Differential Mobility Spectrometry-Based Cardiolipin Analysis.

Cardiolipins (CL) are special lipids in many respects. First of all, CL are composed of four fatty acids linked by two phosphatidic acids, which provide CL a unique molecular structure. Secondly, in eukaryotic cells they are specific to a single organelle, mitochondria, where they are also synthetized. CL are one of the most abundant lipid classes in mitochondria, mainly localized in the inner membrane. They are key determinants of mitochondrial health and homeostasis by modulating membrane integrity and fluidity, mitochondrial shapes, and metabolic pathways. Disturbances in mitochondrial CL composition can lead to tissue malfunction and diseases. It is therefore important to develop analytical tools to study the mitochondrial lipidome, and more particularly the CL. The method described here allows the quantification of cardiolipins at the sum composition level in isolated mitochondria or in liver tissue by flow injection analysis coupled to differential mobility spectrometry (FIA-DMS), also known as DMS-based shotgun lipidomics.

Trabecular Meshwork Regeneration for Glaucoma Treatment Using Stem Cell-Derived Trophic Factors.

Glaucoma is one of the leading causes of irreversible blindness. Stem cell therapy has shown promise in the treatment of primary open-angle glaucoma in animal models. Stem cell-free therapy using stem cell-derived trophic factors might be in demand in patients with high-risk conditions or religious restrictions. In this chapter, we describe methods for trabecular meshwork stem cell (TMSC) cultivation, secretome harvesting, and protein isolation, as well as assays to ensure the health of TMSC post-secretome harvesting and for secretome periocular injection into mice for therapeutic purposes.

Effectiveness of direct needle puncture for complete hepaticojejunostomy anastomotic stricture after pancreaticoduodenectomy (with video).

A 79-year-old Japanese woman, who had undergone pancreaticoduodenectomy 6 months prior to presentation owing to pancreatic cancer, complained of jaundice with high fever. Computed tomography revealed proximal bile duct dilatation with complete hepaticojejunostomy anastomotic stricture (HJAS). We performed a single-balloon endoscopy for biliary drainage. The presence of a scar-like feature surrounding the anastomosis was identified as the HJAS. White-light imaging during single-balloon endoscopy revealed that the HJAS contained a milky whitish area (MWA), suggesting that a membranous and fibrosis layer affected continuous inflammation around the center of the anastomosis (within a scar-like feature). Endoscopic dilatation was performed using an endoscopic injection needle, with the MWA used as an indicator. A 23-gauge endoscopic injection needle was used to penetrate the center of the blind lumen within the MWA, and a pinhole was created in the stricture. After confirming the position of the proximal bile duct using a contrast medium with the needle, an endoscopic guidewire with a cannula was inserted into the pinhole. A through-the-scope sequential balloon dilator was used to dilate the stricture, and a plastic stent was inserted into the proximal bile duct. This endoscopic intervention led to positive outcomes. In cases of complete HJAS occlusion, an endoscopic approach to the bile duct is difficult because the anastomotic opening of the HJAS is not visible. Thus, puncturing within the MWA, which can be used as a scar-like landmark within a complete membranous HJAS, is considered a useful endoscopic strategy.

Reactivation of stable neovascular age-related macular degeneration following treat-and-extend regimen discontinuation.

BACKGROUND: To describe the incidence and pattern of reactivation of neovascular age-related macular degeneration (nAMD) following successful treatment with treat-and-extend intravitreal anti-vascular endothelial growth factor therapy. METHODS: Consecutive patients with treated nAMD who did not require further treatment over a 6-month period and who attended their 3-monthly optical coherence tomography monitoring clinic in Moorfields Eye Hospital from 1 November 2019 to 31 January 2020 were included. Patients with diagnoses of macular neovascularization other than AMD, and patients with incomplete data were excluded. Baseline demographics recorded were age, sex, race, laterality, cause of macular neovascularization, drug, number of injections, and duration of treatment. Date, setting, symptoms, and time to retreatment were collected among patients with disease reactivation. RESULTS: The medical records of 286 patients were included. Most patients were female (64.3%), white (68.18%), and were receiving aflibercept monotherapy (55.2%). Mean number of injections at baseline was 17.79 ± 11.74 (range 3-62) with a mean treatment duration of 39.47 ± 30.68 months (range 2-139). Reactivation of AMD was identified in 32.2% of cases with 87% of recurrences identified via scheduled visit. The most common symptom was blurring of vision in 44.6%, while 39.1% were asymptomatic. Mean time from baseline to retreatment was 29.37 ± 22.40 months (range 5-104), with 20.7%, 73.9% and 88.04% of these patients requiring retreatment within 1, 3, and 5 years, respectively. CONCLUSIONS: Despite prior treatment with no reactivation in 6 months, 32.2% reactivate, 73.9% of which within 3 years. A significant proportion, 39.1%, reactivated without symptoms necessitating regular monitoring in the first 5 years.

Application of biosurfactants in enhanced oil recovery ex-situ: a review.

With a growing focus on environmentally friendly solutions, biosurfactants derived from plants or microorganisms have gained attention for Enhanced Oil Recovery (EOR) applications. Biosurfactants offer several advantages over existing options, including biodegradability, low toxicity, availability of raw materials, resistance to harsh reservoir conditions, and improved water/oil interfacial tension reduction. Different organisms, such as bacteria, fungi, and plants, can produce these natural surfactants. Bacillus sp. and Pseudomonas sp. bacteria are extensively studied for their ability to produce biosurfactants using low-cost carbon and nitrogen sources, exhibiting excellent surface activity and low critical micellar concentration (CMC). Fungi, though less commonly used, can also produce biosurfactants, albeit with lower interfacial activity. Plant-derived natural surfactants find wide application in laboratory tests for EOR, despite having higher CMC. This review not only summarizes the current knowledge on biosurfactants but also offers a novel comparative analysis of those produced by bacteria, fungi, and plants, examining their CMC, surface tension, and interfacial tension properties. Additionally, it quantifies the number of publications on the use of biosurfactants for Microbial Enhanced Oil Recovery ex-situ (MEOR ex-situ) over the past 30 years and compares these with biosurfactants derived from plant sources. Our study is unique in its comparative approach and the quantification of literature on MEOR ex-situ. The findings reveal that biosurfactants produced by bacteria generally exhibit superior surface activity, even at lower concentrations, compared to those produced by plants or fungi. This new comparative perspective and thorough literature analysis highlight the distinctive contributions of this study. Overall, the use of biosurfactants for EOR represents a promising approach to cleaner energy production, with the potential to reduce environmental impact while improving oil recovery.

Effect of Danhong injection on pharmacokinetics and pharmacodynamics of rivaroxaban in rats.

BACKGROUND AND OBJECTIVES: Rivaroxaban is often used in combination with DHI to treat thromboembolic disease. Whether the combination causing HDIs is still unknown. The purpose of this study was to evaluate effects of DHI on pharmacokinetics and pharmacodynamics of rivaroxaban in rats and effects on CYP3A2. METHODS: Plasma concentration of rivaroxaban with or without DHI was determined by HPLC. Pharmacokinetics parameters were calculated. Effect of DHI on pharmacodynamics of rivaroxaban was investigated by APTT, PT, TT, FIB, INR, length of tail thrombosis, vWF, t-PA, PAI-1, IL-1ß, TNF-α and histopathological sections. Effect of DHI on CYP3A2 in rats was investigated by probe drug method. RESULTS: Cmax and AUC of rivaroxaban increased significantly in combination group (P < 0.05). APTT, PT, INR and TT increased (P < 0.05), length of tail thrombosis, FIB, vWF, PAI-1, IL-1ß and TNF-α of combination group decreased significantly (P < 0.05) compared with rivaroxaban or DHI alone. Histopathologic section of tail thrombus had significant improvement. Cmax and AUC of dapsone increased (P < 0.05) in DHI group. CONCLUSION: In summary, DHI is an inhibitor of CYP3A2 and could significantly affect pharmacokinetics and pharmacodynamic of rivaroxaban, enhance anticoagulant and antithrombotic efficacy in rats. However, the combination of rivaroxaban and DHI might lead to potential HDIs. The dosage of rivaroxaban should be adjusted in clinical.

Evaluation of the Performance and Safety of a New Micro-Needle Technology in Comparison With the Classic Needle on the Antiaging Effects of a Biorevitalizing Solution: A Randomized Split Face/Neck Study.

BACKGROUND: Skin biorevitalization involves multiple intradermal injections to enhance skin quality, but precise dermal targeting can be challenging due to variations in skin thickness smaller, less painful needles with fewer skin reactions are attractive options. AIMS: This study evaluates a new Micro-Needle device's performance and safety in comparison with the classic needle used in skin biorevitalization. PATIENTS/METHODS: Subjects with facial and neck skin aging were enrolled. Safety outcomes, including immediate and local tolerability, were assessed. Performance outcomes measured skin radiance, wrinkles and photoaging grade, hydration, subepidermal low echogenic band, dermis thickness, and skin elasticity. Both subjects and investigators recorded Global Aesthetic Improvement Scale scores. RESULTS: Micro-Needle injections demonstrated superior performance compared to the classic needle, influenced by the specific skin zones and thickness. Micro-Needle was superior for skin wrinkles at D49 for periorbital zone and nasolabial folds by -14.5% (p = 0.01) and -15% (p = 0.004), respectively, and for neck by 9.6% (p = 0.0008). The Nanosoft device showed a faster improvement for skin hydration at D42 for the cheek zone (p = 0.04) and at D75 for the neck area (p = 0.01); and for skin radiance at D75 (p = 0.03) and at D120 (p = 0.0098). Ex vivo studies confirmed the Micro-Needle's accuracy in product placement in the dermis. Adverse events were milder with Micro-Needle and no serious adverse events occurred. CONCLUSIONS: Both needles significantly improved skin quality, but Micro-Needle enhanced the outcomes of skin biorevitalization procedures, particularly in terms of skin wrinkle reduction, elasticity, and overall skin hydration.

Asymmetrical primary vesicoureteral reflux: Which is the best surgical strategy?

INTRODUCTION: No report has been published regarding the recommended surgical treatment in patients presenting with symptomatic primary asymmetrical vesicoureteral reflux (VUR): high grade on one side and low grade on the contralateral side. The aim of this study was to evaluate the effectiveness and outcome of combined Lich-Gregoir extravesical reimplantation and subureteric Deflux® injection, of high grade and low grade VUR respectively. Non-inferiority to bilateral cross-trigonal reimplantation was investigated in terms of surgical complications, number of post-operative fUTIs and need for re-intervention. PATIENTS AND METHODS: A monocentric retrospective study was undertaken of all consecutive children with primary asymmetrical VUR on MCUG treated over an 18-year period (2004-2022). Surgery was indicated following an episode of febrile urinary tract infection despite appropriate non-operative management. Demographic and clinical such as length of hospital stay for pain management, use of urinary Foley catheter and complications were analyzed. RESULTS: A total of 80 children met the study criteria: 40 patients underwent bilateral cross-trigonal re-implantation (Group 1) and 40 patients the combined Lich-Gregoir extra vesical reimplantation and Deflux® sub ureteric injection (Group 2). Complication and success rates were comparable in the two groups. The median hospital stay was significantly shorter for Group 2, with 50 % of patients who were discharged on day 1. Moreover, the data showed a significant lesser need in number and length of bladder catheter and ureteral stents in Group 2. DISCUSSION: The technique proposed overcome the inconveniences of the other procedures that are commonly used in bilateral RVU: difficulty in retrograde catheterization or ureteroscopy after bilateral cross-trigonal reimplantation, the risk of transient bladder dysfunction after bilateral extravesical reimplantation and the low rate of success for high grade reflux of the sub ureteric Deflux® injection. The main limitation of the study lies in its retrospective nature and in the relatively short median follow-up. CONCLUSION: The combined Lich-Gregoir extra-vesical ureteral reimplantation and sub-ureteric Deflux® injection for the treatment of primary asymmetrical VUR is an effective alternative to the gold standard cross-trigonal ureteral reimplantation. Moreover, the position of the ureteric orifice is not modified in the eventuality of endourological procedures into adulthood.

Role of EYP-1901 in neovascular age-related macular degeneration and diabetic eye diseases: review of Phase I/II trials.

EYP-1901 (Duravyu) has demonstrated promising outcomes in Phases I and II clinical trials for the treatment of neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME)/diabetic retinopathy. This innovative treatment capitalizes on the potent anti-angiogenic properties of vorolanib, an inhibitor that targets all isoforms of VEGF, effectively mitigating the pathological neovascularization and vascular permeability that underpin these retinal conditions. EYP-1901 is integrated with the Durasert drug delivery system to administer a sustained release of vorolanib directly to the posterior segment of the eye. This delivery system ensures a consistent therapeutic effect over an extended period and significantly reduces the frequency of clinical interventions required, offering a more convenient treatment regimen while maintaining patient safety.

Neovascular age-related macular degeneration (nAMD) and diabetic retinopathy (DR) are eye problems that can make you lose your sight. These eye problems happen when blood vessels in the eye do not work right. Right now, people need lots of shots in their eyes to treat it. EYP-1901 (Duravyu) is a new medicine that helps people with fewer shots in their eyes. It has two parts: one that helps the medicine last longer, and another that helps stop the problem in the eye. Early tests show it works well and helps people keep their sight with fewer treatments.

Short pulse grid and subthreshold micropulse laser (the sandwich grid) plus intravitreal ranibizumab for the treatment of diabetic macular edema.

OBJECTIVE: To investigate the effects of two laser treatment procedures combined, short pulse grid laser (SP) and subthreshold micropulse laser (MP) (the sandwich grid [SWG] technique), plus intravitreal ranibizumab (IVR) on central subfield thickness (CSFT), best-corrected visual acuity (BCVA) and macular sensitivity in patients with diabetic macular edema (DME). METHODS: Forty-five eyes (of 33 patients) with center-involving DME were treated with the SWG laser technique plus IVR and followed for 12 months. Laser treatment was performed at baseline: SP laser spots were placed in a grid pattern in the macular area (500 µm from the fovea) according to the extension of DME; subsequently, MP laser was delivered up to the edge of the fovea. MP laser re-treatment sessions could be performed every 3 months if DME was present and CSFT was ≥ 300 µm on SD-OCT. IVR injection was performed at baseline and repeated monthly if CSFT > 300µm. Preoperatively and monthly, ophthalmological examination was performed including measurements of BCVA, CSFT, and macular sensitivity. RESULTS: One-year follow-up data is available for 37 eyes of 27 patients. Mean ± SE CSFT (µm) was 509.36 ± 25.14 and 325.76 ± 15.34 at baseline and 12 months, respectively. A significant reduction in mean CSFT was observed at all study visits compared to baseline (p < 0.001). Mean ± SE BCVA (logMAR) was 0.62 ± 0.04 and 0.45 ± 0.04 at baseline and 12 months, respectively. A significant improvement in mean BCVA was observed at all study visits compared to baseline (p < 0.001). Mean ± SE macular sensitivity (dB) was 17.85 ± 0.80 and improved to 19.05 ± 0.59 after one year of follow-up (p = 0.006). The mean number of IVR injections was 8.29 ± 0.63. The mean number of MP laser procedures including the initial SWG laser session was 3.67 ± 0.22. No ocular or systemic adverse effects were observed. CONCLUSION: The SWG laser technique plus IVR was associated with significant improvement in macular edema, BCVA, and macular sensitivity in patients with center-involving DME. CLINICAL TRIAL NUMBER (CAAE): 22969019.4.0000.5440.

A simple cell proliferation assay and the inflammatory protein content show significant differences in human plasmas from young and old subjects.

Some studies showed a "rejuvenating" effect of exposing aging tissues to a young environment. In mouse heterochronic parabiosis experiments, in response to young organisms, old animals lived longer than isochrony old age-matched conjoint animals. Comparable "rejuvenating" effects were obtained by injecting young plasma in old mice. This raised great hopes of slowing down the senescence process in humans by the injection of young plasma, as well as to prevent or cure age-related diseases. Some clinical trials are currently being performed or were recently completed. However, these studies are small and of limited duration, and we still lack convincing evidence to support the effectiveness of young plasma injection. It is urgent to perform additional investigations, including the development of an assay to measure the cell proliferation induction capability of different human plasmas, before one can seriously think of a large-scale treatment of humans. We adopted a simple method to measure the potential of different plasmas in supporting cell line proliferation, regardless of the co-presence of a platelet lysate. By comparing plasmas from young and old subjects, we observed a decreased activity in plasmas from old individuals. The young plasma effect may be attributed to specific proteins and growth factors more abundant in younger individuals that could decrease with age. Alternatively, or at the same time, the reduced cell proliferation support could be due to inhibitors present in the old plasma. Studying the different protein content of young and old plasmas was out of the scope of this article. Such differences should be adequately investigated by proteomics using many samples. However, a preliminary study of the different protein content of young and old plasmas was part of the assay validation using a commercially available cytokine array for parallel determination of the relative levels of 105 selected human proteins. We could show the existence of specific differences between young and old plasmas and that plasmas from old individuals presented a higher concentration of "inflammatory" proteins.

Redefining hemorrhoid therapy with endoscopic polidocanol foam sclerobanding.

Hemorrhoids are a common and painful condition, with conventional treatments such as endoscopic rubber band ligation (ERBL) and injection sclerotherapy often falling short due to high recurrence rates and significant post-operative pain. A clinical trial by Qu et al introduces a novel approach called endoscopic poli-docanol foam sclerobanding (EFSB). This multicenter randomized trial involved 195 patients with grade II and III internal hemorrhoids and demonstrated that EFSB significantly reduced recurrence rates and post-procedural pain while improving symptom relief and patient satisfaction compared to ERBL. The study's strengths include its robust design, comprehensive outcome evaluation, and patient-centered approach. Despite limitations such as the single-blind design and relatively short follow-up period, the findings suggest that EFSB could enhance clinical practice by offering a more effective and patient-friendly treatment option. Further research is needed to validate these results and explore the long-term benefits and cost-effectiveness of EFSB.

Comparison of Effectiveness of Intraarticular Hyaluronate and Corticosteroid injections in Adhesive Capsulitis: A Systematic Review and Meta-analysis.

BACKGROUND: Adhesive capsulitis of the shoulder causes inflammation and adhesions in the shoulder joint capsule, leading to pain and limited range of motion (ROM). Intraarticular corticosteroid (CS) and hyaluronic acid (HA) injections are common therapeutic options for adhesive capsulitis, but their comparative effectiveness remains unclear. OBJECTIVES: To provide a robust comparison of the outcomes of HA and CS, we conducted a meta-analysis of relevant previous studies that examined the therapeutic effects of intraarticular HA and CS injections in patients with adhesive capsulitis. STUDY DESIGN: Systematic review and meta-analysis. METHODS: This meta-analysis of randomized controlled trials compared the effectiveness of intraarticular HA and CS injections. Of the 10,205 articles, 7 met our predetermined criteria and were included in the analysis. RESULTS: Patients who received CS injections demonstrated superior pain reduction and functional improvement at 2-4 weeks after injection to those who received HA injections. Nevertheless, comparable outcomes were observed between the 2 groups at 6 and 12 weeks. The active or passive range of motion of the shoulder joint was not significantly different between patients who received HA injections and those who received CS injections. LIMITATIONS: The meta-analysis included only a small number of studies, and the number of HA injections examined in those studies varied from one to 3 at a time, whereas an CS injection was performed only once in most of the included studies. CONCLUSIONS: The administration of intraarticular HA injection emerges as a commendable therapeutic option for patients with adhesive capsulitis, particularly for those requiring repetitive injections or at risk of developing side effects from injections of CS. Although intraarticular CS injections offer accelerated short-term (2-4 weeks) pain relief and functional improvement, comparable effects were observed within 6 and 12 weeks after intraarticular HA and CS injections.

Treatment Gaps and Emerging Therapies in Lumbar Disc Herniation.

BACKGROUND: Lumbar disc herniation (LDH) occurs when the central disc material, primarily the nucleus pulposus, is displaced beyond the outer annulus, compressing the spinal nerve roots. LDH symptoms, including radicular leg pain, radiculopathy, and low back pain, are associated with considerable disease burden and the significant utilization of health care resources. OBJECTIVES: Provide overview of the current treatment landscape for LDH, identify unmet needs, and describe emerging treatments. STUDY DESIGN: Narrative literature review. METHODS: A review of literature concerning available LDH treatments and associated outcomes was conducted in PubMed to identify areas of unmet need. Some key words included "lumbar disc herniation," "radicular leg pain," "sciatica," "treatment," "therapy," and "burden." RESULTS: For patients who do not respond to conservative therapy, epidural steroid injections (ESIs) are widely used for persistent LDH symptoms. While ESIs provide short-term improvements in radicular pain, evidence that ESIs bestow sustained benefits is limited. ESIs are not approved by the US Food and Drug Administration (FDA) and, in rare cases, carry risks of infection and neurological injury, as well as the potential for long-term systemic effects of glucocorticoids. In cases when nonsurgical treatment fails to relieve symptoms, lumbar discectomy can provide rapid pain relief; however, in addition to the risk of intraoperative complications, the long-term consequences of lumbar discectomy may include recurrent pain or herniation, revision discectomy, loss of disc height, and Modic changes. Treatments for LDH in late-stage clinical development include sustained-release ESI formulations and a novel agent for chemonucleolysis, a nonsurgical method of minimizing the volume of the displaced nucleus pulposus. Emerging minimally invasive therapies that address the underlying pathophysiology of the disease have the potential to bridge the gap between symptomatic treatments and surgery. LIMITATIONS: Because this paper was a narrative review, literature search and selection processes were not systematic in nature. The evidence regarding the long-term efficacy of some treatments, such as discectomy, was limited by the high rates of crossover between the treatment groups. CONCLUSIONS: The lack of sustained benefits associated with ESIs and the risks associated with surgery underscore the unmet need for novel, minimally invasive interventional therapies able to address the underlying nerve root compression in LDH.

Comparison of the Efficacy of Ultrasound-Guided Suprascapular Nerve Blocks and Intraarticular Corticosteroid Injections for Frozen Shoulder: A Randomized Controlled Trial.

BACKGROUND: The current mainstream treatment for frozen shoulder is a combination of physiotherapy and intraarticular corticosteroid injections (IACIs). Recently, the ultrasound-guided suprascapular nerve block (SSNB) has developed as a notable alternative option to the mainstream treatment. OBJECTIVE: We aimed to compare ultrasound-guided SSNBs' effectiveness to IACIs' as treatments for frozen shoulder. STUDY DESIGN: This study was conducted as a prospective single-blind, randomized controlled trial. SETTING: Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, a medical center in Taipei, Taiwan. METHODS: Patients with frozen shoulder (n = 76) were enrolled as participants and allocated to either an SSNB group (n = 38) or an IACI group (n = 38). Both groups received 2 injections of 20 mg of triamcinolone and 3 mL of 1% lidocaine at 2-week intervals and underwent the same physiotherapy protocol for 3 months. The primary outcome measure was the Shoulder Pain and Disability Index (SPADI). The secondary outcome measures were the Shoulder Disability Questionnaire (SDQ), the active and passive range of motion (ROM) of each patient's affected shoulder, and the 36-item Short Form Health Survey (SF-36). Evaluations were performed at baseline and at 4 and 12 weeks after starting treatment. RESULTS: Both groups achieved significant improvements in all outcome measures, except the general health subscale of the SF-36 at 4 and 12 weeks after starting treatment. For time and group interaction, the results for the SDQ (P = .047) and SF-36 (bodily pain, P = .025) indicated significant differences that favored IACIs. Additionally, the IACI group achieved more favorable outcomes than did the SSNB group on the SPADI (P = .094) and in ROM (i.e., abduction [P = .190] and external rotation [P = .081]) as well as on 2 subscales of the SF-36: bodily pain (P = .059) and role-emotional (P = .072). LIMITATIONS: Our study is limited by the lack of participant stratification based on the stages of frozen shoulder and the 12-week follow-up period. CONCLUSIONS: A combination of ultrasound-guided IACIs and physiotherapy should be attempted first as a frozen shoulder treatment.

DaxibotulinumtoxinA for injection to treat moderate or severe glabellar lines: A randomized, multicenter, Phase III, double-blind, placebo-controlled trial in China.

BACKGROUND: DaxibotulinumtoxinA for injection (DAXI), a novel botulinum toxin type A formulation, is FDA-approved for glabellar lines treatment. Its clinical efficacy has been demonstrated in two Phase III trials (SAKURA 1 and SAKURA 2). OBJECTIVE: To evaluate DAXI efficacy and safety in Chinese adults with moderate/severe glabellar lines. METHODS: In this Phase III, randomized (2:1), double-blind trial, Chinese adults with moderate/severe glabellar lines received 40 U DAXI or placebo into the corrugator muscles bilaterally and the procerus. Glabellar line severity was evaluated by investigators (Investigator Global Assessment-Frown Wrinkle Severity [IGA-FWS] scale) and participants (Patient Frown Wrinkle Severity [PFWS] scale) for ≥24 to 36 weeks. The primary endpoint was the proportion of 2-point composite responders achieving ≥2-point reduction in IGA-FWS and PFWS scores at week 4 post-treatment. RESULTS: Overall, 307 participants received treatment (DAXI, 205; placebo, 102). A significantly greater proportion of participants in the DAXI arm vs the placebo arm achieved a 2-point composite response at week 4: 125 (61.0%) vs 1 (1.0%); difference, 60.0% [95% CI 49.40-66.46]; 2-sided p < 0.0001). At week 4, 94.1% of the DAXI-treated participants achieved an IGA-FWS score 0/1 (none/mild) and 86.3% achieved PFWS 0/1; median time to loss of none/mild on IGA-FWS and PFWS was 23.9 weeks. The benefits of DAXI over placebo through week 24 occurred regardless of the baseline IGA-FWS score, prior botulinum toxin type A (BoNTA) exposure, sex or age. DAXI was well tolerated with no new safety signals. CONCLUSION: DAXI provided durable efficacy and acceptable safety for treating moderate/severe glabellar lines in Chinese participants.

Research on the microscopic pore-throat structure and reservoir quality of tight sandstone using fractal dimensions.

The pore-throat structure is a crucial parameter for evaluating reservoir characteristics and assessing the potential of oil and gas resources. Understanding the relationship between reservoir pore-throat variations and oil-bearing properties is essential. Through a combination of techniques, including thin-section casting, scanning electron microscopy (SEM), micro-computed tomography (micro-CT), and high-pressure mercury injection (HPMI), we examined the tight sandstone reservoirs from the Chang 4 + 5 members of the Yanchang Formation in the study area. This analysis elucidates the relationship between the pore-throat structure and fractal characteristics of the samples and their oil-bearing properties. The results show that : (1) The tight sandstone reservoirs in the study area mainly develop three types of pores: dissolution pores, residual intergranular pores, and microfractures. Residual intergranular pores are primarily controlled by early compaction processes, while dissolution processes easily form secondary pores, increasing the porosity of the reservoir. Microfractures can significantly enhance both the permeability of the reservoir. (2) Using the characteristic parameters of HPMI, the reservoir is classified into four categories, labeled as type I to type IV. As the categories progress from type I to type IV, pore-throat size decreases, porosity and permeability decrease, and reservoir properties deteriorate. The overall fractal dimension of pores decreases, while the fractal dimensions of individual pore types increase. Pore connectivity becomes more complex, and heterogeneity strengthens. (3) Reservoir porosity shows a strong positive correlation with permeability. As reservoir properties improve, the number of macropores increases, leading to a higher Reservoir Quality Index (RQI) and better oil-bearing characteristics.

Impact of Hysteroscopic Instillation of Autologous Platelet-Rich Plasma on Pregnancy Outcomes in Patient With Recurrent Implantation Failure: A Case Report.

Recent advancements in assisted reproductive technology (ART) have enabled couples to achieve pregnancy, who were previously unable to conceive. However, recurrent implantation failure (RIF) remains a significant challenge. This case study exhibits the effective use of hysteroscopic-guided platelet-rich plasma (PRP) instillation in the treatment of a female patient aged 33 who was nulliparous and diagnosed with RIF and a thin endometrium, which resulted in primary infertility. The couple had a history of 10 years of infertility and had previously undergone ART procedures, including intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI), which failed. The female partner was diagnosed with a thin endometrium (<7 mm) and underwent hysteroscopy, revealing no other significant intrauterine pathologies. Following hormonal treatment and ovum pick-up, hysteroscopic PRP was administered, resulting in improved endometrial thickness (ET) and successful embryo implantation, as evidenced by a positive serum ß-hCG level of 1470 mIU/mL. This case demonstrates the hysteroscopic injection of PRP's potential for increasing endometrial receptivity and enhancing ART outcomes in women with RIF due to thin endometrium, making it a promising alternative to conventional therapies.

Injectable Platelet-Rich Fibrin and Hyaluronic Acid Mesotherapy for Management of Actinic Elastosis of Lower Eyelids: A Case Series.

Rejuvenating the skin on the lower eyelids is often complicated. Treatment alternatives that have been practiced in the past had several complications. Additionally, they were not completely effective in addressing skin aging or actinic elastosis symptoms such as dark circles under the eyes. A minimally invasive therapy approach that improves the above-mentioned issues in a desirable way has been discussed in this case series. The patients selected were of the age group between 20-40 years who had actinic elastosis of the lower eyelid. The patients were injected twice at one-month intervals with a combination of injectable platelet-rich fibrin (iPRF) and hyaluronic acid. The patients were examined on the day of treatment and one month after the second injection. A progressive improvement in the esthetic outcome and a high level of patient satisfaction were observed. Apart from the predicted visible swelling right away following the iPRF injection. The outcomes have shown that a series of iPRF with hyaluronic acid injections in the lower eyelid region is a safe, proficient, pain-free, simple and rapid treatment option for actinic elastosis.

Comparative Effectiveness of Acupuncture Versus Non-surgical Modalities for Treating Plantar Fasciitis: A Network Meta-Analysis.

Plantar fasciitis, or plantar heel pain, causes inflammation of the plantar fascia due to various causes, with no clear consensus on the treatment protocol. Standard first-line treatment includes non-steroidal anti-inflammatory drugs and physiotherapy. Second-line treatment prior to surgery includes extracorporeal shockwave therapy (ESWT), ultrasound-guided (USG) therapy, corticosteroid injection (CSI), and platelet-rich plasma (PRP) injection. Recently, the use of acupuncture treatment has been gaining popularity, with increasing published evidence showing its effectiveness in treating plantar fasciitis. The objective of this study was to determine whether acupuncture intervention was a viable alternative treatment method for managing plantar fasciitis when compared to ESWT, USG therapy, CSI, and PRP injection. Data sources from PubMed, Google Scholar, Scopus, Science Direct, and China National Knowledge Infrastructure were reviewed. Clinical trials were searched from their inception over the period of January 2000 to October 2020. A total of 32 relevant papers were included for analysis, totaling 2390 samples. Visual Analog Scale (VAS) scores measuring pain were analyzed in terms of outcome after one and three months of treatment. Each time point was analyzed separately through a network meta-analysis using the frequentist approach. VAS scores for each intervention at baseline and the two-time points (i.e., one and three months) were included in the comprehensive meta-analysis. Then, differences in VAS scores were calculated in R studio (V4.1.2; RStudio: Integrated Development for R, RStudio, Inc., Boston, USA) using the netmeta package. The netmeta package was also used to perform the network meta-analysis and generate corresponding figures. Direct and indirect effects were assessed and visualized through a direct evidence plot and a node-splitting forest plot. Randomized controlled trials (RCTs) and non-RCTs involving treatments of acupuncture, ESWT, USG therapy, CSI, or PRP injection, either in comparison with each other or with a placebo, were included in our review. Our meta-analysis showed that at one month, VAS scores for acupuncture treatment had the highest mean difference (MD) of -1.33 (95% confidence interval (95% CI) = -2.19 to -0.46) compared to placebo, indicating that acupuncture treatment was more effective than other treatment arms when compared to placebo. Analysis at threemonths showed that the highest-ranked treatment was PRP injection, with an MD of -2.67 (95% CI = -6.23 to 0.89). However, the CI for the net effect of all treatments crossed the null effect on the forest plot, indicating no statistically significant difference between the treatment and placebo. Acupuncture treatment should be considered as a second-line treatment for treatment of plantar fasciitis together with other common treatment options such as ESWT, PRP injection, CSI, and USG therapy. Further long-term studies measuring acupuncture treatment outcomes would be beneficial in the future.