Keloids are a fibrotic skin disorder caused by abnormal wound healing and featuring the activation and expansion of fibroblasts beyond the original wound margin. Signal transducer and activator of transcription 3 (STAT3) has been found to mediate the biological functions of keloid fibroblasts (KFs). Therefore, we aimed to demonstrate whether ASC-J9, an inhibitor of STAT3 phosphorylation, can suppress the activation of KFs. Western blotting results showed that ASC-J9 inhibited the levels of COL1A1 and FN1 proteins, which were upregulated in KFs, by decreasing the expression of pSTAT3 and STAT3. RNA sequencing and in vitro studies further demonstrated that ASC-J9 treatment of KFs reduced cell division, inflammation, and ROS generation, as well as extracellular matrix (ECM) synthesis. ELISA assays verified that ASC-J9 treatment significantly mitigated IL-6 protein secretion in KFs. Transmission electron microscopy images revealed that ASC-J9 induced the formation of multilamellar bodies in KFs, which is associated with autophagy-related signaling. These results suggested that inhibiting a vicious cycle of the ROS/STAT3/IL-6 axis by ASC-J9 may represent a potential therapeutic approach to suppress cell proliferation and ECM production in KFs.

Background: Patients sustaining multiple rib fractures have a significant risk of developing morbidity and mortality. More evidence is emerging that the indication of surgical stabilization of rib fractures (SSRF) should expand beyond flail chest. Nevertheless, little is known about factors associated with poor outcomes after surgical fixation. We reviewed patients with rib fractures to further explore the role of SSRF; we matched two groups by propensity score (PS). Method: A comparison of patients with blunt thoracic trauma treated with SSRF between 2010 and 2020 was compared with those who received conservative treatment for rib fractures. Risk factors for poor outcomes were analyzed by multivariate regression analysis. Results: After tailored SSRF, the number of fractured ribs was not associated with longer ventilator days (p = 0.617), ICU stay (p = 0.478), hospital stay (p = 0.706), and increased nonprocedure-related pulmonary complications (NPRCs) (p = 0.226) despite having experienced much more severe trauma. In the multivariate regression models, lower GCS, delayed surgery, thoracotomy, and flail chest requiring mechanical ventilation were factors associated with prolonged ventilator days. Lower GCS, higher ISS, delayed surgery, and flail chest requiring mechanical ventilation were factors associated with longer ICU stays. Lower GCS and older age were factors associated with increased NPRCs. In the PS model, NPRCs risk was reduced by SSRF. Conclusions: The risk of NPRCs was reduced once ribs were surgically fixed through an algorithmic approach, and poor consciousness and aging were independent risk factors for NPRCs.

SignificanceThe multispectral imaging–based tissue oxygen saturation detecting (TOSD) system offers deeper penetration (∼2 to 3 mm) and comprehensive tissue oxygen saturation (StO2) assessment and recognizes the wound healing phase at a low cost and computational requirement. The potential for miniaturization and integration of TOSD into telemedicine platforms could revolutionize wound care in the challenging pandemic era.AimWe aim to validate TOSD’s application in detecting StO2 by comparing it with wound closure rates and laser speckle contrast imaging (LSCI), demonstrating TOSD’s ability to recognize the wound healing process.ApproachUtilizing a murine model, we compared TOSD with digital photography and LSCI for comprehensive wound observation in five mice with 6-mm back wounds. Sequential biochemical analysis of wound discharge was investigated for the translational relevance of TOSD.ResultsTOSD demonstrated constant signals on unwounded skin with differential changes on open wounds. Compared with LSCI, TOSD provides indicative recognition of the proliferative phase during wound healing, with a higher correlation coefficient to wound closure rate (TOSD: 0.58; LSCI: 0.44). StO2 detected by TOSD was further correlated with proliferative phase angiogenesis markers.ConclusionsOur findings suggest TOSD’s enhanced utility in wound management protocols, evaluating clinical staging and therapeutic outcomes. By offering a noncontact, convenient monitoring tool, TOSD can be applied to telemedicine, aiming to advance wound care and regeneration, potentially improving patient outcomes and reducing healthcare costs associated with chronic wounds.

Thoracic injuries, especially rib fractures, carry high morbidity and mortality. Surgical stabilization of rib fractures (SSRF) has emerged as a promising approach to reduce pulmonary complications. We aimed to analyze the benefits of SSRF beyond flail chest and make the study applicable to clinical practice. This study compared SSRF and conservative treatments at a tertiary trauma center. A time series analysis and propensity score matching were applied to evaluate the outcomes. Data from a trauma registry (January 2017 to December 2020) were used. Exclusion criteria included patients with non-salvageable injuries and those transferred after 72 h. Primary outcomes were ventilator-free days on day 28 (VFD28) and non-procedural pulmonary complications (NPRCs). Of 770 eligible patients, 692 were enrolled, with 164 undergoing SSRF. SSRF patients had significantly longer VFD28 (22.5 vs. 19.0; P = 0.042) and reduced NPRCs (8.0 % vs. 14.5 %; P = 0.086). Subgroup analysis showed that SSRF patients requiring mechanical ventilation had longer ICU-free days (IFD28) and hospital-free days (HFD90) and lower mortality rates. Those not receiving ventilation but with more than three rib fractures also benefited from SSRF in terms of reduced NPRCs. SSRF improved clinical outcomes in more than just flail chest cases, benefiting patients with multiple rib fractures, both with and without mechanical ventilation. These findings support the broader clinical application of SSRF.