毛囊隆突区β神经生长因子水平对乳鼠烫伤创面愈合的影响

背景：毛囊干细胞在受到外界环境刺激作用下,例如创伤,化学伤等,其理化性质及细胞状态会有所变化。但是从目前文献来看,涉及其在皮肤烫伤中变化的研究的比较少。目的：初步观察大鼠烫伤模型中,毛囊隆突区β神经生长因子的表达变化以及对烫伤组织愈合的影响。方法：随机选取30只乳鼠,采用90 ℃水温持续3 s时间的方式制作大鼠触须部表皮组织浅Ⅱ度烫伤模型,造模后第12,24,36,48,60小时对毛囊隆突区进行分离,并进行匀浆,以同窝新生6只乳鼠正常唇部组织作为对照。采用Brandford法进行总蛋白检测及ELISA定量检测β神经生长因子。免疫组织化学进行神经生长因子的定性半定量检测。结果与结论：在烫伤后各时间点检测的β神经生长因子与总蛋白比值中,β神经生长因子的表达在烫伤后36 h开始后增高,60 h达到峰值。组织切片中同样发现这一规律。通过图像软件分析表明,提取β神经生长因子蛋白检测与组织水平β神经生长因子表达一致。提示烫伤后12~60 h时间段内,烫伤后60 h隆突区表达的β神经生长因子达到峰值,对烫伤愈合的修复作用也达到峰值。隆突区是毛囊干细胞的巢,此部位β神经生长因子表达增强可能对毛囊干细胞的分化和组织修复具有一定的积极意义。     

脂肪组织促进创面愈合的机制*

背景：随着对脂肪组织研究的不断深入,脂肪组织在创面愈合中的作用备受关注,脂肪组织促进创面愈合的机制以及应用方面的研究广泛开展。目的：文章从脂肪因子和脂肪干细胞两方面探讨脂肪组织促进创面愈合的机制,并就相关应用研究进行归纳分析,为临床创面治疗提供理论依据。方法：由第一作者用计算机检索中国期刊全文数据库(CNKI：2009/2010）和PubMed数据库(2009/2010),检索词分别为“脂肪组织,瘦素,抵抗素,脂肪干细胞,创面愈合”和“adipose tissue,leptin,resistin,adipose-derived stem cells,wound healing”,语言分别设定为中文和英文。从脂肪因子和脂肪干细胞两方面入手,对脂肪组织促进创面愈合的机制及脂肪组织促进创面愈合的现有研究进行介绍。结果与结论：共检索到文献329篇,阅读标题和摘要后,按纳入标准,共纳入31篇。总结并分析文献内容后发现,血管再生、成纤维细胞及角朊细胞等的增殖是创面愈合的关键,而脂肪组织可通过脂肪干细胞及分泌脂肪因子促进血管内皮、成纤维、角朊等细胞增殖的方式,促进创面愈合,提高创面愈合质量。但有关创烧伤过程脂肪因子的调控机制,脂肪干细胞增殖、分化的机制,以及如何进而进一步提高创面愈合速率及质量等问题,仍需进一步研究。关键词：脂肪组织;创面愈合;瘦素;抵抗素;生长因子;脂肪干细胞     

带神经血管肌束分点植入后失神经肌肉形态学改变

背景：失神经支配的肌萎缩一直是临床治疗的难点,目前仍没有突破性的研究成果。 目的：观察带神经血管的肌束分点植入后对失神经支配肌肉形态学影响，探求一种失神经支配肌萎缩研究的新思路。 设计、时间及地点：同体对照动物实验，于2006-07/2007-12在南京鼓楼医院手外科完成。 材料：清洁级健康Wistar大白鼠30只，雌雄不限，体质量250 g左右。 方法：建立大鼠双下肢腓肠肌外侧头失神经支配模型。其中右侧在腓肠肌外侧头肌腹中远1/3处做两切口，用比目鱼肌作成带神经血管肌束，分点植入失神经支配肌肉内，作为实验组。左侧只切断腓肠肌外侧头肌支作为对照组。分别于术后4，8，12周取材。 主要观察指标：观察肌肉外观、超微结构变化，测定肌纤维周径及截面积、胶原纤维含量。 结果：①实验侧的腓肠肌饱满、有弹性、色泽好、切之出血多。对照组肌肉萎缩变细、色泽灰白、切之出血少。②各时间点实验组肌细胞周长和肌肉纤维横截面积测量值大于对照组（P均< 0.01）；胶原纤维含量低于对照组（P < 0.01）。③实验组细胞核基本正常，肌膜光滑，肌纤维间距小，线粒体数量多、嵴完整。对照组肌肉细胞核变形、空泡化，肌膜呈乳突样改变，肌纤维明显变细，间距增大，线粒体数量少、出现空泡化及絮状化，脂滴增多。 结论：带神经血管肌束分点植入法是一种延缓失神经支配肌肉萎缩的有效方法。     

激活Hacat细胞表面Toll样受体促进创面愈合的机制★

目的：细胞表面Toll样受体对激发先天性免疫、抵抗微生物感染有重要作用。最近研究发现激活细胞表面Toll样受体不仅可以预防微生物感染，还可以促进组织再生。实验通过脂多糖激活体外培养的角质细胞株Hacat细胞表面Toll样受体，观察其促进创面愈合的可能机制。 方法：实验于2007-07在解放军第四军医大学西京医院烧伤与皮肤外科完成。①实验分组及方法：角质细胞株Hacat由解放军第四军医大学西京医院皮肤科馈赠；脂多糖为Sigma公司产品；小鼠抗人Toll样受体2单克隆抗体、兔抗人Toll样受体4多克隆抗体购于ebioscience公司。体外培养Hacat细胞，根据脂多糖(500 ng/L)与Hacat细胞共培养24，48，72 h将细胞随机分为脂多糖作用24 h 组、脂多糖作用48 h 组、脂多糖作用72 h 组，另设对照组，只加溶剂二甲基亚枫。②实验评估：蛋白免疫印迹技术检测脂多糖对Hacat细胞Toll样受体2、Toll样受体4及核因子-κB表达的影响；荧光定量聚合酶链反应检测脂多糖作用后Hacat细胞内基质金属蛋白酶3、基质金属蛋白酶9及血管内皮生长因子的表达。 结果：光学显微镜下正常人皮肤表皮及角质细胞Toll样受体2、Toll样受体4表达呈蓝黑色；脂多糖作用于Hacat细胞24，48，72 h 后Toll样受体2、Toll样受体4、核因子-κB表达均高于对照组（P < 0.01）。与对照组相比，其他3组基质金属蛋白酶3及血管内皮生长因子表达均增高（P < 0.01，P < 0.05）。脂多糖作用24 h 组基质金属蛋白酶9表达与对照组差异无显著性（P > 0.05），脂多糖作用48，72 h 组与对照组比较，差异显著（P < 0.05）。 结论：激活Hacat细胞表面Toll样受体有促进创面愈合作用，其机制可能与脂多糖作用于Toll样受体从而激活核因子-κB信号传导通路促进细胞释放基质金属蛋白酶3、基质金属蛋白酶9及血管内皮生长因子等因素有关。     

创面愈合与瘦素促进的跨膜信号途径***

背景：瘦素与其受体结合时,能以内分泌和旁分泌等方式促进新血管生成,调节炎症及免疫功能。 目的：探讨瘦素在创面愈合中的作用及跨膜信号传导机制。方法：采用计算机检索CNKI数据库和PubMed数据库,以“瘦素,创面愈合,跨膜信号传导”和“leptin,wound healing,transmembrane singal”为关键词,语言设定为中文或英文。从瘦素在创面愈合的作用及跨膜信号传导2个方面进行总结。结果与讨论：共检索到78篇文章,按纳入和排除标准对文献进行筛选,共纳入22篇文章。结果表明瘦素能够促进表皮角质形成细胞增殖、迁移,其跨膜信号传导涉及到JAK2,STST3,ERK1等多个信号分子。瘦素-受体信号的激活则改善创面愈合,其与瘦素促进表皮角质形成细胞增殖和再上皮化有关。     

糖尿病大鼠皮肤伤口愈合过程中结缔组织生长因子的表达*

背景：结缔组织生长因子表达在糖尿病伤口愈合过程中的变化及意义少见报道。目的：观察链脲佐菌素诱导的糖尿病模型大鼠复合创伤修复过程中结缔组织生长因子表达的变化及意义。方法：将Wistar大鼠随机分成正常对照组和模型组,3周后将各组动物复合背部1.3 cm2全厚皮切除形成伤口。结果与结论：链脲佐菌素诱发的糖尿病模型大鼠伤口愈合明显延迟,创伤后第4,8,12 和16天创面愈合率明显低于正常对照组(P < 0.01)。术后第8天,糖尿病组大鼠肉芽组织成熟度和新生血管形成指标得分均低于正常对照组(P < 0.01)。正常对照组的结缔组织生长因子蛋白表达呈时间递增趋势,而糖尿病组的结缔组织生长因子表达在整个创面愈合过程的后期(第12天后)均明显低于正常对照组(P < 0.01)。结果提示,糖尿病大鼠皮肤伤口愈合后期创面组织结缔组织生长因子表达相对正常对照组减少可能是导致创面愈合迟缓的重要原因之一。     

去神经支配骨骼肌萎缩的多种治疗

背景：骨骼肌去神经支配后出现肌萎缩和收缩功能的丧失,肌纤维发生与萎缩相关的一系列的形态学和组织学的变化。近年来随着技术水平及理论研究的进展,治疗效果有了较大的提高,但仍未达到满意的效果。 目的：总结并讨论近年来有关去神经支配骨骼肌萎缩的治疗新进展,为肌肉功能的恢复提供理论基础。 方法：由第一作者用计算机检索中国期刊全文数据库(CNKI：2000/2010)和Medline数据库(2000/2010),检索词分别为“去神经支配,骨骼肌,肌萎缩,治疗”和“denervated,skeletal muscles,atrophy,treatment”。共检索到135篇文章,按纳入和排除标准对文献进行筛选,共纳入30篇文章,从物理治疗、神经修复和植入、细胞移植、药物、基因和中药治疗等方面进行总结和分析。 结果与结论：近年来去神经支配骨骼肌的治疗取得了很大进展,但这些方法只能在一定程度上缓解骨骼肌萎缩,在一段时间内维持肌肉的生理功能。目前研究随着去神经支配骨骼肌萎缩机制的阐明,针对性的治疗措施将会取得更好的效果。     

脑血管肾上腺素能神经支配与调节

本文综述了近几年来有关脑血管肾上腺素能神经支配的解剖学和神经生理学研究进展,着重介绍了脑血管肾上腺素能神经的走行、分布规律,及其外周和中枢性神经对脑血流的调节作用,阐述了肾上腺素能神经与脑血管疾病之间的联系和临床治疗方面的研究现状.     

生肌液复合封闭负压引流对创面肉芽组织增殖的作用

背景：传统生肌中药促进创面愈合疗效独特，封闭负压引流技术是新兴的创面治疗方法。 目的：从组织学角度观察生肌液和封闭负压引流技术相结合对实验动物创面愈合的影响。 设计、时间及地点：随机对照动物实验，于2006-05/10在河南省正骨研究院生物工程实验室完成。 材料：100只SD大鼠随机分为模型组、麻油纱布组、生肌液纱布组、封闭负压引流组、生肌液复合封闭负压引流组，每组20只。生肌液和麻油煎剂均由本院制剂室规范制备。 方法：在每只大鼠背部制作2个皮肤切除伤创面模型。模型组等待创面自然愈合，麻油纱布组以两层麻油纱布敷于创面上，生肌液纱布组以两层生肌液纱布敷于创面上；封闭负压引流组给予创面封闭负压引流治疗。生肌液外用结合封闭负压引流组：给予创面封闭负压引流治疗，负压吸引间歇期从注药管注入生肌液。每组20只动物随机分4批各10个创面，第1，2，3个批次分别用于3，6，9天取材观察创面的愈合率和创面组织形态学变化。第4个批次观察创面愈合时间。 主要观察指标：①创面的愈合率。②创面愈合时间。③创面组织形态学变化。 结果：①各组创面第3天愈合率比较差异无显著性意义(P > 0.05)。3 d后封闭负压引流组及复合组愈合速度明显加快。第9天愈合率由高到低依次为复合组、封闭负压引流组、生肌液纱布组、麻油纱布组和模型组，组间比较差异有显著性意义(P < 0.05)。各组愈合时间由快到慢排序同上。②第3天封闭负压引流组毛细血管数略高于复合组(P > 0.05)；第6天复合组毛细血管数高于封闭负压引流组(P < 0.05)；第3天各组成纤维细胞数均维持在较低水平，组间比较差异无显著性意义(P > 0.05)第6天复合组成纤维细胞数高于封闭负压引流组(P < 0.05)。 结论：生肌液复合封闭负压引流技术可以更好地促进创面愈合。封闭负压引流技术在创面愈合的早期能明显促进组织细胞增殖；生肌液在中后期可以延续组织细胞的增殖趋势。     

神经生长因子对大鼠胫骨骨折愈合的影响

背景：临床中发现失神经可导致骨折断端骨痂过度生长甚至在肌肉中出现异位骨化 ,这一现象提示神经因素对骨折愈合有影响。 目的：探讨神经生长因子对大鼠胫骨骨折愈合的影响。 设计、时间及地点：随机对照动物实验，于2005-06/2006-03在解放军第二军大学动物实验中心完成。 材料：健康雄性3个月龄SD大鼠120只，体质量250~300 g，随机分为单纯左胫骨骨折组和神经生长因子治疗组，每组60只。注射用神经生长因子由厦门北大之路生物工程有限公司提供。 方法：两组大鼠制备单纯胫骨骨折，神经生长因子治疗组肌注2 000 AU(1.4 g)，1 次/ d,分别注射两侧腓肠肌，连续肌注2周。伤后第4周对2组大鼠骨折断端行断层CT，测量骨折断端最大横截面及计算骨痂灰度值，行生物力学3点折弯试验。 主要观察指标：①骨组织形态计量学、骨密度测定。②骨痂组织形态学的观察。③免疫组化法测定骨痂组织骨钙素的表达。④观察2组大鼠骨痂中成骨细胞的超微结构变化。⑤Western印迹检测Ⅰ、Ⅱ型胶原的表达。 结果：神经生长因子治疗组3点折弯试验各项生物力学参数均优于单纯左胫骨骨折组(P < 0.05)。形态学及超微结构观察见神经生长因子治疗组骨折愈合优于单纯左胫骨骨折组。神经生长因子治疗组Ⅰ型胶原蛋白表达明显高于单纯左胫骨骨折组(P < 0.05)；而单纯左胫骨骨折组骨痂Ⅱ型胶原蛋白的表达明显高于神经生长因子治疗组(P < 0.05)。 结论：生物力学测试及Ⅰ型胶原蛋白表达和成骨细胞微观结构均说明神经生长因子对骨折断端的骨化有促进作用，其途径有可能在骨痂生长的不同时期通过调节Ⅰ、Ⅱ型胶原的量来调控骨折的愈合。     

脊神经根离断对周围皮肤神经再生和创面愈合的影响

Burn wounds were produced on two sides on the backs of Wistar rats,in addition to denervation on one side.The skin neural regeneration at the injury site and burn wound healing were evaluated following spinal nerve root incision.No nerve regeneration was observed in the burn wound region post-denervation,and the degree of epithelization was significantly less than the control group.With increasing time,expression of type I collagen,which plays a supporting role,and collagen III,which exhibits elastic properties,were significantly increased in the two groups,but the expression was less in the denervation group compared with the control group,and the wound healing was faster in the control group.The ratio of type I collagen to type III collagen was significantly lower in the den-ervation group compared with the control group.The ratio gradually decreased with prolonged time in the denervation group,but remained unchanged in the control group.However,the elasticity of the tissues in the denervation group was better than the control group.During burn wound healing,innervations can promote wound healing,but denervation can improve the quality of wound re-modeling.     

4000/蛆虫匀浆物影响大鼠创面神经再生的实验研究

背景：蛆虫可以促进创面愈合,而创面愈合又与创面神经再生密切相关。 目的：研究蛆虫匀浆物与创面神经再生的关系。 设计、时间、单位：随机对照动物实验,于2008年8月—2009年4月在大连医科大学附属第一医院骨科实验室完成。 材料：48只体重为200—220克SD健康雄性大鼠由大连医科大学动物实验中心提供, 活体蛆虫在本实验室饲养繁殖。 方法：于每只大鼠背部制作2个圆形直径为1.5厘米的急性全层皮肤缺损创面。蛆虫经过两步消毒法消毒之后,在实验组大鼠创面中每平方厘米应用10只蛆虫的匀浆物;而在对照组中,只应用同等体积的生理盐水。在不同时间段,切除创面组织,应用组织学和免疫组织化学方法进行检测。 主要观察指标：在不同时间段计算创面的愈合率。应用HE染色和Masson三色法在组织水平上观察创面愈合情况。应用免疫组织化学方法观察P物质(SP)及蛋白基因产物9.5（PGP9.5）的表达,以评估创面神经再生情况。 结果：在第7、10、14天,实验组创面愈合率显著高于对照组,且实验组愈合质量好于对照组。在第3、7、10天,实验组SP在细胞和再生神经中的表达显著高于对照组。在第7、10天,可以在再生的神经中检测到PGP9.5的表达,且实验组的表达高于对照组。 结论：蛆虫匀浆物可以通过促进创面神经再生,进而促进创面的愈合。     

Effect of wound healing and tissue transplantation on the navigation of axons in organ-cultured embryonic chick eyes

Wound closure and repair of embryonic neuroepithelium were studied in organ-cultured embryonic retinae. Eyes from 3 to 4-day-old embryos were cultured after removing pieces of retinal tissue. During the subsequent 24 hours of incubation, the 150 to 200 μm wide holes in the retina closed completely. Histological studies showed that the wound closure was not accomplished by cell migration or cell proliferation, but by an approximation of the wound edges mediated by extracellular matrix fibrils of the vitreous body. The wound contraction facilitated the integration of transplants into the retinal neuroepithelium with a perfect alignment of the implants with the host at the vitreal surface. Within 24 hours, a continuous inner limiting membrane between transplant and host retina was established. The effect of wound healing and tissue transplantation on the navigation of optic axons in the retina was investigated. The wound contraction in the retina caused the optic axons near the lesion site to grow to the wound center, where the axons traversed the retina and formed a neuroma at the ventricular side, resembling the organization of axons at the optic disc. In the transplantation paradigm, axons from the host retina migrated into the transplant and vice versa. However, due to the wound contraction around the transplant, most axons grew into the interface between the transplant and host tissue. 1993 Wiley-Liss, Inc.     

烧伤创面愈合过程中胶原代谢与针刺作用的影响

背景：针刺可促进烧伤创面愈合，但对创面组织胶原代谢的影响尚不清楚。 目的：观察针刺对烧伤创面愈合过程中胶原代谢的影响。 设计、时间及地点：随机对照动物实验，于1997-01/2005-12在广州市创伤外科研究所完成。 材料：雌性新西兰大白兔27只，体质量2.0~2.5 kg，用于制备深Ⅱ度烧伤模型。 方法：每个兔背部脊柱两旁造成10个创面。实验分为3组，正常组(n=3)：只背部剃毛备用；常规治疗组：伤后自由进食，创面外用25 g/L的碘伏暴露；针刺组：在常规治疗的基础上，伤后24 h内开始针刺治疗，取双侧“足三里 (ST36)”穴，针刺后接电针仪，频率20 Hz，时间30 min，1次/d。伤后3，7，13，21 d常规治疗组和针刺组各取3只动物处死，取组织待测。 主要观察指标：各组动物不同时间点创面组织中羟脯氨酸水平。 结果：27只大白兔均进入结果分析。烧伤后13 d常规治疗组和针刺组创面组织中羟脯氨酸水平均低于正常皮肤组织(P < 0.05)。伤后21 d 常规治疗组创面组织中羟脯氨酸达到正常皮肤组织水平，两组相比差异无显著性意义(P > 0.05)。而针刺组创面组织中羟脯氨酸水平高于常规治疗组和正常皮肤组织 (P < 0.05)。 结论：针刺可促进烧伤创面胶原的合成。     

羊膜负载表皮干细胞促进糖尿病大鼠创面的愈合

背景：表皮干细胞作为皮肤组织的特异性干细胞,具有强大增殖及多向分化潜能,与创面修复紧密相关。近期研究表明糖尿病皮肤创面愈合过程中表皮干细胞数量减少、活性降低是导致其创面难愈的重要原因。 目的：观察表皮干细胞在糖尿病大鼠创面愈合中的作用。 方法：分离培养及鉴定SD大鼠表皮干细胞,并以BrdU标记。建立糖尿病SD大鼠创面模型,抽签法随机分为3组：表皮干细胞组创面移植羊膜负载BrdU标记的表皮干细胞;羊膜组创面移植羊膜;空白对照组创面未给予干预。 观察创面愈合情况、计算创面愈合率,苏木精-伊红及免疫组织化学SP法检测创面愈合组织中BrdU及增殖细胞核抗原表达。用图像分析软件测量阳性细胞积分吸光度平均值。 结果与结论：表皮干细胞组治疗后7d创面缩小明显,治疗后14 d创面基本愈合,创面愈合率明显高于羊膜组、空白对照组 (P < 0.01)。表皮干细胞组创面及新生表皮中可见BrdU阳性细胞,而另两组皮肤创面组织中始终未见BrdU阳性细胞。各组创面组织中可见增殖细胞核抗原阳性细胞表达,但表皮干细胞组的阳性细胞积分吸光度平均值与羊膜组、空白对照组比较差异有显著性意义(P < 0.01)。结果证实糖尿病大鼠创面愈合过程中表皮干细胞与创缘表皮移行、创面的上皮化有直接关联,可有效促进其创面愈合。     

Three morphologically distinct types of interface develop between adult host and fetal brain transplants: implications for scar formation in the adult central nervous system

The development of the host/graft interface of cerebellar and cerebral transplants was studied 1-60 days after operation. Grafts from fetal Wistar rats were transplanted to a cavity over the superior colliculus of adult rats by removing parts of the overlying cortex and hippocampus according to the Bj?rklund/Stenevi technique. In sham-operated control rats, in which a cavity was made in the brain but no graft was implanted, the parenchyma bordering the entire cavity developed a complete glial-meningeal scar within 2 weeks after operation consisting of multilayered glial processes, a basal lamina, and fibroblasts (meningeal cells). A similar interface also developed between graft and host in the most superficial parts of the transplantation cavity. In the basal parts of the transplantation cavity, the host/graft interface consisted either of an incomplete sheet of astrocyte processes aligned in parallel to each other but without a covering basal lamina or of completely fused neuropil without any morphological signs of separation between host and transplant. It is concluded that these three zones of host/graft interface are established by differential interaction between the growing transplant and the host cicatrix. At the basal host/graft parenchymatous interface the fetal transplant interferes with the normal adult cicatrization process of the host, possibly by either releasing inhibitory factors or by preventing contact between the astroglia of the host and fibroblasts (meningeal cells). In white matter regions of the transplantation cavity, voluminous cysts developed, both in sham-operated controls and in graft recipients, which were invaded by transplanted neurons.     

Maggot homogenate is associated with neural regeneration and wound healing in the rat

BACKGROUND:Live delivery limits the clinical application of maggot therapy. To date in China, there are no in vivo reports regarding wound healing mechanisms of maggot therapy or the effects of maggot homogenate on wound nerve regeneration.OBJECTIVE:To avoid complications due to the use of live maggots, an aseptic maggot homogenate was applied. Substance P (SP) and gene protein product 9.5 expression in a cutaneous wound was analyzed to explore possible mechanisms of neural regeneration and wound healing in the rat.DESIGN, TIME AND SETTING:A random grouping and controlled animal study was performed at the laboratory of the Department of Orthopedic Surgery, First Affiliated Hospital, Dalian Medical University from August 2008 to April 2009.MATERIALS:Live maggots were cultured and provided by the laboratory of the Department of Orthopedic Surgery of the First Affiliated Hospital, Dalian Medical University, China.METHODS:A total of 48 adult rats were selected and two acute, full-thickness wounds (round, 1.5 cm diameter) were created on the back of each rat. The two wounds were randomly assigned to homogenate product and control groups. Following two-step disinfection of maggots, a homogenate was produced from 10 maggots and applied to the wound area in the homogenate product group, while the wounds in the control group were treated with normal saline alone.MAIN OUTCOME MEASURES:On days 1,3, 7, 10, 14, and 21 following injury, the wound tissue was excised. Histological examination of the wound was observed by hematoxylin and eosin staining or Masson's Trichrome staining. SP and protein gene product 9.5 expressions were examined by immunohistochemistry to evaluate wound neural regeneration.RESULTS:On days 7, 10, and 14, the rate of wound healing was significantly greater in the homogenate product group compared with the control group (P < 0.05), and homogenate healing was better than that seen in the control group. On days 3, 7, and 10, SP expression in cells and regenerative nerves was significantly greater in the homogenate product group compared with the control group (P < 0.05). On days 7 and 10, protein gene product 9.5 expression was detected in the regenerative nerve, and expression level was significantly greater in the homogenate product group compared with the control group (P < 0.05).CONCLUSION:Maggot homogenate resulted in upregulated SP and protein gene product 9.5 expressions, thereby promoting neural regeneration and wound healing.     

银离子敷料联合水凝胶对Ⅱ度烧伤创面愈合的作用

目的：了解银离子敷料联合水凝胶促进Ⅱ度烧伤创面愈合的作用。 方法：选择2007-05/2009-05南通市第一人民医院烧伤整形科住院烧伤患者104例作为观察对象。随机分为2组：治疗组应用银离子敷料联合水凝胶序贯换药;对照组采用1%磺胺嘧啶银冷霜抹在凡士林纱布上外敷,于伤后7,10,15,17,21 d进行创面分泌物细菌培养、观察记录创面愈合情况及速度、观察药物不良反应、换药时创面痛感、肉芽破坏情况。 结果：治疗组创面细菌检出率明显低于对照组(P < 0.05)。治疗组浅Ⅱ度创面愈合时间比对照组平均缩短三四天,治疗组深Ⅱ度创面愈合时间比对照组平均缩短五六天。治疗组创面愈合速度较对照组明显加快(P < 0.05)。两组均无药物不良反应,治疗组创面换药时无明显疼痛感,肉芽组织无明显破坏。 结论：银离子敷料联合水凝胶序贯治疗Ⅱ度烧伤创面具有显著抗菌及促进创面肉芽组织和上皮再生、促进创面愈合的作用,且无不良反应。 关键词：银离子敷料;水凝胶;Ⅱ度烧伤创面     

Perioperative complications of scoliosis surgery in patients with Duchenne muscular dystrophy and spinal muscular atrophy,focussing on wound healing disorders

Purpose: Patients with Duchenne muscular dystrophy (DMD) or spinal muscular atrophy (SMA), both neuromuscular diseases, sustain spinal scoliosis in the course of their disease. To reduce the concomitant major morbidity and to improve their quality of life, patients require surgical spine stabilization. This can lead to complications like respiratory, cardiac or neurological complications or wound healing disorders (WHD). To find out the different complexities and risk factors increasing the chance to develop a WHD, the inpatient database was analyzed. Methods: We performed a retrospective statistical study. Therefore, we analyzed the inpatient database of 180 patients (142 DMD and 38 SMA patients). The focus was on WHD. To figure out the risk factors leading to WHD, we conducted a logistic regression. Results: Cardiac complications occurred most frequently, followed by pulmonary complications and neurological lesions. Fifty-seven out of 180 patients developed a WHD. In 23 cases the WHD was aseptic, in the other 34 cases dermal organisms, Pseudomonas species and intestinal organisms were responsible. By means of the logistic regression, we were able to identify two more risk factors, in addition to diagnosis and gender, for developing a WHD in our patients: the year of surgery and the direction of pelvic tilt. Conclusions: Most common complications following scoliosis surgery are respiratory and cardiac complications. WHD is a severe complication that implies a prolonged therapy. Some risk factors for developing WHD could be identified in this analysis. Specifically, these were the date of surgery and the direction of pelvic tilt.