Objective To explore the expression characteristics of chaperone interacting protein (CHIP) in normal, scar and chronic ulcer tissues and its relationship with wound healing. Methods Twenty biopsies including scar tissues(n=8), chronic ulcer tissues(n=4) and normal tissues(n=8)were used in this study. The immunohistochemical staining (power visionTMtwo-step histostaining reagent) was used to explore the amount and expression characteristics of such protein.Results The positive expression of CHIP was observed in fibroblasts, endothelial cells and epidermal cells in dermis and epidermis. It was not seen ininflammatory cells. The expression amount of CHIP in scar tissues, chronic ulcer tissues and normal tissues was 89%, 83% and 17% respectively. Conclusion Although the function of CHIP is not fully understood at present, the fact that this protein is expressed only at the mitogenic cells indicates that it may be involved in mitogenic regulation during wound healing.
OBJECTIVE: To provide a new reconstructive method to treat refractory ulcers on the sole of the forefoot. METHODS: The reversed medial plantar flap with the medial plantar pedal artery and vein as pedicle was used to treat the refractory ulcers on the sole of the forefoot in 5 cases. The size of the flap was 3.5-5.0 cm x 4.0-5.5 cm. The deformities were corrected at the same time and the flaps were protected after operation. RESULTS: All flaps survived without complications. There was no recurrence after 6-month following-up. The patients could walk. CONCLUSION: The distal ends of medial plantar pedal artery and vein have plenty anastomoses with dorsal pedal artery and deep plantar arch. The reversed medial plantar flap has reliable blood supply by these anastomoses. The reversed medial plantar flap should be a choice in treating refractory ulcers on the sole of the forefoot.
OBJECTIVE: Retrospective clinical analysis of primary surgical operation in the treatment of lower limb accompanied by chronic leg ulcer were adopted in this study. METHODS: From September 1990 to June 1998, there were 31 males and 20 females, aged 68 years in average, the area of ulcer varied from 5 cm x 3 cm to 22 cm x 11 cm. The ligation and strip of saphenous vein, debridement and free skin flap grafting were finished in primary operation. RESULTS: The skin flaps were survived completely in 50 cases, only 1 case was necrosis partially and healed after changing dressing. Forty-two cases were followed up for 16 months to 9 years (66 months in average), the varicosis and ulcer were healed in 39 cases and only 3 relapsed in ulceration. CONCLUSION: Primary surgical operation in the treatment of varicosis of lower limb accompanied by chronic ulcer is practicable in clinic. The curative efficacy is satisfactory and the operative manipulation is simple.
OBJECTIVE To observe the effects of basic fibroblast growth factor(bFGF) on the healing of cutaneous chronic wounds. METHODS Twenty-eight cases with thirty-three wounds from trauma, diabetes, pressure and radiation injuries were locally treated with bFGF in a dosage of 150 U/cm2 wounds. The healing time of wounds was used to evaluate the treatment results. RESULTS The healing time in all of chronic wounds were accelerated. All wounds from trauma, diabetes and pressure were healed within 4 weeks and another 2 wounds from radiation injuries were healed over 4 weeks. The healing rate within 4 weeks was 93.9%. CONCLUSION The results indicate that bFGF can be used as a promoter to accelerate the healing of chronic wounds in clinic.
ObjectiveTo explore the effect and mechanisms of bone marrow mesenchymal stem cells (BMSCs) on healing quality of acetic acid-induced gastric ulcer. MethodsForty-eight clean grade male Wistar rats were used to establish the model of gastric ulcer with acetic acid and were randomly divided into 3 groups after 3 days of modeling, 16 rats each group. After the abdominal cavity was open and stomach was pulled out, no treatment was given in group A, 150 μL phosphate buffered saline (PBS) and 150 μL BMSCs at passage 4+PBS (1×108 cells/100 μL) were injected into the gastric wall surrounding the ulcer at 5 different points in groups B and C respectively. After 10 days, the ulcer area was measured, the mucosal thickness and the number of dilated glands were tested in the regenerative mucosa by histological method. And the expression of vascular endothelial growth factor (VEGF) was detected at ulcerative margin by immunohistochemical method. ResultsThe ulcer area in group C was significantly smaller than that of groups A and B (P<0.01), but no significant difference was found between groups A and B (P>0.05). HE staining showed that group C had thicker regenerative gastric mucosa, less dilated glands, and more regular mucosal structure than groups A and B, showing significant differences in regenerative gastric mucosa thickness and dilated glands number (P<0.01), but no significant difference between groups A and B (P>0.05). Immunohistochemical staining showed that the positive expression of VEGF in the ulcer margin mucosa of group C was significantly higher than that of groups A and B. The integral absorbance (IA) value of VEGF expression in group C was significantly higher than that in groups A and B (P<0.01), but no significant difference between groups A and B (P>0.05). ConclusionBMSCs can accelerate ulcer healing by the secretion of VEGF, and improve the quality of ulcer healing.
目的 针对近期收治的1例常规治疗疗效不理想的溃疡性结肠炎患者,我们进行了证据检索和评价,以期找到更有效的治疗方法.方法 计算机检索MEDLINE(1978～2004)、CBMdisc(1978～2004)及Cochrane图书馆(2004年第3期),查找 5-氨基水杨酸(5-ASA)灌肠液治疗溃疡性结肠炎及与病情缓解有关的系统评价、临床随机对照试验等,并对所获证据进行评价.结果 高质量的临床证据表明,5-ASA灌肠液治疗溃疡性结肠炎及帮助病情缓解均优于口服5-ASA及柳氮磺胺嘧啶局部灌肠治疗.据此临床证据,结合医生经验及病人意愿,对该例患者实施5-ASA 1g+生理盐水100 ml qd,睡前保留灌肠治疗.1周后,患者临床症状明显缓解,腹泻基本停止,每天解黄色黏液便1～2次.肠镜复查,炎症较前明显减轻.出院后继续用上述方案维持治疗,每周2次.门诊随访1年,患者未再复发,也无明显副作用发生.结论 5-ASA灌肠液是控制溃疡性结肠炎活动期间病情及帮助缓解、减少复发的有效药物.
ObjectiveTo summarize the recent progress in studies of intestinal immunity in inflammatory bowel disease (IBD). MethodsThe literatures on studying the intestinal immunity in IBD, including ulcerative colitis and Crohn disease were reviewed and analyzed. ResultsIBD comprised two main diseases that cause inflammation of the intestines: ulcerative colitis and Crohn disease. Although the diseases had some features in common, there were some important differences in clinical symptoms and pathological features. Accumulating evidence suggested that IBD results from an inappropriate inflammatory response to intestinal microbes in a genetically susceptible host. Immunity studies highlighted the importance of host-microbe interactions in the pathogenesis of these diseases. Prominent among these findings were genomic regions containing nucleotide oligomerization domain 2 (NOD2), autophagy genes, miRNAs, and components of the interleukin-23/type 17 helper T-cell (Th17) pathway. The disfunction of the intestinal microbiome, intestinal epithelium, intestinal immune cells, and the intestinal vasculature played a key role in the process of IBD. The treatment with monoclonal antibody had been introduced to treat IBD and had been certificated effective. ConclusionThe study of basic intestinal immunity and regulation network of molecules in pathogenic process of IBD provides theory basis on prevention of IBD, while related genes of IBD can offer more gene therapy targets.
To study the influence of maggot secretion on expression of bFGF and connective tissue growth factor(CTGF) in ulcer tissue of diabetes mell itus(DM)rats and its antibacterial function. Methods There were 40 3-month-old SD male rats (weighing 300-350 g) which were randomly divided into 2 groups: control group and experimental maggot secretion group. The model of ulcer wound of DM rats was made. The ulcer wound of DM rats in maggot secretiongroup spread maggot secretions, but no secretion on ulcer wound was found in control group. The morphological and tissue changes of ulcer wound were observed at different times, and the conditions of bacterial infection on ulcer wound in the two groups were checked. Tissue sl ices were prepared on 7, 14 and 21 days, respectively; immunohistological detection of bFGF and CTFG in ulcer wound of the two groups was done; and the cell number of positive expression of bFGF and CTFG was counted. Results It was found that the heal ing of ulcer was dominant in experimental group; the wound was clean; the tissue regenerated and no Staphylococcus aureus infection was seen. Bad heal ing was obtained in control group; tissue necrosis was found and the rate of Staphylococcus aureus infection was 60%. Positive expression cell number of bFGF in ulcer wound was detected on 7 and 14 days after operation with 23.76 ± 3.34 and 52.76 ± 4.84 in experimental group, and 18.88 ± 2.16 and 46.04 ± 4.00 in control group. Positive expression cell number of CTGF in ulcer wound was detected on 7 and 14 days after operation with 18.76 ± 3.24 and 46.52 ± 4.07 in experimental group, and 12.52 ± 3.03 and 40.52 ± 3.96 in control group. There was significant difference between positive expressions of bFGF and CTFG in the two groups (P﹤0.05). Conclusion The maggot secretion can elevate the expressions of bFGF and CTFG in ulcers, promote heal ing and prevent bacterial infection.
Objective To evaluate the effectiveness and safety of sarpogrelate hydrochloride for patients with peripheral arterial disease (PAD). Methods The randomized controlled trials (RCTs) on PAD treated by sarpogrelate hydrochloride were identified from CBM (1978 to September 2011), CNKI (1979 to May 2011), PubMed (1950 to May 2011), EMbase (1970 to May 2011) and The Cochrane Library (Issue 3, 2011). According to the criteria of the Cochrane Handbook, two reviewers independently screened the studies, extracted and cross-checked the data, and assessed the methodological quality. Then meta-analysis was conducted by using RevMan 5.0 software. Results Nine RCTs involving 522 patients and 532 limbs were included, with low methodological quality in most trials. The results of meta-analyses indicated that compared with the conventional treatment, sarpogrelate hydrochloride could reduce the area of ulcers (MD= –3.22, 95%CI –3.99 to –2.45), and it could increase the ankle-brachial index (SMD=0.49, 95%CI 0.07 to 0.91), blood flow of dorsalis pedis artery (MD=0.16, 95%CI 0.09 to 0.23) and pain-free walking distance (MD=200.87, 95%CI 3.39 to 398.36). Five trials reported the adverse effects of sarpogrelate hydrochloride, most of which were mild gastrointestinal symptoms. Conclusion Based on the review, sarpogrelate hydrochloride may have positive effect on patients with PAD. However, the evidence is not b enough due to the general low methodological quality, so the reliable conclusion has to be drawn with more high quality studies in future.
OBJECTIVE: To observe the effects of ANSON NANOTECH on the healing of cutaneous chronic wounds. METHODS: Thirty-four cases with 44 wounds were locally treated with ANSON NANOTECH in the wounds after debridement. Among them, there were 15 cases with traumatic ulcer (23 wounds), 9 cases with pressure ulcer(11 wounds), 5 cases with diabetes ulcer, and 5 cases with radiation ulcer. The healing time of wounds was used to evaluate the treatment results. RESULTS: The healing time in all of chronic wounds were accelerated. All wounds from trauma, diabetes and pressure were healed within 4 weeks and another 2 wounds from radiation injuries were healed over 4 weeks. The healing rate within 4 weeks was 95.5%. CONCLUSION: The results indicate that ANSON NANOTECH can accelerate the healing of chronic wounds. The mechanism probably include sterilization, improvement of local microcirculation, promotion of cell growth, and so on.