Advances in surgical treatment of hidradenitis suppurative. / åŒ–è„“æ€§æ±—è ºç‚Žå¤–ç§‘æ²»ç–—ç ”ç©¶è¿›å±•.

Hidradenitis suppurative is a chronic, refractory and recurrent dermatological disease. The disease should be managed by targeted surgical intervention on the basis of medical treatment. Currently, the surgical treatment methods include local treatments like incision and drainage, unroofing, laser therapy, intense pulsed light therapy, photodynamic therapy, as well as complete lesion resection such as skin-tissue saving excision with electrosurgical peeling and extended excision. The clearance range, therapeutic effect, postoperative complications, and recurrence risk vary among the different treatment methods. Local treatments cause less damage, but have high recurrence rates, and are mainly for mild to moderate hidradenitis suppurative patients. Complete lesion resections have relatively low recurrence rates, but may bring more surgical injuries, and postoperative reconstructions are needed, which are mainly for moderate to severe hidradenitis suppurative patients. In this article, the surgical treatment principles and various surgical treatment methods of hidradenitis suppurative are reviewed, to provide a reference for the diagnosis and treatment of this disease in clinical practice.

High performance C-A-S-H seeds from fly ash-carbide slag for activating lithium slag towards a low carbon binder.

In this work, one-step synthesis of high-performance C-A-S-H (calcium alumina silicate hydrate) seeds from low-calcium fly ash (FA) and carbide slag (CS) by 7 days of mechanochemical mixing was proposed and used to activate lithium slag (LS) cement. The results showed that the seeding effect of C-A-S-H seeds was increased with the increasing Ca/Si (i.e. from 1.0 to 1.5), i.e. the mortar compressive strength of 1 day and 28 days were increased by 67% and 29% with the addition of 1.0% C-A-S-H nano-seeds at Ca/Si = 1.5 in the presence of polycarboxylate superplasticizer (PCE), respectively. Moreover, the chloride resistance of lithium slag cement was improved significantly, i.e. the electric flux was decreased by more than 30% than that of plain lithium slag cement mortar. The performance difference of various C-A-S-H seeds is mainly attributed to their high proportion and polymerization degree, more stretch and three-dimensional foil-like morphology at high Ca/Si. This study provides guidance for obtaining low-cost and high-performance C-A-S-H seeds from wastes and the highly efficient utilization of LS as supplementary cementitious materials (SCMs) in the future.

Triage and Evaluation of Blast-Injured Patients in Wenling Liquefied Petroleum Gas Tanker Explosion.

On June 13, 2020, a liquefied petroleum gas tanker exploded in Wenling. Here, the authors describe the mass casualty emergency response to the explosion. The authors collected the medical records of 176 inpatients at 8 hospitals in Taizhou and Hangzhou. The 176 inpatients with blast injuries comprised 70 females and 106 males, with an average age of 45.48 ± 19.96 years, and more than half of the patients were farmers. They were transported to six hospitals distributed around the explosion site in Taizhou in the initial rescue period and were grouped according to their new injury severity score as having mild, moderate, severe, or extremely severe injuries. Most patients with severe and extremely severe injuries were admitted to a superior hospital for postsecondary triage. Forty-four patients experienced primary blast injuries, 137 experienced secondary blast injuries, 37 experienced tertiary blast injuries, and 40 patients experienced quaternary blast injuries. Multiple blast injuries were suffered by 62 patients. Most patients (95.45%) suffered external injuries, with the chest, extremities, and face as the main affected areas. Burns were diagnosed in 26 adults, of whom 15.38%, 19.23%, 7.70%, and 57.69% suffered mild, moderate, severe, and extremely severe cases. Sixteen burn patients suffered from burn-blast injuries. Upper limbs and the head/face/neck area, as exposed areas, were more likely to experience a burn injury. Inhalation was the main accompanying injury. Of the eight patients who died in the prehospital session, seven had burn injuries. This report on the accident and injury characteristics of an open-air LPG-related explosion will facilitate responses to subsequent catastrophes.

Effects of nano metal oxide particles on denitrifying phosphorus removal system: Potential stress mechanism and recovery strategy.

The accumulation of nano metal oxide particles (NMOPs) in municipal sewage treatment systems harms the microbial community and its metabolism in activated sludge system, resulting in the degradation of its pollutants removal performance. In this work, the stress effect of NMOPs on the denitrifying phosphorus removal system was systematically investigated in terms of pollutants removal performance, key enzyme activities, microbial community diversity and abundances, and intracellular metabolites. Among the ZnO NPs, TiO2 NPs, CeO2 NPs, and CuO NPs, the ZnO NPs showed the most significant impacts with the chemical oxygen demand, total phosphorus, and nitrate nitrogen removal ratio decreased from above 90 % to 66.50 %, 49.13 %, and 57.11 %, respectively. The addition of surfactants and chelating agents could relieve the toxic effect of NMOPs on the denitrifying phosphorus removal system, and the chelating agents were more effective than surfactants in performance recovery. After adding ethylene diamine tetra acetic acid, the removal ratio of chemical oxygen demand, total phosphorus, and nitrate nitrogen under ZnO NPs stress was restored to 87.31 %, 88.79 %, and 90.35 %, respectively. The study provides valuable knowledge to better understand the impacts and stress mechanism of NMOPs on activated sludge systems and provides a solution to recover the nutrients removal performance of denitrifying phosphorus removal system under NMOPs stress.

An integrated process for struvite recovery and nutrient removal from ship domestic sewage.

Marine pollution caused by the untreated and substandard discharge of ship domestic sewage has received widespread attention. A novel integrated process for struvite recovery and nutrient removal from ship domestic sewage (SRNR-SDS) based on seawater magnesium source was developed in this study. Removal efficiencies of the total nitrogen (TN) and total phosphorus (TP) for the activated sludge unit in SRNR-SDS process were approximately 67.61% and 41.35%, respectively, under the salinity of 7.85 g/L. The coupling-induced struvite crystallization unit significantly improved the removal efficiency of TN and TP, and the scanning electron microscopy and X-ray diffraction demonstrated that magnesium ammonium phosphate (MAP) crystals were successfully formed on the surface of zeolite. The SRNR-SDS process had an ideal performance for pollutant removal and MAP recovery under the optimal hydraulic retention time of 20 h. The effluent concentrations of COD, NH4+-N, TN and TP in SRNR-SDS process were approximately 34.73 mg/L, 4.31 mg/L, 10.07 mg/L and 0.23 mg/L, respectively, which meet the Chinese and international ship sewage discharge standards. SRNR-SDS process has obvious environmental, social and economic benefits, which could save 6.20%∼57.14% of the operation cost of ship domestic sewage treatment via MAP recovery. The results could provide theoretical and technical support for the development and application of ship sewage treatment process with the functions of pollutant removal and resource recovery.

Cardiotonic Pills® protects from myocardial fibrosis caused by in stent restenosis in miniature pigs.

BACKGROUND: Stent implantation has been increasingly applied for the treatment of obstructive coronary artery disease, which, albeit effective, often harasses patients by in-stent restenosis (ISR). PURPOSE: The present study was to explore the role of compound Chinese medicine Cardiotonic Pills® (CP) in attenuating ISR-evoked myocardial injury and fibrosis. STUDY DESIGN: Chinese miniature pigs were used to establish ISR model by implanting obsolete degradable stents into coronary arteries. Quantitative coronary angiography (QCA) was performed to confirm the success of the model. METHODS: CP was given at 0.2 g/kg daily for 30 days after ISR. On day 30 and 60 after stent implantation, the myocardial infarct and myocardial blood flow (MBF) were assessed. Myocardial histology was evaluated by hematoxylin-eosin and Masson's trichrome staining. The content of ATP, MPO, and the activity of mitochondrial respiratory chain complex Ⅳ were determined by ELISA. Western blot was performed to assess the expression of ATP5D and related signaling proteins, and the mediators of myocardial fibrosis. RESULTS: Treatment with CP diminished myocardial infarct size, retained myocardium structure, attenuated myocardial fibrosis, and restored MBF. CP ameliorated energy metabolism disorder, attenuated TGFß1 up-regulation and reversed its downstream gene expression, such as Smad6 and Smad7, and inhibited the increased expression of MCP-1, PR S19, MMP-2 and MMP-9. CONCLUSION: CP effectively protects myocardial structure and function from ISR challenge, possibly by regulating energy metabolism via inactivation of RhoA/ROCK signaling pathway and inhibition of monocyte chemotaxis and TGF ß1/Smads signaling pathway.

Epidemiology and Early Bacteriology of Extremely Severe Burns from an LPG Tanker Explosion in Eastern China.

The incidence of liquefied petroleum gas (LPG)-related accidents in China has increased over the recent years. In addition, infection remains a big challenge in cases of severe burns. Therefore, the present study aimed to provide valuable information for a better control of infections in the event of such disasters. In this study, a total of 16 patients who suffered extremely severe burns after an LPG tanker explosion were included. Thereafter, bacteriological culture results were collected within a week. Of 16 patients, 13 (81.25%) were male and the average age of all patients was 60.63 years. In addition, the mean burned area was 83.03% TBSA. Additionally, a total of 553 organism cultures were conducted out of which 287 isolates (51.90%) showed positive results. Notably, 38.52% were Gram-negative bacteria, 7.59% were Gram-positive bacteria and 5.79% were fungi. Moreover, the most prevalent Gram-negative bacteria were Stenotrophomonas maltophilia (28.97%) followed by Acinetobacter baumannii (28.53%), and Klebsiella pneumoniae (14.02%). On the other hand, the three most predominant Gram-positive bacteria were Enterococcus faecalis (33.33%), Staphylococcus aureus (28.89%) and Staphylococcus sciuri (17.78%). Furthermore, the most common fungi included Candida (38.24%), Fusarium (20.59%) and Aspergillus fumigatus (14.71%). With regard to the bacterial resistance patterns, carbapenem-resistant organisms included Acinetobacter baumannii (97.80%), Pseudomonas aeruginosa (67.57%), and Klebsiella pneumoniae (75.56%). In addition, Staphylococcus sciuri, Staphylococcus epidermidis, and Staphylococcus haemolyticus were identified to be methicillin-resistant. This study revealed that there was a high incidence of infection in victims of severe burns as a result of mass burn accidents, accompanied by early fungal infection.

Simultaneous denitrification and phosphorus removal: A review on the functional strains and activated sludge processes.

Eutrophication has attracted extensive attention owing to its harmful effects to the organisms and aquatic environment. Studies on the functional microorganisms with the ability of simultaneously nitrogen (N) and phosphorus (P) removal is of great significance for alleviating eutrophication. Thus far, several strains from various genera have been reported to accomplish simultaneous N and P removal, which is primarily observed in Bacillus, Pseudomonas, Paracoccus, and Arthrobacter. The mechanism of N and P removal by denitrifying P accumulating organisms (DPAOs) is different from the traditional biological N and P removal. The denitrifying P removal (DPR) technology based on the metabolic function of DPAOs can overcome the problem of carbon source competition and sludge age contradiction in traditional biological N and P removal processes and can be applied to the treatment of urban sewage with low C/N ratio. This paper reviews the mechanism of N and P removal by DPAOs from the aspect of the metabolic pathways and enzymatic processes. The research progress on DPR processes is also summarized and elucidated. Further research should focus on the efficient removal of N and P by improving the performance of functional microorganisms and development of new coupling processes. This review can serve as a basis for screening DPAOs with high N and P removal efficiency and developing new DPR processes in the future.

Astaxanthin protects against early acute kidney injury in severely burned rats by inactivating the TLR4/MyD88/NF-κB axis and upregulating heme oxygenase-1.

Early acute kidney injury (AKI) contributes to severe morbidity and mortality in critically burned patients. Renal inflammation plays a vital role in the progression of early AKI, acting as a therapeutic target. Astaxanthin (ATX) is a strong antioxidant widely distributed in marine organisms that exerts many biological effects in trauma and disease. ATX is also suggested to have anti-inflammatory activity. Hence, we attempted to explore the role of ATX in protecting against early postburn AKI via its anti-inflammatory effects and the related mechanisms. A severely burned model was established for histological and biochemical assessments based on adult male rats. We found that oxidative stress-induced tissue inflammation participated in the development of early AKI after burn injury and that the MyD88-dependent TLR4/NF-κB pathway was activated to regulate renal inflammation. The TLR4 and NF-κB inhibitors TAK242 and PDTC showed similar effects in attenuating burn-induced renal inflammation and early AKI. Upon ATX treatment, the release of inflammatory mediators in the kidneys was downregulated, while the TLR4/MyD88/NF-κB axis was inhibited in a dose-related manner. TAK242 and PDTC could enhance the anti-inflammatory effect of high-dose ATX, whereas lipopolysaccharide (LPS) reversed its action. Furthermore, the expression of heme oxygenase (HO)-1 was upregulated by ATX in a dose-related manner. Collectively, the above data suggest that ATX protects against renal inflammation in a dose-related manner by regulating the TLR4/MyD88/NF-κB axis and HO-1 and ultimately prevents early AKI following severe burns.

Nitrous oxide emission during denitrifying phosphorus removal process: A review on the mechanisms and influencing factors.

Excessive emissions of nitrogen (N) and phosphorus (P) pollutants are leading to increased eutrophication of water bodies. Biological N and P removal processes have become a research priority in the field of sewage treatment with the aim of improving sewage discharge standards in countries worldwide. Denitrifying P removal processes are more efficient for solving problems related to carbon source competition, sludge age conflict, and high aeration energy consumption compared to traditional biological N and P removal processes, but they are easy to produce nitrous oxide (N2O) in the process of sewage treatment. N2O is a greenhouse gas with a global warming potential approximately 190-270 times that of CO2 and 4-21 times that of CH4, which was produced and released into the environmental in denitrifying P removal systems under conditions of a low C/N ratio, high dissolved oxygen, and low activity of denitrifying phosphorus accumulating organisms (DPAOs). This paper reviews the emission characteristics and influencing factors of N2O during denitrifying P removal processes and proposes appropriate strategies for controlling the emission of N2O. This work serves as a basis for the development of new sewage treatment processes and the reduction of greenhouse gas emissions in future wastewater treatment plants.

Gradient local anesthesia for percutaneous endoscopic interlaminar discectomy at the L5/S1 level: a feasibility study.

BACKGROUND: During the process of shearing the ligamentum flavum, rotating the working channel, and manipulating the annulus fibrosis, the sinuvertebral nerve and the spinal nerve root can be irritated, inducing intolerable back and leg pain. Thus, general anesthesia is recommended and well accepted by most surgeons when performing percutaneous endoscopic lumbar discectomy (PELD) via the interlaminar approach. The aim of our study was to explore the efficacy and safety of percutaneous endoscopy interlaminar lumbar discectomy with gradient local anesthesia (LA) in patients with L5/S1 disc herniation. METHODS: This retrospective study was conducted between December 2017 and June 2018. The study included 50 consecutive patients who met the study criteria, had single-level L5/S1 disc herniation, and underwent PELD via the interlaminar approach under gradient LA. Different concentrations of local anesthetic compound (LAC) were injected into different tissues inside and outside the ligamentum flavum to complete gradient LA. The evaluation criteria included the intraoperative satisfaction score, visual analog scale (VAS) score, Oswestry Disability Index (ODI), complications, and adverse reactions. RESULTS: The intraoperative satisfaction score was consistently over 7, with an average score of 9.3 ± 0.7, indicating that LAC can achieve satisfactory pain control throughout the PELD operation without additional anesthesia. The postoperative VAS score and ODI were dramatically improved at each follow-up interval (P < 0.001, respectively). There was no serious complication such as dural rupture caused by puncture, dural laceration caused by manipulation under endoscopy, total spinal anesthesia, iatrogenic nerve root injury, epidural hematoma, infections, or local anesthetic-related adverse reactions. Three patients experienced transient postoperative dysesthesia of the lower limbs that gradually recovered within 24 h. CONCLUSIONS: Gradient local anesthesia can satisfactorily and safely control intraoperative pain during the PELD via the interlaminar approach. It can not only improve intraoperative satisfaction, but also reduce local anesthesia-related adverse reactions and surgery-related complications.

Dissolving microneedles for transdermal delivery of huperzine A for the treatment of Alzheimer's disease.

Increasingly attention has been paid to the transdermal drug delivery systems with microneedles owing to their excellent compliance, high efficiency, and controllable drug release, therefore, become promising alternative with tremendous advantages for delivering specific drugs such as huperzine A (Hup A) for treatment of Alzheimer's disease (AD) yet with low oral bioavailability. The purpose of the present study is to design, prepare, and evaluate a dissolving microneedle patch (DMNP) as a transdermal delivery system for the Hup A, investigating its in vitro drug release profiles and in vivo pharmacokinetics as well as pharmacodynamics treating of AD. Skin penetration experiments and intradermal dissolution tests showed that the blank DMNP could successfully penetrate the skin with an adequate depth and could be quickly dissolved within 5 min. In vitro transdermal release tests exhibited that more than 80% of the Hup A was accumulatively permeated from DMNP through the skin within three days, indicating a sustained release profile. In vivo pharmacokinetic analysis demonstrated that the DMNP group resulted in longer T max (twofold), longer t 1/2 (fivefold), lower C max (3:4), and larger AUC(0-∞) (twofold), compared with the oral group at the same dose of Hup A. Pharmacodynamic research showed a significant improvement in cognitive function in AD rats treated with DMNP-Hup A and Oral-Hup A, as compared to the model group without treatment. Those results demonstrated that this predesigned DMNP is a promising alternative to deliver Hup A transdermally for the treatment of AD.

Modeling and performance improvement of an anaerobic-anoxic/nitrifying-induced crystallization process via the multi-objective optimization method.

The trade-off between energy savings and emission reductions of an activated sludge process is a multi-objective problem relating to several potentially conflicting objectives. Therefore, the optimal modification of an anaerobic-anoxic/nitrifying/induced crystallization (A2N-IC) process by multi-objective optimization method was studied in this work. The multi-objective optimization model comprised three evaluative indices, (effluent quality (EQ), operation cost (OC), and total volume (TV) of structures), and 14 process parameters (decision variables) solving by non-dominated sorting genetic algorithm II (NSGA-II) in MATLAB. The trade-off relationships among EQ, OC, and TV were investigated under 30 days of dynamic influent with different constraint conditions. A series of Pareto solutions were obtained, and one Pareto solution was selected for further analysis. Results showed improved effluent concentrations of chemical oxygen demand (COD), total nitrogen (TN), ammonia-nitrogen (NH4+-N), and total phosphorous (TP) under the optimized strategy compared to the original strategy, where the average effluent concentrations decreased by 2.22, 0.47, 0.13, and 0.02 mg/L, respectively. The values of EQ and OC decreased from 0.015 kg/day and 0.15 ¥/m3 to 0.0023 kg/day and 0.12 ¥/m3, respectively, while the TV increased from 0.31 to 0.33 m3. These results indicated that the multi-objective optimization method is useful for modifying activated sludge processes.

Five-year epidemiology of liquefied petroleum gas-related burns.

BACKGROUND: The incidence of liquefied petroleum gas (LPG)-related burns has increased over recent years, and it has become a serious public health issue in developing countries such as India and Turkey. This paper aims to investigate the epidemiological characteristics of LPG-related burns to provide assistance and suggestions for planning prevention strategies. METHODS: A 5-year retrospective study was conducted in patients with LPG-related burns admitted to the Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, between 1st January 2011 and 31st December 2015. Information obtained for each patient included age, gender, education status, occupation, medical insurance, average hospital cost, length of hospital stay, monthly distribution of incidence, place of burns, mechanism of burns, extent of burns, site of burns, accompanying injuries, and treatment outcomes. RESULTS: For the first 4 years (2011-2014), the yearly incidence of LPG-related burns was at approximately 10% of all burns; however, in the fifth year (2015) alone, there was a surge to 26.94%. A total of 1337 burn patients were admitted during this period. Of these, 195 patients were admitted because of 169 LPG-related accidents; there were 11 accidents involving more than one victim. LPG-related burns occurred most frequently in patients aged 21-60 years (73.85%). The majority of injuries occurred from May to August (56.41%), and the most common place was home (83.08%, 162 patients). Gas leak (81.03%) was the main cause of LPG-related burns, followed by inappropriate operation (7.69%) and cooking negligence (2.05%). The mean burn area was 31.32±25.40% of TBSA. The most common sites of burns were the upper extremities (37.47%), followed by the head/face and neck (24.80%) and lower extremities (19.95%). The most common accompanying injuries included inhalation injury (23.59%), shock (8.71%), and external injury (7.18%). The average hospital stay was 22.90±19.47days (range 2-84 days). Only 48 patients (24.62%) had medical insurance, while 124 patients (63.59%) had no medical insurance. The average hospital cost of the no medical insurance group was significantly higher (p<0.0001) than that of the medical insurance group. In addition, 72.73% of patients who left against medical advice (LAMA) were uninsured. The number of patients who recovered at our hospital was 165 (84.62%), while 22 patients (11.28%) LAMA. The overall mortality rate was 4.10% (8 patients). CONCLUSION: Our study shows that the exponential increase in LPG-related burns is alarming. This calls for rigorous precautions. Because gas leak was the main cause of LPG-related burns, any part of LPG stove system that shows signs of weathering should be replaced regularly. In addition, we also found that most of the LAMA patients were uninsured. Thus, comprehensive medical insurance should be involved early in the recovery process to assure a safe and adequate discharge.

Editor's Highlight: Transgenic Zebrafish Reporter Lines as Alternative In Vivo Organ Toxicity Models.

Organ toxicity, particularly liver toxicity, remains one of the major reasons for the termination of drug candidates in the development pipeline as well as withdrawal or restrictions of marketed drugs. A screening-amenable alternative in vivo model such as zebrafish would, therefore, find immediate application in the early prediction of unacceptable organ toxicity. To identify highly upregulated genes as biomarkers of toxic responses in the zebrafish model, a set of well-characterized reference drugs that cause drug-induced liver injury (DILI) in the clinic were applied to zebrafish larvae and adults. Transcriptome microarray analysis was performed on whole larvae or dissected adult livers. Integration of data sets from different drug treatments at different stages identified common upregulated detoxification pathways. Within these were candidate biomarkers which recurred in multiple treatments. We prioritized 4 highly upregulated genes encoding enzymes acting in distinct phases of the drug metabolism pathway. Through promoter isolation and fosmid recombineering, eGFP reporter transgenic zebrafish lines were generated and evaluated for their response to DILI drugs. Three of the 4 generated reporter lines showed a dose and time-dependent induction in endodermal organs to reference drugs and an expanded drug set. In conclusion, through integrated transcriptomics and transgenic approaches, we have developed parallel independent zebrafish in vivo screening platforms able to predict organ toxicities of preclinical drugs.

Identification of benzopyrone as a common structural feature in compounds with anti-inflammatory activity in a zebrafish phenotypic screen.

Neutrophils are essential for host defence and are recruited to sites of inflammation in response to tissue injury or infection. For inflammation to resolve, these cells must be cleared efficiently and in a controlled manner, either by apoptosis or reverse migration. If the inflammatory response is not well-regulated, persistent neutrophils can cause damage to host tissues and contribute to the pathogenesis of chronic inflammatory diseases, which respond poorly to current treatments. It is therefore important to develop drug discovery strategies that can identify new therapeutics specifically targeting neutrophils, either by promoting their clearance or by preventing their recruitment. Our recent in vivo chemical genetic screen for accelerators of inflammation resolution identified a subset of compounds sharing a common chemical signature, the bicyclic benzopyrone rings. Here, we further investigate the mechanisms of action of the most active of this chemical series, isopimpinellin, in our zebrafish model of neutrophilic inflammation. We found that this compound targets both the recruitment and resolution phases of the inflammatory response. Neutrophil migration towards a site of injury is reduced by isopimpinellin and this occurs as a result of PI3K inhibition. We also show that isopimpinellin induces neutrophil apoptosis to drive inflammation resolution in vivo using a new zebrafish reporter line detecting in vivo neutrophil caspase-3 activity and allowing quantification of flux through the apoptotic pathway in real time. Finally, our studies reveal that clinically available 'cromones' are structurally related to isopimpinellin and have previously undescribed pro-resolution activity in vivo These findings could have implications for the therapeutic use of benzopyrones in inflammatory disease.

Management of chronic pruritus with a UV filtering topical cream.

Chronic pruritus is a common dermatological condition affecting 10-13% of the general population. UVB phototherapy has been demonstrated to be effective in relieving the symptoms of pruritus. However, phototherapy is rarely administered because the treatment is time-consuming and expensive, when compared to other topical drugs. In previous works, it has been reported that a topical cream, which selectively filters solar UVB can be used as a convenient alternative to traditional phototherapy. Here, we report the results of a pilot study aimed at assessing the effectiveness of the cream for treating pruritus. Seven patients with pruritus symptoms were included in the study. After 3 months of treatment (3 sessions per week), all patients noted improvement in pruritus symptoms. These preliminary results demonstrate that the novel topical cream could provide a convenient, low cost treatment for chronic pruritus patients.

Topical cream delivers NB-UVB from sunlight for the treatment of vitiligo.

Ultraviolet-B (UVB) phototherapy for the treatment of vitiligo is an effective first-line choice. However, the cost of multiple doctor visits and the lengthy treatment regimen has resulted in low compliance, limiting access to this safe and effective mode of treatment. Topical Photocil represents an innovative solution to this problem. The drug selectively filters solar radiation to deliver narrow-band UVB to vitiligo lesions. Here, we discuss how this novel topical cream could provide a convenient alternative to artificial light phototherapy.

A review of treatment strategies for hydrofluoric acid burns: current status and future prospects.

Hydrofluoric acid (HF), a dangerous inorganic acid, can cause severe corrosive effects and systemic toxicity. HF enters the human body via where it contacts, such as skin and mucosa, alimentary and respiratory tracts, and ocular surfaces. In the recent years, the incidence of HF burn has tended to increase over time. The injury mechanism of HF is associated primarily with the massive absorption of HF and the release of hydrogen ions. Correct diagnosis and timely treatment are especially important for HF burns. The critical procedure to treat HF burn is to prevent on-going HF absorption, and block the progressive destruction caused by fluoride ions. Due to the distinct characteristics of HF burns, the topical treatment, as well as systemic support, has been emphasised. Whereas, management of patients with HF burns remains a great challenge in some situations. To date, there has been no widely accepted protocol for the rescue of HF burns, partly due to the diversity of HF burns. This paper overviews the current status and problems of treatment strategies for HF burns, for the purpose of promoting the future researches and improvement.

Arabidopsis EDM2 promotes IBM1 distal polyadenylation and regulates genome DNA methylation patterns.

DNA methylation is important for the silencing of transposons and other repetitive elements in many higher eukaryotes. However, plant and mammalian genomes have evolved to contain repetitive elements near or inside their genes. How these genes are kept from being silenced by DNA methylation is not well understood. A forward genetics screen led to the identification of the putative chromatin regulator Enhanced Downy Mildew 2 (EDM2) as a cellular antisilencing factor and regulator of genome DNA methylation patterns. EDM2 contains a composite Plant Homeo Domain that recognizes both active and repressive histone methylation marks at the intronic repeat elements in genes such as the Histone 3 lysine 9 demethylase gene Increase in BONSAI Methylation 1 (IBM1) and is necessary for maintaining the expression of these genes by promoting mRNA distal polyadenylation. Because of its role in maintaining IBM1 expression, EDM2 is required for preventing CHG methylation in the bodies of thousands of genes. Our results thus increase the understanding of antisilencing, genome methylation patterns, and regulation of alternative RNA processing by intronic heterochromatin.