Biological scaffold as potential platforms for stem cells:Current development and applications in wound healing

Wound repair is a complex challenge for both clinical practitioners and researchers.Conventional approaches for wound repair have several limitations.Stem cell-based therapy has emerged as a novel strategy to address this issue,exhibiting significant potential for enhancing wound healing rates,improving wound quality,and promoting skin regeneration.However,the use of stem cells in skin regeneration presents several challenges.Recently,stem cells and biomaterials have been identified as crucial components of the wound-healing process.Combination therapy involving the development of biocompatible scaffolds,accompanying cells,multiple biological factors,and structures resembling the natural extracellular matrix(ECM)has gained considerable attention.Biological scaffolds encompass a range of biomaterials that serve as platforms for seeding stem cells,providing them with an environment conducive to growth,similar to that of the ECM.These scaffolds facilitate the delivery and application of stem cells for tissue regeneration and wound healing.This article provides a comprehensive review of the current developments and applications of biological scaffolds for stem cells in wound healing,emphasizing their capacity to facilitate stem cell adhesion,proliferation,differentiation,and paracrine functions.Additionally,we identify the pivotal characteristics of the scaffolds that contribute to enhanced cellular activity.

Adipose-derived stem cells in diabetic foot care:Bridging clinical trials and practical application

Diabetic foot ulcers(DFUs)pose a critical medical challenge,significantly impairing the quality of life of patients.Adipose-derived stem cells(ADSCs)have been identified as a promising therapeutic approach for improving wound healing in DFUs.Despite extensive exploration of the mechanical aspects of ADSC therapy against DFU,its clinical applications remain elusive.In this review,we aimed to bridge this gap by evaluating the use and advancements of ADSCs in the clinical management of DFUs.The review begins with a discussion of the classification and clinical management of diabetic foot conditions.It then discusses the current landscape of clinical trials,focusing on their geographic distribution,reported efficacy,safety profiles,treatment timing,administration techniques,and dosing considerations.Finally,the review discusses the preclinical strategies to enhance ADSC efficacy.This review shows that many trials exhibit biases in study design,unclear inclusion criteria,and intervention protocols.In conclusion,this review underscores the potential of ADSCs in DFU treatment and emphasizes the critical need for further research and refinement of therapeutic approaches,with a focus on improving the quality of future clinical trials to enhance treatment outcomes and advance the field of diabetic wound care.

Application and prospect of adipose stem cell transplantation in treating lymphedema

BACKGROUND Lymphedema is a chronic,debilitating and incurable disease that affects 0.13%-2%of the global population.Emerging evidence indicates that adipose-derived stem cells(ADSCs)might serve as suitable seed cells for lymphatic tissue engineering and lymphedema therapy.AIM To summarize applications of ADSCs for treating lymphedema in both animal studies and clinical trials.METHODS A systematic search was performed on four databases-PubMed,Clinicaltrials.gov,the evidence-based Cochrane Library,and OVID-using the following search string:(“lymphedema”or“lymphoedema”or“lymphangiogenesis”)and(“adipose-derived stem cells”or“adipose-derived stromal cells”or“adipose-derived regenerative cells”).A manual search was performed by skimming the references of relevant studies.Animal studies and clinical trials using adipose-derived cells for the treatment of any kind of lymphedema were included.RESULTS A total of eight research articles published before November 2019 were included for this analysis.Five articles focused on animal studies and another three focused on clinical trials.ADSC transplantation therapy was demonstrated to be effective against lymphedema in all studies.The animal studies found that coadministration of ADSCs and controlled-release vascular endothelial growth factor-C or platelet-rich plasma could improve the effectiveness of ADSC therapy.Three sequential clinical trials were conducted on breast cancer-related lymphedema patients,and all showed favorable results.CONCLUSION ADSC-based therapy is a promising option for treating lymphedema.Large-scale,multicenter randomized controlled trials are needed to develop more effective and durable therapeutic strategies.

Expander implantation for correction of high-riding nipple with enlarged nipple-areola complex using revision mastopexy: A case report

BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged areola.CASE SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged areola.Expanders were used and multi-stage techniques were performed.After one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast contour.CONCLUSION The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.

Application of adipose-derived stem cells in treating fibrosis

Fibrosis is the hyperactivation of fibroblasts that results in excessive accumulation of extracellular matrix,which is involved in numerous pathological changes and diseases.Adipose-derived stem cells(ASCs)are promising seed cells for regenerative medicine due to their bountiful source,low immunogenicity and lack of ethical issues.Their anti-fibrosis,immunomodulation,angiogenesis and other therapeutic effects have made them suitable for treating fibrosis-related diseases.Here,we review the literature on ASCs treating fibrosis,elaborate and discuss their mechanisms of action,changes in disease environment,ways to enhance therapeutic effects,as well as current preclinical and clinical studies,in order to provide a general picture of ASCs treating fibrotic diseases.

Chinese medical students’interest in COVID-19 pandemic

BACKGROUND The outbreak of coronavirus disease 2019(COVID-19)happened in early December and it has affected China in more ways than one.The societal response to the pandemic restricted medical students to their homes.Although students cannot learn about COVID-19 through clinical practice,they can still pay attention to news of COVID-19 through various channels.Although,as suggested by previous studies,some medical students have already volunteered to serve during the COVID-19 pandemic,the overall willingness of Chinese medical students to volunteer for such has not been systematically examined.AIM To study Chinese medical students’interest in the relevant knowledge on COVID-19 and what roles they want to play in the pandemic.METHODS Medical students at Peking Union Medical College were surveyed via a webbased questionnaire to obtain data on the extent of interest in the relevant knowledge on COVID-19,attitude towards volunteerism in the pandemic,and career preference.Logistic regression modeling was used to investigate possible factors that could encourage volunteerism among this group in a pandemic.RESULTS A total of 552 medical students responded.Most medical students showed a huge interest in COVID-19.The extent of students’interest in COVID-19 varied among different student-classes(P<0.05).Senior students had higher scores than the other two classes.The number of people who were‘glad to volunteer’in COVID-19 represented 85.6%of the respondents.What these students expressed willingness to undertake involved direct,indirect,and administrative job activities.Logistic regression analysis identified two factors that negatively influenced volunteering in the pandemic:Student-class and hazards of the voluntary job.Factors that positively influenced volunteering were time to watch COVID-19 news,predictable impact on China,and moral responsibility.CONCLUSION More innovative methods can be explored to increase Chinese medical students’interest in reading about the relevant knowledge on COVID-19 and doing voluntary jobs during the pandemic.

Radiation Therapy in Keloids Treatment： History, Strategy,Effectiveness, and Complication

Objective：Radiation therapy combined with surgical excision was considered as one of the most effective treatment plans for keloid lesions.However,there was no unanimity found over present literatures regarding the issue on optimized treatment strategy for keloids.We here provide a comprehensive review over this issue and emphasize on the influencing factors.Data Sources：The data analyzed in this review were searched from articles included in PubMed and EMBASE databases.Study Selection：The original articles and critical reviews discussing the application of radiation therapy in keloids treatment were selected for this review.Results：The application of radiation therapy has transitioned from simple superficial X-ray irradiation to brachytherapy.Furthermore,several factors including radiation type,dose,fraction,interval,and complications were reviewed,and the results revealed that these factors were significant toward clinical outcome at various levels.Conclusions：Both past and present evidence support the idea that combination therapy of radiation and surgical therapy is safe and feasible.However,the optimization of treatment strategy was based on different radiation types and should take dose,fractions,interval,and complications into consideration,which will then decrease the rate of recurrence and increase the level of satisfaction.

Sonographic Assessment of the Terminal Thoracic Duct in Patients with Lymphedema

INTRODUCTIONLymphedema is a chronic, debilitating disorder characterized by abnormal tissue swelling, adipose deposition, tissue fibrosis, and edema resulting from disruption, blockage, or genetic abnormalities of the lymphatic system.

Diagnostic workup of lymphedema

Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedema patients.Early stage lymphedema could be challenging to diagnose.The aim of this review is to provide an objective appraisal of current diagnostic methods,such as lymphoscintigraphy,lympho-fluoroscopies,lymphangiography and etc.focusing on their respective advantages and weaknesses,and hopefully shed some lights on developing a practical diagnosis modality beneficial to early detection and clinical decision making of lymphedema.

Application of a Feedback Journal Club

The first documented journal club was organized in 1875 by William Osler at McGill University, to keep staff informed of medical science in a cost-effective manner. Nowadays, journal club has already become a common form of interactive education in hope to keep medical practitioners up-to-date of current literature, understand research design and statistics, and expand critical appraisal skills. A considerable amount of literatures describing journal clubs in different forms have been published; most were to enhance students＇ critical thinking, research competency,

The radiation therapy in keloids treatment: a comprehensive review of pathomechanism, damage mechanisms and cellular response

Keloid management has always been frustrating and challenging. The combination therapy of surgical excision and radiation therapy was deemed as the last resort for decades. The authors performed a thorough and comprehensive review over the mechanisms on how radiation therapy damages the keloid cells. The keloid cells' cellular response towards damage induced by irradiation was also studied based on original and current literatures. Mechanisms of damage generated by radiation therapy on keloid cells remained partially understood. However, direct damage was identified playing dominant role, in contrast to damage involved cancer cell apoptosis. Moreover, the p53 pathway and some inflammatory factors like interleukin-6 were believed to function in cellular response to irradiation. However, the transforming growth factor beta, which was the major dysregulated pathway involved in pathogenesis of keloid formation showed no apparent correlation with cellular response to irradiation damage. These pathways could partially explain radiation resistance in some refractory keloid lesions. The scientific basis and experimental proof in this field was still inadequate, which drove us to find more evidence to identify the key regulator response to damage engendered by radiation therapy. Further pathway identification may benefit the drug development to prevent keloid recurrence.