Objective:To systematically evaluate the effectiveness of manual lymphatic drainage (MLD) in the prevention and treatment of breast cancer-related lymphedema (BCRL).Methods:Randomized controlled trials (RCTs) on the application of MLD for lymphedema after breast cancer surgery were retrieved from PubMed, Embase, Web of Science, CNKI, and Wanfang databases. The search covered studies published in English and Chinese from January 1, 2000 to February 1, 2024. Literature management and screening were conducted using EndNote X9 software based on inclusion and exclusion criteria. Relevant data from the final included studies for the meta-analysis were extracted. The outcome measures included the incidence of BCRL, reduced values in upper limb volume or circumference in BCRL patients, and the incidence of axillary web syndrome (AWS). Meta-analysis was performed using RevMan 5.4 software. The incidence of BCRL and AWS was expressed as relative risk ( RR) with 95% confidence intervals ( CI), and the Mantel-Haenszel method was used to calculate pooled effect sizes. For the reduction in limb volume or circumference in BCRL patients, standard mean difference ( SMD) with 95% CI was used, and the inverse variance method was applied to calculate pooled effect sizes. A P-value of <0.05 was considered statistically significant. The I2statistic was used to assess heterogeneity among studies; a fixed-effect model was applied when I2<50%, and a random-effects model was used when I2≥50%. Results:A total of 760 studies were retrieved, and 12 RCTs involving 2 279 post-breast cancer surgery patients were ultimately included. Among them, 1 132 patients in the control group received conventional treatment or combined compression bandaging, while 1 147 patients in the experimental group received MLD in addition to the control group interventions. Moderate to high heterogeneity was observed among the studies ( I2>50%, P<0.05), and a random-effects model was used for the analysis of all outcome measures between the two groups. The result showed that compared to the control group, the experimental group had a lower incidence of BCRL ( RR=0.35, 95% CI: 0.20-0.64, Z=3.42, P<0.001), the reduction in limb volume or circumference measurements increased( SWD=-1.28, 95% CI: -2.45~-0.10, Z=2.13, P=0.030), and a lower incidence of AWS ( RR=0.20, 95% CI: 0.07-0.55, Z=3.11, P=0.002). Conclusion:MLD can significantly prevent the occurrence of lymphedema and AWS in patients after breast cancer surgery, and for patients who have already developed lymphedema, MLD can also effectively reduces the degree of swelling. However, more high quality clinical studies are still needed for further verification.

The skin is one of the most vital organs in the human body, and skin wounds caused by various factors can severely impact patients’ physical and mental health. Among the therapeutic strategies for skin wound repair, mesenchymal stem cell-derived exosomes (MSC-Exos) have emerged as a promising biological therapy, attracting significant attention in related research. As critical mediators of stem cell biological effects, MSC-Exos fuse with target cells and transfer bioactive proteins and nucleic acids from stem cells into recipient cells. These exosomes modulate inflammatory responses, promote cell proliferation, migration, and angiogenesis, and regulate extracellular matrix remodeling, thereby accelerating wound healing. In recent years, studies on the mechanisms by which exosomes promote skin wound repair have advanced and refined continuously. This article summarized the key signaling pathways through which MSC-Exos participate in skin wound repair, aiming to enhance the understanding of their roles in facilitating wound healing.

Objective:To identify potential therapeutic targets for the treatment of hair color and hair shaft abnormalities, thereby offering innovative insights and strategies for the management of the associated conditions.Methods:Using the protein quantitative trait locus(pQTL) data derived from extensive proteomics studies, a two-sample Mendelian randomization was conducted to preliminarily identify potential drug therapeutic targets. Following this, sensitivity analyses were performed to evaluate potential confounding factors, including heterogeneity and horizontal pleiotropy. A leave-one-out sensitivity analysis was also conducted, systematically excluding each single nucleotide polymorphism (SNP) to evaluate their individual impact. Additionally, co-localization analysis was carried out to determine the presence of shared genetic variants between the identified plasma proteins and the relevant traits.Results:The proteomic data analyzed in this investigation encompassed 4 907 pQTLs, while the genetic data pertaining to hair pigmentation and shaft abnormalities included 124 cases and 432 686 controls. Through the Mendelian randomization screening, six candidate protein genes were identified: HLA-DQA2, CTSB, KIR2DS2, SVEP1, HOMER2, and HOMER1. Sensitivity analyses revealed no evidence of heterogeneity or horizontal pleiotropy among these proteins. The leave-one-out sensitivity analysis demonstrated that no single SNP significantly affected the overall findings. Notably, HOMER2 was substantiated by co-localization analysis, which provided robust evidence of its potential role in regulating the genetic mechanisms associated with hair pigmentation and shaft integrity.Conclusion:This study successfully identified six potential therapeutic targets for hair pigmentation and shaft abnormalities, with HOMER2 exhibiting the most compelling evidence. These findings pave the way for novel therapeutic approaches in the treatment of hair color and hair shaft disorders.

Objective:To identify potential therapeutic targets for the treatment of hair color and hair shaft abnormalities, providing novel insights and approaches for managing related conditions.Methods:Using the pQTL data from large-scale proteomics studies, a two-sample Mendelian randomization (TwoSampleMR) was conducted to preliminarily identify potential drug therapeutic targets. Subsequently, sensitivity analysis was performed to evaluate potential confounding factors such as heterogeneity and horizontal pleiotropy, and a leave-one-out sensitivity analysis was conducted by eliminating each single nucleotide polymorphism (SNP) one by one. Finally, co-localization analysis was carried out to explore whether there are shared genetic variants between the identified plasma proteins and traits.Results:The proteomic data used in this study included 4, 907 pQTLs, while the genetic data related to hair pigmentation and shaft abnormalities comprised 124 cases and 432, 686 controls. After Mendelian randomization screening, six candidate protein genes were identified: HLA-DQA2, CTSB, KIR2DS2, SVEP1, HOMER2, and HOMER1. Sensitivity analyses revealed no evidence of heterogeneity or horizontal pleiotropy among these proteins. Leave-one-out sensitivity analysis indicated that no single SNP significantly influenced the overall result. Notably, HOMER2 was supported by colocalization analysis with strong evidence, suggesting its potential role in regulating genetic mechanisms underlying hair pigmentation and shaft health.Conclusions:This study identified six potential therapeutic targets for hair pigmentation and shaft abnormalities, with HOMER2 showing stronger evidence. These findings provide novel directions for the treatment of hair color and hair shaft abnormalities.

Objective:To investigate changes in psychological status before and after sequential therapy in patients with skin circulatory disorders following hyaluronic acid injection.Methods:A retrospective study was conducted on 17 female patients, with a mean age of 28-54 (39.5±1.2) years, admitted to the Fourth Medical Center of PLA General Hospital from December 2021 to July 2022. Patients received ultrasound-guided percutaneous arterial puncture or digital subtraction angiography (DSA) guided catheter intervention for hyaluronidase injection, alongside corticosteroid pulse therapy, diuretic administration, neurotrophic support, wound protection, and laser therapy. Psychological assessments, including the Minnesota multiphasic personality inventory (MMPI) and symptom check list-90 (SCL-90), were performed at admission and 30-45 days post-discharge. Changes in assessment scores and patient satisfaction were analyzed.Results:Two patients failed to complete all assessments, leaving 15 cases for final analysis. Affected anatomical regions included the nose/perinasal area (13 cases), temporal region (3 cases), lips (3 cases), and forehead (7 cases). MMPI scores for hypochondriasis, depression, hysteria, psychopathic deviation, paranoia, psychasthenia, and hypomania showed statistically significant reductions compared to baseline (all P<0.05). SCL-90 scores for somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and sleep/appetite disturbances also demonstrated significant decreases (all P<0.05). Among the 15 patients, 7 patients reported being very satisfied, 6 patients were satisfied, and 2 patients were moderately satisfied, with no dissatisfaction reported. Conclusion:Sequential therapy is associated with improved psychological outcomes in patients with skin circulatory disorders secondary to hyaluronic acid injection.

Objective:To explore the risk factors for complications of facial autologous fat transplantation.Methods:A total of 51 female patients (case group) with moderate to severe complications following facial autologous fat transplantation at the Fourth Medical Center of Chinese PLA General Hospital from November 2016 to October 2022 were included in this retrospective study. The median age was 31.0 (27.0, 40.0) years. After age and surgical date were matched with ratio of 1∶1, a total of 51 female patients who received autologous fat transplants at several official medical facilities and experienced no complications within a year after the procedure made up the control group. The median age of the control group was 32.0 (26.0, 41.0) years. The clinical characteristics of the two groups were compared, and the factors for complications of facial autologous fat transplantation were examined using a multivariate logistic regression model.Results:In the case group, complications included facial artery embolism (7 cases), ophthalmic artery embolism (19 cases), infection (19 cases), and fat necrosis (6 cases), with 26 severe and 25 moderate cases. No significant differences were found between the two groups in age, body mass index (BMI), marital status, history of hypertension, infectious diseases, allergies, smoking, or alcohol consumption (all P>0.05). However, significant differences were observed in a history of facial surgery, perimenstrual phase, surgical site, and fat donor site (all P<0.05). Multivariate logistic regression analysis revealed that a history of facial surgery ( OR=17.289, 95% CI: 4.851-61.616, P<0.001) and the surgical site being a clinic/outpatient department (compared to a hospital, OR=7.708, 95% CI: 2.482-23.939, P<0.001) were risk factors for postoperative complications after facial autologous fat transplantation. Conclusion:A history of facial surgery and the surgical site being a clinic/outpatient department (compared to a hospital) are risk factors for complications of facial autologous fat transplantation.

Objective:To investigate the clinical effect of microplasma radiofrequency combined with oral traditional Chinese medicine (TCM) Babao Dan capsule to improve damp-heat TCM constitution in the treatment of hypertrophic scar.Methods:A prospective randomized controlled trial method was used to recruit patients diagnosed with damp-heat TCM constitution and suffering from hypertrophic scar who admitted to the Fourth Medical Center of Chinese PLA General Hospital from March to July 2024. All patients were randomly divided into microplasma radiofrequency combined with TCM treatment group (combination group), microplasma radiofrequency (RF) treatment group (RF group), and oral TCM treatment group (TCM group). Both the combination group and the RF group were treated with a microplasma radiofrequency instrument. Transverse, longitudinal and oblique scar grinding were performed three times with 90 W power, and regular scabs appeared in the treatment area as the treatment end point. After RF treatment in the combination group and the TCM group, Babao Dan capsule was taken with regular warm water, 0.6 g each time, 3 times/day, for 3 months. The Vancouver scar scale (VSS) score (higher score indicating more severe scar), visual analogue scale (VAS) of scar pain and itch (higher score indicating more severe symptom), and TCM constitution score (higher score indicating more severe moist heat constitution) were compared before treatment and 3 months after the first treatment. SPSS 26.0 software was used for statistical analysis. Measurement data conforming to normal distribution were expressed as Mean±SD, ANOVA was used for comparison among groups, and LSD- t method was used for pair comparison between groups. Paired sample t test was used before and after treatment in the same group. Counting data were expressed as cases (%), and the χ2 test was used for inter-group comparison. P<0.05 was considered statistically significant. Results:A total of 60 patients were included, 20 in each group. There were no significant differences in gender distribution, disease course, scar area and distribution among the three groups ( P>0.05), indicating comparability. Before treatment, there were no statistically significant differences in VSS, VAS and TCM physique scores among the 3 groups ( P>0.05). After treatment, VAS scores in the 3 groups, VSS scores in combination group and RF group, TCM physique scores in combination group and TCM group were improved compared with those before treatment, and the differences were statistically significant ( P<0.05). The VSS score of the combination group was significantly lower than that of the RF group and the TCM group ( P<0.05), but there was no statistical significance between the RF group and the TCM group ( P>0.05). The pruritus VAS score of the combination group was significantly lower than that of TCM group and RF group ( P<0.05), but there was no statistical significance between RF group and TCM group ( P>0.05). There was no significant difference in pain VAS scores among the three groups after treatment ( P>0.05). The TCM physique scores of the combination group and TCM group were significantly lower than those of the RF group ( P<0.01), but there was no statistical significance between the combination group and TCM group ( P>0.05). Conclusion:Microplasma radiofrequency combined with oral Babao Dan capsule can effectively improve the VSS score, pain and pruritus of hypertrophic scars in patients with damp-heat constitution, and the effect is better than that of radiofrequency or TCM alone.

Objective:To systematically evaluate the effectiveness of manual lymphatic drainage (MLD) in the prevention and treatment of breast cancer-related lymphedema (BCRL).Methods:Randomized controlled trials (RCTs) on the application of MLD for lymphedema after breast cancer surgery were retrieved from PubMed, Embase, Web of Science, CNKI, and Wanfang databases. The search covered studies published in English and Chinese from January 1, 2000 to February 1, 2024. Literature management and screening were conducted using EndNote X9 software based on inclusion and exclusion criteria. Relevant data from the final included studies for the meta-analysis were extracted. The outcome measures included the incidence of BCRL, reduced values in upper limb volume or circumference in BCRL patients, and the incidence of axillary web syndrome (AWS). Meta-analysis was performed using RevMan 5.4 software. The incidence of BCRL and AWS was expressed as relative risk ( RR) with 95% confidence intervals ( CI), and the Mantel-Haenszel method was used to calculate pooled effect sizes. For the reduction in limb volume or circumference in BCRL patients, standard mean difference ( SMD) with 95% CI was used, and the inverse variance method was applied to calculate pooled effect sizes. A P-value of <0.05 was considered statistically significant. The I2statistic was used to assess heterogeneity among studies; a fixed-effect model was applied when I2<50%, and a random-effects model was used when I2≥50%. Results:A total of 760 studies were retrieved, and 12 RCTs involving 2 279 post-breast cancer surgery patients were ultimately included. Among them, 1 132 patients in the control group received conventional treatment or combined compression bandaging, while 1 147 patients in the experimental group received MLD in addition to the control group interventions. Moderate to high heterogeneity was observed among the studies ( I2>50%, P<0.05), and a random-effects model was used for the analysis of all outcome measures between the two groups. The result showed that compared to the control group, the experimental group had a lower incidence of BCRL ( RR=0.35, 95% CI: 0.20-0.64, Z=3.42, P<0.001), the reduction in limb volume or circumference measurements increased( SWD=-1.28, 95% CI: -2.45~-0.10, Z=2.13, P=0.030), and a lower incidence of AWS ( RR=0.20, 95% CI: 0.07-0.55, Z=3.11, P=0.002). Conclusion:MLD can significantly prevent the occurrence of lymphedema and AWS in patients after breast cancer surgery, and for patients who have already developed lymphedema, MLD can also effectively reduces the degree of swelling. However, more high quality clinical studies are still needed for further verification.

The skin is one of the most vital organs in the human body, and skin wounds caused by various factors can severely impact patients’ physical and mental health. Among the therapeutic strategies for skin wound repair, mesenchymal stem cell-derived exosomes (MSC-Exos) have emerged as a promising biological therapy, attracting significant attention in related research. As critical mediators of stem cell biological effects, MSC-Exos fuse with target cells and transfer bioactive proteins and nucleic acids from stem cells into recipient cells. These exosomes modulate inflammatory responses, promote cell proliferation, migration, and angiogenesis, and regulate extracellular matrix remodeling, thereby accelerating wound healing. In recent years, studies on the mechanisms by which exosomes promote skin wound repair have advanced and refined continuously. This article summarized the key signaling pathways through which MSC-Exos participate in skin wound repair, aiming to enhance the understanding of their roles in facilitating wound healing.

Objective:To identify potential therapeutic targets for the treatment of hair color and hair shaft abnormalities, thereby offering innovative insights and strategies for the management of the associated conditions.Methods:Using the protein quantitative trait locus(pQTL) data derived from extensive proteomics studies, a two-sample Mendelian randomization was conducted to preliminarily identify potential drug therapeutic targets. Following this, sensitivity analyses were performed to evaluate potential confounding factors, including heterogeneity and horizontal pleiotropy. A leave-one-out sensitivity analysis was also conducted, systematically excluding each single nucleotide polymorphism (SNP) to evaluate their individual impact. Additionally, co-localization analysis was carried out to determine the presence of shared genetic variants between the identified plasma proteins and the relevant traits.Results:The proteomic data analyzed in this investigation encompassed 4 907 pQTLs, while the genetic data pertaining to hair pigmentation and shaft abnormalities included 124 cases and 432 686 controls. Through the Mendelian randomization screening, six candidate protein genes were identified: HLA-DQA2, CTSB, KIR2DS2, SVEP1, HOMER2, and HOMER1. Sensitivity analyses revealed no evidence of heterogeneity or horizontal pleiotropy among these proteins. The leave-one-out sensitivity analysis demonstrated that no single SNP significantly affected the overall findings. Notably, HOMER2 was substantiated by co-localization analysis, which provided robust evidence of its potential role in regulating the genetic mechanisms associated with hair pigmentation and shaft integrity.Conclusion:This study successfully identified six potential therapeutic targets for hair pigmentation and shaft abnormalities, with HOMER2 exhibiting the most compelling evidence. These findings pave the way for novel therapeutic approaches in the treatment of hair color and hair shaft disorders.