Cosmetic use is increasingly common among young college students; however, its potential link to hepatic steatosis remains unclear. This exploratory study examined associations between external cosmetic use, internal metal exposure, and hepatic steatosis indices, as well as the possible mediating roles of adipokines. A panel study with 70 college students collected cosmetics exposure data, quantified serum levels of 26 metals, and measured plasma adipokine levels. Hepatic steatosis was assessed using the HSI and ZJU index as non-invasive indirect biomarkers. Generalized linear models (GLM) and generalized weighted quantile sum (gWQS) models evaluated associations between cosmetic and metal exposure with HSI, ZJU, and adipokines, including the interaction between sex and cosmetic exposure-related metals. Causal mediation analysis assessed adipokine mediation effects. Exposure to cosmetics, particularly hair and body products, was associated with elevated HSI and ZJU in college students. Cobalt (Co) and copper (Cu), biomarkers of cosmetic exposure, exhibited positive dose-response relationships with HSI, ZJU, and leptin, independent of sex. Leptin mediated the associations between lip and hair cosmetics, Co, Cu, and increased HSI and ZJU. Co and Cu biomarkers indicate an association between cosmetic use and biomarkers of hepatic steatosis in college students, in which leptin may play a mediating role. This exploratory study offers preliminary epidemiological evidence and suggests potential intervention targets for cosmetics-related liver health risks. However, given the indirect nature of HSI and ZJU and the observational design, causality cannot be inferred; further investigations are warranted.
The friction characteristics of organogel-type cosmetics play a crucial role in texture improvement. In this study, we evaluated the friction behavior of 32 organogel-type cosmetics when they were applied to artificial skin utilizing a sinusoidal motion friction evaluation system. The principal component analysis on the friction parameters demonstrated that the principal components Z1 and Z2 incorporated the static friction coefficient μs, dynamic friction coefficient μk, delay time δ, and viscosity coefficient C. The cluster analysis on Z1 and Z2 classified these cosmetics into four different categories based on friction dynamics: Group 1 comprised 14 formulations containing hydrogenated polyisobutene (a low-polarity oil) and triethylhexanoin (a medium-polarity oil); Group 2 comprises cosmetics with high pigment content, hardness and friction coefficient; Group 3 comprises cosmetics with high viscosity response. and positive velocity dependence due to the presence of various paste-type oils; and Group 4, in which the friction coefficient decreases with the increasing acceleration at the onset of sliding, demonstrates a negative viscosity coefficient. These cosmetics contain medium- to high-polarity oils exemplified by diisostearyl malate and tri(caprylic/capric)glyceryl. The classification method based on friction parameters proposed in this study is useful for understanding the application texture of organogel-type cosmetics and designing improved formulations.
Terminology used to describe products applied to the vulva and vagina is inconsistent and poorly standardized, limiting clarity in research, clinical practice, and regulation. Products marketed under the umbrella of "feminine hygiene" or "intimate care" include both menstrual management items and products intended primarily for aesthetic purposes, such as douches, sprays, wipes, and scented tampons. The use of health-oriented language such as "hygiene" and "care" may imply medical necessity or health benefit despite limited evidence of therapeutic value and growing concern regarding chemical exposures associated with some of these products. Ambiguous terminology may obscure product function, hinder risk communication, and contribute to regulatory and research gaps. We propose the term intimate cosmetics to describe vulvovaginal products intended for aesthetic purposes rather than for menstrual management. This terminology aligns with established regulatory definitions of cosmetics as products applied to the body for cleansing, beautifying, or altering appearance, without implying disease prevention or treatment. Reframing these products as cosmetics more accurately reflects their intended use and clarifies distinctions between aesthetic and health-promoting interventions. Many intimate cosmetics contain fragrances and other chemicals associated with endocrine disruption, reproductive toxicity, or carcinogenicity, yet marketing claims such as "gynecologist tested" or "pH balanced" may confer an impression of clinical legitimacy. Clear, function-based terminology can improve research categorization, enhance post-market safety monitoring, and support more transparent regulatory oversight. Importantly, imprecise and gendered language may also reinforce stigma and obscure patterns of disproportionate exposure among populations already overburdened by environmental toxicants. Adopting the term intimate cosmetics represents a practical public health strategy to improve precision in scientific discourse, strengthen risk communication, and promote more equitable regulatory attention. Intentional, function-based nomenclature can better align product labeling, research, and policy with exposure realities and consumer protection goals.
Childhood burn injuries can lead to persistent digital contractures and contour deformities that affect both function and psychosocial well-being. We report the case of a 17-year-old female patient with a longstanding post-burn contracture and cosmetic deformity of the small finger after a burn sustained at age two, initially treated conservatively with compression dressings. Years later, she presented with residual soft tissue atrophy and tethering with clinically apparent foreshortening and expressed concern primarily about the cosmetic appearance. A modified Farmer's flap, traditionally described for hallux varus correction of the great toe, was adapted as a local rotational flap to address the soft tissue deficiency and restore contour after scar release. The procedure improved the overall appearance and contour of the small finger with a satisfactory cosmetic match using local tissue. At postoperative follow-up, the patient reported satisfaction with the aesthetic outcome; a decrease in small-finger range of motion was anticipated and accepted as a trade-off, and no complications were observed. This case demonstrates that Farmer's flap principles may be adapted for selected post-burn hand deformities when cosmetic restoration is a primary goal and local tissue rearrangement is appropriate.
Whitening is a core function of cosmetics， and ingredients including acetyl glucosamine， tranexamic acid， nicotinamide， phenethyl resorcinol， glabridin， and ascorbyl tetraisopalmitate are widely used due to their clearly established whitening mechanisms. However， existing analytical methods face notable limitations： photodiode array detectors （PDA） cannot reliably detect weakly or non-ultraviolet （UV）-absorbing components； evaporative light scattering detectors （ELSD） suffer from inadequate sensitivity for low-concentration analytes； mass spectrometry （MS） is costly； and single-column cannot achieve the separation of ingredients with significantly different polarities. To address these challenges， this study established an analytical method for the determination of the six whitening ingredients in cosmetics using ultra performance liquid chromatography coupled with a photodiode array detector and a corona charged aerosol detector （UPLC-PDA-CAD）. For sample pretreatment： 0.2 g of sample was weighed， and 10 mL dichloromethane and 10 mL deionized water were added for vortex extraction of whitening ingredients. The mixture was then centrifuged for phase separation. The aqueous layer and dichloromethane layer were collected separately. The aqueous layer was washed twice with dichloromethane； all dichloromethane fractions were combined， concentrated to less than 1 mL under a nitrogen stream， and finally made up to volume with isopropanol. Both the aqueous layer and the reconstituted isopropanol solution were filtered through 0.22 μm hydrophilic polytetrafluoroethylene （PTFE） membranes before UPLC injection. For chromatographic separation， a Waters HSS T3 column （150 mm×2.1 mm， 1.7 μm） was selected. The column temperature was set at 40 ℃， the injection volume was 1 μL， and the flow rate was 0.3 mL/min. The mobile phase consisted of isopropanol， acetonitrile， and 20 mmol/L ammonium acetate solution （pH adjusted to 4.5 using formic acid）， using a gradient elution program. For detection， a tandem PDA-CAD system was used： PDA （scan range 200-400 nm） was employed for components with UV absorption， while CAD （nebulization temperature 35 °C， acquisition frequency 5 Hz） was used for components with weak UV absorption. Quantification was performed using the external standard method.Method validation results showed good linear relationships for all six whitening ingredients within their respective concentration ranges. The correlation coefficients （r） were all greater than 0.999. The limits of detection （LODs， S/N=3） were 5.0-50.0 µg/g， and the limits of quantification （LOQs， S/N=10） were 12.0-120.0 µg/g. Spiked recovery tests were conducted on negative cosmetic matrices （emulsion， cream， oil） at low， medium， and high levels. The recoveries ranged from 92.8% to 110.1%， and the relative standard deviations （RSDs， n=6） were 0.12%-5.45%， indicating excellent precision and accuracy. This method was applied to seven commercially cosmetics. The results revealed that all target whitening ingredients declared on the product labels were detected， with significant differences in their content. Nicotinamide was the most frequently detected compound， found in five products， and also exhibited the highest concentrations， ranging from 0.19% to 2.29%. Phenethyl resorcinol was detected in three products， with contents ranging from 0.02% to 0.52%. Ascorbyl tetraisopalmitate was detected in two products， at 0.09% and 3.08%， respectively. Acetyl glucosamine， tranexamic acid， and glabridin were each detected in only one product. In conclusion， this established UPLC-PDA-CAD method is simple， efficient， sensitive and accurate. It effectively overcomes the technical challenge of detecting whitening ingredients with widely varying polarities， offering reliable technical support for cosmetic quality control， regulatory supervision， and evaluation of product whitening efficacy and potential sensitization risks. 建立了一种超高效液相色谱-二极管阵列检测器串联电雾式检测器（UPLC-PDA-CAD）测定化妆品中乙酰壳糖胺、氨甲环酸、烟酰胺、苯乙基间苯二酚、光甘草定及抗坏血酸四异棕榈酸酯6种美白成分的分析方法。样品用二氯甲烷和水涡旋提取，收集二氯甲烷层和水层；水层经二氯甲烷洗涤后，合并二氯甲烷相，氮吹浓缩至<1 mL并以异丙醇定容。水层和异丙醇定容液分别过滤，注入液相色谱仪，通过Waters HSS T3柱（150 mm×2.1 mm，1.7 μm）分离。流动相为异丙醇-乙腈-20 mmol/L乙酸铵缓冲液（甲酸调节pH至4.0），采用梯度洗脱方式，以二极管阵列检测器串联电雾式检测器进行检测，外标法定量。分别对样品前处理方法和色谱条件进行了优化。在优化的实验条件下，6种美白功效成分在一定范围内线性关系良好，相关系数（r）均>0.999，在乳、霜、油3种化妆品基质中的加标回收率为92.8%~110.1%，相对标准偏差（RSD，n=6）为0.12%~5.54%。对市售的7款化妆品进行检测，检出的美白成分与产品包装标示成分一致，但各成分含量差异较大。烟酰胺的使用频率和测得含量均较高，5款产品的测试结果为0.19%~2.29%。该方法操作简便，稳定可靠，重复性好，适用于化妆品中这几种极性差异显著的美白成分的检测。
The impact of globalization, along with the change in societal values and economic growth, has contributed to the growing popularity of cosmetic procedures across the Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. This study explores the prevalence of cosmetic procedures and their correlation with body image perception in this region. Utilizing a comprehensive literature review of research published preferably between 2011 and 2024, this study explores the trends of surgical and non-surgical procedures, the demographics of the users, as well as the determinants of the decision to undergo the procedure in the region. Key determinants include social media popularity, an increased level of awareness towards aesthetic options, and cultural shifts. There is a growing trend of increasing acceptance of rhinoplasty, liposuction, and Botox procedures among women and men aged 20-40. The motivations behind these choices include societal trends, professional image, and self-esteem. However, disparities in access, cultural sensitivities, and ethical concerns persist, especially when balancing traditional values with modern beauty standards. The implications of cosmetic surgery go beyond aesthetics, encompassing physical health risks, psychological outcomes, and ethical dilemmas. Much attention has focused on strengthening robust regulatory frameworks, ethical practices, and patient education to ensure patients are safe and well-informed before making a decision. Moreover, the literature remains sparse on several fronts, including male underrepresentation, long-term psychosocial outcomes, and the influence of cultural and religious norms. Further investigation into these issues will broaden understanding and inform policy formulation in the rapidly evolving field of cosmetic surgery in GCC countries.
Restorative cosmetic dermatology involves the application of traditionally aesthetic techniques to correct appearance and function in patients with underlying medical dermatologic conditions. Restorative interventions can improve disease activity, physical function, and quality of life. This CME article reviews foundational principles for clinical implementation, including the classification of sequelae by morphologic features, a structured approach to patient evaluation, key elements of post-procedural care, and practical considerations. Morphologic classification guides treatment planning and patient counseling, while a structured evaluation framework helps identify appropriate candidates and procedural risk factors. Key management considerations include coordination with medical dermatology, screening for functional or psychosocial impairment, counseling patients on realistic expectations, and tailoring procedural approaches to high-risk populations. Thoughtful application within appropriate multidisciplinary settings can help restore skin integrity, improve patient confidence, and support long-term recovery.
To investigate the impact of music and white noise on the pain caused by cosmetic botulinum toxin injections. Seventy-six participants between the ages of 18 and 45 who requested cosmetic botulinum toxin application to the upper face were enrolled in the study in three groups: favorite music (20), white noise (31), and control (25). The first and second groups listened to their favorite music and white noise, respectively, during and 10 min after the procedures, while the control group was exposed to background noise only. The participants rated their pain levels during the procedure and the impact of the sound on their stress level using a visual analog scale ranging from 0 to 10. Additionally, the participants in both the music and white noise groups were surveyed regarding their preferences for sound intervention for future botulinum toxin procedures. The pain scores (95% confidence interval) for the control, music, and white noise groups were 6.80 [6.37-7.23], 5.7 [5.13-6.27], and 5.52 [4.99-6.04], respectively. Both the white noise group and the music group had significantly lower pain scores compared to the control group. Furthermore, individuals receiving botulinum toxin for the first time reported significantly higher pain scores than those who had prior experience with the treatment. Listening to white noise or music during cosmetic botulinum toxin injections can effectively reduce procedure-related pain. However, further studies are required to reveal the mechanism of action of sound applications in pain management during cosmetic procedures and to determine the selection of appropriate candidates and specific application conditions.
The true incidence of Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare cancer associated with textured breast implants, remains uncertain due to limitations of implant exposure data and long-term follow-up. Concerns regarding other implant-associated malignancies are growing. This study aimed to determine the incidence of BIA-ALCL, non-BIA-ALCL lymphoma, and Breast Implant Associated-Squamous Cell Carcinoma (BIA-SCC). 10,339 women with a first-time breast implantation during 1998-2011 were identified in the nationwide prospective Danish Registry for Plastic Surgery of the Breast (DPB). Linkage to national health registries provided outcome data. Incidence of non-BIA-ALCL was compared with the incidence in 1) 3486 women with breast reduction or mastopexia and 2) 153,728 age-matched women from the general population. Cumulative incidences were estimated using competing risk models. We followed 8516 women with cosmetic and 1823 with reconstructive implantation for a median of 17.3 and 17.4 years, respectively. Five BIA-ALCL cases were identified. The incidence rate of BIA-ALCL among women with textured cosmetic implants was 2.83 per 100,000 person-years (95% CI, 0.77-7.26), and for the reconstructive cohort, 3.44 per 100,000 person-years (95% CI, 0.09-19.16). No statistically significant differences were found across indications or implant texturing types, and almost all implant brands on the market were involved. The incidence of other lymphomas after cosmetic implantation resembled that of the control cohorts. No BIA-SCC cases were identified. This study provides a population-based estimate of BIA-ALCL incidence, more precise and higher than most previous studies. No textured implants are without risk.
In laparoscopic surgery, specimen retrieval can require enlarging abdominal incisions, reducing the minimally invasive benefits. Transvaginal specimen extraction (TVSE) can offer a safer, more cosmetic alternative for women. This systematic review and meta-analysis evaluated the safety and outcomes of TVSE compared with transabdominal extraction, regardless of surgical indication. EMBASE, Scopus, PubMed, MEDLINE, Web of Science, and the Cochrane Library were searched from inception to April 2025. Studies were grouped by design, surgical specialty, and extraction method (port enlargement versus mini-laparotomy) to explore heterogeneity. Twenty-five studies were included for 2751 patients (1144 TVSE, 1607 transabdominal extraction) in general, urologic, or gynecologic surgery. TVSE was associated with lower postoperative pain (mean difference -0.98, 95%CI -1.30 to -0.66), rescue analgesia use (OR 0.38, 95%CI 0.28 to 0.51), postoperative complications (OR 0.55, 95%CI 0.34 to 0.89), shorter hospital stays (mean difference -1.04, 95%CI -1.77 to -0.30), and higher cosmetic satisfaction (mean difference 0.91, 95% CI 0.46 to 1.35), especially versus mini-laparotomy. Blood loss, intraoperative complications, and dyspareunia did not differ. TVSE is associated with improved postoperative outcomes when it replaces mini-laparotomy, whereas less benefit is observed versus laparoscopic port-site enlargement. Further randomized controlled trials are needed to confirm these findings.
Lactic acid is a key microbial metabolite with widespread industrial applications in food preservation, cosmetics, pharmaceuticals, polymer industries, and others. The direct detection of lactic acid in complex microbial cultures remains a challenge. Enzymatic assays and high-performance liquid chromatography are traditional methods for detecting lactic acid, but they require extensive sample preparation. In this study, we report a non-enzymatic Raman sensing framework for the direct detection and mapping of lactic acid in microbial culture. We used Lactobacillus plantarum and Lactobacillus acidophilus as representative lactic acid-producing microbes, and detected the characteristic Raman signal of lactic acid in their culture supernatants. An additional multiplex advantage of the approach is that both protonated and deprotonated forms of lactic acid were detected across species under varying culture pH conditions. Raman imaging was also performed directly on microbial cultures, enabling visualization of the spatial distribution of lactic acid. Raman images revealed a diffuse distribution of lactic acid within the unprocessed culture matrix, consistent with metabolic secretion by actively growing cells. This work pipeline highlights the analytical utility of Raman spectroscopy for a non-enzymatic, non-invasive, and minimal-signal-processing sensing platform for lactic detection and spatially resolved analysis, with potential for future integration into in-line monitoring systems in bioreactors.
Natural blue colorants are exceptionally scarce, and achieving stable blue hues from anthocyanins typically requires structural features such as extensive acylation or metal complexation, which limits their broader application. Developing alternative stabilization strategies therefore represents a critical challenge in anthocyanin-based blue pigment research. This study introduces a novel strategy to induce vivid and stable blue coloration of anthocyanins through pH-modulated, non-covalent complexation with protein, and elucidates the underlying mechanisms. Malvidin-3-O-glucoside (M3G) and bovine serum albumin (BSA) were employed as a model system. Complex formation was investigated across different pH values using UV-Vis spectroscopy, isothermal titration calorimetry, competitive binding assay, and computational simulations to characterize blue color development, absorption spectral shifts, proton transfer equilibria of M3G quinoidal bases, binding thermodynamics, and molecular interactions. Both blue color and anthocyanin stability were further evaluated during storage at 5 and 22 ℃ using UV-Vis spectroscopy and HPLC. The BSA-M3G complexes exhibited pronounced bathochromic and hyperchromic shifts in absorption spectra, yielding highly stable blue hues under alkaline conditions. Mechanistic investigations revealed that BSA preferentially binds the negatively charged quinoidal base of M3G, shifting the proton transfer equilibrium toward enhanced formation of bluish dianionic species. The binding was enthalpy-driven and dominated by electrostatic interactions and hydrogen bonding. This pH-dependent interaction conferred remarkable improvements in both color retention and chemical stability, with negligible color loss or anthocyanin degradation after 28 days at pH 9 and 5°C. These findings uncover a protein-mediated mechanism for stabilizing anthocyanin-derived blue hues and establish a broadly applicable framework for developing natural blue colorants suitable for food, cosmetic, and pharmaceutical applications.
Breast abnormalities present complex reconstructive challenges requiring a tailored surgical approach combining both esthetic and reconstructive breast surgery. The purpose of this study was to evaluate the reliability of microsurgical procedures for the correction of breast abnormalities. We conducted a retrospective multicenter study on female patients who underwent microsurgical procedures to correct congenital or acquired breast abnormalities in four plastic surgery units (January 2010-December 2024). The indications, microsurgical technique, and refinement surgeries were analyzed. In 40 patients (median age, 42 years; median BMI, 23.9 kg/m2) 52 microsurgical procedures were performed. Congenital abnormalities included Poland syndrome (N = 9), aplasia/hypoplasia (N = 5), and tuberous breast (N = 4). Acquired abnormalities resulted from non-oncologic breast surgery (N = 7), chronic abscesses formation (N = 6), massive weight loss (N = 1), burns (N = 4), and failed cosmetic surgery (N = 4). Thirty-four patients had previous surgical interventions. Abdominal-based flaps (N = 26) were used more often than alternative flaps (TMG, N = 14). The flap survival rate was 96%. In 23 patients, on an average 2 refinement procedures were performed to optimize the result. This multicenter study highlights the versatility and reliability of microsurgical procedures to correct breast abnormalities. Given the esthetic adaptability and evident advantages of microsurgical breast reconstruction in patients with breast cancer, this surgical approach should be considered as a valuable alternative in patients without cancer, particularly those with implant-associated complications, tissue excess, or younger individuals seeking a natural solution.
We aimed to identify the main factors influencing the achievement of high efficacy or negative outcomes for ethanol ablation (EA) of cystic thyroid nodules. We conducted a retrospective cohort study on consecutive patients treated with EA for cytologically benign and symptomatic CTNs at the Vanvitelli University Hospital in Naples (Italy) over a period of four years. Data was analyzed using multivariable logistic regression and Fisher's exact test. All tests were performed at the significant level of 0.05. We included 118 nodules undergoing EA with one year follow-up [median volume 16.2 (7.0-32.8) mL], with important cervical symptomatology [overall visual analogue scale (VAS) score 26.0 (22.0-30.0) and cosmetic score (CS) 4.0 (3.0-4.0)]. At 12 months follow-up (T12), median VRR was 88.9 (77.2-97.6) %, overall VAS score and CS were 0 (0.0-1.5) and 1.0 (1.0-1.0), respectively. The classical EA was the only predictor of VRR > 75% (OR = 3.27; 95% CI 1.01-10.57; p = 0.048). Monolocular aspect was the only predictor (OR = 5.719; 95% CI 1.664-19.652; p = 0.006) of VAS = 0 and CS = 1. EA for CTNs is usually associated with high efficacy and rarely (one out of ten patients) with negative outcomes at one-year follow-up. The classical EA procedure (when the cystic content can be initially aspirated) and the monolocular aspect thyroid nodules seem to be factors that positively influence the high efficacy of EA, regardless of baseline nodule volume, ultrasound composition, number of EA sessions, and total ethanol amount.
To compare the surgical and functional outcomes of PSARVUP and TUM in a contemporary cohort of patients with cloacal malformations, with particular emphasis on urological results and the influence of individual patient anatomy on these outcomes. A retrospective cohort study of patients with cloacal malformations who underwent definitive repair between 2020 and 2023. Inclusion criteria were confirmed cloacal malformation with prior colostomy and definitive repair by PSARVUP or TUM, whilst cases with complex sacral and spinal anomalies were excluded. Preoperative workup included cystoscopy, pelvic and spinal MRI, renal ultrasound, and voiding cystourethrography. Outcome measures included postoperative complications, ability to void spontaneously, requirements for clean intermittent catheterization (CIC), status of urinary continence, incidence of febrile urinary tract infections (UTIs), and urodynamic findings. A total of 27 patients with confirmed cloacal malformations were included. Of these, 16 patients (59.3%) underwent PSARVUP and 11 patients (40.7%) underwent TUM. Within the PSARVUP cohort, wound dehiscence represented the most frequent complication compared to vaginal stenosis in TUM group. As regards recurrent frequent UTIs, the overall incidence of infection was lower in PSARVUP as compared to TUM. Overall, approximately two-thirds of all evaluated patients demonstrated abnormal findings on urodynamic assessment with neurogenic bladder patterns were the most common. PSARVUP and TUM are effective techniques for repairing long common channel cloaca, each with distinct advantages and limitations. TUM offers an improved cosmetic outcome but can result in long-term urological complications. On the other hand, PSARVUP yields an improved functional outcome despite a more complex operative course and higher rates of vesicourethral fistulas. Longer follow-up and multicenter studies are required to refine surgical planning and optimize outcomes.
The genus Polygonatum comprises medicinal and edible plants with an ethnomedicinal history over 2,000 years. These plants have long been regarded as important tonic herbs in China, Japan, Korea, India, Iran, and the Himalayan region, and are traditionally used for anti-aging, fatigue reduction, and the management of metabolic disorders. This review aims to systematically summarize the botany, traditional applications, phytochemistry, pharmacology, toxicology, and industrial uses of Polygonatum, thereby highlighting their potential for pharmaceutical and functional food development. Information on Polygonatum was retrieved from databases, including the Web of Science Core Collection, PubMed, CNKI, Google Scholar, ScienceDirect, and Springer. Research trends were further analyzed using bibliometric approaches. Polygonatum comprises approximately 107 species. To date, 501 compounds have been identified from Polygonatum, including saponins, polysaccharides, flavonoids, alkaloids, phenylpropanoids, and other constituents, which possess diverse bioactivities, including immunomodulatory, hypoglycemic, and hypolipidemic effects, and have been widely applied in the pharmaceutical, functional food, and cosmetic industries. In addition, Polygonatum genus exhibit low toxicity. However, despite these promising properties, the underlying mechanisms remain insufficiently elucidated, and clinical evidence supporting their therapeutic efficacy is still lacking. Polygonatum species are valuable resources in traditional medicine and show great promise for therapeutic and functional applications. Future research should focus on clarifying the links between chemical constituents and their pharmacological activities, elucidating mechanisms of action, promoting the development of preventive healthcare products, and facilitating clinical translation.
Acne vulgaris is a common inflammatory skin condition that affects up to 85% of adolescents and is primarily driven by Cutibacterium acnes (anaerobic bacteria, formerly Propionibacterium acnes). With the rise of antibiotic resistance, research on alternative antimicrobial agents that can address anaerobic bacteria resistance is becoming increasingly important, especially for patients who cannot use systemic antimicrobial therapy. In this study, a hyaluronic acid (HA)-based hydrogel incorporating ferrous lactate (FeLac) was developed as a non-antibiotic antimicrobial strategy targeting anaerobic pathogens to evaluate the bactericidal effects of FeLac on C. acnes. FeLac-loaded HA hydrogels exhibited excellent mechanical properties, good biocompatibility, superior storage stability, and robust antibacterial activity through sustained Fe2+ release, suggesting their potential as topical antimicrobial formulations. In a rat model of C. acnes-induced acneiform lesions, topical application of FeLac-loaded hydrogel significantly reduced inflammation and promoted lesion resolution through Fe2+ release, with efficacy comparable to conventional topical antibiotics. Mechanistically, FeLac (200 μM) treatment significantly increased intracellular iron levels, induced iron-dependent non-canonical ferroptosis, disrupted key pathways related to translation, biosynthesis, and cell wall integrity, and induced marked morphological alterations, achieving a bactericidal rate exceeding 99.9% after 3 h of treatment. These findings indicate that the FeLac-loaded hyaluronic acid (HA) hydrogel represents a promising non-antibiotic platform for treating acne and anaerobic bacterial infections via an iron-dependent ferroptosis-mediated pathway, demonstrating significant potential in dermatology and the cosmetics industry.
Proximal interphalangeal (PIP) joint dislocations of the lesser toes are uncommon injuries, particularly in the pediatric population. Irreducible dislocations, where closed reduction fails due to interposed soft tissue, present a unique diagnostic and therapeutic challenge. We report a rare case of an irreducible lateral PIP joint dislocation of the fifth toe in a two-year-old child with a six-year follow-up. The child presented with blunt trauma to the right foot resulting from an abduction force to the fourth and fifth toes. Radiographs revealed a lateral dislocation of the right fifth toe PIP joint with an associated valgus angulated fracture of the proximal phalanx. Closed reduction failed in the emergency department. Open reduction under general anesthesia via a dorsal midline incision revealed the medial collateral ligament avulsed and interposed within the joint space, acting as a mechanical block. The ligament was removed, the joint reduced, and transarticular Kirschner wire (K-wire) fixation (1.6 mm) was performed. The K-wire was removed at three weeks. At six-year follow-up, clinical evaluation revealed no angular deformity, shortening, or scar tethering, with full range of motion and participation in age-appropriate activities. This case highlights that prompt open reduction, removal of interposed soft tissue, and temporary K-wire fixation can yield excellent long-term functional and cosmetic outcomes. Early recognition and timely surgery are essential in pediatric irreducible PIP joint dislocations to prevent chronic deformity.
Adolescent idiopathic scoliosis (AIS) affects 0.5%-5% of the adolescent population, representing the most common spinal deformity in this age group. This systematic review and meta-analysis aimed to determine optimal exercise prescription parameters for Schroth training in AIS by examining dose-response relationships between exercise frequency, duration, and clinical outcomes. Systematic searches of PubMed, Scopus, Web of Science, and SPORTDiscus were conducted following PRISMA 2020 guidelines. Randomized controlled trials examining Schroth interventions in adolescents aged 10-18 years with idiopathic scoliosis were included. Network meta-analysis was performed using MetaInsight platform for Cobb angle outcomes, with traditional pairwise meta-analyses conducted for all outcomes using standardized mean differences with 95% confidence intervals. 15 randomized controlled trials encompassing 620 participants were included. The overall meta-analysis demonstrated Schroth exercises produced statistically significant Cobb angle improvements (SMD = -0.52, p < 0.0001; I2 = 0%). Subgroup analysis revealed dose-response relationships favouring moderate exercise frequencies (3-4 sessions/week), which showed the largest pooled effect (SMD = -0.58, I2 = 3%). Duration analysis demonstrated medium duration interventions (46-75 min) provided the most precise improvements (MD = -2.92°), while optimal frequency was the moderate (MD = -2.79°, 95% CI: -4.05, -1.48). Combined subgroup analysis identified moderate frequency plus medium duration as the most robust combination (SMD = -0.65, I2 = 10%). Health-related quality of life outcomes showed non-significant improvements with substantial heterogeneity (SMD = 0.52, p = 0.43; I2 = 93%). Secondary outcomes showed statistically significant improvements in trunk rotation (SMD = -0.86, p = 0.002; I2 = 22%) and cosmetic appearance perception (SMD = -0.73, p = 0.01; I2 = 0%), while postural stability measures showed non-significant effects (SMD = 0.08; p = 0.81; I2 = 68%). Publication bias assessment using Egger's test shows no statistically significant funnel plot asymmetry (p = 0.745). Exploratory subgroup and network meta-analyses suggest that moderate frequency Schroth exercises (3-4 sessions/week) combined with medium duration sessions (46-75 min) may represent optimal parameters for Cobb angle improvement in AIS. Non-linear dose-response patterns show diminishing returns at higher frequencies, challenging conventional exercise prescription assumptions. These findings require validation through prospective studies with pre-specified dose-stratification examining long-term effectiveness, cost-effectiveness, and patient adherence across diverse healthcare contexts before broad clinical implementation.
Protein-based microneedles (MNs) have emerged as a minimally invasive platform for transdermal therapy, enabling precise and localized delivery of bioactive molecules to cutaneous lesions. This review provides a comprehensive overview of protein-based MN systems, including key matrix materials, fabrication strategies, and their therapeutic applications across a wide range of skin diseases. Natural proteins such as gelatin, silk fibroin, zein, and collagen, are widely employed in MN fabrication due to their favorable physicochemical properties, including excellent biocompatibility, biodegradability, and tunable mechanical strength. These materials support mild drug encapsulation and efficient transdermal delivery, while their intrinsic bioactivity-such as pro-regenerative and biointeractive functions-can further enhance therapeutic outcomes through synergistic effects. Recent advances in protein-based MNs have demonstrated significant potential in the treatment of inflammatory skin diseases, wound healing, melanoma, and cosmetic dermatology. However, several challenges remain, including limited long-term stability, batch-to-batch variability, and the high cost of large-scale sterile manufacturing, which hinder clinical translation. In addition, regulatory complexity associated with device-drug combination products presents further barriers to commercialization. Future research is expected to focus on the development of stimuli-responsive and theranostic MN systems, as well as scalable, reproducible, and sustainable manufacturing strategies. Overall, protein-based MNs represent a versatile and promising platform for next-generation dermatological therapies, with strong potential for clinical translation and commercial development.