Objective To investigate the expression changes of paxillin and focal adhesion kinase(FAK) in scar tissues at different periods.Methods The expressions of paxillin and FAK of scar tissue samples from 30 babies at age of 3-12 months were detected by means of immunohistochemistry.Results The expressions of paxillin and FAK in the scar tissues at the 3th and 6th months were increased more significantly than that in normal skin tissues.Whereas,there was no significant difference upon the expressions of paxillin and FAK in the scar tissues at the 12th week compared with normal skin tissues.Conclusion Focal adhesion varies with change of composition,structures and mechanical properties of extracellular matrix(ECM) and with different intracellular framework.Different signal transmissions of ECM,integrin and focal adhesion compound may result in different changes of cellular function.

Objective To assess the correlation of intima media thickness (IMT) in two dimension ultrasound and hemodynamic parameters of Doppler with arteriosclerosis.Methods Eighteen male New Zealand white rabbits were fed by fat rich feed.At the beginning and the end of 4th week,8th week, 10th week, and 12th week, the parameters of systolic velocity(SV),diastolic velocity(DV),mean velocity(MV),pulsitive index(PI),resistent index(RI) and SV/DV in Doppler as well as maximum IMT and mean IMT in two dimensional ultrasound were obtained in all objects' abdominal aorta and their correlations with arteriosclerosis confirmed by partly animal dissection at the end of 4th week,8th week,10th week and 12th week were compared.Results Of all parameters,SV,SV/DV,PI and RI had significant positive correlation with arteriosclerosis (P 0.05 ).Conclusions Among above hemodynamics parameters of Doppler and morphologic change in two dimensional ultrasound,maximum IMT and mean IMT were found to be best correlative with arteriosclerosis.

Objective To assess the deep inferior epigastric perforator (DIEP) vessels in patients with breast reconstruction flaps by contrast-enhanced ultrasound (CEUS) and three-dimensional ultrasound (3DUS) reconstruction techniques.Methods Conventional ultrasound,CEUS and 3DUS were used to evaluate DIEP vessels of breast reconstruction flaps in 43 patients before surgical procedures.The identification,localization and spatial relationship of DIEP vessels were analyzed with conventional ultrasound,CEUS and 3DUS methods.The findings of CEUS and 3DUS were compared to conventional ultrasound and surgical outcome.Results Compared to CDFI,40 cases (93％) were observed more clearly with CEUS,and were showed more accurately than conventional ultrasound.41 cases (95％) could be displayed wonderfully in 3D ultrasound.Perforators which were detected by ultrasound were confirmed in the surgery and the transferred flaps survived completely.Conclusions Perforators can be displayed more clearly and located more accurately by CEUS and 3DUS.CEUS and 3DUS could play a very important role in the preoperative navigation of the DIEP than conventional ultrasound.

Objective To study the subjective sleep quality in patients with obstructive sleep apnea syndrome(OSAS). Methods Two hundred and seventeen patients with OSAS confirmed by an all-night (7 hrs) polysomnogram(PSG) were evaluated by Pittsburgh Sleep Quality Index (PSQI). Results According to the testing results of PSQI, 88 subjects (40.5%) were identified as "poor sleepers" (4≤PSQI

Objective To detect the histological characteristics of collagen nodules from hypertrophic scars (HS) and investigate the origin of collagen nodules.Methods The scar tissues were collected from patients with plastic operation.Morphological characteristics of collagen nodules were observed by light microscopy of HE-stained sections; expressions of type Ⅰ /Ⅲ collagens were observed by polarized light microscopy of sirius red-stained sections; expression and distribution of myofibroblasts (MFb)-specific protein (α-smooth muscle actin,α-SMA) were observed by immunostaining in order to observe level of local tissue tension.Results Collagen nodules varied in shape,not only sphereshaped,and in size.Moreover,abundant fibroblasts (Fb) with large and light-stained nuclei were seen in the nodules compared to non-nodule area,indicating that the cells located in the modules were active.Some collagen nodules were composed largely of collagen type Ⅲ (green),but some mainly contained collagen type Ⅰ (red or yellow),indicating the difference in the time of nodule formation.α-SMA was expressed mainly in the deep dermis equivalent to the level of reticular layer of the new scar tissues (2 months after injury) ; α-SMA was expressed mainly in the nodules of the old scar tissues (2-10 years after injury),but almost not in non-nodule areas except for a strongly positive staining in the vessels.Moreover,α-SMA presented a heterogeneous distribution in the collagen nodules,with stronger expression in the epidermal end than in the subcutaneous tissue end and stronger expression in the superficial dermis than that in the deeper part.It was suggested that there existed massive amount of MFb and high tension in the nodules arid that the tension distribution was not uniform in or between the nodules.Conclusions Collagen nodules are of varying shape and size and collagen types are associated with the time of nodule formation.Moreover,Formation of the collagen nodules may be closely related to the distribution and evolution of the local tissue tension.

Purpose To observe the protective effects of low molecular hirudo peptides on focal cerebral ischemia reperfusion injury in rats and to explore its possible mechanism. Methods Middle cerebral artery occlusion (MCAO) was used to prepare focal cerebral ischemia and the neurological scores and infarction area of brain slices, and water content of brains were assessed. Superoxide dismustase (SOD) activity and malondi-aldehyde ( MDA) content in homogenate of ischemic brain tissue were determined by spectrophotometric assay. Results Hirudo peptides could reduce the percentage of infarction area and the water content in the cerebral hemisphere, increase SOD activity and decrease MDA content in ischemic brain tissue. Conclusion Low molecular hirudo peptides have protective effects on focal cerebral ischemia injury, and its mechanism may be related to the antioxidant action.

Objective To explore the repair method for refractory diabetic wound. Methods A total of 206 patients with refractory diabetic foot ulcers were treated with proper surgical treatments.Results Of all, 106 patients were treated by skin flap (51.5 % ), with one stage wound healing rate of 85.8%; 122 patients were repaired with split-thickness skin graft ( 59.2% ), with survival rate of the graft for 79.5%. Simple toe amputation was made in 34 patients (46 toes). The high level amputation was performed in 56 patients (27.2%). Of all, 132 patients were followed up for 6-18 months, which showed that ulcer recurred in 12 patients (9.1%). Conclusion Timely and effective treatment as well as flap and skin graft repair could reduce high level amputation rate of diabetic foot ulcer and promote the quality of life.

Objective To explore the effect of diabetes mellitus (DM) on biological behavior of epidermal keratinocyte in rats. Methods A total of 40 Sprague-Dawley rats were randomized into control group and streptozotocin (STZ) -induced diabetes group. Of each group, 10 rats were implemented with deep partial-thickness scalding. The re-epithelialization rate was observed at the 3rd, 7th, 14th and 21th post-burn day. Histological characteristics and thickness of epidermal tissue in both groups were observed. The adhesion rate, cell cycles, apoptosis rate and migration ability of keratinocyte were measured. The accumulation of advanced glycosylation end products (AGEs) of epidermal tissue was observed. Results The percentages of re-epithelialized area at the 7th, 14th and 21th post-burn day were much lower in DM group than in control group (P<0.05). In DM group, the epidermal thickness was reduced obviously with obscure multilayered epithelium and less amount of prickle cells; The adhesion rates of 12, 24 h after culturing keratinocyte and the percentage of G2/M phase cells were lower in DM group than in control group (P<0.05). However, apoptosis rate of keratinocyte was higher, the amount of migration cell was significantly less in DM group than in control group (both P<0.05). There were lots of AGEs accumulated in epidermal tissue in DM group, while there were hardly AGEs in control group. Conclusions Re-epithelization blocked exists on non-healing wound in DM rats, which is related with the impaired keratinocyte biological behavior. A large of AGEs accumulate in the epidermal tissue of DM rats, which may be a important reason to inhibit keratinocyte function in diabetic environment.

Objective: To investigate the effects of denatured collagen type Ⅰ on differentiation of human fibroblasts into myofibroblasts. Methods: A small amount of normal skin donated by burn patients undergoing scar surgery was collected. Human fibroblasts were obtained by method of explant culture and then sub-cultured. The fourth passage of cells were used in the following experiments. (1) Fibroblasts were divided into normal collagen group and denatured collagen group according to the random number table, with 10 wells in each group. Fibroblasts in normal collagen group were cultured on normal collagen type Ⅰ coated coverslips. Fibroblasts in denatured collagen group were cultured on denatured type Ⅰ collagen coated coverslips. Expression of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemical method, and the percentage of PCNA positive cells was calculated. (2) Another batch of fibroblasts were grouped and treated as in (1), with 12 wells in each group. Proliferation activity of cells was determined with methyl-thiazolyl-tetrazolium colorimetry method. (3) Another batch of fibroblasts were grouped and treated as in (1), and the microfilament morphology of cells was observed by rhodamine-phalloidin staining. (4) Another batch of fibroblasts were grouped and treated as in (1). Expression of α smooth muscle actin (α-SMA) of cells was detected by immunohistochemical method, and expression of OB-cadherin of cells was detected by immunofluorescence method. (5) Another batch of fibroblasts were divided into normal collagen, denatured collagen, and common coverslips groups according to the random number table, with 6 wells in each group. Fibroblasts in normal collagen and denatured collagen groups were treated as in (1), while fibroblasts in common coverslips group were cultured on coverslips without collagen coating. Expressions of α-SMA and OB-cadherin of cells were determined with Western blotting. (6) Another batch of fibroblasts were grouped and treated as in (5), and then the mRNA expressions of collagen type Ⅰ, collagen type Ⅲ, and α-SMA of cells were determined with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with t test, one way analysis of variance, and least-significant difference test. Results: (1) The percentage of PCNA positive cells in denatured collagen group was (83±9)%, significantly higher than (29±9)% in normal collagen group (t=13.53, P<0.01). (2) The proliferation activity of fibroblasts in denatured collagen group was 0.32±0.06, significantly higher than 0.25±0.05 in normal collagen group (t=3.06, P<0.01). (3) The microfilament of fibroblasts in normal collagen group was arranged vertically and in parallel way, paralleling the long axis of cells. The microfilament of fibroblasts in denatured collagen group was denser and thicker. (4) Most fibroblasts in normal collagen group showed long shuttle-like shape typically. Morphology of fibroblasts in denatured collagen group changed, and cells were obviously spreading. Expressions of α-SMA and OB-cadherin of fibroblasts in denatured collagen group were stronger than those in normal collagen group. (5) Expressions of α-SMA of fibroblasts in denatured collagen, normal collagen, and common coverslips groups were respectively 1.69±0.41, 0.89±0.27, and 1.46±0.42. Expression of α-SMA of fibroblasts in denatured collagen group was significantly higher than that in normal collagen group (P<0.01). Expressions of OB-cadherin of fibroblasts in denatured collagen, normal collagen, and common coverslips groups were respectively 5.17±0.28, 2.21±0.10, and 4.01±0.56. Expression of OB-cadherin of fibroblasts in denatured group was significantly higher than that in normal collagen group (P<0.01). (6) There was no significant difference in mRNA expression of collagen type Ⅰ of fibroblasts in denatured collagen, normal collagen, and common coverslips groups (F=2.71, P>0.05). The mRNA expressions of collagen type Ⅲ and α-SMA of fibroblasts in normal collagen group were significantly lower than those in denatured collagen group (P<0.01). Conclusions Denatured collagen type Ⅰ may influence the activity of fibroblasts, thus inducing fibroblasts differentiating into myofibroblasts.

Objective: To explore the application value of endoscope in probing the chronic wound with sinus tract in clinic. Methods: Twenty-eight chronic wounds with sinus tracts from 27 patients conforming to the inclusion criteria admitted to Outpatient Department of Wound Healing Center of Ruijin Hospital from December 2017 to March 2018 were investigated in a prospective and self-controlled trial. After being cleaned, the diameter of the opening of sinus tract was measured with a rule. A probe was used to measure the depth of a sinus tract according to the touch from the probe extremity in operation, and to measure the depth of a sinus tract that could be observed with naked eyes with the help of a pair of hemostatic forceps. Five minutes later, a probe was inserted deeply into the sinus tract to measure the depth under the endoscopic view combined with touch from the probe extremity in operation. Afterwards, the sinus tract was observed with endoscope, and the depth of the tract which could be observed under the endoscopic view was measured using a probe inserted deeply into the sinus tract. After completion of the above exploration, the sinus tract was infused with contrast agent Omnipaque 350 and scanned by computed tomography (CT) later to obtain its depth. The following indicators were calculated: the ratio of the depth of the sinus tract measured by CT to the diameter of the opening of the sinus tract (hereinafter referred to as the depth/diameter ratio of the sinus tract), the deviation rate comparing the depth of the sinus tract measured by conventional method (measured by probe only) and by endoscope (measured by probe under the endoscope view) with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the measured depth of the sinus tract), the deviation rate comparing the depth of the sinus tract that could be observed measured by conventional method and by endoscope with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the depth of the sinus tract that could be observed). Data were processed with paired t test. Pearson correlation analysis was applied to analyze the correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope. Results: The depth/diameter ratio of the sinus tract of this group of wounds was 1-32 (8±7). The deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method were (19±14)% and (79±18)%, respectively, both obviously larger than (9±9)% and (25±25)% by endoscope (t=3.837, 13.626, P<0.01). Positive correlation existed between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by conventional method, and between the depth/diameter ratio of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope (r=0.514, 0.585, 0.651, P<0.01). However, there was no obvious correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by endoscope (r=0.113, P>0.05). Conclusions Compared with the conventional method, application of endoscope is able to get more accurate data of chronic wounds with sinus tracts and observe the wounds with wider range.