Vascular complications caused by hyaluronic acid injection: a clinical analysis / 中华医学美学美容杂志

Objective:To analyze the epidemiological characteristics of vascular complications induced by hyaluronic acid facial injection.Methods:Patients with vascular complication induced by facial hyaluronic acid facial injection were collected in the Fourth Medical Center of the General Hospital of the Chinese People's Liberation Army from January 1, 2016 to October 1, 2021, including 5 males and 37 females. The age ranged from 16 to 70 (34±10) years. The clinical data, injection site, clinical symptoms and previous facial surgery history of the patients were analyzed and investigated.Results:Vascular complications occurred in 12 cases (28.6%). Nasolabial fold in 8 (19.0%) cases; Glabella in 6 (14.3%) cases; frontal part in 6 (14.3%) cases. There were 27 patients (64.3%) with a history of facial surgery. Furthermore, history of facial surgery had no effect on the clinical manifestations of vascular complications ( P>0.05). Among the 18 patients with visual impairment, 12 patients reported that the symptoms of ptosis, bulbar conjunctival congestion, and eye movement dysfunction had diminished after thrombolytic treatment, while 4 patients showed recovery to some extent in visual acuity. Likewise, 24 patients with blood circulation disorders were healed after treatment, with residual pigmentation and a slight scar left. Conclusions:Women aged 30 to 39 years old are the main target population of cosmetic surgery, as well as the most common population of vascular complications. Particular care should be taken in the nose, nasolabial fold, glabella and forehead areas of the operation. Patients with previous surgical history should be adequately informed before surgery, and postoperative observation time should be appropriately prolonged.

Epidemiological and pathogenic investigation on the first case of human Streptococcus suis type 2 infection in Minhang District, Shanghai / 公共卫生与预防医学

Objective To investigate and analyze the epidemiological and pathogenic characteristics on a case of human Streptococcus suis type 2 infection in Minhang District, Shanghai, and to provide evidence for early warning and prevention and control measures of rare and imported zoonotic acute infectious diseases in Shanghai. Methods By inquiring the patient medical history and epidemiological history and on-site environmental investigation, the infection route and source of the case were examined. The pathogenic culture of cerebrospinal fluid (CSF) was used to isolate Streptococcus suis, and Vitek2GP was used to identify the isolated strains. The PCR technique was used to detect species specific genes and virulence genes. Results The clinical manifestations of the patient were high fever with headache, nausea, vomiting and stiff neck. Blood tests showed a significant increase in c-reactive protein, an increase in lymphocyte percentage, and a decrease in platelet count. Head CT examination showed bilateral ethmoidal sinus and bilateral maxillary sinus inflammation, and significantly increased CSF white blood cell count and immunoglobulin. The case's CSF sample was positive for species specific genes (16SrRNA) and 2 virulence genes (cps-2j and ef). Conclusion This case was human Streptococcus suis type 2 with meningitis symptoms. Good prognosis was associated with timely diagnosis and treatment as well as the types of virulence factors. Medical institutions should identify early infection and take timely treatment as soon as possible to avoid severe illness and death cases. Departments of agriculture, health, market management, and others should consummate the reporting mechanism of animal epidemic situation, and establish necessary active sentinel monitoring.

Autologous fat grafting and adipose- derived stem cells for scar treatment: a review of the literature / 中华整形外科杂志

With the increasing application of autologous fat grafting and adipose-derived stem cells (ASC) in regenerative medicine, more researchers pay attention to its effects on scar, which may provide a promising alternative for scar treatment. In this article, a systemic review of available literature was undertaken, regarding the current progress in repairing scars with autologous granule fat, the introduction of nanofat grafting and its effects on scar, and the mechanism of ASCs in the treatment of scar. This review provides a reference for the clinical application and basic research of fat transplantation in scar treatment.

Antagonistic effect of platelet-rich plasma on photo-aged skin in rat / 中华医学美学美容杂志

Objective To observe the effect of platelet-rich plasma (PRP) on photoaging skin of rat.Methods F344 rats were used as model animals and skin photoaging model was established by UV irradiation.The model animals were divided into 5 groups:group A was injected with activated PRP (A-PRP);group B was injected with inactive PRP (N-PRP);group C was injected with normal saline;group D was irradiated only with UV;Four weeks after the injection,the appearance and histological characteristics of the rat's skin were evaluated.Results Compared with group C and group D,the wrinkles and skin color in group A and group B were significantly improved.Histological observation showed that the histological features of group A and group B were significantly better than that of group C and D (P＜0.01).The thickness of dermis in group A was higher than that in group B (P＜0.05).There was no significant difference between groups C and D (P＞0.05).The thickness of dermis in group E was significantly higher than that in group C (P＜0.01).Conclusions Injection of PRP can improve the appearance and histological features of photo-aged skin in rats.A-PRP is better than N-PRP.

Treatment of mycobacterium tuberculousis induced with cosmetic injection / 中华医学美学美容杂志

Objective To explore the diagnosis and treatment of non-tuberculosis mycobacteria (NTM) infection after cosmetic injection via scientific debridement surgery combined with regular application of anti-NTM drugs.Methods 14 patients who were infected with NTM after cosmetic injection and were not cured over a long period of time in other hospitals from 2012 to 2016.The patients were treated with VSD thorough surgical debridement,the bacterial type of NTM was identified by bacterial culture and PCR identification and anti-NTM drugs were systematically used according to the results of drug sensitivity.Results Fourteen patients who were treated with scientific debridement surgeries combined with regular anti-NTM drug treatment in our hospital for 2-4 months were discharged after their skin lesions were cleared and healed and they were continually treated with antiNTM drugs for 12 months.Fourteen patients were completely cured by using the above treatments without severe side effects,such as liver and kidney dysfunction,nervous system disorders and so on.Only colpitis mycotica occurred in 3 patients.In addition,one patient presented the decrease of leukopenia after using anti-NTM drugs for 2 months and continued to complete the treatment after we adjusted the treatment plan to returning the level of leukopenia to the normal.These 14 patients were followed up for 1-5 years with no recurrence of the lesion.The facial appearance of 12 patients were almost normal with slight scars.The facial surgery area of 2 patients were uneven and nearly recovered to normal facial appearance by tissue transplantation and photoelectric therapy.Conclusions For the NTM patients caused by invasive procedures such as injection,the comprehensive treatment program,which combined scientific debridement surgery and systematically targeted drug treatment,not only can effectively cure NTM infection,but also minimize secondary injury and restore the patients' appearance,which is worthy of clinical application.

The effects of down-regulated ITGB5 expression on the proliferation of keloid fibroblasts / 中华整形外科杂志

Objective@#To explore the effects of down-regulated ITGB5 expression on the proliferation of keloid fibroblasts and clarify the possible role of β5-integrin(ITGB5) in keloid.@*Methods@#Construct lentiviral sh-RNA-expression vector targeting ITGB5 and infect keloid fibroblasts, the expression of ITGB5 were detected by Western Blot, the proliferation ability was identified by MTT.@*Results@#The expression quantity of ITGB5 mRNA and protein in KFb group, LV-NC group and LV-KFb group are 1.00±0.00, 1.08±0.05, 0.34±0.01 and 0.91±0.03, 0.93±0.02, 0.28±0.07. Compared with LV-NC group and KFb group, the expression quantity of ITGB5 mRNA and protein in LV-KFb group decreased significantly(P<0.01). Compared with LV-NC group and KFb group, the proliferation rate decreased significantly in LV-KFb group at 48 h(P<0.01).@*Conclusions@#These results suggest that ITGB5 can accelerate fibroblasts proliferation in keloids.

Whole-genome sequencing on one case of Han familial keloids / 中华整形外科杂志

<p><b>OBJECTIVE</b>To screen SNP information of keloid pedigrees through whole genome sequencing.</p><p><b>METHODS</b>We Collected information and clinical data of the keloid pedigree and constructed charts of the pedigree. The DNA was extracted from peripheral venous blood samples of the pedigree to sequence the whole genome.</p><p><b>RESULTS</b>27 SNP and 8 disease-associated genes were screened out.</p><p><b>CONCLUSIONS</b>Whole genome sequencing technology can select new genetic mutations associated with keloid, and provide a new way for the research of keloid.</p>

Clinical characteristics and genetic survey on four families of keloid / 中华医学美学美容杂志

Objective To study the clinical and genetic characteristics of keloid through investigating on four Han Chinese pedigrees.Methods The pedigree information and clinical data from Han Chinese keloid pedigrees were collected,which consisted of 22 patients in 127 family members,and then the charts of these pedigrees were constructed according to the data.Using the genetic model and pedigree analyses we summarized the clinical features of the disease in the families.Results Four Han Chinese keloid pedigrees were discovered.The three pedigree spans included 3 generations and one was 4 generations.Incidence of KD in the consanguinity family member was 23.7％ (23/93),and 20.8％ (11/53) in male KD,and 27.5％ (11/40) in female.Incidence of anterior chest KD was 40.9 ％.The inheritance pattern observed in these pedigrees was consistent with an autosomal dominant inheritance multi-gene hereditary disease with incomplete penetrance,and its nonpenetrance of KD gene carriers was 12％ (3/25).Conclusions The pattern of inheritance observed in these four Han Chinese keloid pedigrees is similar to previous reports and no gender differences are found in the incidence of disease,but differences in pathogenic site.Pedigree investigation helps to reveal the genetic characteristics of keloid.

Effects of botulinum toxin type A on the expression of alpha-SMA and myosin-II of fibroblasts in scars / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of botulinum toxin type A (BTXA) on the expression of alpha smooth muscle actin(alpha-SMA) and myosin-II of fibroblasts in scars. Methods Fibroblasts were isolated from tissue specimens of scars contracture. Cells from passages 3-5 were randomly divided into 3 groups (control group, low BTXA group (1 U/10(6) Cells), and high BTXA group (2.5 U/ 10(6)Cells)). Growth condition of fibroblasts was observed at 1 , 4, 7 day after BTXA treated. Changes of alpha-SMA and myosin-II in fibroblasts were detected by Western blot.</p><p><b>RESULTS</b>Fibroblasts grew well in control group. The proliferation was decreased 4 days later in BTXA groups. Lots of apoptotic cells were seen in high BTXA group at 7th day. Proteins of alpha-SMA and myosin-II in fibroblasts were statistically different between BTXA group and control groups at 4th day (P < 0.05). The expression of alpha-SMA and myosin-II in low BTXA group was higher than that in high BTXA group at 7th day (P < 0.05).</p><p><b>CONCLUSIONS</b>BTXA could induce the apoptosis of fibroblasts and decrease the expression of alpha-SMA and myosin-II in fibroblasts. The inhibitory effect was strengthened with BTXA concentration increase within a certain range.</p>

The preliminary study of structure variation related to keloid based on the whole-gene resequencing technique / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the genome structure variation (SV) related with keloid using the whole-gene resequencing technology.</p><p><b>METHODS</b>We studied a keloid pedigree containing 4 generation of 27 people. 5 people (4 cases of keloid patients, and 1 case of normal) were selected to extract the genomic DNA. Then the whole-gene resequencing technique was used to check the variations.</p><p><b>RESULTS</b>Through database comparison and variation annotation analysis, we obtained 2 SVs associated with keloid formation. We used DAVID software to do the gene ontology and pathway analysis. We found a 168 bp inversion in gene tetraspanin 8 (TSPAN8) in all keloid patients, which contained the forth exon of TSPAN8.</p><p><b>CONCLUSIONS</b>There was no report about SVs related to keloid. In this study, we found 2 SVs associated with keloid, especially TSPAN8. The tumor cells express the TSPAN8 can up-regulate the vascular endothelial growth factor and its receptors, promote the adjacent fibroblasts secrete matrix metalloproteinases and uridylyl phosphate adenosine. So we hypothesis that the inversion of the forth exon in TSPAN8 may lead to the signal transduction disorder in the keloid patients. This study was a preliminary research. It needs a further study containing large sample to confirm.</p>

The preliminary study of gene copy number variation association with scar hyperplasia based on the whole-gene resequencing / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the genome copy number variation (CNV) related with keloid using the whole-gene resequencing technology.</p><p><b>METHODS</b>A keloid pedigree containing 4 generation of 27 people was studied. Five people (4 cases of keloid patients, and 1 case of normal) were selected to extract the genomic DNA. Then the whole-gene resequencing technique was used to check the variations based on the Illumina Hiseq 2000.</p><p><b>RESULTS</b>Through database comparison and variation annotation analysis, 15 CNVs associated with scar hyperplasia were obtained. DAVID software was used to do the Gene Ontology and pathway analysis. Five CNVs were closely related to the keloid formation. They were growth factor receptor-bound 7 (Grb7), mitogen-activated protein kinase kinase kinase kinase 4 (MAP4K4), mitogen-activated protein kinase kinase kinase 15 (MAP3K15), kruppel-like factors 7 (KLF7) and NK2 homeobox 2 (NKX2-2). These CNVs were involved in the process of epidermal cells formation and differentiation, cell exocrine and cell adhesion.</p><p><b>CONCLUSIONS</b>There are 5 CNVs associated with scar hyperplasia. Especially MAP3K15 and MAP4K4 deserve more research to find their function in keloid formation.</p>

Treatment of scar contracture with intralesional botulinum toxin type A injection / 中华医学美学美容杂志

Objective To evaluate the validity of botulinum toxin type A (BTXA) injections for the treatment of scar contracture.Methods 26 patients with scar contracture were randomly assigned into BTXA group and triamcinolone acetonide (TAC) group.Pinpoint tattooing was performed on each side of each scar in the plane of its longest axis.A template was used to ensure consistent length.These two tattoo points were measured to assess scar contraction at baseline,at every month for a total of 6 months.Histological analysis was conducted to study the physiological environment and immunohistochemistry to detect the expression of α-SMA and myosin-Ⅱ at different groups.Results Scar contraction was more relaxed in BTXA group than that in TAC group after 1 month (P＜0.05),especially in the 6th month (the D value in BTXA group and TAC group was (1.23±0.42) cm,and (0.56±0.33) cm respectively).For immunohistochemistry,the expression of α-SMA and myosin-Ⅱ also decreased in BTXA group (P＜0.05).Conclusions The treatment of scar contracture by suitable BTXA injections is safe and effective.

Island scapular flap based on transverse branch of circumflex scapular artery for axillary burn scar contracture / 中华医学美学美容杂志

Objective Island scapular flap (ISF) based on transverse branch of circumflex scapular artery is less reported than ISF based on ascending or descending branch. This article presented authors' experiences in correction of severe axillary burn scar contracture with ISF based transverse branch of circumflex scapular artery. Methods ISFs based transverse branch was harvested in 12 patients with 15 severe axillary burn scar contracture, rotating an arc of about 180°. Flap size was between 12 cm× 5cm to 20 cm × 10 cm. The donor site was closed primarily. Results All 15 flaps survived completely and axillary burn scar contracture was corrected successfully. 8 patients were satisfied with both the functional and aesthetic results after 1-3 years' follow-up. Conclusion ISF based transverse branch of circumflex scapular artery is a good choice for reconstruction of severe axillary burn scar contracture, especially for female patients or ones whose ISF based on ascending or descending branch could not be harvested because of formation of hypertrophic scar in donor site.

Differentiation of human epidermal stem cells into fibroblasts induced by TGF-β1 in vitro / 中华医学美学美容杂志

Objective To investigate the correlation between human epidermal stem cell (hESCs) and hypertrophic scar or keloid. Methods Improved collagen Ⅳ-coated adhesion methods was used to isolate and culture the epidermal stem cells after neutral protease selectively digested the dermo-epidermal junctions. After the cells were cultured and expanded in vitro, and passage 3 hESCs were induced by different concentrations of TGF-β1 (0.1, 5.0, and 10.0 ng/ml). Morphological fea-tures and identification of these cells were meseasured by HE, Masson, immunohistochemical staining on the days 3 and 7, respectively. Results After induced by TGF-β1 for 3 and 7 days, the morpholo-gy of the epidermal stem cell (hESCs) was changed into fusiform shape, similar to fibroblasts. 70 % ofthe cell which was induced by TGF-β1 were blue stained in the cytoplasm by Masson stain, which is the distinctive method for collagen, suggesting collagen appeared or increased in the cells. The collagen concentrations in supernatants of hESCs were 0.4150±0.0014, 0.3380±0. 0020, and 0.3870±0.0020, much higher than that in control group (0.0780±0.0025) and normal skin fibro-blast group (0.15004±0.0051) (P<0.05). Immunohistochemical staining revealed that positive rates of these cells for anti-vimentin staining were more than (95.00±1.20)% in experiments and (5.70±0.20)% in control group. Conclusion The differentiantion of hESCs induced by TGF-β1 into fibro-blasts indicates that hESCs may play a role in the pathogenesis of hypetrophic scar and keloid.

Prevention and treatment of early hypertrophic scars with botulinum toxin type A / 中华医学美学美容杂志

Objective To explore the effect of botulinum toxin type A(BTXA)in the treatment of early hypertrophic scars(HTS).Methods BTXA was injected into and around the eady HTS,and then the modal and histological changes of the scars as well as the clinical reaction were observed in the patient.BTXA was also injected into muscle around the incision and effect on the cicatrization observed.Results Injection of BTXA could obviously alleviate ache and pruritus of eady HTS and could impel the atrophy and inteneration of eady HTS.Changes were found in paraffin-embedded tissue section by the hemetoxylin and eosin(HE)staining.Injection of BTXA into muscle around the cut could can reduce occurrence of HTS.Conclusion BTXA can help prevent the early HTS to a certain extent.The mechanism underlying this effect may be related to the reducing the tension around scars and proliferative activity,interfering with the signal transduction of small nerves,affecting the proliferation and apoptosis of fibroblasts and subsequently decreasing the collagen synthesis.

Clinical application of expanders in reconstruction after burn / 中华医学美学美容杂志

Objective To explore the application range of expand er s and its clinical efficacy in repair and reconstruction after burn. Methods Two hundred and eighty-six expanders were implanted in 80 burned patients. Volume of the smallest expander was 80cc, and that of the bi ggest one was 800cc. The expansive time ranged from 3 weeks to 2 months. In the second operation, expansive flaps were created and used in the de fected lesion where the scar was removed. Results 7 5 patients were followed up for at least one year with satisfactory results and only 3 patients showed complications that expanders exposed during expan sion. Conclusion Reasonable application of expanders coul d get satisfactory results in repair and reconstruction of severe scar, especia lly for scar at extremities and special sites after burn.

Effect of integrin expression on procollagen synthesis of fibroblasts in wound healing / 中华医学美学美容杂志

Objective To investigate the effect of integrin expression on procollagen synthesis of fibroblasts in wound healing. Methods Antisense oligonucleotides were used to intercept the expression of integrin ? 5 or ? 1 subunit on fibroblasts respectively in wound healing, then the changes of procollagen mRNA were detected by RT-PCR. Results The antisense oligoncleotdes could specifically inhibit the expression of integrin subunit. Decreased expression of integrin?5 or ?1 subunit on fibroblasts significantly lowered mRNA of procollagen ? 1(Ⅰ) and ? 1(Ⅲ). Conclusion Reduction of integrin expression on fibroblasts in wound may inhibit procollagen synthesis in the level of transcription. These results provide the experimental gists on studying of scar reduction in wound healing.

THE USE OF PREFABRICATED EXPANDED CERVICO-SCAPULO-DORSAL REVERSE AXIAL FLAP COMBINED WITH CERVICO-THORACIC SKIN FLAP TO REPAIR CICATRICIAL CONTRACTURE OF LATERAL NECK / 解放军医学杂志

Objective To explore the efficacy of prefabricated expanded cervico-scapulo-dorsal reverse axial flap combined with cervico-thoracic skin flap to repair cicatricial contracture of lateral neck. Methods Ten patients with cicatricial contracture of lateral neck were repaired by prefabricated expanded cervico-scapulo-dorsal reverse axial flap combined with cervico-thoracic skin flap. The flaps were transferred to repair the wound caused by excision of the scar on the lateral side of the neck. Results All the twenty skin flaps survived in first intention. Both the configuration and function were satisfactory after 6 to 18-month follow-up. Conclusion Prefabricated expanded cervico-scapulo-dorsal reverse axial flap combined with cervico-thoracic skin flap is an ideal method to repair the cicatricial contracture of lateral neck.