Nicotinamide Riboside Enhances Endothelial Precursor Cell Function to Promote Refractory Wound Healing Through Mediating the Sirt1/AMPK Pathway

Zhen-hua Wang1,2† , Xiao-gang Bao3† , Jun-jie Hu4 , Si-bo Shen5 , Guo-hua Xu3 * and Ye-lin Wu1*

1 Tongji University Cancer Center, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China,  2 Department of Laboratory Medicine, Changzheng Hospital, Naval Medical University, Shanghai, China, 3 Department of Orthopedic Surgery, Spine Center, Changzheng Hospital, Naval Medical University, Shanghai, China, 4 Basic Medical College, Naval Medical University, Shanghai, China, 5 Hebei Key Laboratory of Active Components and Functions in Natural Products, College of Chemical Engi-neering, Hebei Normal University of Science and Technology, Qinhuangdao, China

       Lack of vascularization is directly associated with refractory wound healing in diabetes mellitus (DM). Enrichment of endothelial precursor cells (EPCs) is a promising but challenging approach for the treatment of diabetic wounds. Herein, we investigate the action of nicotinamide riboside (NR) on EPC function for improved healing of diabetic wounds. Db/ db mice that were treated with NR-supplemented food (400 mg/kg/d) for 12 weeks exhibited higher wound healing rates and angiogenesis than untreated db/db mice. In agreement with this phenotype, NR supplementation significantly increased the number of blood EPCs and bone marrow (BM)-derived EPCs of db/db mice, as well as the tube formation and adhesion functions of BM-EPCs. Furthermore, NR-supplemented BM-EPCs showed higher expression of sirtuin 1 (Sirt1), phosphorylated adenosine monophosphate–activated protein kinase (p-AMPK), and lower expression of acetylated peroxisome proliferator–activated receptor γ coactivator (PGC-1α) than BM-EPCs isolated from untreated db/db mice. Knockdown of Sirt1 in BM-EPCs significantly abolished the tube formation and adhesion function of NR as well as the expression of p-AMPK and deacetylated PGC-1a. Inhibition of AMPK abolished the NR-regulated EPC function but had no effect on Sirt1 expression, demonstrating that NR enhances EPC function through the Sirt1-AMPK pathway. Overall, this study demonstrates that the oral uptake of NR enhances the EPC function to promote diabetic wound healing, indicating that NR supplementation might be a promising strategy to prevent the progression of diabetic complications.

Keywords: diabetes mellitus, endothelial precursor cells, nicotinamide riboside, wound healing, sirtuin 1, adenosine monophosphate–activated protein kinase

Kikuhime Device in the Management of Venous Leg Ulcers

This article was published in the following Dove Press journal: Clinical Interventions in Aging

Marian Karafa Anna Karafova Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland

Abstract: The effectiveness of compression therapy in the treatment of venous leg ulcers has been confirmed in many scientific studies. The healing process depends on many of its parameters, such as the type of compression bandages, their elastic properties and subbandage pressure. However, there is no standard protocol that would ensure success for all patients. A pressure of about 83 mmHg provides complete compression for both superficial and deep veins; however, applying compression bandages under such high pressure is a difficult task, even for experienced therapists. Here, we present the case of a 61-year-old woman with approximately 2.5-year-old venous ulcer in her left leg due to chronic venous insufficiency (CVI). Our study aimed to show that routine pressure control at each bandage renewal using the Kikuhime device, as well as their twice daily application in the first week of therapy reduced the healing time of a venous leg ulcer with an area of about 20 cm2 to four weeks.

Keywords: venous ulcers, compression therapy, sub-bandage pressure, Kikuhime device

Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial

Qian Lu,1 Zhifei Yin,2 Xuefeng Shen,3 Jinhua Li,3 Panpan Su,1 Min Feng,1 Xingjun Xu,2 Weiwei Li,1 Chuan He,1 Ying Shen

ABSTRACT

Objective To investigate the effectiveness of highintensity laser therapy (HILT) on chronic refractory wounds.

Design

Randomised controlled trial.

Setting The outpatient wound care department of the Affiliated Jiangsu Shengze Hospital of Nanjing Medical University from August 2019 to June 2020.

Participants Sixty patients were enrolled in this study and were randomised into control (n=30) and treatment (n=30) groups.

Interventions and outcome measures The control group was treated only with conventional wound dressing, whereas the treatment group received irradiation with HILT in addition to standard wound care, such as debridement, wound irrigation with normal saline solution and application of dressing and sterile gauze. Patient scores on the Bates-Jensen Wound Assessment Tool (BWAT) and Pressure Ulcer Scale for Healing (PUSH) were evaluated before and after 1, 2 and 3 weeks of treatment.

Results One patient was excluded from the control group, and a total of 59 subjects completed the trial. The BWAT scores significantly decreased in the treatment group compared with the control group at the end of 3-week treatment (difference=−3.6; 95% CI −6.3 to–0.8; p<0.01). Similarly, patients in treatment group showed a significant reduction of PUSH scores compared with the control group (difference=−5.3; 95% CI −8.1 to –2.6; p<0.01).

Conclusions The therapeutic effects of HILT on chronic refractory wounds are significant and far more superior to those of conventional wound dressing.

Trial registration number Chinese Clinical Trial Registry; ChiCTR1900023157. URL: http://www.chictr.org.cn/ showproj.aspx?proj=38866

A modified negative pressure wound therapy for the treatment of refractory wounds

A preliminary study

Dong Xing, MD, Zhaoxu Yang, MM, Can Cao, MM, Zhijie Dong, MM, Jingchao Wei, MM, Xuehong Zheng, MM, Wenyi Li, MM

Abstract

       Negative pressure wound therapy (NPWT) is an important therapy for the management of refractory wounds. The aim of this retrospective preliminary study was to introduce a modified NPWT (m-NPWT) and compared the efficacy of it with conventional NPWT (c-NPWT) in the management of refractory wounds. A total of 127 patients with refractory wounds receiving the NPWT from January 2010 to October 2017 in our hospital were retrospectively reviewed. The demographics and clinical data were collected from medical records and compared between m-NPWT group and c-NPWT group. There were 65 patients in c-NPWT group and 62 patients in m-NPWT group. No significant difference was observed between 2 groups in antimicrobial use (P=.51), hospitalization time (P=.24), wound-healing rate (P=.44) or complication rate (P=.59). However, patients in m-NPWT group had shorter wound-healing time (24.82 vs 27.66 days, P<.01), less debridement times (1.23 vs 2.08, P<.01), less total cost (3743.93 vs 6344.33 yuan, P<.01) and higher satisfaction rate (56/62 vs 44/65, P=.02) compared to those in c-NPWT group. The m-NPWT technique was an efficient and safe alternative therapy for refractory wounds.

Abbreviations: c-NPWT = conventional NPWT, m-NPWT = modified NPWT, NPWT = negative pressure wound therapy.

Keywords: modified negative pressure wound therapy, refractory wounds, total cost., wound-healing time

纳米银医用抗菌敷料、 康复新液与湿润烧伤膏 联合应用治疗Ⅳ期压疮的疗效分析

邓金星 林君德 邓飞扬

作者单位： ３３６１００ 江西 宜春， 万载县人民医院烧伤整形科 （邓金星， 林君德）， 外科 （邓飞扬） 通讯作者： 邓金星， Ｅｍａｉｌ： ｗｚｄｊｘ６５０２２８＠ １６３.ｃｏｍ

【摘要】 目的 对比分析纳米银医用抗菌敷料、 康复新液及湿润烧伤膏联合应用与磺胺嘧啶银软膏及复方 烧伤油联合应用治疗Ⅳ期压疮的临床疗效。 方法 选取 ２０１７ 年 １ 月至 ２０１９ 年 ８ 月万载县人民医院收治的 ５６ 例Ⅳ 期压疮患者作为研究对象， 并按照不同治疗方法将其分为观察组 （２８ 例） 与对照组 （２８ 例）， 其中观察组患者 局部创面行纳米银医用抗菌敷料、 康复新液及湿润烧伤膏联合治疗， 对照组患者局部创面行磺胺嘧啶银软膏及复 方烧伤油联合治疗， 对比两组患者创面愈合时间及临床疗效。 结果 治疗 ２ 个月后， 观察组患者治愈 ２０ 例、 有 效 ８ 例， 总有效率为 １００％ ， 明显优于对照组患者的治愈 １４ 例、 有效 ６ 例、 无效 ８ 例， 总有效率 ７１.４３％ （Ｍａｎｎ⁃ Ｗｈｉｔｎｅｙ Ｕ ＝ ２７６.０００， Ｚ ＝ － ２.１８３， Ｐ ＝ ０.０２９）。 最终两组患者创面均完全愈合， 其中观察组患者创面愈合时间 为 （５０.６５ ± １２. ３４） ｄ， 明显短于对照组患者的创面愈合时间 （８２.３５ ± １９. ７９） ｄ （ ｔ ＝ ７. １９２， Ｐ ＝ ０.０００）。 结 论 纳米银医用抗菌敷料、 康复新液及湿润烧伤膏联合应用有利于Ⅳ期压疮创面的再生修复， 缩短创面愈合时 间， 疗效显著， 值得临床推广应用。

【关键词】 湿润烧伤膏； 纳米银医用抗菌敷料； 康复新液； 磺胺嘧啶银； 压疮； 疗效

【标志符】 ｄｏｉ： １０.３９６９ ／ ｊ.ｉｓｓｎ. １００１⁃０７２６. ２０２０.０４. ００３

【文章类型】 临床应用

ＭＥＢＯ 联合 ＶＳＤ 对糖尿病性难愈创面患者血清 ＩＬ⁃６、 ＴＮＦ⁃α、 ＣＲＰ 水平的影响

徐 鑫 赵 锴

作者单位： ４７６１００ 河南 商丘， 商丘市第一人民医院内分泌科 通讯作者： 徐鑫， Ｅｍａｉｌ： ５３４３８０７８＠ ｑｑ. ｃｏｍ

【摘要】 目的 分析探讨湿润烧伤膏 （ ｍｏｉｓｔ ｅｘｐｏｓｅｄ ｂｕｒｎ ｏｉｎｔｍｅｎｔ， ＭＥＢＯ） 联合负压封闭引流 （ ｖａｃｕｕｍ ｓｅａｌｉｎｇ ｄｒａｉｎａｇｅ， ＶＳＤ） 对糖尿病性难愈创面患者血清白细胞介素⁃６ （ ＩＬ⁃６）、 肿瘤坏死因子⁃α （ＴＮＦ⁃α） 及 Ｃ⁃反 应蛋白 （ＣＲＰ） 水平的影响。 方法 选取 ２０１７ 年 ６ 月至 ２０１９ 年 ６ 月商丘市第一人民医院收治的 ９０ 例糖尿病性难 愈创面患者作为研究对象， 并按照随机数表法将其随机分为研究组 （４５ 例） 与对照组 （４５ 例）， 其中研究组患 者予以 ＭＥＢＯ 联合 ＶＳＤ 治疗局部创面， 对照组患者单独予以 ＶＳＤ 治疗局部创面， 动态监测对比两组患者血清 ＩＬ⁃６、 ＴＮＦ⁃α、 ＣＲＰ 水平变化情况。 结果 治疗第 ３、 ７、 １４、 ２１ 天， 两组患者血清 ＩＬ⁃６、 ＴＮＦ⁃α、 ＣＲＰ 水平均呈 先升高后降低的趋势， 且治疗第 ３ 天研究组患者血清 ＩＬ⁃６、 ＴＮＦ⁃α、 ＣＲＰ 水平均明显高于对照组 （ ｔ ＝ ４.３５７、 ２.２１９、 ３.００６， Ｐ ＝ ０.０００、 ０. ０２９、 ０. ００３）， 而治疗第 ２１ 天研究组患者血清 ＩＬ⁃６、 ＴＮＦ⁃α、 ＣＲＰ 水平均明显低于 对照组 （ｔ ＝ ５.２９１、 ３.７１７、 ３.７６４， Ｐ 均 ＝ ０. ０００）。 结论 与 ＶＳＤ 单独应用相比， ＭＥＢＯ 与 ＶＳＤ 联合应用可使创 面快速进入炎症反应期， 从而促进创面快速愈合。

【关键词】 湿润烧伤膏； 负压封闭引流； 糖尿病性难愈创面； 白细胞介素⁃６； 肿瘤坏死因子⁃α； Ｃ⁃反应蛋 白； 临床意义 【标志符】 ｄｏｉ： １０.３９６９ ／ ｊ.ｉｓｓｎ. １００１⁃０７２６.２０２０.０４.００２

【文章类型】 临床应用