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
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
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
Diabetic wounds present challenges in clinical management due to persistent inflammation caused by excessive exudate infiltration.Inspired by the gradient wettability of cactus thorn,this study has devised a biomimeti...Diabetic wounds present challenges in clinical management due to persistent inflammation caused by excessive exudate infiltration.Inspired by the gradient wettability of cactus thorn,this study has devised a biomimetic Janus nanofiber membrane as a water diode,which endows with gradient wettability and gradient pore size,offering sustainable unidirectional self-drainage and antibacterial properties for enhanced diabetic wound healing.The Janus membrane is fabricated by depositing a hydrophilic polyacrylonitrile/chlorin e6 layer with smaller pore sizes onto a hydrophobic poly(ε-caprolactone)with larger pore sizes,thereby generating a vertical gradient in both wettability and pore structure.The incorporation of chlorin e6 in the upper layer enables the utilization of external light energy to generate heat for evaporation and produce reactive oxygen species,achieving a high sterilization efficiency of 99%.Meanwhile,the gradient structure of the Janus membrane facilitates continuous antigravity exudate drainage at a rate of 0.95 g cm^(−2) h^(−1).This dual functionality of effective exudate drainage and sterilization significantly reduces inflammatory factors,allows the polarization of macrophages toward the M2 proliferative phenotype,enhances angiogenesis,and accelerates wound healing.Therefore,this study provides a groundbreaking bioinspired strategy for the development of advanced wound dressings tailored for diabetic wound regeneration.展开更多
Skin injury repair is a complicated process that involves wound healing.Effective wound dressings play a crucial role in enhancing this process by providing multiple functions,such as wettability,antibacterial activit...Skin injury repair is a complicated process that involves wound healing.Effective wound dressings play a crucial role in enhancing this process by providing multiple functions,such as wettability,antibacterial activity,and drug release.In this study,Calophyllum inophyllum oil(CIO)is incorporated into polyethylene oxide-polyvinyl acetate(PEO-PVAc)nanofibers using an electrospinning technique.The successful incorporation is verified by Fourier-transform infrared spectroscopy,while the morphology is observed by scanning electron microscopy.The fabricated nanofibers are beadless and have fiber diameter distributions of 333–472 nm.The addition of CIO significantly improves the wettability of the nanofibers,as indicated by a decrease in water contact angle,which is crucial for accelerating the healing process.Additionally,the CIO exhibits potent antibacterial activity against both Gram-positive(Escherichia coli)and Gram-negative(Staphylococcus aureus)bacteria,with expanding inhibition zones as the CIO concentration is increased.These findings highlight the great potential of PEO-PVAc/CIO nanofibers for advanced wound healing applications.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
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
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
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
The use of artificial intelligence(AI)in wound care has become a crucial instrument in improving the diagnosis,treatment,and management of chronic wounds.This study examines the several functions of AI in wound care,e...The use of artificial intelligence(AI)in wound care has become a crucial instrument in improving the diagnosis,treatment,and management of chronic wounds.This study examines the several functions of AI in wound care,emphasizing its ability to better wound evaluation,hasten healing,alleviate pain,and improve cost-effectiveness.AI-driven technology,including mobile applications and intelligent bandages,provides precise wound assessment,tissue analysis,and continuous monitoring,hence allowing for tailored treatment strategies and prompt intervention.Moreover,AI-driven algorithms forecast wound healing trajectories and find individuals susceptible to chronic wounds,allowing prompt preventative interventions.There are also practical issues with integrating it into clinical practice.Adding AI to current healthcare systems,like electronic medical records(EMRs),needs careful planning and teamwork to make sure that AI-driven insights are used well in real-time clinical decision-making.To make sure AI is used safely,legal frameworks need to be set up to provide clear rules for its use in healthcare.These frameworks should include openness,risk management,and data evaluation.Lastly,clinical validation and acceptance are still big problems.Many AI-powered tools don't have enough clinical validation and aren't widely available,which makes it hard to use them in everyday clinical practice.Solving these problems is important for getting the most out of AI in wound care and making sure it is used safely and effectively.The article combines current advancements and prospective trajectories in AI-assisted wound care,highlighting its revolutionary ability to revolutionize patient outcomes and healthcare delivery.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
This guideline summarizes evidence-based recommendations for cleansing and antisepsis in chronic wounds.It defines target populations,assessment and decision frameworks,preferred cleansing solutions and pressures,indi...This guideline summarizes evidence-based recommendations for cleansing and antisepsis in chronic wounds.It defines target populations,assessment and decision frameworks,preferred cleansing solutions and pressures,indications and limits for antiseptics,biofilm-oriented strategies,pain control,and adaptations for high-risk patients and low-resource settings.The aim is to optimize wound bed preparation,protect viable tissue,reduce infection and iatrogenic injury,and standardize outpatient and home-care practice.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide ...BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide a comprehensive meta-analysis of the role of NPWT in the manage-ment of DFUs.METHODS A systematic review was performed based on Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses guidelines,searching databases like PubMed,Embase,Web of Science,and the Cochrane Library.Randomized clinical trials(RCTs)were included to compare NPWT to other dressings for DFUs.Outcomes measured were wound healing time and rate,granulation tissue formation time,amputation rate,and adverse events.Study quality was evaluated using Coch-rane's risk of bias tool.Analyses utilizedχ2,I2,fixed or random-effects models via Stata v17.RESULTS Of the 1101 identified articles,9 RCTs were selected for meta-analysis.Studies spanned from 2005 to 2020 and originated from countries including the United States,Chile,Pakistan,Italy,India,and Germany.Meta-analysis demonstrated a significant improvement in wound healing rate[risk ratio(RR)=1.46,95%CI:1.22-1.76,P<0.01]and a reduction in amputation rate(RR=0.69,95%CI:0.50-0.96,P=0.006)with NPWT.Furthermore,the time for granulation tissue formation was significantly reduced by an average of 19.54 days.However,the incidence of adverse events did not significantly differ between NPWT and control treatments.CONCLUSION NPWT significantly improves wound healing rates and reduces amputation rates in DFUs.It also hastens the formation of granulation tissue.However,the therapy does not significantly alter the risk of adverse events compared to alternate treatments.展开更多
Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(...Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(NPWT)has shown considerable advantages in accelerating wound healing and mitigating functional impairment.A retrospective study by Lipatov et al.demonstrated that NPWT significantly reduced the time needed for wound closure preparation while enhancing the success rate of local repair.Despite its benefits,certain limitations highlight the need for further optimization.This paper investigates the potential for personalized dynamic regulation of NPWT,its integration with adjunctive therapies,and the role of multidisciplinary collaboration.Furthermore,it explores the incorporation of advanced technologies such as artificial intelligence,imaging modalities,and biomaterials,presenting novel pathways for the personalized management and global standardization of NF treatment.展开更多
The healing of diabetic wounds poses a significant healthcare burden due to persistent inflammation,M1 macrophage aggregation,and high glucose levels in the microenvironment.Previous studies have demonstrated that imm...The healing of diabetic wounds poses a significant healthcare burden due to persistent inflammation,M1 macrophage aggregation,and high glucose levels in the microenvironment.Previous studies have demonstrated that immunomodulatory hydrogel dressings can facilitate diabetic wound healing.However,current immunomodulatory hydrogels require costly and complex treatments such as cell therapy and cytokines.Herein,a hierarchical hydrogel dressing with continuous biochemical gradient based on glycyrrhizic acid(GA) was constructed to modulate immunomodulatory processes in diabetic wounds.The hydrogels present many desirable features,such as tunable mechanical properties,broad antibacterial ability,outstanding conductive,transparent,and self-adhesive properties.The resultant hydrogel can promote diabetic wound healing by preventing bacterial infection,promoting macrophage polarization,improving the inflammatory microenvironment,and inducing angiogenesis and neurogenesis.Furthermore,electrical stimulation(ES) can further promote the healing of chronic diabetic wounds,providing valuable guidance for relevant clinical practice.展开更多
Rapidly-advancing microneedle-based bioelectronics integrated with electrical stimulation(ES)therapy exhibit significant potential for improving chronic wound management.Herein,bio-inspired by the serrated structure o...Rapidly-advancing microneedle-based bioelectronics integrated with electrical stimulation(ES)therapy exhibit significant potential for improving chronic wound management.Herein,bio-inspired by the serrated structure of bee-stingers,we developed a temperature-sensitive,two-stage microneedle-based electro active platform(GP-PPy/PLA-MN)featuring rivet-like micros tructures that integrates intelligent,precise drug-releasing,ES-transmission,and real-time wound-assessment monitoring for comprehensive chronic wound-management and diagnostic therapy.The bionic-design mechanically anchors the microneedle beneath the skin's dermis,while GP-PPy/PLA-MN demonstrates versatile therapeutic characteristics,including outstanding biocompatibility,antimicrobial properties,and antimigratory origins.The GP-PPy/PLA-MN enables the sustained release of insulin at body temperature for up to24 hours through the poly-N-isopropyl acrylamide grafted amidated-gelatin-based thermo-sensitive hydrogel at the needle-tip,thereby providing long-term stable blood glucose control.GP-PPy/PLA-MN indicates its potential as a novel bioelectronics-based patch to record the temperature and humidity during the wound-healing process,realizing significant wound diagnosis and real-time wound assessment,and fundamentally facilitating the therapeutic efficacy by supplying solid data to protect the clinical practice.Extensive in vitro and in vivo studies have demonstrated that GP-PPy/PLA-MN can provide effective ES and sustained drug release,thereby promoting chronic wound healing and increasing the wound healing rate by 20%compared to the control group after 14 days of treatment.This innovative approach combines bioelectronics with intelligent drug delivery and microneedling technology to effectively address the critical challenges of chronic wound management,offering promising prospects for precision diagnostics and therapeutic interventions.展开更多
The treatment of chronic wounds presents significant challenges due to the necessity of accelerating healing within complex microenvironments characterized by persistent inflammation and biochemical imbalances.Factors...The treatment of chronic wounds presents significant challenges due to the necessity of accelerating healing within complex microenvironments characterized by persistent inflammation and biochemical imbalances.Factors such as bacterial infections,hyperglycemia,and oxidative stress disrupt cellular functions and impair angiogenesis,substantially delaying wound repair.Nanozymes,which are engineered nanoscale materials with enzyme-like activities,offer distinct advantages over conventional enzymes and traditional nanomaterials,making them promising candidates for chronic wound treatment.To enhance their clinical potential,nanozyme-based catalytic systems are currently being optimized through formulation advancements and preclinical studies assessing their biocompatibility,anti-oxidant activity,antibacterial efficacy,and tissue repair capabilities,ensuring their safety and clinical applicability.When integrated into multifunctional wound dressings,nanozymes modulate reactive oxygen species levels,promote tissue regeneration,and simultaneously combat infections and oxidative damage,extending beyond conventional enzyme-like catalysis in chronic wound treatment.The customizable architectures of nanozymes enable precise therapeutic applications,enhancing their effectiveness in managing complex wound conditions.This review provides a comprehensive analysis of the incorporation of nanozymes into wound dressings,detailing fabrication methods and emphasizing their transformative potential in chronic wound management.By identifying and addressing key limitations,we introduce strategic advancements to drive the development of nanozyme-driven dressings,paving the way for next-generation chronic wound treatments.展开更多
After brain damage,regenerative angiogenesis and neurogenesis have been shown to occur simultaneously in mammals,suggesting a close link between these processes.However,the mechanisms by which these processes interact...After brain damage,regenerative angiogenesis and neurogenesis have been shown to occur simultaneously in mammals,suggesting a close link between these processes.However,the mechanisms by which these processes interact are not well understood.In this work,we aimed to study the correlation between angiogenesis and neurogenesis after a telencephalic stab wound injury.To this end,we used zebrafish as a relevant model of neuroplasticity and brain repair mechanisms.First,using the Tg(fli1:EGFP×mpeg1.1:mCherry)zebrafish line,which enables visualization of blood vessels and microglia respectively,we analyzed regenerative angiogenesis from 1 to 21 days post-lesion.In parallel,we monitored brain cell proliferation in neurogenic niches localized in the ventricular zone by using immunohistochemistry.We found that after brain damage,the blood vessel area and width as well as expression of the fli1 transgene and vascular endothelial growth factor(vegfaa and vegfbb)were increased.At the same time,neural stem cell proliferation was also increased,peaking between 3 and 5 days post-lesion in a manner similar to angiogenesis,along with the recruitment of microglia.Then,through pharmacological manipulation by injecting an anti-angiogenic drug(Tivozanib)or Vegf at the lesion site,we demonstrated that blocking or activating Vegf signaling modulated both angiogenic and neurogenic processes,as well as microglial recruitment.Finally,we showed that inhibition of microglia by clodronate-containing liposome injection or dexamethasone treatment impairs regenerative neurogenesis,as previously described,as well as injury-induced angiogenesis.In conclusion,we have described regenerative angiogenesis in zebrafish for the first time and have highlighted the role of inflammation in this process.In addition,we have shown that both angiogenesis and neurogenesis are involved in brain repair and that microglia and inflammation-dependent mechanisms activated by Vegf signaling are important contributors to these processes.This study paves the way for a better understanding of the effect of Vegf on microglia and for studies aimed at promoting angiogenesis to improve brain plasticity after brain injury.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
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.
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.
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financially supported by the National Key Research and Development Program of China (2021YFA1201304)the National Natural Science Foundation of China (52503082)+3 种基金China Postdoctoral Science Foundation (2024M750402)Postdoctoral Fellowship Program of CPSF (GZC20230419)Shanghai Anticancer Association EYAS PROJECT (SACA-CY23C05)The Fundamental Research Funds for the Central Universities (2232023D-03, 2232024Y-01)
文摘Diabetic wounds present challenges in clinical management due to persistent inflammation caused by excessive exudate infiltration.Inspired by the gradient wettability of cactus thorn,this study has devised a biomimetic Janus nanofiber membrane as a water diode,which endows with gradient wettability and gradient pore size,offering sustainable unidirectional self-drainage and antibacterial properties for enhanced diabetic wound healing.The Janus membrane is fabricated by depositing a hydrophilic polyacrylonitrile/chlorin e6 layer with smaller pore sizes onto a hydrophobic poly(ε-caprolactone)with larger pore sizes,thereby generating a vertical gradient in both wettability and pore structure.The incorporation of chlorin e6 in the upper layer enables the utilization of external light energy to generate heat for evaporation and produce reactive oxygen species,achieving a high sterilization efficiency of 99%.Meanwhile,the gradient structure of the Janus membrane facilitates continuous antigravity exudate drainage at a rate of 0.95 g cm^(−2) h^(−1).This dual functionality of effective exudate drainage and sterilization significantly reduces inflammatory factors,allows the polarization of macrophages toward the M2 proliferative phenotype,enhances angiogenesis,and accelerates wound healing.Therefore,this study provides a groundbreaking bioinspired strategy for the development of advanced wound dressings tailored for diabetic wound regeneration.
基金funded by Rekognisi Tugas Akhir(RTA)program(Contract No.5286/UN1.P1/PT.01.03/2024)supported by Universitas Gadjah Mada,Indonesia.
文摘Skin injury repair is a complicated process that involves wound healing.Effective wound dressings play a crucial role in enhancing this process by providing multiple functions,such as wettability,antibacterial activity,and drug release.In this study,Calophyllum inophyllum oil(CIO)is incorporated into polyethylene oxide-polyvinyl acetate(PEO-PVAc)nanofibers using an electrospinning technique.The successful incorporation is verified by Fourier-transform infrared spectroscopy,while the morphology is observed by scanning electron microscopy.The fabricated nanofibers are beadless and have fiber diameter distributions of 333–472 nm.The addition of CIO significantly improves the wettability of the nanofibers,as indicated by a decrease in water contact angle,which is crucial for accelerating the healing process.Additionally,the CIO exhibits potent antibacterial activity against both Gram-positive(Escherichia coli)and Gram-negative(Staphylococcus aureus)bacteria,with expanding inhibition zones as the CIO concentration is increased.These findings highlight the great potential of PEO-PVAc/CIO nanofibers for advanced wound healing applications.
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.
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.
文摘The use of artificial intelligence(AI)in wound care has become a crucial instrument in improving the diagnosis,treatment,and management of chronic wounds.This study examines the several functions of AI in wound care,emphasizing its ability to better wound evaluation,hasten healing,alleviate pain,and improve cost-effectiveness.AI-driven technology,including mobile applications and intelligent bandages,provides precise wound assessment,tissue analysis,and continuous monitoring,hence allowing for tailored treatment strategies and prompt intervention.Moreover,AI-driven algorithms forecast wound healing trajectories and find individuals susceptible to chronic wounds,allowing prompt preventative interventions.There are also practical issues with integrating it into clinical practice.Adding AI to current healthcare systems,like electronic medical records(EMRs),needs careful planning and teamwork to make sure that AI-driven insights are used well in real-time clinical decision-making.To make sure AI is used safely,legal frameworks need to be set up to provide clear rules for its use in healthcare.These frameworks should include openness,risk management,and data evaluation.Lastly,clinical validation and acceptance are still big problems.Many AI-powered tools don't have enough clinical validation and aren't widely available,which makes it hard to use them in everyday clinical practice.Solving these problems is important for getting the most out of AI in wound care and making sure it is used safely and effectively.The article combines current advancements and prospective trajectories in AI-assisted wound care,highlighting its revolutionary ability to revolutionize patient outcomes and healthcare delivery.
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.
文摘This guideline summarizes evidence-based recommendations for cleansing and antisepsis in chronic wounds.It defines target populations,assessment and decision frameworks,preferred cleansing solutions and pressures,indications and limits for antiseptics,biofilm-oriented strategies,pain control,and adaptations for high-risk patients and low-resource settings.The aim is to optimize wound bed preparation,protect viable tissue,reduce infection and iatrogenic injury,and standardize outpatient and home-care practice.
基金Supported by the National Natural Science Foundation of China,No.82202454 and No.81873934the Wang Zhengguo Trauma Medicine Fund(Growth Factor Revival Plan)No.SZYZ-TR-09+1 种基金the Shandong Provincial Natural Science Foundation Youth Fund,No.ZR2020QH168the Jinan Science and Technology Plan Project,No.202225065。
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide a comprehensive meta-analysis of the role of NPWT in the manage-ment of DFUs.METHODS A systematic review was performed based on Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses guidelines,searching databases like PubMed,Embase,Web of Science,and the Cochrane Library.Randomized clinical trials(RCTs)were included to compare NPWT to other dressings for DFUs.Outcomes measured were wound healing time and rate,granulation tissue formation time,amputation rate,and adverse events.Study quality was evaluated using Coch-rane's risk of bias tool.Analyses utilizedχ2,I2,fixed or random-effects models via Stata v17.RESULTS Of the 1101 identified articles,9 RCTs were selected for meta-analysis.Studies spanned from 2005 to 2020 and originated from countries including the United States,Chile,Pakistan,Italy,India,and Germany.Meta-analysis demonstrated a significant improvement in wound healing rate[risk ratio(RR)=1.46,95%CI:1.22-1.76,P<0.01]and a reduction in amputation rate(RR=0.69,95%CI:0.50-0.96,P=0.006)with NPWT.Furthermore,the time for granulation tissue formation was significantly reduced by an average of 19.54 days.However,the incidence of adverse events did not significantly differ between NPWT and control treatments.CONCLUSION NPWT significantly improves wound healing rates and reduces amputation rates in DFUs.It also hastens the formation of granulation tissue.However,the therapy does not significantly alter the risk of adverse events compared to alternate treatments.
基金Supported by Henan Province Key Research and Development Program,No.231111311000Henan Provincial Science and Technology Research Project,No.232102310411+2 种基金Henan Province Medical Science and Technology Key Project,No.LHGJ20220566 and No.LHGJ20240365Henan Province Medical Education Research Project,No.WJLX2023079Zhengzhou Medical and Health Technology Innovation Guidance Program,No.2024YLZDJH022.
文摘Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(NPWT)has shown considerable advantages in accelerating wound healing and mitigating functional impairment.A retrospective study by Lipatov et al.demonstrated that NPWT significantly reduced the time needed for wound closure preparation while enhancing the success rate of local repair.Despite its benefits,certain limitations highlight the need for further optimization.This paper investigates the potential for personalized dynamic regulation of NPWT,its integration with adjunctive therapies,and the role of multidisciplinary collaboration.Furthermore,it explores the incorporation of advanced technologies such as artificial intelligence,imaging modalities,and biomaterials,presenting novel pathways for the personalized management and global standardization of NF treatment.
基金supported by Natural Science Foundation of Jilin Province(No.SKL202302002)。
文摘The healing of diabetic wounds poses a significant healthcare burden due to persistent inflammation,M1 macrophage aggregation,and high glucose levels in the microenvironment.Previous studies have demonstrated that immunomodulatory hydrogel dressings can facilitate diabetic wound healing.However,current immunomodulatory hydrogels require costly and complex treatments such as cell therapy and cytokines.Herein,a hierarchical hydrogel dressing with continuous biochemical gradient based on glycyrrhizic acid(GA) was constructed to modulate immunomodulatory processes in diabetic wounds.The hydrogels present many desirable features,such as tunable mechanical properties,broad antibacterial ability,outstanding conductive,transparent,and self-adhesive properties.The resultant hydrogel can promote diabetic wound healing by preventing bacterial infection,promoting macrophage polarization,improving the inflammatory microenvironment,and inducing angiogenesis and neurogenesis.Furthermore,electrical stimulation(ES) can further promote the healing of chronic diabetic wounds,providing valuable guidance for relevant clinical practice.
基金financially supported by the National Natural Science Foun-dation of China(22278257)the Key R&D Program of Shaanxi Province(2024SF-YBXM-586)the Project of Innovation Capability Support Program in Shaanxi Province(2024ZC-KJXX-005)。
文摘Rapidly-advancing microneedle-based bioelectronics integrated with electrical stimulation(ES)therapy exhibit significant potential for improving chronic wound management.Herein,bio-inspired by the serrated structure of bee-stingers,we developed a temperature-sensitive,two-stage microneedle-based electro active platform(GP-PPy/PLA-MN)featuring rivet-like micros tructures that integrates intelligent,precise drug-releasing,ES-transmission,and real-time wound-assessment monitoring for comprehensive chronic wound-management and diagnostic therapy.The bionic-design mechanically anchors the microneedle beneath the skin's dermis,while GP-PPy/PLA-MN demonstrates versatile therapeutic characteristics,including outstanding biocompatibility,antimicrobial properties,and antimigratory origins.The GP-PPy/PLA-MN enables the sustained release of insulin at body temperature for up to24 hours through the poly-N-isopropyl acrylamide grafted amidated-gelatin-based thermo-sensitive hydrogel at the needle-tip,thereby providing long-term stable blood glucose control.GP-PPy/PLA-MN indicates its potential as a novel bioelectronics-based patch to record the temperature and humidity during the wound-healing process,realizing significant wound diagnosis and real-time wound assessment,and fundamentally facilitating the therapeutic efficacy by supplying solid data to protect the clinical practice.Extensive in vitro and in vivo studies have demonstrated that GP-PPy/PLA-MN can provide effective ES and sustained drug release,thereby promoting chronic wound healing and increasing the wound healing rate by 20%compared to the control group after 14 days of treatment.This innovative approach combines bioelectronics with intelligent drug delivery and microneedling technology to effectively address the critical challenges of chronic wound management,offering promising prospects for precision diagnostics and therapeutic interventions.
基金supported by the Key Project of the Joint Fund for Regional Innovation and Development of the National Natural Science Foundation of China(U23A20686)the National Natural Science Foundation of China(81901979)+2 种基金the Peking University People’s Hospital Scientific Research Development Funds(RDJP2022-07)the Joint Funds for the Innovation of Science and Technology,Fujian Province(2023Y9226)the Introduced High-Level Talent Team Project of Quanzhou City(2023CT008).
文摘The treatment of chronic wounds presents significant challenges due to the necessity of accelerating healing within complex microenvironments characterized by persistent inflammation and biochemical imbalances.Factors such as bacterial infections,hyperglycemia,and oxidative stress disrupt cellular functions and impair angiogenesis,substantially delaying wound repair.Nanozymes,which are engineered nanoscale materials with enzyme-like activities,offer distinct advantages over conventional enzymes and traditional nanomaterials,making them promising candidates for chronic wound treatment.To enhance their clinical potential,nanozyme-based catalytic systems are currently being optimized through formulation advancements and preclinical studies assessing their biocompatibility,anti-oxidant activity,antibacterial efficacy,and tissue repair capabilities,ensuring their safety and clinical applicability.When integrated into multifunctional wound dressings,nanozymes modulate reactive oxygen species levels,promote tissue regeneration,and simultaneously combat infections and oxidative damage,extending beyond conventional enzyme-like catalysis in chronic wound treatment.The customizable architectures of nanozymes enable precise therapeutic applications,enhancing their effectiveness in managing complex wound conditions.This review provides a comprehensive analysis of the incorporation of nanozymes into wound dressings,detailing fabrication methods and emphasizing their transformative potential in chronic wound management.By identifying and addressing key limitations,we introduce strategic advancements to drive the development of nanozyme-driven dressings,paving the way for next-generation chronic wound treatments.
基金supported by European Regional Development Funds RE0022527 ZEBRATOX(EU-Région Réunion-French State national counterpart,to Nicolas Diotel and Jean-Loup Bascands).
文摘After brain damage,regenerative angiogenesis and neurogenesis have been shown to occur simultaneously in mammals,suggesting a close link between these processes.However,the mechanisms by which these processes interact are not well understood.In this work,we aimed to study the correlation between angiogenesis and neurogenesis after a telencephalic stab wound injury.To this end,we used zebrafish as a relevant model of neuroplasticity and brain repair mechanisms.First,using the Tg(fli1:EGFP×mpeg1.1:mCherry)zebrafish line,which enables visualization of blood vessels and microglia respectively,we analyzed regenerative angiogenesis from 1 to 21 days post-lesion.In parallel,we monitored brain cell proliferation in neurogenic niches localized in the ventricular zone by using immunohistochemistry.We found that after brain damage,the blood vessel area and width as well as expression of the fli1 transgene and vascular endothelial growth factor(vegfaa and vegfbb)were increased.At the same time,neural stem cell proliferation was also increased,peaking between 3 and 5 days post-lesion in a manner similar to angiogenesis,along with the recruitment of microglia.Then,through pharmacological manipulation by injecting an anti-angiogenic drug(Tivozanib)or Vegf at the lesion site,we demonstrated that blocking or activating Vegf signaling modulated both angiogenic and neurogenic processes,as well as microglial recruitment.Finally,we showed that inhibition of microglia by clodronate-containing liposome injection or dexamethasone treatment impairs regenerative neurogenesis,as previously described,as well as injury-induced angiogenesis.In conclusion,we have described regenerative angiogenesis in zebrafish for the first time and have highlighted the role of inflammation in this process.In addition,we have shown that both angiogenesis and neurogenesis are involved in brain repair and that microglia and inflammation-dependent mechanisms activated by Vegf signaling are important contributors to these processes.This study paves the way for a better understanding of the effect of Vegf on microglia and for studies aimed at promoting angiogenesis to improve brain plasticity after brain injury.
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.
