ型胶原比例的变化知之甚少。 目的：观察负压封闭引流技术促进创面愈合过程中Ⅰ/Ⅲ型胶原的比例变化,探讨其对大鼠急性创面的修复机制。方法：建立大鼠背部皮肤全层缺损模型,创面直径20 mm,建立创面模型以后随机分为负压封闭引流治疗组和空白对照组。创面愈合过程中于术后第1,3,7天对创面进行固定高度连续拍照,进而计算和比较创面愈合率;实时荧光定量PCR检测Ⅰ,Ⅲ型胶原mRNA的表达;免疫组织化学染色分析Ⅰ/Ⅲ型胶原比例;组织学检测创面组织肉芽组织再生和再上皮化长度的变化。结果与结论：①与空白对照组相比,负压封闭引流治疗组提高了Ⅰ,Ⅲ型胶原的mRNA和蛋白表达水平(P < 0.05);②术后第3天开始,负压封闭引流治疗组的Ⅰ/Ⅲ型胶原比例高于空白对照组(P < 0.05);③负压封闭引流治疗组的创面愈合率均高于空白对照组(P < 0.05);④上述结果证实,负压封闭引流技术可能通过提高Ⅰ,Ⅲ型胶原蛋白表达和Ⅰ/Ⅲ型胶原比例,增加创面的抗拉伸强度,促进创面的早期愈合。ORCID: 0000-0003-2399-6202(赵鑫) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

间充质干细胞源性外泌体在创面修复中的研究进展

外泌体是由细胞通过旁分泌途径产生的一种直径在30～100 nm的囊泡结构。作为活细胞分泌的一种亚细胞成分,外泌体广泛参与细胞间的信息交流。多项研究表明,间充质干细胞源性外泌体调控创面修复的多个过程。它可以通过抑制创面过度炎症反应,促进创面血管新生,促进成纤维细胞增殖、迁移,以及抑制创面瘢痕形成来促进创面的修复与再生。本文就间充质干细胞源性外泌体在创面修复中的作用及相关机制进行综述,为外泌体在临床中的应用提供依据。     

间充质干细胞源性外泌体在促创面愈合中的应用与挑战

间充质干细胞(MSC)能够有效促进各类创面的愈合且已进入临床试验阶段.进一步研究发现MSC通过旁分泌产生的外泌体也具有与MSC等效的生物学作用.基于MSC源性外泌体的"无细胞"疗法具有广阔的应用前景,但其面临的争议与挑战也值得关注.本文就MSC及其源性外泌体的应用进展和争议,以及微环境对其的影响进行简要评述,与读者共同...     

甾醇调节元件结合蛋白在创面修复中的作用机制与应用途径

背景:甾醇调节元件结合蛋白(sterol regulatory element binding proteins,SREBP)是一类转录因子家族,主要通过控制内源性胆固醇、脂肪酸、磷脂和三酰甘油合成所需的一系列酶的表达来调控脂质稳态.近年来研究表明SREBP可以参与创面的炎症反应、血管生成及表皮细胞生成来调控创面愈合....     

负压封闭引流促进创面愈合机制的研究进展

创面修复是医学中古老的问题之一。封闭负压引流（vacuum sealing drainage,VSD）技术的发明与应用,改变了创面的被动愈合过程,促进伤口愈合。该技术自1992年德国Ulm大学创伤外科Fleischman博士首创以来[1],在临床医学各个学科得到了广泛应用,但其促进创面愈合的确切作用机制尚未完全清楚,本文将就其研究进展进行综述。     

外泌体miRNAs在器官纤维化中作用的研究进展

外泌体是由多种细胞主动分泌产生的可携带蛋白质、脂质、miRNAs等生物分子的微小囊泡。外泌体微小RNAs(miRNAs)稳定的存在于体液循环中,参与器官多项病理过程。在器官纤维化疾病中,外泌体miRNAs的含量与正常组织相比呈现出明显的差异性表达,通过调控不同信号通路促进或抑制器官纤维化。外泌体miRNAs可作为临床诊断器官纤维化及判断其纤维化程度的最新生物指标和纤维化疾病新的治疗靶点。     

外泌体在病毒感染中的研究进展

外泌体（exosomes）是由细胞释放至胞外的膜性囊泡,直径40~100nm。外泌体可介导细胞间信息传递和物质交换,在疾病的发生发展中发挥着重要作用。在病毒感染过程中,外泌体既可传递病毒核酸、RNA和蛋白质,又可传递抗病毒分子引起免疫应答。通过对外泌体的深入研究,可在病毒感染临床治疗中提供新前景。     

Cyclic AMP accumulation in the beta adrenergic mechanism of eccrine sweat secretion

Tissue cyclic 35-AMP (cAMP) concentrations were measured after stimulation of isolated monkey palm eccrine sweat glands with various stimulants of sweat secretion. The cellular cAMP levels increased curvilinearly with time of incubation to reach a steady state after 5 min of incubation with isoproterenol. Theophylline more than doubled the isoproterenol-induced cAMP accumulation, whereas theophylline alone increased the basal cAMP level to a minor extent. Phenylephrine failed to stimulate cAMP accumulation. There was no increase in the cAMP level after stimulation with methacholine. A calcium ionophore, A23187, also failed to stimulate cAMP accumulation. Since isoproterenol, theophylline (or isobutylmethylxanthine), and dibutyryl cAMP all induced eccrine sweat secretion in isolated, cannulated sweat glands to varying degrees in vitro, cAMP is probably involved in the beta adrenergic mechanism of sweat induction. The isoproterenol-induced cAMP accumulation was not inhibited by removal of Ca²⁺ from the incubation medium for as long as 30 min. The striking similarity between the eccrine sweat gland and the salivary glands in the roles that Ca²⁺ and cAMP play in stimulus secretion coupling indicates that the eccrine sweat gland will serve as another useful model system for the study of the mechanisms of exocrine secretion.     

Immunoreactivity to desmin in secretory epithelium of eccrine sweat glands

The finding of immunoreactivity to desmin in eccrine sweat glands is reported. Two monoclonal anti-desmin antibodies of the same clone (33) produced a distinct positivity in the secretory cells of the sweat glands in 15/16 biopsies. No immunoreactivity for desmin was found in control sections from apocrine sweat glands, salivary, mammary, prostate and lacrimal glands.     

壳寡糖在糖尿病皮肤伤口愈合中的应用及研究进展

糖尿病慢性皮肤伤口的愈合,是临床治疗中的难点和基础研究中的热点。传统治疗方法效果并不理想,而组织工程技术的发展,为其治疗提供了新途径。现今已有将壳寡糖作为伤口敷料的研究,并引起越来越多的关注,但关于壳寡糖用于糖尿病难愈性创面的研究并不多。本篇综述将概述壳寡糖促进伤口愈合的生物学机制及特点,以及糖尿病皮肤创面的病理学改变,总结壳寡糖在糖尿病皮肤伤口愈合中的研究进展。     

外源性透明质酸对创面愈合影响的研究进展

对透明质酸参与创面修复过程及其机制的研究进展进行综述,回顾、总结与分析透明质酸盐的理化性质、代谢途径及代谢产物与创面修复的关系。透明质酸盐在创面修复过程中具有清创、抗炎、促进创伤愈合重要作用,其代谢产物能够促进血管生成及成纤维细胞增殖,调控胶原合成。透明质酸盐凭借在创面修复的重要作用,将会在创面修复及组织工程等领域得到广泛的应用。     

A reliable method of determining wound healing rate

Several wound healing rate measures have been introduced with the main goal of enabling quantification of the effects of various therapeutic modalities on the healing of open wounds. Different definitions of wound healing rate render comparison of clinical results difficult. The goal of the present study was to propose a measure of wound healing rate that is independent of initial wound extent and to present a method of wound healing rate prediction. Comparisons were made of wound healing rate defined as absolute area healed per day, percentage of initial area healed per day and advance of the wound margin towards the wound centre per day. Analysis was performed on 300 wound cases. A disadvantage of wound healing measures that either use absolute area healed per day or percentage of initial area healed per day is their very limited use for comparing healing rates of wounds with different initial sizes. This disadvantage was overcome by incorporating a wound perimeter; thus obtaining a measure of the advance of the wound margin towards the wound centre. A definition of healing rate expressed as the greatest average wound margin distance from the wound centre divided by the time to complete wound closure is proposed. Because not all wounds are closed in the observation period, the time to complete wound closure has to be predicted. A method of wound healing rate prediction is presented based on a delayed exponential model the parameters of which are obtained from at least five weekly wound area measurements. Paired t-tests between actual time needed to complete wound closure and the predicted time resulted in p=0.062 after four, 0.484 after five and 0.900 after six weeks of observation.     

皮肤成纤维细胞在创面愈合中的研究进展

皮肤成纤维细胞是参与创面愈合的主要修复细胞,近年来其异质性及其与周围细胞间的通讯正逐渐引起重视.真皮成纤维细胞亚群主要包括乳头状成纤维细胞和网状成纤维细胞,对创面愈合发挥不同的作用.成纤维细胞通过自分泌和旁分泌信号分子与周围细胞之间相互作用构成创面微环境,影响创面愈合.慢性创面中的成纤维细胞表现出多种功能障碍.本文就成...     

自噬对烧伤创面愈合的影响

细胞自噬是细胞在应激状态下应用溶酶体对自身损伤细胞器等物质进行分解,将产生的大分子物质予以回收利用,从而保留细胞活性的降解过程。自噬在细胞的发育和分化进程中起着至关重要的作用。烧伤创面经历炎症期、细胞增殖期和组织重塑期3个时期完成组织愈合。细胞自噬在烧伤创面愈合过程中,具有促进病原体清除,参与新生血管增殖、肉芽组织形成,改善上皮的角质化以及瘢痕重塑的作用。调控自噬,可影响烧伤创面愈合。本文综述细胞自噬在烧伤创面愈合中的研究进展。     

创面愈合相关机制的研究进展

创面是一种以皮肤缺损或功能受限为主要特征的常见外科病症.感染、异物、局部血液循环障碍及某些基础疾病等因素不仅会影响创面的愈合,持续发展甚至还会出现全身皮肤感染,代谢紊乱,创周血管硬化,周围神经损伤及肢体功能障碍等一系列并发症.创面愈合问题一直是烧伤整形科面临的最具挑战的问题.本文阐述了国内外对相关炎症因子、生长因子、免...     

Effects of Zn-7® on open wound healing in dogs

Analysis of the accelerating effects of open wound healing by Zn-7 gel compared with normal saline was carried out in dogs. Five normal male, mixed breed dogs approximately 3 years old were selected. Histological and macroscopic aspects of second-intention wound healing were studied. Two rectangular, full-thickness skin wounds (20 × 30 mm) were created symmetrically on each dog at both sides of the dorsal midline at 0, 1, 2, 3, and 4 weeks. Left wounds were treated with Zn-7 gel (test group) and right wounds were treated with normal saline (control group) twice daily. Photographs were taken twice a week. Rulers were held vertically and horizontally close to the wound as a reference. The area of epithelialization and granulation tissue were measured for each wound, using the Scion Image software. Percentage wound contraction, epithelialization, and healing were calculated for each wound. No significant differences were observed in wound contraction, epithelialization and healing in the test and control groups (P > 0.05). At day 35 after initial wounding, biopsies were taken from wounds for histological examination. There were no significant differences in the number of inflammatory cells, fibrocyte, or amount of the fibrin and collagen (P > 0.05) between the test and control wounds.