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Objective:To explore the safety and efficacy of ultrasound-assisted facial filler injection, based on the anatomy of facial vessels to prevent intravascular embolization.Methods:From Jan. 2019 to Sep. 2020, 142 patients were treated with facial soft-tissue filler injection (mean age, 39.7 years; 131 female and 11 male). According to the patients＇ own will, autologous fat or hyaluronic acid was applied respectively. When injecting, the assistant could press over the periorbital artery to temporarily occlude the artery, confirmed with Doppler ultrasound, thus reduced the risk of intravascular embolization, and carefully injected with minimal pressure and tiny amount.Results:A total of 142 patients were enrolled in the study, and 54 patients were treated with autologous fat grafting, while 88 patients were injected with hyaluronic acid. The injection sites included forehead, temple, glabella, nasal root, tear trough, nasolabial fold, cheek, chin, and lips. Facial rejuvenation improvement was satisfied with a smooth contour and proper augmentation. No vascular embolization occurred. 9 patients received a second or third round fat grafting to achieve better outcome. Follow-up duration ranged from 1 month to 6 months.Conclusions:With ultrasound assistant, digital pressure over the orbital artery could temporarily occlude the artery and may reduce the risk of intravascular embolization. The simple technique may add a significant benefit with no additional cost or risk to the patients.
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Objective@#To investigate the clinical efficacy and safety profile of hyaluronic acid dermal filler(Restylane®) in treating nasolabial folds in Chinese population.@*Methods@#103 subjects in this study were recruited from five Chinese clinical trial centers between July 2014 and December 2015. Subjects were treated with hyaluronic acid dermal filler in correcting nasolabial folds and an optional re-treatment was performed after 12 months according to the subjects′wishes. The improved of nasolabial folds was evaluated by the change of severity (wrinkle severity rating scale, WSRS) and aesthetic improvement (global aesthetic improvement scale, GAIS). Satisfaction of subjects on treatment was evaluated using subject satisfaction questionnaires (SSQ). Safety indicators such as pain, skin and soft tissue presentation at the injection site were continuously evaluated throughout the whole treatment process.@*Results@#Significant improvement in scores of WSRS and GAIS of all subjects was observed after treatment. Nine months after treatment, the scores of WSRS in 80 subjects (77.7%) and GAIS in 96 subjects (93.2%) were still improved. The 68 subjects (95.8%) received re-treatment after 12 months gained further improvement in nasolabial folds. Most adverse events were mild or moderate (transient/reversible local manifestations) and all resolved before study end, no severe adverse event related to products observed.@*Conclusions@#Hyaluronic acid dermal filler is effective and safe in treatment of nasolabial folds in Chinese population and the effect can last up to 12 months.
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Objective@#To investigate the clinical efficacy of circumferential thigh liposuction with three incisions in thigh.@*Methods@#From April 2017 to October 2018, 31 patients received circumferential thigh liposuction with three incisions. All patients were females at 17-42 years old, with the mean age of 25.6± 0.8 years. An incision was designed in the pubic area, two in right and left inferior gluteal folds respectively. After injecting tumescent liquid into operation area, blunt and bent cannulas with 2.5-3.5 mm in diameter and 20-45 cm in length were used to extract deep subcutaneous fat, but 0.5 cm thick subcutaneous superficial fat was preserved. Elastic pants were dressed for 3 months after surgery. The thigh contour improvement was evaluated by the patients and 2 doctors.@*Results@#All the patients recovered uneventfully, without complications of fat embolism or infection. Satisfaction ratios of overall thigh and inner thigh contour increased from 81.7% to 80.6%, evaluated by patients. Ten patients completed postoperative outpatient revisit after 2 months. Satisfaction ratios of overall thigh and inner thigh contour increased from 80% to 75%, evaluated by doctors.@*Conclusion@#Three-incision circumferential thigh liposuction is an effective method in thigh contouring with concealed incision scar.
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Objective@#To investigate the effect of perioperative fluid therapy on early postoperative pulmonary complication (PPC) after orthotopic liver transplantation (OLT).@*Methods@#The clinical data of 132 patients who underwent OLT in the First Affiliated Hospital of Xi′an Jiaotong University from April 2016 to December 2017 were analyzed retrospectively. These patients included 96 males and 36 females, aged (47.3±9.6) years (range: 24-69 years). Based on the clinical manifestations, laboratory and imaging findings of patients in ICU and PPC occurrence within 7 days after OLT surgery, the patients were divided into 2 groups: non-PPC group and PPC group. Univariate and multivariate logistic regression analyses were used to evaluate the association between perioperative variables and PPC. The Kaplan-Meier method was used to estimate cumulative survival of recipients with or without PPC within 2-years.@*Results@#During the follow-up, 11 patients (8.3%) died and 72 patients (54.5%) developed PPC after operation. There were 34 cases, 6 cases, 3 cases, 4 cases, 15 cases, 6 cases and 4 cases of only pleural effusion, only pulmonary edema, only pneumonia, pleural effusion with pneumonia, pleural effusion with pulmonary edema, pleural effusion with atelectasis, and pleural effusion with pneumonia and pneumonia in PPC, respectively. Univariate analysis showed that the preoperative factors (model for end-stage liver disease score), the intra-operative factors (duration of surgery, total infusion volume, total blood products) and the postoperative cumulative fluid balance within the first 24 h, 48 h, and 72 h were the prognosis factors of PPC (P<0.05). At least two out of the first three postoperative days with a fluid balance of ≤-500 ml was a protective factor. Using multivariate analysis by Logistic regression, only the red blood units >10 U (OR=3.55, 95% CI: 1.35-9.26, P=0.010) and the cumulative fluid intake >12 L (OR=2.98, 95% CI: 1.14-7.80, P=0.026) within the first 72 h after operation were independent prognosis factors of PPC after OLT. Kaplan-Meier analysis showed that the cumulative survival rate was lower in PPC group than that in non-PPC group (χ2=6.590, P=0.01).@*Conclusion@#Massive red blood cell transfusion and the cumulative fluid volume >12 L during perioperative 72 hours are independent prognosis factors of PPC after OLT.
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Objective@#To observe the safety and efficiency of face-lift combined with fat grafting in facial rejuvenation.@*Methods@#We performed a retrospective study, which included 23 patients. SMAS suspension and multi-site suspension were combined to correct the nasolabial fold, mid-cheek aging and malar mounds. Structural fat grafting was performed to treat the volume loss in mid-face.@*Results@#All patients demonstrated a significant improvement in midfacial appearance. No infection or nerve injury were found in this study. Only three patients did not get primary healing in temple region, which led to temporal hair loss from secondary healing.@*Conclusions@#This study demonstrates that fat grafting and multiple layers face-lift are efficient method for facial rejuvenation. These approaches appear to be very promising for facial anti-aging techniques.
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Objective@#This paper discusses a surgical method to improve the middle part of face and the temporal surface by using the patented technology of embedding guidance technology.@*Methods@#On the basis of not removing the skin, the application of embedding guidance technology was applied to achieve the effect of facial lifting by placing a 2-0 polyester knitting line under the scalp with a minimally invasive incision(3-5 mm) , paving up to the skull periosteum and down to the hairline edge for compound fixation.@*Results@#Among the 200 patients, 197 were female and 3 were male. Aging from 23-62 years old, all of the patients suffered from mild to moderate problem of saggy skin.Post-operation follow-up was kept from 3 months to 5 years after the treatment, which demonstrated that all of the patients showed different degrees of facial lifting after edema subsided at 3 months, including improvedfacial skin condition, shallower nasolabial groove, lifting of the lateral canthus and tightening of facial skin. The patients were satisfied with the effect.@*Conclusions@#The surgical method is an effective method to solve the problem of facial aging with advantages, such as simple execution, minimized wound, fast recovery, no post-operation bandage requirement and showing great result towards patients suffering from mild and moderate saggy facial skin problem.
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Objective@#To explore the clinical effect of cervico-acromial fasciocutaneous flap based on the supraclavicular artery as a method for face and neck reconstruction.@*Methods@#From Oct 1990 to June 2014, 17 patients, with the age range of 7 to 51 years, suffering from cicatricle contractures of neck or facial defect, were treated with cervico-acromial fascicutaneous flaps. 29 flaps were used in 12 patients bilaterally or multiply. The donor sites of 2 patients were closed by skin graft; while in the rest 15 patients, the donor sites were closed by expanded flaps.@*Results@#All the 29 flaps were survived, with satisfactory color and texture. Hematoma occurred in 1 case after tissue expander implantation, but the flap was successfully expanded after evacuation of hematoma. The size of flaps ranged from 15 cm×7 cm to 35 cm×15 cm. 10 patients completed 6 months follow-up, and presented with satisfactory appearance and better functional results.@*Conclusions@#Cervico-acromial fascicutaneous flap based on the supraclavicular artery is an good choice for reconstruction of neck and facial defects.
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<p><b>OBJECTIVE</b>Augmentation rhinoplasty is a commonly procedure in clinical work for a plastic surgeon. Autologous costal cartilage is widely used in aesthetic rhinoplasy because of the abundant in quality. However, the cartilage may warp, and it is not easy-handling for inexperienced plastic surgeons. We-used diced cartilage combined with thin strips as columellar struts, which can be easily shaped, and reduce the warping incidence.</p><p><b>METHODS</b>From July 2012 to March 2014, 61 patients were performed diced costal cartilage for nasal augmentation via endonasal approach. Standardized photographs are obtained before and after surgery. Postoperative outcome is graded by patient's self-evaluation of the nasal appearance with a satisfaction scale.</p><p><b>RESULTS</b>Among the 61 cases, 25 were revision cases. The follow-up time was no less than 6 months, with an average time of 10.9 months. 28 patients reported improved or better nasal appearance. One patient required revision surgery because of overcorrection. Supratip step-off was observed in one patient and corrected by external reshaping. No warping, infection, irregularity, absorption, airway obstruction, or donor-site morbidity were observed. All patients were satisfied with the final appearance.</p><p><b>CONCLUSIONS</b>Diced costal cartilage is a reliable option for nasal augmentation and revision rhinoplasty. Good outcomes can be achieved postoperatively, with aesthetically pleasing appearance and simple procedure.</p>
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Humans , Costal Cartilage , Transplantation , Esthetics , Nasal Septum , Reoperation , Retrospective Studies , Rhinoplasty , MethodsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of epidermal stem cells from human hypertrophic scar (HS-ESCs) on the skin wound healing in nude mice.</p><p><b>METHODS</b>40 mice were randomly divided into two groups as experimental group (n = 20) and control group (n = 20). Wounds, 1 cm in diameters, were made on every mouse back. The wounds were treated with HS-ESCs and erythromycin ointment in experimental group, or only with erythromycin ointment in control group. The wound healing was observed during the following 14 days. The expression of collagen-I, collagen-III, epidermal growth factor (EGF), fibroblast growth factor (FGF2) , transforming growth factor (TGFbeta1, and TGFbeta2) were studied.</p><p><b>RESULTS</b>The wound healing time in the experimental group was (20.8 +/- 0.84) d, which was (25.6 +/- 0.89) d in the control group. HE staining revealed that the extent of vascularization in the experimental group was 11.60 +/- 0.55, while it was 8.04 +/- 0.33 in the control group. Immunochemistry analysis showed the expression of collagen-I, collagen-III, EGF, FGF2, TGFbeta1, and TGFbeta2 in the experimental group were significantly higher, compared with those in control group (P < 0.05).</p><p><b>CONCLUSION</b>HS-ESCs may promote wound healing through enhancement of the vascularization of the wound tissue and the expression of growth factors.</p>
Subject(s)
Animals , Female , Humans , Male , Mice , Cicatrix, Hypertrophic , Pathology , Epidermis , Cell Biology , Mice, Nude , Skin , Wounds and Injuries , Stem Cell Transplantation , Stem Cells , Wound HealingABSTRACT
Objective To observe the efficiency of infection of adenovirus containing hepatocyte growth factor(Ad-HGF) on adipose derived stem cells and to prove whether the valid HGF can appear after infection and the multiplicity of infection. Methods We use the digestion separation method and the attachingwall characteristic of the adipose-derived stem cells to separate the human adipose-derived stem cells. Adipose-derived stem cells were infected by the vector of adenovirus (Ad-GFP) which carries the GFP gene,and the GFP acts as the indicating gene to determine the infection efficiency of recombinant adenovirus to adipose- derived stem cells. HGF-ELISA was used to detect HGF as expression-secretion. Results The adherent cells displayed themselves as fibroblast in morphology. The primary cultured cells fusion can arrive to 70% - 80% in 7 - 10 days. The infected HGF can be highly expressed in 48hours. Conclusion Adenovirus can meditate the expression of HGF gene in adipose-derived stem cells effectively.
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Objective To evaluate the elimination of melasma with nonablative Q-switched Nd : YAG1 064 nm laser. Methods 23 cases of melasma were treated with Q-switched Nd :YAG 1 064 nm laser using the following parameters: spot size, 6 mm; pulse duration, 5-7 ns; frequency, 10 Hz, and flu-ence, 1.8-2. 0 J/cm2. The procedure was repeated weekly. Results The treatment was well tolerated without the use of topical anesthetic. There was slight congestion, no blister and crust after treatment. Routine clean and make-up can be done after treatment. The melasmas were obviously lighten or fully eliminated after 8-10 treatments and 52. 17 % of patients showed excellent results. Only 5 cases experienced an episode of purpura on eyelid after treatment and disappeared spontaneously without post-inflammatory hyperpigmentation and scarring. Followed up over 6 months, there was recurrence in 7 patients who were effective by additional treatment. Conclusions Nonablative Q-switched Nd :YAG 1 064 nm laser is a more ideal method to eliminate melasma because of the credible effect, safe, simple operation, and no downtime, in despite of recurrence.
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BACKGROUND: Facial nerve injury causes facial nerve paralysis (or facial palsy) and even results in psychosocial disturbances of the patients. Repair the injured facial nerve and reconstruction of the nerve function as early as possible have been the primary concern in clinical studies.OBJECTIVE: To investigate the timing and surgical approaches for repairing facial paralysis in order to provides evidences for its therapeutic and prognostic evaluation.DESIGN: Case analysis based on patients.SETTING: Hospital of Plastic Surgery of Chinese Academy of Medical Sciences.PARTICIPANTS: Nine patients with traumatic facial paralysis hospitalized in the Hospital of Plastic Surgery of Chinese Academy of Medical Sciences from December 1993 to November 2001.METHODS: Facial nerve anastomosis was performed microsurgically along with the implantation of the sural nerve graft into orbicular muscle of the eye 3 or 4 months after nerve injury in the 9 patients. The clinical data of the patients were retrospectively reviewed.MAIN OUTCOME MEASURES: The facial nerve function was evaluated with House-Brackmann scale and photographs of the patients' faces before and after surgical treatment were taken.RESULTS: In the follow-up of these patients lasting 6 months to 2 years,all the patients attained satisfactory outcome.CONCLUSION: Early operation is crucial for the treatment of traumatic facial paralysis,with facial nerve anastomosis as the primary choice. The implantation of the nerve graft into muscle is also indicated for repairing traumatic facial paralysis in some cases. The importance of individualized treatment choice is reiterated on the basis of cicatrectomy and the extent and specific features of the injury.
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<p><b>OBJECTIVE</b>To monitor the microcirculation of lateral groin skin flaps.</p><p><b>METHODS</b>The microcirculation in 12 lateral groin skin flaps was monitored continuously by laser doppler flowmetry (LDF).</p><p><b>RESULTS</b>The microcirculatory changes in lateral groin skin flaps were divided into two phases: rapid rising (2-6 days after operation) and plateau (6-11 days after operation). PU values were 2.83 +/- 0.46, 3.21 +/- 0.41, 3.66 +/- 0.43, 4.77 +/- 0.71, 7.08 +/- 0.37; 7.53 +/- 0.41, 7.57 +/- 0.62, 7.70 +/- 0.44, 7.60 +/- 0.26, 7.58 +/- 0.17.</p><p><b>CONCLUSION</b>In clinical application, division of the lateral groin skin flaps within the plateau, and the values (PU) returned to or exceeded 50% of that values (PU) determined before application of the tourniquet, causes flaps survival (100%). The time of division was decreased to 8-11 postoperative days in our clinical application.</p>
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Adolescent , Adult , Humans , Middle Aged , Groin , General Surgery , Laser-Doppler Flowmetry , Microcirculation , Skin Transplantation , Methods , Surgical Flaps , Time FactorsABSTRACT
<p><b>OBJECTIVE</b>On the basis of the concept of adhesive deformity from upper eyelid fold formation, the clinical results after using various methods to correct the adhesive deformities are summarized.</p><p><b>METHODS</b>A total of 33 cases of adhesive deformity from upper eyelid fold formation have been treated using various corrective methods including taking off the sutures, shifting of the septal fat or the pre-septal orbicularis muscle, transferring of pretarsal orbicularis muscle, grafting of autogenous fat tissue, and repairing or/and shortening of the palpebral levator. Postoperative follow-up ranged from 3 months to 2 years.</p><p><b>RESULTS</b>The effective results have been got with the used methods except shifting of the pre-septal orbicularis muscle or transferring of pretarsal orbicularis muscle.</p><p><b>CONCLUSIONS</b>The suitable methods to correct the adhesive deformity from upper eyelid fold formation must be chosen according to the causes and the local situations.</p>
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Adult , Female , Humans , Middle Aged , Eyelids , Congenital Abnormalities , General Surgery , Follow-Up Studies , Treatment OutcomeABSTRACT
Objective To investigate the relationship between the change of blood flow in exceedingly expanded skin and the viability of the flaps. Methods In 21 expansions of 10 patients, the skin blood flow and its amplitude were measured by laser Doppler in different stages. The results were compared with the final outcomes of patients. Results The volume of blood flow and its amplitude of normal skin were very low and stable, but after expanded, the volume of blood flow and the amplitude grew up, which were significantly higher than that of normal skin (P
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In the present study ~3H-Leucine or WGA-HRP was injected into the superior colliculus of one side in the rat.The terminal areas of the efferent projection fibers from the superior colliculus were examined. The efferent fibers of the superfical layer of the superior colliculus descended ipsilaterally to terminate in the parabigeminal nucleus(predominantly the dorsal and ventral part of the same side)and dorso-lateral part of the ipsilateral pontine nucleus.Ascending projections terminated to the medial geniculate nucleus,the posterior pretectal nucleus and latero-posterior nucleus of the thalamus(all bila- terally,but with ipsilateral predominance),the ipsilateral medial and lateral optic nuclei,and the dorsal and ventral lateral geniculate nucleus.In addition,labeled granules were also found in bilateral optic tracts and the optic chiasma. The efferent fibers of the middle and deep layers terminated to the ipsilateral central gray,the nucleus of Darkschewitsch,the interstitial nucleus of Cajal,the cuneiform nucleus and the contralateral superior colliculus.Ascending fibers ter- minated to the medial geniculate nucleus,the suprageniculate nucleus,the anterior- pretectal nucleus,the postero-lateral nucleus of the thalamus(all bilaterally,but more on the ipsilateral side),the parafascicular nucleus,the zona incerta,the ventral nucleus of the thalamus(all ipsilaterally).Descending fibers terminated to ipsilateral parabigeminal area and the parabigeminal nucleus,the dorso-lateral part of the pontine nucleus,the lateral part of the inferior colliculus,the reticular formation of the medulla oblongata and pons,and the lateral part of the inferior olive.The fibers terminated also to contralateral nuclei such as the parabigeminal nucleus,the medial part of the reticular formation of the medulla oblongata and ports,the medial accessory nucleus of the inferior olive,the anterior horn of the cervical spinal cord.