Hyaluronic acid injection in the auricular base for the aesthetic correction of lying ears:A retrospective study

Background Ears play an important role in facial profiles.Lying ears are not perceived favorably in Asian cultures;therefore,surgical procedures are implemented to adjust this defect.However,surgery has complications and requires recovery time.We introduced a hyaluronic acid(HA)injection technique to aesthetically improve ear prominence.Methods This retrospective study examined 25 Chinese patients aged 20-47 years with congenital lying ears who received HA injections in the auricular base at Shanghai Ninth People’s Hospital and Hangzhou Yijie Medical Cosmetology Clinic between November 2019 and December 2022.The average injection volume was 6.32±1.22 mL in the auricular base unilaterally,and the follow-up time ranged from 6 to 24 months.Morphological measurement data were recorded.Two-dimensional(2D)and three-dimensional(3D)images were obtained to evaluate the effects.Results All patients showed improvements in ear prominence.The cranioauricular angle(CAA)increased from 22.24°±4.53°to 65.90°±5.38°immediately post-injection and was maintained at 49.18°±4.74°6 months later.The ear projection(EP)increased from 14.75±2.72 mm to 26.26±2.94 mm immediately post-injection and was 22.51±2.68 mm after 6 months.No serious complications were noted.Conclusion HA injection in the auricular base effectively corrected the lying ears and aesthetically optimized the facial profile.It also had a face-lift effect that made the face look younger and more compact.The injection procedure was minimally invasive and required no recovery period.The effect was maintained for a long time and was satisfactory.

Different concentrations of hyaluronic acid eye drops for dry eye syndrome: a systematic review and Meta-analysis

AIM:To compare high or low concentration of hyaluronic acid eye drops(HY)for dry eye syndromes(DES).METHODS:Randomized controlled trials(RCTs)comparing various concentrations of HY were searched in PubMed,Embase,Web of Science,Cochrane,SinoMed,CNKI,Wanfang Database,CQVIP,and Chinese journals databases between inception and July 2023.Pooled standardized mean differences(SMD)or weighted mean difference(WMD)with 95%confidence intervals(CI)from RCTs evaluating Schirmer’s I test(SIT),corneal fluorescein staining score(CFS),tear breakup time(TBUT),DES score(DESS),and Ocular Surface Disease Index(OSDI)were calculated.Sensitivity analysis,Egger’s test and Meta-regression analysis were performed for all indicators.RESULTS:We conducted a Meta-analysis of 10 RCTs that met the inclusion criteria,involving 1796 cases.High-concentrations group significantly improved the outcome of CFS according to random effects modelling(SMD,-3.37;95%CI,-5.25 to-1.48;P=0.0005).The rest of the results were not statistically significant,including indicators such as SIT,TBUT,DESS and OSDI.CONCLUSION:For dry eyes with positive corneal staining,a high concentration of HY is recommended,whereas in other cases,a high concentration of HY does not offer a more pronounced advantage over a low concentration of HY in the treatment of dry eyes.

Impacts of mesenchymal stem cells and hyaluronic acid on inflammatory indicators and antioxidant defense in experimental ankle osteoarthritis

BACKGROUND No effective treatment guarantees full recovery from osteoarthritis(OA),and few therapies have disadvantages.AIM To determine if bone marrow mesenchymal stem cells(BMMSCs)and hyaluronic acid(HA)treat ankle OA in Wistar rats.METHODS BMMSCs were characterized using flow cytometry with detection of surface markers[cluster of differentiation 90(CD90),CD105,CD34,and CD45].Fifty male Wistar rats were divided into five groups of 10 rats each:Group I,saline into the right tibiotarsal joint for 2 days;Group II,monosodium iodate(MIA)into the same joint;Groups III,MIA+BMMSCs;Group IV,MIA+HA;and Group V,MIA+BMMSCs+HA.BMMSCs(1×106 cells/rat),HA(75μg/rat),and BMMSCs(1×106 cells/rat)alongside HA(75μg/rat)were injected intra-articularly into the tibiotarsal joint of the right hind leg at the end of weeks 2,3,and 4 after the MIA injection.RESULTS The elevated right hind leg circumference values in the paw and arthritis clinical score of osteoarthritic rats were significantly ameliorated at weeks 4,5,and 6.Lipid peroxide significantly increased in the serum of osteoarthritic rats,whereas reduced serum glutathione and glutathione transferase levels were decreased.BMMSCs and HA significantly improved OA.The significantly elevated ankle matrix metalloproteinase 13(MMP-13)mRNA and transforming growth factor beta 1(TGF-β1)protein expression,and tumor necrosis factor alpha(TNF-α)and interleukin-17(IL-17)serum levels in osteoarthritic rats were significantly downregulated by BMMSCs and HA.The effects of BMMSCs and HA on serum TNF-αand IL-17 were more potent than their combination.The lowered serum IL-4 levels in osteoarthritic rats were significantly upregulated by BMMSCs and HA.Additionally,BMMSCs and HA caused a steady decrease in joint injury and cartilage degradation.CONCLUSION BMMSCs and/or HA have anti-arthritic effects mediated by antioxidant and anti-inflammatory effects on MIAinduced OA.MMP-13 and TGF-β1 expression improves BMMSCs and/or HA effects on OA in Wistar rats.

Intra-articular interventions in osteoarthritis:Navigating the landscape of hyaluronic acid,mesenchymal stem cells,and plateletrich plasma

Osteoarthritis(OA)poses a substantial burden on patients,leading to pain,functional decline,and reduced quality of life.While conventional treatments focus on symptom management,disease-modifying interventions are yet to be established.This review explores the efficacy of intra-articular interventions,particularly hyaluronic acid(HA),mesenchymal stem cells(MSCs),and platelet-rich plasma(PRP),in the context of OA management.HA injections,with diverse formulations like Hylan G-F20,sodium hyaluronate,and hyaluronan,present varying outcomes,necessitating a nuanced understanding of their effectiveness and timing.MSC therapy,derived from adipose tissue,umbilical cord,or bone marrow,shows promising results in clinical improvement,with adipose-derived MSCs demonstrating efficacy in maintaining benefits over 6 mo.Conversely,bone-marrow-derived MSCs show limited effectiveness,highlighting the need for sourcespecific considerations.PRP has emerged as a superior option for long-term pain reduction and quality of life improvement,with leukocyte-poor formulations and a critical platelet count of 10 billion demonstrating optimal results.This comprehensive analysis underscores the potential of intra-articular interventions in OA management,emphasizing the need for personalized and evidence-based approaches to enhance treatment efficacy and patient outcomes.

Intraarticular injections(corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis

Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.

Adjunctive platelet-rich plasma and hyaluronic acid injection after arthroscopic debridement in Kellgren-Lawrence grade 3 and 4 knee osteoarthritis

BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Kellgren-Lawrence(KL)grade 3 and 4 knee OA.As such,joint replacement is often recommended,although only 15%-33%of candidates accept it.Alternative therapeutic options are still needed to prevent the progression of joint damage and delay the need for knee arthroplasty.AIM To investigate the effect of adjunctive platelet rich plasma(PRP)and hyaluronic acid(HA)after arthroscopic debridement in KL grade 3 and 4 knee OA.METHODS This retrospective cohort study used the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and WOMAC sub-scores(pain,stiffness,and function)to assess 21 patients,grouped according to medical record data of treatment received:Arthroscopic debridement(n=7);arthroscopic debridement with PRP(n=7);or arthroscopic debridement with HA(n=7).WOMAC scores and sub-scores at baseline and at 3 mo and 5 mo posttreatment were recorded.The three-group data were statistically analyzed using the tests of paired t,one-way analysis of variance,and post hoc least significant difference.RESULTS All three treatment groups showed significant improvements in WOMAC score and sub-scores from before treatment to 3 mo and 5 mo after treatment.However,the arthroscopic debridement with PRP treatment group,in particular,showed a significantly lower WOMAC pain score than the group who received arthroscopic debridement alone at 5 mo after the procedure(P=0.03).CONCLUSION Compared to arthroscopic debridement alone,adjunctive PRP after arthroscopic debridement significantly lessened the patients’pain symptom.

Use of High-Resolution Ultrasound (HRU) in the Assessment of Deep Injections of CHAP-Hyaluronic Acid (CHAP-HA) Fillers for Midface Lift

High-resolution ultrasound (HRU) imaging is a useful tool to study hyaluronic acid (HA) filler injection in the face. It is noninvasive, quick, well-tolerated, and can provide in vivo and dynamic information. The formations of pools or pearls in HA fillers could be observed real time during injection. The plane of injection could be determined accurately, and there were no specimen manipulation artifacts. It was observed that HA gel fillers with differing production technologies showed distinct spread and distribution patterns in the periocular tissues on HRU examination. The authors used HRU to assess deep injections of CHAP-Hyaluronic Acid (CHAP-HA) fillers for midface lift. 10 patients who underwent bilateral midface deep injections using CHAP-HA filler were examined with HRU before and immediately after treatment, and in 2 weeks and one month later. The CHAP-HA appeared as hypoechoic densities within the preperiosteal plane in HRU. CHAP-HA adopted variable morphology within the tissue depending on individual tissue densities and the compliance of the tissues in the plane of injection. CHAP-HA was unidentifiable with surrounding tissue after one month in 13 of the 20 injection sites. HRU allows in vivo study of CHAP-HA injection behavior and could be a tool for further studies of HA-tissue reactions.

A Guide to Cheek Augmentation: Single-Point Deep Injection of Hyaluronic Acid Filler at Midface in Close Proximity to Medial Suborbicularis Oculi Fat (SOOF) Area

Loss of volume in midface can result in an aged, wasted appearance. Osseous and fat atrophy with aging may further contribute to the loss of soft tissue support and midface ptosis. In the aging of periorbital area and midface, fat atrophy occurs mostly in the suborbicularis oculi fat (SOOF) area. The authors proposed that injection of hyaluronic acid (HA) filler to support the SOOF area could counteract the aging sign due to fat atrophy, restore volume loss and achieve a more youthful appearance. The authors described the treatment of 10 female patients who received CHAP®-particle hyaluronic acid (CHAP®-HA) injections for cheek augmentation, using single-point deep injection technique at midface in close proximity to SOOF area. Such approach provides satisfactory cheek augmentation results without significant complications. The authors discussed a rationale for their choice of dermal filler and provided an injection technique for restoring volume in the midface region with CHAP®-HA. Such technique is relatively quick to perform, have little down time, and result in a high rate of patient satisfaction.

Majocchi’s granuloma caused by Trichophyton rubrum after facial injection with hyaluronic acid:A case report

BACKGROUND Facial cosmetic procedures become popular for people with a desire to have a younger appearance,and cosmetic technology has developed rapidly over the past several decades.However,increasing complications related to cosmetic injections have been reported,and infection is one of the most serious problems and can cause anxiety and facial injury.We here report a case of Majocchi’s granuloma(MG)caused by Trichophyton rubrum after facial injection of hyaluronic acid.CASE SUMMARY A 37-year-old woman presented to our hospital with a history of red papules,nodules,and abscesses on her left zygomatic arch for 2 mo.She had received a cosmetic injection of hyaluronic acid on the left side of her face prior to the appearance of the lesions.MG caused by Trichophyton rubrum after facial injection of hyaluronic acid was diagnosed based on morphology and molecular biological identification.In vitro antifungal susceptibility testing was conducted according to the Clinical and Laboratory Standards Institute M38-A2 method.Minimal inhibitory concentrations were used to evaluate the antifungal susceptibility.The antifungal agents and their minimal inhibitory concentrations for the strain were terbinafine(<0.5μg/mL),itraconazole(0.06μg/mL),amphotericin B(0.25μg/mL),fluconazole(32μg/mL),voriconazole(0.125μg/mL),posaconazole(0.125μg/mL),and isavuconazole(0.06μg/mL).We initially administered 250 mg/d oral terbinafine for 2 mo,but the patient still had painful papules,nodules and abscesses on her face.Then,we adjusted the treatment to itraconazole 400 mg/d for 8 wk based on the in vitro antifungal susceptibility testing results.The skin lesions improved significantly,and there was no recurrence during follow-up.CONCLUSION This case revealed that facial injection of hyaluronic acid may cause serious MG.Antifungal susceptibility testing should be considered in the treatment of MG caused by Trichophyton rubrum.

Use of hyaluronic acid for sperm immobilisation and selection before intracytoplasmic sperm injection:A systematic review and meta-analysis

AIM:To appraise critically the published randomised controlled trials(RCTs)reporting on the effectiveness of using hyaluronic acid(HA)for sperm immobilisation and selection before intracytoplasmic sperm injection(ICSI).METHODS:Two authors used the PICO Method in order to perform a comprehensive literature search of the standard medical databases in June 2015.Data from the included studies was extracted independently by two authors using a predefined pro-forma.Review Manager(RevM an)was used to calculate the combined outcomes where multiple studies contributed with their results.Risk ratio(RR)with a 95%CI using the Mantel-Haenszel method was calculated for binary data variables.Heterogeneity was measured using the χ2 test and quantified using I2.In case of substantial heterogeneity(P < 0.10 for χ2 test or I2 > 50%)the combined outcome was calculated using the random effects model.The results from the meta-analysis were displayed as forest plots.The guideline of the Cochrane Collaboration was used to assess the risk of bias and it was illustrated as a risk of bias graph.RESULTS:The systematic literature search identified 166 different studies related to sperm immobilisation and selection for ICSI.Eleven RCTs involving 13719 oocyte intracytoplasmatic injections with sperm immobilised and selected using HA or polyvinylpyrrolidone(PVP)were included in this systematic review and metaanalysis.There was low heterogeneity among the included trials(χ2 = 16.86,df = 11,P = 0.11; I2 = 35%).There was no statistical difference between HA and PVP groups in terms of fertilisation rate(RR = 1.01; 95%CI:0.99-1.03; z = 0.75; P = 0.45),good embryos rate(RR = 1.01; 95%CI:0.96-1.06; z = 0.30; P = 0.76),live birth rate(RR = 1.15; 95%CI:0.86-1.54; z = 0.92; P = 0.36),clinical pregnancy rate(RR = 1.04; 95%CI:0.92-1.17; z = 0.62; P = 0.53)and implantation rate(RR = 1.17; 95%CI:0.94-1.46; z = 0.40; P = 0.16).The quality of most of the included studies was moderate to poor because of unclear randomisation technique,inadequate allocation concealment and blinding.CONCLUSION:This systematic review and metaanalysis provides evidence of similar efficiency between using HA or PVP for sperm immobilisation and selection before ICSI.

Effectiveness of a Single High Dose of Platelet-Rich Plasma (PRP) Injection Over Corticosteroid and Hyaluronic Acid Injections on Osteoarthritis, Chronic Tendinitis and Tennis Elbow Treatment

Background: Corticosteroid, hyaluronic acid (HA) injections and Anti-inflammatory agents are considered as non-invasive treatments for knee osteoarthritis (OA), Chronic Tendinitis (CT) and Tennis elbow (TE) that are supposed to provide symptomatic relief and to help surgical delay intervention. Platelet rich plasma (PRP) is a biological component shown to be beneficial for different orthopedic dysfunctionalities treatment. The presence of GFs in PRPs such as transforming growth factor-β, insulin-like growth factor 1co-stimulate the mesenchymal stem cells and fibroblasts secretions and promotes the fibrin matrix formation which effectively drive the healing process, induces regenerative response and lead to the damage structure repair in orthopedics trauma. Methods: Three groups of a total of 30 patients presenting OA, CT and TE diagnosis, non-responding to corticosteroid, HA and non-steroid anti-inflammatory treatments were randomized to undergo one intra-articular injections of single high dose of PRP. The efficacy of Intra-articular PRP Injections was evaluated before the injection and one month after. The efficiency assessment score was based on [1] Knee injury and Osteoarthritis Outcome Score, [2] Physical Function Short Form (KOOS-PS) Arabic (KSA) version LK 1.0, [3] HOOS-Physical Function Short form (HOOS-PS), and [4] Macdermid patient-rated Tennis Elbow. Results: A significant reduction of pain and a marked improvement in movements was observed in the 3 patient’s groups, PRP-injected patients showed significantly higher values compared with baseline: (p < 0.005 vs baseline), improve functional status and reduce clearly the articular dysfunctions over the time. In our study, single High dose injection of PRP provided an overall superior clinical improvement compared with HA and corticosteroid treatments over the time and the different follow-up checkpoints of the study.

A hyaluronic acid granular hydrogel nerve guidance conduit promotes regeneration and functional recovery of injured sciatic nerves in rats

A hyaluronic acid granular hydrogel can promote neuronal and astrocyte colony formation and axonal extension in vitro,suggesting that the hydrogel can simulate an extracellular matrix structure to promote neural regeneration.However,in vivo experiments have not been conducted.In this study,we transplanted a hyaluronic acid granular hydrogel nerve guidance conduit to repair a 10-mm long sciatic nerve gap.The Basso,Beattie,and Bresnahan locomotor rating scale,sciatic nerve compound muscle action potential recording,Fluoro-Gold retrograde tracing,growth related protein 43/S100 immunofluorescence staining,transmission electron microscopy,gastrocnemius muscle dry/wet weight ratio,and Masson’s trichrome staining results showed that the nerve guidance conduit exhibited similar regeneration of sciatic nerve axons and myelin sheath,and recovery of the electrophysiological function and motor function as autologous nerve transplantation.The conduit results were superior to those of a bulk hydrogel or silicone tube transplant.These findings suggest that tissue-engineered nerve conduits containing hyaluronic acid granular hydrogels effectively promote the morphological and functional recovery of the injured sciatic nerve.The nerve conduits have the potential as a material for repairing peripheral nerve defects.

CHAP-Hyaluronic Acid (CHAP-HA) Filler as an Optimal Candidate for Forehead Filler Augmentation Using a 3-Point Injection Technique

Minimally invasive forehead augmentation is becoming increasingly popular in Asia. However, treatment of the glabella is associated with injection-related complications. The safety of injections can be increased through a thorough understanding of the anatomy and precise injection planes. The authors propose a 3-point injection technique for forehead augmentation in Asian patients that uses CHAP-hyaluronic acid (CHAP-HA) filler. The longevity of the filler was assessed using high-resolution ultrasound (HRU) imaging. Fifteen patients were examined using HRU before and immediately after treatment and at 1 month, 3 months, 6 months, and 12 months. As evident in HRU imaging, CHAP-HA remained visible within surrounding tissue for 6.4 ± 3.7 months. The mean Global Aesthetic Improvement Scale rating was 2.4 ± 0.5 immediately after treatment, 2.8 ± 0.3 at 1 month, 2.7 ± 0.5 at 3 months, 2.1 ± 0.6 at 6 months, and 1.5 ± 0.6 at 12 months. Minimal side effects were reported. The authors demonstrated that CHAP-HA filler may be an optimal candidate for forehead filler augmentation using a 3-point injection technique.

Development of hyaluronic acid-based edible film for alleviating dry mouth

For alleviating dry mouth symptoms,edible films based on hyaluronic acid(HA)with 3 different m(800,1200 and 2300 kDa)were prepared(800 F,1200 F and 2300 F,respectively),and the properties as well as effectiveness were compared.The concentration of each HA dispersion for film forming was set as 3.0%,1.5%or 1.0%,for the m800,1200 and 2300 kDa,respectively,based on the solubility.The 800 F showed the highest thickness,tensile strength,and water vapor transparency,whereas obtained the lowest transparency and elongation at break among samples.All of the HA films showed safety against microorganism during 28 storage day at 40℃with 60%humidity.The optimum site for film attachment in mouth was the palate,and800 F was the most effective for stimulating saliva secretion,eliciting a 38%increase compared to control(without film),tested by the elderly over 65 years old.By the sensory test,800 F was also the most acceptable.Based on above results,the edible films effectively stimulating saliva secretion could be produced with HA,and the physical,sensory characteristics as well as disintegration times of the film could be controlled by mand the dissolution concentration of HA.

A Comprehensive Review of Long-Term Safety and Effectiveness of FACILLE Modified Sodium Hyaluronate Gel for Injection over 3 Years

FACILLE modified sodium hyaluronate gel was designed to be used for nasolabial fold (NLF) correction. However, no study has investigated the long-term safety and effectiveness of FACILLE. Thus, a retrospective study of 14 aesthetic clinics in China was conducted. This was the first large-scale, postmarketing study on FACILLE to evaluate the occurrence of adverse events (AEs) and provide essential information on the satisfaction of patients with FACILLE injections. This study recruited participants aged >18 years. FACILLE was injected into the NLFs on both sides of each participant’s face. The primary endpoint for safety was systemic or severe AEs at an injection site. Effectiveness was assessed on the basis of the participants’ subjective perceptions and satisfaction levels. Safety and effectiveness data were collected on the day of injection and at 2 weeks and 1, 3, 6, 9, 12, 18, 24, 30 and 36 months postinjection. In total, 1552 participants were enrolled (mean age, 29.1 years), and most of them (96.5%) were women. The mean injection volume was 1.39 ± 0.658 mL, and the average number of injections was 2.4 ± 1.68. AEs were reported by 205 participants (13.2%). All AEs occurred at local injection sites. No systemic or severe AEs were observed. Local pain was the most frequently reported AE regardless of the number of injections or the injection volume. Only eight AE cases were correlated with FACILLE administration, with two cases involving local allergic reactions. The participants self-reported that they perceived the procedure to have an effectiveness of ≥90% within 6 months postinjection although this percentage decreased substantially after 9 months. Their satisfaction level was >90% within 1 month postinjection but decreased gradually after 3 months. Our results indicate that the long-term safety of FACILLE injection is adequate. The high self-reported perceived effectiveness and satisfaction levels indicate the considerable potential of FACILLE injections for correcting NLFs.

Design of Novel Wound Dressing Composed of Collagen and Hyaluronic Acid Containing Epidermal Growth Factor

This research aims to develop a wound dressing composed of collagen (Col) and hyaluronic acid (HA) containing epidermal growth factor (EGF). First important issue is to contain EGF in the wound dressing in a stable state. The sheet-shaped sponge was manufactured by freeze-vacuum drying an aqueous solution of Col. Both sides of sponge were treated with ultraviolet (UV) irradiation to introduce intermolecular cross links between collagen molecules. This sponge was named Sponge-Col. Another sheet-shaped sponge was manufactured by freeze-vacuum drying an aqueous solution of HA containing EGF. This sponge was named Sponge-HA/EGF. The wound dressing was manufactured by laminating Sponge-Col on the top, Sponge-HA/EGF in the middle, and Sponge-Col on the bottom to create a sandwich structure. This method can prevent the reducing of EGF activity due to UV irradiation for intermolecular cross-linking. Second important issue is to enable gradual release of EGF from the wound dressing. The elution behavior of this wound dressing was investigated by measuring the weight change after immersion in water for a predetermined time. This wound dressing showed initially fast elution and subsequent very slow elution properties. The upper layer and lower layer Sponge-Col enabled gradual release of the middle layer Sponge-HA/EGF. This result suggests that EGF contained in the wound dressing is gradually released together with HA from the wound dressing. Third important issue is to provide moist wound-healing environment. The upper layer and lower layer Sponge-Col can provide the wound dressing with high water absorption and long-term water retention properties.

Preparation and Evaluation of an Injectable Chitosan-Hyaluronic Acid hydrogel for Peripheral Nerve Regeneration

The aim of this study was to obtain the fillers in the lumen of hollow nerve conduits（NCs） to improve the microenvironment of nerve regeneration. A p H-induced injectable chitosan（CS）-hyaluronic acid（HA） hydrogel for nerve growth factor（NGF） sustained release was developed. Its properties were characterized by gelation time, FT-IR, SEM, in vitro swelling and degradation. Furthermore, the in vitro NGF release profiles and cell biocompatibility were also investigated. The experimental results show that the CS-HA aqueous solution can undergo a rapid gelation 3 minutes after its environmental p H is changed to 7.4. The CSHA hydrogel has interconnected channels with a controllable pore diameter and with a porosity of about 80%. It has a favorable swelling behavior and can be degraded by about 70% within 8 weeks in vitro and is suitable for NGF release. The CS-HA/NGF hydrogel exhibits a lower cytotoxicity and is in favor of the adhesion and proliferation of the BMMSCs cells. It is indicated that the CS-HA/NGF will be a promising candidate for neural tissue engineering.

Intraplaque injections of hyaluronic acid for the treatment of stable-phase Peyronie’s disease:a retrospective single-center experience

Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men worldwide.In the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining attention.The current literature shows dataon the efficacy of intraplaque injections of hyaluronic acid(HA)mainly in acute-phase PD.However,data on injections of HA instable-phase PD are lacking.Data for this retrospective study were derived from a prospectively maintained database of privatepatients presenting at a private medical practice affiliated to the University of Naples“Federico II”(Naples,Italy)with stable-phasePD between January 2020 and March 2023.Patients underwent a standard protocol of three injections,each administered at atwo-week interval.During the intervals,patients performed vacuum device therapy,penile stretching,and modeling exercises.Allpatients compiled the Peyronie’s Disease Questionnaire(PDQ)and Global Assessment of Peyronie’s Disease(GAPD)at baselineand 2 weeks after the third injection.A penile Doppler ultrasound was performed 2 weeks after the last injection to record thefinal curvature.Overall,we recruited 62 patients with stable-phase PD and a mean(±standard deviation[s.d.])curvature of52.7°(±9.7°).After 6 weeks,eight(12.9%)patients did not experience any curvature improvement.The remaining 54 patientshad a final mean(±s.d.)curvature of 40.3°(±9.1°)with P<0.001,compared to that before treatment.We found improvement inall PDQ domains(all P≤0.01),and 50(80.6%)patients reported subjective improvement of the penile curvature according to theGAPD.In conclusion,we demonstrated that after three injections of HA administered according to the adopted protocol,patientswith stable-phase PD could experience significant improvements in penile curvature,and physical and psychological consequencesof the disease without significantly relevant side effects.

Preparation of Rosmarinic Acid Injection from Folium perillae

[Objective] To extract the effective component rosmarinic acid from Folium perillae,study preparation technology and quality control of rosmarinic acid injection and provide test basis for hemorheological drug development and clinic application.[Method]The coarse powder of Folium perillae(40 μm)was lixiviated with hot water and acidized to make aqueous extracts.Rosmarinic acid from the aqueous mixture was extracted with Ethyl Acetate.And Et Ac was evaporated to obtain primary product.The injection was purified by pH adjustment.Concentration of rosmarinic acid in the injection was detected by high performance liquid chromatography(HPLC).Contents of tannin,resin and oxalate were eliminated according to the Chinese Pharmacopeia(2005 edition).Stability,irritation,haemolyticus,LD50 and thermogenic substance of this injection were also detected.[Result]The content of rosmarinic acid in Folium perillae injection is 2.81 mg/ml,and the content of LD50 was 406.82 mg/kg.This injection was consistent with the stipulation of Chinese Pharmacopeia(2005 edition).[Conclusion]The preparation technology of this experiment was reasonable.The stable qualities of the prepared injection meet the injection requirement.

The Value of the Measurement of Urinary Hyaluronic Acid Levels for the Diagnosis of Bladder Cancer

Objective To investigate the value of the measurement of urinary hyaluronic acid (HA) levels for the diagnosis of bladder cancer and the possibility of replacing ELISA-like assay with radioimmunoassay to detect the levels of urinary HA. Methods Using the ELISA-like assay and radioimmunoassay at the same time to measure the HA levels in the urine specimens from 49 bladder cancer patients, 12 benign bladder tumor patients, 30 other genitourinary disease patients and 20 normal controls. Results There is not much difference between the consequences of the urinary HA levels whether we used the ELISA-like assay or radioimmunoassay to detect every specimen (P>0.05). When we used the results with radioimmunoassay for analysis, we found the levels of urinary HA of bladder cancer patients were 2–4 times than those of the benign bladder tumor patients, other genitourinary disease patients or normal individuals (P<0.01); With 137.5 ngHA/mg protein (113.6±23.9 ng/mg) as a minimum cutoff limit, this assay had a good sensitivity (91.8%) and specificity (91.9%) for the diagnosis of bladder cancer. Its difference in sensitivity meant a lot when compared with urine cytology (48.9%,P<0.01). Conclusion The urinary HA assay is a simple, convenient, noninvasive credible and cheap method with satisfactory sensitivity and specificity for the diagnosis of bladder carcinoma; radioimmunoassay is also a good means to measure the urinary HA levels. Key words Bladder carcinoma - Hyaluronic acid - Urine