Search

BACKGROUND: The exosomes are one of important active components of adult stem cells paracrine, providing the basis for stem cell “non-cellular” treatment. Exosomes from stem cells can play different roles in the wound through different mechanisms to promote the healing of diabetic wounds. OBJECTIVE: To summarize the main mechanism and application of stem cell derived exosomes in the treatment of diabetic wounds. METHODS: Computers were used to retrieve English databases such as PubMed database, Web of Science database, FMRS foreign language medical information resource retrieval platform, and Chinese databases such as CNKI and Wanfang Data Knowledge Service Platform. The retrieval scope was from the inception of the database to September 2020. The English and Chinese search terms were “stem cells, exosomes, wound healing, cell proliferation, neovascularization, inflammation, extracellular matrix, therapeutic use”. According to the inclusion and exclusion criteria, 66 articles were included and the results were analyzed. RESULTS AND CONCLUSION: (1) It is summarized that stem cell-derived exosomes can promote diabetic wound healing by regulating inflammation, promoting neovascularization, re-epithelialization and remodeling of extracellular matrix. (2) The application of stem cell-derived exosomes in diabetic wounds was listed. (3) The exosomes from stem cells can avoid the immune response of stem cells in the treatment of diabetic wounds, and the genetic material of stem cells carried by them is more widely regulated and more effective than that from ordinary cells in the treatment of diabetic wounds. (4) At present, the application of stem cell derived exosomes in diabetes wounds still has some problems, such as low purity, high cost of separation, low production efficiency, and the way to reach the target area, loss rate and diffusion efficiency. [ABSTRACT FROM AUTHOR]

BACKGROUND: Keloid is a benign skin tumor with excessive proliferation of fibroblasts and deposition of collagen after trauma. Vascular occlusion, inflammation, fibroblast proliferation and collagen secretion in keloid tissues all lead to tissue hypoxia, which plays an important role in the pathogenesis and prognosis of keloids. OBJECTIVE: To review the research progress of hypoxia-inducible factor 1 alpha (HIF-1α) in the tumor-like characteristics of keloid. METHODS: CNKI, VIP, WanFang, PubMed, Biosos Preview, and Web of Science databases were searched for relevant articles from their inception to November 2020. The retrieval key words were “keloids, HIF-lα; radioresistance” in Chinese and English, respectively. After reading the title, abstract and full text, 104 articles that met the selection criteria were finally selected. RESULTS AND CONCLUSION: The hypoxic microenvironment inhibits the degradation of HIF-1α, and increased HIF-1α induces several biological behaviors in keloid tissue similar to malignant tumors, including epithelial-mesenchymal transition, angiogenesis, glycolysis, radioresistance, and recurrence after radiation. These pathophysiological processes in turn exacerbate tissue hypoxia and increase HIF-1αexponentially, thereby forming a vicious circle. Current treatments for keloids mainly focus on surgical resection combined with radiotherapy. HIF-1α targeting therapies, such as hyperbaric oxygen therapy, can significantly improve the hypoxic environment of keloid tissue, promote wound healing, and reverse the tumor-like properties of keloid fibroblasts. However, there are few studies on the treatment of keloids with hyperbaric oxygen therapy combined with radiotherapy, and the clinical treatment of keloids with HIF-1α as the target is still under exploration. [ABSTRACT FROM AUTHOR]

BACKGROUND: Soft silicone silver ion dressing, a kind of high molecular weight organic compound prepared with Safetac technology, has the characteristics of anti-infection, good permeability and good air permeability. It can provide a good moist environment for wound healing. OBJECTIVE: To evaluate the effectiveness of soft silicone silver ion dressings in repairing deep II degree and milder bum wounds. METHODS: A computer-based retrieval of CNKI, VIP, WanFang, CBM, PubMed, Embase and Web of Science databases was performed. The randomized controlled trials conceming soft silicone silver ion dressing for repairing deep II degree and milder bum wounds were selected. The treatment group was treated with a single soft silicone silver ion dressing, or a soft silicone silver ion dressing combined with conventional treatment, or combined with other treatments. The control group was treated with conventional treatment, or other treatments, or placebo. After screening, data extraction and quality evaluation, meta-analysis was performed using Review Manager 5.3 software. RESULTS AND CONCLUSION: (1) Eleven articles were included, involving 784 patients, 381 patients in the treatment group and 403 patients in the control group. (2) The results of meta-analysis showed that the bum wound healing rate in the treatment group was higher than that in the control group [OR=11.56, 95%Cl (9.60, 13.53), P < 0.000 01; OR=13.29, 95%Cl (7.54, 19.04), P < 0.000 01; OR=4.10, 95%Cl (2.28, 5.93), P < 0.000 1; OR=1.17, 95%Cl (0.42, 1.93), P=0.002] at 7, 14 and 21 days, and the last measurement. The healing time of bum wounds in the treatment group was shorter than that in the control group [OR=-2.81, 95%Cl (一3.49, -2.12), P < 0.000 01]. The degree of pain in bum wounds in the treatment group was lower than that in the control group [OR=0.38, 95%Cl (-0.53,一0.24), P < 0.000 01]. There was no significant difference in the positive rate of bacterial culture on wound surface [OR=1.16, 95%Cl (0.47, 2.85), P=0.74], bum wound infection [OR=1.44, 95%Cl (0.47, 4.41), P=0.52], dressing frequency [OR=-8.04, 95%Cl (-18.82, 2.74), P=0.14], wound treatment cost [OR=-98.26, 95%Cl (-272.91, 76.40), P=0.27] and adverse reaction [OR=0.61, 95%Cl (0.31, 1.20), P=0.15] between treatment and control groups. (3) These results show that the application of soft silicone silver ion dressing on deep II degree and milder bum wounds can improve wound healing rate, shorten wound healing time and alleviate pain. [ABSTRACT FROM AUTHOR]

BACKGROUND: At present, platelet-rich plasma has been used in bums, plastic surgery, surgery and orthopedics. However, due to the different standards for platelet-rich plasma preparation, the results of research on bums are controversial. OBJECTIVE: To systematically evaluate the effectiveness of platelet-rich plasma in the repair of bum wounds. METHODS: A computer-based online search of CNKI, VIP, WanFang, CBMdisc, PubMed, Embase, Cochrane Library, Web of Science databases to retrieve randomized controlled trials regarding platelet-rich plasma repair of bum wounds. In the treatment group, platelet-rich plasma therapy or platelet-rich plasma therapy combined with conventional or other therapies were used. In the control group, conventional therapy, other therapies, or placebo treatment were used. After literature screening, information extraction and quality evaluation, Review Manager 5.3 software was used for meta analysis. RESULTS AND CONCLUSION: Eleven articles were included, involving 837 patients consisting of 420 patients in the treatment group and 417 patients in the control group. Meta analysis results revealed that the wound healing rate in the treatment group was significantly higher than that in the control group [OR=12.61, 95%C/ (6.93, 18.29), P < 0.000 1]. Wound healing time in the treatment group was significantly shorter than that in the control group [OR=-4.64, 95%C/ (-6.21, -3.06), P < 0.000 01]. The number of layers of gauze soaked by dressing [OR=-4.01, 95%C/ (-4.91, -3.11), P< 0.000 01], the times of changing inner gauze [OR=-3.79, 95%C/ (-5.33, -2.26), P < 0.000 01, and the times of dressing change on wound surface [OR=-3.41, 95%C/ (-5.93, -0.88), P=0.008) in the treatment group were significantly less than those in the control group. The positive rate of bacterial culture in wound [OR=0.46, 95%C/ (0.22, 0.94), P=0.03] and the incidence of inflammatory reaction in wound [OR=0.30, 95%C/ (0.17, 0.56), P=0.000 1) in the treatment group were significantly lower than those in the control group. The results suggested that platelet-rich plasma can increase the wound healing rate, shorten wound healing time, reduce the number of layers of gauze soaked by dressing, the times of changing inner gauze, and the times of dressing change on wound surface, and lower the positive rate of bacterial culture and the incidence of inflammatory reaction in wound. [ABSTRACT FROM AUTHOR]