Background:Wound healing is a sophisticated biological process characterized by the orchestrated interplay of diverse cellular components,growth factors,and signaling cascades.Recent research has highlighted the pivot...Background:Wound healing is a sophisticated biological process characterized by the orchestrated interplay of diverse cellular components,growth factors,and signaling cascades.Recent research has highlighted the pivotal role of fibroblast exosomes in mediating intercellular communication and facilitating tissue regeneration.This investigation aimed to elucidate the therapeutic efficacy of fibroblast exosomes in enhancing wound repair mechanisms,with a particular emphasis on their differential effects in normal and diabetic wound healing paradigms.Methods:A mouse full-thickness skin defect model was used to evaluate the effects of fibroblast exosomes on wound re-epithelialization,granulation tissue formation,and epidermal barrier function.Molecular and cellular experiments were conducted to analyze the roles of exosomes in epidermal stem cell proliferation,migration,differentiation,and antioxidant stress,with further validation of the associated signaling pathways.The therapeutic efficacy was additionally confirmed in a type 1 diabetic mouse model.Results:Fibroblast exosomes significantly enhanced wound re-epithelialization by promoting the proliferation,migration,and differentiation of epidermal stem cells.Additionally,exosomes increased fibroblast abundance and myofibroblast activation,facilitating granulation tissue formation as well as improving extracellular matrix(ECM)deposition and the biomechanical properties of healed skin.Furthermore,exosomes improved epidermal barrier function by upregulating tight junction proteins(e.g.Claudin-1 and ZO-1)and reducing transepidermal water loss(TEWL).In diabetic mouse models,exosomes accelerated wound closure,restored ECM deposition and biomechanical integrity,and repaired epidermal barrier function.Mechanistically,exosomes target the 3'untranslated region(UTR)of Keap1 mRNA through miR-29a-3p and activate the KEAP1/Nrf2 antioxidant pathway,mitigating oxidative stress and protecting epidermal stem cells from reactive oxygen species(ROS)-induced damage.Conclusion:Fibroblast exosomes alleviate oxidative damage by modulating the KEAP1/Nrf2 pathway through miR-29a-3p and enhancing epidermal stem cell function.These exosomes exhibit remarkable therapeutic potential in accelerating wound healing and improving healing quality under both normal and diabetic conditions,offering a robust foundation for innovative therapeutic strategies.展开更多
Neuromuscular electrical stimulation(NMES)is a well-established therapeutic approach for chronic wounds.Conventionally,NMES involves direct electrode contact with wounds or adjacent healthy skin;however,it is limited ...Neuromuscular electrical stimulation(NMES)is a well-established therapeutic approach for chronic wounds.Conventionally,NMES involves direct electrode contact with wounds or adjacent healthy skin;however,it is limited by the need for wound exposure and by increased pain.Our preliminary study demonstrated the innovative application of remote NMES(rNMES)to the skeletal muscle of the distal calf,which showed the potential to accelerate wound healing in remote areas.rNMES was effective in human clinical trials in our previous work,although the underlying mechanisms remain unclear.As rNMES is often used to stimulate muscle contraction in long-term bedridden patients,we analyzed data from the Gene Expression Omnibus(GEO)database and found that exercise promotes midkine(MDK)expression in muscle.MDK is a small secreted heparin-binding protein that interacts with multiple cell surface receptors to promote growth.In the present study,we found that MDK significantly enhanced macrophage efferocytosis in a low-density lipoprotein receptor-related protein 1(LRP1)-dependent manner.Our findings demonstrate that rNMES upregulates MDK expression in skeletal muscles through the AMPK-ERK axis,facilitating its delivery to wounds through the circulatory system and promoting LRP1-mediated efferocytosis of apoptotic cells,thereby expediting wound healing.展开更多
Diabetes mellitus is an escalating global health issue,with 463 million adults affected in 2019.Without intervention,this number is projected to increase to 578 million by 2030 and 700 million by 2045[1].Diabetic woun...Diabetes mellitus is an escalating global health issue,with 463 million adults affected in 2019.Without intervention,this number is projected to increase to 578 million by 2030 and 700 million by 2045[1].Diabetic wound,a significant complication,is characterized by delayed healing,high disability rates,and elevated mortality[2].The challenges of wound healing in diabetic patients,compounded by their high morbidity and mortality rates,have drawn growing attention in biomedical research.展开更多
Wound management continues to present major clinical challenges,often necessitating therapeutic strategies that extend beyond conventional dressings,which provide only passive protection.Magnesium(Mg),a biologically i...Wound management continues to present major clinical challenges,often necessitating therapeutic strategies that extend beyond conventional dressings,which provide only passive protection.Magnesium(Mg),a biologically indispensable element,has attracted considerable attention for its multifaceted role in wound repair,including modulation of inflammatory responses,stimulation of fibroblast and keratinocyte proliferation,promotion of angiogenesis,and enhancement of collagen synthesis.However,the direct application of Mg formulations is limited by uncontrolled Mg ion(Mg^(2+))release,localized cytotoxicity at elevated concentrations,and inadequate mechanical stability at the wound site.To address these challenges,Mg-incorporated polymeric scaffolds have been developed as advanced delivery platforms.These systems integrate the regenerative capacity of Mg with the tunable properties of polymers,enabling controlled degradation,mechanical reinforcement,and sustained Mg^(2+)release to establish a favorable microenvironment for tissue repair.This review critically examines the role of Mg in wound healing and the effectiveness of polymeric matrices for controlled Mg^(2+)delivery.It further provides a comprehensive evaluation of recent advances in Mg-incorporated polymeric scaffolds,including nanofibers,hydrogels,and sponges,with emphasis on fabrication strategies,structural characteristics,and therapeutic efficacy.Key challenges,such as optimizing ion release kinetics,enhancing scaffold stability,and facilitating clinical translation,are also discussed.Collectively,this work underscores the potential of Mg-polymeric scaffolds as a next-generation platform for advanced wound care and highlights perspectives for future research and development.展开更多
The development of highly efficient and multifunctional nanozymes holds promise for addressing the challenges posed by drugresistant bacteria.Here,copper single-atom-loaded MoS_(2) nanozymes(CuSAs/MoS_(2))were develop...The development of highly efficient and multifunctional nanozymes holds promise for addressing the challenges posed by drugresistant bacteria.Here,copper single-atom-loaded MoS_(2) nanozymes(CuSAs/MoS_(2))were developed to effectively combat drug-resistant bacteria by synergistically integrating the triple strategies of oxidative damage,cuproptosis-like death and disruption of cell wall synthesis.Density functional theory revealed that each Cu center coordinated with three sulfur ligands,enhancing the adsorption of H_(2)O_(2),which reduced the activation energy of the key step by 17%,thereby improving peroxidase-like(PODlike)activity.The generation of reactive oxygen species in combination with CuSAs/MoS_(2) glutathione peroxidase-like(GSH-Px-like)for glutathione scavenging resulted in an imbalance in redox homeostasis within bacteria.CuSAs/MoS_(2),which act as nanopioneers,drive oxidative stress to initiate the process of cuproptosis-like death,leading to abnormal aggregation of lipoylated proteins and inactivation of iron-sulfur cluster proteins.Moreover,CuSAs/MoS_(2) inhibited the biosynthesis of the peptidoglycan synthesis precursors D-glutamate and m-diaminopimelic acid and disrupted the peptidoglycan cross-linking process mediated by penicillin-binding proteins,effectively blocking the compensatory cell wall remodeling pathway ofβ-lactam-resistant bacteria.Overall,CuSAs/MoS_(2) with multiple functions can not only efficiently kill bacteria but also decelerate the development of bacterial resistance to combat drug-resistant bacterial infections.展开更多
Methicillin-resistant Staphylococcus aureus(MRSA) causes widespread infections and poses serious public health concerns. Its high level of resistance to multiple antibiotics has garnered growing interest in identifyin...Methicillin-resistant Staphylococcus aureus(MRSA) causes widespread infections and poses serious public health concerns. Its high level of resistance to multiple antibiotics has garnered growing interest in identifying and applying novel antibacterial compounds derived from natural sources. In this study, we purified a biosurfactant(BS) from Bacillus rugosus HH2 to develop a natural antibacterial agent. This agent was then reinforced with chitooligosaccharide(COS) and polyvinyl alcohol(PVA) to create a hydrogel that promoted healing in MRSA-infected wounds. The COS/PVA/BS hydrogel was readily fabricated via the freeze-thaw method and demonstrated excellent mechanical strength, biological activity,and biocompatibility. In vitro assays confirmed that the hydrogel significantly enhanced the proliferation, migration, angiogenesis, and extracellular matrix deposition of fibroblasts,keratinocytes, and endothelial cells. Moreover, it exhibited strong bacteriostatic and bactericidal activities against MRSA, along with potent antibiofilm activity and inhibition of virulence factors relevant to MRSA-induced wound infections. Its anti-virulence effects have been linked to the downregulation of quorum sensing and virulence-related genes in MRSA. In an in vivo model of MRSA-induced infection, the COS/PVA/BS hydrogel significantly accelerated wound healing and markedly reduced the MRSA burden. Immunofluorescence staining confirmed enhanced neovascularization and regulated macrophage responses,underscoring the angiogenic and immunomodulatory effects of the hydrogel. Overall,the COS/PVA/BS hydrogel represents a promising therapeutic strategy for addressing antibiotic-resistant bacterial infections and promoting wound repair, supported by the use of common raw materials, a simple fabrication process, and high-yield production of natural antibacterial agents.展开更多
Burn infection is one of the most common and severe complications in burn patients and a major factor contributing to high mortality rates.The loss of skin barrier function and the immunosuppressive state following bu...Burn infection is one of the most common and severe complications in burn patients and a major factor contributing to high mortality rates.The loss of skin barrier function and the immunosuppressive state following burns make patients highly susceptible to wound infections,which can progress to systemic sepsis.Although burn wounds are initially sterile,they are rapidly colonized by Gram-positive bacteria(e.g.,Staphylococcus aureus)within a short period,followed by colonization with Gram-negative bacteria(e.g.,Pseudomonas aeruginosa),thereby increasing therapeutic challenges.Current clinical management relies on a multidisciplinary collaborative approach,combining conventional antibiotics,emerging therapies,and comprehensive care strategies.Among these methods,early intervention,precise treatment administration,and prevention and control are critical to improving patient survival and prognosis.In recent years,drug-loaded hydrogels,as a class of wound repair materials characterized by biocompatibility,controlled drug release,and multifunctional integration,have demonstrated significant advantages in the treatment of burn infections.They can effectively inhibit pathogenic microorganisms,alleviate inflammation,and promote tissue regeneration.This review systematically summarizes recent research advances in the application of drug-loaded hydrogels for the treatment of infected burn wounds,aiming to provide a reference for their further development and clinical translation.展开更多
Debate over the benefits and harms of icing acute muscle injuries remains unresolved.Some contend that ice is ineffective or even harmful,while others promote cryotherapy as a universal remedy.Centrists,often academic...Debate over the benefits and harms of icing acute muscle injuries remains unresolved.Some contend that ice is ineffective or even harmful,while others promote cryotherapy as a universal remedy.Centrists,often academics,call for more high-quality randomized controlled trials(RCTs)to resolve the issue.This viewpoint reframes the debate around 3 key points:first,although ice produces analgesia,evidence for sustained pain relief,beyond the immediate post-treatment period.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
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
The inherent oxygen sensitivity of hydrogenases has limited their biomedical use.We report a hybrid peptide-nanocluster hydrogel that establishes a self-sustained anaerobic microenvironment,enabling hydrogenase-cataly...The inherent oxygen sensitivity of hydrogenases has limited their biomedical use.We report a hybrid peptide-nanocluster hydrogel that establishes a self-sustained anaerobic microenvironment,enabling hydrogenase-catalyzed hydrogen therapy under aerobic conditions.The Fmoc-KYF peptide network traps O_(2) in hydrophobic pockets,while photoexcited silver nanoclusters rapidly scavenge residual oxygen,ensuring stable hydrogen evolution.In vitro,the generated hydrogen mitigates oxidative stress and inflammation.In diabetic mice,the light-activated system accelerates wound closure,promotes angiogenesis,and drives macrophage polarization toward a reparative phenotype.This study introduces a bioengineering strategy that integrates material design,enzyme catalysis,and photodynamics to overcome oxygen limitation and advance hydrogenase-based therapeutic applications.展开更多
International patients are flocking to Hainan for healing through the ancient technique of traditional Chinese medicine.SAREN,a traditional Chinese medicine(TCM)doctor,keeps vipbooks filled with warm messages in var...International patients are flocking to Hainan for healing through the ancient technique of traditional Chinese medicine.SAREN,a traditional Chinese medicine(TCM)doctor,keeps vipbooks filled with warm messages in various languages in her consulting room at Sanya International Friendship Sanatorium of TCM.These expressions of gratitude not only document a long medical career,but also vividly testify to how a Chinese doctor has used acupuncture to cure patients from around the world.展开更多
Objective:To analyze the clinical application value of autologous periosteum graft combined with platelet-rich plasma(PRP)in the treatment of long bone fractures in the extremities.Methods:A total of 40 patients with ...Objective:To analyze the clinical application value of autologous periosteum graft combined with platelet-rich plasma(PRP)in the treatment of long bone fractures in the extremities.Methods:A total of 40 patients with long bone fractures in the extremities admitted to Santai Hospital Affiliated to North Sichuan Medical College from January 2023 to January 2025 were included,including cases of upper extremity forearm fractures and lower extremity femoral and tibial fractures.The patients were evenly divided using a random number table,with the control group undergoing open reduction and internal fixation(ORIF)combined with autologous periosteum graft,and the observation group undergoing ORIF,autologous periosteum graft,and PRP injection.Surgical indicators,complication rates,excellent fracture healing rates,functional satisfaction,and joint range of motion were compared between the two groups.Results:The surgical indicators in the observation group were similar to those in the control group(p>0.05).The complication rate in the observation group was lower than that in the control group,while the excellent fracture healing rate and functional satisfaction were higher in the observation group(p<0.05).Conclusion:Autologous periosteum graft combined with PRP technology is safe and reliable for the treatment of long bone fractures in the extremities,with satisfactory clinical outcomes.展开更多
This study presents a physics-informed modelling framework that combines finite element method(FEM)simulations and supervised machine learning(ML)to predict the self-healing performance of microbial concrete.A FEniCS-...This study presents a physics-informed modelling framework that combines finite element method(FEM)simulations and supervised machine learning(ML)to predict the self-healing performance of microbial concrete.A FEniCS-based FEM platform resolves multiphysics phenomena including nutrient diffusion,microbial CaCO_(3) precipitation,and stiffness recovery.These simulations,together with experimental data,are used to train ML models(Random Forest yielding normalized RMSE≈0.10)capable of predicting performance over a wide range of design parameters.Feature importance analysis identifies curing temperature,calcium carbonate precipitation rate,crack width,bacterial strain,and encapsulation method as the most influential parameters.The coupled FEM-ML approach enables sensitivity analysis,design optimization,and prediction beyond the training dataset(consistently exceeding 90%healing efficiency).Experimental validation confirms model robustness in both crack closure and strength recovery.This FEM–ML pipeline thus offers a generalizable,interpretable,and scalable strategy for the design of intelligent,self-adaptive construction materials.展开更多
One of the key challenges for underground rock reservoirs is ensuring prevention of the unwanted fluid leakage through rock fracture networks during their service life.Microbial-induced calcium carbonate precipitation...One of the key challenges for underground rock reservoirs is ensuring prevention of the unwanted fluid leakage through rock fracture networks during their service life.Microbial-induced calcium carbonate precipitation(MICP)technology has emerged as a promising bio-healing method for rock fractures with small apertures.In this study,a new“three-stage”injection strategy-based MICP(TS-MICP)bio-healing method was proposed,aiming to achieve a“three-high”performance that includes high bridging rate,high mechanical strength,and high homogeneity.A series of meter-scale rock fracture models were prepared to conduct TS-MICP grouting tests.Compared with the traditional injection strategy-based biohealing methods,the TS-MICP method significantly improved the bridging rate(32.1%e89.5%),mechanical properties(0.138e1.023 MPa),and homogeneity of CaCO_(3)precipitation(334.4%).Additionally,it achieved a higher material utilization rate(1.72 times higher),reducing the consumption of cementation solution(CS)by 258.8%,thereby demonstrating greater potential for field applications.The underlying mechanism for achieving high bridging rate and high homogeneity in CaCO_(3)precipitation can be attributed to the synergistic effects of the coupling injection strategy,which optimizes the advantages at each stage.In stage I,under the influence of gravity,the rapid flocculation and hydrogen bonding interactions of organic matter lead to formation of the dense and high-strength CaCO_(3)precipitation at the bottom using a low-concentration bacterial suspension(BS).This process establishes bridging steps along the wall sides for subsequent uniform CaCO_(3)precipitation.In stage II,concentrated BS is utilized to produce looser CaCO_(3)flocculation,which precipitates uniformly on the pre-existing bridging steps.In stage III,a two-step injection strategy was employed to reinforce the loose CaCO_(3)crystals formed in stages I and II,and finally forms a strong bridging effect with“three-high”performance.展开更多
Advanced age impairs bone fracture healing;the underlying mechanism of this phenomenon remains unknown.We determined that apolipoprotein E(ApoE)increases with age and causes poor fracture healing.After deletion of hep...Advanced age impairs bone fracture healing;the underlying mechanism of this phenomenon remains unknown.We determined that apolipoprotein E(ApoE)increases with age and causes poor fracture healing.After deletion of hepatic ApoE expression(ΔApoE),24-month-oldΔApoE mice displayed a 95%reduction in circulating ApoE levels and significantly improved fracture healing.ApoE treatment of aged BMSCs inhibited osteoblast differentiation in tissue culture models;RNA-seq,Western blot,immunofluorescence,and RT-PCR analyses indicated that the Wnt/β-catenin pathway is the target of this inhibition.Indeed,we showed that ApoE had no effect on cultures with stabilizedβ-catenin levels.Next,we determined that Lrp4 serves as the osteoblast cell surface receptor to ApoE,as expression of Lrp4 is required in ApoE-based inhibition of Wnt/β-catenin signaling and osteoblast differentiation.Importantly,we validated this ApoE-Lrp4-Wnt/β-catenin molecular mechanism in human osteoblast differentiation.Finally,we identified an ApoE-neutralizing antibody(NAb)and used it to treat aged,wildtype mice 3 days after fracture surgery resulting in fracture calluses with 35%more bone deposition.Our work here identifies novel liver-to-bone cross-talk and a noninvasive,translatable therapeutic intervention for aged bone regeneration.展开更多
In the northeastern and southwestern areas of the Ogcheon folded belt where Mesozoic granites are distributed,healed microcracks and fluid inclusions in the granite bodies were measured to elucidate the paleostress fi...In the northeastern and southwestern areas of the Ogcheon folded belt where Mesozoic granites are distributed,healed microcracks and fluid inclusions in the granite bodies were measured to elucidate the paleostress field that acted on these areas.The predominant orientations of healed microcracks in the northeastern and southwestern areas of the Ogcheon folded belt are the N50°W for the Inje granite,N30°W for the Jecheon granite,N55°W for the Wolaksan granite,N5°W for the Sokrisan granite,N30°W for the Daebo granite,and N70°W for the foliated granite.The homogenization and trapping temperatures of fluid inclusions in the Jecheon granite are 170–290°C and 260–390°C,respectively,and the formation period of healed microcracks is estimated to be 209–149 Ma.In the Inje granite,the homogenization and trapping temperatures of fluid inclusions are 165–290°C and 250–400°C,respectively,and the formation period of healed microcracks is estimated to be 176–160 Ma.In the Wolaksan granite,the homogenization and trapping temperatures of fluid inclusions are 165–375°C and 230–570°C,respectively,and the formation period of healed microcracks is estimated to be 116–88 Ma.In the Sokrisan granite,the homogenization and trapping temperatures of fluid inclusions are 155–280°C and 210–410°C,respectively,and the formation period of healed microcracks is estimated to be 92–84 Ma.In the foliated granite,the homogenization and trapping temperatures of fluid inclusions are 150–310°C and 380–550°C,respectively,and the formation period of healed microcracks is estimated to be 120–166 Ma.In the Daebo granite,the homogenization and trapping temperatures of fluid inclusions are 150–320°C and 380–440°C,respectively,and the formation period of healed microcracks is estimated to be 183–166 Ma.Consequently,during the Mesozoic,the predominant maximum horizontal stress direction in the Korean Peninsula was NW-SE,with secondary influences from N-S and E-W directions.Moreover,the direction of these maximum horizontal stresses is thought to have rotated from NW–SE to N–S around the mid Cretaceous period.The directions and formation periods of healed microcracks in the study area coincide well with the Mesozoic orogenies of the Korean Peninsula.The Daebo orogeny of the Jurassic to early Cretaceous mainly influenced the Jecheon granite,Inje granite,Wolaksan granite,foliated granite,and Daebo granite in the NW-SE direction,while the Bulguksa orogeny of the mid to late Cretaceous mainly influenced the Sokrisan granite in the N-S direction.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficu...Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.展开更多
基金supported by grants from the National Natural Sciences Foundation of China(No.81630055 and No.81920108022 to GXL,No.82172232,No.31872742 and No.82472568 to WFH)the Military Medical Science and Technology Youth Training Program of the Army Military Medical University(Third Military Medical University)(No.20QNPY024 to WFH)the Special Project for Enhancing Science and Technology Innovation Ability(frontier exploration)of the Army Military Medical University(Third Military Medical University)(No.2019XQY12 to WFH).
文摘Background:Wound healing is a sophisticated biological process characterized by the orchestrated interplay of diverse cellular components,growth factors,and signaling cascades.Recent research has highlighted the pivotal role of fibroblast exosomes in mediating intercellular communication and facilitating tissue regeneration.This investigation aimed to elucidate the therapeutic efficacy of fibroblast exosomes in enhancing wound repair mechanisms,with a particular emphasis on their differential effects in normal and diabetic wound healing paradigms.Methods:A mouse full-thickness skin defect model was used to evaluate the effects of fibroblast exosomes on wound re-epithelialization,granulation tissue formation,and epidermal barrier function.Molecular and cellular experiments were conducted to analyze the roles of exosomes in epidermal stem cell proliferation,migration,differentiation,and antioxidant stress,with further validation of the associated signaling pathways.The therapeutic efficacy was additionally confirmed in a type 1 diabetic mouse model.Results:Fibroblast exosomes significantly enhanced wound re-epithelialization by promoting the proliferation,migration,and differentiation of epidermal stem cells.Additionally,exosomes increased fibroblast abundance and myofibroblast activation,facilitating granulation tissue formation as well as improving extracellular matrix(ECM)deposition and the biomechanical properties of healed skin.Furthermore,exosomes improved epidermal barrier function by upregulating tight junction proteins(e.g.Claudin-1 and ZO-1)and reducing transepidermal water loss(TEWL).In diabetic mouse models,exosomes accelerated wound closure,restored ECM deposition and biomechanical integrity,and repaired epidermal barrier function.Mechanistically,exosomes target the 3'untranslated region(UTR)of Keap1 mRNA through miR-29a-3p and activate the KEAP1/Nrf2 antioxidant pathway,mitigating oxidative stress and protecting epidermal stem cells from reactive oxygen species(ROS)-induced damage.Conclusion:Fibroblast exosomes alleviate oxidative damage by modulating the KEAP1/Nrf2 pathway through miR-29a-3p and enhancing epidermal stem cell function.These exosomes exhibit remarkable therapeutic potential in accelerating wound healing and improving healing quality under both normal and diabetic conditions,offering a robust foundation for innovative therapeutic strategies.
基金supported by the National Natural Science Foundation of China(Grant No.82271252 to W.L.,No.8217091029 to T.W.and No.82204542 to L.H.)the Key Medical Research Projects of Jiangsu Health and Health Commission(Grant No.K2023066 to L.Z.)the Taishan Industrial Talent Project(Grant No.2020-371722-73-03-097290 to W.L.).
文摘Neuromuscular electrical stimulation(NMES)is a well-established therapeutic approach for chronic wounds.Conventionally,NMES involves direct electrode contact with wounds or adjacent healthy skin;however,it is limited by the need for wound exposure and by increased pain.Our preliminary study demonstrated the innovative application of remote NMES(rNMES)to the skeletal muscle of the distal calf,which showed the potential to accelerate wound healing in remote areas.rNMES was effective in human clinical trials in our previous work,although the underlying mechanisms remain unclear.As rNMES is often used to stimulate muscle contraction in long-term bedridden patients,we analyzed data from the Gene Expression Omnibus(GEO)database and found that exercise promotes midkine(MDK)expression in muscle.MDK is a small secreted heparin-binding protein that interacts with multiple cell surface receptors to promote growth.In the present study,we found that MDK significantly enhanced macrophage efferocytosis in a low-density lipoprotein receptor-related protein 1(LRP1)-dependent manner.Our findings demonstrate that rNMES upregulates MDK expression in skeletal muscles through the AMPK-ERK axis,facilitating its delivery to wounds through the circulatory system and promoting LRP1-mediated efferocytosis of apoptotic cells,thereby expediting wound healing.
基金supported by a grant from General Scientific Research Project of Zhejiang Provincial Department of Education(No.Y202455614).
文摘Diabetes mellitus is an escalating global health issue,with 463 million adults affected in 2019.Without intervention,this number is projected to increase to 578 million by 2030 and 700 million by 2045[1].Diabetic wound,a significant complication,is characterized by delayed healing,high disability rates,and elevated mortality[2].The challenges of wound healing in diabetic patients,compounded by their high morbidity and mortality rates,have drawn growing attention in biomedical research.
文摘Wound management continues to present major clinical challenges,often necessitating therapeutic strategies that extend beyond conventional dressings,which provide only passive protection.Magnesium(Mg),a biologically indispensable element,has attracted considerable attention for its multifaceted role in wound repair,including modulation of inflammatory responses,stimulation of fibroblast and keratinocyte proliferation,promotion of angiogenesis,and enhancement of collagen synthesis.However,the direct application of Mg formulations is limited by uncontrolled Mg ion(Mg^(2+))release,localized cytotoxicity at elevated concentrations,and inadequate mechanical stability at the wound site.To address these challenges,Mg-incorporated polymeric scaffolds have been developed as advanced delivery platforms.These systems integrate the regenerative capacity of Mg with the tunable properties of polymers,enabling controlled degradation,mechanical reinforcement,and sustained Mg^(2+)release to establish a favorable microenvironment for tissue repair.This review critically examines the role of Mg in wound healing and the effectiveness of polymeric matrices for controlled Mg^(2+)delivery.It further provides a comprehensive evaluation of recent advances in Mg-incorporated polymeric scaffolds,including nanofibers,hydrogels,and sponges,with emphasis on fabrication strategies,structural characteristics,and therapeutic efficacy.Key challenges,such as optimizing ion release kinetics,enhancing scaffold stability,and facilitating clinical translation,are also discussed.Collectively,this work underscores the potential of Mg-polymeric scaffolds as a next-generation platform for advanced wound care and highlights perspectives for future research and development.
基金supported by the National Natural Science Foundation of China(82372552)the Excellent Youth of Natural Science Research Projects in Anhui Province Universities(2023AH030060)+1 种基金Anhui Provincial Natural Science Foundation(2408085Y016)Anhui Province Excellent Research and Innovation Team Project(2024AH010013)。
文摘The development of highly efficient and multifunctional nanozymes holds promise for addressing the challenges posed by drugresistant bacteria.Here,copper single-atom-loaded MoS_(2) nanozymes(CuSAs/MoS_(2))were developed to effectively combat drug-resistant bacteria by synergistically integrating the triple strategies of oxidative damage,cuproptosis-like death and disruption of cell wall synthesis.Density functional theory revealed that each Cu center coordinated with three sulfur ligands,enhancing the adsorption of H_(2)O_(2),which reduced the activation energy of the key step by 17%,thereby improving peroxidase-like(PODlike)activity.The generation of reactive oxygen species in combination with CuSAs/MoS_(2) glutathione peroxidase-like(GSH-Px-like)for glutathione scavenging resulted in an imbalance in redox homeostasis within bacteria.CuSAs/MoS_(2),which act as nanopioneers,drive oxidative stress to initiate the process of cuproptosis-like death,leading to abnormal aggregation of lipoylated proteins and inactivation of iron-sulfur cluster proteins.Moreover,CuSAs/MoS_(2) inhibited the biosynthesis of the peptidoglycan synthesis precursors D-glutamate and m-diaminopimelic acid and disrupted the peptidoglycan cross-linking process mediated by penicillin-binding proteins,effectively blocking the compensatory cell wall remodeling pathway ofβ-lactam-resistant bacteria.Overall,CuSAs/MoS_(2) with multiple functions can not only efficiently kill bacteria but also decelerate the development of bacterial resistance to combat drug-resistant bacterial infections.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education (RS-2021-NR060118,RS-2024-00408404, and RS-2025-00555808)supported by the Korea Institute of Marine Science&Technology Promotion (KIMST)funded by the Ministry of Oceans and Fisheries (RS-2024-00404977)。
文摘Methicillin-resistant Staphylococcus aureus(MRSA) causes widespread infections and poses serious public health concerns. Its high level of resistance to multiple antibiotics has garnered growing interest in identifying and applying novel antibacterial compounds derived from natural sources. In this study, we purified a biosurfactant(BS) from Bacillus rugosus HH2 to develop a natural antibacterial agent. This agent was then reinforced with chitooligosaccharide(COS) and polyvinyl alcohol(PVA) to create a hydrogel that promoted healing in MRSA-infected wounds. The COS/PVA/BS hydrogel was readily fabricated via the freeze-thaw method and demonstrated excellent mechanical strength, biological activity,and biocompatibility. In vitro assays confirmed that the hydrogel significantly enhanced the proliferation, migration, angiogenesis, and extracellular matrix deposition of fibroblasts,keratinocytes, and endothelial cells. Moreover, it exhibited strong bacteriostatic and bactericidal activities against MRSA, along with potent antibiofilm activity and inhibition of virulence factors relevant to MRSA-induced wound infections. Its anti-virulence effects have been linked to the downregulation of quorum sensing and virulence-related genes in MRSA. In an in vivo model of MRSA-induced infection, the COS/PVA/BS hydrogel significantly accelerated wound healing and markedly reduced the MRSA burden. Immunofluorescence staining confirmed enhanced neovascularization and regulated macrophage responses,underscoring the angiogenic and immunomodulatory effects of the hydrogel. Overall,the COS/PVA/BS hydrogel represents a promising therapeutic strategy for addressing antibiotic-resistant bacterial infections and promoting wound repair, supported by the use of common raw materials, a simple fabrication process, and high-yield production of natural antibacterial agents.
基金Supported by Natural Science Foundation of Guangxi(2025GXNSFHA069111,2020GXNSFAA159033,2019GXNSFAA245078)National Undergraduate Innovation and Entrepreneurship Training Program(202410601054).
文摘Burn infection is one of the most common and severe complications in burn patients and a major factor contributing to high mortality rates.The loss of skin barrier function and the immunosuppressive state following burns make patients highly susceptible to wound infections,which can progress to systemic sepsis.Although burn wounds are initially sterile,they are rapidly colonized by Gram-positive bacteria(e.g.,Staphylococcus aureus)within a short period,followed by colonization with Gram-negative bacteria(e.g.,Pseudomonas aeruginosa),thereby increasing therapeutic challenges.Current clinical management relies on a multidisciplinary collaborative approach,combining conventional antibiotics,emerging therapies,and comprehensive care strategies.Among these methods,early intervention,precise treatment administration,and prevention and control are critical to improving patient survival and prognosis.In recent years,drug-loaded hydrogels,as a class of wound repair materials characterized by biocompatibility,controlled drug release,and multifunctional integration,have demonstrated significant advantages in the treatment of burn infections.They can effectively inhibit pathogenic microorganisms,alleviate inflammation,and promote tissue regeneration.This review systematically summarizes recent research advances in the application of drug-loaded hydrogels for the treatment of infected burn wounds,aiming to provide a reference for their further development and clinical translation.
文摘Debate over the benefits and harms of icing acute muscle injuries remains unresolved.Some contend that ice is ineffective or even harmful,while others promote cryotherapy as a universal remedy.Centrists,often academics,call for more high-quality randomized controlled trials(RCTs)to resolve the issue.This viewpoint reframes the debate around 3 key points:first,although ice produces analgesia,evidence for sustained pain relief,beyond the immediate post-treatment period.
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.
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.
文摘International patients are flocking to Hainan for healing through the ancient technique of traditional Chinese medicine.SAREN,a traditional Chinese medicine(TCM)doctor,keeps vipbooks filled with warm messages in various languages in her consulting room at Sanya International Friendship Sanatorium of TCM.These expressions of gratitude not only document a long medical career,but also vividly testify to how a Chinese doctor has used acupuncture to cure patients from around the world.
文摘Objective:To analyze the clinical application value of autologous periosteum graft combined with platelet-rich plasma(PRP)in the treatment of long bone fractures in the extremities.Methods:A total of 40 patients with long bone fractures in the extremities admitted to Santai Hospital Affiliated to North Sichuan Medical College from January 2023 to January 2025 were included,including cases of upper extremity forearm fractures and lower extremity femoral and tibial fractures.The patients were evenly divided using a random number table,with the control group undergoing open reduction and internal fixation(ORIF)combined with autologous periosteum graft,and the observation group undergoing ORIF,autologous periosteum graft,and PRP injection.Surgical indicators,complication rates,excellent fracture healing rates,functional satisfaction,and joint range of motion were compared between the two groups.Results:The surgical indicators in the observation group were similar to those in the control group(p>0.05).The complication rate in the observation group was lower than that in the control group,while the excellent fracture healing rate and functional satisfaction were higher in the observation group(p<0.05).Conclusion:Autologous periosteum graft combined with PRP technology is safe and reliable for the treatment of long bone fractures in the extremities,with satisfactory clinical outcomes.
基金funding from the European Union’s Horizon 2020 Research and Innovation Programme under the Marie Skłodowska-Curie Grant Agreement No.945478(SASPRO2)supported by the ReBuilt project:Circular and Digital Renewal of Central Europe Construction and Building Sector CE0100390 ReBuiltthe Slovak Research and Development Agency under APVV-23-0383 and the Slovak Grant Agency VEGA No.2/0080/24.
文摘This study presents a physics-informed modelling framework that combines finite element method(FEM)simulations and supervised machine learning(ML)to predict the self-healing performance of microbial concrete.A FEniCS-based FEM platform resolves multiphysics phenomena including nutrient diffusion,microbial CaCO_(3) precipitation,and stiffness recovery.These simulations,together with experimental data,are used to train ML models(Random Forest yielding normalized RMSE≈0.10)capable of predicting performance over a wide range of design parameters.Feature importance analysis identifies curing temperature,calcium carbonate precipitation rate,crack width,bacterial strain,and encapsulation method as the most influential parameters.The coupled FEM-ML approach enables sensitivity analysis,design optimization,and prediction beyond the training dataset(consistently exceeding 90%healing efficiency).Experimental validation confirms model robustness in both crack closure and strength recovery.This FEM–ML pipeline thus offers a generalizable,interpretable,and scalable strategy for the design of intelligent,self-adaptive construction materials.
基金supported by the National Key Research and Development Program of China(Grant No.2023YFC3007102)the National Natural Science Foundation of China(Grant Nos.42477188 and 41925012).
文摘One of the key challenges for underground rock reservoirs is ensuring prevention of the unwanted fluid leakage through rock fracture networks during their service life.Microbial-induced calcium carbonate precipitation(MICP)technology has emerged as a promising bio-healing method for rock fractures with small apertures.In this study,a new“three-stage”injection strategy-based MICP(TS-MICP)bio-healing method was proposed,aiming to achieve a“three-high”performance that includes high bridging rate,high mechanical strength,and high homogeneity.A series of meter-scale rock fracture models were prepared to conduct TS-MICP grouting tests.Compared with the traditional injection strategy-based biohealing methods,the TS-MICP method significantly improved the bridging rate(32.1%e89.5%),mechanical properties(0.138e1.023 MPa),and homogeneity of CaCO_(3)precipitation(334.4%).Additionally,it achieved a higher material utilization rate(1.72 times higher),reducing the consumption of cementation solution(CS)by 258.8%,thereby demonstrating greater potential for field applications.The underlying mechanism for achieving high bridging rate and high homogeneity in CaCO_(3)precipitation can be attributed to the synergistic effects of the coupling injection strategy,which optimizes the advantages at each stage.In stage I,under the influence of gravity,the rapid flocculation and hydrogen bonding interactions of organic matter lead to formation of the dense and high-strength CaCO_(3)precipitation at the bottom using a low-concentration bacterial suspension(BS).This process establishes bridging steps along the wall sides for subsequent uniform CaCO_(3)precipitation.In stage II,concentrated BS is utilized to produce looser CaCO_(3)flocculation,which precipitates uniformly on the pre-existing bridging steps.In stage III,a two-step injection strategy was employed to reinforce the loose CaCO_(3)crystals formed in stages I and II,and finally forms a strong bridging effect with“three-high”performance.
基金supported by a Borden Scholars awardDuke Claude D.Pepper Older Americans Independence Center Pilot Award(P30AG028716)by the NIH/NIA(R01AG081393)。
文摘Advanced age impairs bone fracture healing;the underlying mechanism of this phenomenon remains unknown.We determined that apolipoprotein E(ApoE)increases with age and causes poor fracture healing.After deletion of hepatic ApoE expression(ΔApoE),24-month-oldΔApoE mice displayed a 95%reduction in circulating ApoE levels and significantly improved fracture healing.ApoE treatment of aged BMSCs inhibited osteoblast differentiation in tissue culture models;RNA-seq,Western blot,immunofluorescence,and RT-PCR analyses indicated that the Wnt/β-catenin pathway is the target of this inhibition.Indeed,we showed that ApoE had no effect on cultures with stabilizedβ-catenin levels.Next,we determined that Lrp4 serves as the osteoblast cell surface receptor to ApoE,as expression of Lrp4 is required in ApoE-based inhibition of Wnt/β-catenin signaling and osteoblast differentiation.Importantly,we validated this ApoE-Lrp4-Wnt/β-catenin molecular mechanism in human osteoblast differentiation.Finally,we identified an ApoE-neutralizing antibody(NAb)and used it to treat aged,wildtype mice 3 days after fracture surgery resulting in fracture calluses with 35%more bone deposition.Our work here identifies novel liver-to-bone cross-talk and a noninvasive,translatable therapeutic intervention for aged bone regeneration.
文摘In the northeastern and southwestern areas of the Ogcheon folded belt where Mesozoic granites are distributed,healed microcracks and fluid inclusions in the granite bodies were measured to elucidate the paleostress field that acted on these areas.The predominant orientations of healed microcracks in the northeastern and southwestern areas of the Ogcheon folded belt are the N50°W for the Inje granite,N30°W for the Jecheon granite,N55°W for the Wolaksan granite,N5°W for the Sokrisan granite,N30°W for the Daebo granite,and N70°W for the foliated granite.The homogenization and trapping temperatures of fluid inclusions in the Jecheon granite are 170–290°C and 260–390°C,respectively,and the formation period of healed microcracks is estimated to be 209–149 Ma.In the Inje granite,the homogenization and trapping temperatures of fluid inclusions are 165–290°C and 250–400°C,respectively,and the formation period of healed microcracks is estimated to be 176–160 Ma.In the Wolaksan granite,the homogenization and trapping temperatures of fluid inclusions are 165–375°C and 230–570°C,respectively,and the formation period of healed microcracks is estimated to be 116–88 Ma.In the Sokrisan granite,the homogenization and trapping temperatures of fluid inclusions are 155–280°C and 210–410°C,respectively,and the formation period of healed microcracks is estimated to be 92–84 Ma.In the foliated granite,the homogenization and trapping temperatures of fluid inclusions are 150–310°C and 380–550°C,respectively,and the formation period of healed microcracks is estimated to be 120–166 Ma.In the Daebo granite,the homogenization and trapping temperatures of fluid inclusions are 150–320°C and 380–440°C,respectively,and the formation period of healed microcracks is estimated to be 183–166 Ma.Consequently,during the Mesozoic,the predominant maximum horizontal stress direction in the Korean Peninsula was NW-SE,with secondary influences from N-S and E-W directions.Moreover,the direction of these maximum horizontal stresses is thought to have rotated from NW–SE to N–S around the mid Cretaceous period.The directions and formation periods of healed microcracks in the study area coincide well with the Mesozoic orogenies of the Korean Peninsula.The Daebo orogeny of the Jurassic to early Cretaceous mainly influenced the Jecheon granite,Inje granite,Wolaksan granite,foliated granite,and Daebo granite in the NW-SE direction,while the Bulguksa orogeny of the mid to late Cretaceous mainly influenced the Sokrisan granite in the N-S direction.
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
基金supports received from Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)+3 种基金the Natural Science Foundation of Liaoning Province(Grant No.2024-MS-075)the National Natural Science Foundation of China(32201179)National Key R&D Program of China(2023YFC2508200)Liaoning Provincial Natural Science Foundation Joint Fund(General Support Program Project)(2023-MSBA-093).
文摘Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.
