The application of pedicle orbital fat flap for the correction of lacrimal groove and palpebromalar groove deformity in the middle-aged and old people / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the effective techniques for correction of lacrimal groove and palpebromalar groove deformity in the middle-aged and old people.</p><p><b>METHOD</b>The lacrimal groove and palpebromalar groove deformity was corrected by the techniques of transcutaneous orbital fat releasing and pedicle orbital fat flap filling. From 1996 to 2011, 426 patients, aged from 35 to 72 (average, 48), were treated by the techniques. Among them, 54 patients had underwent the surgical treatment before this operation. 362 patients were followed up for 3-24 months.</p><p><b>RESULTS</b>Completely correction was achieved in 283 patients, obvious improvement in 79 patients. The result was not satisfied in 2 patients with severe deformity who had surgical treatment before.</p><p><b>CONCLUSION</b>The lacrimal groove and palpebromalar groove deformity can be effectively corrected by transcutaneous orbital fat releasing and pedicle orbital fat flap in the middle-aged and old people.</p>

The treatment of lower eyelid retraction at the different degree / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the effective methods for the correction of lower eyelid retraction at different degree.</p><p><b>METHODS</b>258 patients with lower eyelid retraction were treated in our department since 1999. The lower eyelid retraction could be divided into mild, moderate and severe degree. The lateral canthal anchoring (n = 150), Hamra's lower eyelid blepharoplasty (n = 80) and translid cheek lifting (n = 28) were adopted according to the severity. The therapeutic effect for different degree of lower eyelid retraction was compared.</p><p><b>RESULTS</b>98 patients were followed up for 3-12 months, including 51 patients of mild degree, 29 patients of moderate degree, and 18 patients of severe degree. The retraction were corrected completely in 91 patients. The lower eyelid was repositioned to the level of inferior limbus without inferior scleral show when eyes opened. The palpebral fissure could close completely. The blunt lateral canthus turned to be acute and the scar was inconspicious. The retraction was improved, but not corrected completely in 3 patients of moderate degree and 4 patients of severe degree. The complications included petechiae, chemosis, and so on.</p><p><b>CONCLUSIONS</b>The lower eyelid retraction can be corrected effectively if the appropriate techniques are performed according to the degree of retraction.</p>

Correlation between expression of α-melanocyte-stimulating hormone and melanin level in human skin autografts / 第二军医大学学报

Objective: To examine the expression of α-melanocyte-stimulating hormone (α-MSH) and the melanin in different kinds of human skin autografts and in the normal skins, so as to elucidate the role of α-MSH in hyperpigmentation in the skin autografts. Methods: Immunohistochemical technique was employed to detect the expression and distribution of α-MSH in skin autografts (including the full thickness skin autografts, medium thickness skin autografts, razor-thin skin autografts, and normal skins adjacent to the donor site and the recipient site). Masson-Fontana staining technique was used to detect the melanin contents in all the above skin specimens. Results: The location of α-MSH expression was at the cytoplasm of melanocytes and keratinocytes in epiderm; α-MSH was positive in most skin autografts and its expression was higher in the thinner skin autografts. The expression of α-MSH in all types of skin autografts was significantly different from that in normal skin (P<0.01); α-MS expression was also significantly different between all the skin autografts (P<0.01); α-MSH expression in normal skin around donor site and recipient site had no statistical difference. The contents of melanin in skin autografts was obvious increased compared with that in normal skin(P<0.01); the contents of melanin between all the skin autografts were also significantly different (P<0.01). The melanin contents increased with the decrease of skin autografts thickness. The expression of α-MSH was positively correlated with the contents of melanin in epidermis. Conclusion: The expression of α-MSH in skin autografts is positively correlated with the contents of melanin in skin autografts. Overexpression of α-MSH may play an important role in hyperpigmentation process of skin autografts.

Immediate reconstruction of tissue defects on eyelid caused by tumor excision / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the methods for immediate reconstruction of tissue defects on eyelid caused by tumor excision.</p><p><b>METHODS</b>Single or combined local skin flaps were used to repair tissue defects on eyelids after tumor excision.</p><p><b>RESULTS</b>Since 1994, 216 patients (224 sides) were treated. All flaps survived with primary healing. 149 patients were followed up for 3 months to 10 years with satisfactory results. 2 patients with squamous cell carcinoma recurred and reoperated with local skin flap again.</p><p><b>CONCLUSIONS</b>It is a simple, safe, flexible and reliable method to immediately repair the tissue defects with local flaps on eyelid caused by tumor excision.</p>

Discoidin domain receptors (DDRs) expression in pathological scar fibroblast formation / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the role of discoidin domain receptors (DDRs) in the formation of the keloid.</p><p><b>METHODS</b>The real-time quantitative PCR was used to compare the DDRs expression in the keloids and normal fibroblasts.</p><p><b>RESULTS</b>The level of DDR1 expression was significantly higher in keloid than in normal fibroblast (20.98 vs 4.2, P <0.01; 7.9 vs 4.23, P <0.05). The level of DDR1 expression in keloid was also higher significantly than that in hypertropic scar (20.98 vs 7.9, P < 0.01). However, the level of DDR2 expression was somewhat higher in keloid than in normal fibroblasts, the difference seemed not to be significantly in probability (358, 332 vs 278, P > 0.05).</p><p><b>CONCLUSIONS</b>DDRs may exert effect on keloid cell behaviours.</p>

Local flap for reconstruction of nasal tip defect: functional and aesthetic evaluations / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the experience of reconstruction of nasal tip defect, which could obtain good functional and aesthetic results.</p><p><b>METHODS</b>Based on the aesthetic subunit principle, according to the size, shape, depth of nasal tip defect, and the conditions of surrounding skin, homologous local flap (include: frontonasal flap, bilobed flap, nasolabial flap, reforming rhomboid flap and forehead flap, etc.) was designed to cover the defect wound. The secondary defect of donor area was directly sutured.</p><p><b>RESULTS</b>A total of 83 patients with nasal tip defect were treated by local flap transfers. The area of the defect ranged between 0.6 x 0.6 cm and 2.5 cm x 2.5 cm. The nasal tip defect was successfully closed in all patients, and all flaps survived well without obvious complications. 76 out of these 83 patients were available for follow-up from 1 to 36 months. The repaired tissue was in good match with surrounding tissue, with nice nasal contour, and cosmetic results were satisfactory. No tumor recurrence occurred.</p><p><b>CONCLUSIONS</b>Based on the nasal aesthetic subunit principle, local flap could be used to reconstruct the nasal tip defect below 2.5 cm x 2.5 cm, and obtain good color, contour and texture in match with the surrounding skin. Cosmetic results were satisfactory.</p>

Influence of agouti signal protein on melanocyte function in skin autograft / 第二军医大学学报

Objective: To study the influence of agouti signal protein (ASIP) on melanocyte function in skin autograft, so as to understand the cause of hyperpigmentation in skin autograft. Methods: Guinea pigs were used to establish a skin autograft hyperpigmentation model. The skin autografts in model animals were injected with ASIP or normal saline (control). RT-PCR technique was used to detect the tyrosinase mRNA expression in melanocytes of skin autografts and Masson-Fontana staining technique was used to detect the melanin contents in skin autografts in ASIP treatment group; and the results were compared with those of control group (n=13) and normal guinea pigs (n=5). Results: The expression of tyrosinase mRNA and the melanin content in skin autografts in ASIP treatment group were both lower than those of control group and normal guinea pigs (P<0.01). Conclusion: The results indicate that ASIP can antagonize the melanogenic effect of α-MSH, resulting in reduced pigmentation in skin autografts. It is also indicated that overexpression of α-MSH in epidermal cells after skin grafting is an important cause of hyperpigmentation in skin autografts.

Expression of alpha-melanocyte-stimulating hormone in human split-thickness skin graft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of alpha-melanocyte-stimulating hormone (alpha-MSH) in human split-thickness skin autograft and the role of alpha-MSH in hyperpigmented process of the grafted skin.</p><p><b>METHODS</b>Immunohistochemical technique was used to detect the expression and distribution of alpha-MSH in the split-thickness grafted skin and normal skin separately.</p><p><b>RESULTS</b>The expression of alpha-MSH in most of the split-thickness grafted skin was much stronger than the control skin. The positive ratio of alpha-MSH expression was 61.1% in the split-thickness grafted skin, 11.1% in the normal skin of the donor area and 16.7% in the normal skin around the recipient area. The expression of alpha-MSH in the split-thickness grafted skin was significant high, compared with the normal skins (P < 0.01). The expression of alpha-MSH in the normal skin of the donor area was no statistic remarkably differences compared to the normal skin around the recipient area.</p><p><b>CONCLUSION</b>The results indicate that the expression of alpha-MSH may markedly increase in the split-thickness grafted skin and correlate with its pigmentation after the skin graft. Overexpression of alpha-MSH may play an important role in hyperpigmented process of the skin graft.</p>