Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the ...Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.展开更多
Objective:To evaluate the effects of a piceatannol-loaded self-nanoemulsifying drug delivery system(PIC-SNEDDS)on wound healing in diabetic rats and its mechanisms of wound healing action.Methods:Diabetes was induced ...Objective:To evaluate the effects of a piceatannol-loaded self-nanoemulsifying drug delivery system(PIC-SNEDDS)on wound healing in diabetic rats and its mechanisms of wound healing action.Methods:Diabetes was induced in rats using streptozotocin,after which full-thickness excisional wounds were created.Piceatannol was administered topically either as a raw hydrogel or formulated into a PIC-SNEDDS,which was prepared using an optimized oil-surfactant mixture and incorporated into a hydrogel for application.Wound healing activity was assessed through measurements of wound contraction,oxidative stress biomarkers,and collagen content,along with histological and immunohistochemical evaluation of inflammatory,angiogenic,and remodeling markers.Results:PIC-SNEDDS markedly enhanced diabetic wound healing by promoting epithelial regeneration,granulation tissue formation,epidermal proliferation,and keratinization.The formulation also reduced the expression of pro-inflammatory markers(interleukin-6,nuclear factor-kappa B,and tumor necrosis factor-α)while increasingα-smooth muscle actin,transforming growth factor-β1,vascular endothelial growth factor-A,and hydroxyproline levels.Additionally,it improved antioxidant status by lowering malondialdehyde levels and boosting superoxide dismutase and catalase activity,along with upregulation of COL1A1 mRNA expression.Conclusions:PIC-SNEDDS promotes the healing of diabetic wounds and exhibits anti-inflammatory,antioxidant,pro-collagen,and angiogenic properties.展开更多
Chronic,non-healing wounds represent a significant challenge for healthcare systems worldwide,often requiring significant human and financial resources.Chronic wounds arise from the complex interplay of underlying com...Chronic,non-healing wounds represent a significant challenge for healthcare systems worldwide,often requiring significant human and financial resources.Chronic wounds arise from the complex interplay of underlying comorbidities,such as diabetes or vascular diseases,lifestyle factors,and genetic risk profiles which may predispose extremities to local ischemia.Injuries are further exacerbated by bacterial colonization and the formation of biofilms.Infection,consequently,perpetuates a chronic inflammatory microenvironment,preventing the progression and completion of normal wound healing.The current standard of care(SOC)for chronic wounds involves surgical debridement along with localized wound irrigation,which requires inpatient care under general anesthesia.This could be followed by,if necessary,defect coverage via a reconstructive ladder utilizing wound debridement along with skin graft,local,or free flap techniques once the wound conditions are stabilized and adequate blood supply is restored.To promote physiological wound healing,a variety of approaches have been subjected to translational research.Beyond conventional wound healing drugs and devices that currently supplement treatments,cellular and immunotherapies have emerged as promising therapeutics that can behave as tailored therapies with cell-or molecule-specific wound healing properties.However,in contrast to the clinical omnipresence of chronic wound healing disorders,there remains a shortage of studies condensing the current body of evidence on cellular therapies and immunotherapies for chronic wounds.This review provides a comprehensive exploration of current therapies,experimental approaches,and translational studies,offering insights into their efficacy and limitations.Ultimately,we hope this line of research may serve as an evidence-based foundation to guide further experimental and translational approaches and optimize patient care long-term.展开更多
BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds pre...BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds present significant therapeutic challenges,requiring novel strategies to improve healing outcomes.AIM To investigate the potential of fetal dermal mesenchymal stem cells(FDMSCs)in enhancing wound healing through modulation of macrophage polarization,specifically by promoting the M2 phenotype to address inflammatory responses in chronic wounds.METHODS FDMSCs were isolated from BalB/C mice and co-cultured with RAW264.7 macrophages to assess their effects on macrophage polarization.Flow cytometry,quantitative reverse transcriptase polymerase chain reaction,and histological analyses were employed to evaluate shifts in macrophage phenotype and wound healing in a mouse model.Statistical analysis was performed using GraphPad Prism.RESULTS FDMSCs induced macrophage polarization from the M1 to M2 phenotype,as demonstrated by a reduction in proinflammatory markers(inducible nitric oxide synthase,interleukin-6)and an increase in anti-inflammatory markers[mannose receptor(CD206),arginase-1]in co-cultured RAW264.7 macrophages.These shifts were confirmed by flow cytometry.In an acute skin wound model,FDMSC-treated mice exhibited faster wound healing,enhanced collagen deposition,and improved vascular regeneration compared to controls.Significantly higher expression of arginase-1 further indicated an enriched M2 macrophage environment.CONCLUSION FDMSCs effectively modulate macrophage polarization from M1 to M2,reduce inflammation,and enhance tissue repair,demonstrating their potential as an immunomodulatory strategy in wound healing.These findings highlight the promising therapeutic application of FDMSCs in managing chronic wounds.展开更多
Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.A...Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.Accumulating evidence underscores the potential of targeted modulation of mechanical cues to enhance skin regeneration,promoting scarless repair by influencing the extracellular microenvironment and driving the phenotypic transitions.The field of skin repair and skin appendage regeneration has witnessed remarkable advancements in the utilization of biomaterials with distinct physical properties.However,a comprehensive understanding of the underlying mechanisms remains somewhat elusive,limiting the broader application of these innovations.In this review,we present two promising biomaterial-based mechanical approaches aimed at bolstering the regenerative capacity of compromised skin.The first approach involves leveraging biomaterials with specific biophysical properties to create an optimal scarless environment that supports cellular activities essential for regeneration.The second approach centers on harnessing mechanical forces exerted by biomaterials to enhance cellular plasticity,facilitating efficient cellular reprogramming and,consequently,promoting the regeneration of skin appendages.In summary,the manipulation of mechanical cues using biomaterial-based strategies holds significant promise as a supplementary approach for achieving scarless wound healing,coupled with the restoration of multiple skin appendage functions.展开更多
Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomime...Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomimetic scaffold aimed at facilitating rapid and scarless wound healing.This highly in-tegrated 3D-printed dermal scaffold comprised modified recombinant human type III collagen(rhCOLIII-MA),gelatin methacrylate(GelMA),and liposomes encapsulating SB431542 to target TGF-β1(Lip@SB).The rhCOLIII-MA/GelMA(CG)scaffold retained inherent biomaterial characteristics,exhibited tailored physicochemical properties,and demonstrated favorable biocompatibility.Moreover,the Lip@SB-loaded CG scaffold(CGL)effectively promoted in vitro wound healing,while enabling controlled release of SB431542 to inhibit pathological collagen deposition.In a full-thickness skin defect rat model,the CGL dermal scaffold combined with split-thickness skin graft(STSG)minimized scar contraction,stimulated functional neovascularization,and enhanced graft aesthetics comparable to normal skin.Remarkably,the performance of the CGL scaffold surpassed that of commercially available anti-scarring alternatives.This innovative strategy presents a straightforward approach toward scarless skin regeneration and holds promise in alleviating the prolonged,painful postoperative rehabilitation.展开更多
BACKGROUND Mucosal healing has become an important goal of Crohn’s disease(CD)treat-ments.Modulen,enriched with transforming growth factor-beta 2,and budeso-nide are commonly accepted treatments for mild-moderate CD....BACKGROUND Mucosal healing has become an important goal of Crohn’s disease(CD)treat-ments.Modulen,enriched with transforming growth factor-beta 2,and budeso-nide are commonly accepted treatments for mild-moderate CD.However,their effects on the small bowel(SB)mucosa remain underexplored.AIM To prospectively assess clinical and mucosal responses to Modulen vs budesonide in adults with CD,using SB capsule endoscopy.METHODS Thirty patients were divided into two groups:Modulen+home-based diet(21 patients)and budesonide(9 patients)for an eight-week intervention followed by four weeks of follow-up.Clinical,laboratory,and endoscopic responses were evaluated.The mucosal changes were assessed through SB capsule endoscopy.RESULTS Results indicated significant clinical improvement in the Modulen group with reduced CD activity index(P=0.041)and improved inflammatory bowel disease questionnaire score(P=0.016).Moreover,Modulen was associated with a signifi-cant SB mucosal improvement,evidenced by a decrease in Lewis score(P=0.027).No significant changes were observed in calprotectin or other laboratory parame-ters.Conversely,budesonide exhibited more modest clinical effects,but it improved calprotectin,hemoglobin,and C-reactive protein levels(P=0.051,P=0.014,and P=0.038,respectively).The capsule endoscopy did not reveal a significant mucosal response in the budesonide group.CONCLUSION Both interventions have a role in CD treatment.Yet,their effects differ and may complement each other:Modulen yields clinical and mucosal improvements,while budesonide primarily leads mainly to laboratory improvements.展开更多
Loss-of-function variants of low-density lipoprotein receptor-related protein 5(LRP5)can lead to reduced bone formation,culminating in diminished bone mass.Our previous study reported transcription factor osterix(SP7)...Loss-of-function variants of low-density lipoprotein receptor-related protein 5(LRP5)can lead to reduced bone formation,culminating in diminished bone mass.Our previous study reported transcription factor osterix(SP7)-binding sites on the LRP5 promoter and its pivotal role in upregulating LRP5 expression during implant osseointegration.However,the potential role of SP7 in ameliorating LRP5-dependent osteoporosis remained unknown.In this study,we used mice with a conditional knockout(c KO)of LRP5 in mature osteoblasts,which presented decreased osteogenesis.The in vitro experimental results showed that SP7 could promote LRP5 expression,thereby upregulating the osteogenic markers such as alkaline phosphatase(ALP),Runt-related transcription factor 2(Runx2),andβ-catenin(P<0.05).For the in vivo experiment,the SP7 overexpression virus was injected into a bone defect model of LRP5 c KO mice,resulting in increased bone mineral density(BMD)(P<0.001)and volumetric density(bone volume(BV)/total volume(TV))(P<0.001),and decreased trabecular separation(Tb.Sp)(P<0.05).These data suggested that SP7 could ameliorate bone defect healing in LRP5 c KO mice.Our study provides new insights into potential therapeutic opportunities for ameliorating LRP5-dependent osteoporosis.展开更多
Objective:To evaluate the effectiveness of surgical combination with traditional Chinese medicine dialectical therapy in three phases for the treatment of intertrochanteric fracture of the femur(IFF).Methods:84 patien...Objective:To evaluate the effectiveness of surgical combination with traditional Chinese medicine dialectical therapy in three phases for the treatment of intertrochanteric fracture of the femur(IFF).Methods:84 patients with IFF admitted to the hospital from December 2022 to December 2024 were selected and randomly divided into two groups using a random number table.The combined group received surgery and traditional Chinese medicine dialectical therapy in three phases,while the control group received surgery alone.The total effective rate,fracture healing time,hip function score,and lower extremity function score were compared between the two groups.Results:The total effective rate was higher in the combined group than in the control group(P<0.05).After treatment,the fracture healing time was shorter in the combined group than in the control group,and the hip function and lower extremity function scores were higher in the combined group than in the control group(P<0.05).Conclusion:Surgical combination with traditional Chinese medicine dialectical therapy in three phases can shorten the fracture healing time of IFF patients and restore their hip and lower extremity function,demonstrating significant efficacy.展开更多
BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significan...BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a significant contributor to disability and mortality in diabetic patients.Macrophage polarization and functional regulation are promising areas of research and show therapeuti...BACKGROUND Diabetic foot ulcers(DFUs)are a significant contributor to disability and mortality in diabetic patients.Macrophage polarization and functional regulation are promising areas of research and show therapeutic potential in the field of DFU healing.However,the complex mechanism,the difficulty in clinical translation,and the large heterogeneity present significant challenges.Hence,this study was to comprehensively analyze the publication status and trends of studies on macrophage polarization and DFU healing.AIM To examine the relevant literature on macrophage polarization in DFU healing.METHODS A bibliometric analysis was conducted using the Web of Science database.Relevant literature was retrieved from the Web of Science Core Collection database between 2013 to 2023 using literature visualization and analysis software(VOSviewer and CiteSpace)and bibliometric online platforms.The obtained literature was then subjected to visualization and analysis of different countries/regions,institutions,journals,authors,and keywords to reveal the research’s major trends and focus.RESULTS The number of publications on the role of macrophage polarization in DFU healing increased rapidly from 2013 to 2023,especially in the latter period.Chinese researchers were the most prolific in this field,with 217 publications,while American researchers had been engaged in this field for a longer period.Qian Tan of Nanjing Drum Tower Hospital and Qian Ding of Nanjing University were the first to publish in this field.Shanghai Jiao Tong University was the institution with the most publications(27).The keywords“bone marrow”,“adjustment,replacement,response,tissue repair”,and“activation,repair,differentiation”appeared more frequently.The study of macrophage polarization in DFU healing focused on the regulatory mechanism,gene expression,and other aspects.CONCLUSION This study through the bibliometric method reveals the research trends and development trends in this field of macrophage polarization in DFU healing from 2013 to 2023 in the Web of Science Core Collection database.The key hotspots in this field mainly include the regulation of macrophage activation,gene expression,wound tissue repair,and new wound materials.This study provides references for future research directions.展开更多
BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and te...BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.展开更多
Self-healing hydrogels utilize inherent intermolecular forces to autonomously heal physical damage resulting from excessive strain,pressure,or tearing.Applying these materials in soft robotics and tissue engineering c...Self-healing hydrogels utilize inherent intermolecular forces to autonomously heal physical damage resulting from excessive strain,pressure,or tearing.Applying these materials in soft robotics and tissue engineering could be beneficial.On the other hand,their efficacy in stretchable and mechanically resistant circuits is hindered by their limited electrical conductivity.展开更多
As Thailand and China mark the 50th anniversary of their diplomatic ties this year,most headlines will naturally focus on trade deals,railways,and strategic partnerships.But tucked behind the golden spires of Bangkok...As Thailand and China mark the 50th anniversary of their diplomatic ties this year,most headlines will naturally focus on trade deals,railways,and strategic partnerships.But tucked behind the golden spires of Bangkok’s Wat Po temple lies a quieter,gentler form of diplomacy—one that happens through kneading hands,respectful bows,and an ancient art passed down across generations.At the Wat Po Thai Traditional Medical School,headmaster Serat Tangtrongchitr sees Thai massage not only as a healing craft,but as a cultural bridge—one that connects people across borders,languages,and belief systems.“We don’t just teach massage,”Serat said,his voice calm but assured.“We teach a way of life.And when people from other cultures learn this with us—Chinese students included—they come to understand not just the techniques,but the heart of Thai culture.”展开更多
Objective:This study aims to develop an assessment tool for postoperative wound healing in adult patients with benign anal canal and rectal diseases and to validate its reliability and validity.Methods:Based on Levine...Objective:This study aims to develop an assessment tool for postoperative wound healing in adult patients with benign anal canal and rectal diseases and to validate its reliability and validity.Methods:Based on Levine’s Conservation Model as the theoretical framework,an item pool was formed through literature review,and the initial draft of the scale was refined through two rounds of Delphi expert consultation.A total of 200 postoperative patients were selected for item analysis,internal consistency testing,content validity,and structural validity analysis.Results:The final tool comprises four dimensions:energy conservation,structural integrity,personal integrity,and social integrity,with a total of 24 items.It demonstrates good content validity(I-CVI 0.82-1.00,S-CVI/Ave 0.95,S-CVI/UA 0.87)and excellent internal consistency(Cronbach’sαfor the overall scale was 0.934).Exploratory factor analysis revealed a KMO value of 0.931,Bartlett’s test of sphericityχ^(2)=4147.853(p<0.001),and four common factors were extracted,accounting for a cumulative variance contribution rate of 64.345%,indicating ideal structural validity.Conclusion:The results indicate that the assessment tool has good reliability and validity and can systematically evaluate postoperative wound healing,providing a scientific basis for clinical individualized nursing interventions.展开更多
I have never given birth but have heard it said many times that as awful as labor is,when it's over and your newborn is placed in your arms,that pain is forgotten.That's how I feel now about the earliest days ...I have never given birth but have heard it said many times that as awful as labor is,when it's over and your newborn is placed in your arms,that pain is forgotten.That's how I feel now about the earliest days of grief.展开更多
Objective:To explore the wound healing potential and chemical components of Lindernia ruellioides from Mizoram,India.Methods:Plant extraction was conducted by cold maceration using chloroform,ethanol,and distilled wat...Objective:To explore the wound healing potential and chemical components of Lindernia ruellioides from Mizoram,India.Methods:Plant extraction was conducted by cold maceration using chloroform,ethanol,and distilled water as solvents.To guarantee the safety of the plant extract,an acute dermal toxicity test was conducted before the experiment.Antioxidant assays were performed.Excision and incision wound models were used to assess the wound healing activities,including wound closure rate,epithelialization period,and tensile strength.A histopathological examination was carried out.Results:Lindernia ruellioides contained bioactive compounds,such as mycolactone F,1-O-octadec-9-enyl glycerol,reserpine,tetracosanoic acid,2-O-caffeoylglucarate and several others which are found to possess various pharmacological activities.Acute dermal toxicity evaluation showed that the doses were deemed safe.Ethanol extract of Lindernia ruellioides(LREE)treatment significantly elevated glutathione,glutathione-S-transferase,and superoxide dismutase,and decreased malondialdehyde in a dose-dependent manner.It showed increased wound contraction rate,shorter epithelialization time,and elevated wound breaking strength in the LREE-treated group when compared with the control.In addition,the histological examination showed enhanced neovascularization,fibroblasts,and collagen in LREE-treated animals.Conclusions:Lindenia ruellioides exhibits remarkable effects on wound healing.The study validates the traditional use of this plant in Mizoram region as a wound-healing agent.展开更多
BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to...BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to their original attachment site.Soft tissue healing can be evaluated with imaging methods or alternatively with second-look arthroscopy.AIM To investigate shoulder tendon and capsule healing after arthroscopic rotator cuff and instability repair using second-look arthroscopy.METHODS In this study,24 adult patients with rotator cuff tears(13 patients)or anterior shoulder instability(11 patients)were included.All patients were initially subjected to arthroscopic repair using suture anchors and were re-evaluated with second-look arthroscopy for reasons not related to the original pathology.The second operation was performed in 8 patients due to mild but persistent pain or stiffness,in 3 patients for recalcitrant stiffness,in 5 patients for secondary biceps tenotomy,in 6 patients for persistent acromioclavicular joint pain and in 2 patients for suture anchor prominence causing shoulder grinding.Soft tissue healing was evaluated visually and by probing,whereas clinical outcomes were evaluated using the University of California–Los Angeles(UCLA)and Rowe rating scales.RESULTS In almost all patients,complete soft tissue healing occurred at the site of tissue reattachment,either on the glenoid articular surface or the greater humeral tuberosity.The strongest repair,as confirmed by probe palpation,was encountered at the site of suture passage through the soft tissue.All suture material was covered with bursal synovial tissue,with no cases of knot impingement or cartilage fraying.The mean preoperative and postoperative UCLA scores for rotator cuff repair patients were 1354±3205 and 2931±2898,respectively(P<0.001),whereas for shoulder instability patients,the mean Rowe scores preoperatively and postoperatively were 2591±1338 and 9272±754,respectively(P<0.001).The use of bioabsorbable implants did not cause synovitis or other tissue reactions.CONCLUSION Soft tissue healing in the shoulder is successful and strongest at the site of suture anchor placement.展开更多
Regenerative medicine has attracted increasing attention across diverse organs,including the skin,musculoskeletal tissues,eye,and nervous system,where structural repair is limited.Among these,skin wound care is partic...Regenerative medicine has attracted increasing attention across diverse organs,including the skin,musculoskeletal tissues,eye,and nervous system,where structural repair is limited.Among these,skin wound care is particularly urgent and challenging because diabetic ulcers,pressure injuries,and severe burns often resist standard dressings,debridement,and revascularization,resulting in infection,amputation,and high costs.Platelet-rich plasma(PRP)has gained value because platelets release coordinated growth factors and cytokines(e.g.,platelet-derived growth factor,transforming growth factor-β,vascular endothelial growth factor,epidermal growth factor,fibroblast growth factor,and insulin-like growth factor-1)that modulate hemostasis,inflammation,angiogenesis,fibroplasia,and reepithelialization.PRP provides concentrated multiple growth factors and,owing to its autologous nature,shows low immunogenicity.Even allogeneic or xenogeneic PRP is generally considered to evoke minimal immune responses,positioning PRP as a promising and effective treatment.Recently,diverse platelet derivatives developed through processing and formulation have enabled more efficient applications and long-term storage.Nevertheless,substantial issues remain,including the lack of standardized preparation protocols,unclear dosing and retreatment schedules,potential disease-specific adverse effects,and donor-dependent variability in blood quality.Here,we review plateletmediated mechanisms of wound healing,summarize the efficacy and clinical use of platelet derivatives,and discuss unresolved issues with potential solutions.These insights may support more efficient and effective use of platelets and PRP in wound care while advancing their translation across regenerative medicine.展开更多
Tendon-bone healing remains a significant clinical challenge due to the high risk of re-rupture following injury.While mesenchymal stem cells(MSCs)show great potential in enhancing tendon-bone healing,their clinical a...Tendon-bone healing remains a significant clinical challenge due to the high risk of re-rupture following injury.While mesenchymal stem cells(MSCs)show great potential in enhancing tendon-bone healing,their clinical application is limited by issues such as low delivery efficiency,restricted differentiation potential,and potential immunogenicity.Recently,various strategies combining MSCs with other approaches,such as preconditioning,biomaterial integration,gene modification,and exosome application,have been developed,resulting in improved therapeutic outcomes.This review explored the current methods used to optimize MSC therapy for tendon-bone healing,examining the advantages,disadvantages,and underlying mechanisms of each approach,providing a foundation for future research and clinical applications.展开更多
文摘Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.
基金funded by the Deanship of Scientific Research at King Abdulaziz University,Jeddah,under Grant No.G:534-140-1443.
文摘Objective:To evaluate the effects of a piceatannol-loaded self-nanoemulsifying drug delivery system(PIC-SNEDDS)on wound healing in diabetic rats and its mechanisms of wound healing action.Methods:Diabetes was induced in rats using streptozotocin,after which full-thickness excisional wounds were created.Piceatannol was administered topically either as a raw hydrogel or formulated into a PIC-SNEDDS,which was prepared using an optimized oil-surfactant mixture and incorporated into a hydrogel for application.Wound healing activity was assessed through measurements of wound contraction,oxidative stress biomarkers,and collagen content,along with histological and immunohistochemical evaluation of inflammatory,angiogenic,and remodeling markers.Results:PIC-SNEDDS markedly enhanced diabetic wound healing by promoting epithelial regeneration,granulation tissue formation,epidermal proliferation,and keratinization.The formulation also reduced the expression of pro-inflammatory markers(interleukin-6,nuclear factor-kappa B,and tumor necrosis factor-α)while increasingα-smooth muscle actin,transforming growth factor-β1,vascular endothelial growth factor-A,and hydroxyproline levels.Additionally,it improved antioxidant status by lowering malondialdehyde levels and boosting superoxide dismutase and catalase activity,along with upregulation of COL1A1 mRNA expression.Conclusions:PIC-SNEDDS promotes the healing of diabetic wounds and exhibits anti-inflammatory,antioxidant,pro-collagen,and angiogenic properties.
基金supported by grants from the German Research Foundation (DFG)
文摘Chronic,non-healing wounds represent a significant challenge for healthcare systems worldwide,often requiring significant human and financial resources.Chronic wounds arise from the complex interplay of underlying comorbidities,such as diabetes or vascular diseases,lifestyle factors,and genetic risk profiles which may predispose extremities to local ischemia.Injuries are further exacerbated by bacterial colonization and the formation of biofilms.Infection,consequently,perpetuates a chronic inflammatory microenvironment,preventing the progression and completion of normal wound healing.The current standard of care(SOC)for chronic wounds involves surgical debridement along with localized wound irrigation,which requires inpatient care under general anesthesia.This could be followed by,if necessary,defect coverage via a reconstructive ladder utilizing wound debridement along with skin graft,local,or free flap techniques once the wound conditions are stabilized and adequate blood supply is restored.To promote physiological wound healing,a variety of approaches have been subjected to translational research.Beyond conventional wound healing drugs and devices that currently supplement treatments,cellular and immunotherapies have emerged as promising therapeutics that can behave as tailored therapies with cell-or molecule-specific wound healing properties.However,in contrast to the clinical omnipresence of chronic wound healing disorders,there remains a shortage of studies condensing the current body of evidence on cellular therapies and immunotherapies for chronic wounds.This review provides a comprehensive exploration of current therapies,experimental approaches,and translational studies,offering insights into their efficacy and limitations.Ultimately,we hope this line of research may serve as an evidence-based foundation to guide further experimental and translational approaches and optimize patient care long-term.
基金National Natural Science Foundation of China,No.81873934and Jinan Science and Technology Planning Project,No.202225065.
文摘BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds present significant therapeutic challenges,requiring novel strategies to improve healing outcomes.AIM To investigate the potential of fetal dermal mesenchymal stem cells(FDMSCs)in enhancing wound healing through modulation of macrophage polarization,specifically by promoting the M2 phenotype to address inflammatory responses in chronic wounds.METHODS FDMSCs were isolated from BalB/C mice and co-cultured with RAW264.7 macrophages to assess their effects on macrophage polarization.Flow cytometry,quantitative reverse transcriptase polymerase chain reaction,and histological analyses were employed to evaluate shifts in macrophage phenotype and wound healing in a mouse model.Statistical analysis was performed using GraphPad Prism.RESULTS FDMSCs induced macrophage polarization from the M1 to M2 phenotype,as demonstrated by a reduction in proinflammatory markers(inducible nitric oxide synthase,interleukin-6)and an increase in anti-inflammatory markers[mannose receptor(CD206),arginase-1]in co-cultured RAW264.7 macrophages.These shifts were confirmed by flow cytometry.In an acute skin wound model,FDMSC-treated mice exhibited faster wound healing,enhanced collagen deposition,and improved vascular regeneration compared to controls.Significantly higher expression of arginase-1 further indicated an enriched M2 macrophage environment.CONCLUSION FDMSCs effectively modulate macrophage polarization from M1 to M2,reduce inflammation,and enhance tissue repair,demonstrating their potential as an immunomodulatory strategy in wound healing.These findings highlight the promising therapeutic application of FDMSCs in managing chronic wounds.
基金supported in part by the National Nature Science Foundation of China(92268206,81830064)the CAMS Innovation Fund for Medical Sciences(CIFMS,2019-I2M-5-059)+4 种基金the Military Medical Research Projects(145AKJ260015000X,2022-JCJQ-ZB-09600)the Military Key Basic Research of Foundational Strengthening Program(2020-JCJQ-ZD-256-021)the Science Foundation of National Defense Science and Technology for Excellent Young(2022-JCJQ-ZQ-017)the Military Medical Research and Development Projects(AWS17J005,2019-126)the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province(YSPTZX202317).
文摘Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.Accumulating evidence underscores the potential of targeted modulation of mechanical cues to enhance skin regeneration,promoting scarless repair by influencing the extracellular microenvironment and driving the phenotypic transitions.The field of skin repair and skin appendage regeneration has witnessed remarkable advancements in the utilization of biomaterials with distinct physical properties.However,a comprehensive understanding of the underlying mechanisms remains somewhat elusive,limiting the broader application of these innovations.In this review,we present two promising biomaterial-based mechanical approaches aimed at bolstering the regenerative capacity of compromised skin.The first approach involves leveraging biomaterials with specific biophysical properties to create an optimal scarless environment that supports cellular activities essential for regeneration.The second approach centers on harnessing mechanical forces exerted by biomaterials to enhance cellular plasticity,facilitating efficient cellular reprogramming and,consequently,promoting the regeneration of skin appendages.In summary,the manipulation of mechanical cues using biomaterial-based strategies holds significant promise as a supplementary approach for achieving scarless wound healing,coupled with the restoration of multiple skin appendage functions.
基金supported by the National Natural Science Foundation of China(No.82272297).
文摘Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomimetic scaffold aimed at facilitating rapid and scarless wound healing.This highly in-tegrated 3D-printed dermal scaffold comprised modified recombinant human type III collagen(rhCOLIII-MA),gelatin methacrylate(GelMA),and liposomes encapsulating SB431542 to target TGF-β1(Lip@SB).The rhCOLIII-MA/GelMA(CG)scaffold retained inherent biomaterial characteristics,exhibited tailored physicochemical properties,and demonstrated favorable biocompatibility.Moreover,the Lip@SB-loaded CG scaffold(CGL)effectively promoted in vitro wound healing,while enabling controlled release of SB431542 to inhibit pathological collagen deposition.In a full-thickness skin defect rat model,the CGL dermal scaffold combined with split-thickness skin graft(STSG)minimized scar contraction,stimulated functional neovascularization,and enhanced graft aesthetics comparable to normal skin.Remarkably,the performance of the CGL scaffold surpassed that of commercially available anti-scarring alternatives.This innovative strategy presents a straightforward approach toward scarless skin regeneration and holds promise in alleviating the prolonged,painful postoperative rehabilitation.
文摘BACKGROUND Mucosal healing has become an important goal of Crohn’s disease(CD)treat-ments.Modulen,enriched with transforming growth factor-beta 2,and budeso-nide are commonly accepted treatments for mild-moderate CD.However,their effects on the small bowel(SB)mucosa remain underexplored.AIM To prospectively assess clinical and mucosal responses to Modulen vs budesonide in adults with CD,using SB capsule endoscopy.METHODS Thirty patients were divided into two groups:Modulen+home-based diet(21 patients)and budesonide(9 patients)for an eight-week intervention followed by four weeks of follow-up.Clinical,laboratory,and endoscopic responses were evaluated.The mucosal changes were assessed through SB capsule endoscopy.RESULTS Results indicated significant clinical improvement in the Modulen group with reduced CD activity index(P=0.041)and improved inflammatory bowel disease questionnaire score(P=0.016).Moreover,Modulen was associated with a signifi-cant SB mucosal improvement,evidenced by a decrease in Lewis score(P=0.027).No significant changes were observed in calprotectin or other laboratory parame-ters.Conversely,budesonide exhibited more modest clinical effects,but it improved calprotectin,hemoglobin,and C-reactive protein levels(P=0.051,P=0.014,and P=0.038,respectively).The capsule endoscopy did not reveal a significant mucosal response in the budesonide group.CONCLUSION Both interventions have a role in CD treatment.Yet,their effects differ and may complement each other:Modulen yields clinical and mucosal improvements,while budesonide primarily leads mainly to laboratory improvements.
文摘Loss-of-function variants of low-density lipoprotein receptor-related protein 5(LRP5)can lead to reduced bone formation,culminating in diminished bone mass.Our previous study reported transcription factor osterix(SP7)-binding sites on the LRP5 promoter and its pivotal role in upregulating LRP5 expression during implant osseointegration.However,the potential role of SP7 in ameliorating LRP5-dependent osteoporosis remained unknown.In this study,we used mice with a conditional knockout(c KO)of LRP5 in mature osteoblasts,which presented decreased osteogenesis.The in vitro experimental results showed that SP7 could promote LRP5 expression,thereby upregulating the osteogenic markers such as alkaline phosphatase(ALP),Runt-related transcription factor 2(Runx2),andβ-catenin(P<0.05).For the in vivo experiment,the SP7 overexpression virus was injected into a bone defect model of LRP5 c KO mice,resulting in increased bone mineral density(BMD)(P<0.001)and volumetric density(bone volume(BV)/total volume(TV))(P<0.001),and decreased trabecular separation(Tb.Sp)(P<0.05).These data suggested that SP7 could ameliorate bone defect healing in LRP5 c KO mice.Our study provides new insights into potential therapeutic opportunities for ameliorating LRP5-dependent osteoporosis.
文摘Objective:To evaluate the effectiveness of surgical combination with traditional Chinese medicine dialectical therapy in three phases for the treatment of intertrochanteric fracture of the femur(IFF).Methods:84 patients with IFF admitted to the hospital from December 2022 to December 2024 were selected and randomly divided into two groups using a random number table.The combined group received surgery and traditional Chinese medicine dialectical therapy in three phases,while the control group received surgery alone.The total effective rate,fracture healing time,hip function score,and lower extremity function score were compared between the two groups.Results:The total effective rate was higher in the combined group than in the control group(P<0.05).After treatment,the fracture healing time was shorter in the combined group than in the control group,and the hip function and lower extremity function scores were higher in the combined group than in the control group(P<0.05).Conclusion:Surgical combination with traditional Chinese medicine dialectical therapy in three phases can shorten the fracture healing time of IFF patients and restore their hip and lower extremity function,demonstrating significant efficacy.
基金Supported by Natural Science Foundation of Anhui Medical University,No.2023xkj130.
文摘BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.
基金Supported by the Qilu Medical School Traditional Chinese Medicine Academic School Inheritance Project,No.93 LW[2022]Construction Project of the Inheritance Studio of National Famous Traditional Chinese Medicine Experts,Traditional Chinese Medicine Teaching Letter No.75[2022]Qilu Health and Fitness Talents in 2019,No.3 LWRZ[2020].
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a significant contributor to disability and mortality in diabetic patients.Macrophage polarization and functional regulation are promising areas of research and show therapeutic potential in the field of DFU healing.However,the complex mechanism,the difficulty in clinical translation,and the large heterogeneity present significant challenges.Hence,this study was to comprehensively analyze the publication status and trends of studies on macrophage polarization and DFU healing.AIM To examine the relevant literature on macrophage polarization in DFU healing.METHODS A bibliometric analysis was conducted using the Web of Science database.Relevant literature was retrieved from the Web of Science Core Collection database between 2013 to 2023 using literature visualization and analysis software(VOSviewer and CiteSpace)and bibliometric online platforms.The obtained literature was then subjected to visualization and analysis of different countries/regions,institutions,journals,authors,and keywords to reveal the research’s major trends and focus.RESULTS The number of publications on the role of macrophage polarization in DFU healing increased rapidly from 2013 to 2023,especially in the latter period.Chinese researchers were the most prolific in this field,with 217 publications,while American researchers had been engaged in this field for a longer period.Qian Tan of Nanjing Drum Tower Hospital and Qian Ding of Nanjing University were the first to publish in this field.Shanghai Jiao Tong University was the institution with the most publications(27).The keywords“bone marrow”,“adjustment,replacement,response,tissue repair”,and“activation,repair,differentiation”appeared more frequently.The study of macrophage polarization in DFU healing focused on the regulatory mechanism,gene expression,and other aspects.CONCLUSION This study through the bibliometric method reveals the research trends and development trends in this field of macrophage polarization in DFU healing from 2013 to 2023 in the Web of Science Core Collection database.The key hotspots in this field mainly include the regulation of macrophage activation,gene expression,wound tissue repair,and new wound materials.This study provides references for future research directions.
基金Supported by 2021 Disciplinary Construction Project in School of Dentistry,Anhui Medical University,No.2021kqxkFY05.
文摘BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.
文摘Self-healing hydrogels utilize inherent intermolecular forces to autonomously heal physical damage resulting from excessive strain,pressure,or tearing.Applying these materials in soft robotics and tissue engineering could be beneficial.On the other hand,their efficacy in stretchable and mechanically resistant circuits is hindered by their limited electrical conductivity.
文摘As Thailand and China mark the 50th anniversary of their diplomatic ties this year,most headlines will naturally focus on trade deals,railways,and strategic partnerships.But tucked behind the golden spires of Bangkok’s Wat Po temple lies a quieter,gentler form of diplomacy—one that happens through kneading hands,respectful bows,and an ancient art passed down across generations.At the Wat Po Thai Traditional Medical School,headmaster Serat Tangtrongchitr sees Thai massage not only as a healing craft,but as a cultural bridge—one that connects people across borders,languages,and belief systems.“We don’t just teach massage,”Serat said,his voice calm but assured.“We teach a way of life.And when people from other cultures learn this with us—Chinese students included—they come to understand not just the techniques,but the heart of Thai culture.”
基金Sichuan Provincial Nursing Research Project of the Sichuan Nursing Association in 2023(Project No.:H23028)。
文摘Objective:This study aims to develop an assessment tool for postoperative wound healing in adult patients with benign anal canal and rectal diseases and to validate its reliability and validity.Methods:Based on Levine’s Conservation Model as the theoretical framework,an item pool was formed through literature review,and the initial draft of the scale was refined through two rounds of Delphi expert consultation.A total of 200 postoperative patients were selected for item analysis,internal consistency testing,content validity,and structural validity analysis.Results:The final tool comprises four dimensions:energy conservation,structural integrity,personal integrity,and social integrity,with a total of 24 items.It demonstrates good content validity(I-CVI 0.82-1.00,S-CVI/Ave 0.95,S-CVI/UA 0.87)and excellent internal consistency(Cronbach’sαfor the overall scale was 0.934).Exploratory factor analysis revealed a KMO value of 0.931,Bartlett’s test of sphericityχ^(2)=4147.853(p<0.001),and four common factors were extracted,accounting for a cumulative variance contribution rate of 64.345%,indicating ideal structural validity.Conclusion:The results indicate that the assessment tool has good reliability and validity and can systematically evaluate postoperative wound healing,providing a scientific basis for clinical individualized nursing interventions.
文摘I have never given birth but have heard it said many times that as awful as labor is,when it's over and your newborn is placed in your arms,that pain is forgotten.That's how I feel now about the earliest days of grief.
文摘Objective:To explore the wound healing potential and chemical components of Lindernia ruellioides from Mizoram,India.Methods:Plant extraction was conducted by cold maceration using chloroform,ethanol,and distilled water as solvents.To guarantee the safety of the plant extract,an acute dermal toxicity test was conducted before the experiment.Antioxidant assays were performed.Excision and incision wound models were used to assess the wound healing activities,including wound closure rate,epithelialization period,and tensile strength.A histopathological examination was carried out.Results:Lindernia ruellioides contained bioactive compounds,such as mycolactone F,1-O-octadec-9-enyl glycerol,reserpine,tetracosanoic acid,2-O-caffeoylglucarate and several others which are found to possess various pharmacological activities.Acute dermal toxicity evaluation showed that the doses were deemed safe.Ethanol extract of Lindernia ruellioides(LREE)treatment significantly elevated glutathione,glutathione-S-transferase,and superoxide dismutase,and decreased malondialdehyde in a dose-dependent manner.It showed increased wound contraction rate,shorter epithelialization time,and elevated wound breaking strength in the LREE-treated group when compared with the control.In addition,the histological examination showed enhanced neovascularization,fibroblasts,and collagen in LREE-treated animals.Conclusions:Lindenia ruellioides exhibits remarkable effects on wound healing.The study validates the traditional use of this plant in Mizoram region as a wound-healing agent.
文摘BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to their original attachment site.Soft tissue healing can be evaluated with imaging methods or alternatively with second-look arthroscopy.AIM To investigate shoulder tendon and capsule healing after arthroscopic rotator cuff and instability repair using second-look arthroscopy.METHODS In this study,24 adult patients with rotator cuff tears(13 patients)or anterior shoulder instability(11 patients)were included.All patients were initially subjected to arthroscopic repair using suture anchors and were re-evaluated with second-look arthroscopy for reasons not related to the original pathology.The second operation was performed in 8 patients due to mild but persistent pain or stiffness,in 3 patients for recalcitrant stiffness,in 5 patients for secondary biceps tenotomy,in 6 patients for persistent acromioclavicular joint pain and in 2 patients for suture anchor prominence causing shoulder grinding.Soft tissue healing was evaluated visually and by probing,whereas clinical outcomes were evaluated using the University of California–Los Angeles(UCLA)and Rowe rating scales.RESULTS In almost all patients,complete soft tissue healing occurred at the site of tissue reattachment,either on the glenoid articular surface or the greater humeral tuberosity.The strongest repair,as confirmed by probe palpation,was encountered at the site of suture passage through the soft tissue.All suture material was covered with bursal synovial tissue,with no cases of knot impingement or cartilage fraying.The mean preoperative and postoperative UCLA scores for rotator cuff repair patients were 1354±3205 and 2931±2898,respectively(P<0.001),whereas for shoulder instability patients,the mean Rowe scores preoperatively and postoperatively were 2591±1338 and 9272±754,respectively(P<0.001).The use of bioabsorbable implants did not cause synovitis or other tissue reactions.CONCLUSION Soft tissue healing in the shoulder is successful and strongest at the site of suture anchor placement.
基金funded by the National IT Industry Promotion Agency(NIPA,RQT-25-030567)the National Research Foundation of Korea(NRF-2022R1A2C1003638)+1 种基金the Basic Research Lab Program(2022R1A4A1025557)through the NRF of Koreafunded by the Ministry of Science and ICT.
文摘Regenerative medicine has attracted increasing attention across diverse organs,including the skin,musculoskeletal tissues,eye,and nervous system,where structural repair is limited.Among these,skin wound care is particularly urgent and challenging because diabetic ulcers,pressure injuries,and severe burns often resist standard dressings,debridement,and revascularization,resulting in infection,amputation,and high costs.Platelet-rich plasma(PRP)has gained value because platelets release coordinated growth factors and cytokines(e.g.,platelet-derived growth factor,transforming growth factor-β,vascular endothelial growth factor,epidermal growth factor,fibroblast growth factor,and insulin-like growth factor-1)that modulate hemostasis,inflammation,angiogenesis,fibroplasia,and reepithelialization.PRP provides concentrated multiple growth factors and,owing to its autologous nature,shows low immunogenicity.Even allogeneic or xenogeneic PRP is generally considered to evoke minimal immune responses,positioning PRP as a promising and effective treatment.Recently,diverse platelet derivatives developed through processing and formulation have enabled more efficient applications and long-term storage.Nevertheless,substantial issues remain,including the lack of standardized preparation protocols,unclear dosing and retreatment schedules,potential disease-specific adverse effects,and donor-dependent variability in blood quality.Here,we review plateletmediated mechanisms of wound healing,summarize the efficacy and clinical use of platelet derivatives,and discuss unresolved issues with potential solutions.These insights may support more efficient and effective use of platelets and PRP in wound care while advancing their translation across regenerative medicine.
基金Jinhua Public Welfare Technology Application Research Project,No.2025-4-229Zhejiang Province Medical and Health Science and Technology Plan,No.2022KY1343.
文摘Tendon-bone healing remains a significant clinical challenge due to the high risk of re-rupture following injury.While mesenchymal stem cells(MSCs)show great potential in enhancing tendon-bone healing,their clinical application is limited by issues such as low delivery efficiency,restricted differentiation potential,and potential immunogenicity.Recently,various strategies combining MSCs with other approaches,such as preconditioning,biomaterial integration,gene modification,and exosome application,have been developed,resulting in improved therapeutic outcomes.This review explored the current methods used to optimize MSC therapy for tendon-bone healing,examining the advantages,disadvantages,and underlying mechanisms of each approach,providing a foundation for future research and clinical applications.
