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Objective To explore the method and clinical effects of treatment for correcting severe contracture nasal deformity after rhinoplasty.Methods Totally 19 patients with severe contracture nasal deformity after rhinoplasty were treated with a new procedure in our hospital since March 2014.The soft tissue was treated with manual traction preoperatively to improve nasal skin and mucosa extensibility and flexibility.The costicartilage was taken as structure transplantation to build the nasal support structure.Results This group of patients were followed up for 5-27 months,contracture of nasal deformity was corrected and the shape of the nose was improved with no obvious contracture deformation.Conclusions Nasal shape is improved by nasal scaffold and coated tissue.It is a simple and feasible method to modify the condition of soft tissue by manual traction and autogenous costicartilage support reconstruction to ensure the long-term efficacy of backing;two combination therapy for correction of iatrogenic contracture nasal deformity can achieve better long-term nasal prolonged postoperative effect,which is suitable for clinical promotion.
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Objective@#To investigate the method of relocating the lower eyelid surgery to increase the vertical height of palpebral fissure and improve the eye of introverted and make the face more beautiful.@*Methods@#Based on the principles of the lower eyelid traction system, 79 cases underwent eyelid surgery by plicating the lower eyelid tarsus and the lower eyelid retractor. Along the lower eyelid eyelashes edge at the lateral 1/3, cut the skin layer by layer to the pretarsal orbicularis oculi muscle to locate the inferior tarsal muscle behind the orbital fat, under the tarsal plate lower edge with the lower eyelid retractor plicating suture , remove the excessive skin about 2-3mm, observe the lower eyelid down to adjust to the satisfaction of the suture incision.@*Results@#In the group of 79 cases, 70 cases have been followed up for an average of 6 months, the long-term results are stable, no contraction and tarsal eversion and other obvious complications are noted. The distances between the lower eyelid lateral 1/3 point and the alar margin from shorter than before surgery (2.0 ± 0.2) mm, and between the angulus oculi laterallis and the alar margin from shortening distance (3.3 ± 0.7) mm.@*Conclusions@#Relocating the lower eyelid surgery can increase the palpebral fissure height and improve the palpebral fissure introversion, and the proportion of the face. This method is simple, reliable and easy to apply.
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Objective To investigate the effect and safety of PTFE filling on correction of nasal basal treatment of midfacial sag.Methods Top of the vestibular sulcus groove was cut along the alveolar mucosa under direct maxillary periosteum,and then face inward in depression and the side line of the scope of subperiosteal separation from near to the medial nasal spine and the lateral side of pyriform aperture;range of separation was the same of both sides as marked before operation,slightly larger than the prosthesis;then the arc being carved,which was consistent with the nasal triangle expansion,was implanted into sub-periosteal site along pear-shaped arc edge of the hole placement and the prosthesis was fixed;as the appearance was satisfied,the incision was sutured.Results Clinical follow-up lasted for 6 months,and all the wound healing was well in primary intention without infection,implant exposure and other complications and facial expressions were natural.The filled results were satisfactory.Conclusions For correction of midfacial depression without need of osteotomy,nasal application of PTFE filling is simple with good efficacy and it is worth promoting.
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Objective To explore the comprehensive approach and efficacy of secondary unilateral cleft rhinoplasty by using autologous costal cartilage grafts.Methods Secondary rhinoplasty was performed in 28 patients with unilateral cleft-lip nasal deformity.The costal cartilage was harvested through a mini-invasive incision.Septal deviation was corrected,and nasal tip framework was reconstructed with the autologous costal cartilage through direct transcolumellar incision.Diced cartilage fragments were used to augment the depressed alar base.Nasolabial muscles were repositioned to restore the balance of muscular tension system.Results The appearance of the nasal deformity was greatly improved in all the 28 cases postoperatively by follow-up from 3 to 12 months.Increased stability and symmetry of the nasal tip,along with the improvement of nasal breathing function was achieved and sustained effectively.Conclusions Definitive secondary unilateral cleft rhinoplasty using autologous costal cartilage grafts provides good aesthetic and functional results.
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Correction for the Results section of the Abstract is needed. There was a mistake in the numerical values of Results section of the Abstract.
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Objective To investigate the safety and effectiveness of digital subtraction angiography (DSA) in the surgical treatment of intracranial arteriovenous malformations (AVMs) in children.Methods Between December 2015 and February 2017,the clinical and imaging data of 9 children with AVM (2-14 years) underwent hybrid surgery at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.According to the Spetzler-Martin grade,there were 2 patients with grade Ⅰ,3 with grade Ⅱ,2 with grade Ⅲ,and 2 with grade Ⅳ.All the children were treated with microsurgery,and their AVMs were removed by real-time assistance using DSA technique during the operation.The imaging cure rate of surgical treatment and the complications of intraoperative angiography of the children were analyzed.The children were followed up clinically after procedure.According to the modified Rankin scale (mRS) score,their prognoses were evaluated.Results Intraoperative angiography revealed that the AVMs in 8 of 9 children were resected completely,and 1 had a residual lesion,then it was resected completely.Immediately after the resection of the nidi,the angiography confirmed that the nidi of 9 children were resected completely.No related complications caused by intraoperative angiography were observed.Nominal aphasia occurred in 1 child after procedure,and he recovered gradually after 6 months.Pulmonary infection occurred in 2 children,and they were cured after anti-infection treatments.Postoperative follow-up mRS scores were 0-1 in 8 children,2 in 1 child,and no rebleeding was observed.Conclusions In children undergoing AVM surgery,initial observation of DSA is safe and effective.Intraoperative angiography can guide the complete resection of the lesions in real time,improve the surgical cure rate of AVMs,and improve the prognosis of children.
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Objective To analyze the clinical efficacy and technical key points of genioplasty for the deformities of the chin.Methods 153 patients with chin deformities were treated with the genioplasty,and the chin was moved in any direction,including sagittally,vertically and transversely;the key points of this procedure were summarized.Results There was no severe complication such as infection or nonunion observed.15 patients had ecchymosis and faded in 2 weeks;33 patients had hypaesthesia and recovered in 12 weeks.With the 12-24 months follow-up,all the patients healed well with satisfactory aesthetic results.Conclusions The genioplasty is a reliable and efficient method for the deformities of the chin,and it can significantly improve the appearance of the chin.
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Objective To compare the efficacy between autologous fat and hyaluronic acid in filling nasolabial grooves.Methods Sixty patients who wanted improvement of nasolabial grooves were involved in the study.They were randomly and equally classified into two groups:autologous fat injection group and hyaluronic acid injection group.Photographs were taken before,half a year,and one year after injection.The nasolabial grooves were also graded before,half a year,and one year after injection.The grade improvement was obtained after postoperative grade minus preoperative grade.If the grade improvement was more than 1 grade,the treatment was regarded as effective to evaluate the outcome between the two methods.Results The results of the two groups were tested by SPSS 13.0 software.The effects of the two methods were not significantly different after half a year of filling (P＞0.05).The difference was significant one year after filling (P＜0.05).In autologous fat injection,the patients had a long and magnificant swelling and redness around the nasolabial grooves;on the contrary,the patients who underwent hyaluronic acid had slight and short-time local reaction like swelling and redness.No other serious complications were found in both the groups.Conclusions The effects of the autologous fat and the hyaluronic acid are equal after half a year of filling.The autologous fat has a longer effect in one year.Both methods are safe and effective.Surgeons can select the method accordingly.
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Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage and e-PTFE,and to observe the outcome and possible complications.Methods A 3-4 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.Structural reconstruction of the nasal tip was then done with these costal cartilage parts.Radix augmentation was conducted with e-PTFE.Results From Jan.2013 to Sept.2014,48 patients were treated with this method,all females,aged 22-35 years.36 of them had received rhinoplasty before,12 of them received none.Satisfying aesthetic contouring of the nasal tip and dorsum had been achieved in 45 patients.Deviation of the collumella and nostril asymmetry were found in 3 patients.Among all patients,no such complications as pneumothorax,hemothorax,infection,or hemotoma were observed.The scar on the donor site was not obvious.Conclusions Costal cartilage is sufficient,supportive and easily shapable,when applied to the structural reconstruction of the nasal tip,which can meet the demands of patients who prefer more outstanding and delicate nasal tip contouring.
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Objective To evaluate an improved technique of vertical mammaplasty with purse string suture for correction of breast ptosis and its clinical application.Methods The adjustable markings of vertical mammaplasty was improved with an upper pedicle for the areola,and breast reduction was adapted with the lower part.The breast tissue was lifted and fixed on the second rib level to reshape the breast,which did not rely on the skin,with purse string suture for the lower half of vertical incision.32 patients with breast ptosis had been operated from May 2009 to February 2014.Results 32 cases were treated with vertical mammaplasty with short scar.The shape of the breasts was strengthen,without obvious scar,and follow-up results of patients were satisfied.Conclusions The vertical mammaplasty with short scar design is simple,operation is convenient,breast shape is plump,and postoperative long-term effect is great.This procedure can be used as one of the feasible operation for breast ptosis correction.
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<p><b>OBJECTIVE</b>To determine whether the onset of acute lung injury (ALI) induces the up-regulation of pentraxin 3 (PTX3) expression in mice and whether PTX3 concentration in the biofluid can help recognizing sepsis-induced ALI.</p><p><b>METHODS</b>Wild-type C57BL/6 mice (12-14 weeks old) were randomly divided into 3 groups. Mice in the group 1 (n=12) and group 2 (n=12) were instilled with lipopolysaccharide via intratracheal or intraperitoneal routes, respectively. Mice in the group 3 (n=8) were taken as blank controls. Pulmonary morphological and functional alterations were measured to determine the presence of experimental ALI. PTX3 expression in the lung was quantified at both protein and mRNA levels. PTX3 protein concentration in blood and bronchoalveolar lavage fluid was measured to evaluate its ability to diagnose sepsis-induced ALI by computing area under receiver operator characteristic curve (AUROCC).</p><p><b>RESULTS</b>ALI was commonly confirmed in the group 1 but never in the other groups. PTX3 expression was up-regulated indiscriminately among lipopolysaccharide-challenged mice. PTX3 protein concentration in the biofluid was unable to diagnose sepsis-induced ALI evidenced by its small AUROCC. PTX3 concentration in bronchoalveolar lavage fluid did not correlate with that in serum.</p><p><b>CONCLUSIONS</b>Lipopolysaccharide challenges induced PTX3 expression in mice regardless of the presence of ALI. PTX3 may act as an indicator of inflammatory response instead of organ injury per se.</p>
Subject(s)
Animals , Male , Mice , Acute Lung Injury , Metabolism , Blotting, Western , C-Reactive Protein , Metabolism , DNA Primers , Enzyme-Linked Immunosorbent Assay , Lipopolysaccharides , Mice, Inbred C57BL , Nerve Tissue Proteins , Metabolism , Real-Time Polymerase Chain Reaction , Up-RegulationABSTRACT
Objective Toinvestigatetheroleofcontrolledanticoagulationinocclusionofvertebral arteriesforthetreatmentofgiantfusiformaneurysmsofthebasilartrunkinchildren.Methods The clinical data of 3 children with giant fusiform aneurysms of the basilar trunk were analyzed retrospectively. Three children underwent bilateral vertebral artery occlusion with endovascular intervention,and conducted controlled anticoagulation by intravenous infusion of heparin sodium (10-30 U/[kg·h])after procedure. Results Intheprocessofanticoagulation,2patientshadsomeseverebleedingcomplications,including epistaxis,gastrointestinal bleeding,and after transient cessation of anticoagulation,they had severe brainstem ischemic symptoms,including vomiting,hemiplegia,loss of consciousness and respiratory dysfunctions (one recovered after using low-molecular weight heparin and one died),another patient did not have any serious complicationsandwascuredafteradjustingtheanticoagulationstrategy.Conclusion Inthetreatmentof basilar artery trunk giant fusiform aneurysms in children through the bilateral vertebral artery occlusion,the controlled anticoagulation after procedure may reduce the occurrence of brain stem infarction and severe bleeding complications. It may be an important measure for improving the safety and effectiveness of bilateral vertebral artery occlusion.
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<p><b>OBJECTIVE</b>To explore whether the amount of lipocalin-2 in the biofluid could reflect the onset of sepsis-induced acute lung injury (ALI) in mice.</p><p><b>METHODS</b>Lipopolysaccharide (LPS, 10 mg/kg) injection or cecal ligation and puncture (CLP) was performed to induce severe sepsis and ALI in C57 BL/6 male mice randomly divided into 5 groups (n=10 in each group): group A (intraperitoneal LPS injection), group B (intravenous LPS injection via tail vein), group C (CLP with 25% of the cecum ligated), group D (CLP with 75% of the cecum ligated), and the control group (6 sham-operation controls plus 4 saline controls). All the mice received volume resuscitation. Measurements of pulmonary morphological and functional alterations were used to identify the presence of experimental ALI. The expressions of lipocalin-2 and interleukin (IL)-6 in serum, bronchoalveolar lavage fluid (BALF), and lung tissue were quantified at both protein and mRNA levels. The overall abilities of lipocalin-2 and IL-6 tests to diagnose sepsis-induced ALI were evaluated by generating receiver operator characteristic curves (ROC) and computing area under curve (AUC).</p><p><b>RESULTS</b>In both group B and group D, most of the main features of experimental ALI were reproduced in mice, while group A and group C showed septic syndrome without definite evidence for the presence of ALI. Compared with septic mice without ALI (group A+group C), lipocalin-2 protein expression in septic mice with ALI (group B+group D) was significantly up-regulated in BALF (P<0.01) and in serum (P<0.01), and mRNA expression boosted in lung tissues (all P<0.05). Lipocalin-2 tests performed better than IL-6 tests in recognizing sepsis-induced ALI cases, evidenced by the larger AUC of the former (BALF tests, 0.8800 versus 0.6625; serum tests, 0.8500 versus 0.7000). Using a dual cutoff system to diagnose sepsis-induced ALI, BALF lipocalin-2 test exhibited the highest positive likelihood ratio (13.000) and the lowest negative likelihood ratio (0.077) among the tests of lipocalin-2 and IL-6 in blood and BALF. A statistically significant correlation was found between lipocalin-2 concentration in BALF and that in serum (Spearman r=0.8803, P<0.0001).</p><p><b>CONCLUSIONS</b>Lipocalin-2 expression is significantly up-regulated in septic ALI mice compared with those without ALI. Lipocalin-2 tests with a dual cutoff system could be an effective tool in distinguishing experimental ALI cases.</p>
Subject(s)
Animals , Male , Mice , Acute-Phase Proteins , Metabolism , Base Sequence , Bronchoalveolar Lavage Fluid , DNA Primers , Lipocalin-2 , Lipocalins , Metabolism , Lung Injury , Diagnosis , Mice, Inbred C57BL , Oncogene Proteins , Metabolism , Real-Time Polymerase Chain Reaction , SepsisABSTRACT
Though all the marketed drugs of dipeptidyl peptidase IV inhibitors are structurally different, their inherent correlation is worthy of further investigation. Herein we rapidly discovered a novel DPP-IV inhibitor 8g (IC50 = 4.9 nmol.L-1) which exhibits as good activity and selectivity as the market drugs through scaffold hopping and drug splicing strategies based on alogliptin and linagliptin. This study demonstrated that the employment of classic medicinal chemistry strategy to the marketed drugs with specific target is an efficient approach to discover novel bioactive molecules.
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Humans , Dipeptidyl-Peptidase IV Inhibitors , Chemistry , Drug Design , Drug Discovery , Methods , Hypoglycemic Agents , Chemistry , Linagliptin , Chemistry , Molecular Structure , Piperidines , Chemistry , Structure-Activity Relationship , Uracil , ChemistryABSTRACT
Objective To evaluate the effect of double L-shape osteotomy combined bony Z-plasty for prominent malar complex.Methods Thirty-two patients with prominent malar complex were treated with double L shape osteotomy combined bony Z plasty for prominent malar complex.Width of lower face was observed during follow-up phase.Questionnaires were used to assess the patents' level of satisfaction at 6 months after operation.Results All wounds got primary intention healing and no severe complication in perioperative period.Postoperative appearance of all 32 cases showed that the width of middle face was efficiently reduced.All patients expressed high levels of satisfaction 6 months after operation.Conclusions Double L-shape osteotomy combined bony Z-plasty for prominent malar complex is an effective and safe method for the treatment of prominent malar complex.
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Objective To correct the nasal deformities of cleft lip by expanded-polytetrafluoroe thylene (e-PTFE) combined with autologous nasal septal cartilage.Methods e-PTFE was placed nearby verge of anterior nasal aperture to raise the fundament of nose.Autologous nasal septal cartilage was harvested and combined with e-PTFE to form a sandwich structure.Nasal tip and collapsed nasaI alar were repaired by this method.Results Fifty cases were treated by this method and 42 cases were followed up for about one year.The results were satisfying.The contour of the nose was similar to normal.Only 3 cases were relapsed after one year.Conclusions e-PTFE combined with autologous nasal septal cartilage is an ideal method to correct nasal deformities of cleft lip.
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Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage,and to observe the outcome and summarize the possible complications.Methods A 6-7 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.A lancet shaped piece was used for dorsal augmentation,several cartilage bars for collumellar elevation and nasal tip elongation.Comprehensive structural rhinoplasty was then done with open rhinoplasty incision.Results 52 patients were treated with this method and satisfying aesthetic contouring of the nasal tip and dorsum was achieved.Among these patients,no such complications as implant extrution or dislocation,cartilage distortion,pneumothorax,hemothorax,infection or hemotoma were observed.The scar on the donor site was not obvius.Conclusions Costal cartilage can meet the demands of patients who consider prosthesis as an unacceptable option.For secondary revision rhinoplasties,costal cartilage provides sufficient materials to ensure a promising outcome with lower risk of infection and other complications.
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Objective To employ autologous septal cartilage grafting as a new method of elongating the nose and adjusting the nasolabial angle in order to correct the deformities of short nose and bulbous tip.Methods A set of techniques,including,yet not limited to,releasing and sculpturing of the alar cartilages,harvesting of septal cartilages and carving them into L shape and cap-like shape for transplant,moulding the soft tissue envelop with buried through and through sutures etc.were used to lengthen the nose and modify the tip.Results From 2004 to now,the new technique had been applied to 345 patients with short nose and bulbous tip.Follow-up ranged from 6- 48 months,satisfactory outcomes were obtained.Conclusions The new technique adopted by the author in which autologous septal cartilages are settled to the anterior angle of the nasal septum and between the domes of alar cartilages has been proved to be a viable and reliable way to lengthen the nose.Further advantages of this technique include the easiness of harvesting grafts,minimal injury,rare complications of infection and rejection etc.
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Objectives To explore a comprehensive approach for the functional and aesthetic correction of septal deviation. Methods From Jan. 2007 to Dec. 2009, 48 patients with deviation of the frontier and ceiling border of the septal cartilage, 6 males, 42 females, average age of 26.5 years, were surgically treated with a comprehensive use of several techniques, such as septoplasty, reconstruction of septal support, precise osteotomies and nasal tip plasty. Results Functional improvement achieved in all the patients, contour satisfaction achieved in 91.7 % patients; 30 patients were very satisfied, and 14 satisfied with the outcome. Conclusions With the thorough understanding of surgical anatomy of the nose and the use of comprehensive surgical approach, satisfactory outcomes can be achieved both functionally and aesthetically in patients with septal deviation.
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<p><b>BACKGROUND</b>Stroke and traumatic injury to the nerve system may trigger axonal destruction and the formation of scar tissue, cystic cavitations and physical gaps. Olfactory ensheathing cells (OECs) can secrete neurotrophic factors to promote neurite growth and thus act as a prime candidate for autologous transplantation. Biological scaffolds can provide a robust delivery vehicle to injured nerve tissue for neural cell transplantation strategies, owing to the porous three-dimensional structures (3D). So transplantation of the purposeful cells seeded scaffolds may be a promising method for nerve tissue repair. This study aimed to evaluate the compatibility of a novel collagen-heparan sulfate biological scaffold with olfactory ensheathing cells in vitro.</p><p><b>METHODS</b>Collagen-heparan sulfate (CHS) biological scaffolds were made, and then the scaffolds and OECs were co-cultured in vitro. The viability of OECs was tested by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium (MTT) assay at days 1, 3, 5 and 7. Statistical analysis was evaluated by student's t test. Significance was accepted at P < 0.05. OECs were labeled with carboxyfluorescein diacetate succinimidyl ester (CFSE), and the CFSE-labeled OECs were seeded into CHS scaffolds. The attachment and growth of OECs in CHS scaffolds were observed and traced directly by fluorescent microscopy and environmental scanning electron microscope (ESEM).</p><p><b>RESULTS</b>CHS biological scaffolds had steady porous 3D structures and no cytotoxicity to OECs (F = 0.14, P = 0.9330). CHS biological scaffolds were good bridging materials for OECs attachment and proliferation, and they promoted the axonal growth.</p><p><b>CONCLUSION</b>The compatibility of CHS biological scaffolds with OECs is pretty good and CHS biological scaffold is a promising cell carrier for the implantation of OECs in nerve tissue bioengineering.</p>