Objective To investigate the clinical efficacy and mechanism of vacuum-assisted closure (VAC) in the preoperative and postoperative treatment of bedsore united with skin flap.Methods Twenty two cases with bedsore were randomly divided into experimental and control groups.In the control group,the surgery of flap was performed after the treatment of continuous negative pressure about 7-10 days and the VAC was not applied after operation.While in the experimental group,VAC was not used before operation.It was applied on flaps as soon as sutured the border of flap and decubitus ulcers and removed after 7-10 days.By comparing the general appearance of two groups,microvessel count and the detection rate of bacterial culture and other indicators,the clinical effects of two treatments were investigated and the preliminary mechanism was analyzed.Results After preoperative VAC treatment,11 cases of control group showed a little granulation tissue growth,less subcutaneous hematoma and wound effusion,increased microvessel count and negative bacterial culture.However,there were 4 cases of death cavity residual,subcutaneous hematoma and wound effusion,positive bacterial culture and another 4 cases of delayed healing with skin flap repairing bedsore.The application of VAC in experimental group showed close contact of flap with the basement,less effusion,increased microvessel count and negative bacterial culture.One case of skin flap had a small area of separation,after the dressing of skin and the flap survived.The other wounds healed by first intention.Conclusions The use of VAC to repair bedsore can reduce the number of operation,and it is beneficial to the flap survival.

Objective To study the drug dosage and time dependency characteristics of high-fructose-high-fat-feeding plus dexamethason for inducing the mouse acute fatty liver model and to optimize the condition of drug induced fatty liver model.Methods Male KM mice were divided into the normal control group and high-fructose-high-fat-feeding plus peritoneal injection of dexamethason group.The mice were killed at 3 different time points.The mouse body mass and liver mass were detected.The liver index was calculated.The serum and liver tissue homogenate TG and serum glucose(GLU) levels were detected.The liver tissue pathological change was observed by HE staining.Total RNA reverse expression related gene was extracted from the liver tissue.The total protein was extracted from the liver tissue and the related protein expression was detected by Western Blot.Results Compared with the control group,blood and liver homogenate TG after 7 d in the dexamethason model group was increased,the liver index was increased,the pathological section displayed that the fatty liver was formed.RT-PCR showed that lipid metabolism related gene expression had obvious change.Western Blot showed that SIRT1 was significantly decreased.But with the dexamethason dosage decrease and time extending,the fatty liver related indexes were decreased,lipid metabolic gene PPAR,FOXO3 and FXR were gradually increased,while LXR was gradually decreased and protein SIRT1 was gradually increased.Conclusion High-fructose-high-fatfeeding plus peritoneal injection of dexamethason could establish the mouse acute fatty liver model,moreover the model maintenance has dependency on dexamethason dosage and medication time,which has a guidance significance for the drug interventional experiment.

Objective To explore the clinical features and treatment of skin ulcers.Methods A total of 185 skin ulcer patients with clinical data was analyzed retrospectively in our hospital from October 2014-October 2016.Results Of the 185 patients with skin ulcers,84(45.4％) were 51-70 years old,diabetic ulcers were most common,and most occurred in ankle (44.3％) and limbs (35.7％).After further statistical analysis,the healing rate of patients treated by surgery was significantly higher than non-surgical patients.Surgical procedures of local flap transfer after ulcer resection were most commonly used and of the highest healing rate.The number of ulcers,the largest diameter of ulcers,scar ulcers and blood barrier ulcers were four factors that were independent of the outcome of skin ulcers.Conclusions Skin ulcers hospitalized patients are more common in patients over 50 years of age,occur most in the lower limbs.Surgical therapy is the preferred treatment for most ulcers,of which local flap transfer after ulcer resection has the best effect.Ulcer patients should actively treat the primary disease,strengthen the care,early diagnosis,and early treatment.

Objective To study the influence of let-7b on cell proliferation and aerobic glycolysis of human melanoma cell A375.Methods Transfect A375 cell line with hsa-let-7b oligonucleotide or antisense.Glucose and lactate in medium were determined by spectrophotometry at 24 h and 48 h time point after transfection.The cell proliferation was determined by methylthiazol tetrazolium (MTT) assay.Results Over expression of let-7b in melanoma cell reduced cell proliferation notably,compared to the other groups by MTT(P ＜0.05).However,the glucose consumption and lactate production differences were not observed during 24 h or 48 h ( P ＞ 0.05 ),the blank control group transformed about 57％ and 43％ glucose to lactate during 24 h and 48 h.Conclusions Melanoma cell line A375 has notably aerobic glycolysis hallmark,let-7b could inhibit proliferation of melanoma cell line A375,but it may has no influence on glucose metabolism.

The prevention and treatment of scars has always been an important task in the field of wound repair.Humans have started treatment for scars long time ago and have created a series of treatments.At the same time,with the development of science and technology,the diagnosis and treatment of scars have made great progress.Through the basic research for new therapeutic targets and innovative of treatment methods,treatment for scar turns more diversified and integrated.As a result,clinicians will suffer many challenges while having more options for scars treatment.Combined with traditional treatment,developing new treatments,and the comprehensive therapy of multiple treatment methods is the mainstream trend of scar treatment.

Objective To explore the differences in autophagic expression levels between hypertrophic scar (HS) tissue and normal skin tissue,and further investigate the relationship between hypertrophic scar formation and autophagy protein expression through the rabbit ear hypertrophic scar model.Methods 30 patients with hypertrophic scar were collected.One hypertrophic scar tissue and one normal skin tissue were harvested.The relative expressions of LC3,P62 and Beclin-1 in each tissue specimen were detected by immunohistochemistry and Western blot.Western blot was used to detect the autophagic-associated protein LC3 (MAPLC3),P62 and Beclin-1 in the hypertrophic scar tissue of rabbit ear and the corresponding normal tissue of rabbit ears at 4 weeks,8 weeks,12 weeks,and 24 weeks,and further explore their clinical significance.Results In vivo,the expression of hypertrophic scar tissue protein LC3 and Beclin-1 was significantly stronger than that in normal skin tissue (P ＜ 0.05).The expression of P62 was significantly weaker than that in normal skin tissue (P ＜ 0.05).In animal experiments,during the process of HS formation,the protein expression of LC3 gradually increased,while the protein expression of P62 gradually decreased;the protein expression of Beclin-1 was higher than that of normal rabbit ears tissue,with statistically significant differences (P ＜ 0.05).Conclusions The expression of LC3 and Beclin-1 in human hypertrophic scar tissues is higher than that in normal tissues.While the expression of P62 is lower than that in normal tissues.That is,the expression of autophagy in human hypertrophic scar tissue showed an upward trend in a certain period of time,and was significantly higher than that in normal tissue.