BACKGROUND Skin wounds are common injuries that affect quality of life and incur high costs.A considerable portion of healthcare resources in Western countries is allocated to wound treatment,mainly using mechanical,b...BACKGROUND Skin wounds are common injuries that affect quality of life and incur high costs.A considerable portion of healthcare resources in Western countries is allocated to wound treatment,mainly using mechanical,biological,or artificial dressings.Biological and artificial dressings,such as hydrogels,are preferred for their biocompatibility.Platelet concentrates,such as platelet-rich plasma(PRP)and platelet-rich fibrin(PRF),stand out for accelerating tissue repair and minimizing risks of allergies and rejection.This study developed PRF and PRP-based dressings to treat skin wounds in an animal model,evaluating their functionality and efficiency in accelerating the tissue repair process.AIM To develop wound dressings based on platelet concentrates and evaluating their efficiency in treating skin wounds in Wistar rats.METHODS Wistar rats,both male and female,were subjected to the creation of a skin wound,distributed into groups(n=64/group),and treated with Carbopol(negative control);PRP+Carbopol;PRF+Carbopol;or PRF+CaCl_(2)+Carbopol,on days zero(D0),D3,D7,D14,and D21.PRP and PRF were obtained only from male rats.On D3,D7,D14,and D21,the wounds were analyzed for area,contraction rate,and histopathology of the tissue repair process.RESULTS The PRF-based dressing was more effective in accelerating wound closure early in the tissue repair process(up to D7),while PRF+CaCl_(2) seemed to delay the process,as wound closure was not complete by D21.Regarding macroscopic parameters,animals treated with PRF+CaCl_(2) showed significantly more crusting(necrosis)early in the repair process(D3).In terms of histopathological parameters,the PRF group exhibited significant collagenization at the later stages of the repair process(D14 and D21).By D21,fibroblast proliferation and inflammatory infiltration were higher in the PRP group.Animals treated with PRF+CaCl_(2) experienced a more pronounced inflammatory response up to D7,which diminished from D14 onwards.CONCLUSION The PRF-based dressing was effective in accelerating the closure of cutaneous wounds in Wistar rats early in the process and in aiding tissue repair at the later stages.展开更多
BACKGROUND Bone regeneration is a central focus of regenerative medicine,with applications in orthopedics and dentistry,particularly for treating bone defects caused by trauma,infection,or congenital anomalies.Synthet...BACKGROUND Bone regeneration is a central focus of regenerative medicine,with applications in orthopedics and dentistry,particularly for treating bone defects caused by trauma,infection,or congenital anomalies.Synthetic biomaterials,often combined with fibrin derivatives,offer promising solutions for bone healing and restoration.AIM To Explore the increasingly important role of the association of synthetic biomaterials with fibrin in bone regeneration.METHODS Search terms included:“synthetic biomaterials AND fibrin sealant”,“hydroxyapatite AND fibrin sealant”,“tricalcium phosphate AND fibrin sealant”,and“synthetic biomaterials AND platelet-rich fibrin(PRF)”,resulting in 67 articles.After rigorous screening,21 articles met the inclusion criteria.RESULTS The reviewed studies assessed biomaterials like hydroxyapatite(HA),β-tricalcium phosphate(β-TCP),and fibrin-based products.Key findings highlighted the enhanced osteoconductivity and biocompatibility of HA andβ-TCP,especially when combined with fibrin sealants.These composites show significant potential for improving cellular adhesion,promoting osteogenic differentiation,and accelerating bone regeneration.The antimicrobial properties and structural support for cell growth of certain biomaterials indicate a promising potential for clinical applic-ations.CONCLUSION This systematic review emphasizes the growing role of fibrin-based biomaterials in bone regeneration and urges continued research to improve their clinical use for complex bone defects.展开更多
In this editorial,we comment on the article by Sá-Oliveira et al.We focus specifi-cally on the role of platelet-rich fibrin(PRF)in modulating innate immunity to enhance wound repair.The process of wound healing i...In this editorial,we comment on the article by Sá-Oliveira et al.We focus specifi-cally on the role of platelet-rich fibrin(PRF)in modulating innate immunity to enhance wound repair.The process of wound healing is complex and involves a coordinated series of biological events,including inflammation,cell proliferation,and tissue remodeling.The innate immune system is important in the early stages of wound repair,with inflammation being a crucial initial phase in tissue rege-neration.However,the inflammatory response should be regulated,as excessive or dysregulated inflammation can impair healing.Platelet concentrates,specifi-cally PRF,have originated as promising tools to optimize the tissue repair process.PRF is a second-generation platelet concentrate,and the release of growth factors(GFs)plays a determining role in several aspects of wound healing,including promoting cell proliferation,stimulating angiogenesis,and modulating inflam-mation.PRF forms a fibrin matrix that entraps platelets and GFs.This structure allows for their sustained release over time,which is believed to provide a more favorable microenvironment for tissue repair.Recent research by Sá-Oliveira et al has provided valuable evidence supporting the efficacy of PRF in promoting wound healing.Their study,conducted on an animal model,demonstrated that PRF-based dressings were more effective in accelerating wound closure in the early stages of the healing process,enhancing tissue repair,and modulating the inflammatory response.We explore how PRF's unique properties contribute to a more controlled and effective healing process.By examining these findings,we aim to highlight PRF's potential as a promising therapeutic strategy for improved wound management.展开更多
BACKGROUND The World Health Organization defined long coronavirus disease 2019(COVID-19)as the continuation or development of new symptoms 3 months after the initial severe acute respiratory syndrome coronavirus 2 inf...BACKGROUND The World Health Organization defined long coronavirus disease 2019(COVID-19)as the continuation or development of new symptoms 3 months after the initial severe acute respiratory syndrome coronavirus 2 infection,with these symptoms lasting for at least 2 months with no other explanation.AIM To evaluate the potential laboratory and instrumental findings(short-term and long-term)resulting from COVID-19.METHODS This longitudinal observational COVID-19 cohort study(March 1,2020-March 1,2021)was carried out on patients≥18 years old who were admitted to the University Hospitals of Pisa,Siena and Careggi and the Azienda USL Toscana Nord Ovest,Sud Est and USL Centro Toscana and were subjected to follow-up.Follow-up was conducted between 0 day and 89 days,90 days and 179 days,180 days and 269 days,270 days and 359 days,and more than 360 days after hospitalization.RESULTS Of 2887 patients(58.5%males,average age 66.2 years)hospitalized in the study period(March 1,2020-March 1,2021)carrying out at least one follow-up examination within 12 months of discharge,a total of 1739 patients(705 males,average age 66 years)underwent laboratory tests,of whom 714 patients(470 males,average age 63 years)underwent spirometry.Some laboratory test results remained above the threshold even at follow-up beyond 360 days(C-reactive protein:36%,fibrin degradation fragment:48.8%,gamma-glutamyl transferase:16.8%),while others showed a return to normal range more quickly in almost all patients.Alterations in liver enzymes,hematocrit,hemoglobin,lymphocytes and neutrophils were associated with the risk of requiring oxygen therapy or forced expiratory volume in one second/forced vital capacity alterations at follow-up.CONCLUSION Alterations in liver enzymes,hematocrit or hemoglobin,lymphocytes and neutrophils were associated with risk outcomes(need for oxygen therapy or spirometry alterations).These imbalanced conditions may contribute to pulmonary dysfunction.展开更多
Bone defects caused by trauma,infection,or congenital anomalies remain a significant challenge in orthopedic and dental practice,necessitating innovative strategies to enhance healing and functional restoration.This s...Bone defects caused by trauma,infection,or congenital anomalies remain a significant challenge in orthopedic and dental practice,necessitating innovative strategies to enhance healing and functional restoration.This systematic review by Pagani et al synthesizes evidence on the synergistic role of synthetic biomaterials,such as hydroxyapatite(HA)andβ-tricalcium phosphate(β-TCP),combined with fibrin derivatives in bone regeneration.Analyzing 21 studies,the authors demonstrate that HA andβ-TCP composites exhibit superior osteoconductivity and biocompatibility when integrated with fibrin sealants or plateletrich fibrin,promoting cellular adhesion,osteogenic differentiation,and accelerated healing.While these studies underscore the potential of these biomaterialfibrin hybrids,limitations such as variability in fibrin preparation,lack of longterm data,and insufficient standardization hinder clinical translation.This editorial contextualizes these findings within the evolving landscape of regenerative medicine,emphasizing the need for optimized formulations,interdisciplinary collaboration,and robust clinical trials to bridge laboratory innovation to bedside application.展开更多
BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatmen...BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.AIM To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing.These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.METHODS The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected.The relationships between the cure rate and characteristics such as age,sex,body mass index,albumin level,primary disease,cause of the fistula,location of the fistula,number of fistulas,nature of the fistula,infection status,diagnostic methods,nutritional support methods,somatostatin therapy,growth hormone therapy,and fibrin glue therapy were analyzed.RESULTS A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease(P=0.044),location of the fistula(P=0.006),number of fistulas(P=0.007),and use of adhesive sealing(χ2=12.194,P<0.001)between the uncured and cured groups.The use of fibrin glue was a significant factor associated with a cure for fistulas(odds ratio=5.459,95%CI:1.958-15.219,P=0.01).CONCLUSION The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.展开更多
Peyronie’s disease(PD)is a disorder characterized by fibrous plaque formation in the penile tissue that leads to curvature and complications in advanced stages.In this study,we aimed to compare four injectable induct...Peyronie’s disease(PD)is a disorder characterized by fibrous plaque formation in the penile tissue that leads to curvature and complications in advanced stages.In this study,we aimed to compare four injectable induction agents for the establishment of a robust rat model of PD:transforming growth factor-β1(TGF-β1),fibrin,sodium tetradecyl sulfate(STS)combined with TGF-β1,and polidocanol(POL)combined with TGF-β1.The results showed that injection of TGF-β1 or fibrin into the tunica albuginea induced pathological endpoints without causing penile curvature.The STS+TGF-β1 combination resulted in both histological and morphological alterations,but with a high incidence of localized necrosis that led to animal death.The POL+TGF-β1 combination produced pathological changes and curvature comparable to STS+TGF-β1 and led to fewer complications.In conclusion,fibrin,STS+TGF-β1,and POL+TGF-β1 all induced PD with a certain degree of penile curvature and histological fibrosis in rats.The POL+TGF-β1 combination offered comparatively greater safety and clinical relevance and may have the greatest potential for PD research using model rats.展开更多
This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly i...This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly impairs quality of life and is frequently underdiagnosed,as sensitive diagnostic tests are only performed after symptoms occur.Imaging is crucial for the diagnosis of BM but is not routinely used for screening and is expensive.Examining laboratory risk factors for BM in GC patients using multivariate analysis could be a more effective approach.展开更多
Dear Editor,We report a surgical method for treating repeat Descemet’s membrane(DM)detachments in two cases with DM micro-perforation during deep anterior lamellar keratoplasty(DALK).DM micro-perforation is a common ...Dear Editor,We report a surgical method for treating repeat Descemet’s membrane(DM)detachments in two cases with DM micro-perforation during deep anterior lamellar keratoplasty(DALK).DM micro-perforation is a common intraoperative complication that occurs during the performance of DM baring in DALK,using methods such as the bigbubble air technique[1].The sequelae of DM micro-perforations include postoperative DM detachments,higher endothelial cell loss,endothelial decompensation,and transplant interface scarring[2].展开更多
Pseudogene and fibrin peptide which has rapid evolve speed and good stability are used in this study to determine the divergence date among groups.Through calculating the evolutionary rate of hemoglobin α chain,γ ch...Pseudogene and fibrin peptide which has rapid evolve speed and good stability are used in this study to determine the divergence date among groups.Through calculating the evolutionary rate of hemoglobin α chain,γ chain in vertebrate（including birds and mammals）,it is concluded that the evolutionary rate of hemoglobin α chain,γ chain is not invariable.It shows different evolutionary rates in different periods,that is,faster in early evolution stage and relatively slow in later stage.展开更多
Two monoclonal antibodies (McAbs) against Aα chain's C terminus offibrinogen (Fg) have been prepared and designated SZ-78 and SZ-79. Both theantigens in binding assay and immunoblot analysis showed that the two M...Two monoclonal antibodies (McAbs) against Aα chain's C terminus offibrinogen (Fg) have been prepared and designated SZ-78 and SZ-79. Both theantigens in binding assay and immunoblot analysis showed that the two McAbs recognized the epitopes located in residues 549-560 of the Aαchain. The two McAbs couldaccelerate rate of fibrin polymer assembly both in the purified system and in the humanplasma. From the pictures of transmission electronmicroscope, the average diametersof the fibers increase significantly to an average diameters of 375 nm after incubationwith the McAbs, while it was only 75nm without addition of the McAbs. There were al-so more branchings of fibers with addition of McAbs. These observations demonstratethat the amino acid sequences ofα 549-560 in the COOH terminus of the Aα chain mayplay an important role in the assembly of a fibrin clot, presumably being involved in lat-eral aggregation of protofibrils. The preparation of the McAbs supplies a usuful probe for the investigation of the展开更多
Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surge...Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.展开更多
Platelet-rich fibrin(PRF)has been widely used owing to its ability to stimulate tissue regeneration.To date,few studies have described the antibacterial properties of PRF.Previously,PRF prepared by horizontal centrifu...Platelet-rich fibrin(PRF)has been widely used owing to its ability to stimulate tissue regeneration.To date,few studies have described the antibacterial properties of PRF.Previously,PRF prepared by horizontal centrifugation(H-PRF)was shown to contain more immune cells than leukocyte-and platelet-rich fibrin(L-PRF).This study aimed to compare the antimicrobial effects of PRFs against Staphylococcus aureus and Escherichia coli in vitro and to determine whether the antibacterial effects correlated with the number of immune cells.Blood samples were obtained from eight healthy donors to prepare L-PRF and H-PRF.The sizes and weights of L-PRF and H-PRF were first evaluated,and their antibacterial effects against S.aureus and E.coli were then tested in vitro using the inhibition ring and plate-counting test methods.Flow-cytometric analysis of the cell components of L-PRF and H-PRF was also performed.No significant differences in size or weight were observed between the L-PRF and H-PRF groups.The H-PRF group contained more leukocytes than the L-PRF group.While both PRFs had notable antimicrobial activity against S.aureus and E.coli,H-PRF demonstrated a significantly better antibacterial effect than L-PRF.Furthermore,the antimicrobial ability of the PRF solid was less efficient than that of wet PRF.In conclusion,H-PRF exhibited better antibacterial activity than L-PRF,which might have been attributed to having more immune cells.展开更多
AIM: To investigate the levels of D-dimer(DD) and von Willebrand factor(vWF) and the relationship between DD and vWF in ulcerative colitis(UC) patients. METHODS: A total of 29 plasma specimens were obtained from patie...AIM: To investigate the levels of D-dimer(DD) and von Willebrand factor(vWF) and the relationship between DD and vWF in ulcerative colitis(UC) patients. METHODS: A total of 29 plasma specimens were obtained from patients with ulcerative colitis (male 13, female 16) aged 21-47 years (33+/-11). Disease activity was assessed by Truelove-Writeria. Patients with a score of above 5 were regarded as having active colitis. Twenty healthy people(male 12, female 8) aged 19-53 years(31+/-14) served as normal controls. Blood samples were taken from an antecubital vein puncture. Blood(1.8 mL) was injected into the tubes containing sodium citrate (0.13 mmol/L). The plasma was obtained by centrifugation at 3000 r.min(-1) for 10 min, and stored at -80 degrees until assayed by ELISA. RESULTS: The mean plasma levels of DD and vWF in active UC patients were significantly higher than those of the controls (0.69+/-0.41 vs 0.27+/-0.11, P【0.01 143+/-46 vs 103+/-35, P【0.01). The mean plasma levels of DD in the patients with active disease were higher than those with inactive disease(0.69+/-0.41 vs 0.48+/-0.29 P【0.05). The levels of vWF were not different between active and inactive patients. DD levels were positively related to vWF levels( r =0.574, P【0.01). There was no significant difference between levels of DD and vWF and the scope of disease and sex of the patients. CONCLUSION: vWF is an important feature and a good marker of UC intravascular thrombus and endothelial cell dysfunction were found in UC patients and the combined test of DD and vWF is helpful to distinguish the activity of the UC patients.展开更多
Bone marrow mesenchymal stem cells were isolated from New Zealand white rabbits, culture-expanded and differentiated into Schwann cell-like cells. Autologous platelet-dch plasma and Schwann cell-like cells were mixed ...Bone marrow mesenchymal stem cells were isolated from New Zealand white rabbits, culture-expanded and differentiated into Schwann cell-like cells. Autologous platelet-dch plasma and Schwann cell-like cells were mixed in suspension at a density of 1 x 106 cells/mL, prior to introduction into a poly （lactic-co-glycolic acid） conduit. Fabricated tissue-engineered nerves were implanted into rabbits to bridge 10 mm sciatic nerve defects （platelet-rich plasma group）. Controls were established using fibrin as the seeding matrix for Schwann cell-like cells at identical density to construct tissue-engineered nerves （fibrin group）. Twelve weeks after implantation, toluidine blue staining and scanning electron microscopy were used to demonstrate an increase in the number of regenerating nerve fibers and thickness of the myelin sheath in the platelet-rich plasma group compared with the fibrin group. Fluoro-gold retrograde labeling revealed that the number of Fluoro-gold-positive neurons in the dorsal root ganglion and the spinal cord anterior horn was greater in the platelet-rich plasma group than in the fibrin group. Electrophysiological examination confirmed that compound muscle action potential and nerve conduction velocity were superior in the platelet-rich plasma group compared with the fibrin group. These results indicate that autologous platelet-rich plasma gel can effectively serve as a seeding matrix for Schwann cell-like cells to construct tissue-engineered nerves to promote perJpheral nerve regeneration.展开更多
Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears th...Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears that the majority of fistulas unrelated to specific causes (e.g.Tuberculosis,Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces.The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases.The problem with this single,yet effective,treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses,the patient will have varying degrees of fecal incontinence from minor to total.In an attempt to preserve continence,various procedures have been proposed to deal with the fistulas.These include: (1) simple drainage (Seton);(2) closure of fistula tract using fibrin sealant or anal fistula plug;(3) closure of primary opening using endorectal or dermal flaps,and more recently;and (4) ligation of intersphincteric fistula tract (LIFT).In most complex cases (i.e.Crohn’s disease),a proximal fecal diversion offers a measure of symptom-atic relief.The fact remains that an "ideal" procedure for anal fistula remains elusive.The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations.In essence,the price of preservation of continence at all cost is multiple and often different operations,prolonged disability and disappointment for the patient and the surgeon.Nevertheless,the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist.Conversely,an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.展开更多
AIM:To investigate the safety and efficacy of implant-ing fibrin sealant with sustained-release ropivacaine in the gallbladder bed for pain after laparoscopic chole-cystectomy(LC).METHODS:Sixty patients(American Socie...AIM:To investigate the safety and efficacy of implant-ing fibrin sealant with sustained-release ropivacaine in the gallbladder bed for pain after laparoscopic chole-cystectomy(LC).METHODS:Sixty patients(American Society of Anes-thesiologists physical status wasⅠorⅡand underwent LC)were randomly divided into three equal groups:group A(implantation of fibrin sealant in the gallbladder bed),group B(implantation of fibrin sealant carrying ropivacaine in the gallbladder bed),and group C(normal saline in the gallbladder bed).Postoperative pain was evaluated,and pain relief was assessed by visual analog scale(VAS)scoring.RESULTS:The findings showed that 81.7%of patients had visceral pain,50%experienced parietal,and 26.7% reported shoulder pain after LC.Visceral pain was significantly less in group B patients than in the other groups(P<0.05),and only one patient in this group experienced shoulder pain.The mean VAS score in group B patients was lower than that in the other groups.CONCLUSION:Visceral pain is prominent after LC and can be effectively controlled by implanting fibrin sealant combined with ropivacaine in the gallbladder bed.展开更多
AIM To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy(POEM).METHODS Twenty-four patients who underwent POEM and experienced mucosal ...AIM To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy(POEM).METHODS Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration. Penetration-related characteristics, treatment, and recovery were reviewed for all 21 patients to assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia. Clinical data, including general characteristics, procedure-related parameters, Eckardt scores, lower esophageal sphincter pressures (LESP), and esophagogastroduodenoscopy(EGD) results, were analyzed to determine their influence on treatment success after mucosal penetration during POEM.RESULTS All 21 patients had a solitary mucosal penetration in the cardia (12 in esophageal region of the cardia, 9 in the stomach region of the cardia, and 1 in both the esophageal and stomach regions). Twelve had ahole-like penetration and 9 had a linear penetration. For those with a hole-like penetration, the mean size was 0.14 cm2 (0.02-0.32 cm2). For those with a linear penetration, the median size was 0.37 cm (0.10-1.00 cm). Closure of the mucosal penetration using fibrin sealant was performed successfully in all 21 patients(two patients required 5 m L fibrin sealant, and the remaining 19 patients required 2.5 mL). Two patients had a nasogastric tube placed for five days after POEM; the remaining 19 patients were kept fasting for 3 d. All 21 patients were discharged after a median of 5 d(range: 5-7 d) postoperatively. During a median 42 mo (range: 9-62 mo) follow-up, all 21 patients with a mucosal penetration successfully healed without the occurrence of infection, ulcer, or esophagitis. Furthermore, the median LESP decreased from 31.9 mm Hg (range: 21.9-67.1 mm Hg) preoperatively to 20.3 mm Hg (range: 6.0-41.0 mm Hg) postoperatively(P < 0.05). The median preoperative and postoperative Eckardt scores were 5.0(range; 4-10) and 1.0(range: 0-4), respectively (P < 0.05). Of the 21 patients with mucosal penetration, symptom remission, which is defined as a postoperative Eckardt score ≤ 3, was achieved in 20 patients(95.2%) indicating that mucosal penetration did not influence the success of POEM treatment if closed successfully using fibrin sealant.CONCLUSION Fibrin sealant is safe and effective for closure of mucosal penetration during POEM. Mucosal penetrations do not appear to influence the treatment success of POEM if closed successfully using fibrin sealant. Additional studies regarding the feasibility, efficacy, and safety of fibrin sealant for closure of larger mucosal penetrations is warranted.展开更多
文摘BACKGROUND Skin wounds are common injuries that affect quality of life and incur high costs.A considerable portion of healthcare resources in Western countries is allocated to wound treatment,mainly using mechanical,biological,or artificial dressings.Biological and artificial dressings,such as hydrogels,are preferred for their biocompatibility.Platelet concentrates,such as platelet-rich plasma(PRP)and platelet-rich fibrin(PRF),stand out for accelerating tissue repair and minimizing risks of allergies and rejection.This study developed PRF and PRP-based dressings to treat skin wounds in an animal model,evaluating their functionality and efficiency in accelerating the tissue repair process.AIM To develop wound dressings based on platelet concentrates and evaluating their efficiency in treating skin wounds in Wistar rats.METHODS Wistar rats,both male and female,were subjected to the creation of a skin wound,distributed into groups(n=64/group),and treated with Carbopol(negative control);PRP+Carbopol;PRF+Carbopol;or PRF+CaCl_(2)+Carbopol,on days zero(D0),D3,D7,D14,and D21.PRP and PRF were obtained only from male rats.On D3,D7,D14,and D21,the wounds were analyzed for area,contraction rate,and histopathology of the tissue repair process.RESULTS The PRF-based dressing was more effective in accelerating wound closure early in the tissue repair process(up to D7),while PRF+CaCl_(2) seemed to delay the process,as wound closure was not complete by D21.Regarding macroscopic parameters,animals treated with PRF+CaCl_(2) showed significantly more crusting(necrosis)early in the repair process(D3).In terms of histopathological parameters,the PRF group exhibited significant collagenization at the later stages of the repair process(D14 and D21).By D21,fibroblast proliferation and inflammatory infiltration were higher in the PRP group.Animals treated with PRF+CaCl_(2) experienced a more pronounced inflammatory response up to D7,which diminished from D14 onwards.CONCLUSION The PRF-based dressing was effective in accelerating the closure of cutaneous wounds in Wistar rats early in the process and in aiding tissue repair at the later stages.
文摘BACKGROUND Bone regeneration is a central focus of regenerative medicine,with applications in orthopedics and dentistry,particularly for treating bone defects caused by trauma,infection,or congenital anomalies.Synthetic biomaterials,often combined with fibrin derivatives,offer promising solutions for bone healing and restoration.AIM To Explore the increasingly important role of the association of synthetic biomaterials with fibrin in bone regeneration.METHODS Search terms included:“synthetic biomaterials AND fibrin sealant”,“hydroxyapatite AND fibrin sealant”,“tricalcium phosphate AND fibrin sealant”,and“synthetic biomaterials AND platelet-rich fibrin(PRF)”,resulting in 67 articles.After rigorous screening,21 articles met the inclusion criteria.RESULTS The reviewed studies assessed biomaterials like hydroxyapatite(HA),β-tricalcium phosphate(β-TCP),and fibrin-based products.Key findings highlighted the enhanced osteoconductivity and biocompatibility of HA andβ-TCP,especially when combined with fibrin sealants.These composites show significant potential for improving cellular adhesion,promoting osteogenic differentiation,and accelerating bone regeneration.The antimicrobial properties and structural support for cell growth of certain biomaterials indicate a promising potential for clinical applic-ations.CONCLUSION This systematic review emphasizes the growing role of fibrin-based biomaterials in bone regeneration and urges continued research to improve their clinical use for complex bone defects.
基金Supported by The Oman Ministry of Higher Education,Research,and Innovation,No.BFP/RGP/HSS/24/015.
文摘In this editorial,we comment on the article by Sá-Oliveira et al.We focus specifi-cally on the role of platelet-rich fibrin(PRF)in modulating innate immunity to enhance wound repair.The process of wound healing is complex and involves a coordinated series of biological events,including inflammation,cell proliferation,and tissue remodeling.The innate immune system is important in the early stages of wound repair,with inflammation being a crucial initial phase in tissue rege-neration.However,the inflammatory response should be regulated,as excessive or dysregulated inflammation can impair healing.Platelet concentrates,specifi-cally PRF,have originated as promising tools to optimize the tissue repair process.PRF is a second-generation platelet concentrate,and the release of growth factors(GFs)plays a determining role in several aspects of wound healing,including promoting cell proliferation,stimulating angiogenesis,and modulating inflam-mation.PRF forms a fibrin matrix that entraps platelets and GFs.This structure allows for their sustained release over time,which is believed to provide a more favorable microenvironment for tissue repair.Recent research by Sá-Oliveira et al has provided valuable evidence supporting the efficacy of PRF in promoting wound healing.Their study,conducted on an animal model,demonstrated that PRF-based dressings were more effective in accelerating wound closure in the early stages of the healing process,enhancing tissue repair,and modulating the inflammatory response.We explore how PRF's unique properties contribute to a more controlled and effective healing process.By examining these findings,we aim to highlight PRF's potential as a promising therapeutic strategy for improved wound management.
基金Supported by Regione Toscana,No.D55H20000210002.
文摘BACKGROUND The World Health Organization defined long coronavirus disease 2019(COVID-19)as the continuation or development of new symptoms 3 months after the initial severe acute respiratory syndrome coronavirus 2 infection,with these symptoms lasting for at least 2 months with no other explanation.AIM To evaluate the potential laboratory and instrumental findings(short-term and long-term)resulting from COVID-19.METHODS This longitudinal observational COVID-19 cohort study(March 1,2020-March 1,2021)was carried out on patients≥18 years old who were admitted to the University Hospitals of Pisa,Siena and Careggi and the Azienda USL Toscana Nord Ovest,Sud Est and USL Centro Toscana and were subjected to follow-up.Follow-up was conducted between 0 day and 89 days,90 days and 179 days,180 days and 269 days,270 days and 359 days,and more than 360 days after hospitalization.RESULTS Of 2887 patients(58.5%males,average age 66.2 years)hospitalized in the study period(March 1,2020-March 1,2021)carrying out at least one follow-up examination within 12 months of discharge,a total of 1739 patients(705 males,average age 66 years)underwent laboratory tests,of whom 714 patients(470 males,average age 63 years)underwent spirometry.Some laboratory test results remained above the threshold even at follow-up beyond 360 days(C-reactive protein:36%,fibrin degradation fragment:48.8%,gamma-glutamyl transferase:16.8%),while others showed a return to normal range more quickly in almost all patients.Alterations in liver enzymes,hematocrit,hemoglobin,lymphocytes and neutrophils were associated with the risk of requiring oxygen therapy or forced expiratory volume in one second/forced vital capacity alterations at follow-up.CONCLUSION Alterations in liver enzymes,hematocrit or hemoglobin,lymphocytes and neutrophils were associated with risk outcomes(need for oxygen therapy or spirometry alterations).These imbalanced conditions may contribute to pulmonary dysfunction.
文摘Bone defects caused by trauma,infection,or congenital anomalies remain a significant challenge in orthopedic and dental practice,necessitating innovative strategies to enhance healing and functional restoration.This systematic review by Pagani et al synthesizes evidence on the synergistic role of synthetic biomaterials,such as hydroxyapatite(HA)andβ-tricalcium phosphate(β-TCP),combined with fibrin derivatives in bone regeneration.Analyzing 21 studies,the authors demonstrate that HA andβ-TCP composites exhibit superior osteoconductivity and biocompatibility when integrated with fibrin sealants or plateletrich fibrin,promoting cellular adhesion,osteogenic differentiation,and accelerated healing.While these studies underscore the potential of these biomaterialfibrin hybrids,limitations such as variability in fibrin preparation,lack of longterm data,and insufficient standardization hinder clinical translation.This editorial contextualizes these findings within the evolving landscape of regenerative medicine,emphasizing the need for optimized formulations,interdisciplinary collaboration,and robust clinical trials to bridge laboratory innovation to bedside application.
文摘BACKGROUND Enterocutaneous(EC)fistula incidence has been increasing in China,along with increases in the volume and complexity of surgeries.The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.AIM To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing.These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.METHODS The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected.The relationships between the cure rate and characteristics such as age,sex,body mass index,albumin level,primary disease,cause of the fistula,location of the fistula,number of fistulas,nature of the fistula,infection status,diagnostic methods,nutritional support methods,somatostatin therapy,growth hormone therapy,and fibrin glue therapy were analyzed.RESULTS A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease(P=0.044),location of the fistula(P=0.006),number of fistulas(P=0.007),and use of adhesive sealing(χ2=12.194,P<0.001)between the uncured and cured groups.The use of fibrin glue was a significant factor associated with a cure for fistulas(odds ratio=5.459,95%CI:1.958-15.219,P=0.01).CONCLUSION The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.
基金supported by the National Natural Science Foundation of China(grant No.81971380 and No.82301822).
文摘Peyronie’s disease(PD)is a disorder characterized by fibrous plaque formation in the penile tissue that leads to curvature and complications in advanced stages.In this study,we aimed to compare four injectable induction agents for the establishment of a robust rat model of PD:transforming growth factor-β1(TGF-β1),fibrin,sodium tetradecyl sulfate(STS)combined with TGF-β1,and polidocanol(POL)combined with TGF-β1.The results showed that injection of TGF-β1 or fibrin into the tunica albuginea induced pathological endpoints without causing penile curvature.The STS+TGF-β1 combination resulted in both histological and morphological alterations,but with a high incidence of localized necrosis that led to animal death.The POL+TGF-β1 combination produced pathological changes and curvature comparable to STS+TGF-β1 and led to fewer complications.In conclusion,fibrin,STS+TGF-β1,and POL+TGF-β1 all induced PD with a certain degree of penile curvature and histological fibrosis in rats.The POL+TGF-β1 combination offered comparatively greater safety and clinical relevance and may have the greatest potential for PD research using model rats.
文摘This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly impairs quality of life and is frequently underdiagnosed,as sensitive diagnostic tests are only performed after symptoms occur.Imaging is crucial for the diagnosis of BM but is not routinely used for screening and is expensive.Examining laboratory risk factors for BM in GC patients using multivariate analysis could be a more effective approach.
基金Supported by Guangdong Basic Research Center of Excellence for Major Blinding Eye Diseases Prevention and Treatment(No.2024-YXGG-016).
文摘Dear Editor,We report a surgical method for treating repeat Descemet’s membrane(DM)detachments in two cases with DM micro-perforation during deep anterior lamellar keratoplasty(DALK).DM micro-perforation is a common intraoperative complication that occurs during the performance of DM baring in DALK,using methods such as the bigbubble air technique[1].The sequelae of DM micro-perforations include postoperative DM detachments,higher endothelial cell loss,endothelial decompensation,and transplant interface scarring[2].
基金Supported by Youth Foundation of Hunan Institution of Humanities,Science and Technology(2009QN08)Educational Reform Project of Hunan Institution of Humanities,Science and Technology(RKJGZ1013)~~
文摘Pseudogene and fibrin peptide which has rapid evolve speed and good stability are used in this study to determine the divergence date among groups.Through calculating the evolutionary rate of hemoglobin α chain,γ chain in vertebrate（including birds and mammals）,it is concluded that the evolutionary rate of hemoglobin α chain,γ chain is not invariable.It shows different evolutionary rates in different periods,that is,faster in early evolution stage and relatively slow in later stage.
文摘Two monoclonal antibodies (McAbs) against Aα chain's C terminus offibrinogen (Fg) have been prepared and designated SZ-78 and SZ-79. Both theantigens in binding assay and immunoblot analysis showed that the two McAbs recognized the epitopes located in residues 549-560 of the Aαchain. The two McAbs couldaccelerate rate of fibrin polymer assembly both in the purified system and in the humanplasma. From the pictures of transmission electronmicroscope, the average diametersof the fibers increase significantly to an average diameters of 375 nm after incubationwith the McAbs, while it was only 75nm without addition of the McAbs. There were al-so more branchings of fibers with addition of McAbs. These observations demonstratethat the amino acid sequences ofα 549-560 in the COOH terminus of the Aα chain mayplay an important role in the assembly of a fibrin clot, presumably being involved in lat-eral aggregation of protofibrils. The preparation of the McAbs supplies a usuful probe for the investigation of the
文摘Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.
基金This work was supported by the National Natural Science Foundation of China(81771050).
文摘Platelet-rich fibrin(PRF)has been widely used owing to its ability to stimulate tissue regeneration.To date,few studies have described the antibacterial properties of PRF.Previously,PRF prepared by horizontal centrifugation(H-PRF)was shown to contain more immune cells than leukocyte-and platelet-rich fibrin(L-PRF).This study aimed to compare the antimicrobial effects of PRFs against Staphylococcus aureus and Escherichia coli in vitro and to determine whether the antibacterial effects correlated with the number of immune cells.Blood samples were obtained from eight healthy donors to prepare L-PRF and H-PRF.The sizes and weights of L-PRF and H-PRF were first evaluated,and their antibacterial effects against S.aureus and E.coli were then tested in vitro using the inhibition ring and plate-counting test methods.Flow-cytometric analysis of the cell components of L-PRF and H-PRF was also performed.No significant differences in size or weight were observed between the L-PRF and H-PRF groups.The H-PRF group contained more leukocytes than the L-PRF group.While both PRFs had notable antimicrobial activity against S.aureus and E.coli,H-PRF demonstrated a significantly better antibacterial effect than L-PRF.Furthermore,the antimicrobial ability of the PRF solid was less efficient than that of wet PRF.In conclusion,H-PRF exhibited better antibacterial activity than L-PRF,which might have been attributed to having more immune cells.
文摘AIM: To investigate the levels of D-dimer(DD) and von Willebrand factor(vWF) and the relationship between DD and vWF in ulcerative colitis(UC) patients. METHODS: A total of 29 plasma specimens were obtained from patients with ulcerative colitis (male 13, female 16) aged 21-47 years (33+/-11). Disease activity was assessed by Truelove-Writeria. Patients with a score of above 5 were regarded as having active colitis. Twenty healthy people(male 12, female 8) aged 19-53 years(31+/-14) served as normal controls. Blood samples were taken from an antecubital vein puncture. Blood(1.8 mL) was injected into the tubes containing sodium citrate (0.13 mmol/L). The plasma was obtained by centrifugation at 3000 r.min(-1) for 10 min, and stored at -80 degrees until assayed by ELISA. RESULTS: The mean plasma levels of DD and vWF in active UC patients were significantly higher than those of the controls (0.69+/-0.41 vs 0.27+/-0.11, P【0.01 143+/-46 vs 103+/-35, P【0.01). The mean plasma levels of DD in the patients with active disease were higher than those with inactive disease(0.69+/-0.41 vs 0.48+/-0.29 P【0.05). The levels of vWF were not different between active and inactive patients. DD levels were positively related to vWF levels( r =0.574, P【0.01). There was no significant difference between levels of DD and vWF and the scope of disease and sex of the patients. CONCLUSION: vWF is an important feature and a good marker of UC intravascular thrombus and endothelial cell dysfunction were found in UC patients and the combined test of DD and vWF is helpful to distinguish the activity of the UC patients.
基金supported by the High Education Development Foundation of Shandong Province,No.J11LF22
文摘Bone marrow mesenchymal stem cells were isolated from New Zealand white rabbits, culture-expanded and differentiated into Schwann cell-like cells. Autologous platelet-dch plasma and Schwann cell-like cells were mixed in suspension at a density of 1 x 106 cells/mL, prior to introduction into a poly （lactic-co-glycolic acid） conduit. Fabricated tissue-engineered nerves were implanted into rabbits to bridge 10 mm sciatic nerve defects （platelet-rich plasma group）. Controls were established using fibrin as the seeding matrix for Schwann cell-like cells at identical density to construct tissue-engineered nerves （fibrin group）. Twelve weeks after implantation, toluidine blue staining and scanning electron microscopy were used to demonstrate an increase in the number of regenerating nerve fibers and thickness of the myelin sheath in the platelet-rich plasma group compared with the fibrin group. Fluoro-gold retrograde labeling revealed that the number of Fluoro-gold-positive neurons in the dorsal root ganglion and the spinal cord anterior horn was greater in the platelet-rich plasma group than in the fibrin group. Electrophysiological examination confirmed that compound muscle action potential and nerve conduction velocity were superior in the platelet-rich plasma group compared with the fibrin group. These results indicate that autologous platelet-rich plasma gel can effectively serve as a seeding matrix for Schwann cell-like cells to construct tissue-engineered nerves to promote perJpheral nerve regeneration.
文摘Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears that the majority of fistulas unrelated to specific causes (e.g.Tuberculosis,Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces.The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases.The problem with this single,yet effective,treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses,the patient will have varying degrees of fecal incontinence from minor to total.In an attempt to preserve continence,various procedures have been proposed to deal with the fistulas.These include: (1) simple drainage (Seton);(2) closure of fistula tract using fibrin sealant or anal fistula plug;(3) closure of primary opening using endorectal or dermal flaps,and more recently;and (4) ligation of intersphincteric fistula tract (LIFT).In most complex cases (i.e.Crohn’s disease),a proximal fecal diversion offers a measure of symptom-atic relief.The fact remains that an "ideal" procedure for anal fistula remains elusive.The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations.In essence,the price of preservation of continence at all cost is multiple and often different operations,prolonged disability and disappointment for the patient and the surgeon.Nevertheless,the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist.Conversely,an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.
文摘AIM:To investigate the safety and efficacy of implant-ing fibrin sealant with sustained-release ropivacaine in the gallbladder bed for pain after laparoscopic chole-cystectomy(LC).METHODS:Sixty patients(American Society of Anes-thesiologists physical status wasⅠorⅡand underwent LC)were randomly divided into three equal groups:group A(implantation of fibrin sealant in the gallbladder bed),group B(implantation of fibrin sealant carrying ropivacaine in the gallbladder bed),and group C(normal saline in the gallbladder bed).Postoperative pain was evaluated,and pain relief was assessed by visual analog scale(VAS)scoring.RESULTS:The findings showed that 81.7%of patients had visceral pain,50%experienced parietal,and 26.7% reported shoulder pain after LC.Visceral pain was significantly less in group B patients than in the other groups(P<0.05),and only one patient in this group experienced shoulder pain.The mean VAS score in group B patients was lower than that in the other groups.CONCLUSION:Visceral pain is prominent after LC and can be effectively controlled by implanting fibrin sealant combined with ropivacaine in the gallbladder bed.
文摘AIM To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy(POEM).METHODS Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration. Penetration-related characteristics, treatment, and recovery were reviewed for all 21 patients to assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia. Clinical data, including general characteristics, procedure-related parameters, Eckardt scores, lower esophageal sphincter pressures (LESP), and esophagogastroduodenoscopy(EGD) results, were analyzed to determine their influence on treatment success after mucosal penetration during POEM.RESULTS All 21 patients had a solitary mucosal penetration in the cardia (12 in esophageal region of the cardia, 9 in the stomach region of the cardia, and 1 in both the esophageal and stomach regions). Twelve had ahole-like penetration and 9 had a linear penetration. For those with a hole-like penetration, the mean size was 0.14 cm2 (0.02-0.32 cm2). For those with a linear penetration, the median size was 0.37 cm (0.10-1.00 cm). Closure of the mucosal penetration using fibrin sealant was performed successfully in all 21 patients(two patients required 5 m L fibrin sealant, and the remaining 19 patients required 2.5 mL). Two patients had a nasogastric tube placed for five days after POEM; the remaining 19 patients were kept fasting for 3 d. All 21 patients were discharged after a median of 5 d(range: 5-7 d) postoperatively. During a median 42 mo (range: 9-62 mo) follow-up, all 21 patients with a mucosal penetration successfully healed without the occurrence of infection, ulcer, or esophagitis. Furthermore, the median LESP decreased from 31.9 mm Hg (range: 21.9-67.1 mm Hg) preoperatively to 20.3 mm Hg (range: 6.0-41.0 mm Hg) postoperatively(P < 0.05). The median preoperative and postoperative Eckardt scores were 5.0(range; 4-10) and 1.0(range: 0-4), respectively (P < 0.05). Of the 21 patients with mucosal penetration, symptom remission, which is defined as a postoperative Eckardt score ≤ 3, was achieved in 20 patients(95.2%) indicating that mucosal penetration did not influence the success of POEM treatment if closed successfully using fibrin sealant.CONCLUSION Fibrin sealant is safe and effective for closure of mucosal penetration during POEM. Mucosal penetrations do not appear to influence the treatment success of POEM if closed successfully using fibrin sealant. Additional studies regarding the feasibility, efficacy, and safety of fibrin sealant for closure of larger mucosal penetrations is warranted.
