Efficacy of Percutaneous Superficial Temporal Arterial Hyaluronidase Injection for Hyaluronic Acid Filler-Induced Necrosis of Frontotemporal Skin and/or the Ipsilateral Scalp With Subsequent Alopecia.

BACKGROUND: Necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia after hyaluronic acid (HA) filler injection into the temple is rare complications with superficial temporal artery embolization are suspected as the major pathological mechanism. The main treatment currently is intralesional hyaluronidase (HAase) injection, but the effectiveness of percutaneous superficial temporal arterial HAase injection still lacks consensus. OBJECTIVES: To investigate the effectiveness of superficial temporal arterial HAase injection in dissolving HA filler-induced necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia. METHODS: Five recent clinical cases with necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia after HA filler injection into the temple were analyzed retrospectively. The patients underwent HAase injection via superficial temporal artery combined with adjunctive treatments, and the clinical progress was observed. RESULTS: Significant improvement was observed in terms of necrosis of frontotemporal skin and the ipsilateral scalp after treatment, and the patients were relieved of their clinical symptoms. Alopecia occurred approximately 1 to 2 weeks after HA filler injection, and the well-defined alopecia areas were formed 15 to 20 days after HAase injection. Patients were followed for 3 to 6 months. During follow-up, the skin lesions of all patients were restored to near normal appearance. Hair regrowth was observed 2 to 3 months after HAase treatment, and hair density nearly reached the normal level 3 to 4 months later. CONCLUSIONS: Percutaneous superficial temporal arterial HAase injection is an effective treatment option for HA filler-induced necrosis of frontotemporal skin and/or the ipsilateral scalp with subsequent alopecia.

Diminazen Aceturate Protects Pulmonary Ischemia-Reperfusion Injury via Inhibition of ADAM17-Mediated Angiotensin-Converting Enzyme 2 Shedding.

Lung ischemia-reperfusion (IR) injury is induced by pulmonary artery occlusion and reperfusion. Lung IR injury commonly happens after weaning from extracorporeal circulation, lung transplantation, and pulmonary thromboendarterectomy; it is a lethal perioperative complication. A definite therapeutic intervention remains to be determined. It is known that the enzyme activity of angiotensin-converting enzyme 2 (ACE2) is critical in maintaining pulmonary vascular tone and epithelial integrity. In a noxious environment to the lungs, inactivation of ACE2 is mainly due to a disintegrin and metalloprotease 17 (ADAM17) protein-mediated ACE2 shedding. Thus, we assumed that protection of local ACE2 in the lung against ADAM17-mediated shedding would be a therapeutic target for lung IR injury. In this study, we established both in vivo and in vitro models to demonstrate that the damage degree of lung IR injury depends on the loss of ACE2 and ACE2 enzyme dysfunction in lung tissue. Treatment with ACE2 protectant diminazen aceturate (DIZE) maintained higher ACE2 enzyme activity and reduced angiotensin II, angiotensin type 1 receptor, and ADAM17 levels in the lung tissue. Concurrently, DIZE-inhibited oxidative stress and nitrosative stress via p38MAPK and NF-κB pathways consequently reduced release of pro-inflammatory cytokines such as TNF-α, IL-6, and IL-1ß. The underlying molecular mechanism of DIZE contributed to its protective effect against lung IR injury and resulted in the improvement of oxygenation index and ameliorating pulmonary pathological damage. We concluded that DIZE protects the lungs from IR injury via inhibition of ADAM17-mediated ACE2 shedding.

Unraveling the impact of Pto4CL1 regulation on the cell wall components and wood properties of perennial transgenic Populus tomentosa.

Cell wall components and structure impact the physical and mechanical properties of plants, thereby affecting wood applications. Lignin is the most abundant biopolymer after cellulose in the wood cell wall and can be modified by certain lignin biosynthesis enzymes. 4-Coumarate: coenzyme A ligase(4CL) is an important lignin biosynthesis enzyme. To demonstrate the impact of the regulation of Pto4CL1 from poplar on wood properties, we analyzed the composition and anatomy of 5-year-old Pto4CL1-modified poplar cell walls, assessing the density, strength, volume shrinkage, and impact toughness of the transgenic trees. These results showed that the up-regulation of Pto4CL1 increased the lignin content to 46.65% from 33.11% in the control plants, while hydrophilic polysaccharides such as cellulose, hemi-cellulose, and pectin decreased. In contrast, the down-regulation of Pto4CL1 resulted in a reduction in lignin content to 27.39%, and the content of cellulose and hemi-cellulose showed compensatory variation. Raman spectroscopy showed that the change in lignin in the transgenic events was embodied in the deposition and concentration of lignin in the secondary cell wall. Moreover, the increased lignin content caused significantly increased wood strength and slightly increased wood density. In contrast, a reduction in lignin content resulted in a significant decrease in wood strength and a slight decrease in wood density. However, the Pto4CL1-modified trees had similar stiffness to the control group. We also found a significant decrease in volume shrinkage and increase in impact toughness in the low-lignin events. These results indicate that Pto4CL1 regulation alters the chemical composition of plant cell walls and these changes affect the physical and mechanical properties of the wood.

Prevalence of complications after surgery in treatment for cervical compressive myelopathy: A meta-analysis for last decade.

PURPOSE: We aim to perform a meta-analysis on prevalence of all kinds of operation-related complications following surgery treating cervical compressive myelopathy (CCM) and to provide reference for surgeons making surgical plan. METHODS: An extensive search of literature was performed in PubMed/MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG databases on incidence of operation-related complications from January 2007 to November 2016. Data was calculated and data analysis was conducted with STATA 12.0 and Revman 5.3. RESULTS: A total of 107 studies included 1705 of 8612 patients (20.1%, 95% CI 17.3%-22.8%) on overall complications. The incidence of C5 plasy, cerebrospinal fluid (CSF), infection, axial pain, dysphagia, hoarseness, fusion failure, graft subsidence, graft dislodgment, and epidural hematoma is 5.3% (95% CI 4.3%-6.2%), 1.9% (95% CI 1.3%-2.4%), 2.8% (95% CI 1.7%-4.0%), 15.6% (95% CI 11.7%-19.5%), 16.8% (95% CI 13.6%-19.9%), 4.0% (95% CI 2.3%-5.7%), 2.6% (95% CI 0.2%-4.9%), 3.7% (95% CI 2.0%-5.5%), 3.4% (95% CI 2.0%-4.8%), 1.1% (95% CI 0.7%-1.5%), respectively. Patients with ossification of posterior longitudinal ligament (OPLL) (6.3%) had a higher prevalence of C5 plasy than those with cervical spondylotic myelopathy (CSM) (4.1%), and a similar trend in CSF (12.2% vs 0.9%). Individuals after laminectomy and fusion (LF) had highest rate of C5 plasy (15.2%), while those who underwent anterior cervical discectomy and fusion (ACDF) had the lowest prevalence (2.0%). Compared with patients after other surgical options, individuals after anterior cervical corpectomy and fusion (ACCF) have the highest rate of CSF (4.2%), infection (14.2%), and epidural hematoma (3.1%). Patients after ACDF (4.8%) had a higher prevalence of hoarseness than those with ACCF (3.0%), and a similar trend for dysphagia between anterior corpectomy combined with discectomy (ACCDF) and ACCF (16.8% vs 9.9%). CONCLUSIONS: Based on our meta-analysis, patients with OPLL have a higher incidence of C5 palsy and CSF. Patients after LF have a higher incidence of C5 palsy, ACCDF have a higher incidence of dysphagia, ACCF have a higher incidence of CSF and infection and ACDF have a higher incidence of hoarseness. These figures may be useful in the estimation of the probability of complications following cervical surgery.

[Development of traditional Chinese medicine in United States].

The United States government established Complementary and Alternative Medicine (CAM) to meet the public needs. In 1991, the National Institutes of Health (NIH) approved the first acupuncture clinic for their patients. The National Center of Complementary and Alternative Medicine (NCCAM) was founded at NIH in 1998 to sponsor and develop CAM research. In 2001, the budget for NCCAM had grown to 130 million USD. Of the 3 300 papers on CAM published in the past ten years, 520 were funded by NIH. NCCAM goals are to focus on "mind and body medicine" and "herbals" for future research. Traditional Chinese medicine (TCM) is one of the major components in CAM. From 1998 to 2012, NCCAM funded 248 research subjects on TCM, with a total budget of 236 million USD. The subjects were as follows: 160 for acupuncture, 36 for Chinese medicine, 33 for Tai Chi, and 19 for Qigong. The American public is increasingly supportive of CAM, including TCM. According to the national survey in 2008, nearly 40% of American used CAM, 11% of them were children, self-spending 33.9 billion USD in 2007. In the same year, 3.7 million people received acupuncture in the United States. The data also indicate that women, higher income and higher educated people used CAM more frequently. An increasing number of allopathic medical professionals are open to CAM, and recommend their patients to use acupuncture and other modalities. TCM, as an important part of CAM, has become a new option for patients in improving their healthcare services in conjunction with allopathic medicine. TCM will have more potential to be utilized in the United States.

Triterpene saponins from the leaves of Ilex kudingcha.

Three new triterpene saponins, ilekudinosides T-V (1-3), along with six known saponins were isolated from the 70% ethanolic extract of the leaves of Ilex kudingcha. The new saponins were characterized as 3-O-beta-d-glucopyranosyl-(1 --> 3)-[alpha-l-rhamnopyranosyl-(1 --> 2)]-alpha-l-arabinopyranosyl-3beta,19alpha-dihydroxy-urs-12(13)-en-28,20beta-lactone (1), 3-O-beta-d-glucopyranosyl-(1 --> 3)-[alpha-l-rhamnopyranosyl-(1 --> 2)]-alpha-l-arabinopyranosyl-3beta,19alpha-dihydroxy-12-ethoxy-urs-13(18)-ene-28,20beta-lactone (2), 3-O-beta-d-glucopyranosyl-(1 --> 3)-[alpha-l-rhamnopyranosyl-(1 --> 2)]-alpha-l-arabinopyranosyl-3beta,19alpha-dihydroxy-11-oxo-urs-13(18)-ene-28,20beta-lactone (3), respectively. The structures of compounds 1-3 were elucidated on the basis of the chemical and spectroscopic evidence, and the structures of known compounds were identified by comparison of their spectroscopic data with those reported in the literature.

[Studies on chemical constituents of aerial parts of Ammopiptanthus mongolicus].

OBJECTIVE: To investigate the chemical constituents of the aerial parts of Ammopiptanthus mongolicus. METHOD: The chemical constituents were isolated by various column chromatographic methods. The structures were identified by spectral data. RESULT: Ten compounds were isolated and identified as m-hydroxybenzoic acid (1), 1-(4-hydroxyphenyl) ethanone (2), beta-sitosterol (3), (-)-syringaresinol (4), (+)-lariciresinol (5), blumenol A (6), blumenol B (7), beta-daucosterol (8), coniferin (9), syringin (10). CONCLUSION: The ten compounds were obtained from the genus Ammopiptanthus for the first time.