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.

Relationship between Serum Hyaluronic Acid Level and Patient Prognosis in Hepatocellular Carcinoma Patients Who Underwent Hepatectomy

We examined the relationship between hyaluronic acid (HA) and tumor-related factors after hepatectomy in 158 patients with hepatocellular carcinoma (HCC) who underwent hepatectomy. We examined serum HA levels before hepatectomy by evaluating data for clinicopathological parameters, surgical records, postoperative complications and survival. The mean HA level was 190 ± 202 ng/ml. Patients were divided into 3 groups: group A had serum HA levels less than 50 ng/ml (normal range), group B had levels between 50 and 190 ng/ml, and group C had levels over 190 ng/ml. Group C had a higher rate of poor liver function compared to others. Multiple tumors were significantly more frequent in groups B and C compared to A. The grade of fibrosis and the inflammatory responses were positively correlated with the serum HA level. Postoperative long-term ascites was significantly more frequent in group C compared to others. Although the recurrence rate and the relapse-free period were not significantly related to the serum HA level, the serum HA level was significantly associated with overall survival after hepatectomy (p 0.05). Cox’s multivariate analysis did not show a significant relationship between HA level and survival. Serum HA reflects progression and survival in HCC patients.

A Face Serum Containing Palmitoyl Tripeptide-38, Hydrolyzed Hyaluronic Acid, Bakuchiol and a Polyherbal and Vitamin Blend Improves Skin Quality

A face serum composed of a combination of biologically active compounds was evaluated for safety and efficacy in vitro, in a repeat insult patch test and in a human clinical efficacy trial. The serum inhibited tyrosinase activity modestly, decreased collagenase activity and exhibited notable free radical scavenging activity in vitro. It is gentle to the skin, as the serum did not irritate the skin or produce symptoms of allergic contact dermatitis in the 55 healthy adults that participated in the repeat insult patch test. In the efficacy trial, daily application of the face serum for 30 days significantly increased skin hydration, with all 35 volunteers experiencing improvement. Substantial improvements in skin elasticity, roughness (fine lines and wrinkles), and brightness also occurred during the trial. Dermatological examination also revealed a trend for reduced comedone count with use of the serum. Self-assessment responses revealed that all volunteers experienced improvements in multiple skin quality parameters and that participant perceptions are consistent with the results of the instrumental analyses. These findings indicated that the measured improvements in skin quality are not only statistically significant but are also clinically relevant as they were great enough for users of the face serum to feel and recognize.

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.

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.

Effect of the hyaluronic acid-poloxamer hydrogel on skin-wound healing: in vitro and in vivo studies

Background: Recent research into skin injury and wound healing has focused mainly on post‐trauma hemostasis, infection prevention, dermal regeneration and angiogenesis. However, less attention has been paid to air permeability and moisture loss prevention which also play important roles in injury healing. Methods: In the present work, we prepared a hyaluronic acid‐poloxamer (HA‐POL) hydrogel and tested the therapeutic effect of the hydrogel on skin‐wound healing. Results: The HA‐POL hydrogel transformed from sol to gel at 30°C, close to body temperature, and had stable moisturizing properties. HA‐POL hydrogel promoted skin‐wound healing and increased protein accumulation in the wound area. HA‐POL hydrogel allowed greater air permeability than Band‐aid, a typical wound covering. Results from transwell assays showed that the HA‐POL hydrogel effectively isolated skin‐wounds from bacterial invasion. Conclusion: This work demonstrates the advantages of using HA‐POL gel materials in the treatment of cutaneous wounds.

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.

流体剪切力下CD44-HA介导的MDA-MB-231细胞及HL60细胞的滚动黏附

目的探究胞外基质中的透明质酸(hyaluronic acid,HA)如何调控血流中CD44+肿瘤细胞的黏附滚动行为。方法采用平行平板流动腔装置,观察记录流场中MDA-MB-231细胞及HL60细胞在固定HA上的运动,提取细胞滚动黏附特征参数。结果MDA-MB-231细胞在HA底板上的黏附受到HA浓度的正向调控,但不受HA分子量影响;与物理吸附相比,生物素-亲和素固定的HA可显著提高细胞的黏附比率。在30~50 mPa剪切力范围内,剪切力的增加加快了细胞的滚动速度,降低了细胞的黏附比率,但对细胞的栓缚时间影响不大。同样流场中,与MDAMB-231细胞比较,CD44表达水平较低的HL60细胞在HA底板上的栓缚时间短、滚动速度快、黏附比率低(<1.5%)。结论流体剪切力可能通过调节CD44-HA的结合速率而非解离速率来调控MDA-MB-231细胞的滚动速度;CD44-HA相互作用参与HL60细胞的初始黏附,但不起主要作用。研究结果为抗肿瘤药物的开发提供参考。

35 kDa透明质酸片段B-HA对白细胞移走与活性氧水平的影响

旨在开发一种组织渗透性好的35 kDa生物活性透明质酸片段(bioactive hyaluronic acid fragment,B-HA),并围绕着B-HA对白细胞移走与活性氧水平的影响展开研究,探究其临床抗炎机制,为B-HA在临床领域的应用提供试验依据。使用重组人透明质酸酶PH20切割高分子量透明质酸,制备低分子量35 kDa的透明质酸片段B-HA;使用伽马相机动态采集小鼠体内放射性元素标记的99m Tc-B-HA的组织分布;使用最接近人体临床研究的新鲜提取的人外周血中性粒细胞和单个核细胞(淋巴细胞为主),采用琼脂糖微滴法探究B-HA对人中性粒细胞和单个核细胞移走的影响。99m Tc-B-HA组织分布显示,B-HA静脉注射后血液半衰期仅为5 min,除绝大部分进入代谢器官肝脏,其余大部分分布在淋巴器官脾脏;300μg/mL的B-HA促进了新鲜提取的人外周血单个核细胞移走(P<0.05),300μg/mL的B-HA在有(P<0.001)和没有(0.001<P<0.05)内毒素LPS存在的情况下均明显抑制外周血中性粒细胞的移走,40μg/mL的B-HA抑制了人外周血中性粒细胞产生活性氧水平(P<0.01)。

血清HA、PCⅢ、CⅣ及LN的水平在肝纤维化与早期肝硬化中的意义

目的 通过检测血清透明质酸（ＨＡ） 、Ⅲ型前胶原（ＰＣⅢ） 、Ⅳ型胶原（ＣⅣ） 及层粘素（ＬＮ） 的水平，了解该四项血清指标与肝纤维化及早期肝硬化的关系。方法 ３６ 例慢性乙型肝炎（ 慢乙肝） 患者的血清ＨＡ、ＰＣⅢ及ＬＮ 用放免法检测（ ＲＩＡ） ；ＣⅣ用酶免法检测（ＥＩＡ） ，并与肝穿病理炎症分级（Ｇ） 和纤维化分期（Ｓ） 进行比较。结果 血清中ＨＡ、ＰＣⅢ、ＣⅣ及ＬＮ 水平与肝纤维化及早期肝硬化关系密切（ Ｐ＜ ０－０５ － ０－０１） 。结论 血清中ＨＡ、ＰＣⅢ、ＣⅣ及ＬＮ 均为较好反映肝纤维化及早期肝硬化的指标。其中ＨＡ 价值最大。

血清HA、PCⅢ和PCⅣ联合检测评估肝纤维化的临床病理价值

目的 寻求反映肝纤维化的无创性检查。方法 联合检测 48例各种类型的肝病血清Ⅲ前胶原 (serumtypeⅢ procollagen ,PCⅢ )、透明质酸 (hyaluronateacid ,HA)、血清Ⅳ型胶原 (serumtypeⅣ procogen ,PCⅣ ) ,并与其肝组织病变对照研究。结果 显示血清HA、PCⅢ和PCⅣ水平在慢性肝炎轻度、中度、重度和重型肝炎呈现进行性升高。血清HA、PCⅢ和PCⅣ随肝组织炎症活动指数和肝组织纤维化程度加重而升高。结论 若能去除炎症因素的影响 。

乙型肝炎患者血清IL-1β、γ-IFN、HA、LN和PCⅢ在肝炎肝纤维化时水平的变化及其意义

目的探讨乙型性肝炎患者血清细胞因子白细胞介素-1β(IL-1β)、γ-干扰素(γ-IFN)与肝纤维化指标层黏蛋白(LN)、透明质酸(HA)、前Ⅲ胶原(PCⅢ)的水平变化及其意义。方法检测2012年5月至2014年5月收集的96例各种类型的乙型肝炎患者,其中急性肝炎组16例,慢性肝炎轻度组18例,慢性肝炎中度组21例,肝炎性肝硬化17例,慢性肝炎重度组24例。另取20例体检肝功能正常的研究对象作为对照组。观察六组对象IL-1β、γ-IFN、LN、HA、PCⅢ水平和肝功能等指标,并比较不同类型患者间各指标的差异与相关性。结果不同组别的肝炎患者IL-1β、γ-IFN、LN、HA、PCⅢ水平差异显著(P<0.05);随着肝炎病情的不断加重IL-1β、LN、HA、PCⅢ水平不断增高,γ-IFN水平不断下降(P<0.05)。不同肝炎严重程度疾病间的肝功能指标比较,急性肝炎患者的丙氨酸氨基转移酶(ALT)水平显著高于其他组研究对象(P<0.05);随着疾病程度的加重患者的总胆红素(TBIL)逐渐升高,白蛋白(ALB)、凝血酶原活动度(PTA)逐渐降低。随着肝纤维化程度的加重,患者的IL-1β、LN、HA、PCⅢ显著地升高,γ-IFN显著地降低(P<0.05)。γ-IFN与HA、PCⅢ呈显著的负相关,IL-1β与HA、PCⅢ呈显著的正相关(P<0.05),与LN相关性具有统计学意义(P>0.05)。结论细胞因子IL-1β、γ-IFN与肝损伤有良好的相关性,且与肝纤维化的形成密切相关。LN、HA、PCⅢ水平可作为反映肝纤维化的良好指标。因此,检测乙型肝炎患者血清中IL-1β、γ-IFN、LN、HA、PCⅢ水平对判断肝纤维化程度及评价临床治疗效果及预后具有重要意义。

肝病患者血清HA、PC-Ⅲ、C-Ⅳ、LN测定的临床意义

目的探讨肝病患者血清HA、PC-Ⅲ、C-Ⅳ、LN测定诊断肝纤维化的临床价值。方法用RIA法检测血清HA、PC-Ⅲ、C-Ⅳ、LN的浓度。结果HA水平在急性黄疸性肝炎、慢性迁延性肝炎、肝硬化及肝癌组较正常对照组显著增高(P<0.005),并随肝纤维化程度的增加而逐渐升高且以肝硬化组最高,组间比较肝硬化显著高于急性黄疸性肝炎、慢迁肝组(P<0.001),肝癌组与急性黄疸性肝炎组比较P<0.05;PC-Ⅲ各组均较对照组明显升高(P<0.001),并随着肝纤维化程度的增加而增高,但组间比较差别无显著性;C-Ⅳ除急性黄疸性肝炎外其余各组与对照组比较增高有显著性(P<0.001),组间比较以上各组随肝纤维化程度的增加而逐渐增高且差别有显著性,慢迁肝与急性黄疸性肝炎组比P<0.01,肝硬化与急性黄疸性肝炎、慢迁肝组比较P<0.001,肝癌与急性黄疸性肝炎、慢迁肝组比较P<0.01;各组LN水平逐渐升高且以肝硬化组最高,与正常组比有显著性差异(P<0.005),组间比较肝硬化较急性黄疸性肝炎、慢迁肝组显著增高(P<0.001)。结论血清HA、PC-Ⅲ、C-Ⅳ、LN联合检测可对肝纤维化程度的判定、肝硬化的早期诊断、肝病治疗效果的评价以及病情的动态观察均具有一定的临床意义。

自身免疫性心肌炎大鼠模型血清HA和LN的表达

目的:探讨实验性自身免疫性心肌炎(EAM)大鼠血清透明质酸(HA)和层黏连蛋白(LN)的动态变化及其意义。方法:Lewis大鼠60只,随机等分为6组,其中5组采用心肌C蛋白和完全弗氏佐剂足底注射,百日咳毒素腹腔内注射制作EAM大鼠模型。在免疫注射后1w、2w、4w、6w和8w,取心脏,行苏木素-伊红染色检测心肌炎症积分,天狼星红染色检测心肌纤维化积分,同时行放射免疫分析检测血清HA和LN。另外1组不予免疫注射,作为空白组。结果:EAM大鼠心肌炎症积分在免疫注射后1w较空白组大鼠无明显改变,2w后迅速升高,高水平状态维持到第4w,以后逐渐下降;心肌间质纤维化积分在免疫注射后第1w、2w较空白组大鼠无明显改变,第4w后迅速升高,并维持高水平状态到第8w;血清HA和LN在免疫注射后第1w、2w水平较空白组大鼠无明显改变,第4w迅速升高,并维持高水平状态到第8w,同心肌间质纤维化积分变化一致。结论:血清HA和LN水平可作为判断心肌自身免疫性心肌炎心肌间质纤维化程度和活动性,且能作为预测心脏病转归方向的指标。

养元柔肝汤对兔膝骨性关节炎模型滑液中TNF-α、HA的影响

目的探讨养元柔肝汤对实验性兔膝骨性关节炎模型滑液中肿瘤坏死因子α(TNF-α)、透明质酸(HA)的影响,并探讨其作用机制。方法将32只新西兰白兔随机分为4组,即正常对照组、模型对照组、养元柔肝汤组和葡立胶囊组各8只。兔膝骨性关节炎模型采用兔膝关节腔内注入木瓜蛋白酶的造模方法。养元柔肝汤组经胃管灌入兔胃养元柔肝汤药液,每次100 mL,每日2次。葡立胶囊组将葡立胶囊溶入水中经胃管灌胃,每次0.3 g,每日2次。正常对照组和模型对照组正常喂养。给药30 d。于治疗前、后分别提取兔膝关节滑液,分别采用酶联免疫吸附测定法和放射免疫法检测关节滑液中TNF-α、HA含量。结果养元柔肝汤组、葡立胶囊组治疗后较治疗前TNF-α水平均明显降低(P<0.05),HA水平均明显升高(P<0.05);养元柔肝汤组治疗后较葡立胶囊组TNF-α水平降低(P<0.05),HA水平升高(P<0.05)。结论养元柔肝汤可提高关节滑液HA水平,保护关节软骨,提高软骨细胞功能,促进软骨修复;降低关节滑液TNF-α水平,减轻炎症对关节软骨的破坏及所产生的疼痛。

肝病患者血清IGF-Ⅱ水平与HA,PⅢP的关系

目的 :探讨了肝病患者血清IGF -Ⅱ水平及临床意义。方法 :采用放射免疫分析 118例肝病患者血清中IGF -Ⅱ和HA、PⅢP含量 ,并与 30名正常人作比较。结果 :肝病患者血清中IGF水平非常显著地高于正常人组(P <0 0 1) ,尤以肝癌组为甚。且与HA、PⅢP呈明显的正相关。结论 :血清中IGF -Ⅱ测定有助于肝癌和肝硬化患者的病情观察和预后判断 ,具有一定的临床价值。

非侵袭性指标S指数与血清HA联合诊断慢性乙肝肝纤维化的临床应用

目的:探讨慢性乙型肝炎(CHB)肝纤维化非侵袭性诊断指标S指数与血清透明质酸(HA)联合应用的临床诊断价值。方法:对76例CHB患者行肝活检分期,参照有关文献通过γ﹣谷氨酰转肽酶(GGT)、血小板(PLT)和白蛋白(Alb)三个常规项目计算S指数[S指数=1000×GGT/(PLT×Alb2)],同时应用放射免疫分析测定血清HA。结果:单用S指数(以0.1为阴性界值,0.5为阳性界值)作为排除和诊断显著肝纤维化的指标,可避免44.7%(34/76)的肝活检,其准确率为73.5%(25/34);用HA对未被S指数确定的42例患者进行再评价,又可避免57.1%(24/42)的肝活检,其准确率为79.2%(19/24);将S指数与血清HA进行联合应用,则可避免76.3%(58/76)的肝活检,其准确率为75.9%(44/58)。结论:S指数与血清HA的联合应用及动态监测可提高无创评估CHB肝纤维化的诊断效率,减少或避免肝活检。

肝硬化患者血清IGF-Ⅰ、脂联素和HA测定及其临床意义

目的:探讨肝硬化患者血清中胰岛素样生长因子-Ⅰ(IGF-Ⅰ)、脂联素和透明质酸(HA)的关系及临床意义。方法:应用放射免疫分析对178例肝硬化患者进行血清IGF-Ⅰ、脂联素和HA含量测定,同时设60名健康体检者为正常对照组。结果:肝硬化患者血清IGF-Ⅰ、脂联素水平较正常组显著降低(P<0.01,P<0.05),而HA水平明显升高,且二者与HA水平呈负相关(r=-0.737、-0.692,P<0.01)。结论:检测血清IGF-Ⅰ、脂联素和HA水平对判断病情的轻重和预后观察均具有重要的临床价值。

PRP和HA治疗膝关节早期骨关节炎的临床疗效观察

目的:比较关节腔内注射富血小板血浆(PRP)和透明质酸钠(HA)治疗Ⅰ～Ⅲ期膝关节骨性关节炎的临床疗效。方法:选择86例Keligren Lawrence分级(K-L分级)为Ⅰ～Ⅲ期的膝骨关节炎患者,采用随机数字表法将其分为HA组45例和PRP组41例。两组患者分别采用关节镜探查清理后,关节腔内注射2.5 mL HA和3 mL PRP进行治疗。患者在治疗前和完成全部注射后的1、3、6、12个月均进行检查并记录美国西部Ontario与Mc Master大学骨关节炎指数(WOMAC)评分。比较两组治疗效果以及不同时间点的疗效。结果:治疗后,两组患者WOMAC评分较治疗前均明显降低(P<0.05);治疗后1、3个月,两组WOMAC评分无统计学差异(P>0.05);治疗后6个月和12个月,PRP组WOMAC评分明显低于治疗后1个月和3个月时(P<0.05),且PRP组WOMAC评分明显低于HA组(P<0.05)。结论:关节内注射PRP治疗膝关节软骨退行性病变安全有效,可缓解疼痛,改善患者肢体功能,提高患者治疗后长期疗效及其生活质量。

丙肝患者外周血铁指标与病毒载量及HA的相关分析

目的:探讨丙型肝炎(下称"丙肝")患者外周血铁指标与病毒载量及血清透明质酸(Hyaluronic acid,HA)之间的关系。方法:对63例丙肝患者行外周血HCV-RNA检测,按病毒载量分为高复制组(n=21)、低复制组(n=18)、病毒清除组(n=24);同时检测20例健康对照者及上述3组患者血清铁蛋白(Serum ferritin,SF)及游离铁(Serum iron,SI),分析组间差异。选取其中26例肝功能异常(ALT>40U/L)的患者样本,分别探讨其SF、SI与HA的相关性,并观察与肝功能正常患者相比,SF和SI的变化。结果:(1)丙肝患者SF和SI均高于对照组(P<0.05)。清除组SF显著高于高复制组(P<0.05)及低复制组(P<0.05),高、低复制组之间SF无统计学差异(P>0.05);SI在3组丙肝患者之间无明显变化(P>0.05)。(2)63例丙肝患者中,肝功能异常组(n=26)SI、SF均明显高于肝功能正常组(n=37)(P<0.05)。(3)肝功能异常患者血清HA与SF无显著相关性(r=0.192,P=0.349),但与SI存在弱正相关(r=0.373,P=0.061)。结论:丙肝患者外周血铁指标明显高于健康人,且可能与肝损伤有关。丙肝患者SI与血清HA弱相关,提示SI也许可作为评估肝功能损伤及纤维化发生风险的指标之一。