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Mechanical strategies to promote vascularization for tissue engineering and regenerative medicine. 促进组织工程和再生医学血管化的机械策略。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-30 eCollection Date: 2024-01-01 DOI: 10.1093/burnst/tkae039
Yiran Wang, Meixuan Liu, Wei Zhang, Huan Liu, Fang Jin, Shulei Mao, Chunmao Han, Xingang Wang

Vascularization is a major challenge in the field of tissue engineering and regenerative medicine. Mechanical factors have been demonstrated to play a fundamental role in vasculogenesis and angiogenesis and can affect the architecture of the generated vascular network. Through the regulation of mechanical factors in engineered tissues, various mechanical strategies can be used to optimize the preformed vascular network and promote its rapid integration with host vessels. Optimization of the mechanical properties of scaffolds, including controlling scaffold stiffness, increasing surface roughness and anisotropic structure, and designing interconnected, hierarchical pore structures, is beneficial for the in vitro formation of vascular networks and the ingrowth of host blood vessels. The incorporation of hollow channels into scaffolds promotes the formation of patterned vascular networks. Dynamic stretching and perfusion can facilitate the formation and maturation of preformed vascular networks in vitro. Several indirect mechanical strategies provide sustained mechanical stimulation to engineered tissues in vivo, which further promotes the vascularization of implants within the body. Additionally, stiffness gradients, anisotropic substrates and hollow channels in scaffolds, as well as external cyclic stretch, boundary constraints and dynamic flow culture, can effectively regulate the alignment of vascular networks, thereby promoting better integration of prevascularized engineered tissues with host blood vessels. This review summarizes the influence and contribution of both scaffold-based and external stimulus-based mechanical strategies for vascularization in tissue engineering and elucidates the underlying mechanisms involved.

血管生成是组织工程和再生医学领域的一大挑战。机械因素已被证明在血管生成和血管生成中发挥着根本性作用,并能影响生成的血管网络结构。通过调节工程组织中的机械因素,可以使用各种机械策略来优化预先形成的血管网络,并促进其与宿主血管的快速整合。优化支架的机械性能,包括控制支架硬度、增加表面粗糙度和各向异性结构,以及设计相互连接的分层孔隙结构,有利于体外形成血管网络和宿主血管的生长。在支架中加入中空通道可促进图案化血管网络的形成。动态拉伸和灌注可促进体外预成型血管网络的形成和成熟。几种间接机械策略可为体内的工程组织提供持续的机械刺激,从而进一步促进体内植入物的血管化。此外,支架中的刚度梯度、各向异性基底和中空通道,以及外部循环拉伸、边界约束和动态流动培养,都能有效调节血管网络的排列,从而促进预血管化工程组织与宿主血管更好地融合。本综述总结了基于支架和外部刺激的机械策略对组织工程中血管化的影响和贡献,并阐明了相关的内在机制。
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引用次数: 0
Beta blockers in critical illness: promising but appropriate subphenotyping is needed. 重症患者使用β受体阻滞剂:前景广阔,但需要适当的亚表型分析。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-30 eCollection Date: 2024-01-01 DOI: 10.1093/burnst/tkae060
Luyao Zhang, Lu Ke
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引用次数: 0
Lymphangiogenesis: novel strategies to promote cutaneous wound healing 淋巴管生成:促进皮肤伤口愈合的新策略
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-27 DOI: 10.1093/burnst/tkae040
Yang Jian, Yanqi Li, Yanji Zhang, Mingyuan Tang, Mingfu Deng, Chenxiaoxiao Liu, Maolin Cheng, Shune Xiao, Chengliang Deng, Zairong Wei
The cutaneous lymphatic system regulates tissue inflammation, fluid balance and immunological responses. Lymphangiogenesis or lymphatic dysfunction may lead to lymphedema, immune deficiency, chronic inflammation etc. Tissue regeneration and healing depend on angiogenesis and lymphangiogenesis during wound healing. Tissue oedema and chronic inflammation can slow wound healing due to impaired lymphangiogenesis or lymphatic dysfunction. For example, impaired lymphangiogenesis or lymphatic dysfunction has been detected in nonhealing wounds such as diabetic ulcers, venous ulcers and bedsores. This review summarizes the structure and function of the cutaneous lymphatic vessel system and lymphangiogenesis in wounds. Furthermore, we review wound lymphangiogenesis processes and remodelling, especially the influence of the inflammatory phase. Finally, we outline how to control lymphangiogenesis to promote wound healing, assess the possibility of targeting lymphangiogenesis as a novel treatment strategy for chronic wounds and provide an analysis of the possible problems that need to be addressed.
皮肤淋巴系统调节组织炎症、体液平衡和免疫反应。淋巴管生成或淋巴功能障碍可导致淋巴水肿、免疫缺陷、慢性炎症等。组织的再生和愈合取决于伤口愈合过程中的血管生成和淋巴管生成。由于淋巴管生成受损或淋巴功能障碍,组织水肿和慢性炎症会导致伤口愈合缓慢。例如,在糖尿病溃疡、静脉溃疡和褥疮等无法愈合的伤口中就发现了淋巴管生成受损或淋巴功能障碍。本综述概述了皮肤淋巴管系统的结构和功能以及伤口中的淋巴管生成。此外,我们还回顾了伤口淋巴管生成过程和重塑,尤其是炎症阶段的影响。最后,我们概述了如何控制淋巴管生成以促进伤口愈合,评估了以淋巴管生成为目标作为慢性伤口新型治疗策略的可能性,并分析了需要解决的可能问题。
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引用次数: 0
Glutamine promotes the proliferation of intestinal stem cells via inhibition of TP53-induced glycolysis and apoptosis regulator promoter methylation in burned mice 谷氨酰胺通过抑制 TP53 诱导的糖酵解和凋亡调节因子启动子甲基化促进烧伤小鼠肠干细胞的增殖
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-27 DOI: 10.1093/burnst/tkae045
Panyang Zhang, Dan Wu, Xule Zha, Sen Su, Yajuan Zhang, Yan Wei, Lin Xia, Shijun Fan, Xi Peng
Background Intestinal stem cells (ISCs) play a pivotal role in maintaining intestinal homeostasis and facilitating the restoration of intestinal mucosal barrier integrity. Glutamine (Gln) is a crucial energy substrate in the intestine, promoting the proliferation of ISCs and mitigating damage to the intestinal mucosal barrier after burn injury. However, the underlying mechanism has not yet been fully elucidated. The objective of this study was to explore the mechanism by which Gln facilitates the proliferation of ISCs. Methods A mouse burn model was established to investigate the impact of Gln on intestinal function. Subsequently, crypts were isolated, and changes in TP53-induced glycolysis and apoptosis regulator (TIGAR) expression were assessed using real-time quantitative polymerase chain reaction (RT-qPCR), western blotting, immunohistochemistry, and immunofluorescence. The effects of TIGAR on cell proliferation were validated through CCK-8, EdU, and clonogenicity assays. Furthermore, the effect of TIGAR on Yes-associated protein (YAP) nuclear translocation and ferroptosis was examined by western blotting and immunofluorescence staining. Finally, dot blot analysis and methylation-specific PCR were performed to evaluate the effect of Gln on TIGAR promoter methylation. Results The mRNA and protein levels of TIGAR decreased after burn injury, and supplementation with Gln increased the expression of TIGAR. TIGAR accelerates the nuclear translocation of YAP, thereby increasing the proliferation of ISCs. Concurrently, TIGAR promotes the synthesis of nicotinamide adenine dinucleotide phosphate (NADPH) and glutathione to suppress ferroptosis in ISCs. Subsequent investigations demonstrated that Gln inhibits TIGAR promoter methylation by increasing the expression of the demethylase ten-eleven translocation. This change increased TIGAR transcription, increased NADPH synthesis, and reduced oxidative stress, thereby facilitating the restoration of intestinal mucosal barrier integrity post-burn injury. Conclusions Our data confirmed the inhibitory effect of Gln on TIGAR promoter methylation, which facilitates YAP translocation into the nucleus and suppresses ferroptosis, ultimately promoting the proliferation of ISCs.
背景 肠道干细胞(ISCs)在维持肠道平衡和促进恢复肠道粘膜屏障完整性方面发挥着关键作用。谷氨酰胺(Gln)是肠道中重要的能量底物,可促进肠干细胞的增殖,减轻烧伤后肠粘膜屏障的损伤。然而,其潜在机制尚未完全阐明。本研究旨在探索 Gln 促进 ISC 增殖的机制。方法 建立小鼠烧伤模型,研究 Gln 对肠道功能的影响。随后分离隐窝,使用实时定量聚合酶链式反应(RT-qPCR)、Western 印迹、免疫组织化学和免疫荧光评估 TP53 诱导的糖酵解和细胞凋亡调节因子(TIGAR)表达的变化。TIGAR对细胞增殖的影响通过CCK-8、EdU和克隆生成试验进行了验证。此外,还通过 Western 印迹和免疫荧光染色法检测了 TIGAR 对是相关蛋白(YAP)核转位和铁突变的影响。最后,通过点印迹分析和甲基化特异性 PCR 来评估 Gln 对 TIGAR 启动子甲基化的影响。结果 烧伤后 TIGAR 的 mRNA 和蛋白水平下降,补充 Gln 可增加 TIGAR 的表达。TIGAR 可加速 YAP 的核转位,从而增加 ISC 的增殖。同时,TIGAR 还能促进烟酰胺腺嘌呤二核苷酸磷酸(NADPH)和谷胱甘肽的合成,从而抑制 ISC 的铁突变。随后的研究表明,Gln通过增加去甲基化酶十-十一转位的表达来抑制TIGAR启动子甲基化。这一变化增加了 TIGAR 的转录,增加了 NADPH 的合成,降低了氧化应激,从而促进了烧伤后肠粘膜屏障完整性的恢复。结论 我们的数据证实了 Gln 对 TIGAR 启动子甲基化的抑制作用,而 TIGAR 启动子甲基化可促进 YAP 转位至细胞核并抑制铁变态反应,最终促进 ISC 的增殖。
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引用次数: 0
The pharmacological landscape of chronic subdural hematoma: a systematic review and network meta-analysis of randomized and non-randomized controlled studies. 慢性硬膜下血肿的药物治疗:随机和非随机对照研究的系统回顾和网络荟萃分析。
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-26 DOI: 10.1093/burnst/tkae034
Tao Liu,Zhihao Zhao,Mingqi Liu,Shuo An,Meng Nie,Xuanhui Liu,Yu Qian,Ye Tian,Jianning Zhang,Rongcai Jiang
BackgroundThere are various treatment modalities for chronic subdural hematoma (CSDH) and there is extensive debate surrounding pharmaceutical interventions. There is no consensus regarding the relative efficacy and safety of multiple treatment modalities. This study aims to investigate this issue and offer potential clinical recommendations.MethodsWe searched PubMed, Web of Science, Embase and the Cochrane Library from January 2000 to May 2023 to identify randomized and nonrandomized controlled studies reporting one or more outcomes associated with the pharmacologic management of CSDH. The primary outcomes of interest included recurrence, favorable prognosis and adverse events, while the secondary outcomes included a reduction in hematoma volume and mortality. Pooled estimates, credible intervals and odds ratios were calculated for all outcomes using a fixed effects model. Confidence in network meta-analysis judgments were employed to stratify the evidential quality. This study was registered with PROSPERO: CRD42023406599.ResultsThe search strategy yielded 656 references; ultimately, 36 studies involving 8082 patients fulfilled our predefined inclusion criteria. The findings suggested that statins + glucocorticoids (GCs) ranked highest for preventing recurrence, improving prognosis and facilitating hematoma absorption. Tranexamic acid ranked second highest for preventing recurrence. Statins were found to be the preferred drug intervention for decreasing mortality and preventing adverse events. Antithrombotic agents ranked lowest in terms of decreasing mortality and improving prognosis.ConclusionsOur findings indicate that statins + GCs may be the most effective treatment modality for preventing recurrence, improving patient prognosis and facilitating hematoma absorption. In terms of reducing mortality and preventing adverse events, statins may be superior to other pharmacological interventions. Routine use of GCs is not suggested for patients with CSDH. Further prospective research is needed to directly compare the efficacy and superiority of various pharmaceutical interventions targeting CSDH to reinforce and validate our findings.
背景慢性硬膜下血肿(CSDH)有多种治疗方法,围绕药物干预存在广泛的争议。关于多种治疗方式的相对疗效和安全性,目前尚未达成共识。本研究旨在调查这一问题,并提供潜在的临床建议。方法我们检索了 2000 年 1 月至 2023 年 5 月期间的 PubMed、Web of Science、Embase 和 Cochrane 图书馆,以确定报道一种或多种与 CSDH 药物治疗相关结果的随机和非随机对照研究。主要研究结果包括复发、预后良好和不良事件,次要研究结果包括血肿体积缩小和死亡率。采用固定效应模型计算了所有结果的汇总估计值、可信区间和几率比。采用网络荟萃分析可信度判断对证据质量进行分层。本研究已在 PROSPERO 注册:CRD42023406599.Results检索策略共获得 656 篇参考文献,最终有 36 项研究(涉及 8082 名患者)符合我们预先设定的纳入标准。研究结果表明,他汀类药物+糖皮质激素(GCs)在预防复发、改善预后和促进血肿吸收方面的作用最高。氨甲环酸在预防复发方面排名第二。研究发现,他汀类药物是降低死亡率和预防不良事件的首选药物干预措施。结论我们的研究结果表明,他汀类药物+GCs可能是预防复发、改善患者预后和促进血肿吸收的最有效治疗方式。在降低死亡率和预防不良事件方面,他汀类药物可能优于其他药物干预措施。不建议 CSDH 患者常规使用 GCs。需要进一步开展前瞻性研究,直接比较针对 CSDH 的各种药物干预措施的疗效和优越性,以巩固和验证我们的研究结果。
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引用次数: 0
Thermo-responsive cascade antimicrobial platform for precise biofilm removal and enhanced wound healing 热响应级联抗菌平台可精确清除生物膜并促进伤口愈合
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-25 DOI: 10.1093/burnst/tkae038
Ting Du, Jiangli Cao, Zhannuo Zhang, Zehui Xiao, Jingbo Jiao, Zhiyong Song, Xinjun Du, Shuo Wang
Background Bacterial infection, tissue hypoxia and inflammatory response can hinder infected wound repair. This study aimed to develop a multifunctional specific therapeutic photo-activated release nanosystem [HMPB@MB@AuNPs@PMB@HA (HMAPH)] by loading photosensitizer methylene blue (MB) into hollow mesoporous Prussian blue nanostructures and modifying the surface with gold particles, polymyxin B (PMB) and hydrophilic hyaluronic acid. Methods The HMAPH was characterized using transmission electron microscopy, UV–vis, Fourier-transform infrared spectroscopy, X-ray diffraction and X-ray photon spectroscopy. The photothermal performance, iron ion release and free radical generation of the HMAPH were measured under different conditions to investigate its thermo-responsive cascade reaction. The antibacterial ability of HMAPH was investigated using live/dead fluorescence tests. The morphology and membrane integrity of Pseudomonas aeruginosa (P. aeruginosa) were investigated using transmission electron microscopy. The anti-biofilm activity of HMAPH was evaluated using crystal violet and SYBR Green I staining. Finally, we established a mouse model of a skin wound infected by P. aeruginosa to confirm the in vivo effectiveness of HMAPH. We used immunofluorescent staining, hematoxylin–eosin staining, Masson staining and enzyme-linked immunosorbent assay to examine whether HMAPH promoted wound healing and reduced inflammatory damage. Results In this study, hyaluronic acid was decomposed under the action of hyaluronidase. Also, the exposed nanomaterials specifically bound to the outer membrane of P. aeruginosa through PMB to increase the membrane sensitivity to photodynamic treatment. Under dual-light irradiation, a large amount of iron ions released by HMAPH underwent a Fenton reaction with H2O2 in bacteria to generate hydroxyl radicals (•OH), enabling direct killing of cells by hyperthermia. Additionally, the photodynamic activity of MB released by photo-induced activation led to the generation of reactive oxygen species, achieving synergistic and effective inhibition of P. aeruginosa. HMAPH also inhibited biofilm formation and downregulated the expression of virulence factors. In vivo experiments revealed that HMAPH accelerated the healing of P. aeruginosa-infected wounds by promoting angiogenesis and skin regeneration, inhibiting the inflammatory response and promoting M1 to M2 polarization. Conclusions Our study proposed a strategy against bacteria and biofilms through a synergistic photothermal–photodynamic–Fenton reaction, opening up new prospects for combating biofilm-associated infections.
背景 细菌感染、组织缺氧和炎症反应会阻碍感染伤口的修复。本研究旨在将光敏剂亚甲基蓝(MB)载入中空介孔普鲁士蓝纳米结构,并用金颗粒、多粘菌素 B(PMB)和亲水性透明质酸修饰其表面,从而开发一种多功能特异性治疗光激活释放纳米系统[HMPB@MB@AuNPs@PMB@HA(HMAPH)]。方法 利用透射电子显微镜、紫外-可见光、傅立叶变换红外光谱、X 射线衍射和 X 射线光子光谱对 HMAPH 进行表征。在不同条件下测量了 HMAPH 的光热性能、铁离子释放和自由基生成,以研究其热响应级联反应。利用活/死荧光试验研究了 HMAPH 的抗菌能力。使用透射电子显微镜研究了铜绿假单胞菌(P. aeruginosa)的形态和膜完整性。使用结晶紫和 SYBR 绿 I 染色法评估了 HMAPH 的抗生物膜活性。最后,我们建立了铜绿假单胞菌感染皮肤伤口的小鼠模型,以证实 HMAPH 在体内的有效性。我们采用免疫荧光染色、苏木精-伊红染色、Masson 染色和酶联免疫吸附试验来检验 HMAPH 是否能促进伤口愈合和减轻炎症损伤。结果 在这项研究中,透明质酸在透明质酸酶的作用下被分解。同时,暴露的纳米材料通过 PMB 与铜绿假单胞菌的外膜特异性结合,从而提高了铜绿假单胞菌外膜对光动力治疗的敏感性。在双光照射下,HMAPH 释放的大量铁离子与细菌中的 H2O2 发生 Fenton 反应,生成羟自由基(-OH),从而通过热效应直接杀死细胞。此外,光诱导活化释放的甲基溴的光动力活性还导致生成活性氧,从而实现协同和有效抑制铜绿假单胞菌。HMAPH 还能抑制生物膜的形成并下调毒力因子的表达。体内实验表明,HMAPH 可促进血管生成和皮肤再生,抑制炎症反应,促进 M1 到 M2 极化,从而加速铜绿假单胞菌感染伤口的愈合。结论 我们的研究提出了一种通过协同光热-光动力-芬顿反应对抗细菌和生物膜的策略,为对抗生物膜相关感染开辟了新的前景。
{"title":"Thermo-responsive cascade antimicrobial platform for precise biofilm removal and enhanced wound healing","authors":"Ting Du, Jiangli Cao, Zhannuo Zhang, Zehui Xiao, Jingbo Jiao, Zhiyong Song, Xinjun Du, Shuo Wang","doi":"10.1093/burnst/tkae038","DOIUrl":"https://doi.org/10.1093/burnst/tkae038","url":null,"abstract":"Background Bacterial infection, tissue hypoxia and inflammatory response can hinder infected wound repair. This study aimed to develop a multifunctional specific therapeutic photo-activated release nanosystem [HMPB@MB@AuNPs@PMB@HA (HMAPH)] by loading photosensitizer methylene blue (MB) into hollow mesoporous Prussian blue nanostructures and modifying the surface with gold particles, polymyxin B (PMB) and hydrophilic hyaluronic acid. Methods The HMAPH was characterized using transmission electron microscopy, UV–vis, Fourier-transform infrared spectroscopy, X-ray diffraction and X-ray photon spectroscopy. The photothermal performance, iron ion release and free radical generation of the HMAPH were measured under different conditions to investigate its thermo-responsive cascade reaction. The antibacterial ability of HMAPH was investigated using live/dead fluorescence tests. The morphology and membrane integrity of Pseudomonas aeruginosa (P. aeruginosa) were investigated using transmission electron microscopy. The anti-biofilm activity of HMAPH was evaluated using crystal violet and SYBR Green I staining. Finally, we established a mouse model of a skin wound infected by P. aeruginosa to confirm the in vivo effectiveness of HMAPH. We used immunofluorescent staining, hematoxylin–eosin staining, Masson staining and enzyme-linked immunosorbent assay to examine whether HMAPH promoted wound healing and reduced inflammatory damage. Results In this study, hyaluronic acid was decomposed under the action of hyaluronidase. Also, the exposed nanomaterials specifically bound to the outer membrane of P. aeruginosa through PMB to increase the membrane sensitivity to photodynamic treatment. Under dual-light irradiation, a large amount of iron ions released by HMAPH underwent a Fenton reaction with H2O2 in bacteria to generate hydroxyl radicals (•OH), enabling direct killing of cells by hyperthermia. Additionally, the photodynamic activity of MB released by photo-induced activation led to the generation of reactive oxygen species, achieving synergistic and effective inhibition of P. aeruginosa. HMAPH also inhibited biofilm formation and downregulated the expression of virulence factors. In vivo experiments revealed that HMAPH accelerated the healing of P. aeruginosa-infected wounds by promoting angiogenesis and skin regeneration, inhibiting the inflammatory response and promoting M1 to M2 polarization. Conclusions Our study proposed a strategy against bacteria and biofilms through a synergistic photothermal–photodynamic–Fenton reaction, opening up new prospects for combating biofilm-associated infections.","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":"35 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142321381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Developing a calculable risk prediction model for sternal wound infection after median sternotomy: a retrospective study 开发胸骨正中切开术后胸骨伤口感染的可计算风险预测模型:一项回顾性研究
IF 5.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-14 DOI: 10.1093/burnst/tkae031
Yang Chen, Fei He, Fan Wu, Xiaolong Hu, Wanfu Zhang, Shaohui Li, Hao Zhang, Weixun Duan, Hao Guan
Background Diagnosing sternal wound infection (SWI) following median sternotomy remains laborious and troublesome, resulting in high mortality rates and great harm to patients. Early intervention and prevention are critical and challenging. This study aimed to develop a simple risk prediction model to identify high-risk populations of SWI and to guide examination programs and intervention strategies. Methods A retrospective analysis was conducted on the clinical data obtained from 6715 patients who underwent median sternotomy between January 2016 and December 2020. The least absolute shrink and selection operator (LASSO) regression method selected the optimal subset of predictors, and multivariate logistic regression helped screen the significant factors. The nomogram model was built based on all significant factors. Area under the curve (AUC), calibration curve and decision curve analysis (DCA) were used to assess the model's performance. Results LASSO regression analysis selected an optimal subset containing nine predictors that were all statistically significant in multivariate logistic regression analysis. Independent risk factors of SWI included female [odds ratio (OR) = 3.405, 95% confidence interval (CI) = 2.535–4.573], chronic obstructive pulmonary disease (OR = 4.679, 95% CI = 2.916–7.508), drinking (OR = 2.025, 95% CI = 1.437–2.855), smoking (OR = 7.059, 95% CI = 5.034–9.898), re-operation (OR = 3.235, 95% CI = 1.087–9.623), heart failure (OR = 1.555, 95% CI = 1.200–2.016) and repeated endotracheal intubation (OR = 1.975, 95% CI = 1.405–2.774). Protective factors included bone wax (OR = 0.674, 95% CI = 0.538–0.843) and chest physiotherapy (OR = 0.446, 95% CI = 0.248–0.802). The AUC of the nomogram was 0.770 (95% CI = 0.745–0.795) with relatively good sensitivity (0.798) and accuracy (0.620), exhibiting moderately good discernment. The model also showed an excellent fitting degree on the calibration curve. Finally, the DCA presented a remarkable net benefit. Conclusions A visual and convenient nomogram-based risk calculator built on disease-associated predictors might help clinicians with the early identification of high-risk patients of SWI and timely intervention.
背景 诊断胸骨正中切开术后的胸骨伤口感染(SWI)仍然费力而麻烦,导致死亡率高,对患者造成极大伤害。早期干预和预防至关重要,也极具挑战性。本研究旨在建立一个简单的风险预测模型,以确定 SWI 的高危人群,并指导检查项目和干预策略。方法 对2016年1月至2020年12月期间接受胸骨正中切开术的6715名患者的临床数据进行回顾性分析。最小绝对缩小和选择算子(LASSO)回归法选出了最佳预测因子子集,多变量逻辑回归帮助筛选出了重要的因素。根据所有重要因素建立了提名图模型。采用曲线下面积(AUC)、校准曲线和决策曲线分析(DCA)来评估模型的性能。结果 LASSO 回归分析选出了一个最佳子集,该子集包含 9 个预测因子,这些因子在多元逻辑回归分析中均具有统计学意义。SWI的独立风险因素包括女性[几率比(OR)= 3.405,95% 置信区间(CI)= 2.535-4.573]、慢性阻塞性肺病(OR = 4.679,95% CI = 2.916-7.508)、饮酒(OR = 2.025,95% CI = 1.437-2.855)、吸烟(OR = 7.059,95% CI = 5.034-9.898)、再次手术(OR = 3.235,95% CI = 1.087-9.623)、心力衰竭(OR = 1.555,95% CI = 1.200-2.016)和反复气管插管(OR = 1.975,95% CI = 1.405-2.774)。保护因素包括骨蜡(OR = 0.674,95% CI = 0.538-0.843)和胸部理疗(OR = 0.446,95% CI = 0.248-0.802)。提名图的 AUC 为 0.770(95% CI = 0.745-0.795),灵敏度(0.798)和准确度(0.620)相对较好,显示出中等水平的辨别能力。该模型在校准曲线上的拟合度也很高。最后,DCA 显示出显著的净效益。结论 基于疾病相关预测因子的可视化、便捷的提名图风险计算器可帮助临床医生早期识别 SWI 高危患者并及时干预。
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引用次数: 0
Reshaped commensal wound microbiome via topical application of Calvatia gigantea extract contributes to faster diabetic wound healing. 通过局部应用钙华菊提取物重塑共生伤口微生物群有助于加快糖尿病伤口愈合。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI: 10.1093/burnst/tkae037
Xiaotong Ding, Chenxi Yang, Yue Li, Tangtang He, Yan Xu, Xuxi Cheng, Jinyun Song, Nannan Xue, Wen Min, Weimeng Feng, Hongyu Zhao, Jie Dong, Pei Liu, Yiwei Wang, Jun Chen

Background: Calvatia gigantea (CG) is widely used as a traditional Chinese medicine for wound treatment. In this study, we aimed to determine the effects of CG extract (CGE) on diabetic wound healing and the commensal wound microbiome.

Method: A wound model was established using leptin receptor-deficient db/db mice, with untreated mice as the control group and CGE-treated mice as the treatment group. The wound healing rate, inflammation and histology were analyzed. Additionally, wound microbiome was evaluated via 16S ribosomal RNA (rRNA) gene sequencing.

Results: CGE significantly accelerated the healing of diabetic ulcer wounds, facilitated re-epithelialization, and downregulated the transcription levels of the inflammatory cytokines, interleukin-1β and tumor necrosis factor-α. Furthermore, CGE treatment positively affected the wound microbiome, promoting diversity of the microbial community and enrichment of Escherichia-Shigella bacteria in the CGE-treated group.

Conclusions: Overall, CGE enhanced diabetic wound healing by modulating the wound microbiome and facilitating macrophage polarization during inflammation. These findings suggest modulation of the commensal wound microbiome using medicinal plants as a potential therapeutic strategy for diabetic wounds.

背景:石菖蒲(CG)被广泛用作治疗伤口的传统中药。本研究旨在确定石杉碱甲提取物(CGE)对糖尿病伤口愈合和伤口微生物群的影响:方法:利用瘦素受体缺陷的 db/db 小鼠建立伤口模型,以未处理的小鼠为对照组,CGE 处理的小鼠为治疗组。对伤口愈合率、炎症和组织学进行分析。此外,还通过 16S 核糖体 RNA(rRNA)基因测序评估了伤口微生物组:结果:CGE能明显加速糖尿病溃疡伤口的愈合,促进伤口的再上皮化,并能降低炎症细胞因子、白细胞介素-1β和肿瘤坏死因子-α的转录水平。此外,CGE 还对伤口微生物组产生了积极影响,促进了微生物群落的多样性,并富集了 CGE 治疗组中的埃希氏-志贺氏菌:总之,CGE 通过调节伤口微生物群和促进炎症期间巨噬细胞的极化,促进了糖尿病伤口的愈合。这些研究结果表明,利用药用植物调节共生伤口微生物群是治疗糖尿病伤口的一种潜在策略。
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引用次数: 0
BRD3308 suppresses macrophage oxidative stress and pyroptosis via upregulating acetylation of H3K27 in sepsis-induced acute lung injury. 在脓毒症诱发的急性肺损伤中,BRD3308通过上调H3K27的乙酰化抑制巨噬细胞氧化应激和脓毒症。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-02 eCollection Date: 2024-01-01 DOI: 10.1093/burnst/tkae033
Bohao Liu, Ning Li, Yi Liu, Yan Zhang, Limei Qu, Hongfei Cai, Yang Li, Xiaojing Wu, Qing Geng

Background: Sepsis-induced acute lung injury (ALI) leads to severe hypoxemia and respiratory failure, contributing to poor prognosis in septic patients. Endotoxin dissemination triggers oxidative stress and the release of inflammatory cytokines in macrophages, initiating diffuse alveolar damage. The role of epigenetic histone modifications in organ injury is increasingly recognized. The present study aimed to investigate the use of a histone modification inhibitor to alleviate sepsis-induced ALI, revealing a new strategy for improving sepsis patient survival.

Methods: In vivo models of ALI were established through the intraperitoneal injection of lipopolysaccharide and cecal ligation and puncture surgery. Furthermore, the disease process was simulated in vitro by stimulating Tamm-Horsfall protein-1 (THP-1) cells with lipopolysaccharide. Hematoxylin and eosin staining, blood gas analysis and pulmonary function tests were utilized to assess the extent of lung tissue damage. Western blot analysis, real-time polymerase chain reaction, enzyme-linked immunosorbent assay and immunofluorescence were used to measure the levels and distribution of the indicated indicators within cells and tissues. Reactive oxygen species and autophagic flux alterations were detected using specific probes.

Results: BRD3308, which is a inhibitor of histone deacetylase 3, improved lung tissue damage, inflammatory infiltration and edema in ALI by inhibiting Nod-like receptor protein3-mediated pyroptosis in macrophages. By upregulating autophagy, BRD3308 improved the disruption of redox balance in macrophages and reduced the accumulation of reactive oxygen species. Mechanistically, BRD3308 inhibited histone deacetylase 3 activity by binding to it and altering its conformation. Following histone deacetylase 3 inhibition, acetylation of H3K27 was significantly increased. Moreover, the increase in H3K27Ac led to the upregulation of autophagy-related gene 5, a key component of autophagosomes, thereby activating autophagy.

Conclusions: BRD3308 inhibits oxidative stress and pyroptosis in macrophages by modulating histone acetylation, thereby preventing sepsis-induced ALI. The present study provides a potential strategy and theoretical basis for the clinical treatment of sepsis-induced ALI.

背景:败血症诱发的急性肺损伤(ALI)会导致严重的低氧血症和呼吸衰竭,导致败血症患者预后不良。内毒素扩散引发氧化应激和巨噬细胞释放炎性细胞因子,导致肺泡弥漫性损伤。人们越来越认识到表观遗传组蛋白修饰在器官损伤中的作用。本研究旨在探讨使用组蛋白修饰抑制剂缓解脓毒症诱发的 ALI,为改善脓毒症患者存活率揭示一种新策略:方法:通过腹腔注射脂多糖和盲肠结扎穿刺手术建立ALI体内模型。此外,还通过脂多糖刺激 Tamm-Horsfall 蛋白-1(THP-1)细胞模拟体外发病过程。利用血红素和伊红染色、血气分析和肺功能测试来评估肺组织损伤的程度。Western 印迹分析、实时聚合酶链反应、酶联免疫吸附试验和免疫荧光被用来测量细胞和组织中所述指标的水平和分布。使用特定探针检测了活性氧和自噬通量的变化:结果:BRD3308 是组蛋白去乙酰化酶 3 的抑制剂,它通过抑制巨噬细胞中 Nod 样受体蛋白 3 介导的热凋亡,改善了 ALI 中的肺组织损伤、炎症浸润和水肿。通过上调自噬,BRD3308 改善了巨噬细胞中氧化还原平衡的破坏,减少了活性氧的积累。从机理上讲,BRD3308 通过与组蛋白去乙酰化酶 3 结合并改变其构象来抑制其活性。组蛋白去乙酰化酶 3 受抑制后,H3K27 的乙酰化显著增加。此外,H3K27Ac的增加导致自噬相关基因5(自噬体的关键成分)的上调,从而激活了自噬:BRD3308通过调节组蛋白乙酰化抑制巨噬细胞中的氧化应激和脓毒症,从而预防脓毒症诱发的ALI。本研究为脓毒症诱发的 ALI 的临床治疗提供了潜在的策略和理论依据。
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引用次数: 0
Applications of mesenchymal stem cell-exosome components in wound infection healing: new insights. 间充质干细胞外泌体成分在伤口感染愈合中的应用:新见解。
IF 6.3 1区 医学 Q1 DERMATOLOGY Pub Date : 2024-08-13 eCollection Date: 2024-01-01 DOI: 10.1093/burnst/tkae021
Arshia Fakouri, Zahra-Sadat Razavi, Adil Tawfeeq Mohammed, Abbas Hameed Abdul Hussein, Hamed Afkhami, Mohammad Hosseini Hooshiar

The healing process at a wound is made up of many types of cells, growth factors, the extracellular matrix, nerves and blood vessels all interacting with each other in complex and changing ways. Microbial colonization and proliferation are possible at the place of injury, which makes infection more likely. Because of this, any cut has a chance of getting an infection. Researchers have found that wound infections make patients more upset and cost the healthcare system a lot of money. Surgical site infections happen a lot to people who have recently had surgery. This study shows that such surgical infection is linked to a high rate of illness and death. This is shown by the fact that 25% of patients get serious sepsis and need to be transferred to an intensive care unit. In both animal models and people, mesenchymal stem cells (MSCs) play an active role in all stages of wound healing and have positive effects. Exosomes are one of the main things MSCs release. They have effects that are similar to those of the parent MSCs. Various effector proteins, messenger RNA and microRNAs can be transported by extracellular vesicles to control the activity of target cells. This has a big impact on the healing process. These results suggest that using MSC-exosomes as a new type of cell-free therapy could be a better and safer option than whole cell therapy. This review is mostly about how to use parts of MSC-exosomes to help wound infections heal.

伤口的愈合过程是由多种类型的细胞、生长因子、细胞外基质、神经和血管以复杂多变的方式相互作用组成的。受伤处可能会有微生物定植和增殖,这就增加了感染的可能性。因此,任何伤口都有感染的可能。研究人员发现,伤口感染会让病人更加难过,也会让医疗系统花费大量金钱。手术部位感染经常发生在刚做完手术的人身上。这项研究表明,这种手术感染与高患病率和高死亡率有关。25%的患者会患上严重的败血症,需要转入重症监护室,这就说明了这一点。在动物模型和人体中,间充质干细胞(MSCs)在伤口愈合的各个阶段都发挥着积极作用,并产生积极影响。外泌体是间充质干细胞释放的主要物质之一。它们具有与母体间充质干细胞相似的作用。各种效应蛋白、信使核糖核酸和微核糖核酸可通过细胞外囊泡运输,从而控制靶细胞的活性。这对愈合过程有很大影响。这些结果表明,使用间充质干细胞外泌体作为一种新型的无细胞疗法,可能是比全细胞疗法更好、更安全的选择。这篇综述主要介绍了如何利用间充质干细胞外泌体的一部分来帮助伤口感染愈合。
{"title":"Applications of mesenchymal stem cell-exosome components in wound infection healing: new insights.","authors":"Arshia Fakouri, Zahra-Sadat Razavi, Adil Tawfeeq Mohammed, Abbas Hameed Abdul Hussein, Hamed Afkhami, Mohammad Hosseini Hooshiar","doi":"10.1093/burnst/tkae021","DOIUrl":"10.1093/burnst/tkae021","url":null,"abstract":"<p><p>The healing process at a wound is made up of many types of cells, growth factors, the extracellular matrix, nerves and blood vessels all interacting with each other in complex and changing ways. Microbial colonization and proliferation are possible at the place of injury, which makes infection more likely. Because of this, any cut has a chance of getting an infection. Researchers have found that wound infections make patients more upset and cost the healthcare system a lot of money. Surgical site infections happen a lot to people who have recently had surgery. This study shows that such surgical infection is linked to a high rate of illness and death. This is shown by the fact that 25% of patients get serious sepsis and need to be transferred to an intensive care unit. In both animal models and people, mesenchymal stem cells (MSCs) play an active role in all stages of wound healing and have positive effects. Exosomes are one of the main things MSCs release. They have effects that are similar to those of the parent MSCs. Various effector proteins, messenger RNA and microRNAs can be transported by extracellular vesicles to control the activity of target cells. This has a big impact on the healing process. These results suggest that using MSC-exosomes as a new type of cell-free therapy could be a better and safer option than whole cell therapy. This review is mostly about how to use parts of MSC-exosomes to help wound infections heal.</p>","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":"12 ","pages":"tkae021"},"PeriodicalIF":6.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Burns & Trauma
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