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Expert Forum
Recognition of inhalation injuries
Guo Guanghua, Huang Shengyu
2024, 40(11): 1001-1006.   doi: 10.3760/cma.j.cn501225-20240616-00234
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Expert Forum
Strategies for the diagnosis and treatment of inhalation injuries in children
Yu Jia'ao, Zhang Xiuhang
2024, 40(11): 1007-1015.   doi: 10.3760/cma.j.cn501225-20240816-00310
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Expert Forum
Respiratory care for burn-related lung injury--shoulder heavy responsibilities, and a long way to go
Zhu Feng, Guo Guanghua
2024, 40(11): 1016-1023.   doi: 10.3760/cma.j.cn501225-20240802-00291
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Original Article · Burn and Trauma Related Lung Injury
A multicenter study on the impact of the early infusion rate on prognosis and the factors of influencing the infusion rate in patients with severe burns and inhalation injury
Huang Shengyu, Ma Qimin, Wang Yusong, Tang Wenbin, Chu Zhigang, Xin Haiming, Chang Liu, Li Xiaoliang, Guo Guanghua, Zhu Feng
2024, 40(11): 1024-1033.   doi: 10.3760/cma.j.cn501225-20240409-00130
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Original Article · Burn and Trauma Related Lung Injury
Role and mechanism of ferroptosis in combined burn-blast injury with acute lung injury in rats
Zhang Hao, Guan Hao, Wang Yuhang, Zhang Wanfu, Tian Linqiang, Ren Wenjie
2024, 40(11): 1034-1042.   doi: 10.3760/cma.j.cn501225-20240528-00199
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National expert consensus on early management of scars (2020 version)
Chinese Association of Plastics and Aesthetics Scar Medicine Branch
2021, 37(2): 113-125.   doi: 10.3760/cma.j.cn501120-20200609-00300
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Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China
Dong Wei, Xiao Yurui, Wu Minjie, Jiang Duyin, Nie Lanjun, Liu Yingkai, Tang Jiajun, Tian Ming, Wang Chunlan, Huang Lifang, Dong Jiaoyun, Cao Xiaozan, Song Fei, Ji Xiaoyun, Ma Xian, Kang Yutian, Jin Shuwen, Qing Chun, Lu Shuliang
2018, 34(12): 868-873.   doi: 10.3760/cma.j.issn.1009-2587.2018.12.010
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2020, 36(8): E01-E52.   doi: 10.3760/cma.j.cn501120-20200217-01000
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2017, 33(1): 46-48.   doi: 10.3760/cma.j.issn.1009-2587.2017.01.011
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Clinical effects of autologous platelet rich plasma gel combined with vacuum sealing drainage techno-logy in repairing refractory wounds
Wang Ai, Ma Wenguo, Wang Chengde, Zhang Huanqi, Liu Fei
2021, 37(1): 42-48.   doi: 10.3760/cma.j.cn501120-20200105-00004
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摘要:
Analysis of differential gene expressions of inflammatory and repair-related factors in chronic refractory wounds in clinic
Wang Lian, Guo Fei, Min Dinghong, Liao Xincheng, Yu Shaoqing, Long Xingxing, Ding xiang, Guo Guanghua
2019, 35(1): 18-24.   doi: 10.3760/cma.j.issn.1009-2587.2019.01.005
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Clinical effects of application of antibiotic bone cement in wounds of diabetic foot ulcers
Huang Hongjun, Niu Xihua, Yang Guanlong, Wang Liying, Shi Fanchao, Xu Shaojun, Xu Lingang, Li Yonglin
2019, 35(6): 464-466.   doi: 10.3760/cma.j.issn.1009-2587.2019.06.013
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Theories and strategies of chronic wound treatment
Tan Qian, Xu Ye
2020, 36(9): 798-802.   doi: 10.3760/cma.j.cn501120-20200728-00361
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2017, 33(3): 129-135.   doi: 10.3760/cma.j.issn.1009-2587.2017.03.001
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Clinical effects of a combination treatment with narrow-spectrum intense pulsed light and fractional carbon dioxide laser on hypertrophic scar pruritus
Zhang Yiqiu, Dong Jiying, Wang Shen, Yan Min, Yao Min
2018, 34(9): 608-614.   doi: 10.3760/cma.j.issn.1009-2587.2018.09.010
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Effects of in situ cross-linked graphene oxide-containing gelatin methacrylate anhydride hydrogel on wound vascularization of full-thickness skin defect in mice
Liang Liting, Song Wei, Zhang Chao, Li Zhao, Yao Bin, Zhang Mengde, Yuan Xingyu, Enhejirigala, Fu Xiaobing, Huang Sha, Zhu Ping
2022, 38(7): 616-628.   doi: 10.3760/cma.j.cn501225-20220314-00063
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Abstract:
  Objective  To prepare graphene oxide (GO)-containing gelatin methacrylate anhydride (GelMA) hydrogel and to investigate the effects of in situ photopolymerized GO-GelMA composite hydrogel in wound vascularization of full-thickness skin defect in mice.  Methods  The experimental study method was used. The 50 μL of 0.2 mg/mL GO solution was evenly applied onto the conductive gel, and the structure and size of GO were observed under field emission scanning electron microscope after drying. Human skin fibroblasts (HSFs) were divided into 0 μg/mL GO (without GO solution, the same as below) group, 0.1 μg/mL GO group, 1.0 μg/mL GO group, 5.0 μg/mL GO group, and 10.0 μg/mL GO group treated with GO of the corresponding final mass concentration, and the absorbance value was detected using a microplate analyzer after 48 h of culture to reflect the proliferation activity of cells (n=6). HSFs and human umbilical vein vascular endothelial cells (HUVECs) were divided into 0 μg/mL GO group, 0.1 μg/mL GO group, 1.0 μg/mL GO group, and 5.0 μg/mL GO group treated with GO of the corresponding final mass concentration, and the migration rates of HSFs at 24 and 36 h after scratching (n=5) and HUVECs at 12 h after scratching (n=3) were detected by scratch test, and the level of vascular endothelial growth factor (VEGF) secreted by HSFs after 4, 6, and 8 h of culture was detected by enzyme-linked immunosorbent assay method (n=3). The prepared GO-GelMA composite hydrogels containing GO of the corresponding final mass concentration were set as 0 μg/mL GO composite hydrogel group, 0.1 μg/mL GO composite hydrogel group, 1.0 μg/mL GO composite hydrogel group, and 5.0 μg/mL GO composite hydrogel group to observe their properties before and after cross-linking, and to detect the release of GO after soaking with phosphate buffer solution for 3 and 7 d (n=3). The full-thickness skin defect wounds were made on the back of 16 6-week-old female C57BL/6 mice. The mice treated with in situ cross-linked GO-GelMA composite hydrogel containing GO of the corresponding final mass concentration were divided into 0 μg/mL GO composite hydrogel group, 0.1 μg/mL GO composite hydrogel group, 1.0 μg/mL GO composite hydrogel group, and 5.0 μg/mL GO composite hydrogel group according to the random number table, with 4 mice in each group. The general condition of wound was observed and the wound healing rate was calculated on 3, 7, and 14 d of treatment, the wound blood perfusion was detected by laser Doppler flowmetry on 3, 7, and 14 d of treatment and the mean perfusion unit (MPU) ratio was calculated, and the wound vascularization on 7 d of treatment was observed after hematoxylin-eosin staining and the vascular density was calculated (n=3). The wound tissue of mice in 0 μg/mL GO composite hydrogel group and 0.1 μg/mL GO composite hydrogel group on 7 d of treatment was collected to observe the relationship between the distribution of GO and neovascularization by hematoxylin-eosin staining (n=3) and the expression of VEGF by immunohistochemical staining. Data were statistically analyzed with analysis of variance for repeated measurement, one-way analysis of variance, and Tukey's method.  Results  GO had a multilayered lamellar structure with the width of about 20 μm and the length of about 50 μm. The absorbance value of HSFs in 10.0 μg/mL GO group was significantly lower than that in 0 μg/mL GO group after 48 h of culture (q=7.64, P<0.01). At 24 h after scratching, the migration rates of HSFs were similar in the four groups (P>0.05); at 36 h after scratching, the migration rate of HSFs in 0.1 μg/mL GO group was significantly higher than that in 0 μg/mL GO group, 1.0 μg/mL GO group, and 5.0 μg/mL GO group (with q values of 7.48, 10.81, and 10.20, respectively, P<0.01). At 12 h after scratching, the migration rate of HUVECs in 0.1 μg/mL GO group was significantly higher than that in 0 μg/mL GO group, 1.0 μg/mL GO group, and 5.0 μg/mL GO group (with q values of 7.11, 8.99, and 14.92, respectively, P<0.01), and the migration rate of HUVECs in 5.0 μg/mL GO group was significantly lower than that in 0 μg/mL GO group and 1.0 μg/mL GO group (with q values of 7.81 and 5.33, respectively, P<0.05 or P<0.01 ). At 4 and 6 h of culture, the VEGF expressions of HSFs in the four groups were similar (P>0.05); at 8 h of culture, the VEGF expression of HSFs in 0.1 μg/mL GO group was significantly higher than that in 0 μg/mL GO group and 5.0 μg/mL GO group (with q values of 4.75 and 4.48, respectively, P<0.05). The GO-GelMA composite hydrogels in the four groups were all red liquid before cross-linking, which turned to light yellow gel after cross-linking, with no significant difference in fluidity. The GO in the GO-GelMA composite hydrogel of 0 μg/mL GO composite hydrogel group had no release of GO at all time points; the GO in the GO-GelMA composite hydrogels of the other 3 groups was partially released on 3 d of soaking, and all the GO was released on 7 d of soaking. From 3 to 14 d of treatment, the wounds of mice in the 4 groups were covered with hydrogel dressings, kept moist, and gradually healed. On 3, 7, and 14 d of treatment, the wound healing rates of mice in the four groups were similar (P>0.05). On 3 d of treatment, the MPU ratio of wound of mice in 0.1 μg/mL GO composite hydrogel group was significantly higher than that in 0 μg/mL GO composite hydrogel group, 1.0 μg/mL GO composite hydrogel group, and 5.0 μg/mL GO composite hydrogel group (with q values of 10.70, 11.83, and 10.65, respectively, P<0.05 or P<0.01). On 7 and 14 d of treatment, the MPU ratios of wound of mice in the four groups were similar (P>0.05). The MPU ratio of wound of mice in 0.1 μg/mL GO composite hydrogel group on 7 d of treatment was significantly lower than that on 3 d of treatment (q=14.38, P<0.05), and that on 14 d of treatment was significantly lower than that on 7 d of treatment (q=27.78, P<0.01). On 7 d of treatment, the neovascular density of wound of mice on 7 d of treatment was 120.7±4.1 per 200 times of visual field, which was significantly higher than 61.7±1.3, 77.7±10.2, and 99.0±7.9 per 200 times of visual field in 0 μg/mL GO composite hydrogel group, 1.0 μg/mL GO composite hydrogel group, and 5.0 μg/mL GO composite hydrogel group (with q values of 12.88, 7.79, and 6.70, respectively, P<0.01), and the neovascular density of wound of mice in 1.0 μg/mL GO composite hydrogel group and 5.0 μg/mL GO composite hydrogel group was significantly higher than that in 0 μg/mL GO composite hydrogel group (with q values of 5.10 and 6.19, respectively, P<0.05). On 7 d of treatment, cluster of new blood vessels in wound of mice in 0.1 μg/mL GO composite hydrogel group was significantly more than that in 0 μg/mL GO composite hydrogel group, and the new blood vessels were clustered near the GO; a large amount of VEGF was expressed in wound of mice in 0.1 μg/mL GO composite hydrogel group in the distribution area of GO and new blood vessels.  Conclusions  GO with mass concentration lower than 10.0 μg/mL had no adverse effect on proliferation activity of HSFs, and GO of 0.1 μg/mL can promote the migration of HSFs and HUVECs, and can promote the secretion of VEGF in HSFs. In situ photopolymerized of GO-GelMA composite hydrogel dressing can promote the wound neovascularization of full-thickness skin defect in mice and increase wound blood perfusion in the early stage, with GO showing an enrichment effect on angiogenesis, and the mechanism may be related to the role of GO in promoting the secretion of VEGF by wound cells.
A prospective randomized controlled study of antibiotic bone cement in the treatment of diabetic foot ulcer
Cao Tao, Ji Peng, Zhang Zhi, Xiao Dan, Wang Kejia, Li Na, Li Wen, Jin Guangjun, Hao Tong, Tao Ke
2023, 39(4): 311-318.   doi: 10.3760/cma.j.cn501225-20221111-00485
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Abstract:
  Objective   To investigate the clinical effects and related mechanism of antibiotic bone cement in treating diabetic foot ulcer (DFU).   Methods   A prospective randomized controlled study was conducted. From August 2020 to August 2022, 24 patients with DFU who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University. According to the block randomization, the patients were divided into 2 groups, with 12 patients in each group. In antibiotic bone cement group, there were 7 male and 5 female patients, aged (64±8) years, with the ulcer area of (41±21) cm 2. In silver sulfadiazine group, there were 8 male and 4 female patients, aged (62±8) years, with the ulcer area of (38±19) cm 2. Under the condition of ensuring the patency of at least one main inferior genicular artery in each patient, the continuous vacuum sealing drainage was performed for 3-5 days after thorough debridement. Thereafter, the wounds in antibiotic bone cement group were treated with gentamicin-laden bone cement, and the wounds in silver sulfadiazine group were treated with silver sulfadiazine cream for dressing change. After 3 weeks of dressing change, the wound was covered with split-thickness skin graft from the lateral thigh on the affected side. Before debridement and after 3 weeks of dressing change, the blood flow intensities of wound tissue and normal skin tissue in foot were measured using laser Doppler flowmeter, and then, the percentage of relative blood flow intensity of wound and the change rate of blood flow intensity were calculated. After 3 weeks of dressing change, the wound margin tissue was taken, the number of CD31-positive neovascular and the vascular morphology were observed and detected by immunohistochemical staining, the morphology of blood vessels surrounded by CD31 and α-smooth muscle actin (α-SMA) double-positive cells was observed by immunofluorescence staining, the cell proliferation activity was evaluated by immunofluorescence staining (denoted as the ratio of Ki67 positive cells), and the protein expression of vascular endothelial growth factor receptor 2 (VEGFR2) was detected by Western blotting. The skin graft survival was observed 3-5 days after skin grafting, and the wound healing time was recorded. Data were statistically analyzed with independent sample t test and Fisher's exact probability test.   Results   The percentages of relative blood flow intensity of wounds of patients before debridement were similar between the two groups ( P>0.05). After 3 weeks of dressing change, the percentage of relative blood flow intensity of wounds and the change rate of blood flow intensity of patients in antibiotic bone cement group were (44.7±2.0)% and (129±12)%, respectively, which were significantly higher than (28.3±1.2)% and (41±8)% in silver sulfadiazine group (with t values of 24.15 and 20.97, respectively, P<0.05). After 3 weeks of dressing change, compared with those in silver sulfadiazine group, the number of CD31-positive neovascular in the wound margin tissue of patients in antibiotic bone cement group was significantly increased ( t=33.81, P<0.05) with larger diameter and more regular arrangement, the vascular wall continuity surrounded by CD31 and α-SMA double-positive cells was better, and the ratio of Ki67 positive cells and protein expression of VEGFR2 were significantly increased (with t values of 40.97 and 47.38, respectively, P<0.05). On post skin grafting day 3-5, all the patients in antibiotic bone cement group and 8 patients in silver sulfadiazine group had good skin graft survival, while 4 patients in silver sulfadiazine group showed spotted/patchy skin graft necrosis, which were cured after corresponding treatment. The wound healing time of patients in antibiotic bone cement group was (47.1±2.9) d, which was significantly shorter than (58.8±2.3) d in silver sulfadiazine group ( t=10.86, P<0.05).   Conclusions   Compared with silver sulfadiazine, clinical application of antibiotic bone cement for treating DFU has the characteristics of accelerating wound healing and better reconstruction of local blood flow, which may be closely related to the fact that antibiotic bone cement promoted the local angiogenesis effectively in the wound through enhancing the expression of VEGFR2.

《CHINESE JOURNAL OF BURNS AND WOUNDS》

ISSN:2097-1109

CN:50-1225/R

Supervisor:China Association for Science and Technology(CAST)

Sponsor:Chinese Medical Association

Editor in chief:Luo Gaoxing

Executive Deputy Editor-in-Chief:Liang Guangping

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