The potential of galactomannan from Caesalpinia ferrea on erosive dentin wear reduction in vitro

Abstract Gels containing juca seed galactomannan (JSG) were evaluated for their potential to prevent the progression of dentin erosive wear in an in vitro study with four experimental groups (n = 9). The treatments included distilled water (DW), 0.05% stannous fluoride (121 ppm F), and 0.5% or 1% JSG. The specimens underwent a cycle (3 times/day) consisting of immersion in 1% citric acid (5 minutes), treatment (5 minutes), and artificial saliva exposure (2 hours/overnight) for 5 days. Surface changes were assessed using mechanical profilometry (wear), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). The data were analyzed using ANOVA followed by Tukey's post-test (p < 0.05). The negative control group exhibited the highest wear (6.0 µm ± 3.5), significantly differing from the group treated with 0.05% stannous fluoride gel (p = 0.007), which showed less dentin loss. The groups treated with 0.5% and 1% JSG showed results similar to the negative control (p = 0.661; p = 0.212, respectively) and the stannous fluoride group (p = 0.103; p = 0.379, respectively). In the SEM images, the specimen treated with stannous fluoride showed obliterated tubules, while the JSG gels formed crystals on the dentin surface, as confirmed by the presence of oxygen and calcium in the EDS analysis. Although the JSG gels showed similar results to the stannous fluoride, did not exhibit superior efficacy at the tested concentrations.

Resumo Géis contendo galactomanana da semente de jucá (GSJ) foram avaliados quanto ao seu potencial na prevenção da progressão do desgaste erosivo dentinário em um estudo in vitro com quatro grupos experimentais (n = 9). Os tratamentos incluíram água destilada (AD), 0,05% de fluoreto de estanho (121 ppm F) e 0,5% ou 1% de GSJ. Os espécimes passaram por um ciclo (3 vezes ao dia) que consistia em imersão em ácido cítrico 1% (5 minutos), tratamento (5 minutos) e exposição a saliva artificial (2 horas/durante a noite) por 5 dias. As alterações de superfície foram avaliadas utilizando perfilometria mecânica (desgaste), microscopia eletrônica de varredura (MEV) e espectroscopia de raios-X por dispersão de energia (EDS). Os dados foram analisados por ANOVA, seguida do pós-teste de Tukey (p < 0,05). O grupo controle negativo apresentou o maior desgaste (6,0 µm ± 3,5), diferindo significativamente do grupo tratado com gel de fluoreto de estanho a 0,05% (p = 0,007), que apresentou menor perda de dentina. Os grupos tratados com 0,5% e 1% de GSJ apresentaram resultados semelhantes ao grupo controle negativo (p = 0,661; p = 0,212, respectivamente) e ao grupo de fluoreto de estanho (p = 0,103; p = 0,379, respectivamente). Nas imagens de MEV, o espécime tratado com fluoreto de estanho mostrou túbulos obliterados, enquanto os géis GSJ formaram cristais na superfície da dentina, como confirmado pela presença de oxigênio e cálcio na análise de EDS. Embora os géis GSJ tenham apresentado resultados semelhantes ao fluoreto de estanho, eles não demonstraram eficácia superior nas concentrações testadas.

Compromiso del parénquima pulmonar secundaria a la inyección subcutánea de geles de silicona: reporte de caso

El compromiso del parénquima pulmonar secundario a la inyección subcutánea de geles de silicona es un cuadro de presentación excepcional, que se presenta con mayor frecuencia en mujeres entre los 22 a 55 años. Aunque se han planteado distintas teorías sobre su etiología, esta se desconoce y puede presentar complicaciones locales, sistémicas e incluso tener un desenlace fatal. Son pocos los casos reportados en América del Sur, y en el Perú no existe reporte alguno de esta singular entidad. Se presenta el caso de un paciente varón de 28 años, transexual, previamente sano, quien tras la inyección subcutánea de geles de silicona en la región glútea, en forma ilegal y por una persona que no es profesional de la salud, manifestó, dentro de las primeras 24 horas, un cuadro clínico caracterizado por dificultad respiratoria progresiva y dolor torácico punzante de aproximadamente 7 de 10 en la escala del dolor. Al ingresar a emergencias se evidenció de manera objetiva insuficiencia respiratoria, ya que el paciente presentó una saturación de oxígeno del 72 % a Fio₂: 21 %, asimismo, el compromiso del parénquima pulmonar tanto en la tomografía y radiografía de tórax con signos muy sugerentes de esta patología. Mediante la prueba ARN para SARS-CoV-2 en la muestra respiratoria por RT-PCR en tiempo real se descartó la neumonía secundaria al virus SARS-CoV-2, igualmente se excluyó la patología por inmunosupresión y tromboembolismo pulmonar. Debido a que no existe un tratamiento estandarizado se le brindó las medidas de soporte pertinentes, tales como administración de oxígeno suplementario a bajo flujo por cánula binasal, corticoides sistémicos vía endovenosa, además de antibioticoterapia, y se logró una evolución favorable con resolución del cuadro clínico inicial. Después de 10 días de tratamiento intrahospitalario el paciente fue dado de alta.

Pulmonary parenchymal involvement secondary to the subcutaneous injection of silicone gels is an unusual condition which occurs more frequently in women aged between 22 and 55 years. Although different theories have been put forward about its etiology, it is unknown and the condition may cause local and systemic complications and even have a fatal outcome. Few cases have been reported in South America and there is no report of this unique entity in Peru. We present the case of a previously healthy 28-year-old male transgender patient who, after an illegal subcutaneous injection of silicone gels in the gluteal region given by a non-healthcare professional, showed progressive respiratory distress and stabbing chest pain of approximately 7 out of 10 on the pain scale within the first 24 hours. Upon admission to the emergency room, respiratory failure was objectively evidenced since the patient had an oxygen saturation of 72 % at a FiO₂ of 21 %, as well as pulmonary parenchymal involvement both in the CT scan and chest X-ray with signs highly suggestive of this pathology. Using a SARS-CoV-2 RNA real-time RT-PCR test performed on a respiratory specimen, COVID pneumonia, immunodeficiency disorders and pulmonary embolism were ruled out. Since there is no standard treatment, the patient was given relevant support measures such as the administration of supplemental oxygen at a low flow rate by binasal cannula, intravenous systemic corticosteroids and antibiotic therapy, thus achieving good progress with resolution of the initial clinical presentation. Then, after 10 days of intrahospital treatment, the patient was discharged.

Prevención de hipoglicemia neonatal en recién nacidos con factores de riesgo mediante la administración bucal de una dosis de gel de dextrosa al 40%: ensayo clínico aleatorizado / Prevention of neonatal hypoglycemia in newborns with risk factors by buccal administration of a dose of 40% dextrose gel: randomized clinical trial / Prevenção da hipoglicemia neonatal em recém-nascidos com fatores de risco através da ingestão bucal de gel de dextrose no 40%: ensaio clínico randomizado

Introducción: la hipoglicemia neonatal es un trastorno metabólico frecuente en neonatos, con mayor incidencia en aquellos con factores de riesgo como ser hijos de madre diabética, pequeño para la edad gestacional y pretérmino tardíos. Material y métodos: se realizó un ensayo analítico aleatorizado, controlado por placebo para evaluar la eficacia de la administración de gel de dextrosa al 40% para la prevención de hipoglicemia neonatal en esta población. Se reclutaron un total de 120 pacientes. Resultados: se encontró una menor incidencia de hipoglicemia neonatal al compararla con la incidencia reportada en la literatura internacional. No se encontraron diferencias estadísticamente significativas en cuanto al número de ingresos a áreas de internación para tratamiento de hipoglicemia ni en la alimentación a pecho directo exclusivo al alta entre los grupos. Conclusiones: el gel de dextrosa al 40% en recién nacidos podría ser un tratamiento alternativo para profilaxis de hipoglicemia en recién nacidos con factores de riesgo.

Introduction: neonatal hypoglycemia is a frequent metabolic disorder in neonates, with a higher incidence in those with risk factors such as being children of diabetic mothers, small for gestational age, and late preterm. Methodology: a randomized, placebo controlled analytic trial was conducted to evaluate the efficacy of 40% dextrose gel administration for the prevention of neonatal hypoglycemia in this population. A total of 120 patients were recruited. Results: a lower incidence of neonatal hypoglycemia was found when compared to the incidence reported in the international literature. No statistically significant differences were found in terms of the number of admissions to inpatient areas for hypoglycemia treatment or exclusive direct breastfeeding at discharge between the groups. Conclusions: 40% dextrose gel in newborns could be an alternative treatment for hypoglycemia prophylaxis in newborns with risk factors.

Introdução: a hipoglicemia neonatal é um disturbio metabólico comum em neonatos, com maior incidencia naqueles que apresentam fatores de risco, tais como filhos de mães diabéticas, pequenos para a idade gestacional e prematuros tardios. Metodologia: foi realizado um ensaio analítico randomizado e controlado por placebo para avaliar a eficácia da administração de gel de dextrose a 40% para prevenção de hipoglicemia neonatal nesta população. Um total de 120 pacientes foram recrutados. Resultados: foi encontrada menor incidência de hipoglicemia neonatal quando comparada com a incidência relatada na literatura internacional. Não foram encontradas diferenças estatisticamente significativas relativas ao número de internações em áreas de internação para tratamento de hipoglicemia ou aleitamento materno direto exclusivo para descarga entre os grupos. Conclusões: o gel de dextrose a 40% em recém nascidos pode ser uma alternativa de tratamento para profilaxia de hipoglicemia em recém nascidos com fatores de risco.

Explante de silicone mamário: um estudo longitudinal multicêntrico / Breast silicone explant: a multicenter longitudinal study

Introdução: Após a colocação de implantes mamários de silicone, algumas pacientes apresentam sintomas descritos como doença do implante mamário e buscam a cirurgia de explante. O objetivo deste estudo é analisar o histórico de sintomas e verificar as impressões dos pacientes submetidos ao explante mamário em três momentos distintos: antes de colocar os implantes mamários, enquanto estavam com os implantes e após a cirurgia de explante. Métodos: Essa pesquisa foi delineada como um estudo observacional longitudinal multicêntrico utilizando um questionário on-line de participação voluntária enviado por e-mail. Resultados: Foram analisados 156 pacientes, 84% apresentavam três ou mais sintomas e 66,1% destes obtiveram melhora de sua sintomatologia após o explante (p<0,001). Antes da colocação de silicone, a mediana de autossatisfação corporal era de 7, enquanto estavam com os implantes a mediana tornou-se 9 e após a cirurgia de explante a mediana se manteve em 9 (p<0,001). Grupos de apoio em redes sociais auxiliaram na decisão de fazer o explante em 87,2% das pacientes. Conclusão: Pacientes que têm sintomas após colocarem silicone apresentam melhora com a retirada dos implantes mamários. A autossatisfação corporal aumenta com a colocação de implantes mamários e permanece elevada após a retirada destes. Pacientes que fazem a cirurgia do explante costumam estar arrependidas de terem colocado silicone, muito satisfeitas com a decisão de removêlos e igualmente satisfeitas com o resultado da cirurgia de explante mamário. Grupos de apoio em redes sociais foram importantes na tomada de decisão destas pacientes.

Introduction: Following silicone breast implant placement, some patients present symptoms described as breast implant illness and seek explant surgery. This study aims to analyze the historical symptoms and ascertain breast explant patients' impressions at three different times: before breast implant placement while having the implants, and after the explant surgery. Methods: This survey was designed as a multicenter longitudinal observational study using an online voluntary participation questionnaire sent by e-mail. Results: 156 patients were analyzed, 84% had three or more symptoms, and 66.1% improved their symptoms after the explant (p<0.001). Before the placement of silicone, the median self-body satisfaction was 7, while with the implants, the median became 9, and after the explant surgery, the median remained up to 9 (p<0.001). Support groups on social networks helped in the decision to explant in 87.2% of the patients. Conclusion: Patients presenting symptoms after silicone placement show improvement with breast implant removal. Body self-satisfaction increases with the placement of breast implants and remains increased after their removal. Patients who undergo the explant surgery usually regret having implanted silicone; they are very satisfied with the decision to remove them and equally satisfied with the result of the breast explant surgery. Support groups on social networks were important in the decision-making of these patients.

Evaluation of Antimicrobial Activity of Chlorhexidine-Containing Oral Gels against Aspiration Pneumonia-Inducing Bacteria: An In Vitro Study

Aim: Hospitalised patients have a high risk of developing aspiration pneumonia because of poor oral care and oral microbial flora changes. Chlorhexidine (CHX) solution has been used to reduce inflammation and prevent infections in oral cavity, but it is difficult to use in inpatients. Gel?type antimicrobial agents rather than the liquid form may be effective for the oral management of hospitalised patients. Therefore, we evaluated the in vitro antimicrobial effects of CHX?containing oral gels on aspiration pneumonia?inducing bacteria compared to the CHX solution. Materials and Methods: The experimental products of two oral gel types containing 1% and 0.1% CHX, respectively, were selected. Hexamedine, a 0.12% CHX solution, was used as a positive control. The antimicrobial activity of CHX agents against six pneumonia?causing bacteria and Streptococcus mutans, one of the most common oral bacteria, was comparatively analysed using the agar disk diffusion method. Results: In the disk diffusion assay, the 1% CHX gels showed the highest inhibitory effect on all bacteria. All CHX agents including gels and solution had the highest antibacterial activity against Staphylococcus aureus compared with other bacteria. Conclusions: We confirmed the significant antimicrobial effects of the 1% CHX oral gels on aspiration pneumonia?inducing bacteria. These results suggest that CHX gels may be an effective oral care method for preventing infection in inpatients who have difficulty using the solution.

Efficacy of aggregation nano gel pheromone traps on the catchability of Rhynchophorus ferrugineus (Olivier) in Egypt / Eficácia das armadilhas de feromônio de nano gel de agregação na capturabilidade de Rhynchophorus ferrugineus (Olivier) no Egito

Field experiments were carried out in the reclaimed land east of Cairo-Alexandria Desert Road, Village of Wardan, Giza Governorate, Egypt, to evaluate the impact of using nano-gels pheromone for the first time on the attraction of the RPW adults by pheromone traps compared to the control which is normal pheromone during two successive seasons in 2018 and 2019. Also, this study aimed to compare the efficacy of two types of trap, traditional trap (type 1) and dry funnel trap (type 2) in capturing of RPW adults. Results revealed that the nano gel pheromone traps attracted significantly more adults with an average of (4.26 and 3.56) adults/trap and total of (55.33 and 46.33) adults/trap compared to control with an average (2.69 and 2.46) and total of (35.00 and 32.00) adults/trap for the two seasons 2018 and 2019 respectively. Results indicated that the use of nano gel pheromone for the first time in field improved the trap catchability to RPW adults by 22.51 and 18.30% of total number of RPW adults captured throw out the two successive seasons respectively. In addition, there was no significant difference between the total numbers of RPW adults collected by the two tested type of traps over the two successive seasons. Furthermore, the sex ratio between males and females of total collected RPW adults found to be1: 1.43 and 1: 1.94 at 2018 and 2019 respectively.

Experimentos de campo foram realizados na terra recuperada a leste da estrada do deserto de Cairo-Alexandria, vila de Wardan, província de Giza, Egito, para avaliar o impacto do uso de feromônio de nano géis pela primeira vez na atração de adultos RPW por armadilhas de feromônio comparado ao controle que é o feromônio normal durante duas temporadas sucessivas em 2018 e 2019. Além disso, este estudo teve como objetivo comparar a eficácia de dois tipos de armadilha, armadilha tradicional (tipo 1) e armadilha de funil seco (tipo 2) na captura de RPW adultos. Os resultados revelaram que as armadilhas de nano gel de feromônio atraíram significativamente mais adultos, com uma média de (4,26 e 3,56) adultos/armadilha e total de (55,33 e 46,33) adultos/armadilha em comparação ao controle com uma média (2,69 e 2,46) e total de (35.00 e 32.00) adultos/armadilha para as duas temporadas 2018 e 2019, respectivamente. Os resultados indicaram que o uso de feromônio nano gel pela primeira vez em campo melhorou a capturabilidade de armadilhas para adultos com RPW em 22,51 e 18,30% do número total de adultos com RPW capturados durante as duas estações sucessivas, respectivamente. Além disso, não houve diferença significativa entre o número total de adultos RPW coletados pelos dois tipos de armadilhas testados ao longo das duas estações sucessivas. Além disso, a proporção sexual entre homens e mulheres do total de adultos coletados de RPW foi de 1: 1,43 e 1: 1,94 em 2018 e 2019, respectivamente.

Passado, presente e futuro utilizando implantes mamários de silicone no Brasil, um relato de 45 anos / Past, present and future using silicone breast implants in Brazil, a 45-year report

O autor conviveu com implantes mamários e relata a história da evolução em seus 45 anos de experiência. Aponta os pontos principais dessa evolução, as coincidências e as complicações no transcorrer do tempo, e propõe ao final acontecimentos possíveis no futuro.

The author lived with breast implants and tells the story of evolution in his 45 years of experience. It points out the main points of this evolution, the coincidences, and complications over time, and proposes possible future events in the end.

Tratamento cirúrgico de ptose mamária com inclusão de prótese de silicone: avaliação de resultados cirúrgicos e satisfação de pacientes / Surgical treatment for breast ptosis with silicone prosthesis: evaluation of surgical results and patient satisfaction

Introdução: A correção da ptose mamária associada à flacidez de pele é corrigida através da mastopexia com inclusão de implante. O objetivo deste trabalho foi avaliar os resultados cirúrgicos e a satisfação de pacientes submetidas à cirurgia de ptose mamária com inclusão de prótese de silicone. Métodos: Foram selecionadas 22 pacientes submetidas à mastopexia com inclusão de implante, no período de fevereiro a setembro de 2016, no Serviço de Cirurgia Plástica do Hospital Heliópolis. Foi realizada entrevista com as pacientes, por meio de aplicação de questionário, com a finalidade de verificar o grau de satisfação e as alterações no cotidiano diário após a cirurgia. A avaliação dos resultados cirúrgicos foi realizada mediante avaliação de três cirurgiões, do qual atribuíram notas a diferentes itens. Resultados: 100% das entrevistadas se sentem satisfeita com a cirurgia e todas relataram a melhora da autoestima delas. Na avaliação das cirurgias realizada com os cirurgiões, cerca de 91% dos resultados estão entre regular e bom. Conclusão: O grau de satisfação das pacientes submetidas à mastopexia com inserção foi excelente e houve impacto favorável na qualidade de vida e bem-estar das pacientes avaliadas, sendo que o resultado pós-cirúrgico se enquadra como regular ou bom.

Introduction: The correction of breast ptosis associated with skin flaccidity is done through mastopexy with the inclusion of an implant. This work's objective was to evaluate the surgical results and the satisfaction of patients who underwent breast ptosis surgery with silicone prosthesis placement. Methods: We selected 22 patients who underwent mastopexy with implant placement, from February to September 2016, at the Plastic Surgery Service of Hospital Heliópolis. Interviews were conducted applying to the patients a questionnaire to verify the degree of satisfaction and changes in the daily routine after surgery. The surgical results evaluation was carried out by three surgeons, who attributed scores to different items. Results: 100% of the interviewees feel satisfied with the surgery, and all reported an improvement in their self-esteem. In the evaluation of surgeries performed with surgeons, about 91% of the results are between regular and good. Conclusion: The degree of patient's satisfaction who underwent mastopexy with insertion was excellent. There was a favorable impact on the quality of life and well-being of the patients evaluated, with the post-surgical result being classified as regular or good.

Comparative Evaluation of Clinical Anaesthetic Efficacy of 15 % Lidocaine Spray and 20 % Benzocaine Gel during Removal of Arch Bars

Application of arch bar is considered as a gold standard for intermaxillary fixation (IMF) in the management of mandibular fractures. Both the application and removal of arch bars can inflict pain for patients who require IMF. For removal of the arch bars, local anaesthesia (local infiltration or conduction block) is often indicated. The study aimed at comparing and validating the efficacy of topical lidocaine spray and benzocaine gel in patients undergoing removal of arch bars. METHODS30 subjects were included in this prospective randomized controlled trial. Maxillary arch was chosen as the test site. 10 patients (Group A) were anaesthetized in the upper gingiva with 15 % lidocaine spray and remaining 10 patients (Group B) were anaesthetized with 20 % benzocaine gel, following which removal of arch bar was done. 10 patients were included in the control group (Group C) where 2 % lignocaine infiltration was offered only on request. Visual analog scale and Wong-Baker Faces Pain Rating Scale was used to measure the pain perceived by the patient during the procedure. RESULTSThe mean and standard deviation of the pain scores of Group A was 2.5 ± 0.70, Group B was 2.7 ± 0.67 and Control group was 5.5 ± 0.85. Both the test groups had a significant pain reduction when compared with the control group. CONCLUSIONSTopical application of both 15 % lidocaine spray and 20 % benzocaine gel provided equally efficient analgesia and can be useful alternatives to conventional local anaesthetic infiltration during arch bar removal.

Self-assembled small molecule natural product gel for drug delivery: a breakthrough in new application of small molecule natural products

Natural products, as a gift of nature to humanity, have long been used as drugs or pharmacological actives to help people cure various diseases. Yet we still know comparatively little about their ability to be materials. In recent years, some small molecule natural products isolated from traditional Chinese medicines have been found to have new features, namely, self-assembly to form gels (., natural product gels, NPG). However, the application development of these natural products is seriously lacking, which greatly weakens their practical value and delays the maturity of the field. Here, a series of self-assembled triterpenoid natural products are used as materials (gel scaffolds) to construct drug delivery systems. Surprisingly, these NPG not only exhibit the excellent self-healing, controlled gelation, good safety and sustained release, but also achieve synergistic treatment of tumors through bioactive natural products. Compared with non-bioactive gel scaffolds, NPG scaffolds show great advantages in tumor therapy, including optimal tumor inhibition, preferable health, better body recovery, stronger immune function, less toxic side effects and longer survival. The successful construction of NPG scaffolds not only takes full advantage of the self-assembled natural products, but also takes an important step in the development of new applications for natural products.

Effect of (, TLZT) gel preparation on p53 /miR-502-5p /NF-κBp65 in synovial tissue of knee osteoarthritis / 中国骨伤

OBJECTIVE@#To observe effects of (, TLZT) gel preparation on p53, miR-502-5p, NF-κBp65 in synovial tissue of knee osteoarthritis (KOA), and to explore mechanism of TLZT gel preparation in treating KOA.@*METHODS@#Thirthy-six Wistar rats aged 8 weeks and weighed 200 to 220 g (meaned 208 g) were randomly divided into normal group, model group and traditional Chinese medicine (TCM) group, 12 rats in each group. KOA model was established by modified Hulth method. After 4 weeks of modeling, TCM group treated with TLZT gel preparation for external use, 3 times daily for 2 weeks;normal group and model group were fed normally without intervention. After treatment, morphological changes of specimens in each group were observed, changes of miR-502-5p in synovial tissue were detected by qPCR, and contents of p53, NF-κBp65, IL-1β, TNF-α, MMP-13 in synovial tissue were detected by qPCR and Western Blot respectively.@*RESULTS@#(1)Morphological observation of specimens showed that the articular cartilage in model group was hyaline and uneven, the synovial membranes were hypertrophic and proliferative with a large number of inflammatory cells infiltrating, the joint fluid was thicker in texture;the articular cartilage in TCM group was more transparent and smooth, synovial hyperplasia was mild with a small amount of inflammatory cell infiltration, the texture of articular fluid was clear and sparse. (2) Compared with normal group, content of miR-502-5p of synovial tissue in model and TCM group were increased, mRNA and expression of p53 decreased, expression of NF-κBp65, IL-1β, TNF-α, MMP-13 increased. (3)Compared with model group, content of miR-502-5p in synovial tissue of TCM group decreased (<0.05), mRNA and protein expression of p53 increased (<0.05), mRNA and protein expression of NF-κBp65, IL-1β, TNF-α, MMP-13 decreased (<0.05).@*CONCLUSION@#Expression of p53, miR-502 -5p, NF -κBp65 in synovial tissue is closely related to synovial hyperplasia and inflammatory reaction, TLZT gel preparation may reduce proliferation and inflammatory reaction of KOA synovium by regulating the expression of p53, miR- 502-5p, NF-κBp65 in synovial tissues.

Technical Specification (Draft) for Clinical External Application of Traditional Chinese Medicine Gels / 中国实验方剂学杂志

Based on the data mining of clinical application of traditional Chinese medicine (TCM) gels, and combined with the actual clinical application and related experimental research, the technical specification (draft) for clinical application of TCM gels was formed after repeated demonstration by experts from the external treatment branch. This technical specification (draft) includes indications, contraindications, pre-medication evaluation, preparation before medication, preparation of gels, clinical application methods of gels, frequency of administration, period of treatment, evaluation after medication, matters needing attention, adverse reactions and countermeasures. The purpose of this paper is to standardize the clinical application of TCM gels, improve the curative effect of this preparation, and reduce its adverse reactions.

Host response in vivo and the expression of IL-4 in different cross-linked hyaluronic acid composite gels / 国际生物医学工程杂志

Objective To observe the host response and the expression of interleukin-4 (IL-4) in different cross-linked hyaluronic acid composite gels at different time points after the implantation in vivo, and to explore the significance of biocompatibility and macrophage polarization in post-implantation inflammatory response and tissue remodeling. Methods New Zealand white rabbits were respectively injected with crosslinked hyaluronic acid-crosslinked hydroxypropyl methylcellulose gel (sample 1), crosslinked hyaluronic acid-hydroxypropyl methylcellulose gel (sample 2) and commercially available modified sodium hyaluronate gel (control) in subcutaneous tissue at both sides of the spine. Then the rabbits were dissected at 1, 4 and 12 weeks after the implantation. The tissues were fixed with 10％formaldehyde solution, embedded in paraffin and sliced. Hematoxylin-eosin (HE) staining was performed to observe the degree of inflammation and fibrosis. Masson staining was performed to observe the formation of collagen fibers. Immunohistochemical staining was performed to observe the expression of IL-4. Results The results of HE staining showed that the inflammatory reaction in the sample 1 and sample 2 groups was significantly higher than that in the control group 1 and 4 weeks after the implantation. The inflammatory cells aggregated, and the wall of capsule and microcapsule was thick. The sample 1 group was more obvious, and the result was mild stimulation. For all the groups, the results were all non-irritating at 12 weeks after the implantation. The results of Masson staining showed that the collagen fibers in the sample 1 and sample 2 groups were increased compared with the control group, mainly distributed around the implantation site, and a small amount among the gels after 1 and 4 weeks. After 12 weeks, the collagen fibers were further increased, especially among the gels, which were consistent with the control group. The results of immunohistochemical staining showed that, at the same time point, the expression of IL-4 in sample 1 and sample 2 groups was higher than that in the control group, and the expression of IL-4 increased gradually with time. The expression of IL-4 in the control and sample 1 group at 12 weeks after the implantation was higher than that at 1 and 4 weeks respectively, and the differences were statistically significant (all P<0.05). In the sample 1 group, the expression of IL-4 at 12 weeks after the implantation was higher than that at 1 week, and the difference was statistically significant (P<0.05). The expression of IL-4 in the sample 1 group was significantly higher than that in the control group at 4 weeks after the implantation, and the difference was statistically significant (P<0.05). Conclusions The two different cross-linked sodium hyaluronate composite gels have good biocompatibility. The formation of collagen fiber and the expression of IL-4 can gradually increased within 12 weeks after the subcutaneous implantation, which is beneficial to the tissue remodeling.

Optimized the preparation process of thermo-sensitive Yinhuang ophthalimic gel by central composite design-response surface method / 国际中医中药杂志

Objective To optimize the preparation technology of thermo-reversible Yinhuang opthalimic gel by the central composite design-response surface method.Methods The poloxamer 407 and poloxamer 188 were used as the investigation factors, and the evaluation index was the gel temperature. Central composite design-response surface method was used to evaluate the mathematic relation between the evaluation index and tow investigation indexes to identify the optimum prescription.Results According to the quadratic models, it was found that there was reliable quantitative relation between the evaluation index and two investigation indexes,among which the optimun dosage was 20％ for P407, 1％ for P188, 0.1％ for hyaluronic acid, 0.01％ for benzalkonium chloride, 0.02％ for EDTA.Conclusions This method is reliable and feasible, whicn can realize the prescription optimization of the gel.

Complications of polyacrylamide hydrogel injection for breast augmentation: A case report and literature review

Polyacrylamide hydrogel (PAAG) was developed in the 1980s as an injectable filler for breast augmentation and tissue contour improvement, but its potential risk for oncogenesis and the frequent occurrence of chronic complications after injections led to the prohibition of its further use as an injectable material. Although breast augmentation with PAAG injections was mostly performed in China and Eastern Europe, the migration of patients and long-term complications of the procedure made it a global concern. Herein, we describe the case of a 49-year-old woman who immigrated to Korea after undergoing breast augmentation via PAAG injection in China, and complained of persistent mastodynia and retraction of both breasts. Surgical treatment was undertaken, along with removal of the PAAG and total capsulectomy of the fibrous capsule containing the gel through an inframammary fold incision. We share our experience of diagnosing and treating this case, and present a literature review.

Compatibility of raw material and excipients in dexmetomidine hydrochloride gel / 国际药学研究杂志

Objective: To establish a method for the determination of related substances in dexmetomidine hy- drochloride gels,and investigate the compatibility of dexmedetomidine hydrochloride and excipients in the dexmetomi- dine hydrochloride gels. Methods: HPLC was performed on an octadecylsilane bonded silica gel column by a gradient elution with acetonitrile/0.008 mol/L NaH2PO4 solution as mobile phase. Flow rate was 1.0 ml/min. Column temperature was 30℃. Injection volume was 50 μl. Detection wavelength was 210 nm. According to the Basic Technical Guidelines for the Research of Chemical Drug Preparations,dexmetomidine hydrochloride was mixed with excipients in a certain propor- tion,and the mixtures were treated as test sample at the conditions of high temperature(60℃)and strong light(4500± 500)Lx irradiation. Sampling was performed on the 0,10th and 30th day of treatment,respectively. The appearance of the test samples was examined,and related substances in the samples were determined by the established HPLC method. Results: The established HPLC method showed a good specificity and durability,which could be used to accurately and effectively determine the changes of related substances. The appearance of the test samples the mixtures of dexmetomi- dine hydrochloride and excipients showed no changes in the full course of treatment at the tested conditions,and the re- lated substances were also not increased under the same conditions. Conclusion: The selected excipients(HPMC,pro- pylene glycol,methylparaben,sodium benzoate,and benzyl alcohol)all showed a good compatibility with dexmetomi- dine hydrochloride,and the tested mixture samples with the excipients and dexmetomidine hydrochloride were stable un- der the conditions of high temperature and strong light irradiation. These excipients could be used for the formulation screening for the dexmedetomidine hydrochloride gel development.

Manejo de cicatrizes com uso de placas e gel de silicone / Management of scars with the use of silicone gel and sheets

A formação de cicatriz é a resposta de cura natural da pele para restabelecer a integridade dérmica após uma lesão. As cicatrizes, além de inestéticas, podem ainda apresentar-se hipertróficas ou queloidianas, tornando o tratamento difícil e, por vezes, insatisfatório. A etnia e a localização da ferida desempenham um papel importante na gênese dos tipos de cicatriz, mas nem sempre podemos prever o resultado final. O uso do silicone tópico tem sido uma opção para o manejo da cicatriz e alvo de diversas publicações ao longo dos anos. Acredita- se que o uso precoce possa prevenir o desenvolvimento de cicatrizes anormais e tratar cicatrizes existentes.

Scar formation is the natural healing response of the skin to reestablish dermal integrity after an injury. Besides being unsightly, the scars can also be hypertrophic or keloids, which makes treatment challenging and many times unsatisfactory. Ethnicity and site of the lesion have an important role in the formation of scar types, but it is not always possible to predict the final result. The use of topical silicone has been an option for scar management and the target of many publications over the years. It is believed that its early use can prevent the development of abnormal scars and treat existing scars.

Transdermal characteristics and mechanism of asiaticoside nanoemulsions and asiaticoside nanoemulsions-based gels / 中国中药杂志

To prepare the asiaticoside nanoemulsions (ASI-NEs) and asiaticoside nanoemulsions-based gels (ASI-NBGs), compare them with the commercial cream of asiaticoside (ASI-C) in terms of transdermal characteristics, and investigate the transdermal mechanism of ASI-NEs and ASI-NBGs. Their transdermal characteristics were studied by using Franz diffusion cells. The effect of topical ASI-NEs and ASI-NBGs on ultrastructure of rabbit skin was evaluated by using HE staining method. The localization and the permeation pathway of asiaticoside were visually investigated by using laser scanning confocal microscope (CLSM). The transdermal studies in vitro showed that the cumulative amount of ASI permeated from ASI-NEs and ASI-NBGs at 12 h after application were (3 504.30±180.93), (1 187.40±128.88) μg·cm⁻² respectively, 6.57, 2.23 times of that in the control group of ASI-C; the drug deposition of ASI-NEs and ASI-NBGs in skin was (159.48±7.47), (120.53±5.71) μg·cm⁻² respectively, 5.93, 4.48 times of that of ASI-C. HE staining of the rabbit skin after application of ASI-NEs and ASI-NBGs showed that the epidermis structure was basically intact; stratum corneum was loosed and the keratin fragment was increased; at the same time, the gap of prickle cell was increased and the basal cells were arranged loosely. The study of CLSM showed that significant percutaneous enhancer effect was observed for ASI-NEs after the topical application of 6 h, as the fluorescent compound was penetrated in the dermis and diffused uniformly. The fluorescence area and the integral optical density (IOD) were 28.81, 32.51 times of that in the FITC aqueous solution group, respectively. The fluorescent preparations showed strong fluorescence in the epidermis, but weak in deeper layers; with the increase of treatment time, the fluorescence in deeper layer was increased and stronger in skin appendages. The prepared ASI-NEs and ASI-NBGs have good transdermal characteristics and the transdermal mechanism is related to breaking the ultrastructure of stratum corneum and penetrating by the path of skin adnexa.

Quantitative analysis of the therapeutic effect of topical medication for seborrheic dermatitis / 中华全科医师杂志

Fifty one female outpatients with facial seborrheic dermatitis attending in Xuanwu Hospital during February 2016 to July 2016 were randomly assigned in two groups:28 patients were treated with hyaluronic acid gel(study group)and 23 patients were treated with tacrolimus ointment(control group) for 28 days.The improvement of symptoms after treatment was observed by a questionnaire,and VISIA was used to quantify the skin index of the patients.There was no difference in the therapeutic effect between the study group and control group after 28 days(P>0.05).The facial spots and red areas were decreased in both groups,compared to those before treatment(P<0.05).The results indicate that hyaluronic acid gel is safe,non-irritating and effective in treatment of seborrheic dermatitis,and VISIA provides an objective and effective method for assessing the skin lesions seborrheic dermatitis.

Preparation of thermosensitive intestinal gels of Houttuynia cordata volatile oils HPCD inclusion compound / 中成药

AIM To prepare the thermosensitive intestinal gels of Houttuynia cordata Thunb volatile oils hydroxypropyl-β-cyclodextrin (HPCD) inclusion compound.METHODS For the gels prepared by cold dissolving method,poloxamer 407 consumption and poloxamer 188 consumption were taken as influencing factors,together with phase transition temperature as an evaluation index,central composite design-response surface method was applied to optimizing the formulation.With 2-undecanone as an index component,the gels' dissolution rate and in vitro release rate were investigated by non-membrane dissolution method and dialysis bag method respectively,whose stability was then evaluated by high temperature (40,60 ℃),low temperature (4 ℃),strong light [(4 500 ±500) 1x] and acceleration (three months) tests.RESULTS The optimal conditions were determined to be 20.61％ for P407 consumption and 3.03％ for P188 consumption,the phase transition temperature was 36.5 ℃.Within the time range of 30-150 min,the HPCD inclusion compound gels exhibited higher accumulative dissolution rate than the volatile oils gels,which tended to be consistent in 150-210 min,but the former exhibited higher accmulative release rate (0-50 h) than the latter all the time.The obtained gels showed good stability at low temperature,whose appearance,characteristic (except for high temperature) and pH were stable at high temperature,strong light and acceleration with obviously decreased 2-undecanone content.CONCLUSION The thermosensitive intestinal gels of Houttuynia cordata Thunb volatile oils HPCD inclusion compound should be stored at low temperature (4 ℃).