Microcirculation in hypertrophic scars after burn injury

Hypertrophic scar formation is a common complication after burn injury. Early active scars show hyperemic appearances that change as the scar matures. This is a report on microcirculation in hypertrophic scars after burn injury among 50 Chinese patients with a laser Doppler flowmeter. The average period of follow-up for the patients was 20 months. The microcirculatory response in scars to vasodilation (heat) stimulus was studied. Significant differences (p less than 0.0001) were demonstrated between scars of different clinical grades of maturity when compared with normal skin. The qualitative and quantitative differences in microcirculatory blood flow were correlated with site variations and different physiologic demands from different grades of scars. The study showed that laser Doppler flowmetry was useful in the clinical grading assessment of or for scar maturity.     

Analysis of gene expression patterns in human postburn hypertrophic scars

Hypertrophic scars cause cosmetic disfigurement and limited mobility in burn patients. To better understand the molecular pathophysiology of hypertrophic scar formation, microarray analyses were performed on normal skin and hypertrophic scars from four burn patients. Microarray analyses were determined in an effort to identify genes whose expression discriminated between normal skin and mature, hypertrophic scars. Surgical biopsies were obtained from two pediatric and two adult patients 6 to 15 months after burn injury. Total RNA was isolated from the samples and subjected to microarray analysis using the Affymetrix U95Av2 GeneChip. Results from this analysis revealed 31 probe sets representing genes that were consistently up-regulated at least two-fold in hypertrophic scar specimens from all four patients and four probe sets that were down-regulated. The significance analysis of microarrays algorithm also identified 35 probe sets whose increased expression resulted in the hierarchal clustering of the hypertrophic scar and normal tissue, seven of which were identical to the six genes identified by paired analyses. These six genes all displayed elevated levels of expression in the scar tissue. Proteins encoded by the genes identified included germline oligometric matrix protein, matrix metalloproteinase-16, collagen type 1alpha, pleiotrophin, and thrombospondin-4. Although the results presented here suggest that there may be unique patterns of gene expression in hypertrophic scars that may be important in the evaluation and treatment of hypertrophic scarring, the results must be confirmed with larger datasets.     

Epidemiology and impact of scarring after burn injury: a systematic review of the literature

The purpose of this study was to perform a systematic review of the existing literature on the incidence of hypertrophic scarring and the psychosocial impact of burn scars. In a comprehensive literature review, the authors identified 48 articles published since 1965 and written in English which reported the incidence and risk factors for hypertrophic scarring or assessed outcomes related to scarring. Most studies had important methodological limitations limiting the generalizability of the findings. In particular, the absence of standardized valid measures of scarring and other outcome variables was a major barrier to drawing strong conclusions. Among studies on hypertrophic scarring, the prevalence rate varied between 32 and 72%. Identified risk factors included dark skin, female gender, young age, burn site on neck and upper limb, multiple surgical procedures, meshed skin graph, time to healing, and burn severity. With regard to psychosocial outcomes, two studies compared pediatric burn survivors with a nonburn comparison group on a body image measure; neither study found differences between groups. Across studies, burn severity and location had a modest relationship with psychosocial outcome variables. Psychosocial variables such as social comfort and perceived stigmatization were more highly associated with body image than burn characteristics. To advance our knowledge of the epidemiology of scars and the burden of scars, future studies need to implement more rigorous methodologies. In particular, standardized valid measures of scarring and other outcomes should be developed. This process could be facilitated by an international collaboration among burn centers.     

兔耳增生性瘢痕的形态学观察与羟脯氨酸含量变化

Inrecentyears，excessivedermalhyperplasiafollowingtotalskinlossofrabbit＇seariswidelyreportedbydomesticandforeignre－searchers．Histologicalstudiesshowexcessivedermalhyperplasiahascloserelationwithhypertrophicscarofhuman犤１－２犦．Characteristicsofcollagenmetabolismandmorphologicalchangeslawaboutexcessivedermalhyperplasiaremainunclear．Theinvolvedmechanismistheobjectiveofthisstudy．１Materialandmethod１．１Treatmentandcreationofwoundsinanimals８Japaneselarge－earrabbitsregardingnogenderwerei…     

基质金属蛋白酶13和转化生长因子β1在瘢痕疙瘩和增生性瘢痕中的表达

背景：与瘢痕疙瘩和增生性瘢痕发生机制相关的基质金属蛋白酶13和转化生长因子β1信号传递通路研究多集中在体外成纤维细胞的培养上,而在组织中的相关研究少见报道。目的：观察瘢痕疙瘩和增生性瘢痕中基质金属蛋白酶13和转化生长因子β1蛋白的表达。方法：取自2004/2008唐山市工人医院烧伤整形科手术患者,瘢痕疙瘩54例,增生性瘢痕42例。选取同期45例因非感染手术切除的正常瘢痕组织作为对照组,选取同期45例正常皮肤组织作为正常对照组。应用流式细胞仪检测4组中基质金属蛋白酶13和转化生长因子β1的表达,分析两者的相关性。结果与结论：瘢痕疙瘩和增生性瘢痕中转化生长因子β1的表达明显高于正常瘢痕组织和正常皮肤组织;正常瘢痕组织中转化生长因子β1的表达明显则高于正常皮肤组织,而基质金属蛋白酶13的表达与之相反。瘢痕疙瘩、增生性瘢痕和正常瘢痕组织中基质金属蛋白酶13和转化生长因子β1表达呈负相关。由此推测基质金属蛋白酶13和转化生长因子β1在瘢痕组织中异常表达,二者可能具有协同负向作用,共同参与病理性瘢痕的发生发展。     

细菌纤维素减轻兔耳增生性瘢痕的作用

背景：国内外已有研究报道细菌纤维素对皮肤创伤愈合具有促进作用,但是其对增生性瘢痕是否有治疗作用尚不清楚。目的：观察细菌纤维素对兔耳增生性瘢痕的疗效。方法：建立兔耳腹侧增生性瘢痕模型,术后第21天创面上皮化后,对每只兔耳5个不同瘢痕面随机给予5种不同处理方式：持水性分别为1：5,1：6,1：8细菌纤维素组、阳性对照组（贴敷瘢痕贴）、阴性对照组（未贴任何敷料且瘢痕自然生长）。观察不同处理后第0,14,21,28,42,56天瘢痕面大体形态学及组织学变化。结果与结论：持水性1：5,1：6,1：8细菌纤维素组瘢痕增生厚度低于阴性对照组,但高于阳性对照组（P〈0.01）。与阴性对照组比较,持水性1：5,1：6,1：8细菌纤维素组瘢痕组织中真皮层薄,成纤维细胞少,胶原纤维较细、排列较整齐;与阳性对照组组比较,持水性1：5,1：6,1：8细菌纤维素组成纤维细胞数稍多,胶原也稍粗、排列也稍不整齐。3种细菌纤维素组间瘢痕厚度及成纤维细胞数量为1：5细菌纤维素组〉1：6细菌纤维素组〉1：8细菌纤维素组（P〈0.05）。说明细菌纤维素有效抑制了兔耳创面愈合后增生性瘢痕的形成,并且持水性越高,效果越好。     

The effect of silicone gel sheets on perfusion of hypertrophic burn scars

The mechanism of action of topical silicone gel sheets on hypertrophic scars is not well understood and their effect on the blood flow within hypertrophic scars has not been investigated. The purpose of this study was to examine whether application of silicone gel sheets produced any acute effects on blood flow in hypertrophic burn scars. Perfusion of hypertrophic scars and adjacent normal skin was measured using a laser Doppler with and without application of silicone gel sheets. Continuous measurements were made for 5 minutes before gel application, for 30 minutes during gel application and for 5 minutes following gel removal. Surface temperature of the scar was continuously monitored. An occupational therapist, blinded to the perfusion level, rated each scar using the Vancouver Scar Scale. Eighteen scars and adjacent control sites in sixteen adult burn patients (11 male, 5 female; mean age: 42 +/- 14 years) were evaluated. The mean scar age was 5.4 +/- 3.7 months. The mean Vancouver Scar Scale was 5.5 +/- 2.4. Hypertrophic scars demonstrated higher perfusion measurements at baseline compared to control areas (58.5 +/- 19.3 flux units vs 25.0 +/- 8.4 flux units; P < 0.001). Application of silicone sheeting gel did not significantly alter perfusion in either the hypertrophic scar or normal tissue from the baseline measurements. However, application of silicone gel sheeting did significantly increase the mean baseline surface temperature of the hypertrophic scar from 29 +/- 0.8 degrees C to 30.7 +/- 0.6 degrees C (P < 0.001). The mechanism of action of silicone gel sheeting probably does not involve an acute alteration in blood flow within the scar. However, surface temperature of the scar increased significantly following gel application, raising the possibility that temperature alteration is involved in the mechanism of action.     

A new model for studying the development of human hypertrophic burn scar formation

Hypertrophic scar formation remains the major problem for severely burned patients who survive their injuries. This scarring can result in both cosmetic and functional deformities. One of the major problems in dealing with this complication is the lack of an adequate animal model with which to test various possible therapeutic modalities. We describe an animal model that uses human skin applied to the backs of nude mice to investigate the problem. Immunosuppression is not necessary in this model since the nude mouse lacks a thymus gland and is therefore not able to reject the skin. With this model we have been able to achieve contracture of meshed normal human skin grafts and hypertrophic scar formation in normal human skin that was burned a month after grafting to the mouse. We have also had success in grafting human hypertrophic scars, obtained from burn patients, to the mice. This model offers unique opportunities for investigation of the cause and treatment of burn scars in humans.     

Smad3和转化生长因子β1在瘢痕疙瘩、增生性瘢痕及正常皮肤中的表达:48∶40∶40例标本病理检测

目的:与病理性瘢痕发生机制相关的Smad3/转化生长因子β1信号传递通路研究多集中在体外成纤维细胞的培养上,在瘢痕疙瘩中的表达少见报道.检测病理性瘢痕中Smad3和转化生长因子β1蛋白的表达,探讨其在病理性瘢痕发生及发展中的作用.方法:实验标本均来自2004-06/2008-0 6河北医科大学附属唐山工人医院烧伤整形科手术患者,瘢痕疙瘩48例,年龄16～52岁;增生性瘢痕40例,年龄18～56岁;选取同期因其他手术切除的正常皮肤组织40例作为对照组.应用流式细胞术检测48例瘢痕疙瘩、40例增生性瘢痕及40例正常皮肤组织Smad3和转化生长因子β1的表达.结果:Smad3和转化生长因子β1在瘢痕疙瘩和增生性瘢痕中的表达明显高于正常皮肤组织中的表达(P＜0.05),Smad3和转化生长因子β1在瘢痕疙瘩和增生瘢痕中的表达差异无显著性意义(P＞0.05).瘢痕疙瘩和增生性瘢痕中Smad3和转化生长因子β1表达呈正相关(r=0.489 2,P=0.000 4;r=0.471 0,P=0.002 2),Smad3和转化生长因子β1在正常皮肤组织中的表达未见明显相关性(P=0.4714).结论:Smad3和转化生长因子β1在病理性瘢痕中高表达,Smad3和转化生长因子β1的协同作用可能参与病理性瘢痕的发生发展.     

A new instrument for serial measurements of elasticity in hypertrophic scar

The "elastometer," a hand-held device, was designed and constructed to permit noninvasive quantification of the elastic properties of normal skin or hypertrophic scar. The instrument utilizes a constant-tension spring and a sensitive strain gauge to distract two loci of skin. Normal skin from 15 dogs was measured in vivo with the elastometer and in vitro using standard tensometry. The results correlated significantly by regression analysis (r = .87, p less than .01, 1/Young's Modulus of Elasticity v percent stretch in vivo). Normal dorsal hand skin was tested elastometrically in six volunteers of both sexes. Values (units: percent stretch) ranged from 29 to 43 with a small standard error (+/- 4%). In nine patients with hypertrophic burn scars, the mean percent stretch was 16.2 +/- 1.8 v 37.9 +/- 6.5 in the mirror-image normal skin. There was no overlap between the two groups. There was a trend towards higher values in older scars. Elastometric measurements have increased appreciably in some burn scars undergoing treatment. The elastometer should be useful in documenting objectively the spontaneous maturation of burn scars and/or their response to treatment.     

瘢痕组织中神经丝蛋白的表达特征及生物学意义

目的：观察瘢痕组织与成人正常皮肤中神经丝蛋白(NFP)及其表皮细胞生长因子受体(EGFR)表达变化，阐明神经再支配对增生性瘢痕形成的影响。方法：标本取自烧伤瘢痕愈合后11～26个月来我院进行修复手术的患者，正常对照选自同一患者的供皮区。利用单克隆抗体免疫组织化学染色技术，光镜下观察瘢痕组织及正常皮肤上皮中NFP的表达和EGFR在表皮基底层细胞的标记情况。结果：随着瘢痕的形成，瘢痕组织与正常皮肤上皮中神经纤维的数量表现为早期明显增多，随着瘢痕的成熟，神经纤维的数量逐渐减少。EGFR的表达与NFP的动态变化呈现一致性，瘢痕早期表皮细胞生长因子受体的表达较强，瘢痕后期表达减弱。结论：增生性瘢痕与正常的皮肤中NFP的变化和EGFR活性与创面愈合的结局密切相关。神经调节在瘢痕形成的过程中可能充当了重要的角色。     

Analysis of hypertrophic and normal scar gene expression with cDNA microarrays

Hypertrophic scar is one form of abnormal wound healing. Previous studies have suggested that hypertrophic scar formation results from altered gene expression of extracellular matrix molecules. A broadscale evaluation of gene expression in hypertrophic scars has not been reported. To better understand abnormalities in hypertrophic scar gene expression, we compared messenger RNA expression in hypertrophic scars, normal scars, and uninjured skin with the use of complementary (c)DNA microarrays. Total RNA was extracted from freshly excised human hypertrophic scars, normal scars, or uninjured skin and reverse transcribed into cDNA with the incorporation of [33P] deoxycytidine triphosphate. The resulting radioactive cDNA probes were hybridized onto cDNA microarrays of 4000 genes. Hybridization signals were normalized and analyzed. In the comparison of tissue samples, mean intensities were calculated for each gene within each group (hypertrophic scars, normal scars, and uninjured skin). Ratios of the mean intensities of hypertrophic scars to normal scars, hypertrophic scars to uninjured skin, and normal scars to uninjured skin were generated. A ratio that was greater than 1 indicated upregulation of any particular gene and a ratio that was less than 1 indicated downregulation of any particular gene. Our data indicated that 142 genes were overexpressed and 50 genes were underexpressed in normal scars compared with uninjured skin, 107 genes were overexpressed and 71 were underexpressed in hypertrophic scars compared with uninjured skin, and 44 genes were overexpressed and 124 were underexpressed in hypertrophic scars compared with normal scars. Our analysis of collagen, growth factor, and metalloproteinase gene expression confirmed that our molecular data were consistent with published biochemical and clinical observations of normal scars and hypertrophic scars. cDNA microarray analysis provides a powerful tool for the investigation of differential gene expression in hypertrophic scar samples and either uninjured skin or normal scars. Our data validate the use of this technology for future studies on gene expression during repair processes of normal and abnormal wounds.     

增生性瘢痕成纤维细胞中CyclinD1,CDK2,CDK4作用及与细胞周期的相关性

背景:增生性瘢痕的发生和发展可能与细胞周期调节相关基因的异常表达有关。目的:检测增生性瘢痕不同阶段细胞CyclinD1、CDK2和CDK4 mRNA及蛋白的表达,以及同一标本增生性瘢痕成纤维细胞的细胞周期运行中3者之间的一致性。方法:采集32份增生性瘢痕标本,以增生性瘢痕形成时段分为3个月组、6个月组、1年组、2年组,各8份,并以8份正常真皮标本作为对照。利用实时荧光定量PCR法、Western blotting法检测标本中CyclinD1、CDK2、CDK4 mRNA及蛋白表达,流式细胞术检测成纤维细胞的细胞周期。结果与结论:增生性瘢痕标本发展过程中CyclinD1、CDK2、CDK4 mRNA及蛋白表达水平由强至弱变化。3,6个月增生性瘢痕中成纤维细胞主要分布在S、G2/M期;1,2年增生性瘢痕与对照组成纤维细胞多处于G0/G1期。表明增生性瘢痕不同时期CyclinD1、CDK2、CDK4各自的mRNA和蛋白表达趋势基本一致,同时增生性瘢痕中成纤维细胞的细胞周期分布与这3个蛋白所执行的功能情况相对应。     

病理性瘢痕中胰岛素样生长因子1及受体mRNA的表达

背景：多种肿瘤中胰岛素样生长因子1受体及其配体表达异常,且胰岛素样生长因子1是多种细胞的有丝分裂原和抗细胞凋亡的因子,控制多种细胞的增殖、分化和凋亡的进程。目的：观察胰岛素样生长因子1及胰岛素样生长因子1受体在病理性瘢痕中的表达。方法：收集中山大学附属第一医院烧伤外科收治患者增生性瘢痕、瘢痕疙瘩及其正常皮肤等手术切除标本,荧光定量实时PCR检测不同组织中胰岛素样生长因子1及其受体mRNA的表达水平。结果与结论：瘢痕疙瘩及增生性瘢痕中胰岛素样生长因子1mRNA表达水平均高于正常皮肤（P〈0.05）,且在瘢痕疙瘩及增生性瘢痕组织中胰岛素样生长因子1表达水平差异无显著性意义（P〉0.05）,胰岛素样生长因子1受体在增生性瘢痕表达水平与正常皮肤接近（P〉0.05）;而瘢痕疙瘩中胰岛素样生长因子1受体明显高于瘢痕周围正常皮肤（P〈0.05）。说明胰岛素样生长因子1及其受体在病理性瘢痕的形成过程中起重要作用。     

Increases in tissue Pco2 during circulatory shock reflect selective decreases in capillary blood flow

OBJECTIVES: Tissue Pco2 reflects metabolic alterations due to circulatory failure during circulatory shock. This study addresses simultaneous changes in gastric and buccal tissue Pco2 with changes in microcirculatory blood flow in a rat model of circulatory shock induced by cecal ligation and puncture. DESIGN: Prospective controlled laboratory study. SETTING: University-affiliated research laboratory. SUBJECTS: Male breeder Sprague-Dawley rats. INTERVENTIONS: Induction of polymicrobial, abdominal sepsis by cecal ligation and puncture. MEASUREMENTS AND MAIN RESULTS: Tissue Pco2 was continuously measured with the aid of a miniature carbon dioxide electrode. Using orthogonal polarization spectral imaging, recordings of the microcirculation were taken at baseline and hourly intervals until death and compared with sham-operated animals. Gastric and buccal tissue Pco2 values progressively increased in animals after cecal ligation and puncture and terminated in death. Microcirculatory blood flow in vessels >20 microm was well preserved during progression of shock, whereas there was an early and progressive decrease in microcirculatory blood flow in vessels <20 microm, mostly representing capillaries. Tissue Pco2, the tissue Pco2-Paco2 gradient, and blood flow in vessels <20 microm were highly correlated. This contrasted with sham control animals in which no significant hemodynamic, blood gas, lactate, microcirculatory, and tissue Pco2 abnormalities were observed. CONCLUSIONS: These observations suggest that microcirculatory failure in capillaries appears as an early defect in close association with anaerobic metabolism during progression of circulatory shock in an animal model of septic peritonitis.     

细菌纤维素减轻兔耳增生性瘢痕的作用

背景:国内外已有研究报道细菌纤维素对皮肤创伤愈合具有促进作用,但是其对增生性瘢痕是否有治疗作用尚不清楚。目的:观察细菌纤维素对兔耳增生性瘢痕的疗效。方法:建立兔耳腹侧增生性瘢痕模型,术后第21天创面上皮化后,对每只兔耳5个不同瘢痕面随机给予5种不同处理方式:持水性分别为1:5,1:6,1:8细菌纤维素组、阳性对照组(贴敷瘢痕贴)、阴性对照组(未贴任何敷料且瘢痕自然生长)。观察不同处理后第0,14,21,28,42,56天瘢痕面大体形态学及组织学变化。结果与结论:持水性1:5,1:6,1:8细菌纤维素组瘢痕增生厚度低于阴性对照组,但高于阳性对照组(P<0.01)。与阴性对照组比较,持水性1:5,1:6,1:8细菌纤维素组瘢痕组织中真皮层薄,成纤维细胞少,胶原纤维较细、排列较整齐;与阳性对照组组比较,持水性1:5,1:6,1:8细菌纤维素组成纤维细胞数稍多,胶原也稍粗、排列也稍不整齐。3种细菌纤维素组间瘢痕厚度及成纤维细胞数量为1:5细菌纤维素组>1:6细菌纤维素组>1:8细菌纤维素组(P<0.05)。说明细菌纤维素有效抑制了兔耳创面愈合后增生性瘢痕的形成,并且持水性越高,效果越好。     

细胞外信号调节激酶1/2传导通路对增生性瘢痕的影响

目的观察细胞外信号调节激酶1/2(ERK1/2)传导通路对增生性瘢痕的影响。方法用免疫组化方法和常规病理技术检测Ras、磷酸化ERK1/2和C-fos在14例增生性瘢痕和14例正常皮肤中的表达变化规律。结果在正常皮肤中,Ras、磷酸化ERK1/2和C-fos蛋白表达较低,随着增生性瘢痕不断成熟,这3种蛋白表达逐渐增强。在成熟期瘢痕中,这3种蛋白阳性细胞率明显高于正常皮肤(P<0.01)。结论增生性瘢痕的发生和成熟可能与激活ERK1/2信号传导通路,促进C-fos转录因子表达有关。     

增生性瘢痕组织中p53和c-myc蛋白含量的变化及其对瘢痕内细胞凋亡发生的影响

目的 :观察 p5 3和 c myc两种蛋白在增生性瘢痕和正常皮肤组织内的表达特征及其对增生性瘢痕内细胞凋亡发生的影响。方法 :在 16份被测标本中包括创面愈合后不同时期的增生性瘢痕 8例和其对应的周围正常皮肤组织 8例 ,用免疫组织化学方法和常规病理技术确定 p5 3和 c myc两种蛋白在增生性瘢痕和正常皮肤组织中的定位和表达量及变化规律。结果 :p5 3和 c myc蛋白在正常皮肤和瘢痕组织内都有表达。正常皮肤组织中 p5 3蛋白主要分布于表皮基底层细胞的胞质和胞核中 ;而 c myc蛋白的阳性信号则存在于表皮基底细胞、血管内皮细胞、毛囊和汗腺细胞的胞浆和胞核内。增生性瘢痕组织中 p5 3和 c myc两种蛋白表达均增强 ,p5 3主要存在于角质形成细胞和部分成纤维细胞的胞质和胞核内 ;而 c m yc阳性表达颗粒则分布于表皮细胞和部分成纤维细胞内。与正常皮肤组织相比 ,增生性瘢痕的 p5 3蛋白含量虽有增高趋势 ,但差异不显著 ;而c m yc蛋白的阳性颗粒明显增多。结论 :在增生性瘢痕发生过程中 ,p5 3和 c myc蛋白不同的分布和表达变化规律显示 ,这两种蛋白可能参与调控增生性瘢痕形成过程中细胞凋亡的发生 ,以 c myc蛋白的作用更为重要。     

红花对兔耳增生性瘢痕成纤维细胞及Ⅰ、Ⅲ型胶原的影响

背景：研究发现红花对体外培养的人增生性瘢痕成纤维细胞的增殖和胶原合成有抑制作用,但其具体作用机制与活体研究尚未进一步展开。目的：观察红花对兔耳增生性瘢痕成纤维细胞及Ⅰ、Ⅲ型胶原表达的影响。设计、时间、地点：随机对照动物实验,于2006-11/2008-03在重庆医科大学附属儿童医院动物实验中心及研究所完成。材料：新西兰大白兔27只,雌雄不限;50%红花注射液由山西太原华卫药业有限公司产品,批准文号：国药准字Z14020008。方法：兔耳腹侧建立增生性瘢痕模型,每耳2块。分为5组。术后第45天开始对增生性瘢痕行注射治疗。①正常皮肤组：为自身兔耳腹侧皮肤。②阳性对照组：右耳外侧增生性瘢痕,不予以任何处理。③生理盐水组右耳内侧增生性瘢痕,注射生理盐水。④低浓度红花组：左耳内侧增生性瘢痕,注射125 g/L红花液。⑤高浓度红花组：左耳外侧增生性瘢痕,注射500 g/L红花液。1次/周,连续注射4次。注射后第2,4,6周分别切取8只兔耳增生性瘢痕及皮肤待查。主要观察指标：瘢痕厚度,硬度;Mallory染色检测成纤维细胞密度胶原纤维排列及致密度。免疫组织化学方法检测每块组织Ⅰ、Ⅲ型胶原面密度,计算Ⅰ/Ⅲ型胶原比值。结果：注射后第4,6周,各组增生性瘢痕色泽均逐渐变浅,厚度及硬度均逐渐变小,尤以高浓度组明显,差异与其他增生性瘢痕组比较存在显著性意义（P 〈 0.05）。注射后第4,6周,高浓度红花组成纤维细胞密度较其他增生性瘢痕组低（P 〈 0.05）。注射后第4,6周,高、低浓度红花组I型胶原面密度值较阳性对照及生理盐水组低（P 〈 0.05）,且高浓度红花组低于低浓度红花组（P 〈 0.05）;各增生性瘢痕组Ⅰ/Ⅲ型胶原比值在注射后第2,4,6周均逐渐增高;同一时间段,高浓度红花组Ⅰ/Ⅲ型胶原比值为所有增生性瘢痕组中最低（P 〈 0.05）,低浓度红花组Ⅰ/Ⅲ型胶原比值与阳性对照及生理盐水组比较,差异有显著性意义。结论：高浓度红花液能促进兔耳增生性瘢痕的软化,组织顺应性增加。     

P物质在增生性瘢痕成纤维细胞内的表达和意义

目的了解P物质在增生性瘢痕成纤维细胞内的表达情况,探讨P物质在增生性瘢痕发生发展中的作用机制,为增生性瘢痕的治疗提供帮助。方法采用细胞培养技术,建立成纤维细胞系,应用免疫组化方法检测P物质在增生性瘢痕和正常皮肤成纤维细胞中的表达情况。结果P物质在增生性瘢痕成纤维细胞中阳性率为(75±4)%,在正常皮肤P物质阳性率为(46±5)%,明显高于在正常皮肤成纤维细胞中的表达。结论P物质在增生性瘢痕的发生发展中有着重要的作用。