Efficacy observation of Toric intraocular lens in correcting corneal astigmatism and vector analysis of residual astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical effect of Toric intraocular lens(Toric IOL)implantation in the correction of corneal astigmatism, and vector analysis of residual astigmatism and corneal astigmatism.<p>METHODS: A retrospective case observation study. A total of 63 patients with 77 eyes who underwent phacoemulsification combined with Toric IOL implantation in our hospital from September 2018 to October 2019 were selected. LogMAR uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), residual astigmatism of subjective refraction were observed after operation in 1wk, 1mo, and 3mo. And after dilated pupil, the Toric IOL axis position was measured by OPD-scanⅢ, and compared with the target axis position(LAD).<p>RESULTS: The median(interquartile range)of UCDVA at 1wk, 1mo, and 3mo after operation were 0.22(0.15, 0.40), 0.30(0.15,0.40),and 0.30(0.15, 0.40), which were better than those of UCDVA \〖0.82(0.60, 1.22)\〗 and BCDVA \〖0.52(0.30, 0.70)\〗 before operation(<i>P</i><0.008). The residual astigmatism was 0.75(0.50, 1.00), 0.75(0.38, 1.00), 0.50(0.25, 1.00)D, respectively, which was significantly lower than that of preoperative corneal astigmatism \〖2.19(1.73, 2.69)D\〗(<i>P</i><0.008). At 3mo after surgery, the proportion of UCDVA(LogMAR)≤0.301 was 69%; the proportion of residual astigmatism ≤0.75D was 73%. The median LAD at 1wk, 1mo, and 3mo after surgery were 2.0°, 2.0°, and 3.0°; 81%, 82%, 77% were less than 5°. The maximum LAD value is 11°. Astigmatism vector analysis: preoperative corneal astigmatism was 2.31±0.80D, centroid value was 1.44D@177°±1.99D; Predicted postoperative residual astigmatism was 0.14±0.17D, centroid value was 0.02D@58°±0.22D; residual astigmatism at 3mo after operation was 0.69±0.53D, centroid value was 0.05D@142°±0.88D.<p>CONCLUSION: Toric IOL can effectively correct corneal astigmatism in patients with cataract and has good rotational stability. Astigmatism vector analysis can directly show the difference between predicting postoperative astigmatism and actual residual astigmatism, which is helpful to analyze and optimize the measurement of corneal astigmatism, calculation of IOL degree, surgical design, postoperative observation.

Studies on Anti-inflammatory Effects of Gutong Plasters on Acute Inflammation in Rats / 中国药师

Objective: To study the anti-inflammatory effect and mechanism of Gutong plasters in acute inflammatory model of rats. Methods:Totally 60 SD rats were randomly divided into the blank group,the model group,Gutong plasters at low,medium and high dose groups(0.594,1.188 and 2.376 g/patch containing crude drug 0.48,0.96 and 1.92 g,respectively) and prednisone ace-tate group(0.005 4 g·kg-1). The acute inflammation model was prepared by injecting 5% formaldehyde into right side of foot plan-tar. And then,the anti-inflammatory effect was evaluated by measuring the foot plantar volume. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of nitric oxide(NO),histamine(HIS) and 5-hydroxytryptamine(5-HT) in serum and inflam-matory tissue,the levels of prostaglandin E2(PGE2),tumor necrosis factor alpha(TNF-α),interleukin 1 beta(IL-1β) and interleu-kin 6 (IL-6) in inflammatory tissue were also determined. Pathological changes were observed through the pathological sections pre-pared by HE staining. Results:When compared with the model group,Gutong plasters could significantly inhibit the swelling of foot plantar in inflammatory rats(P<0.01). At the same time,Gutong plasters could significantly reduce the levels of NO,5-HT and HIS in serum and inflammatory tissue in different degrees(P<0.05 or P<0.01),significantly reduce the content of PGE2in inflammatory tissue (P<0.05 or P<0.01),increase the content of IL-6 in inflammatory tissue and improve the pathological changes of inflammato-ry tissues (the pathological score was significantly reduced). In partical indictor changes,Gutong plasters and prednisone acetate showed an equal effect.In addition,Gutong plasters didn't show significant dose-dependent manner in inhibiting foot swelling,affect-ing inflammatory mediators and improving pathological changes(P>0.05). Conclusion:Gutong plasters have better anti-inflammato-ry effect in the acute inflammation model induced by formaldehyde in rats. The anti-inflammatory effect may be associated with the de-crease of the levels of NO,5-HT and HIS in serum and inflammatory tissue,the decrease of the content of PGE2and the increase of the content of IL-6 in inflammatory tissue. In addition,the anti-inflammatory effect may be relevant to improving the local inflammatory tis-sue subcutaneous edema and inflammatory cell infiltration.

Line Scanning Quantitative Analysis by Laser Ablation Inductively Coupled Plasma Mass Spectrometry with Small Laser Beam / 分析化学

Line scanning quantitative analysis method on silicate with small laser beam ( < 15 μm) was developed using laser ablation sector field inductively coupled plasma mass spectrometry (LA-SF-ICP-MS). Differences on signal intensity and elemental fractionation induced by different laser sampling patterns were compared. While spot ablation with small laser beam, the elemental signal intensity decreased with time significantly, and the elemental fractionation was obvious. In contrast, the elemental signal intensity by line scanning was higher and more stable and line scanning was free of elemental fractionation. Therefore, identical ablation pattern and condition should be used for the standard and the unknown sample in LA-ICP-MS quantitative analysis. A single pulse experiment was carried out to investigate the washout time when coupled to two-volume ablation cell. The result indicated that the elemental intensity decayed to the background value needed 2-3 s. The optimal parameters on SF-ICP-MS were set to reduce the effect of signal overlapping. Homogeneous sample KL2-G and titanite grains with composition zoning were analyzed by this method. Accurate element contents and element ratios indicated that fast washout time and optimal instrument parameters made it feasible to perform line scanning quantitative analysis accurately. Comparing to traditional microanalysis, line scanning quantitative analysis could reduce the laser beam size (<15 μm) and improve the spatial resolution efficiently. The potential of the technique to unveil compositional complexities in greater detail would help to improve our understanding of geochemical processes in mineral scale.

Study on the Analgesic Effect and Mechanism of Gutongtie Paste on Model Rats with Formaldehyde-in-duced Pain / 中国药房

OBJECTIVE:To study the analgesic effect and mechanism of Gutongtie paste on model rats with formaldehyde-in-duced pain. METHODS:60 SD rats were randomly divided into blank group,model group,Gutongtie paste low-dose,medi-um-dose,high-dose groups(0.594,1.188. 2.376 g/paste,containing crude drug 0.48,0.96,1.92 g)and prednisone acetate group (ig,0.0054 g/kg,external bonding matrix). Model rats with pain was induced by formaldehyde method and immediately adminis-trated after modeling. Electronic tenderness instrument was adopted to determine the pain threshold of rats'ankle joint after adminis-tration of 1,2,3,4,6 h. After 6 h,blood sample 0.3 mL was taken from abdominal aorta then rats were sacrificed. Enzyme linked immunosorbent assay (ELISA) was conducted to determine the β-endorphin (β-EP),prostaglandin E2 (PGE2) contents;spectrophotometry was used to determine nitric oxide(NO)content in rats'serum and inflammatory tissue;and radioimmunoassay was adopted to detect the substance P content in rats'serum,inflammatory tissue and brain tissue. RESULTS:Compared with be-fore modeling,pain thresholds in model group at each period were significantly decreased (P<0.05 or P<0.01). Compared with blank group,PGE2,NO of rats,substance P content in inflammatory tissue and brain tissue in model group were significantly in-creased (P<0.05 or P<0.01). Compared with model group,pain thresholds in Gutongtie paste groups at corresponding time points were increased,PGE2 and substance P contents in inflammatory tissue and brain tissue were decreased (P<0.05 or P<0.01);β-EP and NO contents in serum in Gutongtie paste medium-dose,high-dose groups(P<0.05 or P<0.01),NO contents in serum in Gutongtie paste high-dose group were decreased(P<0.05). CONCLUSIONS:Gutongtie paste has a certain analgesic and anti-inflammatory effect,and the mechanism may be related to reducing PGE2, NO, substance P contents, increasing β-EP content.

Effect of cataract surgical incision on original astigmatism and tear film stability of corrected cornea / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of the size of cataract surgical incision on original astigmatism and tear film stability of corrected cornea.METHODS: Totally 92 cataract patients (92 eyes) who were admitted to our hospital from July 2014 to July 2016 were randomly divided into the control group and the observation group,46 cases (46 eyes) in each group.Both groups were treated by clear corneal tunnel incision phacoemulsification combined with intraocular lens implantation.The incision of the control group was 3.0mm while of the observation group was 1.8mm.The uncorrected visual acuity,corneal astigmatism,Schirmer I test (SⅠt) and break-up time (BUT) were detected before surgery and at 1d,1wk,1mo and 3mo after surgery.The surgery induced astigmatism (SIA) was recorded at 1d,1wk,1 and 3mo after surgery.RESULTS: There were significant differences in the uncorrected visual acuity between the two groups at 1 and 3mo before surgery (P0.05).At 1wk,1 and 3mo after surgery,SIA of two groups decreased continuously,and the SIA of the observation group was significantly lower than that of the control group at 1d,1wk and 1mo after surgery (P0.05).SⅠt and BUT in the observation group were less or shorter than those in the control group at 1wk after surgery (P0.05).CONCLUSION: Compared with 3.0mm standard incision,1.8mm clear corneal incision can reduce SIA and shorten the time for corneal stability recovery.

Biomechanics and imaging evaluation on stable structure of pelvis / 中国骨伤

The treatment of difficulty and prognosis of pelvic fracture are directly related to the pelvic girdle stability. Diagnosis of pelvic fracture is mainly imaging manifestations based on biomechanics of pelvic anatomy. With the progress of biomechanics experiment technology, previousopinion has changed, such as separation of symphysis pubis 2.5 cm could not be seen as distinguishing feature of type I and II for anterior-posterior compression;displacement of sacroilliac joints less than 1 cm could cause loss of vertical stability;lateral extrusion could also cause vertical instability;part description of Young-Burgess classification is not suitable for experiment results;ligament plays an important role in restricting displacement and having proprioceptors;SPECT-CT could improve sensitivity of diagnosis, but could not evaluate stability of pelvic fractures precisely.

Safety Study of Polyisobutylene Gutong Plaster by Transdermal Administration / 中国药房

OBJECTIVE:To investigate the safety of Polyisobutylene (PIB) Gutong plaster by transdermal administration. METHODS:66 rabbits were randomly divided into a normal group,a group with intact skin and a group with damaged skin. The latter two groups were respectively re-divided into PIB group,the groups of low,medium and high-dose PIB Gutong plaster and Gutong plaster group. An acute toxicity test was conducted on the rabbits,which 14 d of continuous observation was made 24 h af-ter transdermal administration. Another 60 rabbits were divided into several groups as above except for a normal group. A single pri-mary skin irritation test was conducted on them,where skin irritation reactions were recorded 6 h after a single administration based on intra-individual left/right self comparison method. 70 guinea pigs were randomized into a negative control group (vase-line),a PIB group,a positive control group(2,4-dinitrochlorobenzene),a Gutong plaster group and the groups of low,medium and high-dose PIB Gutong plaster,which were dosed for sensitization,followed by a skin sensitization test. RESULTS:No obvi-ous toxicity symptoms could be seen after administration of PIB Gutong plaster. The rabbits’intact or damaged skin had no irrita-tion response to PIB and low and medium-dose PIB Gutong plaster. PIB Gutong plaster caused no irritation response in the rabbits’ intact skin,but slight irritation in damaged skin 1 h after administration. The allergic reaction incidence of the positive control group of guinea pigs was 100% while that of any other groups was 0. CONCLUSIONS:The PIB Gutong plaster is safe for trans-dermal administration.

Relationship between gene p53 codon 72 polymorphism and pathological scar formation after caesarean section / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the relationship between gene p53 codon 72 polymorphism and pathological scar formation occurrence after caesarean section.</p><p><b>METHODS</b>The method of molecular beacon with real-time PCR was applied to detect gene polymorphism of p53 codon 72 in blood samples taken from 303 pregnant women (within a week after caesarea section). The clinical visits were taken 3 times for 12th to 18th months to ascertain clinical formation of pathological scar and its relationship to genotype of p53. The chi-square method was used to analyze the relationship of p53 gene polymorphism and abnormal scar formation occurrence by statistical software SPSS 13.0.</p><p><b>RESULTS</b>Total of 303 pregnant women were assayed. 30 patients were found with pathological scar by clinical visit in the total 303 pregnant women. The genotype frequencies of total three types (C/C, C/G and G/G) of p53 gene codon 72 in patients with pathological scar are significantly different from that of normal pregnant woman. The frequency of C/C genotype in patients are higher than that of normal pregnant women (P < 0.01). The frequency of C/C genotype in these patients with pathological scar is higher (46.7%, 14/30) than C/G (33.0%, 10/30, P < 0.01) or G/G (20%, 6/30) genotype (P < 0.01). The C allele frequency in the patients is 63.7%. It is also higher than G allele (36.7%, P < 0.01). The OR value is 2.30. Therefore the C allele of p53 gene codon 72 is a risk factor for pathological scar.</p><p><b>CONCLUSIONS</b>There was a certain relationship between p53 gene codon 72 C allele and pathological scar formation after caesarean section.</p>

Dislocation risk after total hip arthroplasty / 医用生物力学

Objective To investigate and analyze the risk of dislocation failure after total hip arthroplasty (THA). Methods The optical motion capture system was used to obtain the kinematic data of the lower limbs during actions of daily living (ADLs) from normal people. The visual hip prosthesis motion analysis software was designed and developed to measure the maximum safe motion space of the hip prosthesis with different design parameters and judge the safety of the hip prosthesis by analyzing the relative motion relation between the cup and prosthetic stem. Results Based on the measured kinematics data, the motion analysis software could compare the range of motion of the natural joints and that after THA. Thus, the relationship between the dislocation of hip prosthesis and ADLs was obtained and the dislocation risk after THA was investigated. Conclusions There is a high risk when activities that require a high flexion motion are performed, especially for the kneeling and squatting activity.

Association between cell apoptosis and the quality of early mouse embryos / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between cell apoptosis and the quality of early mouse embryos, understand the significance of apoptosis-regulatory genes in early embryonic development, and explore a new approach to improving the embryo quality.</p><p><b>METHODS</b>The levels of cell apoptosis and proliferation in early mouse embryos in different developmental status (morphologically normal embryos, arrested embryos and fragmented embryos) were analyzed with terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), caspase in situ fluorescence and Bcl-2 immunofluorescence, and immunofluorescent detection of proliferating cell nuclear antigen (PCNA).</p><p><b>RESULTS</b>The cells in arrested embryos and embryonic fragments showed positive results in TUNEL assay with enhanced caspase activity and lowered expressions of Bcl-2 and PCNA.</p><p><b>CONCLUSION</b>Cell apoptosis in early mouse embryos may be closely related to embryonic arrest and fragmentation.</p>

Establishment of molecular beacon real-time PCR for detecting p53 gene single nucleotide polymorphism / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a method based on molecular beacon real-time PCR for detecting single nucleotide polymorphisms (SNP) in codon 72 of scar-related p53 gene.</p><p><b>METHODS</b>Two fluorescence-labeled molecular beacon probes were synthesized targeting CCC/CGC SNP of p53 codon 72. The genomic DNA was extracted from the peripheral blood of 28 patients with keloid, and the CCC/CGC SNP of P53 gene codon 72 were assayed with molecular beacon real-time PCR. The results of SNP typing were compared with the results of reverse dot hybridization and confirmed by direct DNA sequencing.</p><p><b>RESULTS</b>The goodness of fit of this method was 100% in comparison with direct DNA sequencing, higher than that of reverse dot hybridization.</p><p><b>CONCLUSION</b>Molecular beacon real-time PCR is suitable for rapid clinical detection of SNPs in p53 gene.</p>

Research traditional Chinese medicine properties by detecting rats' monoamine neurotransmitter after given two different traditional Chinese medicine / 中国中药杂志

<p><b>OBJECTIVE</b>To find out the essence of the traditional Chinese medicine properties from detecting the rats' monoamine neurotransmitter after given different traditional Chinese drug.</p><p><b>METHOD</b>The property of rhizome curcumae and radix curcumae is opposite, they were given to rats respectively for one month. Next, HPLC-ECD method was used to detect the rats' monoamine neurotransmitter in different encephalic region.</p><p><b>RESULT</b>Rhizome curcumae can raise the rats' monoamine neurotransmitter, but radix curcumae inhibits the rats' monoamine neurotransmitter.</p><p><b>CONCLUSION</b>There are correlations between the traditional Chinese medicine properties and monoamine neurotransmitter.</p>

Inhibitory effect of RNA interference targeting BaxBak on apoptosis of human granulosa cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the inhibitory effect of small interfering RNA (siRNA) targeting Bax-Bak on the apoptosis of human granulosa cells.</p><p><b>METHODS</b>Human granulosa cells were transfected with Bax-siRNA and Bak-siRNA either alone or in comibnation, and the cell morphological changes were obsered and the cell apoptosis was detected with flow cytometry. Western blotting was performed to examine the changes in Bax and Bak expressions in the transfected cells.</p><p><b>RESULTS</b>Western blotting demonstrated significantly weakened expressions of Bax and Bak in the transfected cells. The cell morphology of the cells tranfected with Bak siRNA and with both Bak and Bax siRNA remained normal; the cells with exclusive Bax siRNA transfection presented with basically normal cell morphology, but black spots were noted in the cytoplasm. In the positive and negative control groups, the cells became rounded and shrank with expanded intercellular spaces and numerous black spots in the cytoplasm. Flow cytometry showed apoptotic indexes of 3.44% and 3.97% in cells transfected with Bak siRNA and Bax-Bak siRNA, respectively, significantly lower than that in the negative group. Bax siRNA transfection resulted in an apoptotic index of 19.98%, similar to that in the negative group.</p><p><b>CONCLUSION</b>Interference of the expression of Bak gene inhibits the apoptosis of human granulosa cells, and the inhibitory effect can be enhanced by simultaneous Bax interference, which, when used alone, does not obviosuly inhibit the apoptosis of human granulosa cells.</p>

Expression of oxyntomodulin in bifidobacteria and effect of oxyntomodulin-transformed bifidobacteria on the body weight of obese mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of pBBADs-OXM-transformed bifidobacteria on the body weight of obese mice.</p><p><b>METHODS</b>B. longum was transformed with pBBADs-OXM by electroporation, and arabopyranose-induced oxyntomodulin expression by the bacterium was detected by ELISA. pBBADs-OXM-transformed bifidobacteria was administered orally obese mice on a daily basis with pBBADs-GFP-transformed bifidobacteria as the negative control, and the body weight changes of the mice were observed.</p><p><b>RESULTS</b>OXM was detected by ELISA not only in the supernatant but also the precipitant of the transformed bacterial culture. The body weight of the obese mice fed with pBBADs-OXM-transformed bifidobacteria decreased significantly compared with that of the mice in the obese model group (P<0.05).</p><p><b>CONCLUSION</b>Administration of pBBADs-OXM-transformed B.longum can reduce the body weight of obese mice.</p>

BRCA1 regulates progesterone receptors A and B protein expressions in breast cancer cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the regulatory role of BRCA1 in the expression of progesterone receptors A and B (PRA and PRB) in breast cancer cells.</p><p><b>METHODS</b>Breast cancer MCF-7 cells were transfected with pFlag-CMV2-BRCA1 wt plasmid containing a full-length BRCA1 cDNA or with BRCA1-specific siRNA via lipofectamine 2000 to induce overexpression or suppressed expression of BRCA1, respectively. Twenty-four hours after the transfection, the cells were incubated in fresh culture medium containing 100 nmol/L progesterone for 24 h. The total RNA extract or whole cell lysate was prepared for detecting BRCA1, PRA and PRB expressions using RT-PCR and Western blotting.</p><p><b>RESULTS</b>The protein expressions of PRA and PRB were significantly decreased whereas their mRNA expressions remained unchanged in MCF-7 cells overexpressing BRCA1. In MCF-7 cells with BRCA1 knock-down, in contrast, the PRA and PRB protein expressions were markedly increased.</p><p><b>CONCLUSION</b>In breast cancer cells, exogenous and endogenous BRCA1 can both down-regulate the expressions of PRA and PRB at the protein level.</p>

Antitumour effects on human colorectal carcinomas cells by stable silencing of phospholipase C-gamma 1 with lentivirus-delivered siRNA / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In most colorectal carcinomas, the level of phospholipase C (PLC)-gamma 1 expression is greatly elevated. Increased expression of PLC-gamma 1 may play an important role in colon carcinogenesis, but the mechanism is not well known. The aim of this study was to evaluate the role of PLC-gamma 1 in colon carcinogenesis by using recombinant lentivirus that stably suppressed the PLC-gamma 1 expression in human colorectal carcinoma LoVo cells.</p><p><b>METHODS</b>Recombinant lentivirus producing PLC-gamma 1 siRNA were prepared. After LoVo cells were transduced by each lentivirus, stably transduced cells were selected by Blasticidin. The protein and mRNA expression of PLC-gamma 1 were examined by Western-blot and reverse transcription-polymerase chain reaction (RT-PCR) analysis, and the effects of the lentivirus on the cell adhesion, migration and apoptosis were analyzed.</p><p><b>RESULTS</b>Stable LoVo cell line deficient in PLC-gamma 1, was established. Notably, PLC-gamma 1 was silenced without affecting the levels of other subtypes of PLC so that the role of PLC-gamma 1 in colon carcinogenesis could be examined. Silencing of endogenous PLC-gamma 1 resulted in efficient inhibition of the adhesion and migration of LoVo cells in vitro and a great increase of 5-fluorouracil induced apoptosis (30%-40%) of LoVo cells.</p><p><b>CONCLUSIONS</b>PLC-gamma 1 may play an important role in metastasis and anti-apoptosis in human colorectal carcinomas.</p>

The Procaryotic Expression, Purification and Activity Analysis of VIP-sTNFRII / 中国生物工程杂志

A prokaryotic expression plasmid containing VIP (vasoactive intestinal peptide) and sTNFRII(soluble tumor necrosis factor receptor II ) genes was constructed. The sTNFRII was cloned by PCR by using special primers which contained VIP gene ORF and a linker in its forward primer. The amplified fragment was inserted into the expression vector pET32a between BamHI and Hind III restriction sites. Transformed E.coli DH5 by pET32a-VIP- sTNFRIIexpressed the fusion protein. After being identified, the protein was purified by ion exchange chromatography and by hydrophobic interaction chromatography. The reconstructed protein showed high bio-activity and could be applied for further use.

p53 gene codon 72 polymorphism and susceptibility to keloid / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between p53 codon 72 polymorphism and susceptibility to keloid in a southern Chinese population.</p><p><b>METHODS</b>The p53 genotypes were determined by polymerase chain reaction-reverse dot blot (PCR-RDB) and DNA direct sequencing in 45 patients with keloid and 60 unrelated healthy controls.</p><p><b>RESULTS</b>The frequency of the p53 Pro allele among keloid patients was significantly higher than that among healthy controls (chi2 = 4.485, P = 0.034). The Pro/Arg and Arg/Arg genotype distribution among keloid patients was not significantly different from that among healthy controls (chi2 = 0.949, 1.346; P = 0.330, 0.246, respectively). However, the Pro/Pro genotype frequency among keloid patients was significantly higher than that among healthy controls (chi2 = 4.375, P = 0.036). The p53 Pro/Pro genotype significantly increased the risk for developing keloid, compared to the combination of Pro/Arg and Arg/Arg genotypes,with the odds ratio (OR) of 2.400 (95%CI: 1.048-5.498).</p><p><b>CONCLUSIONS</b>Determination of the p53 codon 72 genotype may be used as a stratification marker to predicate high-risk individuals for keloid.</p>