The Application of Cartilage Tissue Engineering with Cell-Laden Hydrogel in Plastic Surgery: A Systematic Review

BACKGROUND@#As a contour-supporting material, the cartilage has a significant application value in plastic surgery.Since the development of hydrogel scaffolds with sufficient biomechanical strength and high biocompatibility, cell-laden hydrogels have been widely studied for application in cartilage bioengineering. This systematic review summarizes the latest research on engineered cartilage constructed using cell-laden hydrogel scaffolds in plastic surgery. @*METHODS@#A systematic review was performed by searching the PubMed and Web of Science databases using selected keywords and Medical Subject Headings search terms. @*RESULTS@#Forty-two studies were identified based on the search criteria. After full-text screening for inclusion and exclusion criteria, 18 studies were included. Data collected from each study included culturing form, seed cell types and sources, concentration of cells and gels, scaffold materials and bio-printing structures, and biomechanical properties of cartilage constructs. These cell-laden hydrogel scaffolds were reported to show some feasibility of cartilage engineering, including better cell proliferation, enhanced deposition of glycosaminoglycans and collagen type II in the extracellular matrix, and better biomechanical properties close to the natural state. @*CONCLUSION@#Cell-laden hydrogels have been widely used in cartilage bioengineering research. Through 3-dimensional (3D) printing, the cell-laden hydrogel can form a bionic contour structure. Extracellular matrix expression was observed in vivo and in vitro, and the elastic modulus was reported to be similar to that of natural cartilage. The future direction of cartilage tissue engineering in plastic surgery involves the use of novel hydrogel materials and more advanced 3D printing technology combined with biochemistry and biomechanical stimulation.

OShnscc: a novel user-friendly online survival analysis tool for head and neck squamous cell carcinoma based on RNA expression profiles and long-term survival information / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.

Clinical efficacy observation on pediatric massage for chronic cough in children / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of pediatric massage (tuina) for chronic cough in children. Methods: A total of 96 cases were randomized into a control group and an observation group, with 48 cases in each group. Cases in the control group received routine pediatric massage manipulations. Cases in the observation group received additional Mo-rubbing abdomen manipulation. The treatment was done 3 times a week and 12 times made up a treatment session. The cough symptom scores were evaluated before treatment and after 3, 6, 9 and 12 treatments respectively. Results: There were 8 dropouts in the observation group and 5 dropouts in the control group. Before treatment, there was no statistical difference in coughing score between the two groups (P>0.05). After 9 times of treatment, the total coughing scores were significantly reduced in both groups (both P<0.05); however, there were no statistical differences between the two groups in the score differences between before treatment and after 3, 6 and 9 times of treatment (all P>0.05). After 12 times of treatment, the total coughing scores were significantly reduced in both groups (both P<0.05), along with a statistical difference between the two groups in the score difference between before treatment and after 12 times of treatment (P<0.05). There was a statistical difference between the two groups in overall response (P<0.05). The total effective rate in the observation group was 92.5％, versus 86.0％ in the control group, showing a statistical difference (P<0.05). Conclusion: The routine pediatric massage manipulations alone or in combination with Mo-rubbing abdomen manipulation both can significantly improve chronic cough in children; however, the combination obtains a better effect.

Morphological and functional evaluation of digital technology combined with endoscope-assisted surgery of crooked nose / 中华医学美学美容杂志

Objective:To explore the clinical effect of digital endoscopic-assisted one-stage rhinoplasty and septoplasty by using subjective and objective methods.Methods:Thirty-two patients with skeletal crooked nose and nasal septum deviated who underwent endoscopic-assisted rhinoplasty and septoplasty were included in this study from January 2015 to January 2020. This study used objective measurements such as 3D digital imaging technology and CT scans, as well as subjective measurements such as Visual Analogue Scale (VAS), Rhinoplasty Outcomes Evaluation (ROE) scale, Nasal Obstruction Symptom Evaluation (NOSE) and Functional Rhinoplasty Outcome Inventory (FROI-17) to evaluate the crooked nose morphology and nasal respiratory function before and after surgery.Results:Compared with preoperatively, postoperative 3D facial imaging results showed that the deviation distance and deviation angle of the crooked nose were significantly improved (both P<0.05), and the long-term effect of the operation was stable. Subjectively, the patient＇s appearance VAS score and ROE score were significantly higher than those before surgery, while the NOSE score and FROI-17 score of nasal congestion symptoms were lower than those before surgery. Conclusions:Endoscope-assisted one-stage rhinoplasty and septoplasty can achieve the purpose of repairing the nose appearance and improving the nasal respiratory function at the same time. Through a combination of subjective and objective evaluations, our study found that this procedure had the advantages of minimally invasive, stable effect and shorter recover time; meanwhile, this procedure has high patients＇ satisfaction and is worthy of clinical promotion.

Sequential transcatheter arterial chemoembolization and selective portal vein embolization before major hepatectomy for large hepatocellular carcinoma: a pilot study / 中华肝胆外科杂志

Objective:To preliminarily study the feasibility, safety and efficacy of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE) before surgical resection in the treatment of large liver cancer.Methods:A retrospective study was conducted on the clinical data of 17 patients with large liver cancer treated with TACE combined with SPVE from January 2016 to December 2019 at the Department of Hepatobiliary Surgery, the Sixth Medical Center of PLA General Hospital. The study included 15 males and 2 females, aged (59.17±10.30) years. The levels of alanine aminotransferase, tumor changes and patient survival were analyzed before operation, after TACE, and after SPVE.Results:Among the 17 patients, the levels of alanine aminotransferase on the 1st and 3rd day after SPVE was significantly higher than those after TACE [191.4 (30.5-1966.4) IU/L vs 125.3 (35.7-846.2) IU/L on the first day, and 298.5 (24.6-1334.2) IU/L vs 208.6 (21.6-775.6) IU/L on the 3rd day], all P<0.05. One month after the two combined embolism, among the 6 patients with a tumor diameter of 5-10 cm, 2 patients (33.3%) had complete remission, 3 patients (50.0%) had partial remission, and 1 patients (16.6%) had stable disease. For the tumor’s longest diameter, among the 11 patients with tumors >10 cm, 1 patient had complete remission (9.1%), 4 patients had partial remission (36.4%), 5 patients had stable diseases (45.5%), and 1 patient had disease progression (9.1%). Eventually, 11 patients underwent surgical exploration. The median residual liver volume before treatment was 329.5 (284.9-365.7) ml, and after the combined procedure 415.6 (354.7-718.8) ml. The median hyperplasia ratio was 28.1% (14.1%-51.3%). Eight patients finally underwent surgical resection. There was no death in the perioperative periods. The median tumor-free survival time was 17 (7-42) months, and the median survival time was 27 (7-42) months. Conclusion:For patients with large liver cancer with insufficient remnant liver volume, preoperative TACE+ SPVE has certain value in controlling tumor progression, promoting remnant liver hyperplasia, increasing surgical resection rate and improving prognosis.

Multi-omics approaches identify

Autophagy is a critical cellular homeostatic mechanism, and its dysfunction is linked to invasive breast carcinoma (BRCA). Recently, several omics methods have been applied to explore autophagic regulators in BRCA; however, more reliable and robust approaches for identifying crucial regulators and druggable targets remain to be discovered. Thus, we report here the results of multi-omics approaches to identify potential autophagic regulators in BRCA, including gene expression (EXP), DNA methylation (MET) and copy number alterations (CNAs) from The Cancer Genome Atlas (TCGA). Newly identified candidate genes, such as

Case-control study on remnant-preserving strategy for preservation and reconstruction of anterior cruciate ligament / 中国骨伤

OBJECTIVE@#To investigate and compare the clinical efficacies of remnant-preserving and remnant-non-preserving, remnant-non-preserving remnant segment preserving and remnant root preserving with anterior cruciate ligament reconstruction.@*METHODS@#From March 2014 to December 2017, 204 patients with anterior cruciate ligament (ACL) injuries were treated by single-bundle ACL reconstruction with hamstring tendon autograft. According to the different methods of remnant preservation, the procedures were divided into remnant segment preserving group (A), remnant root preserving group (B), and remnant-non-preserving group (C). There were 37 males and 39 femalesin group A aged from 16 to 43 years old with an average of (28.80±5.41) years old. The time from injury to operation ranged from 2 to 11 weeks with an average of (3.68±1.04) weeks. In group B, there were 39 males and 25 females aged from 18 to 41 years old with an average of (28.42±5.60) years old. The time from injury to operation ranged from 2 to 10 weeks with an average of (3.36±1.68) weeks. In group C, there were 37 males and 27 females aged from 18 to 43 years old with an average of (29.10±6.11) years old. The time from injury to operation ranged from 3 to 11 weeks with an average of (3.54±1.46) weeks. The range of motion (ROM) of the knee was used to assess the range of extension and flextion of the knee at pre-operation and 24 months after operation. Lysholm score and the international knee documentation committee (IKDC) score were used to assess the knee function. The differences among three procedures were judged by comparing among the three groups at 6, 12 and 24 months postoperatively.@*RESULTS@#All incisions got a one stage healing, and no complications, such as vascular injury, nerve damage and articular infect or the like, occurred. All the patients were followed up, and the follow-up duration of group A ranged from 24.00 to 45.96 months with a mean of (35.52±14.40) months;the follow up duration of group B ranged from 27.96 to 48.00 months with a mean of (37.56±10.68) month;and the follow up duration of group C ranged from 24.00 to 66.00 months with a mean of (37.08±13.44) month. There were no significant differences in follow up time among three groups (@*CONCLUSION@#Compared with remnant-non-preserving group, the residual tissue of anterior cruciate ligament is preserved, which is conducive to promote the healing and remodeling of tendon graft and accelerate the recovery of joint function. Proper fixation of residual tissue and restoration of its tension are the key factors affecting the postoperative efficacy.

Roles of ten eleven translocation proteins family and 5-hydroxymethylcytosine in epigenetic regulation of stem cells and regenerative medicine / 北京大学学报(医学版)

The methylation of cytosine is one of the most fundamental epigenetic modifications in mammalian genomes, and is involved in multiple crucial processes including gene expression, cell differentiation, embryo development and oncogenesis. In the past, DNA methylation was thought to be an irreversible process, which could only be diluted passively through DNA replication. It is now becoming increa-singly obvious that DNA demethylation can be an active process and plays a crucial role in biological processes. Ten eleven translocation (TET) proteins are the key factors modulating DNA demethylation. This family contains three members: TET1, TET2 and TET3. Although three TET proteins have relatively conserved catalytic domains, their roles in organisms are not repeated, and their expression has significant cell/organ specificity. TET1 is mainly expressed in embryonic stem cells, TET2 is mainly expressed in hematopoietic system, and TET3 is widely expressed in cerebellum, cortex and hippocampus. This family catalyzes 5-methylcytosine to 5-hydroxymethylcytosine and other oxidative products, reactivates silenced-gene expression, in turn maintains stem cell pluripotency and regulates lineage specification. With the development of tissue engineering, organ transplantation, autologous tissue transplantation and artificial prosthesis have been widely used in clinical treatment, but these technologies have limitations. Regenerative medicine, which uses stem cells and stem cell related factors for treatment, may provide alternative therapeutic strategies for multiple diseases. Among all kinds of human stem cells, adipose-derived stem cells (ADSCs) are the most prospective stem cell lineage since they have no ethical issues and can be easily obtained with large quantities. To date, ADSCs have been shown to have strong proli-feration capacity, secrete numerous soluble factors and have multipotent differentiation ability. However, the underlying mechanism of the proliferation, secretion, acquired pluripotency, and lineage specific differentiation of ADSCs are still largely unknown. Some studies have explored the role of epigenetic regulation and TET protein in embryonic stem cells, but little is known about its role in ADSCs. By studying the roles of TET proteins and 5-hydroxymethylcytosine in ADSCs, we could provide new theoretical foundation for the clinical application of ADSCs and the stem cell-based therapy. In the future, combined with bioprinting technology, ADSCs may be used in tissue and organ regeneration, plastic surgery reconstruction and other broader fields.

Application of 3D digital reconstruction technique in adult sinus CT based volume / 解剖学报

Objective To calculate the volume of maxillary sinus and sphenoid sinus of adults in China by CT, and to analyze the differences of gender in the adult maxillary sinus and sphenoid sinus. Methods Ninety-three CT images of sinus were randomly selected from Peking University Third Hospital. The digital model of maxillary sinus and sphenoid sinus was reconstructed by Mimicsl7. 0 3D reconstruction software. And the sinus volume was obtained by the three-dimensional digital model. Results The average volume of the right maxillary sinus in the male was ( 16. 69±6. 90) ml, and the average volume of the maxillary sinus in the left side of the male was ( 16. 88±7. 12) ml. The average volume of the right sphenoid sinus of male was (4. 62±2. 99) ml, and the average volume of the left sphenoid sinus of male was (5. 58± 3. 72) ml. The average volume of the right maxillary sinus in female was (11. 39±5. 63) ml, and the average volume of the left maxillary sinus in female was (11. 37±5. 38) ml. The average volume of the right sphenoid sinus of female was (4. 12 ±2. 53) ml, and the average volume of the left sphenoid sinus of female was (3. 32±2. 30) ml. The left sphenoid sinus and bilateral maxillary sinus volume had gender differences. Conclusion Three-dimensional reconstruction can quickly obtain a three-dimensional model of the sinus, accurately calculate the sinus volume, and indirectly reflect gender through the sinus volume. It provides a certain reference for further understanding of sinus anatomy.

Arthroscopic repair of Bankart lesion with bioabsorbable suture anchors / 中国骨伤

OBJECTIVE@#To evaluate early clinical effects of bioabsorbable suture anchors for the treatment of Bankart lesion.@*METHODS@#Total 23 patients with the Bankart lesion were treated with arthroscopic repair using bioabsorbable suture anchors from January 2010 to June 2017. There were 20 males and 3 females, with an average age of (23.4±3.9) years old (ranged, 19 to 34 years old). Fourteen patients had injuries on the right shoulder joint and 9 patients had the injuries on the left side. The mechanism of primary dislocation included 17 cases of training, 5 cases of sports injury and 1 case of falling down. The mean interval time from injury to surgery was(10.9±5.8) months (ranged, 3 to 36 months). The Bankart lesion was repaired by bio-cortical suture anchors. The Rowes rating system for Bankart repair was used to evaluate therapeutic effects.@*RESULTS@#All 23 patients were followed up, with a mean duration of(24.5±3.7) months(ranged, 18 to 39 months). At the latest follow up, there was no recurrent dislocation occurred, and all patients had returned to sports and work. The Rowes rating system for Bankart repair was 53.91±11.67 pre-operationally and 91.74±12.30 post operationally, respectively (@*CONCLUSION@#Applying bio-cortical bone suture anchors for the Bankart lesion is a reliable, efficient and cost effective treatment, which is also suitable for the revision of the Bankart lesion.

Three-dimensional facial morphological features of young Han Chinese women: A preliminary study / 中华医学美学美容杂志

Objective To explore the feasibility of our method on assessing the three-dimensional facial morphological features based on three-dimensional surface imaging techniques.Methods According to the admission criteria,three-dimensional facial images of 34 attractive young Chinese women and 172 healthy reference young women were selected from the three-dimensional facial images database of our department.For those images,anthropometric facial measurements including facial height,width,the degree of convexity and concavity were computed using three-dimensional surface imaging techniques combined with three-dimensional coordinate system.The variance between attractive group and reference group was analyzed and the facial morphological features of each group were preliminarily summarized.Results Both groups met the criteria of mesoprosopy,not the "vertical facial trisection and rule of fifths".The attractive group had a relatively narrow anterior facial frame,a more rounded and full upper face compared with the reference group.They also had smaller intercan thai width compared with the reference group.Moreover,the attractive group showed more prominent nose,more full and prominent medial cheek.In addition,the attractive group shared less protruded upper lips and less retruded chin compared with the reference group.Conclusions Assessing facial morphology using three-dimensional surface imaging techniques is a convenient and feasible method.The evaluation of sagittal facial convexity and concavity is an indispensable part of facial morphology features assessment.

Clinical observation on acupoint injection of Chuankezhi injection plus acupoint sticking in treating bronchial asthma / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of acupoint injection of Chuankezhi plus acupoint sticking treatment for bronchial asthma, and provide clinical evidence for the synergy of the two therapies, and explore their synergistic mechanism. Methods: A total of 70 patients were randomized into an acupoint injection plus sticking group and an acupiont sticking group by the random number table, with 35 cases in each group. The treatment took place in July and August. The acupoint injection plus sticking group was treated with acupoint injection and acupiont sticking, while the acupiont sticking group was treated only with acupiont sticking therapy. The treatment course was 4 weeks. After the treatment, the scores of symptom scale in the two groups before treatment, 3 months and 6 months after the treatment were observed. Results: During the treatment, there were 5 dropouts in the acupoint injection plus sticking group with 30 cases remained, and 4 dropouts in the acupiont sticking group with 31 cases remained. Before the treatment, there was no significant difference in the total scores of symptom scale between the two groups. Three months after the treatment, the total scores of symptom scale of both groups were lower than those before treatment, and the intra-group differences were statistically significant (bothP<0.05). In the inter-group comparison, there was no significant difference in the difference values of the scores before treatment and 3 months after treatment (P>0.05). Six months after the treatment, the total scores of symptom scale in both groups were lower than those before treatment, and the intra-group differences were statistically significant (bothP<0.05), so were the differences in the difference values of the scores before treatment and 6 months after treatment (bothP<0.05). Conclusion: Acupoint injection of Chuankezhi plus acupoint sticking or acupoint sticking alone both can improve the symptoms of patients with bronchial asthma. Acupoint injection of Chuankezhi plus acupoint sticking has a higher total effective rate than single acupoint sticking therapy.

Therapeutic effects on rheumatoid arthritis treated with -deep needling and bloodletting techniques / 中国针灸

OBJECTIVE@#To observe the difference in the therapeutic effects on rheumatoid arthritis (RA) between the combined -deep needling and bloodletting technique and the regular needling technique.@*METHODS@#A total of 70 patients were randomized into an observation group (35 cases) and a control group (35 cases, 4 cases dropped-out). Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jinsuo (GV 8), Ganshu (BL 18), Shenshu (BL 23), Zhibian (BL 54), Weizhong (BL 40), Taixi (KI 3) and Tianzong (SI 11), etc. were selected in the two groups. Additionally, in the observation group the -deep needling technique was adopted at Tianzong (SI 11) and Zhibian (BL 54), the bloodletting technique at the local swollen area and the even-needling technique at the rest acupoints. In the control group, the even-needling technique was applied to all of the acupoints. Acupuncture treatment was given once every two days, 3 times a week and for 12 weeks totally. The numbers of tender points at the knee joint, the numbers of swollen sites at the knee joint, the visual analogue scale (VAS) score and the American health assessment questionnaire (HAQ) score were observed in the two groups before and after treatment, as well as the changes in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The American College of Rheumatology (ACR) criteria was adopted to evaluate the therapeutic effects of the two groups.@*RESULTS@#After treatment, the numbers of tender points, the numbers of swollen sites, VAS score and HAQ score were all improved as compared with those before treatment in the two groups (all 0.05). The standard-reaching rates of ACR 20 and ACR 50 in the observation group were 94.3% (33/35) and 31.4% (11/35) respectively, which were better than 67.7% (21/31) and 6.5% (2/31) in the control group (<0.01, <0.05).@*CONCLUSION@#The acupuncture with the -deep and bloodletting techniques and the acupuncture with regular needling technique are all effective on RA. The therapeutic effects of the acupuncture treatment with the -deep and bloodletting techniques are better than that with regular needling technique.

An experimental study of simvastatin-collagen composite sponge as a direct pulp capping material in rat molars / 华西口腔医学杂志

OBJECTIVE@#To assess the feasibility and efficacy of simvastatin-collagen composite sponge as a novel, direct pulp capping material.@*METHODS@#A total of 120 Sprague-Dawley rats were randomly divided into three groups: the simvastatin-collagen composite sponge group (SIM group), the collagen sponge group (CS group), and the Ca(OH)2 group (CH group). An endodontic entry cavity was prepared on the occlusion of the first molar on the left maxillary of each rat. The contralateral teeth were utilized as the normal control group. The rats were experimented after 1, 3, 7, 14, and 28 days. X-ray observations were conducted and the specimens underwent hematoxylin-eosin (HE) and Masson's Thichrome staining. Dentin bridge formations and pulpal biology reactions were evaluated histopathologically.@*RESULTS@#X-ray results: high-density images could be observed on the pulp exposure sites in the CH group on the 28th day. In the SIM group, high-density images could be observed after 14 and 28 days, whereas in the CS group, high-density images were not observable in the exposed area. HE and Masson's Thichrome staining results: different degrees of inflammation under the cavity were detected in the three groups at different time points. The inflammatory reaction of the CS group was the most serious. The degree of the inflammatory reaction varied significantly between the SIM and the CS groups on the 14th and 28th days (P<0.01). The inflammatory reaction in the SIM group was lighter than in the CH group. There was a statistical difference between the SIM and the CH groups on the 14th day (P<0.05). During the observation period, the SIM group induced the best and fastest formation of reparative dentin. As for dentin bridge formation, a significantly higher complete bridge rate was observed in the SIM group than in the CH and in the CS groups on the 14th day (P<0.05) and for the SIM and the CH groups compared with the CS group on the 28th day (P<0.05).@*CONCLUSIONS@#The simvastatin-collagen composite sponge exhibited satisfactory biocompatibility with the pulp tissue and promoted the formation of reparative dentin. The application of simvastatin-collagen composite sponge as a pulp-capping material has satisfactory potential.

Expression and significance of L-FABP in hilar cholangiocarcinoma / 中华消化外科杂志

Objective To explore the expression of liver fatty acid binding protein (L-FABP) in tissues of hilar cholangiocarcinoma and the relationship between expression of L-FABP and clinicopathological factors and prognosis of the patients.Methods The retrospective case-control study was conducted.The clinicopathological data of 132 patients with hilar cholangiocarcinoma who were admitted to the Navy General Hospital between January 2003 and January 2013 were collected.The expression of L-FABP in tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues were respectively detected by immunohistochemistry.Observation indicators:(1) expression of L-FABP by immunohistochemistry;(2) relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues;(3) follow-up and survival situations;(4) prognostic analysis of patients after radical resection of hilar cholangiocarcinoma.Follow-up using outpatient examination and telephone interview was performed to detect postoperative overall survival time up to June 2017.Count data were described as percentage and compared using the chi-square test.The survival time was calculated by the Kaplan-Meier method.Measurement data with skewed distribution were described as M (range).The univariate analysis and multivariate analysis were respectively done using the nonparametric test and COX regression model.Results (1) Expression of L-FABP by immunohistochemistry:the positive expressions of L-FABP were located in the cytoplasm.The low,moderate and high expression rates of L-FABP in tumor tissues were respectively 11.36％ (15/132),71.97％ (95/132) and 16.67％ (22/132),and positive-staining cells showed platy and / or diffuse distribution;the low,moderate and high expression rates of L-FABP in adjacent tissues of hilar cholangiocarcinoma were respectively 77.27％ (102/132),7.58％ (10/132) and 15.15％ (20/132),and positive-staining cells showed scattered or platy distribution,with a weaker staining intensity compared with tumor tissues;there was no positive expression in normal bile duct tissues.There was a statistically significant difference in expressions of L-FABP among tumor tissues and adjacent tissues of hilar cholangiocarcinoma and normal bile duct tissues (x2=5.423,P ＜ 0.05).(2) Relationship between clinicopathological factors of patients and expression of L-FABP in tumor tissues:cases with low,moderate and high expressions of L-FABP in tumor tissues were respectively 10,30,5 in 45 patients with tumor diameter ＜ 3 cm and 4,29,9 in 42 patients with 3 cm ≤ tumor diameter ≤ 5 cm and 1,36,8 in 45 patients with tumor diameter ＞ 5 cm,with a statistically significant difference (x2 =10.171,P＜ 0.05).(3) Follow-up and survival situations:132 patients were followed up for 5-90 months,with a median time of 33 months.During the followup,postoperative overall median survival time of 132 patients was 31 months.(4) Prognostic analysis of patients after radical resection of hilar cholangiocarcinoma:results of univariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were related factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (Z =1.845,3.156,1.243,P＜0.05).Results of multivariate analysis showed that tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues were independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma (odds ratio =0.431,1.806,3.692,95％ confidence interval:0.292-0.693,0.974-2.973,1.875-11.364,P＜0.05).Conclusions The high expression of L-FABP in tumor tissues is significantly correlated with the tumor diameter.Tumor differentiation,lymph node metastasis and expressions of L-FABP in tumor tissues are independent factors affecting prognosis of patients after radical resection of hilar cholangiocarcinoma.

Three-dimensional anatomical analysis of the perpendicular plate of ethmoid among Chinese and its safety harvesting range in rhinoplasty / 中华整形外科杂志

Objective@#To investigate the morphology and structure of the perpendicular plate of ethmoid and measure its anatomical parameters among Chinese population. To discuss the safety range of harvesting perpendicular plate of ethmoid in rhinoplasty.@*Methods@#Sixty-four healthy Chinese were included in accordance with certain requirements and their paranasal sinus was examined using 64 slices computed tomography (CT). The three-dimensional (3D) structure of their perpendicular plate of ethmoid was reconstructed, and the area, length, height and thickness were measured by Mimics 17.0 software. Statistical analysis was completed by SPSS 22.0 software and was checked out by t-test.@*Results@#According to the result from 3D anatomical analysis, the length of the anterior border of perpendicular plate of ethmoid was (28.58±2.91) mm, the inferior border was (26.17±5.76) mm and the posterior border was (19.84±3.17) mm. The thickness of the anterior border three sections were (3.07±0.72) mm, (3.09±0.73) mm and (1.75±0.55) mm respectively. The thickness of the inferior border in three sections were (1.96±0.62) mm, (1.94±0.73) mm and (1.87±0.67) mm, respectively. The length of the middle and lower third of the perpendicular plate of ethmoid anterior border was (10.04±2.39) mm. As to the superior border, the length was (35.31±6.52) mm. The total area of the perpendicular plate of ethmoid was (1 057.85±184.38) mm2, the lower section area was (474.09±109.60) mm2, and the ratio of middle and lower third to the total area was 0.45±0.07.@*Conclusions@#The thickness of the lower 1/3 segment of the vertical plate of the ethmoid bone is thinner than that of the upper segment, and it is far away from the skull base, which is easily to harvest and meet the application in surgery.

The sagittal morphological and clinical application study of nose in Chinese / 中华整形外科杂志

Objective@#The purpose of this study is to analyze the nasal morphological characteristics in Chinese adult, of Han nationality, by the measurements in sagittal plan and the proportionality between nose and facial structures, in order to provide aesthetic references for rhinoplasty, and individual surgical planning.@*Methods@#During 2017 November to December, 258 healthy Han Youth volunteers were included. Three-dimensional (3D) models of the facial characteristic information were collected using Artec 3D scanner, by standardized procedures. The nasal and facial distances and angulations were measured, based on predesigned facial landmarks. Thereafter, the proportions of above measurements were calculated.@*Results@#There was no significant difference between genders in absolute prominence. As for relative prominence, male nose is more prominent, resulted in a more stereoscopic facial profile. The nasal basal plane of both male and female, was more anterior than the infraorbital points, with 7% of the absolute degree of the infraorbital points. The range of the angle between the nasal basal plane and coronal plane was 2-4 degrees.@*Conclusions@#This study sets a database for the external nasal characteristics of the young adult in Chinese Han nationality, which could provide quantitative references for preoperative evaluation and individually surgical planning.

Experimental study on the in vitro perfusion culture of human abdominal adipose tissue and its myogenic induction / 中华整形外科杂志

Objective@#To investigate the feasibility of in vitro perfusion culture of human adipose tissue and its induction into muscle tissue.@*Methods@#Human abdominal adipose tissue were cultured in vitro by perfusion culture. After 1, 3, 5 or 7 weeks, FAD/PI staining was used to detect the tissue vitality. Histological staining was used to observe the changes of its histomorphology. Protein expressions of myogenic molecules Myf-5 and myoD1 as well as muscle specific protein Desmin were measured by immunohistochemistry and Western blot assay.@*Results@#The adipose tissues cultured in myogenic induction media were still in the appearance of adipose tissue at 7 weeks. While in the basal medium without inducing, vascular pedicles shed after 7 weeks and could not continue to be cultured. FAD/PI staining showed that the tissue cultured in the induction media remained viable at 7 weeks, while the viability of the tissue in the basal culture medium decreased significantly at 5 weeks. Histologically, Myf-5, myoD1 and Desmin were all positively expressed in muscle tissues, while in adipose tissues, some mesenchymal and vascular endothelial cells expressed Myf-5 but not myoD1, and only separate vascular smooth muscle cells expressed Desmin. Interestingly, in adipose tissues cultured in myogenic induction medium, partial muscle-like tissue formed, evidenced as positive expression of Myf-5, myoD1 and Desmin. There was no muscle-like tissue formation in adipose tissue cultured in basal medium and the expression patterns were similar to that of the control group. Western blot results showed that the expression levels of Myf-5 and Desmin in muscle tissue were significantly higher than that of the other groups (P<0.05). The expression level of Myf-5 was slightly higher in inducing group than that in non-inducing group at the same time points, but the difference was not statistically significant. Similarly, the expression of Desmin was higher in inducing group than that in non-inducing group, yet there was statistically significant difference only in the first week. The protein expression of myoD1 was not detected in any group using Western blot.@*Conclusions@#The adipose tissue cultured in the perfusion bioreactor can survive for up to 7 weeks, and it can be partially induced into muscle-like tissue in the myogenic induction medium.

Application of perpendicular plate of ethmoid bone in short nose plasty in Chinese with insufficient septal cartilage / 中华医学美学美容杂志

Objective To evaluate the applied value of septal cartilage combined with perpendicular plate of ethmoid bone graft in short nose plasty in Chinese people with insufficient septal cartilage.Methods From February 2015 to March 2017,thirty-five women with short noses underwent septal extension grafting in our institute.We used perpendicular plate of ethmoid bone to enhance the L-strut structure.An L-strut,comprising 0.6 cm segments of the caudal and dorsal cartilaginous septum,was left altered to harvest more cartilages for septal extension.The harvested septal cartilage was grafted on one side of the caudal septum.Then the alar cartilage was fixed at the end of the septal cartilage graft.Nasal lengths and nasolabial angles were measured pre-and postoperatively.Results The average nasal lengthening was (3.37±1.87) mm (P＜0.001).There was no infection,cerebral spinal fluid leakage,hemorrhage and other complications postoperatively.The average follow-up was 10 months (6 months to 2 years).After operation,33 patients were satisfied with the nasal contour,1 patient complained of high tip projection whereas one patient complained of low tip projection,and the dissatisfactions were corrected by revision surgeries.Conclusions Combining the septal cartilage with perpendicular plate of ethmoid bone graft presents an adequate nose lengthening and a decreased nostril show,even in patients with very little septal cartilage.With minimum complications,this novel technique provides promising clinical outcomes and high patient satisfaction.

Flow Perfusion Maintaining Long-term Viability of the Rat Groin Fat Flap: A Novel Model for Research on Large-scale Engineered Tissues / 中华医学杂志(英文版)

BACKGROUND@#Large-scale muscle tissue engineering remains a major challenge. An axial vascular pedicle and perfusion bioreactor are necessary for the development and maintenance of large-scale engineered muscle to ensure circulation within the construct. We aimed to develop a novel experimental model of a large-scale engineered muscle flap from an existing rat groin fat flap.@*METHODS@#A fat flap based on the superficial inferior epigastric vascular pedicle was excised from rats and placed into a perfusion bioreactor. The flaps were kept in the bioreactor for up to 7 weeks, and transdifferentiation of adipose to muscle tissue could have taken place. This system enabled myogenic-differentiation medium flow through the bioreactor at constant pH and oxygen concentration. Assessment of viability was performed by an immunofluorescence assay, histological staining, a calcein-based live/dead test, and through determination of RNA quantity and quality after 1, 3, 5, and 7 weeks.@*RESULTS@#Immunofluorescence staining showed that smooth muscle around vessels was still intact without signs of necrosis or atrophy. The visual assessment of viability by the calcein-based live/dead test revealed viability of the rat adipose tissue preserved in the bioreactor system with permanent perfusion. RNA samples from different experimental conditions were quantified by spectrophotometry, and intact bands of 18S and 28S rRNA were detected by gel electrophoresis, indicating that degradation of RNA was minimal.@*CONCLUSIONS@#Flow perfusion maintains the long-term viability of a rat groin engineered muscle flap in vitro, and a large-scale vascularized muscle could be engineered in a perfusion bioreactor.