背景:生长激素具有免疫调节、促进细胞增殖及蛋白合成等生理作用,已被证实可以促进急慢性创面愈合.目的:构建过表达生长激素的脂肪干细胞系(生长激素-脂肪干细胞),并探究其对成纤维细胞增殖迁移能力的影响及其分子机制.方法:①体外分离并鉴定脂肪干细胞;②构建生长激素过表达慢病毒,将脂肪干细胞分为生长激素组、空载组、对照组,以上3组分别转染生长激素过表达慢病毒、空载慢病毒或不进行传染;③RT-qPCR、Western blot、ELISA检测各组细胞内及上清中生长激素的mRNA和蛋白表达、ERK1/2通路相关基因的表达情况;④划痕实验和Transwell实验、MTS实验检测生长激素组和空载组细胞对成纤维细胞的迁移和增殖能力的影响、RT-qPCR检测生长激素-脂肪干细胞与成纤维细胞共培养后成纤维细胞内相关基因的表达变化;⑤ERK抑制剂抑制生长激素组细胞后,观察其与成纤维细胞共培养后成纤维细胞内相关基因的表达变化.结果 与结论:①分离并鉴定脂肪干细胞,成功构建生长激素-脂肪干细胞系;②生长激素组细胞内生长激素的mRNA和蛋白表达较空载组和对照组显著升高(P<0.01),且上清中生长激素浓度更高;生长激素组细胞内ERK1/2及p-ERK1/2蛋白表达上调;③生长激素组较空载组促成纤维细胞迁移和增殖能力增强(P<0.05);④生长激素-脂肪干细胞与成纤维细胞共培养后成纤维细胞内基质金属蛋白酶2基因表达下调,Ⅰ型胶原蛋白基因表达上调,Ⅲ型胶原蛋白基因表达无显著变化;⑤抑制生长激素-脂肪干细胞内ERK蛋白后,成纤维细胞内上述基因mRNA表达差异消失;⑥结果表明,慢病毒转染法构建过表达生长激素的脂肪干细胞效率较高,且该细胞可持续分泌生长激素并促进成纤维细胞增殖迁移,该生理作用可能与上调细胞内ERK1/2信号通路有关.

Acute and chronic wounds seriously threaten patients' life health and quality of life, therefore, wound repair has become a hot topic of research for scholars at home and abroad in recent years. With the development of material science and tissue engineering, more and more biomaterials prepared from natural ingredients were used in basic research and clinical treatment of wound repair. Such biomaterials can be used as templates for wound tissue regeneration to induce autologous cell adhesion and migration, and promote the deposition of extracellular matrix, which have broad clinical application prospects. This paper reviews the characteristics and application advance of natural biomaterials which are popular in the field of wound repair, aiming to provide ideas for the research and development of new wound dressing and tissue engineering skin.

Inflammation is generally considered as a pathological process, and the occurrence of multi-organ inflammatory diseases is usually accompanied by an inflammatory response. Persistent inflammation can eventually lead to organ dysfunction. In recent years, the study of mesenchymal stem cell-derived exosomes has found its unique anti-inflammatory effect, which provides a new idea for the treatment of multi-organ inflammatory diseases. This article reviews the effect of mesenchymal stem cell exosomes on multi-organ inflammatory diseases.

Objective:To investigate the clinical effects of ultra-pulsed fractional carbon dioxide laser (UFCL) in the treatment of mild to moderate microstomia after burns.Methods:A retrospective observational study was conducted on 19 patients with mild to moderate microstomia after burns who were admitted to Inner Mongolia Baogang Hospital from January 2018 to January 2022, including 15 males and 4 females aged (35±14) years. Patients had an average course of 71 d of microstomia, with 8 cases of moderate microstomia and 11 cases of mild microstomia. All the patients received UFCL treatment every 2-3 months until the microstomia was corrected or the treatment bottleneck was reached. The times of UFCL treatment for patients and the time interval from the last treatment to the last follow-up were recorded. Before the first treatment and at the last follow-up, the opening degree of mouth (finger measurement method), oral gap width, and the distance between the upper and lower incisors during mouth opening were recorded. Before the first treatment and at the last treatment, the new Vancouver scar scale (VSS) was used to evaluate the scar. At the last follow-up, the degree of satisfaction was evaluated by the Likert 5 scale by the patients themselves, and the satisfaction ratio was calculated; the adverse reactions such as pigmentation, blisters, infection, and persistent erythema in the treatment area were counted. Data were statistically analyzed with Mann-Whitney rank sum test or paired sample t test. Results:Patients received UFCL treatment of 3 (2, 6) times. The interval from the last treatment to the last follow-up was 26 months at most and 4 months at least. At the last follow-up, the opening degree of mouth of patients was significantly improved than that before treatment ( Z=4.68, P<0.01). At the last follow-up, the oral gap width of patients was (35±6) mm, and the distance between upper and lower incisors during mouth opening was (3.2±0.4) cm, which was significantly improved compared with those before treatment (with t values of 10.73 and 18.97, respectively, P<0.01). The VSS score after the last treatment was 4.1±1.6, which was significantly better than that before treatment ( t=22.96, P<0.01). At the last follow-up, the satisfaction ratio of patients with treatment was 18/19, and no pigmentation, blisters, infection, persistent erythema, and other adverse reactions of all patients in the treatment area occurred, however, one of the patients reported that the disease recurred about half a year after treatment. Conclusions:UFCL is an effective method for treating mild to moderate microstomia after burns, with which patients are highly satisfied, and it is worth of further study and promotion.

Wound is normal skin tissue damage caused by physical, chemical, pathogenic microorganisms or local blood circulation obstacle. Wound repair is an increasingly important global problem, and dressings play an important role in wound repair. Selecting appropriate dressings according to the specific conditions of the wound can prevent wound infection and improve the comfort of patients in the treatment process. However, there are various types and characteristics of dressings in clinical practice, so how to choose dressings is a difficult problem faced by clinicians. This paper reviews the characteristics and indications of various new wound dressings, aiming to provide reference for clinicians to select appropriate wound dressings.

Burns are a common traumatic injuries with considerable morbidity and mortality rates. Post-burn intestinal injuries are closely related to oxidative stress and inflammatory response. The aim of the current study was to investigate the combined effect of sodium butyrate (NaB) and probiotics (PROB) on severe burn-induced oxidative stress and inflammatory response and the underlying mechanism of action. Sprague-Dawley rats with severe burns were treated with NaB with or without PROB. Pathomorphology of skin and small intestine tissue was observed using hematoxylin and eosin staining and severe burn-induced apoptosis in small intestine tissue was examined via terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. The release of factors related to inflammation was quantified using ELISA kits and qRT-PCR and levels of oxidative stress markers were evaluated using biochemical assays. Furthermore, mitochondrial morphological changes in small intestinal epithelial cells were observed using transmission electron microscopy. In addition, the underlying mechanism associated with the combined effect of NaB and PROB on severe burn-induced oxidative stress and inflammatory response was investigated using western blotting. The combination of NaB and PROB exerted protective effects against severe burn-induced intestinal barrier injury by reducing the levels of diamine oxidase and intestinal fatty acid binding protein. Combined NaB and PROB treatment inhibited severe burn-induced oxidative stress by increasing superoxide dismutase levels and decreasing those of malondialdehyde and myeloperoxidase levels. Severe burn-induced inflammation was suppressed by combined NaB and PROB administration, as demonstrated by the decreased mRNA expression of tumor necrosis factor-α, interleukin-6, interleukin-1β, and high mobility group box-1 in the small intestine. In addition, this study showed that combined NaB and PROB administration increased nuclear factor-erythroid 2-related factor 2 (Nrf2) protein expression and decreased the phosphorylation of nuclear factor (NF)-κB and extracellular signal-regulated kinase 1/2 (ERK 1/2). In conclusion, our findings indicate that combined NaB and PROB treatment may inhibit severe burn-induced inflammation and oxidative stress in the small intestine by regulating HMGB1/NF-κB and ERK1/2/Nrf2 signaling, thereby providing a new therapeutic strategy for intestinal injury induced by severe burn.

目的:探究负压封闭引流(vacuum sealing drainage,VSD)联合富血小板血浆(platelet-rich plasma,PRP)治疗难愈性创面的有效性及安全性.方法:回顾性分析我院烧伤科2017年1月至2019年12月收治的59例难愈性创面患者的病历资料,根据治疗方法的差异,分为试验组和对照组,试验组27例,给予VSD联合PRP综合治疗;对照组32例,仅给予VSD治疗.记录两组患者的基本资料、创面愈合率、愈合时间、VSD更换次数、二期手术数.结果 试验组患者在3、4周时创面愈合率及平均愈合时间优于对照组,其差异有统计学意义(P<0.05);试验组患者VSD的平均更换次数及二期手术率优于对照组,差异均有统计学意义(P<0.05).结论:在治疗难愈性创面时,联合应用VSD与PRP可以有效改善创面的恢复情况,提高愈合率、缩短愈合时间,并减少行VSD的次数及二期手术的可能.