Search Results (4)

Facial aging is not a singular phenomenon but a cascade of anatomical and biological transformations unfolding across the skeleton, fat, ligaments, muscles, dermis, and epidermis. Its clinical expression-volume loss, sagging, wrinkling, and surface irregularities-cannot be adequately explained by simplistic metaphors of “filling” or “lifting.” This article is a narrative review synthesizing current anatomical, physiological, and clinical evidence relevant to multimodal facial rejuvenation. Traditional monotherapies, while sometimes effective in isolation, are increasingly inadequate for contemporary patients who demand outcomes that are natural, harmonious, and durable. Modern esthetic practice has therefore shifted toward multimodal approaches that address aging across multiple planes. Hyaluronic acid (HA) fillers provide volumetric scaffolding and hydration; collagen stimulators such as poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) induce neocollagenesis and long-term dermal remodeling; botulinum toxin restores balance to muscular vectors and improves expression dynamics; while energy-based devices (EBDs), including fractional lasers, radiofrequency microneedling, and high-intensity focused ultrasound (HIFU), enhance skin texture, tone, and elasticity. When applied in a sequenced and evidence-based manner, these modalities act synergistically to deliver results unattainable by any single intervention. In addition to established modalities, the field has recently witnessed aggressive promotion of “regenerative” therapies-growth factors, exosomes, platelet-rich plasma (PRP), and platelet-rich fibrin (PRF). While biologically plausible, their efficacy and safety remain uncertain due to the absence of robust, randomized clinical trials and the heterogeneity of current data. This raises a critical question: is aesthetic medicine advancing through science, or being driven by novelty and marketing? This review synthesizes current anatomical and physiological knowledge of aging, evaluates the mechanisms, clinical applications, and safety considerations of major treatment modalities, and proposes practical sequencing strategies. It also emphasizes the ethical imperative that aesthetic medicine, while innovative and fast-evolving, must remain anchored in scientific evidence and patient safety—because aesthetic medicine is, fundamentally, still medicine. Full article

Skin aging arises from extracellular matrix degradation, inflammation, and pigmentation dysregulation, yet most existing rejuvenation strategies target only a subset of these processes. This study investigated the multimodal rejuvenation potential of a dual hyaluronic acid compound (DHC), composed of low- and high-molecular-weight HA integrated within a minimally cross-linked hybrid complex. In vitro assays using dermal fibroblasts, melanoma cells, and macrophages demonstrated that DHC enhanced fibroblast viability, collagen I/III and elastin production, antioxidant enzyme activity, and wound-healing capacity while reducing senescence markers. DHC markedly suppressed melanogenesis by downregulating the gene expression of MITF, TYR, and TRP1, and exerted strong anti-inflammatory activity by decreasing nitric oxide (NO) production and key cytokines, including TNF-α, IL-1β, IL-6, and CCL1. In a UVB-induced photoaging rat model, DHC reduced wrinkle depth, epidermal thickening, and melanin accumulation while improving elasticity, collagen density, hydration, and barrier integrity. Across these outcomes, DHC demonstrated biological effects that were comparable to, and in selected endpoints greater than, those of commonly used biostimulators and HA fillers in preclinical models. Collectively, these laboratory findings suggest that DHC exhibits broad preclinical bioactivity through combined biostimulatory, antioxidant, anti-inflammatory, and pigmentation-modulating effects. Further mechanistic and clinical studies are required to determine its translational relevance. Full article

Background: Diabetic retinopathy (DR), as a complication of diabetes mellitus (DM), remains a significant contributor to preventable vision impairment in the working-age population. Laser photocoagulation is essential in treating DR in conjunction with anti-vascular endothelial growth factor (VEGF) injection, steroids, and vitrectomy. This review summarizes the history of laser photocoagulation and highlights its current role and long-term effectiveness in real-world conditions. Methods: The National Clinical Trial (NCT), PubMed, Google Scholar, and China National Knowledge Infrastructure (CNKI) databases were searched utilizing combined or individual keywords, and a total of 121 articles were reviewed by the authors. Results: Several novel laser photocoagulation technologies, such as patterned scanning laser, subthreshold micropulse laser, navigated laser, multimodal imaging-guided laser, and retina rejuvenation therapy, substantially decrease the adverse effects and improve the accuracy and security of laser therapy. Numerous studies have demonstrated the outstanding clinical efficacy of combination therapies with pharmacologic treatments like anti-VEGF in treating DR and diabetic macular edema (DME). A 20-year follow-up retrospective study in our center preliminarily demonstrated the long-term effectiveness of conventional laser photocoagulation. Conclusions: More clinical trials are required to confirm the clinical effectiveness of novel laser technologies. Better treatment protocols for the combination therapy may be detailed. Anti-VEGF treatment has better effects, especially for DME and in a short period. But in real-world conditions, given the long-term effectiveness and economic advantages of conventional laser treatment, it should be prioritized over anti-VEGF injection in certain situations. Full article

Sequential Monte Carlo (SMC) methods are widely used for non-linear filtering purposes. However, the SMC scope encompasses wider applications such as estimating static model parameters so much that it is becoming a serious alternative to Markov-Chain Monte-Carlo (MCMC) methods. Not only do SMC algorithms draw posterior distributions of static or dynamic parameters but additionally they provide an estimate of the marginal likelihood. The tempered and time (TNT) algorithm, developed in this paper, combines (off-line) tempered SMC inference with on-line SMC inference for drawing realizations from many sequential posterior distributions without experiencing a particle degeneracy problem. Furthermore, it introduces a new MCMC rejuvenation step that is generic, automated and well-suited for multi-modal distributions. As this update relies on the wide heuristic optimization literature, numerous extensions are readily available. The algorithm is notably appropriate for estimating change-point models. As an example, we compare several change-point GARCH models through their marginal log-likelihoods over time. Full article