Complications and management of penile augmentation with hyaluronic acid injection

Hyaluronic acid injection is becoming a popular way for penile augmentation.However,only few studies and follow-ups have investigated the various complications of hyaluronic acid injection and their corresponding management.In this study,a total of 230 patients who had penile augmentation with hyaluronic acid injection from January 2018 to December 2019 were examined on follow-up for penile girth,complications,and their corresponding management.At 1-month,3-month,and 6-month postoperative follow-ups,the penile circumference had increased by 2.66±1.24 cm,2.28±1.02 cm,and 1.80±0.83 cm,respectively.During the entire 6-month follow-up,4.3%had complications such as subcutaneous bleeding,subcutaneous nodules,and infection.There were no systemic or local allergic reactions among all the patients.All complications were treated accordingly,and no further deterioration or severe sequelae were observed.Although complications of hyaluronic acid injections are mild and rare,these may affect the patient's satisfaction postoperatively.Preoperative redundant prepuce may increase the incidence of penile edema or postoperative gel migration.Standardization of the surgery protocol and elucidation of the effects of other injection parameters are still lacking.Nevertheless,it still highlights the importance of preoperative preparation and surgical technique.

Clinical Non-inferiority Trial on Treatment of Coronary Heart Disease Angina Pectoris of Xin-blood Stasis Syndrome Type with Lyophilized Salvia Salt of Lithospermic Acid Powder for Injection

Objective： To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection （SSLA） in treating coronary heart diseases angina pectoris （CHD-AP） of Xin-blood stasis syndrome type, and to conduct the non-inferiority trial with Danshen injection （丹参注射液, DSI） as positive control. Methods： An non-inferiority clinical layered, segmented, randomized, and blinded trial on three parallel and multiple centered groups was conducted in 480 patients with stable effort angina grade Ⅰ , Ⅱand Ⅲ, who had two or more times of attack every week. The 240 patients in test group A were treated with SSLA 200 mg added in 250 ml of 5% glucose solution for intravenous dripping every day; the 120 patients in test group B were treated with SSLA but the dosage doubled; and the 120 patients in the control group were treated with DSI 20 ml daily in the same method as SSLA was given. The clinical effectiveness and safety were evaluated after the patients were treated for 14 days. Results： The results showed that the markedly effective rate in test groups A, B and control group was 37.45 %, 36.75 % and 30.09 % respectively, while the total effective rate in them was 88.09%, 89.74% and 67.26% respectively. Statistical significance was shown in comparisons of the therapeutic effect between control group with test group A and test group B, with that in the two test groups superior to that in the control group, and non-inferiority trial showed eligibility （P〈0.01）. Adverse reaction appeared in 8 patients in the test groups and 2 in the control group. Conclusion： SSLA has definite therapeutic effect in treating patients with CHD-AP, with its effect not inferior to that of DSI, and no evident toxic-adverse reaction.

Progress in the study of antiplatelet and antithrombotic effects of salvia polyphenolic acid for injection

Salvia polyphenolic acid for injection is a new generation of Chinese medicine injectable,which is developed by extracting and separating the water-soluble phenolic acid active ingredients of Salvia divinorum by using modern advanced technology as raw material.Pharmacological research shows that salvia polyphenolic acid has anti-inflammatory,anti-oxidative stress,neurotrophic,regenerative and protective effects on ischemic brain injury and can reduce myocardial ischemic injury.In clinical practice,it is mainly used in the treatment of stroke(mild to moderate cerebral infarction)in the recovery period of fetish blood obstruction.In recent years,it has also been gradually extended to treating acute cerebral infarction and respiratory syndrome.Since its launch,the pharmacological effects and clinical applications of Danshen polyphenolic acid for injection are reviewed to provide research clues for further essential trials and reference basis for clinical promotion and application.

Research progress on pharmacological effect of Salvianolic acid for injection in post-stroke depression

Post-stroke depression (PSD) is one of the most common affective disorders after acute cerebrovascular injury. It significantly increases the mortality, disability rate and recurrence rate of stroke, which places a heavy burden on families and society. The etiology of PSD is not yet clear, involving a series of complex mechanisms. Inflammatory response, apoptosis, neurotrophic factors, neurotransmitters and many others may play important roles, and there is no effective treatment. Salvianolic acid for injection (SAFI) has the functions of anti-inflammatory, anti-oxidative stress, anti-apoptotic and can improve depressive behavior. It is expected to become a new antidepressant for the treatment of PSD.

Liver injury after aluminum potassium sulfate and tannic acid treatment of hemorrhoids

We are reporting a rare case of acute liver injury that developed after an internal hemorrhoid treatment with the aluminum potassium sulfate and tannic acid(ALTA) regimen. A 41-year-old man developed a fever and liver injury after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA with lidocaine. The acute liver injury was classified clinically as hepatocellular and pathologically as cholestastic. We could not classify the mechanism of injury. High eosinophil and immunoglobulin E levels characterized the injury,and a drug lymphocyte stimulation test was negative on postoperative day 25. Fluid replacement for two weeks after hospitalization improved the liver injury. ALTA therapy involves injecting chemicals into the submucosa,from the rectum to the anus,and this is the first description of a case that developed a severe liver disorder after this treatment; hence,an analysis of future cases as they accumulate is desirable.

Local injection therapy for hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world and ranks the third most common cause of cancer-related death. Surgical resection, liver transplantation and percutaneous ablation are generally considered the only curative treatment for early stage HCC. Besides the limitations of insufficient organ donors and a long waiting time for liver transplantation, however, resection is applied only to patients with good hepatic reserve and localized tumors, with a resectability of 30%. DATA SOURCES: Local ablation therapy, which is minimally invasive but contributes to the significant improvement of survival in patients with unresectable tumor, hasbeen widely used in treating small HCC. Among the techniques of local therapy, percutaneous ethanol injection (PEI) with a complete response in 80% of HCCs less than 3 cm has been accepted as an alternative to surgery in patients with small HCC. Moreover, percutaneous hepatic quantified ethanol injection (PHQEI) or PEI according to the standard criteria has been confirmed to benefit patients with HCC, especially when quantified ethanol is given at a short interval (QESI, the interval was 2-3 days). RESULT: Several limitations related to local percutaneous methods may result in incomplete therapeutic effect in case of larger HCC nodules (>3 cm). CONCLUSION: The combined use of different methods according to the clinical status of patients or tumors may be essential to the effective treatment of HCC.

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.

The double intervention clinical value and application research of TACE with PAI on massive hepatocellular carcinoma

Objective： To study the efficacy of transcatheter arterial chemoembolization （TACE） combined with percutaneous acetic acid injection （PAI） on massive hepatocellular carcinoma （MHCC）. Methods： TACE was performed in 57 patients with MHCC, which were randomly divided into group A （n = 28） and group B （n = 29）. Patients in the group A received conventional TACE for the first time and then received low dose TACE （10 mg mitomycin C） for the repeated treatment, Re-examined CT scans after TACE for a week. Based on filled status of Lipiodol in the Lesions, PAl was underwent in the area of rarefaction or defect filled by Lipiodol. Patients in the group B received conventional TACE. Then The survival rate and masses variation and hepatic function and a-FP and side effects were observed. Results： The 1-, 2- and 3-year survival rate after TACE were 96.4%, 78.6% and 32.1% for group A, and 65.5%, 48.3% and 20.7% for group B. Masses diminution were found in all patients in group A, while 20 cases were found in group B, unchanged in 5 cases and enlarged in 4 cases. Conclusion： The efficacy of TACE combined with PAl are significantly better than that of TACE only, low dose TACE produces less hepatic damage and less side effect.

Safety threshold of intravitreal clonidine in rabbit's eyes

AIM： To determine the safe dose of intravitreal clonidine（IVC）, a potential drug for neuroprotection and angiogenesis inhibition in rabbits. METHODS： A total of 28 rabbits were divided into four groups. Three groups received IVC with concentrations of 15（Group A）, 25（Group B）, and 50（Group C） g/0.1 m L and the control group（Group D） received 0.1 m L balanced salt solution（BSS）. To investigate IVC safety, electroretinography（ERG） was performed at baseline, then at 1, 4 and 8 wk after injection. After last ERG, all rabbits were euthanized, their eyes were enucleated and subjected to routine histopathological evaluation, immunohistochemistry for glial fibrillary acidic protein（GFAP） and terminal deoxynucleotidyl transferase d UTP nick end labeling（TUNEL） test.RESULTS： Based on ERG, histopathology, GFAP and TUNEL assay findings, 15 g IVC was determined as the safe dose in rabbit eyes. While, the results of routine histopathology and TUNEL assay were unremarkable in all groups, toxic effects attributed to 25 and 50 g IVC were demonstrated by ERG and GFAP tests. CONCLUSION： Totally 15 g clonidine is determined as the safe dose for intravitreal injection in rabbits. Contribution of IVC in neuroprotection and inhibition of angiogenesis deserve more studies.

Glycidyl methacrylate-compatibilized poly(lactic acid)/hemp hurd biocomposites： Processing, crystallization, and thermo-mechanical response

Poly（lactic acid）-based biocomposites were developed with hemp hurd （Cannabis sativa L.） with grafting-based interfacial compatibilization. Poly（lactic acid） was extruded with hemp hurd and glycidyl methacrylate as the polymer/hurd interfacial compatibilizer, and injection molded. Interfacial compatibility between poly（lactic acid） and hemp hurd increased with grafted glycidyl methacrylate in comparison to the non-compatibilized control, as corroborated by scanning electron microscopy fractog- raphy and mechanical analysis, which showed increases in the glycidyl methacrylate-grafted 20% （w/w） hemp hurd/poly（lactic acid） biocomposite, retaining 94% of the neat polymer strength, with increases in crystallinity, and showing a range of thermo-mechanical properties desirable for rigid biocomposite aoolications.

An amino acid-based gelator for injectable and multi-responsive hydrogel

Hydrogels formed by gelators have attracted growing attention for their promising application in biomaterials and biotechnology, We describe in this paper the generation and characterization of a novel photo-, thermal- and pH-responsive hydrogel based on an amino acid gelator AA-Azo-EG6. Specifically, the gelator bears an amino acid head, an azobenzene （Azo） linker, and a short oligoethylene glycol tail （EG6）. The resulting AA-Azo-EG6 hydrogel is injectable and exhibits interesting helical self-assembled structures, Meanwhile, the hydrogel is able to experience a gel-sol or gel-precipitate phase transition responding to external stimuli. Thus, this AA-Azo-EG6 gelator is a promising building block for intelligent materials and drug delivery.

Clinical study on acupuncture combined with western medication for diabetic peripheral neuropathy

Objective:To compare the clinical effect differences between western medication,acupuncture,and acupuncture combine with western medication in the treatment of diabetic peripheral neuropathy.Methods:Ninety-three patients were randomized into western medication group,acupuncture group,and combination group,with 31 cases in each.The patients in western medication group were treated with lipoic acid injection and mecobalamin injection/tablets.The patients in acupuncture group were treated with acupuncture,and the acupoints were selected according to the symptoms.The needles were retained for 30 min,once a day.The patients in combination group were treated with both western medication and acupuncture,specific methods as the above.The treatments were for 18 days in succession in all of three group.The motor nerve conduction velocity(MNCV) and sensory nerve conduction velocity(SNCV) of median nerve and common peroneal nerve,as well as the changes of symptoms and signs of patients were observed before and after treatment.The clinical effect was evaluated.Results:After treatment,the median nerve MNCV in the three groups,the median nerve SNCV and common peroneal nerve MNCV in acupuncture group and combination groups,and the common peroneal nerve SNCV in acupuncture group were all higher than those of before treatment,with significantly statistical differences(all P<0.05).After treatment,the MNCV and SNCV of median nerve and common peroneal nerve in combination group were higher than those in western medication group and acupuncture group,with significantly statistical differences(all P<0.05).After treatment,the number of patients in the three groups with the symptoms and signs was lower than that of before treatment.The effective rate in combination group was 96.8%(30/31),higher than those of western medication group,74.2%(23/31),and acupuncture group,83.8%(26/31),with significantly statistical differences(both P<0.05).Conclusion:Acupuncture combined with western medication in the treatment of diabetic peripheral neuropathy can improve the nerve conduction velocity and improve the symptoms and signs of diabetic patients,with a better effect than those of western medication and simple acupuncture.