Tamanu Oil in Acne Management: Potential Anti-Inflammatory and Wound-Healing Properties for Scar Reduction

Tamanu oil, derived from the nuts of Calophyllum inophyllum, has gained increasing attention for its potential in acne management due to its purported anti-inflammatory and wound-healing properties. This analysis evaluates the efficacy of tamanu oil in acne treatment with a specific focus on its impact on inflammation and scar reduction. The novelty of this research lies in its comprehensive analysis of tamanu oil’s dual mechanism of action: reducing acne-related inflammation and promoting the healing of acne scars. Clinical trials and laboratory analyses were conducted to assess the oil’s effectiveness in diminishing erythema, swelling, and post-acne scarring compared to conventional treatments. Preliminary findings demonstrate that tamanu oil significantly reduces inflammation and accelerates wound healing, potentially offering a promising adjunct or alternative to standard acne therapies. Future research should aim to optimize formulation and application protocols, long-term effects, and comparative therapeutic efficacy with other anti-inflammatory agents. Tamanu oil offers a novel and effective approach to acne management, with potential advantages that go beyond inflammation reduction to include enhanced scar reduction, making it a subject that warrants further investigation.

A Case Report of Concurrent Acne-Related Occurrence Complications: Telangiectasia, Post-Inflammatory Erythema, Post-Inflammatory Hyperpigmentation, and Atrophic and Hypertrophic Scars

Prior to his initial diagnosis, a 21-year-old male had been experiencing facial acne for two years and had been treated by a doctor in private practice. The patient visited our department because the clinical manifestations of mandibular acne did not improve. At the time of initial examination, telangiectasia (TE), post-inflammatory erythema (PIE), post-inflammatory hyperpigmentation (PIH), atrophic scars (ASs), and a hypertrophic scar (HS) with induration were observed on the right neck. We diagnosed this as an acne vulgaris complication. HS lesions were topically treated by injecting triamcinolone acetonide, and the patient was prescribed 8.1 g/day of oral Saireito (Japanese herb). Adapalene benzoyl peroxide gel and topical tacrolimus hydrate ointment were used to treat PIE and TE. Both HSs and PIE improved;however, TE and AS did not improve. Currently, the patient is under observation. We consider this to be a very rare concurrent occurrence of diverse complications of acne vulgaris, and present the following case study.

Long Term Follow-Up Results of a Fractional Radio Frequency Ablative Treatment of Acne Vulgaris and Related Acne Scars

Introduction: Acne vulgaris and acne scarring are prevalent conditions that can have a negative effect on a patient’s quality of life. Fractional radiofrequency technologies have been shown to be clinically safe and effective in managing acne scars through dermal remodeling without causing direct damage to the epidermis. In a recently published study, we presented our clinical and histological results in the treatment of patients with active acne and acne related scarring using a Fractional RF (FRF) device. In the current article we demonstrate long term follow-up results, up to two years post last fractional treatment. Methods: Four out of the eight patients who completed a four treatment regimen were invited for long term follow-up visit to document treatment results. In some cases, touch-up treatments were conducted to optimize clinical results. Results: Patients demonstrated significant improvement of acne lesions, acne scarring, pores and skin texture. Long term photos demonstrated that clinical improvement progressed with time. Conclusion: The current study further supports the previous findings that FRF is a safe and effective treatment modality for active acne and acne related scars. Treatment protocol can be customized according to patient needs and clinical results last for long term.

Curative observation and the influence on the mental status of the patients with acne scars treated with pixe12940 laser

目的：了解痤疮凹陷性瘢痕患者的心理健康状况，观察Pixel 2940激光治疗痤疮凹陷性瘢痕的疗效及对患者心理健康的影响。方法：2010年10月～2012年8月，笔者科室采用Pixel 2940激光治疗痤疮瘢痕患者39例，并在治疗前和治疗结束后1月用Cardiff痤疮心理评估量表评估患者心理状况。结果：Pixel 2940激光治疗痤疮凹陷性瘢痕有效率达94．9％，副反应少而轻；痤疮影响了患者的心理健康，患者常常感到焦虑、愤怒和自信心下降等，但治疗后心理明显好转。结论：用Pixel 2940激光治疗痤疮凹陷性瘢痕疗效稳定、副反应少，可改善患者心理健康状况。

Depressed Acne Scars—Effective, Minimal Downtime Treatment with a Novel Smooth Motion Non-Insulated Microneedle Radiofrequency Technology

Background: The microneedle fractional RF handpiece used in our study (Intensif Handpiece, EndyMed Medical, Caesarea, Israel) is a novel handpiece that uses a tip with 25 non-insulated, gold plated microneedle electrodes. The needles are inserted into the skin by a specially designed electronically controlled, smooth motion motor minimizing patient discomfort. RF emission delivered over the whole dermal portion of the needle allows effective coagulation resulting in minimal or no bleeding, together with bulk volumetric heating. Study Design/Materials and Methods: The study included 20 patients, treated for depressed acne scars using the IntensifTM?Microneedles handpiece (EndyMed PRO Platform System, EndyMed Medical, Caesarea, Israel). The degree of clinical improvement was assessed by the global aesthetic improvement scale (GAIS) and subjects satisfaction by post treatment questionnaires. Results: The number of treatments per patient varied between 1 and 6 (average 3.3 treatments per patient). Eleven patients (55%) reported none to minimal pain, six (30%) moderate discomfort and only three (15%) reported significant pain. Objective evaluation of the improvement by a board certified dermatologist showed improvement in 95% of patients. 25% showed excellent improvement, 50% experienced good improvement, and the 20% showed minimal improvement. One patient showed no improvement. Conclusions: The presented results show that the tested electronically controlled motorized insertion, non-insulated microneedle treatment technology provides a minimal discomfort, minimal downtime, effective and safe treatment for depressed acne scars.

Effect of Dermabrasion and ReCell on Large Superficial Facial Scars Caused by Burn, Trauma and Acnes

Objective To explore the effects of dermabrasion combined with ReCell on large superficial facial scars caused by burn, trauma and acnes. Methods Nineteen patients with large superficial facial scars were treated by the same surgeon with dermabrasion combined with ReCell？. According to the etiology, patients were classified into post-burning group （n=5）, post-traumatic group （n=7） and post-acne group （n=7）. Fifteen patients completed the follow-ups, 5 patients in each group. Healing time, complication rate, the preoperative and 18-month-post-operative assessments using Patient Satisfaction Score （PSS）, Vancouver Scar Scale （VSS）, and Patient and Observer Scar Assessment Scale （POSAS） of each group were analyzed to compare the effect of the combined therapy on outcomes.Results The healing time of post-burning group （19.6±4.0 days）, post-traumatic group （15.8±2.6 days）, and post-acne group （11.4±3.1 days） varied remarkably （F=7.701, P=0.007）. The complication rates were 60%, 20%, and 0 respectively. The post-operative POSAS improved significantly in all groups （P〈0.05）, where the most significant improvement was shown in the post-acne group （P〈0.05）. The post-operative PSS and VSS improved only in the post-traumatic group and post-acne group （all P〈0.05）, where the more significant improvement was also shown in the post-acne group （P〈0.05）. Conclusions The combined treatment of dermabrasion and ReCell has remarkable effect on acne scars, moderate effect on traumatic scars and is not suggested for burn scars. POSAS should be applied to assess the therapeutic effects of treatments for large irregular scars.

Effective Treatment of Atrophic and Icepick Acne Scars Using Deep Non-Ablative Radiofrequency and Multisource Fractional RF Skin Resurfacing

Background and Objectives: Effective treatment for atrophic (depressed) and icepick acne scars requires treatment of both epidermis—for roughness, texture and hyperpigmentation, and the dermis—for collagen remodeling. All first generation radiofrequency systems allow nonablative RF treatment while a few others allow simple bipolar Fractional RF skin resurfacing. The FDA cleared multisource radiofrequency therapy system (EndyMed PRO, EndyMed Ltd., Cesarea, Israel) allows, for the first time, phase controlled multisource RF for both deep (up to 11 mm) non ablative RF and fractional RF skin resurfacing on the same treatment device. Study Design/Materials and Methods: Ten subjects with atrophic acne scars were enrolled in the study. Patients were photographed using standardized methods. In each treatment session, each patient received a full face 3DEEP non ablative skin tightening treatment followed by a Fractional skin resurfacing treatment. The treatment sessions were repeated once a month to a total of up to 4 treatments. Results: All subjects experienced mild-moderate edema and erythema as an immediate response to treatment. Edema resolved after up to three hours post treatment and erythema lasted up to 2 days. Micro ablative crusts were formed 1 - 2 days post treatments and lasted up to 5 days on facial areas. Patients' photographs—before each treatment session and 1 and 3 months after the last session—were graded according to the accepted Cosmetic Improvement Scale. All patients obtained significant skin improvement. Seventy percent of patients had 50% - 75% improvement one month after the third treatment session while the other thirty percent experienced a 25% - 50%. Discussion and Conclusions: The presented results describe for the first time a new treatment system (EndyMed PROTM) that allows both deep non ablative RF delivery and Fractional skin resurfacing on the same treatment platform. This work shows the synergy of combining these two applications for the improvement of acne scars, as well as for some secondary possible pigmentation and vascular improvement.

Retrospective Study of the Use of a Fractional Radio Frequency Ablative Device in the Treatment of Acne Vulgaris and Related Acne Scars

Background: Acne vulgaris (AV) is a common disease that often results in disfiguring facial scarring that carries into adulthood. Here we report our experience with fractional radiofrequency (FRF) device in treatment of patients with acne and acne related scarring. Materials & Methods: We retrospectively reviewed the charts of all patients with acne scarring who completed a four treatment regimen in our clinic. Results: We identified eight patients who completed four treatments with median age of 20.5 years (range 17 - 41). All patients demonstrated significant improvement of acne lesions and acne scarring. Skin biopsies demonstrated reduction of scar depth and increased new collagen production, and repopulation of the scar tissue by elastic fibers and adnexal structures after the fourth treatment. Conclusion: FRF emerges as a safe and effective treatment modality for AV and acne related scars. Further randomized controlled studies are required to fully evaluate the magnitude of this positive effect and more basic science studies are needed in order to better characterize its mechanism of action on acne lesions.

Novel Histological Evidence of Collagen and Elastin Regeneration in Fractional RF-Treated Acne Scars

Introduction: Fractional radiofrequency (RF) technology has been shown to be a gold standard therapy for acne scars. We have previously published clinical and histological results from the treatment of 8 patients with active acne and acne related scarring using a fractional RF device. Evidence of safety and efficacy was demonstrated, including long term follow-up clinical results from 4 patients, up to two years post last fractional treatment. In the current article we present histology evidence of acne scar skin renewal 3.5 years post treatment. Methods: Skin biopsies from acne scars in a concealed facial area were taken before, after four treatments and at 3.5 years after the last fractional treatment. Biopsies were examined with standard hematoxylin and eosin (H&E) stain, as well as Verhoeff’s Van Gieson (VVG) and Shikata stains for elastic fibers. Results: Histological findings demonstrate regeneration of elastic fibers and reduction of the dermal fibrosis. Scar depth of Patient #2 was reduced by 80% in the corresponding follow-up period. Conclusion: The long-term histological results further support the previously published findings that fractional RF is a safe and effective treatment for acne related scars.

Treatment of Wrinkles and Acne Scars Using the TriFractional, a Novel Fractional Radiofrequency Technology—Clinical and Histological Results

Introduction: The need for cosmetic facial enhancement procedures with minimal down time and low risk has led to the development of methods for non-surgical skin rejuvenation. Various ablative lasers were developed, which remove the full skin surface in a controlled manner. However, the prolonged recovery and the significant risks prompted the development of fractional lasers which ablate the skin in a fractional manner, leaving untreated areas to improve healing process. In the past few years, fractional radiofrequency (RF) systems have been introduced that enable controlled skin resurfacing accompanied with dermal collagen remodeling. The new TriFractional technology from Pollogen? is designed to enable skin resurfacing and treatment of wrinkles using RF energy. The objective of the current research was to evaluate the safety and effectiveness of the novel TriFractional technology using the TriFractional applicator (A3F) for micro-ablative skin resurfacing and the treatment of wrinkles and acne scars. Methods: Healthy volunteers consented to undergo TriFractional treatments for various aesthetic indications. In addition, in-vivo and ex-vivo histologycal results showing immediate and long term effects of the TriFractional technology were obtained. A portion of the subjects underwent the complete TriLipo MedTM Procedure which includes 2 TriFractional treatments spaced one month apart, with 2 TriLipo RF + Dynamic Muscle Activation (DMA) face treatments two weeks after each TriFractional treatment. Results: Subjects experienced an improvement of wrinkles, skin texture and acne scars along with facial contouring. No significant adverse effects were detected post-treatment. Histology findings demonstrated immediate and long term TriFractional effects on both epidermal and dermal skin layers. Conclusions: TriFractional is a promising technology for skin resurfacing, treatment of wrinkles and improvement of additional aesthetic indications such as acne scars. The TriLipo MEDTM procedure is a unique combination approach for total facial rejuvenation and contouring.

Subcision in the Treatment of Acne Scar in Iraqi Patients

Background: Acne vulgaris is a very common skin disease among young people which might be associated with scarring that has a great impact on the emotional, psychological and social life of the patients as it will go with them for life. Subcision is a new technique for the treatment of acne scars. Objective: To assess objectively and subjectively the efficacy and safety of subcision in the treatment of depressed acne scars. Patients and Methods: This is an open-label therapeutic trial. A total of 16 patients were enrolled in this study. Twelve were males and 4 were females. Their ages ranged from 19 - 39 with a mean of 26.64 ± 5.64. The duration of scar varied between 6 months and 10 years with a mean of 4.14 ± 2.54 years. subcision was done by introducing a sterile, hypodermic, 18-gauge needle. The needle was held by a three ml syringe for better orientation of the sharp tip of the needle. It was kept horizontal to the skin surface with the bevel up, and was introduced in a high sub dermal plane. The needle was slowly advanced parallel to the skin surface. Initially, rapid, repetitive linear back-and-forth motion of the needle makes the skin free of the underlying scar. This procedure was repeated in all directions in a fan-like manner. Results: According to Modified Sharquie’s scoring system for grading acne scars, 4 (25%) patients had severe grade, 11 (68.8%) patients had moderate grade and only 1 (6.2%) patient had mild grade. Evaluation at 6 months after treatment revealed that 8 (50%) patients had mild acne scar, 7 (43.8%) had moderate acne scar and only 1 (6.2%) patient still had severe grade. This change in the grades was statistically significant (p-value = 0.01713441). The average score before treatment was 13.13 ± 2.363;it became 9.50 ± 2.944 after 6 months. By paired t-test comparison, the difference in the score was statistically highly significant (p = 0.000044). Regarding the photographic assessment, the difference in the visual analogue scale before and after treatment was statistically significant (p-value = 0.043823). All patients were satisfied regarding subcision as treatment for their acne scars with variable degrees. In general the reported side effects were transient and vanished within 3 - 7 days apart from firm bumps which resolved within 12 weeks in all patients. Conclusion: Subcision appears to be simple, safe, minimally invasive, well-tolerated, and effective surgical procedure that provides significant long-term betterment for depressed acne scars especially for the rolling type.

Surgical Treatment of Scarring Alopecia Associated with Acne Keloidalis Nuchae

Acne keloidalis nuchae (AKN) is a relatively rare chronic inflammatory condition that leads to alopecia on the occipital scalp. Multiple large keloids and alopecia associated with long-lasting folliculitis impair the psychosocial functioning of patients. We report successful treatment of alopecia associated with AKN. When a 23-year-old male was referred to us, a large area of alopecia and multiple keloids associated with AKN were found. Following total excision of the lesion, the defect was reconstructed with two rotation flaps elevated bilaterally. Most patients with AKN undergo conservative treatments including oral antibiotics and local steroid injections. As surgical treatments, excision followed by skin grafting or second-intention healing has been reported. However, all of the previously-reported treatments have left alopecia on the occipital region. Although long scars might be left in the scalp, local flap reconstruction would be an option for the treatment of large areas of alopecia associated with AKN.

Non-Surgical Treatment with Chemical Peeling and Subsequent Vitamin C Iontophoresis for Rolling Scars in Acne Vulgaris

A 19-year-old man had atrophic scars on bilateral temple for several years. The atrophic scars were composed of rolling scars (three depressions, 8 × 4 mm in diameter), ice pick scars and boxcar scar. The patient was treated with chemical peeling (CP) using 20% glycolic acid (GA) (pH 3.2) and subsequent iontophoresis with vitamin C derivative at one month’s interval twice. Remarkable improvement was observed;the rolling scars almost disappeared with traces of hypopigmented macule. However, the ice pick scars and boxcar scar did not improve. CP and subsequent vitamin C iontophoresis can be an alternative non-surgical and non-invasive treatment for rolling scar in acne.

Improvement of Atrophic Acne Scar and Skin Complexity by Combination of Aqueous Human Placenta Extract and Mesenchymal Stem Cell Mesotherapy

Atrophic scars, a permanent complication of severe acne, have negative effect on psychology in adolescent. The treatment of atrophic scar is depended on types of scar and it is difficult to improve by a single treatment. Mesenchymal stem cell is a scientific approval for surgery scar treatment and wound healing. We present a case report of female presented with atrophic acne scar distributed on both cheeks. The case aims to prove that the combination of MSCs and aqueous human placenta extract (RGF&#174) contained bioactive therapeutic molecules obviously promoted the improvement of skin scar to reach the optimal outcomes. We first found that MSCs-contained human placenta extract solution combination subcision improves the atrophic acne scar and skin complexity by enhancement of skin cell regeneration.

Autocrine IL-8 Contributes to Propionibacterium Acnes-induced Proliferation and Differentiation of HaCaT Cells via AKT/FOXO1/Autophagy

Objective Proprionibacterium acnes(P.acnes)-induced inflammatory responses,proliferation and differentiation of keratinocytes contribute to the progression of acne vulgaris(AV).P.acnes was found to enhance the production of interleukin-8(IL-8)by keratinocytes.This study aimed to investigate the role of IL-8 in P.acnes-induced proliferation and differentiation of keratinocytes and the underlying mechanism.Methods The P.acnes-stimulated HaCaT cell(a human keratinocyte cell line)model was established.Western blotting and immunofluorescence were performed to detect the expression of the IL-8 receptors C-X-C motif chemokine receptor 1(CXCR1)and C-X-C motif chemokine receptor 2(CXCR2)on HaCaT cells.Cell counting kit-8(CCK-8)assay,5-ethynyl-20-deoxyuridine(EdU)assay and Western blotting were performed to examine the effects of IL-8/CXCR2 axis on the proliferation and differentiation of HaCaT cells treated with P.acnes,the IL-8 neutralizing antibody,the CXCR2 antagonist(SB225002),or the CXCR1/CXCR2 antagonist(G31P).Western blotting,nuclear and cytoplasmic separation,CCK-8 assay,and EdU assay were employed to determine the downstream pathway of CXCR2 after P.acnes-stimulated HaCaT cells were treated with the CXCR2 antagonist,the protein kinase B(AKT)antagonist(AZD5363),or the constitutively active forkhead box O1(FOXO1)mutant.Finally,autophagy markers were measured in HaCaT cells following the transfection of the FOXO1 mutant or treatment with the autophagy inhibitor 3-methyladenine(3-MA).Results The expression levels of CXCR1 and CXCR2 were significantly increased on the membrane of HaCaT cells following P.acnes stimulation.The IL-8/CXCR2 axis predominantly promoted the proliferation and differentiation of P.acnes-induced HaCaT cells by activating AKT/FOXO1/autophagy signaling.In brief,IL-8 bound to its receptor CXCR2 on the membrane of keratinocytes to activate the AKT/FOXO1 axis.Subsequently,phosphorylated FOXO1 facilitated autophagy to promote the proliferation and differentiation of P.acnes-induced keratinocytes.Conclusion This study demonstrated the novel autocrine effect of IL-8 on the proliferation and differentiation of P.acnes-induced keratinocytes,suggesting a potential therapeutic target for AV.

Ocular surface changes in moderate-to-severe acne vulgaris

AIM:To investigate ocular surface disorders and tear function changes in patients with acne vulgaris and explore the potential relationship between acne vulgaris and dry eye.METHODS:This cross-sectional study included right eyes of 53 patients with acne vulgaris and 54 healthy controls.The participants completed the Ocular Surface Disease Index(OSDI)questionnaire.The following ocular surface-related parameters were measured:tear meniscus height(TMH),noninvasive tear breakup time(NIBUT),Schirmer I test(SIT),lipid layer thickness(LLT)score of the tear film,meibum score,meibomian gland orifice obstruction score,the ratio of meibomian gland loss,conjunctival hyperemia score,and corneal fluorescein staining(CFS)score.RESULTS:The stability of the tear film decreased in acne vulgaris patients.In the acne group,the TMH and NIBUT were lower,whereas the OSDI,meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss,and conjunctival hyperemia score were higher compared with controls(P<0.05).There were no significant differences in the CFS score,SIT,or LLT score between the groups(P>0.05).In two dry eye groups,the TMH,NIBUT,and LLT score were lower in the acne with dry eye(acne-DE)group,and the meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss and conjunctival hyperemia score in the acne-DE group were higher(P<0.05).There were no significant differences between OSDI,SIT,and CFS score(P>0.05).CONCLUSION:Patients with moderate-to-severe acne vulgaris are more likely to experience dry eye than those without acne vulgaris.Reduced tear film stability and meibomian gland structure dysfunction are more pronounced in patients with moderate-to-severe acne and dry eye.

Re-evaluating the necessity of routine laboratory monitoring during isotretinoin therapy for acne

In this letter,we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne.According to Park and colleagues,it is advisable to monitor the levels of triglycerides,alanine aminotransferase,and aspartate aminotransferase every 5 to 6 months.Additionally,the levels of total cholesterol and low-density lipoprotein should be checked within the first two months of treatment.Isotretinoin is a commonly prescribed agent mainly used to treat acne.Despite its high effectiveness,it necessitates regular monitoring of laboratory parameters due to its side effect profile.Currently,there remains a lack of consensus on the appropriate frequency for monitoring these parameters during treatment with isotretinoin.This letter will provide insight into this complex and controversial topic.Based on existing literature,we concluded that the incidence of changes in lipid and liver aminotransferase levels during isotretinoin treatment for acne was low and likely clinically insignificant.For generally healthy people,we recommend testing lipid and liver profiles once at baseline and a second time at the peak dosage.However,frequent testing might still be beneficial in certain populations of patients.

Astrocytes, reactive astrogliosis, and glial scar formation in traumatic brain injury

Traumatic brain injury is a global health crisis,causing significant death and disability worldwide.Neuroinflammation that follows traumatic brain injury has serious consequences for neuronal survival and cognitive impairments,with astrocytes involved in this response.Following traumatic brain injury,astrocytes rapidly become reactive,and astrogliosis propagates from the injury core to distant brain regions.Homeostatic astroglial proteins are downregulated near the traumatic brain injury core,while pro-inflammatory astroglial genes are overexpressed.This altered gene expression is considered a pathological remodeling of astrocytes that produces serious consequences for neuronal survival and cognitive recovery.In addition,glial scar formed by reactive astrocytes is initially necessary to limit immune cell infiltration,but in the long term impedes axonal reconnection and functional recovery.Current therapeutic strategies for traumatic brain injury are focused on preventing acute complications.Statins,cannabinoids,progesterone,beta-blockers,and cerebrolysin demonstrate neuroprotective benefits but most of them have not been studied in the context of astrocytes.In this review,we discuss the cell signaling pathways activated in reactive astrocytes following traumatic brain injury and we discuss some of the potential new strategies aimed to modulate astroglial responses in traumatic brain injury,especially using cell-targeted strategies with miRNAs or lncRNA,viral vectors,and repurposed drugs.

Exploring the potential mechanism of WuFuYin against hypertrophic scar using network pharmacology and molecular docking

BACKGROUND Hypertrophic scar(HTS)is dermal fibroproliferative disorder,which may cause physiological and psychological problems.Currently,the potential mechanism of WuFuYin(WFY)in the treatment of HTS remained to be elucidated.AIM To explore the potential mechanism of WFY in treating HTS.METHODS Active components and corresponding targets were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.HTSrelated genes were obtained from the GeneCards,DisGeNET,and National Center for Biotechnology Information.The function of targets was analyzed by performing Gene Ontology and Kyoto Encyclopaedia of Genes and Genome(KEGG)enrichment analysis.A protein+IBM-protein interaction(PPI)network was developed using STRING database and Cytoscape.To confirm the high affinity between compounds and targets,molecular docking was performed.RESULTS A total of 65 core genes,which were both related to compounds and HTS,were selected from multiple databases.PPI analysis showed that CKD2,ABCC1,MMP2,MMP9,glycogen synthase kinase 3 beta(GSK3B),PRARG,MMP3,and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit gamma(PIK3CG)were the hub targets and MOL004941,MOL004935,MOL004866,MOL004993,and MOL004989 were the key compounds of WFY against HTS.The results of KEGG enrichment analysis demonstrated that the function of most genes were enriched in the PI3K-Akt pathway.Moreover,by performing molecular docking,we confirmed that GSK3B and 8-prenylated eriodictyol shared the highest affinity.CONCLUSION The current findings showed that the GSK3B and cyclin dependent kinase 2 were the potential targets and MOL004941,MOL004989,and MOL004993 were the main compounds of WFY in HTS treatment.

Vaginal Cesarean Section, an Alternative to High-Risk Trigger on Scarred Uterus

The objective is to report a clinical case of vaginal cesarean section performed to expel a dead fetus in scarred uterus. For this indication, vaginal hysterectomy constitutes an alternative to vaginal expulsion with a high risk of uterine rupture and to classic abdominal cesarean section with risk of significant surgical trauma, particularly adhesions. However, this surgical technique, described since the 19th century, remains unknown to many practitioners and few publications exist on the subject throughout the world. Considered obsolete by some practitioners, it retains all its advantages in the practice of modern obstetrics. We report this case of expulsion of fetal death on a tri-scarred uterus performed by vaginal cesarean section at the Health District Reference Health Center (District Hospital) of Commune I in Bamako, Mali in a 37-year-old patient with a pregnancy of 27 weeks of amenorrhea.