BACKGROUND Women with a history of serious psychotic disorders are at increased risk of disease relapse during pregnancy.Long-acting injectable(LAI)antipsychotics have been widely used to improve adherence and prevent...BACKGROUND Women with a history of serious psychotic disorders are at increased risk of disease relapse during pregnancy.Long-acting injectable(LAI)antipsychotics have been widely used to improve adherence and prevent relapse in patients with various severe psychotic disorders,but there is a lack of high-quality data from previous research on the safety of LAI antipsychotics during pregnancy.AIM To summarize relevant data on maternal,pregnancy,neonatal,and developmental outcomes from published cases of LAI antipsychotic use in pregnancy.METHODS A literature search was performed through November 11,2023,using three online databases:PubMed/MEDLINE,Scopus,and Web of Science.Case reports or case series that reported information about the outcomes of pregnancy in women who used LAI antipsychotics at any point in pregnancy,with available full texts,were included.Descriptive statistics,narrative summation,and tabulation of the extracted data were performed.RESULTS A total of 19 publications satisfied the inclusion criteria:3 case series,15 case reports,and 1 conference abstract.They reported the outcomes of LAI antipsychotic use in 74 women and 77 pregnancies.The use of secondgeneration LAI antipsychotics was reported in the majority(n=47;61.0%)of pregnancies.First-generation LAI antipsychotics were administered during 30 pregnancies(39.0%).Most of the women(approximately 64%)had either satisfactory control of symptoms or no information about relapse,while approximately 12%of them had developed gestational diabetes mellitus.A minority of cases reported adverse outcomes such as stillbirth,spontaneous abortion,preterm birth,low birth weight,congenital anomalies,and neurological manifestations in newborns.However,there were no reports of negative long-term developmental outcomes.CONCLUSION Currently available data seem reassuring,but further well-designed studies are required to properly evaluate the risks and benefits of LAI antipsychotic use during pregnancy.展开更多
Injectable bone cements are used in minimally invasive surgical techniques including vertebroplasty and kyphoplasty.This work is devoted to the development of magnesium-calcium phosphate cements(MCPCs)doped with gadol...Injectable bone cements are used in minimally invasive surgical techniques including vertebroplasty and kyphoplasty.This work is devoted to the development of magnesium-calcium phosphate cements(MCPCs)doped with gadolinium ions(Gd^(3+))for bone defect repair.Interaction between cement powders and a cement liquid resulted in the formation of newberyite and brushite phases,which gave mechanical strength up to 17 MPa without a thermal effect.The introduction of Gd3+into the lattice was confirmed by electron paramagnetic resonance spectroscopy;the doping increased injectivity while giving rise to antibacterial properties against Escherichia coli.Assays of the cement samples soaking in Kokubo’s simulated body fluid revealed the formation of calcium phosphate coatings on the cements’surface.The cements manifested biocompatibility with the MG-63 cell line and significantly enhanced contrast when Gd-MCPC was placed into a bone defect and examined by X-ray micro-computed tomography.For the first time,visualization of a Gd-doped cement material was achieved in a model of a bone defect analyzed by MRI.展开更多
Endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)are well-established therapeutics for gastrointestinal neoplasias,but complications after EMR/ESD,including bleeding and perforation,result in ...Endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)are well-established therapeutics for gastrointestinal neoplasias,but complications after EMR/ESD,including bleeding and perforation,result in additional treatment morbidity and even threaten the lives of patients.Thus,designing biomaterials to treat gastric bleeding and wound healing after endoscopic treatment is highly desired and remains a challenge.Herein,a series of injectable pH-responsive selfhealing adhesive hydrogels based on acryloyl-6-aminocaproic acid(AA)and AA-g-N-hydroxysuccinimide(AA-NHS)were developed,and their great potential as endoscopic sprayable bioadhesive materials to efficiently stop hemorrhage and promote the wound healing process was further demonstrated in a swine gastric hemorrhage/wound model.The hydrogels showed a suitable gelation time,an autonomous and efficient self-healing capacity,hemostatic properties,and good biocompatibility.With the introduction of AA-NHS as a micro-cross-linker,the hydrogels exhibited enhanced adhesive strength.A swine gastric hemorrhage in vivo model demonstrated that the hydrogels showed good hemostatic performance by stopping acute arterial bleeding and preventing delayed bleeding.A gastric wound model indicated that the hydrogels showed excellent treatment effects with significantly enhanced wound healing with type I collagen deposition,α-SMA expression,and blood vessel formation.These injectable self-healing adhesive hydrogels exhibited great potential to treat gastric wounds after endoscopic treatment.展开更多
The auto-gelling and drug release properties of the thermosensitive chitosan-β-glycerophosphate formulation were investigated. According to rheological study, gelation lag time of chitosan/β-glycerophosphate （GP） ...The auto-gelling and drug release properties of the thermosensitive chitosan-β-glycerophosphate formulation were investigated. According to rheological study, gelation lag time of chitosan/β-glycerophosphate （GP） solutions varied from 2 to 60min with different deacetylation degree of chitosan, pH, gelation temperature, and the particles in the sol. The gelation properties were also found to influence the release profilles of a hydrophilic drug, 5-fluorouracil （5-FU）. Morphological examination by scanning electron microphotography demonstrated that large ＂pores＂ occurred during the gel-forming process, which created hydrophilic environment and led to the rapid initial release of the drug （85% in f＇LrSt 8h）. Poly-3-hydroxybutyrate （PHB）, a biodegradable material, was applied here as scaffold to capture 5-FU into microparticles with high encapsulation efficiency by solvent-nonsolvent method. Combination of these microparticles into the chitosan-β-GP formulation could drop the rapid initial release from 85% down to 29% in the optimized PHB content （75%, by mass）. The release could sustain for about 10 months. Tiffs study provided an understanding of the potential of injectable implant using thermosensitive chitosan-β-GP formulation containing PHB based particles for the water soluble drugs that need the property of long-term delivery.展开更多
Hydrogels with multifunctionalities,including sufficient bonding strength,injectability and self-healing capacity,responsive-adhesive ability,fault-tolerant and repeated tissue adhesion,are urgently demanded for invas...Hydrogels with multifunctionalities,including sufficient bonding strength,injectability and self-healing capacity,responsive-adhesive ability,fault-tolerant and repeated tissue adhesion,are urgently demanded for invasive wound closure and wound healing.Motivated by the adhesive mechanism of mussel and brown algae,bioinspired dynamic bonds cross-linked multifunctional hydrogel adhesive is designed based on sodium alginate(SA),gelatin(GT)and protocatechualdehyde,with ferric ions added,for sutureless post-wound-closure.The dynamic hydrogel cross-linked through Schiff base bond,catechol-Fe coordinate bond and the strong interaction between GT with temperature-dependent phase transition and SA,endows the resulting hydrogel with sufficient mechanical and adhesive strength for efficient wound closure,injectability and self-healing capacity,and repeated closure of reopened wounds.Moreover,the temperature-dependent adhesive properties endowed mispositioning hydrogel to be removed/repositioned,which is conducive for the fault-tolerant adhesion of the hydrogel adhesives during surgery.Besides,the hydrogels present good biocompatibility,near-infrared-assisted photothermal antibacterial activity,antioxidation and repeated thermo-responsive reversible adhesion and good hemostatic effect.The in vivo incision closure evaluation demonstrated their capability to promote the post-wound-closure and wound healing of the incisions,indicating that the developed reversible adhesive hydrogel dressing could serve as versatile tissue sealant.展开更多
The present studies were conducted to compose an injectable solution of colistin sulfate containing local anaesthesia, antioxidant and other additions. Results showed that the novel preparation was stable either to he...The present studies were conducted to compose an injectable solution of colistin sulfate containing local anaesthesia, antioxidant and other additions. Results showed that the novel preparation was stable either to heat or to light. The term of validity of the preparation was 2 years at room temperature.The preparation containing 25. 0 mg ml-1 colistin sulfate showed no local tissue irritation, but the concentration of 50. 0 mg ml-1 colistin sulfate showed obvious local tissue irritation. Result of acute toxicity test showed that the LD50 of intramuscular injection in mice was 38. 72 mg kg-1, and oral LD50 was 431. 39 mg kg-1. The evidence of neurotoxicity was observed in mice in the acute toxicity test. A dose of 10.0 mg kg-1 b. w. or 15:0 mg kg-1b. w. was administered intramuscularly to piglet once daily for 5 days. No changes were detected in the piglet body except for the slight epithelial tissue's granular degenerations in the kidney and liver at the dose of the 10.0 mg kg-1. While at the dose of 15. 0 mg kg-1, the obvious neurotoxicity was observed at 4-5 days. The epithelial tissues in the kidney and liver showed moderate granular degenerations, especially in the tubuli renales cells. Blood cell's morphosis indexes were normal. With relation to liver's function, the indexes went beyond the normal scope. But with relation to kidney's function, the indexes showed mostly normal.When the preparation was separately administered into muscle(i. m.) in piglets with the dose of 2. 5 and 5. 0 mg kg-1 b. w, whose Cmax were 3.73±0. 28 and 6. 40±0.18 Abstract:g ml-1; Tmax were 32±1. 5 and 34±1.8min; t1/2β were 256±14 min and 264±29 min, respectively. t1/2βt was 251±13 min for the injection given into aural vein( i. v.) with the dose of 2.5 mg kg1-1 b. w.. Samples of the experimentally determined plasma concentration of colistin sulfate generated two-exponential model with first-order absorption. The mean absolute bioavail-ability coefficient of 2.5 and 5. 0 mg kg-1 b. w. (i. m.) were 98. 30 and 88. 54%, respectively. The high bio-availability and the long maintaining time of the valid blood-drug concentration showed that the injectable solution was suitable for i. m. in pigs, whose recommended dose was 2.5 mg kg-1 b. w. , twice daily.展开更多
Aim： To report our experience with penile girth augmentation using liquid injectable silicone. Methods： Between August 2003 and July 2006, 324 men （mean age 35 years, range 19-65 years） received a series of liquid...Aim： To report our experience with penile girth augmentation using liquid injectable silicone. Methods： Between August 2003 and July 2006, 324 men （mean age 35 years, range 19-65 years） received a series of liquid silicone subcutaneous injections between the penile skin and the corpora cavernosa on the dorsal and lateral aspects of the penile shaft, under local anesthesia. Digital photographs taken pre- and post-procedure （n = 324）, and penile contour measurements （n = 30） yielded objective results. Subjective results were derived from patient and partner testimony of satisfaction. Follow-up averaged 20 months （range 1-36 months）. Results： Three hundred and twenty-four procedures were primary augmentations. Most men （61%） were married, 7% were accompanied by their partners, and 93% were circumcised. The mean measured penile circumference was 9.5 cm （7.5-11.5 cm） pretreatment and 12.1 cm （10.3-15.3 cm） post-treatment （mean increase of 27% in circumference and 0.84 cm in diameter）. Patient and partner satisfaction was already expressed after the first two treatments. Sexual activity could be resumed after 8 h. Complications （mild bruising） were easily resolved. Conclusion： Penile girth augmentation using liquid injectable silicone yields very satisfactory short-term results with no immediate or short-term complications.展开更多
Background: There is a large assortment of modalities for the surgical treatment/management of distal radius fractures (DRFs), where the most widely used is the fixed-angle volar plating (VLP) system, which, sometimes...Background: There is a large assortment of modalities for the surgical treatment/management of distal radius fractures (DRFs), where the most widely used is the fixed-angle volar plating (VLP) system, which, sometimes, is referred to as the “surgical modality of choice”. While outcomes with each modality are usually good to excellent, each has its share of shortcomings and complications. Thus, there is scope for improvements to existing modalities and/or introduction of new ones. Study Purpose: We introduce a novel modality, namely, the prototype of an intramedullary injectable bioresorbable polymer-bioresorbable balloon osteosynthesis (IPBO) system, and investigated its plausibility. Experimental Procedures: The biomechanical performance of a construct comprising a synthetic distal radius (fourth-generation Sawbones?) on which a simulated fracture was created (4-mm wide osteotomy positioned 25 mm from the most distal end of the radius) and fixated with a placement of the IPBO system (SIPBO Construct) was compared to that when the fixation was with an approved Ti-6Al-4V alloy VLP system (SVLP Construct), under a clinically-relevant compressive loading protocol. Performance involved determination of quantitative parameters of the construct (initial longitudinal stiffness (ICLS), final longitudinal stiffness (FCLS), and load-to-failure (Pf)) and observation and recording of features of the construct at the fracture point. We also determined the quantitative parameters for the intact synthetic distal radius (control). Results: For each of the quantitative parameters, the range of values for SIPBO Construct was within that for SVLP Construct, suggesting that the IPBO System is a plausible modality. Also, for SIPBO Construct, failure occurred within the polymer zone, whereas, for SVLP Construct, some failure features were fracture of the cortical wall and of the dorsal proximal fragments. Conclusion: The findings suggest that the IPBO system is plausible. As such, it merits further study;for example, determination of the influence of fracture gap fill ratio (defined as the proportion of the fracture gap that is filled by the expanding balloon as the polymer is injected into the balloon) on a large collection of quantitative biomechanical parameters.展开更多
BACKGROUND Collagen membrane and platelet-rich fibrin(PRF)have emerged as vital biomaterials in the field of periodontal regeneration.Minimally invasive techniques are being preferred by most periodontists,as it is pa...BACKGROUND Collagen membrane and platelet-rich fibrin(PRF)have emerged as vital biomaterials in the field of periodontal regeneration.Minimally invasive techniques are being preferred by most periodontists,as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques.Thus,in this study we have evaluated the effect of injectable PRF(i-PRF)with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access(VISTA)technique for gingival recession coverage.AIM To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage.METHODS A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study.The sites were randomly assigned to control group(VISTA using collagen membrane alone)and the test group(VISTA using collagen membrane with i-PRF).The clinical parameters assessed were pocket depth,recession depth(RD),recession width(RW),relative attachment level,keratinised tissue width(KTW),keratinised tissue thickness(KTT),and percentage root coverage.RESULTS RD showed a statistically significant difference between the test group at 3 mo(0.5±0.513)and 6 mo(0.9±0.641)and the control group at 3 mo(0.95±0.51)and 6 mo(1.5±0.571),with P values of 0.008 and 0.04,respectively.RW also showed a statistically significant difference between the test group at 3 mo(1±1.026)and 6 mo(1.65±1.04)and the control group at 3 mo(1.85±0.875)and 6 mo(2.25±0.759),with P values of 0.008 and 0.001,respectively.Results for KTW showed statistically significant results between the test group at 1 mo(2.85±0.489),3 mo(3.5±0.513),and 6 mo(3.4±0.598)and the control group at 1 mo(2.45±0.605),3 mo(2.9±0.447),and 6 mo(2.75±0.444),with P values of 0.04,0.004,and 0.003,respectively.Results for KTT also showed statistically significant results between test group at 1 mo(2.69±0.233),3 mo(2.53±0.212),and 6 mo(2.46±0.252)and the control group at 1 mo(2.12±0.193),3 mo(2.02±0.18),and 6 mo(1.91±0.166),with P values of 0.001,0.001,and 0.001,respectively.The test group showed 91.6%,81.6%,and 67%root coverage at 1 mo,3 mo,and 6 mo,while the control group showed 82.3%,66.4%,and 53.95%of root coverage at 1 mo,3 mo,and 6 mo,respectively.CONCLUSION The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.展开更多
Background: Lower-lid pretarsal fullness rejuvenation is a popular surgery for Asian women. However, the current procedures have clinical complications and are not stable in the long-term. Here, we analyzed the effect...Background: Lower-lid pretarsal fullness rejuvenation is a popular surgery for Asian women. However, the current procedures have clinical complications and are not stable in the long-term. Here, we analyzed the effect of injectable collagen on lower-lid pretarsal fullness rejuvenation.Methods: To investigate the clinical effect of injectable collagen in lower-lid pretarsal fullness rejuvenation, we observed 32 Chinese Han female patients aged 18–55 years with non-distinctive lower-lid pretarsal fullness and no history of lower eyelid surgery or trauma. The injectable collagen products were used for local filling correction. After surgery, the patients were followed up for 12 months. A correction effect was evaluated through an analysis of volume changes using a visual analog scale. Adverse reactions were also recorded.Results: All patients achieved good aesthetic outcomes and strong stereoscopic impressions of lower-lid pretarsal fullness. Complications, such as edema and bruising, were not observed after the injection. Immediately after the operation, the average visual analog score was 2.65 ± 0.56. Six months after the operation, the average visual analog score was 2.96 ± 0.41. The patients reported high satisfaction levels. Immediately after the operation, the average lower-lid pretarsal fullness volume increase was 0.19 ± 0.04 m L on the left side and 0.21 ± 0.03 m L on the right side. After a 12-month follow-up, the average residual volume was 0.17 ± 0.06 m L on the left side and 0.19 ± 0.04 m L on the right side, suggesting that the injected collagen impact was stable.Conclusion: Injectable collagen promotes a vivid, natural appearance and is highly effective in rejuvenating lowerlid pretarsal fullness with low absorption rates in later stages. Therefore, injectable collagen should be considered in correcting congenital, non-distinctive, lower-lid pretarsal fullness in clinical practice.展开更多
To get a sort of new scaffold material for soft tissue reconstruction,we have prepared XLHA-PNIPAAm and XLHA-MC injectable hydrogels through blending crosslinked HA(XLHA) and two temperature-sensitive materials differ...To get a sort of new scaffold material for soft tissue reconstruction,we have prepared XLHA-PNIPAAm and XLHA-MC injectable hydrogels through blending crosslinked HA(XLHA) and two temperature-sensitive materials differed in degradation poly(N-isopropylacrylamide)(PNIPAAm) and methylcellulose(MC),respectively.We tested the injectablility,enzymatic biodegradability,temperature-sensitivity,structure cytotoxicity and hemolysis of the two injectable hydrogels.Our research has successfully obtained the preparation condition of XLHA-PNIPAAm injectable hydrogel,and verified that adding non-degradable material PNIPAAm can postpone the degradation of HA more effectively than degradable material MC.PNIPAAm prepared with 5 kGy dose radiation,MBAAm/NIPAAm(M/M)=0.015,monomer concentration=3% produced XLHA-PNIPAAm with slowest enzymatic biodegradability.DSC results showed that temperature-sensitivity of the XLHA-PNIPAAm was more stable than that of XLHA-MC.Two composite hydrogels were qualified in cytotoxicity and hemolysis tests and the biocompatibility of XLHA-PNIPAAm hydrogel showed better than XLHA-MC hydrogel.展开更多
BACKGROUND Given the low survival rate in pancreatic cancer,new therapeutic techniques have been explored,especially for unresectable or borderline resectable disease.Endoscopic ultrasound(EUS)provides real-time imagi...BACKGROUND Given the low survival rate in pancreatic cancer,new therapeutic techniques have been explored,especially for unresectable or borderline resectable disease.Endoscopic ultrasound(EUS)provides real-time imaging and minimally invasive access for local and targeted injection of anti-tumor agents directly into the pancreatic tumor.Limited studies have been reported using this technique for the treatment of pancreatic ductal adenocarcinoma(PDAC).AIM To evaluate the progress made with EUS-guided injectable therapies in the treatment of PDAC.METHODS All original articles published in English until July 15,2021,were retrieved via a library-assisted literature search from Ovid Evidence-Based Medicine Reviews and Scopus databases.Reference lists were reviewed to identify additional relevant articles.Prospective clinical studies evaluating the use of EUS-guided injectable therapies in PDAC were included.Studies primarily directed at non-EUS injectable therapies and other malignancies were excluded.Retrieved manuscripts were reviewed descriptively with on critical appraisal of published studies based on their methods and outcome measures such as safety,feasibility,and effectiveness in terms of tumor response and survival.Heterogeneity in data outcomes and therapeutic techniques limited the ability to perform comparative statistical analysis.RESULTS A total of thirteen articles(503 patients)were found eligible for inclusion.The EUS-injectable therapies used were heterogeneous among the studies consisting of immunotherapy(n=5)in 59 patients,chemotherapy(n=1)in 36 patients,and viral and other biological therapies(n=7)in 408 patients.Eleven of the studies reviewed were single armed while two were double armed with one randomized trial and one non-randomized comparative study.Overall,the included studies demonstrated EUS-guided injectable therapies to be safe and feasible with different agents as monotherapy or in conjunction with other modalities.Promising results were also observed regarding their efficacy and survival parameters in patients with PDAC.CONCLUSION EUS-guided injectable therapies,including immunotherapy,chemotherapy,and viral or other biological therapies have shown minimal adverse events and potential efficacy in the treatment of PDAC.Comparative studies,including controlled trials,are required to confirm these results in order to offer novel EUS-based treatment options for patients with PDAC.展开更多
Risperidone long-acting injectable (RLAI) is approved for the treatment of schizophrenia in many countries. The suggested site is the gluteal muscle with a needle length of two inches (50 mm) in Japan, which is longer...Risperidone long-acting injectable (RLAI) is approved for the treatment of schizophrenia in many countries. The suggested site is the gluteal muscle with a needle length of two inches (50 mm) in Japan, which is longer than the ordinarily used needle for intramuscular injections. The aim of this study was to determine the optimal needle insertion length for accurate delivery of RLAI procedure among subjects who have normal body mass index (BMI: 18 to 25) and high BMI (>25). Thirty-seven patients with schizophrenia were administered RLAI intramuscularly into the dorsogluteal muscle. The standard procedure required inserting 80% of the two inch needle. By using data collected by ultrasonography, the findings confirmed that the median needle insertion lengths for subjects with normal and high BMI were 39.0 and 45.5 mm, respectively. To deliver RLAI effectively and safely, the authors strongly recommend that a specialized needle be used that is “marked” at the 40 mm point from the tip of the needle to the base. In this way regardless of subcutaneous fat content, the RLAI can be safely delivered into the muscle without causing untoward or side effects.展开更多
A new type of injectable premixed bone cement consisting of nano hydroxyapatite (n HA) and polyamide 66(PA66) composite is investigated. This cement can be handled as paste and easily shaped, which can set in air, in ...A new type of injectable premixed bone cement consisting of nano hydroxyapatite (n HA) and polyamide 66(PA66) composite is investigated. This cement can be handled as paste and easily shaped, which can set in air, in physiological saline solution and in blood. The setting time, injectability and compressive strength of the cement largely depend on the ratio of liquid to powder (L/P). Moreover, the content of n HA in composite also affects the compressive strength and injectability of the cement. The premixed composite cement can remain stable in the package for a long period and harden only after delivery to the defects site. The results suggest that injectable premixed cement has a reasonable setting time, reasonable viscosity for injecting, excellent washout resistance and high mechanical strength, which can be developed for root canal filling, sealing and various bone defects augmentation.展开更多
In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is de...In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is deeper than anticipated, needle penetration may cause damage to nerves, arteries and veins. Few clinical studies were done to evaluate the depth of needle length insertion reaching the intended gluteal muscle. The aim of this study was to evaluate the suitable depth of injecting RLAI. Twenty-six patients with schizophrenia were treated with RLAI, and randomly divided into two groups: 50 mm needle inserted group (Group-D, deep insertion, n = 13) and 20 mm needle insertion group (Group-S, shallow insertion, n = 13). For Group-S, the needle length was marked with a spacer at exactly 20 mm. Injections were performed by the psychiatrist or nurse, alternating between the two gluteal sites by double-cross method every two weeks. Clinical psychotic symptoms and injection site reactions were recorded throughout the study period. Experienced psychologists who were blinded from the needle-length experimental variable evaluated patients’ psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS) every two weeks. The plasma 9-hydroxyrisperidone (9-OH-RIS) concentrations were measured every two weeks;comparison data were determined on the 8th week and the 14th week. No significant difference was observed in 9-OH-RIS concentrations, psychotic symptoms, injection site skin reactions of subjects in both groups. However, in Group-D, injection site adverse reactions were confirmed in two subjects (15%). In Group-S, injection site reactions were confirmed in six subjects (46%). Although effective 9-OH-RIS concentrations were obtained with the insertion using both depth, it was concluded that the 50 mm insertion length was more suitable for dorsogluteal IM injections in adult patients with schizophrenia as demonstrated by the incidence of local adverse skin reactions.展开更多
A novel injectable hydrogel that was synthesized by in situ crosslinking of hyaluronan and polyvinyl phosphonic acid was proposed in this study. Fourier transform infrared spectrum (FT-IR) analysis, scanning electron ...A novel injectable hydrogel that was synthesized by in situ crosslinking of hyaluronan and polyvinyl phosphonic acid was proposed in this study. Fourier transform infrared spectrum (FT-IR) analysis, scanning electron microscope (SEM), pH measurement, and biodegradation test were used to confirm its characteristics. The results permitted to prove successful crosslinking, observe the inner morphology of hydrogel and pore sizes distribution, and determine the decomposition of hydrogel components during incubation time. Result of pH measurement showed that the pH scale of hydrogel decreased when volume of PVPA increased. As a consequence, it affected the cytotoxicity value, cell proliferation, and cell growth behaviors of each hydrogel. Optical microscope observation showed that chondroblasts cell proliferated well on HA-PVPA hydrogel. Therefore, these results suggest that the new injectable hydrogel is appropriate for bone/cartilage regeneration applications.展开更多
Africa is the world region that is most affected by malaria. Among the therapies used, injectable quinine is considered to be one of the effective antimalarial drug, however non-quality assured antimalarials clearly h...Africa is the world region that is most affected by malaria. Among the therapies used, injectable quinine is considered to be one of the effective antimalarial drug, however non-quality assured antimalarials clearly have a strong market penetration across Africa. To overcome this problem, it becomes more and more necessary to set up quantitative and qualitative analysis system for antimalarial quality control. The objective of the present investigation is an attempt to use customized multispectral microscope equipped with UV-Visible lasers for injectable quinine quality assurance control routinely. For that, we have established the calibration curve of quinine solution concentration as a function of area under light intensity histogram crossing the solution. From this calibration curve, we can check the conformity of any injectable quinine according to the pharmacopoeia involved. The proposed technique is a promising alternative for drug quality control routinely.展开更多
The use of injectable agents for the treatment of stress urinary incontinence(SUI)is an option for female patients who are unwilling to undergo surgery,or have concurrent conditions or diseases that render surgical tr...The use of injectable agents for the treatment of stress urinary incontinence(SUI)is an option for female patients who are unwilling to undergo surgery,or have concurrent conditions or diseases that render surgical treatment unsuitable.To be effective for SUI,an injectable agent must be nonimmunogenic,hypoallergenic,biocompatible,permanent,nonerosive,nonmigratory and painless.It must also heal with minimal fibrosis,possess a long-term bulking effect,and be easily stored and handled.Glutaraldehyde cross-linked bovine collagen(Contigen),silicone polymers(Macroplastique),Durasphere,calcium hydroxyapatite(Coaptite),polyacrylamide hydrogel(Aquamid,Bulkamid),Permacol,and stem cell therapy have been used as injectable agents.Patients must be informed that treatment with injectable agents is not as effective as surgical treatment,and that such agents might necessitate additional and repeated administrations in order to achieve the desired therapeutic effect.展开更多
Importance: Dermal filler use in aesthetic clinics, are now widespread and although complications are rare, the formation of granulomas or abscesses and subsequent defects can be devastating to the patient. Design: Re...Importance: Dermal filler use in aesthetic clinics, are now widespread and although complications are rare, the formation of granulomas or abscesses and subsequent defects can be devastating to the patient. Design: Retrospective chart review of 4 cases over the period of 10 years, from 2002-2012 were examined from The Nasal and Facial Plastic Cosmetic Surgery Institute. Results: Four female patients experienced delayed onset reactions (>2 weeks) with sterile abscess formation and eventual resolution with serial drainage and macrolide antibiotics were observed over a prolonged period until resolution occurred. Only 1 case identified an organism (streptococci) on culture after 8 months, however, the initial culture still showed only sterile abscess. All 4 had a history of previous injectable fillers, 2 patients had evidence of pre existing autoimmune disorders. Conclusions and Relevance: Since the treatment of all of these patients, there is new evidence that infections may present as delayed onset sterile abscesses due to biofilm formation. Fluorescent in situ hybridization (FISH) test has shown to be as specific in identifying responsible organisms in biofilm infections as simple culture but is more sensitive;thus preventing misdiagnosis of sterile abscess. Counter intuitively steroid injection may promote abscesses, while hyaluronidase may be useful.展开更多
The aim of this study was to obtain the fillers in the lumen of hollow nerve conduits（NCs） to improve the microenvironment of nerve regeneration. A p H-induced injectable chitosan（CS）-hyaluronic acid（HA） hydroge...The aim of this study was to obtain the fillers in the lumen of hollow nerve conduits（NCs） to improve the microenvironment of nerve regeneration. A p H-induced injectable chitosan（CS）-hyaluronic acid（HA） hydrogel for nerve growth factor（NGF） sustained release was developed. Its properties were characterized by gelation time, FT-IR, SEM, in vitro swelling and degradation. Furthermore, the in vitro NGF release profiles and cell biocompatibility were also investigated. The experimental results show that the CS-HA aqueous solution can undergo a rapid gelation 3 minutes after its environmental p H is changed to 7.4. The CSHA hydrogel has interconnected channels with a controllable pore diameter and with a porosity of about 80%. It has a favorable swelling behavior and can be degraded by about 70% within 8 weeks in vitro and is suitable for NGF release. The CS-HA/NGF hydrogel exhibits a lower cytotoxicity and is in favor of the adhesion and proliferation of the BMMSCs cells. It is indicated that the CS-HA/NGF will be a promising candidate for neural tissue engineering.展开更多
文摘BACKGROUND Women with a history of serious psychotic disorders are at increased risk of disease relapse during pregnancy.Long-acting injectable(LAI)antipsychotics have been widely used to improve adherence and prevent relapse in patients with various severe psychotic disorders,but there is a lack of high-quality data from previous research on the safety of LAI antipsychotics during pregnancy.AIM To summarize relevant data on maternal,pregnancy,neonatal,and developmental outcomes from published cases of LAI antipsychotic use in pregnancy.METHODS A literature search was performed through November 11,2023,using three online databases:PubMed/MEDLINE,Scopus,and Web of Science.Case reports or case series that reported information about the outcomes of pregnancy in women who used LAI antipsychotics at any point in pregnancy,with available full texts,were included.Descriptive statistics,narrative summation,and tabulation of the extracted data were performed.RESULTS A total of 19 publications satisfied the inclusion criteria:3 case series,15 case reports,and 1 conference abstract.They reported the outcomes of LAI antipsychotic use in 74 women and 77 pregnancies.The use of secondgeneration LAI antipsychotics was reported in the majority(n=47;61.0%)of pregnancies.First-generation LAI antipsychotics were administered during 30 pregnancies(39.0%).Most of the women(approximately 64%)had either satisfactory control of symptoms or no information about relapse,while approximately 12%of them had developed gestational diabetes mellitus.A minority of cases reported adverse outcomes such as stillbirth,spontaneous abortion,preterm birth,low birth weight,congenital anomalies,and neurological manifestations in newborns.However,there were no reports of negative long-term developmental outcomes.CONCLUSION Currently available data seem reassuring,but further well-designed studies are required to properly evaluate the risks and benefits of LAI antipsychotic use during pregnancy.
基金supported by the Russian Science Foundation,grant No.23-63-10056.
文摘Injectable bone cements are used in minimally invasive surgical techniques including vertebroplasty and kyphoplasty.This work is devoted to the development of magnesium-calcium phosphate cements(MCPCs)doped with gadolinium ions(Gd^(3+))for bone defect repair.Interaction between cement powders and a cement liquid resulted in the formation of newberyite and brushite phases,which gave mechanical strength up to 17 MPa without a thermal effect.The introduction of Gd3+into the lattice was confirmed by electron paramagnetic resonance spectroscopy;the doping increased injectivity while giving rise to antibacterial properties against Escherichia coli.Assays of the cement samples soaking in Kokubo’s simulated body fluid revealed the formation of calcium phosphate coatings on the cements’surface.The cements manifested biocompatibility with the MG-63 cell line and significantly enhanced contrast when Gd-MCPC was placed into a bone defect and examined by X-ray micro-computed tomography.For the first time,visualization of a Gd-doped cement material was achieved in a model of a bone defect analyzed by MRI.
基金This work was jointly supported by the National Natural Science Foundation of China(grant Nos.:51973172,51673155,81201927,82002957 and 81672460)the National Key Research and Development Plan of China(No.2018YFC0115300)+5 种基金the State Key Laboratory for Mechanical Behavior of Materials,the World-Class Universities(Disciplines)the Characteristic Development Guidance Funds for the Central Universities,the Natural Science Foundation of Shaanxi Province(No.2020JC-03 and 2019TD-020)the Innovation Talent Promotion Plan of Shaanxi(No.2017KJXX-07)the Key Research and Development Program of Shaanxi Province(No.2019SF-012)the Opening Project of Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology,Xi’an Jiaotong University(No.2019LHM-KFKT008)Fundamental Research Funds for the Central Universities of China(No.xjj2018090).
文摘Endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)are well-established therapeutics for gastrointestinal neoplasias,but complications after EMR/ESD,including bleeding and perforation,result in additional treatment morbidity and even threaten the lives of patients.Thus,designing biomaterials to treat gastric bleeding and wound healing after endoscopic treatment is highly desired and remains a challenge.Herein,a series of injectable pH-responsive selfhealing adhesive hydrogels based on acryloyl-6-aminocaproic acid(AA)and AA-g-N-hydroxysuccinimide(AA-NHS)were developed,and their great potential as endoscopic sprayable bioadhesive materials to efficiently stop hemorrhage and promote the wound healing process was further demonstrated in a swine gastric hemorrhage/wound model.The hydrogels showed a suitable gelation time,an autonomous and efficient self-healing capacity,hemostatic properties,and good biocompatibility.With the introduction of AA-NHS as a micro-cross-linker,the hydrogels exhibited enhanced adhesive strength.A swine gastric hemorrhage in vivo model demonstrated that the hydrogels showed good hemostatic performance by stopping acute arterial bleeding and preventing delayed bleeding.A gastric wound model indicated that the hydrogels showed excellent treatment effects with significantly enhanced wound healing with type I collagen deposition,α-SMA expression,and blood vessel formation.These injectable self-healing adhesive hydrogels exhibited great potential to treat gastric wounds after endoscopic treatment.
基金Supported by the National Natural Science Foundation of China (No.20376038) and the Research Foundation of the Ministry ofEducation of China (No.2002003056).
文摘The auto-gelling and drug release properties of the thermosensitive chitosan-β-glycerophosphate formulation were investigated. According to rheological study, gelation lag time of chitosan/β-glycerophosphate （GP） solutions varied from 2 to 60min with different deacetylation degree of chitosan, pH, gelation temperature, and the particles in the sol. The gelation properties were also found to influence the release profilles of a hydrophilic drug, 5-fluorouracil （5-FU）. Morphological examination by scanning electron microphotography demonstrated that large ＂pores＂ occurred during the gel-forming process, which created hydrophilic environment and led to the rapid initial release of the drug （85% in f＇LrSt 8h）. Poly-3-hydroxybutyrate （PHB）, a biodegradable material, was applied here as scaffold to capture 5-FU into microparticles with high encapsulation efficiency by solvent-nonsolvent method. Combination of these microparticles into the chitosan-β-GP formulation could drop the rapid initial release from 85% down to 29% in the optimized PHB content （75%, by mass）. The release could sustain for about 10 months. Tiffs study provided an understanding of the potential of injectable implant using thermosensitive chitosan-β-GP formulation containing PHB based particles for the water soluble drugs that need the property of long-term delivery.
基金supported by the National Natural Science Foundation of China (No. 51973172)Natural Science Foundation of Shaanxi Province (Nos. 2020JC-03 and 2019TD-020)+2 种基金the State Key Laboratory for Mechanical Behavior of Materials,the World-Class Universities (Disciplines) and Characteristic Development Guidance Funds for the Central UniversitiesFundamental Research Funds for the Central Universitiesthe Opening Project of the Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology,Xi’an Jiaotong University (No. 2019LHM-KFKT008).
文摘Hydrogels with multifunctionalities,including sufficient bonding strength,injectability and self-healing capacity,responsive-adhesive ability,fault-tolerant and repeated tissue adhesion,are urgently demanded for invasive wound closure and wound healing.Motivated by the adhesive mechanism of mussel and brown algae,bioinspired dynamic bonds cross-linked multifunctional hydrogel adhesive is designed based on sodium alginate(SA),gelatin(GT)and protocatechualdehyde,with ferric ions added,for sutureless post-wound-closure.The dynamic hydrogel cross-linked through Schiff base bond,catechol-Fe coordinate bond and the strong interaction between GT with temperature-dependent phase transition and SA,endows the resulting hydrogel with sufficient mechanical and adhesive strength for efficient wound closure,injectability and self-healing capacity,and repeated closure of reopened wounds.Moreover,the temperature-dependent adhesive properties endowed mispositioning hydrogel to be removed/repositioned,which is conducive for the fault-tolerant adhesion of the hydrogel adhesives during surgery.Besides,the hydrogels present good biocompatibility,near-infrared-assisted photothermal antibacterial activity,antioxidation and repeated thermo-responsive reversible adhesion and good hemostatic effect.The in vivo incision closure evaluation demonstrated their capability to promote the post-wound-closure and wound healing of the incisions,indicating that the developed reversible adhesive hydrogel dressing could serve as versatile tissue sealant.
文摘The present studies were conducted to compose an injectable solution of colistin sulfate containing local anaesthesia, antioxidant and other additions. Results showed that the novel preparation was stable either to heat or to light. The term of validity of the preparation was 2 years at room temperature.The preparation containing 25. 0 mg ml-1 colistin sulfate showed no local tissue irritation, but the concentration of 50. 0 mg ml-1 colistin sulfate showed obvious local tissue irritation. Result of acute toxicity test showed that the LD50 of intramuscular injection in mice was 38. 72 mg kg-1, and oral LD50 was 431. 39 mg kg-1. The evidence of neurotoxicity was observed in mice in the acute toxicity test. A dose of 10.0 mg kg-1 b. w. or 15:0 mg kg-1b. w. was administered intramuscularly to piglet once daily for 5 days. No changes were detected in the piglet body except for the slight epithelial tissue's granular degenerations in the kidney and liver at the dose of the 10.0 mg kg-1. While at the dose of 15. 0 mg kg-1, the obvious neurotoxicity was observed at 4-5 days. The epithelial tissues in the kidney and liver showed moderate granular degenerations, especially in the tubuli renales cells. Blood cell's morphosis indexes were normal. With relation to liver's function, the indexes went beyond the normal scope. But with relation to kidney's function, the indexes showed mostly normal.When the preparation was separately administered into muscle(i. m.) in piglets with the dose of 2. 5 and 5. 0 mg kg-1 b. w, whose Cmax were 3.73±0. 28 and 6. 40±0.18 Abstract:g ml-1; Tmax were 32±1. 5 and 34±1.8min; t1/2β were 256±14 min and 264±29 min, respectively. t1/2βt was 251±13 min for the injection given into aural vein( i. v.) with the dose of 2.5 mg kg1-1 b. w.. Samples of the experimentally determined plasma concentration of colistin sulfate generated two-exponential model with first-order absorption. The mean absolute bioavail-ability coefficient of 2.5 and 5. 0 mg kg-1 b. w. (i. m.) were 98. 30 and 88. 54%, respectively. The high bio-availability and the long maintaining time of the valid blood-drug concentration showed that the injectable solution was suitable for i. m. in pigs, whose recommended dose was 2.5 mg kg-1 b. w. , twice daily.
文摘Aim： To report our experience with penile girth augmentation using liquid injectable silicone. Methods： Between August 2003 and July 2006, 324 men （mean age 35 years, range 19-65 years） received a series of liquid silicone subcutaneous injections between the penile skin and the corpora cavernosa on the dorsal and lateral aspects of the penile shaft, under local anesthesia. Digital photographs taken pre- and post-procedure （n = 324）, and penile contour measurements （n = 30） yielded objective results. Subjective results were derived from patient and partner testimony of satisfaction. Follow-up averaged 20 months （range 1-36 months）. Results： Three hundred and twenty-four procedures were primary augmentations. Most men （61%） were married, 7% were accompanied by their partners, and 93% were circumcised. The mean measured penile circumference was 9.5 cm （7.5-11.5 cm） pretreatment and 12.1 cm （10.3-15.3 cm） post-treatment （mean increase of 27% in circumference and 0.84 cm in diameter）. Patient and partner satisfaction was already expressed after the first two treatments. Sexual activity could be resumed after 8 h. Complications （mild bruising） were easily resolved. Conclusion： Penile girth augmentation using liquid injectable silicone yields very satisfactory short-term results with no immediate or short-term complications.
文摘Background: There is a large assortment of modalities for the surgical treatment/management of distal radius fractures (DRFs), where the most widely used is the fixed-angle volar plating (VLP) system, which, sometimes, is referred to as the “surgical modality of choice”. While outcomes with each modality are usually good to excellent, each has its share of shortcomings and complications. Thus, there is scope for improvements to existing modalities and/or introduction of new ones. Study Purpose: We introduce a novel modality, namely, the prototype of an intramedullary injectable bioresorbable polymer-bioresorbable balloon osteosynthesis (IPBO) system, and investigated its plausibility. Experimental Procedures: The biomechanical performance of a construct comprising a synthetic distal radius (fourth-generation Sawbones?) on which a simulated fracture was created (4-mm wide osteotomy positioned 25 mm from the most distal end of the radius) and fixated with a placement of the IPBO system (SIPBO Construct) was compared to that when the fixation was with an approved Ti-6Al-4V alloy VLP system (SVLP Construct), under a clinically-relevant compressive loading protocol. Performance involved determination of quantitative parameters of the construct (initial longitudinal stiffness (ICLS), final longitudinal stiffness (FCLS), and load-to-failure (Pf)) and observation and recording of features of the construct at the fracture point. We also determined the quantitative parameters for the intact synthetic distal radius (control). Results: For each of the quantitative parameters, the range of values for SIPBO Construct was within that for SVLP Construct, suggesting that the IPBO System is a plausible modality. Also, for SIPBO Construct, failure occurred within the polymer zone, whereas, for SVLP Construct, some failure features were fracture of the cortical wall and of the dorsal proximal fragments. Conclusion: The findings suggest that the IPBO system is plausible. As such, it merits further study;for example, determination of the influence of fracture gap fill ratio (defined as the proportion of the fracture gap that is filled by the expanding balloon as the polymer is injected into the balloon) on a large collection of quantitative biomechanical parameters.
文摘BACKGROUND Collagen membrane and platelet-rich fibrin(PRF)have emerged as vital biomaterials in the field of periodontal regeneration.Minimally invasive techniques are being preferred by most periodontists,as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques.Thus,in this study we have evaluated the effect of injectable PRF(i-PRF)with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access(VISTA)technique for gingival recession coverage.AIM To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage.METHODS A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study.The sites were randomly assigned to control group(VISTA using collagen membrane alone)and the test group(VISTA using collagen membrane with i-PRF).The clinical parameters assessed were pocket depth,recession depth(RD),recession width(RW),relative attachment level,keratinised tissue width(KTW),keratinised tissue thickness(KTT),and percentage root coverage.RESULTS RD showed a statistically significant difference between the test group at 3 mo(0.5±0.513)and 6 mo(0.9±0.641)and the control group at 3 mo(0.95±0.51)and 6 mo(1.5±0.571),with P values of 0.008 and 0.04,respectively.RW also showed a statistically significant difference between the test group at 3 mo(1±1.026)and 6 mo(1.65±1.04)and the control group at 3 mo(1.85±0.875)and 6 mo(2.25±0.759),with P values of 0.008 and 0.001,respectively.Results for KTW showed statistically significant results between the test group at 1 mo(2.85±0.489),3 mo(3.5±0.513),and 6 mo(3.4±0.598)and the control group at 1 mo(2.45±0.605),3 mo(2.9±0.447),and 6 mo(2.75±0.444),with P values of 0.04,0.004,and 0.003,respectively.Results for KTT also showed statistically significant results between test group at 1 mo(2.69±0.233),3 mo(2.53±0.212),and 6 mo(2.46±0.252)and the control group at 1 mo(2.12±0.193),3 mo(2.02±0.18),and 6 mo(1.91±0.166),with P values of 0.001,0.001,and 0.001,respectively.The test group showed 91.6%,81.6%,and 67%root coverage at 1 mo,3 mo,and 6 mo,while the control group showed 82.3%,66.4%,and 53.95%of root coverage at 1 mo,3 mo,and 6 mo,respectively.CONCLUSION The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.
文摘Background: Lower-lid pretarsal fullness rejuvenation is a popular surgery for Asian women. However, the current procedures have clinical complications and are not stable in the long-term. Here, we analyzed the effect of injectable collagen on lower-lid pretarsal fullness rejuvenation.Methods: To investigate the clinical effect of injectable collagen in lower-lid pretarsal fullness rejuvenation, we observed 32 Chinese Han female patients aged 18–55 years with non-distinctive lower-lid pretarsal fullness and no history of lower eyelid surgery or trauma. The injectable collagen products were used for local filling correction. After surgery, the patients were followed up for 12 months. A correction effect was evaluated through an analysis of volume changes using a visual analog scale. Adverse reactions were also recorded.Results: All patients achieved good aesthetic outcomes and strong stereoscopic impressions of lower-lid pretarsal fullness. Complications, such as edema and bruising, were not observed after the injection. Immediately after the operation, the average visual analog score was 2.65 ± 0.56. Six months after the operation, the average visual analog score was 2.96 ± 0.41. The patients reported high satisfaction levels. Immediately after the operation, the average lower-lid pretarsal fullness volume increase was 0.19 ± 0.04 m L on the left side and 0.21 ± 0.03 m L on the right side. After a 12-month follow-up, the average residual volume was 0.17 ± 0.06 m L on the left side and 0.19 ± 0.04 m L on the right side, suggesting that the injected collagen impact was stable.Conclusion: Injectable collagen promotes a vivid, natural appearance and is highly effective in rejuvenating lowerlid pretarsal fullness with low absorption rates in later stages. Therefore, injectable collagen should be considered in correcting congenital, non-distinctive, lower-lid pretarsal fullness in clinical practice.
基金The Nattional Key Scientific Program-Nanoscience and Nanotechnologygrant number:2009CB930000
文摘To get a sort of new scaffold material for soft tissue reconstruction,we have prepared XLHA-PNIPAAm and XLHA-MC injectable hydrogels through blending crosslinked HA(XLHA) and two temperature-sensitive materials differed in degradation poly(N-isopropylacrylamide)(PNIPAAm) and methylcellulose(MC),respectively.We tested the injectablility,enzymatic biodegradability,temperature-sensitivity,structure cytotoxicity and hemolysis of the two injectable hydrogels.Our research has successfully obtained the preparation condition of XLHA-PNIPAAm injectable hydrogel,and verified that adding non-degradable material PNIPAAm can postpone the degradation of HA more effectively than degradable material MC.PNIPAAm prepared with 5 kGy dose radiation,MBAAm/NIPAAm(M/M)=0.015,monomer concentration=3% produced XLHA-PNIPAAm with slowest enzymatic biodegradability.DSC results showed that temperature-sensitivity of the XLHA-PNIPAAm was more stable than that of XLHA-MC.Two composite hydrogels were qualified in cytotoxicity and hemolysis tests and the biocompatibility of XLHA-PNIPAAm hydrogel showed better than XLHA-MC hydrogel.
文摘BACKGROUND Given the low survival rate in pancreatic cancer,new therapeutic techniques have been explored,especially for unresectable or borderline resectable disease.Endoscopic ultrasound(EUS)provides real-time imaging and minimally invasive access for local and targeted injection of anti-tumor agents directly into the pancreatic tumor.Limited studies have been reported using this technique for the treatment of pancreatic ductal adenocarcinoma(PDAC).AIM To evaluate the progress made with EUS-guided injectable therapies in the treatment of PDAC.METHODS All original articles published in English until July 15,2021,were retrieved via a library-assisted literature search from Ovid Evidence-Based Medicine Reviews and Scopus databases.Reference lists were reviewed to identify additional relevant articles.Prospective clinical studies evaluating the use of EUS-guided injectable therapies in PDAC were included.Studies primarily directed at non-EUS injectable therapies and other malignancies were excluded.Retrieved manuscripts were reviewed descriptively with on critical appraisal of published studies based on their methods and outcome measures such as safety,feasibility,and effectiveness in terms of tumor response and survival.Heterogeneity in data outcomes and therapeutic techniques limited the ability to perform comparative statistical analysis.RESULTS A total of thirteen articles(503 patients)were found eligible for inclusion.The EUS-injectable therapies used were heterogeneous among the studies consisting of immunotherapy(n=5)in 59 patients,chemotherapy(n=1)in 36 patients,and viral and other biological therapies(n=7)in 408 patients.Eleven of the studies reviewed were single armed while two were double armed with one randomized trial and one non-randomized comparative study.Overall,the included studies demonstrated EUS-guided injectable therapies to be safe and feasible with different agents as monotherapy or in conjunction with other modalities.Promising results were also observed regarding their efficacy and survival parameters in patients with PDAC.CONCLUSION EUS-guided injectable therapies,including immunotherapy,chemotherapy,and viral or other biological therapies have shown minimal adverse events and potential efficacy in the treatment of PDAC.Comparative studies,including controlled trials,are required to confirm these results in order to offer novel EUS-based treatment options for patients with PDAC.
文摘Risperidone long-acting injectable (RLAI) is approved for the treatment of schizophrenia in many countries. The suggested site is the gluteal muscle with a needle length of two inches (50 mm) in Japan, which is longer than the ordinarily used needle for intramuscular injections. The aim of this study was to determine the optimal needle insertion length for accurate delivery of RLAI procedure among subjects who have normal body mass index (BMI: 18 to 25) and high BMI (>25). Thirty-seven patients with schizophrenia were administered RLAI intramuscularly into the dorsogluteal muscle. The standard procedure required inserting 80% of the two inch needle. By using data collected by ultrasonography, the findings confirmed that the median needle insertion lengths for subjects with normal and high BMI were 39.0 and 45.5 mm, respectively. To deliver RLAI effectively and safely, the authors strongly recommend that a specialized needle be used that is “marked” at the 40 mm point from the tip of the needle to the base. In this way regardless of subcutaneous fat content, the RLAI can be safely delivered into the muscle without causing untoward or side effects.
基金theKeyResearchProgramoftheMinistryofScience&Technology China (2 0 0 1BA31 0A 7)
文摘A new type of injectable premixed bone cement consisting of nano hydroxyapatite (n HA) and polyamide 66(PA66) composite is investigated. This cement can be handled as paste and easily shaped, which can set in air, in physiological saline solution and in blood. The setting time, injectability and compressive strength of the cement largely depend on the ratio of liquid to powder (L/P). Moreover, the content of n HA in composite also affects the compressive strength and injectability of the cement. The premixed composite cement can remain stable in the package for a long period and harden only after delivery to the defects site. The results suggest that injectable premixed cement has a reasonable setting time, reasonable viscosity for injecting, excellent washout resistance and high mechanical strength, which can be developed for root canal filling, sealing and various bone defects augmentation.
文摘In some cases, if the insertion depth is shallower than expected, intramuscular (IM) injection of risperidone long-acting injectable (RLAI) may not penetrate the muscle fascia. However, if needle insertion depth is deeper than anticipated, needle penetration may cause damage to nerves, arteries and veins. Few clinical studies were done to evaluate the depth of needle length insertion reaching the intended gluteal muscle. The aim of this study was to evaluate the suitable depth of injecting RLAI. Twenty-six patients with schizophrenia were treated with RLAI, and randomly divided into two groups: 50 mm needle inserted group (Group-D, deep insertion, n = 13) and 20 mm needle insertion group (Group-S, shallow insertion, n = 13). For Group-S, the needle length was marked with a spacer at exactly 20 mm. Injections were performed by the psychiatrist or nurse, alternating between the two gluteal sites by double-cross method every two weeks. Clinical psychotic symptoms and injection site reactions were recorded throughout the study period. Experienced psychologists who were blinded from the needle-length experimental variable evaluated patients’ psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS) every two weeks. The plasma 9-hydroxyrisperidone (9-OH-RIS) concentrations were measured every two weeks;comparison data were determined on the 8th week and the 14th week. No significant difference was observed in 9-OH-RIS concentrations, psychotic symptoms, injection site skin reactions of subjects in both groups. However, in Group-D, injection site adverse reactions were confirmed in two subjects (15%). In Group-S, injection site reactions were confirmed in six subjects (46%). Although effective 9-OH-RIS concentrations were obtained with the insertion using both depth, it was concluded that the 50 mm insertion length was more suitable for dorsogluteal IM injections in adult patients with schizophrenia as demonstrated by the incidence of local adverse skin reactions.
文摘A novel injectable hydrogel that was synthesized by in situ crosslinking of hyaluronan and polyvinyl phosphonic acid was proposed in this study. Fourier transform infrared spectrum (FT-IR) analysis, scanning electron microscope (SEM), pH measurement, and biodegradation test were used to confirm its characteristics. The results permitted to prove successful crosslinking, observe the inner morphology of hydrogel and pore sizes distribution, and determine the decomposition of hydrogel components during incubation time. Result of pH measurement showed that the pH scale of hydrogel decreased when volume of PVPA increased. As a consequence, it affected the cytotoxicity value, cell proliferation, and cell growth behaviors of each hydrogel. Optical microscope observation showed that chondroblasts cell proliferated well on HA-PVPA hydrogel. Therefore, these results suggest that the new injectable hydrogel is appropriate for bone/cartilage regeneration applications.
文摘Africa is the world region that is most affected by malaria. Among the therapies used, injectable quinine is considered to be one of the effective antimalarial drug, however non-quality assured antimalarials clearly have a strong market penetration across Africa. To overcome this problem, it becomes more and more necessary to set up quantitative and qualitative analysis system for antimalarial quality control. The objective of the present investigation is an attempt to use customized multispectral microscope equipped with UV-Visible lasers for injectable quinine quality assurance control routinely. For that, we have established the calibration curve of quinine solution concentration as a function of area under light intensity histogram crossing the solution. From this calibration curve, we can check the conformity of any injectable quinine according to the pharmacopoeia involved. The proposed technique is a promising alternative for drug quality control routinely.
文摘The use of injectable agents for the treatment of stress urinary incontinence(SUI)is an option for female patients who are unwilling to undergo surgery,or have concurrent conditions or diseases that render surgical treatment unsuitable.To be effective for SUI,an injectable agent must be nonimmunogenic,hypoallergenic,biocompatible,permanent,nonerosive,nonmigratory and painless.It must also heal with minimal fibrosis,possess a long-term bulking effect,and be easily stored and handled.Glutaraldehyde cross-linked bovine collagen(Contigen),silicone polymers(Macroplastique),Durasphere,calcium hydroxyapatite(Coaptite),polyacrylamide hydrogel(Aquamid,Bulkamid),Permacol,and stem cell therapy have been used as injectable agents.Patients must be informed that treatment with injectable agents is not as effective as surgical treatment,and that such agents might necessitate additional and repeated administrations in order to achieve the desired therapeutic effect.
文摘Importance: Dermal filler use in aesthetic clinics, are now widespread and although complications are rare, the formation of granulomas or abscesses and subsequent defects can be devastating to the patient. Design: Retrospective chart review of 4 cases over the period of 10 years, from 2002-2012 were examined from The Nasal and Facial Plastic Cosmetic Surgery Institute. Results: Four female patients experienced delayed onset reactions (>2 weeks) with sterile abscess formation and eventual resolution with serial drainage and macrolide antibiotics were observed over a prolonged period until resolution occurred. Only 1 case identified an organism (streptococci) on culture after 8 months, however, the initial culture still showed only sterile abscess. All 4 had a history of previous injectable fillers, 2 patients had evidence of pre existing autoimmune disorders. Conclusions and Relevance: Since the treatment of all of these patients, there is new evidence that infections may present as delayed onset sterile abscesses due to biofilm formation. Fluorescent in situ hybridization (FISH) test has shown to be as specific in identifying responsible organisms in biofilm infections as simple culture but is more sensitive;thus preventing misdiagnosis of sterile abscess. Counter intuitively steroid injection may promote abscesses, while hyaluronidase may be useful.
基金Funded by the National Natural Science Foundation of China(Nos.51473130,51403168 and 51572206)the National CollegeStudents'Innovation and Entrepreneurship Training Programof Wuhan University of Technology(Nos.20161049720008,20161049720009,and 20161049720012)
文摘The aim of this study was to obtain the fillers in the lumen of hollow nerve conduits（NCs） to improve the microenvironment of nerve regeneration. A p H-induced injectable chitosan（CS）-hyaluronic acid（HA） hydrogel for nerve growth factor（NGF） sustained release was developed. Its properties were characterized by gelation time, FT-IR, SEM, in vitro swelling and degradation. Furthermore, the in vitro NGF release profiles and cell biocompatibility were also investigated. The experimental results show that the CS-HA aqueous solution can undergo a rapid gelation 3 minutes after its environmental p H is changed to 7.4. The CSHA hydrogel has interconnected channels with a controllable pore diameter and with a porosity of about 80%. It has a favorable swelling behavior and can be degraded by about 70% within 8 weeks in vitro and is suitable for NGF release. The CS-HA/NGF hydrogel exhibits a lower cytotoxicity and is in favor of the adhesion and proliferation of the BMMSCs cells. It is indicated that the CS-HA/NGF will be a promising candidate for neural tissue engineering.
