Laponite intercalated biomimetic multilayer coating prevents glucocorticoids induced orthopedic implant failure.

Implant failure, which is commonly associated with failure of osseointegration and peri-implant infection, is a severe complication of orthopedic surgery. In particular, the survival rate of implants is significantly decreased in patients using long-term glucocorticoids (GCs). However, the exact molecular mechanism underlying GCs-induced implant loosening, as well as preventive strategies for these patients, is unclear. To address this problem, we performed RNA-sequencing and found that WNT16 was correlated with GCs-induced osteopenia (LogFC = -5.17, p ＜ 0.01). Inspired by the concept of "organic-inorganic" hybrid, we theorized to introduce a bioactive two-dimensional nanosheet into a layer-by-layer (LbL) self-assembly coating to construct a customized implant that targets WNT16. After screening commercially available nanosheets, laponite (LAP) was identified as a cost-effective rescuer for GCs-induced WNT16 inhibition, which was then intercalated into LbL deposition system consisting of quaternized chitosan (QCS) and hyaluronic acid (HA). The hybrid coating (QCS/HA/LAP) showed micrometer thickness and improved hydrophilicity and interface roughness. Furthermore, QCS/HA/LAP coated polyetheretherketone (PEEK) implant enhanced cell viability, adhesion, and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and promoted osteointegration of PEEK in GCs-treated rats by targeting the WNT16/ß-catenin axis. The assembled QCS has proven antibacterial properties, and the hybrid coating exerted potent detrimental effects against methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli), both in vitro and in vivo. Taken together, these results suggest that QCS/HA/LAP coating has great potential for use in implants customization, and has synergistic pro-osteogenic and antibacterial effects that help prevent implant failure in GCs-treated patients.

Single-cell transcriptome analysis reveals development atlas of mouse molar pulp cells / 中华口腔医学杂志

Objective: Single-cell RNA sequencing (scRNA-seq) was used to analyze the developing mouse molars, in order to construct a spatiotemporal development atlas of pulp cells, and further to reveal the developmental process and regulatory mechanism of tooth development. Methods: Ten mandibular first molars from C57BL/6 mice in postnatal day (PN) 0 and 3 were respectively dissected and digested to obtain single-cell suspensions. scRNA-seq was performed on 10× Genomics platform. PN 7 mouse molar scRNA-seq data were obtained from our previous study. PN 0, 3, and 7 scRNA-seq data were integrated for following analysis. The initial quality control, mapping and single cell expression matrix construction were performed by Cell Ranger. Quality control, standardization, dimensional reduction and cluster analysis were performed by using Seurat. Monocle was used to generate the pseudotime trajectory. Scillus was used to perform gene ontology analysis. In order to detect the spatiotemporal change of different population of pulp cells, the marker genes of each cluster were demonstrated by RNAscope in situ hybridization. Results: There were twenty-six cell clusters within mouse molars, which were identified as eight different cell types, including dental pulp cells, dental follicle cells, epithelial cells, immune cells, endothelial cells, perivascular cells, glial cells and erythrocytes. We further re-clustered and analyzed dental pulp cells. Cluster 0 were mature pulp cells, which located at the upper portion of crown. The main functions of cluster 0 were osteogenesis and extracellular structure organization. Cluster 1 were apical papilla cells, which located at the apical part of roots, whose main functions were extracellular structure organization and organ development. Cluster 2 were cycling cells, which were actively proliferated, resided in the lower portion of the crown. Cluster 3 and 4 were preodontoblasts and odontoblasts, respectively. Their functions were closely related to biomineralization. The proportion of mature pulp cells increased with the development process, while the proportion of cycling cells and odontoblast lineage decreased. According to the expression pattern of marker genes of each cluster, we constructed a cell atlas of dental pulp. Pseudotime trajectory analysis found there were two development trajectories within dental pulp. They both started from SPARC related modular calcium binding 2 (Smoc2)+ dental papilla cells, then went through DNA topoisomerase Ⅱ alpha (Top2a)+ cycling cells, and finally divided into coxsackie virus and adenovirus receptor (Cxadr)+ mature pulp cells or dentin sialophosphoprotein (Dspp)+ odontoblasts two lineages. Conclusions: scRNA-seq could fully discover the intercellular heterogeneity of cells on transcriptome level, which provides a powerful tool to study the process and regulatory mechanism of organ development.

Decellularized tilapia fish skin: A novel candidate for tendon tissue engineering.

The poor regenerative ability of injured tendon tissues remains a clinical challenge. However, decellularized extracellular matrix (ECM) combined with stem cells shows promise. In contrast to bovine and porcine ECM, marine-derived decellularized ECM has several advantages; it is easily obtained, poses less biological risk, and is not contraindicated on religious grounds. This study successfully fabricated decellularized tilapia fish skin (DTFS) with copious preserved collagen fibers and natural pore structures. The outer layer is smooth and dense, while the inner layer has a soft structure with a rough surface. After crosslinking with 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDC) and N-hydroxysuccinimide (NHS), crosslinked DTFS (C-DTFS) showed improved mechanics in dry and wet conditions. In vitro, the leach liquor of crosslinked DTFS showed no cytotoxicity and promoted migration and tenonic differentiation of tendon-derived stem cells (TDSCs). Meanwhile, TDSCs seeded in the inner surface of DTFS maintained viability, differentiated, and exhibited spreading. Furthermore, cell-seeded scaffolds guided the regeneration of tendon tissue in a rat Achilles tendon defect model. Our results suggest that DTFS combined with TDSCs is a novel and promising therapeutic option for tendon tissue engineering.

Whole exome sequencing and analysis of hypohidrotic ectodermal dysplasia patients / 中华口腔医学杂志

Objective: To detect gene mutation in patients with hypohidrotic ectodermal dysplasia (HED) by using whole exome sequencing, to analyze the pathogenicity of the mutations, and to provide reference for the genetic diagnosis of HED patients. Methods: Peripheral blood genomic DNA was extracted from each of the HED patients and their family members collected in Peking University School and Hospital of Stomatology from August 2016 to August 2021. Whole exome sequencing and sanger sequencing were performed to detect gene mutations. Functions of the rare variants after the database filtering were analyzed by bioinformatics tools. Results: Three reported mutations of ectodysplasin A (EDA) gene (c.2T>C, c.161A>G, c.467G>A) and a mutation of ectodysplasin A receptor (EDAR) gene (c.871G>A) were detected by whole genome sequencing in four HED patients, and were verified by Sanger sequencing in four HED families. The EDAR gene mutation founded in this research was reported in HED patients for the first time. Bioinformatics tools predicted that the mutations of EDA gene detected in this study were highly species conserved and disease-causing. The combined annotation dependent depletion (CADD) scores of EDA gene mutations c.2T>C, c.161A>G and c.467G>A were 22.5, 26.3 and 25.5 respectively, and the genomic evolutionary rate profiling (GERP) scores were 2.16, 2.26 and 2.18 respectively. The EDAR gene mutation c.871G>A detected in this study was species conserved and possibly disease-causing. The CADD and GERP scores of EDAR gene mutation c.871G>A were 22.0 and 1.93 respectively. Conclusions: Three reported mutations of EDA gene and a previously unreported mutation of EDAR gene were detected in four HED families. Different mutations of EDA gene and EDAR gene could make different influence on the protein function and lead to the occurrence of HED.

Effects of mineral trioxide aggregate and ethanolic extracts of Shandong propolis on the biological properties of human dental pulp fibroblasts / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the effect of mineral trioxide aggregate (MTA) and propolis from Shangdong province on the cell viability, mineralization and migration and anti-inflammatory ability of dental pulp fibroblasts.@*METHODS@#The human dental pulp fibroblasts were cultured and subjected to 10 mg/L of propolis and 1:8 dilution of MTA extraction. The cell viability was evaluated with cell counting kit-8 (CCK-8) after 1, 5, 7 and 9 days. The cells in the upper inserts and the test culture media on the bottoms of 24-well plates interacted for 15 hours. Then the numbers of cells migrated through the permeable membranes were compared. The cells seeded in the 24-well plates were incubated in osteogenic medium with different materials for 21 days and stained with alizarin red S, then photographed. To evaluate the deposition of calcified matrix, the wells were destained with 100 mmol/L cetylpyridinium chloride. Finally, the cells were exposed to 1 mg/L lipopolysaccharide (LPS) to induce an inflammatory response, in the presence of propolis, MTA extraction. The cells were collected after 3 h, and the expressions of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were determined using real-time polymerase chain reaction (real-time PCR). Statistical analysis was performed by one-way ANOVA and nonparametric tests (P<0.05).@*RESULTS@#The cell viability of propolis group was significantly lower than those of MTA and control groups on days 5, 7 and 9, while MTA significantly increased the numbers of the viable cells on days 7 and 9. The migration cells of propolis group (26.67±2.52) were fewer than control group (61.33±4.93), and the cells of MTA group (80.00±2.65) were statistically more than those of the other two groups. The propolis group significantly induced more calcified matrix deposition than MTA group after 21 days of culture. Propolis significantly suppressed the expressions of IL-1β and IL-6 after LPS exposure compared with MTA and control groups.@*CONCLUSION@#The propolis from Shandong compared with MTA showed a certain degree of cytotoxicity, and had no significant effect on cell migration. On the other hand, propolis exhibited significant anti-inflammatory and mineralization promotion effect, suggesting that the active ingredients of propolis could be introduced as a supplement of pulp capping materials, or used as an irrigant or intracanal medicament due to its excellent anti-inflammatory effect. Propolis may have potential in vital pulp treatment of young permanent tooth suffering pulp inflammation.

Comparative study of differentiation potential of mesenchymal stem cells derived from orofacial system into vascular endothelial cells / 北京大学学报(医学版)

OBJECTIVE@#To compare the proliferation and capacity of differentiation to vascular endothelial cells and angiogenesis induction among stem cells from human exfoliated deciduous teeth (SHED), dental pulp stem cells (DPSC) and human bone marrow mesenchymal stem cells (BMSC) from orofacial bone.@*METHODS@#SHED and DPSC were isolated from pulp tissue of the patients. BMSC were isolated from orthognathic or alveolar surgical sites. The surface markers of the cells were detected by flowcytometry. Cell counting kit-8 (CCK-8) assays were conducted to detect the proliferation ability of the cells. The cells were induced into endothelial cells with conditional medium and then the induced cells were cultured in Matrigel medium. The expression of angiogenesis-related genes such as platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31), vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 1 (VEGFR1), vascular endothelial growth factor receptor 2 (VEGFR2) and von Willebrand Factor (vWF) were quantified by real-time PCR. The cells were cultured in chick embryo chorioallantoic membrane (CAM) and the vessels were counted after 5 days.@*RESULTS@#The cell surface markers CD73, CD90, CD105 and CD146 of all the stem cells were positive, CD34 and CD45 were negative. The CD146 positive rate of SHED and DPSC was higher than that of BMSC. SHED had a higher proliferation rate than DPSC and BMSC. After angiogenic induction for 14 d, 3 kinds of cells emanated pseudopodia formed grid structure long vasculature in Matrigel media. The total length of tube formation of induced BMSC (7 759.7 μm) and SHED (7 734.3 μm) was higher than DPSC (5 541.0 μm). The meshes number of induced SHED (70.7) was higher than DPSC (60) and BMSC (53.7) in Matrigel medium. The expression of CD31, VEGFR2 and vWF genes of SHED were higher than those of BMSC and DPSC. VEGFR1 gene expression of BMSC was higher than that of the other groups, and SHED was higher than DPSC. The expression of VEGF showed no difference among the cells. No deference was showed between the effect of the stem cells and negative control on new formed vessels in CAM. The total length of vessels of SHED (30.4 mm) was higher than that of the negative control (20.9 mm) and BMSC (28.0 mm).@*CONCLUSION@#SHED, DPSC and BMSC can differentiate into vascular endothelial cells. SHED showed a stronger angiogenesis differentiation and proliferation potential compared with DPSC and BMSC.

Enhancement of exposure and reduction of elimination for paeoniflorin or albiflorin via co-administration with total peony glucosides and hypoxic pharmacokinetics comparison / 中国药理学与毒理学杂志

OBJECTIVE Paeoniflorin (PF) and albiflorin (AF) are the major active components of total peony glucosides(TPG)from Paeonia lactiflora Pal,which have many biological activities such as anti-inflammatory, antioxidation and anti-hypertension effects. The drug-drug pharmacokinetic interaction among PF,AF and TPG,the pharmacokinetic comparisons of AF between hypoxia and normoxia,the transport of AF cross the blood-brain barrier cell model and the transport of AF/PF/TPG cross Caco-2 cell model were investigated.METHODS A highly sensitive and rapid UPLC-MS method with multiple-reaction monitoring(MRM)scanning via electrospray ionization(ESI)source operating both in the positive and negative ionization mode was successfully developed and validated for simultaneous quantitation of PF and AF in rat plasma after an oral administration of PF,AF and TPG. RESULTS The validated and developed UPLC-MS/MS method was successfully applied to simultaneously determine the AF and PF concentration in rat plasma and investigate pharmacokinetic interactions after a single intragastrical ad-ministration of PF,AF,co-administration of PF with AF and TPG,respectively.The elimination of both PF co-administered with AF and PF in TPG were slower than those for PF alone and the distribution in the tissues was wider.The combination of PF with AF or TPG could significantly increase the values of the AUC, MRT and t1/2of the drug PF, and reduce the values of CL of PF. From a comparison of the main pharmacokinetic parameters among AF alone, AF combined with PF and AF in TPG, the values of the MRT and t1/2of AF in TPG were greater than that of AF alone,and there were statistically signifi-cant differences in these parameters(P<0.05,P<0.01).It was also noticed that AUC and Cmaxof PF in hypoxia rats were significantly decreased compared with that of normaxia rats, suggesting that there was a decreased exposure of PF in rats under hypoxia. The multiple active components in TPG may lead to DDIs between some P-gp substrates. CONCLUSION The clinical performance of total peony glucosides would be better than that of single constitute. The outcomes of the study are expected to serve as a basis for development of clinical guidelines on total peony glucosides usage.

Retrospective study of dental treatment under general anesthesia of 62 disabled children and adolescents / 北京大学学报(医学版)

OBJECTIVE@#To retrospectively figure out the oral health status, treatment and follow-ups after dental treatment under general anesthesia (DGA) of disabled children or adolescents.@*METHODS@#Clinical data of disabled children or adolescents and normal children as control received DGA in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology from August 2008 to September 2015 were recorded, including: gender, birth date, treatment date, disability type, oral health status before treatment, treatment content and follow-ups (in 1 year). Differences among ages and disabilities were analyzed statistically.@*RESULTS@#Sixty-two disabled patients and fifty-seven controls were recruited, mean aged (9.38±5.22) years and (3.00±1.41) years. Most patients had 10 to 15 problem teeth with which the mean number of the disabled children and adolescents was (11.79±4.98) while that of the normal controls was (12.40±4.11). Caries, pulpitis, periapical periodontitis, dental trauma and developmental tooth anomalies of the disabled patients accounted for 67.56%, 13.54%, 15.15%, 1.07%, and 2.68%, respectively and the DMFT/dmft index was 11.55±5.56 while in the control group those were at 65.35%,19.09%,14.14%,0,1.41% and 12.23±4.42. The DMFT/dmft index of the disabled patients in the group 6-12 years (8.35±4.69) was significantly less than that of the other three groups (P<0.01) while no differences were found in disabilities (P=0.239). Resin restoration, pit and fissure sealant, preventive resin restoration, pulpotomy, pulpectomy/RCT, extraction and crown of the disabled patients were performed as 52.71%, 7.24%, 8.56%, 0.72%, 17.13%, 10.01% and 3.62% respectively whereas those made up as 56.31%, 1.27%, 0.13%, 2.29%, 19.87%, 7.90% and 12.23% in the control group. Thirty-five (56.45%) disabled patients and forty-three (75.44%) controls recalled. Problem teeth within one year after operation in diabled patients and controls were both nearly twice as much as the number within half a year. Restoration loss/fractured mainly occurred in anterior primary teeth while secondary/ recurrent caries and pulpitis/perapical periodontitis mostly occurred in primary molars.@*CONCLUSION@#Oral health status in our disabled children and adolescents is poor. Though dental treatment under GA is an effective way to improve the oral health of disabled children and adolescents, periodic follow-ups and family oral health care are equal important for oral health maintenance.

Comparison of the properties of CD146 positive and CD146 negative subpopulations of stem cells from human exfoliated deciduous teeth / 北京大学学报(医学版)

OBJECTIVE@#Stem cells from human exfoliated teeth (SHED) were sorted by magnetically activated cell sorting (MACS) technique to obtain the CD146 positive and negative cell subpopulation. Then the biological characteristics of these subpopulations were compared to explore their specific application potential in tissue engineering.@*METHODS@#In this study, freshly extracted deciduous teeth without any caries or dental pulp disease were obtained. SHED was isolated using enzyme digestion method and then sorted by MACS, CD146 positive cells and CD146 negative cells were obtained after cell sorting. The biological characteristics of the unsorted mixed cells, CD146 positive subpopulation and CD146 negative subpopulation were compared. The proliferation ability was detected through cell counting kit-8 (CCK-8) and colony-forming unit (CFU). After osteogenic induction, alizarin red staining was performed and the gene expression of osteogenic related markers was detected by quantitative real-time polymerase chain reaction(qPCR). After adipogenic induction, oil-red O staining was performed and the gene expression of adipogenic related markers was detected. After neurogenic differentiation induction, the expression of neural markers was detected by immunofluorescence and the gene expression of neural markers was detected by qPCR.@*RESULTS@#SHED of the fifth passage was sorted by MACS. And the CD146 positive cell subpopulation and CD146 negative cell subpopulation were obtained. CCK8 assay showed that the proliferative tendency of the three cell groups was consistent, but the proliferation potential of CD146 positive and negative cell subpopulations was significantly lower than that of the unsorted cells. The colony forming rates of the unsorted mixed cell group, CD146 positive and negative populations were 28.6%±3%,17.1%±2.3% and 27.5%±2.5%, respectively. After 21 days of osteogenic induction, alizarin red staining and qPCR showed that the CD146 positive cell population had more mineralized nodule formation and expressed higher level of osteogenic related genes compared with the other two groups. After 21 days of adipogenic induction, oil red O staining and qPCR results showed that the CD146 negative subpopulation produced more lipid droplets and the expression of lipid related genes increased more significantly. After 14 days of neural induction, cell immunofluorescence and qPCR results showed that the unsorted mixed cell group and CD146 positive subpopulation expressed glial cell marker, and the expressions of neural precursor cells and neuronal marker increased significantly in negative subpopulation.@*CONCLUSION@#The unsorted mixed cells showed better proliferative potential than CD146 positive and negative subpopulations. The CD146 positive subpopulation was most potent in osteogenic differentiation; it was more suitable for bone tissue engineering. The CD146 negative cells had stronger adipogenic differentiation potential than the other two cell groups; different subpopulations differed in neural differentiation.

Preliminary clinical observations on autologous cultured skin fibroblasts transplantation to treat the facial soft tissue deficiencies / 中华整形外科杂志

<p><b>OBJECTIVE</b>To observe the effect and safety of autologous cultured skin fibroblasts transplantation for treating depressed facial skin defects.</p><p><b>METHODS</b>A total of 19 patients were treated from Jan, 2010 to Oct, 2010. Autologous skin fibroblasts were separated from postauricular skin biopsy or resected skin tissue in other surgeries such as blepharoplasty. They were cultured and expanded with exclusive method. Cells (2 x 10(7)/ml) within three passages were injected intradermally at the site of skin depression three times at one-month interval. Adverse events were observed and recorded. Clinical effects were evaluated and graded by two unrelated physicians before and 6 months after the first injection.</p><p><b>RESULTS</b>Cells from 16 patients were successfully cultured at the first time. The other 3 patients underwent a second harvest. A total amount of 6 x 10(8) cells could be reached within three passages in 45 days. 16 out of 19 patients accomplished the whole course of this study. Minor adverse events were observed in two patients including small ulcer caused by over injection in one patient and slightly redness and swelling in the other. The redness disappeared after a week without any treatment. No serious complications were observed. Significant difference was noticed between the scores obtained before and after the treatment.</p><p><b>CONCLUSIONS</b>From this study, neither serious complications nor excessive cell proliferation or scar formation was found after cell injection. The effect of using autologous fibroblast transplantation was obvious and long-lasting, which provides a new choice for the treatment of depressed facial skin defects.</p>

Isolation and identification of Beagle dog dental pulp stem cells / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To identify the existence of the dental pulp stem cells in Beagle's pulp tissue by using the same methods of isolating and culturing the human dental pulp stem cells.</p><p><b>METHODS</b>Pulp tissue was extirpated from the crown and root of the Beagle's healthy permanent tooth, and digested by dispase for cell culture. Classical identification methods of mesenchymal stem cells including observation of biological characteristics, capacity of multilineage differentiation, and expression of specific markers associated with mesenchymal stem cells were applied to verify the existence of Beagle's dental pulp stem cells.</p><p><b>RESULTS</b>A clonogenic, rapidly proliferative population of cells were isolated from Beagle' pulp tissue. Under the same culture condition, the Beagle's dental pulp stem cells had a significant higher colony-forming unit-fibroblast (CFU-F) formation rate (150 colony/10(4) cells) than the dental pulp cells derived from the human pulp tissue (60 colony/10(4) cells). These cells also had the multilineage differentiation ability. They could be induced to form mineralized nodules, lipid droplets and chondrocytes. Furthermore these cells expressed the mesenchymal stem cell markers including STRO-1, CD146, alkaline phosphatase, nestin, vimentin and cytokeratin-18.</p><p><b>CONCLUSIONS</b>There are dental pulp stem cells in the Beagle's pulp tissue.</p>

The role of pulp in the root resorption of primary teeth without permanent tooth germs / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the role of pulp in the root resorption of primary teeth without permanent tooth germs.</p><p><b>METHODS</b>The animal model without permanent tooth germs was established by surgery in Beagle dog. The root resorption was observed by taking periapical radiographs periodically. The samples of mandibular bone and pulp at different resorption stages were collected. The distribution of odontoclasts and the activating factor was analyzed by histological staining and semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR). The role of pulp in the root resorption of primary teeth was tested by early pulpectomy.</p><p><b>RESULTS</b>In the root resorption of primary molars without permanent teeth germs, a large number of odontoclasts were present on the pulpal surface of the root canal. Semi-quantification RT-PCR showed that the ratios of the expression of receptor activator of NF-κB ligand (RANKL) mRNA and β-actin in the pulp of permanent teeth and primary teeth without permanent teeth germ during different periods of root resorption are 0.1314, 0.1901, 0.2111 and 0.6058 (P > 0.05). The root resorption of primary teeth without permanent teeth germs in test groups was about 5 weeks later than that of control group.</p><p><b>CONCLUSIONS</b>The pulp of primary tooth played an important role in the root resorption of primary tooth without permanent tooth germ.</p>

Results of functional management of condylar fracture in 3 to 16 years old children / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of soft occlusal splint in the treatment of condylar fracture in children and adolescents.</p><p><b>METHODS</b>Twenty-three children with condylar fracture aged from 3 to 16 were included in this study. Impressions of both jaws were taken and stone working models poured. After occlusion was recovered by mounting on a bionic articulator, a soft occlusal splint was fabricated. The occlusal splint was worn for 1 to 3 months accompanied with functional exercise. Follow-up was carried out by clinical observation and panoramic image.</p><p><b>RESULTS</b>Clinical satisfactory results were obtained in all the patients with good occlusion, unimpaired function and normal growth and development of the mandibles. Panoramic image showed reconstruction of the fractured condyles, which were flattened and short.</p><p><b>CONCLUSIONS</b>Soft occlusal splint is a promising approach for treating condylar fracture in children.</p>

ssociation of HLA class I and II alleles with generalized vitiligo in Chinese Hans in north China / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association of HLA class I and II alleles with generalized vitiligo in ethnic Han Chinese in north China.</p><p><b>METHODS</b>By employing polymerase chain reaction sequence-specific primer (PCR-SSP) procedure 34 generalized vitiligo patients in north China were studied for HLA I and II alleles and were compared with 102 healthy controls.</p><p><b>RESULTS</b>The allelic frequencies of HLA-A*30, Cw*06, DRB1*07, and DQB1*0201 were increased significantly in generalized vitiligo and especially in the patients without family history compared with the controls.</p><p><b>CONCLUSION</b>These alleles positively associated with generalized vitiligo in Chinese Han patients in north China, might provide clues to reveal the susceptibility gene(s) of vitiligo in Chinese and as well as the immunnogenetic mechanisms of disease.</p>

Deep inferior epigastric perforator flap for breast reconstruction: experience with 43 flaps / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In the past decade, there has been increasing breast reconstructions after mastectomy. The ideal material for reconstruction of a breast is fat and skin. The transverse rectus abdominis myocutaneous (TRAM) flap has been the gold standard for breast reconstruction until recently. Abdominal wall function is a major concern for plastic surgeons in breast reconstruction with TRAM flaps. The deep inferior epigastric perforator (DIEP) free flap spares the whole rectus abdominis muscle, includes skin and fat only, and therefore preserves adequate abdominal wall competence. The aim of this study was to summarize our experience in breast reconstruction with DIEP flap.</p><p><b>METHODS</b>Between March 2000 and August 2005, a total of 43 breast reconstructions were performed on 40 patients by our surgeons using DIEP flap (3 patients had bilateral procedures), 14 of them were immediate surgeries and 26 were delayed. Abdominal function, satisfaction with the donor site and reconstructed breast, and the sensation recovery was assessed respectively during follow-up.</p><p><b>RESULTS</b>The mean age of the patients was 38.6 years (range, 28 - 50). The size of the flaps was 11 cm x 26 cm in average (height 10 - 12 cm, width 15 - 33 cm). The mean length of the vascular pedicles was 9.3 cm (range, 7 - 12). The patients were followed up for a mean of 16 months (range, 6 - 30 months). During the follow-up, 2 (5%) patients had total flap loss, 2 (5%) had partial necrosis, 4 (9%) had wound edge necrosis in the abdomen, and 1 had axillary seroma. None of the patients had hernia, and all of them were able to resume their daily activities after the operation. Patient satisfaction with the reconstructed breast rated high, 95% of the patients achieved spontaneous return of sensation in the reconstructed breast, but none of them had a sensation equivalent or approximate to the normal.</p><p><b>CONCLUSIONS</b>The DIEP flap has the same benefits as the TRAM flap without destroying the continuity of the rectus muscle. It can reduce donor-site morbidity and provide an aesthetic refinement in breast reconstruction.</p>

The application of pedicled anterolateral thigh fasciocutaneous flaps for reconstruction of perineal and inguinal defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a method for the reconstruction of defects of perineum and groin with pedicled anterolateral thigh fasciocutaneous flaps.</p><p><b>METHODS</b>From July 2003 to February 2005, 12 pedicled anterolateral thigh fasciocutaneous flap based on the perforators of lateral circumflex femoral artery had been designed and transferred to the defects of perineum and groin.</p><p><b>RESULTS</b>Anterolateral thigh fasciocutaneous island flaps were performed in twelve patients. The size of the transferred flap ranged from 8 cm x 11 cm to 18 cm x 20 cm. Only one patient developed superficial cutaneous necrosis in the posterior aspect of the flap because of fecal contamination and infection. The wounds healed secondarily.</p><p><b>CONCLUSIONS</b>Despite variable vascular anatomy and technical difficulties in elevating the anterolateral thigh flap, the anterolateral thigh flap is a good choice for perineum and groin reconstruction.</p>

Repair of facial skin defect with a skin flap of SMAS pedicle / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report a method of repair facial skin defects with a skin flap of SMAS pedicle.</p><p><b>METHODS</b>According to the size of defect of skin, design a skin flap with SMAS pedicle for repair of defect.</p><p><b>RESULTS</b>The method has been successfully applied for skin defects of eyelid and lip in 14 cases with satisfied results. The area of the largest flap was 5 cm x 3 cm.</p><p><b>CONCLUSION</b>Repairing facial defects such as eyelid skin defect or lip skin defect with skin flap of SMAS pedicle is a very good method. The flap has a good blood supporting and satisfactory color and flexibility.</p>

Aesthetic correct depressed nose and prolong nasal columella using nasal columella base flaps, bilateral labial mucosa flaps, and the silicone imitation / 中华整形外科杂志

<p><b>OBJECTIVE</b>Using simple method to reform depressed middle part of the face and to prolong nasal columella.</p><p><b>METHODS</b>Fill silicone into the subcutaneous cavity of the nase and maxillary attended by using nasal columella base and bilateral labial mucosa flaps.</p><p><b>RESULTS</b>Obtain a satisfactory result to reform depressed nose,nasal columella and maxilla.</p><p><b>CONCLUSIONS</b>It is a propagable economic way to resolve a complex deformation using this simple method, and get a satisfactory result.</p>

A report of 136 cases of upper eyelid fold formation together with medial canthoplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To find a new method to perform medial canthoplasty and upper eyelid fold formation at one stage.</p><p><b>METHODS</b>Based on the principle to release the skin tension and minimize incision scarring around the medial canthus, an operation was designed for medial canthoplasty together with upper eyelid fold formation. 136 patients with mild or moderate epicanthus underwent this procedure. Postoperative follow-up was as long as 34 months.</p><p><b>RESULTS</b>Based on the follow-up of 67 cases, the appearances of the upper eyelid fold and medial canthus were evaluated. The upper eyelid fold was the parallel type. The epicanthus was corrected completely or mostly.</p><p><b>CONCLUSION</b>This new method for medial canthoplasty together with upper eyelid fold formation is suitable to all the simple epicanthus except the reverse epicanthus. The operative results were effective and satisfactory.</p>

The fibroblast primary cell culture by the split-thickness skin slide technique / 中华整形外科杂志

<p><b>OBJECTIVE</b>To acquire lots of cell to culture during the primary cell culture.</p><p><b>METHOD</b>We take the split-thickness skin slide technique to acquire the dissociated fibroblast cell in two big-ear rats.</p><p><b>RESULTS</b>The cell number is above 10(6) from 1 cm x 2 cm split-thickness skin slide and the technique is simple, economic, effectve.</p><p><b>CONCLUSION</b>We think this way is better than other methods, and should be adopted in the primary cell culture, especially in fibroblast transplantation by injection.</p>