The effects and mechanism of Kangfuxin on improving healing quality and preventing recurrence of gastric ulcer.

This study investigated the gastroprotective effects and possible mechanism of Kangfuxin (KFX), an ethanol extract of Periplaneta americana L. (Dictyoptera; Blattidae), on improving healing quality and preventing recurrence of gastric ulcer. The effects of KFX were investigated in patients treated with endoscopic submucosal dissection (ESD), gastric ulcer animal model, and rat gastric mucosal cells and fibroblasts. Moreover, the relationship between KFX and p38/NF-κB pathway were explored both in vivo and in vitro. In patients, KFX exhibited protective effects against gastric ulcers and resulted in a decrease in the CD3 expression. In vivo animal experiments confirmed that KFX accelerated ulcer healing by promoting neovascularization (increased CD34 expression), suppressing inflammation (decreased interleukin-1ß (IL-1ß), myeloperoxidase (MPO), tumor necrosis factor α (TNF-α), intercellular adhesion molecule-1 (ICAM-1), and IL-8 expression), and enhancing growth factor expression, including the epidermal growth factor receptor (EGFR) and hepatocyte growth factor (HGF). In vitro experiments demonstrated that treatment with 10% KFX rat serum decreased IL-1ß, IL-1Ra, SIL-1RAP, TNF-α, and ICAM-1 expression in rat gastric mucosal cells or fibroblasts and increased IL-1R expression compared to that in the group treatment with 10% normal rat serum. Furthermore, KFX inhibited the activation of p38/NF-κB pathway both in vivo and in vitro. In conclusion, KFX treatment could effectively improve healing quality and prevent gastric ulcer recurrence, which might be attributed to neovascularization, suppressed inflammation, and enhanced growth factor expression. The p38/NF-κB pathway may be one of important mechanism to mediate the effects of KFX.

Bacteriological Investigation of Chronic Wounds in a Specialized Wound Healing Department: A Retrospective Analysis of 107 Cases.

To investigate the information of chronic wounds, especially in the aspect of microbiological profile and to explore the relationship between the wound culture result and chronic wounds infection, we retrospectively reviewed the medical records of 107 patients with chronic wounds from January 2011 to December 2013. The sociodemographic data, wound-related information, therapeutic type, and wound infection status were extracted. Microbial specimens were obtained and processed using standard hospital procedure for wound culture. The predominant pathogen isolated was Staphylococcus aureus (n = 11, 26.2%), followed by Escherichia coli (n = 6, 14.3%), Enterobacter cloacae (n = 3, 7.1%), and Pseudomonas aeruginosa (n = 3, 7.1%). Sixty percent of the infectious chronic wounds had positive culture, and 96.2% of the noninfectious wounds had negative culture. In conclusion, the microbial characteristics were mostly in the site of lower extremity, gram-negative bacteria, and monopathogen, respectively. Furthermore, the relationship between the wound culture result and chronic wound infection was not exactly coincident. It may be useful for guiding the empiric therapy of chronic wounds.

[Influence of L-arginine supplementation on the plasma amino acid spectrum in burn patients].

OBJECTIVE: To explore the influence of L-arginine supplementation on the plasma amino acid spectrum in burn patients. METHODS: Ten burn patients were randomly divided into burn control (n = 5, with compound 14 amino acid injection accounting for 2% of the total caloric value), and experimental (n = 5, with intravenous injection of L-arginine which accounted for 2% of total caloric value) groups. The intake of other nutrients for these two groups of patients was the same. The nutrient regimen was begun on the 3 PBD, with one quarter of the daily supply. On 4 and 5 PBD, one half of the daily supply was given, and from 6 to 21 PBD full supplementation was given. Venous blood samples were collected on 3, 7, 14, 21 and 28 PBD for the determination of plasma levels of amino acids. Ten normal volunteers served as normal control. RESULTS: The plasma level of citrulline in both groups was significantly lower than normal value (P < 0.05) on 3 PBD before L-arginine supplementation. There was no obvious difference in plasma levels of ornithine and arginine in the two groups on 3 PBD compared with normal value (P > 0.05). The plasma level of ornithine, citrulline and arginine in burn control group declined on 3 PBD. The plasma level of arginine in experimental group on 14, 21 and 28 PBD were 280 +/- 121 micromol/L, 223 +/- 106 micromol/L and 110 +/- 44 micromol/L, respectively, which were significantly higher than those in burn control group (124 +/- 21 micromol/L, 59 +/- 15 micromol/L, 50 +/- 26 micromol/L). The plasma level of ornithine (30 +/- 5 micromol/L) and citrulline (162 +/- 44 micromol/L) on 21 PBD in experimental group were markedly higher than those in burn control group (8 +/- 7 micromol/L, 66 +/- 4 micromol/L, P < 0.05 or 0.01). There was no difference in the plasma levels of other amino acids at all postburn time points between the two groups (P > 0.05). CONCLUSION: The production process of L-arginine from citrulline was accelerated after burns. The plasma levels of L-arginine, ornithine and citrulline were increased markedly after L-arginine supplementation, while that of other amino acids was not influenced. The pharmacological effects of L-arginine may be related to the promotion of ornithine cycle.

[The influence of L-arginine on the angiogenesis in burn wounds in diabetic rats].

OBJECTIVE: To investigate the possible mechanism of L-arginine supplementation on the angiogenesis of burn wounds in diabetic rats. METHODS: One hundred male Sprague-Dawley (SD) rats were used in the study and were randomly divided into A (scalding control, n = 25), B (scalding of the rats with diabetes, n = 25), C (L-glycine control, n = 25) and D (L-arginine supplementation, n = 25) groups. Diabetes was produced by intra-peritoneal injection of streptozotocin (STZ) in B, C and D groups. The rats in C and D groups were gavaged with L-glycine and L-arginine in dose of 200 mg.kg(-1).d(-1), respectively. The glucose content of the back skin tissue was determined for five rats in each group eight weeks after STZ administration. Deep partial thickness scalding of 20% TBSA was engendered on the back in the other 80 rats. The wound area, wound healing rate, and microvascular density with CD34 immunohistochemistry staining were determined on 3rd, 7th, 14th, and 21st post scalding days (PSDs), In addition, the amount of nitric oxide (NO) released from the wound tissue and the tissue contents of vascular endothelial growth factor (VEGF) and transforming growth factor beta1 (TGF-beta1) from wound were determined at the above time points. RESULTS: Compared to those in group B, the wound healing rate in group D increased significantly since the 7th PSD [(44.10 +/- 3.50)%, P < 0.05], and the wound MVD value was increased significantly at all postburn time points. Furthermore, the levels of VEGF, NO and TGF-beta1 in the wound tissue was also increased significantly, while the glucose content in the cutaneous tissue was decreased to (1.380 +/- 0.120) mg/g. CONCLUSION: L-arginine supplementation could be beneficial to the angiogenesis in the burn wound of the rats with diabetes, as well as to wound healing by increasing the synthesis and the release of VEGF, NO and TGF-beta1 from burn wound and by decreasing the glucose content in the cutaneous tissue of diabetic rats.

[An experimental study on the effects of postburn dietary supplementation of enhanced nutrients].

OBJECTIVE: To evaluate the effects of postburn dietary supplementation of arginine (Arg), omega-3 polyunsaturated fatty acid (omega-3PUFA) and glutamine (Glu) on the metabolism, immunology and wound healing in scalded rats. METHODS: Thirty Sprague-Dawley (SD) rats inflicted with 30% total body surface area deep partial thickness scald on the back after the gastrostomy catheter was placed were employed as the model. The rats were randomly divided into A and B groups, and all of them received continuous isonitrogenous (25% protein, 12% fat, 63% carbohydrate), isocaloric (175 kcal/kg/day), and isovolemic intragastric tube feedings. The contents of Arg, omega-3PUFA, Glu in the dietary of B group were enriched. The parameters were measured on the 10th day after injury, including the response of spleen cells to ConA, the plasma levels of PGE(2), IL-2, albumin, transferrin, glucagons, cortisol in blood, the urinary content of vanillylmandelic acid (VAM) in 24-hour urine, the content of hydroxyproline, the ratio of type I to type III collagen in burn wounds, and the nitrogen content in the liver and in the jejunal mucosa, as well as the weight changes, skin delayed hypersensitivity test, and wound healing time. RESULTS: It was revealed that the serum level of albumin, the nitrogen content in the liver and in the jejunal mucosa were obviously higher in B than those in A group. At the same time, there was no statistical difference in the plasma levels of cortisol and glucagons and urinary content of VAM between the two groups, nor in body weight changes. Meanwhile, the response of spleen cells to ConA and the skin delayed hypersensitivity induced by DNFB 14 days after injury in group B were also enhanced compared with those in group A. Although the expression of PGE2 from peritoneal macrophages was lower, the content of hydroxyproline from burn wounds in group B was significantly higher than that in group A, and the ratio of type l to type III collagen in group B was significantly lower than that in group A. Compared with group A, the wound healing time in group B was significantly shortened (P < 0.05). CONCLUSION: The low-fat and high-protein feeding diet with enriched arginine, omega-3 PUFA, glutamine could benefit the nutritional status after burn injury, thus improve the immunological function and promote wound healing.