Effects of Orthokeratology Lens Compared to Defocus Incorporated Multiple Segments Lens for Adolescent Myopia and Factors Related to Corneal Injury.

Context: Some treatments for myopia, such as corneal surgery and scleral shortening, aren't suitable for adolescents under the age of 18. The orthokeratology lens (OKL) and the defocus incorporated multiple segments (DIMS) lens are two possible nonsurgical alternatives, but their comparative advantages and disadvantages remain unclear. Objective: The study intended to compare the effects of the OKL and the DIMS lens on adolescent myopia and to analyze the related factors affecting corneal injury, to provide a reference for clinical practice. Design: The research team conducted a retrospective case-control study. Setting: The study took place at Chongqing Aier Eye Hospital in Chongqing, China. Participants: Participants were 84 myopic adolescents who had been admitted to the hospital between March 2021 and December 2022. Interventions: The research team divided participants into two groups: (1) 43 participants who received treatment with orthokeratology lens (OKL), the OKL group, and (2) 41 participants who received treatment with defocus incorporated multiple segments (DIMS) because their parents refused to accept OKL lenses, the DIMS group. Outcome Measures: At baseline and postintervention, the research team: (1) comparatively analyzed the uncorrected visual acuity (UCVA), axial length (AXL), and diopter; (2) measured the spherical equivalent (SE), central corneal thickness (CCT), anterior chamber depth (ACD), accommodative lag (PRA), and negative relative accommodation (NRA); (3) counted the adverse reactions during treatment; and (4) evaluated the factors related to corneal injury. Results: No significant differences existed between the groups in AXL, diopter, or NRA postintervention (P > .05), but the OKL group had significantly higher UCVA and significantly lower SE, CCT, and ACD than the DIMS group did (P < .05). In terms of safety, the incidence of adverse reactions was significantly higher for the OKL group than for the DIMS group (P = .016). According to the logistic regression analysis, the OKL treatment, corneal edema, and abnormal intraocular pressure (IOP) were independent risk factors for corneal injury (all P < .001). Conclusions: Both DIMS and OKL can effectively control myopia progression in adolescents, with OKLs being significantly better at improving UCVA and DIMS being safer. Therefore, in the future clinical conservative treatment of myopic adolescents, it's still necessary to choose appropriate myopia-relief methods according to the actual situation and the specific needs of the children.

Comprehensive Systematic Review of Poly-L-lactic Acid in Facial Clinical Application.

OBJECTIVES: With the increasing global clinical application of regenerative injection materials, there is a growing recognition of the crucial role played by poly-L-lactic acid (PLLA). The aim of this study is to conduct a systematic review on the therapeutic efficacy and safety of PLLA in clinical applications for facial treatments. METHODS: We conducted a search of the PubMed, EMBASE, Web of Science, and Wanfang databases, followed by screening of the retrieved articles based on predefined inclusion and exclusion criteria. We then performed an analysis on the final set of included articles that met our inclusion criteria. Within these included articles, quality assessment for randomized controlled trials (RCTs) was carried out using the Jadad scale, while non-randomized controlled trials (non-RCTs) were evaluated using the MINORS scale. RESULTS: Our search of above database, using the relevant search terms, yielded a total of 1300 PLLA-related articles. After applying the inclusion and exclusion criteria, 1280 articles were excluded. Only 20 articles, 16 in English and 4 in Chinese, were included in our final analysis, among them 16 NRCTs and 4 RCTs. According to the different clinical evaluation standards, the treatment of PLLA has achieved good outcomes. Most PLLA injection-related adverse events are mild and self-limited, without any additional treatment requirement. CONCLUSION: PLLA is a reasonably safe and effective facial injection material that can be applied in different facial injection areas and depth using various reconstitute and injection methods. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

An updated review of immunotherapy in esophageal cancer: PD-L1 footprint.

Esophageal cancer is considered one of the most significant challenges to public health worldwide. While various therapeutic options exist for esophageal cancer, including chemotherapy, radiotherapy, and surgery, several adverse effects of these medications have been reported. Therefore, a new generation of therapeutic lines should be applied to minimize complications. In this regard, immunotherapy is a novel approach that aims to kill tumor cells directly by targeting them. Specifically, monoclonal antibodies can target specific markers of esophageal cancer tumor cells, keeping other normal cells safe. Multiple monoclonal antibodies optimized for esophageal cancer, such as pembrolizumab, ramucirumab, trastuzumab, nivolumab, and ipilimumab, are available. On the other hand, esophageal cancer tumor cells express a specific inhibitory ligand and its receptor called programmed cell death, which can suppress T cell immune responses. This receptor provides an inhibitory signal, causing the highest expression of the PD-L1 ligand on tumor cells. The outcomes of this interaction lead to the suppression of the activation and function of T lymphocytes. Therefore, immunotherapy for esophageal cancer targeting the PD-1/PD-L1 pathway has shown a remarkable correlation with cancer care. This study presents a comprehensive review of the latest findings related to immunotherapy in esophageal cancer.

IrGe4: A Predicted Weyl-Metal with a Chiral Crystal Structure.

Polycrystalline IrGe4 was synthesized by annealing elements at 800 °C for 240 h, and the composition was confirmed by energy-dispersive X-ray spectroscopy. IrGe4 adopts a chiral crystal structure (space group P3121) instead of a polar crystal structure (P31), which was corroborated by the convergent-beam electron diffraction and Rietveld refinements using synchrotron powder X-ray diffraction data. The crystal structure features layers of IrGe8 polyhedra along the b axis, and the layers are connected by edge- and corner-sharing. Each layer consists of corner-shared [Ir3Ge20] trimers, which are formed by three IrGe8 polyhedra connected by edge-sharing. Temperature-dependent resistivity indicates metallic behavior. The magnetoresistance increases with increasing applied magnetic field, and the nonsaturating magnetoresistance reaches 11.5% at 9 T and 10 K. The Hall resistivity suggests that holes are the majority carrier type, with a carrier concentration of 4.02 × 1021 cm-3 at 300 K. Electronic band structures calculated by density functional theory reveal a Weyl point with a chiral charge of +3 above the Fermi level.

Multifunctional Cu2TSiS4 (T = Mn and Fe): Polar Semiconducting Antiferromagnets with Nonlinear Optical Properties.

Cu2TSiS4 (T = Mn and Fe) polycrystalline and single-crystal materials were prepared with high-temperature solid-state and chemical vapor transport methods, respectively. The polar crystal structure (space group Pmn21) consists of chains of corner-sharing and distorted CuS4, Mn/FeS4, and SiS4 tetrahedra, which is confirmed by Rietveld refinement using neutron powder diffraction data, X-ray single-crystal refinement, electron diffraction, energy-dispersive X-ray spectroscopy, and second harmonic generation (SHG) techniques. Magnetic measurements indicate that both compounds order antiferromagnetically at 8 and 14 K, respectively, which is supported by the temperature-dependent (100-2 K) neutron powder diffraction data. Additional magnetic reflections observed at 2 K can be modeled by magnetic propagation vectors k = (1/2,0,1/2) and k = (1/2,1/2,1/2) for Cu2MnSiS4 and Cu2FeSiS4, respectively. The refined antiferromagnetic structure reveals that the Mn/Fe spins are canted away from the ac plane by about 14°, with the total magnetic moments of Mn and Fe being 4.1(1) and 2.9(1) µB, respectively. Both compounds exhibit an SHG response with relatively modest second-order nonlinear susceptibilities. Density functional theory calculations are used to describe the electronic band structures.

Use of Remimazolam Combined With Alfentanil for Plastic Surgery Anesthesia Cases: A Clinical Trial.

OBJECTIVE: This study aims to observe the safety and effectiveness of remimazolam benzenesulfonate combined with alfentanil for painless and comfort anesthesia in plastic surgery. METHODS: Two hundred patients with American Society of Anesthesiologists (ASA) I-II for elective facial autologous lipofilling + autologous liposuction (thigh or abdomen) plastic surgery in our hospital were selected. One hundred patients received comfort anesthesia (observation group) on odd-numbered day of surgery, and other 100 patients received painless anesthesia (control group) on even-numbered day. Patients in both groups were given slow injection of remimazolam benzenesulfonate 0.1 mg/kg and alfentanil 5 µg/kg to induce sleep before local anesthesia. Depending on body action reaction to surgical stimulation, patients in the observation group were received with remimazolam 0.05 mg/kg and alfentanil 2.5 µg/kg for maintenance until the end of surgery after local anesthesia, and patients in the control group received with remimazolam 0.25 to 0.5 mg/kg/h and alfentanil 25 to 50 µg/kg/h in continuous pumps. Time to fall asleep, sedation score, time to end of medication, time to open eyes, recovery score, and the presence of body movement, glossoptosis, arousal or jaw support during hypoxia, hypotension, bradycardia, operation time, total amount of remimazolam and alfentanil used, and the presence of postoperative complications such as pruritus, dizziness, nausea, and vomiting were recorded in both 2 groups. RESULTS: There were no significant differences in the preoperative vital sign parameters as mean arterial pressure, heart rate, and oxygen saturation between 2 groups ( P > 0.05). Intraoperative mean arterial pressure and heart rate were significantly lower in both groups compared with preoperative ( P < 0.05), but there was no statistically significant between the 2 groups ( P > 0.05). There was no significant decrease in oxygen saturation in both groups under the condition of intraoperative oxygen inhalation ( P > 0.05). There was no significant difference between the 2 groups in the incidence of adverse reactions, such as intraoperative body movement induced by skin cutting, glossoptosis requiring jaw thrust, postoperative pruritus, dizziness, nausea, and vomiting ( P > 0.05). There was no statistically significant difference in time to fall asleep, sedation score during local anesthesia, time to open eyes after stopping anesthetics, and recovery score between the 2 groups ( P > 0.05). Meanwhile, the total amount of remimazolam and alfentanil use was significantly reduced in patients in the observation group compared with the control group ( P < 0.05). CONCLUSIONS: Remimazolam benzenesulfonate combined with alfentanil can be used as a comfort anesthesia and painless anesthesia protocol in plastic surgery, which has the advantages of rapid onset of action, safety and comfort for patients, rapid recovery, and good cooperation. Furthermore, the protocol of remimazolam benzenesulfonate combined with alfentanil used in the observation group can significantly reduce the total amount of remimazolam and alfentanil used.

Application of Trapezoid Orbital Septum Membrane Flap in Double-Eyelid Blepharoplasty.

BACKGROUND: For a long time, to achieve the natural shape of double-eyelid crease, multiple techniques of double-eyelid plastic surgery have been developed. We describe the trapezoid orbital septum membrane flap in blepharoplasty to achieve a dynamic double-eyelid crease and avoid a depressed static scar. METHODS: The authors developed a trapezoid orbital septum membrane flap in double-eyelid blepharoplasty. The flap base is fixed on the pretarsal plate with the distal end of the flap positioned between the superior and inferior edges of the incision. Layer-by-layer contraposition suturing is then performed. RESULTS: One hundred ninety-one cases of double-eyelid blepharoplasty were performed by a senior surgeon using the trapezoid orbital septum flap method. Patients were followed for 6 to 17 months. Twelve cases were revised secondarily. Patients were satisfied with the palpebral folds, which showed a dynamic crease followed with movements of the eyelids. CONCLUSIONS: The authors introduce a trapezoid orbital septum flap in upper eyelid blepharoplasty. The flap relies on the elasticity of the orbital septum flap as the levator aponeurosis extension segment to produce a natural crease without a depressed static scar.

Application of Dual "Kite" Myomucosal Flaps for the Repair of Medium Lip Defects.

OBJECTIVE: To investigate the application of dual "kite" myomucosal flaps (subcutaneous pedicle advancement flap) for the repair of medium lip defects (one-third to one-half lip width). METHODS: Dual kite myomucosal flaps were designed in the adjacent area of the defect in 17 patients with medium lip defect with the principle of using homogenous tissue as far as possible without affecting local anatomical units. RESULTS: The follow-up time was 3 to 24 months; 16 patients showed primary wound healing, and 1 patient showed prolonged healing. The blood supply of the myomucosal flaps were reliable. The myomucosal flaps were smooth, with no proliferation of scars, and the local appearance was good. CONCLUSION: The dual kite myomucosal flaps provide a reliable method for repairing medium lip defects, decreasing the need for additional excision of normal skin tissue, and reducing skin scar.

Epidemiological Investigation of Facial Soft Tissue Injury in Chinese Preschool Children.

OBJECTIVE: The aim of this study was to analyze the epidemiological characteristics of pediatric facial soft tissue injuries of Chinese preschool-aged children in Hangzhou Plastic Surgery Hospital. METHODS: Medical records of preschool-aged children's facial injuries, 6 years and younger, from January 2017 to December 2019 were collected. Sex; age; time of injury; length of stay; causes of injury; location, type, length, and depth of wound; anesthesia methods; and treatment and evaluation of postoperative scars were analyzed. RESULTS: There were 10,862 cases (male, 6780 cases; female, 4082 cases) in the group. The ratio of male to female was 1.66:1. Mean age was 3.4 (±1.6) years; the youngest was 1 month old. The time of injury occurred frequently between 9:00 and 13:00 and 16:00 to 21:00, with the most common incident time being between 19:00 and 20:00. Collision injury was the main cause of injury (9822 [90.43%]). The most frequently injured area was the forehead (4874 [44.87%]). The main form of injury was laceration wound (9721 [89.45%]). The depth of injuries was mainly middle layer (adipose or muscular layer) (6299 [57.99%]). The length of injuries was 1.7 (±0.9) cm, ranging from 0.2 to 10.5 cm. Furthermore, 9110 cases were repaired by plastic surgeries and 1 or more antiscar measures. After 6-month to 2-year follow-up, 9 cases of animal scratch or bite, lip penetrating wound, or bumping teeth were infected and 26 cases had scar hyperplasia. The others achieved satisfactory results, and the scars were not obvious. CONCLUSION: Preschool-aged children's facial injuries have predictable patterns of occurrence, and targeted preventive measures can reduce the incidence rates. After facial injury, children should present for timely plastic surgery treatment and accept combined antiscarring measures to minimize postoperative scarring.

Application of External Nasal Skin Stretching in Asian Rhinoplasty.

ABSTRACT: Asian nasal characteristics include a low dorsum, short nose, and thick skin envelope, usually requiring lengthening and elevating the nose during rhinoplasty ( Facial Plast Surg Clin North Am 2007;15(3):293-307, v). The increase in rhinoplasty popularity has resulted in a greater prevalence of complications. In a severely short and contracted nose, an extensively scarred or contracted soft tissue envelope results in weak laxity and extensibility of the nasal skin. For these patients, the essential component of rhinoplasty is to improve skin texture and obtain a sufficient nasal skin soft tissue envelope. Tissue expanders have previously been utilized to expand nasal skin and soft tissue ( Plast Reconstr Surg 2006;118(6):1447-1452; Facial Plast Surg 2019;35(1):68-72). However, nasal anatomical characteristics have limited the clinical application of tissue expanders. This article introduces a simple, noninvasive, and easily adopted method of external nasal skin stretching, which was first proposed by the senior author. This approach has been accepted by rhinoplasty surgeons in China and widely used in clinic. The approach can improve skin laxity, yield extra nasal soft tissue, and create adequate soft tissue coverage of the reconstructed nasal framework to reduce the difficulty of surgery with a reliable clinical effect.

LiMo8O10: Polar Crystal Structure with Infinite Edge-Sharing Molybdenum Octahedra.

Polycrystalline LiMo8O10 was prepared in a sealed Mo crucible at 1380 °C for 48 h using the conventional high-temperature solid-state method. The polar tetragonal crystal structure (space group I41md) is confirmed based on the Rietveld refinement of powder neutron diffraction and 7Li/6Li solid-state NMR. The crystal structure features infinite chains of Mo4O5 (i.e., Mo2Mo4/2O6/2O6/3) as a repeat unit containing edge-sharing Mo6 octahedra with strong Mo-Mo metal bonding along the chain. X-ray absorption near-edge spectroscopy of the Mo-L3 edge is consistent with the formal Mo valence/configuration. Magnetic measurements reveal that LiMo8O10 is paramagnetic down to 1.8 K. Temperature-dependent resistivity [ρ(T)] measurement indicates a semiconducting behavior that can be fitted with Mott's variable range hopping conduction mechanism in the temperature range of 215 and 45 K. The ρ(T) curve exhibits an exponential increase below 5 K with a large ratio of ρ1.8/ρ300 = 435. LiMo8O10 shows a negative field-dependent magnetoresistance between 2 and 25 K. Heat capacity measurement fitted with the modified Debye model yields the Debye temperature of 365 K.

Relationship between leaf dust retention capacity and leaf microstructure of six common tree species for campus greening.

Green plants can effectively retain atmospheric particle pollution and purify the air. As an important part of the campus ecosystem, they have a significant effect on absorbing atmospheric pollutants and improving the quality of the campus air environment. Six common greening plants were selected as the object in Xiangnan University. The dust retention capacity of plant leaves, leaf micro-structure, and leaf contact angle were measured. The results show that the highest amounts of dust removed by Osmanthus fragrans Lour was 3.451 g/m2, and the least amounts of dust removed by Magnolia denudata Desr. was 1.005 g/m2, and the maximum is 4.148 times of the minimum. The micro-structure of the plant leaf surface affects the amount of dust retention. The plant dust retention capacity with gully of the leaf surface and fluff, stomata, and sawtooth structure is relatively strong; The plant dust retention capacity with smooth, wax layer, leathery, and gully is relatively weak. The leaf contact area of a plant is related to its dust retention ability, that is, when the measured leaf contact angle is <90°, the leaf dust retention ability of the plant is strong. When the blade contact angle is >90°, the dust retention capacity is weak.

Many studies have found that green plants can effectively retain atmospheric particle pollution and purify the air. As an important part of the campus ecosystem, few people specially study the campus ecosystem. Many scholars focus on the research on urban street trees and different districts of the city. The object of this study is more in-depth and targeted. Through the analysis of the difference of dust retention ability between common plants in campus, this paper compares and analyzes the influencing factors of the difference of dust retention ability among plants, which is not only related to the external environment but also closely related to the micro-structure characteristics of plant leaves. The research on the dust retention ability of different plants will help to better control dust and atmospheric environmental pollution, improve air quality, and select plants with strong dust retention ability as green plants on campus, which will play an important role in reducing dust pollution on campus.

[Growth and development of children and related influencing factors: a cross-sectional study of the families with children aged 0-6 years in Jiangsu Province]. / æ±Ÿè‹çœå„¿ç«¥ç”Ÿé•¿å‘è‚²çŠ¶å†µåŠå ¶å½±å“å› ç´ ­­åŸºäºŽ0~6å²å„¿ç«¥å®¶åº­çš„æ¨ªæ–­é¢ç ”ç©¶.

OBJECTIVES: To investigate the growth and development of children aged 0-6 years in Jiangsu Province of China and the effects of family factors on the children's growth and development. METHODS: The stratified random sampling method was used to select 2 004 families with children aged 0-6 years of Jiangsu Province. A questionnaire survey on nutritional knowledge, attitude, and behavior was performed for the main caregivers. The Z-score method was used to evaluate nutritional status. The ordinal polytomous logistic regression analysis model was used to investigate the influencing factors for nutritional status. RESULTS: A total of 2 290 questionnaires were distributed, among which 2 004 valid questionnaires were collected (87.51%). The mean age of the children was (28±14) months, and there were 1 105 boys (55.14%) and 899 girls (44.86%). The primary caregivers were mostly parents (1 867 families, 93.16%), and the caregivers of 1 466 families (73.15%) had a university/college degree. Most families had an annual income of 50 000-100 000 yuan/year or 100 000-200 000 yuan/year, accounting for 32.88% and 34.23%, respectively. The results of Z-score showed the growth retardation rates of 1.45% (16/1 105) in boys and 1.78% (16/899) in girls, the underweight rates of 0.54% (6/1 105) in boys and 0.67% (6/899) in girls, the emaciation rates of 1.36% (15/1 105) in boys and 2.00% (18/899) in girls, and the obesity rates of 8.78% (97/1 105) in boys and 10.12% (91/899) in girls, respectively. The multivariate logistic regression analysis showed that a higher annual family income and a higher nutrition knowledge level of caregiver were beneficial to the growth and development of children (P<0.05). CONCLUSIONS: Children aged 0-6 years in Jiangsu Province have a good status of growth and development but a relatively high obesity rate, and therefore, the monitoring of obesity should be taken seriously. Family economic status and the level of nutritional knowledge of caregivers have a significant impact on children's growth and development.

Iridate Li8IrO6: An Antiferromagnetic Insulator.

A polycrystalline iridate Li8IrO6 material was prepared via heating Li2O and IrO2 starting materials in a sealed quartz tube at 650 °C for 48 h. The structure was determined from Rietveld refinement of room-temperature powder neutron diffraction data. Li8IrO6 adopts the nonpolar space group R3̅ with Li atoms occupying the tetrahedral and octahedral sites, which is supported by the electron diffraction and solid-state 7Li NMR. This results in a crystal structure consisting of LiO4 tetrahedral layers alternating with mixed IrO6 and LiO6 octahedral layers along the crystallographic c-axis. The +4 oxidation state of Ir4+ was confirmed by near-edge X-ray absorption spectroscopy. An in situ synchrotron X-ray diffraction study of Li8IrO6 indicates that the sample is stable up to 1000 °C and exhibits no structural transitions. Magnetic measurements suggest long-range antiferromagnetic ordering with a Néel temperature (TN) of 4 K, which is corroborated by heat capacity measurements. The localized effective moment µeff (Ir) = 1.73 µB and insulating character indicate that Li8IrO6 is a correlated insulator. First-principles calculations support the nonpolar crystal structure and reveal the insulating behavior both in paramagnetic and antiferromagnetic states.

MicroRNA-425-5p modulates osteoporosis by targeting annexin A2.

BACKGROUND: Studies have shown that the decrease of osteogenic differentiation of bone marrow mesenchymal stem cells (MSC) is an important mechanism of osteoporosis. The object of this study was to explore the role and mechanism of microRNA miR-425-5p in the differentiation of MSC. METHODS: The expression of miR-425-5p in MSC was detected by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Cell proliferation, cell cycle and apoptosis were detected by CCK-8 colorimetry and flow cytometry. The expression of TNF were detected by ELISA. RESULTS: Our data show that MiR-425-5p could modulate TNF-induced cell apoptosis, proliferation, and differentiation. ANXA2 is also the target of miR-425-5p and ANXA2 was involved in TNF-induced MSC cell apoptosis, proliferation, and differentiation. In addition, MiR-425-5p enhanced osteoporosis in mice. CONCLUSION: MiR-425-5p might serve as a potential therapeutic target for the treatment of osteoporosis.

Adsorptive granulomonocytapheresis alters the gut bacterial microbiota in patients with active ulcerative colitis.

BACKGROUND: Ulcerative colitis (UC) is a refractory disease with unclear etiology. Studies have shown that UC is closely associated with gut microbiota dysbiosis. Adsorptive granulomonocytapheresis (GMA) using an Adacolumn has been found to treat UC effectively, but its underlying mechanism of treatment has not been fully elucidated. In this study, we aimed to investigate the influence of GMA on the gut microbiota in patients with active UC. METHODS: We conducted a single-center prospective analysis of patients with active UC who received GMA therapy and ultimately achieved clinical remission. Stool samples of healthy controls and patients before and after 5 or 10 sessions of GMA therapy were collected. Subsequently, high-throughput sequencing of the 16S rRNA V3 and V4 gene region of the stool was conducted and clustering of operational taxonomic units and species annotation were performed. RESULTS: Gut microbial profiles in patients with UC were characterized by low bacterial diversity. After 5 or 10 sessions of GMA therapy, the gut microbiota diversity in patients with UC increased and was similar to that of healthy controls. UC was further characterized by increased abundances of Proteobacteria and Bacteroides, as well as decreased abundances of Faecalibacterium, Roseburia, Firmicutes, and Dialister; however, after GMA therapy, the abundance of Bacteroides decreased, whereas those of Faecalibacterium, Roseburia, and Firmicutes increased. CONCLUSIONS: Active UC is associated with gut microbiota dysbiosis. GMA therapy exerts a strong regulatory effect on the gut microbiota in patients with UC.

Experience With Autologous Nasal Septum Cartilage Combined With Conchal Cartilage in Nasal Tip Reconstruction.

OBJECTIVE: There has been an increase in use of autologous costal cartilage for nasal tip shaping material. However, there are deficiencies in using this plastic material, such as a hard nasal tip, poor nasal tip elasticity and mobility postoperatively, and some nasal tip skin thinning that allows the shape of the cartilage grafts to be felt on the surface of the nasal tip skin. To address these problems, we have combined autologous nasal septum cartilage and conchal cartilage as nasal tip graft materials, which achieve a natural shape and realistic touch postoperatively. METHODS: From January 2017 to September 2019, a total of 47 patients with nasal septal cartilage combined with conchal cartilage transplantation for nasal tip plasty were screened for a retrospective study. They were followed up and evaluated for 6 to 25 months postoperatively. The operation was performed through an incision in the nose. During the operation, a piece of septal cartilage was cut to make a columella strut. Using one side of the cavitas conchae and cymba conchae cartilage as the graft material, 2 long strips of cartilage were excised for the septum extension graft, and a piece of cap cartilage was transplanted to the top of the nasal tip cartilage scaffold. RESULTS: The time between the operation and follow-up was greater than 6 months, with the range of follow-up and evaluation being from 6 to 25 months. Forty-six patients were satisfied with the shape of the nose. One patient complained that the nasal tip was round and large after 1 month postoperatively, but after 6 months, he was satisfied with the shape of the nasal tip after daily use of a nasal clip. In one male case, the implant was removed more than 7 months postoperatively because of hematoma and infection secondary to nasal trauma. There were 2 cases of nasal tip numbness, both of which recovered spontaneously after 12 months. After the operation, the shape of the nasal tip was round, no cartilage contour was seen on the surface, no collapse of upper nasal tip, no obvious deviation of the nasal dorsum and columella, and no deformation and displacement of the nasal tip cartilage scaffold. At the 6-month follow-up visit, each patient palpated the nasal tip for evaluation. Most patients felt their nose felt realistic and that they had good nasal tip motion. Only 1 patient felt that the nasal tip and the nasal dorsum were moving together when the tip of the nose was being pushed. CONCLUSIONS: Nasal septum cartilage and conchal cartilage can be combined as a graft material for reconstruction of the nasal tip. This technique uses different characteristics of each of the 2 cartilages to achieve a more realistic and esthetic outcome.

Prefabricated Expanded Flap Combined With Expanded Scalp Flap for Total Face Resurfacing.

ABSTRACT: Reconstruction of total facial deformities and defects has been a major challenge of reconstructive surgery. Allotransplantation is limited by the number of donors and the need for life-long immunosuppression. Autotransplantation, where multiple autogenous tissue grafts from various donor sites are used to repair facial defects, inevitably leaves conspicuous patchwork scars. A prefabricated monoblock flap, although the preferred treatment modality, is limited by insufficient blood supply and the large size of the flap. In the Journal of Craniofacial Surgery (2014;25:21-25), Li et al applied the technique of flap prefabrication and stem cell-assisted tissue expansion to reconstruct total facial injuries, but the operations were complicated and the final expanded flap area was also uncertain. This article introduces an approach to reconstruct total facial injuries with a prefabricated expanded thoracic flap combined with an expanded scalp flap (called combined flaps), which not only solves the limitations of blood supply and expanded volume but also reduces patchwork scars. The approach is a simple, feasible, and effective surgical method for total face resurfacing.

Differential Diagnosis, Clinical Characteristics, and Interventions of Braid-Like Coronary Artery: Case Series Analysis Based on Optical Coherence Tomography.

AIM: Based on optical coherence tomography (OCT), we aimed to determine the diagnosis, clinical characteristics, and interventions of braid-like coronary arteries, which are rare and tend to be diagnosed as a woven coronary artery (WCA) anomaly. METHODS AND RESULTS: We identified braid-like lesions on coronary angiography (CAG) in 7 patients (6 men; median age 47 years; age range 26 to 57 years). All patients were heavy smokers. Four patients were diagnosed with an old myocardial infarction and the other 3 with unstable angina. The braid-like lesions were located in the left anterior descending arteries in 2 patients and in the right coronary arteries in the other 5. TIMI grade 2 flow was observed in all involved vessels. OCT findings of all lesions were consistent with recanalization of organized thrombi, which consisted of septa that divided the lumen into multiple small cavities communicating with each other. No separate three-layered structure could be defined. Based on the significance of the stenosis and its related symptoms, drug-eluting stents were implanted in all of the lesions. All patients experienced symptomatic improvement after the intervention and were followed up event-free for 12 months. CONCLUSIONS: Braid-like coronary arteries are likely to undergo recanalization of organized thrombi rather than WCA according to our OCT findings. The majority of cases affect men who smoke heavily. Percutaneous stent implantation may be beneficial in selected patients when feasible.

High-Pressure, High-Temperature Synthesis and Characterization of Polar and Magnetic LuCrWO6.

A new polar and magnetic oxide, LuCrWO6, was synthesized under high pressure (6 GPa) and high temperature (1673 K). LuCrWO6 is isostructural with the previously reported polar YCrWO6 (SG: Pna21, no. 33). The ordering of CrO6 and WO6 octahedra in the edge-shared dimers induce the polar structure. The effective size of rare earth, Ln cation does not seem to affect the symmetry of LnCrWO6. Second harmonic generation measurements of LuCrWO6 confirmed the noncentrosymmetric character and strong piezoelectric domains are observed from piezoresponse force microscopy at room temperature. LuCrWO6 exhibits antiferromagnetic behavior, TN, of ∼18 K with a Weiss temperature of -30.7 K.