外源性VEGF促进大鼠Ⅱ度烫伤创面中晚期愈合

目的探究Ⅱ度烫伤时外源性血管内皮生长因子(vascular endothelial growth factor,VEGF)对皮肤愈合及其对表皮干细胞(epidermal stem cells,ESCs)迁移、分化的影响方法健康Wistar大鼠随机分为VEGF组、空白对照组、阿西替尼(Axitinib,VEGF抑制剂)组。采用水浴烫伤法制备Ⅱ度烫伤模型,分别以0.2μg/ml VEGF、PBS溶液和10μg/ml阿西替尼处理各组创面,各组均治疗7d,从烫伤至创面愈合分别在第2d、8d、14d及21d测量创面愈合情况,并取创面组织作组织学检测,运用免疫组化技术检测ECSs的分布及数量。结果①创面愈合率:烫伤后21d VEGF组>对照组>阿西替尼组;②愈合速度:烫伤后1-7d空白对照组>阿西替尼组>VEGF组,其后VEGF组愈合速度逐渐加快,第14d开始愈合速度表现为VEGF组>空白对照组>阿西替尼组;③组织学变化:烫伤后8-21d,VEGF组表皮细胞增殖明显,表皮修复和毛囊再生迅速,均早于空白对照组及阿西替尼组。④ECSs阳性细胞率变化:烫伤后第8-14dVEGF组ECSs阳性细胞率明显高于空白对照组和阿西替尼。结论Ⅱ度烫伤时,外源性VEGF在愈合中晚期加快愈合速度使愈合时间明显缩短,并且促进毛囊汗腺的再生使修复后的创面在外观、功能与正常皮肤相近,有助于提高全层皮肤创面的愈合质量。     

重组融合多肽hEGF-AWRK6的纯化及对小鼠烫伤感染创面愈合的影响

旨在研究重组融合多肽hEGF-AWRK6(EK)对烫伤模型小鼠感染创面的治疗功效。采用大肠杆菌表达系统表达、纯化融合多肽EK,抑菌实验检测EK抑菌活性;构建小鼠II度烫伤和铜绿假单胞菌感染模型,实验组创面滴注EK(30 mg/L),以PBS、庆大霉素(30 mg/L)、烫伤膏(10 mg/L)为对照,计算烫伤后创面愈合率及菌落数;伤后10 d,取各组小鼠的伤口及周边皮肤进行HE染色及胶原蛋白的Western blotting检测,分析创面病理组织结构。实验结果纯化得到了具有抑菌活性的重组表达融合肽EK;伤后6 d始,EK组小鼠创面菌落数少于对照组,差异极显著(P0.01);EK组小鼠烫伤愈合率显著高于PBS对照组(P0.01);与对照组相比,EK组小鼠创面真皮层细胞排列规则,再上皮化较快,毛囊生长较多,Ⅰ型胶原蛋白表达显著增加。结果表明EK具有抑制小鼠烫伤创面感染、促创面愈合功效,具有开发成为治疗烧伤药物的潜力。     

在烫伤条件下VEGF对大鼠皮肤eNOS基因表达的影响

目的:探讨大鼠烫伤愈合过程中VEGF对皮肤组织eNOS基因表达的影响。方法:采用了大鼠深II度烫伤模型,分别以VEGF和阿西替尼(VEGF抑制剂)干预,观察大鼠烫伤后愈合过程的组织学变化,PCR检测创面eNOS基因的表达。结果:肉眼观察VEGF组大鼠创面最早愈合,对照组大鼠愈合速度其次,阿西替尼组创面愈合最晚;HE染色结果显示伤后第2、8、21天VEGF组炎性细胞浸润程度、新生毛细血管数量均高于对照组和阿西替尼组,PCR结果显示烫伤后第2、8天VEGF组的eNOS基因的表达明显上调,且同时间点与对照组比较有统计学意义(P0.05)。结论:VEGF可诱导烫伤创面eNOS基因的表达,增加血管生成重要因子NO的生成,有利于创面愈合。     

烧伤膏对小鼠皮肤烫伤创面愈合的修复作用研究

目的:探讨烧伤膏对烫伤小鼠皮肤创面修复的可能作用机制。方法:将50只小鼠随机分为5组:正常组、模型组,烧伤膏高、中、低剂量组。除正常组和模型组外,烧伤膏实验组小鼠每天外涂烧伤膏治疗,连用15天。治疗结束后,采用Masson染色技术检测各组小鼠皮肤厚度及细胞病理形态;采用生化法检测皮肤中羟脯氨酸(Hyp)含量;采用ELISA技术检测皮肤中的TNF-α,IL-1β、Collagen I、EGF和TGF-β1的含量。结果:与正常组相比,模型组小鼠皮肤烫伤创面可见表皮细胞脱落,结构模糊,细胞变性坏死,表皮和真皮厚度明显减少,胶原纤维变薄,排列紊乱无序,呈断裂状;烧伤后创面局部组织中Hyp、TNF-α、IL-1β的含量显著升高(P0.01,P0.01,P0.01),而EGF、TGF-β1和Collagen I含量均明显减少(P0.01,P0.01,P0.01),而应用烧伤膏治疗15天后,上述各项实验指标明显得到改善。结论:烧伤膏抑制创面早期感染,减少胶原蛋白的分解和促进后期创面修复的作用可能与抑制炎性细胞因子和增加皮肤相关生长因子表达的作用机制有关。     

重度烫伤创面米根霉感染1例

报道1例重度烫伤后引起全身多处米根霉感染。患者,男,50岁,全身大面积热液烫伤4 d伴创面异味,散在霉斑。斜面培养呈:灰白色;皮损组织病理检查示:粗大较短无隔菌丝,多呈直角分支。根据典型的菌丝形态及组织病理学检查,初步诊断为:米根霉。烫伤后出现全身多处米根霉感染合并全身脓毒血症,多器官功能不全,给予手术清创、积极抗真菌及改善循环、增强免疫力等支持治疗后无明显好转,最终死于全身严重感染及多器官衰竭。     

皮肤烫伤修复期斯钙素-1基因表达与组织过氧化氢水平变化

目的：检测皮肤烫伤修复期斯钙素-1（STC1）基因表达与组织过氧化氢（H202）水平的变化。方法：在小鼠Ⅱ度烫伤模型上,采用生物化学和RT-PCR方法检测损伤部位组织H2O2含量及STC1 mRNA水平。结果：组织H2O2水平在皮肤烫伤后12h升高,略微下降后继续升高,至烫伤后120h达到最高值;而STC1 mRNA水平始终处于较高水平,分别在烫伤后12h和120h各出现一次高峰。结论：皮肤烫伤修复期组织STC1 mRNA水平与组织H2O2水平变化具有相关性。     

獾油促进深Ⅱ度烫伤小鼠创面愈合作用的研究

目的:检测獾油对小鼠深Ⅱ度烫伤创面愈合的促进作用.方法:制备小鼠深Ⅱ度烫伤模型,分为烫伤对照组(A组)、植物油治疗组(B组)和獾油治疗组(C组).创面依次用生理盐水纱布、植物油纱布、獾油纱布覆盖.无菌纱布包扎固定,每日换药一次.于伤后7天、10天、15天按照Nagelschmidt法观察并记录创面愈合面积,计算创面愈合率;取创面组织,制成石蜡切片,观察病理及组织形态学变化.结果:獾油能加速烫伤创面的再上皮化,促进创面的愈合;提高烫伤组织细胞的增殖活性;促进烫伤创面表皮干细胞的增殖分化.结论:獾油对深Ⅱ度烫伤创面愈合有促进作用     

应用便携式数字化温控烫伤仪建立标准化大鼠皮肤烫伤模型

目的:研制一种新型便携式数字化温控烫伤仪,通过自制数字化烫伤仪对大鼠进行烫伤实验,建立标准化大鼠皮肤烫伤模型,从而验证数字化烫伤仪的有效及实用性。方法:选取18只SD大鼠分为对照组(3只,不烫伤);实验组(15只),再将实验组大鼠随机分配为A组(6只)、B组(6只)、C组(3只),选取大鼠背部作为烫伤实验部位:1、时间设定为20 s和30 s,烫伤仪温度分别设定为70℃、80℃、90℃、100℃、120℃,对A组和B组大鼠进行烫伤处理。2、温度设定为100℃,烫伤仪加热时间分别设定为10 s、15 s、25 s,对C组大鼠进行烫伤处理。烫伤后48 h切取实验组和对照组大鼠背部皮肤,进行大体及显微镜下组织病理学观察。结果:70℃20s烫伤点为I°烫伤;70℃30 s、80℃20 s、100℃10 s烫伤点为浅Ⅱ°烫伤;80℃30 s和100℃15 s烫伤点为深Ⅱ°烫伤;90℃20 s、90℃30 s、100℃20 s烫伤点为Ⅲ°烫伤;100℃25 s、100℃30 s、120℃20 s、120℃30 s烫伤点为IV°烫伤。结论:新型便携式数字化温控烫伤仪,可以可靠的建立标准化大鼠皮肤烫伤模型。     

烧烫伤创面感染的小鼠模型构建

目的探讨一种简单、稳定的烧烫伤创面感染的小鼠模型构建方法,以便进行相关烧烫伤创面修复研究。方法取30只BALB/c小鼠,采用自制木质烫伤板,沸水浴法烫取直径8 mm的圆形创面,烫伤时间分别为5 s、10 s、15 s。伤后48 h,取创面组织进行HE染色观察,筛选最佳创面烫伤时间。另取72只小鼠制成深Ⅱ度烫伤创面,采用擦刮法分别接种20μL菌浓度为1×106、l×107、1×108CFU/mL金黄色葡萄球菌标准菌株ATCC 25923的菌液。接种细菌后72 h,取创面组织HE染色观察创面炎症反应情况,并测定3、7、14 d的皮肤菌负荷,筛选最佳的细菌接种浓度。最后,按最佳条件建模后,观察创面的完全愈合时间以及创面愈中、愈后的组织学变化,以确定此创面感染模型是否建立成功。结果组织学结果表明,10 s为深Ⅱ度创面的理想致伤时间,最佳接种菌浓度为l×108CFU/mL,此时期,14 d内菌负荷均高于l×105CFU/g。该模型的创面愈合时间(21±0.95 d)较正常创面愈合时间(15.92±0.34 d)明显延长(P<0.01),炎性反应明显,愈后不佳。结论烧烫伤创面感染的小鼠模型构建成功,可作为感染创面防治研究的实验动物模型。     

OCT于大鼠脱水组织中光散射特性的分析研究

目的:探讨活体组织液体含量的改变对OCT成像的影响,以期提高OCT在诊断组织病理性质方面的能力。方法:实验中复制脱水大鼠病理模型,应用光学相干层析成像设备,进行大鼠舌浅表组织在体显微成像检测,并对图像中组织的信号衰减特性进行量化分析。结果:正常对照组大鼠体重明显增加,病理模型组显著下降,病理模型组于脱水3天和5天后组织的平均OCT信号衰减系数明显高于正常对照组(P<0.01),且5天较3天的病理模型组组织的信号衰减系数变化尤其显著(P<0.01)。结论:改变组织含液量,可显著改变OCT成像效果,且通过对OCT图像中信号的衰减系数分析,可获得组织细微的散射变化,从而有望提高OCT技术在组织性质方面的诊断能力。     

基于光学相干层析成像技术的皮肤组织非消融性光热损伤过程

使用OCT技术观察活体小鼠皮肤组织在非消融性激光作用后光热损伤及其修复过程,得出皮肤组织在此过程中形态卜的变化规律.利用OCT散射模型得出皮肤在激光作用前后光学参数中衰减系数的变化,根据所获得的光学参数的变化量来判断热损伤程度,并分析引起散射参数变化的原因,作为临床上无损的判断光热作用下皮肤内部损伤情况的依据.结果表明OCT是一种很有潜力的活体监测光热损伤及其修复过程的工具.     

维生素C对光化学法诱导皮肤光损伤的光保护作用:OCT定量研究

8-甲氧补骨脂素(8-MOP)联合UVA辐射(即光化学疗法PUVA)因诱导皮肤光损伤的副作用,常被用于实验动物皮肤光损伤模型的构建。为研究维生素C(Vc)对皮肤光损伤的保护效应,本研究在Balb/c小鼠背部皮肤涂抹0.1%8-MOP溶液1h后进行UVA辐照(10 J/cn2)。然后分别涂抹7.5%、15%和30%浓度的Vc溶液的进行光保护治疗,利用光学相干层析成像分析皮肤厚度和光信号衰减的变化,从而评估Vc对皮肤的光保护作用。结果显示,相对于溶媒组,Vc治疗组皮肤厚度减小,光衰减系数增加,其中15%效果尤为明显结果表明,局部涂抹Vc溶液具有一定的光损伤保护效应。     

Investigation of changes in optical attenuation of bone and neuronal cells in organ culture or three-dimensional constructs in vitro with optical coherence tomography: relevance to cytochrome oxidase monitoring

Changes in optical attenuation, relevant to cytochrome oxidase, of the rat bone periosteal tissue in explanted culture and human neuronal cells in three-dimensional agarose constructs have been monitored by the use of optical coherence tomography (OCT), with potential applications in tissue engineering and diagnosis. A superluminescent diode (SLD) with a peak emission wavelength (lambda = 820 nm) that is the near-infrared absorption band of the oxidized form of CytOx was employed. The attenuation coefficient was obtained from the depth-resolved reflectance profiles of liquid phantoms (naphthol green B with intralipid), explant culture (periosteum of calvaria from rats) and cells in 3D agarose constructs. The absorption coefficient of naphthol green B can be accurately quantified by the linear relationship between attenuation coefficients and the concentration. The difference in the attenuation coefficient of astrocytoma cells in agarose before and after reduction of CytOx is 0.26 +/- 0.10 mm(-1) ( n = 9), whereas no attenuation is observed with the agarose control. Reduction of the enzyme in periosteal tissue leads to a change in attenuation coefficient of 0.43 +/- 0.24 mm(-1) ( n = 7). For comparison, using a biochemical assay, the absorption coefficient of the oxidized-reduced form of CytOx is measured at approximately 8.3 +/- 1.5x10(-3) mm-1 ( n = 4) and 8.7 +/-2.5x10(-3) mm-1 ( n = 4) at 820 nm for astrocytoma cells and rat periosteum, respectively. The lower value of CytOx concentration using biochemical versus OCT measurements may result from shifts in the scattering profile and the amplifying influences of multiple heme-based oxidases, indicating that conventional OCT is not specific enough to monitor redox changes in cytochrome oxidase. However, qualitative shifts in oxidation state are apparent using the technique. Our results suggest the potential application of OCT in providing high-resolution tomographic imaging of tissues in organ culture and cells grown in three-dimensional constructs in vitro.     

Pilot feasibility study of in vivo intraoperative quantitative optical coherence tomography of human brain tissue during glioma resection

This study investigates the feasibility of in vivo quantitative optical coherence tomography (OCT) of human brain tissue during glioma resection surgery in six patients. High‐resolution detection of glioma tissue may allow precise and thorough tumor resection while preserving functional brain areas, and improving overall survival. In this study, in vivo 3D OCT datasets were collected during standard surgical procedure, before and after partial resection of the tumor, both from glioma tissue and normal parenchyma. Subsequently, the attenuation coefficient was extracted from the OCT datasets using an automated and validated algorithm. The cortical measurements yield a mean attenuation coefficient of 3.8 ± 1.2 mm^?1 for normal brain tissue and 3.6 ± 1.1 mm^?1 for glioma tissue. The subcortical measurements yield a mean attenuation coefficient of 5.7 ± 2.1 and 4.5 ± 1.6 mm^?1 for, respectively, normal brain tissue and glioma. Although the results are inconclusive with respect to trends in attenuation coefficient between normal and glioma tissue due to the small sample size, the results are in the range of previously reported values. Therefore, we conclude that the proposed method for quantitative in vivo OCT of human brain tissue is feasible during glioma resection surgery.     

Attenuation corrected-optical coherence tomography for quantitative assessment of skin wound healing and scar morphology

Imaging the structural modifications of underlying tissues is vital to monitor wound healing. Optical coherence tomography (OCT) images high-resolution sub-surface information, but suffers a loss of intensity with depth, limiting quantification. Hence correcting the attenuation loss is important. We performed swept source-OCT of full-thickness excision wounds for 300 days in mice skin. We used single-scatter attenuation models to determine and correct the attenuation loss in the images. The phantom studies established the correspondence of corrected-OCT intensity (reflectivity) with matrix density and hydration. We histologically validated the corrected-OCT and measured the wound healing rate. We noted two distinct phases of healing—rapid and steady-state. We also detected two compartments in normal scars using corrected OCT that otherwise were not visible in the OCT scans. The OCT reflectivity in the scar compartments corresponded to distinct cell populations, mechanical properties and composition. OCT reflectivity has potential applications in evaluating the therapeutic efficacy of healing and characterizing scars.     

In vivo detection of endotracheal tube biofilms in intubated critical care patients using catheter‐based optical coherence tomography

The formation of biofilms in the endotracheal tubes (ETTs) of intubated patients on mechanical ventilation is associated with a greater risk of ventilator‐associated pneumonia and death. New technologies are needed to detect and monitor ETTs in vivo for the presence of these biofilms. Longitudinal OCT imaging was performed in mechanically ventilated subjects at 24‐hour intervals until extubation to detect the formation and temporal changes of in vivo ETT biofilms. OCT‐derived attenuation coefficient images were used to differentiate between mucus and biofilm. Extubated ETTs were examined with optical and electron microscopy, and all imaging results were correlated with standard‐of‐care clinical test reports. OCT and attenuation coefficient images from four subjects were positive for ETT biofilms and were negative for two subjects. The processed and stained extubated ETTs and clinical reports confirmed the presence/absence of biofilms in all subjects. Our findings confirm that OCT can detect and differentiate between biofilm‐positive and biofilm‐negative groups (P < 10^?5). OCT image‐based features may serve as biomarkers for direct in vivo detection of ETT biofilms and help drive investigation of new management strategies to reduce the incidence of VAP.      

Translational optical coherence elastography for assessment of systemic sclerosis

Systemic sclerosis (SSc‐scleroderma) is an autoimmune disorder with high mortality rate that results in excessive accumulation of collagen in the skin and internal organs. Currently, the modified Rodnan Skin Score (mRSS) is the gold standard for evaluating the dermal thickening due to SSc. However, mRSS has noticeable inter‐ and intra‐observer variabilities as quantified by the interclass correlation coefficient (ICC: 0.6‐0.75). In this work, optical coherence elastography (OCE) combined with structural optical coherence tomography (OCT) image analysis was used to assess skin thickness in 12 SSc patients and healthy volunteers. Inter‐ (ICC: 0.62‐0.99) and intra‐observer (ICC > 0.90) assessment of OCT/OCE showed excellent reliability. Clinical assessments, including histologically assessed dermal thickness (DT), mRSS, and site‐specific mRSS (SMRSS) were also performed for further validation. The OCE and OCT results from the forearm demonstrated the highest correlation (OCE: 0.78, OCT: 0.65) with SMRSS. Importantly, OCE and OCT had stronger correlations with the histological DT (OCT: r = .78 and OCE: r = .74) than SMRSS (r = .57), indicating the OCT/OCE could outperform semi‐quantitative clinical assessments such as SMRSS. Overall, these results demonstrate that OCT/OCE could be useful for rapid, noninvasive and objective assessments of SSc onset and monitoring skin disease progression and treatment response.     

One‐to‐one registration of en‐face optical coherence tomography attenuation coefficients with histology of a prostatectomy specimen

Optical coherence tomography (OCT), enables high‐resolution 3D imaging of the morphology of light scattering tissues. From the OCT signal, parameters can be extracted and related to tissue structures. One of the quantitative parameters is the attenuation coefficient; the rate at which the intensity of detected light decays in depth. To couple the quantitative parameters with the histology one‐to‐one registration is needed. The primary aim of this study is to validate a registration method of quantitative OCT parameters to histological tissue outcome through one‐to‐one registration of OCT with histology. We matched OCT images of unstained fixated prostate tissue slices with corresponding histology slides, wherein different histologic types were demarcated. Attenuation coefficients were determined by a supervised automated exponential fit (corrected for point spread function and sensitivity roll‐off related signal losses) over a depth of 0.32 mm starting from 0.10 mm below the automatically detected tissue edge. Finally, the attenuation coefficients corresponding to the different tissue types of the prostate were compared. From the attenuation coefficients, we produced the squared relative residue and goodness‐of‐fit metric R². This article explains the method to perform supervised automated quantitative analysis of OCT data, and the one‐to‐one registration of OCT extracted quantitative data with histopathological outcomes.      

Investigation of optical attenuation imaging using optical coherence tomography for monitoring of scars undergoing fractional laser treatment

We demonstrate the use of the near‐infrared attenuation coefficient, measured using optical coherence tomography (OCT), in longitudinal assessment of hypertrophic burn scars undergoing fractional laser treatment. The measurement method incorporates blood vessel detection by speckle decorrelation and masking, and a robust regression estimator to produce 2D en face parametric images of the attenuation coefficient of the dermis. Through reliable co‐location of the field of view across pre‐ and post‐treatment imaging sessions, the study was able to quantify changes in the attenuation coefficient of the dermis over a period of ～20 weeks in seven patients. Minimal variation was observed in the mean attenuation coefficient of normal skin and control (untreated) mature scars, as expected. However, a significant decrease (13 ± 5%, mean ± standard deviation) was observed in the treated mature scars, resulting in a greater distinction from normal skin in response to localized damage from the laser treatment. By contrast, we observed an increase in the mean attenuation coefficient of treated (31 ± 27%) and control (27 ± 20%) immature scars, with numerical values incrementally approaching normal skin as the healing progressed. This pilot study supports conducting a more extensive investigation of OCT attenuation imaging for quantitative longitudinal monitoring of scars.

En face 2D OCT attenuation coefficient map of a treated immature scar derived from the pre‐treatment (top) and the post‐treatment (bottom) scans. (Vasculature (black) is masked out.) The scale bars are 0.5 mm.