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Ischemia-induced adhesion is very common after surgery, and leads to severe abdominal adhesions. Unfortunately, many existing barrier agents used for adhesion prevention have only limited success. The objective of this study is to evaluate the efficacy of biodegradable and thermosensitive poly(ε-caprolactone)-poly(ethylene glycol)-poly(ε-caprolactone) (PCL-PEG-PCL) micelles for the prevention of postoperative ischemia-induced adhesion. We found that the synthesized PCL-PEG-PCL copolymer could self-assemble in an aqueous solution to form micelles with a mean size of 40.1 ± 2.7 nm at 10°C, and the self-assembled micelles could instantly turn into a nonflowing gel at body temperature. In vitro cytotoxicity tests suggested that the copolymer showed little toxicity on NIH-3T3 cells even at amounts up to 1,000 μg/mL. In the in vivo test, the postsurgical ischemic-induced peritoneal adhesion model was established and then treated with the biodegradable and thermosensitive micelles. In the control group (n=12), all animals developed adhesions (mean score, 3.58 ± 0.51), whereas three rats in the micelles-treated group (n=12) did not develop any adhesions (mean score, 0.67 ± 0.78; P<0.001, Mann-Whitney U-test). Both hematoxylin and eosin and Masson trichrome staining of the ischemic tissues indicated that the micelles demonstrated excellent therapeutic effects on ischemia-induced adhesion. On Day 7 after micelle treatment, a layer of neo-mesothelial cells emerged on the injured tissues, which confirmed the antiadhesion effect of the micelles. The thermosensitive micelles had no significant side effects in the in vivo experiments. These results suggested that biodegradable and thermosensitive PCL-PEG-PCL micelles could serve as a potential barrier agent to reduce the severity of and even prevent the formation of ischemia-induced adhesions.

Early postoperative small bowel obstruction (ESBO) is a challenging problem. Although it is usually amenable to non-operative management, a significant proportion of patients will require re-operation. Certain causes of ESBO and types of index procedures should prompt consideration for early re-operation. A laparoscopic approach during the index operation, certain barrier agents and closure of mesenteric defects in bariatric surgery may reduce the risk of ESBO. There is no consensus regarding an acceptable length of time for initial non-operative management of ESBO but re-operation beyond two weeks may be associated with increased complications. •Early small bowel obstruction occurs in 1–12% of abdominal operations.•There is no consensus on an acceptable time to wait before re-operation.•Early reoperation should be considered after certain laparoscopic procedures.•Bowel obstruction after Roux-en-Y gastric bypass will usually require reoperation.

Cadmium (Cd)-contaminated soil has been receiving increasing attention worldwide due to the great harm it causes via food-chain enrichment through crops such as wheat. However, there is little research regarding the effects of mannose (MAN) on plants in response to Cd stress. Hence, hydroponic and potted soil experiments were conducted to investigate the mitigation effects of MAN on wheat under Cd stress and the possible mechanism. Compared with Cd treatment alone, foliar spraying of 160 μM MAN significantly reduced the Cd accumulation in shoots and increased the Cd retention in roots. The content of hemicellulose was increased by MAN treatment, and the proportion of Cd retained by hemicellulose in the cell wall of roots was increased. Furthermore, 160 μM MAN significantly reduced the water-extracted and ethanol-extracted Cd in roots, which are easily transported to shoots. In potted soil experiments using Cd-contaminated soil, MAN reduced the Cd content in wheat grain by 26.3%, compared with the control. These findings indicate that foliar spraying of 160 μM MAN resulted in less Cd being transported from roots to shoots by increasing the Cd retention in the cell wall and changing the Cd chemical forms in roots, which promoted wheat growth and reduced the Cd concentration in wheat grain.

Different foliar barrier agents (FBA) were used by foliar spraying in first season field and pot experiments to compare their effects on Cadmium (Cd) reduction in wheat grains. The best two FBA (50 µM SNP and 2 mM Na2EDTA) can significantly reduce Cd concentration in wheat grains, and the filling period was the most effective period for FBA application. Compared with the control (H2O), foliar spraying 50 µM SNP or 2 mM Na2EDTA inhibited the moving of Cd from the lower tissue to upper tissue in stem and also significantly reduced the Cd accumulation in grains. Furthermore, compared with normal wheat variety (AK58), foliar spraying 50 µmol SNP or 2 mM Na2EDTA as the best two FBA significantly reduced Cd concentration in shoots of Cd low accumulation varieties (HZB and HJBY), which can be used for the safe production of wheat in Cd-contaminated farmlands.

In this study, a stimuli-responsive cotton fabric with controlled antimicrobial properties was prepared using temperature- and pH-responsive microgels based on poly(N-isopropylacrylamide) and chitosan (PNCS microgel) in combination with biological-barrier (bio-barrier) forming polysiloxane matrices. For the polysiloxane matrix, (3-aminopropyl)triethoxysilane (APTES) was used in concentrations of 0.5, 2 and 4%. For comparison, 3-(trimethoxysilyl)propyldimethyloctadecyl ammonium chloride (Si-QAC) was included using a concentration of 0.5%. A two-step application process was used, where PNCS microgel was applied to cotton cellulose firstly, followed by the deposition of APTES or Si-QAC secondly. Morphological and chemical changes in the functionalized samples were studied by SEM and FT-IR, and the influence of the polysiloxane matrix structure on functional properties was studied by the determination of the antibacterial activity, moisture content, water vapour transition rate and water uptake. Additionally, for the first time, the cytotoxicity of the samples in the presence of APTES and Si-QAC was assessed. The results show that different structures of the bio-barrier-forming polysiloxane matrices not only have a great influence on functional antimicrobial and responsive properties but also affect the cytotoxicity. Both polysiloxane matrices produced excellent antimicrobial activity, which was also obtained with 0.5% Si-QAC. However, a much higher concentration of APTES (i.e., 4%) was needed for the same antimicrobial effect. Despite its small concentration, the presence of the Si-QAC caused strong cytotoxicity, whereas the other studied samples were non-cytotoxic. The Si-QAC hindered the dual temperature- and pH-responsive properties, but the latter quality was preserved in the presence of APTES. Graphical abstract

Purpose The purpose of this document is to review the non-barrier methods to prevent postoperative adhesion formation in humans. Methods A MEDLINE computer search was performed to identify relevant articles using the keywords “postoperative adhesion prevention” “abdominal” and “humans”. Subsequent searches were performed using the keyword “non-barrier” to further supplement the information obtained. After careful review of the abstracts, 15 articles were selected for inclusion in the manuscript. Results Many methods, drugs and materials have been demonstrated effective for reducing postoperative adhesion in animal models. Among them, four types of drugs have been clinically used in attempts to reduce postoperative adhesions: gonadotropin-releasing hormone agonists, anti-inflammatory drugs, humidified CO 2 and hydroflotation. Many clinical and meta-analyses revealed that hydroflotation materials do not increase adhesion-free outcome. GnRHa pretreatment using a standard clinical dose (3.75 mg monthly) before myomectomy do not decrease adhesion formation. The role of CO 2 on the reduction and/or prevention of postoperative adhesions have been reported only in cardiac surgery. None of them have been adopted for clinical standard therapy, despite positive reports in animals or preclinical applications. Conclusion In contrast to the results from animal studies, there is no substantial evidence that the use of non-barrier materials reduces postoperative abdominal adhesions in humans.

The first edition of this book was the first book devoted to all aspects of moisturizers, a subject given short shrift in dermatologic texts. Completely revised and updated, the second edition presents the most recent research findings and contains highly relevant information for future possibilities to scientifically tailor efficient products for dry skin. With contributions from internationally recognized world-class scientists, this book comprehensively summarizes current knowledge of the field from basic science to clinical practice. The unique combination of detailed information about the skin and moisturizers will enable readers to enhance the well being of patients with dry skin diseases.

There are fewer than normal glucose transporters at the blood-brain barrier (BBB) in Alzheimer’s disease (AD). When reduced expression of transporters aggravates the symptoms of AD, the transporters become a potential target of therapy. The incretin hormone GLP-1 prevents the decline of cerebral metabolic rate for glucose (CMR glc ) in AD, and GLP-1 may serve to raise transporter numbers. We hypothesized that the GLP-1 analog liraglutide would prevent the decline of CMR glc in AD by raising blood-brain glucose transfer, depending on the duration of disease. We randomized 38 patients with AD to treatment with liraglutide (n = 18) or placebo (n = 20) for 6 months, and determined the blood-brain glucose transfer capacity ( T max ) in the two groups and a healthy age matched control group (n = 6). In both AD groups at baseline, T max estimates correlated inversely with the duration of AD, as did the estimates of CMR glc that in turn were positively correlated with cognition. The GLP-1 analog treatment, compared to placebo, highly significantly raised the T max estimates of cerebral cortex from 0.72 to 1.1 umol/g/min, equal to T max estimates in healthy volunteers. The result is consistent with the claim that GLP-1 analog treatment restores glucose transport at the BBB.

This chapter contains sections titled: Healing of Extraction Sockets Factors Influencing the Healing of Extraction Sockets Healing of Extraction Sockets Following Immediate Implant Placement Does the Use of Reconstructive Technologies Alter the Healing Conclusions References

For a blood-borne cancer therapeutic agent to be effective, it must cross the blood vessel wall to reach cancer cells in adequate quantities, and it must overcome the resistance conferred by the local microenvironment around cancer cells. The brain microenvironment can thwart the effectiveness of drugs against primary brain tumours as well as brain metastases. In this Review, we highlight the cellular and molecular components of the blood–brain barrier (BBB), a specialized neurovascular unit evolved to maintain brain homeostasis. Tumours are known to compromise the integrity of the BBB, resulting in a vasculature known as the blood–tumour barrier (BTB), which is highly heterogeneous and characterized by numerous distinct features, including non-uniform permeability and active efflux of molecules. We discuss the challenges posed by the BBB and BTB for drug delivery, how multiple cell types dictate BBB function and the role of the BTB in disease progression and treatment. Finally, we highlight emerging molecular, cellular and physical strategies to improve drug delivery across the BBB and BTB and discuss their impact on improving conventional as well as emerging treatments, such as immune checkpoint inhibitors and engineered T cells. A deeper understanding of the BBB and BTB through the application of single-cell sequencing and imaging techniques, and the development of biomarkers of BBB integrity along with systems biology approaches, should enable new personalized treatment strategies for primary brain malignancies and brain metastases.