Smart Use of Skin Biopsy Punch in Treating Keloids: A Single-Center Retrospective Study.

BACKGROUND: Treatment of scarring has long been a problem due to high incidence and recurrence. Despite many existing treatment therapies, the efficacy remains unstable. OBJECTIVES: To determine the efficacy and safety of skin biopsy punch in combination with corticosteroid injection (BPCI) in treating keloids. APPROACH: This was a retrospective study. In total, 16 patients with keloids received BPCI. Changes in scar appearance, accompanied symptoms, and Vancouver Scar Scale (VSS) were analyzed. Patient satisfaction, VAS scores, and adverse effects were also evaluated. RESULTS: Scar appearance, accompanied symptoms, and VSS scores improved significantly after the treatment. The total effective rate was 93.75% at an 18-month follow-up on average. The mean reduction rate of VSS score was 58.44% (p < 0.0001), especially in height and pliability (84.44% and 78.19%, p < 0.0001). The recurrence rate in this study was 12.5% (n = 2) at an 18-month follow-up on average. Mild adverse effects of pain, pruritus, hypopigmentation, and telangiectasia were recorded. CONCLUSIONS: This study demonstrated BPCI might be an effective and safe therapy in keloids with a low long-time recurrence rate and well tolerance for patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Experimental study on the effect of chrysin on skin injury induced by amiodarone extravasation in rats.

OBJECTIVE: Amiodarone is the first choice for the treatment of arrhythmia, but it is easy to cause extravasation during infusion, after extravasation, it often cause skin injury. The healing of skin injury induced by amiodarone is an inflammatory process. Chrysin, a natural flavonoid, has been investigated to have anti-inflammatory and antioxidant effects. It was reported that chrysin can promote wound healing. So this study aims to investigate the effect of chrysin on amiodarone extravasation-induced skin injury model in rats. METHODS: The rat model of skin extravasation injury was established by subcutaneous injection of 0.5 mL of amiodarone. After successful modeling, the rats were randomly assigned to the five groups: control group, 10% DMSO group, and low-dose, medium-dose, and high-dose chrysin groups (10, 20 and 40 mg/mL). The extravasation injury model was given locally on the same day for seven days. On day 0, 3, 7 and 10 of administration, the lesion's image were taken to calculate the area, and the tissue of the lesion were collected for H&E staining. Then, the level of IL-6 and TNF-α were measured by ELISA, and the protein expression level of bFGF in the wound tissue were detected by immunohistochemical staining. RESULTS: It was found that chrysin groups (20 and 40 mg/mL) compared to contronl group and 10% DMSO solvent group significantly decreased area injury, IL-6 and TNF-α(P < 0.05) on day 3, 7, 10. On the other hand, the chrysin group (40 mg/mL) compared to contronl group and 10% DMSO group significantly increase bFGF(P < 0.05) on day 3, 7. CONCLUSION: Chrysin were effective in reducing injury area, reducing inflammation, and promoting the secretion of bFGF, it can promote the healing of skin injury induced by amiodarone extravasation in rats. These findings provide a good theoretical and experimental basis for the prevention and treatment of amiodarone extravasation-induced skin injury, and provide evidence for finding potential healing agents for the prevention and treatment of amiodarone and other corrosive extravasation-induced injuries from the molecular and cytological levels, thus solving the clinical problems.

Homeostatic generation of reactive oxygen species protects the zebrafish liver from steatosis.

UNLABELLED: Nonalcoholic fatty liver disease is the most common liver disease in both adults and children. The earliest stage of this disease is hepatic steatosis, in which triglycerides are deposited as cytoplasmic lipid droplets in hepatocytes. Through a forward genetic approach in zebrafish, we found that guanosine monophosphate (GMP) synthetase mutant larvae develop hepatic steatosis. We further demonstrate that activity of the small GTPase Rac1 and Rac1-mediated production of reactive oxygen species (ROS) are down-regulated in GMP synthetase mutant larvae. Inhibition of Rac1 activity or ROS production in wild-type larvae by small molecule inhibitors was sufficient to induce hepatic steatosis. More conclusively, treating larvae with hydrogen peroxide, a diffusible ROS that has been implicated as a signaling molecule, alleviated hepatic steatosis in both GMP synthetase mutant and Rac1 inhibitor-treated larvae, indicating that homeostatic production of ROS is required to prevent hepatic steatosis. We further found that ROS positively regulate the expression of the triglyceride hydrolase gene, which is responsible for the mobilization of stored triglycerides in hepatocytes. Consistently, inhibition of triglyceride hydrolase activity in wild-type larvae by a small molecule inhibitor was sufficient to induce hepatic steatosis. CONCLUSION: De novo GMP synthesis influences the activation of the small GTPase Rac1, which controls hepatic lipid dynamics through ROS-mediated regulation of triglyceride hydrolase expression in hepatocytes.

[Analysis of research hotspot and frontier of severe coronavirus disease 2019: visual analysis based on CiteSpace].

OBJECTIVE: To analyze the research hotspot and frontier of severe coronavirus disease 2019 (COVID-19) in China and abroad. METHODS: The CiteSpace software was used to visually analyze the relevant research of severe COVID-19 published by CNKI and Web of Science databases from January 30th to April 20th in 2020. The analysis content included the author of the literature, the publishing institutions, and high-frequency keywords. RESULTS: There were 389 Chinese literatures and 59 English literatures included. Analysis using CiteSpace software showed that there were four large teams in China currently concerning about the research on severe COVID-19. The co-authoring of each team was relatively close, but the teams were lack of cooperation. The main issuing institutions were affiliated hospitals of colleges and universities, but colleges and enterprises had less participation. The authors of English-language publications mainly had five research teams, some of whom had co-authored relationships. The country with the most enormous volume of English-language publications was China, followed by the United States and Canada. The Chinese keyword co-occurrence, clustering and highlighted words analysis showed that the main research areas of severe COVID-19 included clinical features, traditional Chinese medicine treatment, medical imaging, integrated traditional Chinese and Western medicine treatment and so on; nucleic acid detection, clinical features and diagnosis, plague theory and etiology mechanism, traditional Chinese medicine and integrated Chinese and Western medicine treatment, severe COVID-19 combined with diabetes and prognosis research will become future research trends; keyword cluster analysis showed that severe COVID-19, combined chronic underlying diseases, CT imaging characteristics will also become new trends in the field of research. Co-occurrence analysis of keywords in English literatures showed that the main research areas of severe COVID-19 included the names of novel coronavirus, pandemic diseases, infectious diseases, medical supplies distribution, and indicators related to myocardial damage. CONCLUSIONS: Researchers in China and abroad have different concerns about severe COVID-19. Domestic research focuses on the diagnosis and treatment of severe cases, while foreign countries attach importance to epidemic response and prevention.

Different exercises for pregnant women with gestational diabetes: a meta-analysis of randomized controlled trials.

INTRODUCTION: There is evidence that maternal and child outcomes in patients with gestational diabetes mellitus (GDM) are associated with different exercise patterns. However, the evidence on which forms of exercise are beneficial for pregnant women with GDM is unclear. EVIDENCE ACQUISITION: PubMed, EMBASE, the Cochrane Library and the Web of Science were systematically searched for eligible studies until Feb.24, 2019. A randomized controlled trial (RCT) was used as the study method. The literature quality was evaluated and the data extracted by two researchers, and statistical analysis was carried out using Review Manage 5.2 software. EVIDENCE SYNTHESIS: A total of nine RCTs were included. The research results show that compared with the conventional treatment group, aerobic exercise reduced the fasting blood glucose (WMD=-0.35, 95% CI: -0.62 to -0.08, I2=87%), postprandial blood glucose (WMD=-0.62, 95% CI:-0.95 to -0.29, I2=84%) and glycosylated hemoglobin levels (WMD=-0.35, 95% CI:-0.49 to -0.20, I2=71%) in patients with GDM. Compared with the conventional treatment group, the dosage of insulin (WMD=0.97, 95% CI: 0.42-2.26, I2=0%) in patients with GDM in the resistance exercise group was reduced, and the effect of combined treatment was statistically significant. Compared with the conventional treatment group, the combination of aerobic exercise plus resistance exercise training reduced postprandial blood glucose in patients with GDM (WMD=-0.64, 95% CI:-0.94 to -0.34), and the combined treatment effect was statistically significant. CONCLUSIONS: Different types of exercise have different intervention effects on the outcome of patients with gestational diabetes. However, we do not have enough data to determine whether infants benefit from this exercise, and it is still necessary to conduct large-scale, high-quality and long-term intervention studies for verification.