Reconstruction of Nasal Tip Using "Seagull-shaped" Cavum Concha Cartilage Composite Scaffold.

BACKGROUND: The nasal tip plays a crucial role both esthetically and functionally. The application of nasal tip grafts is an effective method for improving nasal tip form. Ear cartilage is a common choice for nasal tip grafts, but it still presents several challenges in clinical application that need to be addressed. This study aims to address the issues associated with the use of ear cartilage in clinical rhinoplasty applications through the development of a novel septal extension graft using ear cartilage for nasal tip reconstruction. METHODS: From May 2018 to April 2022, a total of 132 cases of nasal tip reconstruction surgeries were performed using a seagull-shaped nasal septum extension graft, constructed with bilateral cavum concha cartilage. Among these cases, 25 patients had previously undergone rhinoplasty using silicone implant, 7 patients had undergone augmentation rhinoplasty using expanded polytetrafluoroethylene, whereas the rest were primary rhinoplasty cases. All patients were followed up for a period ranging from 3 months to 4 years postoperatively, with photographs taken to assess the nasal tip morphology. RESULTS: In this study, all patients exhibited good healing of the incisions made at the posterior aspect of the auricular concha, with no occurrences of hematoma and inconspicuous scarring. In 116 cases, significant improvement in nasal appearance and a realistic nasal tip form were achieved postoperatively, yielding satisfactory outcomes. Only 16 patients experienced minor issues with nasal tip morphology, which were subsequently improved through further surgical procedures. CONCLUSION: This study reports a surgical technique for nasal tip refinement using bilaterally harvested cavum concha cartilage to construct a seagull-shaped nasal septal extension graft. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.

Exosomal miR-106a-5p accelerates the progression of nasopharyngeal carcinoma through FBXW7-mediated TRIM24 degradation.

Nasopharyngeal carcinoma (NPC) is prevalent in East Asia and causes increased health burden. Elucidating the regulatory mechanism of NPC progression is important for understanding the pathogenesis of NPC and developing novel therapeutic strategies. Nasopharyngeal carcinoma and normal tissues were collected. Nasopharyngeal carcinoma cell proliferation, migration, and invasion were evaluated using CCK-8, colony formation, wound healing, and transwell assays, respectively. A xenograft mouse model of NPC was established to analyze NPC cell growth and metastasis in vivo. The expression of miR-106a-5p, FBXW7, TRIM24, and SRGN was determined with RT-qPCR and Western blot. MiR-106a-5p, TRIM24, and SRGN were upregulated, and FBXW7 was downregulated in NPC tissues and cells. Exosomal miR-106a-5p could enter NPC cells, and its overexpression promoted the proliferation, migration, invasion, and metastasis of NPC cells, which were suppressed by knockdown of exosomal miR-106a-5p. MiR-106a-5p targeted FBXW7 to regulate FBXW7-mediated degradation of TRIM24. Furthermore, TRIM24 regulated SRGN expression by binding to its promoter in NPC cells. Suppression of exosomal miR-106a-5p attenuated NPC growth and metastasis through the FBXW7-TRIM24-SRGN axis in vivo. Exosomal miR-106a-5p accelerated the progression of NPC through the FBXW7-TRIM24-SRGN axis. Our study elucidates novel regulatory mechanisms of NPC progression and provides potential exosome-based therapeutic strategies for NPC.

[Spatial-Temporal Variation of Water Environment Quality and Pollution Source Analysis in Hengshui Lake].

To study the spatial-temporal variation of water environment quality in Hengshui Lake and determine the associated pollution sources, we used historical water monitoring data (from 2000 onwards) and data from 17 sites sampled in 2019 to determine the trophic level index (TLI), comprehensive water quality index (WQI), and water environment quality index (EQI). The results showed that the proportion of monitoring points reaching level Ⅲ increased from 2000 to 2019. The permanganate index, total nitrogen, and total phosphorus were the main water environmental indicators. Spatially, TLI, WQI, and EQI all generally decreased from the south to the middle and west of the lake, and then further decreased towards the northeast. After the establishment of the Hengshui Lake National Nature Reserve, a series of water body protection policies and measures were implemented. These interventions are reflected in reductions in the TLI, WQI, and EQI between 2000 and 2019 by 20.9%, 53.4%, and 49.2%, respectively. However, side seepage and sewage discharge, agricultural non-point source pollutants transported by water diversion, and the decay of plants in the lake present significant challenges for water quality in Hengshui Lake.

Incomplete convergence of gliding mammal skeletons.

Ecology and biomechanics play central roles in the generation of phenotypic diversity. When unrelated taxa invade a similar ecological niche, biomechanical demands can drive convergent morphological transformations. Thus, examining convergence helps to elucidate the key catalysts of phenotypic change. Gliding mammals are often presented as a classic case of convergent evolution because they independently evolved in numerous clades, each possessing patagia ("wing" membranes) that generate lift during gliding. We use phylogenetic comparative methods to test whether the skeletal morphologies of the six clades of extant gliding mammals demonstrate convergence. Our results indicate that glider skeletons are convergent, with glider groups consistently evolving proportionally longer, more gracile limbs than arborealists, likely to increase patagial surface area. Nonetheless, we interpret gliders to represent incomplete convergence because (1) evolutionary model-fitting analyses do not indicate strong selective pressures for glider trait optima, (2) the three marsupial glider groups diverge rather than converge, and (3) the gliding groups remain separated in morphospace (rather than converging on a single morphotype), which is reflected by an unexpectedly high level of morphological disparity. That glider skeletons are morphologically diverse is further demonstrated by fossil gliders from the Mesozoic Era, which possess unique skeletal characteristics that are absent in extant gliders. Glider morphologies may be strongly influenced by factors such as body size and attachment location of patagia on the forelimb, which can vary among clades. Thus, convergence in gliders appears to be driven by a simple lengthening of the limbs, whereas additional skeletal traits reflect nuances of the gliding apparatus that are distinct among different evolutionary lineages. Our unexpected results add to growing evidence that incomplete convergence is prevalent in vertebrate clades, even among classic cases of convergence, and they highlight the importance of examining form-function relationships in light of phylogeny, biomechanics, and the fossil record.

Osteological Re-Assessment and Taxonomic Revision of "Tanius laiyangensis" (Ornithischia: Hadrosauroidea) from the Upper Cretaceous of Shandong, China.

Tanius is the earliest named ornithischian genus from China. Since 1929, three species of this genus, namely T. sinensis (the type species), "T. chingkankouensis" and "T. laiyangensis", have been reported based on remains from the Wangshi Group of Shandong, China, and were previously recognized as hadrosaurines. Following the recent achievement of consensus on the phylogenetic placement of T. sinensis outside Hadrosauridae, the assignments of the "T. chingkankouensis" and "T. laiyangensis" material of hadrosaurid origin to the genus Tanius become problematic. Related taxonomic issues of "T. laiyangensis" therefore need re-appraisals. Here, we provide an overall taxonomic revision of "T. laiyangensis" from the Jingangkou Formation of northeast Shandong, by means of approaches of comparative anatomy, phylogeny and geometric morphometrics. Our osteological comparisons confirm the hadrosaurine affinity of "T. laiyangensis", given the presence of a suite of characters largely typical of Hadrosaurinae in the single specimen (i.e., a nearly complete sacrum and a partial right ilium), including a dorsoventrally narrow central plate of the ilium with the depth/length ratio <0.80. In the proposed phylogenetic framework, "T. laiyangensis" is inferred to be a member of Kritosaurini within Hadrosaurinae, as the sister taxon to Secernosaurus koerneri. The relative warp analysis on the lateral outline of the supraacetabular process also reveals a close resemblance of shape between the two species. Based on these different lines of evidence and considering no identification of any diagnostic characters from the specimen, we argue that the "T. laiyangensis" material comes from an indeterminate kritosaurin hadrosaurine in Asia. Anat Rec, 303:790-800, 2020. © 2019 Wiley Periodicals, Inc.

Comprehensive Application of Autologous Costal Cartilage Grafts in Rhino- and Mentoplasty.

BACKGROUND: Underdevelopment of nose and chin in East Asians is quite common. Rhinoplasty and mentoplasty are effective procedures to solve the above-depicted defects and can achieve remarkable cosmetic effects. An autologous costal cartilage graft has become an ideal material for rhinoplasty, especially for revision surgery. However, many problems in the clinical application of costal cartilage remain unresolved. This study is to investigate application strategies of autologous costal cartilage grafts in rhino- and mentoplasty. METHODS: The methods involved are as follows: application of an integrated cartilage scaffold; comprehensive application of diced cartilage; and chin augmentation of an autologous costal cartilage graft. RESULTS: In this study, satisfactory facial contour appearance was immediately achieved in 28 patients after surgery; 21 patients had satisfactory appearance of the nose and chin during the 6- to 18-month follow-up. Cartilage resorption was not observed. Two patients had nasal tip skin redness and were cured after treatment. CONCLUSION: This procedure can be used to effectively solve: curvature of the costal cartilage segment itself; warping of the carved costal cartilage; and effective use of the costal cartilage segment. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.

Phacoemulsification in the anterior chamber: An alternative surgical technique in post-vitrectomy cataract.

OBJECTIVE: To evaluate the characteristics, safety and effectiveness of a modified technique of phacoemulsification in post-vitrectomy cataracts. METHODS: This retrospective clinical trial comprised 31 patients (31 eyes) with post-vitrectomy cataract, who had undergone phacoemulsification combined with intraocular lens implantation. An alternative surgical technique known as phacoemulsification in the anterior chamber was used for nucleus management in those cases. The following parameters were evaluated: best corrected visual acuity (BCVA), ocular inflammation, intraocular pressure, endothelial cell count and surgical complications. RESULTS: Three months after surgery, the BCVA improved significantly compared with that before surgery (Z=-10.547; p<0.05). There were no significant differences in IOP before and after surgery (Z=-0.474; p>0.05). There was a statistically significant postoperative decrease in endothelial cell densities (Z=-3.916; p<0.05). The mean endothelial cell loss was -8.71%. A little inflammatory response in the anterior chamber in 11 eyes and mild corneal edema in 8 eyes were observed on the first day after surgery, which subsided after a week. The posterior capsular opacification were observed in three eyes, two of which were denser, and the YAG laser was performed for posterior capsular incision. No obvious surgical complications occurred. CONCLUSION: The modified technique of phacoemulsification, with phacoemulsification in the anterior chamber, is safe and effective to deal with post-vitrectomy cataracts.

Survey of In Situ Splitting Rib Harvesting Surgery for Orbital Deformity: Follow-Up.

BACKGROUND: Our previous study indicated that in situ splitting rib harvesting surgery clinically reduced in related complications compared with the traditional surgical approach in the early stage, but there are few studies pay close attention to long-term recovery of donor area after rib harvesting. In this study, the authors conducted a follow-up study on recovery condition of donor and graft site of patients after in situ rib splitting grafting or simple whole rib grafting surgery. METHODS: Between 2013 and 2016, 8 Chinese patients with orbital deformity were corrected using autogenous rib, of which 3 patients received conventional rib harvesting surgery, 3 patients received in situ splitting harvesting surgery, and 2 patients underwent both. In all patients, 3-dimensional computed tomography study of donor site and graft site were performed before and after operation. The ribs of donor site and graft site volume measurement were assessed using computed tomography 7 days and 12 months postoperation. RESULTS: After 12 months operation, the integrity of rib arch recovered 94.1 ±â€Š2.2% after in situ splitting rib harvesting, compared with 41.4 ±â€Š5.0% after whole rib harvesting. The volume of grafted rib in situ splitting rib harvesting group reduced 69.8 ±â€Š10.0% after 12 months operation compared with the volume after 1 week operation, and the reduced volume of ribs in whole rib harvesting group was 73.62 ±â€Š9.5%. CONCLUSION: Rib regeneration occurred more quickly by in situ rib splitting harvesting approach compared with the traditional surgical approach.

Computer-Assisted Volumetric Analysis and Quantitatively Anophthalmic Orbit Reconstruction With Dorsalis Pedis Flap and Bone Graft.

Current approaches to orbit reconstruction are based on the assumption of facial symmetry and surgeons' experiences, and the reconstructed orbits are not precise. Through computer-assisted volumetric quantitative analysis, the volume of the bony orbit, and the volume of the soft tissues in both the anophthalmic orbit and the contralateral orbit are calculated in 39 anophthalmic patients. The rib graft is used for orbit reconstruction; the dosalis pedis flap and lipo-injection were used for soft tissue reconstruction and skin socket reconstruction. The size and the shape of the rib graft and soft tissues were designed according to the volumetric analysis. The size and the shape of the skin socket were designed according to measurement during surgery. Asymmetry eye sockets with adequate size were created in the 37 patients. Two patients presented with a poor asymmetry with the contralateral orbit, and got gradual extrusion of the eye prosthesis 4 months after operation, which was because of necrosis of the flaps. The flaps were remedied by frontal island flap and skin grafting. Further surgeries, such as lipoinjection, lid surgery, and canthoplasty, were applied to improve the surgical results. The eye prostheses fitted well in all of the reconstructed sockets using this technique. Our studies suggest that the computer-assisted volumetric analysis technique combined with quantitative bone graft and dorsalis pedis flap transfer, ± lipoinjection proved to be an accurate method and a quality assurance for optimization of bony orbit, soft tissue and skin socket reconstruction, and promised a successful postoperative outcome for patients' functional and esthetic appearance.

New gliding mammaliaforms from the Jurassic.

Stem mammaliaforms are Mesozoic forerunners to mammals, and they offer critical evidence for the anatomical evolution and ecological diversification during the earliest mammalian history. Two new eleutherodonts from the Late Jurassic period have skin membranes and skeletal features that are adapted for gliding. Characteristics of their digits provide evidence of roosting behaviour, as in dermopterans and bats, and their feet have a calcaneal calcar to support the uropagatium as in bats. The new volant taxa are phylogenetically nested with arboreal eleutherodonts. Together, they show an evolutionary experimentation similar to the iterative evolutions of gliders within arboreal groups of marsupial and placental mammals. However, gliding eleutherodonts possess rigid interclavicle-clavicle structures, convergent to the avian furculum, and they retain shoulder girdle plesiomorphies of mammaliaforms and monotremes. Forelimb mobility required by gliding occurs at the acromion-clavicle and glenohumeral joints, is different from and convergent to the shoulder mobility at the pivotal clavicle-sternal joint in marsupial and placental gliders.

New evidence for mammaliaform ear evolution and feeding adaptation in a Jurassic ecosystem.

Stem mammaliaforms are forerunners to modern mammals, and they achieved considerable ecomorphological diversity in their own right. Recent discoveries suggest that eleutherodontids, a subclade of Haramiyida, were more species-rich during the Jurassic period in Asia than previously recognized. Here we report a new Jurassic eleutherodontid mammaliaform with an unusual mosaic of highly specialized characteristics, and the results of phylogenetic analyses that support the hypothesis that haramiyidans are stem mammaliaforms. The new fossil shows fossilized skin membranes that are interpreted to be for gliding and a mandibular middle ear with a unique character combination previously unknown in mammaliaforms. Incisor replacement is prolonged until well after molars are fully erupted, a timing pattern unique to most other mammaliaforms. In situ molar occlusion and a functional analysis reveal a new mode of dental occlusion: dual mortar-pestle occlusion of opposing upper and lower molars, probably for dual crushing and grinding. This suggests that eleutherodontids are herbivorous, and probably specialized for granivory or feeding on soft plant tissues. The inferred dietary adaptation of eleutherodontid gliders represents a remarkable evolutionary convergence with herbivorous gliders in Theria. These Jurassic fossils represent volant, herbivorous stem mammaliaforms associated with pre-angiosperm plants that appear long before the later, iterative associations between angiosperm plants and volant herbivores in various therian clades.

A Study of the Morbidity Involved in Whole Rib Harvesting and In Situ Splitting Rib Harvesting Surgery.

BACKGROUND: Although there have been several reports that detail the in situ rib splitting harvesting surgical procedure, there are limited published studies evaluating this procedure and the traditional whole rib harvesting approach. In this study, the authors conducted a retrospective controlled study on the complications related to the 2 rib harvesting approaches. METHODS: From March 2012 to May 2014, 24 patients were treated with rib grating, of whom 9 patients received conventional rib harvesting surgery and 15 patients received in situ splitting harvesting surgery. In all patients, a 3-dimensional computed tomography study of the chest was performed 7 days postoperatively. Postoperative complications were assessed and postoperative pain was assessed using a visual analog scale after the first 24, 48, and 72 hours after the surgery. RESULTS: The complication rate for in situ splitting rib harvesting was 6.67% versus 44.44% for patients treated with whole rib grafting surgery. After 48 and 72 hours, the visual analog scale scores in patients treated with in situ splitting rib grafts were significantly lower than the patients treated with traditional surgery. CONCLUSION: The in situ splitting approach for obtaining a rib results in a clinically significant reduction in complications compared with the traditional approach.

Classification of nasolabial folds in Asians and the corresponding surgical approaches: By Shanghai 9th People's Hospital.

INTRODUCTION: One of the earliest signs of aging appears in the nasolabial fold, which is a special anatomical region that requires many factors for comprehensive assessment. Hence, it is inadequate to rely on a single index to facilitate the classification of nasolabial folds. Through clinical observation, we have observed that traditional filling treatments provide little improvement for some patients, which prompted us to seek a more specific and scientific classification standard and assessment system. METHODS: A total of 900 patients who sought facial rejuvenation treatment in Shanghai 9th People's Hospital were invited in this study. We observed the different nasolabial fold traits for different age groups and in different states, and the results were compared with the Wrinkle Severity Rating Scale (WSRS). We summarized the data, presented a classification scheme, and proposed a selection of treatment options. RESULTS: Consideration of the anatomical and histological features of nasolabial folds allowed us to divide nasolabial folds into five types, namely the skin type, fat pad type, muscular type, bone retrusion type, and hybrid type. CONCLUSION: Because different types of nasolabial folds require different treatments, it is crucial to accurately assess and correctly classify the conditions.

Mammalian evolution. Evolutionary development in basal mammaliaforms as revealed by a docodontan.

A new Late Jurassic docodontan shows specializations for a subterranean lifestyle. It is similar to extant subterranean golden moles in having reduced digit segments as compared to the ancestral phalangeal pattern of mammaliaforms and extant mammals. The reduction of digit segments can occur in mammals by fusion of the proximal and intermediate phalangeal precursors, a developmental process for which a gene and signaling network have been characterized in mouse and human. Docodontans show a positional shift of thoracolumbar ribs, a developmental variation that is controlled by Hox9 and Myf5 genes in extant mammals. We argue that these morphogenetic mechanisms of modern mammals were operating before the rise of modern mammals, driving the morphological disparity in the earliest mammaliaform diversification.

Mammalian evolution. An arboreal docodont from the Jurassic and mammaliaform ecological diversification.

A new docodontan mammaliaform from the Middle Jurassic of China has skeletal features for climbing and dental characters indicative of an omnivorous diet that included plant sap. This fossil expands the range of known locomotor adaptations in docodontans to include climbing, in addition to digging and swimming. It further shows that some docodontans had a diet with a substantial herbivorous component, distinctive from the faunivorous diets previously reported in other members of this clade. This reveals a greater ecological diversity in an early mammaliaform clade at a more fundamental taxonomic level not only between major clades as previously thought.

Reversed Z-plasty and its variations to release wide-scar contraction.

BACKGROUND AND AIM: Z-plasty is one of the most widely used techniques in plastic and reconstructive surgery. It is useful especially to release linear-scar contractures, yet difficult to use for wide scars. The aim of this study was to report on a new technique for the effective release of contractures for wide scars using reversed Z-plasty and its variations. METHODS: This report describes a novel technique to release contractures effectively for wide scars using reversed Z-plasty and its variation. The design is a reverse style of conventional Z-plasty. In our case series, the reversed three-flap, four-flap Z-plasty or its variation was chosen depending on the width of the contracted scar. RESULTS: We performed this technique on 28 patients. All wounds healed well and the scar contracture was satisfactorily released. CONCLUSION: This procedure is useful and practical for wide-scar contractures.

The contribution of melanocytes to pathological scar formation during wound healing.

Both hypertrophic scars and keloid scars are caused by abnormal wound healing, the key feature of which is excess collagen fiber secretion by fibroblasts. Many different factors could affect the process of hypertrophic scar and keloid formation, but most have not been identified to date. We assume that, during wound healing, melanocytes from the stratum basale contact or interact with fibroblasts from the dermal layers after the basal membrane is damaged, which in turn facilitates fibroblast proliferation and the secretion and deposition of collagen. This plays a significant role in the generation of hypertrophic scars and keloids.

Does platelet-rich plasma enhance the survival of grafted fat? An update review.

Autologous fat grafting enables repair and augmentation of soft tissues and is increasingly used in plastic and reconstructive surgery. The main limitation of fat grafting is unpredictable graft resorption. To obviate this disadvantage, several studies have searched for new ways of increasing the viability of the transplanted tissue. One promising approach has been to mix the fat graft with Platelet-Rich Plasma (PRP) before transplantation. The purpose of this article is to review systematically the available comparative evidence about PRP-assisted fat grafting.

Packaged silica microsphere-taper coupling system for robust thermal sensing application.

We propose and realize a novel packaged microsphere-taper coupling structure (PMTCS) with a high quality factor (Q) up to 5×10(6) by using the low refractive index (RI) ultraviolet (UV) glue as the coating material. The optical loss of the PMTCS is analyzed experimentally and theoretically, which indicate that the Q is limited by the glue absorption and the radiation loss. Moreover, to verify the practicability of the PMTCS, thermal sensing experiments are carried out, showing the excellent convenience and anti-jamming ability of the PMTCS with a high temperature resolution of 1.1×10(-3) ◦C. The experiments also demonstrate that the PMTCS holds predominant advantages, such as the robustness, mobility, isolation, and the PMTCS can maintain the high Q for a long time. The above advantages make the PMTCS strikingly attractive and potential in the fiber-integrated sensors and laser.