[Digital orthopedics technology leads the new development direction of arthroplasty].

Digital orthopedics technology is a new interdisciplinary subject, known as the third technological wave in the field of orthopedics. The development direction of arthroplasty is focused on hoping to improve the long-term prognosis of patients by imitating more natural kinematics and optimizing implant positioning strategies. At present, various digital orthopedic technologies such as virtual reality technology, navigation assistance systems, and patient-specific instrumentation (PSI) and robot-assisted surgery in joint surgery are in full swing. In this article, relevant domestic and foreign literature were extensively reviewed and the author's own experiences were summarize, and the advantages, disadvantages, clinical efficacy and future prospects of the above-mentioned various technologies were evaluated too.

[A case of subacute combined degeneration of spinal cord caused by inhaling laughing gas].

Laughing gas (Nitrogen monoxide) is currently abused due to its low price and easy availability. This article discussed the clinical manifestations of a patient with subacute combined degeneration of the spinal cord caused by inhalation of laughing gas. The patient developed numbness of extremities, unstable walking, and decreased serum vitamin B(12) level. MRI of the cervical spine showed abnormal signals in the lateral and posterior cords of the cervical spinal cord (C2-6) , neuroelectrophysiological examination showed peripheral nerve damage in the extremities. After treatment with vitamin B(12) supplementation, the patient's condition gradually improved. Clinicians diagnose subacute combined degeneration of the spinal cord, especially when the patient has no gastrointestinal disease, diet, malnutrition, etc., they need to carefully inquire about the history of nitrous oxide inhalation to avoid missed diagnosis.

The aberrant activation of Wnt pathway caused by ß-catenin mutation and its prognostic significance in NK/T-cell lymphoma.

The aberrant activation of the Wnt/ß-catenin signal has an important role in the progression of cancers. Herein, we investigated ß-catenin mutation and the activation of the Wnt pathway in association with the clinical-pathological characteristics, chemo-resistance and prognosis of NK/T-cell lymphoma (NKTCL). Real-time quantitative PCR, immunocytochemistry and immunohistochemistry SP methods detected the levels of ß-catenin, c-myc and cyclin D1 in human NKTCL cell lines (SNK-6 and YTS) and NKTCL tissues. Mutation analysis was detected in exon 3 of ß-catenin gene; and we analyzed cell viability after histone deacetylase inhibitor (HDACi) treatment. As a result, 19 (38%) of NK/T-cell lymphoma displayed nuclear ß-catenin and 16 (32%) contained mutations in exon 3; while no mutations were detected in lymphomas negative for ß-catenin nuclear staining (p<0.05). Most mutations affecting ß-catenin were adjacent to regulatory phosphorylation sites. ß-catenin, c-myc and cyclin D1 were significantly elevated in SNK-6 and YTS cell lines compared to normal NK/T cells (p<0.05). Furthermore, the high expression of ß-catenin, c-myc and cyclin D1 significantly correlated with the III/IV Ann Arbor stage. Additionally, the expression of ß-catenin in the SNK-6 cell line decreased significantly after treatment with HDACi, and Kaplan-Meier survival analysis revealed that the elevated expression of ß-catenin correlated with poor prognosis in NKTCL patients (23.66±2.77 months vs 31.65±1.78 months, p=0.023). In conclusion: mutations in exon 3 of ß-catenin and the activated Wnt pathway are common in NK/T-cell lymphoma that has nuclear ß-catenin, and it is closely correlated with the Ann Arbor stage and prognosis in NKTCL patients.

[Analysis on epidemiological characteristics and related factors of dyslipidemia among adult residents of Xinjiang Uygur Autonomous Region during 2013-2014].

Objective: To study the epidemiological characteristics and related factors of dyslipidemia among adult residents in Xinjiang Uygur Autonomous Region (Xinjiang) in 2013-2014. Methods: A total of 4 120 adult residents consisting of Han and Uygur group aged over 18 years old were selected by using a stratified cluster random sampling method in 8 counties of Xinjiang from 2013 to 2014. The related factors of dyslipidemia were collected by questionnaire and physical measurement. The total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by enzyme method. Factors associated with dyslipidemia were analyzed by chi-squared test and a multivariate unconditioned logistic regression model adjusted for gender, urban or rural area, age-group, body mass index (BMI), central obesity, smoking, drinking, education attainment, diabetes mellitus and hypertension. Results: The prevalence of dyslipidemia was 45.00% (1 854 cases). The prevalence of dyslipidemia was higher in Uygur group (47.80% (977/2 044)) than that in Han group (42.24% (877/2 076)) (χ(2)=12.84, P<0.001). The analysis showed that dyslipidemia was related with gender (OR=0.41, 95%CI: 0.33-0.51), urban area (OR=0.54, 95%CI: 0.39-0.76), BMI (overweight group (OR=1.52, 95%CI: 1.18-1.96); obesity group (OR=2.20, 95%CI: 1.64-2.96)), central obesity (OR=1.66, 95%CI: 1.29-2.14) and diabetes mellitus (OR=1.49, 95%CI: 1.06-2.11) in Uygur group. The analysis also showed that dyslipidemia was related with BMI (overweight group (OR=1.72, 95%CI: 1.32-2.25), obesity group (OR=2.60, 95%CI: 1.85-3.64)), central obesity (OR=1.45, 95%CI: 1.13-1.87), smoking (OR=1.46, 95%CI: 1.09-1.95), diabetes mellitus (OR=1.77, 95%CI: 1.38-2.25) and hypertension (OR=1.62, 95%CI: 1.31-2.00) in Han group. Conclusions: The prevalence of dyslipidemia in Xinjiang was higher than the national average prevalence. The prevalence of dyslipidemia in Uygur group was significantly higher than that in Han group. The gender, living area, BMI, central obesity and diabetes mellitus were risk factors of dyslipidemia in Uygur group, and BMI, central obesity, smoking, diabetes mellitus and hypertension were risk factors of dyslipidemia in Han group in Xinjiang.

Multimodality treatment for esophageal adenocarcinoma: multi-center propensity-score matched study.

Background: The primary aim of this study was to compare survival from neoadjuvant chemoradiotherapy plus surgery (NCRS) versus neoadjuvant chemotherapy plus surgery (NCS) for the treatment of esophageal or junctional adenocarcinoma. The secondary aims were to compare pathological effects, short-term mortality and morbidity, and to evaluate the effect of lymph node harvest upon survival in both treatment groups. Methods: Data were collected from 10 European centers from 2001 to 2012. Six hundred and eight patients with stage II or III oesophageal or oesophago-gastric junctional adenocarcinoma were included; 301 in the NCRS group and 307 in the NCS group. Propensity score matching and Cox regression analyses were used to compensate for differences in baseline characteristics. Results: NCRS resulted in significant pathological benefits with more ypT0 (26.7% versus 5%; P < 0.001), more ypN0 (63.3% versus 32.1%; P < 0.001), and reduced R1/2 resection margins (7.7% versus 21.8%; P < 0.001). Analysis of short-term outcomes showed no statistically significant differences in 30-day or 90-day mortality, but increased incidence of anastomotic leak (23.1% versus 6.8%; P < 0.001) in NCRS patients. There were no statistically significant differences between the groups in 3-year overall survival (57.9% versus 53.4%; Hazard Ratio (HR)= 0.89, 95%C.I. 0.67-1.17, P = 0.391) nor disease-free survival (52.9% versus 48.9%; HR = 0.90, 95%C.I. 0.69-1.18, P = 0.443). The pattern of recurrence was also similar (P = 0.660). There was a higher lymph node harvest in the NCS group (27 versus 14; P < 0.001), which was significantly associated with a lower recurrence rate and improved disease free survival within the NCS group. Conclusion: The survival differences between NCRS and NCS maybe modest, if present at all, for the treatment of locally advanced esophageal or junctional adenocarcinoma. Future large-scale randomized trials must control and monitor indicators of the quality of surgery, as the extent of lymphadenectomy appears to influence prognosis in patients treated with NCS, from this large multi-center European study.

[Two-stage total hip arthroplasty using an antibiotic-loaded cement spacer for infected internal fixation of hip fractures].

Objective: To evaluate the application and clinical results of two-stage total hip arthroplasty in the treatment of the deep hip infection following the internal fixation of hip fractures. Methods: From May 2007 to November 2014, 21 patients with active hip infection secondary to internal fixation of hip fractures were treated with two-stage total hip arthroplasty using a temporary antibiotic-loaded cement spacers. Of 21 cases, 15 were males and 6 were females, aged from 27 to 64 years (mean, 45); there are 18 cases of femoral neck fractures and 3 cases of intertrochanteric fractures. The serologic examination and X-ray were taken at 1 month, 3 months, 6 months, 12 months and annually thereafter post-operatively to evaluate the clinical results and prosthesis status. Harris hip score system was used to evaluate the joint function. Results: All patients were successfully treated with two stage operations under general anesthesia. The operational interval was 12-44 weeks (mean, 21) and 1 spacer breakage. For the arthroplasty, cementless components were used in 20 cases and cemented component was use in 1 case. The patients were followed up 25-102 months ( mean, 55 ) and infections were eradicated in all hips. The Harris hip score was improved from 23.24±11.81 pre-operatively to 90.24±3.92 post-operatively and the difference was statistically significant (P<0.05). According to this scoring criteria, the excellent and good rate reached up to 95%. At latest fellow-up, the location of prosthesis were well and the function of hip joint was satisfied. All cases had no dislocation, periprosthetic fracture, ectopic ossification or any other complications at the latest fellow-up. Conclusion: By means of an antibiotic-loaded cement spacer, two-stage total hip arthroplasty is an effective salvage procedure eradicating infection and providing functional improvement to the infected internal fixation of hip fractures. The early and mid-term clinical effects are satisfied.

National proficiency-gain curves for minimally invasive gastrointestinal cancer surgery.

BACKGROUND: Minimal access surgery for gastrointestinal cancer has short-term benefits but is associated with a proficiency-gain curve. The aim of this study was to define national proficiency-gain curves for minimal access colorectal and oesophagogastric surgery, and to determine the impact on clinical outcomes. METHODS: All adult patients undergoing minimal access oesophageal, colonic and rectal surgery between 2002 and 2012 were identified from the Hospital Episode Statistics database. Proficiency-gain curves were created using risk-adjusted cumulative sum analysis. Change points were identified, and bootstrapping was performed with 1000 iterations to identify a confidence level. The primary outcome was 30-day mortality; secondary outcomes were 90-day mortality, reintervention, conversion and length of hospital stay. RESULTS: Some 1696, 15 008 and 16 701 minimal access oesophageal, rectal and colonic cancer resections were performed during the study period. The change point in the proficiency-gain curve for 30-day mortality for oesophageal, rectal and colonic surgery was 19 (confidence level 98·4 per cent), 20 (99·2 per cent) and three (99·5 per cent) procedures; the mortality rate fell from 4·0 to 2·0 per cent (relative risk reduction (RRR) 0·50, P = 0·033), from 2·1 to 1·2 per cent (RRR 0·43, P < 0·001) and from 2·4 to 1·8 per cent (RRR 0·25, P = 0·058) respectively. The change point in the proficiency-gain curve for reintervention in oesophageal, rectal and colonic resection was 19 (98·1 per cent), 32 (99·5 per cent) and 26 (99·2 per cent) procedures respectively. There were also significant proficiency-gain curves for 90-day mortality, conversion and length of stay. CONCLUSION: The introduction of minimal access gastrointestinal cancer surgery has been associated with a proficiency-gain curve for mortality and major morbidity at a national level. Unnecessary patient harm should be avoided by appropriate training and monitoring of new surgical techniques.

Contributions of the social environment to first-onset and recurrent mania.

In treated cohorts, individuals with bipolar disorder are more likely to report childhood adversities and recent stressors than individuals without bipolar disorder; similarly, in registry-based studies, childhood adversities are more common among individuals who later become hospitalized for bipolar disorder. Because these types of studies rely on treatment-seeking samples or hospital diagnoses, they leave unresolved the question of whether or not social experiences are involved in the etiology of bipolar disorder. We investigated the role of childhood adversities and adulthood stressors in liability for bipolar disorder using data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=33 375). We analyzed risk for initial-onset and recurrent DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) manic episodes during the study's 3-year follow-up period. Childhood physical abuse and sexual maltreatment were associated with significantly higher risks of both first-onset mania (odds ratio (OR) for abuse: 2.23; 95% confidence interval (CI)=1.71, 2.91; OR for maltreatment: 2.10; CI=1.55, 2.83) and recurrent mania (OR for abuse: 1.55; CI=1.00, 2.40; OR for maltreatment: 1.60; CI=1.00, 2.55). In addition, past-year stressors in the domains of interpersonal instability and financial hardship were associated with a significantly higher risk of incident and recurrent mania. Exposure to childhood adversity potentiated the effects of recent stressors on adult mania. Our findings demonstrate a role of social experiences in the initial onset of bipolar disorder, as well as in its prospective course, and are consistent with etiologic models of bipolar disorder that implicate deficits in developmentally established stress-response pathways.

CAG-repeat polymorphisms in the polymerase γ gene and male infertility: a meta-analysis.

CAG-repeat in the polymerase γ (POLG) gene encoding polymerase γ for mitochondria is important to spermatogenesis. Compared with a few researchers who raised alteration of CAG-repeat-affected male reproductive ability, others did not find the association between CAG-repeat polymorphisms and male infertility. Therefore, a comprehensive meta-analysis is necessary to determine the association; 13 case-control studies were screened out using keywords search. From these studies, characteristics were extracted for conducting meta-analysis. Odds ratio (OR) and 95% confidence interval (CI) were used to describe the results; the results indicated that CAG-repeat allele was not a risk factor to male infertility (pooled OR = 1.03, 95% CI: 0.79-1.34, P = 0.828). Four different genetic comparisons also demonstrated a negative result: heterozygote comparison (not 10/10 versus 10/10. Pooled OR = 0.99, 95% CI: 0.77-1.27, P = 0.948), homozygote comparison (not 10/not 10 versus 10/10. Pooled OR = 1.08, 95% CI: 0.56-2.06, P = 0.816), the recessive genetic comparison (not 10/not 10 versus not 10/10 + 10/10. Pooled OR = 1.07, 95% CI: 0.58-1.95, P = 0.829) and the dominant genetic comparison (not 10/not 10 + not 10/10 versus 10/10. Pooled OR = 0.97, 95% CI: 0.72-1.29, P = 0.804); based on current researches, this meta-analysis demonstrated no apparent association between POLG-CAG-repeat and male infertility. Similarly, CAG-repeat was not a sensitive site to male infertility.

Effects of mutations on the structure and function of silkworm type 1 acetylcholinesterase.

AChE is the target of organophosphate (OP) and carbamate (CB) pesticides, and mutations in the gene can significantly reduce insects' sensitivity to these pesticides. Bombyx mori is highly sensitive to pesticides. To investigate the effects of mutations on AChE1 structure and function, we used a prokaryotic system to express B.mori wild type AChE1 (wAChE1) and mutant AChE1 (mAChE1) in this study. Active AChE1 proteins were obtained after refolding and purification, and wAChE1 and mAChE1 had similar activities. After incubation with 10(-6)M physostigmine and 10(-3)mg/mL phoxim, the remaining enzyme activity of mAChE1 was 4.42% and 8.86% higher than that of wAChE1's, respectively. Three-dimensional analysis of mutation AChE1 (mAChE1) revealed that the Ser and Ala side chains extended toward the central part of S285 with distances of just 2.80Å and 3.68Å, respectively, which changed the spatial structure of the active center and reduced its sensitivity to pesticides. These results indicated that the mutations altered the 3D structure of AChE1, which may affect the binding of physostigmine and phoxim to the serine residue at the active center, leading to reduced sensitivity. Our study helps understand the relationship between AChE1 mutations and pesticide resistance and provides a new direction for the cultivation of new pesticide-resistant varieties of B.mori.

Mechanisms of TiO2 NPs-induced phoxim metabolism in silkworm (Bombyx mori) fat body.

Silkworm is an important economic insect. Abuse of organophosphorus pesticides in recent years often leads to poisoning of silkworms, which significantly affects sericulture development by reducing silk production. Previous studies have shown that TiO2 NPs can effectively mitigate the damages caused by organophosphorus pesticides in silk glands and nerve tissues. The fat body is an important metabolic detoxification organ of silkworms, but it is unknown whether TiO2 NPs affect pesticide metabolism in fat body. In this study, we characterized the transcription of antioxidant genes and enzyme activity in fat body after TiO2 NPs and phoxim treatments using transcriptome sequencing, real-time PCR, and enzyme activity assay. Transcriptome sequencing detected 10 720, 10 641, 10 403, and 10 489 genes for control group, TiO2 NPs group, phoxim group, and TiO2 NPs+phoxim group, respectively. The TiO2 NPs+phoxim group had 705 genes with significantly differential expression (FDR<0.001), among which the antioxidant genes thioredoxin reductase 1 and glutathione S-transferase omega 3 were significantly upregulated. In phoxim group, the expression levels of superoxide dismutase (SOD), catalase (CAT), glutathione S-transferase delta (GSTd), and thioredoxin peroxidase (TPx) were increased by 1.365 -fold, 1.335 -fold, 1.642 -fold, and 1.765 -fold, respectively. The level changes of SOD, CAT, GSTd, and TPx were validated by real time PCR. The contents of reactive oxygen species (ROS), malondialdehyde (MDA), and hydrogen peroxide (H2O2) were increased by 1.598 -fold, 1.946 -fold, and 1.506 -fold, respectively, indicating that TiO2 NPs treatment can relieve phoxim-induced oxidative stress. To clarify the mechanism of TiO2 NPs's effect, the transcription levels of P450 gene family were measured for the TiO2 NPs+phoxim group; the expression levels of CYP4M5, CYP6AB4, CYP6A8, and CYP9G3 were elevated by 2.784 -fold, 3.047 -fold, 2.254 -fold, and 4.253 -fold, respectively, suggesting that high expression of P450 family genes can enhance the metabolism of phoxim in the fat body. The results of this study indicated that TiO2 NPs treatment promoted the transcriptional expression of the P450 family genes to improve the fat body's ability to metabolize phoxim and reduce phoxim-induced oxidative stress. This may be the main mechanism of TiO2 NPs' mitigation of phoxim-induced damages in the fat body.

Association between interleukin 17A gene polymorphisms and risk of coronary artery disease.

Coronary artery disease (CAD) represents a leading cause of morbidity and mortality worldwide, and genetic factors contribute to the development of this disease. We conducted a case-control study to assess the association between interleukin 17A (IL17A) rs2275913 and rs3748067 polymorphisms and development of CAD. A total of 372 CAD patients and 372 healthy controls were recruited in our investigation between January 2013 and December 2014. Genotyping of IL17A rs2275913 and rs3748067 was carried out using polymerase chain reaction combined with restriction fragment length polymorphism. Logistic regression analysis revealed that CC [odds ratio (OR) = 3.81, 95% confidence interval (CI) = 2.11-7.16] and TC+CC (OR = 1.54, 95%CI = 1.11-2.14) rs3748067 genotypes were associated with an increased risk of CAD compared to the TT variant. Individuals carrying the TC+CC genotype were more likely to have a higher risk of CAD if they were smokers, with an adjusted OR (and 95%CI) of 2.20 (1.31-3.71). In conclusion, we suggest that the CC and TC+CC genotypes of rs3748067 are connected with increased risk of CAD in comparison to the wide-type genotype, particularly in smokers.

Clinical validity of consultant technical skills assessment in the English National Training Programme for Laparoscopic Colorectal Surgery.

BACKGROUND: The English National Training Programme for Laparoscopic Colorectal Surgery introduced a validated objective competency assessment tool to accredit surgeons before independent practice. The aim of this study was to determine whether this technical skills assessment predicted clinical outcomes. METHODS: Established consultants, training in laparoscopic colorectal surgery, were asked to submit two operative videos for evaluation by two blinded assessors using the competency assessment tool. A mark of 2·7 or above was considered a pass. Clinical and oncological outcomes were compared above and below this mark, including regression analysis. RESULTS: Eighty-five consultant surgeons submitted 171 videos. Of these, 44 (25·7 per cent) were in the fail group (score less than 2·7). This low scoring group had more postoperative morbidity (25 versus 8·7 per cent; P = 0·005), including surgical complications (18 versus 6·3 per cent; P = 0·020) and fewer lymph nodes harvested (median 13 versus 18; P = 0·004). A score of less than 2·7 was an independent predictor of surgical complication, lymph node yield and distal resection margin clearance. Consultants with higher scores had performed similar numbers of laparoscopic colorectal operations (median 37 versus 40; P = 0·373) but more structured training operations (18 versus 9; P < 0·001). CONCLUSION: An objective technical skills assessment provided a discriminatory tool with which to accredit laparoscopic colorectal surgeons.

Differentially expressed genes in the fat body of Bombyx mori in response to phoxim insecticide.

The silkworm, Bombyx mori, is an economically important insect. However, poisoning of silkworms by organophosphate pesticides causes tremendous loss to the sericulture. The fat body is the major tissue involved in detoxification and produces antimicrobial peptides and regulates hormones. In this study, a microarray system comprising 22,987 oligonucluotide 70-mer probes was employed to examine differentially expressed genes in the fat body of B. mori exposed to phoxim insecticide. The results showed that a total of 774 genes were differentially expressed upon phoxim exposure, including 500 up-regulated genes and 274 down-regulated genes. The expression levels of eight detoxification-related genes were up-regulated upon phoxim exposure, including six cytochrome P450s and two glutathione-S-transferases. It was firstly found that eight antimicrobial peptide genes were down-regulated, which might provide important references for studying the larvae of B. mori become more susceptible to microbial infections after phoxim treatment. In addition, we firstly detected the expression level of metamorphosis-related genes after phoxim exposure, which may lead to impacted reproduction. Our results may facilitate the overall understanding of the molecular mechanism of multiple pathways following exposure to phoxim insecticide in the fat body of B. mori.

Human infection with avian influenza A(H7N9) virus re-emerges in China in winter 2013.

Through a national surveillance system for unexplained pneumonia, a severe case of influenza A(H7N9) in a man in his mid-30s was identified in Zhejiang Province, China on 14 October 2013. Epidemiological and clinical findings were consistent with the patterns reported during the outbreak in spring 2013, and laboratory findings showed that the virus had 99.6% identity with earlier H7N9 viruses identified in humans in the spring except for five mutations in the NA gene.

Biomodulator of Diode Laser Irradiation on Odontoblast-Like Cells by Expression of Vascular Endothelial Growth Factor-A and Transforming Growth Factor-ß1.

OBJECTIVE: This study aimed to prove that the effect of diode laser 650-nm irradiation to the expression of vascular endothelial growth factor (VEGF)-A and transforming growth factor (TGF)-ß1 plays important roles in dental pulp-regulating cell proliferation, differentiation, and revascularization. MATERIALS AND METHODS: The research was performed by randomized posttest only control group design using Rattus norvegicus. A total of 48 samples were provided and divided into eight groups of 6 samples each with a random-sample allocation. Each group were prepared, and perforation of maxillary first molar were done. In control groups (groups 1-4), glass ionomer cement (GIC) was used to restore the teeth, while in laser groups (groups 5-8), the teeth were irradiated with diode laser 650 nm for 40 seconds before application of GIC. Half of the groups (groups 1, 2, 5, and 6) were necropsied in 7 days, and the rest (groups 3, 4, 7, and 8) were necropsied in 14 days. Immunohistochemistry (IHC) evaluation were implemented to check the expression of both VEGF-A and TGF-ß1. STATISTICAL ANALYSIS: Both data of VEGF-A and TGF-ß1 expression were analyzed using a one-way ANOVA (α = 0.05) with SPSS statistical software. RESULTS: The study showed that the diode laser 650-nm irradiation increased expression of VEGF-A and TGF-ß1, and there was a significant difference between diode laser and control group on VEGF-A expression (p = 0.001) and TGF- ß1 (p = 0.000) on days 7 and 14. CONCLUSION: Diode laser 650 nm with 40-second irradiation time shows increment from day 7 to day 14 reflecting increase in pulp healing by modulating VEGF-A and TGF-ß1 expression since days 7 to 14.

Managing the Skin Microbiome as a New Bacteriotherapy for Inflammatory Atopic Dermatitis.

The microbiome, comprising various bacteria, assumes a significant role in the immune system's maturation and maintaining bodily homeostasis. Alterations in the microbial composition can contribute to the initiation and progression of inflammation. Recent studies reveal that changes in microbial composition and function, known as dysbiosis in the skin and gut, have been associated with altered immunological responses and skin barrier disruption. These changes are implicated in the development of several skin diseases, such as atopic dermatitis (AD). This review examines research demonstrating the potential of microbiome repair as a therapeutic approach to reduce the effect of inflammatory processes in the skin during atopic dermatitis. This way, corticosteroids in atopic dermatitis therapy can be reduced or even replaced with treatments focusing on controlling the skin microbiome. This study used scientific literature from recognized platforms, including PubMed, Scopus, Google Scholar, and ScienceDirect, covering publications from 2013 to 2023. The primary aim of this study was to assess the efficacy of skin microbiome management in treating atopic dermatitis. This study concludes that physicians must comprehensively understand the microbiome's involvement in atopic dermatitis, including its pathophysiological implications and its relevance to therapeutic interventions.