To investigate an effective method in clinical application of using different kinds of skin flaps for repair of the finger deep burns. Methods The groin skin flap, the paraumbilical skin flap, the volar digital advancement flap, the island flap from the dorsum of the index finger, the lateral digital neurovascular island flap, and the island skin flap nourished by the cutaneous nerve nutrient vessel of the dorsum were employed to repair 157 fingers in 101 patients (78 males, 23 females, aged 12-56 years, averaged 34.6 years) from January 1997 to December 2006. Of the 101patients, 37 had a deep partial thickness burn involving 59 fingers, and 64 hada full thickness burn involving 98 fingers. The soft tissue defects ranged in area from 1.0 cm×1.0 cm to 6.5 cm×6.0 cm. The interval between the injury and the operation was 4 hours to 5 days in 89 patients, and 18 to 27 days in the other 12 patients who also had infected wounds. The flaps ranged in size from 1.2 cm×1.2 cm to 7.8 cm×6.5 cm. The donor site was directly sutured in 84 patients, and the donor site was covered by a full thickness skin graft in the other 17 patients. Results After operation, 98 patients had an incision healing by first intention and the flaps survived well; the other 3 patients had congestion and necrosis in the flap edges, and had a delayed healing after the dressing changes. All the donor sites had a healing by first intention. The followup of all the patients for 224 months averaged 6.5 months revealed that 9 patients, who had been given the paraumbilical skin flap, had a fat and clumsy finger; 14 patients, who had been given the groin skin flap, also had a fat and clumsy finger; 3 patients developed congestion and necrosis at their edges. The remaining patients had a satisfactory survival of the skin flaps and a normallyshaped finger. The flaps had a good appearance, with the twopoint discrimination of 510 mm, the good finger motion ability, and the satisfactory finger appearance.Conclusion The volar digital advancement flap,the island flap from the dorsum of the index finger, the lateral digital neurov ascular island flap, and the island skin flap nourished by the cutaneous nerve nutrient vessel of the dorsum are good skin flaps for repair of the finger deep burns. The groin skin flap and the paraumbilical skin flap are also good skin flaps for repair of the deep burns of the mutiple fingers but the postoperative finger may become a bit fat and clumsy.
ObjectiveTo investigate the role of PI3K/Akt/HIF-1αsignaling pathway in bleomycin-induced pulmonary fibrosis in mice. MethodsFifty-six C57BL/6 mice were randomly divided into a control group and a bleomycin (BLM) group.The pulmonary fibrosis model was induced by single intratracheal instillation of BLM(2.5 mg/kg) in the BLM group.Similarly, 0.9% saline was instilled directly into the trachea in the control group.Then all mice were sacrificed on 21st day.The lungs were collected for morphometric analysis with HE and Masson staining.The degree of pulmonary fibrosis was evaluated with Ashcroft score and content of hydroxyproline.The activity of PI3K/Akt/HIF-1αsignaling pathway and pro-surfactant protein C (Pro-SPC) were measured by Western blot.The level of collagen3 mRNA was assessed with quantitative real time PCR analysis.Collagen3 protein and numbers of apoptosis cells were observed with immuno-histochemistry. ResultsIt was exhibited that the thickening alveolar septa, accumulation of inflammatory cells, and fibrous obliteration in the BLM group but not in the control group.There was a significant difference in Ashcroft score and hydryoproline content in the BLM group.Meanwhile, the activity of PI3K/Akt/HIF-1αsignaling pathway was up-regulated and the protein of Pro-SPC was decreased in the BLM group.It was revealed that the numbers of apoptosis cells, expressions of Collagen3 protein and mRNA were increased in the BLM group. ConclusionAberrant activity of PI3K/Akt/HIF-1αsignaling pathway may aggravate the pulmonary fibrogenesis.
ObjectiveTo investigate the effect of α-lipoic acid on the oxidative stress of wound tissues and diabetic wound healing in mice with diabetic feet. MethodsSixty male C57BL/6J mice weighting 200-300 g were randomly divided into model group (control group, n=15), α-lipoic acid-treated model group (n=15), miR-29b mimic group (n=15), and miR-29b mimic negative control group (NC group, n=15). All animals received intraperitoneal injection of streptozocin to establish the diabetic model. Then, a full thickness wound of 5 mm×2 mm in size was created at 4 weeks after modeling. All mice were administrated with high-sugar-fat-diet. At the same day after modeling, α-lipoic acid-treated model group was continuously given intravenous injection of 100 mg/(kg·d) α-lipoic acid for 14 days; miR-29b mimic group and NC group received the tail intravenous injection of lentiviral vector for miR-29b mimic and miR-29b mimic negative control (a total of 2×107 TU), respectively, with the treatment of α-lipoic acid. The wound healing was observed and wound area was measured at 7 and 14 days. The wound tissues were harvested to detect the levels of superoxide dismutase (SOD) and glutathione (GSH) using xanthine oxidase method and 5, 5-dithiobis-2-nitrobenzoic acid staining method at 14 days. At the same day, 7, and 14 days after modeling, the relative miR-29b expression in wound tissues from control and α-lipoic acid-treated model groups was detected by real-time fluorescence quantitative PCR. ResultsAll mice survived to the experiment end. The wound healing was faster in α-lipoic acid-treated group than control group. At 7 and 14 days, the relative wound area and miR-29b expression level were significantly lower, while the contents of SOD and GSH were significantly higher in α-lipoic acid-treated group than control group (P < 0.05). In addition, miR-29b mimic group had significantly increased relative wound area and significantly decreased the contents of SOD and GSH when compared with NC group at 7 and 14 days (P < 0.05). Conclusionα-lipoic acid could inhibit oxidative stress and promote diabetic wound healing by suppressing expression of miR-29b in mice.
ObjectivesTo systematically review the efficacy and safety of nalmefene hydrochloride for acute cerebral infarction.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on nalmefene hydrochloride for acute cerebral infarction from inception to February 21st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 8 RCTs involving 1 038 patients were included. The results of meta-analyses showed that, compared to the routine treatment group, the nalmefene hydrochloride group was significantly associated with an increased reduction in total effective rate (RR=1.14, 95%CI 1.04 to 1.23, P=0.003), GCS (MD=1.30, 95%CI 0.66 to 1.94, P<0.0001), patient satisfaction (RR=1.26, 95%CI 1.03 to 1.55, P=0.03), cerebral blood flow (MD=5.00, 95%CI 3.81 to 6.19, P<0.05), and cerebral blood volume (MD=0.28, 95%CI 0.23 to 0.32, P<0.05). It was also significantly associated with an reduction of NIHSS, CSS, level of inflammatory factors after treatment in 14 days, level of MMP-9 and mean transit time of contrast medium (P<0.05). However, no significant association was observed between two groups in level of inflammatory factors after treatment in 20 days. For safety outcomes, no significant association was found between two groups in mortality, dizziness, and nausea and vomiting.ConclusionsThe current evidence indicates that the nalmefene hydrochloride can be used to treat acute cerebral infarction based on routine treatment of acute cerebral infarction, and the safety is relatively good. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo investigate the mechanism of mTOR signaling pathway in bleomycin (BLM)-induced pulmonary fibrosis in mice.MethodsSixty C57BL/6 mice were randomly divided into a control group and a BLM group. Pulmonary fibrosis model was induced by single intratracheal instillation of bleomycin (2.5 mg/kg) in the BLM group. Similarly, 0.9% saline was instilled directly into the trachea in the control group. Then all mice were sacrificed at 21 days. The lungs were collected for morphometric analysis with HE and Masson staining. The degree of pulmonary fibrosis was evaluated with Ashcroft score. The activity of mTOR signaling pathway was measured by Western blot. The level of collagen1, collagen3 mRNA was assessed with quantitative real time PCR.ResultsThe thickening alveolar septa, accumulation of inflammatory cells, and fibrous obliteration in the BLM group were exhibited predominantly compared with the control group. There was a significant difference in Ashcroft score between the BLM group and the control (P<0.05). Also, the activity of mTOR signaling pathway was up-regulated and the expression of collagen1 mRNA and collagen3 mRNA was increased in the BLM group.ConclusionAberrant activation of mTOR signaling pathway aggravates the pulmonary fibrogenesis.