Cross‐linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios

Skin necrosis is the most severe complication arising from hyaluronic acid (HA) injection. To avoid skin necrosis, hyaluronidase should be injected along the course of the involved artery, to allow blood flow restoration. We evaluated the ability of hyaluronidase to degrade a HA filler in two simulated clinical situations—a compression case and an embolization case—to identify differences in the hyaluronidase injection. In the compression case, a bolus of HA filler was directly soaked in hyaluronidase solution; in the embolization case, a vein harvested from a living patient was filled with the same HA filler and then soaked in hyaluronidase. We then evaluated the quantity of HA remaining after 2 hr. While we found hydrolysis of HA in both cases, in the compression case, we detected almost complete hydrolysis, whereas in the embolization case we observed a reduction of the 60%. Our results support the hypothesis that vessel compression can be resolved with only one injection of hyaluronidase, while in the case of vascular embolization, repeated perivascular injections should be performed owing to the reduction of hyaluronidase activity.     

受试者工作特征曲线分析血小板计数与透明质酸对肝硬化的诊断价值

目的 应用受试者工作特征(ROC)曲线分析血小板( PLT)计数与透明质酸(HA)对肝硬化的诊断价值.方法 收集377例慢性HBV感染者,分为慢性乙型肝炎组233例,乙型肝炎肝硬化组144例.化学发光法检测HA,全自动血细胞分析仪检测外周血的PLT计数,进行ROC曲线分析.结果 (1 )PLT计数诊断肝硬化的ROC曲线下面积(AUC)为0.888±0.0165,截断值为91×109/L,以PLT计数≤91×109/L来预测肝硬化灵敏度为84.03％,特异度为82.83％.HA的AUC为0.920±0.0138,截断值为308nmol· ml -1·h-1),以HA ＞308 nmol·ml-1 ·h-1来预测肝硬化灵敏度为84.72％,特异度为88.84％.PLT与HA的AUC之间的差异无统计学意义(P=0.089),二指标均为诊断肝硬化的优良指标.(2)以公式log10( PLT/HA)判断两个指标联合对肝硬化的诊断价值,所得AUC为0.945±0.0113,截断值为-0.595,以log10(PLT/HA)≤-0.595来预测肝硬化灵敏度为88.19％,特异度为89.7％.AUC两两比较显示log10( PLT/HA)与PLT之间的差异有统计学意义(P=0.0008);同样log10( PLT/HA)与HA之间的差异也有统计学意义(P＜0.0001).可见PLT与HA联合检测对肝硬化诊断的灵敏度和特异度更高.结论 在慢性HBV感染者缺乏肝组织病理学检查时,联合检测PLT计数与HA对肝硬化的诊断比单—检测有更高灵敏度和特异度,临床价值更高.     

Hyaluronic acid as a medium for human sperm migration tests

Hyaluronic acid was used as a substitute for human cervical mucus as a medium for sperm migration since its viscosity, molecular weight and structure are similar to constituent glycoproteins of human cervical mucus. Parameters of sperm motility were comparable in human cervical mucus and hyaluronate as measured by a computerized sperm motion analysis system (Hamilton-Thorn 2030 and Str?mberg-Mika System). Sperm migration rates were also similar in human cervical mucus, bovine mucus and hyaluronic acid and the reproducibility was best in hyaluronic acid. Sperm survival for 24 h was maintained in human cervical mucus and hyaluronic acid but not in bovine mucus. The use of hyaluronic acid in sperm migration tests is recommended.     

地奈德乳膏联合透明质酸修护生物膜治疗成人面部湿疹疗效观察

目的观察地奈德乳膏联合透明质酸修护生物膜治疗成人面部湿疹的近期疗效。方法将入选的116例患者随机分为两组,试验组(61例)予透明质酸修护生物膜联合地奈德乳膏外用治疗,对照组(55例)单纯外用地奈德乳膏治疗,两组患者疗程均为2周。结果治疗第1周后,试验组和对照组的疗效总积分较治疗前显著降低(P均0.05),试验组的总积分与对照组相比,差异有统计学意义(P0.05);试验组疗效(有效率为83.61%)和对照组(有效率为60%)相比差异有统计学意义(P0.05)。治疗第2周后,试验组和对照组的总积分均较治疗前显著下降(P均0.05);试验组的总积分与对照组相比差异无统计学意义(P0.05);试验组疗效(有效率为86.89%)和对照组(有效率为85.45%)差异无统计学意义(P0.05)。第4周试验组复发率为5.67%,低于对照组(19.15%)(P0.05)。结论地奈德乳膏联合透明质酸修护生物膜治疗面部湿疹疗效较好,复发率低。     

Role of a hyaluronate-based membrane in the prevention of peritonitis-induced adhesions

Adhesions remain a significant postoperative complication of abdominal surgery; however, recent evidence suggests that physical barriers may reduce their incidence. Although these adhesion prevention barriers are efficacious when used under aseptic conditions, little is known about their use in the presence of peritonitis, which is associated with an increased incidence of abdominal adhesions. A sodium hyaluronate and carboxymethylcellulose bioresorbable membrane (HA membrane) has been shown recently to reduce postoperative adhesions in several animal models and in two clinical trials. To investigate the efficacy of HA membrane in the presence of peritonitis, generalized peritonitis was induced in rats by either cecal ligation and puncture (CLP) or cecal ligation (CL) alone. The ceca were resected after 12 hours, and animals were randomly assigned to receive or not receive HA membrane applied to the cecum. At day 7, abdominal adhesions and abscesses were scored. In the presence of peritonitis, HA membrane did not significantly reduce the number or tenacity of adhesions. A trend toward increased abscess formarion was associated with HA membrane in the CL group. Although HA membrane has been shown to reduce the incidence and severity of abdominal adhesions under aseptic conditions, this study demonstrates that it is not efficacious in preventing abdominal adhesions in the presence of peritonitis. The association between HA membrane and abscess formation in the presence of experimental peritonitis requires further investigation. Supported by the Genzyme Corporation, Cambridge, Mass. Presented at the Fortieth Annual Meeting of The Society for Surgery of the Alimentary Tract, Orlando, Fla., May 16–19, 1999.     

Serum hyaluronic acid reflects the effect of interferon treatment on hepatic fibrosis in patients with chronic hepatitis C

Changes in serum hyaluronic acid (HA) in 35 patients treated with interferon (IFN) were studied and the histological change in fibrosis was analysed. Serum HA levels and hepatitis C virus (HCV) RNA were followed from the start of therapy to 12 months after completion of treatment. Histological changes in pre- and post-treatment liver biopsies were assessed using a modified Knodell's scoring system. The serum levels of HA (r = 0.79; P<0.0001) correlated with the degree of fibrosis more closely than with that of amino terminal peptides of type III procollagen (PIIIP; r = 0.45; P<0.05) or type IV collagen (IV-C; r = 0.42; P<0.05). Only complete responders (CR) had a significant decrease in serum levels of HA and IV-C (P<0.05), in parallel with histological improvement (P<0.01). Neither partial responders (PR) nor non-responders (NR) had significant changes in histological scores and in serum levels of fibrotic markers. Significant differences were observed between CR and NR, both in HA levels (P<0.01) and PIIIP levels (P<0.05) 12 months after the cessation of treatment. These results suggest that serum HA is an indicator of the extent of fibrosis in chronic hepatitis C. Serial determinations of serum HA levels may be of use for monitoring the histological response of hepatic fibrosis to IFN treatment in chronic hepatitis C.     

Serum markers detect the presence of liver fibrosis: a cohort study

BACKGROUND & AIMS: Histologic examination of a liver biopsy specimen is regarded as the reference standard for detecting liver fibrosis. Biopsy can be painful and hazardous, and assessment is subjective and prone to sampling error. We developed a panel of sensitive automated immunoassays to detect matrix constituents and mediators of matrix remodeling in serum to evaluate their performance in the detection of liver fibrosis. METHODS: In an international multicenter cohort study, serum levels of 9 surrogate markers of liver fibrosis were compared with fibrosis stage in liver biopsy specimens obtained from 1021 subjects with chronic liver disease. Discriminant analysis of a test set of samples was used to identify an algorithm combining age, hyaluronic acid, amino-terminal propeptide of type III collagen, and tissue inhibitor of matrix metalloproteinase 1 that was subsequently evaluated using a validation set of biopsy specimens and serum samples. RESULTS: The algorithm detected fibrosis (sensitivity, 90%) and accurately detected the absence of fibrosis (negative predictive value for significant fibrosis, 92%; area under the curve of a receiver operating characteristic plot, .804; standard error, .02; P < .0001; 95% confidence interval, .758-.851). Performance was excellent for alcoholic liver disease and nonalcoholic fatty liver disease. The algorithm performed equally well in comparison with each of the pathologists. In contrast, pathologists' agreement over histologic scores ranged from very good to moderate (kappa = .97-.46). CONCLUSIONS: Assessment of liver fibrosis with multiple serum markers used in combination is sensitive, specific, and reproducible, suggesting they may be used in conjunction with liver biopsy to assess a range of chronic liver diseases.     

Study on the Structure and Skin Moisturizing Properties of Hyaluronic Acid Viscose Fiber Seamless Knitted Fabric for Autumn and Winter

In autumn and winter, the climate is dry and human skin tends to become dry as a result. The application of hyaluronic acid to a fabric has a certain moisturizing effect, which can further improve the wearing comfort of the fabric. In this study, three knitted fabric structures including weft plain stitch, 1 + 1 mock rib, and 1 + 3 mock rib were designed. The face yarn adopted hyaluronic acid viscose fiber, graphene viscose fiber, nylon, and viscose with different interweaving ratios, and the inner yarn adopted nylon/spandex-coated wire. A total of 18 sample knitted fabrics were woven according to the experimental method of the full test. The effects of the fabric structure and fabric raw materials on skin moisturizing properties were studied and analyzed by testing the skin water content and trans-epidermal water loss before and after coating the fabric on the human skin. The results show that the most significant factor affecting the skin moisture content is the raw material used in the fabric. When the interweaving ratio of hyaluronic acid viscose fiber in the fabric decreases, the moisturizing performance of the fabric on human skin is weakened. The second is the fabric structure. In terms of structure, 1 + 1 mock rib fabric has better moisturizing performance for human skin. When the material adopts hyaluronic acid viscose fiber/graphene viscose fiber (100:0) and the structure adopts 1 + 1 mock rib, the moisturizing effect on human skin is better.