Spatially engineering tri-layer nanofiber dressings featuring asymmetric wettability for wound healing

Inspired by the skin structure,an asymmetric wettability tri-layer nanofiber membrane(TNM)consisting of hydrophilic inner layer loaded with lidocaine hydrochloride(LID),hydrophobic middle layer with ciprofloxacin(CIP)and hydrophobic outer layer has been created.The hydrophobic outer layer endows the TNM with waterproof function and anti-adhesion from contaminants.The hydrophobic middle layer with CIP preserves long-term inhibition of bacteria growth and the hydrophilic inner layer with LID possesses optimal waterabsorbing capacity and air permeability.The TNM dramatically elevates the water contact angles from 10°(inner layer)to 120(outer layer),indicating an asymmetric wettability,which could directionally transport wound exudate within the materials and meanwhile maintain a comfortable and moist environment to promote wound healing.Furthermore,the sequential release of LID and CIP could relieve pain rapidly and achieve antibacterial effect in the long run,respectively.In addition,the TNM shows superior biocompatibility towards L929 cells.The in vivo results show the TNM could prevent infection,accelerate epithelial regeneration and significantly accelerate wound healing.This study indicates the developed TNM with asymmetrical wettability and synergetic drug release shows great potential as a wound dressing in clinical application.

Improving pressure ulcer care in intensive care units:Evaluating the impact of bundled care and silver nanoparticle dressings

BACKGROUND Pressure ulcer(PU)are prevalent among critically ill trauma patients,posing substantial risks.Bundled care strategies and silver nanoparticle dressings offer potential solutions,yet their combined effectiveness and impact on patient satisfaction remain insufficiently investigated.AIM To assess the impact of bundled care along with silver nanoparticle dressing on PUs management and family satisfaction in critically ill trauma patients.METHODS A total of 98 critically ill trauma patients with PUs in intensive care unit(ICU)were included in this study.Patients were randomly assigned to either the control group(conventional care with silver nanoparticle dressing,n=49)or the intervention group(bundled care with silver nanoparticle dressing,n=49).The PU Scale for Healing(PUSH)tool was used to monitor changes in status of pressure injuries over time.Assessments were conducted at various time points:Baseline(day 0)and subsequent assessments on day 3,day 6,day 9,and day 12.Family satisfaction was assessed using the Family Satisfaction ICU 24 ques-tionnaire.RESULTS No significant differences in baseline characteristics were observed between the two groups.In the intervention group,there were significant reductions in total PUSH scores over the assessment period.Specifically,surface area,exudate,and tissue type parameters all showed significant improvements compared to the control group.Family satisfaction with care and decision-making was notably higher in the intervention group.Overall family satisfaction was significantly better in the intervention group.CONCLUSION Bundled care in combination with silver nanoparticle dressings effectively alleviated PUs and enhances family satisfaction in critically ill trauma patients.This approach holds promise for improving PUs management in the ICU,benefiting both patients and their families.

The Antibacterial Properties of Silver Dressings and Their Application in Wound Healing

Silver-containing dressings have gained popularity in clinical applications due to their exceptional antibacterial properties and ability to enhance wound healing.These dressings primarily exert their antibacterial effects through the utilization of silver ions or nano-silver particles.The antimicrobial property of silver ions is a result of multiple mechanisms,with the most significant being the interaction between Ag or Ag+and the bacterial cell wall,as well as the interaction between Ag+and bacterial DNA or RNA,which inhibits replication and division.Silver-containing dressings can effectively reduce inflammation in wound tissue and expedite wound healing.The antibacterial and wound-healing promoting effects of these dressings are closely associated with the controlled release rate of silver ions.Consequently,developing novel silver-containing dressings that accurately regulate this release rate has become a prominent area of research interest.With broad prospects for application in wound care,silver-containing dressings are anticipated to offer innovative solutions for addressing numerous challenges encountered in clinical wound management.

高性能慢性伤口敷料的研究进展

慢性伤口愈合是一个复杂且耗时的过程,容易受到大肠杆菌、金黄色葡萄球菌等微生物的攻击.传统敷料如棉花、纱布等,其屏障作用较差,导致伤口容易被细菌侵入,在愈合过程中其纤维会黏附在新生的肉芽组织上,频繁换药会加剧患者痛苦甚至导致二次创伤,并且对创面愈合无明显促进作用.近十年来,新型创面敷料的相关研究不断涌现,这些敷料可以与伤口相互作用,其中的智能敷料还可以通过内置传感器或智能材料(如刺激响应材料和自修复材料)感知和反应伤口状况或环境变化,赋予伤口敷料智能响应释药的功能,从而有效促进伤口愈合.基于此,综述伤口敷料领域的研究进展,同时总结相关性能表征方法,并简要展望该领域的未来研究方向.

自体刃厚头皮回植修复中厚供皮区创面的安全有效性

背景:大面积深度烧伤创面愈合后多伴瘢痕增生,需要移植中厚皮进行修复,所取中厚皮片一般达到真皮乳头层以下,若处理不当容易出现供区皮创面愈合延迟、溃破和愈合后疼痛瘙痒等并发症,因此,供皮区创面修复应得到重视。目的:分析自体头皮修复深度烧伤和瘢痕患者供皮区的安全性和实用性。方法:选择2021年1月至2023年9月郑州市第一人民医院烧伤科收治的60例深度烧伤和瘢痕增生患者作为研究对象,均进行中厚皮移植修复,取皮部位为患者自身腿部或背部中厚皮,采用随机数字表法分为研究组(30例)、对照组(30例),研究组采用自体刃厚头皮回植修复中厚皮供皮区,对照组采用吸水敷料修复中厚皮供皮区。对比两组术后6 d的中厚皮供皮区创面愈合率、创面完全上皮化时间,术后3,6 d供皮区换药疼痛评分,以及术后6个月中厚皮供皮区瘢痕增生情况。结果与结论:①研究组中厚皮供皮区创面上皮化时间短于对照组(P<0.05),中厚皮供皮区创面愈合率高于对照组(P<0.05),术后3,6 d的中厚皮供皮区换药疼痛评分均低于对照组(P<0.05),术后6个月的中厚皮供皮区瘢痕增生率、瘢痕评分及瘙痒评分均低于对照组(P<0.05);②结果表明,自体头皮修复中厚皮供皮区具有加快创面愈合和减轻瘢痕增生的优点。

传统马面裙形制结构考释及其现代设计思辨

基于文化自信与传统文化振兴的背景下,马面裙代表着中国优秀的传统文化走进大众视野、走向国际舞台。文章纵向整理马面裙发展的历史脉络、横向梳理马面裙的款式差别,同时立足现代服装设计,对于马面裙从平面结构的对比到立体形态的差异进行拓展研究。采用实验法、比较研究法,将马面裙实物数据为基础样本,进行实物复原和形制特征记录。同时依据现代裙装结构制版方法,进行相同数据的多样本制作和横向的形制比对。采用概率逻辑分析,从平面结构的比对到立体形态的差异进行拓展分析。通过对比实验结果,就马面裙的结构复原、改良方案和创新视角展开设计思辨。

美国亚裔文学中的徐志摩形象——以《小脚与西服》《中国珍珠》《从东到西》三部小说为中心

以《小脚与西服》《中国珍珠》《从东到西》三部美国亚裔文学作品为中心,分析了不同作者从不同角度塑造的徐志摩形象:在传统与现代间挣扎的冷漠才子、倾心于知识女性的浪漫诗人、胸怀救国之志的浪漫主义者。《小脚与西服》从家族叙事的角度,在肯定徐志摩才华和志向的同时,揭示其在婚恋中自私冷漠、缺乏责任心的一面;《中国珍珠》对徐志摩和赛珍珠的爱情传闻进行文学加工,体现了徐志摩对知识女性的尊重和仰慕;《从东到西》秉持男性立场,着重表现徐志摩的风流多情和救国志向。这三个文本中的徐志摩形象丰富了外国文学中的华人形象,解构了美国白人文学中传统刻板化的华人男性形象,有助于外国读者通过徐志摩进一步了解中国文学和文化。

负载槲皮素的羧甲基壳聚糖水凝胶促进糖尿病大鼠创面愈合

背景:槲皮素具有抗炎、抗癌、抗氧化、抗衰老、抗抑郁等药理作用,具有极高的药用价值。槲皮素可以促进正常大鼠创面的愈合,但是以槲皮素为主要成分的药物研发较少,限制了其在临床的广泛应用。目的:以水凝胶材料负载槲皮素,探讨槲皮素-羧甲基壳聚糖水凝胶在糖尿病大鼠创面中的应用效果。方法:①分别制备羧甲基壳聚糖水凝胶与槲皮素-羧甲基壳聚糖水凝胶,表征水凝胶的微观形貌、体外释药性能。②细胞实验:将小鼠L929成纤维细胞分4组培养,空白对照组常规培养,纯水凝胶组、药物组、载药水凝胶组分别加入羧甲基壳聚糖水凝胶、槲皮素溶液与槲皮素-羧甲基壳聚糖水凝胶,检测细胞增殖与迁移能力。③动物实验:取80只SD大鼠建立糖尿病模型,造模成功后在大鼠背部制作直径2 cm的全层皮肤缺损创面,随机分4组干预,空白对照组、纯水凝胶组、药物组、载药水凝胶组创面分别注射生理盐水、羧甲基壳聚糖水凝胶、槲皮素溶液、槲皮素-羧甲基壳聚糖水凝胶,每组20只,无菌纱布包扎固定。术后观察创面愈合情况、创面病理形态、炎症因子表达及血管生成情况。结果与结论:①扫描电镜下可见两种水凝胶的微观形貌相似,均呈疏松多孔的网络结构,并且槲皮素-羧甲基壳聚糖水凝胶具有良好的体外释药性能。②与空白对照组比较,其他3组细胞增殖与迁移率升高(P<0.05);载药水凝胶组细胞增殖与迁移率高于纯水凝胶组、药物组(P<0.05)。③载药水凝胶组大鼠术后5,11 d的创面愈合率高于其他3组;载药水凝胶组、纯水凝胶组、药物组大鼠术后18 d的创面愈合率基本达到100%,均高于空白对照组(P<0.05)。苏木精-伊红染色显示,载药水凝胶组大鼠术后18 d创面可见完整的皮肤与皮肤附属器,空白对照组、纯水凝胶组、药物组大鼠术后25 d创面可见完整的皮肤与皮肤附属器。载药水凝胶组大鼠创面术后5,11,18 d的创面肿瘤坏死因子α、白细胞介素6水平均低于空白对照组(P<0.05),术后11,18 d的创面转化生长因子β1水平低于空白对照组(P<0.05)。载药水凝胶组大鼠术后11,18 d的CD31、血管内皮生长因子αmRNA表达量均高于其他3组(P<0.05)。④结果表明,槲皮素-羧甲基壳聚糖水凝胶中的槲皮素可发挥调节炎症反应、促进血管新生的作用,可通过促进成纤维细胞的增殖与迁移,促进糖尿病大鼠创面的愈合。

碳材料在医用敷料中的研究及应用进展

敷料作为覆盖伤口的医用材料,是关乎人们健康的重要产品。作为皮肤替代物的敷料,在创伤性伤口的治疗中发挥着重要的作用,然而,传统的医用敷料存在易感染、造成二次伤害、患者舒适度低等问题。因此,开发新型伤口敷料并改进传统敷料具有重要意义。碳材料作为敷料材料,具有生产成本低、生物相容性好、吸附性强以及机械性能优异等优点,因此碳材料敷料具有良好的杀菌活性和更强的伤口愈合能力,具有广阔的发展前景。阐述了伤口愈合的原理,简要介绍了碳材料作为医用敷料的发展历史,综述了碳材料敷料的种类及应用情况并展望了未来碳材料敷料的发展前景。

贵州省剑河县苗族柳利式女装特征及变迁研究

苗族柳利式女性盛装是贵州省剑河地区颇具特色的支系服饰之一,以拼接大片红色刺绣为典型特征。本文依托服饰样本,采用实证研究法和田野调查法,结合相关文献从形制、造型、纹样、色彩等层面梳理盛装的表征特色,从而解读其服饰文化和历史成因,并梳理其演变发展过程,分析其变迁原因。研究表明,苗族柳利式女性盛装的历史变迁与自然环境、社会经济、文化传承、民族交流等密切相关,同时现今的发展受到工业技术、网络市场、多样审美等因素影响。

“骨冷”与“皮冷”:贵州东南山地人群的着装、身体与感知

人的身体每天都藉由着装形成一种衣-身的感知与实践。身体作为衣物穿着的直接载体,是感知、实践甚至具身性(embodiment)的第一现场。对贵州东南山地人群的身体感知与着装进行了民族志考察,不同于既有的“春夏秋冬”四季划分的传统认知范式,而尝试立足于身体穿戴的具身感知来重新审视在社会变迁的情境中着装身体的流动性变化。裤子作为一种外来的服饰单品,提升了当地女性身体着装保暖的程度,同时也强化了具身的冷暖感知,如若传统裙装穿戴之感是“冷皮”,那么平添裤子之后则强化了身体的“冷骨”之感。至此,当地女性身体着装的方式实现了从单一的裙装到裙装与裤装并存,再到完全脱离裙装系统的裤装的转变,身体的着装感受也投射了社会发展的缩影。

四波混频Autler-Townes分裂中的探测光影响

在双Λ-型四波混频系统中,研究了探测光强度对Autler-Townes(AT)分裂效应的影响.随着弱探测光强度增大,由缀饰态共振产生的AT分裂双峰间隔不变,但却逐渐增宽线宽且减弱直至消失;而在强耦合光失谐条件下,不对称地位于单光子共振峰两侧的AT分裂双峰却会逐渐趋于对称分布.详细讨论了探测光场对原子的缀饰影响,提出通过探测光强度可以调控原子两基态之间的有效Raman相干,从而影响AT分裂双峰的特征.

水凝胶:口腔颌面部组织缺损修复中的作用与问题

背景:水凝胶因优越的机械及生物性能在生物医学领域占据独特优势,已成为研究热点。目前水凝胶相关研究涉及组织工程和创口敷料等方面。目的:综述水凝胶的优势性能与在口腔颌面部缺损修复领域中的应用研究进展,探讨水凝胶目前在应用推广中的局限以及在此领域所面临的挑战,为未来研究方向提供新思路。方法:利用计算机检索Pub Med、中国知网、万方数据库发表的相关文献,检索词为“水凝胶,口腔颌面部缺损,机械性能,组织工程,创口敷料”“hydrogel,oral and maxillofacial defects,mechanical properties,guided tissue regeneration,wound dressing”。通过阅读文题和摘要进行初步筛选,排除与文章主题不相关的文献,根据纳入标准和排除标准,最终纳入108篇文献进行结果分析。结果与结论:(1)水凝胶具有良好的生物学活性、机械可控性及刺激响应等优势性能。(2)聚合物、金属和陶瓷联合制备的水凝胶复合物具有适当的机械性能、生物降解性以及可控的释放速率,契合颌面骨组织工程的需求。(3)纤维蛋白基水凝胶可填充穿过神经缺损区域的中空神经导管并促进轴突再生和生长从而恢复颌面神经功能。(4)控制纳米材料和水凝胶的相互作用可以改善肌纤维定向结构的形成以促进颌面肌组织再生。(5)多糖水凝胶,因具有控制药物递送和携带生物活性分子等作用,并且与其他材料联合应用可以产生与细胞外基质相匹配的最佳支架,因此逐渐成为修复不规则牙周缺损的首选。(6)磷酸钙或碳酸钙基水凝胶中填充不规则形状或精细的组织缺损并使牙体硬组织再矿化,自组装水凝胶制备简便且生物活性优良。(7)唾液腺来源的细胞外基质样凝胶有望参与许多唾液腺疾病的治疗。(8)水凝胶可作为伤口敷料结合生物黏合剂、脱细胞生物材料、抗微生物和抗氧化剂或干细胞等而被广泛用于治疗各种伤口。(9)纤维蛋白基水凝胶在口腔颌面部缺损修复中最具潜力,其具有优良的生物相容性、柔韧性和可塑性,可与细胞、细胞外基质蛋白和各种生长因子结合,能够促进间充质干细胞的成骨分化、轴突的再生与生长、血管生成、肌管分化、唾液腺组织再生和牙周组织再生,在口腔颌面部缺损组织的修复中具有广泛前景。然而其治疗效果取决于所携带物质的功能,复杂的制备工艺、安全性和长期疗效以及口腔颌面特殊的解剖结构是阻碍推广的难题,这也为未来的研究提供了方向。

莫匹罗星软膏用于拔甲术后换药的观察

目的探讨在拔甲术后换药期间莫匹罗星软膏药物的应用效果。方法选取厦门市同安区新民街道社区卫生服务中心2022年7月至2023年12月收治的96例拔甲术治疗患者;以投掷硬币法分为两组;参照组(48例)在换药期间,合理选择纱布及敷料实施包扎固定;研究组(48例)在换药期间,采用莫匹罗星软膏药物实施涂抹治疗,完成后,依据参照组方法展开对应治疗。观察比较两组的各项指标差异。结果相较于参照组,研究组的伤口愈合优良率呈现出显著提升(P<0.05);研究组患者平均结痂时间较参照组短,平均换药次数较参照组少,结痂厚度较参照组低(P<0.05);相较于参照组,研究组患者在换药过程中的VAS评分展现出显著降低,其平均伤口愈合时间及平均疼痛消失时间亦均短于参照组(P<0.05)。结论临床对拔甲术治疗患者在选择药物进行治疗期间,莫匹罗星软膏药物的有效应用,可将患者的伤口愈合优良率明显提升,将系列指标明显改善,可促进拔甲术治疗患者的良好预后。

一例人工养殖东北林蛙皮在猫后肢皮肤坏死中的应用

报道了一例猫后肢皮肤坏死后使用人工养殖东北林蛙皮敷料治疗的病例。患猫由于被渔网长期缠绕导致左后肢淤血、水肿和部分皮肤坏死,在治疗前期对患猫左后肢进行清创、红外灯理疗和全身抗生素控制感染。随后患猫左后肢感染减轻,但皮肤出现大面积坏死和脱落,随即采用新鲜消毒的东北林蛙皮敷料包扎治疗患肢,治疗时间为8周。使用东北林蛙皮治疗1周后,新生肉芽组织呈鲜红色,生长良好;治疗3周后患猫伤口快速收缩,表皮大幅再生;治疗8周后伤口基本愈合,患处大部分毛发重新生长,且治疗期间患猫未出现过敏现象。结果表明,东北林蛙皮敷料可促进患猫皮肤伤口肉芽组织的生长和表皮的再生,且不影响皮肤正常功能。

Electrospun antibacterial nanofibers for wound dressings and tissue medicinal fields:A Review

Bacterial infections are a major cause of chronic infections.Thus,antibacterial material is an urgent need in clinics.Antibacterial nanofibers,with expansive surface area,enable efficient incorporation of antibacterial agents.Meanwhile,structure similar to the extracellular matrix can accelerate cell growth.Electrospinning,the most widely used technique to fabricate nanofiber,is often used in many biomedical applications including drug delivery,regenerative medicine,wound healing and so on.Thus,this review provides an overview of all recently published studies on the development of electrospun antibacterial nanofibers in wound dressings and tissue me-dicinal fields.This reviewer begins with a brief introduction of electrospinning process and then discusses electrospun fibers by incorporating various types of antimicrobial agents used as in wound dressings and tissue.Finally,we finish with conclusions and further perspectives on electrospun antibacterial nanofibers as 2D biomedicine materials.

一种普外科用亲水型中药聚氨酯敷料制备及应用

为提高普外科用聚氨酯泡沫的性能,对聚氨酯泡沫敷料进行制备优化,并探究其临床应用效果。实验结果表明,当用水量为60 pbw,稳泡剂硅油L580用量为7.5 pbw,PEG分子量为4000,交联剂甘油的用量为0.75时,得到的聚氨酯泡沫敷料的性能最佳;将该敷料临床用于普外科胃肠道手术患者,使用实验制备的聚氨酯泡沫敷料的患者伤口愈合率要明显高于传统的水凝胶结合无菌纱布组患者(P<0.05)。由此得出,研究制备的聚氨酯泡沫材料可用于普外科患者临床护理,具有一定的临床应用价值。

湿润烧伤膏联合纳米银敷料治疗重度烧伤患者的效果

目的:观察湿润烧伤膏联合纳米银敷料治疗重度烧伤患者的效果。方法:选取2020年9月至2023年5月于该院行清创植皮术的78例重度烧伤患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各39例。两组均给予清创植皮术,在此基础上,对照组给予纳米银敷料治疗,观察组在对照组基础上联合湿润烧伤膏治疗。比较两组临床疗效,预后指标(14 d创面细菌培养阳性率、创面感染率、色素沉着率)水平,瘢痕严重程度[温哥华瘢痕量表(VSS)]评分,创面愈合时间,治疗前后炎性因子[白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,以及并发症发生率。结果:观察组治疗总有效率为94.87%(37/39),高于对照组的74.36%(29/39),差异有统计学意义(P<0.05);观察组14 d创面细菌培养阳性率、创面感染率、色素沉着率均低于对照组,差异有统计学意义(P<0.05);观察组VSS评分低于对照组,创面愈合时间短于对照组,差异均有统计学意义(P<0.05);治疗后,两组IL-2、IL-6、TNF-α水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.56%(1/39),低于对照组的20.51%(8/39),差异有统计学意义(P<0.05)。结论:湿润烧伤膏联合纳米银敷料治疗重度烧伤患者可提高临床疗效,改善预后,减轻瘢痕和机体炎症反应,降低并发症发生率,效果优于单纯纳米银敷料治疗。

Effect of vacuum sealing drainage combined with biological dressings on the angiogenesis and inflammatory response after diabetic foot ulcer wound grafting

Objective: To study the effect of vacuum sealing drainage combined with biological dressings on the angiogenesis and inflammatory response after diabetic foot ulcer wound grafting. Methods: Patients with diabetic foot who were treated in Sichuan Provincial People's Hospital between May 2014 and February 2017 were selected and randomly divided into vacuum drainage group and normal control group who received vacuum sealing drainage combined with biological dressings as well as conventional debridement and dressing change to deal with the wound respectively. Before treatment as well as 1 d, 3 d and 5 d after treatment, the wound tissue was collected to determine the expression of angiogenesis molecules, angiogenesis signaling pathway molecules and inflammatory response molecules. Results: 1 d, 3 d and 5 d after treatment, VEGF, VEGFR, CD105, MMP9, PI3K, AKT, cyclinD1, p38MAPK and NF-kB protein expression in wound tissue of vacuum drainage group were significantly higher than those of normal control group while COX-2, iNOS, TNF-α and IL-6 mRNA expression were significantly lower than those of normal control group. Conclusion: Vacuum sealing drainage combined with biological dressings promotes the angiogenesis and inhibits the inflammatory response after diabetic foot ulcer wound grafting.

Application Experience of Moist Wound Healing Theory Combined with Modern New Dressings in the Treatment of Pressure Ulcers

Objective:Research on the effect of moist wound healing theory in a combination with modern new dressing treatment in patients diagnosed with pressure ulcers.Method:Selected 30 patients with pressure ulcers from our hospital,which is Shandong Tai an Municipal Hospital,from January 2019 to January 2021 were divided into experimental group(15 cases,treated with moist wound healing theory combined with modern new dressings)and control group(15 cases,applied conventional treatments).The treatment effect,time of wound edema subsidence,wound healing time,number of dressing changes,granulation tissue growth time,and diameter reduction time were compared between the two groups.Results:The total effective rate of the experimental group(93.33%,14/15)was higher than that of the control group(53.33%,8/15),P<0.05;the time to subsidence of wound edema in the experimental group was(3.11±0.22),and the time for wound healing was(12.78±0.45),the number of dressing changes(7.13±0.34)times,the growth time of granulation tissue(5.43±2.22),the diameter reduction time(6.25±3.75),compared with the control group,P<0.05.Conclusion:In the clinical treatment of patients diagnosed with pressure ulcers,the effective combination of moist healing theory and modern new dressing therapy has significant effects,whereby it speeds up the healing process of the pressure ulcers,and it is proven to be worthy to be promoted for usage.