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Recent investigations clearly indicate that certain amino acids previously considered as non-essential are conditionally indispensable substrates in various diseased states: Hypermetabolic and hypercatabolic situations are accompanied by a marked depression of the intracellular glutamine pool. This depletion of glutamine stores leads to severe complications, such as infection, poor wound healing, impaired immunity, increased intestinal permeability, and finally multiple organ failure.
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缺锌大鼠烫伤后补锌对血清锌、组织锌、碱性磷酸酶与生长激素影响
目的观察缺锌大鼠烫伤后补锌对体内锌、含锌酶、激素的影响.方法用μg/g低锌饲料喂养大鼠1周,造成缺锌状态后深Ⅱ°烫伤15%.分三组进食不同含锌量饲料,L组(缺锌组)、M(低补锌组)、H组(高补锌组),伤后1、3、7天,分别活杀各组大鼠,留取血、组织标本.结果血清锌,L、M组下降,H组上升.肝脏锌,各组均呈上升趋势,以H组明显.骨骼锌,L组进行性下降,M组缓慢上升,H组上升明显.烫伤皮肤锌,各组均呈上升趋势,以H组明显.AKP,L组明显降低,H组高于L、M组.GH,L、M组烫伤后第一天下降,而后各组逐渐升高,以H组明显.结论烫伤后机体处于低锌状态,补锌可以纠正血清锌降低,增加肝脏、骨骼、皮肤含锌量,特别是皮肤锌含量增加,有利于创面愈合;增加酶活性,提高GH水平,这可能是锌促进创面愈合的机理之一.
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Ala-Gln和BCAA对创伤大鼠静脉营养支持作用的实验研究
目的观察富含丙氨酰谷氨酰胺(Ala-Gln)和支链氨基酸(BCAA)的氨基酸注射液对创伤大鼠的静脉营养支持效果.方法Wistar大鼠40只,行创伤和中心静脉插管后,随机分为无氮组、正常饲料组、对照组和实验组.测定饲料摄入量、体重、氮平衡、血浆蛋白和氨基酸含量、外周血淋巴细胞转化率、伤口埋植海绵中羟脯氨酸含量、皮肤抗张力强度和小肠粘膜蛋白质及核酸.结果无氮组动物营养状况欠佳,各项指标均较差.实验组动物的血浆谷氨酰胺(Gln)、BCAA含量,外周血淋巴细胞转化率,伤口皮肤抗张力强度和羟脯氨酸含量都显著高于对照组和正常饲料组(P<0.05);实验组和正常饲料组动物第8天氮平衡,小肠粘膜核酸和蛋白质明显高于对照组(P<0.05).结论Gln和BCAA有助于改善创伤后机体的营养及代谢状况,增强免疫功能,促进小肠粘膜细胞增殖.
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Aim: To study the expression of MMP1 and TIMP1 in normal and radiation- combined wound healing and their effects on the healing process. Materials and Methods: A rat model of radiation - combined wound healing was used, and routine light microscopy, electron microscopy, immunohistochemistry, and in situ hybridization were used to detect the expression of MMP1 and TIMP1 during the healing process. Results:The wound healing process was impaired and delayed. In rats receiving 25Gy Gamma ray locally, the irradiated wounds healed 6 days later than non - irradiated controls. The following changes were found in the expression of MMP1 and TIMP1: ( 1 ) In the early inflammatory phase and in the period of granulation tissue formation, MMP1 expression was only slightly if at all affected in the newly - formed epidermis of irradiated wounds when compared with that in controls. Later, the epidermal expression of MMP1 in irradiated wounds was comparatively increased following the delayed healing process. 3 to 14 days after wounding, TIMP1 was weakly positive in proliferating keratinocytes of control group and became negative after epidermal covering, whereas no or only slight epidermal expression was detected in the irradiated group before epidermal covering. (2) The expression of MMP1 and TIMP1 in irradiated group was markedly decreased in fibroblasts, endotheliocytes and macrophages when compared to that in controls. The expression phase was prolonged due to the delayed healing process. Conclusions: It is concluded that the reduced expression of MMP1 and TIMP1 in granulation tissue retards such impertant processes as cell migration and angiogenesis, thus slowing the healing process. The expression of MMP1 in the newly - formed epidermis may help the process of reepithelialization, but in the late healing period, overexpression of MMP1 and decreased expression of TIMP1 in the epidermis may hinder the establishment of basal membrane and scar formation.
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Fetal cutaneous wounds that occur in early gestation heal without scar formation. Although much work has been done to characterize the role of transforming growth factor-β (TGF-β) isoforms and their receptors in wound healing process, their roles in scarless wound repair in early gestation,their functions in human fetal skin development and structural and functional maintenance are still not well understood. In this study, we explore the expression and distribution characteristics of three TGF-β isoforms, their receptors, i. e.
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Objective: To investigate the mechanism of the effect of Moist Exposed Burn Therapy (MEBT) and Moist Exposed Burn Ointment (MEBO) on the spontaneous repair and healing of superficial third degree burn wound involving fatty layer. Method: A series of skin tissue samples were taken from deep burn wounds of 2 cases. Immunocytochemistry method, biotin avidin DCS system, and indirect immunofluorescence technique were applied. Mouse anti human keratin type 19 monoclonal antibody was used to detect regenerative epidermal stem cells in wound tissues. Results: Epidermal regenerative stem cells emerged at 24 hours post burn, and the number of epidermal regenerative stem cell increased on day 4 post burn. On days 7 and 14 post burn, the number of epidermal stem cells increased to the peak level. On days 21 and 28 post burn, it decreased and disappeared gradually as burn wound progressed to healing. Conclusion: MEBT/MEBO has the effect of promoting the activation and proliferation of epidermal regenerative stem cells in the residual viable tissue of superficial full thickness burn wound, and these stem cells play an unique role in spontaneous wound healing of deep burn.
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Phytochemical screening and wound healing potential of Cuscuta reflexa
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Objective.To explore the expression characteristic of fibronectin gene in hypertrophic scars and diabetic ulcer tissues.Methods.The biopsies from normal skins,hypertrophic scars and diabetic foot ulcers were taken.The technique of quantitative polymerase chain reaction (PCR) was used to evaluate the gene expression of fibronectin in the above biopsies.Results.Fibronectin gene expression was enhanced in hypertrophic scars and decreased in diabetic foot ulcers compared with that in normal skins.Quantitative comparison showed about 2 fold increase of fibronectin mRNA level in hypertrophic scars and about 3 fold decrease of fibronectin mRNA level in diabetic ulcers as compared with that in normal skins.Conclusions.Fibronectin gene expression is influenced by the tissue environment.Different expression and synthesis of fibronectin may cause different outcomes in wound healing.
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第三届全球伤口愈合大会简介
全球伤口愈合大会是世界伤口愈合学会World Union of Wound Healing Societies(简称 WUWHS)的学术大会,是全球伤口治疗和护理领域的高水准的学术会议,代表了世界伤口领域的高专业水平,每4年召开一次.
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无瘢痕愈合的细胞及分子生物学研究进展
胎儿皮肤组织创伤修复后无瘢痕形成,这种现象由Burrington[1](1971)首先发现,并提出"无瘢痕愈合(Fetal Scarless Wound Healing)"的概念.长期以来,对环境因素和内在因素在胎儿伤口无瘢痕愈合中的作用一直存在争议,目前的研究表明,胎儿独特的外环境,如温暖、无菌的羊水环境及组织氧分压较低等不是伤口无瘢痕愈合的关键因素,而伤口组织固有的内在因素比外部环境更重要[2,3].
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合并全身放射损伤伤口表皮再上皮化延迟的机制研究
Objective To investigate the mechanisms of delayed re epithelization in wounds combined with whole body irradiation (WBI) injury.Methods We observed re epithelization in wounds by histological methods and transmission electron microscopy, detected the contents of proliferation cell nuclear antigen (PCNA) protein and mRNA using immunohistochemistry and in situ hybridization (ISH) methods. Results Re epithelization in wounds combined with WBI injury was significantly delayed as compared with simple incision injury, and the contents of PCNA protein and mRNA significantly decreased too. Conclusions WBI injury has direct effect on wound epidermic cells, especially the suppress of epidermic basal cell proliferation, which may be an important reason why wound combined with WBI injury heals more slowly.
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全身放射损伤对伤口早期局部组织P65蛋白表达及伤口液TNF-α和IL-1的含量与活性的影响
Objective To study the effect of total body irradiation on the quantity and activity of P65,TNF α and IL 1 in irradiated rat wounds. Methods Tumor necrosis factor α (TNFα ) and interleukin 1 (IL 1 ) in wound fluids were quantified by ELISA and their biological activities were measured by L929 cell lysis and thymocyte proliferation,respectively. The expression of P65 protein in wounded tissue was determined by western blotting. Results The biological activities of TNF α and IL 1 in wound fluid decreased significantly after irradiation,while their quantities in wound fluids did not decrease significantly.The expression of P65 protein in wounded tissue also did not decrease obviously after irradiation. Conclusion These results suggestted that total body irradiation may inhibit the biological activities of TNF α , IL 1 and nuclear factor B,there may exist negative factors to disturb the protein functions in wound environments.
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早期应用特异性iRNA对防治烧伤患者感染的作用及机理研究
Objective To explore the effect and mechanism of early using specific immune RNA (iRNA) for preventing burn infection.Method 129 patients with serious burn were randomly divided into two groups by double blind method. The control group (n=64) was treated with routine method; The therapeutic group(n= 65) was given specific iRNA in addition to the routine therapy. The incidence of infection in two groups were investigated; Meantime, with the methods of monoclonal antibody (McAb) APAAP, 3H- TdR incorporation and MTT colorimetery, the various immune functions of patients were determined. Result (1) the incidences of wound infection and bacteriemia after burn in the therapeutic group were markedly lower than those of the control group; (2) the therapeutic group was also superior to the control group in the general condition and time of the wound healing; (3) on the l0th day postburn, the various immune founction tested in the therapeutio group have approximately restored to the normal levels, while those in the control group were still in low levels. The difference between the two groups was statistically significant (P<0.01). Conclusion Specific iRNA, which, when used early after burn, can reduce the incidence of postburn infection, and improve immune functions of burned patients.
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肌成纤维细胞在创伤愈合中的生物学活动及表达调控
肌成纤维细胞(mfb)是一组含有平滑肌肌动蛋白的成纤维细胞,它同时具有平滑肌细胞和成纤维细胞的双重特性.mfb通过分泌炎症介质、抗炎因子、趋化因子、生长因子、细胞外基质和蛋白酶,使其在器官的发生、肿瘤的发生、组织器官的炎症、组织损伤的修复、修复后的纤维化中占有重要的地位[1].在皮肤创伤愈合中期部分成纤维细胞会转化为mfb,肌成纤维细胞对创伤愈合的意义及其表达调控目前还不十分清楚.
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无瘢痕愈合分子医学研究进展
无瘢痕愈合(scarless wound healing)的概念于20世纪70年代由Burrington和Roulatt首先提出,用于描述哺乳动物胚胎创伤愈合后不留瘢痕的特殊现象.Longaker等[1]的实验表明无瘢痕愈合是胚胎皮肤固有的特性.近二十年来,学者们对分子水平的研究表明,无瘢痕愈合与胚胎皮肤特异的基因表达及其调节密切相关.笔者就近年来在生长因子、细胞外基质、胚胎皮肤特异表达基因等方面的研究进展综述如下.
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objective: To find a new way to cover full-thickness wounds. Methods: Biobrane(r), an adherent, flexible temporary wound dressing was incubated with cultured human keratinocytes. The cells adhered quickly forming "membrane-celgrafts" (MCG). Some of the grafts were frozen and after thawing viability was verified with a XTT colorimetric assay.MCGs, fresh and cryopreserved, were transplanted on full thickness wounds created on athymic nude mice. Conventional cultured epidermal grafts (CEG) and wounds without cell grafts served as control. Results: MCGs resulted in a differentiated epithelium of human phenotype and immunohistochemistry, immunofluorescence and electronmicroscopy were performed.Compared with CEG-grafted sites a reduced wound contraction was noticed and complete remodelling of the basement membrane zone was found. Conclusion: The efficiency of the easy, uncomplicated production, cryopreservation and use as well as the short culture period could lead to a new approach in the treatment of burn and chronic wounds.
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Increased glycated basic fibroblast growth factor in diabetic skin reduces the cell viability and angiogenesis of human dermal microvascular endothelial cells
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壳聚糖护肤液促进大鼠伤口愈合的研究
目的 探讨壳聚糖护肤液促进伤口愈合的作用.方法 在大鼠背部伤口模型上用药,对壳聚糖护肤液组(A组)、碱性成纤维细胞生长因子组(B组)、生理氯化钠溶液组(C组)进行两两对照,肉眼观察伤口愈合时间,并于伤后3、7、14d,取皮肤修复组织行光镜观察.结果 A组愈合时间为(17.3±1.35)d,B组为(18.2±1.15)d,C组为(24.0±1.37)d.A组与B组的愈合时间差异无统计学意义(P>0.05),A组、B组与C组的愈合时间差异有统计学意义(P<0.05);壳聚糖护肤液在伤口愈合的早期促进毛细血管芽和血管内皮细胞生成,中期促进成纤维细胞和胶原纤维生成,后期使胶原纤维排列有序.结论 壳聚糖护肤液具有较好的促进伤口愈合的作用.
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围手术期治疗对跟骨骨折内固定切口愈合的影响
跟骨骨折是常见的跗骨骨折,占跗骨骨折的60%,占全身骨折的2%,75%为关节内骨折.对于移位的关节内骨折,切复内固定被证实为有效的治疗方法,平均优良率达70%~92%.
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TGF-β亚型在创伤愈合及瘢痕形成中的作用
创伤愈合有两种形式,完全性修复(即再生)和瘢痕性愈合.转化生长因子β (transforming growth factor β,TGF-β)是迄今为止与创伤愈合关系为密切的生长因子,TGF-β至少有6个亚型,各亚型之间有64%~~82%的同源性[1],在成人皮肤组织中,TGF-β1、β2、β3三种异构体均有阳性表达.TGF-β1、β2、β3参与创伤愈合的诸多步骤:炎症反应、促血管新生、成纤维细胞增殖、胶原合成与分解以及新的ECM重建.以往研究大都聚焦于TGF-β亚型对创伤愈合的促进作用,但TGF-β亚型在创伤愈合和瘢痕形成中的具体作用机制尚未明晰,且近年有关TGF-β亚型对创伤愈合和瘢痕形成有负性作用的报道逐渐增多.本文的目的在于系统梳理TGF-β亚型对创伤愈合和瘢痕形成的正反两方面作用,找出存在的疑点与矛盾,展望实现皮肤创伤再生修复的可能研究途径.