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Objective@#To compare the clinical efficacy and patient satisfaction of 755 nm semiconductor laser for hair removal during different stages of auricular reconstruction.@*Methods@#From July 2016 to September 2018, 86 patients who had ear reconstruction underwent 755 nm semiconductor laser for auricle hair removal in plastic surgery department of Tongji hospital affiliated to Tongji medical college of Huazhong university of science and technology. There were 39 males and 47 females with an average age 12 years old(from 6 to 28 years old). 28 cases were left ear, 58 cases were right ear. With random grouping, 40 patients underwent auricle hair removal treatment after posterior ear tissue expander implantation (post-operation of stage Ⅰ depilation group) and 46 patients underwent treatment after auricular reconstruction (post-operation of stage Ⅱ depilation group). Auricle hair removal treatments(pulse width 10-20 ms, wave length 755 nm, spot size 10 mm×15 mm, energy density 4-8 J/cm2) were respectively started at different intervention time. Each treatment time were 5-10 minutes. The end of the treatment was slight redness or edema of the local hairy follicle. The treatment was repeated every 4 weeks with a total of 5 times. The number of adverse reactions was recorded as while as the hair density, hair clearance rate and patient satisfaction before treatment and 6 months after the 5th depilation.@*Results@#Patients in both groups successfully were completed the treatment and were followed up to about 6 months (23 to 25 weeks) after the last depilation treatment. There were only 2 cases with scratch in skin preparation and 2 cases with blisters in the postoperative of stage Ⅱ group. None of the other patients had adverse reactions. Hair density after treatment (27.63±7.75 bar/cm2) was less than before treatment (84.55±13.68 bar/cm2) in post-operation of stage Ⅰ depilation group. Hair density after treatment was 40.52±5.92 bar/cm2 in post-operation of stage Ⅱ depilation group, less than before treatment (74.78±11.19 bar/cm2). The differences were statistically significant (both P<0.001). After hair removal, the hair density of post-treatment in the post-operation of stage Ⅰ depilation group was less than the post-operation of stage Ⅱ depilation group. The difference was statistically significant (P=0.000). The hair clearance rate of the post-operation of stage Ⅰ (67.32%) was higher than the post-operation of stage Ⅱ(45.81%). The difference was statistically significant (P<0.001). Patients’ satisfaction was 87.5% in the post-operation of stage Ⅰ and 69.5% in the post-operation of stage Ⅱ. The former was superior to the latter.@*Conclusions@#Auricle hair removal with semiconductor 755 nm laserstarted at stage Ⅰ that posterior ear tissue expander was implanted has more favorable clinical efficacy, and higher patient’s satisfaction rate.
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Objective@#To explore the regulatory mechanism of E2F1 transcription factor on M2 macrophages in full-thickness skin defect wounds of mice.@*Methods@#E2F1 gene knockout heterozygotes C57BL/6 mice and wild-type C57BL/6 mice were introduced and self-reproduced. Two weeks after birth, E2F1 gene knockout homozygotes mice and wild-type mice were identified by polymerase chain reaction (PCR). Twelve identified 6-8 weeks old male E2F1 gene knockout homozygotes C57BL/6 mice and wild-type C57BL/6 mice were selected respectively according to the random number table and set as E2F1 gene knockout group and wild-type group. A full-thickness skin defect wound was made on the back of each mouse. On post injury day (PID) 2 and 7, 6 mice in each group were selected according to the random number table and sacrificed, and the wound tissue was excised. The expression of CD68 and CD206 double positive M2 macrophages was observed by immunofluorescence method, and the percentage of CD206 positive cells was calculated. The protein expression of CD206 was detected by Western blotting. The mRNA expression of arginase 1 was detected by real-time fluorescent quantitative reverse transcription PCR (RT-PCR). Wound tissue specimens of the two groups on PID 7 were obtained, and the protein and mRNA expressions of peroxisome proliferator-activated receptor gamma (PPAR-γ) were detected by Western blotting and real-time fluorescent quantitative RT-PCR respectively. The above-mentioned experiments were repeated four times. Three specimens of wound tissue of mice in wild-type group on PID 7 were obtained to detect the relationship between E2F1 and PPAR-γ by co-immunoprecipitation and Western blotting, and this experiment was repeated two times. Data were processed with unpaired t test.@*Results@#The size of PCR products of E2F1 gene knockout homozygotes C57BL/6 mice and wild-type C57BL/6 mice were 227 and 172 bp respectively, which were the same as those of the designed DNA fragments. On PID 2 and 7, the number of CD68 and CD206 double positive M2 macrophages in the wound tissue of mice in E2F1 gene knockout group was more than that of wild-type group, and the percentages of CD206 positive cells in the wound tissue of mice in E2F1 gene knockout group were (0.234±0.032)% and (0.584±0.023)% respectively, which were significantly higher than (0.129±0.017)% and (0.282±0.071)% of wild-type group (t=3.29, 3.54, P<0.05). On PID 2 and 7, the protein expression of CD206 in the wound tissue of mice in E2F1 gene knockout group were 1.00±0.23 and 1.63±0.26 respectively, which were significantly higher than 0.43±0.06 and 0.97±0.08 of wild-type group (t=2.41, 2.45, P<0.05). On PID 2 and 7, the mRNA expressions of arginase 1 in the wound tissue of mice in E2F1 gene knockout group were 0.482±0.105 and 0.195±0.031 respectively, which were significantly higher than 0.163±0.026 and 0.108±0.017 of wild-type group (t=3.04, 2.86, P<0.05). On PID 7, the protein and mRNA expressions of PPAR-γ in the wound tissue of mice in E2F1 gene knockout group were 0.61±0.12 and 0.51±0.13 respectively, which were significantly higher than 0.20±0.04 and 0.20±0.04 of wild-type group (t=3.36, 2.86, P<0.05). On PID 7, detection of the wound tissue of mice in wild-type group showed that PPAR-γ had unidirectional effect on E2F1.@*Conclusions@#E2F1 transcription factor affects the polarization of M2 macrophages by inhibiting the expression of PPAR-γ, thereby inhibiting the healing process of full-thickness skin defect wounds in mice.
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Objective@#To explore the application of asymmetrical sculpture in the ear reconstruction with autologous cartilage through comparing the difference of the balanced sculpture and asymmetrical sculpture.@*Methods@#We used the method of retrospective survey and classified the patients who had undergone ear reconstruction because of microtia into two groups. Group A included the patients who had undergone operation with the application of balanced sculpture method. Group B included the patients who had undergone operation with the application of unsymmetrical sculpture method. We picked out 35 patients containing 19 patients of group A and 16 patients of group B according to our grouping criteria and exclusion criteria. The number of cases with complications was recorded, such as collapse of framework, exposure of cartilage, necrosis of skin flap and reconstructed ear infection. The clinical outcomes of two methods in refining the delicate structures of the reconstructed ear were evaluated (that is the definition, shape, size, color and projection). The time for sculpture was compared. Then we analysed the results and evaluated the effectiveness, safety and feasibility of asymmetrical sculpture′s application in the ear reconstruction.@*Results@#Group A had 2 cases which suffered skin flap necrosis. One of them had cartilage exposure and then had secondary infection leading to local cartilage necrosis and absorption, but after active treatment and local skin flap transplantation it was cured. Group B had no skin flap necrosis, cartilage extrusion, framework deformation and distortion, framework collapse and necrosis or absorption. Group B had a higher score in definition, shape, size, color and projection, and the difference was significant in definition, shape, color and projection. In our clinical practice, the sculpture time in both group was similarly about 40 minutes after the surgery operator had skillfully mastered both techniques.@*Conclusions@#Both methods are safe and feasible. The method of asymmetrical sculpture does not require additional operative time, and the method of asymmetrical sculpture is a better one compared with the method of balanced sculpture in refining the reconstructed ear.
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Human chorionic gonadotrophin (hCG), a glycohormone widely used in treatment of infertility, is a heterodimer composed of an alpha-and a beta-subunit. The heterodimer could be dissociated during production and storage with an impact on its bioactivity. A CE-SDS method for quantitative analysis of hCG subunit dissociation was established in this study by optimization of a variety of method conditions including sample preparation buffer compositions, incubation temperature, separation voltage, and capillary temperature. This method was validated for good sensitivity, linearity, precision, and accuracy for both α-and β-subunit. CE-SDS also showed much better precision and accuracy than SDS-PAGE. The method was successfully used in both recombinant hCG (r-hCG) produced by cell culture and hCG (u-hCG) derived from urine. The CE-SDS method was used in the study of hCG development and stability. Therefore, it is an useful tool for the quality control of hCG.
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MicroRNAs(miRNAs)are a group of non-coding RNA molecules having modulating function,and as a post transcriptional modulating factor is involved in the modulation of expression of eukaryotic genes. Inflammatory bowel disease(IBD)is a chronic non-specific intestinal inflammatory disease and its etiology has not yet been fully clarified. Recent studies have shown that circulating miRNAs were specifically expressed in patients with IBD. This article reviewed the advances in studies on circulating miRNAs and IBD.
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<p><b>OBJECTIVE</b>To investigate the effect of helix and antihelix skin degloving technique in correction surgery of prominent ears.</p><p><b>METHODS</b>Twenty-three cases of prominent ears were corrected by helix and antihelix skin degloving technique. The clinical results were observed.</p><p><b>RESULTS</b>All the prominent ears were corrected with natural appearance and good symmetry results. The distance from the helix to the skull was decreased obviously (P<0.05). Cranial ear angle, the angle of helix and ear boat were significantly reduced (P<0.05). No complications such as infection, hematoma, skin flap necrosis and deformity recurrence occurred.</p><p><b>CONCLUSIONS</b>The auricle skin degloving technique has advantages of exact suture position, good shape, no obvious cartilage hurt and simple operation procedure.</p>
Subject(s)
Humans , Cosmetic Techniques , Ear Auricle , General Surgery , Hematoma , Necrosis , Postoperative Complications , Plastic Surgery Procedures , Methods , Recurrence , Skin , PathologyABSTRACT
Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being "total tumor free", whilst fit into the unique characteristics of China's own medical system as well as patients' demand. From 2007 to 2013, 143 patients with early stage breast cancer were included in the study, with the average age of 46.1 years. Fifty-three patients were subjected to modified breast conserving surgery (MBCS)+latissimus dorsi (LD) flap reconstruction, 41 to skin sparing mastectomy (SSM)+implant+LD flap reconstruction, 29 to MBCS+distal transverse rectus abdominis myocutaneous (DTRAM) flap reconstruction, and 20 to SSM+DTRAM flap reconstruction. The results showed that out of the 143 patients, there was no graft loss. Minor complications included 4 cases of fat liquefaction, and 6 cases of seratoma, which all resolved after conservative treatment. Five patients had visible protuberance in the abdomen, but not leading to any gastrointestinal symptoms. The reconstructed breasts all presented good shape. 96.7% of the patients were satisfied with the outcome. The follow-up period varied from 6 months to 60 months, and only one patient died from tumor metastasis in the brain. No local recurrence occurred. It was concluded that these two modified pedicled-flap surgeries are readily practical, and aesthetically satisfactory, with high applicability in China. They do not compromise the oncological outcomes, but also are well-accepted by Chinese patients.
Subject(s)
Adult , Female , Humans , Middle Aged , Breast Neoplasms , Pathology , General Surgery , China , Follow-Up Studies , Mastectomy, Segmental , Methods , Neoplasm Staging , Postoperative Complications , PathologyABSTRACT
Conventional pedicled-flap based surgeries in treating breast cancer have their limitations. New surgical regimens are yet to be explored, which will follow the oncological principle of being "total tumor free", whilst fit into the unique characteristics of China's own medical system as well as patients' demand. From 2007 to 2013, 143 patients with early stage breast cancer were included in the study, with the average age of 46.1 years. Fifty-three patients were subjected to modified breast conserving surgery (MBCS)+latissimus dorsi (LD) flap reconstruction, 41 to skin sparing mastectomy (SSM)+implant+LD flap reconstruction, 29 to MBCS+distal transverse rectus abdominis myocutaneous (DTRAM) flap reconstruction, and 20 to SSM+DTRAM flap reconstruction. The results showed that out of the 143 patients, there was no graft loss. Minor complications included 4 cases of fat liquefaction, and 6 cases of seratoma, which all resolved after conservative treatment. Five patients had visible protuberance in the abdomen, but not leading to any gastrointestinal symptoms. The reconstructed breasts all presented good shape. 96.7% of the patients were satisfied with the outcome. The follow-up period varied from 6 months to 60 months, and only one patient died from tumor metastasis in the brain. No local recurrence occurred. It was concluded that these two modified pedicled-flap surgeries are readily practical, and aesthetically satisfactory, with high applicability in China. They do not compromise the oncological outcomes, but also are well-accepted by Chinese patients.
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Objective To explore ear reconstruction using autologous rib cartilage ear framework by multi-layer spliced sculpture in microtia patients.Methods From Feb 2010 to May 2011,29 microtia patients were subjected to ear reconstruction using autologous rib cartilage ear framwork by four-layer spliced sculpture.Results In one operation 29 patients achieved 2 cm transverse height of reconstructed ears which were basically coincidence with the normal side.Patents and their families were all satisfied with the results.Follow-up of 3-12 months showed that only 1 case reconstructed-ear height was significantly lower transverse process.Owing to sleeping position,the patient did not protect the reconstructed ear,leading to frequent reconstructed-ear pressure.Conclusions The method of multi-layer spliced sculpture autologous rib cartilage ear reconstruction has good clinical effect.It can make reconstructed ear reach nomal transverse height and avoid the third rib cartilage transplant operation to continue increasing the transvers height.
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Objective To study a new method of correcting flaring ear. Methods Auricular cartilage was slited from posterior auricula. On Gibson's principle of cartilage distortion antero-lateral cartilage membrane was scarified in order of the involute interpolation of anthelix and cartilage membrance was ground. Then the cartilage outside the slited line was put behind the cartilage inside the slited line. Finally,cartilage was operated with Mustarde's mattres suture. Results 12 patients with flaring ear ( 14 ears) were corrected with this operating method and appearance of corrected ears were very good after operation. Following up for 6-18 months, no one recurred. Conclusion Otoplasty of slited cartilage is an effective method of correcting flaring ear.
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Objective To investigate the effect of IGF-1 on the TGF-β3 induced chondrogenesis of MSCs encapsulated in alginate beads and its application in cartilage tissue engineering.Methods MSC chondrogenesis in alginate beads was induced by TGF-β3 and/or IGF-1.Collagen type Ⅱ,aggrecan and Sox-9 expression was evaluated by immunostaining,RT-PCR and Western blot,respectively.Scanning electron microscope and laser confocal microscope were used to observe the differentiated chondrocytes when cultured on the chitosan-based scaffold.Results TGF-β3 with IGF-1 induced MSCs in alginate beads to express the higher level of collagen type Ⅱ,aggrecan and Sox-9 than any other growth factor alone (P＜0.05).The correlation coefficient between Sox9 and collagen type Ⅱ or aggrecan was 0.95 and 0.91,respectively.The chitosan-based scaffold supported the cell's adhesion,migration and proliferation.Conlusion IGF-1 enhances the TGF-β3-induced MSC chondrogenesis via upregulating Sox9 expression.The chitosan-based scaffold is biocompatible with the differentiated chondrocytes.
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Objective To make an inquiry into how to reconstruct a lifelike ear, and which is one of the most thorny problem in plastic surgery. Methods The operation was divided into two stages: the first stage was that an expander was put into a patient's opisthotic subscutaneous region and lobe of the ear was transposed or laid aside; the second stage was that the expander was taken off by a 2.5～3.0 ㎝ incision at the top or bottom of the expanded flap. The reniform incision except the preauriclar pedical part which was 0.5～0.6 ㎝ away from the expander edge was slit until the deep fascia and dissected forword at the same layer in order to form a "bag-shape" flap. Then, an auricle model was put and fixed and aspirating tube was inserted in the "bag". The back of the reconstructive ear was repaired with the full thickness graft. Results It made operating procedure simple, negative pressure plasty looked good, the blood circuit of flap was increased and occurrence rate of complication reduced. The operation had been performed on 18 patients with a satisfactory results. Conclusion The success rate of the procedure is higher and the shape of the reconstructed ear is more lifelike than that of the traditional one.
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Objective To explore an effective method in reconstructing of burn scar contracture of the chin and neck in children. Methods The blood in the transverse cervical artery might flow reverse into the suprascapular artery and the posterior intercostals perforators through anastomic branches. An axial skin flap in the cervico-scapulo-dorsal area could be adequately supplied by this artery, and we had therefore used this flap to repair burn scar in the neck. Results 30 cases obtained satisfactory clinical results with this flap. The follow-up for two years in 18 patients showed that the neck of the patients moved about freely, and the develpment of the chin was not influenced, and the color of flaps was fine. Conclusion The blood supply of the flap is reliable and stable. So it is a very useful method in reconstructing the burn scar of the chin-neck in children.