Evaluation of combining ultrapulse CO2 with fractional CO2 laser for the treatment of atrophic scars in Asians.

Various treatment modalities have been applied to atrophic scars. Fractional CO2 laser treatment has attracted increasingly more attention because of its quicker recovery time and fewer side effects. However, its limitation of sculpting the edge is an urgent shortcoming. In order to achieve a more effective result with fewer complications, we have integrated ultrapulse CO2 and fractional CO2 lasers to for the treatment of facial atrophic scars. The study included 25 patients (10 males and 15 females) diagnosed with moderate to severe atrophic scars between August 2020 and July 2022. All subjects underwent the same surgical treatment. The effects were assessed at baseline, 1 week, 1 month, and 3 months using photographic evidence. Objective evaluation of the results was conducted using a quartile grading scale, while the subjects' satisfaction and any adverse events were also recorded. The patients in the study underwent more than two laser sessions (2-5), resulting in substantial improvement in their appearance. The time interval between each session was 3-6 months. The majority of the patients (19/25, 76%) had a significant or even excellent improvement. Any adverse events observed, such as erythema, superficial crusting, and PIH, were of a mild nature and temporary in duration. This treatment combined two CO2 lasers is an effective and safe choice for atrophic scars in Asians.

Individualized Treatment of Botulinum Toxin Type A for Hypertrophic Muscular Calves With Different Bulging Units in Asian Women.

BACKGROUND: Dermatologic surgeons have performed botulinum toxin type A injection to treat muscular calves, with different dosages and injection sites suggested. OBJECTIVE: We investigated the use of individualized botulinum toxin type A injection protocols to treat hypertrophic calves in Asian women. MATERIALS AND METHODS: A total of 294 calves were examined and their bulging areas divided into 4 units (Units 1, 2, 3, 4). The rare bulging area unit 5 was only seen in 1 case. Thirty-five cases were treated using botulinum toxin type A between September 2011 and May 2016, with the treatment protocol chosen according to the assessed bulging units. Standard photo documentation was performed at each clinical visit. RESULTS: The average injection dose was 187 ± 10 U per patient. The average maximum calf circumference was significantly reduced 3 months postinjection, with that of the right leg reduced from 36.48 ± 0.57 to 34.87 ± 0.44 cm, and that of the left leg from 36.26 ± 0.61 to 34.71 ± 0.53 cm (both p < .01). The overall patient satisfaction rate was 73.08%. CONCLUSION: A botulinum toxin type A injection protocol tailored to the shape of the hypertrophic calf muscle can effectively improve the contour of the lower leg.

V-Y Advancement Flaps Based on Yotsuyanagi Aesthetic Subunit Principles for Small Nasal Defects in Asian Patients.

Cosmesis is paramount in the reconstruction of small nasal defects. Yotsuyanagi et al have previously described nasal aesthetic subunits in patients of Asian descent and their implications for reconstruction of large nasal defects, including forehead flap and Z-plasty. The impact of Asian skin types and aesthetic subunits on reconstruction planning of small nasal defects has not been rigorously explored. The aim of this article is to present a novel method for repairing small nose defects in patients of Asian descent using V-Y advancement flap designed using Yotsuyanagi nasal subunit aesthetic principles. A total of 21 defects ranging from 7 to 22 mm in size in 21 patients of Asian descent were repaired with either 1 or 2 V-Y advancement flaps designed along Yotsuyanagi nasal subunit borders. All reconstructions were completed successfully in one stage. Scars were inconspicuous and nasal subunits were neither displaced nor twisted. All patients were pleased with the cosmetic outcomes. The use of V-Y advancement flaps based on Asian aesthetic nasal subunit principles for the reconstruction of small nasal defects is a novel, cosmetically sensitive alternative.

[Comparison of three different methods in transfection of plasmid pGPU6/GFP/Neo to chicken embryo fibroblasts].

OBJECTIVE: To compare three different methods in transfection of plasmid pGPU6/GFP/Neo into chicken embryo fibroblast. METHODS: Different doses (1.25 µl,2 µl,2.5 µl) of Lipofec-tamin2000, Gbfectene-Elite and HilyMax were used to transfect 1 µg plasmid pGPU6/GFP/Neo. The transfection efficiency was observed by the fluorescence and the cell viabilities were measured. RESULTS: The transfection efficiency of HilyMax was significant higher than that of Lipofectamin2000 and Gbfectene-Elite (86.85%±2.32% compared with 48.33%±3.24% and compared with 37.35%±5.41%; F=18.882, P<0.05). The transfection efficiency of 2.5 µl HilyMax was highest(90.53%±1.15%). The cell viability of Lipofectamin2000 was significantly lower than that of HilyMax and Gbfectene-Elite(65.76%±5.78% compared with 89.54%±0.86% and compared with 82.45%±3.56%;F=90.676, P<0.05). CONCLUSION: HilyMax has the highest transfection efficiency and the lowest cell toxicity in transfection of plasmid pGPU6/GFP/Neo into chicken embryo fibroblast, with the optimal ratio of 2.5 µl HilyMax:1 µg plasmid.

UBE2M-mediated neddylation of TRIM21 regulates obesity-induced inflammation and metabolic disorders.

Inflammation is closely associated with obesity and related metabolic disorders. However, its origin during obesity is largely unknown. Here, we report that ubiquitin-conjugating enzyme E2M (UBE2M) is critical to obesity-related inflammation induced by macrophages. In mice with UBE2M-deficient macrophages, obesity, insulin resistance, and hepatic steatosis induced by a high-fat diet are greatly alleviated, an effect related to the decreased proinflammatory activity of macrophages due to reduced IL-1ß production. Mechanistically, UBE2M deficiency inhibits the neddylation of E3 ubiquitin ligase TRIM21 on K129/134, leading to reduced recruitment and ubiquitination-mediated degradation of E3 ubiquitin ligase VHL. Subsequently, VHL reduces HIF-1α-induced IL-1ß production by degrading HIF-1α. Targeting macrophage TRIM21 with Trim21 antisense oligonucleotide-loaded red blood cell extracellular vesicles effectively inhibits obesity-induced inflammation and related metabolic disorders. Thus, our results demonstrate that macrophage UBE2M is essential for obesity-induced inflammation and that TRIM21 is a proof-of-concept target for treating obesity and associated metabolic diseases.

Autologous nanofat transplantation accelerates foot wound healing in diabetic rats.

Aim: This study explored the effects of local transplantation of autologous nanofat in the treatment of rats with diabetic foot wounds. Materials & methods: Nanofat was transplanted into the left foot wound of diabetic rats. Phosphate-buffered saline injection in the right served as control. We measured wound size, the extent of epithelization, microvessel density and the expression levels of cytokines at six different time-points postoperation. Results: Compared with the control feet, nanofat-treated feet had significantly smaller wound areas at 7 and 9 days after grafting and showed better re-epithelialization, a greater number of microvessels and higher levels of angiogenic factor expression. Conclusion: This research shows that autologous nanofat transplantation can promote diabetic foot wound healing in rats.

Use of Condensed Nanofat Combined With Fat Grafts to Treat Atrophic Scars.

IMPORTANCE: In addition to the physical deformity, there is often great psychological burden of facial scars for patients. In this study, we use condensed nanofat combined with fat grafts in a novel technique to improve atrophic facial scars by raising both the surface and the bottom of the affected area. OBJECTIVE: To assess whether the use of condensed nanofat combined with fat grafting can be effective in treating atrophic facial scars from both an aesthetic and a functional perspective. DESIGN, SETTING, AND PARTICIPANTS: In this prospective case series of 20 patients with 25 atrophic facial scars, each scar was treated with condensed nanofat combined with fat grafts at the Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China. Postoperative results were evaluated by the patients themselves and by 3 senior plastic surgeon observers. MAIN OUTCOMES AND MEASURES: Multiple preoperative and postoperative examinations included the use of the Patient and Observer Scar Assessment Scale (POSAS) to evaluate both the functional and aesthetic aspects of the atrophic facial scars. Punch biopsy specimens were stained for the presence of melanin, elastic fibers, and cytokeratin (CK) 14 and CK19. Images were analyzed using ImageJ software, and the data were analyzed by paired sample t test. RESULTS: Twenty patients (6 men and 14 women; mean age, 38.25 years; age range, 21-62 years) with a total of 25 atrophic facial scars were treated between March 2014 and December 2016. The patients' mean (SD) scar assessment scores were significantly decreased postoperatively in the final examination for color, 6.40 (0.51) vs 2.40 (0.24) (P < .001); stiffness, 7.20 (0.37) vs 3.20 (0.20) (P < .001); thickness, 5.80 (0.73) vs 1.80 (0.37) (P = .001); and irregularity, 5.20 (0.49) vs 2.20 (0.37) (P = .003); and the observers' scores were also significantly decreased for pigmentation, 4.40 (0.51) vs 2.00 (0.32) (P = .004); thickness, 3.00 (0.32) vs 1.80 (0.20) (P = .03); relief, 4.40 (0.51) vs 2.40 (0.24) (P = .003); and pliability, 4.20 (0.37) vs 1.40 (0.24) (P < .001). In the final follow-up examinations, a significantly improved overall POSAS score was found among both patients, 28.80 (1.02) vs 12.20 (0.80) (P < .001), and observers, 18.00 (0.71) vs 9.20 (0.37) (P = .001). Enhancement of Fontana-Masson staining of melanin in the basal cell layer was observed postoperatively, and a significant postoperative change was detected for the mean (SD) values of average optical density from the preoperative measurement, 0.671 (0.083) vs 0.844 (0.110) (P = .01). The sebaceous glands and sweat glands that were not found in the preoperative images were seen postoperatively by immunohistochemical staining with CK14 and CK19. CONCLUSIONS AND RELEVANCE: Our preliminary clinical and pathological results indicate that the use of condensed nanofat combined with fat grafts may be an effective approach to treating atrophic facial scars from both an aesthetic and a functional perspective. LEVEL OF EVIDENCE: 4.

Plane-based sampling for ray casting algorithm in sequential medical images.

This paper proposes a plane-based sampling method to improve the traditional Ray Casting Algorithm (RCA) for the fast reconstruction of a three-dimensional biomedical model from sequential images. In the novel method, the optical properties of all sampling points depend on the intersection points when a ray travels through an equidistant parallel plan cluster of the volume dataset. The results show that the method improves the rendering speed at over three times compared with the conventional algorithm and the image quality is well guaranteed.

Endoscopic transaxillary surgery for congenital muscular torticollis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate a new endoscopic transaxillary technique for release of the sternocleidomastoid (SCM) in congenital muscular torticollis (CMT).</p><p><b>METHODS</b>From May 2008 to March 2014, a total of 25 cases (male 7 and female 18), ranging in age from 14 to 31 years (mean age, 17.6 years), were operated for torticollis by endoscopic-assisted surgery. The sternal and clavicular attachments of the sternocleidomastoid were released by skin lift approach.</p><p><b>RESULTS</b>The primary healing was achieved in all the 25 cases with no injury of major vessels or nerves. The patients were followed up for 6 months with satisfactory result and invisible scar.</p><p><b>CONCLUSIONS</b>The subcutaneous endoscopic transaxillary and skin lift approach for the CMT provides good functional and cosmetic outcomes.</p>

[Endoscope-assisted repair of zygomatic arch fracture via a short hidden preauricular incision].

OBJECTIVE: To investigate the relevant applied technique and clinical value of endoscope-assisted repair of zygomatic arch fracture via a short hidden preauricular incision. METHODS: There were 7 cases of unilateral zygomatic arch fracture and 10 cases of unilateral zygomatic fracture. Reduction and fixation of zygomatic arch in all cases were performed via a short preauricular incision assisted by endoscope. RESULTS: Symmetric malar was achieved in all cases after operation. There was no difficulty in opening mouth, no chewing problems or severe complications. CONCLUSIONS: Endoscope-assisted repair of zygomatic arch fracture via a short hidden preauricular incision can be an alternative operation for zygomatic arch fracture.

[Observe the dissection of the tunnels of augmentation rhinoplasty under endoscope].

OBJECTIVE: To observe and analyse the dissection of the tunnels in traditional blind operation of augmentation rhinoplasty. METHODS: 11 Cases of augmentation rhinoplasty were collected and be observed by an endoscope as soon as the tunnels were formed during the operations. RESULTS: (1) Some of the tunnels did not go through one layer. (2) The bilateral cartilage separated in the mid-line. (3) There were two blood vessels in the surface of alar cartilage. There were perforating blood vessels in the edge of pyriform aperture. (4) In some cases whose incision were in unilateral alar margin, the tunnel were asymmetric. CONCLUSION: In some cases of traditional blind operation of augmentation rhinoplasty, tunnels were not suitable, they were asymmetric; and there were desmo and septa in the tunnels. Those might be the causes of complications post-op of augmentation rhinoplasty.

[The value of endoscopic technique in maxillofacial and neck regions].

OBJECTIVE: To discuss the value of endoscopic technique in maxillofacial and neck regions. METHODS: This retrospective review included 102 clinical patients with superficial masses in maxillofacial and neck regions. The indications, incisions, endoscopic space preparation and the key points of operative process were analysed. RESULT: All of the results were satisfying. CONCLUSION: The endoscopic technique in treating superficial masses in maxillofacial and neck regions had the advantage of wide indications, multiple incision choices, easy control of operative layers and less complications. And the recent and remote effects were excellent.