Clinical application of autologous fat grafting in hand rejuvenation / 中华医学美学美容杂志

Objective:To investigate the effect of autologous fat grafting in hand rejuvenation and to provide effective clinical treatment for the aging hand.Methods:A total of 52 patients received autologous fat grafting in hand. Fat was collected by liposuction from the abdomen or thigh regions utilizing the superwet technique. The harvested fat was washed and injected to the dorsal hand. Standardized photographs were taken before and after the operation, and the patients＇ satisfaction was evaluated.Results:Picture scores between preoperative and postoperative had statistically significant differences ( P<0.01). The majority of patients (75%) were satisfied with their results. All patients were followed up for 6 months with no infection, fat liquefaction, cysts and other complications occurred. Conclusions:This study provides the clinical basis for fat grafting in hand rejuvenation with high satisfactory rates.

Effects and mechanism of allogeneic platelet rich plasma on collagen synthesis in wound healing / 中华外科杂志

Objective@#To investigate the effects and mechanism of allogeneic platelet rich plasma (PRP) on collagen in wound surface at different time.@*Methods@#A total of 50 clean 7-week rats were selected for this study, including 10 rats for platelet-rich blood plasma preparation, 20 rats for PRP group and 20 rats for control group, 0.1 ml allogenic PRP and 0.1 ml saline were smeared respectively on wound surfaces of PRP and control group, wound regeneration and healing were examined. Cellular and histological morphology alteration was observed via Masson staining, type Ⅰ and type Ⅲ collagen protein and mRNA expression level were detected by Western blot and real-time PCR. T test was applied for comparison between two samples and one-way ANOVA was utilized for comparison between two groups.@*Results@#The wound healing rate of PRP group was higher than that of control group on 3rd, 6th, 10th and 15th day (30.33±3.35 vs.18.35±2.04, 55.51±2.74 vs.36.83±2.34, 79.64±1.40 vs.56.92±1.44, 86.88±2.12 vs.65.80±1.76) after wound surface formation, there were statistic differences (t=13.66-50.48, all P<0.05). The wound collagen of PRP group form faster and coarser, and the fibers arrayed more densely in Masson staining. The protein expression of type Ⅰ collagen(1.92±0.09 vs.1.18±0.11) and type Ⅲ collagen(1.16±0.05 vs.0.74±0.11) of PRP group were higher than that of control group (t=22.99, P<0.01; t=17.62, P<0.05); the mRNA expression of type Ⅰ collagen(5.17±0.11 vs.1.79±0.18, 6.97±0.09 vs.1.96±0.08, 6.00±0.26 vs.2.10±0.05, 4.95±0.11 vs.3.58±0.09)and type Ⅲ collagen(2.35±0.08 vs.1.44±0.05, 3.08±0.05 vs.1.84±0.06, 3.48±0.07 vs.2.36±0.09, 4.42±0.07 vs.2.77±0.10) were higher than that of control group on 3rd, 6th, 10th and 15th day after wound surface formation, there were significant differences (t=43.37-188.37, all P<0.05).@*Conclusion@#The allogeneic platelet rich plasma may promote fibroblasts secreted collagen by activated and releasing all kinds of growth factors, especially type Ⅰ and type Ⅲ collagen to accelerate the wound healing.

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.

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.

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>

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>

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.