Does Probiotic Consumption Enhance Wound Healing? A Systematic Review

The use of probiotics is one of the emerging lines of treatment for wound healing. This systematic review aimed to summarize currently available evidence on the effect of oral or enteral probiotic therapy on skin or oral mucosal wound healing in humans. To verify the developments in this field and the level of available scientific evidence, we applied a broad search strategy with no restrictions on wound type, target population, probiotic strain, or intervention protocol used. This review included seven studies involving 348 individuals. Four studies reported positive outcomes for healing improvement after probiotic therapy, and none of the studies reported adverse effects or a marked increase in wound healing time. The positive or neutral results observed do not generate strong evidence regarding the effectiveness of probiotics for wound healing. However, they suggest a promising field for future clinical research where the probiotic strains used, type of wounds, and target population are controlled for.     

Long-term male-specific chronic pain via telomere- and p53‑mediated spinal cord cellular senescence

Mice with experimental nerve damage can display long‑lasting neuropathic pain behavior. We show here that 4 months and later after nerve injury, male but not female mice displayed telomere length (TL) reduction and p53‑mediated cellular senescence in the spinal cord, resulting in maintenance of pain and associated with decreased lifespan. Nerve injury increased the number of p53‑positive spinal cord neurons, astrocytes, and microglia, but only in microglia was the increase male‑specific, matching a robust sex specificity of TL reduction in this cell type, which has been previously implicated in male‑specific pain processing. Pain hypersensitivity was reversed by repeated intrathecal administration of a p53‑specific senolytic peptide, only in male mice and only many months after injury. Analysis of UK Biobank data revealed sex-specific relevance of this pathway in humans, featuring male‑specific genetic association of the human p53 locus (TP53) with chronic pain and a male-specific effect of chronic pain on mortality. Our findings demonstrate the existence of a biological mechanism maintaining pain behavior, at least in males, occurring much later than the time span of virtually all extant preclinical studies.     

脱细胞异体真皮和自体刃厚皮复合移植在功能部位深度烧伤中的应用

目的：探讨脱细胞异体真皮（ acelluar allogenic dermal matrix, ADM）和自体刃厚皮复合移植在机体重要功能部位深度烧伤创面早期治疗中的临床效果。方法解放军白求恩国际和平医院烧伤科2008年1月-2011年12月对37例53处关节功能部位深Ⅱ~Ⅲ度烧伤创面及时进行早期切削痂扩创,用ADM和自体刃厚皮行复合移植,观察复合植皮的成活率、关节功能恢复及后期瘢痕形成情况。结果除2例3个部位复合皮片边缘有散在点状坏死延迟愈合外,其余35例手术均成功,50处关键功能部位复合皮片均成活。随访（12.15±1.35）个月,供皮区无明显瘢痕,关节功能恢复接近正常水平。结论 ADM和自体刃厚皮复合皮应用于重要功能部位深度烧伤创面早期治疗效果满意。     

Numerical analysis of the biomechanical behaviour of a weakened root after adhesive reconstruction and post-core rehabilitation

Objectives

The purpose of this study was to perform a finite element analysis to determine whether adhesive reconstruction is able to restore the original biomechanical behaviour of weakened roots, in terms of fracture resistance, when compared with post/crown-restored teeth with intact roots.

Methods

A three-dimensional model of a maxillary central incisor was created. The model simulated an endodontically treated tooth restored with a glass-fibre post, a composite-resin core and a metal crown (Model 1). Based on Model 1, a new volume was created in the root cervical third that represented the area where the dentine structure was lost, resulting in a structurally damaged root (Model 2). A 100 N load was applied to the palatal surface at 130° from the long axis of the tooth. After processing (Ansys^® 10.0 – Canonsburg, PA, USA), the principal normal stress data were analyzed (S1, tensile; S3, compressive).

Results

The models demonstrated a similar S1 distribution concentrated in the lingual cervical region but different S1 levels (Model 1: 28.7 MPa; Model 2: 35.3 MPa). The S3 distribution indicated differences in behaviour between the models (Model 1: −18 to −27 MPa along the buccal root surface; Model 2: −25 to −32 MPa on the post buccal surface and along the buccal root wall).

Conclusions

Although the stress distribution within the root walls remained below the ultimate stress limit of the root dentine, the adhesive reconstruction of the weakened roots did not recover the load resistance of structurally intact roots.

Clinical significance

The decision of when to prosthetically rehabilitate weakened roots with cervical dentine structural tissue loss is a challenge for clinicians. A ‘monoblock’ adhesive reconstruction has been proposed for root reinforcement. During treatment planning, the possibility of restoring the mechanical resistance of the root must be evaluated if successful long-term results are to be achieved.     

Norepinephrine, dopamine and dexamethasone modulate discrete leukocyte subpopulations and cytokine profiles from human PBMC

The interplay between the immune and neuroendocrine systems is intense, with the cross-talk between these two systems increasing during stress circumstances. Stress events culminate with hormonal pathway activation elevating the plasma levels of glucocorticoids and catecholamines. The majority of the works evaluating the effects of stress hormones on immune cells have utilized in vivo animal models or clinical studies. This work evaluates the effects of norepinephrine, dopamine, dexamethasone, and the combination of norepinephrine and dexamethasone on cellular activation and expression of immunoregulatory cytokines and chemokines by human PBMC in vitro. Norepinephrine and dopamine increased lymphocyte activation accompanied by augmented Th1 and Th2 type cytokine production. Dexamethasone reduced cell activation and decreased frequencies of cytokine producing cells and chemokine production. The action of norepinephrine together with dexamethasone resulted in immunosupression. The observed effects of hormones and neurotransmitters on leukocyte subsets likely underlie their immunomodulatory action in vivo.     

A meta-analytic review of psychosocial interventions for substance use disorders

OBJECTIVE: Despite significant advances in psychosocial treatments for substance use disorders, the relative success of these approaches has not been well documented. In this meta-analysis, the authors provide effect sizes for various types of psychosocial treatments, as well as abstinence and treatment-retention rates for cannabis, cocaine, opiate, and polysubstance abuse and dependence treatment trials. METHOD: With a comprehensive series of literature searches, the authors identified a total of 34 well-controlled treatment conditions-five for cannabis, nine for cocaine, seven for opiate, and 13 for polysubstance users-representing the treatment of 2,340 patients. Psychosocial treatments evaluated included contingency management, relapse prevention, general cognitive behavior therapy, and treatments combining cognitive behavior therapy and contingency management. RESULTS: Overall, controlled trial data suggest that psychosocial treatments provide benefits reflecting a moderate effect size according to Cohen's standards. These interventions were most efficacious for cannabis use and least efficacious for polysubstance use. The strongest effect was found for contingency management interventions. Approximately one-third of participants across all psychosocial treatments dropped out before treatment completion compared to 44.6% for the control conditions. CONCLUSIONS: Effect sizes for psychosocial treatments for illicit drugs ranged from the low-moderate to high-moderate range, depending on the substance disorder and treatment under study. Given the long-term social, emotional, and cognitive impairments associated with substance use disorders, these effect sizes are noteworthy and comparable to those for other efficacious treatments in psychiatry.     

Endogenous IL-4 and IFN-gamma are essential for expression of Th2, but not Th1 cytokine message during the early differentiation of human CD4+ T helper cells

CD4+ T cells can be divided into several distinct effector subpopulations, including Th1 and Th2. Human Th1 cells are essential for the establishment of cellular immune responses, whereas Th2 cells for immunoglobulin E synthesize by B cells and immunoregulation. This study determines the involvement of exogenously and endogenously produced T cell-derived cytokines during early differentiation of naive CD4+ T cells into Th1 and Th2 cells. Cytokine gene expression of purified experienced and naive CD4+T cells in the presence or absence of Th-directing cytokines and neutralizing anti-cytokine antibodies, was determined at early (20 and 40 h) time points, after in vitro activation. These studies demonstrated that: (1) endogenously produced, T cell-derived cytokines (interferon [IFN]-gamma and interleukin [IL]-4), play an important role in the regulation of early gene expression of Th2, but not Th1 type cytokines; (2) Th1-related cytokines, IFN-gamma, and IL-2, are preferentially expressed in cultures directed toward Th1, as compared with Th2; and (3) IL-4 and IFN-gamma showed early message expression in both differentiating populations, indicating a mixed profile of Th1 and Th2 cytokine production in early human Th cell development. These findings point to the critical role for endogenously produced cytokines in the early differentiation of human Th1 or Th2 cells.     

The intron 4c allele of the NOS3 gene is associated with ischemic stroke in African Americans

Background  

Ischemic stroke is the most common cause of disability in North America and in addition to the generally accepted risk factors, there is increasing evidence for the potential pathophysiological role of genes. One of these genes, the endothelial nitric oxide synthase gene (NOS3) has been reported as a genetic risk factor for ischemic stroke. To independently confirm and extend the results of these previous reports, we investigated this gene as a risk factor for stroke in an ethnically diverse study population.