Skin substitutes with noncultured autologous skin cell suspension heal porcine full-thickness wounds in a one-stage procedure

Clinical application of skin substitute is typically a two-stage procedure with application of skin substitute matrix to the wound followed by engraftment of a split-thickness skin graft (STSG). This two-stage procedure requires multiple interventions, increasing the time until the wound is epithelialised. In this study, the feasibility of a one-stage procedure by combining bioengineered collagen-chondroitin-6-sulfate (DS1) or decellularised fetal bovine skin substitute (DS2) with autologous skin cell suspension (ASCS) in a porcine full-thickness wound healing model was evaluated. Twelve full-thickness excisional wounds on the backs of pigs received one of six different treatments: empty; ASCS; DS1 with or without ASCS; DS2 with or without ASCS. The ASCS was prepared using a point-of-care device and was seeded onto the bottom side of DS1, DS2, and empty wounds at 80 000 cells/cm². Wound measurements and photographs were taken on days 0, 9, 14, 21, 28, 35, and 42 post-wounding. Histological analysis was performed on samples obtained on days 9, 14, 28, and 42. Wounds in the empty group or with ASCS alone showed increased wound contraction, fibrosis, and myofibroblast density compared with other treatment groups. The addition of ASCS to DS1 or DS2 resulted in a marked increase in re-epithelialisation of wounds at 14 days, from 15 ± 11% to 71 ± 20% (DS1 vs DS1 + ASCS) or 28 ± 14% to 77 ± 26 (DS2 vs DS2 + ASCS) despite different mechanisms of tissue regeneration employed by the DS used. These results suggest that this approach may be a viable one-stage treatment in clinical practice.     

Dorsal suspension for Morton’s neuroma: A comparison with neurectomy

BackgroundThe purpose of this study was to investigate and compare the clinical outcomes of dorsal suspension with those of neurectomy for the treatment of Morton’s neuroma.MethodsWe conducted a retrospective study of dorsal suspension and neurectomy group. The dorsal suspension was performed by dorsal transposition of neuroma over the dorsal transverse ligament after neurolysis. The visual analog scale (VAS), the Foot and Ankle Ability Measure (FAAM), postoperative satisfaction, and complications were evaluated.ResultsBoth groups reported significant pain relief, and there were no significant differences between the groups with respect to postoperative pain. The postoperative FAAM outcomes showed no significant between-group differences. Satisfaction analysis showed ‘excellent’ and ‘good’ results in the dorsal suspension and neurectomy groups (95% and 77.7%, respectively). Complications of numbness and paresthesia reported in the dorsal suspension group (5% and 5%, respectively) were significantly fewer than those of neurectomy group (61.1% and 33.3%, respectively) (both, p < .05).ConclusionsWith its favorable results, dorsal suspension can be another operative option for the treatment of Morton’s neuroma.Level of Evidence: Level III, retrospective comparative case series.     

布地奈德混悬液联合硫酸沙丁胺醇溶液治疗小儿毛细支气管炎的疗效观察

目的观察布地奈德混悬液（普米克令舒）联合硫酸沙丁胺醇溶液（万托林）治疗小儿毛细支气管炎的疗效。方法随机选择2012年10月-2013年10月本院诊治的毛细支气管炎患儿58例,按照完全随机法1∶1分成两组,在对症治疗与综合治疗基础上,对照组予常规抗喘药物雾化吸入,研究组予普米克令舒联合万托林雾化吸入,比较两组患儿的肺功能指标及近远期临床疗效。结果研究组患儿的发热、气促、咳嗽、憋喘、哮鸣音与湿啰音消失时间均比对照组短,差异有统计学意义（P〈0.05）;研究组患儿治疗后1-3个月的喘息复发率48.28%比对照组75.86%低,随访3、6个月的喘息未复发比例51.72%与34.48%均比对照组的24.14%与10.35%高,差异有统计学意义（P〈0.05）。结论普米克令舒联合万托林治疗小儿毛细管支气炎的临床效果显著。     

强骨抗萎方增强尾吊大鼠承重骨骨矿密度

目的 研究中药复方-强骨抗萎方(QGKWP)对尾吊大鼠骨代谢的影响.方法 21只雄性SD大鼠随机分为对照组(Con),尾吊组(TS)和强骨抗萎方处理组(QGKWP),分别填喂2.5 mL生理盐水或30mg/g中药复方,早晚各1次.每周利用双能X射线吸收测定法检测其骨密度.实验28天后,取血清测定碱性磷酸酶(ALP)、骨碱性磷酸酶(BALP)、骨γ碳氧谷氨酸蛋白(BGLAP)和脱氧吡啶(DPD).同时检测承重骨力学性能、骨干重和骨灰重.免疫组化检测骨Ⅰ型胶原(type Ⅰ collagen),骨钙素(osteocalcin)和骨桥蛋白(osteopontin)含量.结果 与尾吊组相比,强骨抗萎方组股骨、胫骨和腰椎骨密度显著升高,血清ALP和BGLAP表达增加.QGKWP还能明显升高尾吊大鼠股骨Ⅰ型胶原和骨桥蛋白的表达.结论 强骨抗萎方可部分逆转由尾吊引起的失重效应,在对抗骨丢失方面有潜在应用价值.     

尾吊对大鼠心肌损伤及其机制探讨

目的 研究尾吊对大鼠心肌细胞的损伤作用及其机制.方法 雄性SD大鼠分为5组,采用鼠头低位30°尾吊方法模拟失重不同时间,测定各组动物血清LDH和CK-MB活性和血液儿茶酚胺和糖皮质激素浓度;检测线粒体ATP合成的速率和线粒体膜通透性转换孔(MPTP)开放程度.结果 尾吊2周出现明显的心肌缺血性ST段升高和T波高耸、血清LDH和CK-MB活性升高(P＜0.05).尾吊第2周开始血液中儿茶酚胺和糖皮质激素显著升高(P＜0.05),第3周开始出现心肌线粒体ATP酶合成活力的显著下降(P＜0.05)和线粒体膜通透性转换孔的开启.结论 循环血中儿茶酚胺和糖皮质激素的升高可能是尾吊致心肌损伤的重要内分泌机制,线粒体能量代谢的紊乱是介导心肌细胞损伤的重要细胞内机制.     

Transarterial internal radiation therapy with I-131 lipiodol for multifoca hepatocellular carcinoma: Immediate and long-term results

Transarterial internal radiation with I-131 Lipiodol (TAIR) was performed in 21 patients with multifocal hepatic carcinoma. Eight patients were treated by TAIR alone and 13 by combination of TAIR and intraarterial infusion ofcis-diamminedichloroplatinum (CDDP) and/or adriamycin mitomycin C oil suspension (ADMOS). TAIR was found effective immediately and long-term. Serum α-fetoprotein (AFP) levels dropped to 50% or less in 7 of 14 patients. Eleven of 21 patients (52%) showed 50% or greater decrease in tumor size. The overall 1-year survival rate was 43% and 67% in patients who received 50 Gy or greater tumor dose. Lipiodol distribution pattern of the tumor indicated some difference in the prognosis between the scattered pattern and solid pattern. The solid pattern showed a statistically significant better survival rate. Patients treated with TAIR alone versus those treated with TAIR and chemotherapy showed no difference in their survival rate.     

Successful treatment of tracheomalacia associated with esophageal atresia without a tracheoesophageal fistula by aortopexy: Report of a case

Tracheomalacia (TM) is well known as a complication associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF); however, the occurrence of TM requiring surgical treatment in a patient having EA without a tracheoesophageal fistula has never been reported. We describe herein a rare case of TM associated with EA without TEF. Respiratory distress was caused by compression of the trachea by a severely dilated upper esophageal pouch with weakness of the tracheal wall. Aortopexy was performed, and an excellent postoperative result was achieved.