One of the current challenges in burn wound care is the development of multifunctional dressings that can protect the wound from bacteria or organisms and promote skin regeneration and tissue reconstitution. To this end, we report the design and fabrication of a composite electrospun membrane, comprised of electrospun polylactide: poly(vinyl pyrrolidone)/polylactide:poly(ethylene glycol) (PLA:PVP/PLA:PEG) core/shell fibers loaded with bioactive agents, as a functionally integrated wound dressing for efficient burns treatment. Different mass ratios of PLA:PVP in the shell were screened to optimize mechanical, physicochemical, and biological properties, in addition to controlled release profiles of loaded antimicrobial peptides (AMPs) from the fibers for desirable antibacterial activity. Fibroblasts were shown to readily adhere and proliferate when cultured on the membrane, indicating good in vitro cytocompatibility. The introduction of PLA beads by electrospraying on one side of the membrane resulted in biomimetic micro-nanostructures similar to those of lotus leaves. This designer structure rendered the composite membranes with superhydrophobic property to inhibit the adhesion/spreading of exogenous bacteria and other microbes. The administration of the resulting composite fibrous membrane on burnt skin in an infected rat model led to faster healing than a conventional product (sterile silicone membrane) and control detailed herein. These composite fibrous membranes loaded with bioactive drugs provide an integrated strategy for promoting burn wound healing and skin regeneration.

Although difficult, satisfactory reduction of complete lumbar fracture-dislocation can be achieved through pedicle instrumentation. Intraoperative traction is necessary for the reduction procedure. Preoperative duration should be not >3 weeks. For the patient who cannot receive spine surgery in a few days after injury, preoperative traction should be applied. Covering dura sac by autologous fat graft is recommended for all the patients.

There is limited research on the changes of biomechanical characteristics of the lumbar extensor myofascia in elderly patients with chronic low back pain. This study aimed to compare the biomechanical properties of the lumbar extensor myofascia in elderly patients with chronic low back pain and healthy people when resting and to analyze the relationship between the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) score, Cobb angle, and disease course and the biomechanical characteristics of the lumbar extensor myofascia. This case-control study included 40 elderly patients with chronic low back pain and 40 healthy volunteers. MyotonPRO was used to measure the biomechanical properties of the bilateral lumbar extensor myofascia (at L3/L4 level) in all participants, and the reliability of the MyotonPRO test was measured. Cobb angle was measured from lumbar computed tomography or magnetic resonance imaging data. JOA and VAS scores were used to evaluate lumbar function and pain. We found that muscle tone, stiffness, and elasticity of the left and right lumbar extensor myofascia in patients with chronic low back pain were very reliable among different operators. The average lumbar extensor muscle tone and stiffness were significantly higher in patients with chronic low back pain than those in healthy controls. The average elasticity of the lumbar extensor myofascia of patients with chronic low back pain was significantly lower than that of the healthy controls. The JOA score was negatively correlated, while the VAS score was positively correlated with the mean values of tone, stiffness, and elasticity of the bilateral lumbar extensor myofascia (logarithmic decrement). Disease course had no significant correlation with muscle tone, stiffness, and elasticity of the lumbar extensor myofascia. No significant correlation was found between Cobb angle and muscle tone, stiffness, and elasticity of the lumbar extensor myofascia in either group.

Liver cirrhosis remains major health problem. Despite the progress in diagnosis of asymptomatic early-stage cirrhosis, prognostic biomarkers are needed to identify cirrhotic patients at high risk developing advanced stage disease. Liver cirrhosis is the result of deregulated wound healing and is featured by aberrant extracellular matrix (ECM) remodeling. However, it is not comprehensively understood how ECM is dynamically remodeled in the progressive development of liver cirrhosis. It is yet unknown whether ECM signature is of predictive value in determining prognosis of early-stage liver cirrhosis. In this study, we systematically analyzed proteomics of decellularized hepatic matrix and identified four unique clusters of ECM proteins at tissue damage/inflammation, transitional ECM remodeling or fibrogenesis stage in carbon tetrachloride-induced liver fibrosis. In particular, basement membrane (BM) was heavily deposited at the fibrogenesis stage. BM component minor type IV collagen α5 chain expression was increased in activated hepatic stellate cells. Knockout of minor type IV collagen α5 chain ameliorated liver fibrosis by hampering hepatic stellate cell activation and promoting hepatocyte proliferation. ECM signatures were differentially enriched in the biopsies of good and poor prognosis early-stage liver cirrhosis patients. Clusters of ECM proteins responsible for homeostatic remodeling and tissue fibrogenesis, as well as basement membrane signature were significantly associated with disease progression and patient survival. In particular, a 14-gene signature consisting of basement membrane proteins is potent in predicting disease progression and patient survival. Thus, the ECM signatures are potential prognostic biomarkers to identify cirrhotic patients at high risk developing advanced stage disease.

Objective The objective of the study was Tto synthesize the existing literature on benefits and risks of anticoagulant use after traumatic brain injury (TBI). Design: Systematic review A literature search was performed in Medline, IPA, Health Star and CINAHL on October 11, 2012 and updated on September 2, 2013, using terms related to TBI and anticoagulants. Main Measures Human studies evaluating the effects of post-TBI anticoagulation on venous thromboembolism (VTE), hemorrhage, mortality or coagulation parameters with original analyses were eligible for the review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed throughout the conduct of the review. Results Thirty-nine eligible studies were identified from the literature, of which 23 studies with complete information on post-TBI anticoagulant use and patient outcomes were summarized in this review. Meta-analysis was unwarranted due to varying methodological design and quality of the studies. Twenty-one studies focused on the effects of pharmacological thromboprophylaxis (PTP) post-TBI on VTE and/or progression of intracranial hemorrhage (ICH) while two RCTs analyzed coagulation parameters as the result of anticoagulation. Conclusion PTP appears to be safe among TBI patients with stabilized hemorrhagic patterns. More evidence is needed regarding effectiveness of PTP in preventing VTE as well as preferred agent, dose and timing for PTP.

Background: The influences of age and sex on properties of lumbar erector spinae have not been previously studied. Changes in the performance of lumbar erector spinae properties associated with age represent a valuable indicator of risk for lower-back-related disease.Objective: To investigate the lumbar erector spinae properties with regard to age and sex to provide a reference dataset.Methods: We measured muscle tone and stiffness of the lumbar erector spinae (at the L3–4 level) in healthy men and women (50 young people, aged 20–30 years; 50 middle-aged people, aged 40–50 years; and 50 elderly people, aged 65–75 years) using a MyotonPRO device.Results: In general, there are significant differences in muscle tone and stiffness among young, middle-aged, and elderly participants, and there were significant differences in muscle tone and stiffness between men and women, and there was no interaction between age and sex. The muscle tone and stiffness of the elderly participants were significantly higher than those of the middle-aged and young participants (P < 0.01), and the muscle tone and stiffness of the middle-aged participants were significantly higher than those of the young participants (P < 0.01). In addition, the muscle tone and stiffness of men participants were significantly higher than that of women participants (P < 0.01).Conclusion: Our results indicate that muscle tone and stiffness of the lumbar erector spinae increase with age. The muscle tone and stiffness of the lumbar erector spinae in men are significantly higher than in women. The present study highlights the importance of considering age and sex differences when assessing muscle characteristics of healthy people or patients.

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