XB130 inhibits healing of diabetic skin ulcers through the PI3K/Akt signalling pathway

BACKGROUND Diabetic skin ulcers,a significant global healthcare burden,are mainly caused by the inhibition of cell proliferation and impaired angiogenesis.XB130 is an adaptor protein that regulates cell proliferation and migration.However,the role of XB130 in the development of diabetic skin ulcers remains unclear.AIM To investigate whether XB130 can regulate the inhibition of proliferation and vascular damage induced by high glucose.Additionally,we aim to determine whether XB130 is involved in the healing process of diabetic skin ulcers,along with its molecular mechanisms.METHODS We conducted RNA-sequencing analysis to identify the key genes involved in diabetic skin ulcers.We investigated the effects of XB130 on wound healing using histological analyses.In addition,we used reverse transcription-quantitative polymerase chain reaction,Western blot,terminal deoxynucleotidyl transferasemediated dUTP nick end labeling staining,immunofluorescence,wound healing,and tubule formation experiments to investigate their effects on cellular processes in human umbilical vein endothelial cells(HUVECs)stimulated with high glucose.Finally,we performed functional analysis to elucidate the molecular mechanisms underlying diabetic skin ulcers.RESULTS RNA-sequencing analysis showed that the expression of XB130 was up-regulated in the tissues of diabetic skin ulcers.Knockdown of XB130 promoted the healing of skin wounds in mice,leading to an accelerated wound healing process and shortened wound healing time.At the cellular level,knockdown of XB130 alleviated high glucose-induced inhibition of cell proliferation and angiogenic impairment in HUVECs.Inhibition of the PI3K/Akt pathway removed the proliferative effects and endothelial protection mediated by XB130.CONCLUSION The findings of this study indicated that the expression of XB130 is up-regulated in high glucose-stimulated diabetic skin ulcers and HUVECs.Knockdown of XB130 promotes cell proliferation and angiogenesis via the PI3K/Akt signalling pathway,which accelerates the healing of diabetic skin ulcers.

Application of integrated traditional Chinese and Western medicine in the treatment of juvenile localized scleroderma with skin ulcer: a case report

Background:Juvenile Localized Scleroderma(JLS)is a rare pediatric rheumatic disease characterized by inflammation and skin sclerosis.The side effect of consensus-recommended medications and the risk of disability posed challenges to the JLS treatment.We intend to demonstrate the potential of traditional Chinese medicine in treating JLS with skin ulcers and reducing the dose of glucocorticoid.Method:Here we report a case of a 13-year-old male with JLS who took oral methotrexate tablets of 10 mg/week and methylprednisolone of 6 mg/day for over six months without significant effect and suffered from skin ulcers on the dorsal feet one month after drug cessation.Subsequently,the patient was treated with integrated traditional Chinese and Western medicine of low-dose glucocorticosteroid,adjusted Shenqi Huoxue formula and Jinshe Xiaoyan formula,etc.Results:After integrated treatment,the patient’s dorsal feet ulcers healed and the skin sclerosis and hyperpigmentation improved significantly.Conclusions:This case report suggests that integrated traditional Chinese and Western medicine can be used as an effective treatment for JLS.

Isolation and Identification of the Pathogen Causing Skin Ulcer Disease in Cynoglossus semilaevis Günther and Its Sensitivity to Chinese Herbal Medicine

In this study, the pathogen causing skin ulcer disease in Cynoglossus semilaevis Gunther was isolated for morphological observation, physiological and bio- chemical identification. According to the result, the isolated pathogen was identified as Vibrio harveyi. The results of recurrent infection of C. semilaevis Gonther showed that the pathogen was strongly pathogenic to C. semilaevis Gunther. In or- der to explore the pathogenesis, outer membrane protein （OMP） gene of C. semi- laevis Gunther was detected by PCR. The results showed that all the three repre- sentative strains harbored OMP gene. According to the results of sensitivity test of the pathogen to Chinese herbal medicine, Galla Chinensis, Fructus Mume, Fructus Hippophae and Lignum Sappan exerted strong antibacterial effects against V. harveyr, Pericarpium Granati exhibited slight antibacterial effect against V. harveyi; Pericarpium Citri Reticulatae, Rhizoma Acori GramineL Herba Houttuyniae, Herba Portulacae, Herba Andrographis, Eucalyptus globulus Labill. and Herba Menthae Heplocalycis had little effect on V. harveyi. Galla Chinensis, Fructus Mume, Fructus Hippophae and Lignum Sappan were prepared into three prescriptions, among which prescription 1 （Galla Chinensis ＋ Fructus Mume） exhibited the strongest antibacterial effect.

Antibacterial Activity of Extracts from Zostera marina Against Pathogens of Apostichopus japonicus Skin Ulceration Disease

The purpose of this study was to investigate the antibacterial activity of extracts from Zostera marina against the pathogens of Apostichopus japonicus skin ulceration disease.When 95% ethanol (v/v) solvent was used to extract Zostera marina at 50℃,aqueous extract (ZA) showed obvious bacteriostatic effects on the tested bacterial strains (inhibition halo diameters between 8.23 mm and 13.62 mm),whereas the ethyl acetate extract (ZE) was almost inactive.The minimal inhibitory concentration (MIC) of ZA against four pathogens were homogeneous at 12.8 g L-1.ZA components were analyzed by thin layer chromatography (TLC) assay and six fractions were obtained.In another study,the six fractions showed inhibitory effects against the tested bacteria while their functions seemed to counteract the ZA activity.

Metabolomics analysis for skin ulceration syndrome of Apostichopus japonicus based on UPLC/Q-TOF MS

Skin ulceration syndrome(SUS)is the main diseases aff ected the development of sea cucumber(Apostichopus japonicus)culture industries.To better observe the changes in the sea cucumber A.japonicus with SUS and understand the pathogenesis of the disease,activities of superoxide dismutase(SOD),catalase(CAT),and level of malondialdehyde(MDA)in coelomic fluid were detected using the Assay Kit and metabolites in the body wall were assessed using ultra-performance liquid chromatography and quadrupole-time of flight mass spectrometry.The results indicated that level of MDA was increased during SUS compared with healthy individuals(P<0.01),but activities of SOD and CAT were reduced(P<0.05).In metabolomics analysis,metabolites,such as adenosine,choline,betaine aldehyde,palmitic acid,and taurine,were found to be upregulated and 2-oxoadipic acid,anthranilic acid(vitamin L1),thioetheramide-PC,cholesterol-3-sulfate,and pentadecanoic acid were downregulated(VIP>1 and P<0.1).Pathway enrichment analysis indicated most enrichment of KEGG pathways were mainly related to energy metabolism,immunity,and osmoregulation such as ABC transporters,glycine,serine and threonine metabolism,tryptophan metabolism and neuroactive ligand-receptor interaction.Our study reflected the difference in enzyme activity and metabolites between A.japonicus with SUS and those without,which will provide reference data for investigating SUS.

Skin Characteristics of Sites Predisposed to Pressure Ulcers among Bedridden Elderly Patients in Japan

Background: Previous studies have not specifically measured skin characteristics at common sites of pressure ulcers in high-risk elderly patients. Therefore, this study aimed to clarify the physiological skin characteristics at common pressure ulcer sites and their relationship with pressure ulcer risk and demographic/laboratory data in bedridden elderly Japanese patients. Methods: This study involved 55 elderly Japanese patients in a long-term care hospital and 25 female Japanese university students. Skin surface temperature, epidermal water content, transepidermal water loss, skin erythema/redness, skin elasticity, and skin thickness were measured using noninvasive devices. The sacral and both heel areas (sites predisposed to pressure ulcers) and mid-to-lower back area (control site) were observed. Results: Elderly patients showed a low epidermal water content at both heels (right heel, 14.8 ± 9.1 arbitrary units, AU.;left heel, 14.4 ± 8.3 AU). Transepidermal water loss remained acceptable at all sites in older patients despite the presence of dry skin (back, 7.1 ± 1.8 g/hm2;sacrum, 7.4 ± 3.0 g/hm2;right heel, 17.7 ± 7.1 g/hm2;left heel, 19.4 ± 8.1 g/hm2). Back (0.61 ± 0.13 AU) and sacral (0.67 ± 0.11 AU) skin elasticity and sacral skin thickness (0.97 ± 0.56 cm) were significantly lower than those of healthy young people (0.86 ± 0.04 AU, 0.87 ± 0.05 AU, and 2.27 ± 0.84 cm, respectively;p < 0.001 for all sites). Moderate positive correlations were observed between back skin elasticity and serum albumin level (r = 0.445, p < 0.001), and between sacral skin thickness and BMI (r = 0.506, p < 0.001) in older patients. Conclusions: Our findings showed that skin thickness and elasticity should be prioritized when evaluating pressure ulcer risk at the sacral region in bedridden elderly Japanese patients. Moreover, skin moisturization should be considered to minimize the risk at the heels in such patients.

Efficacy of compound Bai Yu San in treating diabetic skin ulcer

Objective:To assess the efficacy of compound Bai Yu San(CBYS)as a new treatment option,in healing diabetic skin ulcer.Materials and Methods:A total of 64 diabetic patients with skin ulcer were enrolled and randomly assigned to experimental group(n=33)and control group(n=31).In the control group,normal saline(NS)was used to cleanse the wound.After debridement,the wound was dressed with modern materials.In the experimental group,the NS‑cleansed wound was dressed with CBYS.The infection rate,healing rate,treatment cost,and patient satisfaction between the two groups were compared.Results:On the 35th day after treatment,the infection rate and healing rate showed no between‑group difference(P>0.05);the experimental group showed lower treatment cost and higher satisfaction than the control group(P<0.05).Conclusion:As a new treatment option for diabetes‑induced skin ulcer,CBYS can effectively control the infection,promote the healing,reduce treatment cost,and increase patient satisfaction.Dressing with CBYS can be clinically replicated in the treatment of diabetic skin ulcer.

Ulcerative colitis presenting as leukocytoclastic vasculitis of skin

A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD), including pyoderma gangrenosum, erythema nodosum, perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.

Anti-nuclear matrix protein 2+ juvenile dermatomyositis with severe skin ulcer and infection: A case report and literature review

BACKGROUND Juvenile dermatomyositis(JDM)is an idiopathic inflammatory myopathy that occurs in childhood.It is characterized by muscle weakness and a characteristic rash.Previous literature reports have rarely described JDM with severe skin ulcers and infections.CASE SUMMARY Herein,we describe a case of a 2-year-old female patient who suffered from JDM,whose myositis-specific autoantibodies were positive for anti-nuclear matrix protein 2 antibody,with progressively worsening skin ulcers and severe infections.The patient was treated with glucocorticoids and various immunosuppressants.Nevertheless,further progression of the disease and the combination of primary disease and severe infection in the later period were fatal.CONCLUSION In children,anti-nuclear matrix protein 2+JDM combined with skin ulcers often indicates severe disease.In such cases,personalized treatment for the primary disease and infection prevention and control are essential.

Differential expression of telomerase reverse transcriptase in chronic human skin ulcer induced by radiation and mechanism of cancer transformation and poor healing

AIM:To study the expression of the catalytic subunit of telomerase, telomerase reverse transcriptase(TRT) and explore the possible relationship between the TR T and cancer transformation or poor healing in radiation-induced chronic human skin ulcer.METHODS:Rabbit antibody to human TRT and SP immunohistochemical metho d were used to detect TRT expression in 24 cases of formalin-fixed,paraffin-em beded chronic human skin ulcer tissues induced by radiation, 5 cases of normal s kin,2 of burnt skin,and 8 of carcinoma.RESULTS: The TRT was detected positive in 14 of 24 (58.3%) chronic radiation ulcers, of which the strongly positive was 10 of 24 (41.7%) and the weakly positive 4 of 24 (16.7%);in 0 of 5 normal and 0 of 2 burnt skins;and in 8 of 8 (100%) carcinomas.The expression of TRT was ob served almost always strongly positive in the cytoplasm and nucleus of squamous epithelial cells of epidermis but negatively in the endoepithelial cells of capi llaries and small blood vessels,or weakly in the cytoplasm of smooth myocytes of media and fibroblasts,of dermis. Chronic inflammtory cells,such as plasma cells and lymphocytes also showed weakly positive for TRT.CONCLUSION:The strong TRT e xpression in the epidermis could be involved in the cancer transformation from c hronic radiation ulcer to squamous carcinoma, whereas the negative or weak TRT e xpression in the capillaries, small blood vessels and fibroblasts of dermis migh t be responsible for the poor healing of chronic ulcers induced by radiation, ca used by sclerosis of small blood vessels and lack of granulation tissue consisti ng of capillaries and fibroblasts.

Research on combination of PRP,PRF and adipose-derived stem cells for wound healing of chronic skin ulcer

Objective To investigate the effects of combination of PRP,PRF and adipose-derived stem cells(ADSC)for wound healing of chronic skin ulcer,and provide evidences for clinical application.Methods Twenty-four SD rats aged 6-8 weeks were used in this study.5 grams of groin adipose tissue were derived from each rat.After collagenase digestion,mesenchyma stem cells derived from adipose tissue(ADSCs)were determined by immunocytochemical method and flow cytometry.After continuous culturing,the 3th passage of ADSCs in good condition was prepared for transplantation.Ten milliliters of whole blood were extracted from one rat for making PRP and PRF backup.Full thickness skin defect model with six wounds with an area of 1.5cm*1.5cm on each side of the spine on the back was established in rats after anesthesia.Then the rats were randomly divided into six groups.Skin wounds were injected with PRF combining ADSC in group A,PRF in group B,ADSC in group C,ADSC combining PRP in group D,PRP in group E,and same amount of normal saline(NS)in group F.Histological analysis was performed to evaluate the velocity and the quality of the wound healing 7 days,14 days,21days and 28 days after treatment,and comparing the regeneration of epidermis,corium,fibroblast,blood vessel and skin appendages respectively.Results The woulds in each group healed well,without symptoms of infection.Skin wounds were almost healed in 21 days,and no significant difference in healing velocity was found among these groups.There were no apparent inflammatory cells in 7 days.The wounds were filled with granulation formed by proliferation of connective tissue with visible new blood capillary and repair cells like fibroblast.Epidermis grew out and became thick,and gradually grew to the wounds,with active proliferation of re-epithelization.Re-epithelization was completed in 14 days,with granulation tissue covered by epidermis and fibrosis showing a significant increase in collagenous fiber,and visible skin appendages like new hair follicle,glandula sebacea,sweat gland and corneum.Appendages like hair follicle,glandula sebacea,sweat gland and corneum increased in 21 days,and granulation tissue gradually formed scar tissue and entered remodeling phase.There was no significant changes from 21 days to 28 days,and the tissues were entering a long remodeling phase.Healing status:Group D,A and C could be observed with more complete epidermis,new blood vessel and new hair follicle.Among them,Group D was most significant,while group A,C,E,B successively and group F had the slowest epidermal migration and the least new hair follicle.The velocity and the quality of these groups were as follows:D>A>C>E>B>F,indicating that ADSC combining PRP can improve quality in wound healing of skin ulcer effectively.Conclusions After the general and pathological observation on the effects,the velocity and the quality for the skin ulcer healing of SD rats on the back were as follows:ADSC+PRP>ADSC+PRF>ADSC>PRP>PRF>NS,indicating that PRP or PRF combining ADSC can improve quality in wound healing of skin ulcer effectively.

Sequential treatment for diabetic foot ulcers in dialysis patients:A case report

BACKGROUND Diabetic foot ulcers(DFUs)are common in patients with diabetes,especially those undergoing hemodialysis.In severe cases,these ulcers can cause damage to the lower extremities and lead to amputation.Traditional treatments such as flap transposition and transfemoral amputation are not always applicable in all cases.Therefore,there is a need for alternative treatment methods.CASE SUMMARY This report describes a 62-year-old female patient who was admitted to the hospital with plantar and heel ulcers on her left foot.The patient had a history of renal failure and was undergoing regular hemodialysis.Digital subtraction angiography showed extensive stenosis and occlusion in the left superficial femoral artery,left peroneal artery and left posterior tibial artery.Following evaluation by a multidisciplinary team,the patient was diagnosed with type 2 DFUs(TEXAS 4D).Traditional treatments were deemed unsuitable,and the patient was treated with endovascular surgery in the affected area,in addition to supportive medical treatment,local debridement,and sequential repair using split-thickness skin and tissue-engineered skin grafts combined with negative pressure treatment.After four months,the wound had completely healed,and the patient was able to walk with a walking aid.CONCLUSION This study demonstrates a new treatment method for DFUs was successful,using angioplasty,skin grafts,and negative pressure.

A Royal Jelly Mixture with Berberine for Dressing Change on a Refractory Skin Ulcer:A Case Report

It has been reported that a 92-year-old female had got a bruise superficial wound on her right leg one and a half years ago,developing into refractory skin ulcer due to improper management before.A prepared cream,mixed royal jelly with berberine for dressing change,was made on the scene through the crush of berberine tablets,working with fresh royal jelly.Topical dressing change with the cream was done every 3 days,and two months later,such the ulcer became clean and was covered fully with fresh granulation tissue.This kind of cream consists of the ingredients of TCM purely,free of antibiotic,and being quite effective clinically,also helpful for proper use of antibiotic.

小檗碱调节HIF-1α/VEGF信号通路对皮肤溃疡大鼠血管生成和创面愈合的影响

目的:探究小檗碱(BR)调节缺氧诱导因子-1α(HIF-1α)/血管内皮生长因子(VEGF)信号通路对皮肤溃疡大鼠血管生成和创面愈合的影响。方法:取SD大鼠采用创面局部多次涂抹冰醋酸建立皮肤溃疡模型,随机数字法分组,包括模型组(M组)、小檗碱低剂量组(BR-L组)、小檗碱高剂量组(BR-H组)、小檗碱高剂量+空载组(BR-H+pc-DNA组)、小檗碱高剂量+HIF-1α敲低组(BR-H+pc-HIF-1αKD组),每组10只,另选10只SD大鼠作为对照组(C组)。以药物分组处理3周后,测定各组大鼠创面愈合率;HE染色检测各组大鼠皮肤溃疡创面组织病理形态;免疫组织化学染色检测各组大鼠皮肤溃疡创面组织微血管密度(MVD)及胶原蛋白Ⅰ(CollagenⅠ)与纤维结合蛋白(FN)表达;酶联免疫吸附测定(ELISA)各组大鼠血清及皮肤溃疡创面组织炎性因子IL-6、IL-8表达水平;免疫印迹法检测各组大鼠皮肤溃疡创面组织HIF-1α/VEGF通路蛋白表达水平。结果:与C组相比,M组大鼠创面组织MVD、血清及创面组织IL-6、IL-8水平升高(均P<0.05)。与M组相比,BR-L组、BR-H组、BR-H+pc-DNA组大鼠创面愈合率、创面组织MVD、HIF-1α及VEGF蛋白表达均升高(均P<0.05),血清及创面组织IL-6、IL-8水平均降低(均P<0.05),且高剂量小檗碱作用更强。敲低HIF-1α可减弱BR对模型组大鼠各指标的作用。结论:小檗碱可通过上调HIF-1α/VEGF通路而降低炎性因子表达,抑制炎症,增强皮肤溃疡大鼠血管生成和胶原形成,促进其创面愈合。

基于“皮-肠轴”理论探讨肠道菌群与糖尿病溃疡的关系

糖尿病溃疡(dabetic ulcer)是糖尿病(diabetes mellitus)的严重并发症之一,具有迁延难愈、易感染、易导致截肢或脓毒症的特点[1]。据统计,2016年,全球糖尿病下肢并发症患者约1.31亿,其中250万患者因足部溃疡导致残疾而缩短生命[2]。糖尿病溃疡难愈原因复杂,涉及血管因素、神经因素、免疫因素及微生物因素,其中创面微生物的变化以及与不同细胞作用产生的免疫应答影响了创面的修复[3]。

甲基莲心碱通过调节AMPK/mTOR/NLRP3信号通路减轻慢性皮肤溃疡大鼠的炎症反应

目的:探讨甲基莲心碱(Nef)调节AMP活化蛋白激酶(AMPK)/哺乳动物雷帕霉素靶蛋白(mTOR)/NOD样受体热蛋白结构域相关蛋白3(NLRP3)信号通路对慢性皮肤溃疡(CSU)大鼠炎症反应的影响。方法:将90只大鼠随机分为空白对照组(NC组)、CSU组、Nef组、AMPK抑制剂(Compound C)组、Nef+Compound C组,每组18只大鼠。除NC组外的其他各组大鼠通过剪开创口注射氢化可的松以及喷洒金黄色葡萄球菌构建CSU大鼠模型。造模完成后,Nef组和Compound C组分别将20%Nef、10μmol·L^(-1) Compound C与50 mL的20%高渗盐水凝胶混合敷在伤口处,Nef+Compound C组将20%Nef和10μmol·L^(-1) Compound C一起添加到20%高渗盐水凝胶中敷在伤口处,持续治疗2周,NC组、CSU组用等量盐水凝胶处理伤口。观察大鼠皮肤创面愈合情况;ELISA法检测血清白细胞介素(IL)-1β、IL-8、TNF-α水平;水解法检测创面肉芽组织中羟脯氨酸(HyP)水平;HE染色检测肉芽组织病理学变化;Western blotting检测CCL4、CCL2、CXCL12以及AMPK/mTOR/NLRP3信号通路蛋白表达水平。结果:CSU组大鼠可看到新生肉芽组织,并且有大量炎症细胞浸润现象,CSU组较NC组IL-1β、IL-8、TNF-α含量显著升高(P<0.05);与CSU组相比,Nef组创面愈合率、HyP含量、p-AMPK/AMPK蛋白水平显著增加(P<0.05),IL-1β、IL-8、TNF-α含量、CCL2、CXCL12、CCL4、mTOR、NLRP3蛋白水平显著下降(P<0.05),而Compound C组趋势相反(P<0.05);Compound C消除了Nef对CSU大鼠炎症反应的减轻作用。结论:Nef可能通过调控AMPK/mTOR/NLRP3信号通路减轻CSU大鼠炎症反应。

预防刺参腐皮综合征复方中药的筛选及体内药效评价

为开发防治刺参腐皮综合征的复方中药,从14种中药中筛选出对灿烂弧菌(Vibrio splendidus)有明显抑制作用的单味中药,并通过正交实验确定最佳抗菌复方FF-Z(诃子﹕五倍子﹕穿心莲﹕川芎=15 g﹕2 g﹕10 g﹕5 g)。在饲料中分别添加10、20、30和40 g/kg的复方FF-Z作为试验组,不含复方FF-Z的饲料为对照组,并以含恩诺沙星粉20 g/kg的饲料为药物对照组,连续投喂刺参10d,继而用终浓度为10^(7) CFU/mL的灿烂弧菌进行浸浴攻毒,以观察预防保护效果。结果显示,灿烂弧菌对复方FF-Z极敏感,抑菌圈直径可达(23.10±0.62)mm,最小抑菌浓度(MIC)和最小杀菌浓度(MBC)值分别为7.81和15.63 mg/mL;与阴性对照组相比,复方FF-Z各剂量组刺参的SOD、ACP和AKP活性显著提高,且优于药物对照组。在灿烂弧菌感染后,复方FF-Z各剂量组处理的刺参发病时间比阳性对照组推迟2d,其中复方FF-Z 20 g/kg组、FF-Z 30 g/kg组和FF-Z 40 g/kg组刺参的20d发病率分别为22.08%、22.14%和14.58%,显著低于阳性对照组的84.45%。组织病理学观察结果表明,添加30 g/kg复方FF-Z的饲料能够有效减轻灿烂弧菌入侵引起的刺参组织炎症反应,从而起到保护作用。研究证明,复方FF-Z能够显著提高刺参的免疫和抗病力,对灿烂弧菌引起的腐皮综合征具有良好的预防保护效果,能延缓该病的发病进程并降低发病率。

临床药师参与1例羟基脲致下肢皮肤溃疡用药实践

目的为羟基脲致下肢皮肤溃疡的诊治提供参考。方法回顾医院收治的1例羟基脲治疗原发性血小板增多症(ET)引起下肢溃疡老年女性患者的诊治过程。患者入院后经验性给予注射用阿莫西林钠克拉维酸钾静脉滴注+羟基脲片口服。但临床药师查房追问病史发现,患者近1年反复出现口腔溃疡且不易恢复,根据患者用药史、羟基脲药品说明书和相关文献,考虑为羟基脲引起的皮肤血管毒性,建议主管医师减量或换药。结果综合血液科医师会诊意见,主管医师换药为阿那格雷。20 d后患者症状改善,带药出院。结论临床药师参与临床会诊,可保证患者用药的安全有效;建议将使用羟基脲的患者纳入重点监护人群,尽早发现该类患者可能出现的药品不良反应,尽早干预,以减少其发生风险。

岭南地区皮肤溃疡患者的临床特征及中医证型分布研究

【目的】回顾性分析岭南地区皮肤溃疡病例的临床资料,探讨其中医证型分布特点及相关影响因素。【方法】收集2012年8月至2022年7月在广东省中医院皮肤科住院治疗的241例皮肤溃疡患者的临床资料,分析其临床特点和中医证型分布规律。【结果】(1)临床特点方面,241例皮肤溃疡患者的发病年龄从10岁到98岁不等,其中70~79岁的年龄段是发病的高发区间;病程从1周到20余年不等,而且大部分患者的病程在1~5年之间;241例皮肤溃疡患者中,以男性为主,男女患病比例为1.62∶1;皮肤溃疡发病率最高的部位为下肢200例(82.99%),其次为躯干17例(7.05%)、全身多发13例(5.39%)、上肢9例(3.73%)、头面部2例(0.83%)。其不同性别病变部位分布比较,差异无统计学意义(P>0.05)。(2)中医证型分布方面,241例皮肤溃疡患者中,以湿热瘀阻证最为常见(46.89%),其他按百分比由高到低依次为脾虚湿盛证(27.39%)、气虚血瘀证(14.11%)、气阴两虚证(11.62%)。4种中医证型的性别分布比较,差异无统计学意义(P>0.05),但其发病年龄段分布比较,差异有统计学意义(P<0.05)。【结论】岭南地区皮肤溃疡患者的发病年龄、性别、部位和病程分布等均存在一定差异,中医证型分布以湿热瘀阻证占比最多。

基于氧化应激反应探讨慢性体表溃疡发病机理及象皮生肌膏联合托里消毒散的干预作用

目的 探讨慢性体表溃疡发病机理以及象皮生肌膏联合托里消毒散的干预作用。方法 将30只SPF级雄性SD大鼠按随机数字表法分为空白对照组、模型组、象皮生肌膏组、托里消毒散组、象皮生肌膏联合托里消毒散组,每组各6只。采用金黄色葡萄球菌造模,连续给药1周后,检测创面组织中血管内皮生长因子(Vascular endothelial growth factor,VEGF)、血管内皮细胞生长因子受体2(Vascular endothelial growth factor receptor 2,VEGFR-2)、核因子E2相关因子2(Nuclear factor erythroid 2-related factor 2,Nrf2)、NAD(P)H醌氧化还原酶1[NAD(P)H quinone oxidoreductase1,NQO1)、血红素加氧酶1(Heme oxygenase-1,HO-1)]表达水平。结果 与空白对照组比较,模型组创面组织中VEGF、VEGFR-2表达均明显降低,差异有统计学意义(P<0.01);与模型组比较,象皮生肌膏组、托里消毒散组、象皮生肌膏联合托里消毒散组VEGF、VEGFR-2表达均明显升高,差异有统计学意义(P<0.01)。与对照组比较,模型组中Nrf2、NQO1、HO-1表达水平升高,差异有统计学意义(P<0.01);与模型组比较,象皮生肌膏组、托里消毒散组、象皮生肌膏联合托里消毒散组Nrf2表达水平均明显升高,NQO1和HO-1表达降低,差异有统计学意义(P<0.01)。结论 大鼠慢性溃疡的形成可能与氧化应激反应抑制了VEGF通路及Nrf2通路有关,而象皮生肌膏联合托里消毒散可能通过调节上述通路促进溃疡处血管新生和抗氧化应激,进而提高创面愈合能力。