BACKGROUND:This multicenter, randomized controlled trial evaluated the safety and efficacy of PermeaDerm, a biosynthetic wound matrix, compared to porcine acellular dermal matrix (ADM) for the treatment of partial-thickness burns in Chinese patients. METHODS:A total of 184 patients were enrolled and randomized 1:1 to receive either PermeaDerm or ADM across the four Chinese centers. The primary endpoint was the proportion of wounds that achieved complete re-epithelialization by day 14 (superficial partial-thickness burns) or 21 (deep partial-thickness burns). The secondary endpoints included complete re-epithelialization over time, wound area reduction rate (cm2/day), time to complete re-epithelialization, pain scores, device performance, and incidence of complications. RESULTS:PermeaDerm was non-inferior to ADM for the primary endpoint. On day 7, significantly more wounds treated with PermeaDerm achieved early complete re-epithelialization for superficial partial-thickness burns (55.6% [20/36] vs. 27.0% [10/37], p = 0.012) and deep partial-thickness burns (37.2% [19/51] vs. 12.7% [7/55], p = 0.005). The median wound area reduction rate at day 7 was also significantly higher with PermeaDerm for both superficial partial-thickness burns (2.41 cm²/day (IQR 0.86-5.07) vs. 1.05 cm²/day (IQR 0.34-3.01), p = 0.034) and deep partial-thickness burns (3.50 cm²/day (IQR 1.40-8.02) vs. 1.78 cm²/day (IQR 0.85-4.40), p = 0.021). After day 7, the healing rates were comparable between the groups. Median time to complete re-epithelialization was 3 days shorter with PermeaDerm for both superficial (7.00 days (IQR 6-10.25) vs. 10.00 days (IQR 7-12.75), p = 0.016) and deep partial-thickness burns (10.00 days (IQR 7-13) vs. 13.00 days (IQR 10-15), p = 0.003). Pain scores and complication rates were similar between the groups, while PermeaDerm was associated with more favorable ease of application, wound visibility, and removal. CONCLUSION:PermeaDerm accelerates early wound healing and shortens the time to complete re-epithelialization compared with ADM, while maintaining a comparable safety profile. These findings suggest that PermeaDerm may represent a clinically useful alternative for the management of partial-thickness burns.

Objective: To explore the effects of resistance training with elastic band at home on muscle function and walking ability of severely burned children. Methods: A prospective non-randomized controlled study was conducted. From January 2022 to April 2023, 40 children with severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital. According to the willingness of the children or their families, the children were assigned to conventional rehabilitation group and combined rehabilitation group. During the study, 8 children dropped out of the study, 17 children were finally included in the conventional rehabilitation group with 6 males and 11 females, aged (8.5±2.4) years, and 15 children were included in the combined rehabilitation group with 5 males and 10 females, aged (9.6±2.5) years. The children in the 2 groups received conventional burn rehabilitation treatment in the hospital, including active and passive activity training, scar massage, and pressure therapy. The children in combined rehabilitation group received resistance training with elastic band of 3 to 5 times per week after discharge, and the children in conventional rehabilitation group received daily activity ability training after discharge. Before home rehabilitation training (1 week before discharge) and 12 weeks after home rehabilitation training, the grip strength was measured using a handheld grip dynamometer, the muscle strengths of the upper and lower limbs were measured using a portable dynamometer for muscle strength, lean body mass was measured by bioelectrical impedance measuring instrument, and the 6-min walking distance was measured. Data were statistically analyzed with independent sample t test, paired sample t test, Mann-Whitney U test, or Fisher's exact probability test. Results: After 12 weeks of home rehabilitation training, the grip strengths of children in combined rehabilitation group and conventional rehabilitation group were (15±4) and (11±4) kg, respectively, which were significantly higher than (10±4) and (9±4) kg before home rehabilitation training (with t values of -9.99 and -11.89, respectively, P values all <0.05); the grip strength of children in combined rehabilitation group was significantly higher than that in conventional rehabilitation group (t=3.24, P<0.05). After 12 weeks of home rehabilitation training, the muscle strengths of upper and lower limbs of children in combined rehabilitation group (with t values of -11.39 and -3.40, respectively, P<0.05) and the muscle strengths of upper and lower limbs of children in conventional rehabilitation group (with t values of -7.59 and -6.69, respectively, P<0.05) were significantly higher than those before home rehabilitation training, and the muscle strengths of upper and lower limbs of children in combined rehabilitation group were significantly higher than those in conventional rehabilitation group (with t values of 3.80 and 7.87, respectively, P<0.05). After 12 weeks of home rehabilitation training, the lean body mass of children in combined rehabilitation group was significantly higher than that before home rehabilitation training (t=0.21, P<0.05). After 12 weeks of home rehabilitation training, the 6-min walking distances of children in conventional rehabilitation group and combined rehabilitation group were significantly longer than those before home rehabilitation training (with t values of -5.33 and -3.40, respectively, P<0.05), and the 6-min walking distance of children in combined rehabilitation group was significantly longer than that in conventional rehabilitation group (t=3.81, P<0.05). Conclusions: Conventional burn rehabilitation treatment in hospital and home resistance training with elastic band for 12 weeks after discharge can significantly improve the muscle function and walking ability of severely burned children.

The success rate of treatment of burns has been greatly improved, but a large number of survivors have burn sequelae such as motor dysfunction or loss and decreased quality of life. In view of the physiological and psychological problems caused by hypermetabolism and long-term braking after large surface burns, exercise rehabilitation training is an effective method. This article reviews the influence of severe burns on physical function and the research status of exercise rehabilitation of severe burns.

The sequelae of pediatric burn seriously affect the physical function and quality of life of children with burns. Rehabilitation exercise training mainly based on aerobic and resistance exercise can effectively alleviate the negative effects. This article reviews the effects of rehabilitation exercise training on cardiopulmonary function, muscle function, and quality of life of children with burns, and introduces the latest rehabilitation exercise training prescription for children with burns based on type, mode, intensity, frequency, and time of exercise, so as to improve the level of rehabilitation treatment for children with burns.

目的 按照自定义分型标准,分析不同程度放射性溃疡的临床特点及治疗结果.方法 将影响放射性溃疡严重程度的主要因素按不同权重计分,分为轻、中、重3型.以此为标准,对我院2014年4月至2020年9月收治的放射性溃疡患者进行回顾性分析,对不同严重程度及不同原发疾病患者的治疗及随访结果进行分组比较.结果 共31例患者纳入本研究.轻、中、重3型分别为3例(10.7％)、12例(38.7％)及16例(51.6％).患者中9例(29.0％)行保守治疗,14例(45.2％)采用局部带蒂皮瓣修复,8例(25.8％)以游离皮瓣修复.3型患者中分型越重溃疡病程越久,采用皮瓣修复者越多,治疗费用越高,创面愈合时间越长(P<0.05).轻、中、重3型患者组的临床治愈率分别为87.5％、100％、100％,溃疡复发率分别为33.3％、25.0％、21.4％,差异无统计学意义(P>0.05).患者行放疗的原发病因包括乳腺癌12例(38.7％)、生殖系统恶性肿瘤5例(16.1％)、皮肤鳞癌4例(12.9％)、血管病变4例(12.9％)、皮肤纤维肉瘤3例(9.7％)、鼻咽癌2例(6.5％)、淋巴瘤1例(3.2％).不同原发病因患者的溃疡严重程度不一(P<0.05),但临床痊愈率及溃疡复发率无统计学差异(P>0.05).结论 不同严重程度放射性溃疡患者的溃疡病程、治疗方法、创面愈合时间及治疗费用有统计学差异,本分型标准对放射性溃疡的病情判断及临床治疗有指导作用.

Objective: To summarize the clinical outcomes of burn patients in different stages of pregnancy and explore a rational therapeutic scheme for burns during pregnancy. Methods: A retrospective observational study was conducted. From June 2010 to June 2020, 21 patients who met the inclusion criteria were admitted to the Department of Burns of Wuhan Third Hospital and 14 patients who met the inclusion criteria were admitted to the Department of Burns of the First Affiliated Hospital of Nanchang University. Based on the pregnancy period when patients suffered burns, the 35 patients were divided into early pregnancy group with 18 patients (aged (26±4) years, with 8 (4, 11) weeks of gestation), middle pregnancy group with 10 patients (aged (26±3) years, with 21 (14, 27) weeks of gestation), and late pregnancy group with 7 patients (aged (30±5) years, with 32 (29, 35) weeks of gestation). All the patients received treatment including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements. The burn-related complications during the treatment, maternal outcomes, fetal outcomes, fetal delivery mode, gestational weeks at delivery, and newborn weight of patients in the 3 groups were recorded. Data were statistically analyzed with one-way analysis of variance, Kruskal-Wallis test, and Fisher's exact probability test. Results: During the treatment, there were 4, 4, and 2 patients who suffered wound infections and 1, 3, and 2 patients who developed shock symptoms, respectively, in early pregnancy group, middle pregnancy group, and late pregnancy group. There were no statistically significant differences in them among the 3 groups (P>0.05). One patient in late pregnancy group developed into multiple organ dysfunction syndrome after debridement. At last, all the pregnant women survived, and no statistically significant difference existed among the 3 groups (P>0.05). In early pregnancy group, middle pregnancy group, and late pregnancy group, the survived fetus cases were 9, 8, and 6, respectively, and the differences between them were not statistically significant (P>0.05). Variables including stillbirth and full-term birth were close in patients in the 3 groups (P>0.05), while the preterm birth and miscarriage in patients in the 3 groups were statistically different (P<0.05 or P<0.01), with the early pregnancy group having the most miscarriage cases and the fewest preterm birth cases. There were no statistically significant differences in fetal delivery mode, gestational weeks at delivery, and newborn weight among the patients with survived fetus in 3 groups (P>0.05). Conclusions: For patients suffering burns during early, middle, and late pregnancy, superior rates of maternal and fetal survival can be achieved after timely and adequate treatments including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements.

武汉市作为新型冠状病毒肺炎疫情重灾区,新型冠状病毒肺炎患者数量自始至终占到全国的绝大多数,对本地医疗系统形成严峻挑战,尤其是对普通疾病治疗造成了巨大冲击.本文介绍了疫情暴发以来的战时状态下,武汉大学同仁医院暨武汉市第三医院烧伤科在医疗处置、感染防控、人力资源管理、工作模式转换、医务人员人性化关怀等方面采取的管理举措,以期对疫情期间各地烧伤科的临床工作提供参考与借鉴.

新型冠状病毒肺炎(新冠肺炎)的传染源主要是新型冠状病毒感染患者及无症状感染者 [1-3],主要传播途径为呼吸道飞沫传播和接触传播,也存在气溶胶传播的可能;人群普遍易感;潜伏期一般1～14 d,多为3～7 d;早期一般表现为发热(体温≥37.3 ℃)、乏力、干咳、气促等急性呼吸道感染症状.武汉市医疗体系在新冠肺炎爆发后受到了严重的影响,尤其是对于其他非新冠肺炎疾病的诊疗形成了严峻的挑战.武汉市第三医院烧伤科是武汉市唯一一家拥有烧伤专科的三级甲等医院,开放床位达155张,平时的日门诊人次达200～300人,患者来源广泛,人员流动性大,而烧伤尤其是小儿烧伤常伴发热,情况复杂.我科根据国家最新发布的新冠肺炎诊疗方案及国内外文献报道,结合我院实际情况,采取了一系列疫情防控措施,效果良好,报告如下.

Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.

Hydroxyethyl cellulose sulfate (HECS) was synthesized by sulfation of hydroxyethyl cellulose with N(SO3Na)3, which was manufactured by reaction of sodium bisulfite and sodium nitrite. Barium sulfate nephelometry and light scattering method were used to determine degrees of substitution (DSs) and molecular weights (Mws), respectively. Sulfate products with DS values from 0.26 to 1.88 and Mw in the range of 12.1–54.8 kDa were obtained at temperatures from 30°C to 80°C. Furthermore, the anticoagulant activity of HECS with different DSs, concentrations, and Mws was studied. Clotting assays revealed that the introduction of sulfate groups into hydroxyethyl cellulose could improve its anticoagulant activity.

Tissue engineering is aiming to build an artificial environment or biological scaffold material that imitates the living environment of cells in the body. In this work, carboxymethyl cellulose sulfates were prepared by reacting carboxymethyl cellulose with N(SO3Na)3 which was synthesized by sodium bisulfite and sodium nitrite in aqueous solution. The reaction conditions affected the degree of substitution (DS) were measured by the barium sulfate nephelometry method. And the anticoagulant activity of carboxymethyl cellulose sulfates with different DS, concentration and molecular weights were investigated by the activated partial thromboplastin time (APTT), thrombin time (TT) and prothrombin time (PT). In addition, the effect of carboxymethyl cellulose sulfates on wound healing had been evaluated by the rate of wound healing and the histological examinations. The results indicated that the introduction of sulfate groups into the carboxymethyl cellulose sulfates improved its anticoagulant activity, and the wound dressings treated with carboxymethyl cellulose sulfates obviously promoted wound healing.

Objective: The aim of this study was to evaluate the roles of podocalyxin (PCX) and connective tissue growth factor (CTGF) in spontaneously hypertensive rats. Methods: Spontaneously hypertensive rats (SHR) and normotensive control Wistar-Kyoto (WKY) rats were divided into groups referred to as SHR 12W, SHR 24W, WKY 12W and WKY 24W. Systolic blood pressure and 24-hour total uric protein were measured every two weeks in the respective groups. CTGF, PCX, alpha-smooth muscle actin (alpha-SMA) and collagen-III were evaluated via immunohistochemical staining. In addition, CTGF, PCX, and alpha-SMA gene expression levels were determined by analyzing mRNA levels. Results: More kidney lesions occurred alongside foot processes effacement in SHR 24W rats than in SHR 12W rats. In SHR 12W rats, blood pressure and 24-hour total uric protein level were elevated and continued to increase thereafter. In the SHR 12W and SHR 24W groups, the expression of CTGF, alpha-SMA and collagen-III was significantly increased. Immunohistochemical staining showed that PCX expression was significantly reduced in the SHR group and CTGF expression was increased. A significant decrease in PCX mRNA and an increase in CTGF mRNA were observed in SHR 24W rats relative to SHR 12W rats. Conclusion: Both the overexpression of CTGF and the loss of podocalyxin reflect renal damage in spontaneously hypertensive rats. CTGF and PCX may be involved in the mechanisms of podocyte injury and apoptosis induced by hypertension.

有研究证实高血压肾小球硬化患者血浆和尿液中的结缔组织生长因子(CTGF)水平升高[1],且与蛋白尿、肾纤维化相关.足细胞是最易受损的细胞,当足细胞减少10％～ 20％时肾小球硬化开始发生[2].CTGF和足细胞标志蛋白(Podocalyxin,PCX)在高血压肾脏的表达情况,及其与肾脏纤维化、足细胞损伤的关系尚未完全明了.我们观察了自发性高血压大鼠(SHR)肾脏CTGF和PCX的表达,拟探讨CTGF在高血压肾纤维化及足细胞损伤中的作用.

OBJECTIVE To investigate the clinical manifestation, diagnosis, and treatment of patients with Marjolin's ulcers. METHODS The clinical materials of 21 patients with Marjolin's ulcers hospitalized from January 2007 to January 2013 were retrospectively analyzed, including age, gender, injury causes, duration time of primary disease in developing Marjolin's ulcer, duration of ulcer, lesion site, ulcer area, symptoms and signs of ulcer region, bacterial culture results before operation, histopathological type, grade of carcinoma cell differentiation, depth of invasion, treatment, and outcome. RESULTS (1) The age of 21 patients at the time of diagnosis of Marjolin's ulcers was 19-74 (47 ± 13) years, and the ratio of male to female was nearly 0.9:1.0. (2) The main primary lesions were flame burns and high temperature liquid scald, respectively occurred in 12 cases (57.1%) and 7 cases (33.3%). The time for development of Marjolin's ulcers from primary injury was 10-56 (40 ± 14) years. (3) Ulceration on top of scar lasted for longer than one year in 12 patients (57.1%). (4) Lesion site was mainly located in the limbs in 13 patients (61.9%), and on head and face in 6 patients (28.6%), respectively. (5) Ulcer area ranged 0.25-74.25 (39 ± 25) cm(2). Foul excretion, bleeding, intensified pain, and gradual enlargement of ulceration were observed in the lesion of most patients. (6) Bacterial culture of wound excretion before operation showed positive results in 16 patients (76.2%). RESULTS of bacterial culture of blood were negative in all patients. (7) Pathological examination revealed squamous cell carcinoma in 20 cases and basal cell carcinoma in 1 case, and mostly of high or medium differentiation. Cancer cells in nearly 40% patients had invaded the subcutaneous tissue or deeper area. (8) All patients were treated by surgery, among them autologous skin grafting was done after excision of lesion in 11 patients, and in 5 patients the defects were closed with skin flaps after excision of lesion, and in 5 patients limbs harboring the lesion were amputated. Twelve patients (57.1%) received postoperative rehabilitation treatment. Two patients with pulmonary metastasis received chemotherapy. (9) Most of the flaps and skin grafts survived well after surgery, and a few cases with failure of skin grafting or transplantation of flaps underwent skin grafts again. Patients were followed up for 6 months to 5 years, in 4 patients recurrence occurred after surgery, and 2 of them died. The other patients survived without recurrence. CONCLUSIONS Squamous cell carcinoma was the most common pathological type of Marjolin's ulcer admitted to our unit. A recurrent ulcer with long course should be considered as Marjolin's ulcer, and it should be scrutinized pathologically. Currently, surgery remains the optimal treatment for Marjolin's ulcer. Regular follow-up should be carried out after resection of the lesion to detect carcinoma recurrence and metastasis.

<正>高血压是以血压升高为首要特征的全身代谢性疾病,世界各国的患病率高达10%20%,并可导致脑血管、心脏、肾脏损害,是危害人类健康的主要疾病之一。血压升高使肾内血管损伤,早期肾脏损害促进高血压的发展,造成肾脏损伤和血压调节失调并形成恶性循环。目前中国高血压患病人数已超过2亿,因高

Objective: To explore the roles of CXCR3 in the pathogenesis of chronic obstructive pulmonary disease (COPD) and the relationship with the airflow limitation in COPD patients. Methods: Thirty patients with COPD during acute exacerbation (AECOPD), 30 patients with COPD stable period, and 30 normal subjects (control group) were chosen. The T-lymphocyte subset (CD4+, CD8+) of peripheral blood was measured by flow cytometry. Expression of CXCR3 and interferon-γ induced protein-10 (CXCL10) in the PBMCs at protein levels were detected by ELISA. Results: Flow cytometry indicated that CD8+ T cells in peripheral blood of the patients with AECOPD were significantly increased as compared with those of the patients with COPD stable period and the control group (P<0.05).While CD8+ T cells in the patients with COPD stable period was significantly increased as compared to the control group (P<0.05). At the protein level, there were significantly higher levels of CXCR3 and CXCL10 on the PBMCs of the patients with AECOPD as compared to the patients with COPD stable period and the control group (P<0.05). The expression of CXCR3 in the control group were significant lower than that in the patients with COPD stable period (P<0.05). The level of CXCR3 and CXCL10 showed a positive correlation with the level of FEV1/FEV% and FEVl% predicted data (P<0.05). Conclusion: CXCR3 and CXCL10 participate in the occurrence and development of COPD, and correlate positively to the degree of airflow limitation in COPD patients.

目的 探讨高血压患者外周血Toll受体4(Toll-like receptor 4,TLR4)、血清胱抑素C(Cystatin C,Cys-C)的表达水平及其作用和意义.方法 用流式细胞仪检测单纯高血压、高血压肾损害组患者及对照组外周血中单核细胞、中性粒细胞和淋巴细胞的TLR4表达率,并分析血清Cys-C、尿素氮(BUN)、血肌酐(SCr)、24 h尿蛋白等各项生化指标,比较各组间各项指标和水平的差异性及相关性.结果 高血压肾损害组的单核细胞及中性粒细胞表面TLR4表达率高于单纯高血压组[(54.71±10.57)]比(34.26±5.37)](P<0.01),[(25.89±13.76)比(19.23±12.49)](P<0.05);单纯高血压组单核细胞及中性粒细胞表面TLR4表达率高于对照组[(34.26±5.37)比(26.39±8.31)](P<0.01);[(19.23±12.49)比(7.67±7.43)](P<0.01),差异有统计学意义;3组淋巴细胞TLR4几乎无表达,无统计学差异(P>0.05).高血压肾损害组血清Cys-C均高于单纯高血压组(P<0.01),单纯高血压组显著高于对照组.单核细胞和中性粒细胞TLR4在高血压肾损害组的表达与Cys-C、SCr及24 h尿蛋白的值呈明显正相关;单纯高血压组单核细胞和中性粒细胞TLR4与Cys-C呈明显正相关,二者均与24 h尿蛋白和SCr无明显相关性(P>0.05).结论 TLR4在高血压和高血压肾损害患者的单核细胞和中性粒细胞中表达增高,同时Cys-C量升高,提示TLR4、Cys-C可能参与高血压的病理生理机制,介导高血压及靶器官损害.

目的 探讨CXC趋化因子受体3(CXCR3)在慢性阻塞性肺疾病(COPD)发病机制中的作用及临床意义.方法 选择COPD急性加重期、稳定期患者和对照组各30例,采用流式细胞术检测外周血单个核细胞中T细胞亚群CD8+T细胞和CD4+T细胞数,实时荧光定量聚合酶链反应检测CXCR3、干扰素-γ(IFN-γ)、IL-4和干扰素-γ诱导蛋白-10( CXCL10) mRNA的表达.结果 流式细胞术检测结果显示,COPD急性加重期患者PMBCs中CD8+T细胞数较COPD稳定期组及对照组明显增高(P＜0.05)；且COPD稳定期组较对照组明显升高(P＜0.05).在mRNA水平,与COPD急性加重期组相比,COPD稳定期组和对照组PMBCs中CXCR3、CXCL10和IFN-γ的表达水平均明显降低(P＜0.05).与对照组相比,COPD稳定期组PMBCs中CXCR3、CXCL10和IFN-γmRNA的表达水平显著上调(P＜0.05).三组间IL-4 mRNA的表达比较差异无统计学意义(P＞0.05).结论 CXCR3可通过募集CD8+T细胞及促进IFN-γ和CXCL10等细胞因子的释放而启动COPD急性加重期的炎症级联反应.因此,CXCR3可作为治疗COPD肺部炎症的新目标.

OBJECTIVE To study the effect of biological protective dressing made from porcine peritoneum in covering wounds with microskin grafts. METHODS Twenty New Zealand rabbits were divided into ten couples according to the random number table. Rabbits in each couple underwent surgery at the same time. A piece of full-thickness skin of 5 cm in diameter was removed symmetrically from the left and right sides of the back of each rabbit, thus forming two wounds with full-thickness skin defect. One fifth of one piece of skin of one rabbit was cut into tiny pieces of 0.2-0.5 mm in size (microskin). Then the microskin pieces were spread on the two wounds of the donor rabbit with the microskin/wound area ratio 1:10. The two wounds of each rabbit covered with microskin were divided into two groups according to the random number table. One wound was covered with biological protective dressing prepared with porcine peritoneum as experiment group, and the other was covered with the rest allograft in full size obtained from the other rabbit of each couple as control group. The general condition of wound was observed at post operation week (POW) 1-4. Wound healing rate was calculated at POW 3 and 4. Wound healing time was recorded. Specimens were harvested from wounds for histological observation at POW 1-4. Data were processed with paired t test. RESULTS (1) At POW 1, the biological protective dressings were found to attach firmly to the wounds in experiment group without obvious inflammatory response; the allografts survived well on the wounds in control group. At POW 2, the coverings attached well to the wounds of both groups, but became drier and darker as compared with those at POW 1. At POW 3, some wounds of the two groups healed when the coverings desiccated and separated. At POW 4, all the wounds of both groups healed without obvious difference in appearance. (2) The wound healing rates of the experiment and control groups were respectively (92.8 ± 6.2)% and (91.3 ± 7.3)% (t = 0.54, P > 0.05) at POW 3 and (98.1 ± 2.3)% and (97.0 ± 4.6)% (t = 0.38, P > 0.05) at POW 4. (3) The wound healing time was (25.0 ± 3.9) d in experiment group and (24.8 ± 2.3) d in control group. The difference between them was not statistically significant (t = 0.82, P > 0.05). (4) Histological observation showed that wounds of the two groups were all infiltrated by inflammatory cells, and new blood vessels were observed at POW 1 and 2. The survived microskin proliferated under the coverings. At POW 3 and 4, the coverings on the wounds of two groups were gradually degenerated and became necrotic and separated from the wound beds, while the wounds underneath were re-epithelialized. CONCLUSIONS The effect of biological protective dressing in covering wounds grafted with microskin is as good as that of the allograft, as they both help the auto-microskin proliferate and repair the wound. It could be considered to be new biological material for clinical application.

<正>趋化因子(chemokines)是一类能够与粒细胞表面表达的特异性受体相结合的分泌性小分子蛋白。已发现的人类趋化因子有50余种,根据残余半胱氨酸的位置,趋化因子分为C、CC、CXC及CX3C四型,其受体对应为CR、CCR、CXCR、CX3CR。趋化因子与其受体的特异性结合后除了参与细胞的生长发育、分化、凋亡等多种生理功能;还在多种疾病的病理过程中发挥作