The protective role of resveratrol in diabetic wound healing.

Diabetic wounds are severe complications of diabetes mellitus (DM), which have difficulty in healing. Although diverse treatments have been used, the prognosis of diabetic wounds is not satisfactory; therefore, an effective therapy to accelerate diabetic wound healing is urgently needed. In our review, we summarized that resveratrol can promote diabetic wound healing by protecting against hyperglycemia, inflammation, oxidative stress, vascular pathology, infection, and peripheral neuropathy. To clarify it clearly, we highlighted its underlying mechanisms of protective effects of resveratrol against diabetic wounds, and high-quality studies are needed to firmly establish its clinical efficacy. Otherwise, with the development of material sciences, resveratrol can exert its therapeutic effectiveness efficiently; however, more high-quality studies are needed to confirm the clinical efficacy of resveratrol on diabetic wounds.

Edaravone promotes viability of random skin flaps via activating PI3K/Akt/mTOR signalling pathway-mediated enhancement of autophagy.

Random skin flap transplantation is a commonly used technique. However, ischemia and ischemia-reperfusion injury always impair its therapeutic effectiveness through acclerating oxidative stress, apoptosis and suppressing angiogenesis. To survive, cells rely on mediating autophagy, DNA repair, immunoregulation to resist these cellular injuries. Thus, mediating autophagy may affect the survival of random skin flaps. The edaravone (EDA), a oxygen radicals scavenger, also possesses autophagy mediator potential, we investigated the effects of EDA on skin flap survival and its autophagy-related mechanisms. In vivo, mice were administered EDA or saline intraperitoneally for 7 days postoperatively. We found that EDA ameliorated the viability of random skin flaps, promoted autophagy and angiogenesis, attenuated apoptosis and oxidative stress. In vitro, mouse umbilical vascular endothelial cells (MUVECs) were administered EDA or 3-methyladenine (3-MA, an autophagy inhibitor) or rapacymin (Rapa, an autophagy activator) at the beginning of oxygen glucose deprivation (OGD). We found that EDA promoted cell viability, activated autophagy, enhanced angiogenesis, alleviated apoptosis and oxidative stress. On one hand, 3-MA reversed the effects of EDA on cell viability, oxidative stress and apoptosis via inhibiting autophagy. On the other hand, Rapa had the similar effects of EDA. Furthermore, EDA-induced autophagy was mediated through downregulating PI3K/Akt/mTOR signalling pathway. The findings showed that EDA ameliorated viability of random skin flaps by promoting angiogenesis, suppressing oxidative stress and apoptosis, which may be mediated by autophagic activation through downregulating PI3K/AKT/mTOR signalling pathway.

Role of curcumin in ischemia and reperfusion injury.

Ischemia-reperfusion injury (IRI) is an inevitable pathological process after organic transplantations. Although traditional treatments restore the blood supply of ischemic organs, the damage caused by IRI is always ignored. Therefore, the ideal and effective therapeutic strategy to mitigate IRI is warrented. Curcumin is a type of polyphenols, processing such properties as anti-oxidative stress, anti-inflammation and anti-apoptosis. However, although many researches have been confirmed that curcumin can exert great effects on the mitigation of IRI, there are still some controversies about its underlying mechanisms among these researches. Thus, this review is to summarize the protective role of curcumin against IRI as well as the controversies of current researches, so as to clarify its underlying mechanisms clearly and provide clinicians a novel idea of the therapy for IRI.

Research progress and insights on the role of ferroptosis in wound healing.

Ferroptosis is a newly discovered cell death type which is different from apoptosis, autophagy, pyroptosis as well as necrosis in the following aspects: morphology, biochemistry, gene and regulatory mechanisms. Ferroptosis is regulated by multiples of mechanisms such as system Xc- mechanism, glutathione peroxidase 4 (GPX4) mechanism, iron metabolism and lipid metabolism. Currently, ferroptosis has been revealed to be significant in wound healing such as diabetic wound, irradiated wound and ultraviolet (UV)-driven wound. Hence, how to intervene in the pathogenesis as well as the development of wounds and promote the wound healing by the regulation of ferroptosis have become a research hotspot. This review systematically summarises the latest scientific advances of ferroptosis and wound healing fields, with hoping to propose a new insight and advance in the wound treatment.

Foam sclerotherapy compared with liquid sclerotherapy for the treatment of lower extremity varicose veins: A protocol for systematic review and meta analysis.

BACKGROUND: There is a continued discussion on which is the best sclerosant to treat lower extremity varicose veins. Therefore, we did this meta-analysis to determine that foam sclerotherapy versus liquid sclerotherapy, which could perform better in the treatment of lower extremity varicose veins. MATERIALS AND METHODS: We independently searched 5 databases from inception to February 1, 2019, for randomized controlled trials and prospective controlled trials for comparing foam sclerotherapy and liquid sclerotherapy for the treatment of lower extremity varicose veins. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies. The primary outcome and secondary outcomes were analyzed using stata 15.0. This meta-analysis was performed according to Cochrane Handbook. RESULTS: There were significant differences in effective rate (P < .001, odd ratios = 5.64, 95% confidence interval = 3.93-8.10) and incidence rate of pain (P = .030, odd ratios = 1.52, 95% confidence interval = 1.04-2.21) between foam sclerotherapy and liquid sclerotherapy. And there were no significant differences among local inflammation (P = .896, rate difference = 0.00, 95% confidence interval = -0.03 to 0.03), thrombophlebitis (P = .90, rate difference = 0.00, 95% confidence interval = -0.02 to 0.02) and hyperpigmentation (P = .336, rate difference = 0.05, 95% confidence interval = -0.05 to 0.14). CONCLUSIONS: Although foam sclerotherapy has a higher incidence rate of complications, it could achieve a more stable clinical efficacy in the treatment of lower extremity varicose veins than liquid sclerotherapy.

Male axillary accessory breast cancer: A case report.

RATIONALE: Accessory breast cancer is extremely rare among all cancerous diseases, especially in male patients. There were only few male axillary accessory breast cancer cases that have been reported in scientific literatures so far. Hereby, we would like to discuss a case of male axillary accessory breast cancer found in our hospital. PATIENT CONCERNS: We report a male senile patient suffering from a painful, enlarged, and hardened right axillary mass for more than 20 years. He came for further treatments due to progressive growth of the mass for 11 months with bloody ulceration for more than 1 month. DIAGNOSIS: Pathological examination manifested a grade II infiltrating ductal carcinoma derived from the accessory mammary gland (right axilla), with invasion of local skin. Immunohistochemical examination result: estrogen receptor (++) 90%, progesterone receptor (+++) 100%, human epidermal growth factor receptor-2 (1+), ki67 (20% positive), prostate specific antigen (-), caudal-related homeobox-2 (-), thyroid transcription factor-1 (-), Synaptophysin (+), NapsinA (1), and CK7 (-). INTERVENTIONS: Modified radical mastectomy and axillary lymph nodes clearance were performed on the accessary breast cancer under general anesthesia. Postoperatively, endocrine therapy was provided for the patient, orally-taken Letrozole was recommended for the rest of the patient's life. OUTCOMES: The patient recovered uneventfully and was discharged 3 days after the operation. The patient continued to take Letrozole orally regularly at home and no signs of recurrence were observed. CONCLUSION: Axillary accessory breast cancer in males is extremely rare, with no conspicuous and typical clinical presentations, which leads to inevitable neglect by clinicians. Therefore, there is significant necessity for clinicians to be cautious with this type of disease.

A new type of surgery for the treatment of bromhidrosis.

It is common to treat bromhidrosis by surgery, but postoperative complications such as subcutaneous exudate and subcutaneous hematoma can occur and lead to delayed healing of the wound and eventually lead to the formation of unattractive scars. In this study, we evaluated our new surgical treatment for bromhidrosis, which we believe improves prognosis over conventional surgery.The new procedure was performed on 22 patients with bromhidrosis. Our procedure is as follows. One centimeter-long incisions are made along the skin and cleaning of the subcutaneous apocrine glands using a special serrated scraping device is completed. Then, several 0.5 cm-long drainage holes are made according to the design of the Sudoku puzzle and 4 anchoring points identified to stabilize the oil gauze. Finally, the incisions were sutured and the wound covered with a bandage.Of 44 axillas, the bromhidrosis of 42 axillas was completely cured, and greatly reduced in 2 axillas. Local epidermal necrosis occurred in 5 axillas, but there was no full-thickness skin necrosis. Subcutaneous hematoma was not observed, and postoperative scarring was minimal.We found that our modified surgery can effectively reduce the occurrence of subcutaneous hematoma, avoid delayed healing of the wound, and minimize postoperative scarring.Level II, therapeutic study.

Intralesional Injection of Botulinum Toxin Type A Compared with Intralesional Injection of Corticosteroid for the Treatment of Hypertrophic Scar and Keloid: A Systematic Review and Meta-Analysis.

BACKGROUND The optimal treatment for hypertrophic scar and keloid remains controversial. Therefore, the aim of this systematic review and meta-analysis was to compare the effectiveness of intralesional injection of botulinum toxin type A compared with placebo and intralesional injection of corticosteroid compared with placebo in patients with hypertrophic scar and keloid. MATERIAL AND METHODS Six databases were searched using Medical Subject Headings (MeSH) keywords and included Web of Science, PubMed, EMBASE, the Cochrane Library, WanFang, and CNKI from their inception to March 1 2019, without language restriction. Randomized controlled trials (RCTs) and prospective controlled trials (PCTs) were identified that compared intralesional injection of botulinum toxin type A with placebo and corticosteroid with placebo in hypertrophic scar and keloid. The quality of controlled trials was assessed by the Newcastle-Ottawa Scale (NOS). RESULTS Comparison of intralesional botulinum toxin type A and corticosteroid showed significant differences in the Visual Analog Scale (VAS) (P<0.001) (WMD, -4.30; 95% CI, -4.44 to -4.16) and effective rate (P=0.012) (RR=0.82; 95% CI, 0.70-0.96). Intralesional injection of botulinum toxin type A compared with placebo showed significant differences in the VAS (P<0.001) (WMD, 1.41; 95% CI, 1.21-1.62), the width of scar (P=0.00) (WMD, -0.15; 95% CI, -0.19 to -0.10) and Vancouver Scar Scale (VSS) (P=0.003) (WMD, -0.69; 95% CI, -1.14 to -0.23). CONCLUSIONS Systematic review and meta-analysis showed that injection of intralesional botulinum toxin type A was more effective in the treatment of hypertrophic scar and keloid than injection of intralesional corticosteroid or placebo.

The Treatment of Axillary Odor: A Network Meta-Analysis.

BACKGROUND Axillary osmidrosis (AO) is common in plastic surgery. But there is no perfect way to treat AO. We systematically compared the efficacy of 10 AO treatments with network meta-analysis in order to provide reference for the clinical treatment of axillary odor. MATERIAL AND METHODS Chinese and English databases were searched by computer. Some relevant studies were collected for network meta-analysis. RESULTS We identified 56 studies, including a total of 8618 patients for meta-analysis. The network meta-analysis showed that 21 out of 45 pairs of 10 AO treatments had no statistical significance. In statistical comparison, subcutaneous curettage and swelling suction subcutaneous pruning were better than a single treatment. In addition, the effects of both laser and electric ion therapy were inferior to those of other treatments. The order of therapeutic effects predicted by surface under the cumulative ranking (SUCRA), curve was swelling aspiration+subcutaneous pruning >subcutaneous pruning >subcutaneous curettage+subcutaneous pruning >spindle excision >botulinum toxin A injection >swelling aspiration >subcutaneous curettage >YAG laser therapy >CO2 laser therapy >electric ion therapy. CONCLUSIONS In operative treatment of AO, swelling aspiration+subcutaneous pruning is the best operative treatment, and botulinum toxin A injection is the best in non-operative treatment. Overall, the effect of surgical treatment was more significant than that of non-surgical treatment.

On a New Subspecies of Ussuriana fani Koiwaya (Lepidoptera, Lycaenidae, Theclini) Discovered from northern China.

Ussuriana fani wangi, ssp. nov. is described and illustrated from Baihuashan of Taihangshan Mountain Range, Beijing. This new subspecies utilizes Fraxinus bungeana as the larval hostplant, representing the first record of U. fani in northern China. The immature biology, larval morphology, and data of COI barcode all indicate the population belonging to U. fani rather than superficially similar U. michaelis.