Bioactive wound dressings that are capable of regulating the local wound microenvironment have attracted a very large interest in the field of regenerative medicine. Macrophages have many critical roles in normal wound healing, and the dysfunction of macrophages significantly contributes to impaired or non-healing skin wounds. Regulation of macrophage polarization towards an M2 phenotype provides a feasible strategy to enhance chronic wound healing, mainly by promoting the transition of chronic inflammation to the proliferation phase of wound healing, upregulating the level of anti-inflammatory cytokines around the wound area, and stimulating wound angiogenesis and re-epithelialization. Based on this, modulation of macrophage functions by the rational design of bioactive scaffolds has emerged as a promising way to accelerate delayed wound healing. This review outlines current strategies to regulate the response of macrophages using bioactive materials, with an emphasis on extracellular matrix-based scaffolds and nanofibrous composites.

Background: Extensive studies have confirmed the efficacy of taxanes in combination with anthracycline-based chemotherapy on breast cancer. However, few studies have assessed the efficacy of weekly taxane–anthracycline regimens on locally advanced breast cancer. This study was to compare the efficacy and safety of a weekly taxane–anthracycline regimen with those of tri-weekly anthracycline-based regimen in patients with locally advanced breast cancer. Methods: Patients with locally advanced breast cancer were randomized to receive 4–6 cycles of neoadjuvant chemotherapy with tri-weekly 5-fluorouracil–epirubicin–cyclophosphamide (FEC) regimen or weekly paclitaxel–epirubicin (PE) regimen. The primary endpoint was the pathologic complete response (pCR) rate. Other endpoints included the clinical tumor response, breast-conserving surgery rate, and adverse events. Results: Between March 2010 and September 2013, 293 patients were randomized to the FEC (n = 151) and PE (n = 142) arms. The overall clinical response rate was significantly higher in the PE arm than in the FEC arm (76.06% vs. 59.95%, P = 0.001). Consistently, the post-chemotherapy pathologic T and N stages were significantly lower in the PE arm than in the FEC arm (P < 0.001). However, the pCR rate was similar in the two arms (10.61% vs. 12.31%, P = 0.665). Overall, 36 (27.27%) patients in the FEC arm and 6 (35.28%) in the PE arm were qualified for breast-conserving surgery. Most adverse events were comparable in both arms, with more severe neutropenia in the PE arm than in the FEC arm (11.97% vs. 5.96%, P = 0.031). Conclusions: In patients with locally advanced breast cancer, weekly PE was not superior to FEC in terms of pCR. However, weekly PE has a higher response rate and superior down-staging effects. On this account, the PE regimen may be considered an alternative option for locally advanced breast cancer. Long-term follow-up data are needed to confirm the efficacy of this regimen on locally advanced breast cancer. Trial registration Chinese clinical trial registry, ChiCTR-TRC-10001043, September 21, 2014

Purpose: Corticosteroids are recommended as a first-line treatment for idiopathic granulomatous mastitis (IGM), a disease that usually occurs in young women. Corticosteroid phobia is a fear of corticosteroids and one of the main reasons for poor treatment compliance. Despite the increasing recognition of corticosteroid phobia, there has been a lack of studies on this issue in IGM. This study was designed to investigate the prevalence and degree of corticosteroid phobia in IGM patients. Patients and Methods: A cross-sectional survey was conducted among IGM patients who were receiving treatment at West China Hospital between June 2023 and December 2023. A modified version of Topical Corticosteroid Phobia Scale (TOPICOP) was used to assess the prevalence and degree of corticosteroid phobia in patients with IGM. Sources of drug information were also identified. Scores were expressed as mean ± standard deviation. Independent t-test was used to compare the TOPICOP item scores between different categorical variables. Results: A total of 50 IGM patients were included in the present study. The median global TOPICOP score was 61.29 ± 11.71%. About 80% of patients represented with severe phobia, which their global TOPICOP score was above 50.0%. About 50% of participants showed fear of adverse effect of oral corticosteroids. About 89.6% of participants who received corticosteroid treatment showed their well to adhere to the doctor’s advice. IGM patients with systemic symptoms were associated with higher scores in the behavior domain and/or global TOPICOP. Young, low educated, and unemployed individuals were more likely to have corticosteroid phobia (p < 0.05). There was no difference in the scores based on skin redness, abscess formation, ulcer or fistula, initial treatment choice, or monthly household income. Medical professionals were the primary sources of information about corticosteroid. Conclusion: Corticosteroid phobia was highly prevalent among the women with IGM, as well as the high treatment adherence. Women showed a high preference for non-corticosteroid therapies as alternative therapies. Providing more comprehensive and professional knowledge by physicians might be an effective method to attenuate corticosteroid phobia.

Background: Granulomatous mastitis is an infrequent and intricate ailment. Limited knowledge exists regarding how granulomatous mastitis progresses and its impact on disease management. We aim to prospectively capture symptoms in the general population to accurately ascertain the duration of illness and the prevalence of long-lasting symptoms. Methods: This study reports data from 169 prospectively enrolled real-world patients with pathologically confirmed granulomatous mastitis. Patients were enrolled after screening according to the inclusion and exclusion criteria. Patients were followed-up every 2–4 weeks during treatment, then every 3–6 months (Year 1) and 6–12 months (Year 2). Outcomes included symptom resolution, disease course, and relapse. Associations between clinical variables and outcomes were assessed using appropriate statistical models, with significance defined as P<0.05. Results: The median disease course of granulomatous mastitis was 257 days (range, 55–1,500 days), with the majority of disease regression occurring within a span of 6 months subsequent to diagnosis; 72.78% of patients preferred steroids as the initial treatment. The use of steroids was associated with a shorter disease course after adjusting for age, lump size, abscess, and sinus formation (P=0.02). Abscess formation was observed in 58.57% of patients. Notably, abscess formation during disease progression contributed to a prolonged disease course (358.67 vs. 278.24 days, P=0.03). Conclusions: Our findings highlighted the heterogeneity of granulomatous mastitis disease course and emphasized the importance of steroid usage in shortening disease course. Avoiding abscess and sinus formation, early steroid usage during granulomatous mastitis treatment might be beneficial. These evidences provide novel insights and supports the use of steroids in patients with granulomatous mastitis for modulating their immune response. Studies are urgently needed to further elucidate the role of steroid in granulomatous mastitis management.

Background: Oral steroids are recommended as the first-line treatment for idiopathic granulomatous mastitis (IGM), but frequently induce significant side effects. Topical steroid therapy has recently emerged as a potential alternative for IGM, however current evidence regarding the efficacy of topical steroids remains scarce, primarily derived from small case series and retrospective reports. This prospective, observational cohort study evaluated the outcomes of patients with IGM treated with topical steroids. Methods: From January 2022 to October 2024, 76 patients diagnosed with IGM and treated with topical steroid therapy at West China Hospital were prospectively included in the study. Inclusion criteria comprised adult females with histologically confirmed IGM who were treatment-naive. At baseline, we recorded demographic data, clinical manifestations, as well as lesion size and location. Clinical evaluations incorporating both physical examination (PE) and ultrasonographic findings were performed biweekly to assess treatment response. Primary outcomes included symptom resolution, lesion size reduction, recurrence rates, and treatment-related adverse events. Follow-up was conducted at 1, 3, and 6 months, and every 6 months thereafter. Results: The median age at IGM diagnosis was 33.2 years. Clinical presentations included unilateral breast masses in nearly all cases (97.5%), with 75% of lesions measuring 2–5 cm in diameter. Breast pain was reported by 67.1% of patients; 64.3% (45/70) of patients responded to topical steroid therapy, with a complete remission (CR) rate of 32.9%. The median time to CR was 60 days. The presence of a breast abscess was associated with significantly reduced response to the treatment (P=0.009). During a median follow-up of 63 days, only 4 patients (8.9%) experienced recurrence. Adverse effects were limited to local issues (e.g., erythema, skin atrophy) with no systemic side effects reported. Conclusions: Topical steroids represent a feasible alternative to oral steroids for select IGM patients, particularly due to their reduced risk of systemic adverse effects. When a breast abscess develops, other intervention should be undertaken promptly.