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郑惠灵 孙 柯 陈 惠 盖玉宁 郑喜灿

作者单位: 450007 河南 郑州, 中国人民解放军联勤保障部队第九八八医院外科 通信作者: 郑喜灿, Email: 13803818952@ 163.com

【摘要】 目的 系统分析负压封闭引流对开放性骨折创面的治疗效果。 方法 计算机检索中国期刊全文数 据库 (中国知网)、 中国生物医学文献数据库 (CBM)、 中文科技期刊数据库 (维普)、 中国学术期刊数据库 (万 方)、 The Cochrane Library、 PubMed、 OVID、 Web of Science、 CINAHL 等数据库建库至 2018 年 8 月公开发表的负 压封闭引流治疗开放性骨折创面的相关文献, 根据纳入与排除标准筛选符合标准的文献, 采用 Cochrane 5. 1.0 手 册中的偏倚风险评估标准对纳入文献进行质量评价, 采用 Rev Man 5.3 软件对纳入文献进行 Meta 分析、 TSA 0. 9 软件对纳入文献进行试验序贯分析。 结果 共纳入符合标准的文献 10 篇, 包含开放性骨折患者 1097 例。 Meta 分 析结果显示, 创面行负压封闭引流治疗的开放性骨折患 者 创 面 感 染 率 明 显 低 于 常 规 治 疗 [ RR = 0.43, 95% CI (0.31,0. 60), P < 0. 001], 治疗有效率明显高于常规治疗 [ RR = 1.33, 95% CI (1.19, 1. 50), P < 0.001], 创面愈合时间明显短于常规治疗 [SMD = - 4. 87, 95% CI ( - 7.21, - 2.52), P < 0.001]; 试验序贯分 析结果显示, 各结局指标在样本量达到期望信息量之前已获得肯定结果。 结论 与常规治疗方法相比, 负压封闭 引流能更有效降低开放性骨折创面感染率, 提高治疗有效率, 缩短创面愈合时间。

【关键词】 负压封闭引流; 开放性骨折; Meta 分析; 试验序贯分析; 感染; 创面愈合时间

【标志符】 doi: 10.3969 / j. issn.1001⁃0726. 2022. 01. 009

【文章类型】 临床研究

黄金梅 唐 婷 韦柳叶 付 军 唐乾利 HUANG Jinmei, TANG Ting, WEI Liuye, FU Jun, TANG Qianli

基金项目: 国家自然科学基金面上项目 (81774327); “广西特聘专家” 专项经费资助项目 (桂人才通字 [2019] 13 号); 广西 医学高层次领军人才培养 “139” 计划资助项目 (桂卫科教发 [2018] 22 号) 作者单位: 530001 广西 南宁, 广西中医药大学研究生院 2020 级中医外科专业 (黄金梅, 唐婷, 韦柳叶); 530023 广西 南宁, 广西中医药大学第一附属医院肛肠外科 (付军); 533000 广西 百色, 右江民族医学院/ 桂西高发病防治重 点实验室 (唐乾利) 通信作者: 唐乾利, Email: htmgx@ 163

作者单位: 124010 辽宁 盘锦, 盘锦市人民医院创面修复科 通信作者: 张伟, Email: 1016733520@ qq

Fang Zhang1,2, Ye Liu2 , Shiqi Wang1 , Xin Yan1 , Yue Lin1 , Deyan Chen2*, Qian Tan1* and Zhiwei Wu2,3,4*

1 Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China, 2 Center for Public Health Research, Medical School, Nanjing University, Nanjing, China, 3 State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China, 4 Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.

       Diabetic foot ulcer (DFU) frequently leads to non-traumatic amputation and finally even death. However, the mechanism of DFU is not fully understood. Interleukin 25 (IL-25), an alarmin cytokine that responds to tissue injury, has been reported to participate in tissue regeneration and maintaining glucose homeostasis. However, the role of IL-25 in diabetic wound healing remains unknown. Here, we showed that interleukin 17 receptor B (IL- 17RB), the functional receptor of IL-25, was significantly inhibited in the wound skin of both diabetic patients with DFU and streptozotocin (STZ)-induced diabetic mice. Topical administration of recombinant IL-25 protein improved angiogenesis and collagen deposition in the wound bed and thus ameliorated delayed diabetic wound healing. IL- 25 increased endothelial-specific CD31 expression in diabetic wounds and exogenous IL- 25 protected endothelial cells from high glucose-impaired cell migration and tube formation in vitro. We further revealed that IL-25-mediated-IL-17RB signaling rescued the downregulation of Wnt/b-catenin pathway both in vivo in diabetic mice and in vitro in HUVECs and induced the phosphorylation of AKT and ERK 1/2 in HUVECs under high glucose conditions. This study defines a positive regulatory role of IL-25-mediated-IL- 17RB signaling in diabetic wound healing and suggests that induction of IL-25-mediated  IL-17RB signaling may be a novel therapeutic strategy for treating poor healing diabetic wounds.

Keywords: IL-25, IL-17RB, diabetes mellitus, wound healing, endothelial cell functions.