^238U and^232Th concentrations measured in different medical drugs by using solid-state nuclear track detectors and resulting radiation doses to the skin of patients

Urban populations in Morocco receive free medical drugs as prescribed by doctors in district health centres.To explore the exposure pathway of ^(238)U and^(232)Th and their decay products on the skin of patients,these radionuclides were measured in various medical drugs by using solid-state nuclear track detectors(SSNTDs).The measured concentrations range of ^(238)U and ^(232)Th in the medical drug samples of interest vary from(4.3±0.3) to(11.1±0.7) mBq 1^(-1) and(0.49±0.03) to(1.3±0.1)mBq 1^(-1),respectively.A new dosimetric model,based on the concept of specific alpha-dose and alpha-particle residual energy,was developed for evaluating radiation doses to skin following the application of different medical drugs by patients.The maximum total equivalent effective dose to skin due to the ^(238)U and ^(232)Th series from cutaneous application of different medical drugs by patients was found to be 2.8 mSv year^(-1) cm^(-2).

The state-of-the-art of atmospheric pressure plasma for transdermal drug delivery

Plasma-enhanced transdermal drug delivery(TDD) presents advantages over traditional methods,including painless application, minimal skin damage, and rapid recovery of permeability. To harness its clinical potential, factors related to plasma’s unique properties, such as reactive species and electric fields, must be carefully considered.This review provides a concise summary of conventional TDD methods and subsequently offers a comprehensive examination of the current state-of-the-art in plasma-enhanced TDD. This includes an analysis of the impact of plasma on HaCaT human keratinocyte cells, ex vivo/in vivo studies, and clinical research on plasma-assisted TDD. Moreover, the review explores the effects of plasma on skin physical characteristics such as microhole formation, transepidermal water loss(TEWL), molecular structure of the stratum corneum(SC), and skin resistance. Additionally, it discusses the involvement of various reactive agents in plasma-enhanced TDD, encompassing electric fields,charged particles, UV/VUV radiation, heat, and reactive species. Lastly, the review briefly addresses the temporal behavior of the skin after plasma treatment, safety considerations, and potential risks associated with plasma-enhanced TDD.

Advances in studies of phospholipids as carriers in skin topical application

Objective： This article provides an overview of characteristics of phospholipids, the characteristics and influential factors of liposome and microemulsion as carriers for skin delivery of drugs, and the latest advances of the phospholipids carriers in transdermal delivery systems. The perspective is that phospholipids carriers may be capable of a wide range of applications in the transdermal delivery system.

Microneedles for Enhanced Topical Treatment of Skin Disorders:Applications,Challenges,and Prospects

Microneedles(MNs)can be used for the topical treatment of skin disorders as they directly deliver therapeutics to the site of skin lesions,resulting in increased therapeutic efficacy while having minimum side effects.MNs are used to deliver different kinds of therapeutics(e.g.,small molecules,macromolecules,nanomedicines,living cells,bacteria,and exosomes)for treating various skin disorders,including superficial tumors,wounds,skin infections,inflammatory skin diseases,and abnormal skin appearance.The therapeutic efficacy of MNs can be improved by integrating the advantages of multiple therapeutics to perform combination therapy.Through careful designing,MNs can be further modified with biomimetic structures for the responsive drug release from internal and external stimuli and to enhance the transdermal delivery efficiency for robust therapeutic outcomes.Some studies have proposed the use of drug-free MNs as a promising mechanotherapeutic strategy to promote wound healing,scar removal,and hair regeneration via a mechanical communication pathway.Although MNs have several advantages,the practical application of MNs suffers from problems related to industrial manufacture and clinical evaluation,making it difficult for clinical translation.In this study,we summarized the various applications,emerging challenges,and developmental prospects of MNs in skin disorders to provide information on ways to advance clinical translation.

Transdermal Drug Delivery by Electroporation： The Effects of Surfactants on Pathway Lifetime and Drug Transport

Electroporation creates aqueous pathways by short high-voltage pulses resulting in a transient perme- abilization of stratum corneum and an increase in the transdermal delivery rate.However the aqueous pathways will reseal after pulsing,which leads to the rapid drop of transdermal flux.In the present study,the surfactants were added to the donor solution to hinder the shrinkage and resealing of the electropore,and to prolong the lifetime of the aqueous pathways with the consideration that the surfactants could reduce the surface energy of the electropore. These effects of surfactants were demonstrated by the dynamic electrical resistance of the skin and the fluorescent imaging of the local transport regions.Piroxicam(PIX)was transported percutaneously in the presence of surfac- tants in vitro.Owing to the longer lifetime of aqueous pathways,together with the promotion of PIX availability at the barrier exterior and the improvement in the partition of PIX into the aqueous pathways,the presence of surfac- tants led to a remarkable increase in the transdermal delivery rate during electroporation and a significant growth of the accumulative transdermal amount of PIX.

Purification and in vitro Activity of an Antimicrobial Peptide from Skin of Rana Temporaria Chensinensis,David

In this study, an antimicrobial component（RTCI） was purified from the skin of Rana temporaria chensinensis, David. Antimicrobial activities of RTCI against clinical multi-drug resistant bacterial strains, including Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureaus, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus fae-calis, and Proteus mirabilis, were measured in vitro by means of minimal inhibitory concentration and time-kill studies. The results indicate that RTCI could inhibit the growth of these bacteria at a proper concentration and suggest that RT-CI shows a better antimicrobial activity to Gram-negative bacterial strains than to Gram-positive bacterial strains.

Treatment of Neurofibromatosis with Chinese Herbal Drugs

Neurofibromatosis is a dominantly inheriteddefect of the ectoderm,characterized by cafe au laitspots since the childhood and multiple tumorsderived from elements of peripheral and cranialnerves.Hernia-like tumors of various sizes can oftenbe felt under the skin and serve as a valuablecharacteristic in making diagnosis.However,theycan also affect brain,vegetative nerve system or othertissues and lead to bony abnormalities,mentaldisturbances and sometimes,endocrine abnormalities,

Fatal Skin and Soft Tissue Infection, Peritonitis and Bacteriemia Caused by Shewanella petrefaciens

We report a case of skin and soft tissue infection, peritonitis and bacteriemia in a 51-year-old drug abuse male. His wife found him lifeless lying on the kitchen floor at his residence. At the time of autopsy, multiple skin ulcers with deep soft tissue infection and peritonitis were found on gross examination. Cultures of postmortem blood and a swab of soft tissue were positive for Shewanella putrefaciens, a gram-negative bacterium that had been isolated from many foods, sewage and fresh and salt water. This is the first reported case in the United States of fatal skin and soft tissue infection, peritonitis and bacteremia caused by this micro-organism.

Skin Disinfection with 2% Chlorine Gluconate-Adine in Autologous Peripheral Hematopoietic Stem Cell Transplantation Patients

Background: Autologous peripheral blood hematopoietic stem cell transplantation is widely used in the treatment of malignant lymphoma. Patients are prone to infection during the transplantation immune deficiency period. There has been a lot of clinical research into how to better manage this period of vulnerability. Objective: This study aims to investigate the efficacy of 2% chlorhexidine gluconate (CHG) for skin disinfection in patients undergoing autologous hematopoietic stem cell transplantation (HSCT) and observe any adverse reactions. Methods: A total of 106 patients receiving autologous hematopoietic stem cell transplantation from November 2019 to December 2020 in our district were selected as the control group. From January 2021 to January 2022, 106 patients with autologous hematopoietic stem cells were included in the experimental group. The control group used the immersion bath method. The experimental group was treated with an improved scrub bath method (including 3M 2% chlorhexidine gluconate medical sanitary wipes to wipe the whole skin once). Results: The bacteria-carrying rate of the improved method (37.74%) was significantly better than that of the traditional soaking method (72.64%), and the difference was statistically significant (P Conclusion: The improved bath/wipe method has a significant positive effect on skin disinfection for patients undergoing HSCT.

Experience of Photopneumatic Therapy in Taiwan Residents Acne Patients

Acne is a disease of the pilosebaceous unit affecting both teenagers and adults. The treatment of acne is sometimes frustrating due to the emergence of antibiotic resistance, skin irritation and lack of novel therapy. Light and vacuum devices, also known as photopneumatic therapy, have been shown promising as a generally well-tolerated adjunctive treatment of acne vulgaris. We conducted a clinical study using such device to assess the efficacy and safety as an adjunctive treatment of acne in Taiwan Residents patients. Twenty patients received six sequential treatments every one to two weeks in the facial region. A 4 × 4 cm2 area on cheek was chosen as a control area and was not treated with photopneumatic device. Safety parameters and adverse events were recorded. VISIA Complexion Analysis System was used for image analysis on the improvement of four parameters, namely, pigmentation, pore reduction, redness and porphyrin levels. There was an overall improvement in pigmentation, pore size, redness and porphyrin levels on treatment areas. The treatment areas showed statistically significant improvement (p < 0.05) in pigmentation and pore sizes compared with the control areas using paired samples T-test. Mild and self-limiting localized adverse events, mostly focal petechiae or mild irritation, were reported. Our study has demonstrated that photopneumatic therapy is an effective, safe and relatively well-tolerated procedure in Taiwan Residents acne patients.

Microneedle patch loaded with ferritin-nanocaged doxorubicin for locally targeted drug delivery and efficient skin cancer treatment

Ferritin has emerged as a promising nanocarrier for delivering therapeutic agents to tumours.However,the limited drug loading and the off-target impacts after systemic administration remain challenges for cancer treatment with ferritin-based agents.Herein,we develop a microneedle patch loaded with ferritin-nanocaged doxorubicin(DoxFe@Fn/MN)for skin cancer treatment.Briefly,doxorubicin(Dox)is encapsulated in ferritin(Fn)using an iron core-assisted strategy,which results in a 3.4-fold increase in Dox loading compared to the direct loading method.Then,a polyvinyl alcohol-based microneedle(MN)patch is used for the transdermal delivery of DoxFe@Fn,enabling targeted tumour accumulation of DoxFe@Fn and preventing off-target impacts.The released DoxFe@Fn can bind to CD71 highly expressed on skin cancer cells,facilitating its uptake.As a result,the DoxFe@Fn/MN therapy presents a robust antitumour effect in a melanoma tumour model,showing its potential as a promising therapeutic modality for skin cancer treatment.

Investigation and analysis of the characteristics and drug sensitivity of bacteria in skin ulcer infections

Purpose： Skin ulcer is a common type of disease affecting patients＇ health and quality of life, and bacterial infection increases the difficulty of its management. Methods： The present study collected the results of bacterial culture sampled from the surface of 110 cases of skin ulcers at our hospital from January 2011 to December 2012. We analyzed the constituent ratios of ulcer surface bacteria, the change in the main infectious bacteria and the results of drugsensitivity testing for common bacteria. In addition, the characteristics of bacterial infection of skin ulcers were summarized. Result： Of the 110 samples, 90 isolated bacteria were cultured. Sixty-one were Gram-negative bacteria, mainly comprising Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli. In addition, 23 isolates were Gram-positive bacteria, mainly comprising Staphylococcus aureus and Enterococcus faecalis. The probability of a negative bacterial culture in 2012 was significantly lower than that in 2011 （16.7% vs. 40.0%, p 〈 0.01）. Moreover, the probability of P. aeruginosa infection in 2012 was significantly higher than that in 2011 （31.7% vs. 14.0%, p 〈 0.01）. P. aeruginosa was resistant to seven commonly used antibiotics. Both K. pneumoniae and E. coli had higher resistance to ampicillin. E. cloacae were not sensitive to piperacillin/tazobactam. Acinetobacter baumannii was resistant to all the tested drugs. S. aureus, E. faecalis and Staphylococcus epidermidis had high resistance to clindamycin. There was other drug resistance to reflect the higher rate of skin bacterial resistance. Conclusion： Skin bacterial resistance rate is high. Gram-negative bacteria gradually account for the majority, and P. aeruginosa becomes the most important skin infection pathogen. These characteristics of bacterial infections of skin ulcers provide a significant reference for guiding the selection of antibiotics, better controlling infections of skin ulcers and accelerating the healing of skin ulcers.

Hydradenitis suppurativa and inflammatory bowel disease: An unusual, but existing association

Inflammatory bowel disease (IBD) could be associated with several extra-intestinal manifestations (EIMs) involving musculoskeletal, hepatopancreatobiliary, ocular, renal, and pulmonary systems, as well as the skin. In the last years, hidradenitis suppurativa (HS) is acquiring an increasing interest. IBD, especially Crohn&#x02019;s disease (CD), is among the most reported associated diseases in HS patients. The aim of this paper is to give a brief overview of data showing a possible epidemiologic and pathogenetic association between IBD and HS. We performed a pooled-data analysis of four studies and pooled prevalence of HS in IBD patients was 12.8%, with a 95%CI of 11.7%-13.9%. HS was present in 17.3% of subjects with CD (95%CI: 15.5%-19.1%) and in 8.5% of UC patients (95%CI: 7.0%-9.9%). Some items, especially altered immune imbalance, are generally involved in IBD pathogenesis as well as invoked by HS. Smoking is one of the most relevant risk factors for both disorders, representing a predictor of their severity, despite, actually, there being a lack of studies analyzing a possible shared pathway. A role for inheritance in HS and CD pathogenesis has been supposed. Despite a genetic susceptibility having been demonstrated for both diseases, further studies are needed to investigate a genetic mutual route. Although the pathogenesis of IBD and HS is generally linked to alterations of the immune response, recent findings suggest a role for intestinal and skin microbiota, respectively. In detail, the frequent finding of Staphylococcus aureus and coagulase-negative staphylococci on HS cutaneous lesions suggests a bacterial involvement in disease pathogenesis. Moreover, microflora varies in the different cutaneous regions of the body and, consequently, two different profiles of HS patients have been identified on these bases. On the other hand, it is well-known that intestinal microbiota may be considered as &#x0201c;the explosive mixture&#x0201d; at the origin of IBD despite the exact relationship having not been completely clarified yet. A better comprehension of the role that some bacterial species play in the IBD pathogenesis may be essential to develop appropriate management strategies in the near future. A final point is represented by some similarities in the therapeutic management of HS and IBD, since they may be controlled by immunomodulatory drugs. In conclusion, an unregulated inflammation may cause the lesions typical of both HS and IBD, particularly when they coexist. However, this is still a largely unexplored field.

Transdermal drug delivery models

In this paper, a preliminary study based on the different models of the skin impedance is carried out. The purpose is to examine the drug delivery method through iontophoresis, which relies on active trans- portation of the charged medication agent within an electric field. It is a kind of transdermal drug delivery method, and hence the method has to handle the variability in skin characteristics of a patient. This paper carries out a simulation study based on three different skin impedance models.

COMPARATIVE TREATMENT OF ACNE VULGARIS USING PALOMAR LUX APPLIQU´E TECHNIQUE AND DIRECT INTRALESIONAL INJECTION

Intralesional injection of triamcinolone(TMC)preparations is an effective therapy for cystic acne lesions.However,invasive delivery techniques limit the use of this modality to a relatively narrow class of cases.Skin permeability can be enhanced through creating a lattice of microzones(islets)of light-induced limited thermal damage in the upper layers of epidermis.In this paper,we directly compared safety and efficacy of delivering TMC acetonide with this novel technique versus conventional intralesional injection for treatment of inflammatory acne lesions.A combination of an intense pulsed light system and a specially designed appliqu´e with a pattern of absorbing centers has been used to create the lattice of islets of damage(LID).Quantitative analysis has included estimation of the following parameters:redness,diameter,and height of acne lesions.Clinical photography has been used to document dynamics of lesion development at successive visits(two hours,24 hours and one week post-treatment).Seven subjects have participated in the study.No difference in lesion dynamics between the treatment and control groups was observed at two-hours follow-up.At 24-hours/one-week follow-ups,TMC-injected and TMC-LID-delivered groups have demonstrated 82%/93%and 80%/89%improvement in height of lesions in comparison to control(60%/68%).Delivery of TMC with the newly proposed LID technique is at least as effective as intralesional injection for treating inflammatory acne lesions.Enhancement of skin permeability using LID approach is a promising technique for accelerating delivery of various compounds to their target areas in the skin.

Innovate combination of sevoflurane dilution in dimethyl sulfoxide: A stability study by gas chromatography and nuclear magnetic resonance

To investigate physicochemical stability of sevofuranein dimethyl sulfoxide using gas chromatography with a fame ionization detector and nuclear magnetic reso-nance （NMR）.METHODSUndiluted sevoflurane, plus dilutions 1：2, 1：5, 1：10, 1：25, and 1：50 in dimethyl sulfoxide were prepared in a vertical laminar fow cabinet class Ⅱ type B and stored at different temperatures （23 ℃, 6 ℃, and -10 ℃） for 45 d. Sterile 1 mL polypropylene amber syringes to minimize light degradation, caps and needles were used. The presence of sevofurane and its degradation products in the samples was determined by gas chroma-tography with flame ionization detector （260 ℃, 40min）, and by 1H, 19F, and proton-decoupled 19F nuclearmagnetic resonance.RESULTS The gas chromatography analysis showed sevofluraneand dimethyl sulfoxide （DMSO） retention times were 2.7and 13.0 min, respectively. Pure DMSO injection into thecolumn resulted in two additional peaks at 2.1 and 2.8min. The same sevofurane peak at 2.7 min was observedin all the dilutions at -10 ℃, 4 ℃ and 25 ℃. The NMRspectra showed signals consistent with the sevoflurane structure in all the dilutions at -10 ℃, 4 ℃ and 25 ℃. In the 1H spectrum, two signals corresponding to the sevoflurane molecule were observed at 5.12 and 4.16 parts per million （ppm5）. In the 19F-NMR spectrum, two signals were observed at -76.77 ppm and -157.13 ppm. In the 19F NMR CPD, two signals were observed at -76.77 ppm and -157.13 ppm. The first one showed a doublet （JF-F = 3.1 Hz） which integrated by six fluorine nuclei from the hexafluoro-isopropyl group. The second signal was integrated by a fuorine atom and showed a septuplet （JF-F = 3.1 Hz）.CONCLUSIONThis study shows that different concentrations ofsevofurane in dimethyl sulfoxide retain their chemicalcomposition after exposure to different temperaturesfor a period of 45 d.

双相情感障碍患者人类白细胞抗原-B^(*)1502基因检测分析及用药风险评估

目的通过检测并分析双相情感障碍(BD)患者人类白细胞抗原-B^(*)1502(HLA-B^(*)1502)基因多态性,评估拉莫三嗪诱发皮肤不良反应的风险。方法回顾性收集2019年1月至2022年8月在枣庄市妇幼保健院就诊并在初次使用拉莫三嗪前采用荧光染色原位杂交测序技术检测HLA-B^(*)1502基因型和用药指导的510例患者作为研究对象,分析其基因型与皮肤型药物不良反应发生情况。结果患者HLA-B^(*)1502基因中阳性结果的占比低于阴性结果,差异有统计学意义(P<0.05)。HLA-B^(*)1502基因阳性结果中,杂合突变型占比高于纯合突变型,差异有统计学意义(P<0.01)。结论临床在初次使用拉莫三嗪控制和治疗双相情感障碍患者的过程中,为降低拉莫三嗪诱发皮肤不良反应的风险,有必要进行HLA-B^(*)1502基因检测。

肿瘤免疫检查点抑制剂相关皮肤毒性管理的证据总结

目的评价并总结免疫检查点抑制剂相关皮肤毒性管理的相关证据,为医护人员对肿瘤免疫检查点抑制剂相关皮肤毒性患者进行管理提供依据。方法系统检索国内外相关网站和数据库,查询关于肿瘤免疫检查点抑制剂相关皮肤毒性管理方面的指南、专家共识、证据总结、系统评价等证据。检索时间为建库至2024年4月30日,由2名具有循证护理知识的研究人员独立对文献进行质量评价和证据级别评定。结果共纳入19篇文献,包括指南7篇、专家共识10篇、系统评价1篇、临床决策1篇,从预防、评估、检查、治疗与护理、监测5个方面形成19条最佳证据。结论有效管理免疫检查点抑制剂相关皮肤毒性可改善皮肤症状,提高患者的生活质量。医护人员需考虑患者的意见,结合临床情境,为肿瘤免疫检查点抑制剂相关皮肤毒性患者提供个性化的指导。

滋燥养荣方治疗抗肿瘤靶向药所致大鼠皮肤干燥的分子机制

目的 基于网络药理学分析和动物实验探讨中药滋燥养荣方治疗抗肿瘤靶向药所致皮肤干燥的分子机制。方法采用在线数据库筛选滋燥养荣方各单味药成分的靶点和皮肤干燥及瘙痒的靶点,对共同靶点进行分析,通过通路富集预测中药可能的效应途径。应用靶向药吉非替尼建立与患者皮肤干燥皮损表现一致的大鼠模型,分为模型组、阳性对照组和中药组,分别予生理盐水、维生素E乳、中药进行干预,以正常大鼠作为正常对照组,观察各组皮肤表型、组织病理学变化、信号通路相关蛋白和炎症因子表达。结果 滋燥养荣方各单味药筛选出预测靶点共3 125个,靶向药所致皮肤干燥及伴有瘙痒的对应靶点共660个。对173个共同靶点进行分析,通路富集预测结果显示表皮角质细胞内磷脂酰肌醇-3-激酶(PI3K)-丝苏氨酸蛋白激酶B (Akt)通路可能是中药起效的信号途径。动物实验表明,与正常对照组比较,其余各组均出现靶向药相关的皮损、结痂、脱屑等皮肤干燥表现;与模型组比较,阳性对照组和中药组小鼠的皮肤干燥均改善,中药组小鼠皮损愈合、毛发生长情况优于阳性对照组。与正常对照组比较,模型组表皮增厚(P<0.05);与模型组比较,阳性对照组、中药组表皮厚度变薄(P<0.05)。与正常对照组比较,模型组Akt蛋白和p-Akt 308蛋白染色呈棕黄色,强度较弱;与模型组比较,中药组Akt蛋白和p-Akt 308蛋白染色呈棕黄色,强度较强,且强于阳性对照组,与正常对照组相近。各组p-Akt 473蛋白染色强度差异不明显。Western blotting检测结果:与正常对照组比较,中药组皮肤组织中p-Akt 308蛋白相对表达量低(P<0.05);与模型组比较,中药组皮肤组织中p-Akt 308蛋白相对表达量高(P<0.05)。各组皮肤组织及血清炎症因子水平比较差异无统计学意义(P>0.05)。结论 中药滋燥养荣方能缓解抗肿瘤靶向药所致大鼠局部皮肤炎症、促进皮肤修复,其分子机制可能与Akt相关信号通路有关。

艾司氯胺酮切皮前用药对腹腔镜全子宫切除术后患者抑郁情绪与睡眠质量的影响

目的:探讨腹腔镜全子宫切除术(LTH)切皮前艾司氯胺酮用药镇痛效果。方法:选取2021年2月-2023年5月本院LTH患者110例,随机数字表法分为2组各55例。均择期行全麻下LTH治疗,观察组于切皮前予以艾司氯胺酮0.3 mg/kg静脉注射、对照组同时间点予以同剂量生理盐水注射。统计两组各时间点17项汉密尔顿抑郁量表(HAMD-17)、数字评定量表(NRS)以及匹兹堡睡眠质量指数(PSQI)评分,比较两组血清神经递质[多巴胺(DA)、肾上腺素(E)、去甲肾上腺素(NE)]水平,统计不良反应。结果:观察组剔除术中转开腹1例、个人因素退出1例,纳入53例;对照组剔除数据不全1例,纳入54例。观察组术后4 h、12 h、24 h、48 h静息时NRS评分(2.27±0.36分、2.53±0.41分、2.40±0.30分、2.12±0.32分)均低于对照组(2.62±0.40分、3.08±0.46分、2.85±0.38分、2.52±0.42分),术后2 d和5 d HAMD-17评分(13.24±2.16分、10.16±2.42分)、PSQI评分(12.46±1.84分、9.35±1.75分)均低于对照组(15.07±2.33分、11.59±2.51分、13.85±2.13分、10.08±1.92分),术后5 d观察组血清NE(129.45±17.25ng/L)、E(33.46±5.42ng/L)及DA(7.37±0.86μg/L)水平均高于对照组(113.62±13.48ng/L、30.72±4.15ng/L、7.03±0.72μg/L)(均P<0.05)。观察组不良反应总发生率(17.0%)与对照组(14.8%)无差异(P>0.05)。结论:艾司氯胺酮切皮前用药可减轻LTH患者术后疼痛,调节神经递质表达水平,改善抑郁、睡眠状态,且未增加不良反应。