Scar formation is characterized by dynamic alterations in collagen secretion, which critically determine scar morphology and pathological progression. In fibroblasts, collagen secretion is initiated through the activation of cytokine- and integrin-mediated signaling pathways, which promote collagen gene transcription. The procollagen polypeptide α chains undergo extensive post-translational modifications, including hydroxylation and glycosylation, within the endoplasmic reticulum (ER), followed by folding and assembly into triple-helical procollagen. Subsequent intracellular trafficking involves the sequential transport of procollagen through the ER, Golgi apparatus, and plasma membrane, accompanied by further structural refinements prior to extracellular secretion. Once secreted, procollagen is enzymatically processed to form mature collagen fibrils, which drive scar tissue remodeling. Recent advances in elucidating regulation of collagen secretion have identified pivotal molecular targets, such as transforming growth factor-beta 1 (TGF-β1), prolyl 4-hydroxylase (P4H), heat shock protein 47 (HSP47), and transport and Golgi organization protein 1 (TANGO1), providing novel therapeutic strategies to mitigate pathological scar hyperplasia and improve regenerative outcomes. This review provides a comprehensive analysis of the molecular mechanisms governing collagen secretion during scar formation, with emphasis on signaling cascades, procollagen biosynthesis, intracellular transport dynamics, and post-translational modifications, thereby offering a framework for developing targeted anti-scar therapies.
Humans ; Collagen/metabolism* ; Cicatrix/pathology* ; Signal Transduction ; Transforming Growth Factor beta1/metabolism* ; Fibroblasts/metabolism* ; Animals

AIM:To evaluate the effect of intrave-nous oxycodone administration at different timing on rebound pain following the resolution of inter-costal nerve blockade after thoracoscopic surgery.METHODS:A total of 114 patients undergoing elec-tive thoracoscopic surgery under general anesthe-sia between January and July 2024 were selected.The patients were aged 18 to 64 years,regardless of gender,with a BMI of 18 to 30 kg/m2,and classi-fied as ASA Ⅰ-Ⅱ.The patients were randomly divided into three groups using a random number table:control group(Group C),oxycodone administration at the end of surgery group(Group Q1),and oxyco-done administration 6 hours postoperatively group(Group Q2),with 38 patients in each group.Group C received a normal saline injection at the end of surgery,Group Q1 received an intravenous injec-tion of oxycodone 0.04 mg/kg at the end of sur-gery,and Group Q2 received an intravenous injec-tion of oxycodone 0.04 mg/kg at 6 hours postoper-atively.Patients in the three groups were treated with a postoperative intravenous self-control anal-gesic pump(PCIA).The occurrence of rebound pain was recorded,the time of the first analgesic pump press,the number of presses,the dosage of sufent-anil,and the need for rescue analgesia were also recorded.Numerical Rating Scale(NRS)scores at rest and during movement were recorded at 6,8,12,24,48 and 72 hours postoperatively.The Pitts-burgh Sleep Quality Index(PSQI)was used to as-sess the sleep quality of patients the night before surgery and for two nights postoperatively.Adverse reactions such as respiratory depression,postoper-ative nausea and vomiting(PONV),and pruritus were recorded.RESULTS:Compared with group C and Q1,the incidence of rebound pain,postopera-tive sufentanil consumption,effective compression frequency of PCIA from 0-24 hours after surgery,and the rate of rescue analgesia were lower in Groups Q2(P＜0.05);Compared to Group C,the NRS scores at rest and during movement at 8,12,and 24 hours postoperatively were significantly lower in Groups Q1 and Q2(P＜0.05).However,compared to Group Q1,Group Q2 exhibited lower NRS scores at rest and during movement at 8,12,and 24 hours postoperatively(P＜0.05).On the first postoperative night,the PSQI scores of patients in Group Q2 were significantly better than those in Groups C and Q1(P＜0.05).There was no statistical-ly significant difference in the incidence of PONV among the three groups(P＞0.05).No respiratory depression,drowsiness,or pruritus were observed postoperatively in any of the groups.CONCLUSION:Intravenous injection of 0.04 mg/kg oxycodone 6 hours after surgery can reduce the occurrence of rebound pain after intercostal nerve block resolu-tion in thoracoscopic surgery and improves pa-tients' sleep quality.

Objective:To explore the clinical characteristics and genetic etiology of a child with Neurofibromatosis-Noonan syndrome (NFNS).Methods:A child with NFNS who was treated at the Department of Endocrinology of Hangzhou Children′s Hospital in January 2024 was selected as the study subject. Clinical data of the child was collected by retrospective analysis method. Peripheral venous blood samples (2 mL each) were collected from the child and his parents. Genomic DNA was extracted, and trio whole exome sequencing (Trio-WES) of the family was carried out. Sanger sequencing was used to perform family verification on the candidate variants. The identified variants were classified for pathogenicity according to the Standards and Guidelines for the Interpretation of Sequence Variants established by the American College of Medical Genetics and Genomics (ACMG) (hereafter referred to as the " ACMG guidelines" ). This study has been approved by the Medical Ethics Committee of Hangzhou Children′s Hospital (Ethics No. 2021-06).Results:The child was a 7-year and 4-month-old male. He has short stature, numerous café-au-lait spots on the neck and trunk, and special facial features such as a full forehead, wide interpupillary distance, a low nasal bridge, and low-set ears.The results of Trio-WES showed that he has harbored a NF1 gene c. 3773G>T (p.W1258L) mutation, which was verified by Sanger sequencing to be de novo in origin. The NF1 gene child was associated with NFNS, which was an autosomal dominant inheritance. According to the ACMG guidelines, this variant was judged to be a likely pathogenic variant (PS2+ PM2+ PP3+ PP2). No pathogenic variant in genes associated with Noonan syndrome, such as those in PTPN11, SOS1, RAF1, RIT1, and KRAS, was found. Conclusion:The child with NFNS has clinical features such as short stature, special facial features, and café-au-lait spots. The c. 3773G>T (p.W1258L) variation in the NF1 gene may be the genetic etiology of the NFNS child in this study. The results of this study has enriched the variation spectrum of the NF1 gene.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a child with Neurofibromatosis-Noonan syndrome (NFNS). METHODS: A child with NFNS who was treated at the Department of Endocrinology of Hangzhou Children's Hospital in January 2024 was selected as the study subject. Clinical data of the child was collected by retrospective analysis. Peripheral venous blood samples (2 mL each) were collected from the child and his parents. Genomic DNA was extracted, and trio-whole exome sequencing (Trio-WES) of the family was carried out. Sanger sequencing was used to perform family verification on the candidate variants. The identified variants were classified for pathogenicity according to the Standards and Guidelines for the Interpretation of Sequence Variants established by the American College of Medical Genetics and Genomics (ACMG) (hereafter referred to as the "ACMG guidelines"). This study has been approved by the Medical Ethics Committee of Hangzhou Children's Hospital (Ethics No. 2021-06). RESULTS: The child was a 7-year and 4-month-old male. He has short stature, numerous café-au-lait spots on the neck and trunk, and special facial features such as a full forehead, wide interpupillary distance, a low nasal bridge, and low-set ears. The results of Trio-WES showed that the he had harbored the NF1 gene c.3773G>T (p.W1258L) mutation, which was verified by Sanger sequencing to be de novo in origin. The NF1 gene was associated with NFNS, which has an autosomal dominant inheritance. According to the ACMG guidelines, this variant was judged to be a likely pathogenic variant (PS2+PM2+PP3+PP2). No pathogenic variant in genes associated with Noonan syndrome, such as PTPN11, SOS1, RAF1, RIT1, and KRAS, was found. CONCLUSION The child with NFNS has clinical features such as short stature, special facial features, and café-au-lait spots. The c.3773G>T (p.W1258L) variation in the NF1 gene may be the genetic etiology of the NFNS child in this study. The results of this study has enriched the variation spectrum of the NF1 gene.
Child ; Humans ; Male ; Exome Sequencing ; Mutation ; Neurofibromatosis 1/genetics* ; Neurofibromin 1/genetics* ; Noonan Syndrome/genetics*

Objective:To investigate the effect of curcumin on Th17/Treg cell immune balance in acne mice by regulating the JAK2/STAT3 signaling pathway.Methods:An acne mouse model was established by injecting propionibacterium suspension.The suc-cessfully established mice were randomly separated into the acne group,low(curcumin-L,50 mg/kg curcumin),medium(curcumin-M,100 mg/kg curcumin),high dose(curcumin-H,150 mg/kg curcumin)curcumin groups,and curcumin-H+JAK2/STAT3 pathway activator-olivelin group(150 mg/kg curcumin+1.0 mg/kg colivelin),with healthy mice as the control group,after intervention,the mice were scored for skin lesions;blood was taken from the orbit,ELISA and flow cytometry were applied to detect serum levels of IL-6 and IL-10,and the ratios of Th17 and Treg cells;HE was applied to detect pathological changes in auricle tissue;Western blot was applied to detect the expressions of p-JAK2,p-STAT3,JAK2,STAT3,Treg transcription factor forked transcription factor 3(FOXP3)and Th17 transcription factor retinoic acid related solitary receptor(RORγt)proteins in auricle tissue.Results:Compared with the control group,the pathological damage in the acne group was severe,the skin lesion and pathological scores,IL-6 level,Th17 cells ratio,p-JAK2/JAK2,p-STAT3/STAT3,and RORγt expression were obviously increased,the IL-10 level,Treg cells ra-tio,and FOXP3 expression were obviously reduced(P<0.05);compared with the acne group,the skin lesion and pathological scores,IL-6 level,Th17 cells ratio,p-JAK2/JAK2,p-STAT3/STAT3 and RORγt expression in curcumin-L,curcumin-M,and curcumin-H groups were obviously reduced,the IL-10 level,Treg cells ratio,and FOXP3 expression were obviously increased(P<0.05);com-pared with the curcumin-H group,the skin lesion and pathological scores,IL-6 level,Th17 cells ratio,p-JAK2/JAK2,p-STAT3/STAT3,and RORγt expression in curcumin-H+colivelin group were obviously increased,the IL-10 level,Treg cells ratio,and FOXP3 expression were obviously reduced(P<0.05).Conclusion:Curcumin can improve the immune balance of Th17/Treg cells in acne mice,which may be related to the inhibition of the JAK2/STAT3 signaling pathway.

Objective To explore the diagnostic value of ultrasonography in ischiofemoral impinge-ment syndrome(IFI).Methods Fifty-six patients who underwent hip MRI with confirmed IFI diagnosis and completed ultrasonography examinations were enrolled as the IFI group,including 44 females and 12 males.Twenty healthy volunteers were concurrently recruited as the control group,consisting of 10 females and 10 males.The control group underwent ultrasonography examinations of bilateral hip joints,whiletheischialfemoralspace(IFS)andquadratusfemoristhickness(QFT)of both groups were measured and recorded.Then measurements were compared within(by laterality and gender)and between the two groups using independent-samples t-tests.Moreover,receiver operating characteristic adults,males exhibited significantly higher IFS and QFT values than females(P<0.05).Within the IFI group,males with affected hips had significantly higher IFS than females(P<0.05),while no sig-nificant differences were observed in QFT between different genders(P>0.05).Moreover,affected hips in the IFI group showed significantly narrower IFS and thicker QFT compared to both contralateral hips and the control group(P<0.001).In addition,the diagnostic cut-off values of IFS and QFT for ultrasound diagnosis of IFI were 22.93 mm and 16.48 mm,respectively.At these thresholds,the ar-eas under the curve(AUC)were 0.997 and 0.977,with sensitivities of 97.8%and 91.8%,and speci-ficities of 98.4%and 97.8%,respectively.Conclusion Ultrasound can serve as a reliable diagnostic technique for IFI,where narrowing of the IFS and thickening of the QFT should raise suspicion of this condition.

AIM:To evaluate the effect of intrave-nous oxycodone administration at different timing on rebound pain following the resolution of inter-costal nerve blockade after thoracoscopic surgery.METHODS:A total of 114 patients undergoing elec-tive thoracoscopic surgery under general anesthe-sia between January and July 2024 were selected.The patients were aged 18 to 64 years,regardless of gender,with a BMI of 18 to 30 kg/m2,and classi-fied as ASA Ⅰ-Ⅱ.The patients were randomly divided into three groups using a random number table:control group(Group C),oxycodone administration at the end of surgery group(Group Q1),and oxyco-done administration 6 hours postoperatively group(Group Q2),with 38 patients in each group.Group C received a normal saline injection at the end of surgery,Group Q1 received an intravenous injec-tion of oxycodone 0.04 mg/kg at the end of sur-gery,and Group Q2 received an intravenous injec-tion of oxycodone 0.04 mg/kg at 6 hours postoper-atively.Patients in the three groups were treated with a postoperative intravenous self-control anal-gesic pump(PCIA).The occurrence of rebound pain was recorded,the time of the first analgesic pump press,the number of presses,the dosage of sufent-anil,and the need for rescue analgesia were also recorded.Numerical Rating Scale(NRS)scores at rest and during movement were recorded at 6,8,12,24,48 and 72 hours postoperatively.The Pitts-burgh Sleep Quality Index(PSQI)was used to as-sess the sleep quality of patients the night before surgery and for two nights postoperatively.Adverse reactions such as respiratory depression,postoper-ative nausea and vomiting(PONV),and pruritus were recorded.RESULTS:Compared with group C and Q1,the incidence of rebound pain,postopera-tive sufentanil consumption,effective compression frequency of PCIA from 0-24 hours after surgery,and the rate of rescue analgesia were lower in Groups Q2(P＜0.05);Compared to Group C,the NRS scores at rest and during movement at 8,12,and 24 hours postoperatively were significantly lower in Groups Q1 and Q2(P＜0.05).However,compared to Group Q1,Group Q2 exhibited lower NRS scores at rest and during movement at 8,12,and 24 hours postoperatively(P＜0.05).On the first postoperative night,the PSQI scores of patients in Group Q2 were significantly better than those in Groups C and Q1(P＜0.05).There was no statistical-ly significant difference in the incidence of PONV among the three groups(P＞0.05).No respiratory depression,drowsiness,or pruritus were observed postoperatively in any of the groups.CONCLUSION:Intravenous injection of 0.04 mg/kg oxycodone 6 hours after surgery can reduce the occurrence of rebound pain after intercostal nerve block resolu-tion in thoracoscopic surgery and improves pa-tients' sleep quality.

Objective:To investigate the effect of curcumin on Th17/Treg cell immune balance in acne mice by regulating the JAK2/STAT3 signaling pathway.Methods:An acne mouse model was established by injecting propionibacterium suspension.The suc-cessfully established mice were randomly separated into the acne group,low(curcumin-L,50 mg/kg curcumin),medium(curcumin-M,100 mg/kg curcumin),high dose(curcumin-H,150 mg/kg curcumin)curcumin groups,and curcumin-H+JAK2/STAT3 pathway activator-olivelin group(150 mg/kg curcumin+1.0 mg/kg colivelin),with healthy mice as the control group,after intervention,the mice were scored for skin lesions;blood was taken from the orbit,ELISA and flow cytometry were applied to detect serum levels of IL-6 and IL-10,and the ratios of Th17 and Treg cells;HE was applied to detect pathological changes in auricle tissue;Western blot was applied to detect the expressions of p-JAK2,p-STAT3,JAK2,STAT3,Treg transcription factor forked transcription factor 3(FOXP3)and Th17 transcription factor retinoic acid related solitary receptor(RORγt)proteins in auricle tissue.Results:Compared with the control group,the pathological damage in the acne group was severe,the skin lesion and pathological scores,IL-6 level,Th17 cells ratio,p-JAK2/JAK2,p-STAT3/STAT3,and RORγt expression were obviously increased,the IL-10 level,Treg cells ra-tio,and FOXP3 expression were obviously reduced(P<0.05);compared with the acne group,the skin lesion and pathological scores,IL-6 level,Th17 cells ratio,p-JAK2/JAK2,p-STAT3/STAT3 and RORγt expression in curcumin-L,curcumin-M,and curcumin-H groups were obviously reduced,the IL-10 level,Treg cells ratio,and FOXP3 expression were obviously increased(P<0.05);com-pared with the curcumin-H group,the skin lesion and pathological scores,IL-6 level,Th17 cells ratio,p-JAK2/JAK2,p-STAT3/STAT3,and RORγt expression in curcumin-H+colivelin group were obviously increased,the IL-10 level,Treg cells ratio,and FOXP3 expression were obviously reduced(P<0.05).Conclusion:Curcumin can improve the immune balance of Th17/Treg cells in acne mice,which may be related to the inhibition of the JAK2/STAT3 signaling pathway.

Objective To explore the diagnostic value of ultrasonography in ischiofemoral impinge-ment syndrome(IFI).Methods Fifty-six patients who underwent hip MRI with confirmed IFI diagnosis and completed ultrasonography examinations were enrolled as the IFI group,including 44 females and 12 males.Twenty healthy volunteers were concurrently recruited as the control group,consisting of 10 females and 10 males.The control group underwent ultrasonography examinations of bilateral hip joints,whiletheischialfemoralspace(IFS)andquadratusfemoristhickness(QFT)of both groups were measured and recorded.Then measurements were compared within(by laterality and gender)and between the two groups using independent-samples t-tests.Moreover,receiver operating characteristic adults,males exhibited significantly higher IFS and QFT values than females(P<0.05).Within the IFI group,males with affected hips had significantly higher IFS than females(P<0.05),while no sig-nificant differences were observed in QFT between different genders(P>0.05).Moreover,affected hips in the IFI group showed significantly narrower IFS and thicker QFT compared to both contralateral hips and the control group(P<0.001).In addition,the diagnostic cut-off values of IFS and QFT for ultrasound diagnosis of IFI were 22.93 mm and 16.48 mm,respectively.At these thresholds,the ar-eas under the curve(AUC)were 0.997 and 0.977,with sensitivities of 97.8%and 91.8%,and speci-ficities of 98.4%and 97.8%,respectively.Conclusion Ultrasound can serve as a reliable diagnostic technique for IFI,where narrowing of the IFS and thickening of the QFT should raise suspicion of this condition.

Objective:To explore the clinical characteristics and genetic etiology of a child with Neurofibromatosis-Noonan syndrome (NFNS).Methods:A child with NFNS who was treated at the Department of Endocrinology of Hangzhou Children′s Hospital in January 2024 was selected as the study subject. Clinical data of the child was collected by retrospective analysis method. Peripheral venous blood samples (2 mL each) were collected from the child and his parents. Genomic DNA was extracted, and trio whole exome sequencing (Trio-WES) of the family was carried out. Sanger sequencing was used to perform family verification on the candidate variants. The identified variants were classified for pathogenicity according to the Standards and Guidelines for the Interpretation of Sequence Variants established by the American College of Medical Genetics and Genomics (ACMG) (hereafter referred to as the " ACMG guidelines" ). This study has been approved by the Medical Ethics Committee of Hangzhou Children′s Hospital (Ethics No. 2021-06).Results:The child was a 7-year and 4-month-old male. He has short stature, numerous café-au-lait spots on the neck and trunk, and special facial features such as a full forehead, wide interpupillary distance, a low nasal bridge, and low-set ears.The results of Trio-WES showed that he has harbored a NF1 gene c. 3773G>T (p.W1258L) mutation, which was verified by Sanger sequencing to be de novo in origin. The NF1 gene child was associated with NFNS, which was an autosomal dominant inheritance. According to the ACMG guidelines, this variant was judged to be a likely pathogenic variant (PS2+ PM2+ PP3+ PP2). No pathogenic variant in genes associated with Noonan syndrome, such as those in PTPN11, SOS1, RAF1, RIT1, and KRAS, was found. Conclusion:The child with NFNS has clinical features such as short stature, special facial features, and café-au-lait spots. The c. 3773G>T (p.W1258L) variation in the NF1 gene may be the genetic etiology of the NFNS child in this study. The results of this study has enriched the variation spectrum of the NF1 gene.