摘要：Cosmetic, functional, and structural sequelae of scarring are innumerable, and measures exist to optimize and ultimately minimize these sequelae. To evaluate the innumerable methods available to decrease the cosmetic, functional, and structural repercussions of scarring, pubMed search of the English literature with key words scar, scar revision, scar prevention, scar treatment, scar remodeling, cicatrix, cicatrix treatment, and cicatrix remodeling was done. Original articles and reviews were examined and included. Seventy-nine manuscripts were reviewed. Techniques, comparisons, and results were reviewed and tabulated. Overall, though topical modalities are easier to use and are usually more attractive to the patient, the surgical approaches still prove to be superior and more reliable. However, advances in topical medications for scar modification are on the rise and a change towards medical treatment of scars may emerge as the next best approach. Comparison studies of the innumerable specific modalities for scar revision and prevention are impossible. Standardization of techniques is lacking. Scarring, the body's natural response to a wound, can create many adverse effects. At this point, the practice of sound, surgical fundamentals still trump the most advanced preventative methods and revision techniques. Advances in medical approaches are available, however, to assist the scarring process, which even the most advanced surgical fundamentals will ultimately lead to. Whether through newer topical therapies, light treatment, or classical surgical intervention, our treatment armamentarium of scars has expanded and will allow us to maximize scar prevention and to minimize scar morbidity.

摘要：New hopes in cell therapies have steadily arisen with ongoing progress in stem cell research, and innumerable conditions could be now treated and cured, from musculoskeletal injuries to diabetes to cardiac failure, to cite but a few, with the appropriate stem cells available. Arguably, the ideal therapeutic stem cells are those that naturally heal, repair, and replenish the target tissue in life, and research from the last decades has uncovered the presence of such committed, specialized stem cells in most organs. However, these cell lineage-specific regenerative cells are rare, difficult to identify and purify, and virtually impossible to culture for amplification as functionally intact, undifferentiated units. For this reason, and with the notable exception of hematopoietic stem cells, these are not presently amenable to clinical utilization.From the 1980's, Prof. Rongxiang Xu developed the theory that some of the pluripotent stem cells that build the embryo in early development also establish through adult life a minor subset of cells which, although seemingly terminally differentiated, retain strong multi-lineage developmental potential. He called these "potential regenerative cells" (PRCs), proposing these can be recruited into tissue repair and regeneration when no other progenitor cells are available (1). Although this hypothesis could not be fully tested experimentally at the time, it later turned out as strikingly visionary: on the one hand, it was demonstrated that mature cells can be reprogrammed into stem cells in culture, a discovery rewarded by attribution of the Nobel Prize in Medicine or Physiology in 2012 (2). Hence, transition from a functional, specialized cell back into a naïve, unbiased stem cell is, biologically, feasible and might explain the persistence of Rongxiang Xu's PRCs in adult organs. Another example in support of PRC existence refers to mesenchymal stem cells. MSCs are multipotent cells that can differentiate in culture into bone, cartilage, fat, tendon, muscle, and indirectly support, via growth factor secretion, the regeneration of multiple other tissues (3). This extraordinary potential has stimulated the use of MSCs in over 2000 clinical trials in attempts to treat multiple conditions in cardiology, orthopaedics, cancerology, nephrology, and many other specialties including medical immunology, since MSCs are also immunosuppressive (see clinicaltrials.gov). Despite such a popularity, progress in MSC science has long been hindered by the unknown identity of native, tissueresident mesenchymal stem cells, since these cells appear and expand in extended cultures of total, unselected cell populations dissociated from bone marrow, adipose tissue, umbilical cord, or other organs. Put in other words, MSCs are normally produced in vitro from elusive, rare ancestor cells that have long resisted description. This changed when multicolour, stringent flow cytometry cell sorting and sensitive differentiation assays were used for MSC prospective identification. In full support of the PRC concept proposed by Rongxiang Xu, innate tissue resident mesenchymal stem cells turned out to be differentiated perivascular cells of documented function. Pericytes, which enwrap capillaries and microvessels, regulate blood pressure and control angiogenesis. Equivalent cells populate the tunica adventitia at the periphery of larger blood vessels. Both purified pericytes and adventicytes give rise to bona fide mesenchymal stem cells when cultured in vitro (4,5). The use of transgenic reporter mice, in which cell lineages can be tracked dynamically, has confirmed the progenitor cell potential of perivascular cells in vivo (6). In aggregate, all these results have confirmed that differentiated cells can be reprogrammed into regenerative cells in culture and in the living organism, thus supporting Dr Xu's hypothesis on the existence of PRCs in adult organs.Professor Rongxiang Xu contributed to the development of formulations, mostly inspired by traditional Chinese medicine, for stem cell (PRC) stimulation in situ and in culture. Such a supplement, for instance, named GIC, was claimed to regenerate the gastrointestinal mucosa, as well as nerves, in culture. More recently, the LifeRegen Inc. company developed a line of products inspired by Dr Xu's research and patents were issued for a proprietary blend of natural ingredients produced via an original manufacturing process. All LifeRegen protocols rely on the infusion of combined black sesame oil, skullcap root, and beeswax. These products are considered GRAS (generally recognized as safe) by the FDA, and represent a scientific breakthrough merging ancient Chinese medicine recipes and Rongxiang Xu's groundbreaking results that are, moreover, being supported and extended by ongoing current research. More precisely, GI Balance and Juvenate Skincare are LifeRegen's proprietary formulations developed to nurture and renew the gut lining and create a cellular, rejuvenation promoting protective barrier for the skin, respectively.The insightful Prof. Rongxiang Xu predicted that some of the cells that constitute developed organs retain stem potential, and hence can be qualified as "potentially regenerative cells", and devised formulations that can stimulate such cells into tissue regeneration. He left us a rich legacy of centers at prestigious institutions, such as the Rongxiang Xu Center for Regenerative Therapeutics at Beth Israel Deaconess Medical Center in Boston, the Rongxiang Xu Center for Regenerative Life Science at the University of Southern California, and the Rongxiang Xu College of Health and Human Services at Cal state LA.The LifeRegen company has resumed and considerably amplified and diversified Dr Xu's approach to regenerative medicine, and is now sponsoring clinical studies for the GI Balance supplement that in previous published research enabled regeneration and rejuvenation of the entire gut mucosa within 6 months. In a more fundamental investigation perspective, PRCs have been prospectively identified and characterized in depth, for instance as pericytes and other perivascular elements, and can be purified to homogeneity and in large numbers from multiple organs (3). This opens unforeseen possibilities in regenerative medicine research whereby such well-characterized potential regenerative cells can be selected from the bone marrow, pancreas, skin, adipose tissue and other organs and treated with natural supplements for enhanced proliferation, migration, and differentiation. Such protocols should be initialized in culture and further developed in vivo by transplantation into relevant animal hosts. In perspective are novel biomolecular manoeuvres to drive the improved healing and replenishment of, for instance but not exclusively, cardiovascular, musculoskeletal, and epithelial tissues.

摘要：Background:? Pressure ulcers often seriously affect the quality of life of patients. Moist Exposed Burn Ointment (MEBO) has been developed to treat patients with pressure ulcers. The present study aimed to evaluate the efficacy and safety of MEBO in the treatment of pressure ulcers in Chinese patients. Methods:? Seventy-two patients with pressure ulcers were randomly assigned to 2 groups who received a placebo or MEBO for 2 months. The primary outcomes included the wound surface area (WSA) and pressure ulcer scale for healing (PUSH) tool. The secondary outcomes included a visual analog scale (VAS), questionnaire of ulcer status, and adverse effects. Results:? Sixty-seven patients completed the study. After 2 months of treatment, the difference of mean change from the baseline was greater for MEBO (vs placebo) for WSA mean (SD) ?6.0 (?8.8, ?3.3), PUSH Tool ?2.6 (?4.7, ?1.5), and VAS score ?2.9 (?4.4, ?1.7). On the basis of the questionnaire, the pressure ulcers were “completely healed” (50.0% vs 16.7%) (P < .05) in patients after 2 months of treatment with MEBO versus placebo. No major adverse effects were found in the 2 groups. Conclusion:? We showed that MEBO is effective and well tolerated for improving wound healing in Chinese patients with pressure ulcers.

摘要：Introduction:? After partial-thickness skin graft (PTSG) harvesting, a dermal surface is exposed and an iatrogenic wound is created. Application of various agents has been studied for enhancement of healing process in PTSG donor area. The ideal agent should accelerate healing, provide comfort to the patient, not allow infection, and be easily applicable and cheap. Materials and Methods:? The Cochrane Central Register of Controlled Trials, PubMed, Scopus. and EMBASE databases were screened for words (“skin graft” + “donor”), by using time limits between 1989 and 2018. This study involved a total of 5 systematic reviews and 43 original articles which met the inclusion criteria. Articles were reviewed and parameters such as healing time, pain, infection rate, cosmetic result, and cost were extracted. Results:? Systematic reviews favor moist dressing materials over dry ones considering healing time and patient comfort. Hydrocolloids provide rapid wound healing, and dressing changes do not cause any disruption to the newly regenerated epithelium. Alginates seem to have a longer healing time than hydrocolloid materials. Polyurethane films are characterized by rapid epithelialization and painless monitoring as well as low costs. The epithelialization time of MEBO?, a cosmeceutical product, is reported to be faster than polyurethane films. Local and systemic drug applications warrant further research before routine clinical usage. Conclusion:? Dressing materials are the most commonly used and appropriate group according to the studies performed to date. It is seen that moist dressing materials are more favorable. Although there is not a subgroup with a clear superiority, it can be seen that the hydrofiber and polyurethane film groups are one step ahead in terms of ease of use, patient comfort, epithelialization speed, and scar quality. Polyurethane films have a cost advantage to the hydrofiber group.