The Nursing Effection And Relative Mechanism Of Boric Acid Promoting Diabetic Refractory Wound Healing

Background and Object：All of the diabetic Foot and other diabetic refractory wounds are the most seriouslychronic diabetic complications. They also cause amputation, even death in many seriouslysituation. Around30%of the non-traumatic amputation initiates by diabetic foot in China.The relative mechanism and nursing strategy are therefore the difficult and research hotpoint in clinic.TGF-β1/Smads signal transduction pathway is one of the important pathway whichaffect diabetic refractory wound recovery. TGF-β1is the key Cytokines who participates inthe cellular differentiation, proliferation, adhesion, as well as angiogenesis, inflammationand wound healing, even the organizational sclerosis and interstitial fibrosis. TGF-β1/Smadssignal transduction pathway can also lead fibroblast migration and proliferation viaextracellular matrix expression. Many researches indicate that the primary biophysicalreason of the refractory wounds is short of TGF-β1. Furthermore, many other studies alsodemonstrate that the weak acid environment can promote the wound healing. Here, in thisstudy, we focus on the laboratory research on nursing effection and relative mechanism ofBoric Acid promoting diabetic refractory wound healing.As the common disinfectants,4%boric acid is acidulous and has lower cytotoxicity iswell known. It also be used as a normal disinfectants of the clinical treatment on skin,mucosal and wound. Many substantial clinical researches have been reported the effects ofboric acid application on the lower limb ulcer and pressure sore. The objective of ourexperimental study is therefore to provide scientific evidence for clinical diabetic refractorywound and nursing strategy.Materials and Methods:1. Grouping and Modeling：Bought from the SPF grade animal Laboratory of TheThird Military Medical University,30C57BL/6mice were divided into two groups, named as the diabetic group and the normal control group. There were15mice in each group.Randomly, we designed three subgroups in each group above, named as3days subgroup,7days subgroup and14days subgroup respectively. Streptozotocin was used to inducediabetic mice. Corneal trephine was used to create skin wounds on the back of mice.2.0.9%normal saline (Treat A),4%boric acid (Treat B),0.5%Iodine+3%Hydrogenperoxide solution (Treat C) were used to mice wounds at the same time everyday,observed, recorded, measured the scab, healing situation as well as the changes of thewounds area.3. Drawing the RNA of mice wounds with Trizol in the different time point, andmeasuring the density of RNA, then conducting RT-PCR.4. Measuring the mRNA expression levels of Tgf-β1, Smad4, Collagen I via Real-TimeqPCR Assay.Results：1. The effection of Boric Acid on wounds recoveryCompare with Treat A and Treat C, using boric acid got the highest healing rates in thediabetic mice group(P＜0.05）2. The effects of Tgf-β1mRNA expression on wounds via Boric Acid treatmentDay3after wounded, in control group, the expression of Tgf-β1mRNA wassignificantly increase via boric acid treatment (P<0.05).Day3and14after wounded, indiabetic mice, the expression of Tgf-β1mRNA had an absolutely significant increase alsovia boric acid treatment (P<0.01).3. The effects of Smad4mRNA expression on wounds via Boric Acid treatmentIn the14th day after wounded, the expression of Tgf-β1mRNA was significantlydecrease via boric acid treatment in diabetic mice group(P＜0.05). Day14after wounded,incontrol group, the expression of Tgf-β1mRNA had an absolutely significant low via normalsaline treatment (P＜0.05).4. The effects of Collagen I mRNA expression on wounds via Boric AcidtreatmentDay3after wounded, in both diabetic and control mice, the Collagen I mRNAexpressions of both the boric acid and Iodine+hydrogen peroxide treatment groups werehigher than NS group (P＜0.05). In the14th day after wounded, the Collagen I mRNA expression in Iodine+hydrogen peroxide treatment group of diabetic mice was statisticallyhigher than other two treatment groups (P＜0.05). However, in control group, the CollagenI mRNA expression in Iodine+hydrogen peroxide treatment group of diabetic mice waslower than other two treatment groups.Conclusions:1. Boric acid has the best effect in promoting wound healing in diabetic wounds；2. Boric acid stimulating Tgf-β1and Collagen I mRNA expression is probably one ofthe mechanism of promoting wound healing.3. Boric acid and NS can promote wound healing in early recovery stage. However, inlater period, Iodine+hydrogen treatment can get a better effects.