• 【皮肤吸收的大气氧气对人类真皮和表皮的氧气供应有很大贡献。】 复制标题 收藏 收藏
    DOI:10.1113/jphysiol.2001.013067 复制DOI
    作者列表:Stücker M,Struk A,Altmeyer P,Herde M,Baumgärtl H,Lübbers DW
    BACKGROUND & AIMS: It has been known since 1851 that atmospheric oxygen is taken up by the human epidermis. The contribution to total respiration is negligible. Until now the significance for the local oxygen supply of the skin has remained unknown. With a newly developed sensor, the oxygen fluxoptode, it has become possible to make local measurements of the transcutaneous oxygen flux (tcJ(O2)). In this study the sensor was calibrated so that absolute values of tcJ(O2) could be reported. At rest, tcJ(O2) was determined on normal, humidified skin on the volar forearm of 20 volunteers of different age groups. In order to evaluate the contribution of the blood flow to the oxygen supply of the skin, tcJ(O2) was recorded at the end of a 5 min suprasystolic occlusion of the forearm. At normal skin surface partial oxygen pressure (163 +/- 9 Torr), tcJ(O2) was 0.53 +/- 0.27 ml O2 min(-1) x m(-2). A 5 min interruption of blood flow resulted in an increase of 9.5 +/- 6.3 % in tcJ(O2). The value of tcJ(O2) was unaffected by the age of the subject. Published data on the oxygen diffusion properties of skin and simulations of intracutaneous profiles of oxygen partial pressure indicated that under these conditions, the upper skin layers to a depth of of 0.25-0.40 mm are almost exclusively supplied by external oxygen, whereas the oxygen transport of the blood has a minor influence. As a consequence, a malfunction in capillary oxygen transport cannot be the initiator of the development of superficial skin defects such as those observed in chronic venous incompetence and peripheral arterial occlusive disease.

    背景与目标: 1851年已经知道,大气中的氧气被人的表皮吸收。对总呼吸的贡献可以忽略不计。到目前为止,皮肤局部氧气供应的重要性仍然未知。借助新开发的传感器氧气通量,可以对经皮氧气通量 (tcJ(O2)) 进行局部测量。在这项研究中,对传感器进行了校准,以便可以报告tcJ(O2) 的绝对值。休息时,在20个不同年龄组的志愿者的前臂掌侧正常湿润皮肤上测定tcJ(O2)。为了评估血流对皮肤氧气供应的贡献,在前臂5分钟的上动脉闭塞结束时记录了tcJ(O2)。在正常皮肤表面氧分压 (163 +/- 9 Torr) 下,tcJ(O2) 为0.53 +/-0.27毫升O2 min(-1) × m(-2)。血流中断5分钟导致tcJ(O2) 的9.5 +/- 6.3% 增加。tcJ(O2) 的值不受受试者年龄的影响。关于皮肤的氧气扩散特性的公开数据和氧分压的皮内分布的模拟表明,在这些条件下,上层皮肤层至0.25-0.40毫米的深度几乎完全由外部氧气供应,而氧气的输送血液的影响很小。结果,毛细血管氧运输的故障不能成为浅表皮肤缺损发展的始作俑者,例如在慢性静脉功能不全和外周动脉闭塞性疾病中观察到的那些。
  • 【使用猪衍生的脱细胞真皮基质或上皮下结缔组织移植物进行冠状高级皮瓣的根部覆盖: 一项随机对照临床试验。】 复制标题 收藏 收藏
    DOI:10.1007/s00784-020-03280-x 复制DOI
    作者列表:Suzuki KT,de Jesus Hernandez Martinez C,Suemi MI,Palioto DB,Messora MR,de Souza SLS,Novaes AB Jr,Chaves Furlaneto FA,Taba M Jr
    BACKGROUND & AIMS: OBJECTIVE:The aim of this study is to investigate the use of a porcine-derived acellular dermal matrix (MD) in root coverage procedures combined with extended coronally positioned flap (eCAF), in comparison to the subepithelial connective tissue graft (SCTG) associated with the eCAF. MATERIAL AND METHODS:Eighteen adult patients presenting bilateral type 1 gingival recession were randomly assigned to SCTG or MD groups. Clinical and patient-based outcomes were recorded at 3 and 6 months after the surgical procedure. RESULTS:Both groups showed a significant reduction in the mean recession height of 3.33 ± 0.89 mm to 1.24 ± 1.10 mm (MD) and 3.21 ± 0.8 mm to 0.83 ± 0.86 mm (SCTG) without difference between groups. Six patients in the test group and eight in the control group obtained complete root coverage. The keratinized tissue height and thickness (KTT) showed a significant increase after 3 and 6 months in both groups. The average KTT gains were 0.39 ± 0.4 mm (MD) and 0.51 ± 0.5 mm (SCTG) (p < 0.05). Performing multivariate analysis suggests that MD addition to coronally advanced flaps may be similar to SCTG. CONCLUSION:The MD had similar results in comparison to SCTG and in the context of reducing patient morbidity it can be used as an alternative for the treatment of gingival recessions. CLINICAL RELEVANCE:The SCTG is the gold standard therapy for root coverage. The MD has been widely used in mucogingival surgery as a substitute for SCTG and proposed similar results. A substitute is very important for clinicians and patients. It will give a better postoperative and possibilities to treat multiples recession. (Clinicaltrials.gov Identifier: NCT03675334).
    背景与目标:
  • 【脱细胞真皮基质在泪槽畸形矫正中的应用】 复制标题 收藏 收藏
    DOI:10.1007/s00266-018-1191-1 复制DOI
    作者列表:Yue D,Wu X,Song H,Zhou Z,Ye M,Zhu M
    BACKGROUND & AIMS: OBJECTIVE:The acellular dermal matrix (ADM) used in correcting the tear trough deformity has been reported, but there were only a few cases. The long-term effectiveness of ADM was not clear. We aim to discuss the technique and the effect of using ADM to correct the tear trough deformity through more cases. METHODS:A retrospective study was conducted from January 2012 to January 2017. Twenty-six patients who showed obvious tear trough deformity with moderate or severe orbital fat bulging and excess of lower eyelid skin were treated with ADM to improve the appearance of the midface. Follow-up was performed for 2-12 months in 26 cases. The level of postoperative satisfaction was assessed by interview during the follow-up and rated as very satisfied, satisfied, acceptable, or unacceptable. RESULT:Twenty patients were very satisfied for having achieved complete correction. Three patients were satisfied for having achieved obvious improvement. Three patients felt the results were just acceptable and were refilled because of the insufficiency of the filler. No one was unacceptable. There were no complications such as rapid resorption, rejection, or inflammation. CONCLUSION:The method of using ADM for the correction of tear trough deformity has the advantages of low absorption rate, good appearance, and high security. It provides a new choice for the treatment of tear trough deformity. LEVEL OF EVIDENCE IV:This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
    背景与目标:
  • 【脱细胞真皮基质增强阴茎周长的并发症和处理。】 复制标题 收藏 收藏
    DOI:10.1016/j.jsxm.2019.09.010 复制DOI
    作者列表:Xu T,Zhang G,Bai W,Li Q,Yang A,Lin Q,Xu T,Zhang X
    BACKGROUND & AIMS: INTRODUCTION:Acellular dermal matrix (ADM) is a common filler used widely in clinical practice to increase penile girth for cosmetic reasons, but there are few studies on its complications. AIM:The aim of this study was to investigate and analyze the complications of penile girth enhancement (PGE) with ADM. METHODS:The medical records of 78 patients who underwent PGE with ADM between June 2016 and January 2019 were retrospectively reviewed. MAIN OUTCOME MEASURE:Related complications and their subsequent management were summarized and analyzed. RESULTS:78 patients (mean age 31.14 years [21-66 years]) received PGE with ADM. At the 3-month follow-up, the penile circumference was increased by 1.1 (0.5-2.1) cm on average. There were 47 patients with erectile discomfort, 12 with delayed healing, 10 with unobvious augmentation effect, 8 with wound hematoma, 7 with prepuce edema, 4 with wound infection, and 3 patients with skin necrosis of the dorsal side. 7 patients eventually underwent ADM removal. CLINICAL IMPLICATIONS:These adverse complications indicate that ADM should be used with caution for PGE. STRENGTH & LIMITATIONS:This study adds important data, as there are few published reports on the complications of PGE with ADM. However, this study did not compare postoperative complications with ADM to those seen with other filler material. CONCLUSION:Even with standardized surgical methods and rigorous postoperative care, complications of PGE using ADM are severe, which indicates that it is not an ideal or safe method for PGE. Xu T, Zhang G, Bai W, et al. Complications and Management of Penile Girth Enhancement with Acellular Dermal Matrix. J Sex Med 2019;16:2011-2017.
    背景与目标:
  • 【六价白喉-破伤风-无细胞百日咳灭活脊髓灰质炎病毒-流感嗜血杆菌结合-乙型肝炎疫苗的两种制剂在15至18个月大儿童中的安全性和免疫原性。】 复制标题 收藏 收藏
    DOI:10.4161/hv.1.6.2377 复制DOI
    作者列表:Halperin SA,Langley JM,Hesley TM,Zappacosta PS,Radley D,Smith B,Hoffenbach A,Boslego J,Silber JL
    BACKGROUND & AIMS: :Combination vaccines decrease the number of injections and improve parental satisfaction and vaccination schedule compliance. In a phase 1, randomized, partially-blinded, single-dose booster study, we evaluated two formulations of an investigational liquid hexavalent vaccine containing diphtheria, tetanus, acellular pertussis (5-component), inactivated poliovirus, Haemophilus influenzae b conjugate and hepatitis B surface antigen (DTaP-IPV-Hib-HBV) in 60 healthy toddlers, 15 to 18 months of age, who had been primed with three doses of a licensed pentavalent diphtheria, tetanus, acellular pertussis (5-component), inactivated poliovirus, Haemophilus influenzae b conjugate (DTaP-IPV//PRP-T) vaccine. The DTaP-IPV//PRP-T vaccine was used as a control in 30 subjects. The investigational formulations, which contained the same DTaP-IPV components, differed only in Hib (content and conjugate) and HBV (content) (PRP-T/HBV10 = 12 mug Hib tetanus toxoid conjugate with 10 microg HBsAg; PRP-OMPC/HBV15 = 6 microg Hib Neisseria meningitidis outer membrane protein complex with 15 microg HBsAg). Injection-site pain, redness and swelling were reported by 46.7%, 46.7%, and 20.0% of the licensed vaccine recipients, 43.3%, 43.3%, and 26.7% of PRP-T/HBV10 recipients and 70.0%, 46.7%, and 46.7% of PRP-OMPC/HBV15 recipients, respectively. Fever > or = 37.8 degrees C and irritability were reported by 0% and 16.7% of licensed vaccine recipients, 10.3% and 23.3% of PRP-T/HBV10 recipients and 30.0% and 16.7% of PRP-OMPC/HBV15 recipients, respectively. There were no apparent differences between the groups in the proportion of participants achieving predefined, threshold or seroprotective immune responses. Geometric mean antibody levels for all antigens were similar except for anti-PRP levels, which were 19.0 microg/mL in recipients of the licensed vaccine, 40.8 microg/mL in PRP-T/HBV10 recipients and 9.4 microg/mL in PRP-OMPC/HBV15 recipients. We conclude that the hexavalent formulations appear generally well tolerated and immunogenic as a booster dose in these toddlers.
    背景与目标: : 联合疫苗减少了注射次数,提高了父母的满意度和疫苗接种计划的依从性。在一项1期,随机,部分盲,单剂量加强研究中,我们评估了两种含白喉,破伤风,无细胞百日咳 (5组分),灭活脊髓灰质炎病毒,乙型流感嗜血杆菌结合物和乙型肝炎表面抗原 (DTaP-IPV-Hib-HBV) 在60名15至18个月大的健康幼儿中使用了三剂经许可的五价白喉,破伤风,无细胞百日咳 (5-组分),灭活脊髓灰质炎病毒,流感嗜血杆菌b偶联物 (DTaP-IPV // prp-t) 疫苗。DTaP-IPV // prp-t疫苗被用作30名受试者的对照。包含相同DTaP-IPV成分的研究性制剂仅在Hib (含量和结合物) 和HBV (含量) 方面有所不同 (prp-t/HBV10 = 12杯Hib破伤风类毒素结合物与10 microg HBsAg; prp-ompc/HBV15 = 6 microg Hib脑膜炎奈瑟氏菌外膜蛋白复合物与15 microg HBsAg)。46.7%,46.7% 和20.0% 的许可疫苗接受者,prp-t/HBV10接受者的43.3%,43.3% 和26.7% 以及prp-ompc/HBV15接受者的70.0%,46.7% 和46.7% 报告了注射部位疼痛,红肿。分别。经许可的疫苗接受者的0% 和16.7%,prp-t/HBV10接受者的10.3% 和23.3% 以及prp-ompc/HBV15接受者的30.0% 和16.7% 分别报告了发烧> 或 = 37.8摄氏度和烦躁不安。两组之间在达到预定义,阈值或血清保护性免疫反应的参与者比例方面没有明显差异。除抗-PRP水平外,所有抗原的几何平均抗体水平相似,抗-PRP水平在许可疫苗的接受者中是19.0微克/毫升,在prp-t/HBV10接受者中是40.8微克/毫升,在prp-ompc/HBV15接受者中是9.4微克/毫升。我们得出的结论是,在这些幼儿中,六价制剂通常表现出良好的耐受性和免疫原性,作为加强剂量。
  • 【父母的疫苗安全问题是否与儿童接受麻疹-腮腺炎-风疹,白喉和破伤风类毒素以及无细胞百日咳或乙型肝炎疫苗有关?】 复制标题 收藏 收藏
    DOI:10.1001/archpedi.158.6.569 复制DOI
    作者列表:Bardenheier B,Yusuf H,Schwartz B,Gust D,Barker L,Rodewald L
    BACKGROUND & AIMS: OBJECTIVES:To identify parental perceptions regarding vaccine safety and assess their relationship with the immunization status of children. DESIGN, SETTING, AND PARTICIPANTS:Case-control study based on a survey of a sample of households participating in the 2000-2001 National Immunization Survey, a quarterly random-digit-dialing sample of US children aged 19 to 35 months. Three groups of case children not up-to-date for 3 vaccines were compared with control children who were up-to-date for each respective vaccine. Main Outcome Measure Measles-containing or measles-mumps-rubella, diphtheria and tetanus toxoids and pertussis or diphtheria and tetanus toxoids with acellular pertussis, and hepatitis B vaccination coverage. RESULTS:Among those sampled from the 2000-2001 National Immunization Survey, the household response rate was 2315 (52.1%) of 4440. Most respondents (>90%) in all groups believed vaccinations are important. In each case-control group, there was no significant difference between the percentage of case and control parents expressing general vaccine safety (range, 53.5%-64.1%). However, case parents were more likely to have asked that their child not be vaccinated for reasons other than illness (range, 10.2%-13.7% vs range, 2.9%-5.3%, respectively) and to believe their children received too many vaccinations (range, 3.4%-7.6% vs range, 0.8%-1.0%, respectively). Among the case-control group receiving a measles-containing or measles-mumps-rubella vaccination, only a small percentage of parents knew about the alleged association between autism and measles-mumps-rubella vaccinations (8.2%), and case parents were more likely to believe it than control parents (4.4% vs 1.5%, respectively; chi(2) P =.04). CONCLUSIONS:Despite belief in the importance of immunization by a vast majority of parents, the majority of parents had concerns regarding vaccine safety. Strategies to address important misperceptions about vaccine safety as well as additional research assessing vaccine safety are needed to ensure public confidence.
    背景与目标:
  • 【一种新型血清: 电泳法制备脱细胞角膜基质作为人工角膜支架。】 复制标题 收藏 收藏
    DOI:10.1177/0391398819869941 复制DOI
    作者列表:Li Q,Xie C,Wang H,Zhang F,Mu L
    BACKGROUND & AIMS: INTRODUCTION:The aim of this study was to develop a novel decellularization method in order to obtain an ideal scaffold with good biocompatibility. METHODS:The porcine corneas were treated with human serum for 5 days or serum-electrophoresis respectively. The electrophoresis (100 V/cm) was performed in sterilized buffer containing 40-mM tris base, 18-mM glacial acetic acid, and antibiotics for 1 h at 4°C. The properties of artificial corneal scaffolds were characterized by morphological and histological examinations. The biocompatibility and biological safety were examined by subcutaneous implant test and lamellar keratoplasty. RESULTS AND CONCLUSIONS:The transparency and appearance of serum-electrophoresis acellular porcine corneal matrix were better than serum acellular porcine corneal matrix. DNA and α-gal in serum-electrophoresis acellular porcine corneal matrix were more efficiently removed than those in serum acellular porcine corneal matrix (p < 0.05). The subcutaneous and corneal implantation experiments showed serum-electrophoresis acellular porcine corneal matrix had better biocompatibility compared to serum acellular porcine corneal matrix (p < 0.01). This novel serum-electrophoresis decellularization method may be valuable for preparation of xenogenic corneal tissue for clinical application.
    背景与目标:
  • 【脂多糖类似物改善小鼠无细胞百日咳疫苗的效力并减少I型超敏反应。】 复制标题 收藏 收藏
    DOI:10.1128/CVI.00074-07 复制DOI
    作者列表:Geurtsen J,Banus HA,Gremmer ER,Ferguson H,de la Fonteyne-Blankestijn LJ,Vermeulen JP,Dormans JA,Tommassen J,van der Ley P,Mooi FR,Vandebriel RJ
    BACKGROUND & AIMS: :Pertussis is an infectious disease of the respiratory tract that is caused by the gram-negative bacterium Bordetella pertussis. Although acellular pertussis (aP) vaccines are safe, they are not fully effective and thus require improvement. In contrast to whole-cell pertussis (wP) vaccines, aP vaccines do not contain lipopolysaccharide (LPS). Monophosphoryl lipid A (MPL) and Neisseria meningitidis LpxL2 LPS have been shown to display immune-stimulating activity while exerting little endotoxin activity. Therefore, we evaluated whether these LPS analogs could increase the efficacy of the aP vaccine. Mice were vaccinated with diphtheria-tetanus-aP vaccine with aluminum, MPL, or LpxL2 LPS adjuvant before intranasal challenge with B. pertussis. Compared to vaccination with the aluminum adjuvant, vaccination with either LPS analog resulted in lower colonization and a higher pertussis toxin-specific serum immunoglobulin G level, indicating increased efficacy. Vaccination with either LPS analog resulted in reduced lung eosinophilia, reduced eosinophil numbers in the bronchoalveolar lavage fluid, and the ex vivo production of interleukin-4 (IL-4) by bronchial lymph node cells and IL-5 by spleen cells, suggesting reduced type I hypersensitivity. Vaccination with either LPS analog increased serum IL-6 levels, although these levels remained well below the level induced by wP, suggesting that supplementation with LPS analogs may induce some reactogenicity but reactogenicity considerably less than that induced by the wP vaccine. In conclusion, these results indicate that supplementation with LPS analogs forms a promising strategy that can be used to improve aP vaccines.
    背景与目标: 百日咳是由革兰氏阴性细菌百日咳杆菌引起的呼吸道传染病。尽管无细胞百日咳 (aP) 疫苗是安全的,但它们并不完全有效,因此需要改进。与全细胞百日咳 (wP) 疫苗相反,aP疫苗不含脂多糖 (LPS)。单磷酰脂质A (MPL) 和脑膜炎奈瑟氏菌LpxL2 LPS已显示出免疫刺激活性,而几乎没有内毒素活性。因此,我们评估了这些LPS类似物是否可以提高aP疫苗的效力。在对百日咳杆菌进行鼻内攻击之前,用铝,MPL或LpxL2 LPS佐剂对小鼠进行白喉-破伤风-aP疫苗接种。与铝佐剂疫苗接种相比,用LPS类似物接种可导致较低的定植和较高的百日咳毒素特异性血清免疫球蛋白G水平,表明功效增强。用LPS类似物接种疫苗会导致肺嗜酸性粒细胞减少,支气管肺泡灌洗液中嗜酸性粒细胞数量减少,支气管淋巴结细胞和脾细胞IL-5体内产生interleukin-4 (IL-4),表明I型超敏反应降低。用任何一种LPS类似物接种疫苗都会增加血清IL-6水平,尽管这些水平仍远低于wP诱导的水平,这表明补充LPS类似物可能会诱导一些反应原性,但反应原性明显低于wP疫苗诱导的反应原性。总之,这些结果表明,补充LPS类似物形成了一种有前途的策略,可用于改善aP疫苗。
  • 【使用膀胱脱细胞基质移植物通过膀胱增强对大鼠脊髓损伤诱导的神经源性膀胱的功能改善。】 复制标题 收藏 收藏
    DOI:10.1007/s00345-006-0142-7 复制DOI
    作者列表:Urakami S,Shiina H,Enokida H,Kawamoto K,Kikuno N,Fandel T,Vejdani K,Nunes L,Igawa M,Tanagho EA,Dahiya R
    BACKGROUND & AIMS: :Spinal cord injury (SCI) rostral to the lumbosacral level causes bladder hyperreflexia and detrusor-sphincter dyssynergia (DSD), which are accompanied by bladder hypertrophy. We hypothesize that bladder augmentation using a bladder acellular matrix graft (BAMG) can improve the function of SCI-mediated neurogenic bladder. In female rats (n = 35), SCI was induced by transection of the spinal cord at the lower thoracic level. Eight weeks following spinalization, bladder augmentation using BAMG was performed after hemicystectomy of the hypertrophic bladder. Cystometrography was performed at 8 weeks after spinalization and again at 8 weeks after augmentation. Several urodynamic parameters were measured and the grafted bladder was histologically evaluated. Thirty one rats were alive 8 weeks after spinalization. Twenty two (71%) rats developed hyperreflexic bladders and nine (29%) rats had underactive bladders before bladder augmentation. Twenty six rats survived until 8 weeks after augmentation. Urodynamic parameters showed improvement in some bladder functions in both hyperreflexic and underactive bladders after augmentation. In addition, bladder compliance was increased in hyperreflexic bladders and decreased in underactive bladders. Bladder augmentation decreased bladder capacity in high-capacity rats and increased it in low-capacity rats. Histological evaluation showed complete regeneration of BAMG in SCI-induced neurogenic bladder at 8 weeks after augmentation. This is the first report suggesting that the voiding function in SCI-induced neurogenic bladder can be improved by augmentation using BAMG. Improved voiding function was accompanied by histological regeneration of BAMG.
    背景与目标: : 脊髓损伤 (SCI) 至腰s水平会导致膀胱反射亢进和逼尿肌括约肌协同失调 (DSD),并伴有膀胱肥大。我们假设使用膀胱脱细胞基质移植物 (BAMG) 进行膀胱增强可以改善SCI介导的神经源性膀胱的功能。在雌性大鼠 (n = 35) 中,脊髓损伤是由胸下部的脊髓横断引起的。旋转后八周,在肥厚性膀胱半晶体切除术后使用BAMG进行膀胱增强。在旋转后8周进行膀胱造影,并在增强后8周再次进行膀胱造影。测量了几个尿动力学参数,并对移植的膀胱进行了组织学评估。旋转后8周,有31只大鼠存活。22 (71%) 只大鼠出现了反射过度膀胱,而9 (29%) 只大鼠在膀胱增大之前出现了活动不足的膀胱。26只大鼠在扩增后存活到8周。尿动力学参数显示增强后,反射过度和活动不足的膀胱的某些膀胱功能均得到改善。此外,反射过度膀胱的膀胱顺应性增加,而活动不良膀胱的膀胱顺应性降低。膀胱增强降低了高容量大鼠的膀胱容量,而在低容量大鼠中增加了膀胱容量。组织学评估显示,增强后8周,SCI诱导的神经源性膀胱中BAMG完全再生。这是第一份报告,表明使用BAMG增强可以改善SCI诱导的神经源性膀胱的排尿功能。排尿功能的改善伴随着BAMG的组织学再生。
  • 【皮肤的体外重建: 成纤维细胞促进角质形成细胞在无细胞网状真皮上的生长和分化。】 复制标题 收藏 收藏
    DOI:10.1111/1523-1747.ep12491522 复制DOI
    作者列表:Krejci NC,Cuono CB,Langdon RC,McGuire J
    BACKGROUND & AIMS: :Extensive full-thickness burns require replacement of both epidermis and dermis. We have described a method in which allogeneic dermis from engrafted cryopreserved cadaver skin was combined with cultured autologous keratinocytes. In the present study we combined human keratinocytes and fibroblasts, and acellular human dermis in vitro and transplanted this "reconstituted skin" into athymic mice. Both human papillary dermis in which the basement membrane zone has been retained and human reticular dermis that has been repopulated with human dermal fibroblasts are good substrates for keratinocyte attachment, stratification, growth, and differentiation. Both of these dermal preparations can be lyophilized and stored at room temperature without losing their ability to support keratinocyte growth. In contrast, human papillary dermis that has been treated with trypsin lacks laminin and collagen type IV in the BMZ and supports keratinocyte attachment and differentiation less well.
    背景与目标: : 广泛的全层烧伤需要更换表皮和真皮。我们已经描述了一种方法,其中将来自植入的冷冻保存的尸体皮肤的同种异体真皮与培养的自体角质形成细胞相结合。在本研究中,我们在体外结合了人角质形成细胞和成纤维细胞以及脱细胞的人真皮,并将这种 “重构的皮肤” 移植到无胸腺小鼠中。保留了基底膜区的人乳头状真皮和重新填充了人真皮成纤维细胞的人网状真皮都是角质形成细胞附着,分层,生长和分化的良好底物。这两种真皮制剂都可以冻干并在室温下保存,而不会失去支持角质形成细胞生长的能力。相反,用胰蛋白酶治疗的人乳头状真皮在BMZ中缺乏层粘连蛋白和IV型胶原,并且对角质形成细胞的附着和分化的支持较差。
  • 【使用无细胞真皮基质进行复杂的腹侧疝修补术: 技术是否会影响结果?】 复制标题 收藏 收藏
    DOI:10.1016/j.jamcollsurg.2007.06.012 复制DOI
    作者列表:Jin J,Rosen MJ,Blatnik J,McGee MF,Williams CP,Marks J,Ponsky J
    BACKGROUND & AIMS: BACKGROUND:The ideal technique for the use of AlloDerm (LifeCell Corp) in complicated ventral hernia repair has not been defined. The expense of these products mandates careful evaluation to justify their widespread use. We compared two techniques of fascial bridging versus fascial reinforcement repair with regard to their longterm recurrence rates using AlloDerm. STUDY DESIGN:We retrospectively studied patients with abdominal defects repaired with AlloDerm at our institution. RESULTS:Thirty-seven patients with abdominal wall repairs using AlloDerm were identified between January 2004 and December 2005. Eleven patients underwent bridged fascial repair; 26 patients had reinforced fascial repair. There was no statistical significance between the 2 groups in terms of average age (57 versus 52 years), body mass index (35 versus 29 kg/m(2)), American Society of Anesthesiologists score (2.9 versus 2.5), or number of earlier abdominal operations (3.4 versus 3.5). The average sizes of AlloDerm used were 175 cm(2) for bridged and 89 cm(2) for reinforced repair (p=0.005). In patients with reinforced closure, primary repair was achieved with lateral component separation in 22 of 26 patients. Mean followup was 21.4 months (range 15 to 36 months). In the bridged group, 1 patient died on postoperative day 20. Of the remaining 10 patients, 8 patients (80%) developed recurrences. Seven patients required reoperation, but one patient refused repair. In the reinforced group, four patients were lost to followup and two patients died. Four of the remaining 20 patients (20%) developed recurrences that required repair; this was significantly different from the recurrence rate in the bridged group (p=0.009). CONCLUSIONS:This study demonstrated that the method in which AlloDerm is used in abdominal wall reconstruction has a significant impact on recurrence rates. Based on our findings, AlloDerm should be used only as a reinforcement after primary fascial reappoximation.
    背景与目标:
  • 【无细胞无脊椎动物血红蛋白作为模型治疗氧载体: 独特的氧化还原电位。】 复制标题 收藏 收藏
    DOI:10.1080/10731190600974491 复制DOI
    作者列表:Harrington JP,Kobayashi S,Dorman SC,Zito SL,Hirsch RE
    BACKGROUND & AIMS: :Natural acellular polymeric hemoglobins (Hb) provide oxygen transport and delivery within many terrestrial and marine invertebrate organisms. It has been our premise that these natural acellular Hbs may serve as models of therapeutic hemoglobin-based oxygen carriers (HBOC). Our attention has focused on the acellular Hb from the terrestrial invertebrate, Lumbricus terrestris (Lt), which possesses a unique hierarchical structure and a unique ability to function extracellularly without oxidative damage. Lumbricus Hb and Arenicola Hb are resistant to autoxidation, chemical oxidation by potassium ferricyanide, and have little or no capacity to transfer electrons to Fe(+3)-complexes at 37 degrees C. An understanding of how these invertebrate acellular oxygen carriers maintain their structural integrity and redox stability in vivo is vital for the design of a safe and effective red cell substitute. We report here a positive redox potential for these giant hemoglobins that may lie at the basis for its resistance to oxidation.
    背景与目标: : 天然无细胞聚合血红蛋白 (Hb) 在许多陆地和海洋无脊椎动物体内提供氧气运输和输送。我们的前提是,这些天然的无细胞Hbs可以用作基于血红蛋白的治疗性氧载体 (HBOC) 的模型。我们的注意力集中在陆地无脊椎动物Lumbricus terrestris (Lt) 的无细胞Hb上,它具有独特的层次结构和独特的细胞外功能而不会造成氧化损伤。Lumbricus Hb和Arenicola Hb耐自氧化,铁氰化钾的化学氧化,并且在37摄氏度下几乎没有或没有将电子转移到Fe (3)-络合物的能力。了解这些无脊椎动物脱细胞氧载体如何在体内保持其结构完整性和氧化还原稳定性对于设计安全有效的红细胞替代品至关重要。我们在这里报告了这些巨大的血红蛋白的正氧化还原电位,这可能是其抗氧化性的基础。
  • 【无细胞细胞外基质治疗肛门直肠瘘: 一项新技术。】 复制标题 收藏 收藏
    DOI:10.3748/wjg.14.4791 复制DOI
    作者列表:Song WL,Wang ZJ,Zheng Y,Yang XQ,Peng YP
    BACKGROUND & AIMS: AIM:To investigate a new technique of the anorectal fistula treatment with acellular extracellular matrix (AEM). METHODS:Thirty patients with anorectal fistula were treated with AEM. All fistula tracts and primary openings were identified using conventional fistula probe. All tracts were curetted with curet and irrigated with hydrogen peroxide and metronidazole. The AEM was pulled into the fistula tract from secondary to primary opening. The material was secured at the level of the primary opening. The excess AEM was trimmed at skin level at the secondary opening. RESULTS:All of the 30 patients had successful closure of their fistula after a 7-14 d follow-up. The healing rate of anal fistula in treatment group was 100%. The ache time, healing time and anal deformation of treatment group were obviously superior to traditional surgical methods. CONCLUSION:Using AEM anal fistula plug in treatment that causes the anorectal fistula is safe and successful in 100% of patients. It can reduce pain, shorten disease course and protect anal function.
    背景与目标:
  • 【用脱细胞真皮基质覆盖和随后的皮肤移植重建全甲床缺陷和生发基质损失。】 复制标题 收藏 收藏
    DOI:10.3390/medicina56010017 复制DOI
    作者列表:Liu TH,Hsieh MC,Chou PR,Huang SH
    BACKGROUND & AIMS: :Background and Objectives: Nail bed and germinal matrix loss due to wide excision for fingertip tumors or malignancy are occasionally encountered complications. These defects also result from severely comminuted fingertip crush injuries. Large-area dorsal finger or toenail bed defects, which usually present with phalangeal bone exposure, remain challenging regardless of the usage of different reconstruction strategies. This study aimed to evaluate the clinical outcome of a staged operation with an acellular dermal matrix coverage and subsequent skin graft as reconstruction for defects of total nail bed, germinal matrix loss, and bone exposure. Materialsand Methods: From April 2018 to October 2019, four patients with total nail bed, germinal matrix, and bone exposure loss after surgery were enrolled in our series. A staged operation of the acellular dermal matrix coverage with subsequent skin graft was performed on these patients. Skin graft take rate, oncological prognosis, and cosmetic outcome were evaluated. Patients were followed up for 5-13 months. An excellent skin graft take rate with a satisfying aesthetic result without local malignancy recurrence was noted. Minimal functional deficit and donor site morbidity were reported. Results: A staged operation with acellular dermal matrix coverage and subsequent skin graft proves to serve as a feasible strategy for patients who experience total nail bed, germinal matrix loss, and bone exposure after surgery. Conclusions: This reconstruction method provides a reliable repair result, satisfying aesthetic outcomes, as well as having minimal functional deficits and donor site morbidity.
    背景与目标: 背景和目的: 由于指尖肿瘤或恶性肿瘤的广泛切除,甲床和生发基质丢失偶尔会遇到并发症。这些缺陷也是由严重粉碎的指尖挤压伤造成的。无论使用不同的重建策略,通常伴有指骨暴露的大面积背指或趾甲床缺损仍然具有挑战性。这项研究旨在评估无细胞真皮基质覆盖的分阶段手术和随后的皮肤移植的临床结果,以重建全甲床缺损,生发基质丢失和骨暴露。材料和方法: 从2018年4月到2019年10月,我们的系列研究纳入了四名全甲床,生发基质和手术后骨暴露减少的患者。对这些患者进行了分阶段的脱细胞真皮基质覆盖手术,并随后进行了皮肤移植。评估了植皮率,肿瘤学预后和美容结果。随访5-13个月。注意到出色的皮肤移植率,具有令人满意的美学效果,而没有局部恶性肿瘤复发。据报道,功能缺陷和供体部位发病率最小。结果: 对于经历全甲床,生发基质丢失和术后骨暴露的患者,分阶段进行脱细胞真皮基质覆盖和随后的皮肤移植被证明是可行的策略。结论: 这种重建方法可提供可靠的修复结果,满足美学效果,并具有最小的功能缺陷和供体部位发病率。
  • 【软骨素酶治疗增加了脱细胞神经移植物的有效长度。】 复制标题 收藏 收藏
    DOI:10.1016/j.expneurol.2007.06.006 复制DOI
    作者列表:Neubauer D,Graham JB,Muir D
    BACKGROUND & AIMS: :Acellular nerve allografts have been explored as an alternative to nerve autografting. It has long been recognized that there is a distinct limit to the effective length of conventional acellular nerve grafts, which must be overcome for many grafting applications. In rodent models nerve regeneration fails in acellular nerve grafts greater than 2 cm in length. In previous studies we found that nerve regeneration is markedly enhanced with acellular nerve grafts in which growth-inhibiting chondroitin sulfate proteoglycan was degraded by pretreatment with chondroitinase ABC (ChABC). Here, we tested if nerve regeneration can be achieved through 4-cm acellular nerve grafts pretreated with ChABC. Adult rats received bilateral sciatic nerve segmental resection and repair with a 4 cm, thermally acellularized, nerve graft treated with ChABC (ChABC graft) or vehicle-treated acellularized graft (Control graft). Nerve regeneration was examined 12 weeks after implantation. Our findings confirm that functional axonal regeneration fails in conventional long acellular grafts. In this condition we found very few axons in the distal host nerve, and there were marginal signs of sciatic nerve reinnervation in few (2/9) rats. This was accompanied by extensive structural disintegration of the distal graft and abundant retrograde axonal regeneration in the proximal nerve. In contrast, most (8/9) animals receiving nerve repair with ChABC grafts showed sciatic nerve reinnervation by direct nerve pinch testing. Histological examination revealed much better structural preservation and axonal growth throughout the ChABC grafts. Numerous axons were found in all but one (8/9) of the host distal nerves and many of these regenerated axons were myelinated. In addition, the amount of aberrant retrograde axonal growth (originating near the proximal suture line) was markedly reduced by repair with ChABC grafts. Based on these results we conclude that ChABC treatment substantially increases the effective length of acellular nerve grafts.
    背景与目标: : 脱细胞神经同种异体移植已被探索为神经自体移植的替代方法。长期以来,人们已经认识到,常规脱细胞神经移植物的有效长度存在明显的限制,对于许多移植应用而言,必须克服这一限制。在啮齿动物模型中,长度大于2厘米的无细胞神经移植物的神经再生失败。在先前的研究中,我们发现脱细胞神经移植物可显着增强神经再生,其中通过用软骨素酶ABC (ChABC) 预处理可降解抑制生长的硫酸软骨素蛋白聚糖。在这里,我们测试了是否可以通过ChABC预处理的4厘米脱细胞神经移植物实现神经再生。成年大鼠接受双侧坐骨神经节段切除,并用4厘米的热脱细胞的神经移植物 (ChABC移植物) 或载体处理的脱细胞移植物 (对照移植物) 进行修复。植入后12周检查神经再生。我们的发现证实,在常规的长脱细胞移植物中,功能性轴突再生失败。在这种情况下,我们在远端宿主神经中发现了很少的轴突,并且在少数 (2/9) 大鼠中存在坐骨神经再支配的边缘迹象。伴随着远端移植物的广泛结构崩解和近端神经中大量的逆行轴突再生。相反,大多数 (8/9) 接受ChABC移植物神经修复的动物通过直接神经捏合测试显示坐骨神经再支配。组织学检查显示,整个ChABC移植物的结构保存和轴突生长要好得多。在除一个 (8/9) 宿主远端神经之外的所有神经中都发现了许多轴突,并且许多这些再生的轴突都有髓鞘。此外,通过使用ChABC移植物修复可显着减少异常的逆行轴突生长 (起源于近端缝合线附近)。基于这些结果,我们得出结论,ChABC治疗大大增加了脱细胞神经移植物的有效长度。

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