Objective To observe the expression and distribution of transforming growth factor-β1 (TGF-β1) in the healing process of bile duct and discuss its function and significance in the process of benign biliary stricture formation. Methods An injury to bile duct of dog was made and then repaired. The expression and distribution of TGF-β1 in the tissue at different time of the healing process were studied after operation with immunohistochemical SP staining. Results TGF-β1 staining was observed in the granulation tissue, fibroblasts and endothelial cells of blood vessels. High expression of TGF-β1 was observed in the healing process lasting for a long time. Conclusion The high expression of TGF-β1 is related closely with the fibroblast proliferating activity, extracellular matrix overdeposition and scar proliferation in the healing process of bile duct.
随着人口老龄化，与老年病相关的慢性伤口护理越来越受重视。1962年，Winter［1］提出了“湿润环境促进伤口愈合”，为伤口换药奠定了现代创面换药的理论基础。20世纪80年代以来，针对各型创面研发了大量的新型敷料，如高分子薄膜敷料、泡沫敷料、水凝胶和水胶体敷料、海藻酸盐敷料、生物活性药物敷料等。正确选用敷料能加快创面修复、减少感染机会、缩短住院时间及降低医疗费用。现结合下肢静脉性溃疡的创面换药问题就如何选用各种医用敷料作一讨论……
OBJECTIVE The effect of platelet-derived wound healing factor (PDWHF) on wound healing in diabetic rats was studied. METHODS Forty-four male SD rats were randomly divided into 2 groups. Thirty-two rats of experimental group accepted intraperitoneal injection of alloxan (1.5 mg/10 g body weight). Within one or two days after injection, while the blood sugar of the rats was higher than 180 mg/dl, the animal model of diabetic rat should have been established. Then a dorsal incision was given to every rat. After the addition of PDWHF (the experimental group) or bovine albumin (the control group), the incision was sutured up. Seven, ten and fourteen days after operation, the breaking strength of the wound was measured. On another hand, specimen from the wound was taken for the culture of fibroblasts. When the cultured fibroblasts have been incubated with 10% PDWHF for 4, 8 and 12 hours, the procollagen I (alpha 1) mRNA levels were examined respectively, and compared with those of control. RESULTS Significant difference in wound breaking strength had been observed between PDWHF-treated incisions and the control on 7, 10 and 14 days after wounding (P lt; 0.01). Experiment in vitro demonstrated that the procollagen I (alpha 1) mRNA levels in wound fibroblasts incubated with 10% PDWHF for 4, 8 and 12 hours were 0.9, 3.7 and 2.2 folds higher than those in fibroblasts in control. CONCLUSION It was suggested that direct stimulation of procollagen I (alpha 1) gene expression was one of the ways that PDWHF played its role in accelerating wound healing.
This experiment was designed to observe the proliferative effects of platelet derived wound healing factor (PDWHF) of different concentrations on fibroblasts from rat wounds and on epithelial from human wounds. Cultured fibroblasts from rat wound and epithelia from human wound were randomly divided into three groups. (1) In blank control, the cells were treated with basic medium (BM, contains 1640/0.5% FCS); (2) the positive control, the cells were treated with 1640/10% FCS and (3) in the PDWHF group, the cells were treated respectively with BM/1% PDWHF, BM/3% PDWHF, BM/5% PDWHF, BM/7% PDWHF, BM/10% PDWHF, BM/12% PDWHF, respectively. The Cells were collected after 48 hours culturing with BM or PDWHF, and the cell proliferation was measured by MTT method according to the OD values. The result showed that the PDWHF could remarkably enhance the proliferation of fibroblasts and epithelial cells when its concentration was between 1% and 7%, which was obviously higher than that of the blank control (P lt; 0.01). When the concentration of PDWHF reached 10%, its proliferative effect was not remarkable when compared with the blank control, When the concentration of PDWHF reached 12%, it showed inhibitory effect on fibroblasts and manifested no obvious inhibitory effect on epithelial cells. It was concluded that the PDWHF was a combination of a variety of growth factors. In a certain range of concentration, the PDWHF might effectively promote the proliferation of fibroblasts and epithelial cells. Howerve, when its concentration reached to relatively higher level, its effect was not remarkable any more, or even showed inhibitory effect on cell proliferation.
It was reported in this article that a preparation of acid/heat-stable peptides (AHSP) from pig serum with a molecular-weight less than 18 ku a without antigenity and toxicity could exert enhancement effect on wound healing. Two pieces of polyvinyl alcohol (PVA) sponge implanted in rat dorsal subcutaneous pouchs of 20 mice were selected as the wound model. The subcutaneous pouch having one piece of sponge was taken as the experimental group and the other as the control. Injection of 50 microliters of such peptide preparation into the test sponge was performed once a day from the time of injury on for 5 consecutive times, while 50 microliters of BSA (5 mg/ml) into the control sponge in the same way. The levels of total DNA, protein and hydroproline in AHSP-treated sponge were observed significantly higher than those in the control sponge on the 7th and 10th days after wounding (P lt; 0.05). No significant difference was seen on the 14th postinjury day (P gt; 0.05). The effect of AHSP on proliferation of wound fibroblast cultured in vitro was also detected. In conclusion, such peptides derived from pig serum had the activity to accelerate wound healing without resultant excessive healing and its direct stimulation of the proliferation of wound fibroblast was probably one of the way which AHSP exerted its action.
目的 观察医用伤口修复液对肛瘘患者术后创面修复的临床疗效。方法 将78例行手术治疗的肛瘘患者随机分为2组，试验组39例，予以医用伤口修复液纱条换药，1次/d，至创面愈合；对照组39例，予以无菌凡士林纱布换药，1次/d，至创面愈合。比较2组患者的创面渗液明显减少时间、出血情况，换药时创面疼痛评分及创面愈合时间。结果 试验组的创面疼痛评分、创面渗液明显减少时间、创面愈合时间及发生创面出血的比例均短于或低于对照组，其差异均具有统计学意义（P＜0.05）。所有患者均未发生不良反应。结论 医用伤口修复液对肛瘘患者术后创面修复具有较好的临床疗效。
Objective To investigate the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) in reducing the occurrence of these complications through a clinical randomized controlled trial. Methods We included 72 coronary heart disease patients in our hospital from December 2013 through March 2014. There were 48 males and 24 females aged 38.4±18.6 years undergoing coronary artery bypass graft(CABG) surgery, and great saphenous veins were chosen as grafts. Patients were equally randomized into a trial group and a control group. The patients in the trial group underwent 5 d of b-NPWT for thigh incision and interrupted suture for shank incision after the harvesting of great saphenous veins. Patients in the control group received an interrupted suture for both thigh incision and shank incision after the harvesting of great saphenous veins. We evaluated the function of b-NPWT by reducing the complications arising from the harvesting of great saphenous veins in CABG patients. Results The incidences of early complications, such as lymphedema, incision infection, non-union, and skin flap necrosis of the vascular zone in the trial group were significantly lower than those of the control group. There was no death or new problem in heart or deep venous thrombosis in both groups. No complication occurred in long term. The incidence of lower limb edema was lower in the trial group than that in the control group at the end of 3 months follow-up. Conclusion B-NPWT can effectively prevent lymphorrhagia in CABG patients who underwent the harvesting of great saphenous veins. It can also reduce the incidence of complications and discomfort of the patients.
Chronic wounds have a high incidence and a long course of disease, and will bring a heavy economic burden to patients, which is the difficulty of clinical treatment at present. Therefore, it is urgent to find an effective method to promote chronic wound healing. In recent years, the application of therapeutic ultrasound in chronic wound treatment has gradually gained attention, and has become a promising adjuvant therapy. This article reviews the process of wound healing, the mechanism of therapeutic ultrasound in promoting wound healing, the biological effects of therapeutic ultrasound in different stages of wound healing and its application in diabetic ulcer, venous ulcer of lower limbs and pressure ulcer, in order to provide new ideas and directions for the treatment of chronic wounds.