Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta-analysis.

BACKGROUND: Tranexamic acid (TA) is a new and promising drug for the treatment of melasma. OBJECTIVES: This network meta-analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma. METHODS: We collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point. RESULTS: At the Weeks 4, 8, and 12 and the last follow-up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8. CONCLUSIONS: Among various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration.

Xenograft-decellularized adipose tissue supports adipose remodeling in rabbit.

BACKGROUND: Decellularized adipose tissue (DAT) provides a suitable microenvironment for adipose stem cells (ADSCs) and promotes their adipogenic differentiation. Recent studies have focused on allogeneic DAT; however, insufficient adipose sources limit its wider application of allogeneic DAT. In this study, we compared the ability of allogeneic and xenogeneic DATs to induce adipose regeneration to explore the feasibility of xenogeneic DAT as an adjunctive material for tissue repair. METHODS: Decellularized adipose tissue from humans and rabbits was prepared using the Flynn's method. The proliferation, migration, and adipogenic functions of the allogeneic and the xenogeneic groups were compared. Rabbits were used to construct transplantation models: allogeneic (transplanted r-DAT) and xenogeneic groups (transplanted h-DAT). Comparison of DAT transplantation outcomes between the two groups. RESULTS: Xenogeneic DAT supports adipose regeneration. In vitro, adipose-derived stem cells cultured on xenogeneic DAT developed adipogenesis without media cues and were not statistically different from the effects of allogeneic DAT on cell migration, proliferation, and adipogenic capacity. In vivo, the animal model showed angiogenesis and adipogenesis, and the adipogenic ability of xenogeneic DAT was not statistically different from that of allogeneic DAT. CONCLUSION: Xenogeneic DATs can induce adipose regeneration, and its adipogenic ability has no statistical difference, compared with allogeneic DATs. Xenografts are expected to be useful for soft tissue repair.

Infectious shock after liposuction.

BACKGROUND: Liposuction has become one of the most popular cosmetic surgeries in China. However, few studies have discussed infectious shock caused by C. perfringens as one of the causes of death after liposuction. CASE PRESENTATION: A 24-year-old woman was brought to the emergency department (ED) of Guangzhou Chinese Overseas Hospital for treatment. The patient had undergone liposuction in her bilateral lower limbs two days prior. At the ED, the patient was unconscious, and had bilateral equal-sized (diameter, 6 mm) round pupils, no light reflex, a blood pressure (BP) of 71/33 mmHg, a heart rate of 133 bpm, and an SpO2 of 70%. She had bilateral limb swelling, extensive ecchymoses in her lower abdomen and bilateral thighs, local crepitus, blisters, weak pulses on her femoral artery and dorsalis pedis, high skin tension, and hemoglobin of 32 g/L. The patient was diagnosed with Clostridium perfringens infection, and she underwent debridement surgery and supportive treatment. But the patient's BP could not improve. At 8:28 pm on the day of admission, the patient was declared clinically dead after the electrocardiograph showed a horizontal line and spontaneous respiration ceased. CONCLUSIONS: Failure to meet surgical disinfection and environmental standards may be the cause of infection of C. perfringens through wounds. Therefore, it is necessary to strengthen the environmental disinfection of the operating room, and standardize the sterile conditions of the operation staff and patients before and during operation. Liposuction surgery necrotizing fasciitis is a rare but fatal complications, especially if diagnosis delay, therefore it is critical for early diagnosis and treatment of gas gangrene.