Objective:To investigate the potential value of cerebral glucose metabolism characteristics in anti-leucine-rich glioma-inactivated protein 1 (LGI1) antibody-related encephalitic patients during acute phase as the clinical indicator of disease outcomes.Methods:From October 2019 to December 2023, 28 patients (18 males, 10 females; age (56.6±11.9) year) with anti-LGI1 antibody-related encephalitis diagnosed at Huashan Hospital, Fudan University were prospectively enrolled. All patients received baseline brain 18F-FDG PET imaging and were divided into different subgroups according to the prognosis (good prognosis and poor prognosis groups) and recurrence (recurrence and non-recurrence groups) after follow-up. The difference of Montreal Cognitive Assessment (MoCA) score between the two groups was compared by Mann-Whitney U test. Statistical parametric mapping (SPM) analysis was used to analyze the PET images of different groups by independent-sample t test, and the characteristics of cerebral glucose metabolism of patients with different outcomes were obtained. Results:MoCA scores between the recurrence group ( n=6) and the non-recurrence group ( n=22; 14.0(9.8, 20.5) vs 22.0(18.0, 24.0); Z=2.17, P=0.030), and between the poor prognosis group ( n=13) and the good prognosis group ( n=15; 14.0(10.0, 22.0) vs 22.0(19.8, 25.3); Z=2.47, P=0.013) were significantly different. Compared with the good prognosis group, the cerebral glucose metabolism in the poor prognosis group was decreased in the bilateral frontal lobe, lateral temporal lobe, inferior parietal lobule and cingulate gyrus, but increased in the brainstem, bilateral lentiform nucleus and bilateral paracentral lobule/postcentral gyrus (all t=1.71, all P<0.05). Compared with the non-recurrence group, the metabolism of bilateral medial frontal gyrus, anterior cingulate gyrus, bilateral insula, superior temporal gyrus and thalamus decreased in the recurrence group, while the metabolism of bilateral precentral gyrus, inferior frontal gyrus and bilateral lentiform nucleus increased (all t=1.71, all P<0.05). Conclusion:18F-FDG PET imaging reveals the differences in brain metabolism of anti-LGI1 antibody-related encephalitic patients at baseline with different outcomes (prognosis, recurrence or not), which can provide a new perspective for the clinical evaluation of the disease at baseline.

Objective:To construct a management program for postoperative home exercise rehabilitation in patients undergoing liver cancer surgery, and to provide guidance for improving home exercise capacity after liver cancer surgery.Methods:A mixed study design was used to summarize the best evidence for a postoperative home exercise rehabilitation program for patients with liver cancer based on a literature review from January to June 2022, and the first draft of a postoperative home exercise rehabilitation program for liver cancer patients was formed after discussion in the research team, and discussed in an expert validation meeting, and the first draft of the program was revised and improved according to the expert′s opinion in combination with clinical practice.Results:This study included 14 articles, including 4 clinical guidelines, 3 systematic evaluations, 2 randomized controlled studies, 3 class experimental research and 2 expert consensuses. And 22 pieces of evidence were included in the summary of evidence, including the principle of exercise, supervision of exercise, type of exercise, time and frequency of exercise, and intensity of exercise. A total of 10 experts participated in the expert validation meeting, with 6 males and 4 females, aged (53.31 ± 10.23) years, with an expert authority coefficient of 0.944, and the final home exercise rehabilitation program for postoperative patients with liver cancer was formed to include six aspects, including pre-exercise assessment, warm-up exercise, whole-body exercise, stretching exercise, organizing exercise, and exercise detection and follow-up.Conclusions:The home exercise rehabilitation program for postoperative liver cancer surgery patients is scientific, practical and feasible, and it is a systematic, standardized and safe exercise management model, which can be used for home guidance of postoperative exercise rehabilitation for liver cancer patients.

The etiology and pathogenesis of melasma have not been fully elucidated. This article summarizes the recent research progress on melasma, explores the roles of photoaging, skin barrier dysfunction, mast cell activation, sex hormone fluctuations, and circadian rhythm disturbances in its pathogenesis, with the aim of providing new directions for its clinical prevention and treatment. With a deeper understanding of the pathogenesis of melasma, future therapeutic strategies are expected to shift from solely addressing skin pigmentation to comprehensive approaches involving anti-photoaging therapies and skin repair interventions.

Objective:To analyze factors influencing the melasma severity, and to evaluate the efficacy of different treatment modalities.Methods:A retrospective analysis was conducted on clinical data from patients diagnosed with melasma at the Pigmentary Disorders Specialty Clinic in the Department of Dermatology, Huashan Hospital, Fudan University from July 2018 to December 2023. Patients' Fitzpatrick skin types, lesion color, locations and subtypes were evaluated by dermatologists, the melasma area and severity index (MASI) scores were calculated, and ΔMASI scores (baseline MASI scores - post-treatment MASI scores) were used for efficacy evaluation. The t test and one-way analysis of variance were used to analyze factors influencing the severity of melasma, the paired t test was used to analyze the differences in MASI scores before and after treatment, and a multivariate linear regression model was established to analyze factors influencing the efficacy in the treatment of melasma. Results:A total of 254 patients (including 249 females, 98.0%) with melasma were included, with ages of 40.8 ± 6.1 years. The Fitzpatrick skin type was Ⅲ in 213 (83.9%) patients, and Ⅳ in 41 (16.1%) patients; 180 (70.9%) patients lacked the habit of using sunscreens regularly. According to the location of pigment deposition, 166 cases (65.4%) were classified as epidermal type, and 88 (34.6%) as mixed type. Pigmented lesions were located on the cheek (174 cases, 68.5%), midface (26 cases, 10.2%), or lower jaw (54 cases, 21.3%), with periorbital involvement observed in 127 cases (50.0%). Before treatment, baseline MASI scores were significantly higher in the skin type Ⅳ group (19.75 ± 5.08) than in the skin type Ⅲ group (14.47 ± 4.18, P < 0.001), in the non-sunscreen users (16.45 ± 4.61) than in the sunscreen users (12.59 ± 3.91, P < 0.001), in the epidermal type group (15.99 ± 4.82) than in the mixed type group (14.07 ± 4.35, P < 0.001), in the mandibular type group (18.37 ± 5.14) than in the midfacial type group (14.23 ± 3.46, P < 0.001) and malar type group (14.54 ± 4.40, P < 0.001), as well as in the patients with periorbital involvement (16.54 ± 4.90) than in those without (14.10 ± 4.26, P < 0.001). According to the main treatment regimens, the patients were divided into the topical 2% hydroquinone group (109 cases, topically treated with 2% hydroquinone cream nightly), topical non-hydroquinone skin-lightening agents group (36 cases, topically treated with non-hydroquinone skin-lightening or exfoliating agents), oral tranexamic acid group (50 cases, treated with oral tranexamic acid 250 mg twice daily), and alpha hydroxy acid (AHA) chemical peeling group (30 cases, receiving AHA chemical peeling treatment monthly with the AHA concentration escalating from 20% to 50%). After treatment, MASI scores were significantly reduced from baseline in all the 4 groups (all P < 0.001), and the ΔMASI values significantly differed among the topical 2% hydroquinone group, topical non-hydroquinone skin-lightening agents group, oral tranexamic acid group, and AHA chemical peeling group (1.65 ± 2.19, 1.40 ± 2.16, 4.58 ± 3.09, 3.39 ± 3.61, respectively, F = 17.40, P < 0.001). The oral tranexamic acid group and AHA chemical peeling group showed significantly superior efficacy compared to the topical 2% hydroquinone group and topical non-hydroquinone skin-lightening agents group (all P < 0.05), while there was no significant difference in the efficacy between the oral tranexamic acid group and the AHA chemical peeling group ( P > 0.05). After adjustment for potential confounders in the multivariate linear regression model, the oral tranexamic acid group (β = 2.64) and AHA chemical peeling group (β = 1.55) still showed significantly superior efficacy compared to the topical 2% hydroquinone group (both P < 0.05) ; the skin type Ⅳ group exhibited significantly superior efficacy compared to the skin type Ⅲ group (β = 1.87, P < 0.001) . Conclusions:Dark skin color, lack of sun protection habits, epidermal melasma, and mandibular-type melasma, and periorbital involvement were associated factors for the severity of melasma. Oral tranexamic acid and AHA chemical peeling appeared to exhibit superior efficacy compared to topical 2% hydroquinone cream and topical non-hydroquinone skin-lightening agents.

Objective:To investigate the characteristics of serum immunoglobulin G (IgG) N-glycans in male patients with different subtypes and severity grades of androgenetic alopecia (AGA) .Methods:A cross-sectional study was conducted on male patients diagnosed with male-pattern hair loss (MPHL) or female-pattern hair loss (FPHL) who attended the Department of Dermatology, Huashan Hospital, Fudan University between June and December 2022. Clinical data were collected, and serum IgG N-glycans were quantitatively analyzed using ultra-performance liquid chromatography (UPLC) . The content of serum IgG N-glycan structures was compared between patients with different AGA subtypes and among patients with different severity grades of MPHL or FPHL, while derived traits were compared between patients with different AGA subtypes. Point-biserial correlation analysis was conducted to assess associations between serum IgG N-glycans and hair loss severity.Results:A total of 85 male patients with AGA were included, comprising 44 MPHL patients and 41 FPHL patients. No significant differences were observed between the two subgroups in terms of age, age at onset, or serum levels of testosterone, sex hormone-binding globulin, uric acid, and 25-hydroxyvitamin D (all P > 0.05) . UPLC showed 23 serum IgG glycans and 5 derived glycan traits (afucosylation, fucosylation, bisecting GlcNAc, terminal galactosylation, and terminal sialylation) . Compared with the MPHL patients, the FPHL patients exhibited significantly increased levels of N-glycans GP5, GP11, GP17, and GP20 (all P < 0.05) , significantly elevated levels of afucosylated IgG N-glycans ( P = 0.047) , but significantly reduced core fucosylated IgG N-glycans ( P = 0.047) . No significant differences in serum IgG N-glycan composition were observed among patients with varying severity grades of MPHL (all P > 0.05) . In the FPHL patients, the levels of N-glycans GP10 ( r = 0.32, P = 0.039) and GP22 ( r = -0.32, P = 0.045) were significantly positively and negatively correlated with hair loss severity respectively; receiver operating characteristic curve analysis showed that both GP10 and GP22 had moderate diagnostic value for predicting hair loss severity, with the area under the curve values being 0.69 (95% CI: 0.52 - 0.86) and 0.71 (95% CI: 0.55 - 0.86) , respectively. Conclusion:Serum IgG N-glycan profiles differed among male patients with different AGA subtypes, and N-glycans GP10 and GP22 may serve as potential biomarkers for early assessment of hair loss severity in male FPHL patients.

Objective:To compare the efficacy and safety of a domestic hair follicle extraction system versus traditional follicular unit excision (FUE) in extracting hair follicles for the treatment of androgenetic alopecia (AGA) .Methods:A multicenter, randomized, self-controlled clinical trial was conducted on AGA patients aged 18 - 59 years who were recruited from the Huashan Hospital, Fudan University, the Affiliated Hangzhou First People's Hospital, and the China-Japan Friendship Hospital between June 2023 and September 2024. Each patient's scalp was randomly divided into two sides (experimental side vs. control side) using an envelope method. The experimental side underwent robotic hair transplantation with a domestic hair follicle extraction system, and the control side underwent traditional FUE. Hair follicles were extracted from the safe donor area in the occipital region, and implanted into the ipsilateral hair loss area. The primary outcome was the hair transection rate which was calculated immediately after follicular extraction. The secondary outcomes included the hair follicle unit loss rate and the change in hair density at the recipient site on postoperative day 14. Safety was evaluated by assessing the incidence of folliculitis at the donor site on postoperative day 14 and the overall incidence of adverse events. Surgical outcomes were evaluated at 9 months after surgery. Comparisons of evaluation indicators among groups were performed by using a paired t test or Wilcoxon signed-rank test. Results:A total of 55 patients with AGA (51 males and 4 females, aged 32.71 ± 5.75 years) completed the hair follicle transplantation and postoperative follow-up. The hair transection rate ( M[ Q1, Q3]) was 6.65% (4.56%, 10.16%) in the experimental group and 5.28% (3.04%, 8.89%) in the control group (difference = 1.24%, 95% CI: -0.24%, 2.65%) . The hair follicle unit loss rate was 2.00% (1.00%, 3.50%) in the experimental group and 0.50% (0, 2.00%) in the control group, with a significant difference between the two groups ( P = 0.008) . On postoperative day 14, there was no significant difference in the hair density between the experimental group and control group (72.20 ± 25.95 per cm 2vs. 76.49 ± 30.84 per cm 2, P = 0.173) . At 9-month follow-up, both groups showed improvement in the investigator's overall score in the recipient areas. Seven adverse events occurred in 7 subjects (12.72%) in each group, and all were mild folliculitis. Conclusion:The domestic hair follicle extraction system demonstrated comparable efficacy and safety to the traditional FUE in hair transplantation.

Oral minoxidil has been used to treat various hair loss disorders, including alopecia areata, though its efficacy as a monotherapy remains unclear. In recent years, oral minoxidil has increasingly been applied as an adjuvant treatment alongside other agents such as Janus kinase inhibitors for alopecia areata. This review summarizes the current application of oral minoxidil in the treatment of alopecia areata.

Changes in hair follicle stem cells (HFSCs) can affect scalp aging and hair growth. With increasing age, HFSCs exhibit a decrease in quiescence maintenance and self-renewal capacity, as well as differentiation potential, leading to shortened hair growth cycles and even hair loss. This review summarizes recent research advances in the multifactorial interactions underlying hair loss, including the regulatory mechanisms of HFSC quiescence, the impact of aging on HFSC function, and aging of the stem cell microenvironment. Additionally, this review discusses the relationship between stem cells and hair shafts, and the mechanisms of action of stem cells in scalp aging, including alterations in signaling pathways, chromatin remodeling, and epigenetic regulation, etc. Furthermore, stem cell-based therapeutic strategies are summarized, such as the use of stem cells or their secreting exosomes, modulation of the stem cell microenvironment, and pharmacological interventions.

Androgenetic alopecia (AGA) is the most common type of hair loss in humans, characterized by the patterned miniaturization of scalp hair follicles and shortened anagen phases. Recent studies have revealed a significant association between AGA and metabolic syndrome (MetS) . The hallmarks of MetS include abdominal obesity, impaired glucose metabolism, hypertension, and dyslipidemia. This commentary evaluates the epidemiological association between AGA and MetS, explores the underlying concurrent mechanisms, and discusses current and potential therapeutic strategies.

Fibrosing alopecia in a pattern distribution (FAPD) is a newly recognized entity of primary lymphocytic cicatricial alopecia with clinical and histopathological characteristics of both androgenetic alopecia and lichen planopilaris. Currently, there is still a lack of full understanding of and standardized treatment protocols for FAPD, which is prone to be clinically underdiagnosed and misdiagnosed. This review systematically summarizes the research progress in FAPD in terms of clinical manifestations, diagnosis, and treatment, in order to facilitate its clinical diagnosis and treatment.