Objective·To investigate the effects of a novel chitosan-silver nitrate gel (CSNG) dressing on anti-septic in wound healing.Methods·By using the ion membrane,the release rate of the new composite materials of silver ion was tested in vitro.Meanwhile,the anti-septic effects of CSNG on methicillin resistant Staphylococcus aureus (MRSA),Escherichia coli and Candida albicans were tested by colony counting.The rat wound healing model was used to detect the ability of new material to kill MRSA in vivo.Results·Compared with control group,the release of silver ions of CSNG was much slower.Sterilization experiment showed that CSNG killed the MRSA,Escherichia coli and Candida albicans much more efficiently,compared to that in the other treatments.Animal experiments also showed that CSNG promoted the rats of wound healing.Conclusion·Combining chitosan with silver nitrate and supplementary material could develop a novel chitosan-silver nitrate gel material,which not only has the obvious effects on antibacterial,but also on promoting wound healing.

Objective·To investigate effect and the possible molecular mechanism of JQ1,a specific inhibitor of bromodomain containing protein 4,on human hypertropic scar.Methods·Primary fibroblasts were isolated from human hypertrophic scars and treated with JQ-1 of different concentrations (0.1,0.5,1.0,2.0,2.5,and 12.5μmol/L) for 48 h.Then CCK-8 kit and wound healing assay were used to measure proliferation and migration of the fibroblasts.ELISA was adopted to detect the levels of collagen type Ⅰ (COL Ⅰ) and TGF-β1 after JQ-1 treatment for 24 h.Thirty-six nude mice were used for hypertrophic scar models.Human hypertrophic scars (1.0 cm× 1.0 cm×0.5 cm) were grafted subcutaneously at the backs of nude mice to establish scar animal models.After 4 weeks,the nude mice were averagely divided into two groups,i.e.JQ-1 group and DMSO group,which were respectively injected with 0.5 μmol/L JQ-1 and 0.1％ DMSO each mouse every day.COL Ⅰ / Ⅲ and α-smooth muscle actin (α-SMA) were examined by immunohistochemical method and sirius red staining.Results·Cell experiments showed that JQ-1 with the concentration of 0.5 μmol/L and above significantly inhibited proliferation of fibroblasts (P＜0.01).JQ-1 inhibited migration of fibroblast (P＜0.01).JQ-1 inhibited secretion of COL Ⅰ and TGF-β1 of fibroblasts (P＜0.01).Animal experiments showed that concentration and proportion of COL Ⅰ / Ⅲ in JQ-1 group decreased compared to DMSO group (P＜0.05).α-SMA protein expression in JQ-1 group also decreased (P＜0.05).Conclusion·JQ-1 can inhibit proliferation,migration,secretion of COL Ⅰ,and production of TGF-β1 of human sear fibroblasts in vitro;it can also inhibit secretion of COL Ⅰ /Ⅲ and fibroblast-myofibroblast differentiation in the human hypertrophic scars in nude mice.

In recent years, researchers have found that CD26 (dipeptidyl peptidase 4) is closely related to the formation and development of many fibrotic diseases. Hypertrophic scar, keloid, and other skin fibrosis diseases are major problems nowadays, which may affect the patient′s appearance and cause joints deformity and dysfunction due to scar contracture. This article briefly reviews the relationship between CD26 and hypertrophic scar and keloid to provide new insights into the treatment of skin fibrotic diseases.

Objective To investigate the relationship between the levels of CD4+/CD8+and D-dimer(D-D)in peripheral blood and the outcome of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis(EBV-HLH).Methods Ninety patients with EBV-HLH who were treated in Beijing Friendship Hospital from September 2021 to August 2023 were included as observation group,and additional 90 patients with infectious mononucleosis(IM)treated in the hospital contemporarily were selected as the control group.The levels of CD4+/CD8+and D-D in peripheral blood were compared between the two groups of patients to examine the correlation between the levels of CD4+/CD8+and D-D in peripheral blood and EBV-DNA load in patients with EBV-HLH,compare the outcome of patients within 3 months in terms of the levels of CD4+/CD8+and D-D in peripheral blood,evaluate the effects of CD4+/CD8+and D-D levels in peripheral blood on the risk of death from EBV-HLH,and analyze the interaction between the levels of CD4+/CD8+and D-D in peripheral blood.Results The patients in observation group showed significantly lower peripheral blood CD4+/CD8+ratio and significantly higher D-D than the patients in control group(P＜0.05).The peripheral blood CD4+/CD8+ratio was negatively correlated with EBV-DNA load(P＜0.05),and D-D was positively correlated with EBV-DNA load(P＜0.05)in EBV-HLH patients.The patients with high peripheral blood CD4+/CD8+ratio were assocaited with lower 3-month mortality rate compared to the patients with low CD4+/CD8+ratio.The patients with high D-D level were associated with higher 3-month mortality rate compared to the patients with low D-D level(P＜0.05).In EBV-HLH patients with low levels of peripheral blood CD4+/CD8+,the risk of death was 6.125 times that of the patients with high levels of CD4+/CD8+.High level D-D was associated with 14.348 times risk of death compared to the patients with low level D-D.CD4+/CD8+and D-D had synergistic effect on death of EBV-HLH patients.Conclusions Peripheral blood CD4+/CD8+levels decreased and D-D levels increased in EBV-HLH patients.Peripheral blood CD4+/CD8+levels and D-D levels and their changes may be useful for predicting the outcome of patients.

Objective·To study early expression levels of serum heparin-binding protein(HBP)and its potential value in early alarming for prognosis and occurrence of sepsis in patients with severe bums.Methods·Retrospective analysis was performed on medical records of 52 severely burned patients admitted to the Department of Bum and Plastic,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine during January 2021 to May 2023.General data of patients on gender,age,total bum area,body mass index(BMI),and whether endotracheal intubation or incision was performed were collected.The level of HBP,serum procalcitonin(PCT),serum C-reactive protein(CRP)and the count of white blood cells within 48 h of admission were collected.The scores of acute physiological and chronic health assessment evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA)within 48 h of admission were collected.Patients were divided into death group and survival group according to the status at discharge.According to whether sepsis occurred during hospitalization,the patients were divided into sepsis group and non-sepsis group.According to whether shock occurred,the septic patients were divided into sepsis without shock group and septic shock group.Risk factors for death,sepsis,and septic shock in severely burned patients were analyzed by using Logistic regression models.Receiver operator characteristic(ROC)curve analysis was established to study risk factors,which may alarm the occurrence of poor prognosis,sepsis,and septic shock.Results·Compared with the survival group,patients in the death group were older,and the difference was statistically significant(P=0.036).Differences in burn area and whether tracheal intubation or tracheotomy was performed were statistically significant in patients with or without sepsis(P=0.011,P=0.001).Compared with the survival group,the serum HBP levels were higher in the death group,and the difference was statistically significant(P=0.002).Compared with the non-sepsis group,patients in the sepsis group had higher levels of serum HBP,APACHE Ⅱ scores,and SOFA scores,and the differences were statistically significant(all P＜0.05).The differences in other indicators were not statistically significant.Compared with the sepsis without shock group,the septic shock group had higher HBP levels,with a statistically significant difference(P=0.008).Logistic regression analysis showed that HBP was an independent risk factor for death in patients with severe burns during hospitalization and also an independent risk factor for the occurrence of septic shock in patients with sepsis after severe burns.ROC curve analysis showed that the area under the curve(AUC)for HBP in predicting patient mortality during hospitalization was 0.798;when HBP ≥147.03 ng/mL,its sensitivity and specificity were 88.33％and 70.00％,respectively.The AUC for HBP in predicting the occurrence of septic shock in patients with sepsis after severe burns was 0.789;when HBP ≥147.03 ng/mL,its sensitivity and specificity were 90.00％and 63.20％,respectively.Conclusion·The level of serum HBP within 48 h of admission might be used as an early alarming index for prognosis in patients with severe burns and for the occurrence of septic shock in patients with sepsis following severe burns.