1. Clinical effects of artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft in repair of scar contracture deformity after extensive burn
Shun CHEN ; Linwen ZHENG ; Wei LIU ; Zhaohong CHEN
Chinese Journal of Burns 2019;35(8):608-610
Objective:
To explore the clinical effects of artificial dermis combined with vacuum sealing drainage (VSD) and autologous split-thickness skin graft in repair of scar contracture deformity after extensive burn.
Methods:
A total of 8 patients with scar hyperplasia and contracture deformity on joint after healing of extensive burn were admitted to our hospital from August 2015 to August 2017. There were 5 females and 3 males aged 8 to 45 years with an average of 23 years. In the first stage operation, scar tissue on contracture site was removed, and the wound was covered by artificial dermis followed by continued VSD treatment. On 10-14 d after the first stage operation, the artificial dermis tissue formed, and the second stage autologous split-thickness skin grafting and continued VSD treatment were performed. Routine anti-scar therapy was carried out after healing of wounds. Time of wound healing after the second stage operation was recorded. Colour and texture of the split-thickness skin graft, scar formation condition of the donor site, and action condition of the operation site during follow-up were observed.
Results:
The wounds of 8 patients were healed in 10-14 d after the second stage operation. During follow-up of 6-24 months, the split-thickness skin graft was with smooth surface and good elasticity, and the function of joint recovered well. The donor site in head healed well with no scar. Only pigmentation was left in the donor site of thigh, and scar was not obvious. The patients and their family members were satisfied.
Conclusions
After application of artificial dermis combined with VSD and autologous split-thickness skin graft in repair of scar contracture deformity after extensive burn, the skin grafting area and donor site were with unobvious scar hyperplasia, and the joint function in the operation area was good.
2.Study on the Spatial-Temporal Deduction of the Mechanism and the Modernization of the System of"Syndrome-Prescription-Herbs"in tocolysis Based on the Theory of"Fetal Stem is Tied to the Spleen"
Hang ZHOU ; Xiaoyan ZHENG ; Linwen DENG ; Qian ZENG ; Weijun DING
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(6):1914-1926
Modern Traditional Chinese Medicine(TCM)physicians believed that"reproduction depends on the kidney"theory is the key in treating fetal leakage,fetal restlessness,slippery fetus and other diseases.However,before the Ming and Qing Dynasties,ancient physicians paid special attention to the theory of"Qi and blood in the spleen and stomach".The"the stem of fetal ties the spleen"came from the summary of Zhao Xianke's"Handan manuscripts"based on analogy of nature in Ming dynasty.However,at present,the relevant research reports on"spleen"and tocolysis are fragmented,and the theoretical traceability,clinical effects and experimental research are not systematically discussed.Based on the"fetal stem ties the spleen"theory,through integrated research,taking the differentiation of ancient and modern theories of traditional Chinese medicine gynecology as the"longitude",and the progress of modern biological research on"syndromes,prescriptions and components"as the"latitude".This study is an initial attempt to reveal the key inflection points deductively in the empty space(territorial schools)during(history and history of)tocolysis,and to systematically explore the"spleen main Qi","spleen main transportation","spleen main rising Qing"and"spleen main muscle",which are associated with the progress of the objectification and the bottleneck of research on the treatment of tocolysis.Furthermore,it is proposed that TCM prescription syndrome metabolism and spatiotemporal omics are the important trends to solve the disputes and difficulties in the study of tocolysis in the future,and provide a new reference idea for the inheritance,innovation,breakthrough and accurate research of modern TCM reproductive theory.
3.Difference in Network Mechanism of Shoutaiwan and Juyuanjian in Reversing Pathology of Decidua of Spontaneous Abortion Patients: Based on "Uterine Collaterals Connecting Kidney" and "Fetal Collaterals Connecting Spleen" Theory
Hang ZHOU ; Xiaoyan ZHENG ; Huan WANG ; Qian ZENG ; Linwen DENG ; Weijun DING
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(20):186-200
ObjectiveTo explore difference in the mechanism of Shoutaiwan, a representative kidney-tonifying and abortion-preventing formula, and Juyuanjian, a typical spleen-invigorating and abortion-preventing formula in reversing the pathology of decidua of spontaneous abortion (SA) patients and to expound the connotation of "uterine collaterals connecting kidney" and "fetal collaterals connecting spleen" theory. MethodThe targets of SA were retrieved from GeneCards, followed by gene ontology-biological process (GO-BP) annotation. Based on Cytoscape and previous research, the main processes and core targets were screened out. High-performance liquid chromatography-mass spectrometry (HPLC-MS) was used to identify the potential active components of Shoutaiwan and Juyuanjian and the regulatory networks were constructed. SA was induced in rats and the model rats were treated with Shoutaiwan and Juyuanjian at the same unit. Hematoxylin and eosin (HE) staining, transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunohistochemistry (IHC), immunofluorescence (IF), and other methods were employed to verify the mechanisms against miscarriage. ResultThe dysregulation of cell adhesion, inflammatory response, cell death, and angiogenesis was the core pathological process of SA. A total of 13 potential specific active components of Shoutaiwan and 14 active components of Juyuanjian were screened out. The regulatory networks showed that the potential active components of the two prescriptions modulated vascular endothelial growth factor (VEGF), interleukin (IL)-2, estrogen receptor (ESR)-1, matrix metalloproteinase-9 (MMP-9), and other targets to regulate the pathological process of SA. The two can significantly improve the pregnancy rate and the integrity rate and blood supply of decidua cells, control the apoptosis morphology and the expression of estrogen (E2), progesterone (P), and its receptor, and down-regulate the expression of MMP-2, MMP-9, IL-2, and IL-6 in decidua tissue of SA rats. At the same time, they up-regulated the expression of anti-apoptotic protein B-cell lymphoma-2 (Bcl-2) and IL-4. Shoutaiwan significantly up-regulated the expression of VEGF, and Juyuanjian significantly down-regulated the expression of E-cadherin (E-Cad). ConclusionBoth Shoutaiwan and Juyuanjian regulate the core pathological process of SA to prevent miscarriage. At the same unit, Shoutaiwan is overall superior to Juyuanjian. Shoutaiwan is better than Juyuanjian in regulating angiogenesis and Juyuanjian is superior to Shoutaiwan in regulating cell adhesion. This conclusion can partly explain the biological basis of "treating the same disease with different methods", and provide objective data reference for the identification of quality marker (Q-marker) of anti-miscarriage Chinese medicine and further study of formula-syndrome metabolome.