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Background In the repair of massive tissue defects using expanded large skin flaps, the incidence of complications increases with the size of the expanded area. Currently, stem cell therapy has limitations to solve this problem. We hypothesized that conditioned medium of adipose-derived stem cells (ADSC-CM) collected following mechanical pretreatment can assist skin expansion. Methods Rat aortic endothelial cells and fibroblasts were cultured with ADSC-CM collected under 0%, 10%, 12%, and 15% stretching force. Ten-milliliter cylindrical soft tissue expanders were subcutaneously implanted into the backs of 36 Sprague-Dawley rats. The 0% and 10% stretch groups were injected with ADSC-CM collected under 0% and 10% stretching force, respectively, while the control group was not injected. After 3, 7, 14, and 30 days of expansion, expanded skin tissue was harvested for staining and qPCR analyses. Results Endothelial cells had the best lumen formation and highest migration rate, and fibroblasts secreted the most collagen upon culture with ADSC-CM collected under 10% stretching force. The skin expansion rate was significantly increased in the 10% stretch group. After 7 days of expansion, the number of blood vessels in the expanded area, expression of the angiogenesis-associated proteins vascular endothelial growth factor, basic fibroblast growth factor, and hepatocyte growth factor, and collagen deposition were significantly increased in the 10% stretch group. Conclusions The optimal mechanical force upregulates specific paracrine proteins in ADSCs to increase angiogenesis and collagen secretion, and thereby promote skin regeneration and expansion. This study provides a new auxiliary method to expand large skin flaps.

Background Alar atrophy associated with Parry–Romberg syndrome (PRS) can lead to significant nasal contour deformities. The primary objective of this study was to address nasal alar deformities in PRS patients through the application of a nasolabial transfer flap combined with an auricular cartilage graft after sequential fat grafting. Methods All PRS patients with alar deformities who underwent our reconstructive surgery were included in this case series. Sequential fat grafting was performed on the affected nasolabial area, followed by a nasolabial transfer flap combined with an auricular cartilage graft. Surgical outcome and complications were recorded during postoperative follow-up. Results From September 2021 to November 2023, a total of 14 PRS patients presenting nasal alar defects underwent nasolabial transfer flap combined with an auricular cartilage graft after sequential fat grafting. Complications at 1 month postoperatively included partial flap necrosis (21%), hyperplastic scarring (14%), undercorrection (14%), overcorrection (7%), and pain (7%). The surgery significantly improved the patient's nasal symmetry. FACE-Q questionnaire indicated the overall aesthetic outcome and quality of life were deemed satisfactory for all patients. Conclusions After sequential fat grafting, the nasolabial fold transfer flap with an auricular cartilage graft is effective to address alar deformities associated with PRS. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

To demonstrate glutamine (Gln) promotes acute wound healing by mediating Gln metabolism and macrophage M2 polarization through the Mitogen-Activated Protein Kinase Kinase (MEK)/Extracellular Regulated Protein Kinases (ERK)/Solute Carrier Family 1 Member 5 (SLC1A5) signaling axis.Thirty C57BL/6J mice were used to establish a full-thickness skin defect model and randomly divided into six groups ( n  = 5 per group): Control group, Model group, Gln treatment group (Gln), Gln combined with MEK inhibitor U0126 group (Gln + MEK inhibitor), Gln combined with GLS1 inhibitor group (Gln+GLS1 inhibitor), and Gln combined with SLC1A5 inhibitor group (Gln+SLC1A5 inhibitor). Immunofluorescence (IF) was used to detect the angiogenesis marker CD31, the fibroblast activation marker α-smooth muscle actin (α-SMA), and macrophage polarization markers (CD86 for M1, CD206 for M2). Gln upregulates the expression of SLC1A5 by activating MEK/ERK pathway, thus promoting Gln metabolic reprogramming and accelerating acute wound healing. This subsequently drives M2 macrophage polarization, angiogenesis, and tissue remodeling. Our findings elucidate the critical role of the Gln metabolism-immune regulation axis in wound repair and provide a novel therapeutic target for metabolically targeted wound interventions.

Background Gonococcal antimicrobial resistance is a global problem. Different resistance plasmids have emerged and spread among the isolates of Neisseria gonorrhoeae worldwide and in China. We conducted this study to monitor the plasmid-mediated penicillin and tetracycline resistance among N. gonorrhoeae isolates in Guangzhou from 2002 to 2012. Methods Consecutive isolates of N. gonorrhoeae were collected from outpatients with gonorrhea attending the STD clinic in Guangdong Provincial Centre for Skin Diseases and STIs Control and Prevention. Penicillinase-producing N. gonorrhoeae (PPNG) isolates were analyzed by the paper acidometric method. Plasmid-mediated resistance to tetracycline in N. gonorrhoeae (TRNG) isolates was screened by the agar plate dilution method. Plasmid types were determined for TRNG and PPNG isolates using polymerase chain reaction (PCR). Minimum inhibitory concentrations (MICs) to penicillin and tetracycline were detected by the agar plate dilution. Results Of 1378 consecutive N. gonorrhoeae isolates, 429 PPNG and 639 TRNG isolates were identified. The prevalence of PPNG, TRNG, and PPNG/TRNG increased from 18.3 to 47.1 % ( χ 2  = 31.57, p  < 0.001), from 29.4 to 52.1 % ( χ 2  = 16.28, p  < 0.001) and from 10.0 to 26.2 % ( χ 2  = 10.46, p  < 0.001) between 2002 and 2012, respectively. Genotyping of plasmids among PPNGs showed that the majority (93.7 %) of the isolates were the Asian type plasmids, while the African type plasmid emerged in 2008 and rapidly increased to 14.0 % in 2012 ( χ 2  = 25.03, p  < 0.001). For TRNGs, all 639 isolates carried the Dutch type plasmid. MICs of penicillin G and tetracycline persisted at high levels and the MIC 90s were 32-fold higher than the resistant cutoff point over 11 years. The prevalence rates of penicillin- and tetracycline-resistant N. gonorrhoeae varied from 90.9 to 91.1 % and from 88.3 to 89.3 % during 2002 to 2012, respectively. Conclusions Resistance to penicillin and tetracycline among N. gonorrhoeae isolates remained at high levels in Guangzhou. The Asian type PPNG continued to spread and Dutch type TRNG was still the dominant strain. The African type PPNG has emerged and is spreading rapidly.

Neomycin is known to preferentially bind to A-form nucleic acid structures including triplex DNA, DNA and RNA hybrid, and duplex RNA. Tethering a DNA intercalator moiety to the C5” position of the ring III of neomycin is a practical approach to develop potent binders targeting various nucleic acid secondary structures via a synergistic effect; however, the minimal stacking surface of the intercalating moiety required to exhibit the effect remains unclear. In the present work, we synthesized four nucleobase and neomycin conjugates via click chemistry. All four conjugates stabilized a DNA oligonucleotide triplex in the thermal denaturation experiments monitored by UV. The guanine-neomycin conjugate ( 6b ) showed a better triplex stabilization effect than neomycin. All the conjugates, as well as neomycin, exhibited no thermal stabilization effect on a human telomeric DNA G-quadruplex. These results suggest that the synergistic effect of binding is vastly dependent on the surface area of the stacking moiety of the conjugates. In addition, tethering a nucleobase to the C5” position of neomycin enhanced the cytotoxicity of neomycin toward MCF-7 and HeLa cancer cells but decreased the antibacterial effect of neomycin against several Gram-negative and Gram-positive bacterial species.