Abstract:Objective:To observe the clinical effect of vacuum-assisted closure treatment combined with flushing with epidermal growth factor solution in treating deep Ⅱ degree burn wound.Methods:Sixty patients with 5%-10% TBSA,deep Ⅱ degree burn wound on extremities,aging from 18 to 60 years old,were randomly divided in-to treatment group and control group. Patients received vacuum-assisted closure treatment,and epidermal growth factor solution (treatment group)or normal saline (control group)was used to flush the wounds,with the vacu-um-assisted closure device operated 2 times per day. The device was renewed on the 5th,10th,15th day,while the wound healing rate and wound healing time were observed.Results:Fever was observed in 1 1 (3 6.6%,)and 1 2 (40.0%)patients in the treatment group and control group respectively,and the difference was not significant(χ2= 0.071,P=0.791). The wound healing rates on the 10th and 15th day respectively in the treatment group [0.476 70±0.027 83 and 0.780 70±0.025 99]were significantly higher than those of the control group [0.425 70±0.024 45 and 0.731 30±0.029 45;P<0.05],and the wound healing time in the treatment group was (19.27±1.82)days,and (23.10±2.07)days in the control group (P<0.05). Before treatment,bacterial cul-ture of wound exudate was positive in 5 wounds of treatment and 6 wounds in control groups. Wounds in two pa-tients were not healed in both groups,but bacterial culture was negative.Conclusions:The vacuum-assisted closure treatment combined with flushing with epidermal growth factor solution can promote wound healing,improve the effect of vacuum-assisted closure treatment alone for deep Ⅱ degree burn wounds.

Abstract:Objective:To compare the clinical effect of artificial dermis conbined with autologous split-thick skin grafting and autologous skin flap grafting in repairing deep burn of hands' soft tissue.Methods:Twenty-two patients with deep burn of hands' soft tissue admitted in the Department of Burns and Plastic Surgery from Jan.2013 to Dec.2016 were divided into two groups according to the treatment method selected by the patients.The wounds of the patients in the observation group were repaired by artificial dermis combined with autologous split-thick skin grafting,and in the control group by autologous skin flap grafting.The patients were followed up for six months,the hyperplasia of scar in the burned area and donor site was assessed by Vancouver Scar Scale,and the appearance of the repaired hands,functional recovery and the degree of patients' satisfaction to the outcome were observed.Results:Following up for 6 months,the scores of Vancouver Scar Scale were less in the observation group both in burned area (2.27±1.19) and donor site (1.02±0.94) than those in control group (4.09±1.83 and 5.27±2.15,respectively) with significant differences (P＜0.05).No obvious abnormity appeared in the burned area in observation group,but it appeared bloating in control group,among which 8 cases received the second surgery repair.The functional recovery of the burned hand in observation group was superior to that in control group,and the surgery outcome was more satisfactory to the patients in observation group (90.9％) than in control group (63.6％).Conclusions:Treatment with artificial dermis and autologous split-thick skin shows clear effect in repairing the deep defect of hands' soft tissue,with mild scar hyperplasia,good functional recovery and less damage to the donor site compared to that with autologous skin flap repairing.

Abstract:Objective:To investigate the changes of monocyte chemoattractant protein(MCP)and cadherin levels in patients with acute ischemic stroke due to large vessel occlusion(AIS-LVO)before and after early endovascular treatment and their clinical significance.Methods:A total of 72 patients with AIS-LVO admitted to the First Affiliated Hospital of Nanyang Medical College from May 2020 to May 2023 were selected.These patients were followed up for 3 months,and the prognosis was statistically analyzed according to the modified Rankin scale(mRS).The changes of MCP and cadherin levels before and after treatment were compared,the risk factors affecting the prognosis of AIS-LVO patients after early endovascular treatment were analyzed,and the effect of MCP and cadherin on predicting the prognosis of AIS-LVO patients after early endovascular treatment were calculated.Results:(1)After treatment,the levels of MCP and cadherin were significantly lower than those before treatment(P＜0.001).(2)All patients completed 3 months of follow-up,and 29 patients were found with good prognosis by mRS score,accounting for 40.28% .There were 43 cases of poor prognosis,accounting for 59.72% .(3)Early CT(ASPECTS)score,MCP and cadherin levels of Alberta Stroke Program were independent risk factors affecting the prognosis of AIS-LVO patients after early endovascular treatment(P＜0.05).(4)ROC curve showed that the sensitivity of combined detection of MCP and cadherin in predicting the prognosis of AIS-LVO patients after early endovascular therapy was 74.42%,specificity was 93.10%,AUC=0.876,sensitivity and AUC were higher than those of single prediction(P＜0.001).Conclusions:Early endovascular treatment can regulate the expression of MCP and cadherin in patients with AIS-LVO.By comprehensively evaluating the levels of the two indicators,the predictive effect on the prognosis of patients can be improved in order to achieve the purpose of improving the prognosis.

Abstract:Objective:To observe the changes in morphology and phenotype of human bone marrow mesenchymal stem cells (BM-MSCs)after co-cultured with human sweat gland cells (SGCs),in order to provide the experimental basis for the study on sweat gland cells induction-associated key transcription factors. Methods:BM-MSCs and SGCs were isolated,cultured, expanded and identified with the methods of differentiation to adipocytes and osteocytes invitro respectively. In transwell co-cultured experiment,BM-MSCs were induced into SGCs by indirect co-culture with 47 ℃heat-shocked confluent SGCs using transwell plate.But in transwell+inducing factors co-culture experiment,BM-MSCs culture medium was supplemented with series of inducing factors,including EDA-A1 ,recombinant human epidermal growth factor and ITS. After being co-cultured, morphological and phenotypic changes in BM-MSCs were observed. The antigen expressions of BM-MSCs were detected by immunofluorescence. Results:After co-cultured with heat-shock SGCs for 10 days,the shape of a part of MSCs changed from long-clostridial shape to flat and polygonal. Non-induced BM-MSCs were negative for CEA and CK1 9. Induced BM-MSCs were positive for CEA and CK19,and the positive cells of transwell + inducing factors co-culture was more abundant than that of transwell co-culture. Conclusions:MSCs could differentiate into sweat gland-like cells at phenotype and shape by a proper in vitro co-culture system of BM-MSCs and SGCs with or without inducing factors,and it was more efficient when they were co-cultured with inducing factors.