Cutis Laxa and the Value of Rhytidectomy: 4 Patients and Years of Follow-Up.

The modalities of the esthetic treatment of cutis laxa (CL) patients have rarely been discussed. Here, the authors present 4 CL rhytidectomy cases. The surgery method was designed based on the traditional full-incision face-lift technique combined with lamellar superficial musculoaponeurotic system flap elevation and plication. Temporal, buccal, mandibular, and cervical regions were targeted. The shortest follow-up was 30 months, and the longest was 72. The results were assessed by subjective satisfaction and third-party photo evaluation. The subjective satisfaction was graded into worse than preoperation, no improvement, slight improvement, moderate improvement, and obvious improvement. The satisfaction rate was the sum of moderate and obvious improvement. Eighteen uncorrelated professionals participated in the third-party photo evaluation, in which the preoperative and follow-up photos were presented, and frontal, temporal, mid-face (including jowl), and cervical (including mandibular line) regions were evaluated as improved or nonimproved. The outcome of the subjective satisfaction was graded as no improvement (2/12, 16.7%), slight improvement (3/12, 25%), moderate improvement (4/12, 33.3%), and obvious improvement (3/12, 25%). The satisfaction rate was 58.3%, most investigators denied the frontal and temporal region improvement, 60% observed mid-face improvement, and 80% noticed cervical improvement. Most patients and their parents had positive attitudes towards the treatment results; however, the full expectation was not achieved. The cervical region maintained the best improvement after our treatment and the mid-face ranked second. This surgery method conduces to the esthetic requirement of CL patients; however, skin laxity remains a challenge.

Exploring the Impact of Digital Inclusive Finance on Agricultural Carbon Emission Performance in China.

This paper attempts to reveal the impact and mechanisms of digital inclusive finance (DIF) on agricultural carbon emission performance (ACEP). Specifically, based on the provincial panel data in China from 2011 to 2020, a super slacks-based measure (Super SBM) model is applied to measure ACEP. The panel regression model and spatial regression model are used to empirically analyze the impact of DIF on ACEP and its mechanism. The results show that: (1) during the study period, China's ACEP exhibited a continuous growth trend, and began to accelerate after 2017. The high-value agglomeration areas of ACEP shifted from the Huang-Huai-Hai plain and the Pearl River Delta to the coastal regions and the Yellow River basin, the provincial differences displayed an increasing trend from 2011 to 2020. (2) DIF was found to have a significant positive impact on ACEP. The main manifestation is that the development of the coverage breadth and depth of use of DIF helps to improve the ACEP. (3) The positive impact of DIF on ACEP had a significant spatial spillover effect, that is, it had a positive effect on the improvement of ACEP in the surrounding provinces. These empirical results can help policymakers better understand the contribution of DIF to low-carbon agriculture, and provide them with valuable information for the formulation of supportive policies.

Variability in biopsy quality informs translational research applications in hepatocellular carcinoma.

In the era of precision medicine, biopsies are playing an increasingly central role in cancer research and treatment paradigms; however, patient outcomes and analyses of biopsy quality, as well as impact on downstream clinical and research applications, remain underreported. Herein, we report biopsy safety and quality outcomes for percutaneous core biopsies of hepatocellular carcinoma (HCC) performed as part of a prospective clinical trial. Patients with a clinical diagnosis of HCC were enrolled in a prospective cohort study for the genetic, proteomic, and metabolomic profiling of HCC at two academic medical centers from April 2016 to July 2020. Under image guidance, 18G core biopsies were obtained using coaxial technique at the time of locoregional therapy. The primary outcome was biopsy quality, defined as tumor fraction in the core biopsy. 56 HCC lesions from 50 patients underwent 60 biopsy events with a median of 8 core biopsies per procedure (interquartile range, IQR, 7-10). Malignancy was identified in 45/56 (80.4%, 4 without pathology) biopsy events, including HCC (40/56, 71.4%) and cholangiocarcinoma (CCA) or combined HCC-CCA (5/56, 8.9%). Biopsy quality was highly variable with a median of 40% tumor in each biopsy core (IQR 10-75). Only 43/56 (76.8%) and 23/56 (41.1%) samples met quality thresholds for genomic or metabolomic/proteomic profiling, respectively, requiring expansion of the clinical trial. Overall and major complication rates were 5/60 (8.3%) and 3/60 (5.0%), respectively. Despite uniform biopsy protocol, biopsy quality varied widely with up to 59% of samples to be inadequate for intended purpose. This finding has important consequences for clinical trial design and highlights the need for quality control prior to applications in which the presence of benign cell types may substantially alter findings.

Salidroside Induces Apoptosis in Human Gastric Cancer Cells via the Downregulation of ENO1/PKM2/GLUT1 Expression.

Salidroside is reported to have a wide range of pharmacological properties and has been proven to play a key anti-cancer effect. This study investigated the effects of purified salidroside, an ingredient of Rhodiola rosea, on the proliferation of two human gastric cancer cell lines and further investigating its possible molecular mechanisms. We verified that salidroside exerts a dose-dependent inhibitory effect on the proliferation of SGC-7901 and MKN-45 human gastric cancer cells. Moreover, salidroside can induce cell apoptosis, which was accompanied by an increase in nuclear fragmentation. In addition, salidroside inhibited glycolysis, as evidenced by the reduced expression levels of the glycolysis-related enzymes pyruvate kinase isoenzyme M2 (PKM2), enolase 1 (ENO1) and glucose transporter 1 (GLUT1), which could play important roles in the metabolism of gastric cancer cells. Further investigation showed that salidroside exerted potent anti-proliferative effects by inhibiting glycolysis in human gastric cancer cells in vitro. In vivo, xenograft tumors treated with salidroside were significantly smaller than those in the control animals. Therefore, salidroside could be a promising therapeutic prospect in the treatment of gastric cancer.

Analysis of Heavy Metal Pollution in Cultivated Land of Different Quality Grades in Yangtze River Delta of China.

The distribution of heavy metal pollution in cultivated land is closely related to the quality of the cultivated land. In this study, 533 soil samples were collected from cultivated land in the Yangtze River delta region in China for Cd, Pb, and Hg analyses. Spatial statistical analysis was used to study the heavy metal pollution in the cultivated land, and the driving forces of heavy metal distribution in different cultivated land quality subdivisions were analyzed with GeogDetector. The conclusions are as follows: (1) Among the three heavy metals in the study area, the coefficient of variation of Cd is the largest, and that of Pb is the smallest. The proportion of Cd and Hg exceeding the standard value (the standard of level two in GB 15618-2018) is relatively large, both of which are 5%; (2) From the perspective of the spatial distribution of soil heavy metal pollution, only four counties (CX, HN, WY, and LH) were free of heavy metal pollution. Soil heavy metal pollution in AJ, SY, QJ, and DS counties is relatively serious, and the pollution may come from agricultural activities, manufacturing, and prevalent coastal shipping industries in these counties; (3) The heavy metal pollution levels of cultivated land with different quality levels are different. The high-quality cultivated land has no high contamination, while the medium and the general cultivated land both have high contamination. High contamination is related to Cd for medium and general cultivated lands, and to Hg in only general cultivated land; (4) The main driving factors of heavy metal concentration in cultivated soil were GDP, followed by soil organic matter, and pH. These results indicate that the spatial distribution of heavy metal concentration in cultivated soil was affected by the level of economic development, followed by the ecological environment, indicating that human activities had a critical impact on the ecological environment of cultivated land.

Damage to the Blood Brain Barrier Structure and Function from Nano Titanium Dioxide Exposure Involves the Destruction of Key Tight Junction Proteins in the Mouse Brain.

Numerous studies have proven that nano titanium dioxide (nano TiO2) can accumulate in animal brains, where it damages the blood brain barrier (BBB); however, whether this process involves destruction of tight junction proteins in the mouse brain has not been adequately investigated. In this study, mice were exposed to nano TiO2 for 30 consecutive days, and then we used transmission electron microscopy to observe the BBB ultrastructure and the Evans blue assay to evaluate the permeability of the BBB. Our data suggested that nano TiO2 damaged the BBB ultrastructure and increased BBB permeability. Furthermore, we used immunofluorescence and Western blotting to examine the expression of key tight junction proteins, including Occludin, ZO-1, and Claudin-5 in the mouse brain. Our data showed that nano TiO2 reduced Occludin, ZO-1 and Claudin-5 expression. Taken together, nano TiO2-induced damage to the BBB structure and function may involve the destruction of key tight junction proteins.

Nanostructured Titanium Dioxide (TiO2) Reduces Sperm Concentration Involving Disorder of Meiosis and Signal Pathway.

Nano-titanium dioxide (nano-TiO2) has been widely used in food and cosmetic industries, and the medical sector. However, nano-TiO2 is potentially toxic to the reproductive system. Previous research has shown that nano-TiO2 can reduce sperm concentration but do not yet known whether this effect occurs because of dysfunctional meiosis in spermatogenic cells. In the present paper, we demonstrate that Nano-TiO2 can penetrate through the blood-testis barrier of a mouse model and enter the testicular tissue, thus causing damage to the testis and epididymis. This reduced the number of developing sperm; we demonstrated that the mechanism underlying this effect was the inhibition or destruction of meiosis in spermatogenic cells, particularly during meiosis I. We also found that the inhibition of meiosis I caused by nano-TiO2 exposure was related to dysfunctional meiosis and that the abnormal expression of meiosis-related factors. Therefore, our data demonstrate that nano-TiO2 reduces sperm concentration by disrupting meiosis and related signaling pathways.

A novel electrochemical immunosensor for the highly sensitive and selective detection of the depression marker human apolipoprotein A4.

The fabrication of electrochemical biosensors to directly, rapidly and ultrasensitively detect disease markers in urine or blood samples has become a new and competitive challenge in the field of sensor research. In this paper, a novel electrochemical immunosensor with high selectivity and sensitivity for the detection of the depression marker human apolipoprotein A4 (Apo-A4) was successfully constructed using zeolite imidazole ester metal organic skeleton-nitrogen doped graphene composites (ZIF-8@N-Gr). To this end, because of the higher surface area and biocompatibility, ZIF-8 with abundant biomolecular binding sites provided a good microenvironment for effectively immobilizing antigens. ZIF-8@N-Gr presented a flake structure, as the electrode displayed excellent electrical conductivity, which enhanced the electron transfer and significantly amplified the current signal of the immunosensor. More importantly, these immunosensors are capable of assaying human apolipoprotein A4 (Apo-A4) in 100% serum without suffering from any significant biological interference. Under optimized experimental conditions, the sensor was used for the analysis of whole serum samples and presented a wide linear range from 1.47 × 10-10 g/mL to 3.00 × 10-7 g/mL with a low detection limit of 8.33 × 10-11 g/mL (3σ, n = 15). The satisfactory results of human serum sample analysis indicated that the proposed immunosensor had promising potential in the clinical diagnosis of depression.

Development of a sensitive electrochemical immunosensor using polyaniline functionalized graphene quantum dots for detecting a depression marker.

As a new type of conductive material, polyaniline functionalized graphene quantum dots (PAGD), which were prepared by in-situ polymerization had been used to construct a novel electrochemical immunosensor for early screening of depression markers-heat shock protein 70 (HSP70). Profiting from the huge specific surface area, good bioactivity and excellent structure of PAGD, a variety of heat shock protein 70 (HSP70) was firmly loaded on the surface of PAGD for successful construction of basic electrode (HSP70/PAGD/GCE), which was characterized by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), respectively. Due to the HSP70 fixed on the surface of basic electrode and the HSP70 in the samples can competitively combine with the horseradish peroxidase labeled human HSP70 antibody (HRP-Strept-Biotin-Ab). As a result, there is negative correlation between the concentration of HSP70 in samples and the detection signal of the proposed electrochemical immunosensor (HRP-Strept-Biotin-Ab-HSP70/PAGD/GCE) in the test liquid. Under conditions optimized for determining HSP70, wide linearity was obtained in the range of 0.0976-100 ng/mL, with a low detection limit of 0.05 ng/mL at 3σ. Moreover, the proposed electrochemical immunosensors was successfully applied to detect HSP70 in plasma samples, and exhibited good precision, acceptable stability and reproducibility. Therefore, this study provides a novel and convenient method for early clinical screening of depression markers, and also provides a reliable and objective analysis method for the diagnosis of depression at the molecular level.

Molecular mechanism of nanoparticulate TiO2 induction of axonal development inhibition in rat primary cultured hippocampal neurons.

Numerous studies have demonstrated the in vitro and in vivo neurotoxicity of nanoparticulate titanium dioxide (nano-TiO2 ), a mass-produced material for a large number of commercial and industrial applications. The mechanism of nano-TiO2 -induced inhibition of axonal development, however, is still unclear. In our study, primary cultured hippocampal neurons of 24-hour-old fetal Sprague-Dawley rats were exposed to 5, 15, or 30 µg/mL nano-TiO2 for 6, 12, and 24 hours, and the toxic effects of nano-TiO2 exposure on the axons development were detected and its molecular mechanism investigated. Nano-TiO2 accumulated in hippocampal neurons and inhibited the development of axons as nano-TiO2 concentrations increased. Increasing time in culture resulted in decreasing axon length by 32.5%, 36.6%, and 53.8% at 6 hours, by 49.4%, 53.8%, and 69.5% at 12 hours, and by 44.5%, 58.2%, and 63.6% at 24 hours, for 5, 15, and 30 µg/mL nano-TiO2 , respectively. Furthermore, nano-TiO2 downregulated expression of Netrin-1, growth-associated protein-43, and Neuropilin-1, and promoted an increase of semaphorin type 3A and Nogo-A. These studies suggest that nano-TiO2 inhibited axonal development in rat primary cultured hippocampal neurons and this phenomenon is related to changes in the expression of axon growth-related factors.

Improving spatial prediction of health risk assessment for Hg, As, Cu, and Pb in soil based on land-use regression.

Heavy-metal pollution is a significant health and environmental concern in areas of rapid industrialization in China. The accuracy of spatial mapping of pollutant is the main constraint on spatial prediction of health risks. Our study addressed the possibility of improving spatial prediction accuracy of risk assessment. We developed land-use regression (LUR) models for Hg, As, Cu, and Pb based on surface soil sampling, land-use data, and soil properties. The regression results suggested that LUR was more accurate than ordinary kriging method. Spatial prediction accuracy of Hg, As, Cu, and Pb were improved by 15%, 59%, 36%, and 20%, respectively. Then, spatial distribution of health risk was assessed by using distributions of heavy metal and exposure parameters. Chronic risk of children was controlled by distribution of Pb and carcinogenic controlled by As. The result indicated that Pb and As were the main sources of health risk for children in Kunshan. Chronic and carcinogenic risk maps could clearly show where we should pay attention to and control the risk. This study provided a simple approach to draw spatially explicit maps of health risk which were useful for pollution control and public health risk management.

FOXO3a regulates rhinovirus-induced innate immune responses in airway epithelial cells.

Forkhead transcription factor class O (FOXO)3a, which plays a critical role in a wide variety of cellular processes, was also found to regulate cell-type-specific antiviral responses. Airway epithelial cells express FOXO3a and play an important role in clearing rhinovirus (RV) by mounting antiviral type I and type III interferon (IFN) responses. To elucidate the role of FOXO3a in regulating antiviral responses, we generated airway epithelial cell-specific Foxo3a knockout (Scga1b1-Foxo3a-/-) mice and a stable FOXO3a knockout human airway epithelial cell line. Compared to wild-type, Scga1b1-Foxo3a-/- mice show reduced IFN-α, IFN-ß, IFN-λ2/3 in response to challenge with RV or double-stranded (ds)RNA mimic, Poly Inosinic-polycytidylic acid (Poly I:C) indicating defective dsRNA receptor signaling. RV-infected Scga1b1-Foxo3a-/- mice also show viral persistence, enhanced lung inflammation and elevated pro-inflammatory cytokine levels. FOXO3a K/O airway epithelial cells show attenuated IFN responses to RV infection and this was associated with conformational change in mitochondrial antiviral signaling protein (MAVS) but not with a reduction in the expression of dsRNA receptors under unstimulated conditions. Pretreatment with MitoTEMPO, a mitochondrial-specific antioxidant corrects MAVS conformation and restores antiviral IFN responses to subsequent RV infection in FOXO3a K/O cells. Inhibition of oxidative stress also reduces pro-inflammatory cytokine responses to RV in FOXO3a K/O cells. Together, our results indicate that FOXO3a plays a critical role in regulating antiviral responses as well as limiting pro-inflammatory cytokine expression. Based on these results, we conclude that FOXO3a contributes to optimal viral clearance and prevents excessive lung inflammation following RV infection.

Rhinovirus-Induced SIRT-1 via TLR2 Regulates Subsequent Type I and Type III IFN Responses in Airway Epithelial Cells.

IFN responses to viral infection are necessary to establish intrinsic antiviral state, but if unchecked can lead to heightened inflammation. Recently, we showed that TLR2 activation contributes to limitation of rhinovirus (RV)-induced IFN response in the airway epithelial cells. We also demonstrated that compared with normal airway epithelial cells, those from patients with chronic obstructive pulmonary disease (COPD) show higher IFN responses to RV, but the underlying mechanisms are not known. Initially, RV-induced IFN responses depend on dsRNA receptor activation and then are amplified via IFN-stimulated activation of JAK/STAT signaling. In this study, we show that in normal cells, TLR2 limits RV-induced IFN responses by attenuating STAT1 and STAT2 phosphorylation and this was associated with TLR2-dependent SIRT-1 expression. Further, inhibition of SIRT-1 enhanced RV-induced IFN responses, and this was accompanied by increased STAT1/STAT2 phosphorylation, indicating that TLR2 may limit RV-induced IFN responses via SIRT-1. COPD airway epithelial cells showed attenuated IL-8 responses to TLR2 agonist despite expressing TLR2 similar to normal, indicating dysregulation in TLR2 signaling pathway. Unlike normal, COPD cells failed to show RV-induced TLR2-dependent SIRT-1 expression. Pretreatment with quercetin, which increases SIRT-1 expression, normalized RV-induced IFN levels in COPD airway epithelial cells. Inhibition of SIRT-1 in quercetin-pretreated COPD cells abolished the normalizing effects of quercetin on RV-induced IFN expression in these cells, confirming that quercetin exerts its effect via SIRT-1. In summary, we show that TLR2 is required for limiting RV-induced IFNs, and this pathway is dysregulated in COPD airway epithelial cells, leading to exaggerated IFN production.

Porous graphene-black phosphorus nanocomposite modified electrode for detection of leptin.

Leptin is a vital biomarker of non-alcoholic fatty liver (NAFLD), and its evaluation of the concentration level in vivo is of great significance to NAFLD diagnosis. Therefore, it is pressing to develop a method for rapid and sensitive detection of leptin. This paper describes an environmentally friendly and label-free immunosensor based on porous graphene functionalized black phosphorus (PG-BP) composite to detect of leptin. The PG-BP was synthesized via strong coherent coupling between porous graphene (PG) surface plasmons and anisotropic black phosphorus (BP) localized surface plasmons, which made the electrochemical performance of PG and BP synergistic as well as increased the stability and conductive capability of BP material. The PG-BP modified electrodes was further prepared by gold nanoparticles, cysteamine, and glutaraldehyde in turn. Due to the cross-linking effect of glutaraldehyde, anti-leptin can be firmly fixed. These properties of the platform improved the conductive capability of the immunosensor and enhanced the load capacity of the proteins, thereby, the sensitivity of the immunosensor was significantly increased. Under the optimal conditions, the proposed immunosensor exhibited a wide linear range of 0.150-2500 pg/mL with a low detection limit of 0.036 pg/mL. The leptin immunosensor displayed excellent selectivity and anti-interference ability, which could be used for early screening and diagnosis of clinical NALFD.

Rhinovirus-induces progression of lung disease in a mouse model of COPD via IL-33/ST2 signaling axis.

Rhinovirus (RV), which is associated with acute exacerbations, also causes persistent lung inflammation in patients with chronic obstructive pulmonary disease (COPD), but the underlying mechanisms are not well-known. Recently, we demonstrated that RV causes persistent lung inflammation with accumulation of a subset of macrophages (CD11b+/CD11c+), and CD8+ T cells, and progression of emphysema. In the present study, we examined the mechanisms underlying the RV-induced persistent inflammation and progression of emphysema in mice with COPD phenotype. Our results demonstrate that at 14 days post-RV infection, in addition to sustained increase in CCL3, CXCL-10 and IFN-γ expression as previously observed, levels of interleukin-33 (IL-33), a ligand for ST2 receptor, and matrix metalloproteinase (MMP)12 are also elevated in mice with COPD phenotype, but not in normal mice. Further, MMP12 was primarily expressed in CD11b+/CD11c+ macrophages. Neutralization of ST2, reduced the expression of CXCL-10 and IFN-γ and attenuated accumulation of CD11b+/CD11c+ macrophages, neutrophils and CD8+ T cells in COPD mice. Neutralization of IFN-γ, or ST2 attenuated MMP12 expression and prevented progression of emphysema in these mice. Taken together, our results indicate that RV may stimulate expression of CXCL-10 and IFN-γ via activation of ST2/IL-33 signaling axis, which in turn promote accumulation of CD11b+/CD11c+ macrophages and CD8+ T cells. Furthermore, RV-induced IFN-γ stimulates MMP12 expression particularly in CD11b+/CD11c+ macrophages, which may degrade alveolar walls thus leading to progression of emphysema in these mice. In conclusion, our data suggest an important role for ST2/IL-33 signaling axis in RV-induced pathological changes in COPD mice.

Cytotoxicity of two water-soluble polysaccharides from Codonopsis pilosula Nannf. var. modesta (Nannf.) L.T.Shen against human hepatocellular carcinoma HepG2 cells and its mechanism.

Two water-soluble polysaccharides named CPP1a and CPP1c were isolated from C. pilosula Nannf. var. modesta L.T.Shen by hot-water extraction and purified by graded alcohol precipitation and DEAE-52 cellulose column. The structure of CPP1c with higher yield has been characterized while its antitumor activities has not been elucidated. In this study, we firstly analyzed the chemical structure of CPP1a. The results of instrumental analysis combined with chemical analysis showed that CPP1a was composed of →1)- ß­l­Rhap­(4→, →1)- ß­Arap­(5→, →1)- ß­d­GalpA­(4→, →1)- ß­d­Galp­(6→, terminal­ß­d­Glcp in a molar ratio of 1:12:1:10:3 and its relative and absolute molecular weight were 1.01 × 105 Da and 1.03 × 105 Da respectively. Further, the cytotoxicity assay indicated that CPP1a and CPP1c were more sensitive to HepG2 cells than cervical carcinoma Hela cells and gastric carcinoma MKN45 cells. Both of CPP1a and CPP1c could influence cell morphology, inhibit the migration and induce apoptosis by affecting the G2/M phase of HepG2 cells. Preliminary mechanism studies confirmed that CPP1a and CPP1c could induce apoptosis through up-regulating the ratio of Bax/Bcl-2 and activating caspase-3. According to previous research, we might speculate that the reason for the stronger cytotoxicity and pro-apoptotic effect of CPP1c than that of CPP1a can be attributed to its high uronic acid content.

A novel electrochemical immunosensor based on PG for early screening of depression markers-heat shock protein 70.

In this study, a novel electrochemical immunosensor for early screening of depression markers-heat shock protein 70 (HSP70) was successfully developed based on the porous graphene (PG) with huge specific surface area and excellent structure. Benefiting from the strong adsorption and good bioactivity of PG which was initially prepared via a simple pyrolysis process, a variety of heat shock protein70 (HSP70) can be firmly loaded on the PG to construct the basic electrode (HSP70/PG/GCE)，which was characterized by the cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), respectively. Due to the HSP70 fixed on the surface of basic electrode and the HSP70 in the samples can competitively combine with the horseradish peroxidase labeled human HSP 70 antibody (HRP-Strept-Biotin-Ab). As a result, it presented a negative correlation between the concentration of HSP70 in samples and the detection signal of the proposed electrochemical immunosensor (HRP-Strept-Biotin-Ab-HSP70/PG/GCE) in the test liquid. The application of PG with excellent electrical conductivity in construction of immunosensor remarkably improved the sensitivity of the immunosensor for detection of HSP70. The proposed immunosensor demonstrated a wide linear range of 0.0448 ~ 100 ng/mL with a low detection limit of 0.02 ng/mL at 3σ. Moreover, the proposed immunosensor could be applied for the sensitive and efficient detection of HSP70 in real samples with good precision, acceptable stability, reproducibility and satisfactory results. Therefore, the HSP70 immunosensor provides a novel and convenient method for early clinical screening of depression markers-heat shock protein 70.

Evaluation of moderate and severe blepharoptosis correction using the interdigitated part of the frontalis muscle and orbicularis oculi muscle suspension technique: A cohort study of 235 cases.

BACKGROUND: Blepharoptosis is defined as an abnormally low-lying upper eyelid margin in the primary gaze, causing vertical narrowing of the palpebral fissure. It is difficult to achieve consistently satisfactory results in moderate or severe cases despite many surgical methods being available to correct them. METHODS: Between January 2001 and December 2014, a retrospective cohort study was conducted using medical records and perioperative photographs of 235 patients. All the patients, having presented with moderate or severe bilateral or unilateral blepharoptosis, underwent blepharoptosis correction with the interdigitated orbicularis oculi-frontalis muscle flap suspension technique and contemporaneous double-eyelid surgery. The results, including complications, were followed up and evaluated. RESULTS: The mean age of the patients was 17.4 years (range 3-50 years). The follow-up period ranged from 6 months to 8 years, with a mean follow-up of 13 months. Long-term postoperative complications included undercorrection (3.0%), overcorrection (0.7%) and eyelid fold deformity (4.0%). No ectropion, entropion, fornix conjunctival prolapse or exposure keratitis was noted. CONCLUSIONS: Blepharoptosis correction with interdigitated orbicularis oculi-frontalis muscle flap suspension is an effective technique for the management of moderate or severe blepharoptosis. The results demonstrated very low complication rates and substantial cosmetic and functional improvement using simple manipulation.

[Surgical treatment of eyelid divided nevus].

OBJECTIVE: To investigate the surgical techniques and therapeutic effect of eyelid divided nevus. METHODS: From January 2000 to January 2014, 27 cases with 27 eyelid divided nevi were treated by staged excision (2 cases), or full-thickness skin graft (20 cases) or frontal and facial expanded flaps (3 cases), or combined expanded flaps with skin grafts (2 cases) for large lesions. One case with skin graft underwent secondary treatment with expanded flap due to obvious scar. RESULTS: Except for one case with residue lesion (0. 5 cm x 0. 5 cm), all the other cases underwent successful treatment with primary healing. All the patients were followed up for 3-48 months (average, 7. 4 months). Except for one case with secondary expanded flap treatment, all the other patients were satisfied with aesthetic and functional results. No occurrence happened. CONCLUSIONS: Staged excision and full-thickness skin grafts are simple and effective method for eyelid divided nevus. For large lesions, expanded flap, or combined with skin graft should be considered.

[Application of the expanded distant skin flaps for the facial and cervical deformities].

OBJECTIVE: To investigate the application of expanded distant skin flaps for the facial and cervical deformities. METHODS: 96 patients with facial and cervical deformities who underwent reconstructive surgery with expanded distant skin flaps were retrospectively reviewed and followed up. RESULTS: Good results were achieved in 95 cases. Necrosis happened in the distal end of one flap. The patients were followed up for 1-8 years with good cosmetic results, such as well-matched flap texture and color. CONCLUSION: The expanded distant skin flap is suitable and reliable for facial and cervical deformities.