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Background Hypertrophic scarring is a disease of abnormal skin fibrosis caused by excessive fibroblast proliferation. Existing drugs have not achieved satisfactory therapeutic effects. Objectives To explore the molecular pathogenesis of hypertrophic scars and screen effective drugs for their treatment. Methods Existing human hypertrophic scar RNA sequencing data were utilized to search for hypertrophic scar-related gene modules and key genes through weighted gene co-expression network analysis (WGCNA). Candidate compounds were screened in a compound library. Potential drugs were screened by molecular docking and verified in human hypertrophic scar fibroblasts and a mouse mechanical force hypertrophic scar model. Results WGCNA showed that hypertrophic scar-associated gene modules influence focal adhesion, the transforming growth factor (TGF)-β signalling pathway and other biologic pathways. Integrin β1 (ITGB1) is the hub protein. Among the candidate compounds obtained by computer virtual screening and molecular docking, crizotinib, sorafenib and SU11274 can inhibit the proliferation and migration of human hypertrophic scar fibroblasts and profibrotic gene expression. Crizotinib had the best effect on hypertrophic scar attenuation in mouse models. At the same time, mouse ITGB1 small interfering RNA can also inhibit mouse scar hyperplasia. Conclusions ITGB1 and TGF-β signalling pathways are important for hypertrophic scar formation. Crizotinib could be a potential treatment drug for hypertrophic scars. [ABSTRACT FROM AUTHOR]

Background: The high recurrence rate after nonsurgical treatment of keloid is a major challenge for clinicians. Although there are many existing treatment options, how to optimize and upgrade the existing options and make a reasonable combination of utilization is our concern. The aim of this study is to provide a comprehensive non‐surgical treatment for keloid—cocktail therapy. Methods: According to the different changes of keloid with treatment, the treatment was divided into four stages, and different treatment schemes were adopted for each stage. The incidence of side effects of keloid at each stage and the effective rate and cure rate 16 months after the end of treatment were analyzed. Results: All patients completed this study on time, and were followed up 16 months after the end of treatment, the treatment effective rate was 100%, and the cure rate was up to 92.8%. Conclusion: Cocktail therapy can achieve a higher cure rate of keloid, and is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Background: Auricular keloids are difficult to treat, and recurrent keloids are more aggressive and more likely to develop aural deformities. Surgical excision, injections, or radiotherapy alone have high recurrence rates. An algorithmic approach of auricular keloid remains to be explored. Aims: To investigate the sequential treatment protocol for the treatment of auricle keloids to maintain auricle morphology and reduce the postoperative recurrence rate. Patients/Methods: A retrospective analysis of 42 patients who attended the scar minimally invasive treatment center of the Hospital of Plastic Surgery, Chinese Academy of Medical Sciences for serial treatment from January 2019 to June 2021. According to the size and involvement of the keloid, the core excision of the scar was excised under the condition of ensuring the priority of the auricular contour, and the scar flap was repaired to reconstruct the auricular appearance, and electron beam treatment was performed within 24 h after the operation, ray energy: 6–7 MeV, dose: Dt18Gy/2f; regular trimethoprim combined with 5‐Fu injection treatment and the application of silicone ear clips for local compression treatment were performed 1 month after the operation. Results: Thirty‐five patients were followed up from 12 to 40 months after surgery, and three of them showed a tendency of recurrence, and early local treatment with trimethoprim and 5‐Fu injection achieved favorable results. Conclusion: A standardized and sequential treatment plan for keloids with different morphology and anatomical locations can achieve remodeling of the auricular morphology and maintain long‐term results. [ABSTRACT FROM AUTHOR]

Background: The nose is located in the middle of the face; therefore, nasal scarring will bring a significant psychological impact on patients. Although there are many treatment methods for depressed scars, these methods have varying degrees of efficacy and all carry certain adverse effects. A better treatment method is urgent to be found. In this study, the effect of micro‐plasma radiofrequency technology combined with subcision to treat nasal depressed scars is evaluated. Methods: 18 Chinese patients with nasal depressed scars participated in this study. All patients received one session of micro‐plasma radiofrequency treatment first. 2 months later, subcision combined with micro‐plasma radiofrequency technology was performed on them at 6‐month intervals, and a total of 2 sessions of combined treatment were performed. Goodman and Baron Scale was used to evaluate nasal scars before treatment and 6 months after the final session. Results: All 18 patients in this study had Grade 4 nasal scars before treatment. 6 months after the end of treatment, 13 patients (72.2%) showed excellent or near total improvement, and 5 patients (27.8%) showed marked improvement. No adverse side effects were observed during treatment. Patient self‐evaluation indicated that all patients were satisfied with the cosmetic outcomes. Conclusions: In this study, we explored a new treatment method for nasal depressed scars. We used micro‐plasma radiofrequency technology combined with subcision to treat nasal depressed scars and obtained relatively satisfactory results with no adverse effects. [ABSTRACT FROM AUTHOR]

80% of the patients underwent 5 maintenance injections, the keloid in the laser treated area showed a white, soft healing state. Treating cysts in keloids with Ultrapulse mode-fractionated carbon dioxide lasers can effectively cure the cysts, thereby inhibiting the growth of keloids and reducing the recurrence rate of keloids. Treatment of sebaceous cysts in keloids: Ultrapulse mode-fractionated carbon dioxide lasers combined with injection of low-concentration triamcinolone acetonide and 5-fluorouracil. [Extracted from the article]

Much existing literature indicates that the efficacy of 5-FU combined with glucocorticoid injection therapy is much higher than that of hormone injection therapy alone, and the recurrence rate is much lower than it. 300 (95.5%) cases were completely cured after one treatment session,10 (3.18%) cases were completely cured after two treatment sessions, and 4 (1.3%) cases were completely cured after three treatment sessions. Keywords: 5-Fluorouracil; acne; keloid; treatment EN 5-Fluorouracil acne keloid treatment 3606 3607 2 08/09/22 20220801 NES 220801 Acknowledgment We are grateful that this work was supported by Key Projects of Medical School Development of Shijingshan District. [Extracted from the article]

Objective: To construct and characterize the TGF-β1, induced epithelial-mesenchymal transition (EMT) model of keloid epithelial cells in vitro, and to investigate the expression of epithelial stem cells related surface markers in keloid epithelial cells during EMT induction., Methods: The epithelial cells from 3 keloid samples of ears were cultured in vitro and induced by transforming growth factor betal (TGF-β1, 1 ng/ml) for 5 days, which was the experimental group, the same cells untreated were considered as the negative control group. The expressions of EMT-associated markers and regulative genes were detected using immunofluorescence staining, real-time PCR and western blot analysis. Then the surface markers of epithelial stem cells were detected using real-time PCR. Statistical significance was determined using Independent-Samples t Test, a p value less than 0. 05 was considered statistically significant., Results: The mRNA expression of transcription factor snail2 and mesenchymal-specific marker vimentin increased significantly in TGF-β1, induced keloid epithelial cells (P < 0. 05), in which snail2 increasing from 0. 91 ± 0. 23 to 1. 69 ± 0. 10, and vimentin from 5. 86 ± 2. 07 to 24. 29 ± 5. 39. Whereas the mRNA expression of epithelial-specific marker E-cadherin decreased from 1. 06 ± 0. 19 to 0. 65 ± 0. 09. The mRNA expression of CD29 and Lgr6, two surface markers of epithelial stem cells, significantly increased after induction of the TGF-β1, (P < 0. 05), from 0. 55 ± 0. 14 and 1. 61 ± 0. 31 to 1. 19 ± 0. 12 and 3. 84 t 0. 62 respectively. In induced cells, the immunofluorescence results showed staining of E- cadherin became faint, but the number of positive staining cells of vimentin increased. Western blot confirmed the protein expression of E-cadherin weakened, and the vimentin and p-Smad3 enhanced (P < 0. 05)., Conclusions: TGF-β1, initiated EMT in keloid epithelial cells by inducing the up-regulation of snail2, and TGF-β1,/Smad3 signaling pathway was involved in EMT. EMT could change the phenotype of epithelial stem cells in keloid.

Objective: To observe the clinical effect of micro-plasma radio frequency treatment of facial post-burn hyperpigmentation., Methods: From June 2012 to August 2013, a total of 25 cases with facial post-burn hyperpigmentation were treated with micro-plasma treatment for 3-5 times. The roller tip was used with setting of 60-90 watts and 3-4 passes were performed in different directions. Treatments were repeated at an interval of 8 weeks., Results: All patients tolerated the pain. After treatment, the facial hyperpigmentation improved. Complete recovery was achieved in 4 cases; significant improvement in 11 cases; moderate in 7 cases and no effect in 3 cases. No hyperpigmentation, depigmentation and scar formation was observed., Conclusion: Micro-plasma radio frequency treatment is an ideal treatment for post-burn hyperpigmentation with lower side effect.

Objective: To investigate the influence of over-expansion on the viability and vascularity of an axial-pattern flap., Methods: Tissue expanders were implanted subcutaneously on the buttock of the mini-pig. After over expansion, an axial-pattern over-expanded skin flap was elevated in the pig of the experimental group. The differences in flap survival, LDF, MDA content and fluorescein stain were observed between the control and the experimental groups. The vascular architecture changes were also recorded using histological and clearing specimen examination., Results: The microcirculation in the distal segment of the axial flap was significantly weakened after over-expansion. There were injury manifestation, change in vessel distribution and reduction of vascular territory in the axial over-expanded flap., Conclusions: Over-expansion could cause chronic injuries to the axial vessel network and damage the blood supply of the axial-pattern flap.

Objective: To investigate the way of revascularization of donator's trachea wrapped in united muscle flap., Methods: Using fiberoptic bronchoscopy, histopathology and microangiography, we evaluated the tracheal mucosal blood flow, the survival rate, the percentage of patency, and the graft viability of autograft tracheas with varying lengths wrapped in one-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap and autograft tracheas with the length of 5 rings without wrapped in muscle flap in 32 dogs., Results: In the tracheal autograft wrapped in the united muscle flap group with a length less than 4 centimeters, the submucosal blood flow of graft could be detected by laser blood flowmetry one week after transplantation, and it reached 60% of the normal, which had no significant difference between the place near the site of anastomosis and the middle part of the graft. Dense vessels could be found to grow from the wrapped muscles into the autografted trachea by microangiography. Histopathological examination demonstrated that the structure of the autograft was the same as what it originally was. the inner surface of the autograft was covered with pseudostratified columnar ciliary epithelia, and no necrotic tracheal cartilages were found. Every autograft could survive over long time. However, at 1 week, most mucous membrane in the middle part of the graft with length over 4 cm was in gray or in pale; hyperemia, edema, and haemorrhage were found near the site of anastomosis. Mucosal blood flow measured by laser blood flowmetry in the middle part of the graft was significantly less than that near the site of anastomosis. Malacia, dissolution or granulation hyperplasia occurred in midportion of the major grafts shortly after transplanatation. As for those autografted trachea without wrapping in muscles flap, mucous membranes turned black one week after the transplantation and all dogs died of graft necrosis later., Conclusion: One-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap can provide blood for the graft and the grafted trachea can survive for a long time.