The potential role of stromal cell-derived factor-1α/CXCR4/CXCR7 axis in adipose-derived mesenchymal stem cells.

To investigate the potential role of stromal cell-derived factor-1α (SDF-1α)/CXCR4/CXCR7 axis in adipose-derived mesenchymal stem cells (ADSCs), quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was employed to screen the effective small interfering RNA against CXCR4 and CXCR7 in ADSCs. The messenger RNA (mRNA) and proteins abundances of AKT (p-AKT), ERK (p-ERK), JNK (p-JNK), and p38 (p-p38) in different groups were identified by qRT-PCR, western blot, and immunofluorescence staining method. Meanwhile, cell migration and cell proliferation with SDF-1 treated were examined by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and transwell permeable assay, respectively. Moreover, the interaction between CXCR4 and CXCR7 was examined by a GST pull-down assay. CXCR4 small interfering RNA3 (siRNA3) and CXCR7 siRNA3 have been proved to the most effective tools for knockdown CXCR4 and CXCR7 expressions. mRNA abundance of JNK and p38 could be affected by SDF-1α/CXCR4/CXCR7 axis. However, western blot analysis of p-AKT, p-ERK, p-JNK, and p-p38 in CXCR43-treated ADSCs was significantly higher than that in the control group. Moreover, the immunofluorescence staining analysis revealed that the expressions of p-ATK and p-JNK proteins were significantly higher in NC- and SDF-1-treated subgroups than that in the CXCR4 and CXCR7 groups. p-ATK and p-JNK proteins in CXCR4 group were similar to that in CXCR7 group. Cell migration analysis of CXCR4-treated ADSCs suggested that knockdown CXCR4 could effectively promote cell migration (p < .05). Moreover, CXCR4 could interact with CXCR7. The results in this study could provide a better understanding of SDF-1α/CXCR4/CXCR7 axis during ADSCs development.

Stromal cell-derived factor 1 promoted migration of adipose-derived stem cells to the wounded area in traumatic rats.

BACKGROUND: Adipose-derived stem cells (ADSCs) were effective in treating wound. Stromal cell-derived factor-1 (SDF-1), a chemokine usually called CXCL12, is well known for its chemotaxis in induction of cell migration. However, little is known about the SDF-1responsible for the complex migration of ADSCs from residence to injured sites. OBJECTIVE: Herein, we firstly showed SDF-1 is a major regulator involved in migration of ADSCs during wound repair in vivo. METHODS: Trauma in rats was induced by surgical operation. The levels of SDF-1 in wounded tissue were assayed by ELISA. ADSCs were labeled with Green Fluorescent Protein (GFP), and then were transferred to injured rats by intracarotid injection. The plasma levels of ADSCs during wound healing were detected by flow cytometry, and ADSCs in injured tissue were evaluated by bioluminescence imaging in vivo and laser confocal microscopy (LCM), respectively. RESULTS: ADSCs were successfully labeled with GFP. SDF-1 level reached to the peak value on 24 h after injury and then decreased continuously. Additionally, levels of plasma ADSCs in SDF-1 treated rats reached to the peak value (12%) at d21 after medicine delivery, while those of normal and injured rats showed the peak values of 6.28% and 9.84% at d7 and d21, respectively. Finally, the results of LCM indicated treatment of ectogenic SDF-1 obviously enhanced GFP-ADSCs distribution in wounded tissues. CONCLUSION: Our results indicated that SDF-1 treatment obviously promoted the migration and directed distribution of ADSCs in traumatic tissue.

Analysis of Age-Related Changes in Lower Facial Fat Compartments and of the Course of Blood Vessels Using Computed Tomography.

BACKGROUND: According to the volume restoration theory, lower facial fat compartments tend to selectively atrophy or hypertrophy with age. The aim of this study was to demonstrate age-related changes in lower facial fat compartments using computed tomography, with strict control of the body mass index and underlying diseases. METHODS: This study included 60 adult women in three age-based categories. The thicknesses of the jowl, labiomandibular, and chin fat compartments were measured using computed tomographic images. The distribution and arrangement of facial blood vessels were further analyzed to provide evidence of the safety of rejuvenation strategies based on the facial volumetric theory. RESULTS: The inferior part of the superficial jowl fat compartment and deep jowl fat compartment thickened with age. The deep layer of the labiomandibular fat compartment thinned with age, and the superficial layer thickened with age. The deep and superficial layers of the chin compartments thickened with age. The facial vein passes through the lower mandibular border at the anterior edge of the masseter muscle and moves upward, perpendicular to the lower mandibular border. The high-risk area of the facial artery had an angle of approximately 45 degrees to the lower mandibular border. CONCLUSIONS: This study suggests that with age, selective thickening or thinning occurs in different lower facial fat compartments. The mandible and masseter muscle were used as reference markers to analyze the courses of the facial artery and facial vein, which can help clinicians to reduce vascular injury.

Intraoral curved ostectomy for prominent mandibular angle by grinding, contiguous drilling, and chiseling.

There are several surgical techniques for mandibuloplasty, for example, ostectomy of the lateral cortex around the mandibular angle, angle-splitting ostectomy, sagittal split ramus ostectomy, multistage osteotomy of the mandibular angle. These techniques all have achieved excellent aesthetic results, but they require a high level of skill and are time consuming. From July 1995 to June 2010, a total of 1006 patients underwent intraoral curved ostectomy for prominent mandibular angle by grinding, contiguous drilling, and chiseling in our department. A round bur was used to reduce the outer cortex thickness of the mandible body. The ostectomy line on the mandibular angle was penetrated contiguously using a long-shaft bur drill. A curved-headed chisel approximately 10 mm in width was hammered to separate the redundant mandibular angle. Concurrent procedures such as reduction malarplasty and genioplasty were performed in patients with protrusion of the malar bone and microgenia. A total of 992 patients were satisfied with the final facial contour. The square-shaped appearance was converted to an ovoid, slender, and feminine facial contour from the frontal view. Ninety-three patients underwent postoperative complications. Among the 93 cases, there were 14 patients who were unsatisfied with the final results. The average operative time was 42 minutes for ostectomy of prominent mandibular angle. Intraoral curved ostectomy for prominent mandibular angle by grinding, contiguous drilling, and chiseling is an appropriate technique for correcting lower facial contour. The surgical technique is not complex, and the ostectomy is easy to manipulate. The operation consumes less time. Complications of various degrees are relatively lower, and most of them can be treated effectively. Both surgeons and most of the patients are satisfied with the results.

Surgical softening of the nasolabial folds by liposuction and severing of the cutaneous insertions of the mimetic muscles.

BACKGROUND: A surgical technique was developed to soften the nasolabial folds by liposuction and severing of the cutaneous insertions of the mimetic muscles. This procedure was used for 11 patients from September 2006 to June 2009. METHODS: With the patients under local tumescent anesthesia, extraoral incisions were made in nine cases and intraoral incisions in two cases. Liposuction was performed superior and lateral to the nasolabial fold using an order-made one-hole 2.5-mm cannula. After liposuction, the fibrae septa and the cutaneous insertions of the mimetic muscles in the nasolabial region were severed by a sharp-edge eye scissors. Compressive dressings were maintained for 3 days. RESULTS: All the patients, followed up from 3 months to 3 years, were satisfied with the aesthetic results. Both the depth and the length of the nasolabial folds were decreased conspicuously. The most obvious change was improvement in the lateral part of the nasolabial folds. The extraoral scars were almost imperceptible. Severe complications were not observed in this series. CONCLUSION: Surgical softening of the nasolabial folds by liposuction and severing of the cutaneous insertions of the mimetic muscles is especially suitable for 40- to 60-year-old women with aging faces who are unwilling to undergo a face-lift. The procedure is simple, and the anatomic causes for deepening of the nasolabial folds can be corrected. Patients usually are satisfied with the final postoperative results.

Analysis of age-related changes in midfacial fat compartments in Asian women using computed tomography.

BACKGROUND: Volume restoration is no more a fresh theory for midfacial rejuvenation. However, lack of knowledge regarding the natural ageing process of fat compartments often leads to an insufficient or excessive clinical result. The aim of this study is to reveal the age-related changes in midfacial fat compartments and the correlation between midfacial grooves and the related fat compartments. METHODS: This study included 60 Asian females in defined age-based categories. The thickness of the infraorbital fat compartment, the nasolabial fat compartment, and the cheek fat compartments were measured using computed tomography (CT) images. Analysis of correlations between midfacial grooves and the related fat compartments was performed using the SPSS software. RESULTS: A tendency of thickening in the infraorbital fat and nasolabial fat compartments with age was observed. The superficial layer of cheek fat compartments was found to be thinner, and a similar tendency was observed in the medial part of deep medial cheek fat. However, it was thicker in the lateral part of deep medial cheek fat. There was a negative correlation between the fat thickness of deep medial cheek fat and both the severity of tear trough deformity and the nasolabial fold. A positive correlation between the lower third of the nasolabial fat compartment and the severity of the nasolabial fold was found as well. CONCLUSION: Different midfacial fat compartments tended to undergo selective hypertrophy or atrophy with ageing. The findings of this study suggested that augmentation of the deflated fat compartment and liposuction of the hypertrophic fat compartment can provide a more natural effect in facial rejuvenation.

[Progress of midfacial fat compartments and related clinical applications].

Objective: To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications. Methods: The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed. Results: Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging. As more anatomical researches have done, recent studies have shown that midfacial fat layer is broadly divided into superficial and deep layers, which are both divided into different fat compartments by fascia, ligaments, or muscles. Midfacial fat compartments tend to atrophy with age, specifically in the deep fat compartments while hypertrophy in the superficial fat compartments. Clinical applications show that fat volumetric restoration with deep medial cheek fat and Ristow's space can restore the appearance of midface effectively. Conclusion: In recent years, the researches of midfacial fat compartments have achieved obvious progress, which will provide new ideas and basis for fat volumetric restoration. Corresponding treatments are selected based on different sites and different layers with different aging changes, reshaping a more youthful midface.

[Effect of tranilast on wound healing and administration time on scar hyperplasia of deep partial-thickness burn in mice].

Objective: To investigate the effect of tranilast on wound healing and the mechanism of inhibiting scar hyperplasia in mice, and to study the relationship between the inhibiting ability of tranilast on scar hyperplasia and administration time. Methods: Sixty-six Kunming mice were selected to build deep II degree burn model, and were randomly divided into the control group (18 mice), the early intervention group (18 mice), the medium intervention group (18 mice), and the late intervention group (12 mice). The mice in the early intervention group, the medium-term intervention group, and the late intervention group were given tranilast 200 mg/(kg·d) by gastrogavage at immediate, 7 days, and 14 days after burn respectively, and the mice in the control group were managed with same amount of normal saline every day. The wound healing was observed regularly. At 14, 28, and 42 days in the early and medium intervention groups and at 28 and 42 days in the late intervention group, fresh tissues were taken from 6 mice to observe the shape of mast cells by toluidine blue staining, collagen content by Masson staining; the collagen type I and collagen type III content were measured to calculate the I/III collagen content ratio by immunohistochemistry method, the contents of transforming growth factor ß 1 (TGF-ß 1) and histamine were detected by ELISA; and the ultrastructure of fibroblasts was observed under transmission electron microscope. Results: There was no significant difference in wound healing time between groups ( F=1.105, P=0.371). The mast cells number, collagen content, TGF-ß 1 content, histamine content, and the I/III collagen content ratio in the early intervention group were significantly less than those in the other groups ( P<0.05). Significant difference was found in mast cells number, collagen content, and histamine content between control group and medium or late intervention group at the other time points ( P<0.05) except between control group and late intervention group at 42 days ( P>0.05). Compared with the control group, the activity of fibroblasts in the early intervention group was obviously inhibited, and the arrangement of the fibers was more regular; the fibroblast activity in the medium and late intervention groups was also inhibited obviously. Conclusion: Tranilast has no obvious effect on the wound healing time in mice. Tranilast intervention shows the inhibitory effect on the scar hyperplasia which can significantly reduce the number of mast cells, the content of histamine and TGF-ß 1, inhibit the ability of fibroblasts synthetic collagen and adjust the proportion of collagen synthesis. The immediate tranilast intervention may have the best inhibitory effect on scar hyperplasia.

Determinants of crease width in inherent double eyelid of Asian young women.

BACKGROUND: The creation of a superior palpebral crease has been the most popular plastic surgery procedure in Asians for several decades. The most important criterion for judging the success of this procedure is the achievement of the desired size and shape of this crease or the perfect crease width. However, the determinants of crease width remain unclear, which may account for the high rate of unsatisfactory results. METHODS: Standard images were used to study the anatomic parameters, including crease width, crease height, and upper eyelid movement distance (ULMD) at the midpupillary axis, of the inherent double eyelid crease in 32 Chinese women aged 19-26 years. The thickness of the eyelid tissue at 5, 7.5, 10, and 15 mm from the lid margin was measured in the oblique sagittal direction by magnetic resonance imaging (MRI) at the central axis of the optic nerve. Multiple linear regression was used to analyze the relationship between crease width and crease height, ULMD, and eyelid thickness. RESULTS: Multiple linear regression revealed that crease height, crease thickness, and ULMD were significantly associated with crease width (partial regression coefficients: 0.67, -0.33, and -0.29 respectively). The determination coefficient R2 was 0.667 in the regression model, and the result of analysis of variance (ANOVA) showed that the regression model was significant (F = 16.04, p = 0.000). CONCLUSIONS: In performing upper blepharoplasty, it is important to consider eyelid thickness and movement distance of the upper eyelid margin rather than relying on crease height alone. Attention to these factors will help to achieve the desired size and shape of the crease.

[Effect of botulinum toxin type A injection into the masseter muscle on mandibular development in rats].

OBJECTIVE: To investigate the effect of Botulinum toxin type A (Botox) injection into the masseter muscle on mandibular development in rats. METHODS: 12 28-day-old Wistar rats were divided into two groups as Botox group (n= 6) and control group (n = 6) which received anesthesia only. In Botox group, Botox was injected into the right masseter muscle, while only sterile saline into the left muscle. When the rats were 75-day-old, CT scan and 3D reconstruction were performed for cephalometry. The masseter muscles at both sides were weighed. Histologic study of masseter muscle and mandible was also performed. RESULTS: The weight of right masseter muscle was (0.4575 +/- 0.0940) g in Botox group, and (0.8899 +/- 0.1030) g in control group (< 0.05). The mandibular height II and III was (10.8 +/- 0.8) mm and (9.5 +/- 0.6) mm in Botox group and (12.5 +/- 0.6) mm and (10.7 +/- 0.4) mm in control group, respectively (P < 0.05). The intergonial distance was (11.6 +/- 0.6) mm and (12.4 +/- 0. 6) mm in Botox and control group, respectively (P > 0.05). CONCLUSIONS: When the rats receive Botox injection into the masseter muscle at young age, the grown-up rats have a decreased mandibular height, but the mandibular length and intergonial distance are not affected.

[Modified technique for correction of the orbital hypertelorism].

OBJECTIVE: To explore the possibility of para-orbital soft-tissue expansion, before orbital osteotomy and medial translocation procedures with a combined intracranial-extracranial approach. METHODS: Tissue expansion in the region of the zygomatic and temporal has been undergone for 3 weeks before the traditional intracranial-extracranial approach for orbital osteotomy and medial translocation in two patients. The healing between the orbital bone was studied with measurement of interorbital distance and three-dimensional CT. RESULTS: The inter-orbital distance of the two patients decreased from 4.4 cm and 3.2 cm to 2.0 cm and 1.4 cm. The intercanthal distance decreased from 6.7 cm and 4.8 cm to 5.0 cm and 3.8 cm. CONCLUSIONS: The para-orbital soft-tissue expansion technique may be an effective technique for the stability of the corrected interorbital distance in orbital hypertelorism.

Complications of breast augmentation with injected hydrophilic polyacrylamide gel.

Since 1997, the hydrophilic polyacrylamide gel (PAAG), an injectable alloplastic biomaterial, imported from the Ukraine has been used for augmentation mammaplasty in China. There were twelve patients with various complications visiting our hospitals after breast augmentation with injected hydrophilic polyacrylamide gel by other clinics, even though such procedures are not performed in our clinical practices. The complications included four cases of PAAG-induced multiple induration and lumps, and one with lactation, three cases of hematoma, two cases of inflammation (infection), and persistent mastodymia, unsatisfactory contour results and abnormal skin sensations in each case. All patients have been treated by removing the injected gel and giving antibiotics. Other procedures included replacement by silicon breast prostheses, mammotomy, and segmental mastectomy. We suggest that the injectable hydrophilic polyacrylamide gel be contraindications for breast augmentation in any young female who is not married, or without a child, with a tendency to hemorrhage, and with little mammary tissue. Some considerations to prevent and manage these complications are discussed.