Closure Rate Research Articles

A novel reopenable clip with sharp claw for complete closure of mucosal defects after colorectal endoscopic submucosal dissection.

The MANTIS Closure Device (MCD; Boston Scientific, Marlborough, Massachusetts, USA) is a reopenable clip with a sharp claw used for closure after endoscopic submucosal dissection (ESD). We evaluated the effectiveness of the MCD for fast and complete closure after colorectal ESD. Cases involving closure with the MCD after ESD of 20-60-mm colorectal lesions between April 2023 and January 2024 were reviewed. The primary end point was complete closure of the ESD defect with the MCD. Secondary end points included closure time, delayed bleeding, delayed perforation, and post-ESD coagulation syndrome (PECS). MCD application involved: 1) grasping the mucosa on the anal-side of the defect; 2) pushing the clip toward the oral-side mucosa and deploying it; 3) adding other reopenable clips for complete closure. 61 cases involving MCD were analyzed. Mean tumor size was 32.3 (SD 9.2) mm. Complete closure rate was 98.4% and mean closure time was 6.9 (SD 2.6) minutes. The mean number of MCDs and other clips used was 1.0 (SD 0.1) and 4.7 (SD 1.4), respectively. Rates of delayed bleeding, delayed perforation, and PECS were 0%, 0%, and 9.8%, respectively. Fast and complete closure after colorectal ESD was successfully achieved using the MCD.

Topical Reconstituted High-Density Lipoproteins Elicit Anti-Inflammatory Effects in Diabetic Wounds.

Objective: Reconstituted high-density lipoproteins (rHDL) improve wound healing in diabetes. We aimed to determine if rHDL elicit anti-inflammatory effects in diabetic wounds, as a mechanism to explain their wound healing benefits. Approach: Diabetes was induced using streptozotocin in C57Bl6/J mice. Two full-thickness wounds were placed on the subflanks of diabetic and nondiabetic (ND) mice. Phosphate-buffered saline (PBS) or rHDL (50 µg/wound/day) were applied topically. Wound closure was assessed daily. Inflammatory gene transcripts were measured by qPCR and proteins by Western blotting and enzyme-linked immunosorbent assay in wounds collected at baseline, 24 h, and 3 days postwounding. Wound macrophages were assessed by flow cytometry 7 days postwounding. The fate of fluorescent 3,3-dioctadecyloxacarbocyanine, perchlorate (DiO)-labeled rHDL was tracked by flow cytometry, fluorescent imaging, and microscopy. Results: In diabetic mice, rHDL increased wound closure rates at days 6 (+288%, p < 0.01) and 7 (+639%, p < 0.0001) postwounding, compared with PBS controls. After 3 days, rHDL-treated diabetic wounds had lower Rela (-65%) and C-C motif chemokine ligand 2 (Ccl2) (-59%) mRNA levels and CCL2 protein (29%) than PBS controls, p < 0.05 for all. Wound macrophage content was higher in diabetic than ND wounds, but rHDL did not change macrophage content or polarity. DiO-rHDL were taken up by key wound cells including fibroblasts, macrophages, keratinocytes and endothelial cells, and retained in wounds for at least 48 h. Innovation: rHDL exerts anti-inflammatory effects in diabetic wounds early postwounding, which may contribute to its wound healing properties. Conclusion: The anti-inflammatory properties of rHDL in diabetic wounds present topical rHDL as a novel treatment option for improving healing in patients with diabetic foot ulcers.

New series of 4,6-diaryl pyrimidines: facile synthesis and antiproliferative activity as dual EGFR/VEGFR-2 inhibitors

IntroductionWe developed and produced a new series of 4,6-diaryl-pyrimidines 9–29 as antiproliferative agents targeting EGFR/VEGFR-2.MethodsThe antiproliferative efficacy of the novel targets was assessed against a panel of 60 NCI cancer cell lines and four cancer cell lines in vitro.Results and DiscussionCompounds 14, 17, 19, 22, 25, and 29 demonstrated the greatest potency among the derivatives, with GI50 values between 22 and 33 nM; compounds 22 and 29 exhibited the highest potency, with GI50 values of 22 and 24 nM, respectively. We subsequently examined the most efficient derivatives as dual EGFR/VEGFR-2 inhibitors, finding that compounds 22 and 29 functioned as dual inhibitors. Moreover, 22 and 29 can act as apoptotic inducers by increasing Bax levels and decreasing levels of the anti-apoptotic protein Bcl2. At both 24- and 48-h intervals, the cell migration rates of compounds 22 and 29 were lower than those of untreated cells, according to the migration rate and wound closure percentage assessment. The wound closure rate reached 100% after 72 h of therapy with compound 22 but only 80% with compound 29. The docking study showed that compounds 22 and 29 had docking scores similar to those of Erlotinib and Sorafenib, co-crystallized ligands, for the EGFR and VEGFR-2 proteins. The experiments on lipophilicity showed that the new pyrimidines had a consistent result. This group of compounds has better biological activity in all the biological systems studied with low lipophilicity.

Evaluation of Rate of Space Closure Between Platelet Rich Plasma (Prp) Injection and Piezocision in Bimaxillary Protrusion Cases

Aim: Reducing orthodontic treatment duration is a significant concern for both patients and clinicians, as prolonged treatments can lead to complications like dental caries, root resorption, and decreased patient compliance. This study aims to compare the effectiveness of two minimally invasive techniques—Piezocision and platelet-rich plasma (PRP) injection—in accelerating orthodontic tooth movement during space closure in patients with bimaxillary protrusion. Methods: Sixteen patients diagnosed with Angle's Class I bimaxillary protrusion requiring extraction of first premolars were randomly assigned to two groups. Group A (n = 8) underwent Piezocision-assisted orthodontic treatment, while Group B (n = 8) received submucosal PRP injections. In both groups, one side of the maxillary arch served as the experimental side, and the contralateral side served as the control. Measurements of space closure were taken at the initiation of retraction (T₀) and after 90 days (T₁). Results: Both Piezocision and PRP significantly enhanced the rate of space closure compared to their control sides. However, Piezocision demonstrated a statistically faster rate of tooth movement than PRP injection. The mean difference in space closure between the Piezocision and PRP groups at T₁ was significant (p &lt; 0.001). Conclusion: While both Piezocision and PRP injections effectively accelerated orthodontic tooth movement, Piezocision proved to be more efficient in reducing treatment time. Clinicians may consider Piezocision as a preferred method for patients seeking expedited orthodontic treatment.

The Role of Interleukin-8 in the Estimation of Responsiveness to Steps 1 and 2 of Periodontal Therapy.

To investigate the association between interleukin-8 (IL-8) levels in gingival crevicular fluid (GCF) and total oral fluid (TOF) and the responsiveness to steps 1 and 2 of periodontal therapy. One-hundred and fifty-nine patients affected by periodontitis received steps 1 and 2 of periodontal therapy. At baseline, TOF and GCF samples were collected and analysed for IL-8 (Il-8TOF/IL-8GCF) using flow cytometry. Therapy outcomes were relative proportions of residual periodontal pockets (PPD%), pocket closure (PC) rates and pocket probing depth (PPD) reductions; these were associated with IL-8TOF/IL-8GCF. High IL-8TOF was significantly associated with higher residual PPD% (p = 0.044) and lower PPD reduction compared to low IL-8TOF (high 0.79 ± 1.20 mm vs. low 1.20 ± 1.20 mm, p < 0.001) in non-smokers, while in smokers high IL-8GCF was related to lower PPD reduction (high 0.62 ± 1.22 mm vs. low 0.84 ± 1.12 mm, p = 0.009). Furthermore, high baseline IL-8TOF was significantly associated with poorer PC rates compared to medium and low concentrations in both non-smokers (high 41% vs. medium 55% vs. low 58%, p < 0.001) and smokers (high 34% vs. medium 44% vs. low 46%, p < 0.001). High IL-8 concentrations at baseline had a significant impact on residual PPD%, PC rates and PPD reduction. The findings suggest that, especially in non-smokers, baseline IL-8 levels collected from the TOF could serve as a component in the estimation of responsiveness to steps 1 and 2 of periodontal therapy.

Berberine inhibits the malignant cell phenotype by inactivating PI3K/AKT/mTOR signaling in laryngeal squamous cell carcinoma.

Berberine is an active compound found in different herbs used in Chinese medicine and is well-known for its potential anticancer properties. The study aimed to figure out the role of berberine in regulating the malignant behavior of laryngeal squamous cell carcinoma (LSCC) cells. LSCC cell lines (SNU-899 and AMC-HN-8) were treated with different concentrations of berberine (0-200 μM) to determine its cytotoxicity. The migration, invasion, and apoptosis of LSCC cells were measured by wound healing assays, Transwell assays, and flow cytometry. Western blot was performed for the quantification of proteins involved in PI3K/AKT/mTOR signaling. The viability of LSCC cells was dose-dependently reduced by berberine. Berberine dampened LSCC cell migration and invasion while augmenting cell apoptosis, as evidenced by a reduced wound closure rate, a decrease in invaded cell number, and a surge in cell apoptosis in the context of berberine stimulation. Importantly, the effects of berberine on the cancer cell process were enhanced by LY294002 (an inhibitor for PI3K) treatment. Moreover, the protein levels of phosphorylated PI3K, AKT, and mTOR were markedly reduced in response to berberine treatment. Berberine inhibits cell viability, migration, and invasion but augments cell apoptosis by inactivating PI3K/AKT/mTOR signaling in LSCC.

Calculation model of shale fracture compressibility and evolution of permeability under water-bearing conditions

Water saturation of shale reservoirs significantly influences the permeability and compressibility of propped fractures. This study focused on the Longmaxi Formation shale reservoir in northern Guizhou, China, where the permeability of water–saturated shale under varying gas and confining pressures was measured. A compressibility model for proppant embedment and compaction deformation was developed and validated against the experimental results. This study examined the compressibility of supported fractures considering water–rock interactions and elucidated the intrinsic relationship between compressibility and water saturation. The findings demonstrated a decreased trend in shale fracture permeability with increasing water saturation under identical conditions. Compared to dry shale, the permeability decreased by 1.2%–16.4% and 2.0%–17.8% at water saturation of 15% and 50%, respectively. The results of the model calculations demonstrate that fracture compressibility is contingent on the degree of variation of the fracture width. Prolonged water–rock interactions intensified the variation in the fracture width increasing the compressibility under the same stress conditions. As the water saturation increased from 0% to 50%, the fracture closure rate increased from 0.034 to 0.179 with the increase in effective stress. Increased water saturation also increases the sensitivity of the fracture compressibility to effective stress while decreasing the elastic modulus of the rock, thereby enhancing the proppant embedment depth and significantly increasing the fracture compressibility. This study provides critical insights into the dynamic evolution of fracture permeability during hydraulic fracturing and offers valuable implications for gas production forecasting.

Wireless power supply near-infrared light drug-loaded microneedle system for the treatment of linear skin wounds

The healing of linear skin wounds is a complex biological process, and traditional treatment methods have certain limitations. This study proposes a wireless power supply near-infrared light drug-loaded microneedle system (NIR-LED-NG-R1-MN), which utilizes microneedles (MNs) to achieve targeted delivery of the active component of traditional Chinese medicine, Notoginsenoside R1 (NG-R1), and combines the biological regulatory effect of near-infrared light (NIR) to achieve efficient synergistic treatment for linear skin wounds. Experimental results show that the device can significantly promote the wound closure rate and reduce the levels of inflammatory factors and the risk of scar formation. By comparing the wound repair conditions of different treatment groups, it was found that the group treated with the NIR-LED-NG-R1-MN patch for NG-R1 and NIR synergistic treatment (MN@NG-R1@LED group) showed superior wound repair effects compared to other groups, thus confirming the synergistic therapeutic advantages of NG-R1 and NIR in skin wound healing. In addition, the application of wireless power supply technology used in this system eliminates the dependence on external power sources, enhancing the convenience of treatment. This study clearly demonstrates that the NIR-LED-NG-R1-MN has the potential to become a new clinical method for the treatment of linear skin wound healing.

Accident Prevention System for Cars, Buses, Trucks

Driver drowsiness is a significant factor in road accidents, contributing to a large number of crashes annually. To enhance road safety, the development of a Drivers Drowsiness Detection System is essential. This system builds to detect early signs of lazyness in drivers and provide timely alerts to prevent accidents. The proposed system uses to track key indicators of drowsiness, such as eye closure, head position, yawning, and blink rate. By utilizing a camera-based real-time monitoring system, it continuously analyzes the driver’s facial expressions. The system employs cadcade algorithms to distinguish a featurebased object detection algorithm to detect objects from images between alert and drowsy states based on collected data. When drowsiness is detected, the system triggers alerts like audio warnings, seat vibrations, or even vehicle slowing mechanisms, depending on the integration. This technology has the potential to significantly reduce the number of road accidents related to driver fatigue and could be applied in both personal vehicles and commercial fleets. The implementation of such systems represents a critical step toward improving road safety and decreasing driver-related incidents. Nowadays it is very challenging to stay active all the time due to busy schedules. Falling asleep while driving can lead to serious consequences, accidents, and even death. This situation is much more common and therefore it is very important to solve this problem. So, to solve this problem, we developed a sleep alarm system for drivers. This system alerts the user when he falls asleep at the wheel, thus the main concern is preventing accidents and saving lives. This system is useful for long- distance travelers and late-night drivers.

Acoustic emission analysis of self-healing properties in cementitious materials with superabsorbent polymers (SAPs) during different environments

This paper studies the coupling effect of superabsorbent polymers (SAPs) and fly ash on the self-healing performance of mortar. The three-point bending test was used to evaluate the mechanical property recovery effect of mortar specimens after curing in different environments, and the relationship between crack closure rate, flexural strength and flexural stiffness recovery was established. The amplitude and energy in acoustic emission were used to evaluate the characteristics of self-healing products. The results show that compared with the control specimens, the addition of SAP improves the crack closure rate and mechanical property recovery effect of mortar specimens. With the increase of SAP particle size and content, the mechanical property recovery rate and crack closure rate increase accordingly. The order of self-healing effect of specimens in different healing environments is saturated calcium hydroxide > water >97 % RH > air. After reloading, the amplitude number and cumulative energy of samples with SAP are larger than those of the control specimens. The SEM results also prove this, and the self-healing products in the crack area of the mortar specimens with SAP are denser than those in the control specimens.

Radiofrequency Ablation Eustachian Tuboplasty for the Treatment of Chronic Otitis Media with Effusion and Premature Extrusion of the Tympanostomy Tube.

Objective: This study evaluated the effects of radiofrequency ablation (RFA) eustachian tuboplasty on the treatment of chronic otitis media with effusion (COME), and associated complications, in patients with premature extrusion of the tympanostomy tube (TT). Materials and Methods: Tuboplasty and T-tube reinsertion were performed in 23 ears with COME, a history of premature TT extrusion, and thickened mucus. Tube retention, perforation closure, hearing improvement, and complications were evaluated. Results: All 23 patients with COME and previous premature TT extrusion had remarkable mucosal hypertrophic disease or mucosal polypoid changes in the posterior cushion or posterior wall in the nasopharyngeal eustachian tube (ET) orifice. All surgeries were completed within 20 minutes after general anesthesia and were performed in the operating room. Pre-and post-air-bone gap gain was 18.3 ± 2.5 dB. The TT was retained for at least 12 months in 19 patients, whereas intentional premature removal at postoperative 8 to 9 months was required in 2 patients and premature extrusion occurred in 2 patients. Thus, the tube retention success rate was 91.3% (21/23). Of the 21 ears with intentional removal, the perforation closure rate was 81.0% (17/21). None of the patients reported RFA-related serious adverse events or a patulous ET. However, a scar synechia of the anterior-posterior wall was seen in 1 ET orifice, and stenosis of the ET orifice in 4 patients. Conclusions: RFA eustachian tuboplasty combined with TT insertion is a simple and minimally invasive technique for the treatment of intractable COME in patients with a thickened mucosa of the nasopharyngeal ET orifice. This technique may prevent premature TT extrusion.

Comparative Effectiveness of Diode Laser Therapy and Topical Turmeric Extract Ointment in Promoting Healing of Wounds in a Murine Model.

The intricate biological process of wound healing is influenced by a wide range of therapeutic techniques. In this work, the effects of topical turmeric extract ointment and diode laser therapy on wound healing in a mouse model were investigated. Out of the sixty mice, three groups of twenty male mice each were created. Three groups received treatment: the first was a control group that got no treatment; the second group received topical application of 5% curcumin twice a day; and the third group received diode laser therapy, which involved direct laser beam therapy for five minutes a day at an output power of 100 mW at an 810 nm wavelength. Over the course of two weeks, the study examined histological changes and wound closure rates. On days 0 through 14, the wound area was measured with digital calipers to provide quantifiable statistics about the process of healing. In histological analyses, epithelializations, and collagen deposition, in addition to inflammatory cells, were investigated using hematoxylin and eosin staining. It was demonstrated by comparing the outcomes to those of a control group that diode laser therapy and turmeric extract ointment are both successful therapeutic options. The results demonstrate that different therapies, while with differing degrees of effectiveness, greatly quicken the healing process of wounds. According to these results, topical turmeric extract ointment could be used as an additional or supporting therapy to aid in the healing of wounds during medical treatments.

PLASMA RICH IN GROWTH FACTORS MEMBRANE IN THE TREATMENT OF MACULAR HOLES ASSOCIATED WITH MACTEL TYPE 2

Purpose: To demonstrate the regenerative effects of Plasma membrane rich in growth factors (PRGFm) as an adjuvant in the surgical treatment of Full-thickness macular holes (FTMH) associated with MacTel type 2 (MacTel). Methods: Observational study of a consecutive case series. Type 2 MacTel patients with FTMH. Best-corrected visual acuity, optical coherence tomography (OCT) data, anatomic closure rates, and duration of follow-up were documented. Results: 3 patients who met the inclusion criteria were enrolled, 2 are naïve and one is already operated with silicon oil in situ. Median follow-up was 6 months (range 6-18 months), anatomic closure rate was 100%, and median visual acuity change was 20/60 (range 20/40 - 20/100). No complications related to PRGFm were found. Conclusion: PRGFm is a valuable option for the treatment of FTMH associated with MacTel type 2. Its application promotes tissue regeneration and facilitates anatomical closure. The technique is reproducible and does not require manipulation of the internal limiting membrane.

Gallic acid functionalized silk fibroin/gelatin composite wound dressing for enhanced wound healing.

ABSTRACT&#xD;As the incidence of chronic wounds increases, the requirements for wound dressings are rising. The specific aim of this study is to propose a novel gallic acid (GA) functionalized silk fibroin (SF) and gelatin (Gel) composite wound dressing in which GA is used as an antibacterial and wound healing substance. Via electrospinning, SF, Gel, and GA mixed solutions could be conveniently fabricated into a composite nanofiber mat (SF-Gel-GA), consisting of uniform fibers with an average diameter around 134.57 ± 84 nm. The internal mesh structure of SF-Gel-GA provides sufficient drug loading capacity, proper moisture permeability, and proper degradation rate. SF-Gel-GA presents excellent biocompatibility. NIH-3T3 fibroblast cells could adhere and spread stably on the SF-Gel-GA surface with slightly promoted proliferation. In the presence of SF-Gel-GA, the growth of both Gram-positive and Gram-negative bacteria, including Staphylococcus aureusand Pseudomonas aeruginosa, is significantly inhibited in both plate and suspension cultures. A cutaneous excisional mouse wound model proves the efficient ability of SF-Gel-GA to promote wound healing. Compared with pure SF dressing and commercial Tegaderm Hydrocolloid3M dressing, the wound closure rate with SF-Gel-GA treatment is significantly improved. The histological assessments further demonstrate SF-Gel-GA could facilitate collagen deposition, neovascularization, and epithelialization at wound sites to promote wound healing. In conclusion, a novel SF-Gel-GA composite wound dressing with efficient wound healing activities have been developed for chronic wound treatment with broad healing potential.

Efficacy and safety of stem cell therapy for fistula management: An overview of existing systematic reviews.

Fistulas, abnormal connections between two anatomical structures, significantly impact the quality of life and can result from a variety of causes, including congenital defects, inflammatory conditions, and surgical complications. Stem cell therapy has emerged as a promising alternative due to its potential for regenerative and immunomodulatory effects. This overview of systematic reviews aimed to assess the safety and efficacy of stem cell therapy in managing fistulas, drawing on the evidence available. This umbrella review was conducted following the Joanna Briggs Institute (JBI) methodology to assess the efficacy and safety of stem cell therapy for treating various types of fistulas. A comprehensive search was performed across multiple electronic databases including PubMed, Embase, Cochrane Register, and Web of Science up to May 5th, 2024. Systematic reviews focusing on stem cell therapy for fistulas were included, with data extracted on study design, stem cell types, administration methods, and outcomes. The quality of the reviews was assessed using the AMSTAR 2 tool, and meta-analyses were conducted using R software version 4.3. Nineteen systematic reviews were included in our umbrella review. The stem cell therapy demonstrated by significant improvements in clinical remission rates, with a relative risk (RR) of 1.299 (95% CI: 1.192 to 1.420). Stem cell therapy enhanced fistula closure rates, both short-term (RR=1.481; 95% CI: 1.036 to 2.116) and long-term (RR=1.422; 95% CI: 1.091 to 1.854). The safety analysis revealed no significant increase in the risk of adverse events with stem cell therapy, showing a pooled RR of 0.972 (95% CI: 0.739 to 1.278) for general adverse events and 1.136 (95% CI: 0.821 to 1.572) for serious adverse events, both of which indicate a safety profile comparable to control treatments. Re-epithelialization rates also improved (RR=1.44; 95% CI: 1.322 to 1.572). Stem cell therapy shows promise as an effective and safe treatment for fistulas, particularly in inducing remission and promoting closure of complex fistulas. The findings advocate for further high-quality research to confirm these benefits and potentially incorporate stem cell therapy into standard clinical practice for fistula management. Future studies should focus on long-term outcomes and refining stem cell treatment protocols to optimize therapeutic efficacy.

Surgical outcomes of inverted internal limiting membrane flap technique for primary rhegmatogenous retinal detachment coexisting with a macular hole.

This retrospective study aimed to evaluate the visual outcomes and foveal restoration in eyes with rhegmatogenous retinal detachment (RRD) and macular hole (MH) following surgery using the inverted internal limiting membrane (ILM) flap technique. We collected data on eyes with coexisting RRD and MH that underwent surgery using the inverted ILM flap technique between January 2016 and December 2018. The primary outcome measures were visual acuity (VA) and optical coherence tomography findings. Of 308 eyes with MH originating from various causes, 8 (2.6%) eyes diagnosed with coexisting RRD and MH treated using the inverted ILM flap technique were included. The average patient age and axial length were 65.00 ± 12.01 years and 23.66 ± 0.77 mm, respectively. The mean preoperative best-corrected VA (BCVA) was 1.84 (spherical equivalent [SE], counting finger) ± 0.32 logMAR and the mean final BCVA had improved significantly to 1.05 (SE, 20/223) ± 0.67 logMAR (P = .017). The primary retinal reattachment, MH closure, and secondary retinal attachment rates were 75% (6/8), 87.5% (7/8), and 100% (7/7), respectively. The inverted ILM flap technique led to significant improvements in anatomical and visual outcomes in patients with coexisting RRD and MH.

Risk factors for developing residual stress urinary incontinence after vesico-vaginal fistula repair: A retrospective cohort study

BackgroundPrevious studies have identified predictors for residual urinary incontinence after successful closure of fistula. However, these findings remain uncertain because the predictors vary from one study to another. The present study aimed to examine the risk of residual stress urinary incontinence after successful closure of vesico-vaginal fistula (VVF). Materials and methodsWe conducted a multicenter retrospective cohort study over 07-years period, from 1st January, 2010 to 31 December, 2016. We included women who underwent VVF repair in one of the seven fistula centers. At three months postoperatively, a cough test was performed among patients who had their fistula successfully closed. The predicted outcome was the urinary continence status after sussessful closure of the fistula and was categorized as (Residual stress urinary incontinence and No Residual stress urinary incontinence). Multivariable binary logistic regression model was performed to analyze association between outcome and predictors. ResultsOverall fistula closure rate at 3 months was 88.6% (404/456). Of the patients who had their fistula successfully closed, 16.3% (66/404) experienced a residual stress urinary incontinence. Risk factors for residual stress urinary incontinence in univariate analysis were: urethro-vesical junction involvement, circumferential fistula, Goh type 3, fistula size greater than 3cm, previous fistula repair, urethra involvement. Three independent predictors have been identified: urethro-vesical junction involvement, previous fistula repair and type 3 of Goh's classification. ConclusionThis study showed that the rate of residual stress urinary incontinence is high in our setting. The involvement of sphincteric mechanism is the main predictor.

Comparison of conventional internal limiting membrane versus pars plana vitrectomy without peeling for small idiopathic macular hole

BackgroundThe aim of this study was to compare functional and anatomical changes in patients with small full thickness macular holes (FTMHs) who underwent pars plana vitrectomy (PPV) with or without Internal limiting membrane (ILM) peeling.Methods42 eyes of 42 patients diagnosed for FTMHs (< 250 micron) were included in our prospective interventional study. Main outcome measures were: Best Corrected Visual Acuity (BCVA), Macular hole closure rate, Ellipsoid Zone (EZ) and External Limiting Membrane (ELM) recover, Vessel Density in both Superficial (VDSCP) and deep (VDDCP) capillary plexus, Macular pigment Optical density (MPOD) and mean Central Macular Sensitivity (CMS).Patients were randomly divided into “peeling group” (21 patients), in which the ILM peeling maneuver was performed and “no-peeling group” (21 patients) in which the ILM was not peeled off. Examinations were repeated one month (T1), three months (T2) and six months (T3) after surgery.ResultsAlthough significant improvements in terms of MPOD, CMS, VDSCP and VDDCP over time (p < 0.001) no significant differences were found between the peeling and no peeling group. Conversely, FTMHs closure was achieved in all cases (100%) in the peeling group, whereas 10% of cases in the no peeling group experienced the hole re-opening at T3, with reported different rates of ELM/EZ recover between the two groups. Nevertheless, BCVA improved significantly (p < 0.001) but without significant differences between the two groups.ConclusionsNo significant differences were found in terms of anatomical and functional outcomes between the peeling or not the ILM in small FTMHs at 6 months follow-up.

Photothermally enhanced antibacterial wound healing using albumin-loaded tanshinone IIA and IR780 nanoparticles.

Chronic and infected wounds, particularly those caused by bacterial infections, present significant challenges in medical treatment. This study aimed to develop a novel nanoparticle formulation to enhance wound healing by combining antimicrobial and photothermal therapy using albumin as a carrier for Tanshinone IIA and the near-infrared photothermal agent IR780. The nanoparticles were synthesized to exploit the antimicrobial effects of Tanshinone IIA and the photothermal properties of IR780 when exposed to near-infrared laser irradiation. Characterization of the nanoparticles was performed using Transmission Electron Microscopy (TEM) and spectroscopic analysis to confirm their successful synthesis. In vitro antibacterial activity was evaluated using cultures of methicillin-resistant Staphylococcus aureus (MRSA), and in vivo efficacy was tested in a mouse model of MRSA-infected wounds. Wound healing progression was assessed over 16days, with statistical analysis performed using two-way ANOVA followed by Tukey's post-hoc test. The nanoparticles demonstrated significant photothermal properties, enhancing bacterial eradication and promoting the controlled release of Tanshinone IIA. In vitro studies showed superior antibacterial activity, especially under photothermal activation, leading to a substantial reduction in bacterial viability in MRSA cultures. In vivo, nanoparticle treatment combined with near-infrared laser irradiation significantly improved wound closure rates compared to controls and treatments without photothermal activation. By the 16th day post-treatment, significant improvements in wound healing were observed, highlighting the potential of the combined photothermal and pharmacological approach. These findings suggest that albumin-loaded nanoparticles containing Tanshinone IIA and IR780, activated by near-infrared light, could offer an effective therapeutic strategy for managing chronic and infected wounds, promoting both infection control and tissue repair.

Phytochemical composition, antimicrobial, antioxidant, and wound healing activities of Thermopsis turcica.

The antioxidant, antimicrobial, anticarcinogenic, wound healing activities and phenolic substance profile of aqueous extracts prepared using branch, leaf, flower parts and above-ground parts of Thermopsis turcica were determined in the study. The analyses indicate that the total phenolic substance contents and total antioxidant status are higher in the mix, flower, and leaf extracts. The extracts reduced cell viability in HGF cells more than in A549 cells. It shows that the extract has low anticarcinogenic activity in A549 cells. Flower extract had the highest wound closure rate. Quinic acid, cyranoside and luteolin were found in high concentrations in all extracts with LC/ESI-MS/LC analysis. It has been determined that the flower extract of the species is the most critical part showing antioxidant, antimicrobial, cytotoxic and wound healing properties. While the leaf and mix extracts stand out with their antioxidative and antimicrobial properties, the branch extract is effective in wound healing.