A functional hydrogel of dopamine-modified gelatin with photothermal properties for enhancing infected wound healing.

Infected skin wound has gradually become a prevalent injury that affects overall health. Currently, biomaterials with good adhesion, efficient antibacterial properties, and angiogenesis are considered as a suitable way to effectively heal infected wound. Herein, a multifunctional hydrogel comprising gelatin, dopamine (DA), and ferric ions (Fe3+) was developed for infected wound healing. The modified gelatin-dopamine (Gel-DA) enhanced adhesive capability. Subsequently introducing ferric ions (Fe3+) to form Gel-DA-Fe3+ hydrogels by Fe3+ and catechol coordination bonds. The designed hydrogels demonstrated multifaceted functionality, encompassing photothermal antibacterial, angiogenesis, and so on. The introduction of DA enhanced the adhesion of Gel-DA-Fe3+ to the skin surface and might serve as a physical barrier to seal wound. Meanwhile, DA and Fe3+ jointly endowed good photothermal effects to composite hydrogels, which could eliminate over 95 % of bacteria. In vitro results revealed that Gel-DA-Fe3+ hydrogels had good biocompatibility and promoted HUVECs migration and tube formation. Furthermore, in vivo studies confirmed that Gel-DA-Fe3+ hydrogels markedly expedited the wound healing of rats through eradicating bacteria, accelerating the deposition of collagen, and promoting angiogenesis. What's more, Gel-DA-Fe3+ hydrogels under near-infrared laser had a more pronounced ability for wound healing. Therefore, Gel-DA-Fe3+ hydrogels had great potential for application in bacteria-infected wound healing.

LncRNA HOTAIR promotes the migration and invasion of cervical cancer through DNMT3B/LATS1/ YAP1 pS127 axis.

Metastasis is the hallmark of cancer that is responsible for the greatest number of cancer-related deaths. As a critical regulator of the Hippo pathway, the phosphorylation status of Yes-associated protein 1 (YAP1), mainly at S127, is critical for its oncogenic function. Herein, we aim to investigate the precise molecular mechanism between long noncoding RNA HOX transcript antisense RNA (HOTAIR) and YAP1 phosphorylation in regulating tumor migration and invasion. In this study, we showed that inhibition of HOTAIR significantly decreased the migration and invasion of cancer cells both in vitro and in vivo through elevating the phosphorylation level of YAP1 on serine 127, demonstrating a tumor suppressive role of YAP1 S127 phosphorylation. Through bisulfite sequencing PCR (BSP), we found that inhibition of HOTAIR dramatically increased Large Tumor Suppressor Kinase 1 (LATS1) expression by regulating LATS1 methylation via DNA methyltransferase 3ß (DNMT3B). In accordance with this observation, DNMT3B just only altered the distribution of YAP1 in the cytoplasm and the nucleus by inhibiting its phosphorylation, but did not change its total expression. Mechanistically, we discovered that HOTAIR suppressed YAP1 S127 phosphorylation by regulating the methylation of LATS1 via DNMT3B, the consequence of which is the translocation of YAP1 into the nucleus, reinforcing its coactivating transcriptional function, which in turn promotes the migration and invasion of cancer cells. Collectively, our data reveal that the phosphorylation of YAP1 S127 plays a vital role in the function of HOTAIR in tumorigenicity, and should be taken into consideration in future therapeutic strategies for cervical cancer.

Composite Hydrogel Dressings with Enhanced Mechanical Properties and Anti-Inflammatory Ability for Effectively Promoting Wound Repair.

Background: Hydrogel dressings have been used as a crucial method to keep the wound wet and hasten the healing process. Due to safety concerns regarding the gel components, low mechanical adhesiveness, and unsatisfactory anti-inflammatory capacity qualities for practical uses in vivo, leading to the clinical translation of wound dressings is still difficult. Methods: A type of composite hydrogel (acrylamide/polyethylene glycol diacrylate/tannic acid, ie, AM/PEGDA/TA) by double bond crosslinking, Schiff base, and hydrogen bond interaction is proposed. The mechanical characteristics, adhesiveness, and biocompatibility of the hydrogel system were all thoroughly examined. Additionally, a full-thickness cutaneous wound model was employed to assess the in vivo wound healing capacity of resulting hydrogel dressings. Results: Benefiting the mechanism of multiple crosslinking, the designed composite hydrogels showed significant mechanical strength, outstanding adhesive capability, and good cytocompatibility. Moreover, the hydrogel system also had excellent shape adaptability, and they can be perfectly integrated into the irregularly shaped wounds through a fast in situ forming approach. Additional in vivo tests supported the findings that the full-thickness wound treated with the composite hydrogels showed quicker epithelial tissue regeneration, fewer inflammatory cells, more collagen deposition, and greater levels of platelet endothelial cell adhesion molecule (CD31) expression. Conclusion: These above results might offer a practical and affordable product or method of skin wound therapy in a medical context.

Oncogenic DNA methyltransferase 1 activates the PI3K/AKT/mTOR signalling by blocking the binding of HSPB8 and BAG3 in melanoma.

Abnormal DNA methylation has been observed in multiple malignancies, including melanoma. In this study, we initially noticed the overexpression of DNA methyltransferase 1 (DNMT1) in melanoma samples in bioinformatics analysis and, subsequently, validated it in the purchased melanoma cell lines. After treatment with short-hairpin RNAs or Decitabine (a DNA methylation inhibitor), silencing of DNMT1 was demonstrated to suppress cell viability and invasive and migratory potentials as well as to augment apoptosis and autophagy in melanoma cells. To further explore the downstream mechanisms, we revealed that DNMT1 inhibited HSPB8 expression through augmenting HSPB8 methylation, thereby suppressing the binding between HSPB8 and BAG3. Then, we elucidated through a series of gain- and loss- of function assays that the interplay of HSPB8 and BAG3 blocked the PI3K/AKT/mTOR pathway, thereby repressing the malignant phenotypes of melanoma cells and contributing to melanoma cell apoptosis and autophagy. We further established a mouse model of melanoma and substantiated that DNMT1 enhanced the in vivo tumorigenesis of melanoma cells via activation of the PI3K/AKT/mTOR pathway through repressing the binding between HSPB8 and BAG3. Taken together, our data supported that DNMT1 repressed the binding between HSPB8 and BAG3 and activated the PI3K/AKT/mTOR pathway, thus playing a tumour-promoting role in melanoma.

Potential mechanism of transient receptor potential cation channel subfamily V member 1 combined with an ATP­sensitive potassium channel in severe preeclampsia.

Severe preeclampsia is one of the most serious obstetric diseases. However, the pathogenesis of the disease is not fully understood. In the present study, placental artery and blood serum was collected from patients with severe preeclampsia, as well as from normal pregnant women. The results of reverse transcription-quantitative (q)PCR, western blotting, and immunohistochemical staining revealed markedly decreased transient receptor potential cation channel subfamily V member 1 (TRPV1), ATP-sensitive potassium channel (KATP) subtype Kir6.1/SUR2B and endothelial nitric oxide synthase (eNOS) expression in severe preeclampsia tissue specimens compared with those in samples from normal pregnant women. The nitrate reduction method indicated lower NO levels in the tissue specimens and serum of patients with severe preeclampsia. Moreover, hematoxylin-eosin staining showed that the endothelial cell layer in the placental artery of patients with severe preeclampsia was notably damaged. To investigate the potential role of TRPV1-KATP channels in severe preeclampsia, HUVECs were used for in vitro experiments. The samples were divided into a control group, a TRPV1 agonist group (capsaicin) and a TRPV1 inhibitor group (capsazepine). qPCR and western blotting revealed that the relative gene and protein expression levels of TRPV1, Kir6.1, SUR2B and eNOS in the control group were significantly lower than those in the capsaicin group and considerably higher than those in the capsazepine group. Based on previous studies and the results of the present study, we hypothesized that impairment of the endothelial TRPV1-KATP channels results in decreased eNOS/NO pathway activity, which may be one of the mechanisms involved in severe preeclampsia. The increase in NO generation mediated by TRPV1-KATP may be a suitable target for the management of severe preeclampsia.

A Retrospective Study of Clinical Efficacy of Cantharidin Cream for Verruca Plantaris.

Verruca plantaris (plantar wart) is a type of benign feet hyperplasia that is caused by a human papillomavirus (HPV) infection. In this study, we aimed to assess the clinical efficacy underlying cantharidin cream in the treatment of Verruca plantaris compared to CO2 laser and liquid nitrogen cryotherapy. One hundred and fifty patients affected with Verruca plantaris were enrolled in this retrospective clinical study. The treatment efficacy rate in the three groups was assessed 4 and 12 weeks after treatment. After 4 weeks of treatment, 46 cases in the externally applied cantharidin cream therapy group were cured with an apparent efficiency of 92.0% (46/50). Contrarily, 42 cases in the CO2 laser group were cured with 84.0% (42/50) efficiency, while 40 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 80.0% (40/50). Although the clinical cure rate of Verruca plantaris in the Cantharidin group was greater than in the CO2 laser group and in the liquid nitrogen cryotherapy group, there were no statistical differences found among the three groups (P = 0.225). After 12 weeks of treatment, 43 cases in the external cantharidin cream therapy group were cured with an apparent efficiency of 86.0% (43/50). Similarly, 39 cases in the CO2 laser group were cured with an apparent efficiency of 78.0% (39/50), while 36 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 72.0% (36/50). The statistical differences among the three groups were not found (P =0.230), but the resolution rate of warts in Cantharidin group was the highest among the three groups. The results from this study demonstrated that external cantharidin cream therapy could be served as an alternative treatment for Verruca plantaris.

NEAT1 in bone marrow mesenchymal stem cell-derived extracellular vesicles promotes melanoma by inducing M2 macrophage polarization.

Bone marrow mesenchymal stem cells (BMSCs)-derived extracellular vesicles (EVs) reportedly play an important role in melanoma pathogenesis. This study aimed to explore the mechanisms of EVs-carried long non-coding RNA (lncRNA) NEAT1 involvement in melanoma. Gain- and loss-of-function experiments were performed to determine biological characteristics of A-375 melanoma cells. Bioinfomatic prediction, RNA immunoprecipitation (RIP), and dual luciferase reporter gene experiments were applied to investigate the roles of NEAT1 and microRNA-374a-5p (miR-374a-5p), and leucine-rich repeat-containing G protein-coupled receptor 4 (LGR4). A subcutaneous tumor model was constructed using nude mice, and in vivo fluorescence imaging was used to observe the effect of NEAT1 on the growth and metastasis of melanoma cells in vivo. The results indicated that BMSC-EVs could be internalized by macrophages to promote the expression of macrophages M2 markers. M2 type macrophages promoted malignancy of melanoma cells. NEAT1 derived from BMSC-EVs promoted the progression of melanoma by promoting M2 polarization of macrophages. NEAT1 inhibits miR-374 expression, while miR-374 could upregulate LGR4-dependent IQGAP1 expression. The tumor-inhibiting effect of NEAT1 silencing was validated in the nude mouse xenograft model. Collectively, the results demonstrated that BMSC-EVs carrying NEAT1 can promote the progression of melanoma by inducing M2 polarization of macrophages, and thus may be considered as a potential target for melanoma therapeutics.

Retrospective Analysis of Drug Sensitivity of Neisseria gonorrhoeae in Teaching Hospitals of South China.

The aim of this study was retrospective analysis of drug sensitivity of Neisseria gonorrhoeae in two teaching hospitals of South China. A total of 304 Neisseria gonorrhoeae isolates obtained from patients in South China from 2016 to 2020 were evaluated. The MICs of penicillin, cefuroxime, ceftriaxone (CRO), cefepime, ciprofloxacin, ceftazidime and azithromycin (AZM) against the isolates were determined by the agar dilution method. Then, Neisseria gonorrhoeae isolates were categorized into sensitive, moderately sensitive and resistant according to MICs. Also, ß-lactamases were detected by enzyme linked immunosorbent assay (ELISA). Ureaplasma urealyticum and Mycoplasma hominis were determined by culture in liquid medium, and Chlamydia was detected by rapid antigen test. The result showed there was 50.99%, 20.72%, 9.87%, 14.47%, 86.84%, 7.57%, 6.91%, 11.18% resistance to penicillin, cefuroxime, ceftriaxone, cefepime, ciprofloxacin, ceftazidime and azithromycin, respectively. Also, ß-lactamase positivity was 53.29% and Chlamydia antigen positivity was 20.07%. Ureaplasma urealyticum and Mycoplasma hominis positivity was 11.84% and 6.25%, respectively. From 2016 to 2020, the resistant rate of ceftriaxone and azithromycin gradually increased. In conclusion, Southern China is among the area reporting gonococci with high-level resistance to AZM and CRO, so N. gonorrhoeae culture and drug sensitivity test will be vital for monitoring trends in antimicrobial resistance.

Identifying possible risk factors for cesarean scar pregnancy based on a retrospective study of 291 cases.

AIM: Cesarean scar pregnancy (CSP) is a rare but life-threatening type of ectopic pregnancy. This study's aim is to investigate the clinical characteristics and possible risk factors for cesarean scar pregnancy. METHODS: A clinically randomized, unpaired and retrospective case-control study was implemented. A study group of 291 CSP patients and a control group of 317 full-term pregnant women with a history of cesarean section (CS) were recruited in our hospital from May 2013 to October 2018. Their demographic characteristics and medical and obstetric history were collected. RESULTS: Only symptoms suggestive of an impending abortion, such as vaginal bleeding with or without abdominal pain, were identified as the clinical characteristics of CSP. Maternal age older than 35 years, gravidity higher than 3 (especially gravidity higher than 5), more than two induced abortions (especially more than five abortions), an interval of less than 5 years (especially less than 2 years) between the current pregnancy and the last CS, history of CS performed in a rural hospital, history of induced abortions after CS and retroposition of the uterus were possible independent risk factors for CSP. CONCLUSION: CSP is a result of a combination of multiple factors associated with CS. There are no unique early clinical features of CSP. As a unique type of ectopic pregnancy, early diagnosis, early termination and early clearance should be the treatment principles. Further research is needed to evaluate the relationship between the cesarean scar defect and CSP in the future.

MCM7 silencing promotes cutaneous melanoma cell autophagy and apoptosis by inactivating the AKT1/mTOR signaling pathway.

Cutaneous melanoma (CM) has become a major public health concern. Studies illustrate that minichromosome maintenance protein 7 (MCM7) participate in various diseases including skin disease. Our study aimed to study the effects of MCM7 silencing on CM cell autophagy and apoptosis by modulating the AKT threonine kinase 1 (AKT1)/mechanistic target of rapamycin kinase (mTOR) signaling pathway. Initially, microarray analysis was used to screen the CM-related gene expression data as well as differentially expressed genes. Subsequently, MCM7 expression vector and lentivirus RNA used for MCM7 silencing (LV-shRNA-MCM7) were constructed, and these vectors, dimethyl sulfoxide (DMSO) and AKT activator SC79 were then introduced into CM cell line SK-MEL-2 to validate the role of MCM7 in cell autophagy, viability, apoptosis, cell cycle, migration, and invasion. To further investigate the regulatory mechanisms of MCM7 in CM progress, the expression of MCM7, AKT1, mTOR, cyclin D1, as well as autophagy and apoptosis relative factors, such as LC3B, SOD2, DJ-1, p62, Bcl-2, Bax, and caspase-3 in melanoma cells was determined. MCM7 might mediate the AKT1/mTOR signaling pathway to influence the progress of melanoma. MCM7 silencing contributed to the increased expression of Bax, capase-3, and autophagy-related genes (LC3B, SOD2, and DJ-1), but decreased the expression of Bcl-2, which suggested that MCM7 silencing promoted autophagy and cell apoptosis. At the same time, MCM7 silencing also attenuated cell viability, invasion, and migration, and reduced the cyclin D1 expression and protein levels of p-AKT1 and p-mTOR. Taken together, MCM7 silencing inhibited CM via inactivation of the AKT1/mTOR signaling pathway.

Subcutaneous botulinum toxin-A injection for treating postherpetic neuralgia.

Postherpetic neuralgia (PHN) is a debilitating disease characterized by continuous, intense pain following an outbreak of herpes zoster. The pain associated with PHN can severely affect a patient's quality of life, quality of sleep, and ability to participate in activities of daily living. The aim of this study was to explore the clinical efficacy of the subcutaneous injection of botulinum toxin-A (BTX-A) for the treatment of PHN. Thirteen patients with PHN were enrolled in this study and treated once with BTX-A. The effects of BTX-A on pain were measured with the visual analogue scale (VAS) 1, 2, 4, 8, 12, and 16 weeks after administration. Compared with pretreatment scores, VAS pain scores decreased at 2 weeks post-treatment in all patients. All patients felt varying degrees of pain relief but remained comfortable. Compared with oral analgesic drugs, VAS scores were significantly different at 2, 4, 8, 12, and 16 weeks post-treatment (p < .05). These results demonstrated that subcutaneous administration of BTX-A can decrease pain in patients with PHN.

An optimized method for neuronal differentiation of embryonic stem cells in vitro.

BACKGROUND: Neural differentiation from embryonic stem cells (ESCs) is an excellent model for elucidating the key mechanisms involved in neurogenesis, and also provides an unlimited source of progenitors for cell-based nerve regeneration. However, the existing protocols such as small molecule substances, 3D matrix, co-culture technique and transgenic method, are complicated and difficult to operate, thus are limited by laboratory conditions. Looking for an easy-to-operate protocol with easily gained material and high induction efficiency has always been a hot issue in neuroscience research. NEW METHODS: This paper established an optimized method for embryonic neurogenesis using a strategy of "combinatorial screening". In our study, the whole process of embryonic neurogenesis was divided into two phases, and the differentiation efficiency of seven experimental protocols in phase I and three protocols in phase II were systematically evaluated in A2lox and 129 ESCs. RESULTS: In phase I differentiation, "2-day embryoid bodies formation + 6-day retinoic acid induction" (Phase I-protocol 3) could effectively induce the differentiation of ESCs into neural precursor cells (NPCs). Furthermore, in phase II, N2B27 medium II (Phase II-protocol 3) could better support the subsequent differentiation from NPCs into neurons. COMPARISON WITH EXISTING METHOD(S): Such a combinational method (phase I-protocol 3 and phase II-protocol 3) can realize embryonic neurogenesis with high efficiency, easy implementation and low-cost, and is suitable for promotion in most laboratories. CONCLUSIONS: Through "combinatorial screening" strategy, we established an optimized method for embryonic neurogenesis in vitro, which is expected to be a powerful tool for neuroscience research.

[Therapeutic effect of Impatiens balsamina, Lawsonia inermis L. and Henna on androgenetic alopecia in mice].

OBJECTIVE: To investigate the therapeutic effect of Impatiens balsamina, Lawsonia inermis L. and Henna in a C57BL/6 mouse model of androgenetic alopecia and explore the mechanisms. METHODS: Forty-eight male C57BL/6 mice were randomized equally into blank control group, androgenetic alopecia model group, Impatiens balsamina group, Lawsonia inermis L. group, Henna group and minoxidil group. In all but those in the blank control group, the mice were subjected to dorsal subcutaneous injection of testosterone propionate solution (daily dose 5 mg/kg) to establish models of androgenetic alopecia and received subsequent treatment with topical application of the corresponding drugs on a daily basis for 35 days. The concentrations of testosterone, dihydrotestosterone and 5α reductase type Ⅱ in the serum and skin tissue were measured, and the histopathological changes of the skin tissues were observed. RESULTS: All the tested drugs were capable of promoting new hair growth in the dorsal skin lesions of the mice. Among these drugs, Henna produced the most pronounced therapeutic effect and resulted in the highest dorsal hair density and a color change of the dorsal skin into gray; Lawsonia inermis L. showed the poorest therapeutic effect and resulted in the lowest dorsal hair density. The total number of follicles and the number of terminal hair follicles in a given field were significantly higher in all the drug treatment groups than in the model group (P < 0.05). In Impatiens balsamina group and Henna group, the contents of testosterone and dihydrotestosterone in the skin were significantly lower than those in the model group (P < 0.05). No significant difference was found in serum testosterone and dihydrotestosterone levels or skin 5α reductase type Ⅱ level between the drug treatment groups and the model group. CONCLUSIONS: Impatiens balsamina, Lawsonia inermis L., and Henna all have therapeutic effects on androgenetic alopecia in C57BL/6 mice. The therapeutic effect of Impatiens balsamina and Henna is possibly achieved by reducing androgen content in local skin tissue.

Photodynamic therapy combined with antifungal drugs against chromoblastomycosis and the effect of ALA-PDT on Fonsecaea in vitro.

BACKGROUND: Chromoblastomycosis is a chronic skin and subcutaneous fungal infection caused by dematiaceous fungi and is associated with low cure and high relapse rates. In southern China, Fonsecaea monophora and Fonsecaea pedrosoi are the main causative agents. PRINCIPAL FINDINGS: We treated 5 refractory and complex cases of chromoblastomycosis with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with oral antifungal drugs. The lesions improved after 4 to 9 sessions of ALA-PDT treatment at an interval of one or two weeks, and in some cases, mycological testing results became negative. The isolates were assayed for susceptibility to antifungal drugs and ALA-PDT in vitro, revealing sensitivity to terbinafine, itraconazole and voriconazole, with ALA-PDT altering the cell wall and increasing reactive oxygen species production. CONCLUSIONS: These results provide the basis for the development of a new therapeutic approach, and ALA-PDT combined with oral antifungal drugs constitutes a promising alternative method for the treatment of refractory and complex cases of chromoblastomycosis.

Human Chrysomya bezziana myiasis: A systematic review.

BACKGROUND: Myiasis due to Old World screw-worm fly, Chrysomya bezziana, is an important obligate zoonotic disease in the OIE-list of diseases and is found throughout much of Africa, the Indian subcontinent, southeast and east Asia. C. bezziana myiasis causes not only morbidity and death to animals and humans, but also economic losses in the livestock industries. Because of the aggressive and destructive nature of this disease in hosts, we initiated this study to provide a comprehensive understanding of human myiasis caused by C. bezziana. METHODS: We searched the databases in English (PubMed, Embase and African Index Medicus) and Chinese (CNKI, Wanfang, and Duxiu), and international government online reports to 6th February, 2019, to identify studies concerning C. bezziana. Another ten human cases in China and Papua New Guinea that our team had recorded were also included. RESULTS: We retrieved 1,048 reports from which 202 studies were ultimately eligible for inclusion in the present descriptive analyses. Since the first human case due to C. bezziana was reported in 1909, we have summarized 291 cases and found that these cases often occurred in patients with poor hygiene, low socio-economic conditions, old age, and underlying diseases including infections, age-related diseases, and noninfectious chronic diseases. But C. bezziana myiasis appears largely neglected as a serious medical or veterinary condition, with human and animal cases only reported in 16 and 24 countries respectively, despite this fly species being recorded in 44 countries worldwide. CONCLUSION: Our findings indicate that cryptic myiasis cases due to the obligate parasite, C. bezziana, are under-recognized. Through this study on C. bezziana etiology, clinical features, diagnosis, treatment, epidemiology, prevention and control, we call for more vigilance and awareness of the disease from governments, health authorities, clinicians, veterinary workers, nursing homes, and also the general public.

Clinical efficacy of paiteling in the treatment of condyloma acuminatum infected with different subtypes of HPV.

Condyloma acuminatum (CA) is a type of mucosal benign hyperplasia skin disease that is caused by human papillomavirus (HPV) infection, which mainly occurs in the genitalia and anus. The aim of the present study was to explore the clinical efficacy underlying the traditional Chinese medicine paiteling in the treatment of CA via the detection of HPV. One hundred CA patients were enrolled in the current study and were externally treated with paiteling for 5 weeks. HPV subtypes were examined both before the treatment and at 6 months after the treatment. After the external paiteling therapy, 92 cases were cured, and the apparent efficiency was 92.0% (92/100), while 8 cases exhibited recurrence. Before the external paiteling therapy, the numbers of cases of low-risk, high-risk, and mixed types of HPV were 40, 35, and 25, respectively. At 6 months after treatment, the numbers of negative cases of low-risk, high-risk, and mixed types of HPV were 38, 32, and 20, respectively. The results demonstrated that external paiteling treatment has a good curative effect on the treatment of CA.

[Long-pulsed 1064 nm Nd: YAG laser combined with terbinafine against chromoblastomycosis caused by Fonsecaea nubica and the effect of laser therapy in a Wistar rat model].

We report a case of chromoblastomycosis caused by Fonsecaea nubica, which was successfully treated by long-pulsed 1064 nm Nd: YAG laser combined with terbinafine. A 60-year-old man was admitted for the presence of a 30 mm×40 mm erythematous plaque on the dorsum of his right hand for about 10 months without any subjective symptoms. Both microscopic examination and tissue biopsy of the lesion showed characteristic sclerotic bodies of chromoblastomycosis. Lesion tissue culture on SDA at 26 ℃ for 2 weeks resulted in a black colony, and slide culture identified the isolate as Fonsecaea species. ITS sequence analysis of the isolate showed a 99% homology with F. nubica strain KX078407. The in vitro susceptibility of the isolate to 9 antifungal agents was determined using the microdilution method according to the guidelines of CLSI M38-A2 protocol, and terbinafine showed the lowest MIC (0.125 µg/ml). We subsequently established a Wistar rat model of chromoblastomycosis using the clinical isolate F. nubica and treated the rats with long-pulsed 1064 nm Nd: YAG laser (pulse width of 3.0 ms, fluence of 24 J/cm2, spot size of 3 mm, frequency of 4 Hz, repeated 3 times at an interval of 30 s) twice a week for a total of 8 sessions. Although the laser treatment alone was not able to eliminate the fungi, histopathological examination showed the aggregation of numerous lymphocytes in the local affected tissue, indicating an immune response that consequently facilitate the regression of the lesion. The patient was successfully treated by long-pulsed 1064 nm Nd: YAG laser once a week combined with terbinafine (0.25 /bid) for 8 weeks, and follow-up for 20 months did not reveal any signs of recurrence.

Effects of CO2 fractional laser therapy on peripheral blood cytokines in patients with vitiligo.

Vitiligo is a disease pathologically characterized by specific damage to melanocytes. The aim of this study was to explore the mechanism underlying CO2 fractional laser treatment of vitiligo by detecting the levels of Th1 cytokines (IL-2 and IFN-γ), Th2 cytokines (IL-4 and IL-10), and Th17 cytokines (IL-17 and IL-23) in peripheral blood. Twenty five vitiligo patients were enrolled in this study and were treated with a CO2 fractional laser four to eight times. The cytokines of 25 vitiligo patients and 20 healthy volunteers were measured by enzyme-linked immunosorbent assay. After CO2 fractional laser therapy, six cases were cured, and the apparent efficiency was 72.0% (18/25), while the efficiency was 92.0% (23/25). Before CO2 fractional laser therapy, IL-2 and IFN-γ levels in vitiligo patients were higher than those in the control group, but the difference was not statistically significant (p > .05). IL-4, IL-10, IL-17, and IL-23 levels were also higher in vitiligo patients than those in the control group (p < .05). After treatment, IL-2 and IFN-γ levels in vitiligo patients were lower than before treatment, but the difference was not statistically significant (p > .05), while IL-4, IL-10, IL-17, and IL-23 levels were significantly lower compared with before treatment (p < .05). The results show that CO2 fractional laser treatment has a good curative effect in the treatment of vitiligo.