Effects of nanographene oxide on adipose-derived stem cell cryopreservation.

Cryoinjury mitigation is key in cell cryopreservation. Here, we aimed to assess the effectiveness of nanographene oxide (nano-GO) for improving cryoprotectant agents (CPAs) in human adipose stem cell (hADSC) cryopreservation. For in vitro experiments, nano-GO (5 µg/mL) was added to the CPAs in the control, and passage (P) 2 hADSCs were collected and cryopreserved for around two weeks. We compared cytotoxicity, cell viability, immunophenotypes, proliferation, cell apoptosis, and tri-lineage differentiation. In vivo, studies used lipoaspirate to create non-enriched or hADSC-enriched fat tissues by combining it with PBS or hADSCs cryopreserved with the aforementioned CPAs. Each nude mouse received a 0.3 mL subcutaneous injection of the graft. At 12 weeks, the grafts were harvested. Histology, adipocyte-associated genes and protein, vascular density and angiogenic cytokines, macrophage infiltration, and inflammatory cytokines were analyzed. Nano-GO CPA contributed to increased cell viability, improved cell recovery, and lowered levels of early apoptosis. Nano GO at concentrations of 0.01-100 µg/mL caused no cytotoxicity to hADSCs. The absence of nano GOs in the intracellular compartments of the cells was confirmed by transmission electron microscopy. The fat grafts from the CPA-GO group showed more viable adipocytes and significantly increased angiogenesis compared to the PBS and CPA-C groups. Adding hADSCs from the CPA-GO group to the graft reduced macrophage infiltration and MCP-1 expression. Nano-GO plays an anti-apoptotic role in the cryopreservation of hADSCs, which could improve the survival of transplanted fat tissues, possibly via improved angiogenesis and lower inflammatory response in the transplanted adipose tissue.

Application Analysis of Low-Pressure Perfusion Combined with Occluder in Holmium Laser Lithotripsy for Patients with Middle and Upper Ureteral Calculi.

BACKGROUND: Ureteroscopic holmium laser lithotripsy has become one of the main methods of treating ureteral calculi. However, in the treatment of middle and upper ureteral calculi, ureteroscopy is difficult to operate owing to the high location of calculi. Thus, how to improve the treatment effect and reduce the stone migration has become the focus in clinical settings. On this basis, we evaluated the application effect of low-pressure perfusion combined with occluder in holmium laser lithotripsy for patients with middle and upper ureteral calculi. METHODS: This retrospective study selected 107 patients with middle and upper ureteral calculi who underwent low-pressure perfusion combined with ureteroscopic holmium laser lithotripsy from January 2021 to December 2022. We excluded 7 patients who did not meet the criteria, and ultimately included 100 patients. According to whether the occluder was used during the surgery, 100 patients were divided into groups A (n = 52, occluder) and B (n = 48, without occluder). The stone-migration rate during surgery, stone-clearance rate at 3 months after surgery, perioperative indicators, postoperative complication rate, and postoperative quality of life between the two groups were compared. RESULTS: The stone-migration rate in group A was significantly lower than that in group B, with statistically significant difference (p < 0.05). Both groups had no significant difference in stone-clearance rate at 3 months after surgery (p > 0.05). Group A had a significantly lower index of EuroQol (EQ) Five Dimensions Questionnaire and significantly higher score of EQ-Visual Analogue Scale than group B (all p < 0.001). CONCLUSIONS: Compared with the simple application of low-pressure perfusion, the combined application of low-pressure perfusion and occluder in ureteroscopic holmium laser lithotripsy can effectively reduce the stone migration and improve the postoperative quality of life.

Comparison of the cytokines levels in aqueous humor in vitrectomized eyes versus non-vitrectomized eyes with diabetic macular edema.

BACKGROUND: This study was conducted to compare concentrations of VEGF family growth factors, inflammation-related factors, and adhesion molecules in the aqueous humor of eyes with diabetic macular edema (DME), with and without prior vitrectomy. METHODS: A total of 31 eyes were included, 11 with DME that had undergone vitrectomy, 9 with DME but without vitrectomy, and 11 from age-related cataract patients as controls. The concentrations of cytokines including TNF-α, IL-6, IL-8, IP-10, MCP-1, IFN-γ, MIP-1 α, MIP-1 ß, PECAM-1, MIF, VCAM-1, ICAM-1, PIGF were quantified using Luminex Human Discovery Assay. Central macular thickness (CMT) values of all eyes were measured using optical coherence tomography (OCT). RESULTS: (1) Vitrectomized DME eyes exhibited significantly higher levels of IL-6 and IL-8 compared to non-vitrectomized eyes (P < 0.05). (2) In vitrectomized group, after Benjamini-Hochberg correction, there was a significant positive correlation between the levels of VEGF and PlGF (rs = 0.855, P < 0.05), as well as the levels of TNF-α and IFN-γ (rs = 0.858, P < 0.05). In non-vitrectomized group, significant positive correlations were found between VEGF and PlGF levels after correcting for multiple comparisons (rs = 0.9, P < 0.05). (3) In non-vitrectomized group, the concentrations of VEGF and PlGF in aqueous humor were significantly positively correlated with CMT values (rs = 0.95, P < 0.05; rs = 0.9, P < 0.05, respectively). CONCLUSIONS: The concentrations of IL-6 and IL-8 in the aqueous humor were significantly higher in vitrectomized DME eyes compared to nonvitrectomized DME eyes and the levels of VEGF were similar in the two groups, suggesting that inflammation after vitrectomy may be a key factor in the occurrence and development of DME.

Effectiveness of intravitreal ranibizumab for diabetic macular edema in vitrectomized versus non-vitrectomized eyes: a Meta-analysis.

AIM: To evaluate the effectiveness and safety of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) in vitrectomized versus non-vitrectomized eyes. METHODS: The PubMed, EMBASE, Web of Science, Cochrane, EBSCO were comprehensively searched for studies comparing vitrectomized and non-vitrectomized eyes with DME. Clinical outcomes of best-corrected visual acuity (BCVA), central macular thickness (CMT), the mean number of intravitreal injection and adverse events were extracted and analyzed. RESULTS: Six studies involving 641 eyes were included. Final visual gain significantly improved and CMT significantly reduced in vitrectomized eyes at 6mo and 12mo visits (P<0.05). Although the mean reduction in CMT among non-vitrectomized eyes was significantly greater than in vitrectomized eyes at the 6mo [mean difference (MD)=53.57, 95% confidence interval (CI): 28.03 to 78.72, P<0.0001] and 12mo (MD=49.65, 95%CI: 19.58 to 79.72, P=0.01), no significant difference was detected in improvement in BCVA at either 6mo (MD=0.05, 95%CI: -0.02 to 0.13, P=0.14) or 12mo (MD=0.03, 95%CI: -0.04 to 0.09, P=0.43). Injection number of ranibizumab in non-vitrectomized eyes was significantly less than that in vitrectomized eyes during 6-month period (MD=0.60, 95%CI: 0.16 to 1.04, P=0.008), while there was no statistically significant difference between the two groups during 12mo of follow-up. CONCLUSION: Evidence from current study suggests that IVR was useful for both vitrectomized group and non-vitrectomized group with DME. Although less reduction in macular thickness is found in vitrectomized group, visual improvement between two groups is similar.

Harnessing fine fibers in decellularized adipose-derived matrix for enhanced adipose regeneration.

Decellularized Adipose-Derived Matrix (DAM) has the function of inducing adipogenesis, but the distribution of adipogenesis is uneven. We found for the first time that DAM contains two structural components: The tough fibers DAM (T-DAM) and the fine fibers DAM (F-DAM). T-DAM was a dense vortex structure composed of a large number of coarse fibers, characterized by myoblast-related proteins, which cannot achieve fat regeneration and forms a typical "adipose-free zone". While the F-DAM was a loose structure consisting of uniform fine fibers, has more matrix-related proteins and adipose-related proteins. It can not only better promote the adhesion and proliferation of adipose stem cells in vitro, but also achieve the regeneration of adipose tissue in vivo earlier and better, with a uniform range of adipogenesis. The F-DAM is the main and effective kind of DAM to initiate adipose tissue regeneration, which can be picked out by ultrasound fragmentation.

Transcriptomic and machine learning analyses identify hub genes of metabolism and host immune response that are associated with the progression of breast capsular contracture.

Capsular contracture is a prevalent and severe complication that affects the postoperative outcomes of patients who receive silicone breast implants. At present, prosthesis replacement is the major treatment for capsular contracture after both breast augmentation procedures and breast reconstruction following breast cancer surgery. However, the mechanism(s) underlying breast capsular contracture remains unclear. This study aimed to identify the biological features of breast capsular contracture and reveal the potential underlying mechanism using RNA sequencing. Sample tissues from 12 female patients (15 breast capsules) were divided into low capsular contracture (LCC) and high capsular contracture (HCC) groups based on the Baker grades. Subsequently, 41 lipid metabolism-related genes were identified through enrichment analysis, and three of these genes were identified as candidate genes by SVM-RFE and LASSO algorithms. We then compared the proportions of the 22 types of immune cells between the LCC and HCC groups using a CIBERSORT analysis and explored the correlation between the candidate hub features and immune cells. Notably, PRKAR2B was positively correlated with the differentially clustered immune cells, which were M1 macrophages and follicular helper T cells (area under the ROC = 0.786). In addition, the expression of PRKAR2B at the mRNA or protein level was lower in the HCC group than in the LCC group. Potential molecular mechanisms were identified based on the expression levels in the high and low PRKAR2B groups. Our findings indicate that PRKAR2B is a novel diagnostic biomarker for breast capsular contracture and might also influence the grade and progression of capsular contracture.

High Vasohibin-2 expression correlated with autophagy in proliferative diabetic retinopathy.

Vasohibin-2 (VASH2) is confirmed to be associated with angiogenesis. To investigate the vitreous levels of VASH2 and how VASH2 induces angiogenesis in proliferative diabetic retinopathy (PDR), a total of 120 eyes were enrolled in this prospective and randomized controlled study and the vitreous level of VASH2 was quantified by Luminex liquid suspension chip. Vector systems were applied in human retinal microvascular endothelial cells (HRMECs) for VASH2 gene overexpression, along with interfering lentiviral vectors (VASH2-shRNA) for VASH2 gene silencing. Cell migration, autophagic flux, as well as the expression of α-tubulin, detyrosinated ⍺-tubulin, LC3 II/LC3 I, P62 were detected under normal, VASH2 overexpression, or interference conditions. The level of VASH2 in PDR patients was significantly higher (218.61 ± 30.14 pg/ml) than that in ERM/MH patients (80.78 ± 2.05 pg/ml) (P = 0.001). The migration ability of HRMECs was significantly increased in VASH2 overexpression group, while in the interfering group, the migration ability decreased. VASH2 increased the detyrosination of ⍺-tubulin. The high fluorescence intensity of autophagic flux showed an activation of autophagy in VASH2 overexpression group, which was also confirmed by the increase of LC3 II/LC3 I ratio and the decrease of P62. Collectively, the present study shows in PDR, vitreous level of VASH2 is higher. VASH2 promotes neovascularization by inducing autophagy, suggesting VASH2 could be a new anti-angiogenic drug target for PDR.

Novel Noninvasive Hybrid Flap Preconditioning (HFP) Surpasses Surgical Delay in the Murine Model.

BACKGROUND: Ischemic necrosis in the distal portion of the flap is a challenging complication in plastic surgery. We hypothesize a novel hybrid flap preconditioning (HFP) device combining foam-mediated external suction and non-surgical delay can promote skin flap survival better than surgical delay. METHOD: Twenty-eight mouse were divided into four groups. Control group: a 4*1.5 dorsal flap was made with no preconditioning. Surgical delay (SD) group: surgical delay was made 7 days before flap elevation. Foam-mediated external suction (FMES) group: foam-mediated external suction at -100mmHg was employed 5 hours per day for 6 days, and the flap was elevated on the seventh day. Hybrid Flap Preconditioning (HFP) group: silicone strips was applied along the contour of the foam interface. Same negative pressure protocol was used as the FMES group. Seven days after flap elevation, macroscopic, histologic, and Western blot analyses were performed. RESULTS: The flap survival rate was 46.25% (8.12%) in the control group, 68.72% (7.00%) in the SD group, 57.03% (8.17%) in the FMES group and 80.66% (3.27%) in the HFP group. Immunohistologic analysis of CD 31+ cell in distal end of viable tissue procured seven days after flap elevation showed a significantly higher angiogenesis in SD group and HFP group. Western Blot results showed an increased expression of VEGF in SD group and HFP group. CONCLUSION: We have developed and fabricated a novel hybrid flap precondition (HFP) device combining foam-mediated external suction and non-surgical delay. The concept of HFP is proved to promote flap survival better than surgical delay.

Effectiveness of a New Enzyme-Free Method for the Preparation of a Decellularized Adipose-Derived Matrix.

BACKGROUND: Decellularized adipose-derived matrix (DAM) represents a new alternative to tissue fillers. The function of DAM is closely associated with the decellularization technique used for its preparation. However, most techniques are time-consuming and expensive, and this might reduce the popularity of DAM. OBJECTIVES: The study aimed to investigate an enzyme-free adipose decellularization method and generate a DAM capable of adipose tissue regeneration. METHODS: DAMs prepared by the enzyme-free and Flynn's methods were compared and co-cultured with human adipose-derived stem cells (hADSCs) to investigate cytocompatibility. Adipose tissue formation was evaluated by injecting the DAMs into the backs of nude mice over 4 weeks. Samples were harvested for gross and perilipin immunohistochemistry analysis at 1 and 4 weeks. RESULTS: The enzyme-free method is effective for adipose decellularization because it removes adipocytes and preserves the microstructure. In vitro, the DAM made by the enzyme-free method could support the attachment, growth, proliferation, and differentiation of hADSCs, and promote the enhanced secretion of vascular endothelial growth factor by hADSCs; this DAM also induced the formation and maturity of adipocytes in vivo. CONCLUSIONS: This study describes a highly effective enzyme-free method for adipose tissue decellularization that also promotes adipocyte formation and adipose tissue volume stability in vitro and in vivo, resulting in a new alternative tissue filler.

Effects of Age on the Biological Properties of Cryopreserved Adipose-Derived Stem Cells and ASC-Enriched Fat Grafts.

BACKGROUND: Donor age is an important factor affecting the biological characteristics of human adipose-derived stem cells. The aim of this study was to compare the effects of age on the biological properties of cryopreserved adipose-derived stem cells and fat survival of cell-assisted lipotransfer. METHODS: Human lipoaspirates were obtained from 60 healthy female patients (aged 18-65 years) who underwent abdominal liposuction. Samples were divided into three groups according to donor age: group A, 18-29 years; group B, 30-49 years; and group C, 50-65 years. Adipose-derived stem cells were obtained by in vitro culture at the second passage and cryopreserved for 4 weeks. The cryopreserved ASCs were examined for biological characteristics, including cell proliferation, wound healing and adipogenic differentiation. Then, the fat survival of cryopreserved ASC-assisted fat transplantation was compared at different ages. RESULTS: SVF viability decreased with increasing age. Moreover, there was a decline in cell proliferation and migration of ASCs with increasing age. A significant difference was found in the adipogenic differentiation of ASCs in the three groups. There were significant differences in graft retention in different age groups. ASC-assisted fat grafting was more effective in young people than in elderly people. CONCLUSIONS: Honor age affects the proliferation and migration of adipose-derived stem cells but not the adipogenic differentiation potential of ASCs. Cryopreserved ASCs from younger people more effectively improved the fat survival of grafts. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Selection of Mechanical Fragmentation Methods Based on Enzyme-Free Preparation of Decellularized Adipose-Derived Matrix.

BACKGROUND: The decellularized adipose-derived matrix (DAM) has emerged as a promising biomaterial for inducing adipose tissue regeneration. Various methods have been employed to produce DAM, among which the enzyme-free method is a relatively recent preparation technique. The mechanical fragmentation step plays a crucial role in determining the efficacy of the enzyme-free preparation. METHODS: The adipose tissue underwent fragmentation through the application of ultrasonication, homogenization, and freeze ball milling. This study compared the central temperature of the mixture immediately following crushing, the quantity of oil obtained after centrifugation, and the thickness of the middle layer. Fluorescence staining was utilized to compare the residual cell activity of the broken fat in the middle layer, while electron microscopy was employed to assess the integrity and properties of the adipocytes among the three methods. The primary products obtained through the three methods were subsequently subjected to processing using the enzyme-free method DAM. The assessment of degreasing and denucleation of DAM was conducted through HE staining, oil red staining, and determination of DNA residues. Subsequently, the ultrasonication-DAM (U-DAM) and homogenation-DAM (H-DAM) were implanted bilaterally on the back of immunocompromised mice, and a comparative analysis of their adipogenic and angiogenic effects in vivo was performed. RESULTS: Oil discharge following ultrasonication and homogenization was significantly higher compared to that observed after freeze ball milling (p < 0.001), despite the latter exhibiting the lowest center temperature (p < 0.001). The middle layer was found to be thinnest after ultrasonication (p < 0.001), and most of the remaining cells were observed to be dead following fragmentation. Except for DAM obtained through freeze ball milling, DAM obtained through ultrasonication and homogenization could be completely denucleated and degreased. In the in vivo experiment, the first adipocytes were observed in U-DAM as early as 1 week after implantation, but not in H-DAM. After 8 weeks, a significant number of adipocytes were regenerated in both groups, but the U-DAM group demonstrated a more efficient adipose regeneration than in H-DAM (p = 0.0057). CONCLUSIONS: Ultrasonication and homogenization are effective mechanical fragmentation methods for breaking down adipocytes at the initial stage, enabling the production of DAM through an enzyme-free method that facilitates successful regeneration of adipose tissues in vivo. Furthermore, the enzyme-free method, which is based on the ultrasonication pre-fragmentation approach, exhibits superior performance in terms of denucleation, degreasing, and the removal of non-adipocyte matrix components, thereby resulting in the highest in vivo adipogenic induction efficiency.

Effect of radiation sterilization on the ability to induce adipose regeneration in vivo in decellularized adipose-derived matrix.

BACKGROUND: Decellularized adipose-derived matrix (DAM), a biological scaffold that can induce adipose regeneration. The balance between its sterilization efficiency and its ability to maintain in situ adipose regeneration should be considered in terminal sterilization. The purpose of this study was to investigate the effects of radiation sterilization of cobalt-60 (60 Co)with different doses on adipogenesis induced by different forms of DAM, so as to reduce radiation dose under the premise of safe and effective sterilization and ensure adipogenesis induced by DAM in vivo. METHODS: High dose (25 kGy) and low dose (5 kGy) radiation were used to sterilize freeze-dried and wet DAM, respectively. The sterilization efficiency, macro and micro characteristics, mechanical and mechanical properties of DAM were compared, and then implanted into the immunocompromised mice to evaluate the adipose regeneration. RESULTS: Under the two radiation doses, no microbial growth was found in the freeze-dried and wet DAM sterility tests, and no significant changes were observed in the macro and micro structures. In terms of mechanical properties, the elastic modulus of high dose freeze-dried DAM decreased significantly (p < 0.001). In vivo animal experiments, the freeze-dried DAM irradiated with high dose almost completely lost its function of adipogenesis in vivo. Although the wet DAM irradiated with high dose could induce fat regeneration in the early stage, the adipocyte deformation and atrophy appeared in the later stage. The freeze-dried and wet DAM after low dose irradiation was similar to the wet DAM without irradiation in the blank control, which could maintain excellent adipogenic and angiogenic functions in vivo. CONCLUSION: High dose 60 Co irradiation can completely destroy the ability of freeze-dried DAM to induce adipose regeneration in situ, while low dose irradiation (5 kGy) can effectively sterilize the DAM without damaging in vivo induced adipose regeneration. Radiation has more damage to freeze-dried DAM than wet DAM in adipogenesis properties.

A Bibliometric Analysis of Research on Decellularized Matrix for Two Decades.

The articles and reviews in the field of decellularized extracellular matrix (dECM) from 2001 to 2021 were retrieved and extracted from the Web of Science Core Collection. The R package Bibliometrix, CiteSpace, VOSviewer, and the online BIBLIOMETRC platform were utilized for bibliometric analysis, including specific characteristics of annual publications, influential countries/regions, core journals, leading institutions, keywords, key references, cocited authors, journals and institutions, cooperation, and historical direct citations. Our study concluded core references that fueled the development of dECM and highlighted current research directions, hotpots, and trends. From 2001 to 2021, 3,046 publications were retrieved in total, including 2,700 articles and 349 reviews. The United States (n = 895) produced the majority of publications, and the University of Pittsburgh (n = 318) published most productions. Biomaterials were identified as the most productive and influential journal in the dECM field considering the number of publications (n = 194), and total citations (n = 15,694). Immunomodulation, bioreactors, aging, three-dimensional (3D) bioprinting, bone tissue engineering, bioink, hydrogel, biomaterials, and regeneration were the latest high-frequency keywords, indicating the emerging frontiers of dECM. In the field, decellularization techniques lay the foundation. Orthotopic transplantation of recellularized dECM and induction of specific cell differentiation promoted the bursts of research. The 3D bioprinting and hydrogel based on dECM were extensively studied in recent years. The present study provided developmental trajectories, current research status, global collaboration patterns, hotpots, and trending topics of dECM. Decellularization techniques, tissue engineering to regenerate organs, and improvements in application are the major themes over the past two decades. Impact Statement The review article is significant because decellularized extracellular matrix (dECM), which derived from biological tissues and removal of immunogenic cells, is characterized by safety, biocompatibility, and low in toxicity. Showing great application prospects, dECM has been applied in multiple scenarios of tissue repairment and reconstruction, among the most popular topics in tissue engineering. Thus, analyzing and concluding the development, current condition and future trends are of great significance. Comparing to conventional review, this review article systemically and comprehensively concluded the historical development, current status, and research trending topics. Thus, it allows scholars to get a rapid overview of the dECM field, and plan research directions.

Real-time risk ranking of emerging epidemics based on optimized moving average prediction limit-taking the COVID-19 pandemic as an example.

BACKGROUND: Mathematical models to forecast the risk trend of the COVID-19 pandemic timely are of great significance to control the pandemic, but the requirement of manual operation and many parameters hinders their efficiency and value for application. This study aimed to establish a convenient and prompt one for monitoring emerging infectious diseases online and achieving risk assessment in real time. METHODS: The Optimized Moving Average Prediction Limit (Op-MAPL) algorithm model analysed real-time COVID-19 data online and was validated using the data of the Delta variant in India and the Omicron in the United States. Then, the model was utilized to determine the infection risk level of the Omicron in Shanghai and Beijing. RESULTS: The Op-MAPL model can predict the epidemic peak accurately. The daily risk ranking was stable and predictive, with an average accuracy of 87.85% within next 7 days. Early warning signals were issued for Shanghai and Beijing on February 28 and April 23, 2022, respectively. The two cities were rated as medium-high risk or above from March 27 to April 20 and from April 24 to May 5, indicating that the pandemic had entered a period of rapid increase. After April 21 and May 26, the risk level was downgraded to medium and became stable by the algorithm, indicating that the pandemic had been controlled well and mitigated gradually. CONCLUSIONS: The Op-MAPL relies on nothing but an indicator to assess the risk level of the COVID-19 pandemic with different data sources and granularities. This forward-looking method realizes real-time monitoring and early warning effectively to provide a valuable reference to prevent and control infectious diseases.

Effect of Intravitreal Conbercept Injection on Complications of Pars Plana Vitrectomy in Patients with Proliferative Diabetic Retinopathy.

BACKGROUND: The effect of intravitreal conbercept (IVC) before pars plana vitrectomy (PPV) on surgical complications in patients with proliferative diabetic retinopathy (PDR) was observed. METHODS: A total of 152 patients with PDR operated on in Jiangsu Provincial People's Hospital from November 2019 to November 2020 were divided into two groups: 124 patients in the preoperative intravitreal conbercept injection + PPV group (IVC group) and 28 patients in the PPV only group (No-IVC group). Vitreous samples were collected in all eyes of patients who underwent vitrectomy, and the content of VEGF-A was measured by Luminex. The effect of conbercept on intraoperative and postoperative complications of PDR was assessed. RESULTS: The content of VEGF in the vitreous of the IVC group was significantly lower than that in the No-IVC group (64.50 ± 58.40 pg/mL vs. 805.17 ± 417.60 pg/mL, p < 0.001). During postoperative follow-up, early postoperative vitreous hemorrhage (VH) occurred in 13 of 142 eyes (9.15%). Compared with the No-IVC group, PDR patients with VH and fibrovascular membrane (FVM) or high complexity in the IVC group had lower intraoperative bleeding rates (p < 0.05). The early postoperative hemorrhage rate in the IVC group was lower than in the No-IVC group (6.03% vs. 23.08%, p < 0.05). The number of intraoperative electrocoagulation and iatrogenic retinal holes in the IVC group was significantly lower than in the No-IVC group (p < 0.05). There were no significant differences in intraocular hypertension and NVG numbers between the two groups. Visual acuity in both groups improved after PPV surgery, reaching the highest level in the 3rd month after the operation. CONCLUSIONS: IVC before PPV can reduce the level of VEGF-A in the vitreous body and reduce surgical complications.

A Computerized Recognition System to Assess Breast Asymmetry after Augmentation Mammaplasty.

BACKGROUND: Breast augmentation patients are often unaware of their preexisting breast asymmetry before surgery but discover it afterward, which leads to postoperative dissatisfaction and increases the reoperation rate. However, elaboration on how patients subjectively analyze breast asymmetry and the recognition thresholds were limited. METHODS: Two hundred female participants, including 100 patients 6 months postoperatively for primary augmentation mammaplasty and 100 preoperative patients, were recruited as two study groups. Self-assessments of breast asymmetry and objective measurements were taken. A computerized recognition experiment was constructed based on standardized three-dimensional models with different nipple-areola complex (NAC) and inframammary fold (IMF) asymmetry combinations. One hundred twenty-one three-dimensional models were generated and shown in random sequence. Participants responded whether they discovered breast asymmetry in each model. The recognition rate and 50% recognition thresholds of the asymmetry in NAC, IMF, lower pole length, volume, and their interrelations were calculated. RESULTS: Self-assessment of the postaugmentation group showed more precise distinguishing of NAC, IMF, and lower pole distance asymmetry than in the preaugmentation group. The 50% recognition thresholds of NAC and IMF level discrepancies were approximately 0.75 cm, with the IMF asymmetry identified with higher accuracy. When the NAC level discrepancy ranged from 0.0 to 1.25 cm, adjusting the IMF level discrepancy from 0.0 to 0.5 cm in the same direction lowered participants' recognition rates of breast asymmetry. CONCLUSIONS: Patients recognize their breast asymmetry issue more accurately after augmentation operations, despite improved parameters. In addition, adjusting the new IMF level, aligning with NAC discrepancy within 0.5 cm when treating mild NAC asymmetry, improved symmetric outcomes.

Genome-Wide Identification and Functional Analysis of the Roles of SAUR Gene Family Members in the Promotion of Cucumber Root Expansion.

Auxin serves as an essential regulator of the expression of many different genes in plants, thereby regulating growth and development. The specific functional roles of members of the SAUR (small auxin-up RNA) auxin early response gene family in the development of cucumber plants, however, remain to be fully clarified. Here, 62 SAUR family genes were identified, followed by their classification into 7 groups that included several functionally associated cis-regulatory elements. Phylogenetic tree and chromosomal location-based analyses revealed a high degree of homology between two cucumber gene clusters and other plants in the Cucurbitaceae family. These findings, together with the results of an RNA-seq analysis, revealed high levels of CsSAUR31 expression within the root and male flower tissues. Plants overexpressing CsSAUR31 exhibited longer roots and hypocotyls. Together, these results provide a basis for further efforts to explore the roles that SAUR genes play in cucumber plants, while also expanding the pool of available genetic resources to guide research focused on plant growth and development.

Comparative Efficacy of Subthreshold Micropulse Laser Photocoagulation versus Conventional Laser Photocoagulation for Diabetic Macular Edema: A Meta-Analysis.

BACKGROUND: Laser photocoagulation is an effective procedure for the treatment of diabetic macular edema (DME). However, the beneficial effects of conventional laser photocoagulation (CLP) are accompanied by the destruction of retinal photoreceptors. Therefore, subthreshold micropulse laser photocoagulation (SMLP) was proposed for DME. OBJECTIVES: This meta-analysis study was performed to evaluate the efficacy and safety of SMLP compared with CLP for the management of DME. METHODS: The PubMed, Embase, Web of Science, Cochrane, SinoMed, ClinicalTrials.gov, Wanfang, and China National Knowledge Infrastructure (CNKI) databases, published until Dec 2021, were searched to identify studies evaluating the clinical outcomes of SMLP for DME. RESULTS: Eight randomized controlled trials were selected for this meta-analysis involving a total of 546 eyes (275 eyes in SMLP group and 271 eyes in CLP group). SMLP of different wavelengths (577 nm and 810 nm) and duty cycles (5% and 15%) was applied. The pooled outcomes showed that SMLP group, especially 577 nm and 810 nm 15% duty cycle parameter settings, had a statistically significant higher efficacy than CLP group in terms of BCVA (MD = -0.02, 95% CI: -0.03 to -0.01, p < 0.01; MD = -0.09, 95% CI: -0.09 to -0.09, p < 0.01) and showed more significant advantages than CLP group in resolving macular edema assessed by reduction of CMT (MD = -32.87, 95% CI: -37.61 to -28.13, p < 0.01; MD = -8.01, 95% CI: -9.06 to -6.96, p < 0.01), whereas the efficacy of 577 nm and 810 nm 5% duty cycle SMLP subgroups remained numerically superior to CLP group, but nonsignificantly (p > 0.05). In the field of CS, SMLP group (no matter parameter settings) resulted in better preservation of CS compared to CLP group (MD = 1.96, 95% CI: 1.47-2.46, p < 0.01). CONCLUSIONS: Compared with CLP, SMLP may get superior efficacy and safety on improvement of BCVA, reduction of CMT, and preservation of CS. In clinical, SMLP can be considered as a safe and effective therapy in the management of DME.

Endoscopic-Assisted Transaxillary Breast Augmentation.

Breast augmentation with implants is becoming a more widely accepted and popular procedure in Asia. The axillary approach remains the preferred incision for Asian women. Endoscope technique is the best option for transaxillary breast augmentation. It greatly increases control over the process, avoids various drawbacks, reduces the incidence of complications, and improves the stability of clinical effects of transaxillary implant breast augmentation. Freestyle endoscopic technique may greatly improve the flexibility and efficiency of the endoscope operation through the axillary approach. This article introduces the freestyle endoscopic-assisted transaxillary breast augmentation with high position dual-plane technique.

Breast Morphological Comparison Between Anatomic and Round Implant Augmentation: A Prospective Study.

BACKGROUND: The choice of implant shape (anatomic or round) is one of the most critical issues for breast augmentation. Determining whether there are differences in the postoperative breast morphology of the 2 implants is pivotal for surgical planning. This issue has been controversial and lacking in evidence. The aim of this study was to provide reference for implant selection by comparing breast morphology after dual-plane augmentation with anatomic and round implants using 3-dimensional scanning technology. METHODS: Patients with implant volume less than 300 mL who underwent transaxillary dual-plane augmentation were included in this study and were grouped according to implant shape. Three-dimensional scans were performed preoperatively and 6 months postoperatively. Postoperative breast height (BH), breast width (BW), BH of upper pole (BHUP), BH of lower pole (BHLP), breast projection (BP), BP of upper pole (BPUP), and BP of lower pole (BPLP) were measured separately, resulting in corresponding ratios (BH/BW, BHUP/BHLP, BP/BH, BPUP/BPLP). Breast volume, and the volumes of each pole (breast volume of upper pole [BVUP], breast volume of lower pole [BVLP]) and its ratio (BVUP/BVLP) were calculated. Correlation and regression analysis on the influencing factors of breast volume were performed. RESULTS: Thirty patients with anatomic implants and 26 with round implants were enrolled in this study. The mean volumes of anatomic and round implants were 260.5 ± 26.7 and 267.9 ± 21.7 mL (P = 0.192). The ratios of BH/BW in the 2 groups were 1.39 ± 0.12 and 1.37 ± 0.19, respectively (P = 0.582). The BHUP/BHLP values of 2 groups were 1.35 ± 0.22 and 1.41 ± 0.25 (P = 0.160). Two sets of BPUP/BPLP were 0.68 ± 0.19 and 0.73 ± 0.17 (P = 0.133). The ratios of BP/BH in the 2 groups were 0.39 ± 0.08 and 0.39 ± 0.06 (P = 0.830). The BVUP/BVLP ratios for both groups were 0.75 ± 0.11 and 0.77 ± 0.12 (P = 0.287). There was a volume loss rate of 13.3% ± 3.9% and 13.9% ± 5% (P = 0.489). The postoperative volume showed a positive correlation with both the preoperative volume and the implant volume. CONCLUSIONS: For patients with breast dysplasia undergoing transaxillary dual-plane augmentation with anatomic or round implants less than 300 mL, the difference in postoperative breast morphology is not obvious. Using these 2 shapes of implants results in a similar degree of volume loss.