Objective:To investigate the effectiveness of methylene blue in pain management after costal cartilage removal.Methods:A prospective, randomized controlled trial was conducted from June 2023 to March 2024. Female patients undergoing rhinoplasty with autologous costal cartilage transplantation were randomly divided into a methylene blue group and a control group. Before costal cartilage harvesting, patients in the methylene blue group received a 5 ml injection of 0.1% methylene blue solution into the skin and subcutaneous tissue of the costal cartilage donor site at the lower edge of the seventh costal cartilage or below the breast contour. Patients in the control group received an equal volume of normal saline injected into the same area. Postoperative management included routine observation and pain control (using oral analgesics and topical analgesia). Pain scores were assessed 24 hours after surgery using a visual analog scale (VAS, 0-10 points, higher scores indicate more severe pain) and a numerical rating scale (NRS, 0-10 points, higher scores indicate more severe pain), as well as the frequency of oral analgesics. Patients were followed up for postoperative complications within one month after surgery, and patient satisfaction with pain control was assessed using a self-made 5-point questionnaire (higher scores indicate greater patient satisfaction). Quantitative data were compared between groups using the independent sample t-test; qualitative data were compared between groups using the chi-square test. P<0.05 was considered statistically significant. Results:A total of 112 female patients were enrolled. Fifty-six patients were in the methylene blue group, aged (35.4 ± 5.6) years (range, 18-55 years), and 56 patients were in the control group, aged (36.1 ± 6.0) years (range, 19-54 years). The methylene blue group had significantly lower oral analgesic use 24 hours after surgery than the control group [(1.5±0.5) times vs. (4.7±1.2) times], with statistically significant differences ( P<0.05). The methylene blue group also had significantly lower VAS scores (3.2±1.2 vs. 5.8±1.3) and NRS scores (3.5±1.0 vs. 6.2±1.1) 24 hours after surgery than the control group ( P<0.05). At one-month follow-up, the incidence of postoperative complications in the methylene blue group was significantly lower than that in the control group [10.7% (6/56) vs. 21.4% (12/56)]. Patient satisfaction in the methylene blue group was significantly higher than that in the control group [4.5 ± 0.6 vs. 3.2 ± 0.8]. The differences were statistically significant ( P< 0.05). No serious adverse reactions were observed in either group. Conclusion:Methylene blue has a good analgesic effect after costal cartilage transplantation, reducing the need for analgesics, and no significant adverse reactions were observed.

Objective:To investigate the effectiveness of methylene blue in pain management after costal cartilage removal.Methods:A prospective, randomized controlled trial was conducted from June 2023 to March 2024. Female patients undergoing rhinoplasty with autologous costal cartilage transplantation were randomly divided into a methylene blue group and a control group. Before costal cartilage harvesting, patients in the methylene blue group received a 5 ml injection of 0.1% methylene blue solution into the skin and subcutaneous tissue of the costal cartilage donor site at the lower edge of the seventh costal cartilage or below the breast contour. Patients in the control group received an equal volume of normal saline injected into the same area. Postoperative management included routine observation and pain control (using oral analgesics and topical analgesia). Pain scores were assessed 24 hours after surgery using a visual analog scale (VAS, 0-10 points, higher scores indicate more severe pain) and a numerical rating scale (NRS, 0-10 points, higher scores indicate more severe pain), as well as the frequency of oral analgesics. Patients were followed up for postoperative complications within one month after surgery, and patient satisfaction with pain control was assessed using a self-made 5-point questionnaire (higher scores indicate greater patient satisfaction). Quantitative data were compared between groups using the independent sample t-test; qualitative data were compared between groups using the chi-square test. P<0.05 was considered statistically significant. Results:A total of 112 female patients were enrolled. Fifty-six patients were in the methylene blue group, aged (35.4 ± 5.6) years (range, 18-55 years), and 56 patients were in the control group, aged (36.1 ± 6.0) years (range, 19-54 years). The methylene blue group had significantly lower oral analgesic use 24 hours after surgery than the control group [(1.5±0.5) times vs. (4.7±1.2) times], with statistically significant differences ( P<0.05). The methylene blue group also had significantly lower VAS scores (3.2±1.2 vs. 5.8±1.3) and NRS scores (3.5±1.0 vs. 6.2±1.1) 24 hours after surgery than the control group ( P<0.05). At one-month follow-up, the incidence of postoperative complications in the methylene blue group was significantly lower than that in the control group [10.7% (6/56) vs. 21.4% (12/56)]. Patient satisfaction in the methylene blue group was significantly higher than that in the control group [4.5 ± 0.6 vs. 3.2 ± 0.8]. The differences were statistically significant ( P< 0.05). No serious adverse reactions were observed in either group. Conclusion:Methylene blue has a good analgesic effect after costal cartilage transplantation, reducing the need for analgesics, and no significant adverse reactions were observed.

Stem cell exosome therapy has shown significant potential in treating hair loss, but its safety profile has not been thoroughly studied. This paper reported a case of a 32-year-old female patient who experienced an allergic reaction following adipose-derived stem cell exosomes injection for hair loss treatment at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences in June 2023. Within 24 hours post-injection, the patient developed swelling of the forehead and right postauricular lymph nodes, accompanied by mild pain, and left posterior ear lymph nodes 48 hours later. Ultrasound examination revealed thickening of the local soft tissue and enlarged lymph nodes. The condition was diagnosed as an injection-induced allergic reaction. The symptoms gradually subsided after combined treatment with lidocaine, 5-fluorouracil, and triamcinolone acetonide injections. During a 6-month follow-up period, the patient did not experience any recurrence of allergic reactions, and the therapeutic effects remained stable. This case report highlights the potential risk of allergic reactions associated with stem cell exosome therapy for hair loss, underscoring the need for close monitoring and timely intervention in clinical applications to ensure both safety and efficacy.

Stem cell exosome therapy has shown significant potential in treating hair loss, but its safety profile has not been thoroughly studied. This paper reported a case of a 32-year-old female patient who experienced an allergic reaction following adipose-derived stem cell exosomes injection for hair loss treatment at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences in June 2023. Within 24 hours post-injection, the patient developed swelling of the forehead and right postauricular lymph nodes, accompanied by mild pain, and left posterior ear lymph nodes 48 hours later. Ultrasound examination revealed thickening of the local soft tissue and enlarged lymph nodes. The condition was diagnosed as an injection-induced allergic reaction. The symptoms gradually subsided after combined treatment with lidocaine, 5-fluorouracil, and triamcinolone acetonide injections. During a 6-month follow-up period, the patient did not experience any recurrence of allergic reactions, and the therapeutic effects remained stable. This case report highlights the potential risk of allergic reactions associated with stem cell exosome therapy for hair loss, underscoring the need for close monitoring and timely intervention in clinical applications to ensure both safety and efficacy.

ObjectiveTo investigate the transformation mechanism and content variation of saponins from Polygalae Radix before and after being boiled with licorice juice and water. MethodSimulated licorice juice boiled products and simulated water boiled products of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ were prepared by simulated processing technology， and analyzed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap/MS）. Then the contents of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin in Polygalae Radix， licorice-boiled Polygalae Radix and water-boiled Polygalae Radix were determined by UPLC-triple quadrupole tandem mass spectrometry（UPLC-QQQ-MS/MS）. ResultDuring the boiling process with licorice juice and water， onjisaponin B could be hydrolyzed to produce 4-methoxycinnamic acid， desacylsenegin Ⅲ， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin Z could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin TF， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin F could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin G， polygalasaponin ⅩⅩⅧ and tenuifolin， and polygalasaponin ⅩⅩⅧ was hydrolyzed to produce tenuifolin. After being boiled with licorice juice or water， the content of onjisaponin B decreased significantly（P<0.05， P<0.01）， but the contents of onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin increased significantly（P<0.05， P<0.01） in Polygalae Radix. Compared with the water-boiled products， the contents of onjisaponin Z and tenuifolin increased significantly（P<0.05， P<0.01）， and the change of tenuifolin content was the most significant in the licorice-boiled products.However， there was no significant difference in the content of onjisaponin B， onjisaponin F and polygalasaponin ⅩⅩⅧ between the water-boiled products and the licorice-boiled products. ConclusionBeing boiled with licorice juice or water can hydrolyze onjisaponin B， onjisaponin Z， onjisaponin F and polygalasaponin ⅩⅩⅧ， and generate secondary glycosides and aglycones（organic acids） through deglycosylation， which leads to obvious changes in the contents of onjisaponins after Polygalae Radix being processed.It is inferred that licorice juice can promote the hydrolysis of some onjisaponins in Polygalae Radix to onjisaponin Z and tenuifolin.This study provides an experimental basis for revealing processing mechanism of Polygalae Radix.