The regulatory role of the apelin/APJ axis in scarring: Identification of upstream and downstream mechanisms.

Scarring, a prevalent issue in clinical settings, is characterized by the excessive generation of extracellular matrix within the skin tissue. Among the numerous regulatory factors implicated in fibrosis across various organs, the apelin/APJ axis has emerged as a potential regulator of fibrosis. Given the shared attribute of heightened extracellular matrix production between organ fibrosis and scarring, we hypothesize that the apelin/APJ axis also plays a regulatory role in scar development. In this study, we examined the expression of apelin and APJ in scar tissue, normal skin, and fibroblasts derived from these tissues. We investigated the impact of the hypoxic microenvironment in scars on apelin/APJ expression to identify the transcription factors influencing apelin/APJ expression. Through overexpressing or knocking down apelin/APJ expression, we observed their effects on fibroblast secretion of extracellular matrix proteins. We further validated these effects in animal experiments while exploring the underlying mechanisms. Our findings demonstrated that the apelin/APJ axis is expressed in fibroblasts from keloid, hypertrophic scar, and normal skin. The regulation of apelin/APJ expression by the hypoxic environment in scars plays a significant role in hypertrophic scar and keloid development. This regulation promotes extracellular matrix secretion through upregulation of TGF-ß1 expression via the PI3K/Akt/CREB1 pathway.

Identification of inflammation-related biomarkers in keloids.

Background: The relationship between inflammation-related genes (IRGs) and keloid disease (KD) is currently unclear. The aim of this study was to identify a new set of inflammation-related biomarkers in KD. Methods: GSE145725 and GSE7890 datasets were used in this study. A list of 3026 IRGs was obtained from the Molecular Signatures Database. Differentially expressed inflammation-related genes (DEGs) were obtained by taking the intersection of DEGs between KD and control samples and the list of IRGs. Candidate genes were selected using least absolute shrinkage and selection operator (LASSO) regression analysis. Candidate genes with consistent expression differences between KD and control in both GSE145725 and GSE7890 datasets were screened as biomarkers. An alignment diagram was constructed and validated, and in silico immune infiltration analysis and drug prediction were performed. Finally, RT-qPCR was performed on KD samples to analyze the expression of the identified biomarkers. Results: A total of 889 DEGs were identified from the GSE145725 dataset, 169 of which were IRGs. Three candidate genes (TRIM32, LPAR1 and FOXF1) were identified by the LASSO regression analysis, and expression validation analysis suggested that FOXF1 and LPAR1 were down-regulated in KD samples and TRIM32 was up-regulated. All three candidate genes had consistent changes in expression in both the GSE145725 and GSE7890 datasets. An alignment diagram was constructed to predict KD. Effector memory CD4 T cells, T follicular helper cell, Myeloid derived suppressor cell, activated dendritic cell, Immature dendritic cell and Monocyte were differentially expressed between the KD and control group. Sixty-seven compounds that may act on FOXF1, 108 compounds that may act on LPAR1 and 56 compounds that may act on TRIM32 were predicted. Finally, RT-qPCR showed that the expression of LPAR1 was significantly lower in KD samples compared to normal samples whereas TRIM32 was significantly higher, while there was no difference in the expression of FOXF1. Conclusion: This study provides a new perspective to study the relationship between IRGs and KD.

Effect of hydrocolloid dressings on preventing air leakage when applying negative pressure wound therapy to the perineum, buttocks, and sacrococcygeal region.

Maintaining a vacuum when applying negative pressure wound therapy (NPWT) is the key to its function, which is a challenge in the perineum, buttocks, and sacrococcygeal region. A retrospective cohort study was conducted to assess the effect of hydrocolloid dressings on preventing air leakage when applying NPWT in these regions. There were 61 patients in Group A (without the aid of hydrocolloid dressings) and 65 patients in Group B (with the aid of hydrocolloid dressings). The hydrocolloid dressing-assisted NPWT significantly reduced the incidence of air leakage compared with conventional NPWT placement (24.6% vs. 7.7%; risk ratio, 3.20; 95% confidence interval, 1.24-8.27; p = 0.009), while decreasing the number of open NPWT applications (2.2 vs. 1.7; difference, 0.43; 95% confidence interval, 0.19-0.66; p < 0.001), shortening hospital stays (20.1 vs. 16.1; difference, 4.07; 95% confidence interval, 1.68-6.46; p = 0.01), and reducing the incidence of adverse skin events (18.0% vs. 4.6%; risk ratio, 3.91; 95% confidence interval, 1.14-13.34; p = 0.017). These findings support the routine use of hydrocolloid dressing-assisted NPWT placement in the perineum, buttocks, and sacrococcygeal region.

Numerical Simulation Analysis of Fracture Propagation in Rock Based on Smooth Particle Hydrodynamics.

The mechanical properties of fractured rock have always been a focal point in the rock mechanics field. Based on previous research, this paper proposes improvements to the SPH method and applies it to the study of crack propagation in fractured rocks. By conducting uniaxial compression tests and simulating crack propagation on various specimens with different crack shapes, the characteristics of crack propagation were obtained. The comparison between the simulated results in this study and existing experimental and numerical simulation results confirms the validity of the SPH method employed in this paper. The present study utilizes the proposed methodology to analyze the influence of the crack angle, width, and orientation on crack propagation. The SPH method employed in this study effectively demonstrates the expansion process of fractured rock under uniaxial compression, providing valuable insights for the engineering applications of SPH.

Shear Damage Simulations of Rock Masses Containing Fissure-Holes Using an Improved SPH Method.

Fissures and holes widely exist in rock mechanics engineering, and, at present, their failure mechanisms under complex compress and shear stress states have not been well recognized. In our work, a fracture mark, ξ, is introduced, and the kernel function of the smoothed-particle hydrodynamics (SPH) is then re-written, thus realizing the fracture modelling of the rock media. Then, the numerical models containing the fissures and holes are established, and their progressive failure processes under the compress and shear stress states are simulated, with the results showing that: (1) the improved SPH method can reflect the dynamic crack propagation processes of the rock masses, and the numerical results are in good agreement with the previous experimental results. Meanwhile, the improved SPH method can get rid of the traditional mesh re-division problems, which can be well-applied to rock failure modeling; (2) the hole shapes, fissure angles, fissure lengths, fissure numbers, and confining pressure all have great impacts on the final failure modes and peak strengths of the model; and (3) in practical engineering, the rock masses are in the 3D stress state, therefore, developing a high performance 3D SPH program and applying it to engineering in practice will be of great significance.

An improved Smoothed Particle Hydrodynamics (SPH) method for modelling the cracking processes of teeth and its applications.

The present work aims to propose a meshless method to establish the tooth meso-structures and model the tooth fracturing processes as well as investigate the influencing factors that affect the dental mechanical properties. To this end, the traditional kernel function in the SPH method has been improved by introducing a fracture mark ξ to realize the progressive failure processes of teeth; The "Particle Searching Method" has been proposed, which can realize the establishments of microstructures of teeth such as enamel, dentine, pulp, PDL and alvedar bones. The Weibull function is introduced to represent the heterogeneity of teeth, which can realize the random distribution characteristics of dental mechanical parameters. The simulation results of homogeneous and heterogeneous teeth show that the failure mode changes from tensile splitting (homogeneous) to shear failure (heterogeneous). Meanwhile, the fracture networks become more complex, and the failure stress decreases sharply. The cuspal angles also have a great impact on the teeth fracture characteristics. The failure modes changes from tensile splitting of the enamel tip to the cracking from the contact points between the enamel and the rigid ball; Different fssural morphologies have little influences on the teeth failure characteristics. The research results can provide some references for the applications of SPH method into biomechanical simulations such as teeth failure. Meanwhile, it can also provide some guidance for the understandings of the internal mechanisms of teeth fracture processes, the diagnosis and treatments of clinical diseased teeth as well as the design of bionic teeth materials.

Stool Management Followed by Surgical Debridement and Surgical Closure Combined With Negative Pressure Wound Therapy in the Treatment of Posterior Trunk Pressure Injury: A Retrospective Descriptive Study.

BACKGROUND: Pressure injuries are a burden to patients and the health care system, and negative pressure wound therapy (NPWT) is a widely used treatment. PURPOSE: This study sought to assess the effect of stool management followed by surgical debridement and surgical closure combined with NPWT in the treatment of posterior trunk pressure injuries. METHODS: A retrospective descriptive study was conducted in patients with stage 3 or 4 posterior trunk pressure injuries by reviewing electronic health records. The collected variables included sex, age, height, weight, initial underlying disease leading to being bedridden, stage and anatomical location of pressure injury, stool frequency, pathogens, number of NPWT applications, complications related to surgical closure, outcome, and treatment time. Fasting and enema were used to reduce the frequency of defecation, followed by surgical debridement and surgical closure combined with NPWT. RESULTS: Among the 63 eligible patients, 35 were male and 28 were female (average age, 72.3 ± 11.3 years). The patients' weight before fasting and after fasting showed no significant difference (62.6 ± 11.2 kg vs 61.6 ± 10.2 kg; 95% confidence interval, -2.78-4.76; P = .60). Stage 3 and stage 4 accounted for 33 (52.4%) and 30 (47.6%) pressure injuries, respectively. There were 36 (57.1%) pressure injuries located on the sacrum, and the remaining 27 (42.9%) were located in the ischia. Underlying causes for being bedridden were cardiopulmonary insufficiency (n = 23; 36.5%), severe brain damage and cerebrovascular accident (n = 19; 30.2%), spinal cord injury (n = 12; 19.0%), and others (14.3%). The wound closure rate was 96.8% (n = 61), with a mean hospital stay of 22.3 days. These patients underwent 1 to 3 cycles of NPWT before surgical wound closure. Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa were the most common pathogens. The complications related to surgical closure (defined as complications that occurred from surgical closure until 30 days later) occurred in 7 patients (11.1%); 3 patients (4.8%) experienced a pressure injury recurrence. CONCLUSION: The treatment approach reported here was effective in these patients with posterior trunk pressure injuries. A satisfactory cure rate, manageable complications, and rare recurrence were achieved. Parenteral nutrition after fasting maintained patients' weight without significant loss. Prospective randomized controlled trials involving larger samples and longer follow-up times are needed.

Laparoscopic Management of Spontaneous Colonic Perforation: A Single Institution Study of 52 Patients.

BACKGROUND: Spontaneous colonic perforation (SCP) is associated with an devastating result. The use of laparoscopy for SCP remains controversial. This study aimed to compare the postoperative outcomes of patients who received either laparoscopic or open surgery and to evaluate the efficacy of laparoscopic surgery and the risk factors affecting prognosis. PATIENTS AND METHODS: A retrospective study of patients who underwent surgery for SCP from January 2005 to December 2020 was performed. Demographic data, intraoperative variables, length of stay, and surgical complications were retrieved. RESULTS: A total of 52 patients were postoperatively diagnosed with SCP. Thirty (57.69%) procedures were performed using laparoscopic surgery (group A) and 22 (42.31%) were performed using open surgery (group B). There were no significant differences between groups A and B in terms of age, sex, chronic concomitant disease, chronic constipation, incentives, imaging findings, preoperative diagnosis, American Society of Anesthesiologists (ASA) score, Mannheim Peritonitis Index (MPI), operation time, days to resumption of liquids, site of perforation, surgical procedures, or types of perforation ( P >0.05). The incidence of wound infection in group A was significantly lower than that in group B ( P <0.05), but there was no significant difference in the incidence of abdominal abscess between the 2 groups ( P >0.05). Significant differences were found in days to start walking and days to resumption of solids between the 2 groups ( P <0.05). Group B had a longer length of hospital stay than group A ( P <0.05). After multivariate analysis, the independent variables associated with worse perioperative complications were an age of 65 years and older, an ASA score of ≥3, and an MPI of >26. CONCLUSIONS: The prognosis of SCP is poor. The operation should follow principles that are simple, rapid, and effective. If there are no contraindications, laparoscopy may be the preferred method. Hartmann procedure is a promising surgical strategy. The age, ASA score, and MPI may indicate the severity and prognosis of SCP.

Protective Effect of Conditioned Media of Human Fetal Dermal Mesenchymal Stem Cells Can Inhibit Burn-induced Microvascular Hyperpermeability.

Burns often cause loss of skin barrier protection, fluid exudation, and local tissue edema, which hinder functional recovery. Effectively improving the quality of deep burn wound healing, shortening the wound healing time, and reducing tissue fluid leakage are urgent problems in the medical field. Human mesenchymal stem cells (MSCs) can effectively stabilize vascular endothelial injury. Fetal dermal MSCs (FDMSCs) are a newly discovered source of MSCs derived from the skin of accidentally aborted fetuses. However, the effect of FDMSCs on vascular permeability remains poorly understood. In this study, conditioned media from FDMSCs (F-CM) extracted from fetal skin tissue was prepared. The effect of F-CM on vascular permeability was evaluated using the internal circulation method FITC-dextran in vivo, and several in vitro assays, including cell viability assay, transwell permeability test, immunofluorescence, and western blotting. Altogether, our results demonstrate that F-CM could inhibit burn-induced microvascular hyperpermeability by increasing the protein expression levels of occludin and VE-cadherin, while restoring the expression of endothelial F-actin, and providing the foundation of a novel therapy for the treatment of burns with F-CM.

Bacterial cellulose membrane combined with BMSCs promotes wound healing by activating the notch signaling pathway.

Objective: The bacterial cellulose membrane (BCM) has been widely studied and applied as a new biomaterial for wound healing, but causes pain with frequent dressing changes. Local application of bone marrow mesenchymal stem cells (BMSCs) requires a niche. Furthermore, the effect and mechanism of the BCM combined with BMSCs have not been reported. Methods: Morphological and chemical identifications of BCMs were investigated by porosity analyses, scanning electron microscopy, and Fourier-transform infrared spectroscopy. Biological wound dressings (BWDs) were prepared by the BCM in combination with BMSCs. The biological effects of BWDs on human dermal fibroblast (HDF) and VEGF-A in human vascular endothelial cells (HuVECs) were detected in vitro, and the effect of BWDs on acute wounds in mice was detected in vivo. Collagen and angiogenesis were evaluated through hematoxylin-eosin staining and Masson staining. The expressions of COL-1 and VEGF-A and the activation of the Notch signaling pathway in vivo and in vitro were detected by quantitative reverse-transcriptase polymerase chain reaction. Results: The BCM had a nanoscale structure and provided a partial niche for the survival and proliferation of BMSCs. BWDs were successfully prepared and regulated the biological behaviors of wound healing-related cells in vitro and upregulated the expressions of COL-1 in HDF and VEGF-A in HuVECs. BWDs promoted wound healing by increasing collagen type I synthesis and angiogenesis in acute wounds in mice. Conclusions: BWDs prepared by the combination of nanomaterial BCMs and BMSCs facilitated acute wound healing, which may be regulated by activating the Notch signaling pathway.

Regulator of G-protein signalling 3 and its regulator microRNA-133a mediate cell proliferation in gastric cancer.

BACKGROUND AND STUDY AIMS: Regulator of G-protein signalling 3 (RGS3) plays a pivotal role in Wnt signalling and epithelial-mesenchymal transition. RGS3 overexpression in gastric cancer suggests that RGS3 and its regulators have the potential to serve as therapeutic targets for gastric cancer. Therefore, we aimed to investigate the roles of RGS3 and its regulator microRNA-133a in gastric cancer tumorigenesis. MATERIAL AND METHODS: mRNA and protein expression levels of RGS3 in 107 paired human gastric cancer tissues and gastric cancer cells were examined using qRT-PCR and immunoblotting, respectively. The relationship between RGS3/microRNA-133a expression and clinicopathological characteristics was assessed using t-test. TargetScan, miRanda and MicroCosm Targets were employed to predict the binding site on the 3'-untranslated region of RGS3 that is targeted by microRNA-133a. Moreover, dual-luciferase reporter assay was performed to validate target prediction. microRNA-133a expression level in gastric cancer tissues and cell lines was determined by qRT-PCR. Finally, the proliferation activity of gastric cancer cells was evaluated using Cell Counting Kit-8 and bromodeoxyuridine incorporation assays. RESULTS: RGS3 expression level markedly increased in both gastric cancer tissues and cells compared with that in the corresponding normal tissues and cells. However, microRNA-133a expression level markedly decreased in gastric cancer tissues and cells and was negatively correlated with RGS3 expression. Higher RGS3 and lower microRNA-133a expression levels were associated with a larger tumour size, lymph node metastasis, local invasion and advanced tumour-node-metastasis stage in gastric cancer. Dual-luciferase reporter assay verified that microRNA-133a targeted RGS3 via mRNA 3'-untranslated region binding. Finally, microRNA-133a inhibited gastric cancer cell proliferation, whereas RGS3 overexpression attenuated this inhibitory effect. CONCLUSION: MicroRNA-133a is a regulator of RGS3 in gastric cancer and the microRNA-133a-RGS3 axis possibly participates in the malignant progression of gastric cancer.

Proposed Constitutive Law of Uniaxial Compression for Concrete under Deterioration Effects.

In order to study the ductile deformation characteristics and failure process of plain concrete under uniaxial compression, this paper proposes a new constitutive model. The new model was used to fit and analyze the constitutive curve of concrete under uniaxial compressive under various degradation forms and was compared with the traditional constitutive models. Finally, the new model was used to quantitatively analyze and predict the stress-strain curve of concrete in different degradation periods of a set of freeze-thaw measured data. The results show that, compared with the traditional constitutive model, the new model is simple in form and has few parameters, and the numerical value of the parameter can reflect the ductile deformation capacity of concrete. The fitting curve of the new model has the highest fitting degree with the measured stress-strain curve of concrete, and the goodness of fit (R2) is also the largest. The new model is suitable for fitting the stress-strain curve of concrete under uniaxial compression under various deteriorating forms, and the degree of fit between the constitutive prediction curve and the measured curve is high. It can be seen from the fitting results of the new model parameters that the ductile deformation capacity of concrete decreases first and then increases slightly, which is inconsistent with the law of gradual deterioration of strength. There is a minimum moment of ductility deformation capacity of concrete (MDC). The MDC of O-C40 concrete is about 114 freeze-thaw cycles, and the MDC of O-C50 concrete is about 116 freeze-thaw cycles; the degree of fit between the constitutive prediction curve and the measured curve is high. We hope that the improvement mentioned offers valid reference to the study of ductile deformation characteristics and failure process of compressed concrete under different deterioration forms.

Vacuum-assisted closure therapy combined with bi-pectoral muscle flap for the treatment of deep sternal wound infections.

Deep sternal wound infection (DSWI) is a fatal complication after median sternotomy. This study was to assess the effect of vacuum-assisted closure (VAC) combined with bi-pectoral muscle advancement flap therapy on rehabilitation for the treatment of DSWI. Fifty-two patients with DSWI underwent treatment of VAC and bi-pectoral muscle flap. These patients were followed-up 12 months postoperation. The patient characteristics, duration of VAC therapy, the mean hospital stay, and postoperative complications were retrospectively analysed. All patients underwent 1 to 3 VAC treatment sessions before closure. Fifty-one of 52 DSWI patients were cured to discharge; the mean hospital stay was 26.5 days. The drainage tube continued to drain a large amount of bloody fluid in three patients after the wound was closed. Respiratory failure occurred in one patient with severe mediastinal and pulmonary infections and died eventually in hospital. One patient died of acute cerebral haemorrhage during the12-month follow-up. VAC therapy combined with bi-pectoral muscle flap is a simple and effective treatment for DSWIs with short hospital stays and few complications. However, this is a retrospective case series presentation with no comparison group; further large-scale controlled studies are needed.

Liensinine inhibited gastric cancer cell growth through ROS generation and the PI3K/AKT pathway.

Liensinine, an isoquinoline alkaloid extracted from the seed embryo of Nelumbo nucifera Gaertn, has been shown to exhibit various phrenological effects, including anti­cancer activity. The aim of this study is to investigate the effects and mechanisms of liensinine in human gastric cancer cells. In this study, we found liensinine can significantly inhibit gastric cancer cell proliferation in vitro and in vivo. Liensinine inducedgastric cancer cell apoptosis by increasing cleaved PARP, caspased 3 and caspased 9. Moreover, liensinine induced cycle arrest by downregulatingcyclinD1/cyclin­dependent kinase4 and phosphorylated protein kinase B. Furthermore, we found liensinine increases ROS levels and inhibits the PI3K/AKT pathway. These data suggested that liensinine might represent a novel and effective agent against gastric cancer.

Effect of peripherally inserted central catheter (PICC) parenteral nutrition on immune function and nutritional support after radical gastrectomy for gastric cancer.

Objective of the present study was to investigate the effects of peripherally inserted central catheter (PICC) parenteral nutrition support on immune function and nutritional support in patients undergoing radical gastrectomy for gastric cancer. 140 patients who underwent radical gastrectomy for gastric cancer were selected as participants and were divided into study group and the control group by random number table, with 70 cases in each group. Patients in the two groups underwent standard gastrectomy under general anesthesia by the same group of doctors. The study group received postoperative PICC catheter parenteral nutrition, and the control group received central venous catheter (CVC) nutrition support. Comparative study was done using t test and Chi-square test. The serum levels of ALB, TFN, PA, Hb, CD4+, CD8+, CD4+/CD8+, IgA, IgG, IgM and CD3+ in the two groups were observed before and after treatment, and the postoperative complications of the two groups were compared. After treatment, the levels of ALB, TFN, PA and Hb in the two groups were significantly increased (P<0.05). Levels of CD3+, CD4+, CD4+/CD8+, IgA, IgG and IgM also amplified significantly after treatment in both the groups, while CD8+ decreased significantly (P<0.05). What's more, the improvement degree of the study group was significantly greater than that of the control group (P<0.05). The time of drawing drainage tube, recovering intestinal function, getting off bed and the length of hospital stay in the study group were significantly shorter than those in the control group (P<0.05). The incidence of postoperative complications in the study group and control group were 8.6% (6/70 cases) and 11.4% (8/70 cases) respectively, and there was no significant difference (P>0.05). PICC catheter parenteral nutrition support and improve the nutritional status of patients, it was proved a safe and effective nutritional support which improve the cellular immune function and accelerated the recovery of gastrointestinal function.

Efficacy and Safety of Therapeutic ERCP in the Elderly: A Single Center Experience.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) has been an important therapeutic measure for the treatment of pancreatobiliary diseases in the elderly, but limited data on the use of ERCP in the super-aged elderly are available. This study aimed to evaluate the efficacy and safety of ERCP in patients 80 years of age or older. METHODS: All therapeutic ERCPs performed from January 2012 to December 2015 at our endoscopy unit were retrospectively reviewed to evaluate the clinical outcomes and ERCP-related complications in patients 80 years of age or older (group A) and in patients younger than 65 years of age (group B). RESULTS: A total of 141 patients (182 procedures) were 80 years of age or older (group A), and 513 patients (610 procedures) were 65 years old or younger (group B). Chronic concomitant diseases (73.05% vs. 31.19%, P<0.01) and the use of antithrombotic drugs (25.53% vs. 15.01%, P<0.01) were more frequent in group A than in group B. Common bile duct (CBD) stones were the most common indication for ERCP in both groups. The rate of a difficult cannulation was higher in group A than in group B (23.63% vs. 16.56%, P<0.01). The mean procedure time was longer, and second ERCPs were performed more frequently in group A than in group B. In addition, periampullary diverticulum was observed significantly more frequently in group A (30.22% vs. 20%, P<0.01) than in group B. The overall success rate (92.31% vs. 93.93%, P>0.05) and the complication rate (6.59% vs. 5.25%, P>0.05) were not significantly different between the 2 groups. CONCLUSIONS: ERCP is a safe and effective intervention in patients 80 years of age or older, although elderly patients had a high rate of concomitant chronic diseases and used antithrombotic drugs more frequently.

Exogenous peripheral blood mononuclear cells affect the healing process of deep­degree burns.

The regenerative repair of deep­degree (second degree) burned skin remains a notable challenge in the treatment of burn injury, despite improvements being made with regards to treatment modality and the emergence of novel therapies. Fetal skin constitutes an attractive target for investigating scarless healing of burned skin. To investigate the inflammatory response during scarless healing of burned fetal skin, the present study developed a nude mouse model, which was implanted with normal human fetal skin and burned fetal skin. Subsequently, human peripheral blood mononuclear cells (PBMCs) were used to treat the nude mouse model carrying the burned fetal skin. The expression levels of matrix metalloproteinase (MMP)­9 and tissue inhibitor of metalloproteinases (TIMP)­1 were investigated during this process. In the present study, fetal skin was subcutaneously implanted into the nude mice to establish the murine model. Hematoxylin and eosin staining was used to detect alterations in the skin during the development of fetal skin and during the healing process of deep­degree burned fetal skin. The expression levels of MMP­9 and TIMP­1 were determined using immunochemical staining, and their staining intensity was evaluated by mean optical density. The results demonstrated that fetal skin subcutaneously implanted into the dorsal skin flap of nude mice developed similarly to the normal growth process in the womb. In addition, the scarless healing process was clearly observed in the mice carrying the burned fetal skin. A total of 2 weeks was required to complete scarless healing. Following treatment with PBMCs, the burned fetal skin generated inflammatory factors and enhanced the inflammatory response, which consequently resulted in a reduction in the speed of healing and in the formation of scars. Therefore, exogenous PBMCs may alter the lowered immune response environment, which is required for scarless healing, resulting in scar formation. In conclusion, the present study indicated that the involvement of inflammatory cells is important during the healing process of deep­degree burned skin, and MMP­9 and TIMP­1 may serve important roles in the process of scar formation.

Inhibiting function of human fetal dermal mesenchymal stem cells on bioactivities of keloid fibroblasts.

BACKGROUND: Keloid is one kind of benign skin disease caused by hyperplasia of fibroblasts and collagen fibrils. It is refractory due to the lack of an effective treatment at present, which puts pressure on seeking a new therapeutic regimen. Mesenchymal stem cells (MSCs) from fetal skin are considered to play a crucial role in scarless healing. Nevertheless, the efficacy of them in keloid disorders remains poorly understood. METHODS: Keloid fibroblasts (KFs), human adult dermal fibroblasts (ADFs), and human fetal dermal mesenchymal stem cells (FDMSCs) were isolated to single cells and cultured in Dulbecco's modified Eagle's medium (DMEM). ADFs and FDMSCs were used to generate ADF-conditioned medium (A-CM) and FDMSC-conditioned medium (F-CM). The effects of A-CM and F-CM on KFs were tested using MTT assay, BrdU assay, TUNEL assay, quantitative polymerase chain reaction, Western blot, and annexin V-FITC/PI binding assay,. RESULTS: FDMSCs inhibited the bioactivity of KFs, downregulated the expression of the antiapoptotic protein BCL-2, and upregulated the expression of the proapoptotic protein BAX of KFs by secreting some soluble substances, thus accelerating the apoptosis of KFs. CONCLUSION: F-CM induces apoptosis of KFs, providing a novel treatment strategy for keloid disorders.

Laparoscopic Appendectomy for Complicated Acute Appendicitis in the Elderly: A Single-center Experience.

BACKGROUND: The use of laparoscopic appendectomy for complicated acute appendicitis remains controversial in the elderly. This study aimed to compare the postoperative outcomes of elderly patients who received either laparoscopic appendectomy or open appendectomy. PATIENTS AND METHODS: A single-centre retrospective analysis of the clinical records of elderly patients (age, above 65 y) who underwent operations from January 2012 to November 2015 was performed. Demographic data, intraoperative variables, length of stay, and surgical complications were retrieved. RESULTS: A total of 145 elderly patients were preoperatively diagnosed with acute appendicitis. There were 43 (29.66%) complicated and 102 (70.34%) uncomplicated appendicitis cases. A total of 65 (44.83%) procedures were performed using the open technique (OA group) and 80 (55.17%) using the laparoscopic technique (LA group). In the laparoscopic group, 19 (23.75%) patients had complicated acute appendicitis (CLA group), and 61 (76.25%) had uncomplicated acute appendicitis (UCLA group). In the complicated group, 19 (44.19%) patients underwent operation using the laparoscopic technique (CLA group) and 24 (55.81%) using the open technique (COA group). There were no significant differences between the LA and OA groups in terms of age, sex distribution, duration of symptoms, American Society of Anesthesiologists score, white blood cells, complicated appendicitis, operation time, drain apposition, days to resumption of liquids, and postoperative complications (P>0.05). Significant differences were found in days to start walking and days to resumption of solids in the LA group (P<0.05). The OA group had a longer length of hospital stay than the LA group (P<0.05). Postoperative complications were not significantly different between the groups (P>0.05). The CLA group had a significantly longer duration of symptoms, operation times, days to resumption of liquids, and days to resumption of solids than the UCLA group (P<0.05). The COA group had significantly longer days to walking and hospital stays than the CLA group (P<0.05). CONCLUSIONS: Our study demonstrated that using LA to treat complicated acute appendicitis in the elderly was not associated with additional surgical complications. Therefore, it seems feasible to use LA as a safe technique for complicated acute appendicitis in the elderly.

miR-132 upregulation promotes gastric cancer cell growth through suppression of FoxO1 translation.

Gastric carcinoma (GC) is a prevalent malignant cancer worldwide and is highly lethal due to its fast growth. Hence, treatments to suppress GC cell growth may be applied together with surgery and chemotherapy to increase therapeutic outcome. Previous studies have shown the involvement of some microRNAs (miRNAs or miRs) in the carcinogenesis of GC, whereas a role of miR-132 in regulating the growth of GC has not been reported. Here, we report that overexpression of miR-132 in GC cells decreased FoxO1 protein levels, whereas depletion of miR-132 increased FoxO1 protein levels, without altering FoxO1 transcripts. Bioinformatics analyses showed that miR-132 bound to 3'-untranslated region (3'-UTR) of FoxO1 messenger RNA (mRNA) to prevent its translation, which was confirmed by luciferase reporter assay. Moreover, miR-132-mediated suppression of FoxO1 in GC cells resulted in a significant increase in GC cell growth in vitro and in vivo, while increases in FoxO1 by expression of antisense of miR-132 significantly decreased GC cell growth in vitro and in vivo. Finally, miR-132 levels were found significantly increased in GC specimens, compared to those in paired non-tumor gastric tissue. Together, our data suggest that miR-132 upregulation in GC cells may promote cell growth through suppression of FoxO1 translation.