Review of long-term adverse effects associated with the use of chemically-modified animal and nonanimal source hyaluronic acid dermal fillers

Although only recently introduced, chemically-modified hyaluronic acid dermal fillers have gained widespread acceptance as “redefining” dermal fillers in the fields of dermatology and cosmetic facial surgery. Although hyaluronic acid-based dermal fillers have a low overall incidence of long term side effects, occasional adverse outcomes, ranging from chronic lymphoplasmacytic inflammatory reactions to classic foreign body-type granulomatous reactions have been documented. These long-term adverse events are reviewed.     

Use of sclera and liquid collagen in the camouflage of superior sulcus deformities

The cosmetic deformities following enucleation are often unavoidable. Loss of orbital volume and atrophy of orbital fat create significant enophthalmos. The literature is filled with numerous procedures that add to the orbital volume of the anophthalmic socket. An outline of three procedures to the upper eyelid to camouflage an enophthalmic appearance are presented. These can be used alone or in conjunction with an "orbital volume increasing" procedure. Two procedures can be used in an office setting to alleviate small deformities; 19 patients have been treated in this manner with a follow-up period of up to 26 months.     

可注射型富血小板纤维蛋白促进人脐静脉内皮细胞成血管能力的体外实验研究

目的 探究可注射型富血小板纤维蛋白(injectable platelet-rich fibrin, iPRF)对体外培养的人脐静脉内皮细胞(human umbilical vein endothelial cells, HUVECs)成血管分化能力的影响。方法 CCK-8实验检测HUVECs增殖能力并筛选最佳浓度的可注射型富血小板纤维蛋白提取液(injectable platelet-rich fibrin extract, iPRFe);划痕实验和小管形成实验分别检测HUVECs迁移能力和成血管分化能力;实时定量PCR检测成血管相关基因的mRNA表达。结果 0.4 mg/mL浓度的iPRFe促进HUVECs增殖效果最佳;iPRFe对HUVECs迁移和小管形成有显著的促进作用,还能明显提高血管生成素(angiogenin, ANG)、C-X-C基序趋化因子受体4(C-X-C motif chemokine receptor 4, CXCR4)、血小板衍生生长因子受体A(platelet-derived growth factor receptor A, PDGFRA)和血管内皮生长因子(vascular endothelial growth factor, VEGF)的表达水平。结论 iPRF可以促进HUVECs增殖、迁移和成血管能力,有望成为用于牙髓再生的新材料。     

社区应用抗精神病药长效针剂治疗精神分裂症专家共识

精神分裂症是一种慢性、高复发性和高致残性的精神病性障碍,提高患者治疗依从性、预防复发是精神分裂症治疗的关键,也是决定患者预后和社会功能改善程度的核心因素。抗精神病药长效针剂（简称长效针剂）作为精神分裂症治疗、预防复发的重要手段,被国内外指南/共识推荐为精神分裂症全病程治疗的方式之一。同时,社区作为精神分裂症康复的重要环境场所,近年来陆续开展了一系列社区管理模式的探索。目前,国内多个管理政策及文件强调在社区精神分裂症管理中应用长效针剂,但是社区医生对长效针剂的知识和应用技能不足,从一定程度上影响了长效针剂在社区的应用,成为患者全面康复的瓶颈之一。在中华医学会精神医学分会精神分裂症协作组的组织下,联合中华医学会全科医学分会,由13位精神科及全科医学专家组成本共识专家组,基于循证医学证据、国内外指南与专家共识、专家经验、我国社区的特征,解决社区长效针剂使用中面临的医学相关问题,以期提高精神分裂症患者用药依从性,改善患者预后。     

Antibacterial‐nanocomposite bone filler based on silver nanoparticles and polysaccharides

Injectable bone fillers represent an attractive strategy for the treatment of bone defects. These injectable materials should be biocompatible, capable of supporting cell growth and possibly able to exert antibacterial effects. In this work, nanocomposite microbeads based on alginate, chitlac, hydroxyapatite and silver nanoparticles were prepared and characterized. The dried microbeads displayed a rapid swelling in contact with simulated body fluid and maintained their integrity for more than 30 days. The evaluation of silver leakage from the microbeads showed that the antibacterial metal is slowly released in saline solution, with less than 6% of silver released after 1 week. Antibacterial tests proved that the microbeads displayed bactericidal effects toward Staphylococcus aureus, Pseudomonas aeruginosa and Staphylococcus epidermidis, and were also able to damage pre‐formed bacterial biofilms. On the other hand, the microbeads did not exert any cytotoxic effect towards osteoblast‐like cells. After characterization of the microbeads bioactivity, a possible means to embed them in a fluid medium was explored in order to obtain an injectable paste. Upon suspension of the particles in alginate solution or alginate/hyaluronic acid mixtures, a homogenous and time‐stable paste was obtained. Mechanical tests enabled to quantify the extrusion forces from surgical syringes, pointing out the proper injectability of the material. This novel antibacterial bone filler appears as a promising material for the treatment of bone defects, in particular when possible infections could compromise the bone‐healing process. Copyright © 2016 John Wiley & Sons, Ltd.     

The use of calcium phosphate cement in vertebroplasty of the base of odontoid process

The authors describe the use of bone cement containing calcium phosphate for vertebroplasty of the cavity in the base of odontoid process. A 23-year-old female patient was operated on by incision in lateral cervical area (anterior open access). After a blunt dissection, the working cannula (Kyphon) was introduced under fluoroscopic guidance through the C2 vertebral body to the cavity in the base of the odontoid process. Intraoperatively biopsy of the lesion was taken and histopathological examination excluded the presence of neoplasm. The cavity, presumably haemangioma, was successfully filled with calcium phosphate bone cement KyphOs? FS (Kyphon). The proper filling without paravertebral cement leak was confirmed by postoperative computed tomography (CT). The CT and magnetic resonance imaging performed 9 months after the procedure showed that cement was still present in the cavity. This is the first use of calcium phosphate cement to conduct the vertebroplasty of C2 vertebra.     

Ocular injuries resulting from commercial cosmetic procedures

The prevalence of potentially precarious cosmetic facial procedures appears to be on the rise. A significant amount of these cosmetic procedures are offered and performed by operators without formal medical training and anatomical knowledge, and with variable degrees of skill. Some of these procedures can result in devastating sight-threatening complications, and many of the individuals undergoing such treatments are relatively young and healthy. Patients need to be aware of the potential risks, including permanent visual loss, before embarking on any cosmetic facial procedure. Optometrists may be the first point of contact for patients with ocular complaints following these treatments. Hence, the authors present here a review on the various ocular injuries that may result from commercial cosmetic procedures.     

Genipin‐crosslinked decellularized annulus fibrosus hydrogels induces tissue‐specific differentiation of bone mesenchymal stem cells and intervertebral disc regeneration

Biomaterial‐based therapy that can restore annulus fibrosus (AF) function in early stage and promote endogenous repair of AF tissues is a promising approach for AF tissue repair. In this study, we established a genipin‐crosslinked decellularized AF hydrogels (g‐DAF‐G) that are injectable and could manifest better in situ formability than noncrosslinked decellularized AF hydrogel, while preserving the capacity of directing differentiation of human bone mesenchymal stem cells (hBMSCs) towards AF cells. Hematoxylin and eosin staining, 4',6‐diamidino‐2‐phenylindole staining, and so forth showed that the majority of cellular components were removed, whereas extracellular matrix and microstructure were largely preserved. The storage modulus increased from 465.5 ± 9.4 Pa to 3.29 ± 0.24 MPa after 0.02% genipin crosslinking of decellularized AF hydrogels (DAF‐G) to form g‐DAF‐G. AF‐specific genes (COL1A1, COL5A1, TNMD, IBSP, FBLN1) were significantly higher in DAF‐G and g‐DAF‐G groups than that in control group after 21 days of culturing. g‐DAF‐G significantly restored nucleus pulposus water content and preserved intervertebral structure in vivo. Summarily, we produced a novel AF regeneration biomaterial, g‐DAF‐G, which exhibited well biocompatibility, great bioactivity, and much higher mechanical strength than DAF‐G. This study will provide an easy and fast therapeutic alternative to repair AF injuries or tears.