Clinical and Magnetic Resonance Image Changes of Platelet-Rich Plasma Therapy in Combination with Human Mesenchymal Stem Cells from Autologous Adipose Tissue for Knee Osteoarthritis Treatment

Objective: To evaluate the efficacy based on clinical symptom and on magnetic resonance image of platelet-rich plasma therapy in combination with mesenchymal stem cells from autologous adipose tissue for knee osteoarthritis treatment. Patients and Method: 30 patients including 26 females and 4 males;correspondingly, 60 knee joints were diagnosed with osteoarthritis with stages II - III of Kellgren and Lawrence, their mean age was 58.63 ± 11.11. All were injected with autologous platelet-rich plasma that was extracted by PRP set, APC 30 PRP PRCEDURE PRAK and autologously extracted mesenchymal stem cells from abdominal adipose tissue using the ADI-25-01 ADIPOSEPRCEDURE PRAK of USA. Results: After 12 months: the pain level according to VAS score at the right knee joint was decreased from 6.0 ± 1.28 before treatment to 1.9 ± 0.3;VAS score at the left knee joint was decreased from 6.43 ± 1.19 to 2.25 ± 0.43. Total Lequene score at right knee joint was decreased from 16.04 ± 1.57 before treatment to 4.31 ± 1.04, at left knee joint was decreased from 17.52 ± 1.74 before treatment to 5.15 ± 1.48. Total WOMAC score at right knee joint was decreased from 55.93 ± 5.56 to 10.37 ± 1.56;at left knee joint was decreased from 53.97 ± 5.57 to 10.07 ± 1.59. There were 86.77% joints with cartilage thickness change and the patellar cartilage thickness was increased from 1.56 ± 0.09 mm before treatment to 1.65 ± 0.09 mm. Conclusion: The treatment of knee osteoarthritis by platelet-rich plasma therapyin combination with mesenchymal stem cells from autologous adipose tissue is effective in reducing pain, improving patient's mobility and walking function, reforming articular cartilage thickness on magnetic resonance image.

Application of platelet-rich plasma with stem cells in bone and periodontal tissue engineering

Presently, there is a high paucity of bone grafts in the United States and worldwide. Regenerating bone is of prime concern due to the current demand of bone grafts and the increasing number of diseases causing bone loss. Autogenous bone is the present gold standard of bone regeneration. However, disadvantages like donor site morbidity and its decreased availability limit its use. Even allografts and synthetic grafting materials have their own limitations. As certain specific stem cells can be directed to differentiate into an osteoblastic lineage in the presence of growth factors(GFs), it makes stem cells the ideal agents for bone regeneration.Furthermore, platelet-rich plasma(PRP), which can be easily isolated from whole blood, is often used for bone regeneration, wound healing and bone defect repair. When stem cells are combined with PRP in the presence of GFs, they are able to promote osteogenesis. This review provides in-depth knowledge regarding the use of stem cells and PRP in vitro, in vivo and their application in clinical studies in the future.

DETECTION AND CLINICAL SIGNIFICANCE OF THROMBOMODULIN IN BOTH PLASMA AND TISSUE EXTRACTS OF CANCER PATIENTS

To study the changes of thrombomodulin(TM) in both plasma and tissue extracts of cancer patients for evaluating its clinical significance. Methods: PlasmaTM levels were measured by enzyme-linked immunosorbent assay (ELISA) in both plasma of 188 cancer patients and 24 cancer tissue extractsincluding their adjacent non-cancer tissues. Results:The plasma TM levels both in cancer patients and in metastasis patients were significantly higher than that in controls [(33.4714.25)mg/L, (41.6816.96)mg/L, vs(20.40 7.22) mg/L,P<0.01]. The plasma TM levels incancer patients after operation decreased obviously thanthat before operation [(18.459.96)mg/L, vs (28.2911.74)mg/L, P<0.01], whereas, the plasma TM levels in patientswith recurrence and metastasis after operation increasedobviously [(34.5012.57)mg/L]. Among the types of cancer,the plasma TM levels in metastasis lung cancers, gastric cancers and pancreatic cancers were significantly higherthan that in non-metastasis respective cancers. Nosignificant differences were found between controls andnon-metastasis cancers including gastric cancers,pancreatic cancers, nasopharyngeal cancers, large intestine cancers and laryngeal cancers (P>0.05). The TM levels incancer tissue extracts were significantly lower than that intheir adjacent non-cancer tissue extracts [(647.71317.51)mg/L vs (1455.63772.22)mg/L, P<0.01]. On the contrary, the plasma TM levels in these cancers were significantly higher than that in controls. Conclusion: The rise of plasma TMlevels in cancer patients was associated with metastasis and diffusion of cancers. The TM levels can be served as ansensitive index for judging progression and metastasis of

Chemical Composition of the Fatty Oil from Fructus Broussonetiae and Its Effects on Rat Plasma Lipids and Adipose Tissue

Context: Broussonetia papyrifera (L.) Vent. (Moraceae), a traditional Chinese medicinal herb, has been extensively applied for many years to treat various diseases. Its fruits (Fructus Broussonetiae) have been commonly used as an important tonic for the treatment of age-related disorders with long history;recent research has proved that it contains 32% to 35% fixed oils. The fixed oil is composed mainly of unsaturated fatty acids, including linoleic acid, methyl palmitate, oleic acid and linoleic acid ester. Objective: To investigate the chemistry of the fatty oil from Fructus Broussonetiae (FOFB) and its effects on plasma lipids. Methods: The chemical composition of FOFB was examined and identified by GC-MS. Thirty male Wistar rats fed diet containing FOFB and cholesterol were studied for 28 days. The effect of dietary FOFB on plasma lipids and adipose tissue was tested. Results: Twelve compounds of FOFB were examined and identified, the major components of fatty oil, 8,11-octadecadienoic acid (83.75%), palmitic acid (10.22%), octadecadienoic acid (2.97%) and 9-octadecenoic acid (1.69%) were found. FOFB significantly exhibited the activities of decreasing the rat adipose tissue weight, triacylglycerol, total cholesterol, and low-density lipoprotein cholesterol (LDL-C) concentrations while the rat body weight remained unchanged. Discussion: FOFB contained a large amount of PUFA which had the effect on reducing plasma lipids and adipose.

Effects of platelet-rich plasma on in vitro proliferation and migration of fibroblasts from human chronic refractory wound granulation tissue

Objective:To observe the effects of platelet-rich plasma(PRP)on in vitro proliferation and migration of fibroblasts from human chronic refractory wound granulation tissue.Methods:Fibroblasts were separated from human chronic refractory wound granulation tissue and then were identified.The obtained fibroblasts were divided into fetal bovine serum(FBS)group,hydrogel group and PRP group,and the three groups were cultured with culture mediums containing FBS,hydrogel and PRP respectively,in order to observe the growth of fibroblasts.The wound scratch assay was used to observe the migration of fibroblasts.Results:PRP group had more fibroblasts than FBS group and hydrogel group since Day 5 of culture,and exhibited greater fibroblast scratch migration area than FBS group on 48 h and 72 h of wound scratch assay(all p<.05).Conclusions:Compared with FBS,human fibroblasts cultured by PRP can more effectively promote the proliferation and migration of fibroblasts.

Silk fibroins modify the atmospheric low temperature plasma-treated poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) film for the application of cardiovascular tissue engineering

Tissue engineered scaffold is one of the hopeful therapies for the patients with organ or tissue damages. The key element for a tissue engineered scaffold material is high biocompatibility. Herein the poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) film was irradiated by the low temperature atmospheric plasma and then coated by the silk fibroins (SF). After plasma treatment, the surface of PHBHHx film became rougher and more hydrophilic than that of original film. The experiment of PHBHHx flushed by phosphate buffer solution (PBS) proves that the coated SF shows stronger immobilization on the plasma-treated film than that on the untreated film. The cell viability assay demonstrates that SF-coated PHBHHx films treated by the plasma significantly supports the proliferation and growth of the human smooth muscle cells (HSMCs). Furthermore, the scanning electron microscopy and hemotoylin and eosin (HE) staining show that HSMCs formed a cell sub-monolayer and secreted a large amount of extracellular matrix (ECM) on the films after one week's culture. The silk fibroins modify the plasma-treated PHBHHx film, providing a material potentially applicable in the cardiovascular tissue engi-neering.

PRP联合曲安奈德局部注射及瘢痕组织瓣修复术治疗瘢痕疙瘩疗效分析

目的:分析富血小板血浆(Platelet-rich plasma,PRP)联合曲安奈德局部注射及瘢痕组织瓣修复术治疗瘢痕疙瘩的美学效果。方法:选取2017年2月-2021年11月遂宁市中心医院医疗美容科收治的瘢痕疙瘩患者85例,遵随机数字表法分为曲安奈德组42例(瘢痕组织瓣修复术联合曲安奈德局部注射)和联用PRP组43例(曲安奈德组基础上联合PRP治疗)。比较两组临床疗效,瘢痕恢复情况,疼痛及瘙痒情况和复发率,记录两组不良反应发生情况。结果:治疗后,联用PRP组治疗总有效率为97.67%,显著高于曲安奈德组的85.71%(P<0.05);治疗后,两组色泽、柔软度、血管及厚度评分均降低(P<0.05),且联用PRP组显著低于曲安奈德组(P<0.05);治疗后,两组疼痛及瘙痒评分均降低(P<0.05),且联用PRP组显著低于曲安奈德组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05);随访1年后,联用PRP组总复发率为2.33%,显著低于曲安奈德组的14.29%(P<0.05)。结论:PRP联合曲安奈德局部注射联合瘢痕组织瓣修复术治疗瘢痕疙瘩疗效确切,能有效促进瘢痕创面恢复,缓解疼痛及瘙痒,降低复发率。

血浆基质在牙髓根尖周病治疗中的应用

血浆基质作为一种自体血液离心产物,具有再生修复的功能,已被广泛应用于口腔颌面部软硬组织再生修复、皮肤美容等领域,并取得了较好的效果。目前,牙髓再生治疗和根尖手术已成为保存牙髓以及保存患牙的主要方法,生物活性材料的应用至关重要,血浆基质作为一种自体生物活性材料,较易获取,可塑性强,具有天然优势。血浆基质可应用于以下情况:①无法刺激根尖出血的根尖孔未闭合年轻恒牙的牙髓血运重建术;②存在骨缺损的根尖屏障术及大面积穿孔髓室底或根侧壁修补术;③大面积根尖病变,伴或不伴随牙周疾病患牙的根尖手术。因血浆基质为自身血液来源制品,使用方面无明显禁忌。虽然已有系统综述表明,相比传统血凝块,血浆基质作为天然再生支架,可有效促进牙髓根尖周病的再生性修复。然而,由于血浆基质的特性受不同制备方式的影响,其适用范围有所差异。此外,目前尚缺乏血浆基质长期的临床研究结果,且组织学证据较难获取,仍然需要大量的体内外研究进一步探索。本文将对不同血浆基质在牙髓再生、根尖手术中的骨组织再生等方面的应用进行阐述,以期为临床医生在适应证选择及预后评估时提供参考。

富血小板血浆与浓缩生长因子修复糖尿病足创面的临床观察

目的:探究富血小板血浆(Platelet rich plasma,PRP)与浓缩生长因子(Concentrated growth factor,CGF)修复糖尿病足创面的临床效果。方法:回顾性分析2017年6月-2022年10月笔者医院收治的90例糖尿病足患者临床资料,按照治疗方法的不同将患者分为CGF组、PRP组和常规治疗组各30例。统计比较三组创面换药次数、愈合时间、细菌培养阳性率、不良反应及治疗总有效率。结果:三组换药次数及创面愈合时间比较均CGF组<PRP组<常规组(P<0.05);治疗1、2周后,三组创面细菌感染阳性率比较,均CGF组<PRP组<常规组(P<0.05)。三组总有效率比较差异有统计学意义(P<0.05);CGF组、PRP组总有效率均高于常规组(P<0.05);CGF组与PRP组总有效率比较差异无统计学意义(P>0.05)。三组均无明显不良反应。结论:CGF和PRP作为血小板活性物质,能够促进创面愈合,发挥抗炎抑菌作用。与PRP相比,CGF更能缩短创面愈合时间,减少换药次数,抑菌效果更好,但两者在治疗总有效率方面效果相当。

MicroRNAs as potential biomarkers for diagnosis of schizophrenia and influence of antipsychotic treatment

Chara cterized by positive symptoms(such as changes in behavior or thoughts,including delusions and hallu cinations),negative symptoms(such as apathy,anhedonia,and social withdrawal),and cognitive impairments,schizophrenia is a chro nic,severe,and disabling mental disorder with late adolescence or early adulthood onset,Antipsychotics are the most commonly used drugs to treat schizophrenia,but those currently in use do not fully reverse all three types of symptoms characte rizing this condition.Schizophrenia is frequently misdiagnosed,resulting in a delay of or inappropriate treatment.Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of schizophrenia.The recent studies reviewed included microRNA profiling in blood-and urine-based materials and nervous tissue mate rials.From the studies that had validated the preliminary findings,potential candidate biomarkers for schizophrenia in adults could be miR-22-3p,-30e-5p,-92a-3p,-148b-5p,-181a-3p,-181a-5p,-181b-5p,-199 b-5p,-137 in whole blood,and miR-130b,-193a-3p in blood plasma.Antipsychotic treatment of schizophrenia patients was found to modulate the expression of certain microRNAs including miR-130b,-193a-3p,-132,-195,-30e,-432 in blood plasma.Further studies are warranted with adolescents and young adults having schizophrenia and consideration should be given to using animal models of the disorder to investigate the effect of suppressing or overexpressing specific microRNAs.

可溶微针负载富血小板裂解液对糖尿病小鼠创面愈合的基础研究

目的采用羧甲基壳聚糖(Carboxymethyl chitosan,CMCS)负载富血小板血浆裂解液(platelet-rich plasma lysate,PL)制备微针,探究PL微针在治疗糖尿病创面领域的应用前景。方法使用CMCS作为基础材料,加入适量聚乙烯基吡咯烷酮K-60(Polyvinylpyrrolidone,PVPK-60)共同制备不同浓度的针体材料,通过考察成针率,形貌特征及力学性能等,确定最佳浓度,并考察PL微针中生长因子活性。制备糖尿病小鼠背部创面,随机分为4组治疗,对照组不做任何处理,PL涂抹组使用PL涂抹,空白微针组使用不含有PL的微针,PL微针组使用含有PL的微针,通过大体观察,H&E染色及免疫组化的检测结果,评价PL微针应用于糖尿病小鼠创面愈合的效果。结果当PVPK60为40 mg/mL时,成针率为100%,阵列完整,针体饱满,针尖锐利。根据力学-位移曲线与砝码压变实验结果显示制备的PL微针具有较好的机械强度。生长因子检测结果显示,PL中血管内皮生长因子(vascular endothelial growth factor,VEGF)含量为(625±35)pg/mL,血小板衍生生长因子-BB(platelet-derived growth factor-BB,PDGF-BB)含量为(18741±1287)pg/mL,制备成针后,VEGF含量为(183±2)pg/mL,PDGF-BB含量为(8049±1157)pg/mL,成针后生长因子浓度虽有所降低,但仍较好地保持了生长因子活性。糖尿病小鼠创面愈合实验结果显示,PL微针组愈合较好,创面愈合率相较于前3组有差异(P<0.01)。H&E染色结果显示PL微针组可见较少的炎细胞浸润和出血点;对照组组织内成纤维细胞,新生毛细血管数量均低于PL涂抹组与PL微针组。免疫组化结果显示PL微针组促炎因子IL-6表达下降,抗炎因子TGF-β表达上升,血管新生指标CD31表达上升,且于其他3组有明显差异(P<0.01)。结论本实验制备的PL微针具有较好的机械性能,能较好地保持生长因子活性,对糖尿病小鼠创面愈合有着积极的作用,为糖尿病创面愈合提供了新思路。

可缓释富血小板血浆生长因子的新型自组装多肽水凝胶制备及性能表征

背景:富血小板血浆水凝胶由于生长因子的突发释放与伤口部位蛋白酶的快速清除,导致生长因子在伤口部位的停留时间较短,近年来研究者关注利用水凝胶材料包封富血小板血浆,以改善富血小板血浆水凝胶的不足。目的:制备自组装多肽-富血小板血浆水凝胶,探究其对富血小板血浆生物活性因子释放的影响。方法:采用固相合成法合成自组装多肽,以D-PBS配制成溶液。将不同体积的多肽溶液分别与富血小板血浆、氯化钙/凝血酶溶液混合制备水凝胶,使体系中多肽的最终质量分数分别为0.1%,0.3%,0.5%,观察成水凝胶状态,并体外检测富血小板血浆中生长因子释放情况。将质量分数1%多肽溶液与质量分数1%人血清白蛋白溶液混合激发多肽自组装,使多肽的最终质量分数分别为0.1%,0.3%,0.5%,观察液体流动状态,并检测自组装多肽的流变力学性能。通过扫描电镜与透射电镜观察多肽(质量分数分别为0.1%,0.001%)-人血清白蛋白溶液的微观结构。结果与结论:①不同体积多肽溶液与富血小板血浆均可形成水凝胶,与富血小板血浆水凝胶相比,0.1%,0.3%多肽-富血小板血浆凝胶可缓解表皮生长因子、血管内皮生长因子的突发释放,延长释放时间至48 h。②添加人血清白蛋白后,0.1%多肽组仍呈流动液体,0.3%多肽组呈半液体状态,0.5%多肽组激发自组装形成水凝胶,确定富血小板血浆中人血清白蛋白可激发多肽自组装;随着多肽质量分数的提高,自组装多肽的存储模量越高,越容易成胶。③透射电镜下可见,添加人血清白蛋白前,多肽纳米纤维较短且无序堆积;添加人血清白蛋白后,多肽纳米纤维明显变长,并且相互交联成束,形成致密的纤维网络结构。扫描电镜下可见,添加人血清白蛋白前,多肽呈无序堆积的片状结构;添加人血清白蛋白后,多肽自组装成相互交联且有序密集排列的多孔状结构。④结果显示,新型自组装多肽可由富血小板血浆激发自组装,根据人血清白蛋白与多肽的比例可精准调节自组装效果,且多肽对富血小板血浆生长因子有缓释作用,可作为一种新型的生物材料应用于组织修复。

死后人体组织中15种金属元素的电感耦合等离子体质谱(ICP-MS)法检测及其结果分析

为了准确检测死后人体组织中金属元素含量,以铋和铟双内标在线校正仪器,采用微波消解-电感耦合等离子体质谱(ICP-MS)法同时测定死后人体肝、肾、肺、胃组织中镁、铝、钙、铬、锰、铁、铜、锌、砷、锶、镉、钡、汞、铊、铅等15种金属元素含量。结果线性良好,准确度高,加标回收率为82.1%~116%,精密度相对标准偏差RSD≤3.4%。不同组织中元素含量的变异系数为27.0%~224.2%,含量差异较大。为了探究不同组织中各金属元素之间的差异与关联性,对金属元素含量开展相关性分析和主成分分析并进行综合评价。结果表明,Cu和Zn等47对金属元素之间具备显著的相关性,相关系数最高达0.91(P<0.01),提取4个主成分,累计方差贡献率达72.942%,通过元素载荷值得出,Al、Mn、Fe、Cu、Zn、Cd等6种元素是死后人体组织15种元素中的主要特征金属元素。计算可知,肝脏中总体金属元素含量最高,其次是肾和肺,胃组织中总体金属元素含量最低。建立的元素测定方法及基础数据的综合评价可以为法医金属元素中毒案件的检验鉴定提供方法参考和数据支撑。

MicroRNAs as potential diagnostic biomarkers for bipolar disorder

Abnormal expression of microRNAs is connected to brain development and disease and could provide novel biomarkers for the diagnosis and prognosis of bipolar disorder. We performed a PubMed search for microRNA biomarkers in bipolar disorder and found 18 original research articles on studies performed with human patients and published from January 2011 to June 2023. These studies included microRNA profiling in bloodand brain-based materials. From the studies that had validated the preliminary findings,potential candidate biomarkers for bipolar disorder in adults could be miR-140-3p,-30d-5p,-330-5p,-378a-5p,-21-3p,-330-3p,-345-5p in whole blood, miR-19b-3p,-1180-3p,-125a-5p, let-7e-5p in blood plasma, and miR-7-5p,-23b-5p,-142-3p,-221-5p,-370-3p in the blood serum. Two of the studies had investigated the changes in microRNA expression of patients with bipolar disorder receiving treatment. One showed a significant increase in plasma miR-134 compared to baseline after 4 weeks of treatment which included typical antipsychotics, atypical antipsychotics, and benzodiazepines. The other study had assessed the effects of prescribed medications which included neurotransmitter receptorsite binders(drug class B) and sedatives, hypnotics, anticonvulsants, and analgesics(drug class C) on microRNA results. The combined effects of the two drug classes increased the significance of the results for miR-219 and-29c with miR-30e-3p and-526b* acquiring significance. MicroRNAs were tested to see if they could serve as biomarkers of bipolar disorder at different clinical states of mania, depression, and euthymia. One study showed that upregulation in whole blood of miR-9-5p,-29a-3p,-106a-5p,-106b-5p,-107,-125a-3p,-125b-5p and of miR-107,-125a-3p occurred in manic and euthymic patients compared to controls, respectively, and that upregulation of miR-106a-5p,-107 was found for manic compared to euthymic patients. In two other studies using blood plasma,downregulation of miR-134 was observed in manic patients compared to controls, and dysregulation of miR-134,-152,-607,-633,-652,-155 occurred in euthymic patients compared to controls. Finally, microRNAs such as miR-34a,-34b,-34c,-137, and-140-3p,-21-3p,-30d-5p,-330-5p,-378a-5p,-134,-19b-3p were shown to have diagnostic potential in distinguishing bipolar disorder patients from schizophrenia or major depressive disorder patients, respectively. Further studies are warranted with adolescents and young adults having bipolar disorder and consideration should be given to using animal models of the disorder to investigate the effects of suppressing or overexpressing specific microRNAs.

富血小板血浆来源的血小板细胞外囊泡分离技术与应用

背景:血小板细胞外囊泡是循环中最丰富的囊泡,富含丰富的生物活性分子、遗传物质及蛋白质等信息分子,参与细胞通讯和物质交换,不仅具有良好的促凝活性,还具有促进组织修复和再生的巨大潜力,在再生医学具有广泛的应用前景。目的:从血小板细胞外囊泡的分泌机制、在再生医学领域的应用及临床转化的限制因素进行阐述,为血小板细胞外囊泡的临床转化提供一些理论支撑。方法:应用计算机检索2005年1月至2023年8月PubMed数据库与血小板细胞外囊泡有关的文章,英文检索词为“platelet-derived,plateletrich plasma,extracellular vesicles,isolated,microvesicles exosomes,applications”,最后纳入符合主题标准的文献62篇进行综述分析。结果与结论:(1)活化的血小板细胞外囊泡可产生血小板微囊泡和血小板外泌体两种类型的囊泡,前者的分泌可能与肌动蛋白细胞骨架的不对称性相关,后者的分泌可能与H^(+)-ATP酶的调节相关。(2)血小板细胞外囊泡是血小板浓缩物和血小板本身的潜在效应物,可能通过促进血管生成、影响细胞行为、促凝与止血以及发挥炎症作用等几方面影响组织再生。(3)血小板细胞外囊泡在组织损伤、肌肉再生、软骨再生、骨关节炎等再生医学领域已有临床前报道,作为伤口愈合的潜在治疗方法已有临床试验数据,但血小板细胞外囊泡的分离方法、样本来源以及激活剂的种类等因素限制了血小板细胞外囊泡在再生医学领域的临床转化。(4)未来血小板细胞外囊泡可能成为再生医学中替代富血小板血浆的无细胞疗法,其临床转化还需要积极寻找鉴别血小板细胞外囊泡和血小板外泌体的特异性标志物,在激活剂刺激血小板细胞外囊泡产生的机制以及血小板细胞外囊泡的最佳收集方式、最佳储存方法、保质期限、临床应用的推荐剂量和最佳临床适应证还需要继续深入研究。

富血小板血浆在手足部骨合并软组织感染中的临床应用

目的探讨富血小板血浆(PRP)在手足部骨合并软组织感染中的临床应用效果。方法前瞻性选择2021年3月至2024年6月顺德和平外科医院收治的60例手足部骨合并软组织感染患者作为研究对象,采用随机数表法分为观察组和对照组各30例。对照组患者采用常规方法治疗,观察组患者在对照组治疗的基础上联合PRP治疗。两组均治疗两周,治疗两周后,比较两组患者的临床疗效以及治疗前后的降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平,同时比较两组患者的创面愈合时间、住院时间、住院费用和并发症发生情况。结果观察组患者的治疗总有效率为93.33%,明显高于对照组的70.00%,差异有统计学意义(P<0.05);治疗后,观察组患者的PCT、hs-CRP水平分别为(12.26±2.47)ng/L、(28.13±5.32)mg/L,明显低于对照组的(20.18±3.56)ng/L、(40.38±6.75)mg/L,差异均有统计学意义(P<0.05);观察组患者的创面愈合时间、住院时间、住院费用分别为(12.47±3.22)d、(16.58±3.86)d、(2.03±0.52)万元,明显短(少)于对照组的(20.38±3.45)d、(31.45±4.33)d、(3.52±0.76)万元,差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为23.33%,明显低于对照组患者的50.00%,差异有统计学意义(P<0.05)。结论PRP在手足部骨合并软组织感染患者中的临床应用效果显著,可有效抑制炎性反应,促进创面愈合、缩短住院时间、降低医疗费用,减少并发症的发生。

高脂血症型胰腺炎患者内脏脂肪组织面积与双重滤过血浆置换临床疗效的相关性分析

目的探讨高脂血症型胰腺炎(hyperlipidemic pancreatitis,HLAP)患者内脏脂肪组织面积(visceral fat area,VFA)与双重滤过血浆置换(double filtered plasmapheresis,DFPP)临床疗效的相关性。方法选取2020年1月—2022年12月自贡市第一人民医院收治的行DFPP治疗的HLAP患者,根据临床疗效不同分为有效组和无效组。比较2组的一般资料及VFA;通过多元Logistic回归分析无效结局的影响因素;分析VFA水平与疗效无效概率的剂量反应关系,基于影响因素逐步Logistic回归模型。结果共纳入225例患者,其中有效组180例,无效组45例。饮酒史(OR=3.603,95%CI:2.577~4.868,P=0.018)、高体质量指数(body mass index,BMI)(OR=2.407,95%CI:1.381~3.672,P=0.016)、高急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health status scoring system II,APACHEⅡ)评分(OR=3.087,95%CI:2.061~4.352,P=0.026)、高空腹血糖(FPG)(OR=1.313,95%CI:1.007~2.578,P=0.009)、高总胆固醇(TC)(OR=2.511,95%CI:1.485~3.776,P=0.025)、高三酰甘油(TG)(OR=4.885,95%CI:3.859~6.150,P=0.035)、高低密度脂蛋白胆固醇(LDL-C)(OR=3.165,95%CI:2.139~4.430,P=0.010)、低高密度脂蛋白胆固醇(HDL-C)(OR=4.163,95%CI:3.137~5.428,P=0.011)、高白细胞介素-6(interleukin-6,IL-6)(OR=2.117,95%CI:1.091~3.382,P=0.006)、高白细胞介素-8(interleukin-8,IL-8)(OR=3.115,95%CI:2.089~4.380,P=0.023)、高C反应蛋白(CRP)(OR=1.975,95%CI:1.049~3.240,P=0.035)、高降钙素原(procalcitonin,PCT)(OR=3.665,95%CI:2.639~4.930,P=0.036)、高血淀粉酶(OR=4.547,95%CI:3.521~5.812,P=0.041)、高血脂肪酶(OR=2.229,95%CI:1.203~3.494,P=0.043)、VFA大(OR=2.827,95%CI:1.801~4.092,P=0.031)是疗效无效的影响因素。剂量反应关系分析提示:随着VFA增加,临床疗效无效的发生概率也相应增加。回归方程P=1/[1+exp(-3.265+1.282×饮酒史+0.878×BMI+1.127×APACHEⅡ评分+0.272×FPG+0.921×TC+1.586×TG+1.152×LDLC+1.426×HDL-C+0.750×IL-6+1.136×IL-8+0.681×CRP+1.299×PCT+1.514×血淀粉酶+0.802×血脂肪酶+1.039×VFA)]。结论HLAP患者VFA与DFPP临床疗效具有显著相关性。随着VFA的增加,临床疗效无效的发生概率逐渐升高。

冷冻在电子支气管镜下肉芽组织清除术中的疗效观察

目的探讨冷冻在电子支气管镜下肉芽组织清除术中的应用疗效,以期为肉芽组织清除术患者找到一种高效、安全的辅助技术。方法选择2021年6月-2022年6月该院收治的41例行肉芽组织清除术的患者作为研究对象,采用单双号对患者进行分组,21例分到单号者为对照组,20例分到双号者为观察组。两组患者均行电子支气管镜下肉芽组织清除术治疗。术中,对照组给予氩等离子体凝固术(APC)治疗,观察组给予冷冻治疗,比较两组患者治疗前后的免疫功能指标水平(CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)等)、术后恢复相关指标和治疗总有效率等。结果治疗前,两组患者CD4^(+)和CD4^(+)/CD8^(+)比较,差异均无统计学意义(P>0.05),治疗后,观察组CD4^(+)和CD4^(+)/CD8^(+)明显高于对照组,差异均有统计学意义(P<0.05);治疗前,两组患者CD8^(+)比较,差异无统计学意义(P>0.05),治疗后,观察组CD8^(+)明显低于对照组,差异有统计学意义(P<0.05);观察组有效率为95.00%,高于对照组的80.95%,观察组术后疼痛视觉模拟评分法(VAS)为(2.14±0.18)分,明显低于对照组的(6.09±0.95)分,差异均有统计学意义(P<0.05);观察组术后首次进食时间为(6.08±0.76)h,住院时间为(5.12±0.68)d,明显短于对照组的(15.39±2.97)h和(7.08±0.93)d,观察组治疗费用为(10500.60±80.70)元,明显低于对照组的(19800.00±126.00)元,差异均有统计学意义(P<0.05);观察组术后并发症发生率为5.00%,明显低于对照组的23.81%,差异有统计学意义(P<0.05)。结论冷冻在电子支气管镜下肉芽组织清除术中的应用较好,不仅能提高治疗效果,改善机体免疫指标水平,还能减轻术后疼痛,降低术后并发症发生率,缩短预后周期,且治疗费用低,值得临床推广应用。

In vitro comparison of human plasma-based and self-assembled tissue-engineered skin substitutes:two different manufacturing processes for the treatment of deep and difficult to heal injuries

Background:The aim of this in vitro study was to compare side-by-side two models of human bilayered tissue-engineered skin substitutes(hbTESSs)designed for the treatment of severely burned patients.These are the scaffold-free self-assembled skin substitute(SASS)and the human plasma-based skin substitute(HPSS).Methods:Fibroblasts and keratinocytes from three humans were extracted from skin biopsies(N=3)and cells from the same donor were used to produce both hbTESS models.For SASS manu-facture,keratinocytes were seeded over three self-assembled dermal sheets comprising fibroblasts and the extracellular matrix they produced(n=12),while for HPSS production,keratinocytes were cultured over hydrogels composed of fibroblasts embedded in either plasma as unique biomaterial(Fibrin),plasma combined with hyaluronic acid(Fibrin-HA)or plasma combined with collagen(Fibrin-Col)(n/biomaterial=9).The production time was 46-55 days for SASSs and 32-39 days for HPSSs.Substitutes were characterized by histology,mechanical testing,PrestoBlue™-assay,immunofluorescence(Ki67,Keratin(K)10,K15,K19,Loricrin,type IV collagen)and Western blot(type I and IV collagens).Results:The SASSs were more resistant to tensile forces(p-value<0.01)but less elastic(p-value<0.001)compared to HPSSs.A higher number of proliferative Ki67+cells were found in SASSs although their metabolic activity was lower.After epidermal differentiation,no significant difference was observed in the expression of K10,K15,K19 and Loricrin.Overall,the production of type I and type IV collagens and the adhesive strength of the dermal-epidermal junction was higher in SASSs.Conclusions:This study demonstrates,for the first time,that both hbTESS models present similar in vitro biological characteristics.However,mechanical properties differ and future in vivo experiments will aim to compare their wound healing potential.

Platelet-rich plasma gel in combination with Schwann cells for repair of sciatic nerve injury

Bone marrow mesenchymal stem cells were isolated from New Zealand white rabbits, culture-expanded and differentiated into Schwann cell-like cells. Autologous platelet-dch plasma and Schwann cell-like cells were mixed in suspension at a density of 1 x 106 cells/mL, prior to introduction into a poly （lactic-co-glycolic acid） conduit. Fabricated tissue-engineered nerves were implanted into rabbits to bridge 10 mm sciatic nerve defects （platelet-rich plasma group）. Controls were established using fibrin as the seeding matrix for Schwann cell-like cells at identical density to construct tissue-engineered nerves （fibrin group）. Twelve weeks after implantation, toluidine blue staining and scanning electron microscopy were used to demonstrate an increase in the number of regenerating nerve fibers and thickness of the myelin sheath in the platelet-rich plasma group compared with the fibrin group. Fluoro-gold retrograde labeling revealed that the number of Fluoro-gold-positive neurons in the dorsal root ganglion and the spinal cord anterior horn was greater in the platelet-rich plasma group than in the fibrin group. Electrophysiological examination confirmed that compound muscle action potential and nerve conduction velocity were superior in the platelet-rich plasma group compared with the fibrin group. These results indicate that autologous platelet-rich plasma gel can effectively serve as a seeding matrix for Schwann cell-like cells to construct tissue-engineered nerves to promote perJpheral nerve regeneration.