ObjectiveTo summarize the recent progress in studies of intestinal immunity in inflammatory bowel disease (IBD). MethodsThe literatures on studying the intestinal immunity in IBD, including ulcerative colitis and Crohn disease were reviewed and analyzed. ResultsIBD comprised two main diseases that cause inflammation of the intestines: ulcerative colitis and Crohn disease. Although the diseases had some features in common, there were some important differences in clinical symptoms and pathological features. Accumulating evidence suggested that IBD results from an inappropriate inflammatory response to intestinal microbes in a genetically susceptible host. Immunity studies highlighted the importance of host-microbe interactions in the pathogenesis of these diseases. Prominent among these findings were genomic regions containing nucleotide oligomerization domain 2 (NOD2), autophagy genes, miRNAs, and components of the interleukin-23/type 17 helper T-cell (Th17) pathway. The disfunction of the intestinal microbiome, intestinal epithelium, intestinal immune cells, and the intestinal vasculature played a key role in the process of IBD. The treatment with monoclonal antibody had been introduced to treat IBD and had been certificated effective. ConclusionThe study of basic intestinal immunity and regulation network of molecules in pathogenic process of IBD provides theory basis on prevention of IBD, while related genes of IBD can offer more gene therapy targets.
OBJECTIVE: To observe the effects of ANSON NANOTECH on the healing of cutaneous chronic wounds. METHODS: Thirty-four cases with 44 wounds were locally treated with ANSON NANOTECH in the wounds after debridement. Among them, there were 15 cases with traumatic ulcer (23 wounds), 9 cases with pressure ulcer(11 wounds), 5 cases with diabetes ulcer, and 5 cases with radiation ulcer. The healing time of wounds was used to evaluate the treatment results. RESULTS: The healing time in all of chronic wounds were accelerated. All wounds from trauma, diabetes and pressure were healed within 4 weeks and another 2 wounds from radiation injuries were healed over 4 weeks. The healing rate within 4 weeks was 95.5%. CONCLUSION: The results indicate that ANSON NANOTECH can accelerate the healing of chronic wounds. The mechanism probably include sterilization, improvement of local microcirculation, promotion of cell growth, and so on.
OBJECTIVE To observe the effects of basic fibroblast growth factor(bFGF) on the healing of cutaneous chronic wounds. METHODS Twenty-eight cases with thirty-three wounds from trauma, diabetes, pressure and radiation injuries were locally treated with bFGF in a dosage of 150 U/cm2 wounds. The healing time of wounds was used to evaluate the treatment results. RESULTS The healing time in all of chronic wounds were accelerated. All wounds from trauma, diabetes and pressure were healed within 4 weeks and another 2 wounds from radiation injuries were healed over 4 weeks. The healing rate within 4 weeks was 93.9%. CONCLUSION The results indicate that bFGF can be used as a promoter to accelerate the healing of chronic wounds in clinic.
To study the influence of maggot secretion on expression of bFGF and connective tissue growth factor(CTGF) in ulcer tissue of diabetes mell itus(DM)rats and its antibacterial function. Methods There were 40 3-month-old SD male rats (weighing 300-350 g) which were randomly divided into 2 groups: control group and experimental maggot secretion group. The model of ulcer wound of DM rats was made. The ulcer wound of DM rats in maggot secretiongroup spread maggot secretions, but no secretion on ulcer wound was found in control group. The morphological and tissue changes of ulcer wound were observed at different times, and the conditions of bacterial infection on ulcer wound in the two groups were checked. Tissue sl ices were prepared on 7, 14 and 21 days, respectively; immunohistological detection of bFGF and CTFG in ulcer wound of the two groups was done; and the cell number of positive expression of bFGF and CTFG was counted. Results It was found that the heal ing of ulcer was dominant in experimental group; the wound was clean; the tissue regenerated and no Staphylococcus aureus infection was seen. Bad heal ing was obtained in control group; tissue necrosis was found and the rate of Staphylococcus aureus infection was 60%. Positive expression cell number of bFGF in ulcer wound was detected on 7 and 14 days after operation with 23.76 ± 3.34 and 52.76 ± 4.84 in experimental group, and 18.88 ± 2.16 and 46.04 ± 4.00 in control group. Positive expression cell number of CTGF in ulcer wound was detected on 7 and 14 days after operation with 18.76 ± 3.24 and 46.52 ± 4.07 in experimental group, and 12.52 ± 3.03 and 40.52 ± 3.96 in control group. There was significant difference between positive expressions of bFGF and CTFG in the two groups (P﹤0.05). Conclusion The maggot secretion can elevate the expressions of bFGF and CTFG in ulcers, promote heal ing and prevent bacterial infection.
To investigate the surgical strategy of diabetic foot (DF) and analyze the therapeutic efficacy. Methods From July 2004 to July 2007, 36 patients (22 males and 14 females) with DF were treated, with an average age of 57 years(43-82 years). The disease course of diabetes was 3 months to 27 years(12 years on average) and the disease course of DF was 1 month to 2 years (7 months on average). According to Wagner classification of DF, there were 3 cases of grade 1, 12 cases of grade 2, 10 cases of grade 3, 7 cases of grade 4 and 4 cases of grade 5. The locations of ulcer were ankle and heel in 9 cases, medial part of foot in 14 cases, in lateral part of foot in 8 cases and sinus formation in 5 cases. The ulcer sizes ranged from 4 cm × 2 cm-18 cm × 9 cm. Initial management of these patients included control of blood sugar level, proper hydration, administration of antibiotics, treatment of coexisting diseases, and repeated debridements of wounds when necessary. Ulcers were treated with debridement and spl it skin transplantation in 3 cases of grade 1, with debridement and drainage of abcesses and spl it skin transplantation in 12 of grade 2, with debridement and transplantation of flap in 17 of grade 3 and grade 4, and with transplantation of fascial flap in 5 cases of sinus; ulcers were treated firstly with artery bypass of lower extremity, and then treated with local amputation of foot to avoid high-level amputation and to save more function of foot in 4 of grade 5. Results In 36 cases, wound in 31 cases (86.1%) cured primaryly, wound did not heal in 1 patient (2.1%) and received re-amputation, there were 2 deaths because of infection with multiple organ failure postoperatively. Twenty-nine cases were followed up 8 months (range, 6 -15 months). Eight patients developed new ulcers, with 3 lesions in situ and 5 lesions in new site. Conclusion Surgicalregimen could play an important role in treatment of diabetic foot. According to different grades of DF, there were differentstrategies in deal ing with the accompanied inflammation and ulcer. An active and comprehensive surgical treatment of DF could save the foot, avoid the high-level amputation and result in more functional extremity.
ObjectiveTo investigate the significance of endoscopic punctiform erosion around appendiceal orifice with diffused inflammation in left semicolon in the diagnosis of ulcerative colitis.
MethodsTwenty-nine patients with endoscopic punctiform erosion around appendiceal orifice with diffused inflammation in left semicolon treated in West China Hospital from January 2007 to November 2012 were included in our study.Patients with either edema,ulcer,polyps around the appendiceal orifice,inflammation in the ascending colon or transverse colon,or segmental inflammation in left semicolon were excluded.The endoscopic characteristic changes and the final diagnosis were compared by means of the pathological biopsy.
ResultsOf the total 29 patients with characteristic changes under the endoscope,26 patients were eventually diagnosed to have left-sided ulcerative colitis,one was identified to be with Cronh's disease,and the remaining two patients could not be classified.
ConclusionOur findings suggest that the characteristic changes under the endoscope may help the diagnosis of ulcerative colitis.
Objective To explore the expression characteristics of chaperone interacting protein (CHIP) in normal, scar and chronic ulcer tissues and its relationship with wound healing. Methods Twenty biopsies including scar tissues(n=8), chronic ulcer tissues(n=4) and normal tissues(n=8)were used in this study. The immunohistochemical staining (power visionTMtwo-step histostaining reagent) was used to explore the amount and expression characteristics of such protein.Results The positive expression of CHIP was observed in fibroblasts, endothelial cells and epidermal cells in dermis and epidermis. It was not seen ininflammatory cells. The expression amount of CHIP in scar tissues, chronic ulcer tissues and normal tissues was 89%, 83% and 17% respectively. Conclusion Although the function of CHIP is not fully understood at present, the fact that this protein is expressed only at the mitogenic cells indicates that it may be involved in mitogenic regulation during wound healing.
Objective To evaluate the effectiveness and safety of sarpogrelate hydrochloride for patients with peripheral arterial disease (PAD). Methods The randomized controlled trials (RCTs) on PAD treated by sarpogrelate hydrochloride were identified from CBM (1978 to September 2011), CNKI (1979 to May 2011), PubMed (1950 to May 2011), EMbase (1970 to May 2011) and The Cochrane Library (Issue 3, 2011). According to the criteria of the Cochrane Handbook, two reviewers independently screened the studies, extracted and cross-checked the data, and assessed the methodological quality. Then meta-analysis was conducted by using RevMan 5.0 software. Results Nine RCTs involving 522 patients and 532 limbs were included, with low methodological quality in most trials. The results of meta-analyses indicated that compared with the conventional treatment, sarpogrelate hydrochloride could reduce the area of ulcers (MD= –3.22, 95%CI –3.99 to –2.45), and it could increase the ankle-brachial index (SMD=0.49, 95%CI 0.07 to 0.91), blood flow of dorsalis pedis artery (MD=0.16, 95%CI 0.09 to 0.23) and pain-free walking distance (MD=200.87, 95%CI 3.39 to 398.36). Five trials reported the adverse effects of sarpogrelate hydrochloride, most of which were mild gastrointestinal symptoms. Conclusion Based on the review, sarpogrelate hydrochloride may have positive effect on patients with PAD. However, the evidence is not b enough due to the general low methodological quality, so the reliable conclusion has to be drawn with more high quality studies in future.
Objective To identify the best therapy regimen for a patient with rare chronic leg ulcer in necrobiosis lipoidica diabeticorum (NLD). Methods We searched the Cochrane Library (Issue 3, 2006), PubMed (1966-July 2006), EMbase (1974-July 2006) and CBM (1978-July 2006) to identify relevant evidence. The quality of the retrieved studies was critically assessed. Results A total of 153 records were retrieved. No clinical guidelines, systematic reviews or clinical randomized studies were identified. Thirty treatment-related studies involving 17 interventions showed that, fumaric acid esters, oral pentoxifylline, topical use of growth factors and surgical skin flap transplant were relatively more effective and safer than conventional therapies. Conclusion After treatment with tropical granulocyte colony-stimulating factor, the patient with chronic leg ulcers was healed.
