静电纺丝用作难愈合伤口敷料的研究进展

静电纺丝伤口敷料作为一种新型功能性敷料,具有较大的比表面积、可调控的孔隙率和良好的生物性能,既有益于细胞呼吸,又 可抑制细菌感染伤口,并能促进细胞增殖和加速创面愈合,是未来伤口敷料研发领域发展的新方向。介绍静电纺丝纳米纤维的原理、特点, 重点阐述各类聚合物、生物活性物质在静电纺丝伤口敷料制备中的应用进展。     

角蛋白/海藻酸钠/聚丙烯酰胺水凝胶皮肤敷料的制备及创口修复研究

为了获得更为理想的皮肤创口修复敷料,在海藻酸钠(SA)和聚丙烯酰胺(PAM)水凝胶的基础上复合人发角蛋白(KTN),制得KTN/SA/PAM水凝胶皮肤敷料.用电子万能测试机、扫描电子显微镜等对其进行表征,结果显示,KTN/SA/PAM水凝胶皮肤敷料拉伸强度为42.41 kPa,弹性模量11.19 kPa,接近人体皮肤组...     

壳聚糖/ 魔芋葡甘露聚糖复合膜体内外促创面愈合研究

目的:制备壳聚糖/魔芋葡甘露聚糖复合膜,研究其促创面愈合作用。方法:壳聚糖溶液和魔芋葡甘露聚糖溶液混合后冷冻干燥制成复合膜。扫描电镜观察膜的形态和孔径,并研究比较膜的吸水率,水蒸气透过率,拉伸强度,断裂伸长率和体外降解率。建立大鼠皮肤损伤模型,敷以复合膜治疗,比较创面愈合率,观察创面组织染色结果,评价复合膜的促创面愈合作用。结果:壳聚糖/魔芋葡甘露聚糖复合膜具有三维网状结构,壳聚糖复合魔芋葡甘露聚糖后,膜的吸水率、拉伸强度和断裂伸长率提高,体外降解加速,水蒸气透过率改善。愈合实验表明壳聚糖/魔芋葡甘露聚糖膜具有促进创面愈合作用。结论:壳聚糖/魔芋葡甘露聚糖复合膜制备工艺简单,能有效促进创面愈合,具有成为创伤敷料的潜力。     

糖尿病足溃疡的危险因素探讨及亲水性纤维含银敷料促进患者伤口愈合的临床对照研究

摘要 目的：探讨糖尿病足溃疡（DFU）的危险因素,并研究亲水性纤维含银敷料促进患者伤口愈合的应用价值。方法：选取2017年8月-2020年12月期间我院收治的糖尿病患者230例。230例糖尿病患者中发生DFU的79例,纳为DFU组,剩余151例未发生DFU,纳为无DFU组。DFU组的患者采用随机数字表法分为治疗1组39例和治疗2组40例,治疗1组给予传统纱布敷料,治疗2组给予亲水性纤维含银敷料。采用多因素Logistic回归分析DFU发生的危险因素。观察治疗1组、治疗2组的临床疗效和临床指标。结果：DFU组、无DFU组在性别、年龄、户籍地、糖尿病病程、并发下肢血管病变、并发周围神经病变、足底有胼胝、血红蛋白（Hb）、C反应蛋白（CRP）、白蛋白（ALB）、总胆固醇（TC）、纤维蛋白原（FIB）、红细胞沉降率（ESR）、高密度脂蛋白（HDL）、 胱抑C（CysC）、 低密度脂蛋白（LDL）、脂蛋白a[Lp(a)]、糖化血红蛋白（HbAlc）方面对比差异有统计学意义（P<0.05）。男性、糖尿病病程、并发下肢血管病变、并发周围神经病变、足底有胼胝、ALB、ESR、CysC、CRP、Lp(a)、HbAlc均是DFU发生的危险因素（P<0.05）。治疗2组的临床总有效率明显高于治疗1组（P<0.05）。治疗2组的创面愈合时间、出现明显肉芽时间、住院时间短于治疗1组,住院费用高于治疗1组（P<0.05）。结论：DFU的发生受到多种因素影响,包括男性、糖尿病病程、并发下肢血管病变等,因此临床应加强对这些因素的预防和控制。此外,亲水性纤维含银敷料可促进DFU患者创面愈合,疗效显著。     

An Improved Method for the Preparation of Type I Collagen From Skin

Soluble type 1 collagen (COL1) is used extensively as an adhesive substrate for cell cultures and as a cellular scaffold for regenerative applications. Clinically, this protein is widely used for cosmetic surgery, dermal injections, bone grafting, and reconstructive surgery. The sources of COL1 for these procedures are commonly nonhuman, which increases the potential for inflammation and rejection as well as xenobiotic disease transmission. In view of this, a method to efficiently and quickly purify COL1 from limited quantities of autologously-derived tissues would circumvent many of these issues; however, standard isolation protocols are lengthy and often require large quantities of collagenous tissues. Here, we demonstrate an efficient COL1 extraction method that reduces the time needed to isolate and purify this protein from about 10 days to less than 3 hr. We chose the dermis as our tissue source because of its availability during many surgical procedures. This method uses traditional extraction buffers combined with forceful agitation and centrifugal filtration to obtain highly-pure, soluble COL1 from small amounts of corium. Briefly, dermal biopsies are washed thoroughly in ice-cold dH₂O after removing fat, connective tissue, and hair. The skin samples are stripped of noncollagenous proteins and polysaccharides using 0.5 M sodium acetate and a high speed bench-top homogenizer. Collagen from residual solids is subsequently extracted with a 0.075 M sodium citrate buffer using the homogenizer. These extracts are purified using 100,000 MW cut-off centrifugal filters that yield COL1 preparations of comparable or superior quality to commercial products or those obtained using traditional procedures. We anticipate this method will facilitate the utilization of autologously-derived COL1 for a multitude of research and clinical applications.     

Wnt信号通路与皮肤创面愈合的关系

创面愈合是由炎性细胞、细胞因子等多种因素共同参与,涉及组织修复、再生、重建的一个复杂有序的病理生理过程。皮肤慢性创面的愈合仍然是临床研究的重点与热点,随着分子生物学的发展,对皮肤创面愈合机制的认识也逐渐深入。Wnt信号通路是一条由Wnt蛋白及其受体、调节蛋白等组成的高度保守的信号通路,参与细胞增殖、凋亡、分化等多种生物学过程。Wnt信号通路作为参与皮肤愈合的信号通路之一,被认为具有调控皮肤及其附属器的发育、诱导皮肤附件的形态发生、调节毛囊的周期生长、促进创面血管新生及上皮重塑等多方面的功能。因此本文试从炎性细胞、成纤维细胞、干细胞、血管新生、表皮新生与毛囊新生等方面对Wnt信号通路与皮肤创面愈合的关系作一综述。     

Wounded tissues and neurotoxicity of polyglutamate

A recent paper in your journal presenting a novel wound dressing material drew our attention. We notice with caution several mistakes regarding the part of the vivo study for wound dressing application in the literature. The specific ones are listed and explained in the letter to editor. In addition, we raise the concern about the potential neurotoxicity of degradation products of poly(glutamic acid).     

局部应用PTD-SOD、SOD对小鼠皮肤创伤的抗氧化应激损伤保护效果及其比较

目的探讨局部应用PTD-SOD、SOD对小鼠皮肤创伤的抗氧化应激损伤保护效果及其差异。方法制备机械性创伤小鼠模型和不同浓度的PTD-SOD(1000、3000、6000 U)及SOD(1000、3000、6000 U)溶液,分别用上述溶液进行治疗,同时设立模型对照组和生理盐水对照组,各组均连续治疗13 d。观察各组创伤愈合情况,记录创伤愈合率和愈合天数;于创伤后第14天取各组小鼠创伤愈合部位皮肤,一部分制成10%组织匀浆液用于检测抗氧化酶(SOD、CAT、GSH-Px)活性及丙二醛(MDA)、羟脯氨酸(Hyp)含量,一部分制成病理组织切片用于皮肤组织学观察。结果①与模型对照组相比,PTD-SOD各组或SOD各组的抗氧化酶活性和Hyp含量显著(P0.05)或极显著(P0.01)升高,MDA含量显著(P0.05)或极显著(P0.01)降低,能显著(P0.05)或极显著(P0.01)提高创伤愈合率、缩短创伤愈合时间;与生理盐水对照组相比,结果类似。②在同等剂量下,从促创伤愈合时间、抗氧化酶活性、MDA含量、Hyp含量等方面比较,PTD-SOD组明显(P0.05)或极明显(P0.01)优于SOD组。③适当剂量的PTD-SOD促创伤愈合效果优于高剂量PTD-SOD的促创伤愈合效果。结论 PTD-SOD或SOD在皮肤创伤治疗中具有良好的抗氧化应激损伤效果,这种保护效果在创伤愈合的早期最显著;同等剂量下,PTD-SOD在促创伤愈合的效果上明显优于SOD。     

Demonstration of the Rat Ischemic Skin Wound Model

The propensity for chronic wounds in humans increases with ageing, disease conditions such as diabetes and impaired cardiovascular function, and unrelieved pressure due to immobility. Animal models have been developed that attempt to mimic these conditions for the purpose of furthering our understanding of the complexity of chronic wounds. The model described herein is a rat ischemic skin flap model that permits a prolonged reduction of blood flow resulting in wounds that become ischemic and resemble a chronic wound phenotype (reduced vascularization, increased inflammation and delayed wound closure). It consists of a bipedicled dorsal flap with 2 ischemic wounds placed centrally and 2 non-ischemic wounds lateral to the flap as controls. A novel addition to this ischemic skin flap model is the placement of a silicone sheet beneath the flap that functions as a barrier and a splint to prevent revascularization and reduce contraction as the wounds heal. Despite the debate of using rats for wound healing studies due to their quite distinct anatomic and physiologic differences compared to humans (i.e., the presence of a panniculus carnosus muscle, short life-span, increased number of hair follicles, and their ability to heal infected wounds) the modifications employed in this model make it a valuable alternative to previously developed ischemic skin flap models.     

Evaluation of bone marrow derived mesenchymal stem cells for full-thickness wound healing in comparison to tissue engineered chitosan scaffold in rabbit

Background

Chronic wounds present a major challenge in modern medicine. Even under optimal conditions, the healing process may lead to scarring and fibrosis. The ability of mesenchymal stem cells (MSCs) to differentiate into other cell types makes these cells an attractive therapeutic tool for cell transplantation. Both tissue-engineered construct and MSC therapy are among the current wound healing procedures and potential care. Chitosan has been widely applied in tissue engineering because of its biocompatibility and biodegradability.

组织工程复合皮肤应用于皮肤缺损创面的临床疗效观察

目的:临床观察组织工程复合皮肤对烧伤整形后需植皮患者的供皮区缺损创面的有效性及安全性。方法:试验选取不同临床中心烧伤整形后需植皮患者,在供皮区部分创面作为试验区应用组织工程复合皮肤覆盖,邻近创面采用盐水纱布替代作为对照区,应用后按常规方法包扎固定。临床试验时间为6个月,治疗期间观察统计患者的创面反应,愈合时间及愈合情况;对组织工程复合皮肤改善创面愈合质量及安全性进行临床评估。根据创面试验组和对照组的创面愈合时间,应用SPSS统计软件对数据进行方差齐性检验,根据检验结果分别进行独立样本t或t’检验。结果:试验共收集有效病例19例。临床观察显示应用后试验区创面无明显免疫排斥及炎性反应,患者自述疼痛明显减轻,试验区创面愈合时间与对照区相比缩短8d,统计学分析有显著性差异。愈后随访部分患者试验区愈合质量好于对照区,应用后患者疼痛、瘢痕形成等不良反应明显减少。结论:结果表明组织工程复合皮肤作为活型皮肤替代物用于医源性皮肤缺损的修复,这为促进供皮区的创面愈合提供了切实可行的方法。     

Engineering 3D Cellularized Collagen Gels for Vascular Tissue Regeneration

Synthetic materials are known to initiate clinical complications such as inflammation, stenosis, and infections when implanted as vascular substitutes. Collagen has been extensively used for a wide range of biomedical applications and is considered a valid alternative to synthetic materials due to its inherent biocompatibility (i.e., low antigenicity, inflammation, and cytotoxic responses). However, the limited mechanical properties and the related low hand-ability of collagen gels have hampered their use as scaffold materials for vascular tissue engineering. Therefore, the rationale behind this work was first to engineer cellularized collagen gels into a tubular-shaped geometry and second to enhance smooth muscle cells driven reorganization of collagen matrix to obtain tissues stiff enough to be handled.The strategy described here is based on the direct assembling of collagen and smooth muscle cells (construct) in a 3D cylindrical geometry with the use of a molding technique. This process requires a maturation period, during which the constructs are cultured in a bioreactor under static conditions (without applied external dynamic mechanical constraints) for 1 or 2 weeks. The “static bioreactor” provides a monitored and controlled sterile environment (pH, temperature, gas exchange, nutrient supply and waste removal) to the constructs. During culture period, thickness measurements were performed to evaluate the cells-driven remodeling of the collagen matrix, and glucose consumption and lactate production rates were measured to monitor the cells metabolic activity. Finally, mechanical and viscoelastic properties were assessed for the resulting tubular constructs. To this end, specific protocols and a focused know-how (manipulation, gripping, working in hydrated environment, and so on) were developed to characterize the engineered tissues.     

Fabrication of a Bioactive,PCL-based Self-fitting Shape Memory Polymer Scaffold

Tissue engineering has been explored as an alternative strategy for the treatment of critical-sized cranio-maxillofacial (CMF) bone defects. Essential to the success of this approach is a scaffold that is able to conformally fit within an irregular defect while also having the requisite biodegradability, pore interconnectivity and bioactivity. By nature of their shape recovery and fixity properties, shape memory polymer (SMP) scaffolds could achieve defect “self-fitting.” In this way, following exposure to warm saline (~60 ºC), the SMP scaffold would become malleable, permitting it to be hand-pressed into an irregular defect. Subsequent cooling (~37 ºC) would return the scaffold to its relatively rigid state within the defect. To meet these requirements, this protocol describes the preparation of SMP scaffolds prepared via the photochemical cure of biodegradable polycaprolactone diacrylate (PCL-DA) using a solvent-casting particulate-leaching (SCPL) method. A fused salt template is utilized to achieve pore interconnectivity. To realize bioactivity, a polydopamine coating is applied to the surface of the scaffold pore walls. Characterization of self-fitting and shape memory behaviors, pore interconnectivity and in vitro bioactivity are also described.     

以胶原膜为支架的心肌细胞体外三维培养

将从新生乳鼠心室肌组织获取的心肌细胞接种于鼠尾胶原膜三维支架和组织培养板,以细胞形态、细胞搏动、葡萄糖比消耗率(q_glu)、乳酸比产率(q_lac)、乳酸转化率(Y_lac/glu)、肌酸激酶及乳酸脱氢酶的活力为观察指标,比较心肌细胞在鼠尾胶原膜中三维(3D)培养和组织培养板中二维(2D)培养的差异。培养于鼠尾胶原膜的乳鼠心肌细胞在第5天形成闰盘连接,形成面积约为80mm³、肉眼可见自律性同步收缩的心肌细胞3D培养物。3D培养体系中乳鼠心肌细胞的q_glu、q_lac和Y_lac/glu的均值分别为7.37 μmol/10.6cells/d、2.92 μmol/106cells/d和0.38 μmol/μmol;2D培养体系中乳鼠心肌细胞的q_glu、q_lac和Y_lac/glu的均值分别为7.59 μmol/10.6cells/d、3.83 μmol/10.6cells/d和 0.51 μmol/μmol。两种培养体系中乳鼠心肌细胞的肌酸激酶及乳酸脱氢酶的活力无明显差别。实验结果表明：培养于鼠尾胶原膜的心肌细胞保持正常心肌细胞的代谢活力和收缩功能。     

Surface Wettability and Chemistry of Ozone Perfusion Processed Porous Collagen Scaffold

Crosslinking treatment of collagen has often been used to improve the biological stability and mechanical properties of 3D porous collagen scaffolds. However, accompanying these improvements, the collagen fibril surface becomes hydrophobic nature resulting in a reduced surface wettability. The wetting of the collagen fibril by culture medium is reduced and it is difficult for the medium to diffuse into the 3D structure of a porous collagen scaffold. This paper reports a “perfusion processing” strategy using ozone to improve the surface wettability of chemical crosslinked collagen scaffolds. Surface wettability, surface composition and biological stability were analyzed to evaluate the effectiveness of this surface processing strategy. It was observed that ozone perfusion processing improved surface wettability for both exterior and interior surfaces of the porous 3D collagen scaffold. The improvement in wettability is attributed to the incorporation of oxygen-containing functional groups onto the surface of the collagen fibrils, as confirmed by X-ray Photoelectron Spectroscopy (XPS) analysis. This leads to a significant improvement in water taking capability without compromising the bulk biological stability and mechanical properties, and confirms that ozone perfusion processing is an effective tool to modify the wettability both for interior and exterior surfaces throughout the scaffold.     

Establishment of a Clinically Relevant Ex Vivo Mock Cataract Surgery Model for Investigating Epithelial Wound Repair in a Native Microenvironment

The major impediment to understanding how an epithelial tissue executes wound repair is the limited availability of models in which it is possible to follow and manipulate the wound response ex vivo in an environment that closely mimics that of epithelial tissue injury in vivo. This issue was addressed by creating a clinically relevant epithelial ex vivo injury-repair model based on cataract surgery. In this culture model, the response of the lens epithelium to wounding can be followed live in the cells’ native microenvironment, and the molecular mediators of wound repair easily manipulated during the repair process. To prepare the cultures, lenses are removed from the eye and a small incision is made in the anterior of the lens from which the inner mass of lens fiber cells is removed. This procedure creates a circular wound on the posterior lens capsule, the thick basement membrane that surrounds the lens. This wound area where the fiber cells were attached is located just adjacent to a continuous monolayer of lens epithelial cells that remains linked to the lens capsule during the surgical procedure. The wounded epithelium, the cell type from which fiber cells are derived during development, responds to the injury of fiber cell removal by moving collectively across the wound area, led by a population of vimentin-rich repair cells whose mesenchymal progenitors are endogenous to the lens¹. These properties are typical of a normal epithelial wound healing response. In this model, as in vivo, wound repair is dependent on signals supplied by the endogenous environment that is uniquely maintained in this ex vivo culture system, providing an ideal opportunity for discovery of the mechanisms that regulate repair of an epithelium following wounding.     

外泌体在皮肤修复与再生中作用的研究进展

外泌体是直径在30-100 nm左右的囊泡结构。作为一种活细胞分泌的亚细胞成分,外泌体广泛参与细胞之间的交流,并可以作为干细胞的旁分泌因子来发挥生物学效应。研究发现外泌体可以参与皮肤组织修复与再生的各个过程,通过促进皮肤细胞的增殖迁移,促进血管新生,调节免疫反应来促进创伤愈合与皮肤组织再生,为进一步实现无细胞治疗提供了新的实现途径。对于某些慢性创面,例如糖尿病性皮肤溃疡等也有较好的治疗效果。本文就外泌体在皮肤修复与再生中作用的研究进展做一综述。     

3D Bio-Plotted Composite Scaffold Made of Collagen Treated Hydroxyapatite-Tricalciumphosphate for Rabbit Tibia Bone Regeneration

Biphasic calcium phosphate scaffolds with 20/80 HA/TCP ratio were fabricated using the 3D-Bioplotting system to heal critical size defects in rabbit tibia bone. Four different architectures were printed in a layer by layer fashion with lay down patterns viz. (a) 0°– 90°, (b) 0°– 45°– 90°– 135°, (c) 0°–108°– 216° and (d) 0°– 60°– 120°. After high-temperature sintering scaffolds were coated with collagen and were further characterized by (FTIR) Fourier Transform Infrared Spectroscopy, (SEM) Scanning Electron Microscopy, (XRD) X-Ray diffraction, Porosity analysis and Mechanical testing. Scaffold samples were tested for its ability to induce cytotoxicity in Balb/c 3T3 cells at in vitro condition using elution method. Skin sensitization potential of scaffolds was evaluated in male guinea pigs using guinea pig maximization test (GPMT). Further, scaffolds were implanted in eight rabbit tibia bones and biocompatibility and histological evaluations were carried out after 4 and 8 weeks implantation periods. In-vitro results include bonding, surface morphology, phases, porosity, mechanical strength and Cytotoxicity. In-vivo results include sensitization, capsule formation, inflammation, presence of polymorphonuclear cells, giant cells, plasma cells, X-Rays and degradation of the material. It was concluded that HA/TCP/Collagen scaffold with 0°– 45°– 90°– 135° architecture exhibits the most excellent properties in healing critical size bone defects in rabbits.