Sodium Hyaluronate Research Articles

METHOD OF USING SODIUM HYALURONATR FOR THE CORRECTION OF LAGOPHTHALMOS AND ITS COMPLICATIONS

A method for minimally invasive correction of lagophthalmos and its complications has been developed. Subcutaneous injections of low-molecular and high-molecular sodium hyaluronate (LM-NaH and HM-NaH) forms with different concentrations of the active substance have been proposed as a new method. The experiment has proven the maximum efficiency of 2% high-molecular sodium hyaluronate in maintaining the shape and width of the palpebral fissure (the effect lasts for 4 weeks). Low-molecular sodium hyaluronate form had the best effect on the condition of the ocular surface. These properties can be explained by the large size of high-molecular sodium hyaluronate molecules and the viscosity of the preparation, which allows the substance to be retained in the thickness of the eyelids for a long time, but does not allow it to penetrate the hematophthalmic barrier. The positive results of the experiment made it possible to use this method in clinical practice for patients with lagophthalmos. To date, one patient has been treated who suffered from facial nerve neuritis with subsequent development of lagophthalmos. A combined technique was used with simultaneous use of subcutaneous injections of 2% high-molecular and subconjunctival injections of 1% low-molecular sodium hyaluronate. After three procedures with an interval of 3 weeks between them, positive dynamics were noted in the form of improved closure of the palpebral fissure, an increase in the Schirmer test, and the absence of complaints from the cornea. Thus, we can talk about the effectiveness of this minimally invasive technique for patients with lagophthalmos and its complications with a one-time impact on the maximum possible number of pathogenesis links.

Features of the Thermal Degradation of Sodium Hyaluronates with Different Molecular Weights

Features of the Thermal Degradation of Sodium Hyaluronates with Different Molecular Weights

In Situ Forming Injectable Gelatin-Based Antibacterial Bioadhesives for Preventing Postoperative Leakage and Abdominal Adhesions.

Postoperative anastomotic leakage (AL) and abdominal adhesions are two major complications after intestinal surgery, with an incidence of 2-25% for AL and 93% for adhesion. Until now, there is no method addressing AL and abdominal adhesions simultaneously. In this work, Bi-PEG-succinimidyl succinate (PEG-NHS), amino-gelatin (Agel) is combined with cefoperazone-sulbactam (SCF) to prepare a multifunctional bioadhesive (SCF/SEAgel) for the postoperative leakage and adhesion prevention. SCF/SEAgel possesses a great sealing capability for tissue, with a bursting pressure of 54kPa. The loaded SCF endows the systems with good antibacterial properties. The in vivo antiadhesion experiments show that SCF/SEAgel possesses better anti-adhesion properties than the commercially used sodium hyaluronate gel. In the cecum leakage model, the SCF/SEAgel effectively seals the leakage with a survival rate of 100%, superior to commercial products (Sainaoning). Meanwhile, it significantly reduces tissue adhesion. Finally, the laparoscopic surgery with dogs shows that the SCF/SEAgel can be injected through minimally invasive surgery, demonstrating its ease of use. Combined with its great biocompatibility, SCF/SEAgel is very promising in intestinal surgery.

Efficacy and Safety of Hyaluronic Acid Combined with Botulinum Toxin Type A in the Treatment of Midcheek Groove: A Prospective Study.

The midcheek groove, a diagonal wrinkle in the infraorbital and infrazygomatic regions, disrupts the entire midface smooth lines and impacts facial aesthetics. Despite current treatments' limited effectiveness, including hyaluronic acid fillers and surgical risks, and the neglect of the medial orbicularis oculi muscle, this study explores the efficacy and safety of combining botulinum toxin type A with sodium hyaluronate injection for midcheek groove treatment, considering anatomical and clinical factors. In this prospective study, healthy participants with midcheek grooves (depth >3 mm) were treated with botulinum toxin type A combined with hyaluronic acid injections. Data were collected at baseline, 4, 12, and 32 weeks as well as 30 min after treatment, and at 1, 3, and 6 months follow-up. Changes in the depth of the midcheek groove were measured using a three-dimensional scanner and assessed using the Patient Satisfaction Assessment Scale. Subgroup analyses were performed to assess the impact of different clinical subtypes on treatment outcomes. Thirty-six volunteers completed this study, and the midcheek groove depth was significantly reduced at 30 min after treatment and at 1, 3, and 6 months of follow-up (p < 0.001). The medial half of the midcheek groove had the best efficacy at 1 month after treatment, while the lateral half responded best at 30 min after treatment. Subgroup analyses showed that clinical subtypes affected treatment efficacy. No complications or severe adverse reactions were observed. Botulinum toxin type A combined with hyaluronic acid injection effectively improved the midcheek groove. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A preliminary investigation on hydrogel disks imbibed with enriched transfersomes as promising tool to promote the cutaneous deposition of vaccine antigens

The skin is an appealing and easily accessible route of administration for fast mass vaccination. However, it relies mainly on injection, meaning no immunization is achieved locally. In addition, pain, fear, and injuries strongly affect and reduce the effectiveness and adherence of patients to vaccination plans. Non-invasive routes of administration offer a safe and reliable solution. On these bases, three series of phospholipid vesicles were eco-friendly developed and adequately modified to pursue cutaneous immunization. Ovalbumin was selected as the model antigen, whereas transfersomes were chosen over liposomes because of their higher capability to cross the skin. Glycerol, sodium hyaluronate, or their combination were added to further improve their penetration, and this led to small (< 60 nm), homogenous vesicles (polydispersity index < 0.2), stable for up to 9 months. The colloidal formulations, alone or combined with occlusive strategies (achieved by cling film or hydrogel disks), were tested on tape-stripped skin to facilitate their application in a potential real-life context. While the enriched transfersomes alone provided better ovalbumin accumulation into the skin, the combination with cling film and especially with the hydrogel disks boosted their performance even further (using the hydrogel disks, in the epidermis, the ovalbumin accumulated ranged from ∼30 to ∼40 μg/cm2 and in the dermis from ∼4 to ∼10 μg/cm2). Despite the antigen-presenting assay do not show any immunogenicity for these vesicles (p > 0.05 with respect to the ovalbumin solution tested at the same dose), they are expected to perform better than the ovalbumin solution due to the protection and the enhanced skin deposition they provide. In addition, all the formulations can be safely administered as they are highly biocompatible in a wide range of doses (> 100% from 0.05 to 50 μg/mL of ovalbumin) and do not exert any inflammatory response. However, further studies are needed to confirm these promising preliminary results.

Enzyme-induced degradation of natural and artificial linear polyanions

Synthetic and natural polymers are widely used for constructing drug delivery systems. Biocompatibility, water solubility and non-toxicity make polymers a convenient matrix for encapsulation, delivery and release of bioactive compounds [1–6]. Coupling of a drug with a biodegraded polymer matrix is a promising way for a controlled drug delivery. Along this line, the degradation of the four polymers in the presence of two enzymes in aqueous solutions was investigated. The following polymers were used: natural polysaccharides, sodium alginate and sodium hyaluronate, artificial (modified) sodium carboxymethylcellulose and synthetic sodium polyacrylate (control); their degradation was caused by the addition of alginate lyase and hyaluronidase. The first enzyme only cleaved the specific alginate substrate and left three other intact. Contrastingly, the second enzyme degraded all three polysaccharides, including artificial carboxymethylcellulose, but did not degrade synthetic polyacrylate. The biodegradation of polymers was accompanied by decreasing the size of polymer particles in solution from 100-200 nm down to 20-30 nm; the latter are capable of removing from the body through the kidneys. The initial polysaccharides showed the negative surface charge in aqueous solution, which changed but retained negative after biodegradation. The initial and biodegraded polysaccharides demonstrated negligible cytotoxicity during long exposure period. The obtained results are valuable for the development of polymer carriers for drug encapsulation and delivery.

Total knee arthroplasty combined with simultaneous open reduction and internal fixation in the treatment of knee osteoarthritis with patellar fracture: a case report and review of the literature

BackgroundPatients with severe knee osteoarthritis combined with patellar fracture are rare, and it is unclear whether single-stage surgery affects the enhanced recovery after surgery.Case presentationThis case report describes two patients of Han nationality. A 69-year-old male patient was previously diagnosed with severe knee osteoarthritis of the left knee joint and was treated conservatively with long-term oral nonsteroidal antiinflammatory drugs and intraarticular injection of sodium hyaluronate. He was hospitalized for acute left knee injury owing to a fall from a height. He was diagnosed with knee osteoarthritis of the left knee joint and patellar fracture. Another 74-year-old female patient was previously diagnosed with severe knee osteoarthritis, long-term oral nonsteroidal antiinflammatory drugs and topical Chinese medicine to relieve the pain. A month ago, she fell down the stairs and fractured the patella in her left knee, she was diagnosed with severe left knee osteoarthritis combined with an old left patella fracture. Both patients were successfully treated by single-stage primary total knee arthroplasty and fixation of the patellar fracture. They both carried out early functional exercise normally and successfully achieved enhanced recovery.ConclusionSuccessful single stage total knee replacement with patella management can not only reduce the number of operations, but also enable patients to achieve rapid postoperative recovery. However, single stage may increase the risk of local surgical complications. Therefore, for most patients, especially those with low risk of anesthesia related complications, standard of treatment remains first fixing the patellar fracture and when the fracture is healed proceed with the total knee arthroplasty.

Comprehensive Assessment of Intradermal Responses to Hyaluronic Acid-Based Skin Injection Fillers through Multi-Pathway Dynamic Synergies

Skin injection filling products must undergo a rigorous evaluation before entering the market, and intradermal reactions are crucial for biocompatibility. However, current evaluation methods for skin injection fillers often lack precision. This study aims to explore a comprehensive evaluation method by incorporating additional indicators: dermoscopy, transepidermal water loss, moisture content, ultrasound, and histological observation. Experimental findings show sodium hyaluronate gel groups exhibited no noticeable erythema or abnormalities, except for skin swelling. The dynamic and quantitative assessment of water content and transdermal water loss provided insights into the injection site skin's edema status. Ultrasound imaging observed subcutaneous material occupation and measured skin protrusion height. Histopathological observations revealed edema and inflammation in positive groups but no significant reactions in any gel samples. The comprehensive use of these methods confirms that the intradermal response of injection fillers in this study is within an acceptable range. However, if solely evaluated based on existing standards, it may exceed the qualified range. Consequently, the study suggests that for sodium hyaluronate gel, a macromolecular injection filler for long-term subcutaneous space occupancy, the traditional intradermal reaction scoring method may be inadequate. The proposed comprehensive evaluation scheme in this study is considered a more objective approach.

Microneedles based on hyaluronic acid-polyvinyl alcohol with antibacterial, anti-inflammatory, and antioxidant effects promote diabetic wound healing

Diabetic wound healing has become one of the major clinical burdens due to uncontrolled bacterial growth and an increase in the risk of various microbial infections. Despite excellent antioxidant properties, the poor aqueous solubility of resveratrol (RES) hampers its applicability. In this study, we proposed a novel multifunctional microneedle patch loaded with RES-encapsulated polymeric micelles. Resveratrol micelles (RES MC) were loaded in the microneedle tip, while the base part was coated with the antibiotic gentamicin (GEN) to promote wound healing. The microneedle tip composed of sodium hyaluronate (HA) could effectively deliver the anti-inflammatory and antioxidant RES MC. Furthermore, the base of the microneedle patch composed of polyvinyl alcohol (PVA) offered excellent flexibility, releasing GEN and providing resistance to bacterial contamination, thereby further promoting wound repair. In vitro antibacterial experiments indicated that the bactericidal rate reached 99 %. Further, the wound healing rate was recorded as 86.05 % on the 11th day of diabetes wound treatment. Together, the multifunctional microneedle patch with excellent biocompatibility exhibited anti-inflammatory, antioxidant, and antibacterial effects on the wound healing process, potentiating its efficacy in the treatment of diabetic wounds.

Defining critical quality attributes and composition parameters for burn wound dressings: Antibiotic-anesthetic films as a model

The management of wounds primarily revolves around pain relief, effective infection control and the promotion of tissue regeneration to prevent complications like chronic skin wounds. While polymeric bioactive films are innovative alternatives to conventional wound dressings, there exists a dearth of guidance regarding their quality control. This underscores the imperative need to establish precise critical quality attributes, a task undertaken within this study using an antibiotic-anesthetic film as a model. The aim was to establish the influence of critical composition and process parameters and optimize the formula.First, the quality target product profile was defined, and critical quality attributes were identified. Our material selection included ciprofloxacin hydrochloride (an antimicrobial), lidocaine hydrochloride (an anesthetic), as well as excipients, such as sodium alginate, sodium hyaluronate, carbomer and glycerol. The critical components were identified through a risk assessment matrix, and their influence on film composition was determined by experimental verification using Design-Expert® software. A full factorial design was employed to assess the effects of sodium hyaluronate, carbomer and glycerol (as independent variables) on transparency, homogeneity, folding capacity and handling. Following this, an optimized formulation was achieved and subjected to further characterization.These optimized antibiotic-anesthetic films exhibited uniform micro-distribution of components, ensuring dosage uniformity. Both ciprofloxacin hydrochloride and lidocaine hydrochloride displayed sustained release profiles, suggesting potential therapeutic benefits for skin wounds. Furthermore, the resistance and elongation properties were similar to those of human skin.Utilizing a QbD approach, we successfully developed an optimized antibiotic-anesthetic film that adhered to the essential critical quality attributes. This films exhibits potential utility as a wound dressing. The findings presented in this study establish a fundamental framework for delineating the critical quality attributes of dressing films and refining their formulation to optimize wound treatment.

The Toll-like receptor 4 antagonist TAK-242 in combination with sodium hyaluronate alleviates postoperative abdominal adhesion in a mouse model

Postoperative abdominal adhesion is one of the most common complications after abdominal surgery. The Toll-like receptor 4 (TLR4) signaling pathway is one of the most common inflammation-related pathways, and it has been demonstrated that TLR4 is highly expressed in adhesive tissues; however, the function of TLR4 in adhesion formation has not yet been studied. In the present study, the expression of TLR4 was first detected by immunohistochemical (IHC) and double-immunofluorescence staining in 40 mice, which were randomly divided into four groups, and sacrificed at 1, 3, 5 and 7 days after surgery. Subsequently, another 40 mice were randomly divided into five groups; with the exception of the sham group, the other groups were modeled and treated with saline that contained DMSO, sodium hyaluronate (HA), TAK-242 or TAK-242 + HA (applied to damaged peritoneal wounds). A total of 7 days after surgery, the mice were sacrificed and specimens were collected. Inflammation was detected by hematoxylin and eosin staining, and ELISA of transforming growth factor- β1 (TGF-β1) and interleukin-6 (IL-6); collagen deposition was examined by Masson staining and IHC staining of α-SMA; and reactive oxygen species (ROS) were detected by ROS staining and malondialdehyde (MDA) assay. The results revealed that TLR4 was highly expressed in the adhesive tissues at 3, 5 and 7 days after surgery. In addition, TAK-242 + HA treatment could reduce abdominal adhesion formation, exhibiting lower Nair’s score and inflammation scores, lower TGF-β1 and IL-6 levels, and lower collagen thickness and α-SMA levels compared with those in the control group. In addition, the TAK-242 + HA group had lower levels of ROS and MDA compared with those in the control group. The present study revealed that TLR4 was highly expressed in the process of adhesion formation and its inhibitor, TAK-242, combined with HA, could reduce adhesion formation by reducing inflammation and ROS, and alleviating collagen deposition.

Neuronal Intranuclear Inclusion Disease with a Corneal Disorder: A Case Report

Background: Neuronal intranuclear inclusion disease (NIID) is a progressive neurodegenerative disorder characterized by the formation of intranuclear inclusions in cells. Adult-type NIID usually develops in elderly patients with various clinical manifestations and is sometimes accompanied by ocular symptoms. A case of adult-onset NIID with early and unique manifestations, including a progressive corneal defect and retinal changes, which are concerning at a young age, is reported. Case Presentation: A 29-year-old woman with adult sporadic NIID presented to our department with a progressive corneal disorder. Her neurological symptoms started at the age of 22 years, and she was diagnosed with NIID by skin biopsy and genetic testing. Ocular examination revealed bilateral corneal superficial punctate keratitis, right corneal opacity, decreased vision, nocturnal lagophthalmos, and early retinal changes. Corneal nerve fiber atrophy was detected by in vivo confocal microscopy. With a Cochet–Bonnet aesthesiometer, the progression of NIID and decreased corneal sensation were confirmed. Findings consistent with neurotrophic keratitis and keratoconjunctivitis due to nocturnal lagophthalmos were both suggested as being complications of her underlying NIID. Treatment with punctal plugs, sodium hyaluronate eye drops, diquafosol sodium eye drops, systemic and local antivirals, and local steroid medications resulted in the gradual improvement in the irregularity and opacity of the epithelium. Conclusions: NIID may lead to neurotrophic keratopathy due to impairment of the corneal sensory nerves. Nocturnal lagophthalmos is a remarkable finding in a case of NIID. The findings in the present case highlight the complex and multifaceted nature of NIID, with neurological and ocular manifestations requiring a multidisciplinary approach to management.

A Preservative-Free Combination of Sodium Hyaluronate and Trehalose Improves Dry Eye Signs and Symptoms and Increases Patient Satisfaction in Real-Life Settings: The TEARS Study.

Dry eye disease (DED) is a frequently observed condition characterized by ocular discomfort and visual disturbance. It is highly prevalent and impairs patients' quality of life (QoL). This study assessed the benefit of a preservative-free bioprotectant eye drop formulation containing sodium hyaluronate and trehalose (SH-trehalose) with regards to DED, as well as patient satisfaction, through a large-scale real-life survey. In a multi-center, international, prospective observational study, subjects with DED received SH-trehalose for 84 days. Ocular Surface Disease Index (OSDI), Dry Eye Questionnaire-5 items (DEQ-5), and patient satisfaction were assessed at baseline, day 28, and day 84, and clinical evaluations included ocular surface staining, Schirmer test, tear film break-up time (TBUT), and conjunctival hyperemia at baseline and day 84. A total of 312 patients were evaluated, of whom 82.4% were women. The mean age was 57.9±15.2 years. The mean OSDI score at baseline was 41.7 ± 20.6. After 84 days, the mean OSDI score was 27.3 ± 19.8 (p < 0.001). The percentage of patients with a severe OSDI score decreased from 60.3 to 34.5%. The DEQ-5 score significantly (p < 0.001) improved after 28 and 84 days, as did patient satisfaction. Ocular surface staining, Schirmer test, TBUT, and conjunctival hyperemia scores improved significantly (all p < 0.001) for both eyes with SH-trehalose between baseline and day 84. Tolerance of SH-trehalose was good. SH-trehalose significantly improved the clinical signs and symptoms of DED after 84 days. Moreover, it significantly increased patient satisfaction and was well tolerated. NCT04803240.

Statistical analysis of predictors of effectiveness of complex physiotherapeutic treatment in patients with involutional skin changes

BACKGROUND: Analysis of predictors of the effectiveness of various treatment regimens for diseases, as well as the correction of involutionary processes in the human body, is increasingly becoming a standard in scientific medical research. The technology for identifying them traditionally includes the use of correlation and regression analysis, as well as the principles of correlation adaptometry, which makes it possible to approach the solution of this problem from the position of system analysis. AIM: Analysis of predictors of the effectiveness of correction of involutive skin changes in middle-aged and older women with metabolic syndrome using various therapeutic regimens, including hyaluronic acid laser phoresis and the use of transcranial magnetic therapy in combination with oxygen barotherapy. MATERIALS AND METHODS: The study was carried out with the participation of 60 patients from middle and older age with involutional changes in the skin against the background of metabolic syndrome. All patients were divided into 2 groups using simple fixed randomization. The first group (comparison, 30 patients) received laser phoresis of hyaluronic acid in the form of a 1.5% sodium hyaluronate gel using a laser and laser-vacuum therapy device LAZMIK. Patients of the second group (main group, 30 patients) were prescribed combined physiotherapy. For transcranial magnetic therapy, the Amo-Atos device with the Headband attachment was used, and oxygen barotherapy was carried out in single pressure chambers of the Oka-MT or Irtysh-Shch1 type under a pressure of 2 atm for 1 hour. RESULTS: It was found that in the initial state, the quality of life of patients with involutional changes in the skin against the background of metabolic skin syndrome was largely determined by the presence of pathological correlation galaxies that integrate changes in the condition of the skin, metabolic disorders, indicators of oxidative stress and microhemodynamics, and the activity of proinflammatory cytokines. At the same time, the leading role in the deterioration of the quality of life belonged to the age of the patients, the insulin resistance index, transepidermal water loss and microcirculation indicator. However, predictors of effectiveness varied across different treatment regimens. With laser phoresis of hyaluronic acid, its effectiveness increases in younger women with minimal involutional manifestations of skin aging, tested for the condition of the skin, while combined physiotherapy is also most effective in women with a low average age limit, with minimal manifestations of metabolic syndrome and inflammatory processes, as well as against the background of high activity values of one of the enzymes of antioxidant protection ― superoxide dismutase. CONCLUSION: The results obtained convincingly prove the effectiveness of combination therapy in correcting involutive skin changes in middle-aged and older women due to metabolic syndrome, which is comparable in a number of parameters to the effectiveness of hyaluronic acid laser phoresis. At the same time, predictors of effectiveness depend on the characteristics of the mechanisms of therapeutic action of the treatment regimens used, which allows for a more correct approach to the choice of personalized treatment methods.

Custo-Efetividade de Diferentes Tratamentos Minimamente Invasivos Para Disfunção Temporomandibular de Origem Articular sob a Perspectiva do Sistema Público de Saúde Brasileiro

ObjectiveThis study aimed to evaluate the cost-effectiveness (CE) of minimally invasive interventions for pain associated with articular temporomandibular dysfunction from the Brazilian Public Health System (SUS) perspective. MethodsThis is a CE study with a 1-year time horizon. Effectiveness data were extracted from a network meta-analysis, and 2 treatments with moderate levels of evidence certainty were evaluated: arthrocentesis (ARTRO) plus intra-articular corticosteroid (CO) injection and ARTRO plus intra-articular injection of sodium hyaluronate (SH). For CE analysis, the costs of 2 types of SH (low and high molecular weight) and 4 COs (betamethasone [B], dexamethasone acetate [D], methylprednisolone sodium succinate [M], or triamcinolone hexacetonide [T]) were considered. Modeling was conducted using TreeAge Pro Healthcare software, with the construction of a decision tree representing a hypothetical cohort of adults with articular temporomandibular dysfunction. Deterministic and probabilistic sensitivity analyses were performed. In addition, an acceptability curve was developed. ResultsThe total costs per joint for ARTRO plus low- and high-molecular-weight SH and ARTRO plus COs B, D, M, and T were, respectively, R$583.32, R$763.85, R$164.39, R$133.93, R$138.57, and R$159.86. ARTRO plus dexamethasone acetate was considered cost-effective, with lower cost and higher net monetary benefit than other technologies. In all sensitivity analysis scenarios, it remained cost-effective. It also showed greater acceptability. ConclusionARTRO plus dexamethasone acetate was considered the cost-effective technology, exhibiting higher net monetary benefit and higher acceptability from the SUS perspective.

Enhanced X-ray shielding efficiency and visible light degradation performance of a multilayer composite protective material

To mitigate the adverse effects of high-energy radiation, such as X-rays, on patients during medical procedures, a multifunctional composite nanofibrous membrane has been engineered to shield against low-energy X-rays. This study involves integrating processed oil-tea camellia shells (OCS) powder into molten polylactic acid (PLA) for modification. Concurrently, metallic Bi is introduced to enhance Bi2WO6, which is subsequently combined with modified PLA and electrospun into nanofibrous membranes for photocatalytic antimicrobial and organic pollutant degradation. Additionally, sodium hyaluronate (NaHA) and a silver nanoparticle solution are electrospun with PLA to form a skin-friendly protective layer. Following this, a chitosan (CS) solution containing WO3 and B4C is used as a coating on the multilayered membranes. The membranes are then freeze-dried to create sandwich-structured multilayer composite protective material. This method addresses challenges associated with polylactic acid (PLA) in electrospinning and alleviates limitations such as low light absorption and slow charge transfer in Bi2WO6. Compared to similar materials, this composite material is lightweight, flexible for cutting, and exhibits strong X-ray shielding capabilities. The composite nanofibrous membrane demonstrates a shielding efficiency of 97.75 ± 2.05 % at low X-ray energy (46 kVp). Moreover, under visible light, the membrane generates reactive oxygen species, resulting in the efficient removal of 98.03 % of methylene blue (MB), 96.35 % of rhodamine B (Rh.B), and 91.51 % of methyl orange (MO) within 180 minutes. Furthermore, it displays bactericidal activity against E. coli and S. aureus under both dark and light conditions. In natural settings, the composite membrane undergoes gradual degradation in soil, completely decomposing within 28 days due to the influence of rainfall and microorganisms. Consequently, this composite membrane holds significant promise for specialized medical protective applications.

Synergistic Gas Therapy and Targeted Interventional Ablation With Size-Controllable Arsenic Sulfide (As2S3) Nanoparticles for Effective Elimination of Localized Cancer Pain.

The elimination of localized cancer pain remains a globally neglected challenge. A potential solution lies in combining gas therapy with targeted interventional ablation therapy. In this study, HA-As2S3 nanoparticles with controlled sizes are synthesized using different molecular weights of sodium hyaluronate (HA) as a supramolecular scaffold. Initially, HA co-assembles with arsenic ions (As3+) via coordinate bonds, forming HA-As3+ scaffold intermediates. These intermediates, varying in size, then react with sulfur ions to produce size-controlled HA-As2S3 particles. This approach demonstrates that different molecular weights of HA enable precise control over the particle size of arsenic sulfide, offering a straightforward and environmentally friendly method for synthesizing metal sulfide particles. In an acidic environment, HA-As2S3 nanoparticles release hydrogen sulfide(H2S) gas and As3+. The released As3+ directly damage tumor mitochondria, leading to substantial reactive oxygen species (ROS) production from mitochondria. Concurrently, the H2S gas inhibits the activity of catalase (CAT) and complex IV, preventing the beneficial decomposition of ROS and disrupting electron transfer in the mitochondrial respiratory chain. Consequently, it is found that H2S gas significantly enhances the mitochondrial damage induced by arsenic nanodrugs, effectively killing local tumors and ultimately eliminating cancer pain in mice.

Tackling the tubes of refractory Sturge–Weber syndrome with secondary glaucoma: A surgeon’s nightmare!

Hypotony with shallow anterior chamber (AC) post glaucoma surgery in Sturge–Weber syndrome (SWS) patients is commonly due to choroidal effusions. We report two cases of SWS patients having hypotony and shallow AC after Ahmed Glaucoma valve (AGV) implantation with no wound leak or choroidal effusion. Case 1 had persistent shallow AC, which was diagnosis of exclusion, as valve malfunction, a rare occurrence in AGV. Case 2 resolved after AC reformation with 1.8% sodium hyaluronate. Two cases describe the clinical approach and surgical management in patients of hypotony with shallow AC after AGV implantation in SWS patients.

Temperature-sensitive injectable chitosan-based hydrogel for endoscopic submucosal dissection

Endoscopic submucosal dissection (ESD) is an effective treatment for polyps and early gastrointestinal cancers, but requires a high level of operator skill. Injecting submucosal materials (SIM) helps create a fluid cushion between the mucosal and muscular layers, making the procedure easier and reducing associated risks. However, SIMs commonly used in current clinical practice tend to spread quickly and fail to provide long-lasting submucosal fluid cushions (SFC). Thus, there is a critical need for a material that is easy to inject while also maintaining a durable barrier. We prepared succinylated hydroxybutyl chitosan (HBC-SA) by adding succinic anhydride (SA) to hydroxybutyl chitosan (HBC). The hydrogel had excellent temperature-sensitive properties and was able to be injected via an endoscopic injection needle even after gel formation. In vitro and in vivo studies showed that it has satisfactory biocompatibility. Functional experiments showed that the submucosal lifting properties of this hydrogel were significantly better than that of normal saline (NS) and sodium hyaluronate (SH), two commonly used clinical materials. In addition, the hydrogel possessed excellent hemostatic properties. Based on these results, HBC-SA is a promising candidate for submucosal injection during ESD.

Development of an antioxidant and anti-lipid peroxidation film based on quercetin-loaded Eudragit EPO®/sodium hyaluronate electrospun fibers

This study focuses on the development of a film based on electrospun fibers for the encapsulation of quercetin, to be applied as an antiradical and anti-lipid peroxidation system. Electrospun nanofibers based on Eudragit EPO (Eud EPO) and sodium hyaluronate (SH) with diameters ranging between 600 and 800 nm, and with smooth and/or rough surfaces were developed. Quercetin was successfully incorporated to the electrospun fiber system (≈92.1 %). Surprisingly, the free nanofibers showed great antiradical, reducing, and lipid antiperoxidation capacities. These properties were enhanced with the incorporation of quercetin, generating an enhanced synergistic effect. A film based on electrospun nanofibers with excellent biological properties was created through a simple method. Diverse bioactive compounds may enhance such biological properties. This system would have great potential for application within the biomedical sector.