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A research background wound treatment is to burn an important part of the treatment, throughout the entire treatment process. Actively seeking more effective treatment methods to shorten the time of wound healing, improve the quality of wound healing, and to alleviate the suffering of burn patients, reduce the rate of disability has important practical significance. Wound healing involves inflammation, cell proliferation, cell migration and wound remodeling and other sequential cross each other pathological and physiological processes, cells, extracellular matrix, inflammatory mediators and a variety of growth factors are involved, through mutual The role constitutes a complex network regulation, the basic elements of the tissue repair process. Burn wound healing mechanisms in the past have been more in-depth discussion, covering a number of areas and levels. In recent years, gradually attracted people's attention about insulin play a positive role in wound repair. Insulin as the body of the most important one of the synthetic hormones in the past that it is mainly involved in the process of glucose, protein, and fat metabolism. In recent years, the study found that insulin also relieve wound inflammation, stimulate traumatized skin and muscle tissue protein synthesis to promote the effectiveness of fibroblast growth and collagen synthesis, suggesting that may play a potential positive role in the process of wound healing. To this end, scholars to local infiltration insulin injections or topical way to treat burn wounds, skin ulcers and diabetes with certain effect. Although insulin for wound treatment has demonstrated a good prospect, but is still a lack of a deeper mechanism of, in particular, the effective concentration of the topical application of security rarely reported. In this study, the rabbit deep Ⅱ degree burn wound model, the choice of four different concentrations of insulin solution, insulin local wet packing method, through the wound tissue and blood sugar content changes observed before and after treatment, different concentrations of insulin on wound healing time The impact evaluation of regional security of insulin therapy and effective drug concentration, and to detect the content of wound tissue, epidermal growth factor (epidermal growth factor, EGF), try different sides to explore the role of insulin on wound healing mechanism, designed to future clinical experimental reference. A model for the production of the two materials and methods: 40 healthy adult New Zealand rabbits (male and female, by the Southern Medical University Experimental Animal Center of) weight (2.3L ± 0.26) kg, were randomly divided into A, B, C, D E group, n = 8. One day before the burns, cut back long-haired, with a 10% solution of sodium sulfide hair removal, wash with water, dried. Wound day, using a solution of 10% chloral hydrate (0.4ml/kg) to do anesthetized by intraperitoneal injection animals fixed prefabricated holes (hole 5.0cm × 5.0cm) stencil covering the back of the animal, with the constant temperature water bath (temperature of 98 ° C ) the same plastic bag is placed on the duration of the 12s, resulting in the back of the animal on each side 2 5.0cm × 5.0cm deep Ⅱ degree burn wounds (wounds were pathologically confirmed). 2 wound medication method: A group wound therapy of saline; B group, wound therapy 4mU / L regular insulin solution; the C group wound therapy ordinary insulin solution 40mU / L; D group, wound therapy 400mU / L the ordinary insulin solution; E group, wound therapy 4000mU / L regular insulin solution, the animals in each group wound full of drugs of gauze wet dressing, plus sterile moisturizing film covering the wound dressing change every day until wound healing. Animals in each group were individually fed, free drinking water, eating. Detection indicators and methods: observation the animal left side of the back two wounds, healing rate, respectively 3,5,7,10,14,18 d after injury, with a transparent film tracings plus weighing method, recording its wound healing time (wound healing time of wounds completely epithelial date); take 1,3,5,7,14 d after injury the Animal right back wound tissue, weighing do homogenate, the supernatant by centrifugation, according to the weight of the tissue blocks adjust the the supernatant quantity and the weight ratio of the tissue blocks to 1ml: 1g, EGF concentration of the supernatant was measured by ELISA, and the concentration of glucose oxidase test supernatant; every day to take the animal the marginal ear vein after injury, the oxidase test blood glucose levels; 1,3,5,7,14 d after injury and wound healing to take animal right back wound tissue, fixed sections, HE staining pathology observed light microscope. 4 statistical data with SPSS13.0 processing, measurement data expressed as mean ± standard deviation (x ± s), healing time information completely randomized design analysis of variance (one-way ANOVA) analysis; healing rate of wound tissue growth factor levels, blood glucose levels and wound tissue sugar content with repeated measurement data analysis of variance analysis, a two-tailed alpha = 0.05 as the level of inspection, inspection standards to P lt; 0.05 for significant differences. The wound tissues sugar content and blood glucose data corresponding time points using bivariate correlation analysis processing. Three results and a wound healing time: shortest of groups wound healing time in group D, 18.75 ± 2.66d, A group of the longest between the two groups wound healing time was 23.63 ± 1.51d, there is a significant difference (P lt; 0.001). The remaining three groups wound healing time were: B group 22.13 ± 2.70d, in group C 19.38 ± 2.88d, Group E 19.38 ± 3.16d, pairwise comparisons among groups C, D, E group wound healing time with A, B The group wound healing time there is a significant difference (P lt; 0.001). Wound healing rate: the rate of wound healing E group was the highest, 46.83 ± 0.40% in group A minimum is 37.39 ± 0.39%, between the two groups wound healing rate showed significant differences (P lt; 0.001). The remaining three groups wound healing rate were: B group 42.64 ± 0.20%, C group 44.79 ± 0.42%, D group 45.71 ± 0.38%; among the groups pairwise comparison of the rate of wound healing, in addition to three days after injury groups wound healing was no significant difference, the remaining time points after injury, showed significant differences (P lt; 0.05). 3 wound tissue growth factor content changes: each group wound tissues EGF content in the highest group D is 10.99 ± 0.12ng / g, A group of the lowest, 5.21 ± 0.09ng / g, between the two groups showed significant differences (P lt; 0.001). The remaining three groups the wound tissues EGF content: 8.24 ± 0.07 ng / g, C group, the B group, 9.54 ± 0.10 ng / g, Group E 10.66 ± 0.06 ng / g, the group wound tissue EGF content in pairwise comparison, injured After each time point, was significantly different (P lt; 0.05). 4 blood glucose concentration and the wound tissues sugar content changes: specimens of the same group at different time points between blood glucose levels without significant difference (F = 1.203, P = 0.287, P gt; 0.05); same phase point groups glucose concentration differences were not significant significance (P gt; 0.05); specimen is not in the same group at different time points between the sugar content of wound tissue no significant difference (F = 0.298, P = 0.874, P gt; 0.05); same phase point groups wound tissue sugar content showed no significant meaning (P gt; 0.05); using bivariate analysis processing, blood glucose concentration and wound tissue sugar content are positively correlated, both Pearson correlation coefficient of r = 0.994 (P lt; 0.001 (bilateral), n = 200). Five histopathological observation: the overall performance of the Group A control group of inflammatory cell infiltration, no epidermal cells and fibroblast proliferation, healing the wound epidermis level less layers of organizational structure is not clear, disordered arrangement of collagen. All treatment groups except group B, the groups overall performance of inflammatory cell infiltration was not obvious, visible epidermal cells and fibroblast proliferation, increase healing wound epidermis thickness layers of clear structure, the number of nail foot, well-differentiated , collagen neatly. The overall performance of the group B of inflammatory cell infiltration than group A light, no epidermal cells and fibroblasts proliferate and heal the wound epidermis level less layers of organizational structure is not clear, the collagen arrangement disorder. Four Conclusions Topical application of insulin wet compress no significant changes in systemic blood sugar, is safe and feasible. The 2 topical application of insulin wet compress on the rabbit deep Ⅱ degree burn wound healing promoting effect may be related to the topical application of insulin wet compress can increase the wound tissues EGF content related. The topical application of insulin wet compress can improve the quality of wound healing. 4 topical application of insulin wet compress treatment of rabbit deep Ⅱ degree burn wound treatment effect 400mU / L, the concentration of its effective dose - bio-effect relationship exists.
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