OBJECTIVETo explore the expression of integrin-linked kinase (ILK) and its effect on VEGF expression in fibroblasts from human hypertrophic scar.

METHODSFibroblasts were isolated from hypertrophic scar of 8 patients and cultured in vitro. Then the cells were divided into three groups: (1) Cells were cultured only in DMEM containing 10% FCS in the control group; (2) Cells were transfected with empty plasmid in the empty plasmid group; (3) Cells were transfected with plasmid expressing ILKcDNA in the ILK cDNA plasmid transfection group. First, the expression of ILK and VEGF was observed by immunocytochemistry before and after ILK cDNA transfection. Second, ILK and VEGF mRNA expression was investigated by real-time PCR (RT-PCR). Third, the protein expression of ILK and VEGF was detected by Western blot. Finally, the protein level of VEGF in supernatant of fibroblasts was measured by ELISA.

RESULTSBefore ILK cDNA transfection, the expression of ILK was positive and the VEGF expression was weak in cytoplasm of fibroblasts . After ILK cDNA transfection, both the expression of ILK and VEGF was enhanced. The level of VEGF mRNA was significantly higher in ILK cDNA transfection group (0.338 +/- 0.060) than that in control group (0.022 +/- 0.001) and empty plasmid group (0.028 +/- 0.005, P < 0.05). The level of VEGF protein was significantly higher in ILK cDNA transfection group (0.819 +/- 0.019) than that in control group (0.607 +/- 0.033) and empty plasmid group (0. 591 +/- 0.024, P<0. 05). Secretion of VEGF increased remarkably in ILK cDNA transfection group comparing with the other two groups (P < 0.05).

CONCLUSIONSILK could up-regulate the VEGF mRNA and protein level in human scar fibroblasts. It may play an important role in the angiogenesis in hypertrophic scar.

Cells, Cultured ; Cicatrix, Hypertrophic ; genetics ; metabolism ; pathology ; Fibroblasts ; secretion ; Humans ; Plasmids ; Protein-Serine-Threonine Kinases ; genetics ; RNA, Messenger ; genetics ; Transfection ; Vascular Endothelial Growth Factor A ; metabolism

Objective:To compare the effects of external fixation as a terminal versus staged treat-ment on the health-related quality of life and function in patients with open tibiofibular fracture.Methods:From March 2017 to October 2018, 52 patients with open tibiofibular fracture were admitted to Department of Orthopaedic Surgery, Honghui Hospital.They were 37 males and 14 females, aged from 19 to 62 years(mean, 39.9 years).They were assigned into 2 groups subjected to 2 different treatment plans.In group A of 35 cases primary external fixation was replaced by terminal internal fixation while in group B of 17 cases primary ex-ternal fixation continued to the end.The 2 groups were compared in terms of the physiological total score (PCS) and mental component summary (MCS) in the 12-item short-form health survey (SF-12) at 1, 3, 6, 9 and 12 months postoperation, fracture healing time, time for external fixation, incidence of complications, and the lower extremity functional scale (LEFS).Results:The 2 groups were compatible due to insignificant differences in the general clinical data ( P>0.05).The follow-ups for the 2 groups were all beyond 12 months.PCS and MCS peaked both at 12 months postoperation in group A, but peaked respectively at 6 and 3 months postoperation in group B.Compared with group B, group A showed significantly higher PCS and MCS at 6, 9 and 12 months postoperation, significantly shorter fracture healing time (19.2 weeks ± 4.6 weeks versus 23.3 weeks ± 5.6 weeks), significantly shorter time for external fixation (15.6 days ± 4.2 days versus 270.0 days ± 15.4 days), significantly lower incidence of complications[5.7%(2/35) versus 35.3%(6/17)], significantly higher LEFS scores (88.3±7.2 versus 78.5 ± 5.2), and significantly higher the excellent and good rate by the Johner-Wruh scoring [94.3%(33/35) versus 70.6%(12/17)] (all P< 0.05). Conclusion:Compared with external fixation as a terminal treatment, external fixation followed by internal fixation can significantly improve the health-related quality of life and function in patients with open tibiofibular fracture and effectively reduce the incidence of postoperative complications.