UNASSIGNED: To explore the early effectiveness and influence on cartilage of local injection of multimodal drug cocktail (MDC) during anterior cruciate ligament reconstruction (ACLR).
UNASSIGNED: Between February 2022 and August 2023, patients undergone arthroscopic ACLR using autologous hamstring tendons were selected as the study subjects. Among them, 90 patients met the selection criteria and were randomly divided into 3 groups ( n=30) according to the different injection drugs after ligament reconstruction. There was no significant difference in baseline data such as gender, age, body mass index, surgical side, disease duration, preoperative thigh circumference, and preoperative levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), IL-1, matrix metalloproteinase 3 (MMP-3), MMP-13, and aggrecan (ACAN) in synovial fluid between groups ( P>0.05). After the ligament reconstruction during operation, corresponding MDC (consisting of ropivacaine, tranexamic acid, and betamethasone in group A, and ropivacaine, betamethasone, and saline in group B) or saline (group C) were injected into the joint and tendon site, respectively. The length of hospital stay, postoperative tramadol injection volume, incidence of complications, degree of knee joint swelling and range of motion, visual analogue scale (VAS) score, International Knee Documentation Committee (IKDC) score, Lyshlom score, and Hospital for Special Surgery (HSS) score were recorded and compared between groups. The T2 * values in different cartilage regions were detected by MRI examination and the levels of TNF-α, IL-6, IL-1, MMP-3, MMP-13, and ACAN in synovial fluid were detected by ELISA method.
UNASSIGNED: The patients in group A, B, and C were followed up (12.53±3.24), (13.14±2.87), and (12.82±3.32) months, respectively. All incisions healed by first intention. Compared with group C, group A and group B had shorter length of hospital stay, less tramadol injection volume, and lower incidence of complications, showing significant differences ( P<0.05); there was no significant difference between group A and group B ( P>0.05). The degree of knee swelling in group A was significantly less than that in group B and group C ( P<0.05), but there was no significant difference between group B and group C ( P>0.05). At 3, 6, 12, 24, and 48 hours after operation, VAS scores of group A and group B were significantly lower than those of group C ( P<0.05); at 72 hours after operation, there was no significant difference among the three groups ( P>0.05). At 3 days, 14 days, and 1 month after operation, the range of motion of knee joint in group A were significantly better than those in group C ( P<0.05), and there was no significant difference between the other groups ( P>0.05). At 1 month after operation, the IKDC score of group A and group B was significantly higher than that of group C ( P<0.05); there was no significant difference among the three groups at other time points ( P>0.05). There was no significant difference in Lyshlom score and HSS score among the three groups at each time point ( P>0.05). At 14 days after operation, the levels of IL-1 and IL-6 in the synovial fluid in groups A and B were significantly lower than those in group C ( P<0.05). There was no significant difference in the levels of TNF-α, MMP-3, MMP-13, and ACAN between groups A and B ( P>0.05). At 1 month after operation, there was no significant difference in the above indicators among the three groups ( P>0.05). At 3, 6, and 12 months after operation, there was no significant difference in the T2 * values of different cartilage regions among the three groups ( P>0.05).
UNASSIGNED: Injecting MDC (ropivacaine, tranexamic acid, betamethasone) into the joint and tendon site during ACLR can achieve good early effectiveness without significant impact on cartilage.
UNASSIGNED: 探讨前交叉韧带重建术（anterior cruciate ligament reconstruction，ACLR）中局部注射多模式混合药物（multimodal drug cocktail，MDC）的早期疗效及对软骨的影响。.
UNASSIGNED: 以2022年2月—2023年8月拟采用自体腘绳肌腱行关节镜下ACLR患者作为研究对象，其中90例符合选择标准纳入研究，根据韧带重建后注射药物不同随机分为3组（ n=30）。3组患者性别、年龄、身体质量指数、手术侧别、病程以及术前大腿周径及关节液中TNF-α、IL-6、IL-1、基质金属蛋白酶3（matrix metalloproteinase 3，MMP-3）、MMP-13、聚集蛋白聚糖（aggrecan，ACAN）含量等基线资料比较，差异均无统计学意义（ P>0.05）。术中韧带重建后，分别于关节内和取腱处注射对应MDC（A组由罗哌卡因、氨甲环酸、倍他米松组成，B组由罗哌卡因、倍他米松、生理盐水组成）或生理盐水（C组）。比较3组患者住院时间、术后曲马多注射量及并发症发生情况，膝关节肿胀程度及活动度、疼痛视觉模拟评分（VAS）、国际膝关节文献委员会（IKDC）评分、Lyshlom评分以及美国特种外科医院（HSS）评分；MRI检查不同软骨区域T2 *值；ELISA法检测关节液中TNF-α、IL-6、IL-1、MMP-3、MMP-13、ACAN含量。.
UNASSIGNED: 3组患者均获随访，A、B、C组随访时间分别为（12.53±3.24）、（13.14±2.87）、（12.82±3.32）个月。术后切口均Ⅰ期愈合。A、B组与C组相比，住院时间缩短、曲马多注射量减少、并发症发生率降低，差异均有统计学意义（ P<0.05）；A、B组间差异均无统计学意义（ P>0.05）。术后A组膝关节肿胀程度较B、C组减轻（ P<0.05），B、C组间差异无统计学意义（ P>0.05）。术后3、6、12、24、48 h时，A、B组VAS评分低于C组（ P<0.05）；术后72 h时3组间差异均无统计学意义（ P>0.05）。术后3 d、14 d、1个月，A组膝关节活动度优于C组（ P<0.05），其余组间比较差异无统计学意义（ P<0.05）。术后1个月时，A、B组IKDC评分高于C组（ P<0.05）；其余时间点组间比较差异均无统计学意义（ P>0.05）。各时间点Lyshlom评分及HSS评分组间比较差异均无统计学意义（ P>0.05）。ELISA检测术后14 d A、B组患膝关节液中IL-1和IL-6含量低于C组（ P<0.05），TNF-α、MMP-3、MMP-13、ACAN含量差异均无统计学意义（ P>0.05）；A、B组上述指标差异均无统计学意义（ P>0.05）。术后1个月时，上述各项指标组间比较差异均无统计学意义（ P>0.05）。术后3、6、12个月时，3组间各软骨区域T2 *值比较差异均无统计学意义（ P>0.05）。.
UNASSIGNED: ACLR术中关节内联合取腱处注射MDC（罗哌卡因、氨甲环酸、倍他米松）可获得良好早期疗效，且对软骨无明显影响。.

For many years, sustained-release drug delivery systems (SRDDS) have emerged as a featured topic in the pharmaceutical field. Particularly for chronic diseases, such as osteoarthritis, there is a lot of demand for SRDDS because of the long treatment period and repetitive medication administration. Thus, we developed an injectable PLGA-F127 microsphere (MS) that is capable of the in situ conversion to an implant. The microprecipitation method for PLGA-F127 MS was established, and the physicochemical stability of the products was confirmed. The microspheres were assembled into a single mass in 37 °C aqueous conditions and showed a remarkably delayed drug release profile. First, the release started with no significant initial burst and lagged for 60 days. After that, in the next 40 days, the remaining 75% of the drugs were constantly released until day 105. We expect that our PLGA-F127 MS could be employed to extend the release period of 2 months of medication to 4 months. This could be a valuable solution for developing novel SRDDS for local injections.

The local injection of therapeutic drugs, including cells, oncolytic viruses and nucleic acids, into different organs is an administrative route used to achieve high drug exposure at the site of action. However, after local injection, material backflow and side effect reactions can occur. Hence, this study was carried out to investigate the effect of gelatin on backflow reduction in local injection. Gelatin particles (GPs) and hydrolyzed gelatin (HG) were injected into tissue models, including versatile training tissue (VTT), versatile training tissue tumor-in type (VTT-T), and broiler chicken muscles (BCM), using needle gauges between 23 G and 33 G. The backflow material fluid was collected with filter paper, and the backflow fluid rate was determined. The backflow rate was significantly reduced with 35 μm GPs (p value < .0001) at different concentrations up to 5% and with 75 μm GPs (p value < .01) up to 2% in the tissue models. The reduction in backflow with HG of different molecular weights showed that lower-molecular-weight HG required a higher-concentration dose (5% to 30%) and that higher-molecular-weight HG required a lower-concentration dose (7% to 8%). The backflow rate was significantly reduced with the gelatin-based formulation, in regard to the injection volumes, which varied from 10 μL to 100 μL with VTT or VTT-T and from 10 μL to 200 μL with BCM. The 35 μm GPs were injectable with needles of small gauges, which included 33 G, and the 75 μm GPs and HG were injectable with 27 G needles. The backflow rate was dependent on an optimal viscosity of the gelatin solutions. An optimal concentration of GPs or HG can prevent material backflow in local injection, and further studies with active drugs are necessary to investigate the applicability in tumor and organ injections.

Palmoplantar pustulosis (PPP), a chronic and stubborn skin disease, is mainly confined to the palms or/and soles, making it possible for localized use of therapeutic antibodies. In this real-world prospective cohort study, 8 patients with PPP received palms/soles injections of ixekizumab (0.8 mg in 0.1 ml) every 2 to 8 weeks due to the COVID-19 pandemic. The treatment endpoint was a 75% improvement from baseline in Palmoplantar Pustulosis/Psoriasis Area and Severity Index (PPPASI 75). At week 8, 75%, 50% and 12.5% of 8 patients reached PPPASI 50, PPPASI 75 and PPPASI 90. At week 12, 100%, 75% and 25% of 8 patients reached PPPASI 50, PPPASI 75 and PPPASI 90. This is the first study to evaluate the efficacy and safety of local injection of micro-dose ixekizumab for PPP in real clinical practice. A high proportion of patients rapidly achieved PPPASI 75, and maintained long-term efficacy with satisfactory safety.

The demand for body fat reduction is increasing. However, conventional lipolytic approaches fail to control adipose tissue reduction and cause severe side effects in adjacent nonadipose tissues. A strategy to specifically reduce subcutaneous fat using adipocytolytic polymer nanoparticles in a minimally invasive manner is reported here. The polymer nanoparticles are designed to generate carbon dioxide gas when selectively absorbed by adipocytes. The carbon dioxide gas generated within late endosomes/lysosomes induces adipocytolysis, thereby reducing the number of cells. Localized injection of the adipocytolytic nanoparticles substantially reduces subcutaneous fat in a high-fat diet-induced obese mouse model, without significant changes in hematological or serum biochemical parameters. The adipocytolytic efficacy of the nanoparticles is also evaluated in a porcine model. This strategy addresses the need to develop safe and effective adipocytolytic agents using functional polymer nanoparticles.

Since there are currently no interesting treatment options for men with early-stage Dupuytren\'s disease, new, safe and effective treatment methods are required to improve the quality of life of such patients. Over the past decade, isotonic sugar water injections have received increasing attention from clinicians worldwide. Glucopuncture is a new term to describe isotonic sugar water injections into dermis, fascia, muscles, tendons and ligaments. In this clinical case, a 75-year-old man was treated with glucopuncture for a painless nodule on the right hand. A marked reduction in hardness and size of the nodule was observed after six sessions. Establishing a case series with imaging before and after treatment could be a first step to further illustrate the effects of this novel injection technique. Next, randomized controlled trials (RCTs) with sufficient sample size are needed to establish the value of glucopuncture for painless nodules in Dupuytren\'s disease.

Introduction Plantar fasciitis is a common musculoskeletal problem in Orthopaedic practice. Heel pain caused due to plantar fasciitis, if persistent, can cause distress to the patient, so the correct intervention at the right time is needed. Plantar fasciitis is also common in the rural population. Objectives To compare the efficacy of local injection of platelet-rich plasma (PRP) and corticosteroid (CS) (methylprednisolone) in patients with chronic plantar fasciitis, and to evaluate the safety, side effect and complications of two different modalities of treatment. Materials and methods The study period was between August 2018 and September 2020. After obtaining proper written consent, 110 patients, who were above the age of 18 years and suffering from plantar fasciitis for more than three months, were included in the study. The patient characteristics including gender, age, weight, history of heel pain, duration of symptoms and types of prior treatment were noted. All the 110 patients were subjected to four parameter assessments before administration of the PRP/CS injections. Out of the 110 patients, 55 patients received PRP injection and 55 received CS - 2 ml (40 mg) methylprednisolone with 2 ml of sterile water injections. Post administration of injections, the patients\' clinical, radiological, subjective and functional outcomes were assessed at the first, third and sixth month by using the Visual Analog Scale (VAS), Foot and Ankle Outcome Instrument Core Scale (FAI), Roles and Maudsley Scores (RMS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot scale and ultrasonogram of plantar fascia thickness. Discussion In this study, 110 patients were screened and evaluated. Out of these 110 patients, five patients who received PRP and five who received CS were lost for follow-up. Out of the 110 patients, 59 were females and 41 were males. The majority of the patients were in the BMI range of 18.5 to 24.9, with a mean BMI of 23.6. Comparing the results in both the groups reflected an improvement in the group of patients who received PRP injections. Two patients had post-operative complications (superficial infection) in the PRP injection group, while 10 patients had post-procedure complications (five patients developed superficial infections, three patients developed skin depigmentation, and two patients had atrophy of fat pad) in the corticosteroid injections (CSI) group. Infections subsided in all the patients as observed during subsequent follow-up. Conclusion This study shows that PRP administration is a good method of managing patients suffering from chronic plantar fasciitis, presenting with some discomfort following activity, with more than three months of symptoms and with a VAS score of more than 6 and plantar fascia thickness of 5 mm and failed conservative management. This is evidenced by a comparison of AOFAS, FAI score and thickness of plantar fascia using an ultrasonogram before and after the procedure. This study reflects better treatment outcomes with PRP injection compared to local steroid infiltration. This is the largest series of cases studied compared to other previously available studies in the literature. PRP injections may thus be used as a superior alternative to the already available treatments for chronic heel pain.

BACKGROUND: Steroid therapy is known to be effective against granulomatous mastitis. We aimed to compare the efficacy of local versus systemic steroid administration in patients with idiopathic granulomatous mastitis.
METHODS: This prospective cohort study included 58 patients who had either local (n = 42) or systemic (n = 16) treatment due to granulomatous mastitis between 2015 and 2019. Recurrence rates were determined as per ultrasound and magnetic resonance imaging examinations and the rate of side effects was evaluated as per patient complaints and physical examinations at the end of a 2-year follow-up period.
RESULTS: Median doses of 140 mg and 3810 mg were administered to the local and systemic group, respectively. Six (14.3%) patients in the local treatment group and 13 (81.3%) in the systemic treatment group had steroid-related side effects. The local treatment group had significantly fewer side effects than the systemic treatment group (P < 0.001). The recurrence rates were similar in both groups (P > 0.05).
CONCLUSIONS: Local steroid injection was as effective as systemic steroid therapy. Compared to systemic therapy, local steroid administration can be considered as a new therapeutic protocol with a lower dose and side effect rate.

Background: Recently, there was a series of clinical studies focusing on local injection of platelet-rich plasma (PRP) for treatment of patients with carpal tunnel syndrome (CTS). However, the safety and efficacy of PRP in these CTS patients remains controversial. Therefore, we performed a systematic review to compare PRP with other conservative treatments in treatment of CTS patients. Methods: We systematically searched from electronic databases (Cochrane, PubMed, Web of Science, and EMBASE) up to 10 December 2021. The data of clinical results were extracted and analyzed by RevMan Manager 5.4. Results: Finally, eight randomized controlled studies, involving 220 CTS patients undergoing local injection of PRP were enrolled in this systematic review. All enrolled trials were considered to be of high quality. In the short-term efficacy, the PRP group was significantly lower in symptom severity scale (SSS) compared with the control group (MD = -2.00; 95% CI, -3.15 to -0.85; p = 0.0007; I2 = 0%). In the mid-term efficacy, the PRP group was significantly effective than the control group in the visual analogue scale (MD = -0.63; 95% CI, -1.22 to -0.04; p = 0.04; I2 = 61%), SSS (MD = -3.56; 95% CI, -4.93 to -2.18; p < 0.00001; I2 = 0%), functional status scale (MD = -2.29; 95% CI, -3.03 to -1.56; p < 0.00001; I2 = 45%), sensory peak latency (MD = -0.39; 95% CI, -0.58 to -0.19; p = 0.0001; I2 = 0%) and cross-sectional area of median nerve (MD = -0.20; 95% CI, -0.31 to -0.10; p = 0.0002; I2 = 0%). In the mid-long-term efficacy, the PRP group was only significantly lower in SSS compared with the control group (MD = -2.71; 95% CI, -4.33 to -1.10; p = 0.001; I2 = 38%). Conclusion: Local PRP injection is more effective than other conservative treatments in terms of mid-term efficacy in relieving pain, improving wrist function and symptoms, reducing MN swelling, and partially improving electrophysiological indicators. However, the long-term adverse side and consensus on standardization of PRP in CTS patients still need further large-scale trials.

Traditional drug solutions or suspensions, have been shown to treat pain in complete Freund\'s adjuvant (CFA)-induced chronic inflammatory pain in rats, with or without combination with magnetic therapy. In this study, we aimed to prepare, characterize, and evaluate the therapeutic effects of microparticles containing dexamethasone for local administration and treatment of chronic inflammatory pain. The results showed the following; a) Preparation and characterization: two ratios of poly(lactic-co-glycolic acid) (PLGA)/poly(lactic acid) (PLA) were used. The prepared batches were similar in size and magnetic responsiveness. The microparticle size distribution assessed via electron microscopy suggested a homogeneous distribution and absence of aggregates. Dexamethasone release profiles (microparticles synthesized with a feed ratio of 1:4) showed a sustained release in vitro and good biocompatibility with tissues. b) Therapeutic effect: the treatment effect of dexamethasone-PLGA magnetic microspheres + magnetic therapy was substantially better than that observed for other groups on day 4, as monitored by appearance, mechanical pain threshold, and histological analysis. This type of carrier could be a suitable magnetically retainable local drug delivery system for treating chronic pain.