摘要：目的 探究湿润烧伤膏对糖尿病大鼠创面再上皮化过程的促进作用及其机制。方法 90只Wistar雄性大鼠用随机数字法分为5组：MEBO组、rb-bFGF组、模型组、对照组、空白组，每组18只。对照组建立急性创面模型；MEBO组、rb-bFGF组、模型组建立糖尿病创面模型。对照组、模型组大鼠创面予以生理盐水外敷治疗；MEBO组、rb-bFGF组分别予以MEBO和rb-bFGF外敷治疗；空白组只做备皮处理。各组创面于第3、7、14天分别随机取6只大鼠，采集创面组织标本并保存。随后进行Masson染色，观察各组胶原纤维生成及再上皮化情况。免疫荧光、蛋白印迹和qRT-PCR方法检测创面组织FoxO1、E-cadherin及Vimentin等因子表达。结果 在造模第7、14天，对照组、MEBO组及rb-bFGF组创面愈合率高于模型组(P<0.05),且创面显示胶原纤维生成及再上皮化情况更好。在造模第3天，MEBO组中AKT蛋白及mRNA表达量高于模型组(P<0.05);第7天，MEBO组及rb-bFGF组中PI3K、AKT、FoxO1、Vimentin蛋白及mRNA表达量高于模型组(P<0.05),E-cadherin、Claudin1则低于模型组(P<0.05);第14天，与模型组相比，MEBO组及rb-bFGF组中AKT、FoxO1、Vimentin蛋白及mRNA表达量降低(P<0.05),E-cadherin、Claudin1表达量升高(P<0.05)。结论 湿润烧伤膏能促进糖尿病大鼠创面愈合，其可能作用机制是通过激活PI3K/AKT/FoxO1通路，并影响创面组织中E-cadherin、Claudin1、Vimentin表达及EMT转化过程实现的。

摘要：目的:本项目拟通过PI3K/AKT/HIF-1α信号通路探讨再生医疗技术促进慢性难愈合创面修复的部分分子机制,结合前期课题研究结果,进一步完善慢性难愈合创面的病理机制研究,为慢性难愈合创面的治疗提供思路及参考。同时也为完善再生医疗技术在慢性难愈合创面上的作用机制,为再生医疗技术在临床上的推广应用增强科学理论依据。方法:90只从广西医科大学购买的SPF级别大鼠,均为雄性大鼠。购买后饲养在右江民族医学院SPF级别动物科学实验中心,随机分为:空白组、急性组及慢性难愈合创面组,其中空白组的大鼠不做任何有损伤性处理,急性组行全层皮肤缺损处理,慢性难愈合创面组是首先进行全层皮肤缺损处理,再参照付小兵等全层皮肤缺损法和沈氏改良塑料环肉芽肿定量法经改进制成的大鼠慢性难愈合创面。即在行全层皮肤切除后注射氢化可的松。慢性难愈合创面组再按造模后的处理方法不同随机分为慢创组(即模型组),贝复新组及美宝组,慢创组即造模后无药物干预治疗;贝复新组是造模后使用贝复新药物干预治疗;美宝组是造模后使用再生医疗技术(moist exposed burn therapy/moist exposed burn ointment,MEBT/MEBO)干预治疗。各组创面制备后立即用药治疗。各组换药前均以1/5000呋喃西林液清洁创面,每日换药2次。动物模型制备完成后,每天使用SONY摄像机拍摄创面,以便创面愈合率分析;各组于造模后3d、7d、14d共3个时相点随机取6只大鼠腹腔麻醉后,切取整个创面肉芽组织。所取组织部分放入甲醛中固定,之后行HE染色及CD31免疫组化检查,余下样品迅速冻于-80℃冰箱,收集所有时相点的组织标本后统一进行Western blot检测。从宏观的创面愈合率及病理切片的炎症细胞浸润和血管新生,到微观的蛋白分子信号转导通路上研究慢性难愈合创面的病理机制及再生医疗技术在慢性难愈合创面的潜在机制。结果:(1)创面愈合率,除空白组外,各组愈合率均逐渐上升,在14d观察时相点,急性组创面的愈合率为:0.965±0.019,慢创组创面的愈合率为:0.468±0.013,贝复新组创面的愈合率为:0.975±0.007,美宝组创面的愈合率为:0.974±0.002。慢创组与急性组的P<0.001,慢创组与贝复新组的P<0.001,慢创组与美宝组的P<0.001,均有统计学差异。急性组与贝复新组的P=0.630,急性组与美宝组的P=0.709,贝复新...

摘要：Ethnopharmacological relevance The diabetic wound is one of the common chronic complications of diabetes, which seriously affects patients’ quality of life and even causes disability and death. Traditional Chinese medicine (TCM) is a unique and precious resource in China, which has a good curative effect and safety. At present, it has been found that Chinese herbal compounds and effective active ingredients can effectively promote diabetic wound healing, and its mechanism needs to be further studied. Signaling pathways are involved in the pathogenesis and progression of diabetic wounds, which is one of the main targets for the pathologic mechanism of diabetic wounds and the pharmacological research of therapeutic drugs. Aim of the review This study has been carried out to reveal the classical signaling pathways and potential targets by the action of TCM on diabetic wound healing and provides evidence for its clinical efficacy. Materials and methods “diabetic wound”, “diabetic foot ulcer”, “traditional Chinese medicine”, “natural plant” and “medicinal plant”, were selected as the main keywords, and various online search engines, such as PubMed, Web of Science, CNKI and other publication resources, were used for searching literature. Results The results showed that TCM could regulate the signaling pathways to promote diabetic wound healing, such as Wnt, Nrf2/ARE, MAPK, PI3K/Akt, NF-κB, Notch, TGF-β/Smad, HIF-1α/VEGF, which maintaining inflammatory interaction balance, inhibiting oxidative stress and regulating abnormal glucose metabolism. Conclusion The effect of TCM on diabetic wound healing was reflected in multiple levels and multiple pathways. It is envisaged to carry out further research from precision-targeted therapy, provide ideas for screening the core target of TCM in treating diabetic wounds and create modern innovative drugs based on this target.

摘要：糖尿病性溃疡的临床发病率较高,且发病机制较为复杂、愈合过程较为缓慢,已成为临床上需要迫切解决的难题。近年来,烧伤创疡再生医疗技术(MEBT/MEBO)等中医疗法在提高糖尿病性溃疡治疗效果、降低患者截肢率方面取得了较为显著的临床疗效。但相关研究资料显示,中医药作为我国传统的治疗方式虽具有其独特的优势,可临床上仅13%的患者会在治疗过程中联合应用。为提高中医药的关注度以及指导糖尿病性溃疡的临床治疗、为MEBT/MEBO治疗糖尿病性溃疡提供理论支持,笔者通过查阅大量基础研究资料,对MEBT/MEBO通过调节PI3K/Akt信号通路、 MAPK信号通路、 Wnt/β-catenin信号通路、 TGF-β1/Smad信号通路、 NF-κB信号通路和PI3K/Akt/mTOR信号通路的转导而参与糖尿病性溃疡修复的作用机制进行了综述。