CTHRC1 promotes wound repair by increasing M2 macrophages via regulating the TGF-ß and notch pathways.

The healing of acute wounds is vital to humans and is a well-orchestrated process that involves systemic and local factors. However, there is a lack of effective and safe clinical therapies. The collagen triple helix repeat containing 1 (CTHRC1) protein is a type of exocrine protein that has been recently reported to contribute to tissue repair. Our aim is to validate the promoting effects of CTHRC1 on the healing of acute wounds and to elucidate the underlying molecular mechanism. Therefore, we first established acute wound healing mouse models and confirmed that CTHRC1 accelerates the healing process of acute wounds. Then, we characterized wound macrophages using a polyvinylalcohol (PVA) sponge model and used Western blotting to investigate the molecular mechanism. We found that CTHRC1 increased the M2 macrophage population and the TGF-ß expression level as a result of the activation of the TGF-ß and Notch pathways, which eventually contributed to the promotion of wound healing. Inhibition of the Notch pathway showed attenuated M2 macrophage recruitment, and it decreased the TGF-ß expression level. These results substantiate our hypothesis that CTHRC1 promotes wound healing by recruiting M2 macrophages and regulating the TGF-ß and Notch pathways.

Suppressive effects of induced pluripotent stem cell-conditioned medium on in vitro hypertrophic scarring fibroblast activation.

Hypertrophic scarring (HS) is a type of fibrosis that occurs in the skin, and is characterized by fibroblast activation and excessive collagen production. However, at present, therapeutic strategies for this condition are ineffective. Previous studies have identified that the mutual regulation of chronic inflammation, mechanical force and fibroblast activation leads to the formation of HS. Induced pluripotent stem cells (iPSCs) are novel bioengineered embryonic­like stem cells, initially created from mouse adult fibroblasts. The current study demonstrated that iPSC­conditioned medium (iPSC­CM) may significantly suppress hypertrophic scar fibroblast activation. It was observed that in the presence of iPSC­CM, the level of collagen I was markedly reduced and α­smooth muscle actin, a marker for myofibroblasts (activated fibroblasts that mediate mechanical force­induced HS formation), exhibited a significantly lower level of expression in human dermal fibroblasts (HDFs) activated with transforming growth factor­ß1. Additionally, iPSC­CM attenuated the local inflammatory cell response by blocking the adhesion of human acute monocytic leukemia cell monocytes and fibroblasts in vitro. In addition, the contractile ability of HDFs may be reduced by iPSC­CM. These observations suggest that iPSC­CM may protect against processes leading to hypertrophic scarring by attenuating fibroblast activation, blocking inflammatory cell recruitment and adhesion and reducing the contractile ability of fibroblasts.

Lumican Accelerates Wound Healing by Enhancing α2ß1 Integrin-Mediated Fibroblast Contractility.

Lumican is a dermatan sulfate proteoglycan highly expressed in connective tissue and has the ability to regulate collagen fibril assembly. Previous studies have shown that lumican is involved in wound healing, but the precise effects of lumican on reepithelialization and wound contraction, the two pivotal aspects of skin wound healing, have not been investigated. Here we explored the roles of lumican in fibroblast contractility, a main aspect of skin wound healing, by adopting mice skin wound healing model and the corresponding in vitro cellular experiments. Our results showed that lumican can promote skin wound healing by facilitating wound fibroblast activation and contraction but not by promoting keratinocyte proliferation and migration. Silencing of integrin α2 completely abolished the pro-contractility of lumican, indicating lumican enhances fibroblast contractility via integrin α2. Our study for the first time demonstrated that lumican can affect fibroblast's mechanical property, which is pivotal for many important pathological processes, such as wound healing, fibrosis, and tumor development, suggesting that lumican might have a potential to be used to modulate these processes.

[Effect of recombinant Sp1 gene on the collagen expression of hypertrophic scar fibroblasts in vitro].

OBJECTIVE: To explore the feasibility of transfecting recombinant Sp1 into hypertrophic scar fibroblasts and investigate the proliferation and collagen I, III synthesis in the transfected cells. METHODS: Recombinant human Sp1 was transfected into hypertrophic scar fibroblasts with the karyocyte expressive vector. The expression of Sp1, collagen I, III mRNA was tested by real time PCR. The change of cell proliferation was observed with CCK8 colorimeter. RESULTS: About 30% of transfected hypertrophic scar fibroblasts showed green fluorescence positive. The relative expression of Sp1 mRNA in transfected cells, empty-vector cell or untransfected cells group was 5.26 +/- 0.76, 1.08 +/- 0.18, 1.09 +/- 0.15, respectively, showing a significant difference between thansfected and untransfected cells or between the transfected cells and empty-vector group (P <0.01, n = 5). Expression of collagen I, III mRNA was 2.49 +/- 0.40 and 1.88 +/- 0.30 in transfected cells, 0.96 +/- 0.18 and 0.95 +/- 0.18 in empty-vector cell, and 0.97 +/- 0.15 and 0.93 +/- 0.13 in untransfected cells, respectively, showing a significant difference between thansfected and untransfected cells or between the transfected cells and empty-vector group (P < 0.01, n = 5). CONCLUSIONS: The hypertrophic scar fibroblasts could be as the target cells of Sp1 gene transfection. Sp1 gene may play an important role in abnormal collagen metabolism in hypertrophic scar.

Combined fascial flap and expanded skin flap for enveloping Medpor framework in microtia reconstruction.

The Medpor implant is another choice for a new auricular framework besides autogenous costal cartilage. However, its relatively frequent exposure and less-matching skin coverage discourage surgeons from using it. In this article, we present a new two-flap method, a combination of the temporoparietal fascial flap and the expanded skin flap, for wrapping the Medpor implant in microtia reconstruction. A staged surgical procedure was performed, including soft tissue expansion in the mastoid region, soft tissue expander removal, expanded skin flap and temporoparietal fascial flap formation, Medpor framework implantation, and the combined two-flap envelopment. Conventional lobule transposition and tragus reconstruction were accomplished for selected patients. In this study, a total of 22 microtias were reconstructed consecutively using this method. Eighteen patients were followed since the first surgery. The postoperative follow-up time ranged from 3 to 12 months. The draped soft tissue covering was thin enough to show the reconstructed ear with excellent, subtle contour when edema gradually vanished 3-6 months postoperatively. The new ear had a stable shape, and its skin color and texture matched the normal surrounding skin very well. No exposure or extrusion of the framework was observed in the series. The Medpor implant enveloped by both a temporoparietal fascial flap and an expanded cutaneous flap appears to be a promising alternative for the auricular framework in microtia reconstruction. Because of the wrapping tissues, auricular construction using a Medpor implant can be a safe, steady, and easily acceptable choice for both microtia patients and their physicians.

[The prevalence and risk factors for coronary stenosis in patients with cerebral infarction].

OBJECTIVE: To study the morbidity rate of and relevance to coronary stenosis in cerebral infarction patients. METHODS: CT coronary angiography was performed in 112 cases of cerebral infarction after CT cerebral angiography. Multivariate logistic regression analysis was carried out between the clinical data and coronary stenosis. RESULTS: In 112 cases receiving CT cerebral angiography, the morbidity rate of coronary stenosis was 46.4%. In 95 cerebral infarction patients, the morbidity rate of coronary stenosis was 51.6%. Multivariate logistic analysis showed that age, hypertension, hyperlipidemia, significant narrowing of cerebral artery were identified as independent predictors for coronary stenosis. CONCLUSIONS: Heart examination with 64 row CT should be routinely performed after cerebral angiography in cerebral infarction patients, especially in those with age greater than 65 years, hypertension, hyperlipidemia and significant narrowing of cerebral artery so as to detect coronary stenosis early.

Etiology and management of axillary bromidrosis: a brief review.

BACKGROUND: Axillary bromidrosis is a distressing condition that poses significant social embarrassment in almost all the countries over the world. However, its definite etiology has not been generalized yet. There have been a lot of treatments for bromidrosis, which can be roughly divided into two types: conservative management and radical surgical therapy. In order to summarize the possible causes of axillary bromidrosis, a brief review of the literatures regarding bromidrosis was performed. METHODS: An English literature search from 1975 to June 2007 was completed with references to treatments for bromidrosis. A total of 29 papers about the treatment were selected to review. After a close reading, all the extracted information was imported into Microsoft Excel. RESULTS: Many therapies were carried out to treat bromidrosis, including nonoperative and operative ones. Almost all the authors thought that the nonoperative management, such as topical antiperspirants, systemic agents, and iontophoresis, did not have a permanent effect. Most surgeons (90%) chose surgical methods to remove axillary sweat glands for bromidrosis and 90.69% of the axillae had good results. CONCLUSION: Axillary sweat glands may play the most important role in the etiology of bromidrosis. In addition, axillary microorganism, hormone, and inherent also contribute to bromidrosis.

Fat embolism syndromes following liposuction.

Fat embolism syndrome (FES) after liposuction is likely a life-threatening disorder, though its incidence is low. The three chief clinical manifestations include respiratory insufficiency, cerebral involvement, and petechial rash. Although FES is a multisystem disorder, the most seriously affected organs are the lungs, brain, cardiavascular system, and skin. Many laboratory findings are characteristic but nonspecific. The pathogenesis of FES after liposuction has been looked at both mechanically and biochemically. Diagnosis is difficult; Gurd and Wilson's diagnostic criteria based on clinical examination is still extensively used in clinics at present. There is no specific therapy for FES after liposuction for the moment, so prevention, early diagnosis, and supportive therapies are important. In this article we discuss the clinical presentation, pathogensis, and current methods to prevent FES and, if possible, ways to treat this complication.

Aesthetic rhinoplasty of the Asian nasal tip: a brief review.

Tip surgery, the most important part of the rhinoplasty procedure, has entered a new era in the past few decades. Various treatment protocols have been attempted. To date, however, opinions on the management of the Asian tip have not been solidified. To generalize and provide appropriate guidelines for the treatment of typical Asian tips, an English literature search from 1977 to March 2007 was conducted. Finally, a total of 26 papers were selected for review. The full text of each paper was read carefully, and data were extracted. Then all extracted information was imported into Microsoft Excel. Nine articles treating 11 groups of patients described the suitable techniques for Asian nasal tips, with 81.8% of the groups advocating that the protocol include a grafting technique, 64% reporting use of the grafting technique alone, and 9% applying cartilage reduction and a suturing technique. Of the 11 (18%) groups, 2 attempted more than one technique. Because of the Asian nasal tip's innate qualities, success with nasal tip plasty for Asians depends on the combined application of appropriate suturing, grafting, and defatting, with grafting techniques contributing the most.

[Application of both expanded cutaneous flap and temporoparietal fascia flap in ear reconstruction with Medpor framework].

OBJECTIVE: To investigate the feasibility and results of application of both expanded cutaneous flap and temporoparietal fascia flap in total ear reconstruction with Medpor framework. METHODS: The main procedure consists of two stages: Stage I-skin expansion; Stage II -auricle formation consists of orientation of Medpor implant and creation of coverage for the implant by both expanded skin flap and temporoparietal fascia flap. RESULTS: Twenty-two ears in 22 unilateral microtia patients were constructed using Medpor implants covered with both expanded cutaneous flap and temporoparietal fascia flap over the last three years, they were accepted as pleasing by the patients. CONCLUSIONS: Application of both expanded cutaneous flap and temporoparietal fascia flap can assure no extrusion of Medpor implant in ear reconstruction. Either more, the two layers of transferred tissues will not affect the profile details of the reconstructed ear. And because the skin covering the framework and fascia is derived from mastoid region, the appearance and profile of the reconstructed auricle is true to nature and close to that of the opposite one.