Embryonic skin development and repair

Fetal cutaneous wounds have the unique ability to completely regenerate wounded skin and heal without scarring. However, adult cutaneous wounds heal via a fibroproliferative response which results in the formation of a scar. Understanding the mechanism(s) of scarless wound healing leads to enormous clinical potential in facilitating an environment conducive to scarless healing in adult cutaneous wounds. This article reviews the embryonic development of the skin and outlines the structural and functional differences in adult and fetal wound healing phenotypes. A review of current developments made towards applying this clinical knowledge to promote scarless healing in adult wounds is addressed.     

糖尿病足患者肾功能和营养状态及脂质代谢与溃疡严重程度的关系

目的:探讨糖尿病足患者肾功能和营养状态及脂质代谢与溃疡严重程度的相关性。方法:选取2015年8月-2017年12月期间我院收治的糖尿病足患者389例为研究对象,根据Wagner分级将患者分为1级组52例,2级组84例,3级组96例,4级组129例,5级组28例,对比分析五组患者肾功能指标[血肌酐(Scr)、胱抑素C(Cys C)、尿素氮(BUN)]、营养状态指标[体重指数(BMI)、血红蛋白(Hb)、血清白蛋白(Alb)]、血脂指标[甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)]水平,并分析Wagner分级与以上指标的相关性。结果:不同Wagner分级患者性别、年龄、BUN水平比较差异无统计学意义(P0.05);2级组、3级组、4级组、5级组患者的BMI、TG、HDL-C、Hb、Alb水平低于1级组,Scr、Cys C水平、吸烟史及高血压所占比例高于1级组(P0.05);4级组、5级组患者的BMI、TG、HDL-C、Hb、Alb水平低于2级组、3级组,Scr、Cys C水平、吸烟史及高血压所占比例高于2级组、3级组(P0.05)。经Spearman相关性分析显示,Wagner分级与Scr、Cys C呈正相关,与TG、HDL-C、Hb、Alb、BMI呈负相关(P0.05)。结论:糖尿病足患者Scr、Cys C与溃疡严重程度存在正相关关系,TG、HDL-C、Hb、Alb、BMI均与溃疡严重程度存在负相关关系。     

双歧杆菌三联活菌胶囊联合莫沙必利对 糖尿病胃轻瘫患者血清胃肠激素水平的影响

目的探讨双歧杆菌三联活菌胶囊联合莫沙必利对糖尿病胃轻瘫(DGP)患者血清胃肠激素水平的影响及疗效。方法选择86例DGP患者,随机分为观察组和对照组。两组患者均予调整饮食、适量运动和控制血糖等基础治疗。观察组患者予以双歧杆菌三联活菌胶囊(630 mg/次,2次/d,餐后约30min温水服用)与莫沙必利(5mg/次,3次/d,口服)联合治疗,连用8周。对照组患者单用莫沙必利治疗,其剂量、方法、用法和疗程与观察组相同。观察两组患者治疗前后血清胃肠激素指标[胃动素(MTL)和血管活性肠肽(VIP)]的变化,并评估其临床疗效及不良反应。结果治疗8周后,两组患者血清MTL和血清VIP水平分别较前明显上升或下降(P0.05或P0.01),且观察组患者变化幅度较对照组更大(P0.05);同时观察组患者临床总有效率(95.35%)高于对照组(79.07%)(χ~2=5.11,P0.05)。观察组与对照组分别出现不良反应4例(9.30%)与6例(13.95%),症状均较轻,两组比较差异无统计学意义(χ~2=0.45,P0.05)。结论双歧杆菌三联活菌胶囊联合莫沙必利治疗DGP患者疗效确切,安全性较高,作用机制可能与其能调节胃肠激素分泌紊乱,上调血清MTL水平,下调血清VIP水平密切相关。     

MG53 and disordered metabolism in striated muscle

MG53 is a member of tripartite motif family (TRIM) that expressed most abundantly in striated muscle. Using rodent models, many studies have demonstrated the MG53 not only facilitates membrane repair after ischemia reperfusion injury, but also contributes to the protective effects of both pre- and post-conditioning. Recently, however, it has been shown that MG53 participates in the regulation of many metabolic processes, especially insulin signaling pathway. Thus, sustained overexpression of MG53 may contribute to the development of various metabolic disorders in striated muscle. In this review, using cardiac muscle as an example, we will discuss muscle metabolic disturbances associated with diabetes and the current understanding of the underlying molecular mechanisms; in particular, the pathogenesis of diabetic cardiomyopathy. We will focus on the pathways that MG53 regulates and how the dysregulation of MG53 leads to metabolic disorders, thereby establishing a causal relationship between sustained upregulation of MG53 and the development of muscle insulin resistance and metabolic disorders. This article is part of a Special issue entitled Cardiac adaptations to obesity, diabetes and insulin resistance, edited by Professors Jan F.C. Glatz, Jason R.B. Dyck and Christine Des Rosiers.     

间充质干细胞治疗糖尿病心脏病研究进展及其机制

糖尿病心脏病(diabetic cardiomyopathy,DCM)患者心脏病变弥漫、病变程度严重,患病率与死亡率逐年上升,缺乏有效的治疗手段,找到其他的治疗途径已成为一项重要内容。有研究发现,间充质干细胞(mesenchymal stem cells,MSCs)作为一种具有多分化潜能的细胞,能够通过多种机制作用于DCM的病理改变,提高心脏射血分数、改善心室重塑,是一种富有前景的治疗手段,本文着重就DCM的发病机制、MSCs对DCM的治疗机制及效果做一综述,为MSCs在DCM治疗中的应用提供重要的临床前实验依据。     

胃溃疡患者血清多肽类激素及胃粘膜中单胺类神经递质的水平及其临床意义

目的:分析胃溃疡患者血清多肽类激素及单胺类神经递质的水平变化及其临床意义。方法:选取2014年8月-2015年8月在我院经胃镜检查确诊为胃溃疡的患者103例作为研究组,另选取54例健康志愿者作为对照组。检测两组血清中胃动素(MTL)、肾上腺髓质素(AM)、胃肠激素胃泌素(Gas)、生长抑素(SS)及降钙素基因相关肽水平(CGRP),以及胃黏膜中血管活性肠肽(VIP)、5-羟色胺(5-HT)、去甲肾上腺素(NE)、P物质(SP)水平。结果:胃溃疡患者血清Gas,AM及MTL明显高于对照组,而SS及CGRP明显低于对照组,差异具有统计学意义(P0.05)。胃溃疡活动期患者血清Gas,AM及MTL明显高于愈合期及瘢痕期患者,而SS及CGRP低于愈合期及瘢痕期患者,差异具有统计学意义(P0.05);胃溃疡愈合期患者血清Gas,AM及MTL高于瘢痕期患者,而SS及CGRP低于瘢痕期患者,差异具有统计学意义(P0.05)。胃溃疡患者胃粘膜内5-HT,SP及NE明显低于对照组,而VIP明显高于对照组,差异具有统计学意义(P0.05)。胃溃疡活动期患者胃粘膜5-HT,SP及NE明显低于愈合期及瘢痕期患者,而VIP明显高于愈合期及瘢痕期患者,差异具有统计学意义(P0.05);胃溃疡愈合期患者胃粘膜5-HT,SP及NE明显低于瘢痕期患者,而VIP明显高于瘢痕期患者,差异具有统计学意义(P0.05)。结论:胃溃疡患者血清多肽类激素及胃黏膜中单胺类神经递质的水平变化与疾病进展密切相关,对胃溃疡的诊断及疗效评价具有指导意义。     

糖尿病性视网膜病变早期mfERG的研究

目的:探讨糖尿病患者糖尿病性视网膜病变早期多焦视网膜电图(multifocal electroretinogram,mfERG)的特点。方法:应用德国ROLAND公司RETIscan系统对24例40眼糖尿病患者,同时对27例40眼正常对照眼记录mfERG。按机器的默认值一阶反应进行记录。整个记录过程中可以分为12个时段,每个时段记录为时间47秒。结果:mERG测得的糖尿病患者组1～5环所在位置的P1波的振幅密度随离心度的增加而降低,P1波和N1波幅值降低和潜伏时延迟。各象限的P1、N1波振幅密度、波幅值降低,潜伏时延迟。结论:糖尿病性视网膜病变受累的区域多发生在黄斑部,功能上的改变早于形态学的变化;病变的早期功能改变最先出现于视网膜的后极偏颞上方;糖尿病患者在未出现眼底改变时各个象限视网膜的外层已经严重受累。     

Growth pattern switch of renal cells and expression of cell cycle related proteins at the early stage of diabetic nephropathy

Renal hypertrophy, partly due to cell proliferation and hypertrophy, has been found correlated to renal function deterioration in diabetes mellitus. We screened the up-regulated cell cycle related genes to investigate cell growth and the expression of cell cycle regulating proteins at the early stage of diabetic nephropathy using STZ-induced diabetic rats. Cyclin E, CDK(2) and P(27) were found significantly up-regulated in diabetic kidney. Increased cell proliferation in the kidney was seen at day 3, peaked at day 5, and returned to normal level at day 30. Cyclin E and CDK(2) expression also peeked at day 5 and P(27) activity peaked at day 14. These findings indicate that a hyperplastic growth period of renal cells is followed by a hypertrophic growth period at the early stage of diabetes. The growth pattern switch may be regulated by cell cycle regulating proteins, Cyclin E, CDK(2), and P(27).