BACKGROUND:Skin transplantation is regarded as the most effective therapy for large-area skin defects, which is limited by donor sources and immune rejection. Therefore, it is extremely accelerate the construction of the dermis in skin tissue engineering.
OBJECTIVE:To investigate the effects of bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane on the repair of ful-thickness skin defects.
METHODS:Bone marrow mesenchymal stem cels were isolated from 15 New Zealand rabbits, and then cultured, amplified, subcultured and purified. Three ful-thickness skin defects were made on the back of every rabbit, and randomly treated with bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane as experimental group, bone marrow mesenchymal stem cels/calcium alginate gel as control 1 group, and calcium alginate gel as control 2 group. The wounds were al covered with amniotic membrane. After 7, 14, 21 days, new wound tissues were taken for hematoxylin-eosin staining, immunohistochemistry staining and image analysis.
RESULTS AND CONCLUSION: Dermis tissues in the experimental group were obviously thicker than those in control 1 and control 2 groups; there were more fibroblasts, vessels and colagen fibers in the experimental group. Especialy at 14 and 21 days after operation, epidermal hyperplasia was faster with a larger coverage area in the experimental group, and at 21 days, the new epidermal tissues mainly exhibited multi-layered structure, which was superior to the control 1 and 2 groups. It folows that the combination of bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane for skin defects can accelerate the repair and regeneration of the dermis, and thus promote the epidermis regeneration and reconstruction.

Objective:To observe any therapeutic effect of combining early pulmonary rehabilitation training with acupuncture at the back-shu and front-mu acupoints in treating stroke-associated pneumonia (SAP).Methods:Eighty SAP patients were randomly divided into a treatment group and a control group, each of 40. Both groups were given routine symptomatic treatment for pneumonia, nutritional support, lipid-lowering and anti-infection measures, as well as acupuncture at the back-shu and front-mu acupoints. The treatment group additionally received pulmonary rehabilitation training. Before and after 14 days of the treatment, both groups were evaluated in terms of their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak flow rate (PEF), white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT). Chinese medicine (TCM) scores for expectoration of phlegm, shortness of breath, pulmonary rales, cough, fever and weakness were also assigned. The duration of antibiotic use and intensive care unit (ICU) stay were compared between the two groups.Results:Treatment efficacy was significantly higher in the treatment group (97.5%) than in the control group (85.0%). The treatment group′s average duration of antibiotic use and ICU stay were significantly shorter than in the control group. The treatment improved the average FVC, FEV1, PEF, WBC, CRP and PCT of both groups significantly leaving the average FVC and PEF of the treatment group significantly higher than the control group′s average, but its average WBC, CRP, PCT and the total TCM syndrome score significantly lower.Conclusions:Combining early pulmonary rehabilitation training with acupuncture at the back-shu and front-mu acupoints has a definite therapeutic effect on SAP patients. It can significantly shorten the use of antibiotics and ICU stay, promote the recovery of lung function, reduce inflammation and relieve clinical symptoms.

The purpose of this study was to explore the reasonable dose of low molecular weight heparin (LMWH) in hemodialysis (HD) and the strategy of preventing extracorporeal circuit coagulation (ECC). A retrospective case-control study included patients who used LMWH for anticoagulation during maintenance hemodialysis (MHD) in the Hemodialysis Center of Beijing Hospital from December 2020 to January 2021. Basic data such as weight, height, basic kidney disease, dialysis age and anti-Ⅹa factor activity before, during and after dialysis were collected. A total of 46 patients were enrolled in this study, including 5 patients in coagulation group (10.9%) and 41 patients in non-coagulation group (89.1%). The anti-Ⅹa factor activity reached its peak at 0.5 h after the start of HD. The level of anti-Ⅹa factor was incorporated into the receiver operating characteristic curve (ROC curve). The results showed that the area under the ROC curve (AUC) was 0.802 (95% confidence interval: 0.651-0.54, P=0.029), and the cutoff was 0.31 IU/ml (sensitivity 1, specificity 0.683). It is suggested that the body surface area should be used as the basis to estimate the anticoagulant dose of LMWH in HD, and the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml, which is of diagnostic value for ECC. In addition, the results of binary logistic regression analysis showed that dialysis age was an independent risk factor for ECC ( OR value 1.319, 95% CI 1.052-1.654, P=0.017). In summary, this study reveals that dialysis age may be a risk factor for ECC and that the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml can be used as a potential diagnostic cut-off point for ECC in HD patients, which provides a scientific basis for monitoring strategies to prevent blood coagulation in HD filters.

The purpose of this study was to explore the reasonable dose of low molecular weight heparin (LMWH) in hemodialysis (HD) and the strategy of preventing extracorporeal circuit coagulation (ECC). A retrospective case-control study included patients who used LMWH for anticoagulation during maintenance hemodialysis (MHD) in the Hemodialysis Center of Beijing Hospital from December 2020 to January 2021. Basic data such as weight, height, basic kidney disease, dialysis age and anti-Ⅹa factor activity before, during and after dialysis were collected. A total of 46 patients were enrolled in this study, including 5 patients in coagulation group (10.9%) and 41 patients in non-coagulation group (89.1%). The anti-Ⅹa factor activity reached its peak at 0.5 h after the start of HD. The level of anti-Ⅹa factor was incorporated into the receiver operating characteristic curve (ROC curve). The results showed that the area under the ROC curve (AUC) was 0.802 (95% confidence interval: 0.651-0.54, P=0.029), and the cutoff was 0.31 IU/ml (sensitivity 1, specificity 0.683). It is suggested that the body surface area should be used as the basis to estimate the anticoagulant dose of LMWH in HD, and the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml, which is of diagnostic value for ECC. In addition, the results of binary logistic regression analysis showed that dialysis age was an independent risk factor for ECC ( OR value 1.319, 95% CI 1.052-1.654, P=0.017). In summary, this study reveals that dialysis age may be a risk factor for ECC and that the activity of HD 4 h anti-Ⅹa factor ≤0.31 IU/ml can be used as a potential diagnostic cut-off point for ECC in HD patients, which provides a scientific basis for monitoring strategies to prevent blood coagulation in HD filters.