[Clinical experience of JIAO Lin in treatment of knee osteoarthritis with manual mobilization of meridian muscle regions].

The paper introduces JIAO Lin's clinical experience in treatment of knee osteoarthritis (KOA) by manual mobilization of meridian muscle regions. Professor JIAO Lin believes that the key to the occurrence and development of KOA lies in the disorder of meridian muscle regions (sinews/fascia). In pathology, four stages are divided, i.e. the acute stage, the blockage stage, the contraction stage and the atrophy stage of muscle regions, characterized as multi-layer, multi-dimensional and multi-morphological distribution. In treatment, based on the principle, "taking pain sites as stimulating points", the sites, with reduced pain threshold and distributed along the meridian muscle regions, are regarded as "acupoints" for intervention. Manual mobilization of meridian muscle regions is the dominant approach, combined with routine acupuncture, heat-sensitive moxibustion, cupping and bloodletting corresponding to the features of syndromes and meridian manifestation at different stages. The comprehensive treatment may restore and reconstruct the physiological functions of the meridian muscle regions around knee joints by "nourishing tendons, strengthening bones and benefiting joints".

PEG-functionalized aliphatic polycarbonate brushes with self-polishing dynamic antifouling properties.

Hydrophilic antifouling polymers provide excellent antifouling effects under usual short-term use conditions, but the long-term accumulation of contaminants causes them to lose their antifouling properties. To overcome this drawback, surface-initiated ring-opening graft polymerization (SI-ROP) was performed on the surface of the material by applying the cyclic carbide monomer 4'-(fluorosulfonyl)benzyl-5-methyl-2-oxo-1,3-dioxane-5-carboxylate (FMC), which contains a sulfonylfluoride group on the side chain, followed by a "sulfur(IV)-fluorine exchange" (SuFEx) post click modification reaction to link the hydrophilic polyethylene glycol (PEG) to the polyFMC (PFMC) brush, and a novel antifouling strategy for self-polishing dynamic antifouling surfaces was developed. The experimental results showed that the antifouling surface could effectively prevent the adsorption of proteins such as bovine serum albumin (BSA, ∼96.4%), fibrinogen (Fg, ∼87.8%) and lysozyme (Lyz ∼69.4%) as well as the adhesion of microorganisms such as the bacteria Staphylococcus aureus (S. aureus) (∼87.5%) and HeLa cells (∼67.2%). Moreover, the enzymatically self-polished surface still has excellent antifouling properties. Therefore, this modification method has potential applications in the field of biosensors and novel antifouling materials.

Janus-type ionic conductive gels based on poly(N,N-dimethyl)acrylamide for strain/pressure sensors.

Strain/pressure sensors with high sensitivity and a wide operation range have broad application prospects in wearable medical equipment, human-computer interactions, electronic skin, and so on. In this work, based on the different solubilities of Zr4+ in the aqueous phase and the hydrophobic ionic liquid [BMIM][Tf2N], we used N,N-dimethylacrylamide (DMA) as a vinyl monomer to prepare a Janus-type ionic conductive gel with one-sided adhesion through "one-step" UV irradiation polymerization. The Janus-type gel has satisfactory mechanical properties (tensile strength: 217.06 kPa, elongation at break: 1121.01%), electrical conductivity (conductivity: 0.10 S m-1), one-sided adhesion (adhesion strength to glass: 72.35 kPa) and antibacterial properties. The sensor based on the Janus gel can be used not only for real-time monitoring of strain changes caused by various movements of the human body (such as finger bending, muscle contraction, smiling, and swallowing) but also for real-time monitoring of pressure changes (such as pressing, water droplets, and writing movements). Therefore, based on the simplicity of this method for constructing Janus-type ionic conductive gels and the excellent electromechanical properties of the prepared gel, we believe that the method provided in this study has broad application prospects in the field of multifunctional wearable sensors.

miR-656-3p inhibits melanomas in vitro and in vivo by inducing senescence via inhibiting LMNB2.

BACKGROUND: Ultra-Violet Radiation (UVR) is the most significant exogenous contributor to skin aging. UVB causes the senescence of melanocytes, which results in a permanent arrest in the proliferative process. Senescence is also regarded as a physiological tumor-suppressing mechanism of normal cells. However, the mechanism of the relationship between melanocyte senescence and melanoma was not sufficiently clarified. METHODS: Melanocytes and melanoma cells were irradiated with UVB for the indicated time. The miRNA expression profile of melanocytes were obtained by miRNA sequencing and confirmed by real-time PCR. Cell count kit-8 assays, cell cycle assays were also employed to explore the effect of miR-656-3p and LMNB2 on senescence. Dual-luciferase reporter assays were applied to determine the miRNA targets. Finally, a xenograft model and a photoaging model of mice were conducted to verified the function of miR-656-3p in vivo. RESULTS: Melanoma cells did not alter into a senescence stage and the expressions of miR-656-3p had no significant changes under the same intensity of UVB radiation. miR-656-3p appeared to be upregulated in melanocytes rather than melanoma cells after UVB radiation. miR-656-3p could promote the photoaging of human primary melanocytes by targeting LMNB2. Finally, overexpression of miR-656-3p significantly induced senescence and inhibited the growth of melanomas in vitro and in vivo. CONCLUSION: Our work not only demonstrated the mechanism by which miR-656-3p induced the senescence of melanocytes but also proposed a treatment strategy for melanomas by using miR-656-3p to induce senescence.

Transparent ionic conductive elastomers with high mechanical strength and strong tensile properties for strain sensors.

Stretchable ionic conductive elastomers have been extensively studied due to their great application potential in the fields of sensors, batteries, capacitors and flexible robots. However, it is still challenging to prepare multifunctional ionic conductive elastomers with high mechanical strength and excellent tensile properties by a green and efficient method. In this study, we prepared PDES-DMA ionic conductive elastomers by a "one step" rapid in situ polymerization of AA/ChCl-type polymerizable deep eutectic solvents (PDES) and N,N-dimethylacrylamide (DMA) under ultraviolet (UV) irradiation. In addition to the characteristics of high mechanical strength (tensile strength of 9.27 MPa) and excellent tensile properties (elongation at break of 1071%), the PDES-DMA elastomer also has high transparency (>80%), strong self-adhesion (adhesion strength with glass surface 133.8 kPa) and self-healing properties. In addition, sensors based on the ionic conductive elastomer can be used to detect human movements such as finger, wrist, elbow, ankle and knee bending. Considering the convenience of the preparation method and the excellent versatility of the prepared PDES-DMA ionic conductive elastomer, we believe that the method proposed in this study has potential application prospects in the field of flexible electronics.

SUMOylation mediates the disassembly of the Smad4 nuclear export complex via RanGAP1 in KELOIDS.

Sentrin/small ubiquitin-like modifier (SUMO) has emerged as a powerful mediator regulating biological processes and participating in pathophysiological processes that cause human diseases, such as cancer, myocardial fibrosis and neurological disorders. Sumoylation has been shown to play a positive regulatory role in keloids. However, the sumoylation mechanism in keloids remains understudied. We proposed that sumoylation regulates keloids via a complex. RanGAP1 acted as a synergistic, functional partner of SUMOs in keloids. Nuclear accumulation of Smad4, a TGF-ß/Smad pathway member, was associated with RanGAP1 after SUMO1 inhibition. RanGAP1*SUMO1 mediated the nuclear accumulation of Smad4 due to its impact on nuclear export and reduction in the dissociation of Smad4 and CRM1. We clarified a novel mechanism of positive regulation of sumoylation in keloids and demonstrated the function of sumoylation in Smad4 nuclear export. The NPC-associated RanGAP1*SUMO1 complex functions as a disassembly machine for the export receptor CRM1 and Smad4. Our research provides new perspectives for the mechanisms of keloids and nucleocytoplasmic transport.

80Gb/s NRZ Ge waveguide electro-absorption modulator.

We demonstrate a Ge electro-absorption modulator (EAM) in L band with a 3 dB electro-optical bandwidth beyond 67 GHz at -3 V bias voltage. The Eye diagram measurement shows a data rate of over 80 Gbps for non-return-to-zero on-off keying (NRZ-OOK) modulation at a voltage swing of 2.3 Vpp and the wavelength of 1605 nm. Through the comparison of multi-device results, it is proved that the introduction of the annealing process after CMP can increase the mean static extinction ratio of the EAM from 7.27 dB to 11.83 dB, which confirms the manufacturability of the device. The dynamic power consumption of the device is 6.348 fJ/bit. The performance of our device is comprehensive. The Ge EAM device also has excellent performance as a photodetector (PD) in the C and L communication bands. The responsivity of the device is 1.04 A/W at the wavelength of 1610 nm, resulting in ∼0.87 mW of static power consumption at -3 V bias voltage under 0.28 mW of optical input and the 3 dB opto-electric bandwidth of the devices are beyond 43 GHz at -3 V bias.

"Red Spitz Tumor" on the Ear: Case Report and Review of the Literature.

Spitz nevus (SN) is a benign melanocytic lesion with cytologic and architectural atypia. It is sometimes difficult to distinguish SNs from atypical Spitz tumor (AST), Spitz melanoma, or conventional melanoma. SNs frequently develop in Caucasians and appear on the skin of the head and lower extremities. Lesions on the ear in Asian populations are rare. Here, we report a "red Spitz tumor" on the ear of a Chinese 18-year-old boy. Dermoscopic examination revealed possibly malignant features presented as polymorphous vessels along with central white area, pseudo-network depigmentation and atypical peripheral globular pattern. The results of histopathological examination strongly suggested that the neoplasm was a compound SN and no recurrences or metastases occurred during 1-year follow-up post-surgery. Further, we review the literature on 4 previously reported cases of SN on the ear and summarize the main points of SN diagnosis and differential diagnosis with atypical Spitz tumors and melanoma.

Oncological safety and complication risks of mastectomy with or without breast reconstruction: A Bayesian analysis.

BACKGROUND: Currently, breast cancer patients undergoing mastectomy (MA) have three surgical options: MA only and reconstruction at the time of MA ("immediate," IBR) or at a later time ("delayed," DBR). To assess the oncological safety and complication risks associated with different surgical choices, a systematic review with Bayesian network analysis was conducted. METHODS: Cochrane library, PubMed/MEDLINE, EMBASE, and the China National Knowledge Infrastructure were systematically searched in November 2019. The odds ratios [OR] were estimated for oncological safety (including disease-free survival, overall survival, local recurrence, and distant metastases) and complication risks (including overall complications, surgical site infection, and lymphedema) among MA, IBR, and DBR groups. RESULTS: In the included 51 studies (265,522 patients), reconstruction after MA for IBR or DBR was associated with increased overall survival compared to simple MA (DBR vs. MA: OR 4.12, 95% credible interval [CrI] 1.80-10.01; IBR vs. MA: OR 1.75, 95% CrI 1.32-2.32). Additionally, IBR was associated with a decreased distant metastasis rate compared to MA (IBR vs. MA: OR 0.67, 95% CrI 0.51-0.90). However, the risk of overall complications and surgical site infection was higher in the IBR group than in the other two groups (complications, IBR vs. DBR: OR 1.40, 95% CrI 1.01-1.93; surgical site infection, IBR vs. MA: OR 1.77, 95% CrI 1.03-3.13). CONCLUSIONS: Evidence suggested that breast reconstruction, whether IBR or DBR, does not adversely affect oncological safety in the setting of breast cancer. IBR is associated with an increased risk of overall complications and surgical site infection, but technical advances in this surgical procedure have cumulated over time.

Correction: An ionic liquid-modified RGO/polyaniline composite for high-performance flexible all-solid-state supercapacitors.

Correction for 'An ionic liquid-modified RGO/polyaniline composite for high-performance flexible all-solid-state supercapacitors' by Chang Dong et al., Chem. Commun., 2020, DOI: 10.1039/d0cc04691d.

An ionic liquid-modified RGO/polyaniline composite for high-performance flexible all-solid-state supercapacitors.

An ionic liquid-modified reduced graphene oxide/polyaniline (RGO-IL/PANI) composite was synthesized successfully. The ionic liquid enlarged the interlayer distance of RGO sheets and acted as a PANI dopant to improve the orderly establishment of PANI. The supercapacitor based on RGO-IL/PANI presented outstanding energy density (24.1 W h kg-1 at 501 W kg-1), good cycling stability (91.5% capacity retention after 1000 cycles) and excellent flexibility. The results demonstrated the significant potential application of the obtained RGO-IL/PANI composite as a flexible electrode for high-performance energy storage devices.

Sumoylation enhances the activity of the TGF-ß/SMAD and HIF-1 signaling pathways in keloids.

Excessive fibrosis and extracellular matrix deposition resulting from upregulation of target genes expression mediated by transforming growth factor-beta (TGF-ß)/SMAD and hypoxia inducible factor-1 (HIF-1) signaling pathways are the main mechanisms that drive keloid formation. Sumoylation is a protein posttranslational modification that regulates the function of proteins in many biological processes. In the present study, we aimed to investigate the mechanism underlying the effects of sumoylation on the TGF-ß/SMAD and HIF-1 signaling pathways in keloids. We used 2-D08 to block sumoylation and silenced the expression of sentrin sumo-specific protease 1 (SENP1) to enhance sumoylation in human foreskin fibroblasts (HFFs) and human keloid fibroblasts (HKFs). We also reduced and increased intracellular SUMO1 levels by silencing SUMO1 and transfecting cells with a SUMO1 overexpression lentivirus, respectively. Sumoylation has the ability to amplify TGF-ß/SMAD and HIF-1 signals in keloids, while SUMO1, especially the SUMO1-RanGAP1 complex, is the key molecule affecting the TGF-ß/SMAD and HIF-1 signaling pathways. In addition, we also found that hypoxia promotes sumoylation in keloids and that HIF-1α is covalently modified by SUMO1 at Lys 391 and Lys 477 in HKFs. In summary, we elucidated the role and molecular mechanism of sumoylation in the formation of keloids, providing a new perspective for a potential therapeutic target of keloids.

TM4SF1 involves in miR-1-3p/miR-214-5p-mediated inhibition of the migration and proliferation in keloid by regulating AKT/ERK signaling.

AIMS: Transmembrane 4 L six family member 1 (TM4SF1) is a small plasma membrane glycoprotein that is highly expressed in cancers. However, the role of TM4SF1 that plays in keloids remains unknown. We investigated the expression, function and the microRNA (miRNA) regulatory network of TM4SF1 in keloids. MAIN METHODS: Small interfering RNAs and lentivirus were used to alter the expression of TM4SF1 in fibroblasts. Dual-luciferase reporter assays were applied to determine the miRNA targets. Immunohistochemistry, western blotting, qRT-PCR, wound healing assays, Transwell assays, cell count kit-8 assays and flow cytometry were also employed in this study. KEY FINDINGS: TM4SF1 was frequently upregulated in human keloid fibroblasts (HKFs) compared with human normal skin fibroblasts (HSFs). The downregulation of TM4SF1 significantly inhibited proliferation and migration, and induced apoptosis in HKFs. Furthermore, si-TM4SF1 inhibited the AKT/ERK signaling. Meanwhile, the upregulation of TM4SF1 promoted proliferation, migration and the activation of AKT/ERK signaling in human foreskin fibroblasts (HFF-1). Moreover, TM4SF1 can be regulated by miRNAs, which have been validated to play important roles in keloids by posttranscriptional regulation of gene expression. After screening, we found miR-1-3p and miR-214-5p targeted TM4SF1, inhibited TM4SF1 expression, cell proliferation, migration, and induced apoptosis in HKFs. And the level of miR-1-3p and miR-214-5p were found lower in HKFs than in HSFs. SIGNIFICANCE: Our study demonstrates a novel regulatory mechanism by which miR-1-3p, miR-214-5p, and TM4SF1 are involved in proliferation, cell motility, and apoptosis, suggesting that they may be potential targets in therapies for keloids.

Auxiliary usage of botulinum toxin A in plastic surgery in China.

BACKGROUND: Currently, botulinum toxin A (BTA) is mainly used in the treatment of muscle spasms and in cosmetic procedures, and its cosmetic indications are expanding rapidly. There have been sporadic reports focused on the preoperative usage of BTA complementing plastic surgery. We briefly summarize the current experience of BTA complementing plastic surgery in China based on clinical experience. METHODS: We reported a brief review of the preoperative use of BTA as an accessory to plastic surgery (blepharoplasty, chin augmentation, mandibular angle ostectomy, rhinoplasty, hyaluronic acid fillers injection for wrinkle reduction) based on previous studies and our experience. RESULTS: Preoperative treatment with BTA in plastic surgery helps surgeons operate and results in better cosmetic results. CONCLUSIONS: Preoperative BTA treatment can reduce the occurrence of surgical complications as well as improve the surgical results in some plastic surgeries. The procedure is suitable for clinical application and worth promoting.

A comparative assessment of three planes of implant placement in breast augmentation: A Bayesian analysis.

BACKGROUND: Techniques based on three planes of implant placement, including the subglandular (SG), subpectoral (SP), and subfascial (SF) planes are used for breast augmentation. The placement that offers the greatest balance of risks and benefits is unclear. This study presents a systematic review with a Bayesian network meta-analysis to compare different implant placement techniques for augmentation mammaplasty. METHODS: A systematic literature search was performed. We estimated the odds ratios (ORs) for capsular contractures, hematomas, seromas, infections, reoperation rates, rippling, nipple numbness, malplacements, ruptures, and asymmetry among the different interventions. Muscle movement events and satisfaction rates were also evaluated. RESULTS: A total of 19 studies (25,744 cases) were included. SG placement significantly increased the incidence of capsular contractures (SP vs. SG: OR 0.42; 95% credible interval [CrI] 0.28-0.63; SF vs. SG: OR 0.41; 95% CrI 0.17-0.97), hematomas (SF vs. SG: OR 0.22; 95% CrI 0.06-0.63), and seromas (SF vs. SG: OR 0.04; 95% CrI 0.00-0.81) compared to other placement techniques. Muscle movement only occurred in the SP group, but it did not increase the risk of subsequent malplacements, asymmetries, or ruptures. Most patients were highly satisfied with their surgical results. Comparisons did not show significant differences in the remaining results. CONCLUSIONS: Our evidence suggests that SG placement increases the risk of capsular contractures, hematomas, and seromas. The SP and SF planes were safe and effective for controlling total complication rates and achieving high satisfaction rates; however, the long-term benefits of the SF technique require further research.

Decreased expression of microRNA-145 promotes the biological functions of fibroblasts in hypertrophic scar tissues by upregulating the expression of transcription factor SOX-9.

The present study aimed to determine the expression of microRNA (miRNA or miR)-145 in hypertrophic scars at the tissue and cellular levels, and to investigate its biological functions and mechanism of action. A total of 36 patients who were diagnosed with hypertrophic scar were included in the present study. Reverse transcription-quantitative polymerase chain reaction was used to determine the expression of miR-145 in tissues and fibroblasts. Primary fibroblasts were transfected with negative control miRNA, miR-145 mimics or inhibitor. A Cell Counting Kit-8 assay was performed to determine the level of proliferation of fibroblasts. Flow cytometry was employed for cell cycles determination and apoptosis in fibroblasts. A Matrigel assay was used to evaluate the invasion ability of fibroblasts. Western blotting was used to determine the expression of the transcription factor SOX-9 (SOX-9) protein in fibroblasts. Rescue experiments were performed to examine the effect of SOX-9 on the regulation of fibroblasts by miR-145. The dual luciferase reporter assay was performed to identify the direct interaction between SOX-9 and miR-145. The expression of miR-145 was reduced in hypertrophic tissues and fibroblasts. Overexpression of miR-145 inhibited the proliferation, G1/S phase transition and invasion of fibroblasts, and promoted the apoptosis of fibroblasts. In addition, overexpression of miR-145 inhibited SOX-9 protein expression. By contrast, the expression of SOX-9 reversed the effects of miR-145 on the proliferation, cell cycle, apoptosis and invasion of fibroblasts. The miR-145 seed region was able to bind with the 3'-untranslated region of the SOX-9 mRNA to regulate its expression. The present study demonstrated that miR-145 expression is reduced in hypertrophic scar tissues and negatively associated with SOX-9 expression. In addition, miR-145 inhibits the proliferation, cell cycle and invasion, and promotes the apoptosis of fibroblasts by down-regulating the expression of SOX-9. The current study provides a potential target for the clinical diagnosis and treatment of hypertrophic scars.

Windmill Flap Nipple Reduction: A New Method of Nipple Plasty.

BACKGROUND: Nipple hypertrophy is a common aesthetic issue for Asian women. Thus, methods to correct this problem are needed. Several nipple reduction procedures have been reported, but all have shortcomings. In this article, we propose a new method to reduce both the height and diameter of the nipple without affecting its function. METHODS: Sixteen female patients, between the ages of 24-41 years, underwent a new nipple reduction method in our department between May 17, 2010, and May 5, 2014. Three crescent-shaped lines were drawn from the top of the side wall of the nipple, extending to the areola. This design reduces both the diameter and height of the nipple with minimal tissue manipulation. RESULTS: Before surgery, the mean diameter and height of the nipple were 15.9 ± 2.7 and 18.3 ± 3.1 mm, respectively, with the patient in the supine position. Immediately after surgery, the mean diameter and height of the nipple were 9.1 ± 1.7 and 7.9 ± 2.1 mm, respectively. No major complications, such as nipple necrosis, infection, delayed wound healing, or loss of sensation, were noted. CONCLUSIONS: This new surgical technique allows the creation of a new nipple of the desired height and diameter with excellent aesthetic results and without significant complications. LEVEL OF EVIDENCE IV: 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 .

A modified surgical method of lower-face recontouring.

BACKGROUND: In general, the width of the lower face is determined by four parts: the mandible, the masseter muscle, the buccal fat pad, and the subcutaneous fat. In this article, we introduce a modified surgical method to reshape the outline of round faces that have no significant overgrowth or eversion of the lower jawbone. METHOD: The procedure includes dissection of the masseter muscle and partial lipectomy of the buccal fat pad through the same intraoral small incision. RESULTS: The patients were satisfied with the aesthetic outcome of both the profile and frontal view. Follow-up of more than 6 months shows no prospective complications. CONCLUSION: This method yields an optimal aesthetic result in patients who have a round face without significant overgrowth or eversion of the lower jawbone. LEVEL OF EVIDENCE IV: 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 .