Application of metal-organic frameworks in infectious wound healing.

Metal-organic frameworks (MOFs) are metal-organic skeleton compounds composed of self-assembled metal ions or clusters and organic ligands. MOF materials often have porous structures, high specific surface areas, uniform and adjustable pores, high surface activity and easy modification and have a wide range of prospects for application. MOFs have been widely used. In recent years, with the continuous expansion of MOF materials, they have also achieved remarkable results in the field of antimicrobial agents. In this review, the structural composition and synthetic modification of MOF materials are introduced in detail, and the antimicrobial mechanisms and applications of these materials in the healing of infected wounds are described. Moreover, the opportunities and challenges encountered in the development of MOF materials are presented, and we expect that additional MOF materials with high biosafety and efficient antimicrobial capacity will be developed in the future.

Exosomes Derived from Adipose Stem Cells Enhance Angiogenesis in Diabetic Wound Via miR-146a-5p/JAZF1 Axis.

Chronic trauma in diabetes is a leading cause of disability and mortality. Exosomes show promise in tissue regeneration. This study investigates the role of exosomes derived from adipose stem cells (ADSC-Exos) in angiogenesis. MiRNA-seq analysis revealed significant changes in 47 genes in human umbilical vein endothelial cells (HUVECs) treated with ADSC-Exos, with miR-146a-5p highly expressed. MiR-146a-5p mimics enhanced the pro-angiogenic effects of ADSC-Exos, while inhibitors had the opposite effect. JAZF1 was identified as a direct downstream target of miR-146a-5p through bioinformatics, qRT-PCR, and dual luciferase assay. Overexpress of JAZF1 resulted in decreased proliferation, migration, and angiogenic capacity of HUVECs, and reduced VEGFA expression. This study proposes that ADSC-Exos regulate angiogenesis partly via the miR-146a-5p/JAZF1 axis.

pH-responsive double-enzyme active metal-organic framework for promoting the healing of infected wounds.

The abuse of antibiotics accelerates the spread and evolution of drug-resistant bacteria, which seriously threatens human health. Hydroxyl radicals (•OH) are generated by peroxidase in the presence of H2O2, which is strongly oxidizing and can effectively kill bacteria. However, high production costs and poor stability limit the clinical use of natural enzymes. "Nanozyme" is a general term for nanomaterials with catalytic activity similar to that of biological enzymes. Compared to biological enzymes, nanozymes have the advantages of low cost, facile preparation, and easy storage, making them a good choice for the development of antibacterial agents. Here, a nickel-based metal-organic framework (Ni-MOF) with dual enzymatic activity that switches depending on the pH environment was studied. In a slightly acidic environment, Ni-MOF can react with hydrogen peroxide to produce hydroxyl radicals that kill bacteria; in a neutral environment, Ni-MOF instead removes excessive reactive oxygen species (ROS) and promotes the transformation of macrophages into M2 macrophages. Compared to most nanozymes, Ni-MOF has unique electrical conductivity and better biosafety. The results of animal experiments show that Ni-MOF can not only treat infected wounds but also promote the healing of acute wounds and exhibits great clinical application potential.

Pathways from media attention and peer communication to body dissatisfaction: the moderating role of protective filtering.

BACKGROUND: Negative body image is a common psychological phenomenon among young Chinese women, and merits further investigation. Peers and the media are important factors that associated with body image. This study explored how media and peers promote body dissatisfaction among young Chinese women, including the mediating role of body surveillance and the moderating role of protective filtering. METHODS: 3499 women from the general China community aged 18-40 years (M = 23.44 years, SD = 1.18 years) were investigated with sociocultural attitudes towards appearance scale-3, objectified body consciousness scale and protective filtering scale. The data were analyzed by using a moderated mediation model with SPSS and the Process 4.0 macro. RESULTS: Correlational analysis results indicated that body surveillance acted as a chained indirect effect between the internalization of media information and body dissatisfaction, as well as between peer comparison and body dissatisfaction. Moreover, protective filtering was demonstrated to moderate the path of media attention affecting the internalization of media information and the path of peer communication affecting peer comparisons. CONCLUSION: Our results contribute to the understanding of the sociocultural mechanisms underlying young women's negative body image. Furthermore, investigating the moderating effect of protective filtering is conducive to guiding future female positive body image interventions.

A new method incorporating deep learning with shape priors for left ventricular segmentation in myocardial perfusion SPECT images.

Accurate segmentation of the left ventricle (LV) is crucial for evaluating myocardial perfusion SPECT (MPS) and assessing LV functions. In this study, a novel method combining deep learning with shape priors was developed and validated to extract the LV myocardium and automatically measure LV functional parameters. The method integrates a three-dimensional (3D) V-Net with a shape deformation module that incorporates shape priors generated by a dynamic programming (DP) algorithm to guide its output during training. A retrospective analysis was performed on an MPS dataset comprising 31 subjects without or with mild ischemia, 32 subjects with moderate ischemia, and 12 subjects with severe ischemia. Myocardial contours were manually annotated as the ground truth. A 5-fold stratified cross-validation was used to train and validate the models. The clinical performance was evaluated by measuring LV end-systolic volume (ESV), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF), and scar burden from the extracted myocardial contours. There were excellent agreements between segmentation results by our proposed model and those from the ground truth, with a Dice similarity coefficient (DSC) of 0.9573 ± 0.0244, 0.9821 ± 0.0137, and 0.9903 ± 0.0041, as well as Hausdorff distances (HD) of 6.7529 ± 2.7334 mm, 7.2507 ± 3.1952 mm, and 7.6121 ± 3.0134 mm in extracting the LV endocardium, myocardium, and epicardium, respectively. Furthermore, the correlation coefficients between LVEF, ESV, EDV, stress scar burden, and rest scar burden measured from our model results and the ground truth were 0.92, 0.958, 0.952, 0.972, and 0.958, respectively. The proposed method achieved a high accuracy in extracting LV myocardial contours and assessing LV functions.

Interventricular septum angle obtained from cardiac computed tomography for origin differentiation of outflow tract ventricular arrhythmia between left and right.

AIMS: Our objective was to explore whether the accuracy of the transitional zone index (TZI) for outflow tract ventricular arrhythmias (OT-VAs) origin is affected by cardiac rotation and the additive value of interventricular septum angle (IVSa) obtained from coronary computed tomography angiography (CCTA). METHODS: Standard 12-lead ECGs of OT-VAs with inferior axis in consecutive patients undergoing both CCTA examination and successful ablation were retrospectively analyzed. The IVSa was defined as an angle between the long axis of IVS and sagittal axis of the body from CCTA. RESULTS: 64 patients (31 men; mean age 54.2 ± 11.6 years) were enrolled. The OT-VAs exhibited right ventricular outflow tract origin in 46 (71.9%) patients and 36 (78.3%) were diagnosed correctly by TZI. The left ventricular outflow tract origin OT-VAs was observed in 18 (28.1%) patients and 16 (88.9%) were diagnosed correctly by TZI. The patients were then divided into TZI correct group (n = 52) and TZI incorrect group (n = 12). In the TZI incorrect group, 11/12 (91.7%) cases were R/S transition in lead V3 with the TZ score during premature ventricular contractions [2.8(2.5-3.4)], and the TZI between -1.5 and 0. The IVSa was significantly larger in the TZI incorrect group than correct group (52.0 ± 6.9° vs. 39.0 ± 6.1°; p < .0001). The IVSa ≥46° predicted TZI incorrect with 92% sensitivity, 94% specificity, and 94% accuracy. CONCLUSION: The IVSa is a novel cardiac rotation index that reliably improves TZI to differentiate the OT-VAs origin, especially for the OT-VAs with lead V3 R/S transition.

Clinical Outcomes of Permanent Left Bundle Branch Area Pacing in Patients With Left Bundle Branch Block and Left Ventricular Ejection Fraction >35 vs. ≤35.

Aims: The present study aimed to compare the effects of left bundle branch area pacing (LBBAP) on cardiac function and clinical outcomes in patients with left bundle branch block (LBBB) and left ventricular ejection fraction (LVEF) >35 vs. ≤35%. Methods and Results: Thirty-six consecutive patients with LBBB and LVEF <50% were enrolled. All patients were followed up for a mean of 6 months. The successful LBBAP was defined as a paced QRS complex presented as right bundle branch block (RBBB) morphology and QRSd < 130 ms. Echocardiography parameters, pacing parameters and clinical outcomes were collected. The successful LBBAP was achieved in 77.8% of all cases (28/36). In LVEF > 35% group (70 ± 8 years, 9 male), the success rate was 81.0% (17/21). QRSd significantly decreased from 174 ± 23 ms to 108 ± 13 ms (P < 0.001). The pacing threshold and R-wave amplitude were 0.6 ± 0.2 V @ 0.5 ms and 12 ± 7 mV, respectively. In LVEF ≤ 35% group (69 ± 5 years, 9 male), the success rate was 73.3% (11/15) with QRSd decreasing from 188 ± 25 ms to 107 ± 11 ms (P < 0.001). The hyperresponders to LBBAP (functional recovery and LVEF ≥ 50%) in LVEF > 35% group was 52.9%, which were almost twice of that in LVEF ≤ 35% group (33.3%). Whether patients had LBBAP or left ventricular septal pacing (LVSP), patients in the LVEF > 35% group showed significantly lower incidence of heart failure hospitalizations or death from any cause (hazard ratio in LVEF > 35% group, 0.22; 95%CI, 0.06 to 0.75, P = 0.011). Conclusions: LBBAP can significantly shorten the QRSd and improve cardiac function in LBBB patients with either LVEF > 35 or ≤ 35%. LBBAP should be considered as an effective therapy for preventing the deterioration of cardiac function in early-stage heart failure patients with LBBB and LVEF > 35%.

Evaluation of the red & blue LED effects on cutaneous refractory wound healing in male Sprague-Dawley rat using 3 different multi-drug resistant bacteria.

OBJECTIVES: Photobiomodulation (PBM) is widely used in clinical therapy, and is an effective approach to resist the bacterial infection of the cutaneous wound and modulate the wound healing process. Due to the several detriments of lasers, Red & Blue LED light (RBLL) may be a more viable light source. This study is aimed to evaluate and compare the therapeutic effect of RBLL light on different multi-drug resistant (MDR) bacteria in vitro and male Sprague-Dawley (SD) rat refractory MDR infection wound model in vivo. MATERIALS AND METHODS: Methicillin-resistant Staphylococcus aureus (MRSA), Extended-spectrum ß-lactamases -producing Escherichia coli (ESBLs-Eco), and the MDR Pseudomonas aeruginosa (MDR-Pae) were employed to evaluate the antibacterial effects of the Blue LED light in vitro. Effects of RBLL on in vivo wound healing were evaluated by analyzing time to closure, wound score, semi-quantitative test for bacterial culture, histopathological examination and Masson staining of skin tissue, immunohistochemical (IHC) staining, and western blot analysis (WB) of wound tissue. RESULTS: Blue LED light inhibited MRSA, ESBLs-Eco, and MDR-Pae in vitro study. In vivo, RBLL accelerated wound healing, reduced levels of pathogenic bacteria on the wound surface while increasing the blood supply to the wound surface and inhibiting the excessive inflammatory response. CONCLUSION: RBLL showed a great potential gain for the treatment of MDR bacterial infected wounds, suggesting PBM therapy is an inexpensive, convenient, pain-free, and safe therapeutic intervention for refractory MDR infection wounds.

Artificial Dermis and Autologous Platelet-Rich Plasma for Treatment of Refractory Wounds: A Clinical Study.

Refractory wounds present a complex and serious clinical dilemma in plastic and reconstructive surgery. However, there are currently no standard guidelines for the treatment of refractory wounds. Artificial dermis (AD) has achieved some satisfactory results, but also has some limitations. Autologous platelet-rich plasma (PRP), as a cell-therapy material, was a valuable and safe treatment dressing for chronic non-healing wounds. This study aimed to evaluate the efficacies of artificial dermis (AD) with and without autologous platelet-rich plasma (PRP) in patients with refractory wounds. Sixteen patients with refractory wounds were randomly allocated to autologous PRP therapy combined with artificial dermis (PRP + AD [N = 8]) or an artificial dermis program only (AD [N = 8]). We compared the efficacies of the two methods in terms of times to wound healing, infection control, and AD vascularization, as well as hospitalization days and eventual clinical outcomes.13 patients achieved complete healing, including seven (87.5%) in the PRP + AD group and six (75.0%) in the AD group (P > .05). The times to wound healing, infection control, and AD vascularization, and hospitalization time after transfer were significantly shorter in the PRP + AD group compared with the AD group (P < .05). In conclusion, the combination of AD and PRP promoted refractory wound healing and shortened waiting times compared with simple dermal grafts.

Clinical experience of the use of Integra in combination with negative pressure wound therapy: an alternative method for the management of wounds with exposed bone or tendon.

The use of Integra has attracted great interest in the treatment of wounds with exposed bone or tendon, which may lead to associated morbidities. However, the use of Integra alone results in poor wound outcomes. We conducted a randomized clinical study to evaluate the combined effects of Integra and negative pressure wound therapy (NPWT). Thirty-six patients with wounds with exposed bone or tendons were treated with Integra alone and with a combination of Integra and NPWT (n = 18 respectively). Negative pressure (125 mm Hg) was applied intermittently till Integra was revascularized. The take rate of Integra and time taken from Integra coverage to skin transplantation was recorded for each case. The average take rate of Integra in the conventional treatment group (Integra with partial packing compression dressings) was lower than that for the new treatment group (Integra with NPWT) (p < 0.001, 95% CI: 6.44-0.20). The mean time period from Integra coverage to skin transplantation was longer for the conventional treatment group than for the new treatment group (p < 0.001, 95% CI: -13.18 to -11.24). The application of NPWT could potentially increase the take rate of Integra and shorten the duration of hospital stay. The use of Integra with NPWT could be a treatment option for wounds with exposed bone or tendon.

Microfibril-Associated Protein 2 (MFAP2) Potentiates Invasion and Migration of Melanoma by EMT and Wnt/ß-Catenin Pathway.

BACKGROUND Growing evidence indicates an association between microfibril-associated protein 2 (MFAP2) and a number of physiological and pathological mechanisms. The potential role of MFAP2 in cancer requires further elucidation. The present study investigated the biological behavior of MFAP2 in melanoma patients. MATERIAL AND METHODS MFAP2 inhibition was established in the B16 melanoma cell line through the use of RNA interference and was assessed by quantitative real-time PCR (qRT-PCR) and Western blot analysis. Wound-healing analysis, transwell assay, and in vivo imaging were performed to investigate the roles of MFAP2 reducing cell mobility, migration, and invasion abilities in vitro and in vivo. RESULTS We found substantially higher MFAP2 expression in B16 melanoma cells. The knockdown of MFAP2 inhibited B16 melanoma cells migration and invasion. Western blot analysis was used to assess changes in biomarkers of EMT, indicating the function of MFAP2 in EMT. We found that downregulation of MFAP2 altered the expression of Wnt/ß-catenin-linked protein. CONCLUSIONS Our results suggest that MFAP2 has potential as a molecular target to treat melanoma and suppress metastasis of melanoma cells.

Radical treatment of axillary osmidrosis using the VERSAJET™ II Hydrosurgery System or traditional open excision: A prospective cohort study.

BACKGROUND: Axillary osmidrosis, characterized by an unpleasant odor, renders social life difficult for young adults. This study aimed to compare traditional open excision and use of the VERSAJET™ II Hydrosurgery System for effectiveness and treatment complaints in the treatment of axillary osmidrosis. AIM: The current study aimed to assess the curative effect of VERSAJET™ for axillary osmidrosis in a prospective cohort study, comparatively to traditional open excision. METHOD: In this prospective cohort study, from October 2016 to March 2018, 31 and 34 patients treated with the VERSAJET™ II Hydrosurgery System and traditional open excision, respectively, were recruited and followed up for 6 months post-treatment. Treatment outcomes were assessed, including surgical field size, operation time, postoperative complications, odor elimination, hair growth reduction, scarring, and patient satisfaction. RESULTS: The VERSAJET™ group had significantly shorter operation (P < .001) and lower rates of complications, including hematoma (P = .014), wound dehiscence (P = .048), and epidermal erosion (P = .022) compared with the open excision group. A similar rate of good odor elimination (P = .925) was observed in both groups (96.77% and 97.05% in the VERSAJET™ and open excision groups, respectively). Most patients experienced sparsity of armpit hair following both procedures. Based on a comprehensive consideration of the whole operation process, recovery process, postoperative odor and scar, patients in the VERSAJET™ group were more satisfied compared with those in the open excision group (P = .008). CONCLUSION: The VERSAJET™ II procedure is shorter, with less postoperative scarring and fewer postoperative complications, compared with the traditional method. Therefore, the VERSAJET™ II procedure is superior to traditional open excision, as a new, radical treatment method for axillary osmidrosis.

Platelet-rich fibrin as an alternative adjunct to tendon-exposed wound healing: A randomized controlled clinical trial.

BACKGROUND: The use of platelet-rich fibrin (PRF) has attracted great interest in the treatment of oral and maxillofacial procedures, gingival recessions, and bone healing. However, PRF has been reported hardly to prepare wound bed before skin grafting. This randomized clinical study sought to identify the effect of PRF as an alternative adjunct to tendon-exposed wound healing. METHODS: Thirty-six patients with tendon-exposed wounds were treated by applying Integra or PRF (n=18 per group). The take rate of Integra or PRF and pain levels assessed with the four-point verbal rating scale (VRS-4) for the first 5days after application were measured for each condition. Data of texture change analysis were assessed and recorded for a duration of 3 months postoperatively. RESULTS: The take rate was less in the Integra group than in the PRF group (92.39 vs 97.83 P<0.001). After surgery, compared to the Integra group, the patients in the PRF group reported significantly lower pain scores (P<0.001). Texture changes from the Integra group were rated higher than those from the PRF (P<0.001). CONCLUSION: The use of PRF could be an option for tendon exposed areas where the wound is unfit for standard skin grafting or flap transfer.

Improved Target Signal Source Tracking and Extraction Method Based on Outdoor Visible Light Communication Using a Cam-Shift Algorithm and Kalman Filter.

An improved Cam-Shift algorithm with a Kalman filter applied to image-sensor based on outdoor visible light communication (OVLC) is presented in this paper. The proposed optimized tracking algorithm is used to track and extract the region of the target signal source Light Emitting Diode (LED) that carries modulated information for data transmission. Extracting the target signal source LED area is the premise of an image-sensor-based VLC system, especially in outdoor dynamic scenes. However, most of the existing VLC studies focus on data transmission rate, visible light positioning, etc. While the actual first step of realizing communication is usually ignored in the field of VLC, especially when the transmitter (signal source LED) or the receiver (image sensor) is moving in a more complex outdoor environment. Therefore, an improved tracking algorithm is proposed in this paper, aiming at solving the problem of extracting the region of the target signal source LED accurately in dynamic scenes with different interferences so as to promote the feasibility of VLC applications in outdoor scenes. The proposed algorithm considers color characteristics and special distribution characteristics of the moving target at the same time. The image is converted to a color probability distribution map based on the color histogram of the target and adaptively adjusts the location and size of the search window based on the results obtained from the previous frame. Meanwhile, it predicts the motion state of the target in the next frame according to the position and velocity information of the current frame to enhance accuracy and robustness of tracking. Experimental results show that the tracking error of the proposed algorithm is 0.85 cm and the computational time of processing one frame is 0.042 s. Besides, results also show that the improved algorithm can track and extract the target signal source LED area completely and accurately in an environment of many interference factors. This study confirms that the proposed algorithm can be applied to an OVLC system with many interferences to realize the actual first step of communication in an image-sensor-based VLC system, laying foundations for subsequent data transmission and other steps.

[Distribution of deep inferior epigastric perforator vessel and application of the expanded perforator flaps].

OBJECTIVE: To explore the distribution of deep inferior epigastric perforator vessel and application of the expanded perforator flap for large scar on hand and forearm. METHODS: 20 healthy adults were selected to detect the distribution of deep inferior epigastric perforator vessel. 10 cases with cicatricial constriction on hand and forearm were treated with expanded perforator flap. RESULTS: 425 perforator points were detected on the skin surface of abdomen in 20 adults. 80% of the points are located within the area which is 1.1 -5.8 cm far from the mid-line of abdomen. According to the Rand method, the percentage of the points in zone I , II , III were 26%, 43%, and 30%, respectively. There were few points in zone IV. The area around navel had a high density of points. The points were distributed asymmetrically at the two sides of abdomen. 10 cases were treated. Vascular deficiency happened at the distal end of one flap. All the other 9 flaps survived. CONCLUSIONS: The expanded deep inferior epigastric perforator flap is thin and has a large size. It is very suitable for large scar on forearm or hand.