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.

Preparation and characterization of nanoparticles from quaternized cyclodextrin-grafted chitosan associated with hyaluronic acid for cosmetics

Hyaluronic acid(HA, 20–50 kDa) is a hydrophilic macromolecule with anti-wrinkle effects and moisturizing properties. However, its high molecular weight prevents it from penetrating into the deeper layers of the skin and, thus, limits its benefits to topical effects. Thus, the objective of this study is to prepare nanoparticles of quaternized cyclodextrin-grafted chitosan(QCD-g-CS) associated with HA in different molar ratios of QCD-g-CS and HA. The conjugation of the carboxylic moieties of HA and the amides of QCD-g-CS was confirmed by Fourier-transform infrared spectroscopy. Thus, the system was optimized to create nanoparticles with a small size(235.63 ± 21.89 nm), narrow polydispersity index(0.13 ± 0.02), and zeta potential of 16.07 ± 0.65 m V. The association efficiency and loading efficiency were determined by ultra-performance liquid chromatography as 86.77 ± 0.69% and 10.85 ± 0.09%, respectively. The spherical morphology of the obtained nanoparticles was confirmed by transmission electron microscopy. Moreover, the in-vitro hydrating ability was significantly higher( P < 0.001) than that of bulk HA(3.29 ± 0.41 and 1.71 ± 0.05 g water/g sample, respectively). The safety of these nanoparticles at concentrations in the range of 0.01–0.10 mg/ml was confirmed via tests on human skin fibroblasts. Together, these results demonstrate that the developed nanoparticles are promising for future applications in cosmetics.

Correlation Between Hyaluronic Acid,Hyaluronic Acid Synthase And Human Renal Clear Cell Carcinoma

Objective：To study the correlation between hyaluronic acid（HA）,hyaluronic acid synthase（HAS） and human renal clear cell carcinoma（RCCC）.Methods：The expression of three HAS isoforms＇ gene and HA in 93 RCCC tissues,27 nephridial tissues by the side of RCCC from two hospitals were measured with Real-Time RT-PCR、Western Blot and immunohistochemical methods and analyzed.Results：All RCCC and adjacent normal tissues expressed three HASs＇ mRNA protein;at the mRNA level,both RCCC and adjacent normal tissues,expressed more HAS3 than HAS1 or HAS2,their differences were statistically significant（all P values 0.05）;but,at the protein level,all HAS isoforms presented the equivalent expression.Compared with the adjacent non-neoplastic kidney tissues,the expression of all HAS isoforms＇ mRNA in RCCC tissues were increased evidently and their differences were significant（all P values 0.0001）;but at the protein level,only the expression of HAS3 increased evidently（P=0.022）.In all adjacent normal tissues,more than 80% renal tubular cells strongly expressed HA,however,only the minority RCCC cases（16/93） presented weakly positive HA staining in few cancer nests（5%-30%）,the difference were significant（P0.0001）.In RCCC tissues subgrouped according to clinical stage,pathological grade,lymphatic metastasis or not and distant metastasis or not,the HASs＇ mRNA protein differential expression all had no statistical significance（all P values 0.05）.Conclusion：Different from other malignancy,HA and HASs（except for HAS3） may not play important roles in the biological progress of human RCCC.

Synthesis and Kinetics of a Novel Mimic with Glutathione Peroxidase Activity—Tellurium-containing Hyaluronic Acid (TeHA)

A novel mimic was synthesized by modifying hyaluronic acid （HA） with tellurium, whose function is similar to that of glutathione peroxidase （GPX）. The structure of TeHA was characterized by means of IR and NMR, the target-Te was located at -CH2OH of the N-acetyl-D- glucosamine of HA. The H202 reducing activity of TeHA, by glutathione （GSH）, was 163.6 U/μmol according to Wilson＇s method. In contrast to other mimics, TeHA displayed the highest activity. Moreover, TeHA accepted many hydroperoxides as its substrates, such as H2O2, cumenyl hydroperoxide （CuOOH） and tert-butyl hydroperoxide （t-BuOOH）, and CuOOH was the optimal substrate of TeHA. A ping-pong mechanism was observed in the steady-state kinetic studies of the reactions catalyzed by TeHA.

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.

Characteristics of Hyaluronic Acid Derivative Cross-linked by Polyethylene Glycol

Characteristic and dynamic viscosities of Hyaluronic acid （ HA ） derivative modified by polyethylene glycol （PEG） were tested with different reaction times （6 h,12 h,18 h and 24 h ）, different molar ratio of HA/PEG （1/10,1/5,1/3 and 1/2）, different molecular weight of PEG（400,6 000 and 20 000） and mass fraction is 0. 4% by Wushi Viscosimeter and L-90 Rheometer at 25℃ . Characteristic viscosity of HA derivative had the largest value in 12 h, which decreased with increasing of PEG molecular weight, bat its aqueous dynamic viscosity increased with increment of PEG molecular weight. Meanwhile, we tested dynamic mechanic properties of HA derivative by 3ARES3 Rheometer at 25℃ to study viscoelastic changes and to compare change difference from viscosity to elasticity with the changes of vibration frequency between unmodified HA and HA derivative. Change from low vibrated freqnency to high one of solution resulted in change from viscosity to elasticity of solution. In conclusion, as to the rheological properties, structure- modified HA derivative meets the requirement of biomaterial .

Enhancement of Periodontal Healing by Application of a Novel Ointment Compared with Hyaluronic Acid, Histological Observation in Animal Model

Objectives:?The early healing of the periodontal wound in oral cavity may be critical to the treatment outcome. Thus, we made a novel ointment based on natural constituents that our recent investigation suggested a positive therapeutic effects on gingival wounds. The present study was conducted to evaluate the role of this novel biomaterial on periodontal wound healing including soft as well as hard tissue. Materials and Methods: Experimental periodontitis was induced by wire tied around the cement-enamel junction of I2, P1, P3?and M1?in six adult, healthy beagle dogs. After 3 months, mucoperiostal flap elevated and root surfaced was thoroughly scaled and planed. Randomly, three materials including our ointment with two different ratios including materials A and B and hyluronic acid were applied topically and then the flaps were repositioned and sutured. Three dogs at day 7 and the three remaining ones two weeks post-surgery were sacrificed and histological changes were monitored. Results: The result of this study showed that the local applications of this novel ointment promoted the healing process particularly fibroblast proliferation and collagen density remarkably in comparison with hyaluronic acid and control group. Besides, histological finding of our material revealed that in general terms had all the hallmarks of complete healing two weeks post operatively. Conclusion: Our novel material appeared to have outstanding effect on periodontal wound healing which can improve the periodontal healing consequences and provide better strength of periodontal wound flap. From a clinical standpoint, it could play an important role for better repair in diabetic patients who frequently present difficulties in mucosal and cutanous wound healing.

Characteristic of hyaluronic acid derivative films cross-linked by polyethylene glycol of low water content

Objective:To test the characteristics of hyaluronic acid(HA)derivative cross-linked by polyethylene glycol films of low water content.Methods:The cross-linked HA film with 200μm thickness was got at atmospheric pressure at 25℃for 5 d.After dried,cross-linked films of 10 mm×10 mm were weighed and immersed in phosphate buffered saline (PBS pH 7.45)at 37℃for 24 h.Then the solution fraction and water content were estimated.Meanwhile,cross-linked HA derivative films were immersed in phosphate buffered saline(PBS:pH 7.45)at 37℃for determined time and then implanted subcutaneously in the back of white rats to test in vitro or in vivo degradation characteristic.Results and Conclusion:HA hydrogel cross-linked by polyethylene glycol with water content is as low as 60% and this kind of HA derivative has a slow degradation rate.

Preparation and Characterization of AlginateHyaluronic Acid-chitosan based Composite Gel Beads

The aim of this study was to fabricate composite gel beads based on natural polysaccharides. Hyaluronic acid（HA） and Chitosan（CS） were successfully admixed with Ca^2＋/alginate（SA） gel system to produce SA/HA/CS gel beads by dual crosslinking： the ionic gelation and the polyelectrolyte complexation. The preparation procedure was that the weight ratio of SA（2%, m/v） to HA（2%, m/v） was kept at 2：1, then the mixture was dripped into the Ca^2＋ solution for ion-crosslinking, and finally polyelectrolyte crosslinked with 2% low molecular weight CS（LMW-CS） for 1.5 hours. The optimal formulation was achieved by adjusting the concentration and the weight ratio of SA, HA and LMW-CS. Due to the incorporation of HA and LMWCS, the swelling ratio of the beads at pH 7.4 was increased up to 120, and the time for the maximum swelling degree was prolonged to 7.5 h. The swelling behavior was obviously improved compared to the pure SA/Ca^2＋ system. The preliminary results clearly suggest that the SA/HA/CS gel beads may be a potential candidate for biomedical delivery vehicles.

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.

An Association of Vitamins A and E with Hyaluronic and Lactobionic Acids may Prevent Molecular Changes Associated with Keratocyte to Myofibroblast Transition

Inflammatory events in the corneal stroma may activate keratocytes and trigger their transition towards myofibroblasts,which now produce different extracellular matrix(ECM)proteins thus causing corneal opacification.Corneal haze is a frequent side effect after photorefractive keratectomy(PRK)to correct high myopia.Currently,a preventive treatment with mitomycin-c can be used to limit the occurrence of this phenomenon.However,mitomycin-c is a toxic drug,not devoid of side effects,which may occasionally involve the corneal endothelium.Therefore,we have searched for a less risky,natural way,to prevent keratocytes transition.To this purpose,we have used as markers of the phenotype switch the proteins lumican(highly expressed by keratocytes and much less by myofibroblasts)and smooth muscle actin(αSMA)(highly expressed by myofibroblasts and poorly found in keratocytes),beside Fibronectin(Fn),the expression of which is also increased by transforming growth factor-beta(TGFβ)treatment.Treatment of human keratocytes with TGFβwas used to induce the protein shift.Among different possible candidates,we have found that vitamins A and E,hyaluronic and lactobionic acids may prevent,either alone,or much better in association,the shift in the ratio between lumican andαSMA and the increased Fn expression.In conclusion,it could be speculated that topic treatment of the ocular surface with an association of these four compounds could be able to prevent or at least limit the occurrence of post-PRK corneal haze,with the additional advantage of lubrication,hydration and antioxidant defense exerted by these molecules.

Clinical Study on Facial Rejuvenation of Non-crosslinked Small Molecule Hyaluronic Acid Combined with Filorga NCTF®BOOST135 HA

Objective To observe the clinical application of non-crosslinked small molecule hyaluronic acid combined with Filorga NCTF®BOOST135HA in facial rejuvenation.Methods A total of 156 patients were selected from the outpatient department of our department from January 2017 to January 2018,including 36 males and 120 females.They were randomly divided into treatment group(82 cases)and control group(74 cases).The age of the treatment group was 25-50 years old,with an average age of 34 years old,while that of the control group was 26-48 years old,with an average age of 35 years old.group A was treated with non-crosslinked small molecule hyaluronic acid combined with Filorga NCTF®BOOST135 HA,while group B was treated with non-crosslinked small molecule hyaluronic acid alone.Through two methods,the facial skin state is analyzed and the therapeutic effect is evaluated.Results Follow-up for 3-6 months after treatment showed that 73 cases were satisfied and 9 cases were not satisfied in group A,with a satisfaction rate of 89.02%.In group B,52 cases were satisfied and 22 cases were dissatisfied,with a satisfaction rate of 70.27%.Conclusion Hyaluronic acid combined with Filorga NCTF®BOOST135 HA is better than hyaluronic acid alone in the treatment of facial rejuvenation,and patients obtain higher satisfaction.

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

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.

Serum hyaluronic acid, procollagen type Ⅲ and Ⅳ in histological diagnosis of liver fibrosis

OBJECTIVE: To assess the significance of serum hyaluronic acid (HA), proeollagen type Ⅲ (PCⅢ), collagen type Ⅳ (CⅣ) in the histological diagnosis of liver fibrosis. METHODS: The concentrations of serum HA, PCⅢ, CⅣ in 253 patients with chronic liver diseases were measured by radioimmunoassay. Liver biopsies were performed in all patients at the same time. The liver was pathologically evaluated by a pathologist according to a scoring system. Combined with the results of liver pathological diagnosis, the accuracy of serum HA, PCⅢ, CⅣ in diagnosing patients with hepatic fibrosis (staging≥S_2) or cirrhosis (S_4) was assessed using the receiver operating curve (ROC). RESULTS: The cutoff values of serum HA, PCⅢ and CⅣ for identifying patients with hepatic fibrosis (≥S_2) or cirrhosis (S_4) were determined. The cutoff values of serum HA, PCⅢ and CⅣ for detecting patients with fibrosis (stage≥S_2) were 90μg/L, 90μg/L, 75μg/L, respectively; their sensitivity (Se) was 80.4%, 82%, 63.1%; their specificity (Spe) was 70.2%, 60.8%, 83.8%; their positive predictive values (PPV) were 86.7%, 83.5%, 90.4%; their negative predictive values (NPV) were 59.8%, 58.4%, 48.4%, respectively. The cutoff values for detecting patients with liver cirrhosis were 210μg/L for HA, 96.2% for Se, 85.3% for Spe, 65.4% for PPV, 98.8% for NPV; 150μg/L for PCⅢ, 76.4% for Se, 68.7% for Spe, 40.4% for PPV, 91.3% for NPV; 90μg/L for CⅣ, 80% for Se, 75.8% for Spe, 47.8% for PPV, 93.2% for NPV, respectively. CONCLUSIONS: Serum HA, PCⅢ and CⅣ can be determined for an accurate diagnosis of hepatic fibrosis in various stages. HA is the best for screening liver cirrhosis.

Influence of BOL on hyaluronic acid,laminin and hyperplasia in hepatofibrotic rats

AIM: To study the anti-hepatofibrosis mechanism of Bie Jia Jian oral liquid (BOL). METHODS: The model was induced by subcutaneous injection of CCl(4). BOL was administered and the change of serum hyaluronic acid (HA) and laminin (LN) was observed and the degeneration of liver cells and the degree of fibre hyperplasia analyzed. Changes of ultra micro-structure in liver cells were observed in some samples. RESULTS: HA was reduced in both the groups with low and high dosage of BOL, which showed a remarkable difference as compared with that of the model group (low dosage group: 376.15 microg/L+/-35.48 microg/L vs 806.07 microg/L+/-98.49 microg/L P【0.05; high dosage group: 340.14 microg/L+/-30.18 microg/L vs 806.07 microg/L+/-98.49 microg/L P【0.05). The LN content of low and high dosage group of BOL was lower than that of model group (low dosage group: 71.99 microg/L+/-8.15 microg/L vs 133.94 microg/L+/-14.45 microg/L P 【0.01; high dosage group: 71.68 microg/L+/-11.62 microg/L vs 133.94 microg/L+/-14.45 microg/L P【0.01) and colchicine group (low dosage group: 71.99 microg/L+/-8.15 microg/L vs 118.28 microg/L+/-16.13 microg/L P 【 0.05; high dosage group: 71.68 microg/L+/-11.62 microg/L vs 118.28 microg/L+/-16.13 microg/L P 【0.05). Examined by Ridit, BOL could reduce the degeneration and necrosis of liver cells (chi(2)=11.99 P【0.05), the degree of fibre hyperplasia (chi(2)=13.24 P【0.05) and the pathological change of ultra micro-structure as well. CONCLUSION: The BOL has certain therapeutic effect on the experiment hepatofibrosis. Its mechanisms might include: protecting the function of liver cells, inhibiting excessive synthesis and secretion of extracellular matrix from hepatic stellate cells, relieving the capillarization of hepatic sinusoid, improving liver micro-circulation, and regulating immune function.

Single-and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial

BACKGROUND Platelet-rich plasma(PRP)and hyaluronic acid have been shown to be useful in the treatment of knee osteoarthritis.However,investigations comparing the efficacy of these two drugs together are insufficient.AIM To compare the outcomes of PRP vs hyaluronic acid injections in three groups of patients with bilateral knee osteoarthritis.METHODS This randomized controlled trial study involved 95 patients.Thirty-one subjects received a single injection of PRP(group PRP-1),33 subjects received two injections of PRP at an interval of 3 wk(group PRP-2)and 31 subjects received three injections of hyaluronic acid at 1-wk intervals(group hyaluronic acid).The patients were investigated prospectively at the enrollment and at 4-,8-and 12-wk follow-up with the Western Ontario and McMaster Universities Arthritis Index(WOMAC)and Visual Analogue Scale questionnaires.RESULTS Percentages of patients experiencing at least a 30%decrease in the total score for the WOMAC pain subscale from baseline to wk 12 of the intervention were 86%,100%and 0%in the groups PRP-1,PRP-2 and hyaluronic acid,respectively(P<0.001).The mean total WOMAC scores for groups PRP-1,PRP-2 and hyaluronic acid at baseline were 63.71,61.57 and 63.11,respectively.The WOMAC scores were significantly improved at final follow-up to 42.5,35.32 and 57.26,respectively.The highest efficacy of PRP was observed in both groups at wk 4 with about 50%decrease in the symptoms compared with about 25%decrease for hyaluronic acid.Group PRP-2 had higher efficacy than group PRP-1.No major adverse effects were found during the study.CONCLUSION PRP is a safe and efficient therapeutic option for treatment of knee osteoarthritis.It was demonstrated to be significantly better than hyaluronic acid.We also found that the efficacy of PRP increases after multiple injections.

Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B

AIM： To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B （CHB）. METHODS： A total of 137 consecutive patients with CriB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase （ALT） level. The sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV）, the likelihood ratio （LR） of aminotransferase/platelet ratio index （APRI） ≥ 1.5 or 〈 1.5 in combination with different hyaluronic acid （HA） cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis （fibrosis stages 2 and 4） and no to mild fibrosis/cirrhosis （fibrosis stages 0 and 1）. RESULTS： The APRI correlated with fibrosis stage in CriB patients. The APRI ≥1.5 in combination with a cut-off HA cut-off point 〉 300 ng/mL could detect moderate to severe fibrosis （stages 2-4） in Crib patients. The PPV was 93.7%, the specificity was 98.9%. The APRI 〈 1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients. CONCLUSION： The APRI ≥ 1.5 in combination with a HA cut-off point 〉 300 ng/mL can detect moderate to severe fibrosis （stages 2-4） in Crib patients.