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[Research progresses on acute skin failure in children]. [儿童急性皮肤衰竭的研究进展]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20231014-00113
X Yin, F. Chang, J Chen, L. J. Gu, Y H Ge, J M Mao
Acute skin failure (ASF) is an inevitable damage to the skin and subcutaneous tissue caused by hemodynamic instability and/or low perfusion. At present, there are some understandings and reports about adult ASF at home and abroad, but there are few reports about children's ASF. This article reviewed the definition, pathophysiological changes, risk factors, clinical manifestations, and management of children's ASF, and put forward suggestions in order to provide ideas for clinical diagnosis and treatment of children's ASF, and promote the further study of children's ASF.
急性皮肤衰竭(ASF)是由于血流动力学不稳定和/或低灌注引起的皮肤和皮下组织不可避免的损伤。目前,国内外对成人 ASF 有一定的了解和报道,但对儿童 ASF 的报道较少。本文综述了儿童ASF的定义、病理生理变化、危险因素、临床表现及处理,并提出了相关建议,以期为儿童ASF的临床诊治提供思路,促进儿童ASF的深入研究。
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引用次数: 0
[Research advances on the role of aerobic glycolysis in skin fibrosis diseases]. [有氧糖酵解在皮肤纤维化疾病中作用的研究进展]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20230712-00004
L X Zhang, D. H. Hu
Skin fibrosis diseases mainly include hypertrophic scar, keloid, and systemic sclerosis, etc. The main pathological features are excessive activation of fibroblasts and abnormal deposition of extracellular matrix. In recent years, studies have shown that aerobic glycolysis is closely related to the occurrence and development of skin fibrosis diseases. Drugs targeting aerobic glycolysis has provided new ideas for skin anti-fibrosis treatment. This article reviews the role of enzymes and products related to aerobic glycolysis in the occurrence and development of skin fibrosis diseases and the drugs targeting aerobic glycolysis for the treatment of skin fibrosis diseases.
皮肤纤维化疾病主要包括增生性瘢痕、瘢痕疙瘩和系统性硬化症等。其主要病理特征是成纤维细胞过度活化和细胞外基质异常沉积。近年来的研究表明,有氧糖酵解与皮肤纤维化疾病的发生和发展密切相关。针对有氧糖酵解的药物为皮肤抗纤维化治疗提供了新思路。本文综述了有氧糖酵解相关酶和产物在皮肤纤维化疾病发生和发展中的作用,以及针对有氧糖酵解治疗皮肤纤维化疾病的药物。
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引用次数: 0
[Exploring the causality between intestinal flora and hyperplastic scars of human based on two-sample Mendelian randomization analysis]. [基于双样本孟德尔随机分析法探讨肠道菌群与人体增生性疤痕之间的因果关系]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20231129-00215
W. T. Chen, X. X. Wang, W. L. Zheng, W. Q. Zhang, L. J. Mao, J. N. Zhuo, S T Zhou, R. H. Yang
Objective: To investigate the causality between intestinal flora and hypertrophic scars (HS) of human. Methods: This study was a study based on two-sample Mendelian randomization (TSMR) analysis. The data on intestinal flora (n=18 473) and HS (n=208 248) of human were obtained from the genome-wide association study database. Genetically variable genes at five levels (phylum, class, order, family, and genus) of known intestinal flora, i.e., single nucleotide polymorphisms (SNPs), were extracted as instrumental variables for linkage disequilibrium (LD) analysis. Human genotype-phenotype association analysis was performed using PhenoScanner V2 database to exclude SNPs unrelated to HS in intestinal flora and analyze whether the selected SNPs were weak instrumental variables. The causal relationship between intestinal flora SNPs and HS was analyzed through four methods of TSMR analysis, namely inverse variance weighted (IVW), MR-Egger regression, weighted median, and weighted mode. Scatter plots of significant results from the four aforementioned analysis methods were plotted to analyze the correlation between intestinal flora SNPs and HS. Both IVW test and MR-Egger regression test were used to assess the heterogeneity of intestinal flora SNPs, MR-Egger regression test and MR-PRESSO outlier test were used to assess the horizontal multiplicity of intestinal flora SNPs, and leave-one-out sensitivity analysis was used to determine whether HS was caused by a single SNP in the intestinal flora. Reverse TSMR analyses were performed for HS SNPs and genus Intestinimonas or genus Ruminococcus2, respectively, to detect whether there was reverse causality between them. Results: A total of 196 known intestinal flora, belonging to 9 phyla, 16 classes, 20 orders, 32 families, and 119 genera, were obtained, and multiple SNPs were obtained from each flora as instrumental variables. LD analysis showed that the SNPs of the intestinal flora were consistent with the hypothesis that genetic variation was strongly associated with exposure factors, except for rs1000888, rs12566247, and rs994794. Human genotype-phenotype association analysis showed that none of the selected SNPs after LD analysis was excluded and there were no weak instrumental variables. IVW, MR-Egger regression, weighted median, and weighted mode of TSMR analysis showed that both genus Intestinimonas and genus Ruminococcus2 were causally associated with HS. Among them, forest plots of IVW and MR-Egger regression analyses also showed that 16 SNPs (the same SNPs number of this genus below) of genus Intestinimonas and 15 SNPs (the same SNPs number of this genus below) of genus Ruminococcus2 were protective factors for HS. Further, IVW analysis showed that genus Intestinimonas SNPs (with odds ratio of 0.62, 95% confidence interval of 0.41-0.93, P<0.05) and genus Ruminococcus2 SNPs (with odds ratio of 0.62, 95% confidence interval of 0.40-0.97, P<0.05) were negatively correlated with the risk of HS. Scatter plo
目的:研究肠道菌群与人类肥厚性疤痕(HS)之间的因果关系:研究肠道菌群与人类增生性疤痕(HS)之间的因果关系。研究方法本研究是一项基于双样本孟德尔随机分析法(TSMR)的研究。人类肠道菌群(n=18 473)和增生性疤痕(n=208 248)的数据来自全基因组关联研究数据库。提取已知肠道菌群五个层次(门、纲、目、科、属)的遗传变异基因,即单核苷酸多态性(SNPs),作为关联不平衡(LD)分析的工具变量。利用 PhenoScanner V2 数据库进行了人类基因型-表型关联分析,以排除与肠道菌群中的 HS 无关的 SNPs,并分析所选 SNPs 是否为弱工具变量。通过反方差加权(IVW)、MR-Egger 回归、加权中位数和加权模式四种 TSMR 分析方法,分析了肠道菌群 SNPs 与 HS 之间的因果关系。利用 IVW 检验和 MR-Egger 回归检验评估肠道菌群 SNPs 的异质性,利用 MR-Egger 回归检验和 MR-PRESSO 离群检验评估肠道菌群 SNPs 的水平多重性,利用留一敏感性分析确定 HS 是否由肠道菌群中的单个 SNPs 引起。分别对 HS SNP 和肠球菌属或反刍球菌属2 进行反向 TSMR 分析,以检测它们之间是否存在反向因果关系。结果共获得 196 个已知肠道菌群,隶属于 9 个门、16 个类、20 个目、32 个科和 119 个属,并从每个菌群中获得多个 SNPs 作为工具变量。LD分析表明,除rs1000888、rs12566247和rs994794外,肠道菌群的SNPs与遗传变异与暴露因素密切相关的假设一致。人类基因型-表型关联分析表明,经过LD分析后,所选的SNPs均未被排除,也不存在弱工具变量。TSMR的IVW、MR-Egger回归、加权中位数和加权模式分析显示,肠球菌属和反刍球菌属2均与HS有因果关系。其中,IVW和MR-Egger回归分析的森林图还显示,肠杆菌属的16个SNPs(该属的SNPs数量相同,下同)和Ruminococcus2属的15个SNPs(该属的SNPs数量相同,下同)是HS的保护因子。此外,IVW 分析表明,Intestinimonas 属 SNPs(几率比为 0.62,95% 置信区间为 0.41-0.93,P0.05)和 Ruminococcus2 属 SNPs(Q 值分别为 13.67 和 15.61,P>0.05)不存在异质性。MR-Egger回归检验表明,肠杆菌属和反刍球菌属2的SNPs没有水平多重性(截距分别为0.01和0.06,P>0.05);MR-PRESSO离群检验表明,肠杆菌属和反刍球菌属2的SNPs没有水平多重性(P>0.05)。剔除敏感性分析表明,没有一个肠道菌群 SNP 会导致 HS 的发生。反向 TSMR 分析表明,HS SNP 与肠道菌属或反刍球菌属 2 之间没有反向因果关系(几率比分别为 1.01 和 0.99,95% 置信区间分别为 0.97-1.06 和 0.96-1.04,P>0.05)。结论肠道菌群与人类 HS 之间存在因果关系,其中肠球菌属和反刍球菌属对抑制 HS 有一定作用。
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引用次数: 0
[Clinical effects of early rehabilitation treatment after repair surgery of skin and soft tissue defects accompanied by extensor tendon injury on the back of hand]. [伴有手背伸肌腱损伤的皮肤和软组织缺损修复手术后早期康复治疗的临床效果]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20230820-00057
C. Zhu, L. He, T He, Y. Liang, B W Zhang, H. Y. Zhao, H. Guan, X K Yang, D. H. Hu, J. T. Han, J Q Liu
Objective: To explore the clinical effects of early rehabilitation treatment after repair surgery of skin and soft tissue defects accompanied by extensor tendon injury on the back of hand. Methods: This study was a retrospective non-randomized controlled study. From February 2015 to February 2023, 24 patients (15 males and 9 females, aged 12-55 years) with skin and soft tissue defects accompanied by extensor tendon injury on the back of hand, who met the inclusion criteria and were repaired with flap transplantation and tendon grafting or tendon anastomosis, were admitted to the First Affiliated Hospital of Air Force Medical University. According to different intervention time for postoperative rehabilitation treatment of patients, the patients were divided into conventional rehabilitation group and early rehabilitation group, with 12 cases in each group. Patients in early rehabilitation group received rehabilitation treatment immediately after surgery under the rehabilitation guidance of specialized rehabilitation physicians based on the characteristics of different postoperative periods. Patients in conventional rehabilitation group began rehabilitation treatment from the third week after surgery, and their rehabilitation treatment was the same as that of patients in early rehabilitation group from the second week after surgery. The patients in 2 groups were treated in the hospital until the sixth week after surgery. The occurrence of flap vascular crisis and tendon rupture were observed within 6 weeks after surgery. After 6 weeks of surgery, the manual muscle test was used to measure the pinching force between the index finger and thumb, lateral pinching force, three-point pinching force, and grip force of the affected hand; the total action motion method was used to evaluate the finger joint range of motion of the affected hand, and the excellent and good ratio was calculated; the Carroll upper extremity function test was used to score and rate the function of the affected hand. Results: Within 6 weeks after surgery, only 1 patient in conventional rehabilitation group suffered from venous crisis, and the flap survived after the second surgical exploration and anastomosis of blood vessels; there was no occurrence of tendon rupture in patients of 2 groups. After 6 weeks of surgery, there were no statistically significant differences in pinching force between the index finger and thumb, lateral pinching force, three-point pinching force, or grip force of the affected hand between the two groups of patients (P>0.05); the excellent and good ratio of the finger joint range of motion of the affected hand of patients in early rehabilitation group was 11/12, which was higher than 7/12 in conventional rehabilitation group, but there was no statistically significant difference (P>0.05); the affected hand function score of patients in early rehabilitation group was 90±6, which was significantly higher than 83±8 in conventional rehabilitation group (t=2.4
目的探讨伴有手背伸肌腱损伤的皮肤和软组织缺损修复手术后早期康复治疗的临床效果。研究方法本研究为回顾性非随机对照研究。2015年2月至2023年2月,空军军医大学第一附属医院收治了24例手背皮肤软组织缺损伴伸肌腱损伤的患者(男15例,女9例,年龄12-55岁),均符合纳入标准,并进行了皮瓣移植和肌腱移植或肌腱吻合修复。根据患者术后康复治疗干预时间的不同,将患者分为常规康复组和早期康复组,每组12例。早期康复组患者根据术后不同时期的特点,术后立即在专业康复医师的康复指导下接受康复治疗。常规康复组患者从术后第三周开始接受康复治疗,术后第二周开始接受与早期康复组相同的康复治疗。两组患者均在医院接受治疗至术后第六周。术后 6 周内观察到皮瓣血管危象和肌腱断裂的发生。术后6周后,采用徒手肌肉测试法测量患手的食指与拇指间捏合力、侧捏合力、三点捏合力和握力;采用全动作运动法评估患手的手指关节活动范围,并计算优、良比例;采用卡罗尔上肢功能测试法对患手的功能进行评分和评级。结果术后6周内,常规康复组仅有1例患者出现静脉危象,经二次手术探查并吻合血管后皮瓣存活;两组患者均未发生肌腱断裂。手术 6 周后,两组患者的食指与拇指间捏合力、患侧捏合力、三点捏合力、患手握力差异无统计学意义(P>0.05);早期康复组患者患手手指关节活动范围优、良比为 11/12,高于常规康复组的 7/12,但差异无统计学意义(P>0.05);早期康复组患者的患手功能评分为(90±6)分,明显高于常规康复组的(83±8)分(t=2.41,P<0.05);早期康复组患者的患手功能评分明显优于常规康复组(Z=2.04,P<0.05)。结论对手背皮肤软组织缺损伴伸肌腱损伤修复术后患者进行早期康复治疗,可改善手部功能,且不会增加手术相关并发症,值得临床推广应用。
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引用次数: 0
[A cross-sectional survey and analysis of influencing factors on the occurrence of post-burn psychological stress disorder in preschool children]. [学龄前儿童烧伤后心理应激障碍的横断面调查及影响因素分析]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20230731-00028
X. L. Lu, Y P Liu, Y W Liu, J. L. Diao, F. Wang, F. Y. Zhong, J. L. He, L Chen
Objective: To explore the occurrence and influencing factors of post-burn psychological stress disorder in preschool children. Methods: This study was a multi-center cross-sectional survey. From January 2022 to February 2023, 85 preschool children (aged 1 to 6 years) with burns admitted to the Affiliated Hospital of North Sichuan Medical College, Nanchong Central Hospital, Suining Central Hospital, Guang'an People's Hospital, and Guangyuan Central Hospital who met the inclusion criteria were selected as respondents. A self-made general information questionnaire was used to investigate the children's general data including gender, age group, residential area, main caregiver and their education level, and family type, as well as the injury condition including cause of injury and burn severity. The Child Stress Disorders Checklist was used to investigate the occurrence of psychological stress disorder in children at 3 days to 1 month after injury, and the incidence rate was calculated. The children were classified according to their general data and injury condition, and the occurrence of psychological stress disorder in children at 3 days to 1 month after injury was recorded, and the influencing factors for post-burn psychological stress disorder in preschool children were screened. Results: A total of 85 questionnaires were distributed and 85 valid questionnaires were recovered, with an effective recovery rate of 100%. Among the children, there were 45 boys and 40 girls, with most children aged 1 to 3 years. There were slightly more children in rural areas than in cities. About half of the children were mainly cared for by their parents and grandparents, respectively, and the education level of the main caregivers was mainly high school/technical secondary school. The family type was mainly core family and extended family. The main cause of injury was hydrothermal scald, and the severity of burns was mainly moderate. The incidence rate of psychological stress disorder in this group of children at 3 days to 1 month after injury was 34.12% (29/85). There were statistically significant differences in the occurrence of psychological stress disorder in children with different age groups, causes of injuries, and burn severity at 3 days to 1 month after injury (with χ2 values​​of 9.18, 7.80, and 25.47, respectively, P<0.05); there were no statistically significant differences in the occurrence of psychological stress disorder in children with different genders, residential area, main caregivers, main caregivers' education levels, or family types at 3 days to 1 month after injury (P>0.05). Multivariate logistic regression analysis showed that age group and burn severity were independent influencing factors for the occurrence of psychological stress disorder in preschool children after burns (with odds ratios of 8.21 and 33.99, respectively, and 95% confidence intervals of 1.57-43.04 and 5.55-207.93, respectively, P<0.05), the older the child and the more
目的:探讨学龄前儿童烧伤后心理应激障碍的发生和影响因素:探讨学龄前儿童烧伤后心理应激障碍的发生及影响因素。研究方法本研究为多中心横断面调查。选取2022年1月至2023年2月在川北医学院附属医院、南充市中心医院、遂宁市中心医院、广安市人民医院、广元市中心医院收治的85名符合纳入标准的烧伤学龄前儿童(1-6岁)作为调查对象。采用自制的一般资料调查表调查儿童的一般资料,包括性别、年龄组、居住地区、主要照顾者及其受教育程度、家庭类型,以及受伤情况,包括受伤原因和烧伤严重程度。采用儿童应激障碍检查表调查受伤后 3 天至 1 个月内儿童心理应激障碍的发生情况,并计算发生率。根据儿童的一般资料和受伤情况对儿童进行分类,记录受伤后3天至1个月儿童心理应激障碍的发生情况,筛选学龄前儿童烧伤后心理应激障碍的影响因素。研究结果共发放问卷 85 份,回收有效问卷 85 份,有效回收率为 100%。其中男童 45 人,女童 40 人,年龄多在 1-3 岁之间。农村儿童略多于城市儿童。约有一半的儿童分别主要由父母和祖父母照顾,主要照顾者的教育程度以高中/中专为主。家庭类型主要是核心家庭和大家庭。受伤的主要原因是热液烫伤,烫伤的严重程度以中度为主。本组儿童在伤后 3 天至 1 个月的心理应激障碍发生率为 34.12%(29/85)。不同年龄组、受伤原因和烧伤严重程度的儿童在伤后 3 天至 1 个月的心理应激障碍发生率差异有统计学意义(χ2 值分别为 9.18、7.80 和 25.47,P0.05)。多变量逻辑回归分析显示,年龄组和烧伤严重程度是学龄前儿童烧伤后发生心理应激障碍的独立影响因素(几率比分别为 8.21 和 33.99,95% 置信区间分别为 1.57-43.04 和 5.55-207.93,P<0.05),年龄越大、烧伤越严重,发生心理应激障碍的可能性越高。结论学龄前儿童烧伤后心理应激障碍的发生率较高。年龄组和烧伤严重程度是这类儿童发生烧伤后心理应激障碍的独立影响因素。
{"title":"[A cross-sectional survey and analysis of influencing factors on the occurrence of post-burn psychological stress disorder in preschool children].","authors":"X. L. Lu, Y P Liu, Y W Liu, J. L. Diao, F. Wang, F. Y. Zhong, J. L. He, L Chen","doi":"10.3760/cma.j.cn501225-20230731-00028","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20230731-00028","url":null,"abstract":"Objective: To explore the occurrence and influencing factors of post-burn psychological stress disorder in preschool children. Methods: This study was a multi-center cross-sectional survey. From January 2022 to February 2023, 85 preschool children (aged 1 to 6 years) with burns admitted to the Affiliated Hospital of North Sichuan Medical College, Nanchong Central Hospital, Suining Central Hospital, Guang'an People's Hospital, and Guangyuan Central Hospital who met the inclusion criteria were selected as respondents. A self-made general information questionnaire was used to investigate the children's general data including gender, age group, residential area, main caregiver and their education level, and family type, as well as the injury condition including cause of injury and burn severity. The Child Stress Disorders Checklist was used to investigate the occurrence of psychological stress disorder in children at 3 days to 1 month after injury, and the incidence rate was calculated. The children were classified according to their general data and injury condition, and the occurrence of psychological stress disorder in children at 3 days to 1 month after injury was recorded, and the influencing factors for post-burn psychological stress disorder in preschool children were screened. Results: A total of 85 questionnaires were distributed and 85 valid questionnaires were recovered, with an effective recovery rate of 100%. Among the children, there were 45 boys and 40 girls, with most children aged 1 to 3 years. There were slightly more children in rural areas than in cities. About half of the children were mainly cared for by their parents and grandparents, respectively, and the education level of the main caregivers was mainly high school/technical secondary school. The family type was mainly core family and extended family. The main cause of injury was hydrothermal scald, and the severity of burns was mainly moderate. The incidence rate of psychological stress disorder in this group of children at 3 days to 1 month after injury was 34.12% (29/85). There were statistically significant differences in the occurrence of psychological stress disorder in children with different age groups, causes of injuries, and burn severity at 3 days to 1 month after injury (with χ2 values​​of 9.18, 7.80, and 25.47, respectively, P<0.05); there were no statistically significant differences in the occurrence of psychological stress disorder in children with different genders, residential area, main caregivers, main caregivers' education levels, or family types at 3 days to 1 month after injury (P>0.05). Multivariate logistic regression analysis showed that age group and burn severity were independent influencing factors for the occurrence of psychological stress disorder in preschool children after burns (with odds ratios of 8.21 and 33.99, respectively, and 95% confidence intervals of 1.57-43.04 and 5.55-207.93, respectively, P<0.05), the older the child and the more ","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140681346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Application effects of armor chest straps in patients with sternal dehiscence after repair surgery]. [铠甲胸带在修复手术后胸骨开裂患者中的应用效果]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20230904-00074
J Yang, L. Wang, W. F. Zhang, Y Chen, H. Guan
Objective: To investigate the application effects of armor chest straps in patients with sternal dehiscence after repair surgery. Methods: This study was a retrospective cohort study. The 11 patients who were admitted to the First Affiliated Hospital of Air Force Medical University (hereinafter referred to as the hospital) from March 2020 to March 2021 and used conventional chest straps after sternal dehiscence repair surgery were included in conventional chest strap group. The 12 patients who were admitted to the hospital from April 2021 to March 2022 and used armor chest straps after sternal dehiscence repair surgery were included in armor chest strap group. A special team for sternal dehiscence repair was set up, and the nurses in charge in the team instructed the patients in 2 groups on the correct abdominal breathing method, and the members of the surgical team performed the personalized surgery and wore the corresponding chest straps for the patients in 2 groups. The abdominal breathing frequency and chest breathing frequency on the first day after surgery were recorded. The pain intensity at 6, 24, 48, and 72 h after surgery was self-rated by the patients using numerical rating scale. The time of the first active cough and the time of wound healing after surgery were recorded. At postoperative suture removal, the cutting length of sutures induced by respiratory exercise was recorded. Whether there were complications such as redness, swelling, and exudation in flaps within 2 weeks after surgery were recorded, whether there were complications such as wound dehiscence or infection during follow-up of 3-12 months were recorded, and the incidence proportion of postoperative complications was calculated. At 6 months after surgery, the patients' scar status was evaluated by the Vancouver scar scale. Results: The abdominal breathing frequency of patients in armor chest strap group was (16.3±1.2) times/min on the first day after surgery, which was significantly higher than (5.3±1.4) times/min in conventional chest strap group (t=20.00, P<0.05), and the chest breath-ing frequency was (1.2±0.8) times/min, which was significantly lower than (12.4±1.5) times/min in conventional chest strap group (t=22.36, P<0.05). The pain intensity scores of patients in armor chest strap group at 6, 24, 48, and 72 h after surgery were significantly lower than those in conventional chest strap group (with t values of 15.07, 14.70, 13.66, and 11.03, respectively, P<0.05). The time of the first active cough and the time of wound healing after surgery of patients in armor chest strap group were significantly sooner than those in conventional chest strap group (with t values of 5.51 and 8.90, respectively, P<0.05). At postoperative suture removal, the cutting length of sutures induced by respiratory exercise of patients in conventional chest strap group was 2.0 (0, 5.0) mm, which was significantly longer than 2.0 (1.0, 2.0) mm in armor chest strap group (Z=4.10, P<0.05). T
目的探讨胸骨修补术后胸骨开裂患者使用铠甲胸带的效果。方法: 采用回顾性队列研究:本研究为回顾性队列研究。将 2020 年 3 月至 2021 年 3 月空军军医大学第一附属医院(以下简称医院)收治的胸骨裂开修补术后使用常规胸带的 11 例患者纳入常规胸带组。将 2021 年 4 月至 2022 年 3 月期间入院并在胸骨裂开修补术后使用铠甲胸带的 12 名患者纳入铠甲胸带组。成立胸骨裂开修补术专项小组,小组主管护师指导两组患者正确的腹式呼吸方法,手术组成员为两组患者实施个性化手术并佩戴相应的胸带。记录术后第一天的腹式呼吸频率和胸式呼吸频率。术后 6、24、48 和 72 h 的疼痛强度由患者使用数字评分表进行自我评分。记录术后首次活动性咳嗽时间和伤口愈合时间。术后拆线时,记录呼吸运动引起的缝线切割长度。记录术后 2 周内皮瓣是否出现红肿、渗出等并发症,随访 3-12 个月是否出现伤口裂开或感染等并发症,并计算术后并发症的发生率。术后 6 个月,采用温哥华瘢痕量表对患者的瘢痕状况进行评估。结果铠甲胸带组患者术后第一天的腹式呼吸频率为(16.3±1.2)次/分,明显高于常规胸带组(5.3±1.4)次/分(t=20.00,P0.05)。术后 6 个月,铠甲胸带组患者的瘢痕评分为 4.1±1.4,明显低于常规胸带组的 5.6±1.4(t=2.71,P<0.05)。结论对胸骨裂开修补术后患者应用铠甲胸带,可增加腹式呼吸频率,减少伤口切割力,有效缓解术后疼痛,提高首次主动咳嗽和伤口愈合速度,缓解术后瘢痕增生,取得了良好的应用效果。
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引用次数: 0
[Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns]. [在治疗深度烧伤儿童时,早期清创和保守性去除焦痂,然后用细小真皮基质覆盖创面的效果]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20230720-00010
Y. Liang, W Shi, Y Shao, X Z Liu, H. M. Gong, G. H. Cao, C Gao, N. J. Xin, G D Song
Objective: To explore the effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix (ADM), i.e., early surgery, in the treatment of children with deep burns. Methods: This study was a retrospective cohort study. From January 2017 to December 2022, 278 deep burned hospitalized children aged 1-7 years who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. According to the differences in treatment processes, 134 children who underwent early surgery+routine dressing change were enrolled in eschar removal+dressing change group (77 males and 57 females, aged 1 (1, 2) years), and 144 children who underwent only routine dressing change were enrolled in dressing change alone group (90 males and 54 females, aged 1 (1, 2) years). Fifty-one children without full-thickness burns in eschar removal+dressing change group were enrolled in eschar removal+dressing change group 1 (26 males and 25 females, aged 1 (1, 2) years), and 57 cases of the 83 children with full-thickness burns who did not undergo autologous skin grafting at the same time of early surgery (namely early skin grafting) in eschar removal+dressing change group were included in eschar removal+dressing change group 2 (37 males and 20 females, aged 1 (1, 2) years). Seventy-six children without full-thickness burns in dressing change alone group were included in dressing change alone group 1 (51 males and 25 females, aged 1 (1, 3) years), and 68 children with full-thickness burns in dressing change alone group were included in dressing change alone group 2 (39 males and 29 females, aged 1 (1, 2) years). For deep partial-thickness burn wounds and small full-thickness burn wounds in eschar removal+dressing change group, the eschar removal was performed on the basis of retaining a thin layer of denatured dermis so as to preserve the healthy tissue of the wound base, and ADM was applied to all wounds externally after eschar removal. For larger full-thickness burn wounds in this group, especially those located in the functional part of joints, eschar removal to the plane layer of viable tissue and early autologous skin grafting was needed. When the superficial wounds of children healed or tended to heal, the residual wounds were evaluated, and elective autologous skin grafting was performed if it was difficult to heal within 14 days. The healing time, intervention healing time, times of operation/dressing change, and times of intervention operation/dressing change in children with deep partial-thickness burn wounds of children in eschar removal+dressing change group, dressing change alone group, eschar removal+dressing change group 1, and dressing change alone group 1 were recorded. At the last follow-up (follow-up period was set to 7-12 months), the modified Vancouver scar scale (mVSS) scores of the most severe area of scar hyperplasia of healed deep partial-thickness burn wounds of 54 chi
目的探讨在治疗深度烧伤儿童时,早期清创和保守性清除焦痂,然后用细小真皮基质(ADM)覆盖创面(即早期手术)的效果。方法:本研究为回顾性队列研究。2017年1月至2022年12月,山东第一医科大学附属中心医院收治了278名符合纳入标准的1-7岁深度烧伤住院患儿。根据治疗过程的差异,将134名接受早期手术+常规换药的患儿纳入清除焦痂+换药组(男77名,女57名,年龄1(1,2)岁),将144名仅接受常规换药的患儿纳入单纯换药组(男90名,女54名,年龄1(1,2)岁)。在清除焦痂+换药组中,51名没有全层烧伤的儿童被纳入清除焦痂+换药第一组(男 26 名,女 25 名,年龄为 1(1,2)岁)、在清除焦痂+换药组的83例全层烧伤患儿中,有57例未在早期手术(即早期植皮手术)同时进行自体皮肤移植,这些患儿被纳入清除焦痂+换药组2(男37例,女20例,年龄1(1,2)岁)。在单纯换药组中,76名没有全层烧伤的儿童被纳入单纯换药组1(51名男性和25名女性,年龄为1(1,3)岁),在单纯换药组中,68名全层烧伤的儿童被纳入单纯换药组2(39名男性和29名女性,年龄为1(1,2)岁)。对于清除焦痂+换药组中的深部部分厚度烧伤创面和小面积全厚度烧伤创面,清除焦痂是在保留一薄层变性真皮的基础上进行的,以保留创面基底的健康组织,清除焦痂后在所有创面外敷ADM。对于本组中较大的全层烧伤创面,尤其是位于关节功能部位的创面,需要将焦痂清除至存活组织的平面层,并尽早进行自体皮肤移植。当患儿表皮创面愈合或趋于愈合时,对残余创面进行评估,如果在14天内难以愈合,则进行选择性自体植皮。记录了清除焦痂+换药组、单纯换药组、清除焦痂+换药1组和单纯换药1组的深部部分创面烧伤患儿的愈合时间、干预愈合时间、手术/换药次数以及干预手术/换药次数。在最后一次随访时(随访期设定为 7-12 个月),记录清除焦痂+换药组 54 名患儿和单纯换药组 48 名患儿愈合的深局部烧伤创面瘢痕增生最严重区域的改良温哥华瘢痕量表(mVSS)评分。记录了除焦痂+换药组和单纯换药组所有烧伤创面的愈合时间和手术/换药时间,以及除焦痂+换药组2和单纯换药组2的全厚烧伤创面的愈合时间和手术/换药时间。记录清除焦痂+换药组和单纯换药组患儿烧伤5天后创面愈合过程中创面感染、败血症、发热和发烧的发生率。结果显示与单纯换药组相比,清除焦痂+换药组深度部分创面烧伤患儿的创面愈合时间和干预愈合时间明显缩短,手术/换药次数和干预手术/换药次数明显减少(Z值分别为-11.00、-11.33、-12.64和-11.65,P0.05)。结论对于深度烧伤患儿,早期手术、早期植皮或根据需要选择性自体植皮的短期和长期效果均优于未进行早期手术的患儿。
{"title":"[Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns].","authors":"Y. Liang, W Shi, Y Shao, X Z Liu, H. M. Gong, G. H. Cao, C Gao, N. J. Xin, G D Song","doi":"10.3760/cma.j.cn501225-20230720-00010","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20230720-00010","url":null,"abstract":"Objective: To explore the effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix (ADM), i.e., early surgery, in the treatment of children with deep burns. Methods: This study was a retrospective cohort study. From January 2017 to December 2022, 278 deep burned hospitalized children aged 1-7 years who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. According to the differences in treatment processes, 134 children who underwent early surgery+routine dressing change were enrolled in eschar removal+dressing change group (77 males and 57 females, aged 1 (1, 2) years), and 144 children who underwent only routine dressing change were enrolled in dressing change alone group (90 males and 54 females, aged 1 (1, 2) years). Fifty-one children without full-thickness burns in eschar removal+dressing change group were enrolled in eschar removal+dressing change group 1 (26 males and 25 females, aged 1 (1, 2) years), and 57 cases of the 83 children with full-thickness burns who did not undergo autologous skin grafting at the same time of early surgery (namely early skin grafting) in eschar removal+dressing change group were included in eschar removal+dressing change group 2 (37 males and 20 females, aged 1 (1, 2) years). Seventy-six children without full-thickness burns in dressing change alone group were included in dressing change alone group 1 (51 males and 25 females, aged 1 (1, 3) years), and 68 children with full-thickness burns in dressing change alone group were included in dressing change alone group 2 (39 males and 29 females, aged 1 (1, 2) years). For deep partial-thickness burn wounds and small full-thickness burn wounds in eschar removal+dressing change group, the eschar removal was performed on the basis of retaining a thin layer of denatured dermis so as to preserve the healthy tissue of the wound base, and ADM was applied to all wounds externally after eschar removal. For larger full-thickness burn wounds in this group, especially those located in the functional part of joints, eschar removal to the plane layer of viable tissue and early autologous skin grafting was needed. When the superficial wounds of children healed or tended to heal, the residual wounds were evaluated, and elective autologous skin grafting was performed if it was difficult to heal within 14 days. The healing time, intervention healing time, times of operation/dressing change, and times of intervention operation/dressing change in children with deep partial-thickness burn wounds of children in eschar removal+dressing change group, dressing change alone group, eschar removal+dressing change group 1, and dressing change alone group 1 were recorded. At the last follow-up (follow-up period was set to 7-12 months), the modified Vancouver scar scale (mVSS) scores of the most severe area of scar hyperplasia of healed deep partial-thickness burn wounds of 54 chi","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140680069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Regenerative rehabilitation: the effects of physical factors on regeneration]. [再生康复:物理因素对再生的影响]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20231229-00278
J. Wu, Y. T. Wei
Wound regeneration and repair is one of the primary research fields in burn and wound repair surgery. In recent years, with the continuous advancement of treatment concept and technologies in the field of rehabilitation, the connection between rehabilitation treatment and wound regeneration and repair has become closer, forming a new concept "regenerative rehabilitation". This article discussed the concept formation and development status of regenerative rehabilitation, and the future development and potential leading value of regenerative rehabilitation field.
伤口再生与修复是烧伤与创面修复外科的主要研究领域之一。近年来,随着康复领域治疗理念和技术的不断进步,康复治疗与创面再生修复的联系越来越紧密,形成了 "再生康复 "这一新概念。本文探讨了再生康复概念的形成和发展现状,以及再生康复领域的未来发展和潜在引领价值。
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引用次数: 0
[Effects of applying human umbilical cord mesenchymal stem cell exosomes through different pathways to treat full-thickness skin defect wounds in mice]. [通过不同途径应用人脐带间充质干细胞外泌体治疗小鼠全厚皮肤缺损伤口的效果]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20231123-00203
H. Y. Wang, T. Ba, B Zhou, Z. Q. Yan, R. J. Wang, L. Y. Liu
Objective: To investigate the effects of human umbilical cord mesenchymal stem cell (hUCMSC) exosomes in the treatment of full-thickness skin defect wounds in mice through local wound application, subcutaneous injection at the wound margin, and tail vein injection, and to explore the optimal administration route of hUCMSC exosomes for wound treatment. Methods: This study was an experimental study. hUCMSC exosomes were extracted from the discarded umbilical cord tissue of three normal delivery women aged 25-35 years in the Department of Obstetrics and Gynecology of Baogang Hospital of Inner Mongolia and successfully identified. Totally 120 male BALB/c mice aged 6-8 weeks were selected, and full-thickness skin defect wounds were prepared on the back of them. According to the random number table, the injured mice were divided into control group (without drug administration), local wound application group, wound margin subcutaneous injection group, and tail vein injection group (with 30 mice in each group). Mice in the latter three groups were given 0.2 mL phosphate buffer solution containing 200 μg hUCMSC exosomes by local wound application, subcutaneous injection at the wound margin, and tail vein injection, respectively. On post injury day (PID) 7, 14, and 21, the general condition of the wound was observed, and the wound healing rate was calculated; the wound tissue was collected, the pathological changes and collagen fibers were observed respectively by hematoxylin-eosin staining and Masson staining, the number of new microvessels was observed by CD31 immunohistochemical staining, and the content of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) was detected by enzyme-linked immunosorbent assay. The sample number was 10 in each group at each time point. Results: On PID 7, 14, and 21, the wounds of mice in the 4 groups all healed gradually, and the wound healing of the mice in wound margin subcutaneous injection group was the best; the wound healing rates of mice in the three administration groups were significantly higher than those in control group (P<0.05), the wound healing rates of mice in wound margin subcutaneous injection group and tail vein injection group were significantly higher than those in local wound application group (P<0.05), and the wound healing rates of mice in wound margin subcutaneous injection group were significantly higher than those in tail vein injection group (P<0.05). On PID 7, 14, and 21, the growth and epithelialization speed of the wound tissue of mice in the three administration groups were significantly accelerated, and the collagen fibers in the wounds of mice in the three administration groups were larger in number and more neatly arranged in comparison with the control group. On PID 7, 14, and 21, under every 200-fold visual field, the number of new microvessels in the wound tissue of mice in local wound application group was 24.1±2.5, 50.7±4.1, and 44.2±2.3, respectively, the number of new microves
目的研究人脐带间充质干细胞(hUCMSC)外泌体通过伤口局部涂抹、伤口边缘皮下注射和尾静脉注射治疗小鼠全厚皮肤缺损伤口的效果,并探索 hUCMSC 外泌体治疗伤口的最佳给药途径。研究方法从内蒙古包钢医院妇产科 3 名 25-35 岁正常分娩妇女的废弃脐带组织中提取 hUCMSC 外泌体并成功鉴定。选取 120 只 6-8 周龄的雄性 BALB/c 小鼠,在其背部制备全厚皮肤缺损创面。根据随机数字表将受伤小鼠分为对照组(不给药)、伤口局部涂药组、伤口边缘皮下注射组和尾静脉注射组(每组 30 只)。后三组小鼠分别接受 0.2 mL 含有 200 μg hUCMSC 外泌体的磷酸盐缓冲液局部伤口涂抹、伤口边缘皮下注射和尾静脉注射。在损伤后第 7、14 和 21 天,观察伤口的总体情况,并计算伤口愈合率;收集伤口组织,分别用苏木精-伊红染色法和马森染色法观察病理变化和胶原纤维,用CD31免疫组化染色法观察新生微血管的数量,用酶联免疫吸附法检测肿瘤坏死因子α(TNF-α)和白细胞介素-6(IL-6)的含量。每个时间点每组 10 个样本。结果PID7、14、21时,4组小鼠伤口均逐渐愈合,以创缘皮下注射组小鼠伤口愈合最好;3个给药组小鼠伤口愈合率均显著高于对照组(P<0.05),创缘皮下注射组和尾静脉注射组小鼠的伤口愈合率明显高于局部伤口应用组(P<0.05),创缘皮下注射组小鼠的伤口愈合率明显高于尾静脉注射组(P<0.05)。在 PID 7、14 和 21 日,三个给药组小鼠伤口组织的生长和上皮化速度明显加快,且与对照组相比,三个给药组小鼠伤口中的胶原纤维数量更多,排列更整齐。PID7、14和21日,在每200倍视野下,局部伤口给药组小鼠伤口组织中新生微血管的数量分别为(24.1±2.5)、(50.7±4.1)和(44.2±2.3,创缘皮下注射组小鼠创面组织新生微血管数分别为(32.2±2.9)、(67.5±4.9)、(53.6±3.7),尾静脉注射组小鼠创面组织新生微血管数分别为(27.8±2.4)、(59.1±3.7)、(49.6±2.6,分别明显多于对照组的20.6±1.7、46.7±3.4和40.9±2.8(P<0.05);创缘皮下注射组和尾静脉注射组小鼠创面组织新生微血管数明显多于创面局部应用组(P<0.05);创缘皮下注射组小鼠创面组织新生微血管数量明显多于尾静脉注射组(P<0.05)。PID7、14和21日,三组小鼠创面组织中TNF-α和IL-6的含量均显著低于对照组(P<0.05),创缘皮下注射组和尾静脉注射组小鼠创面组织中TNF-α和IL-6的含量显著低于创面局部涂药组(P<0.05),创缘皮下注射组小鼠创面组织中 TNF-α 和 IL-6 的含量明显低于尾静脉注射组(P<0.05)。结论局部伤口涂抹、伤口边缘皮下注射和尾静脉注射 hUCMSC 外泌体都能通过缓解过度炎症反应和促进血管生成来促进小鼠全厚皮肤缺损的伤口愈合。其中,伤口边缘皮下注射的治疗效果更好,表明伤口边缘皮下注射是 hUCMSC 外泌体治疗伤口的最佳给药途径。
{"title":"[Effects of applying human umbilical cord mesenchymal stem cell exosomes through different pathways to treat full-thickness skin defect wounds in mice].","authors":"H. Y. Wang, T. Ba, B Zhou, Z. Q. Yan, R. J. Wang, L. Y. Liu","doi":"10.3760/cma.j.cn501225-20231123-00203","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20231123-00203","url":null,"abstract":"Objective: To investigate the effects of human umbilical cord mesenchymal stem cell (hUCMSC) exosomes in the treatment of full-thickness skin defect wounds in mice through local wound application, subcutaneous injection at the wound margin, and tail vein injection, and to explore the optimal administration route of hUCMSC exosomes for wound treatment. Methods: This study was an experimental study. hUCMSC exosomes were extracted from the discarded umbilical cord tissue of three normal delivery women aged 25-35 years in the Department of Obstetrics and Gynecology of Baogang Hospital of Inner Mongolia and successfully identified. Totally 120 male BALB/c mice aged 6-8 weeks were selected, and full-thickness skin defect wounds were prepared on the back of them. According to the random number table, the injured mice were divided into control group (without drug administration), local wound application group, wound margin subcutaneous injection group, and tail vein injection group (with 30 mice in each group). Mice in the latter three groups were given 0.2 mL phosphate buffer solution containing 200 μg hUCMSC exosomes by local wound application, subcutaneous injection at the wound margin, and tail vein injection, respectively. On post injury day (PID) 7, 14, and 21, the general condition of the wound was observed, and the wound healing rate was calculated; the wound tissue was collected, the pathological changes and collagen fibers were observed respectively by hematoxylin-eosin staining and Masson staining, the number of new microvessels was observed by CD31 immunohistochemical staining, and the content of tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) was detected by enzyme-linked immunosorbent assay. The sample number was 10 in each group at each time point. Results: On PID 7, 14, and 21, the wounds of mice in the 4 groups all healed gradually, and the wound healing of the mice in wound margin subcutaneous injection group was the best; the wound healing rates of mice in the three administration groups were significantly higher than those in control group (P<0.05), the wound healing rates of mice in wound margin subcutaneous injection group and tail vein injection group were significantly higher than those in local wound application group (P<0.05), and the wound healing rates of mice in wound margin subcutaneous injection group were significantly higher than those in tail vein injection group (P<0.05). On PID 7, 14, and 21, the growth and epithelialization speed of the wound tissue of mice in the three administration groups were significantly accelerated, and the collagen fibers in the wounds of mice in the three administration groups were larger in number and more neatly arranged in comparison with the control group. On PID 7, 14, and 21, under every 200-fold visual field, the number of new microvessels in the wound tissue of mice in local wound application group was 24.1±2.5, 50.7±4.1, and 44.2±2.3, respectively, the number of new microves","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Effects of gelatin methacrylate anhydride hydrogel loaded with small extracellular vesicles derived from human umbilical cord mesenchymal stem cells in the treatment of full-thickness skin defect wounds in mice]. [明胶甲基丙烯酸酯酐水凝胶负载从人脐带间充质干细胞提取的细胞外小泡对治疗小鼠全厚皮肤缺损伤口的影响]。
Pub Date : 2024-04-20 DOI: 10.3760/cma.j.cn501225-20231218-00248
Y Q Chen, Y. Q. Zhou, Q Wei, X. Y. Xie, X Z Liu, D. W. Li, Z. A. Shen
Objective: To investigate the effects of gelatin methacrylate anhydride (GelMA) hydrogel loaded with small extracellular vesicles derived from human umbilical cord mesenchymal stem cells (hUCMSCs-sEVs) in the treatment of full-thickness skin defect wounds in mice. Methods: This study was an experimental study. hUCMSCs-sEVs were extracted by ultracentrifugation, their morphology was observed through transmission electron microscope, and the expression of CD9, CD63, tumor susceptibility gene 101 (TSG101), and calnexin was detected by Western blotting. The human umbilical vein endothelial cells (HUVECs), the 3rd and 4th passages of human epidermal keratinocytes (HEKs) and human dermal fibroblasts (HDFs) were all divided into blank control group (routinely cultured) and hUCMSC-sEV group (cultured with the cell supernatant containing hUCMSCs-sEVs). The cell scratch test was performed and the cell migration rates at 6, 12, and 24 h after scratching were calculated, the cell Transwell assay was performed and the number of migration cells at 12 h after culture was calculated, and the proportion of proliferating cells was detected by 5-acetylidene-2'-deoxyuridine and Hoechst staining at 24 h after culture, with sample numbers being all 3. The simple GelMA hydrogel and the GelMA hydrogel loaded with hUCMSCs-sEVs (hereinafter referred to as hUCMSC-sEV/GelMA hydrogel) were prepared. Then the micromorphology of 2 kinds of hydrogels was observed under scanning electron microscope, the distribution of hUCMSCs-sEVs was observed by laser scanning confocal microscope, and the cumulative release rates of hUCMSCs-sEVs at 0 (immediately), 2, 4, 6, 8, 10, and 12 d after soaking hUCMSC-sEV/GelMA hydrogel in phosphate buffer solution (PBS) were measured and calculated by protein colorimetric quantification (n=3). Twenty-four 6-week-old male C57BL/6J mice were divided into PBS group, hUCMSC-sEV alone group, GelMA hydrogel alone group, and hUCMSC-sEV/GelMA hydrogel group according to the random number table, with 6 mice in each group, and after the full-thickness skin defect wounds on the back of mice in each group were produced, the wounds were performed with PBS injection, hUCMSC-sEV suspenson injection, simple GelMA coverage, and hUCMSC-sEV/GelMA hydrogel coverage, respectively. Wound healing was observed on post injury day (PID) 0 (immediately), 4, 8, and 12, and the wound healing rates on PID 4, 8, and 12 were calculated, and the wound tissue was collected on PID 12 for hematoxylin-eosin staining to observe the structure of new tissue, with sample numbers being both 6. Results: The extracted hUCMSCs-sEVs showed a cup-shaped structure and expressed CD9, CD63, and TSG101, but barely expressed calnexin. At 6, 12, and 24 h after scratching, the migration rates of HEKs (with t values of 25.94, 20.98, and 20.04, respectively), HDFs (with t values of 3.18, 5.68, and 4.28, respectively), and HUVECs (with t values of 4.32, 19.33, and 4.00, respectively) in hUCMSC-sEV group we
目的研究甲基丙烯酸明胶酸酐(GelMA)水凝胶负载由人脐带间充质干细胞(hUCMSCs-sEVs)提取的小细胞外囊泡治疗小鼠全厚皮肤缺损伤口的效果。研究方法超速离心提取 hUCMSCs-sEV,透射电镜观察其形态,Western 印迹检测 CD9、CD63、肿瘤易感基因 101(TSG101)和 calnexin 的表达。将人脐静脉内皮细胞(HUVECs)、人表皮角质细胞(HEKs)和人真皮成纤维细胞(HDFs)分为空白对照组(常规培养)和 hUCMSCs-sEV 组(用含 hUCMSCs-sEVs 的细胞上清液培养)。进行细胞划痕试验并计算划痕后 6、12 和 24 h 的细胞迁移率,进行细胞 Transwell 试验并计算培养后 12 h 的迁移细胞数,培养后 24 h 用 5-acetylidene-2'-deoxyuridine 和 Hoechst 染色法检测增殖细胞的比例,样本数均为 3。制备简单的 GelMA 水凝胶和负载 hUCMSCs-sEV 的 GelMA 水凝胶(以下简称 hUCMSC-sEV/GelMA 水凝胶)。然后用扫描电子显微镜观察两种水凝胶的微观形态,用激光扫描共聚焦显微镜观察 hUCMSCs-sEVs 的分布,用蛋白质比色定量法测量并计算 hUCMSCs-sEVs 在磷酸盐缓冲液(PBS)中浸泡 0(立即)、2、4、6、8、10 和 12 d 后的累积释放率(n=3)。将 24 只 6 周大雄性 C57BL/6J 小鼠按随机数字表法分为 PBS 组、单独 hUCMSC-sEV 组、单独 GelMA 水凝胶组和 hUCMSC-sEV/GelMA 水凝胶组,每组 6 只、各组小鼠背部全厚皮肤缺损创面制作完成后,分别进行 PBS 注射、hUCMSC-sEV 悬液注射、单纯 GelMA 覆盖和 hUCMSC-sEV/GelMA 水凝胶覆盖。在损伤后第 0 天(即刻)、第 4 天、第 8 天和第 12 天观察伤口愈合情况,计算第 4 天、第 8 天和第 12 天的伤口愈合率,并在第 12 天收集伤口组织进行苏木精-伊红染色,观察新生组织的结构,样本数均为 6。结果提取的 hUCMSCs-sEVs 呈杯状结构,表达 CD9、CD63 和 TSG101,但几乎不表达 calnexin。划痕后 6、12 和 24 h,hUCMSCs-sEV 组 HEKs(t 值分别为 25.94、20.98 和 20.04)、HDFs(t 值分别为 3.18、5.68 和 4.28)和 HUVECs(t 值分别为 4.32、19.33 和 4.00)的迁移率明显高于空白对照组(P<0.05)。培养 12 h 后,hUCMSC-sEV 组迁移的 HEKs、HDFs 和 HUVECs 数量分别为 550±23、235±9 和 856±35,明显高于空白对照组的 188±14、97±6 和 370±32(t 值分别为 22.95、23.13 和 17.84,P<0.05)。培养 24 h 后,hUCMSC-sEV 组的 HEKs、HDFs 和 HUVECs 增殖细胞比例明显高于空白对照组(t 值分别为 22.00、13.82 和 32.32,P<0.05)。单纯 GelMA 水凝胶内部呈疏松多孔的海绵状结构,未观察到 hUCMSCs-sEV。hUCMSC-sEV/GelMA 水凝胶具有相同的海绵状结构,hUCMSCs-sEV 呈团块状均匀分布。浸泡 2 d 后,hUCMSCs-sEV/GelMA 水凝胶中 hUCMSCs-sEV 的累积释放率曲线趋于平稳,浸泡 12 d 后,hUCMSCs-sEV 的累积释放率为(59.2±1.8)%。从 PID 0 到 12,4 组小鼠的伤口面积逐渐缩小。在 PID 4、8 和 12,hUCMSC-sEV/GelMA 水凝胶组小鼠的伤口愈合率显著高于其他 3 组(P<0.05);单独 GelMA 水凝胶组和单独 hUCMSC-sEV 组小鼠的伤口愈合率显著高于 PBS 组(P<0.05)。在 PID 8 和 12,单用 hUCMSC-sEV 组小鼠的伤口愈合率明显高于单用 GelMA 水凝胶组(P<0.05)。在 PID 12,hUCMSC-sEV/GelMA 水凝胶组小鼠的伤口上皮愈合最好,真皮胶原排列疏松有序,炎症细胞数量最少,而其他三组小鼠的伤口真皮胶原排列密集,炎症细胞有不同程度的浸润。
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Zhonghua shao shang yu chuang mian xiu fu za zhi
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