Histologic analysis and long-term effect of acellular dermal matrix combined with autologous thin split-thickness skin graft

Objective To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft.Methods 23 patients were treated with acellalar dermal matrix(ADM) combined with autoiogous

脱细胞皮肤基质/聚氨酯混纺纤维支架促进大鼠皮肤缺损的修复

背景:研究证实,将脱细胞基质与聚合物进行混合纺丝不仅可改善纤维的结构性质,还可保存脱细胞基质的生物学活性,但是目前将聚氨酯与脱细胞皮肤基质进行静电纺丝制备皮肤组织工程支架还没有相关报道。目的:观察脱细胞皮肤基质/聚氨酯混纺纤维支架对大鼠皮肤缺损的修复作用。方法:利用静电纺丝技术分别制备聚氨酯静电纺丝纤维支架和脱细胞皮肤基质/聚氨酯混纺纤维支架。扫描电镜下观察纤维结构;将大鼠脂肪间充质干细胞分别接种于两组支架上,扫描电镜下观察支架上的细胞形态。取10只SD大鼠,在每只大鼠背部制作3个1 cm×1 cm的全层皮肤缺损,其中2处缺损分别植入聚氨酯静电纺丝纤维支架(对照组)、脱细胞皮肤基质/聚氨酯混纺纤维支架(实验组),剩余缺损处不植入任何材料(空白对照组)。术后第1,2,3周,观察皮肤创面愈合情况;植入后第3周,进行创面苏木精-伊红染色,计算创面瘢痕面积。结果与结论:①扫描电镜下可见两种静电纺丝纤维均为网状结构,并且大鼠脂肪间充质干细胞在两种支架上沿纤维附着,黏附良好。②随着术后时间的延长,各组皮肤创面逐渐愈合,至术后第3周,实验组、对照组皮肤创面基本愈合,空白对照组创面可见小溃疡形成。皮肤创面苏木精-伊红染色显示,对照组、实验组创面表皮覆盖基本完整,真皮层内可见成纤维细胞长入和炎症细胞浸润,并且实验组创面胶原纤维较为丰富、排列规则有序,与表皮面基本平行;空白对照组创面表皮仍有缺损。实验组创面瘢痕面积小于其他两组(P<0.05,P<0.01)。③结果表明,脱细胞皮肤基质/聚氨酯混纺纤维支架可以有效修复大鼠全层皮肤缺损、改善创面瘢痕形成。

Squamous cell carcinoma of the skin: Emerging need for novel biomarkers

The incidence of non-melanoma skin cancers(NMSC)is rising worldwide resulting in demand for clinically useful prognostic biomarkers for these malignant tumors,especially for invasive and metastatic cutaneous squamous cell carcinoma(cSCC).Important risk factors for the development and progression of cSCC include ultraviolet radiation,chronic skin ulcers and immunosuppression.Due to the role of cumulative long-term sun exposure,cSCC is usually a disease of the elderly,but the incidence is also growing in younger individuals due to increased recreational exposure to sunlight.Although clinical diagnosis of cSCC is usually easy and treatment with surgical excision curable,it is responsible for the majority of NMSC related deaths.Clinicians treating skin cancer patients are aware that certain cSCCs grow rapidly and metastasize,but the underlying molecular mechanisms responsible for the aggressive progression of a subpopulation of cSCCs remain incompletely understood.Recently,new molecular markers for progresprogression of cSCC have been identified.

甲基丙烯酰化改性真皮细胞外基质水凝胶促进腹壁缺损修复

背景:目前用于填充腹壁缺损部位的合成高分子材料(如聚丙烯或聚酯)不仅缺乏可降解性和生物活性,还难以适应复杂形状伤口需求,因此,找到免疫原性低、组织相容性好的生物活性材料成为腹壁缺损修复研究的热点。目的:制备甲基丙烯酰化改性真皮细胞外基质水凝胶,探讨其在腹壁缺损中的潜在应用价值。方法:(1)依次用0.25%胰蛋白酶、1%Triton X-100对猪真皮进行脱细胞处理,获得真皮细胞外基质;胃蛋白酶消化真皮细胞外基质,经甲基丙烯酸酐改性后光交联形成甲基丙烯酰化改性真皮细胞外基质水凝胶,扫描电镜观察水凝胶的微观形貌,测试其流变学性能、溶胀性等理化性质;(2)将L929成纤维细胞接种到甲基丙烯酰化改性的真皮细胞外基质水凝胶中,检测细胞相容性;(3)将12只SD大鼠随机分为2组(n=6),创建保留腹膜的腹壁缺损模型,聚丙烯组缺损部位填充聚丙烯材料,水凝胶组缺损部位填充甲基丙烯酰化改性真皮细胞外基质水凝胶,两组创面皮肤均用聚丙烯材料覆盖,观察创面愈合情况并进行组织学分析。结果与结论:(1)采用酶解法对猪真皮进行脱细胞后具有良好的脱细胞效果,并且原有的糖胺聚糖及胶原蛋白保留较好。扫描电镜下可见甲基丙烯酰化改性真皮细胞外基质水凝胶为疏松多孔结构,孔径在70-120μm之间,该水凝胶的溶胀比为(16.88±3.24)%,吸水率为(94.24±1.11)%,流变学性能测试表明该水凝胶状态稳定且具有剪切变稀特点,具备可注射性;(2)CCK-8检测与Live/Dead染色结果显示,甲基丙烯酰化改性真皮细胞外基质水凝胶具有良好的细胞相容性;(3)动物实验结果显示,实验组术后7,10,14 d的皮肤创面愈合率高于对照组(P <0.05);皮肤与肌层组织苏木精-伊红、Masson染色显示,与聚丙烯组比较,水凝胶组术后14 d的皮肤创面上皮化情况、毛囊生成、胶原纤维排列及新生血管情况更好,术后28 d的皮肤创面新生组织结构与正常组织相近,并且瘢痕增生较少,术后28 d时可见少量肌肉组织再生;(4)结果表明,甲基丙烯酰化改性真皮细胞外基质水凝胶可促进腹壁缺损大鼠的皮肤创面愈合和肌肉组织再生。

Inhibition of elastin and collagen networks degradation in human skin by gingival fibroblast. In vitro, ex vivo and in vivo studies.

Skin aging shows an imbalance between synthesis and degradation of the extracellular matrix. The overproduction of degradative enzymes (MMPs) during the chronology- and photo-induced aging leads to a degradation of the elastic and collagen networks. In a model of collagen and elastin destruction, we showed that the gingival fibroblast was able to preserve these macromolecules by inhibiting the overproduction of metalloproteinases by overproduction of TIMP-1 and modulation of the inflammatory cytokines activity. The objective of this study is to evaluate the effect of the gingival fibroblasts on human skin. The results in vitro and ex vivo show that the gingival fibroblast protects the skin collagen and elastic network by the inhibition of MMPs which leads to an overproduction of the TIMP-1. Moreover, the gingival fibroblast modulates the activity of some enzymes responsible for the inflammation;they inhibit the IL-1β and stimulate the production of TGF-β1. In vivo studies with a duration of six months and 50 women with pronounced wrinkles show that the culture supernatant of gingival fibroblasts diluted to 5% leads to a statistically significant decrease in the number and length of wrinkles.

Modulation of a Specific Pattern of microRNAs, Including miR-29a, miR-30a and miR-34a, in Cultured Human Skin Fibroblasts, in Response to the Application of a Biofunctional Ingredient that Protects against Cellular Senescence <i>in Vitro</i>

Skin aging is a process of structural and compositional remodeling that can be manifested by wrinkling and sagging. Remarkably, the dermis plays a dominant role in the aging process. Recent studies suggest that microRNAs are implicated in the regulation of gene expression during aging. However, studies about age-related microRNAs and how they modulate skin aging remain limited. In the present work, a complex of hydrolyzed natural yeast proteins (Saccharomyces cerevisiae) and hydrolyzed natural soya bean was developed and showed the ability to modulate the expression of telomere-binding protein TRF2, which is a key factor for telomere protection and to prevent cellular senescence in vitro and DNA damage. The aim of the study was to identify microRNAs specifically modulated after application of the ingredient complex to cultured fibroblasts, and their possible involvement in remodeling of the human extracellular matrix and fibroblast senescence. Consequently, human skin fibroblasts were cultured and treated with 1% of the ingredient complex for 48 h before analyzing microRNA modulation by RT-qPCR. The use of bioinformatics allowed us to predict the target genes for modulated microRNAs. Results show that the ingredient complex modulated a pattern of microRNAs including the down-regulation of miR-29a-3p, miR-30a-5p and miR-34a-5p, which are associated with fibroblast senescence and remodeling of the human dermal extracellular matrix. In conclusion, our results indicate that miR-29a-3p, miR-30a-5p and miR-34a-5p possibly represent key microRNAs that impact human fibroblast senescence and remodeling of the dermal extracellular matrix.

A spectroscopic study on the effect of ultra-violet solar radiation in Antarctica on the human skin fbroblast cells

A study on the effect of the solar ultra-violet radiation on the human skin fibroblast cells revealed that the production of matrix metalloproteinase-2 was inhibited by the radiation.A CO2 incubator connected by optical fibers to a reflector telescope for collecting the solar light was built at Syowa station by the 49th Japanese Antarctica Research Expedition.The direction of the telescope was continuously controlled by a sun-tracker to follow the movement of the Sun automatically.The intensity of the collected light was monitored by a portable spectrophotometer housed inside.The human skin fibroblast cells were incubated in the CO2 chamber to investigate the effect of the solar radiation at Syowa station and were compared with those reference experiments at a laboratory in Japan.The results showed cell damage by strong UV radiation.The production of matrix metalloproteinase-2 was prompted by the moderate UV-B,but was inhibited by the strong UV-B radiation,as studied under laboratory conditions in Japan.The effect of strong solar radiation at Syowa station involving the radiation of UV-B region was estimated to be of the same extent of the radiation caused by an artificial UV-B light with the intensity more than 50 mJ/cm2.

Effect of fracture-skin on virus transport in fractured porous media

A numerical model is developed for describing the transport of virus in a fracture-matrix coupled system with fracture-skin. An advective dispersive virus transport equation, including first- order sorption and inactivation constant is used for simulating the movement of viruses. Implicit finite-difference numerical technique is used to solve the coupled non-linear governing equations for the triple continuum model consisting of fracture, fracture-skin and the rock-matrix. A varying grid is adopted at the fracture and fracture-skin interface to capture the mass transfer. Sensitivity analysis was performed to investigate the effect of various properties of the fracture-skin as well as viruses on the virus concentration in the fractured formation with fracture-skin. Simulation results suggest that the virus concentration in the fracture decreases with increment in the fracture-skin porosity, fracture-skin diffu- sion coefficient, mass transfer coefficient, inactivation constant and sorption distribution coefficient, and with reduction in the fracture aperture.

Evolving role of skin sparing mastectomy

Skin sparing mastectomy(SSM) can facilitate immediate breast reconstruction and is associated with an excellent aesthetic result. The procedure is safe in selected cases; including invasive tumours < 5 cm, multi-centric tumours, ductal carcinoma in situ and for risk-reduction surgery. Inflammatory breast cancers and tumours with extensive involvement of the skin represent contraindications to SSM due to an unacceptable risk of local recurrence. Prior breast irradiation or the need for post-mastectomy radiotherapy do not preclude SSM, however the aesthetic outcome may be compromised. Preservation of the nipple areola complex is safe for peripherally located node negative tumours. An intraoperative frozen section protocol for the retro-areolar tissue should be considered in these cases. The advent of acellular tissue matrix systems has enhanced the scope of implant-based immediate reconstruction following SSM. Cell-assisted fat transfer is emerging as a promising technique to optimise the aesthetic outcome.

皮肤再生“星舰”:探索ADM在扩张技术中的应用突破与潜能

大面积皮肤缺损后的外观和功能同步重建仍是临床中未攻克的难题。皮肤扩张技术已广泛用于修复重建领域,但受限于较低的扩张效率、高发的并发症,以及尚未明确的作用机制,如今的皮肤扩张技术发展到了瓶颈阶段。为解决该问题,我们提出了脱细胞真皮基质辅助扩张的创新想法,并在临床上取得初步成效。脱细胞真皮基质能提供“生物友好”界面,均衡机械外力,作为活性支架可承载各类细胞,而其在皮肤扩张过程中的具体作用机制更值得深入的探究。脱细胞真皮基质作为扩张伴侣协同皮肤扩张,有望打破现有的扩张极限,进一步拓展皮肤扩张的潜能。

<i>Rehmannia</i>Root Improves Extracellular Matrix Production and Epidermal Differentiation by Upregulation of the Estrogen Receptor

Estrogen is essential for the skin to maintain its physiological function. The binding of estrogen to the estrogen receptor (ER) activates gene transcription, which has biological effects on the target tissue. Estrogen levels and ER expression are known to decrease with aging and exposure to ultraviolet light (UV);therefore, increased estrogen levels and ER expression may improve age-related changes in the skin. Rehmannia root has been reported to have blood circulation-promoting and anti-inflammatory effects;however, few studies have reported the effects of Rehmannia root on skin. In this study, we examined the effects of Rehmannia glutinosa Libosch. var. purpurea Makino root extract (RE) on ER expression, and estrogen, RE, or their related ingredients increased ER expression in human epidermal keratinocytes, human dermal fibroblasts, and skin models. Moreover, RE increased the production of basic fibroblast growth factor, transforming growth factor β1, and epidermal growth factor. The mixture of estrogen and RE improved extracellular matrix (ECM) production to a greater degree than estrogen and RE independently. Although high population doubling levels (PDL) and UV irradiation downregulated ER expression, RE upregulated ER expression in high PDL cells and UV irradiated cells. In addition, RE increased the expression of epidermal differentiation marker proteins compared to their expression levels in the absence of RE. The collective findings suggest that RE aids in the prevention of skin aging by upregulating the ER expression that has been decreased by aging and UV and promoting estrogen activity, ECM production, and epidermal differentiation.

复合皮移植联合VSD修复碾压伤致肘关节外露

目的:探讨复合皮移植联合负压封闭引流(Vacuum sealing drainage,VSD)在碾压伤伴关节外露创面修复中的临床应用效果及可行性。方法:2020年12月,笔者科室收治1例因左上肢车祸伤致皮肤坏死伴肿胀1 d的患者,入院时查体左上肢肿胀,左前臂、肘部可见约15.0 cm×20.0 cm皮肤坏死,左手感觉功能减退,桡动脉尚可触及,急诊手术探查见肘关节外露、脱位,肱三头肌自肱骨大范围撕脱,尺神经外露、移位,肘关节、尺骨外露范围约3.0 cm×5.0 cm。根据患者病史、临床表现、左上肢X线片及手术探查体征诊断左上肢碾压伤,肘关节外露。应用复合皮移植两步法联合VSD覆盖创面,自体中厚皮片移植修复皮肤缺损。结果:患者左上肢皮肤缺损处愈合良好,术后4个月复查,肘关节屈曲、伸直、旋转功能均恢复良好。结论:对于此例肘关节、骨外露创面,应用复合皮移植后可覆盖骨外露创面,大大降低了手术难度及患者的痛苦,为以后相对小面积骨外露创面的修复提供了新思路。

点阵射频导入康复新液治疗面部敏感性皮肤的疗效及对皮肤屏障功能的影响

目的探讨点阵射频导入康复新液治疗面部敏感性皮肤的疗效及对皮肤屏障功能的影响。方法选取2021年10月至2022年11月上海市第六人民医院临港院区皮肤科门诊76例面部敏感性皮肤患者作为研究对象,按治疗方法不同分为对照组与观察组,每组各38例。观察组患者给予点阵射频导入康复新液联合重组牛碱性成纤维细胞生长因子外用凝胶治疗,对照组仅局部外敷康复新液联合重组牛碱性成纤维细胞生长因子外用凝胶治疗,两组均连续治疗4周。比较两组治疗前后的临床疗效、皮损评分、乳酸刺痛评分、乳酸刺痛开始时间、经皮水分丢失量、角质层含水量、VISIA红色区绝对分值及不良反应。结果治疗4周后,两组患者皮损评分、乳酸刺痛评分、乳酸刺痛开始时间、经皮水分丢失量、角质层含水量、VISIA红色区绝对分值均得到明显改善,差异有统计学意义(P<0.05);两组患者均未发生严重不良反应。结论点阵射频导入康复新液治疗面部敏感性皮肤效果良好,能够明显改善皮肤屏障功能,安全性好。

Meek植皮术联合纳米银敷料治疗大面积烧伤患者的效果

目的:探讨Meek植皮术联合纳米银敷料治疗大面积烧伤患者的效果。方法:回顾性分析2021年7月—2023年7月南通市第一人民医院收治的80例大面积烧伤患者的临床资料,根据治疗方式的不同分为对照组和观察组,各40例。对照组给予Meek植皮术治疗,观察组在对照组基础上联合纳米银敷料治疗。对比两组的临床疗效、基质金属蛋白酶(MMPs)水平、炎症因子水平及并发症发生率。结果:观察组创面愈合率、皮片存活率高于对照组,创面愈合时间、皮片融合时间短于对照组,差异有统计学意义(P<0.05)。治疗后,两组金属蛋白酶抑制剂-1(TIMP-1)均高于治疗前,基质金属蛋白酶-1(MMP-1)、基质金属蛋白酶-2(MMP-2)均低于治疗前,且观察组TIMP-1高于对照组,MMP-1、MMP-2低于对照组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)低于治疗前,白细胞介素-10(IL-10)高于治疗前,且观察组IL-6、TNF-α低于对照组,IL-10高于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:Meek植皮术联合纳米银敷料治疗有助于促进大面积烧伤患者的创面愈合,抑制MMPs的表达,减轻炎症反应,减少并发症的发生。

CGF联合脱细胞真皮基质修复兔皮肤缺损的实验研究

目的 探讨脱细胞真皮基质(ADM)联合浓缩生长因子(CGF)对兔全层皮肤缺损的修复效果。方法新西兰兔12只,术前取血制作CGF膜,在兔背部制备2 cm×1 cm的全层皮肤缺损,A组:ADM+CGF、B组:ADM、C组:空白对照。观察愈合情况,Ⅰ/Ⅲ型胶原纤维生长情况以及TGF-β1、VEGF的表达情况。结果A、B组在1周时已实现初级愈合,镜下胶原纤维排列整齐,C组在2周时实现初级愈合,镜下以Ⅰ型胶原纤维为主,胶原纤维排列紊乱;1周时,TGF-β1表达量A组> B组> C组(P<0.05);2周时,A、B组TGF-β1的表达下降,此时C组的TGF-β1呈增长趋势;1、2周时,VEGF表达量A组> B组> C组(P<0.05)。结论 ADM联合CGF修复兔全层皮肤缺损,可加快创口愈合速度、改善创口愈合质量;增加VEGF的释放,稳定调节TGF-β1的释放以利于伤口的愈合。

细胞连接和细胞外基质相关基因在扩张皮肤新生中的表达分析

目的利用生物信息学方法分析细胞连接和细胞外基质(ECM)相关基因在扩张皮肤中的表达。方法下载GEO数据库中大鼠头部扩张皮肤和小鼠背部扩张皮肤的高通量测序数据,筛选差异表达基因(DEGs),对两组DEGs集富集的生物学过程进行GO富集分析和KEGG富集分析,观察扩张皮肤新生过程中细胞连接和ECM相关基因的表达,使用CytoHubba软件分析扩张皮肤新生中的Hub基因。结果大鼠头部扩张皮肤和小鼠背部扩张皮肤的基因表达集中相同的基因共有287个。GO分析和KEGG分析显示两个DEGs集和共有DEGs均富集在表皮发育、细胞细胞连接组织、细胞细胞黏附、ECM的组织、IL-17信号通路上,其中细胞细胞连接基因共有23个,包括黏附连接(Cdh2、Cdh3)和缝隙连接(Gjb2、Gjb6)等在扩张皮肤中表达上调,ECM基因共有15个,包括Serpinb5、Klk7、Mpzl3、Tgm1、Fermt1在扩张皮肤中表达上调。此外,我们表征了富集在表皮发育、细胞细胞连接组织、ECM的组织、细胞细胞黏附的共有DEGs。结论通过生物信息学方法,我们进一步了解细胞连接和ECM相关基因在扩张皮肤新生过程中的表达,为研究机械牵拉介导的扩张皮肤新生机制提供了新的思路。

手术后伤口皮肤张力变化与病理性瘢痕形成相关性的基础与临床研究

目的:探究手术后伤口皮肤张力变化与病理性瘢痕形成的相关性。方法:选取2021年5—12月东莞市东南部中心医院收治的手腕或足踝处有较大开放性手术切口残留的患者180例作为研究对象。根据治疗后的伤口皮肤张力分为高张力组(33例)、正常张力组(117例)、低张力组(30例)。比较三组瘢痕宽度、温哥华瘢痕量表评分、细胞外基质成分、成纤维细胞分泌细胞因子水平,分析手术后伤口皮肤张力变化与瘢痕宽度的相关性。结果:术后90 d,三组瘢痕宽度大于术后30 d,差异有统计学意义(P<0.05);术后30、90 d,三组瘢痕宽度比较,差异有统计学意义(P<0.05)。术后90 d,三组温哥华瘢痕量表评分高于术后30 d,差异有统计学意义(P<0.05);术后30、90 d,三组温哥华瘢痕量表评分比较,差异有统计学意义(P<0.05)。术后90 d,三组瘢痕组织标本转化生长因子-β1、血小板源性生长因子、内皮缩血管肽、血管内皮细胞生长因子、碱性成纤维细胞生长因子水平比较,差异有统计学意义(P<0.05)。三组纤维连接蛋白、免疫球蛋白G、免疫球蛋白A、胶原纤维、网状纤维、中性黏多糖、酸性黏多糖成分比较,差异有统计学意义(P<0.05)。术后伤口皮肤张力与瘢痕宽度呈正相关(r=0.996,P=0.032)。结论:手术后伤口皮肤张力变化与瘢痕宽度相关,手术后伤口皮肤张力越大,越容易导致瘢痕增大。

异体脱细胞真皮基质复合自体刃厚皮片移植在面颈部烧伤后期瘢痕挛缩整形中的应用效果

目的分析异体脱细胞真皮基质(ADM)复合自体刃厚皮片移植在面颈部烧伤后期瘢痕挛缩整形中的应用效果。方法选取2018年1月至2022年4月诸城市人民医院收治的45例面颈部烧伤后期瘢痕挛缩患者作为研究对象,按照整形修复方案分为对照组(n=22)与观察组(n=23),两组均切除面颈部瘢痕组织并松解挛缩,对照组接受自体中厚皮片移植,观察组接受ADM复合自体刃厚皮片移植。比较两组皮片成活率、二次手术率、创面感染率、植皮区及供皮区愈合时间、创面修复效果、颏颈角及颈部主动活动度的矫正度数。结果观察组皮片成活率高于对照组,差异有统计学意义(P<0.05);两组二次手术率、创面感染率比较差异均无统计学意义。两组植皮区愈合时间比较差异无统计学意义;观察组供皮区愈合时间短于对照组,差异有统计学意义(P<0.05)。术后6个月,两组皮肤柔软度、厚度、色泽、血管分布评分均低于术后3个月,差异有统计学意义(P<0.05);两组术后3、6个月皮肤柔软度、厚度、色泽、血管分布评分比较差异无统计学意义。两组术后6个月颏颈角及颈部主动活动度的矫正度数比较差异均无统计学意义。结论面颈部烧伤后期瘢痕挛缩整形中应用ADM复合自体刃厚皮片移植的整形修复效果与自体中厚皮片移植相近,然而复合移植的皮片成活率更高,供皮区愈合时间更短。

微孔点阵激光联合表皮生长因子对面部痤疮凹陷性瘢痕患者美容评分及皮肤屏障功能的影响

目的探讨微孔点阵激光联合表皮生长因子(rhEGF)对面部痤疮凹陷性瘢痕患者美容评分及皮肤屏障功能的影响。方法前瞻性选取2019年7月至2021年3月国药同煤总医院在皮肤科就诊的128例面部痤疮凹陷瘢痕患者作为研究对象。按照随机数字表法分为观察组(n=64)和对照组(n=64)。两组患者均接受常规护理干预,对照组仅采用超脉冲CO_(2)点阵激光治疗,观察组在采用超脉冲CO_(2)点阵激光治疗的基础上使用rhEGF。比较两组患者治疗前与治疗6周后的美容评分、皮肤屏障功能、痤疮瘢痕权重(ECCA)评分、痂皮脱落时间和治疗总有效率。结果观察组患者的主观美容评分、客观评分分别为(20.33±3.48)、(22.37±3.18)分,均显著高于对照组[(16.66±2.49)、(17.22±2.26)分],差异均有统计学意义(P<0.05)。观察组患者治疗6周后的油脂值和表皮水分丢失量分别为(56.42±2.98)AU、(18.51±2.03)g/(h·m^(2)),均明显低于对照组[(60.58±3.21)AU、(25.15±3.07)g/(h·m^(2))],皮肤含水量为(49.12±4.37)AU,明显高于对照组[(43.56±3.12)AU],差异均有统计学意义(P<0.05)。观察组患者治疗6周后的ECCA评分为(11.11±2.15)分,明显低于对照组[(21.98±4.22)分],痂皮脱落时间为(6.55±0.67)d,短于对照组[(8.99±1.09)d],差异均有统计学意义(P<0.05)。观察组的总有效率为67.19%,显著高于对照组(48.44%),差异有统计学意义(P<0.05)。结论相较于单独使用微孔点阵激光治疗,微孔点阵激光联合rhEGF治疗面部痤疮凹陷性瘢痕患者,能显著改善患者的美容评分和皮肤屏障功能,加速皮肤恢复,提高临床疗效,是一种值得推广的治疗方法。

口服银耳多糖对自然衰老小鼠皮肤的改善作用及机制实验研究

目的:探讨口服银耳多糖(TFPS)对自然衰老小鼠皮肤的改善作用及可能机制。方法:将75只12月龄雌性KM小鼠随机分成衰老模型组(M组)、TP-100组[给予100 mg/(kg·d)TFPS]、TP-200组[给予200 mg/(kg·d)TFPS]、TP-400组[给予400 mg/(kg·d)TFPS]和透明质酸(HA)组[200 mg/(kg·d)],每组15只。每周在实验组小鼠饮水中加入不同剂量TFPS和HA,干预12周。另取15只2月龄雌性KM小鼠作为年轻对照组(Y组)。干预结束后,取小鼠背部皮肤,检测小鼠皮肤理化特性、氧化应激指标[过氧化氢酶(CAT)、总抗氧化能力(T-AOC)、谷胱甘肽过氧化物酶(GSH-Px)]、内源性组分[HA、Ⅰ型胶原蛋白(ColⅠ)、Ⅲ型胶原蛋白(ColⅢ)]及胶原降解指标[基质金属蛋白酶(MMP)-1、MMP-3、MMP-9]。结果:与Y组比较,M组皮肤水分含量下降(P<0.05);与M组比较,HA组和TFPS各剂量组皮肤水分含量升高(均P<0.05)。与Y组比较,M组皮肤重量下降(P<0.05);与M组比较,HA组和TP-400组皮肤重量升高(均P<0.05)。与Y组比较,M组皮肤GSH-Px、CAT和T-AOC水平下降(均P<0.05)。与M组比较,HA组、TP-100组和TP-200组皮肤GSH-Px升高,TP-400组皮肤CAT水平升高,HA组和TFPS各剂量组皮肤T-AOC升高(均P<0.05)。与Y组比较,M组皮肤ColⅠ、ColⅢ、HA含量下降(均P<0.05)。与M组比较,TP-100和TP-400组皮肤ColⅠ含量升高,HA组和TFPS各剂量组皮肤ColⅢ含量升高,TP-400组皮肤HA含量升高(均P<0.05)。与Y组比较,M组皮肤MMP-3和MMP-9含量升高(均P<0.05)。TFPS各剂量组和HA组皮肤MMP-3和MMP-9含量与M组比较差异有统计学意义(均P<0.05)。各组皮肤MMP-1含量比较差异无统计学意义(均P>0.05)。结论:口服TFPS能够延缓小鼠皮肤自然衰老,其机制可能是通过增强小鼠皮肤抗氧化酶活性减少氧自由基产生来抑制皮肤MMP活性,从而减少皮肤胶原蛋白的流失。