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双语推荐：瘢痕防治

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术后切口的愈合是一个复杂的病理生理过程,基因的表达调控和各种生长因子的分泌调节等多个环节均会影响切口愈合而引起瘢痕的形成。防治术后瘢痕形成不仅要了解皮肤解剖和切口愈合机制,而且要选择恰当的缝合材料通过专业的伤口缝合技术和物理、化学等适当干预方法来最大限度地降低术后瘢痕形成。防治术后瘢痕形成的物理、化学干预方法较多,但是机制并不十分明确,对其进行研究并深入探讨在术后瘢痕防治方面具有重要意义。
Postoperative incision healing is a complex pathophysiological process, including gene expression regulation and the secretion of various growth factors to adjust multiple links, all can affect the healing of incision and scar formation. The prevention and treatment of postoperative scarring need not only to understand the anatomy and skin incision healing mechanism, but also to choose the proper suture materials and through professional wound closure techniques and using the physical, chemical and other appropriate intervention methods to minimize postoperative scarring. There are quite a lot of physical and chemical methods to prevent and treat postoperative scarring intervention, but the mechanism is not very clear. To study and explore in the aspect of prevention and control of postoperative scar is of great significance.

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增生性瘢痕的发生发展与烧(创)伤患者密切相关,其防治一直是创伤康复领域的研究重点和难点。花生四烯酸作为人体内性质活跃的必需脂肪酸之一,广泛参与炎症反应、氧化应激以及发挥第二信使作用等,其在防治瘢痕增生过程中可能具有重要作用。本文就花生四烯酸生物学作用的研究和增生性瘢痕发生机制,以及花生四烯酸与增生性瘢痕关系的研究进行综述。
The formation and development of hypertrophic scar are closely related with the burn (trauma) patients, its prevention and treatment has been a research focus and difficulty in the field of trauma rehabilitation. Arachidonic acid is one of the essential fatty acids in vivo which widely participates in inflammation, oxidative stress and plays a second messenger role, so it may play an important role in the process of prevention and treatment of hypertrophic scar. This paper mainly reviewed the current research status of arachidonic acid in hypertrophic scar.

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背景：瘢痕是创伤修复的产物，严重的瘢痕增生常常导致机体的畸形及功能障碍。血管生成伴随着瘢痕形成的整个过程，与瘢痕的形成密切相关。细胞因子也参与了与瘢痕的形成的过程。 目的：关于血管生成相关细胞因子与瘢痕增生进行阐述，了解血管生成相关细胞因子通过影响瘢痕形成过程中血管的生成与成熟，影响瘢痕的增生及萎缩成熟，最终为临床防治瘢痕提供新的理论依据及方法。 方法：应用计算机检索中文数据库CNKI，应用“瘢痕，血管生成，细胞因子”等为检索词进行检索；应用计算机检索英文数据库PubMed及Medline，应用“scar，angiogenesis，cytokine”等为检索词进行检索。筛选关于瘢痕增生与血管生成，瘢痕增生与细胞因子，血管生成与细胞因子的相关文献，最后筛选纳入54条文献。 结果与结论：瘢痕的形成是机体各种复杂因素综合作用的结果，受多种因素的影响。瘢痕的形成过程中存在血管生成和成熟。各种血管生成相关因子必然会通过影响血管生成成熟，从而影响瘢痕的增生和萎缩。在临床应用中通过干预相关血管生成因子的表达或阻断其作用，影响瘢痕组织中的血管生成与成熟，从而达到防治瘢痕的目的，为瘢痕治疗与预防提供新的思路及方法。
BACKGROUND:Scar is the product of wound healing. Severe scar hyperplasia often leads to the deformity and dysfunction. The scar generates along with angiogenesis. Angiogenesis is closely related to the formation of scar. Cytokines are involved in the scar formation. OBJECTIVE:To summarize the relationship between the cytokines of angiogenesis and scar hyperplasia and to understand the cytokines of angiogenesis effect on scar hyperplasia and atrophy by influencing the angiogenesis and vascular maturity during scar formation, thereby providing a new theoretical basis and measures for clinical prevention and treatment of scar. METHODS:A computer-based online search of PubMed, Medline and CNKI databases was performed for acquiring relevant articles in English and Chinese, respectively, by using the key words of “scar, angiogenesis, cytokines”. Fifty-four articles were included which related to angiogensis in scar hyperplasia, cytokines in scar hyperplasia and cytokines of angio

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目的：分析研究弹力套与硅凝胶贴膜联合应用防治烧伤后瘢痕增生的临床效果观察及临床护理。方法将收集到的116例烧伤后瘢痕增生患者随机分为观察组和对照组，各组58例，观察组采用弹力套与硅凝胶贴膜联合防治，对照组单纯采用弹力套进行防治，比较两组患者治疗前、治疗后8周及治疗后12周临床效果，掌握两种方法的护理要点。结果治疗前两组临床症状及瘢痕增生情况无显著变化（P＞0.05），治疗后8周及12周，观察组临床症状及瘢痕增生情况明显改善好转，而对照组虽有变化，但改变不明显，两组间差异性具有统计学意义（P＜0.05）。结论弹力套与硅凝胶贴膜联合预防及治疗烧伤后瘢痕增生临床效果显著，值得临床上广泛推广及使用。
Objective To study elastic sleeve with silica gel iflm after the combined use of prevention and treatment of burn scar hyperplasia, the clinical effect of observation and clinical care. Methods Collected 116 cases of burn scar hyperplasia after the patients were randomly divided into observation group and control group, each group of 58 cases, observation group with elastic sleeve with silicon gel sticker joint prevention and control, prevention and control of the control group only with elastic sleeve, compared two groups of patients before and after treatment of 8 weeks and 12 weeks after treatment the clinical effect, master the nursing key points of the two methods.Results The clinical symptoms and scar hyperplasia of two groups before treatment had no signiifcant change (P>0.05), 8 weeks and 12 weeks after treatment, clinical symptoms and scar hyperplasia of observation group was obviously improve better, while the control group, although have change, but change is not obvious, th

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目的探讨综合康复治疗对深度烧伤患者增生性瘢痕的防治效果。方法对343例深度烧伤患者进行综合性的康复治疗,观察其防止瘢痕增生和挛缩的效果。结果通过综合康复治疗,有331例患者在减轻瘢痕厚度、颜色、硬度、瘙痒感及改善关节活动、提高生活自理能力方面效果明显。结论通过综合康复治疗,有效地抑制了瘢痕增生,减轻了致残程度,取得了较好的临床效果。
Objective To study the effect of comprehensive rehabilitation for deep burn patients with hypertrophic scar prevention. Methods We have treated 343 cases of patients with deep burns through comprehensive rehabilitation, and study the effect to prevent scar formation and contracture. Results Through comprehensive rehabilitation therapy, 331 patients had a marked effect in reduce scar thickness, color, hardness, itching sensation, improve joint activities and improve daily living. Conclusion Through comprehensive rehabilitation therapy, we can effectively suppress scar formation, reduce the degree of disability.

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瘢痕是组织创伤修复和愈合过程的产物,过度的增生性瘢痕和瘢痕疙瘩,统称为病理性瘢痕,影响正常组织的修复[1].目前仍无明确有效的防治方法.我们采用Er:YAG激光联合脉冲染料激光治疗增生性瘢痕,获得良好效果,现报道如下. 一、资料与方法 1.临床资料:选择80例患者,均为增生性瘢痕患者,来自我科日常门诊.入选标准:①瘢痕形成1个月至3年不等;②瘢痕高出皮肤2～6 mm;③3个月内未经其他药物、手术、激光等治疗瘢痕.排除标准:①皮肤损害超过原有损伤范围并向周围正常皮肤侵犯,且持续性增长;②患有严重高血压、心脏疾病等;③瘢痕体质者.选择增生性瘢痕125处,按完全随机化非平衡设计分为两组.治疗组68处,对照组57处.同一患者的皮损可既有治疗组又有对照组.两组皮损的严重程度大致相同.
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目的探讨小切口掻刮术治疗腋臭的并发症及防治策略。方法2009年4月~2010年4月采用小切口掻刮术治疗腋臭60例120侧。结果本组有效60例，有效率100%，优良38例，优良率63%；术后并发皮肤坏死20侧，皮下血肿6侧，皮下粘连瘢痕与色素沉着34侧，残留余味4侧。结论小切口掻刮术是治疗腋臭的有效方法，术后并发症有皮肤坏死、皮下血肿、皮下粘连、瘢痕、色素沉着、残留余味等，其防治关键在于顶泌大汗腺清除解剖层次的精确性与清除解剖范围的完整性以及术区的良好有效引流固定。
Objective To discuss the strategies of prevention to the complications of axil ary osmidrosis by micro-incision subcutaneous scratch. Methods 60 cases of axil ary osmidrosis by micro-incision subcutaneous scratch were observed from 2009-4 to 2010-4. Results 60 cases were treated ef ectively, complicated by skin necrosis 20 armpits, subcutaneous hematoma 6 armpits, adhesion, scar and pigmentation 34 armpits, remnant smel 4 armpits. Conclusion Micro-incision subcutaneous scratch is an ef ective surgery to axil ary osmidrosis with bad complications. The key to the operation and the prevention to the complications is exact anatomic layer, intact anatomic range of top sweat glands elimination, and the cavity drainage thoroughly, the flat fix reliably.

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目的 研究维A酸涂膜剂对兔耳早期增生性瘢痕的影响,探讨其防治瘢痕的可行性.方法 选取新西兰白兔24只,建立兔耳增生性瘢痕模型后,随机分为4组,每组6只.A组:对照组,B组:涂膜剂组,C组:0.05％维A酸涂膜剂组,D组:0.1％维A酸涂膜剂组,连续用药6周,期间观察记录瘢痕大小、厚度、颜色、硬度,6周后分别切取兔耳瘢痕组织,HE染色,胶原染色(VG法),行病理学观察、检测及分析.结果 A组瘢痕颜色深、厚而硬,并明显高于皮肤,表面凹凸不平;B组、C组、D组瘢痕颜色浅,质地软,厚度薄,皮下结节小,其中C、D组与周围正常皮肤接近,D组瘢痕表面有脱皮现象.HE、VG染色中,A组胶原排列紊乱,有旋涡状结构;C组和D组单位面积内成纤维细胞、微血管数量、胶原沉积量较A组和B组少,且胶原排列整齐,与瘢痕长轴平行.瘢痕增生指数(HI):A组3.17±0.26,B组2.46±0.19,C组1.91±0.21,D组1.90±0.23;成纤维细胞密度(NA):A组5836.70±527.03,B组4128.73±387.66,C组3207.59±439.17,D组3200.28±421.48;胶原纤维的面密度(AA):A组45.38±5.83,B组36.57±6.84,C组28.09±3.82,D组28.07±3.47.A组与B、C、D组比较,HI、NA、AA值差异均有统计学意义(P＜0.01);B组与C、D组比较,HI、NA、AA值差异均有统计学意义(P＜0.01);
Objective To estimate the effect of tretinoin gel sheeting on early-stage hyperplastic scars in rabbit ears,and to evaluate the feasibility to prevent and treat hyperplastic scars with it.Methods The ears of 24 rabbits were used to establish a model of hyperplastic scar according to previously reported methods.Then,the rabbit ears were randomly divided into four groups:control group receiving no treatment,gel sheeting group treated with the vehicle of the tretinoin gel sheeting,0.05％ tretinoin group treated with 0.05％ tretinoin gel sheeting,0.1％ tretinoin group treated with 0.1％ tretinoin gel sheeting.All the gel sheetings were topically used twice daily for six consecutive weeks.During the treatment,the size,thickness,color and texture of scars were estimated.After six weeks of treatment,all the scar tissues were resected from the rabbit ears and subjected to hematoxylin and eosin (HE) staining and van Gieson (VG) staining.Statistical analysis was carried out by analysis

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背景：既往研究发现神经生长因子在创面愈合过程中发挥重要作用，但对于成纤维细胞中神经生长因子低亲和力受体 p75及 sortilin 的研究较少，p75及 sortilin 在瘢痕组织成纤维细胞及正常皮肤组织成纤维细胞中的表达量是否有差异目前未见报道。目的：比较神经生长因子低亲和力受体 p75及 soritilin 在瘢痕疙瘩成纤维细胞及正常皮肤成纤维细胞的中表达的差异。方法：体外培养瘢痕疙瘩成纤维细胞及正常皮肤成纤维细胞，并以人永生化上皮细胞 HaCaT 为阳性对照。通过实时定量 PCR 在 mRNA 水平检测 p75及 sortilin 在瘢痕疙瘩成纤维细胞及正常皮肤成纤维细胞的表达及差异，进一步通过 Western-blot 及细胞免疫化学方法观察 p75神经营养因子受体及 sortilin 在蛋白水平的表达及差异。结果与结论：实时定量 PCR 及 Western blot 结果可见，在 mRNA 及蛋白水平瘢痕疙瘩成纤维细胞及正常皮肤成纤维细胞中 p75，sortilin 均呈阳性表达，其中瘢痕疙瘩成纤维细胞及正常皮肤成纤维细胞中 p75及 sortilin在 mRNA 及蛋白水平表达量明显少于 HaCaT，且 p75在瘢痕疙瘩成纤维细胞及正常皮肤成纤维细胞中表达差异无显著性意义，sortilin 表达量在瘢痕疙瘩成纤维细胞中明显低于正常皮肤成纤维细胞(P <0.05)。免疫细胞化学结果显示 p75及 sortilin 在瘢痕疙瘩成纤维细胞及正常皮肤成纤维细胞中的表达部位均位于胞膜及胞浆。由于神经生长因子前体与 p75受体高亲和力结合并在 sortilin 协助下发挥促进细胞凋亡的作用，sortilin在瘢痕成纤维细胞的表达明显低于正常皮肤成纤维细胞，可能与其高增殖状态有关，该结果为病理性瘢痕的防治提供了新的靶点。
BACKGROUND: Previous studies have found that nerve growth factors play an important role in the process of wound healing, but there is less research for the low-affinity nerve growth factor receptor p75 and sortilin in fibroblasts, and no reports on whether there are differences in expression of p75 and sortilin in the scar fibroblasts and normal skin fibroblasts. OBJECTIVE: To study the expression of low-affility nerve growth factor receptor p75 and sortilin in the normal human skin fibroblasts and the human keloid fibroblasts. METHODS: The keloid fibroblasts and normal hunman skin fibroblasts were cultured in vitro, and the immortalized epithelial cells HaCaT were used as the positive control. The real-time PCR was used to detect the mRNA expression of the p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts, and western blot and immunocytochemical staining were used to detect the protein expression of p75 and sortilin. RESULTS AND CONCLUSION: The real-time PC

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目的探讨苦参碱对体外培养人增生性瘢痕成纤维细胞(HSFb)基质金属蛋白酶(MMP-1、MMP-9)表达的影响。方法将浓度分别为0 mmol/L(对照组)、2.5 mmol/L、5.0 mmol/L、10.0 mmol/L苦参碱作用于体外培养人HSFb,采用酶联免疫吸附试验检测加药后上清液中MMP-1、MMP-9表达量。结果苦参碱作用24 h、48 h时各浓度组MMP-1、MMP-9的表达量均高于对照组(P0.05),5.0 mmol/L组表达量明显高于2.5 mmol/L组、10.0 mmol/L组(P0.05)。结论苦参碱可增加HSFb MMP-1、MMP-9的表达,抗瘢痕作用好,在增生性瘢痕防治上具有一定的应用前景。
Objective To study the effects of matrine on the expressions of matrix metalloproteinase (MMP)-1, MMP-9 in human hypertropic scar fibroblasts ( HSFb) in vitro.Methods HSFb was cultured in vitro by being treated with different concentrations of matrine[0 mmol/L(control group),2.5 mmol/L,5.0 mmol/L,10.0 mmol/L].Enzyme-linked immunoadsorbent assay(ELISA) was used to detect the expressions of MMP-1,MMP-9 in the treated supernatants.Results The expression levels of MMP-1,MMP-9 in groups of different concentrations of matrine were higher than those in the control group 24 or 48 hours after matrine treatment(P<0.05),the expression levels of MMP-1,MMP-9 in the 5.0 mmol/L matrine group were higher than those in the 2.5,10.0 mmol/L matrine groups ( P<0.05).Conclusion Matrine can increase the expression of MMP-1,MMP-9.It can be applied to hyperplastic scar prevention and treatment .

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