Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign, acquired proliferative vascular lesion of the skin and mucous membrane that can be diagnosed by medical history, clinical manifestations, and examinations such as dermoscopic and histopathology. The diagnosis, differential diagnosis and treatments of pyogenic granuloma were summarized. According to different lesion sites, cure rates and complications, the appropriate treatment should be selected to achieve better therapeutic effect.

Objective: To investigate whether the combination of oral propranolol and topical 0.5% timolol maleate cream is more effective than oral propranolol alone for treating infantile hemangioma (IH). Methods: From September 2015 to July 2016, 14 patients with proliferative IH, visited the infantile hemangioma outpatient clinic of the Department of Plastic and Reconstructive Surgery of Shanghai 9th People′s Hospital, were enrolled in this study. All patients took oral propranolol. Half of each IH lesion was treated with 0.5% timolol maleate cream. There were 5 male patients and 9 female patients, aged from 1.5 to 5.0 months. After 4 months of treatment, the color, size, extent, volume and the overall clinical outcomes of each lesion were measured, and the side effects were recorded. The therapeutic outcomes of oral propranolol alone and the combination of propranolol and timolol were analyzed and compared using Wilcoxon matched-pair signed-rank nonparametric tests. Results: Both oral propranolol alone and oral propranolol combined with topical 0.5% timolol maleate cream were proved to effectively improve the regression of IH with minor side effects. The color VAS score of oral propranolol alone group was 6.92±2.63, while the combination group was 6.88±2.33 (Z=0.043, P=0.966). The volume VAS score of oral propranolol alone group was 6.94±2.00, while the combination group was 6.98±2.11(Z=-0.051, P=0.959). Conclusions Oral propranolol combined with topical application of 0.5% timolol maleate could not increase the efficacy in the treatment of IH, compared with oral propranolol alone in the short-term observation.

Objective:To reveal the mechanism of Mahuang Lianqiao Chixiaodou decoction and its disassembled formula for improving the skin barrier function in a mouse model of atopic dermatitis (AD).Methods:Sixty specific-pathogen free male BALB/c mice were randomly divided into the control group,model group,whole formula group (WF),exterior-releasing formula group (ERF),interior-clearing for-mula group (ICF),and positive control group (PC).A mouse model of AD was established using the semi-antigen 2,4-dinitrofluorobenzene induction method.The lesion scores,transepidermal water loss and pH,and skin histopathology of mice in each group were observed.The expressions of filaggrin,loricrin,and involucrin were detected by the streptavidin peroxidase immunohistochemical method and western blotting,and their mRNA expressions were detected by quantitative polymerase chain reaction.Results:Mice in the WF,ERF,ICF,and PC groups showed reduced skin lesion performance,improved histopathology,decreased skin lesion score,transepidermal water loss and pH,and upregulated ex-pressions of proteins including filaggrin,loricrin,and involucrin,and their mRNAs.The most obvious regulatory effect was observed in the WF group,followed by the ICF,ERF,and PC groups,accordingly.Conclusions:Mahuang Lianqiao Chixiaodou decoction and its disassembled formula can improve the skin barrier function in a mouse model of AD by upregulating filaggrin,loricrin,and involucrin,and their mRNA expressions,and the most optimal effect was noted in the WF group,followed by the ICF and ERF groups,which suggests that the effect of clearing heat and resolving dampness in improving the skin barrier function of AD is more obvious and is one of the key treatments for AD.

Objective:To explore the safety and efficacy of radiofrequency in the treatment of overactive bladder(OAB).Methods:A prospective, multicenter, non-randomized controlled trial was conducted. Eligible patients were divided into test group and control group in Zhejiang Provincial People’Hospital, The First Affiliated Hospital of Wenzhou Medical University, and Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from March 2019 to June 2020. Inclusion criteria: patients diagnosed with OAB, and bladder capacity>100ml. Exclusion criteria: pregnant and lactating women; patients with secondary OAB symptoms such as urinary tract obstruction; patients with uncontrolled urinary tract infection within 1 week; patients in stable stage by using other treatment methods; patients implanted with any nerve stimulator, cardiac pacemaker or implantable defibrillator; patients with malignant tumors, serious cardiovascular, cerebrovascular diseases, renal insufficiency or received BTX treatment in recent 12 months. The patients were allocated to test group and the control group in a ratio of 2∶1 according to the time sequence of the visit. The patients in the test group were treated with radiofrequency treatment. After entering the group, they were treated for 4 times at the 1st, 2nd, 7th and 8th week respectively. In the control group, the energy was turned off during the radiofrequency treatment. The patients were followed-up every week until the end of the 12th week. The treatment success rate [the average frequency of urination in 24 h was reduced more than 50% from the baseline or returned to the normal (≤8 times/day) or the average frequency of urgent urination in 24 h was reduced more than 50% from the baseline], the frequency of urination, urgent urination and nocturnal urination before and after treatment, the residual urine volume of the bladder, the quality of life (QOL) score and the occurrence of catheter related adverse events in two groups were compared.Results:114 patients were enrolled in the study, including 76 patients in the test group and 38 patients in the control group. There were no significant differences in the age [(44.2±12.8) vs. (41.7 ± 12.1) years old], male female ratio (13/63 vs. 4/34), average course of disease [2.0(1.2, 5.0) vs. 2.0 (1.0, 4.0) years], the frequency of urination[12.8 (10.6, 16.8) vs. 12.8 (10.3, 17.0) times], urgency urination [11.8(9.3, 15.8) vs. 11.8 (9.0, 17.0) times], nocturia [2.7 (1.3, 3.7) vs. 2.3(0.7, 3.3) times], residual urine volume of bladder [12.0 (3.0, 28.0) vs. 14.0 (3.7, 20.0) ml ] and the QOL score [5.0(4.0, 5.0) vs. 4.0(4.0, 5.0)]before the treatment between the two groups ( P>0.05). The treatment success rate in the test group was 76.3% (58/76), while 26.3% (10/38) in the control group, with a statistically significant difference ( P<0.01). There were significant differences between the test group and control group in the frequency of urination [9.7 (7.7, 12.0) vs. 12.9 (9.6, 15.7) times], urgent urination [7.3 (5.0, 10.0) vs. 11.7 (7.3, 15.3) times], nocturia [1.3 (0.7, 2.0) vs. 1.7 (1.0, 3.0) times] and the QOL score of the patients[3.0(1.0, 3.0) vs. 4.0(3.0, 4.5)]after the treatment(all P<0.05). The frequency of urination, urgency urination, nocturia, the residual urine volume and the QOL score in the test group were significantly improved ( P<0.05) after the treatment.The frequency of urination, nocturia, residual urine volume and the QOL score in the control group were improved ( P<0.05) after the treatment. 13 (11.4%) patients had catheter related adverse events. In the test group and the control group, there were 7 cases of macroscopic hemorrhage caused by the placement of instruments (5/76 vs. 2/38), 5 cases of acute urinary tract infection within 3 days (3/76 vs. 2/38), and 1 case of instrument breakage (catheter breakage) (0/76 vs. 1/38). There were no significant differences in the adverse events between the two groups ( P> 0.05). Conclusions:Radiofrequency treatment of OAB can effectively improve the symptoms of patients, improve the QOL of patients, and has low incidence of adverse events, with good efficacy and safety.

ObjectiveTo investigate the effect of high-definition transcranial direct current stimulation (HD-tDCS) combined with upper limb robot on upper limb dysfunction in patients with ischemic stroke. MethodsFrom January, 2023 to March, 2024, 56 inpatients with upper limb dysfunction after ischemic stroke were selected from Zhejiang Rehabilitation Medical Center, and divided into control group (n = 28) and experimental group (n = 28) randomly. All the patients received comprehensive treatment and upper limb robot training, while the control group received sham HD-tDCS and the experimental group received HD-tDCS, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Wolf Motor Function Test (WMFT) and modified Barthel Index (MBI) before and after treatment. The cortical amplitude, cortical latency and central motor conduction time (CMCT) of transcranial magnetic stimulation motor-evoked potential (MEP) were recorded, and a correlation analysis was conducted. ResultsThe scores of FMA-UE, WMFT and MBI, and MEP cortical amplitude, cortical latency and CMCT improved in both groups after treatment (t > 3.177, P < 0.01), and they were better in the experimental group than in the control group (t > 3.610, P < 0.01). The scores of FMA-UE and WMFT negatively correlated with MEP cortical latency and CMCT, and positively correlated with MEP cortical amplitude (|r| > 0.448, P < 0.001). ConclusionHD-tDCS is effective on upper limb motor function and activities of daily living for patients with ischemic stroke, and can improve corticospinal motor conduction.