摘要:Purpose: To investigate the bioactive components and mechanism of action of moist exposed burn ointment (MEBO) for treatment of diabetic foot ulcers using network pharmacology (NP) and molecular docking technology Methods: Through pharmacology database of traditional Chinese medicine (TCM) systems (TCMSP), analysis platform and symptom mapping (SymMap) database, the bioactive components of MEBO were screened for and protein binding to bioactive components was predicted. Proteins related to Diabetic foot ulcer (DFU) were collected from GeneCards, OMIM, PharmGkb and TTD disease databases. With R language software, the binding proteins of bioactive components of MEBO intersected with the proteins related to occurrence of DFU. Proteins of DFU linked to treatment with MEBO were subjected to analysis using gene ontology (GO) and KEGG with R language software. AutoDock and PyMOL software were employed to dock active components of MEBO and major proteins of DFU. Targeted binding potential of bioactive compounds in MEBO to core proteins of DFU was analyzed. Results: One hundred and five (105) bioactive ingredients and 246 likely therapeutic proteins were obtained. Proteins were mainly involved in biological processes in wound healing, oxidative stress, and lipopolysaccharide. The enriched signaling pathway focused on lipid metabolism and the process of atherosclerosis which involved PI3K and Akt, advanced glycation end-products (AGE)-receptor (RAGE) and mitogen-activated protein kinase (MAPK). The absolute values of these proteins were screened out with a docking score greater than 5 kcal/mol. Conclusion: The biological effects of MEBO are related to multiple proteins and multiple signaling pathways. Therefore, healing effect of MEBO on DFU occurs via multiple pathways. The biological characteristics of MEBO need to be fully elucidated in further studies.
摘要:In laser-induced partial-thickness burns of pig skin, moist exposed burn ointment (MEBO) produces a moist environment, allows drainage of exudates, reduces eschar formation, and accelerates debridement and wound healing. A prospective multi-center study was conducted to evaluate the effect of MEBO on the healing of partial-thickness burn wounds. We included 52 patients with 100 burn sites ranging from 0.5% to 15% total body surface area in the study. Treatment efficacy was assessed on physical examination of the wound, the course of time of trans-epidermal water loss (TEWL) and moisture values, bacterial wound colonization and the degree of pain experienced by patients during and between dressing changes. Using the Visual Analogue Thermometer device (VAT) a progressive decrease of pain was found throughout the treatment which was statistically significant at 6, 9 and 12 post-burn days. TEWL, as an indicator of re-epithelialization, demonstrated a decreasing trend on day 3, and the reduction became significant from the 6th post-burn day. Moisture was significantly decreased during the first 5 post-burn days. As re-epithelialization progressed there was a net decrease in moisture paralleling TEWL. After 1 week of MEBO treatment, bacterial wound colonization decreased to 10% in the immediate group and to 61% in the late group of application. By the second week, colonization dropped to 5% and 23% respectively. Topical ointment application contributed to the debridement of the wound bed facilitating rapid epithelialization within 2–6 days, depending on the burn depth. MEBO is an ointment that can effectively produce a moist and wet environment for optimal healing of partial-thickness burns.
摘要:Cutaneous delayed wounds are a challenging clinical problem, and vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) exhibit key roles in wound healing. Moist exposed burn ointment (MEBO), a Chinese burn ointment with a USA patented formulation, has been reported to promote chronic ischemic and neurogenic ulcer healing in patients; however, the underlying mechanisms remain unclear. In the present study, MEBO significantly promoted the formation of granulation tissue in cutaneous excisional wounds, shortened the time of wound healing, and increased neovascularization and the number of fibroblasts. Furthermore, as well as enhancing the protein expression, MEBO application also increased the gene expression of VEGF and bFGF. The results indicate that MEBO promotes cutaneous excisional wound healing by at least partially enhancing VEGF and bFGF production, implicating the potential uses of MEBO for delayed cutaneous wound healing.
摘要:作者应用烧伤湿润暴露疗法结合抗休克、抗感染、营养支持疗法治疗护理重度、特重度烧伤84例,除4例因DIC及多功能脏器衰竭死亡,余80例均治愈出院,效果满意。文章着重从休克期护理、创面护理、营养护理和心理护理等进行了经验总结,可供临床护理工作者参考。