Spinal cord injury （SCI） is an unexpected event that is both devastating and debilitating, resulting in not just motor and sensory loss, but also autonomic dysfunction of the bladder, bowel and sexual organs. Curren...Spinal cord injury （SCI） is an unexpected event that is both devastating and debilitating, resulting in not just motor and sensory loss, but also autonomic dysfunction of the bladder, bowel and sexual organs. Currently, there are no treatments available to improve outcome follow- ing SCI, leaving individuals with permanent and lifelong physical disability. Worldwide it is estimated that more than 500,000 people sustain a SCI each year, with average lifetime cost of paraplegia and quadriplegia estimated at $5 million and $9.5 million respectively. We therefore urgently need effective therapies to improve quality of life following SCI, and this requires a greater understanding of how cell and axonal injury develops after the traumatic event.展开更多
Background:LL-37 peptide is a member of the human cathelicidin family,and has been shown to promote the healing of pressure ulcers.However,the low stability of this peptide within the wound environment limits its clin...Background:LL-37 peptide is a member of the human cathelicidin family,and has been shown to promote the healing of pressure ulcers.However,the low stability of this peptide within the wound environment limits its clinical use.Chitosan(CS)hydrogel is commonly used as a base material for wound dressing material.Methods:CS hydrogel(2.5%w/v)was encapsulated with LL-37.Cytotoxicity of the product was examined in cultured NIH3 T3 fibroblasts.Effects on immune response was examined by measuring tumor necrosis factor-α(TNF-α)release from RAW 264.7 macrophages upon exposure to lipopolysaccharides.Antibacterial activity was assessed using Staphylococcus aureus.Potential effect on pressure ulcers was examined using a mouse model.Briefly,adult male C57 BL/6 mice were subjected to skin pressure using magnets under a 12/12 h schedule for 21 days.Mice were randomized to receive naked LL-37(20μg),chitosan gel containing 20μg LL-37(LL-37/CS hydrogel)or hydrogel alone under the ulcer bed(n=6).A group of mice receiving no intervention was also included as a control.Results:LL-37/CS hydrogel did not affect NIH3 T3 cell viability.At a concentration of 1–5μg/ml,LL-37/CS inhibited TNF-αrelease from macrophage.At 5μg/ml,LL-37/CS inhibited the growth of Staphylococcus aureus.The area of the pressure ulcers was significantly lower in mice receiving LL-37/CS hydrogel in comparison to all other 3 groups on days 11(84.24%±0.25%),13(56.22%±3.91%)and 15(48.12%±0.28%).Histological examination on days 15 and 21 showed increased epithelial thickness and density of newly-formed capillary with naked LL-37 and more so with LL-37/CS.The expression of key macromolecules in the process of angiogenesis(i.e.,hypoxia inducible factor-1α(HIF-1α)and vascular endothelial growth factor-A(VEGF-A))in wound tissue was increased at both the mRNA and protein levels.Conclusion:Chitosan hydrogel encapsulated with LL-37 is biocompatible and could promote the healing of pressure ulcers.展开更多
Objective: To explore the treatment and nursing characteristics for pressure injury on the inside of the thigh caused by forced posture in patients with cirrhosis and diabetes mellitus. Methods: A patient with cirrhos...Objective: To explore the treatment and nursing characteristics for pressure injury on the inside of the thigh caused by forced posture in patients with cirrhosis and diabetes mellitus. Methods: A patient with cirrhosis and diabetes mellitus complicated with abscess of right inner thigh pressure injury was selected as the study object, who was admitted to Xuzhou Medical University Hospital on June 29, 2019. The analysis of the clinical diagnosis, treatment and nursing process were applied to explore the prognosis of the patient with cirrhosis and diabetes mellitus complicated with deep abscess of the thigh. Results: The traditional treatment including incision and drainage was not allowed, as the general treatment was not effective for the patients with cirrhosis and diabetes mellitus complicated with deep abscess in the inner thigh. After 8 days of negative pressure manual dressing change combined with mupirocin ointment treatment, the local skin condition returned to normal. Conclusion: After literature search, it was found that the above-mentioned cirrhosis combined with diabetes and deep abscess cases in the inner thigh were rare clinically. When the traditional treatment of incision and drainage is limited, negative pressure manual dressing change combined with antibiotics is an effective method, which is worthy of clinical application and promotion.展开更多
Deep tissue pressure injuries(DTPIs)have witnessed a growing prevalence in hospitals and other health care units especially among individuals with pathological conditions that give rise to restricted mobility,impaired...Deep tissue pressure injuries(DTPIs)have witnessed a growing prevalence in hospitals and other health care units especially among individuals with pathological conditions that give rise to restricted mobility,impaired sensation,and reduced tissue tolerance.The etiology of DTPIs has been a subject of controversy,to which several explanatory models have been proposed,including direct mechanical insult,ischemia-reperfusion,lymphatic occlusion,and inflammatory cytokines.In line with these pathophysiological scenarios,ultrasound,subepidermal moisture detection,and biomarker technologies have been proposed as potential early detection methods of DTPIs.This paper provides a systematic review involving these three methods.The conclusion is that combining and implementing these methods at different time periods during DTPIs development and progression respectively is likely to be the most universal,effective and promising way for DTPIs diagnosis.展开更多
Objective: To study the effect of adjuvant therapy of ganglioside sodium on intracranial pressure (ICP), partial pressure of brain tissue oxygen (PbtO2), nerve injury molecules, nerve protection molecules and indexes ...Objective: To study the effect of adjuvant therapy of ganglioside sodium on intracranial pressure (ICP), partial pressure of brain tissue oxygen (PbtO2), nerve injury molecules, nerve protection molecules and indexes of oxidative stress in patients with acute severe craniocerebral injury. <br> Methods: Forty-seven patients with severe craniocerebral injury treated in the emergency department of our hospital during the period time from December 2012 to October 2015 were selected for retrospective analyses. They were divided into the ganglioside group and the normal treatment group according to the usage of ganglioside sodium in the process of the emergency treatment. At days 1, 3, 5 and 7 before and after treatment, theICP and PbtO2 in patients of the two groups were measured. After 7 days of treatment, the nerve injury molecules, nerve protection molecules and the indexes of oxidative stress in serum of the patients of the two groups were determined. <br> Results: At days 1, 3, 5 and 7 before and after treatment, theICP in patients of the ganglioside group were all significantly lower than those of the normal treatment group, while the PbtO2 were all significantly higher than those of normal treatment group. After 7 days of treatment, the contents of serum methane dicarboxylic aldehyde, advanced oxidation protein products, 8-hydroxy-2'-deoxyguanosine urine, S100β, glial fibrillary acidic portein, neuron specific enolase, myelin basic protein, neuroglobin and ubiquitin carboxyl-terminal hydrolase L1 in patients of the ganglioside group were notably lower than those of the normal treatment group, while the contents of superoxidase dismutase, glutathione peroxidase, catalase, nerve growth factor and brain derived neurotrophic factor were significantly higher than those of the normal treatment group. <br> Conclusions: The adjuvant therapy of ganglioside sodium in patients with severe craniocerebral injury can effectively reduceICP, improve PbtO2 and alleviate the injuries of neurons and glial cells caused by oxidative stress.展开更多
背景:铁死亡介导的缺血再灌注损伤对压疮的发生发展起重要作用,可能存在压疮相关的铁死亡生物标志物,但其机制尚未阐明。目的:通过生物信息学手段探讨压疮的分子机制,寻找压疮过程中铁死亡相关差异基因,为其临床治疗提供新的视角。方法...背景:铁死亡介导的缺血再灌注损伤对压疮的发生发展起重要作用,可能存在压疮相关的铁死亡生物标志物,但其机制尚未阐明。目的:通过生物信息学手段探讨压疮的分子机制,寻找压疮过程中铁死亡相关差异基因,为其临床治疗提供新的视角。方法:使用GEO数据库和FerrDb数据库下载数据集并进行预处理。对单细胞转录组测序数据进行聚类和占比分析、代谢活性和拟时序分析、细胞通讯分析、铁死亡基因集细胞识别和富集分析,确定铁死亡差异基因,并通过动物实验进一步验证。将20只SD大鼠随机分为正常组和模型组,每组10只。正常组大鼠不进行任何处理,模型组大鼠采用缺血再灌注循环周期模式制备压疮大鼠模型,采用荧光定量PCR和免疫印迹检测压疮大鼠创面组织内差异表达基因和蛋白的变化。结果与结论:(1)单细胞转录组测序数据聚类划分为6种细胞类型,压疮组2型和3型角质形成细胞占比较高。(2)不同细胞亚群之间具有明显的代谢异质性和演变轨迹。(3)2型和3型角质形成细胞在细胞通讯中作用最强,2型角质形成细胞配体-受体强度最佳。(4)2型角质形成细胞铁死亡得分较高,有显著上调或下调的差异基因,并得到27个GO富集条目、20个KEGG富集条目和24个铁死亡相关差异基因,以谷胱甘肽过氧化物酶4(glutathione peroxidase 4,GPX4)和长链酯酰辅酶A合成酶4(acyl-CoA synthetase long chain family member 4,ACSL4)为主。(5)动物实验验证了与正常组相比,模型组大鼠铁死亡抑制蛋白GPX4表达下调,铁死亡促进蛋白ACSL4表达上调。上述结果证实,压疮组织中存在铁死亡,GPX4和ACSL4为调控压疮组织中铁死亡的重要基因。展开更多
基金supported by the Neil Sachse Foundation,Australia,a philanthropic organisation supporting research into spinal cord injury
文摘Spinal cord injury （SCI） is an unexpected event that is both devastating and debilitating, resulting in not just motor and sensory loss, but also autonomic dysfunction of the bladder, bowel and sexual organs. Currently, there are no treatments available to improve outcome follow- ing SCI, leaving individuals with permanent and lifelong physical disability. Worldwide it is estimated that more than 500,000 people sustain a SCI each year, with average lifetime cost of paraplegia and quadriplegia estimated at $5 million and $9.5 million respectively. We therefore urgently need effective therapies to improve quality of life following SCI, and this requires a greater understanding of how cell and axonal injury develops after the traumatic event.
基金supported by the National Natural Science Foundation of China(No.81701838)the China Postdoctoral Science Foundation(2018M632628)
文摘Background:LL-37 peptide is a member of the human cathelicidin family,and has been shown to promote the healing of pressure ulcers.However,the low stability of this peptide within the wound environment limits its clinical use.Chitosan(CS)hydrogel is commonly used as a base material for wound dressing material.Methods:CS hydrogel(2.5%w/v)was encapsulated with LL-37.Cytotoxicity of the product was examined in cultured NIH3 T3 fibroblasts.Effects on immune response was examined by measuring tumor necrosis factor-α(TNF-α)release from RAW 264.7 macrophages upon exposure to lipopolysaccharides.Antibacterial activity was assessed using Staphylococcus aureus.Potential effect on pressure ulcers was examined using a mouse model.Briefly,adult male C57 BL/6 mice were subjected to skin pressure using magnets under a 12/12 h schedule for 21 days.Mice were randomized to receive naked LL-37(20μg),chitosan gel containing 20μg LL-37(LL-37/CS hydrogel)or hydrogel alone under the ulcer bed(n=6).A group of mice receiving no intervention was also included as a control.Results:LL-37/CS hydrogel did not affect NIH3 T3 cell viability.At a concentration of 1–5μg/ml,LL-37/CS inhibited TNF-αrelease from macrophage.At 5μg/ml,LL-37/CS inhibited the growth of Staphylococcus aureus.The area of the pressure ulcers was significantly lower in mice receiving LL-37/CS hydrogel in comparison to all other 3 groups on days 11(84.24%±0.25%),13(56.22%±3.91%)and 15(48.12%±0.28%).Histological examination on days 15 and 21 showed increased epithelial thickness and density of newly-formed capillary with naked LL-37 and more so with LL-37/CS.The expression of key macromolecules in the process of angiogenesis(i.e.,hypoxia inducible factor-1α(HIF-1α)and vascular endothelial growth factor-A(VEGF-A))in wound tissue was increased at both the mRNA and protein levels.Conclusion:Chitosan hydrogel encapsulated with LL-37 is biocompatible and could promote the healing of pressure ulcers.
文摘Objective: To explore the treatment and nursing characteristics for pressure injury on the inside of the thigh caused by forced posture in patients with cirrhosis and diabetes mellitus. Methods: A patient with cirrhosis and diabetes mellitus complicated with abscess of right inner thigh pressure injury was selected as the study object, who was admitted to Xuzhou Medical University Hospital on June 29, 2019. The analysis of the clinical diagnosis, treatment and nursing process were applied to explore the prognosis of the patient with cirrhosis and diabetes mellitus complicated with deep abscess of the thigh. Results: The traditional treatment including incision and drainage was not allowed, as the general treatment was not effective for the patients with cirrhosis and diabetes mellitus complicated with deep abscess in the inner thigh. After 8 days of negative pressure manual dressing change combined with mupirocin ointment treatment, the local skin condition returned to normal. Conclusion: After literature search, it was found that the above-mentioned cirrhosis combined with diabetes and deep abscess cases in the inner thigh were rare clinically. When the traditional treatment of incision and drainage is limited, negative pressure manual dressing change combined with antibiotics is an effective method, which is worthy of clinical application and promotion.
基金the Shanghai Pujiang Program(No.19PJ1406400)the Interdisciplinary Program of Shanghai Jiao Tong University(Nos.YG2019ZDB02 and YG2021QN142)。
文摘Deep tissue pressure injuries(DTPIs)have witnessed a growing prevalence in hospitals and other health care units especially among individuals with pathological conditions that give rise to restricted mobility,impaired sensation,and reduced tissue tolerance.The etiology of DTPIs has been a subject of controversy,to which several explanatory models have been proposed,including direct mechanical insult,ischemia-reperfusion,lymphatic occlusion,and inflammatory cytokines.In line with these pathophysiological scenarios,ultrasound,subepidermal moisture detection,and biomarker technologies have been proposed as potential early detection methods of DTPIs.This paper provides a systematic review involving these three methods.The conclusion is that combining and implementing these methods at different time periods during DTPIs development and progression respectively is likely to be the most universal,effective and promising way for DTPIs diagnosis.
文摘Objective: To study the effect of adjuvant therapy of ganglioside sodium on intracranial pressure (ICP), partial pressure of brain tissue oxygen (PbtO2), nerve injury molecules, nerve protection molecules and indexes of oxidative stress in patients with acute severe craniocerebral injury. <br> Methods: Forty-seven patients with severe craniocerebral injury treated in the emergency department of our hospital during the period time from December 2012 to October 2015 were selected for retrospective analyses. They were divided into the ganglioside group and the normal treatment group according to the usage of ganglioside sodium in the process of the emergency treatment. At days 1, 3, 5 and 7 before and after treatment, theICP and PbtO2 in patients of the two groups were measured. After 7 days of treatment, the nerve injury molecules, nerve protection molecules and the indexes of oxidative stress in serum of the patients of the two groups were determined. <br> Results: At days 1, 3, 5 and 7 before and after treatment, theICP in patients of the ganglioside group were all significantly lower than those of the normal treatment group, while the PbtO2 were all significantly higher than those of normal treatment group. After 7 days of treatment, the contents of serum methane dicarboxylic aldehyde, advanced oxidation protein products, 8-hydroxy-2'-deoxyguanosine urine, S100β, glial fibrillary acidic portein, neuron specific enolase, myelin basic protein, neuroglobin and ubiquitin carboxyl-terminal hydrolase L1 in patients of the ganglioside group were notably lower than those of the normal treatment group, while the contents of superoxidase dismutase, glutathione peroxidase, catalase, nerve growth factor and brain derived neurotrophic factor were significantly higher than those of the normal treatment group. <br> Conclusions: The adjuvant therapy of ganglioside sodium in patients with severe craniocerebral injury can effectively reduceICP, improve PbtO2 and alleviate the injuries of neurons and glial cells caused by oxidative stress.
文摘背景:铁死亡介导的缺血再灌注损伤对压疮的发生发展起重要作用,可能存在压疮相关的铁死亡生物标志物,但其机制尚未阐明。目的:通过生物信息学手段探讨压疮的分子机制,寻找压疮过程中铁死亡相关差异基因,为其临床治疗提供新的视角。方法:使用GEO数据库和FerrDb数据库下载数据集并进行预处理。对单细胞转录组测序数据进行聚类和占比分析、代谢活性和拟时序分析、细胞通讯分析、铁死亡基因集细胞识别和富集分析,确定铁死亡差异基因,并通过动物实验进一步验证。将20只SD大鼠随机分为正常组和模型组,每组10只。正常组大鼠不进行任何处理,模型组大鼠采用缺血再灌注循环周期模式制备压疮大鼠模型,采用荧光定量PCR和免疫印迹检测压疮大鼠创面组织内差异表达基因和蛋白的变化。结果与结论:(1)单细胞转录组测序数据聚类划分为6种细胞类型,压疮组2型和3型角质形成细胞占比较高。(2)不同细胞亚群之间具有明显的代谢异质性和演变轨迹。(3)2型和3型角质形成细胞在细胞通讯中作用最强,2型角质形成细胞配体-受体强度最佳。(4)2型角质形成细胞铁死亡得分较高,有显著上调或下调的差异基因,并得到27个GO富集条目、20个KEGG富集条目和24个铁死亡相关差异基因,以谷胱甘肽过氧化物酶4(glutathione peroxidase 4,GPX4)和长链酯酰辅酶A合成酶4(acyl-CoA synthetase long chain family member 4,ACSL4)为主。(5)动物实验验证了与正常组相比,模型组大鼠铁死亡抑制蛋白GPX4表达下调,铁死亡促进蛋白ACSL4表达上调。上述结果证实,压疮组织中存在铁死亡,GPX4和ACSL4为调控压疮组织中铁死亡的重要基因。
