AIMSPropranolol may have shown excellent results as a first line therapy in infantile haemangiomas (IHs) at all sites in the body, but this conclusion remains controversial. In an attempt to resolve this issue, we performed a meta-analysis. METHODSA search of the literature using PubMed, MEDLINE, Cochrane Library databases and China National Knowledge Infrastructure (CNKI) was performed to identify studies which estimated the efficacy of propranolol therapy in infants with haemangiomas all sites of the body. The pooled odds ratio (OR) along with the corresponding 95% confidence intervals (CI) were assessed using a fixed effects model. RESULTSThirty-five studies involving 324 infantile haemangioma(IH) patients and 248 controls were retrieved and analyzed. The efficacy of propranolol was greater than other therapies in treating IHs (OR = 9.67, 95% CI 6.62, 14.12, P < 0.001). In a stratified analysis by sites of tumour, propranolol was a more effective therapy when compared with steroids (OR = 9.67, 95% CI 6.61, 14.15, P < 0.001), vincristine (OR = 9.00, 95% CI 2.15, 37.66, P = 0.003) and laser treatment (OR = 9.00, 95% CI 1.42, 57.12, P = 0.020) in treating cutaneous IHs (OR = 24.95, 95% CI 9.48, 65.64, P < 0.001), peri-ocular IHs (OR = 9.39, 95% CI 3.88, 22.71, P < 0.001), infantile airway haemangiomas (OR = 20.91, 95% CI 7.81, 55.96, P < 0.001) and infantile hepatic haemangiomas (OR = 9.89, 95% CI 1.20, 81.54, P = 0.033). CONCLUSIONThe current meta-analysis provided strong evidence for propranolol as a first line therapy for IHs. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Propranolol has shown excellent results in treating infantile hemangiomas of all sites of the body, but this conclusion remains controversial. WHAT THIS STUDY ADDS• This meta-analysis has provided strong evidence that propranolol is better than other treatment modalities for the resolution of infantile hemangiomas of all sites of the body for the first time.

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BackgroundDNA repair gene X-ray repair cross complementing group 1 (XRCC1) plays an important role in the maintenance of the genomic integrity and protection of cells from DNA damage. Sequence variation in XRCC1 gene may alter head and neck cancer (HNC) susceptibility. However, these results are inconclusive. To derive a more precise estimation of the relationship between XRCC1 polymorphism and HNC risk, we undertook a meta-analysis involving 16,344 subjects.MethodsA search of the literature by PubMed, Embase, Web of Science and China National Knowledge Infrastructure was performed to identify studies based on the predetermined inclusion criteria. The odds ratio (OR) with 95% confidence interval (CI) was combined using a random-effects model or a fixed-effects model.ResultsTwenty-nine studies consisting of 6,719 cases and 9,627 controls were identified and analyzed. Overall, no evidence of significant association was observed between XRCC1 Arg194Trp, XRCC1 Arg280His, XRCC1 Arg399Gln genotypes and the risk of HNC in any genetic models. Subgroup analyses according to ethnicity, tumor site, publication year, genotyping method also detected no significant association in any subgroup, except that oral cancer was associated with Arg194Trp variant in recessive model. Furthermore, no significant effect of these polymorphisms interacted with smoking on HNC risk was detected but Arg194Trp homozygous variant.ConclusionIn conclusion, this meta-analysis suggests that the XRCC1 Arg194Trp, Arg280His and Arg399Gln polymorphism may not involve in HNC susceptibility. Further studies about gene-gene and gene-environment interactions in different populations are required.

Background: Several randomized controlled trials comparing platelet-rich plasma to standard wound care for chronic wounds have been published. Previous articles have revealed that the role of platelet-rich plasma in promoting chronic wound healing is uncertain. This quantitative meta-analysis was conducted to evaluate whether superior outcomes can be obtained by using platelet-rich plasma in nonhealing ulcers compared with traditional wound care. Methods: The PubMed, EMBASE, EBSCO (Cumulative Index to Nursing and Allied Health Literature), and Cochrane databases were searched through November of 2018 for randomized controlled trials comparing platelet-rich plasma to standard wound care for chronic wounds. For binary outcome measures, we calculated the risk ratio. The continuous outcomes were expressed as the mean differences. Subgroup analyses were also performed according to the type of chronic ulcer. Results: Overall, 630 adult patients in 15 randomized controlled trials from 2000 to 2018 were included. The number of ulcers healed in the platelet-rich plasma group was higher than in the control group, and the difference was statistically significant (risk ratio, 1.26; 95 percent CI, 1.11 to 1.42; p = 0.0003). During the fourth week of follow-up, the number of ulcers healed in the platelet-rich plasma group was significantly greater than in the control group (risk ratio, 3.50; 95 percent CI, 1.80 to 6.81; p = 0.0002). Conclusions: Platelet-rich plasma is a valuable and safe treatment dressing for chronic nonhealing ulcers; it is simple to prepare and has remarkable effects. Further high-quality prospective studies are necessary to validate these results. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

We have investigated the mapping of several deep inferior epigastric artery perforator (DIEAP) vessels in each patient, the effect of tissue expansion on the variation in the diameter of the DIEAP vessel, and the clinical effect of repair of hand scars by applying a dilated DIEAP flap. From 2000 to 2009, we did some research on this flap using a Doppler probe and computed tomographic (CT) angiography, and found that the inferior epigastric arteries are distributed between 4 cm above the umbilicus and 8 cm below the umbilicus. Most of the vessels are distributed in zones I, II, and III according to the Rand zonal approach. The arteries were rarely found in zone IV, and there was a relatively dense distribution of perforators in the nearby umbilical plane. Most of the biggest perforators were located in the peripheral umbilicus, and the mean (SD) diameter of perforator vessels was increased by 33% (8)% after expansion. The dilated DIEAP flap was used to treat 18 cases of hand scars. After the operation, 16 flaps survived; the two that did not, had slight blood flow defects in the distal portion of the flap, and the overall effects of the treatment were good. After the DIEAP flaps had been expanded for a long time, blood supply and the area of the flap are increased. The flap generated by this method is thin, has good resistance, and a nice appearance, and is therefor a better method for treating wounds of the hand and arm, and claw hand.