The effect of basic fibroblast growth factor on regeneration in a surgical wound model of rat submandibular glands

This study developed an animal model of surgically wounded submandibular glands （SMGs） and investigated the effects of collagen gel with basic fibroblast growth factor （bFGF） on tissue regeneration of surgically wounded SMGs in vivo. The animal model was produced by creating a surgical wound using a 3-mm diameter biopsy punch in SMGs. The wound was filled with collagen gel with bFGF （bFGF group） or without bFGF （control group）. In the animal model of surgically wounded SMGs, salivary glands without scar tissue around the wound area were observed with smaller areas of collagen gel. Small round and spindle-shape cells invaded the collagen gel in both groups after operation day （AOD） 5, and this invasion dramatically increased at AOD 7. Host tissue completely replaced the collagen gel at AOD 21. The invading immune cells in the group treated with collagen gel with bFGF were positive for vimentin, g-smooth muscle actin （αSMA）, CD49f, c-kit and AQP5 at AOD 7. Similarly, the mRNA expression of vimentin, αSMA, CD49f, keratin 19 and AQP5 was also increased. This study suggests that the use of collagen gels with bFGF improves salivary gland regeneration.

Wound Treatment Using Growth Factors

Treatment with growth factors is an effective method to promote wound healing. Several growth factors have been used in wound treatment, including basic fibroblast growth factor (bFGF) discovered in the 1970s, platelet-derived growth factor (PDGF), epidermal growth factor (EGF), and bone morphogenetic protein (BMP). In 2001, Kaken Pharmaceutical Co., Ltd. launched Fiblast Spray in Japan. This product is a topical formulation containing recombinant human bFGF. It is used to treat decubitus ulcers and skin ulcers (burn ulcers and leg ulcers). There is increasing interest in its stimulatory effect on wound healing and its inhibitory effect on scar formation. Wound healing is a physiological phenomenon that involves a complex series of integrated cellular and biochemical responses, characterized by phases of hemostasis, inflammation, proliferation, and maturation. However, much of its detailed mechanism remains unknown. There have been many basic research studies on wound healing using cells and experimental animals. If findings can be used from such studies and clinical practice, development of even more effective treatments might be possible.

Successful Management of Wound Dehiscence after Total Knee Arthroplasty by Topically Using Recombinant Basic Fibroblast Growth Factor

Wound complications are estimated to be affected in about 9% of TKA patients, which may increase the risk of deep periprosthetic infection and results in re-operation, joint fusion, or amputation. Here we have reported a female patient who suffered wound rupture due to early post-operation mobilization and weight-bearing. The wound dehiscence was successfully managed by applying recombinant basic fibroblast growth factor-2 and anti-infective treatment without removing prosthetic joint.

Design of Novel Wound Dressing Composed of Collagen and Hyaluronic Acid Containing Epidermal Growth Factor

This research aims to develop a wound dressing composed of collagen (Col) and hyaluronic acid (HA) containing epidermal growth factor (EGF). First important issue is to contain EGF in the wound dressing in a stable state. The sheet-shaped sponge was manufactured by freeze-vacuum drying an aqueous solution of Col. Both sides of sponge were treated with ultraviolet (UV) irradiation to introduce intermolecular cross links between collagen molecules. This sponge was named Sponge-Col. Another sheet-shaped sponge was manufactured by freeze-vacuum drying an aqueous solution of HA containing EGF. This sponge was named Sponge-HA/EGF. The wound dressing was manufactured by laminating Sponge-Col on the top, Sponge-HA/EGF in the middle, and Sponge-Col on the bottom to create a sandwich structure. This method can prevent the reducing of EGF activity due to UV irradiation for intermolecular cross-linking. Second important issue is to enable gradual release of EGF from the wound dressing. The elution behavior of this wound dressing was investigated by measuring the weight change after immersion in water for a predetermined time. This wound dressing showed initially fast elution and subsequent very slow elution properties. The upper layer and lower layer Sponge-Col enabled gradual release of the middle layer Sponge-HA/EGF. This result suggests that EGF contained in the wound dressing is gradually released together with HA from the wound dressing. Third important issue is to provide moist wound-healing environment. The upper layer and lower layer Sponge-Col can provide the wound dressing with high water absorption and long-term water retention properties.

Effect of recombinant human epidermal growth factor on porcine partial-thickness wound healing

Wound healing is a complex biologic event. Numerous growth factors are involved in the regulation of tissue repair and remodelling processes. In this study, several techniques were used to observe the effects of recombinant human epidermal growth factors (rh-EGF) on porcine partial-thickness burn wound healing. Healing rates of the burn wounds were quantitated by computer image analysis of the wound Pkotographs. Biopsies were taken for examining the cell DNA cycle by flow cytometry, and for observing the keratinocyte migration and degree of reepithelialization quantitated by anti-keratin antibodies. The results indicated that daily topical application of rh-EGF in suitable concentrations accelerated epithelial healing of partial-thickness burn wounds, and there was also a dose-dependent effect of rh-EGF on healing rates of the partial-thickness burn wounds.

Usefulness of Basic Fibroblast Growth Factor (bFGF) Loaded Dissolving Microneedles for Local Therapy of Skin Wounds

Purpose: The usefulness of dissolving microneedles (DMs) for local skin therapy by basic fibroblast growth factor (bFGF) was studied in rats. Methods: We prepared four kinds of bFGF-loaded DMs, approximately 500 μm length and 300 μm diameter at the bottom. Long-term stability and dissolution studies were performed by HPLC method. Pharmacokinetic and pharmacological evaluations were performed after administration of bFGF loaded DMs to rats. Results: The bFGF contents were 2.15 ± 0.07, 1.07 ± 0.04, 0.56 ± 0.07 and 0.12 ± 0.03 μg. The 100.2 ± 3.4%, 100.2 ± 3.3%, 99.3 ± 1.4% and 100.4 ± 3.0% of bFGF were recovered after 1, 3 and 6 months and 1 year incubation at 40°C. The bFGF was released from DMs within 5 min. In a pharmacokinetic study using 2.0 and 1.0 μg bFGF-loaded DMs, no systemic exposure of bFGF was detected. The initial bFGF concentrations in the rat skin tissue after administration of bFGF-loaded DMs to the hair-removed rat abdominal skin were 510.2 ± 20.1 ng/g wet weight for 2 μg bFGF DMs and 264.2 ± 56.5 ng/g wet weight for 1 μg DMs, declining slowly thereafter to 226.3 ± 33.5 and 105.1 ± 27.4 ng/g wet weight at 6 hr after administration. Good dose-dependency was observed. Pharmacological evaluation of bFGF-loaded DMs of 2.0, 1.0, 0.5, and 0.1 μg, in the wound healing rat model, all used DMs, but 0.1 μg DMs, showed good healing effects. Considered collectively, these results suggest the usefulness of bFGF-loaded DMs for local therapy of skin wound disease.

Effect of FK506 on Expression of Hepatocyte Growth Factor in Murine Spinal Cord Following Peripheral Nerve Injury

This study is to investigate the effect of FK506 on expression of hepatocyte growth factor （HGF） in rats＇ spinal cord following peripheral nerve injury and to elucidate the mechanisms for neuroprotective property of FK506. Fifty male rats were randomly divided into normal group, injury group and treatment group. Models of peripheral nerve injury were established by bilateral transection of sciatic nerve 0.5 cm distal to piriform muscle. Then the treatment group received subcutaneous injection of FK506 （1 mg/kg） at the back of neck, while the injury group was given 0.9% saline. The L4-6 spinal cords were harvested at various time points after the surgery. Western blotting and immunofluorescent staining were used to detect the level and position of HGF in spinal cord. Immunofluorescent staining showed that HGF-positive neurons were located in anterior horn, intermediate zone and posterior horn of gray matter in normal spinal cord. Western blotting revealed that there was no significant difference in the expressions of HGF between the injury group and the normal group, while the expression of HGF was significantly higher in the treatment group than in the injury group 7 and 14 days after surgery. It is suggested that peripheral nerve injury does not result in up-regulation of the expression of HGF in spinal cord, while FK506 may induce high expression of endogenous HGF after injury thereby protecting neurons and promoting axonal outgrowth.

Increased glycated basic fibroblast growth factor in diabetic skin reduces the cell viability and angiogenesis of human dermal microvascular endothelial cells

Objective To explore the glycation of basic fibroblast grow th factor( bFGF) in diabetic skin.Methods The abdom inal full-thickness skin tissues from 58 patients( 29 diabetic and 29 non-diabetic) aged 40 to69 years and granulation tissues from 15 patients( 8 diabetic and 7 non-diabetic) aged 50 to 59 were analyzed.The proportion of advanced glycation end products( AGEs)-b FG F intotal b FGF was measured with co-immunoprecipitation and the histological characteristics of wound skin were detected with hem atoxylin and eosin staining. The cell viability, apoptosis, and angiogenesis of human derm al m icrovascular endothelial cells( HDMECs) after exposure to AG Es-b FG For bFGF were measured with cell counting kit-8, flow cytom etry,and tube form ation assay, respectively. Results The proportion of AG Es-b FG F in total b FG F showed agedependent increaseboth in diabetic and non-diabetic skin. As com pared with non-diabetic skin, the constituent ratio in diabetic skin increased significantly in the equal age-group, and the same result could be obtained in granulation tissues from patients aged 50 to 59. The proportion of AG Es-b FG F in diabetic granulation was low er than that in diabetic skin from patients aged 50 to 59. H istological analysis show ed few er vessels in diabetic skin wound. In vitro, the viability and vascularization of H D M EC s were promoted by b FG F and inhibited after exposure to AGEs-bFGF for 7d. Conclusion The present study indicates that one cause for im paired wound healing in diabetic skin could be the glycated b FG F and its changed angiogenic function.

Keratinocyte growth factor-2 and autologous serum potentiate the regenerative effect of mesenchymal stem cells in cornea damage in rats

AIM:To investigate the healing process after severe corneal epithelial damage in rats treated with mesenchymal stem cells(MSCs)cultured with or without keratinocyte growth factor(KGF-2)and autologous serum(AS)on amniotic membrane(AM).Many patients are blind and devastated by severe ocular surface diseases due to limbal stem cell deficiency.Bone marrow-derived MSCs are potential sources for cellbased tissue engineering to repair or replace the corneal tissue,having the potential to differentiate to epithelial cells.METHODS:The study included 5 groups each including 10 female'Sprague Dawley'rats in addition to20 male rats used as bone marrow donors.Group I rats received AM+MSCs,Group II rats AM+MSCs cultured with KGF-2,Group III rats AM+MSCs cultured with KGF-2+AS,Group IV rats only AM and Group V rats,none.AS was derived from blood drawn from male rats and bone marrow was obtained from the femur and tibia bones of the same animals.Therapeutic effect was evaluated with clinical,histopathological and immunohistochemical assessment.MSC engraftment was demonstrated via detection of donor genotype(Y+)in the recipient tissue(X)with polymerase chain reaction.RESULTS:Corneal healing was significantly better in Groups I-III rats treated with MSC transplantation compared to Group IV and Group V rats with supportive treatment only.The best results were obtained in Group III rats with 90%transparency,70%lack of neovascularization,and 100%epithelium damage limited to less than 1/4 of cornea.CONCLUSION:We suggest that culture of MSCs with KGF-2 and AS on AM is effective in corneal repair in case of irreversible damage to limbal stem cells.

A Prospective Study of Factors Influencing Wound Dehiscence after Midline Laparotomy

Aim: To evaluate the factors influencing fascial wound dehiscence after midline laparotomy in the patients of perforation peritonitis with an emphasis on measurement of “intra-abdominal” pressure (IAP) and fascial transforming growth factor-beta (TGF-beta). Methods: Hundred eligible adult patients with the diagnosis of perforation peritonitis who underwent emergency exploratory laparotomy were prospectively recruited. Forty five patients who developed midline abdominal wound dehiscence were compared with 55 patients without dehiscence. Results: The variables that were significantly associated with wound dehiscence include anemia, hypo proteinemia, duration of surgery, prolonged postoperative ileus, wound infection and postoperative pulmonary infection. Age, gender, jaundice, cause of peritonitis, wound contamination and types of surgery were non significant variables. The mean IAP value in the patients with dehiscence was significantly higher than “non-dehiscence” group (p = 0.000). The patients with wound dehiscence strongly expressed TGF-beta on the day of burst. Conclusion: The patients of peritonitis undergoing prolonged surgery in the presence of risk factors like anemia, hypo proteinemia, postoperative ileus, wound infection and postoperative pulmonary infection have high risk of abdominal wound dehiscence.

A STUDY OF mRNA EXPRESSION OF GROWTH FACTORS IN FULL-THICKNESS BURNT RATS AFTER INTERMINGLEDTRANSPLANTATION OF AUTO-ALLOGRAFT SKIN

Objective To scrutinize the effect of growth factors resulting from the intermingled skin graft onwound healing. Methods By means of RT-PCR technique, mRNA expressions of TGFα, TGFβ1, PDGF andbFGF of autografts and allografts on burnt rats were quantitatively analysed. Results (1) mRNA expressions ofall the four growth factors mentioned above were found both in allografts and autografts, the expressions beinghigher in autografts than allografts; (2) In autografts, TGFα expression began to rise from second post transplantday (D2), reaching a peak on D18,. TGFβ1 expression gained a high level on D2 and had itS peak on D18; PDGFexpression had its peak on D4, rebounding on D25; bFGF expression, exceedingly high on D2, dropped andrebounded in the same manner as in PDGF; (3) In the early stage of the wound healing, mRNA expression of thefour growth factors was lower in allografts, rising up in varying degrees thereafter. Conclusion (1) Graftsurvival took place both in autografts and allografts, with the former pederming better than the latter; (2) Thecombining action of growth factors that reached the affected area through autosecretion and bysecretion probablypromoted the healing of the burn wound, following signal transmission channels; (3) Rejection, which occurred inallogralts, was responsible for the decreasing viability of allografts and their replacement by the host skin.

Mechanical tension promotes skin nerve regeneration by upregulating nerve growth factor expression

This study aimed to explore the role of mechanical tension in hypertrophic scars and the change in nerve density using hematoxylin-eosin staining and S100 immunohistochemistry, and to observe the expression of nerve growth factor by western blot analysis. The results demonstrated that mechanical tension contributed to the formation of a hyperplastic scar in the back skin of rats, in conjunction with increases in both nerve density and nerve growth factor expression in the scar tissue. These experimental findings indicate that the cutaneous nervous system plays a role in hypertrophic scar formation caused by mechanical tension.

外源性碱性成纤维细胞生长因子促进大鼠创面愈合的机制

背景:深入揭示外源性碱性成纤维细胞生长因子促进创面愈合的分子机制。目的:探讨外源性碱性成纤维细胞生长因子对大鼠创面修复中巨噬细胞表型转换和肉芽再生的影响。方法:(1)体外细胞实验:分为正常对照组、低剂量碱性成纤维细胞生长因子组、高剂量碱性成纤维细胞生长因子组以及碱性成纤维细胞生长因子+丙戊酸组,其中低、高剂量碱性成纤维细胞生长因子组细胞培养基中分别添加100,200μg/L碱性成纤维细胞生长因子,碱性成纤维细胞生长因子+丙戊酸组细胞培养基中添加200μg/L碱性成纤维细胞生长因子和20 mmol/L Notch1/Jagged1激动剂丙戊酸。通过EdU实验、划痕实验、小管生成实验检测碱性成纤维细胞生长因子对人脐静脉内皮细胞增殖、迁移和血管新生的影响。(2)体内动物实验:SD大鼠按照随机数字表法分为模型组、低剂量碱性成纤维细胞生长因子组、高剂量碱性成纤维细胞生长因子组以及碱性成纤维细胞生长因子+丙戊酸组,构建大鼠全层皮肤缺损开放性创面模型,其中低、高剂量碱性成纤维细胞生长因子组皮下注射100,200μg/L碱性成纤维细胞生长因子,碱性成纤维细胞生长因子+丙戊酸组大鼠皮下注射200μg/L碱性成纤维细胞生长因子的同时腹腔注射10 mg/kg丙戊酸。给药7,14 d检测大鼠创面的愈合率;TUNEL检测创面组织中的细胞凋亡情况;酶联免疫吸附实验检测大鼠血清中丙二醛、超氧化物歧化酶、肿瘤坏死因子α和白细胞介素10水平;免疫荧光检测创面组织中巨噬细胞的表型转换情况;免疫组化检测创面组织中增殖细胞核抗原、CD31和血管内皮生长因子的表达;Western blot法检测创面组织中Notch1、Jagged1的表达。结果与结论:(1)与正常对照组相比,碱性成纤维细胞生长因子能明显促进人脐静脉内皮细胞的增殖、迁移和血管新生,并且具有剂量依赖性;(2)与模型组相比,碱性成纤维细胞生长因子能明显促进创面的愈合,下调创面组织中的细胞凋亡率;降低大鼠血清中丙二醛和肿瘤坏死因子α水平,升高超氧化物歧化酶和白细胞介素10水平;促使创面组织中巨噬细胞向M2型转换,上调创面组织中增殖细胞核抗原、CD31和血管内皮生长因子的表达;抑制创面组织中Notch1、Jagged1的表达,并且均具有剂量依赖性。丙戊酸可部分逆转碱性成纤维细胞生长因子对创面愈合的促进作用。结果表明,碱性成纤维细胞生长因子能明显促进创面愈合与肉芽再生以及诱导巨噬细胞向M2型转换,这可能与调控Notch1/Jagged1信号有关。

富血小板血浆促进创面愈合的细胞和分子机制

背景:尽管富血小板血浆在促进创面愈合方面显示出治疗潜力,但其临床应用仍需要进一步的研究和验证。此外,对于富血小板血浆作用的机制仍存在一些争议和不确定性。目的:通过对富血小板血浆促进创面愈合的机制进行概述和分析,以增进对该治疗方法的理解,为未来的基础研究和临床应用提供有益的指导。方法:在中国知网、PubMed数据库检索2000年1月至2023年12月发表的相关文献。英文检索词为“platelet rich plasma,PRP,wound,wound healing,refractory wounds,chronic wounds,cellular and molecular mechanisms,signaling pathways,regenerative medicine”,中文检索词为“富血小板血浆,PRP,创面,伤口,创面愈合,难愈性创面,慢性创面,细胞和分子机制,信号通路,再生医学”。根据纳入和排除标准,最终对80篇文献进行综述。结果与结论:①富血小板血浆在创面愈合中具有许多潜在的优势,它能够提供丰富的生长因子和细胞因子等生物活性物质;②富血小板血浆可以调节参与创面愈合的各种细胞类型的功能,包括表皮细胞、血管内皮细胞、成纤维细胞、干细胞和炎症细胞等;③在富血小板血浆疗法中,细胞外囊泡、线粒体对于创面愈合可能扮演着重要角色;④负载富血小板血浆水凝胶可广泛用于增强组织再生和作为药物传递的功能性载体;⑤富血小板血浆对创面细胞外基质合成和降解起调节作用,从而影响伤口愈合过程中基质重建;⑥富血小板血浆可能通过动态调节多种信号通路和上皮间质转化来影响组织修复与再生,从而为创面愈合的研究提供了全新的视角。

改良CO_(2)点阵激光联合光动力对难愈性创面的疗效

目的探究改良CO_(2)点阵激光治疗难愈性创面的临床疗效及机制。方法选取2022年5月至2024年5月医院接诊的难愈性创面患者122例,以抽签法随机分为常规组(常规换药治疗+光动力治疗+常规CO_(2)点阵激光治疗)、改良组(常规换药治疗+光动力治疗+改良CO_(2)点阵激光治疗),各61例。比较治疗前及治疗1、2、3周后两组血清C反应蛋白(CRP)、红细胞沉降率(ESR)水平及创面细菌数量;比较治疗1、2、3周后两组创面愈合率;比较两组临床疗效;比较治疗前及治疗1、2、3周后创面渗液碱性成纤维细胞生长因子(bFGF)、促血管生成素-1(Ang-1)水平;比较两组不良反应。结果重复测量方差分析显示,两组血清CRP、ESR水平及创面细菌数量在组间、时间上均存在交互作用(P<0.05);治疗前两组血清CRP、ESR水平及创面细菌数量比较,差异无统计学意义(P>0.05);治疗1、2、3周后改良组血清CRP、ESR水平及创面细菌数量均低于常规组(P<0.05);重复测量方差分析显示,两组创面愈合率在组间、时间上均存在交互作用(P<0.05);治疗1、2、3周后改良组创面愈合率均高于常规组(P<0.05);改良组临床总有效率高于常规组(P<0.05)。重复测量方差分析显示,两组创面渗液bFGF、Ang-1水平在组间、时间上均存在交互作用(P<0.05);治疗前两组创面渗液bFGF、Ang-1水平比较,差异无统计学意义(P>0.05);治疗1、2、3周后改良组创面渗液bFGF、Ang-1水平均高于常规组(P<0.05);两组疼痛、瘙痒、红疹发生率比较,差异均无统计学意义(P>0.05)。结论难愈性创面的治疗中改良CO_(2)点阵激光联合光动力疗法可促进创面渗液生长因子分泌,抑制创面细菌繁殖及炎症反应,加快创面愈合,提高临床疗效,且安全性高,其作用机制与促进创面渗液生长因子分泌有关。

解毒生肌汤对正虚邪恋型低位肛瘘术后早期创面的影响及作用机制研究

目的观察解毒生肌汤治疗低位肛瘘术后创面愈合的效果及对创面细胞因子的影响。方法将100例低位肛瘘术后患者随机分为对照组与观察组各50例。对照组局部坐浴后给予专科换药常规处理,观察组在对照组基础上予解毒生肌汤内服,疗程均为14 d。两组治疗前后进行创面情况评分;比较治疗后3、7、14 d的创面愈合率,随访并记录创面愈合的时间;进行创面组织形态、创面细胞因子水平和创面血流灌注情况评价。结果治疗后,两组创面情况评分均明显下降(P<0.05),且观察组低于对照组(P<0.05)。治疗后3、7 d,两组创面成纤维细胞数和新生毛细血管数均较治疗前增加(P<0.05);且观察组创面成纤维细胞数和新生毛细血管数均多于同期对照组(P<0.05)。治疗后3、7 d,两组创面组织白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平较治疗前下降(P<0.05),VEGF和TGF-β1水平较治疗前升高(P<0.05);且观察组创面IL-6、TNF-α水平低于同期对照组(P<0.05);VEGF和TGF-β1水平高于同期对照组(P<0.05)。治疗后3、7、14 d,两组创面血流灌注情况逐渐增加(P<0.05);且观察组创面血流灌注情况均优于同期对照组(P<0.05)。在治疗后7、14 d,观察组创面愈合率高于对照组(P<0.05);观察组创面愈合时间短于对照组(P<0.05)。治疗后,观察组临床疗效总有效率为92.00%,明显高于对照组的74.00%(P<0.05)。结论解毒生肌汤具有抗炎、改善局部血流灌注、促进血管形成等作用,可促进低位肛瘘术后创面修复、减轻临床症状、提高愈合率、缩短愈合时间,临床疗效好,且使用安全。

Preliminary Clinical Study Using a Novel Wound Dressing Composed of Hyaluronic Acid and Collagen Containing EGF

This clinical trial aimed to evaluate the efficacy and safety of a novel wound dressing composed of hyaluronic acid (HA) and collagen (Col) containing epidermal growth factor (EGF), referred to as EGF-wound dressing. EGF-wound dressing was prepared by freeze-drying a mixed aqueous solution of high-molecular-weight HA, low-molecular-weight HA and heat-denatured Col containing EGF. EGF-wound dressing was applied to skin defects, such as intractable skin ulcers, burn ulcers, traumatic skin defects and skin donor-site wounds. The dressing was changed twice a week for a period of 6 weeks or longer, if necessary. The primary endpoints were size of wound area, formation of granulation tissue, extent of epithelialization, infection control and macroscopic appearance. Effectiveness, safety and overall clinical evaluation were scored by plastic surgeons, as authorized by the Japanese Society of Plastic and Reconstructive Surgery. This study was registered with the University Hospital Medical Information Network (UMIN0000005264). Healthy granulation tissue and rapid epithelialization were observed for a given period after application of EGF-wound dressing onto the wounds. Most cases were assessed as having achieved good or excellent results. This clinical study demonstrated that EGF-wound dressing was beneficial in the treatment of various skin defects.

Low-intensity Treadmill Exercise Promotes Rat Dorsal Wound Healing

In order to investigate the promoting effect of low-intensity treadmill exercise on rat dorsal wound healing and the mechanism, 20 Sprague-Dawley rats were randomly divided into two groups： exercise group（Ex） and non-exercise group（non-ex）. The rats in Ex group were given treadmill exercise for one month, and those in non-ex group raised on the same conditions without treadmill exercise. Both groups received dorsal wound operation with free access to food and water. By two-week continuous observation and recording of the wound area, the healing rate was analyzed. The blood sample was collected at day 14 post-operation via cardiac puncture for determination of the number of endothelial progenitor cells（EPCs） by flow cytometry, and the concentrations of relevant cytokines such as basic fibroblast growth factor（b FGF）, endothelial nitric oxide synthase（e NOS） and vascular endothelial growth factor（VEGF） were measured by ELISA. The skin tissue around the wound was dissected to observe the vascular density under the microscope after HE staining, to detect the m RNA level of VEGFR2 and angiopoietin-1（Ang-1） receptor using RT-q PCR, and protein expression of α-smooth muscle actin（αSMA） and type collagenⅢ（ColⅢ） using Western blotting. It was found that the wound area in Ex group was smaller at the same time point than in non-ex group. The number of circulating EPCs was greater and the concentrations of vasoactive factors such as VEGF, e NOS and b FGF were higher in Ex group than in non-ex group. HE staining displayed a higher vessel density in Ex group than in non-ex group. Moreover, the m RNA expression of VEGFR2 and Ang-1 detected in the wound tissue in Ex group was higher than in non-ex group. Meanwhile, the protein expression of αSMA and Col Ⅲwas more abundant in Ex group than in non-ex group. Conclusively, the above results demonstrate Ex rats had a higher wound healing rate, suggesting low-intensity treadmill exercise accelerates wound healing. The present work may provide some hint for future study of treating refractory wound.

Endoscopic resection of the pancreatic tail and subsequent wound healing mechanisms in a porcine model

BACKGROUND Laparoscopic resection of the pancreatic body and tail is the predominant methodology to remove lesions in these locations;its safety and surgical planning are relatively mature, but it remains a complex and high-precision surgical operation, requiring abundant experience and skills in laparoscopic surgery, with a 10% rate of complications. AIM To verify the feasibility and safety, as well as to examine the complications of endoscopic pancreatectomy and healing mechanisms of pancreatic wounds after endoscopic resection. METHODS Transgastric endoscopic resections of varying sizes of pancreases were performed in 15 healthy Bama miniature pigs. The technical success rate, the incidence of serious complications, and the survival of the animals were studied. The healing of the wounds was evaluated by sacrificing the animals at various time points. Finally, the expression of transforming growth factor-β1 and Smad3/Smad7 in the surgical site was examined by immunohistochemistry to explore the role of these factors in wound healing of the pancreas. RESULTS Partial and total resections were successfully performed in two groups of animals, respectively. The technical success rate and the survival rate of the pigs were both 100%. We obtained 12 pancreatic tissue samples by endoscopic resection. The pancreatic wounds were closed with metal clips in one group and the wounds healed well by forming scars. There was a small amount of pancreatic leakage in the other group, but it can be fully encapsulated. The level of transforming growth factor-β1 (TGF-β1) in the wounds increased during the inflammatory and fibrous hyperplasia phases, and decreased in the scar phase. The expression of Smad3 paralleled that of TGF-β1, while the expression of Smad7 had an inverse relationship with the expression of TGF-β1. CONCLUSION Purely transgastric endoscopic resection of the pancreas is a safe, effective, and feasible procedure, but the incidence of pancreatic leakage in total pancreatic tail resection is high. The expression of TGF-β1 and Smad3/Samd7 is related to the progression of pancreatic wound healing.

基于中药性味归经理论探讨祛瘀消肿汤对混合痔术后愈合的影响

目的探究基于中药性味归经理论指导下探讨祛瘀消肿汤对混合痔术后愈合的影响。方法选取2021年1月—2022年12月收治的98例混合痔患者,以随机数字表法分为观察组与对照组进行研究。对照组(49例)采用外剥内扎手术治疗方法,观察组(49例)在此基础上结合内服祛瘀消肿汤治疗。观察两组患者治疗前后血清炎症因子、视觉模拟疼痛评分、水肿评分、创面愈合情况、生长因子水平。观察两组患者临床疗效、症状缓解时间。结果治疗前两组患者白介素-6(interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factor,TNF-α)及C反应蛋白(C-reactive protein,CRP)、视觉模拟疼痛评分(visual analogue scale,VAS)与水肿评分、碱性成纤维细胞生长因子(basic fibroblast growth fac⁃tor,b-FGF)及血管内皮生长因子(vascular endothelial growth factor,VEGF)水平比较(P>0.05);治疗后观察组IL-6、TNF-α和CRP水平及VAS和水肿评分均降低,且观察组低于对照组,b-FGF、VEGF水平均上升,观察组高于对照组(P<0.05)。治疗10 d后,两组患者创面出血评分、创面渗液评分比较,P>0.05;治疗14 d后观察组评分比对照组低(P<0.05)。与对照组患者肛门坠胀缓解时间及肛门水肿缓解时间、创面渗液消失时间和疼痛缓解时间比较,观察组时间均更短(P<0.05)。观察组临床总有效率95.92%(47/49),显著高于对照组的81.64%(40/49)(χ^(2)=5.018,P=0.025)。结论在中药性味归经理论指导下,祛瘀消肿汤能降低混合痔术后血清炎症因子水平、减少创面疼痛、加快愈合时间和提高临床疗效。