Immunomodulatory hydrogels for skin wound healing: cellular targets and design strategy.

Skin wounds significantly impact the global health care system and represent a significant burden on the economy and society due to their complicated dynamic healing processes, wherein a series of immune events are required to coordinate normal and sequential healing phases, involving multiple immunoregulatory cells such as neutrophils, macrophages, keratinocytes, and fibroblasts, since dysfunction of these cells may impede skin wound healing presenting persisting inflammation, impaired vascularization, and excessive collagen deposition. Therefore, cellular target-based immunomodulation is promising to promote wound healing as cells are the smallest unit of life in immune response. Recently, immunomodulatory hydrogels have become an attractive avenue to promote skin wound healing. However, a detailed and comprehensive review of cellular targets and related hydrogel design strategies remains lacking. In this review, the roles of the main immunoregulatory cells participating in skin wound healing are first discussed, and then we highlight the cellular targets and state-of-the-art design strategies for immunomodulatory hydrogels based on immunoregulatory cells that cover defect, infected, diabetic, burn and tumor wounds and related scar healing. Finally, we discuss the barriers that need to be addressed and future prospects to boost the development and prosperity of immunomodulatory hydrogels.

The impact of merkel cell polyomavirus positivity on prognosis of merkel cell carcinoma: A systematic review and meta-analysis.

Introduction: There are numerous findings over the past decade have indicated that Merkel cell carcinoma (MCC) may have two pathways of pathogenesis: one related to ultraviolet irradiation and the other to the Merkel cell polyomavirus (MCPyV). However, the predictive and clinicopathological value of MCPyV positivity in MCC patients is still debatable. This article aims to examine the most recent data regarding this issue. Methods: The thorough literature searches were conducted in the Medline Ovid, PubMed, Web of Science, the Cochrane CENTRAL Databases, and Embase Databases until December 31, 2021. The associations between overall survival (OS), Merkel cell carcinoma-specific survival (MSS), recurrence-free survival (RFS), progression-free survival (PFS), clinicopathologic features, and MCPyV positivity were examined in our meta-analysis. Results: This meta-analysis included a total of 14 studies involving 1595 patients. Our findings demonstrated a significant correlation between MCPyV positivity and improved OS (HR=0.61, 95%CI:0.39-0.94, P=0.026) and improved PFS (HR=0.61, 95% CI: 0.45-0.83, P=0.002). MCPyV positivity did not, however, appear to be associated with either MSS (HR=0.61, 95%CI: 0.28-1.32, P=0.209) or RFS (HR= 0.93, 95%CI: 0.37-2.34, P=0.873). Pooled results revealed a correlation between MCPyV positivity with gender (male vs. female, OR=0.606, 95%CI: 0.449-0.817, P=0.001), histopathological stage (AJCC I-II vs. III-IV, OR=1.636, 95%CI: 1.126-2.378, P=0.010) and primary site (head and neck vs. other sites, OR=0.409, 95%CI: 0.221-0.757, P=0.004). Conclusion: These results imply that MCPyV positivity may present a promising predictive biomarker for human MCC and call for further study.

Abdominoplasty with Scarpa Fascia Preservation: A Systematic Review and Meta-analysis.

BACKGROUND: Scarpa fascia preservation has been proposed to minimize complications associated with conventional abdominoplasty, but its efficacy is unclear. The purpose of this article is to determine the influence of preserving scarpa fascia on reducing postabdominoplasty complications. METHODS: A comprehensive search of Medline Ovid, PubMed, Web of Science, and the Cochrane CENTRAL databases was conducted from the inception till June 2021. Eligible studies were prospective controlled studies investigating postoperative complications after scarpa fascia preservation following abdominoplasty. Stata 15.1 software was used for the meta-analysis. RESULTS: The meta-analysis included seven studies with 682 abdominoplasty patients. Abdominoplasty with scarpa fascia preservation could significantly reduce incidence of seroma (OR = - 1.34, 95% CI = - 2.09 - - 0.59, P < 0.05), length of hospital stay (SMD = - 1.65; 95% CI = - 3.50-0.20; P = 0.08), time to drain removal (SMD = - 3.64; 95% CI = - 5.76 - - 1.52; P < 0.05), and total drain output (SMD = - 401.60; 95% CI = - 593.75 - - 209.44; P < 0.05) compared with that of conventional abdominoplasty. However, it failed to achieve a statistically significant reduction in hematoma (OR=- 1.30, 95% CI = - 2.79-0.18, P = 0.08), infection (OR = - 1.03; 95% CI = - 2.17-0.12; P = 0.08), skin necrosis (OR = 0.63; 95% CI = - 1.20-2.45; P = 0.50), and wound dehiscence (OR = 0.28; 95% CI = - 0.28-0.83; P = 0.33). The seroma incidence rate was lower when a scalpel was utilized for dissection rather than electrocautery (3% (95% CI = 1-7%) versus 11% (95% CI = 5-18%)). CONCLUSIONS: Preservation of scarpa fascia during abdominoplasty might reduce the likelihood of postoperative seroma, length of hospital stay, time to drain removal, and total drain output. However, it did not significantly affect the incidence of hematoma, infection, skin necrosis, and wound dehiscence. LEVEL OF EVIDENCE III: 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 .

Modified Use of Costal Cartilage in Asians for the Correction of Nostril Asymmetry in Unilateral Secondary Cleft Lip Nasal Deformity.

BACKGROUND: Weak alar cartilage and lack of soft tissue on the cleft side are considered to be the main critical factors leading to the asymmetry of bilateral nostrils. The costal cartilage can provide strong structural support and can be used to maintain long-term stability of nostril shape after surgical correction. With the advancement in rhinoplasty techniques, the application and understanding of costal cartilage in cleft lip nasal deformity is still on going. Herein, we present our technique of applying costal cartilage to provide nostril support and correct asymmetry in Asian patients with unilateral secondary cleft lip nasal deformity. METHODS: Ninety-seven patients who underwent nostril asymmetry correction from January 1, 2013, to October 31, 2018, were analyzed retrospectively. Modified integrative alar cartilage strut and diced nostril augmentation with costal cartilage were implemented to improve the collapsed and flat cleft-side nostril. The release and restoration of muscle and bone were also performed when required. Surgical outcomes were analyzed based on the comparison of nostril parameters, the shape and contour, and symmetry of bilateral nostrils after surgery. During postoperative follow-up, the patients' satisfactions with the corrective outcomes were also investigated. RESULTS: All patients received the corrective operations with complete survival of all implanted cartilages. The nostril width was narrower in postoperative group (P < 0.05). The nostril height and long axis angle were higher postoperatively (P < 0.05). After correction, the proportion of moderate type increased from 13.4% to 80.4%, whereas the proportion of horizontal type decreased from 86.6% to 17.5%. The symmetry score on the nostril parameters manifested the rate of high score (AS >3) in postoperative groups were 84.5%, 93.8%, and 87.6% for width, height, and angle of the long axis, respectively. They were higher compared with those of preoperative group (0%). More than 95% of the patients were satisfied with the overall aesthetic outcome of the surgery. CONCLUSIONS: Through ameliorating its constructive technology and optimizing its filling form, the modified use of costal cartilage displayed excellent correction effects in the width, height, and long axis angle asymmetry of Asian patients' nostril. Precise and comprehensive rhinoplasty technique is the cornerstone for achieving satisfactory long-term aesthetic outcomes, especially in severe cases, such as secondary cleft lip nasal deformity.

A novel constructed carbonate-mineralized functional bacterial consortium for high-efficiency cadmium biomineralization.

A stable, urease-producing consortium (UPC) was constructed for high-efficiency cadmium (Cd) ion mineralization via a short-term and efficient acclimation process (five acclimation transfers). 16S rRNA gene high-throughput sequencing and quantitative polymerase chain reaction (qPCR) analyses of the urease subunit C (ureC) gene suggested that the three functional genera, all belonging to the phylum Firmicutes, rapidly increased during the process and finally composed the UPC (70.22-75.41 % of Sporosarcina, 13.83-20.66 % of norank_f_Bacillaceae, and 5.91-13.69 % of unclassified_f_Bacillaceae). The UPC exhibited good adaptability to a wide range of environmental conditions (a pH range of 4.0-11.0, temperature range of 10-45 °C, and Cd concentration range of 0-200 mg L-1). After 8 h of incubation, 92.87 % of Cd at an initial concentration of 100 mg L-1 was mineralized by UPC, exhibiting a great improvement as compared to the first acclimated consortium (C-1). Furthermore, although the acclimated consortium had been successively transferred 21 times, the Cd biomineralization efficiency remained stable, and this was consistent with the observed stable microbial community structure. X-ray diffraction (XRD) spectra revealed that Cd was mineralized in a (Ca0.67, Cd0.33)CO3 phase. This research obtained a promising microbial resource for the biomineralization of Cd or other hazardous heavy metal contaminants.

Clinical application of axillary reverse mapping in patients with breast cancer: A systematic review and meta-analysis.

BACKGROUND: The axillary reverse mapping (ARM) technique, identify and preserve arm nodes during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND), was developed to prevent breast-cancer related lymphedema (BCRL) remains controversial. METHODS: A comprehensive search of Medline Ovid, Pubmed, Web of Science and the Cochrane CENTRAL databases was conducted from the inception till January 2020. The key word including "breast cancer", "axillary reverse mapping", and "lymphedema". Stata 15.1 software was used for the meta-analysis. RESULTS: As a result, twenty-nine related studies involving 4954 patients met our inclusion criteria. The pooled overall estimate lymphedema incidence was 7% (95% CI 4%-11%, I2 = 90.35%, P < 0.05), with SLNB showed a relatively lower pooled incidence of lymphedema (2%, 95% CI 1%-3%), I2 = 26.06%, P = 0.23) than that of ALND (14%, 95% CI 5%-26%, I2 = 93.28%, P < 0.05) or SLNB and ALND combined (11%, 95% CI 1%-30%). The ARM preservation during ALND procedure could significantly reduce upper extremity lymphedema in contrast with ARM resection (OR = 0.27, 95% CI 0.20-0.36, I2 = 31%, P = 0.161). Intriguingly, the result favored ALND-ARM over standard-ALND in preventing lymphedema occurrence (OR = 0.21, 95% CI 0.14-0.31, I2 = 43%, P = 0.153). The risk of metastases in the ARM-nodes was not significantly lower in the patients who had received neoadjuvant chemotherapy, as compared to those without neoadjuvant treatment (OR = 1.20, 95% CI 0.74-1.94, I2 = 49.4%, P = 0.095). CONCLUSIONS: ARM was found to significantly reduce the incidence of BCRL. The selection of patients for this procedure should be based on their axillary nodal status. Preoperative neoadjuvant chemotherapy has no significant impact on the ARM lymph node metastasis rate.

Simultaneous reduction of arsenic and cadmium bioavailability in agriculture soil and their accumulation in Brassica chinensis L. by using minerals.

In situ immobilization of heavy metal cations in contaminated soil using natural minerals is an attractive remediation technique. However, little research has focused on the remediation of arsenic (As) and cadmium (Cd) co-contaminated. In this work, three different crystal structures and chemical compositions minerals, zeolite; bentonite; and dolomite, were applied to simultaneously reduce the uptake of As and Cd in Brassica chinensis L., and the mechanism on reducing As and Cd bioavailability in soil were also investigated. The results showed that the three minerals decreased the bioavailability of As and Cd and restrained their uptake by Brassica chinensis L. with the order followed bentonite > zeolite > dolomite. Particularly, bentonite decreased the exchangeable As and Cd by 4.05% and 32.5% and the concentrations of As and Cd in shoots of Brassica chinensis L. by 36.2% and 64.6%, as compared with the controls. Moreover, with the addition of minerals increased, the dry biomass of Brassica chinensis L. and the rhizosphere microbial functional diversity increased significantly, and the highest biomass increased by 289% at 4.0% addition of bentonite. Correlation analysis indicated that the uptake of As and Cd was positive with the available Cd and As in soil, and was negative with soil pH and available N. Furthermore, the Scanning Electron Microscopy-Energy Dispersive Spectroscopy and Fourier Transform Infrared Spectroscopy analysis illustrated the interaction between minerals and Cd mainly involved ion-exchange and adsorption, while As was mainly immobilized by calcium and magnesium through forming precipitation. In conclusion, this present study implied that the bentonite can be recommended as the more effective amendment to immobilize metal (loid)s in soil and thereby reduce the exposure risk of metal (loid)s associated with grains consumption.

The influence of corncob-based biochar on remediation of arsenic and cadmium in yellow soil and cinnamon soil.

Biochar plays a significant role in soil remediation. However, the simultaneous immobilization mechanism and relationship of biochar to cations and anions have never been clear. We designed a batch incubation experiment to investigate the impact of corncob-based biochars to cadmium (Cd) and arsenic (As) contaminations in yellow soil and cinnamon soil, and analyze the relationships among biochars physicochemical characteristics (surface area: SA, total pore volume: TV, average pore size: AV and the C/O rate), soil properties, metals immobilization and microbial diversity indices. Results showed that the modified biochars (inorganic-modified biochar: BCTD) had a good effect on heavy metals immobilization and transformed acid extractable and reducible fraction into the residual fraction. Total nitrogen, organic matter and available potassium increased in both soils after biochar application. The principal component analysis presented that the smaller C/O rate was favorable to As stabilization; the SA and TV of biochar were negatively correlated with the leaching concentration of Cd. The larger surface area, higher porosity and organic matters of biochar were more beneficial to soil microbial diversity. This work not only can demonstrate remediation mechanisms of heavy metals contaminated soil by biochars, but also gain an application of biochars technology in the recycling and reutilize of agricultural waste, and provide a clear strategy for heavy metals contaminated soil, especially As and Cd.

Efficient simultaneous removal of cadmium and arsenic in aqueous solution by titanium-modified ultrasonic biochar.

Simultaneous removal of cations and anions in wastewater has always been a great concerned environmental problem. In this study, a friendly and inexpensive biosorbent to simultaneously remove Cd(II) and As(V) from aqueous solution was synthesized by ultrasonic biochar and nanoscale TiO2 (TD), and the obtained sorbent was named as BCTD. The maximum sorption capacities of Cd (72.62 mg/g) and As (118.06 mg/g) were much higher than that of other carbon-materials. Both experiments showed that the Cd(II) and As(V) adsorption capacity was above 70% at pH = 5. The Cd(II) and As(V) adsorption on BCTD had a competitive effect in binary metal solutions at above 100 mg/L. The BET, SEM-EDS, FTIR and XPS analyses proved that ultrasonically reacting enhanced the surface area and pore volume of biochar and TD was supported on the biochar surface and inner pores successfully, and the dominant sorption mechanism by BCTD was the ion exchange and complexation.

The effect of substrates on the removal of low-level vanadium, chromium and cadmium from polluted river water by ecological floating beds.

Ecological floating beds (EFBs) is one of the effective methods lately used to remove heavy metals pollutions in water. However, the role of substrate in EFBs was mainly focused on the study of microorganisms, and the effect of substrates on plants enrichment of heavy metals was rarely investigated. This study aimed to investigate the promotion of different substrates (green zeolite, sepiolite, absorbent paper, and ceramsite) on the removal of multi-heavy metals (V, Cr, and Cd) by Acorus calamus L. It also investigated the plant growth status. Results showed that the relative increase rate of Acorus calamus L. fresh weight increased the most in EFBs with green zeolite group (EFB-GZ), which was 60.50%, higher than 38.17% in EFBs with Acorus calamus L. (EFB-A). The enrichment ability of multi-metals in Acorus calamus L. was stronger in EFBs with substrates than in EFB-A, and green zeolite was the best. After 34 days, the total removal efficiency of V, Cr and Cd in EFB-GZ were 79.91%, 95.24% and 91.80%, respectively. Heavy metals translocation from root to shoot influenced by the kinds of substrates. In EFB-GZ, the translocation factor (TF) of V, Cr and Cd were 0.081, 0.263 and 0.180, respectively (0.024, 0.608 and 0.032 in EFB-A). The ability of Acorus calamus L. to resist multi-metals stress was significantly higher in EFBs with substrates than that in EFB-A and the activity of SOD, POD and CAT were increased by heavy metals stress. Our results acquired that green zeolite was the best substrate to promote multi-metals uptake by Acorus calamus L., which could effectively maintain the pH of water, provide a stable environment and nutriment for Acorus calamus L. Green zeolite can promote the translocation of V and Cd from root to shoot in Acorus calamus L., but is not conducive to Cr.

A novel modification of lignin on corncob-based biochar to enhance removal of cadmium from water.

In order to improve the adsorption capacities of corncob-based biochars for heavy metal, the different pyrolysis temperature (350 °C, 450 °C and 550 °C) of corncob-based biochars were modified with the acrylonitrile, and adsorption capacities of Cadmium from solution by biochars were studied. The results showed that only at 350 °C the biochar can be successfully modified. The Cd adsorption capacity (85.65 mg/g) by the biosorbent was higher than other methods of modifying biochars previously reported. SEM-EDS and FTIR confirmed that the CN group was grafted on the biochar at low pyrolysis temperature. Batch adsorption experiment including pH-dependence, adsorption kinetics, and isotherms and XPS results showed that the removal mechanism of Cd(II) by the modified biochar was ion exchange and adsorption-complexation. This research not only obtained a novel method to modify biochar but also furthered research into the lignin of biochar composition, and provided an efficient sorbent for heavy metal.