Application of septal extension grafts with auricular cartilage in rhinoplasty. / 耳廓软骨鼻中隔延伸支架移植物在鼻整形术中的应用.

OBJECTIVES: Rhinoplasty is one of the most common cosmetic surgeries in China. Septal extension grafts (SEG) have been widely used in rhinoplasty, but there are few reports on SEG derived from ear cartilage. This study aims to explore the effectiveness and stability of auricular cartilage nasal SEG transplantation in Chinese rhinoplasty. METHODS: A retrospective analysis of 35 rhinoplasty patients admitted from September 2019 to March 2022 has been conducted. Among them, 29 patients underwent rhinoplasty for the first time and 6 patients underwent rhinoplasty with the age of 18-32 (average 22.4) years old. The postoperative follow-up was 3-28 (average 18.5) months. The improvement of the nose shape was observed. The changes of the nose tip angle, nasolabial angle, and nasofrontal angle were compared between before and after the operation, and the complications were recorded. RESULTS: All patients who underwent rhinoplasty with a septal extension grafts constructed from the concha cavity and concha cartilage showed significant improvement in nasal contour. The preoperative nasal tip angle, nasolabial angle, and nasofrontal angle were significantly improved compared with 3 months after operation (all P<0.001), and there was no significant difference between 3 months and 14 months after operation (all P>0.05). The appearance of nasal cavity was satisfactory in 32 patients after operation. Columella deviation occurred in 2 patients and 1 patient complained of downward rotation of the nasal tip, which was satisfied after readjustment of the graft. CONCLUSIONS: The simplified SEG derived from auricular cartilage can provide stable support for the nasal tip, the nasal shape is natural after operation, and minimal trauma of unilateral auricle cartilage transplantation remains.

A Novel Fat Making Strategy With Adipose-Derived Progenitor Cell-Enriched Fat Improves Fat Graft Survival.

BACKGROUND: A low survival rate is one of the main challenges in fat grafting. OBJECTIVES: This study aimed to evaluate whether microfat obtained by a novel strategy promoted the survival and retention of fat grafts. METHODS: A 5-mm-diameter blunt tip cannula with large side holes (~30 mm2/hole) was used to obtain macrofat. A novel strategy based on a newly invented extracorporeal cutting device was then used to cut the macrofat into microfat, which was named adipose-derived progenitor cell enrichment fat (AER fat); Coleman fat was used as the control. Aliquots (0.5 mL) of both types of fat were transplanted into 10 nude mice and analyzed 10 weeks later. Western blotting, flow cytometry, and immunofluorescence were performed to assess the AER fat characteristics and underlying mechanisms. RESULTS: The retention rate of fat grafts in AER fat-treated animals was significantly higher than that in the Coleman group (mean [standard deviation] 54.6% [13%] vs 34.8% [9%]; P < 0.05) after 10 weeks. AER fat contained more dipeptidyl peptidase-4-expressing progenitor cells (3.3 [0.61] × 103 vs 2.0 [0.46] × 103 cells/mL; P < 0.05), adipose-derived plastic-adherent cells (6.0 [1.10] × 104 vs 2.6 [0.17] × 104 cells/mL; P < 0.001), and viable adipocytes than Coleman fat. Moreover, histologic analysis showed that AER fat grafts had better histologic structure and higher capillary density. CONCLUSIONS: AER fat transplantation is a potential strategy to improve the survival and long-term retention of fat grafts. AER fat contained more dipeptidyl peptidase-4-expressing progenitor cells.

Clinical application of the 6th autogenous costal cartilage in the treatment of severe saddle nose deformity after trauma. / 第6自体肋软骨在外伤后重度鞍鼻畸形修复中的临床应用.

OBJECTIVES: Saddle nose deformity is a common clinical nose deformity. This study aimed to evaluate the effectiveness of the 6th autogenous costal cartilage in the treatment of severe saddle nose deformity after trauma. METHODS: A retrospective analysis was conducted on 15 patients with severe post-traumatic saddle nose deformity from March, 2016 to March, 2019. The nasal tip and dorsum were reconstructed with autogenous costal cartilage. All patients were followed up for 6 to 13 months and changes in nasal appearance were evaluated. The changes in dorsum sag, nasolabial angle, nasal dorsal angle, and dorsum length were measured. RESULTS: Fourteen patients were basically satisfied with post-operative outcome. Only one patient developed infection afterwards, which was improved by the revised rhinoplasty 2 months after active treatment. The immediate nasal dorsal depression [(1.19±0.94) mm] and nasolabial angle [(94.06±1.52)°] after operation decreased compared with those before surgery [(8.28±0.24) mm, (109.42±2.78)°, respectively; all P<0.05]. The immediate nasal dorsal length [(44.18±1.02) mm] and nasal dorsal angle [(132.84±2.33)°] increased compared with those before operation [(31.73±1.86) mm, (122.87±2.42)°, respectively; all P<0.05]. The data at follow-ups showed no statistical difference compared with the immediate data after operation. CONCLUSIONS: Rhinoplasty with the 6th autogenous costal cartilage is an effective method for the correction of severe saddle nose deformity after trauma.

Mandibular Augmentation With a New Sandwich Osteotomy: A Morphologic Study.

OBJECTIVE: Facial asymmetry is one of common complaints in plastic and craniofacial surgery in Orient. Hemimandibular dysplasia has considered to be the key role in facial asymmetry. Despite of the undergrow of mandibular length and height, the lackness of mandibular thickness contributes to the asymmetry. The aim of this study was to describe the therapeutic efficiency of mandibular augmentation with a new sandwich osteotomy with interpositional natural coral and coralline hydroxyapatite (CHA). METHODS: Nine goats were randomly divided into 3 groups and observed at 6, 12, and 18 months after surgery. All goats received splitting of bilateral mandibular outer cortex and interpositional grafting with natural coral and CHA, respectively (sandwich osteotomy). Data were evaluated and statistically analyzed by t-test. RESULTS: All goats were observed at 3 different time points. The computed tomography images show that the area of operation was healed and the thickness of the mandible was increased in 3 time points. In the 3 groups, mandibular thickness and volume were significantly different compared with those before operation (P < 0.05). The volume of CHA group improved better than coral group (P < 0.05). CONCLUSION: This study provides a promising alternative method for mandibular augmentation with a sandwich osteotomy and interpositional grafting with natural coral and CHA. The thickness and volume of mandible had been effectively increased in follow-ups.

Customized Titanium Mesh for Repairing Cranial Defects: A Method With Comprehensive Evaluation.

Titanium cranioplasty is one of the well-established and widely used techniques for repairing cranial defects. In this paper, we present an improved way to design and create titanium meshes with more evaluation process. Computed tomography scan data of patients were used to create three-dimensional virtual models. Implants were designed with NX ImageWare 13.2 (Siemens PLM Software, Plano, TX). Final titanium meshes were assessed by Geomagic Studio 12 (Geomagic, Inc., Morrisville, NC) and NX ImageWare 13.2.Titanium meshes were designed and applied to cranioplasty surgery on 8 patients. Postoperative results were evaluated by computed tomography scanning and further analyzed with rainbow difference tomography. All patients were satisfied with the outcome. With this method, surgeons, engineers, and patients work together to evaluate and edit implant design. Our method provides better communication and comprehensive evaluation, which result in a satisfying outcome.

[Endovascular treatment for venous malformations with three-point anhydrous ethanol injection].

OBJECTIVE: To explore the safe method with anhydrous ethanol injection in the treatment of venous malformation.
 METHODS: A total of 96 patients with venous malformation were conducted anhydrous ethanol injection for 245 times through percutaneous puncture by three-point method. The complications were observed. In animal experiment, according to the different concentrations of anhydrous ethanol injection, rats were divided into an anhydrous ethanol group, a 75% ethanol group, a 50% ethanol group and a 25% ethanol group (n=5 in each group), and the damage of vessels after ethanol injection was observed.
 RESULTS: The successful rate for three-point ethanol injection was 88%. The incidence for both skin ulcer and numbness was 0.9% without severe complications in lung and heart. In the animal experiments, the entire vessel wall including outer membrane was damaged in the anhydrous ethanol group. Part of vessel walls, including the inner membrane and muscle layer, were damaged in both the 75% ethanol group and the 50% ethanol group. However, there was no damage in the vessels in the 25% ethanol group.
 CONCLUSION: With the decrease in ethanol concentration, the vascular damage is decreased and eventually disappeared. Three-point anhydrous ethanol injection is safe and effective.

GelMA-based bioactive hydrogel scaffolds with multiple bone defect repair functions: therapeutic strategies and recent advances.

Currently, the clinical treatment of critical bone defects attributed to various causes remains a great challenge, and repairing these defects with synthetic bone substitutes is the most common strategy. In general, tissue engineering materials that mimic the structural, mechanical and biological properties of natural bone have been extensively applied to fill bone defects and promote in situ bone regeneration. Hydrogels with extracellular matrix (ECM)-like properties are common tissue engineering materials, among which methacrylate-based gelatin (GelMA) hydrogels are widely used because of their tunable mechanical properties, excellent photocrosslinking capability and good biocompatibility. Owing to their lack of osteogenic activity, however, GelMA hydrogels are combined with other types of materials with osteogenic activities to improve the osteogenic capability of the current composites. There are three main aspects to consider when enhancing the bone regenerative performance of composite materials: osteoconductivity, vascularization and osteoinduction. Bioceramics, bioglass, biomimetic scaffolds, inorganic ions, bionic periosteum, growth factors and two-dimensional (2D) nanomaterials have been applied in various combinations to achieve enhanced osteogenic and bone regeneration activities. Three-dimensional (3D)-bioprinted scaffolds are a popular research topic in bone tissue engineering (BTE), and printed and customized scaffolds are suitable for restoring large irregular bone defects due to their shape and structural tunability, enhanced mechanical properties, and good biocompatibility. Herein, the recent progress in research on GelMA-based composite hydrogel scaffolds as multifunctional platforms for restoring critical bone defects in plastic or orthopedic clinics is systematically reviewed and summarized. These strategies pave the way for the design of biomimetic bone substitutes for effective bone reconstruction with good biosafety. This review provides novel insights into the development and current trends of research on GelMA-based hydrogels as effective bone tissue engineering (BTE) scaffolds for correcting bone defects, and these contents are summarized and emphasized from various perspectives (osteoconductivity, vascularization, osteoinduction and 3D-bioprinting). In addition, advantages and deficiencies of GelMA-based bone substitutes used for bone regeneration are put forward, and corresponding improvement measures are presented prior to their clinical application in near future (created with BioRender.com).

Changes in width of lower face after unilateral mandibular distraction osteogenesis.

Distraction osteogenesis (DO) has been popular to improve hypoplastic mandible in patients with hemifacial microsomia in craniofacial surgery. However, changes in width of the lower face after DO still lack in literatures. The aim of this pilot study was to evaluate cephalometric changes in width of the lower face at different time points after DO and to give an insight into the influence on facial contour. A total of 10 patients (8 males and 2 females) with hemifacial microsomia received DO of the mandibular body measured by posteroanterior cephalograms. Five landmarks (crista galli, latero-orbitale, gonion of the unaffected side, incisor point superior of the unaffected maxilla, incisor point inferior of the unaffected side of the mandible) were chosen for cephalometric analysis. Six distances from the soft tissue contour perpendicularly to the vertical reference line (through crista galli) were calculated through the incisor point superior of the unaffected maxilla, gonion of the unaffected side, incisor point inferior of the unaffected side of the mandible. Measurements were taken preoperatively and postoperatively on the day distraction started (time 1), at the end of distraction (time 2), and at the end of the consolidation period (time 3). Calculations for statistical significance were done for all patients. Mean differences between 3 periods were measured by repeated-measures analysis with significance determined at the 0.05 level of confidence. The results suggested that the values of 6 distances at times 2 and 3 had no significant differences when compared with the values at time 1 (P>0.05). In conclusion, DO of the unilateral mandibular body in patients with hemifacial microsomia should not be beneficial to improve the width of the lower face at a short-term follow-up.

Feasibility of absorbable plates and screws for fixation in reduction malarplasty with L-shaped osteotomy.

Reduction malarplasty with L-shaped osteotomy has been widely applied to correct malar prominence because of its simple manipulation, satisfactory outcome, and few complications in east Asians. Secondary surgery for the removal of titanium miniplates or microplates and screws is often needed because of the drawbacks of implants. To overcome the disadvantage, the authors applied absorbable plates and screws instead of titanium fixation system and evaluated the feasibility of them. A total of 47 women (mean age, 26.8 y) diagnosed with malar prominence were randomly selected and received L-shaped osteotomy for malar reduction from January 2008 to December 2009. Of these, 22 patients (group A) received absorbable plates and screws (Fixsorb-MX, Takiron, Japan) for fixation and 25 patients received titanium fixation system as control (group B). The outcomes were evaluated by photographs and x-ray films. The distance of the anterior protrusive point of the bilateral zygoma (Zv-Zv), the distance from the paries anterior of acoustic duct (P) to the anterior protrusive point of zygoma (P-Zv), and the angle formed by the nasion-Zv line and the P-Zv line (∠NZP) were analyzed through posteroanterior and lateral cephalograms preoperatively, 10 days postoperatively, and at 6 to 12 months of follow-up, respectively. In group A, 20 patients (90.9%) were satisfied with the outcomes compared with 92.0% in group B. No zygomatic nonunion and other complications occurred after surgery in both groups. In group A, the values of Zv-Zv and P-Zv were 88.4±1.6 and 68.6±6.8 mm at 10 days after surgery, which increased to 90.6±1.5 and 70.7±3.0 mm at 6 to 12 months of follow-up. The value of ∠NZP was 105.0±4.3 degrees at 10 days after surgery and 103.2±3.6 degrees at 6 to 12 months after surgery. In group B, the values of distance and degree maintained almost the same at different time points after surgery. The results had no significant difference between groups A and B (P>0.05). The findings of the study suggested that the application of absorbable plate system in reduction malarplasty with L-shaped osteotomy is feasible. The absorbable fixation system would have a wider application in craniofacial surgery.

[Retracted] MicroRNA­138 inhibits migration and invasion of non­small cell lung cancer cells by targeting LIMK1.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that certain of the western blotting data shown in Figs. 3C and 5A were strikingly similar to data appearing in different form in another article by different authors, which had already been published elsewhere at the time of the present article's submission. Furthermore, cell Transwell assay data in the article (featured in Fig. 4B) were strikingly similar to data appearing in different form in other articles by different authors, which were either already under consideration for publication or had already been published elsewhere at the time of the present article's. Owing to the fact that the contentious data in the above article were either already under consideration for publication, or had already been published elsewhere, prior to its submission to Molecular Medicine Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office never received any reply. The Editor apologizes to the readership for any inconvenience caused. [the original article was published in Molecular Medicine Reports 14: 4422­4428, 2016; DOI: 10.3892/mmr.2016.5769].

LINC00470 accelerates the proliferation and metastasis of melanoma through promoting APEX1 expression.

Recently studies found that APEX1 was abnormally expressed in melanoma, indicating that it might be involved in the development of melanoma. However, the underlying mechanism and the interaction between APEX1 and LINC00470 in melanoma are not clear. Therefore, we aimed to investigate the role of LINC00470 in the development of melanoma in this work. We discovered that LINC00470 was overexpressed in melanoma tissues and cells compared with the adjacent normal tissues and cells by qPCR. The overexpression of LINC00470 promoted the proliferation and migration of melanoma cells. The functional investigation demonstrated that LINC00470 activated the transcription factor, ZNF131, to regulate the APEX1 expression, which finally promoted cell proliferation and migration. In contrast, knockdown of LINC00470 could significantly inhibit the melanoma cell proliferation and migration, and suppress the growth of tumor in vivo. Overexpression of APEX1 could reverse the impact of the silence of LINC00470 in melanoma cells. In summary, our studies revealed that LINC00470 promoted melanoma proliferation and migration by enhancing the expression of APEX1, which indicated that LINC00470 might be a therapeutic target for the treatment of melanoma.

Changes in occlusal force after intraoral one-stage curved osteotomy of the prominent mandibular angle.

BACKGROUND: Curved osteotomy of a prominent mandibular angle is widely used in narrowing the width of the lower face, but its influence on occlusal force has not been evaluated. METHODS: The maximum occlusal forces of five different teeth areas in 20 consecution patients with an average age of 26.5 years were studied. The examinations were performed both before the operation and 6 months afterward. RESULTS: The values of maximum occlusal force had reached the preoperative levels or slightly above for the incisor teeth, bilateral premolar teeth, and bilateral molar teeth 6 months after operation. There were no significant differences between the levels before the operation and 6 months afterward (P > 0.05). CONCLUSION: According to the study findings, curved osteotomy of the prominent mandibular angle had no long-term harmful effects on occlusal force.

NEDD4 Negatively Regulates GITR via Ubiquitination in Immune Microenvironment of Melanoma.

INTRODUCTION: Melanoma is a common skin cancer that is usually associated with poor clinical outcomes. Recently, the immune checkpoint GITR has been identified as a promising target for immunotherapy of melanoma. In this study, we aimed to investigate the post-translational regulation mechanism of GITR in melanoma. METHODS: Western blotting was used to evaluate the protein expression of NEDD4, GITR and Foxp3. Real-time PCR (RT-PCR) was performed to determine expression levels of NEDD4, GITR, Foxp3 and IL-2. Cell viability was detected by MTT assay. The ubiquitination of GITR was evaluated by immunoprecipitation. NEDD4 expression data and melanoma survival data were obtained from The Cancer Genome Atlas (TCGA) and cBioPortal databases. RESULTS: We demonstrate that E3 ligase NEDD4 binds to GITR and mediates ubiquitination and degradation of GITR. Overexpression of NEDD4 inhibits anti-tumor immunity mediated by T cells against melanoma cells. We also found that the expression of NEDD4 is increased in metastatic melanoma. High NEDD4 expression level is correlated with the poor prognosis of melanoma patients. DISCUSSION: In summary, our findings demonstrated that E3 ligase NEDD4 mediates ubiquitination and degradation of GITR and suppresses T-cell-mediated-killings on melanoma cells. Our work highlighted the E3 ligase NEDD4 as a novel prognosis biomarker and therapeutic target for melanoma.

MicroRNA-138 inhibits migration and invasion of non-small cell lung cancer cells by targeting LIMK1.

MicroRNA (miR)-138 has previously been demonstrated to have a suppressive role in numerous types of human cancer, including non-small cell lung cancer (NSCLC). LIM domain kinase 1 (LIMK1) is a serine/threonine kinase that regulates actin polymerization via phosphorylation and inactivation of cofilin. Previous studies have reported that LIMK1 is associated with NSCLC; however, the underlying regulatory mechanism of LIMK1, and the association between LIMK1 and miR­138 in NSCLC cells, remains largely unknown. The present study aimed to reveal the regulatory roles of miR­138 and LIMK1 in NSCLC cell migration and invasion. Reverse transcription­quantitative polymerase chain reaction and western blot analysis were used to examine the mRNA and protein expression levels. Transwell and wound healing assays were conducted to determine cell invasion and migration. A luciferase reporter assay was used to determine the target association between miR­138 and LIMK1. The present study demonstrated that miR­138 was markedly downregulated in NSCLC tissues and cell lines, whereas the expression levels of LIMK1 were significantly upregulated. LIMK1 was further identified as a direct target of miR­138 in NSCLC H460 cells. Furthermore, overexpression of miR­138 significantly inhibited the protein expression of LIMK1, whereas knockdown of miR­138 upregulated the protein expression of LIMK1 in H460 cells. In addition, overexpression of miR­138 significantly inhibited the migration and invasion of NSCLC cells; however, overexpression of LIMK1 significantly promoted NSCLC cell migration and invasion. An investigation into the underlying molecular mechanism revealed that overexpression of miR­138 significantly decreased cofilin signaling activity, whereas knockdown of miR­138 notably enhanced cofilin signaling activity. In conclusion, the present study suggests that miR­138 may inhibit the migration and invasion of NSCLC cells by targeting the LIMK1/cofilin signaling pathway. Therefore, miR-138/LIMK1/cofilin may be considered a potential therapeutic target for the treatment of NSCLC.

Restoration of facial symmetry in hemifacial microsomia with mandibular outer cortex bone grafting combined with distraction osteogenesis.

BACKGROUND: Mandibular distraction is a well-established method of correcting facial asymmetry in hemifacial microsomia. However, asymmetry in lower facial width remains after distraction because of its inability to increase bone thickness. Therefore, the authors used mandibular outer cortex bone grafting to augment the lower face following distraction to restore facial symmetry. METHODS: From January of 1997 to December of 2007, 21 patients with hemifacial microsomia underwent unilateral mandibular distraction followed by mandibular augmentation using mandibular outer cortex bone graft harvested from the normal side. Age at surgery ranged from 7 to 27 years. Facial symmetry was evaluated based on medical photography and radiography with a minimum 6-month follow-up. RESULTS: Mandibular height and length were expanded successfully with distraction, resulting in improvements in chin position and oral commissure level. Lower facial width was increased on the affected side and reduced on the normal side after bone grafting. Thus, three-dimensional facial symmetry was significantly improved in all patients. Long-term follow-up showed no evidence of relapse. The majority of the patients were satisfied with the reconstructive outcome. CONCLUSION: Mandibular augmentation with bone grafts harvested from the contralateral outer cortex effectively addressed the asymmetry in lower facial width that was uncorrected by distraction alone, achieving three-dimensional restoration of facial symmetry in hemifacial microsomia.

[The influence on masticatory function after curved osteotomy of prominent mandibular angle].

OBJECTIVE: To investigate the influence of mandibular curved osteotomy on masticatory function by analyzing the bite force before and after operation. METHODS: From Jan. to Oct. 2008, 20 female cases underwent mandibular curved osteotomy. The maximal bite force in incisor area, bilateral premolar area and molar area was measured before operation and 6 months after operation. RESULTS: The maximal bite force in incisor area, right premolar area, left premolar area, right molar area, left molar area was (11.7 +/- 3.9) kg, (23.2 +/- 1.6) kg, (30.9 +/- 2.3) kg, (35.6 +/- 4.2) kg, (38.5 +/- 3.1) kg, respectively before operation; and was (11.9 +/- 2.1) kg, (23.0 +/- 4.5) kg (31.0 +/- 1.8) kg,(35.9 +/- 3. 5) kg. (38.5 +/- 2.7) kg, respectively 6 months after operation. The postoperative maximal bite force reached the preoperative level, and even slightly above it. There was no significant difference between the measured data before operation and 6 months afterward (P > 0.05). CONCLUSIONS: The curved osteotomy of prominent mandibular angle has no long-term effect on masticatory function.

[Experimental study on gelatin/polycaprolactam composite nanofiber scaffold in wound healing].

OBJECTIVE: To explore the effects of the gelatin (Gt)/(polycaprolactam) PCL composite nanofiber scaffold on wound healing of full-thickness defect in rabbits. METHODS: Sixteen rabbits were inflicted with full-thickness skin open wounds on the back, and they were divided into A group (with treatment of Gt/PCL nanofiber membrane, 8 wounds), B group (with treatment of PCL fiber membrane, 8 wounds), and C group (with treatment of vaseline gauze, 8 wounds), the wounds in A , B groups served as self controls. Wound healing time was recorded. Wound healing rates were calculated on 3, 7, 10 post operation day (POD). Wound specimens and their adjacent skin were examined histologically on 3, 7, and 10 POD. RESULTS: There was obvious difference in wound healing time among A, B, C groups, and they were (18.2 +/- 1.3) d, (20.3 +/- 1.1) d, (22.0 +/- 0.6) d, respectively. Wound healing rate in A group was obviously higher than that in B, C group on 3, 7, 10 POD (P < 0.05). Compared with those in other groups, the proliferation of granulation tissue in dermis in A group was less, the epidermal cells were proliferated quickly, and collagen was arranged regularly. CONCLUSION: Gt/PCL composite nanofiber membrane can promote wound healing of full-thickness skin defect in rabbits, which is an ideal material for tissue engineering.