Yaoming Shi

bFGF-grafted electrospun fibrous scaffolds via poly(dopamine) for skin wound healing

Electrospun fibrous membranes coated with basic fibroblast growth factor (bFGF) are effective medical devices to promote wound healing. However, the current strategies of adding bFGF generally cause degradation of electrospun materials or damage to the bioactivity of the biomolecules. Here, we have developed a simple strategy for surface bFGF-functionalization of electrospun fibers in an aqueous solution, which maintained original fiber properties and growth factor bioactivity. Polydopamine (PDA) forming the mussel foot protein was chosen as an adhesive polymeric bridge-layer between substrate poly(lactide-co-glycolide) (PLGA) fibers and bFGF. The bFGF-grafted PDA was analyzed using scanning electron microscopy, water contact angle measurements, and X-ray photoelectron spectroscopy. Improved hydrophilicity together with a stable fibrous structure and biodegradable fibrous matrix suggested that the PLGA/PDA-bFGF electrospun fibrous scaffolds have great potential for promoting wound healing. In vitro experiments showed that the bFGF-grafted PLGA electrospun fibrous scaffolds have highly enhanced adhesion, viability, and proliferation of human dermal fibroblasts. In vivo results showed that such scaffolds shortened wound healing time, accelerated epithelialization and promoted skin remodeling. Therefore, this PDA modification method can be a useful tool to graft biomolecules onto polymeric electrospun fibrous scaffolds which are potential scaffold candidates for repairing skin tissue.

Use of ginsenoside Rg3-loaded electrospun PLGA fibrous membranes as wound cover induces healing and inhibits hypertrophic scar formation of the skin

Prevention of hypertrophic scar formation of the skin requires a complex treatment process, which mainly includes promoting skin regeneration in an early stage while inhibiting hypertrophic formation in a later stage. Electrospinning PLGA with the three-dimensional micro/nano-fibrous structure and as drugs carrier, could be used as an excellent skin repair scaffold. However, it is difficult to combine the advantage of nanofibrous membranes and drug carriers to achieve early and late treatment. In this study, Ginsenoside-Rg3 (Rg3) loaded hydrophilic poly(D,L-lactide-co-glycolide) (PLGA) electrospun fibrous membranes coated with chitosan (CS) were fabricated by combining electrospinning and pressure-driven permeation (PDP) technology. The PDP method was able to significantly improve the hydrophilicity of electrospun fibrous membranes through surface coating of the hydrophilic fibers with CS, while maintaining the Rg3 releasing rate of PLGA electrospun fibrous membranes. Experimental wounds of animal covered with PDP treated fibrous membranes completely re-epithelialized and healed 3-4 days earlier than the wounds in control groups. Scar elevation index (SEI) measurements and histologic characteristics revealed that Rg3 significantly inhibited scar formation 28 days post-surgery. Moreover, RT-PCR assays and western blot analysis revealed that at day 28 after wound induction the expression of VEGF, mRNA and Collagen Type I in the scars treated with Rg3 was decreased compared to control groups. Taken together PLGA-Rg3/CS electrospun fibrous membranes induced repair of tissue damage in the early stage and inhibited scar formation in the late stage of wound healing. These dual-functional membranes present a combined therapeutic approach for inhibiting hypertrophic scars of the skin.

In vivo inhibition of hypertrophic scars by implantable ginsenoside-Rg3-loaded electrospun fibrous membranes.

Clinically, hypertrophic scarring (HS) is a major concern for patients and has been a challenge for surgeons, as there is a lack of treatments that can intervene early in the formation of HS. This study reports on a Chinese drug, 20(R)-ginsenoside Rg3 (GS-Rg3), which can inhibit in vivo the early formation of HS and later HS hyperplasia by inducing the apoptosis of fibroblasts, inhibiting inflammation and down-regulating VEGF expression. Implantable biodegradable GS-Rg3-loaded poly(l-lactide) (PLA) fibrous membranes were successfully fabricated using co-electrospinning technology to control drug release and improve drug utilization. The in vivo releasing time of GS-Rg3 lasts for 3 months, and the drug concentration released in rabbits can be controlled by varying the drug content of the electrospun fibers. Histological observations of HE staining indicate that GS-Rg3/PLA significantly inhibits the HS formation, with obvious improvements in terms of dermis layer thickness, epidermis layer thickness and fibroblast proliferation. The results of immunohistochemistry staining and Massons trichrome staining demonstrate that GS-Rg3/PLA electrospun fibrous membranes significantly inhibit HS formation, with decreased expression of collagen fibers and microvessels. VEGF protein levels are much lower in the group treated with GS-Rg3/PLA eletrospun membranes compared with other groups. These results demonstrate that GS-Rg3 is a novel drug, capable of inhibiting the early formation of HS and later HS hyperplasia. GS-Rg3/PLA electrospun membrane is a very promising new treatment for early and long-term treatment of HS.

In Vivo Early Intervention and the Therapeutic Effects of 20(S)-Ginsenoside Rg3 on Hypertrophic Scar Formation

Background Intra-lesional injections of corticosteroids, interferon, and chemotherapeutic drugs are currently the most popular treatments of hypertrophic scar formation. However, these drugs can only be used after HS is formed, and not during the inflammatory phase of wound healing, which regulates the HS forming process. Objective To investigate a new, effective, combining therapeutic and safe drug for early intervention and treatment for hypertrophic scars. Methods Cell viability assay and flow cytometric analysis were studied in vitro. Animal studies were done to investigate the combining therapeutic effects of 20(S)-ginsenoside Rg3 (Rg3) on the inflammatory phase of wound healing and HS formation. Results In vitro studies showed that Rg3 can inhibit HS fibroblasts proliferation and induce HSF apoptosis in a concentration-dependent manner. In vivo studies demonstrated that Rg3 can limit the exaggerated inflammation, and do not delay the wound healing process, which indicates that Rg3 could be used as an early intervention to reduce HS formation. Topical injection of 4 mg/mL Rg3 can reduce HS formation by 34%. Histological and molecular studies revealed that Rg3 injection inhibits fibroblasts proliferation thus reduced the accumulation of collagen fibers, and down-regulates VEGF expression in the HS tissue. Conclusion Rg3 can be employed as an early intervention and a combining therapeutic drug to reduce inflammation and HS formation as well.

Pedicled superficial temporal fascia sandwich flap for reconstruction of severe facial depression.

Facial soft tissue hypoplasia is a prominent feature of Parry-Romberg syndrome and hemifacial microsomia. Superficial temporal fascia has been used in the clinical application of the contour restoration, but it is too thin to reconstruct severe facial depression. To improve the thickness of the transplanted tissue flap, the pedicled superficial temporal fascia sandwich complex flap was designed for the reconstruction of severe facial depression and evaluation of its effect. There were 2 kinds of these complex flaps. The first kind was 2 free dermis-fat flaps fixed onto the superficial temporal fascia, which were applied in large and deep depression. The second was a piece of free dermis-fat flap sandwiched between the folded superficial temporal fascia, which were applied in small but deep upper-midface depression. Fifteen patients with facial depression deformities were involved in this study, in which 8 patients had Parry-Romberg syndrome, 4 patients had hemifacial microsomia, and 3 patients had traumatic facial depression. Postoperative follow-up for 2 to 24 months showed that the method had a good cosmetic result. Based on the results of our patients in this series, the surgical results were favorable, and it is a simple procedure and yields effective, safe, and satisfactory results.

Classification of nasolabial folds in Asians and the corresponding surgical approaches: By Shanghai 9th People's Hospital

INTRODUCTION One of the earliest signs of aging appears in the nasolabial fold, which is a special anatomical region that requires many factors for comprehensive assessment. Hence, it is inadequate to rely on a single index to facilitate the classification of nasolabial folds. Through clinical observation, we have observed that traditional filling treatments provide little improvement for some patients, which prompted us to seek a more specific and scientific classification standard and assessment system. METHODS A total of 900 patients who sought facial rejuvenation treatment in Shanghai 9th Peoples Hospital were invited in this study. We observed the different nasolabial fold traits for different age groups and in different states, and the results were compared with the Wrinkle Severity Rating Scale (WSRS). We summarized the data, presented a classification scheme, and proposed a selection of treatment options. RESULTS Consideration of the anatomical and histological features of nasolabial folds allowed us to divide nasolabial folds into five types, namely the skin type, fat pad type, muscular type, bone retrusion type, and hybrid type. CONCLUSION Because different types of nasolabial folds require different treatments, it is crucial to accurately assess and correctly classify the conditions.

Evaluation of lower blepharoplasty treated with the SmartLipo 1064-nm system and its clinical implications: A retrospective review.

Introduction: This study used the SmartLipo 1064-nm system to remove herniated orbital fat tissue to improve lower eyelid appearance. A retrospective review of 128 patients was performed to evaluate the size of prominent fat pads and complications. Materials and methods: Altogether, 128 patients underwent a procedure using the SmartLipo 1064-nm system via postseptal access, which helped locate fat tissue more precisely. Digital photographs were taken preoperatively and at one week and six months postoperatively. Eyebag sizes were determined preoperatively and six months postoperatively using the Non-Contact 3D Digitizer. Results: Altogether, 118 primary and 10 revision patients (average age 31 years) were placed in one of two groups: mildly protruding fat pads (group 1, 86 patients) and moderately protruding fat pads (group 2, 42 patients). After injection of about 1 ml of anesthetic and 1 ml of 0.9% iced saline on each side, the patients received an average 450 joules of energy delivered at 20 Hz and 3 W. Postoperatively, the eyebags height, depth, and area were significantly reduced in both groups (р = 0.000). The main symptoms (swelling, chemosis, engorgement, and pain) subsided within 5–7 days. Conclusion: The SmartLipo 1064-nm system with postseptal access, a minimally invasive procedure, can be used to correct mildly and moderately prominent fat pads.

A facilely fabricated in vivo hypertrophic scar model through continuous gradient elastic tension

The role of mechanical force is increasingly being recognized in the pathophysiology of hypertrophic scars (HScs). Many mechanically loaded scar models have been used to study the HScs formation mechanism. However, current load models are either too complicated or non-economical. Furthermore, the impact of different mechanical loading modes on different phases of HScs formation remains unknown. In this study, a facile, reproducible, and economical rat HScs model was successfully fabricated, driven through elastic tension. The study of three types of elastic tension showed that early elastic tension during wound healing can only lead to narrow linear scar formation, later gradient elastic tension during wound healing results in narrow HScs formation, while continuous gradient elastic tension during wound healing can induce the true wide HScs formation. Macromorphological features were observed, which showed that the resulting true wide HScs mimic well the pathological process of human HScs. The histopathological study demonstrated that the HScs in rats are similar to human HScs, with dramatic increases in scar width (26-fold, by week 8) compared to the control group, a thickened epidermis, overabundant extracellular matrix deposition, augmented neovascularization and increased TGF-β1 expression, which are all typical characteristics of human HScs. Hence, we concluded that a facile and reproducible rat HScs model can be constructed through continuous gradient elastic tension. This new rat scar model is an easily fabricated model that can be used for systematically studying HScs. Tension contributed to scar formation in all phases of wound healing. Continuous gradient elastic tension can induce wider hypertrophic scar formation than early elastic tension and later gradient elastic tension.

Advances in the research of autologous fibroblast injections for aging skin

With the development of autologous stem cells transplantation, the application of autologous fibroblast graft has been an important therapy in defect repair. In the past decade, amounts of studies have reported favorable treatment effect and safety about the therapy. The material has the ability to produce human collagen in vivo. This article details recent scientific work of the cases, effect, injection technique, complications and safety of autologous fibroblast injection treatment.

A Study of the Morbidity Involved in Whole Rib Harvesting and In Situ Splitting Rib Harvesting Surgery.

Background:Although there have been several reports that detail the in situ rib splitting harvesting surgical procedure, there are limited published studies evaluating this procedure and the traditional whole rib harvesting approach. In this study, the authors conducted a retrospective controlled study on the complications related to the 2 rib harvesting approaches. Methods:From March 2012 to May 2014, 24 patients were treated with rib grating, of whom 9 patients received conventional rib harvesting surgery and 15 patients received in situ splitting harvesting surgery. In all patients, a 3-dimensional computed tomography study of the chest was performed 7 days postoperatively. Postoperative complications were assessed and postoperative pain was assessed using a visual analog scale after the first 24, 48, and 72 hours after the surgery. Results:The complication rate for in situ splitting rib harvesting was 6.67% versus 44.44% for patients treated with whole rib grafting surgery. After 48 and 72 hours, the visual analog scale scores in patients treated with in situ splitting rib grafts were significantly lower than the patients treated with traditional surgery. Conclusion:The in situ splitting approach for obtaining a rib results in a clinically significant reduction in complications compared with the traditional approach.