Comparison of different treatment strategies for T3N1-3 stage gastric cancer based on the SEER database.

Treatment options for T3N1 stage gastric cancer exhibit regional variation, with optimal approach remaining unclear. We derived our data from the SEER database, using Cox proportional risk regression models for univariate and multivariate analyses of 5-years overall survival (5yOS) and 5-years cancer-specific survival (5yCSS). The results showed that younger age, female, non-white race, highly differentiated histologic grade, non-Signet ring cell adenocarcinoma, low N stage, lesser curvature of the stomach, OP followed by adjuvant C/T with or without RT, partial gastrectomy, C/T and others, Radiation therapy, and Chemotherapy were significantly associated with better 5yOS and 5yCSS. For patients with stage T3N1-3 gastric cancer, multimodal treatment regimens demonstrate superior survival outcomes compared to surgery or radiotherapy alone. Among them, OP followed by adjuvant C/T with or without RT emerges as particularly efficacious, potentially offering enhanced benefits for non-Asian populations.

Induced skin aging by blue-light irradiation in human skin fibroblasts via TGF-ß, JNK and EGFR pathways.

BACKGROUND: Studies indicate that blue light (BL) irradiation can damage human skins, but the impact of BL irradiation on skin aging is unknown. OBJECTIVES: This study aimed to give an insight to phenotypic characteristics and molecular mechanism of blue light-induced skin aging, and thus provide a theoretical basis for the precise protection of photodermatosis. METHODS: The effect of BL on skin photoaging in mice was evaluated by non-invasive measurement equipment and histopathology analysis. The effect of BL irradiation on the proliferation of HFF-1 cells was detected by the Real-Time Cell Analyzer. The expression and protein levels of genes associated with skin aging were examined. RESULTS: Our studies indicated photoaging caused by BL irradiation, including collagen disorder and increased MMP1. BL irradiation also inhibited cell proliferation and collagen expression in human skin fibroblasts by inhibiting TGF-ß signaling pathway, based on in vitro experiments. Importantly, BL irradiation promoted the degradation of collagen by increasing MMP1 activated by the JNK/c-Jun and EGFR pathways. Moreover, ROS levels were significantly increased after BL irradiation in human skin fibroblasts. Yet, the transcriptional change in human skin fibroblasts caused by BL irradiation was unable to be completely restored by ROS scavenger. CONCLUSION: BL irradiation down-regulated expression of type I collagen genes and up-regulated MMP1 expression to inhibit the proliferation of human skin fibroblasts. Multiple key pathways including TGF-ß, JNK, and EGFR signaling were involved in BL-induced skin aging. Our results provide theoretical bases for the protection of photoaging caused by BL irradiation.

Abnormal expression of interleukin-6 is associated with epidermal alternations in localized scleroderma.

OBJECTIVES: Localized scleroderma (LSc) is a disease characterized by the excessive deposition of collagen and thereby thickening of the dermis. In recent years, studies reported that LSc demonstrated compromised skin barrier related to the progression of the disease. However, human studies examining epidermis in scleroderma are still sparse and lack systematic research. This study aims to investigate the structural and functional changes in the LSc epidermis and further explore the underlying mechanisms, providing a new angle to treat LSc in the clinic. METHODS: A total of 136 skin sites, including lesion and non-lesion control, from 27 LSc patients were analyzed. Ultrasonic testing, trans-epidermal water loss (TEWL), and epidermal hydration were assessed to investigate the structural and functional alternations; correlations between these parameters were analyzed. To explore the underlying mechanism, skin-fibrosis mouse model and cellular model by bleomycin (BLM) were deployed. RESULTS: The epidermal thickness was markedly increased, with a significant decline of hydration (dryness) in the LSc lesion skin. Epidermal hydration presented a negative correlation with the thickness. TEWL was not altered. The mouse model validated these morphological changes in the epidermis and indicated that interleukin-6 (IL-6) was significantly elevated. Furthermore, cellular study demonstrated that increased phosphorylation of p38 in keratinocyte promoted the secretion of IL-6, stimulating cell proliferation. CONCLUSION: This study characterized the epidermal alterations in LSc patients, suggesting that keratinocyte-derived abnormal IL-6 secretion can lead to the thickening of the epidermis, promoting dryness. The topical application of moisturizer may largely relieve dryness and related pruritus, thus improve the quality of life in LSc patients. Key Points • Epidermal thickness was increased in LSc lesion skin with declined hydration level. • Skin fibrosis mouse model validated the epidermal alteration in LSc patient. • p38-dependent IL-6 overexpression in keratinocyte result in epidermal thickening.

Impact of solar ultraviolet radiation on daily outpatient visits of atopic dermatitis in Shanghai, China.

The potential roles of solar ultraviolet radiation (UVR) as an environmental risk factor in inducing atopic dermatitis (AD) have not been well quantified. To determine the short-term associations between UVR and AD outpatient visits, we obtained daily outpatient visits of AD in Shanghai Skin Disease Hospital from 2013 to 2018. Data of hourly ground UVR were collected. We applied overdispersed generalized additive model to explore its associations. We found that daily exposure to UVR-A rather than UVR-B was positively associated with AD outpatient visits. The visits increased on the present day (lag 0 days) and decreased appreciably with longer lags and became insignificant at lag 4 days. For 10 w/m2 increase in daytime mean and noontime mean exposure to overall UVR and UVR-A from lag 0 to 6 days, the cumulative relative risk of AD was 1.12/1.13 and 1.08/1.08, respectively. Stronger effects of UVR exposure on AD occurred in patients aged 0-7 and > 45 years and in the cold seasons. This study contributed to the few epidemiological evidences that acute exposure to solar UVR may elevate the risks of AD.

The acute effects of ultraviolet radiation exposure on solar dermatitis in Shanghai, China.

Ultraviolet radiation (UVR) has long been considered associated with solar dermatitis, but the associations have not been well quantified. To depict the full-range exposure-response association between daily UVR exposures and daily outpatient visits of solar dermatitis. We collected the daily number of outpatient visits of solar dermatitis and monitored hourly ground data of UVR (the sum of A- and B-band) from 1 January 2013 to 31 December 2017 in Shanghai, China. The data were analyzed using the time-series approach, in which overdispersed generalized additive model was used and time trends and weather conditions were controlled for. During the study period, we recorded a total of 15,051 outpatient visits of solar dermatitis. There was a consistently increasing risk of solar dermatitis associated with stronger UVR without a discernible threshold. The effects occurred on the present day, increased to the largest at lag 1 or 2 days, and attenuated to the null at lag 5 days or more. A unit (w/m2) increase in daily maximum-hour UVR was associated with 1.70% (95%CI: 1.19%, 2.20%) increase of outpatient visits of solar dermatitis. Stronger effects occurred among the young people, females, and in the warm season. The risks of solar dermatitis due to UVR exposure would be overestimated if ambient temperature was not adjusted. This study provides quantitative epidemiological estimates for the positive associations between short-term exposure to UVR and increased risks of solar dermatitis. The associations were more prominent among young people, females, and in warm seasons.

Non-ablative radio frequency for the treatment of androgenetic alopecia.

INTRODUCTION: Medical treatment of androgenetic alopecia (AGA) is mainly limited to pharmacological and surgical interventions. Patients' desire for noninvasive and non-systemic treatments has accelerated research into medical devices that can promote hair growth. Low-level laser therapy (LLLT) was the first such device. However, its success has been limited by contradictory and often controversial efficacy claims. Work previously performed in animal models of AGA has demonstrated the viability of the wound repair mechanism as a potential treatment modality. This study therefore explores the use of a non-ablative radio frequency (RF) device in the treatment of AGA. METHODS: A single blindedstudy compared a non-ablative RF device versus a sham device in 24 men with AGA. Each subject received four treatments over the 12-week study. RESULTS: In this preliminary study of 24 AGA patients treated with a novel RF device, we demonstrated that 54% showed a clinical response. Furthermore, among patients that underwent four or more treatment sessions, 40% experienced a 30% or more increase in hair counts compared to baseline. CONCLUSIONS: If validated in a larger cohort, non-ablative RF may prove to be an important clinical tool in the treatment of AGA.

Evaluation of 5-aminolevulinic acid-mediated photorejuvenation of neck skin.

OBJECTIVE: To evaluate the outcomes of the combination of red light or intense pulsed laser (IPL) with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) in the treatment of photodamaged neck skin. METHODS: The anterior of the neck was divided into four 2 cm × 2 cm sections and randomly assigned to red-light, red-light-PDT, IPL or IPL-PDT group. ALA cream of 5% was applied to PDT regions for 2h prior to light irradiation. Treatment was repeated once. The stratum corneum (SC) hydration, transepidermal water loss (TEWL), L(*), a(*), b(*) values, melanin index (MI), erythema index (EI), skin elasticity and skin thickness were examined by a blinded investigator. The function and volume of thyroid were also measured. RESULTS: After red-light-PDT, IPL-PDT and IPL treatment, the appearance of photoaging lesion was improved. The SC hydration, L(*) value, elasticity and thickness increased, whereas the TEWL and MI value decreased. These changes in red-light-PDT and IPL-PDT group were more obvious than IPL group. The a(*) and EI value increased in red-light-PDT group. No significant change was noticed in red-light group. Partial irradiation of the thyroid did not affect the function and volume of the thyroid. CONCLUSION: IPL-PDT and red-light-PDT showed better rejuvenation effect than IPL or red light alone on the neck skin.

Effects of sunscreen on human skin's ultraviolet radiation tolerance.

PURPOSE: To observe the alteration ultraviolet radiation (UVR) of skin's tolerance after its exposure to the small dose of UVR under the protection of sunscreen. METHODS: Eleven subjects who applied sunscreen were exposed to 0.75 dose minimal persistent pigment darkening (MPPD) and minimal erythema dose (MED) by the Phototherapy Unit for 4 weeks. Each week their MPPDs and MEDs were measured by solar simulator. Meanwhile, SPECTCOLOMETER® and VISIOSCAN VC98® were used to detect the test areas and control areas. RESULTS: The values of MPPD and MED increased significantly after the exposure to UVR. But there were no visible changes on the surface of skin's texture. CONCLUSION: With the protection of sunscreen, the UVR tolerance of skin was greatly increased after the skin's exposure to the small dose UV.