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In the field of plastic and reconstructive surgery, the loss of organs or tissues caused by diseases or injuries has resulted in challenges, such as donor shortage and immunosuppression. In recent years, with the development of regenerative medicine, the decellularization-recellularization strategy seems to be a promising and attractive method to resolve these difficulties. The decellularized extracellular matrix contains no cells and genetic materials, while retaining the complex ultrastructure, and it can be used as a scaffold for cell seeding and subsequent transplantation, thereby promoting the regeneration of diseased or damaged tissues and organs. This review provided an overview of decellularization-recellularization technique, and mainly concentrated on the application of decellularization-recellularization technique in the field of plastic and reconstructive surgery, including the remodeling of skin, nose, ears, face, and limbs. Finally, we proposed the challenges in and the direction of future development of decellularization-recellularization technique in plastic surgery.
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Tissue Engineering/methods , Tissue Scaffolds/chemistry , Surgery, Plastic , Regenerative Medicine/methods , Extracellular MatrixABSTRACT
BACKGROUND@#The phenotype maintenance of diced cartilage is a very important factor to reduce cartilage absorption rate in augmentation rhinoplasty. A novel method which combined diced cartilage with chondrocyte spheroids in gelatin methacrylate (GelMA) hydrogel may have potentially good performance in phenotype maintenance, and is worth exploring. @*METHODS@#The complex grafts formed by loading diced cartilage with chondrocyte spheroids into GelMA hydrogel were used as the experimental group, and the grafts formed of diced cartilage in GelMA were used as the control group.The two groups of grafts were implanted subcutaneously in nude mice. After 1 month and 3 months, the grafts were taken for general observation and histological analysis. The diameter changes of cartilage, the nuclei loss of chondrocyte, and glycosaminoglycan secretion were analyzed. @*RESULTS@#Chondrocyte spheroids with obvious proliferation can be seen in the experimental group. Some diced cartilages had become a whole through the interconnection of chondrocyte spheroids. In addition, the diameter of the chondrocyte spheroids—diced cartilage complex in the experimental group increased significantly, and its nuclei loss rate was less than 1/2 of that in the control group. The maintenance of proteoglycans in diced cartilages in the experimental group was significantly better than that in the control group. @*CONCLUSION@#The combination of diced cartilage with chondrocyte spheroids in GelMA hydrogel can significantly reduce the absorption of cartilage extracellular matrix, enhance phenotype maintenance during subcutaneous ectopic implantation, and can produce inter-chondral connections.
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BACKGROUND@#As a contour-supporting material, the cartilage has a significant application value in plastic surgery.Since the development of hydrogel scaffolds with sufficient biomechanical strength and high biocompatibility, cell-laden hydrogels have been widely studied for application in cartilage bioengineering. This systematic review summarizes the latest research on engineered cartilage constructed using cell-laden hydrogel scaffolds in plastic surgery. @*METHODS@#A systematic review was performed by searching the PubMed and Web of Science databases using selected keywords and Medical Subject Headings search terms. @*RESULTS@#Forty-two studies were identified based on the search criteria. After full-text screening for inclusion and exclusion criteria, 18 studies were included. Data collected from each study included culturing form, seed cell types and sources, concentration of cells and gels, scaffold materials and bio-printing structures, and biomechanical properties of cartilage constructs. These cell-laden hydrogel scaffolds were reported to show some feasibility of cartilage engineering, including better cell proliferation, enhanced deposition of glycosaminoglycans and collagen type II in the extracellular matrix, and better biomechanical properties close to the natural state. @*CONCLUSION@#Cell-laden hydrogels have been widely used in cartilage bioengineering research. Through 3-dimensional (3D) printing, the cell-laden hydrogel can form a bionic contour structure. Extracellular matrix expression was observed in vivo and in vitro, and the elastic modulus was reported to be similar to that of natural cartilage. The future direction of cartilage tissue engineering in plastic surgery involves the use of novel hydrogel materials and more advanced 3D printing technology combined with biochemistry and biomechanical stimulation.
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Objective:To compare the anti-androgenic effect of cyproterone acetate (CPA) and spironolactone (SPL) on male-to-female transsexuals.Methods:From January 2012 to September 2021, 185 male-to-female transsexuals (95 using CPA and 90 using SPL) who visited the Peking University Third Hospital and under stable medication for ≥3 months were enrolled, aged 16 to 40 (23±5) years. General information and laboratory indicators of the last visit were collected for a cross-sectional study.Results:The median doses of antiandrogens in the CPA group and SPL group were 25 mg/d and 80 mg/d, respectively. And the median dose of oral estradiol valerate in both groups was 2 mg/d. Testosterone level in the CPA group was significantly lower than the SPL group [0.7 (0.7-1.5) nmol/L vs. 13.2(6.7-18.4) nmol/L, U= 6 970.500, P<0.001]. The CPA group also had better subjective effects on testicular atrophy, erection decrease, body hair decrease, skin softening and figure feminization (all P<0.05). The prolactin level of CPA group was significantly higher than that of SPL group [21.5 (12.6-30.1) ng/ml vs. 11.9 (7.7-20.0) ng/ml, U= 2 053.500, P<0.001]. Conclusions:CPA has a more significant effect on lowering testosterone levels than SPL, and is better than SPL in terms of testicular atrophy, erection decrease, body hair decrease, skin softening and figure feminization, albeit with a potentially higher risk of hyperprolactinemia.
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Objective:To evaluate the improvement of nasal appearance, symptoms and psychological burden in patients with secondary cleft rhinoplasty by using retrospective research methods, through preoperative and postoperative questionnaires.Methods:Twenty-three cleft lip patients that underwent surgery in our unit since April 2016 were enrolled in this study. The self-designed questionnaire was used to explore the changes of patients before and after the operation. The questionnaire star was utilized to collect the data, and after the data was sorted and summarized, SPSS 20.0 was used for analysis and statistics.Results:The average follow-up time was 28.9 months. The total score of ROE satisfaction before surgery was 46.74 points, while after surgery it reached 63.04 points ( t=4.10, P<0.01); the self-scores of nasal shape were significantly improved after surgery; but there was no significant change in the ventilation function in the VAS scale before and after the operation; the nasal symptoms and psychological status in the SNOT-22 questionnaire, such as, nasal congestion, embarrassment, depression, restlessness and irritability, were significantly improved ( P<0.05). Conclusions:Our semi-autonomous designed questionnaire can be used to effectively evaluate the satisfaction, nasal shape, and symptoms of patients with nasal deformity secondary to cleft lip. Data analysis shows that our secondary cleft lip rhinoplasty for cleft lip and palate can improve patients′ satisfaction after the repair, as well as nose shape and function, at the same time the psychological burden caused by it.
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Objective:To explore the clinical effect of digital endoscopic-assisted one-stage rhinoplasty and septoplasty by using subjective and objective methods.Methods:Thirty-two patients with skeletal crooked nose and nasal septum deviated who underwent endoscopic-assisted rhinoplasty and septoplasty were included in this study from January 2015 to January 2020. This study used objective measurements such as 3D digital imaging technology and CT scans, as well as subjective measurements such as Visual Analogue Scale (VAS), Rhinoplasty Outcomes Evaluation (ROE) scale, Nasal Obstruction Symptom Evaluation (NOSE) and Functional Rhinoplasty Outcome Inventory (FROI-17) to evaluate the crooked nose morphology and nasal respiratory function before and after surgery.Results:Compared with preoperatively, postoperative 3D facial imaging results showed that the deviation distance and deviation angle of the crooked nose were significantly improved (both P<0.05), and the long-term effect of the operation was stable. Subjectively, the patient＇s appearance VAS score and ROE score were significantly higher than those before surgery, while the NOSE score and FROI-17 score of nasal congestion symptoms were lower than those before surgery. Conclusions:Endoscope-assisted one-stage rhinoplasty and septoplasty can achieve the purpose of repairing the nose appearance and improving the nasal respiratory function at the same time. Through a combination of subjective and objective evaluations, our study found that this procedure had the advantages of minimally invasive, stable effect and shorter recover time; meanwhile, this procedure has high patients＇ satisfaction and is worthy of clinical promotion.
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Exosome is a double-layer membrane vesicle secreted by several kinds of cells. Exosome is major way of cell paracrine activity with a wide range of sources and high security feature. This paper reviews recent progress of exosomes in promoting wound healing. Studies have shown that exosomes can be applied to wound treatment by immune regulation, regulating fibroblast activity, promoting angiogenesis, inhibiting scar formation and other mechanisms. Compared with traditional stem cell therapy, exosomes have better applied prospect in clinical practise.
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Objective@#To investigate the differences in miRNA expression levels between giant congenital melanocytic nevi, medium-sized congenital melanocytic nevi and normal skin.@*Methods@#The experiment was divided into three groups: giant congenital melanocytic nevi group, medium-sized congenital melanocytic nevi group and normal skin group, with ten samples in each group. Firstly, 3 samples of each group were detected by Agilent miRN Amicroarray to screen the different miRNAs between different groups. 5 differential miRNAs related to MAPK, Wnt, NF-kB signaling pathways were selected for further verification: miR-146a-5p, miR-140-5p, miR-106b-5p, miR-17-5p, and miR-483-5p. miRNA expression levels were measured using real-time quantitative PCR (Taqman) in ten clinical samples from each group. .Experimental data were analyzed using SPSS 22.0.@*Results@#A total of 23 differential miRNAs between congenital melanocytic nevi and normal skin were found by miRNA microarray detection. The results of real-time PCR showed that miR-146a-5p expression was significantly different between the three groups: giant congenital melanocytic nevi VS medium-sized congenital melanocytic nevi (P=0.003); giant congenital melanocytic nevi VS normal skin (P=0.000); medium-sized congenital melanocytic nevi VS normal skin (P=0.013). There was no statistically significant difference in the expression of the other four miRNAs between the 3 groups.@*Conclusions@#The expression of miR-146a-5p is increased in congenital melanocytic nevi, especially in giant congenital melanocytic nevi, which may be related to the proliferation and senescence of melanocytes in different tissues.
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Objective According to the fine artery anatomy of the lower lip, we developed an innovative partial-thickness myocutaneous flap based on the vascular network of the submucosal and subcutaneous layers of the lower lip.We attempted to treat the secondary bilateral cleft lip deformities using this innovative cross-lip flap.Methods From July 2009 to June 2015, this new technique was used in 98 patients with secondary bilateral cleft lip deformities.The central defects usually occurred in these patients.The defects were reconstructed partially or completely according to the severities of the defects.The operative procedures were as follows: The split flap was elevated from the posterior portion of the oris orbicularis muscle after the inferior labial arteries were divided.Then the partial-thickness flap was rotated 180 degrees horizontally and inverted 180 degrees upward to the upper lip defect.Results All 98 musculomucosal pedicle flaps were viable.The upper lips were reconstructed according to the severities.Conclusions This myocutaneous cross-lip flap with musculomucosal-pedicle has a more reliable blood supply, better flexibility and plasticity.It is an effective method for aesthetic reconstruction for the secondary bilateral cleft lip deformities.
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<p><b>OBJECTIVE</b>To classify the patients with cleft lip and palate who need orthognathic surgery and to propose the corresponding operations.</p><p><b>METHODS</b>From January 2005 to May 2015, 121 patients with cleft lip and palate diagnosed as maxillary retrusion were treated by orthognathic surgery. Inclusion criteriar: (1) male aged over 16, female aged over 14; (2) diagnosed as non-syndromic cleft lip and palate without systemic disease and other genetic diseases; (3) without previous orthodontic and orthognathic treatment; (4) having no other craniofacial malformation. Maxillary features and repaired types were recorded.</p><p><b>RESULTS</b>93 patients were included and divided into two categories depended on the dental crowding. Class I: the teeth quantity and bone quantity is coordinated, space analysis ≤ 4 mm (mild dental crowding). The forward distance of maxillary less than 6 mm was defined as Class I a (36 cases) more than 6 mm as Class I b (28 cases). Class II: the teeth quantity and bone quantity is not coordinated, space analysis > 4 mm ( moderate or severe dental crowding). After the simulation of distraction osteogenesis, the anterior crossbite was corrected defined as Class II a (23 cases), not corrected defined as Class II b (6 cases). Class I a were corrected by conventional orthognathic surgery. While Class I b were corrected by Le Fort I maxillary advancement using distraction osteogenesis. Class II a were repaired just by anterior maxillary distraction. While Class II b need to combine conventional orthognathic surgery with anterior maxillary distraction. All the patients were satisfied with the treatment effect.</p><p><b>CONCLUSIONS</b>The patients of cleft lip and palate with maxillary retrusion who need orthognathic surgery can be classified as the method mentioned above, and then choose the appropriate operations.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Cleft Lip , Cleft Palate , Maxilla , Osteogenesis, Distraction , Osteotomy, Le Fort , Retrognathia , Classification , General SurgeryABSTRACT
Objective To investigate the genetic data of 21 autosom al STR included in G oldeneyeTM DNA ID 22N CK it in Chinese H an nationality and to evaluate the forensic application. Methods B y detected 500 unrelated healthy individuals in Chinese H an nationality of East China w ith G oldeneyeTM DNA ID 22N CK it, allele frequencies, population genetics param eters and linkage disequilibrium inform ation of the 21 autosom al STR w ere statistically analyzed. Results In the 21 autosom al STR , no deviations from H ardy-W einberg equilibrium w ere detected and all loci w ere independent form each other. D P values of 21 au-tosom al STR w ere all above 0.85, and the com bined discrim ination pow er w as 1-3.616 5×10-26. Com bined m ean exclusion chance of this system in duo cases w as 1-2.786 81×10-6, in trio cases w as 1-8.545 82× 10-10. Conclusion Tw enty-one autosom al STR included in G oldeneyeTM DNA ID 22N CK it are highly polym orphic in the H an nationality. Com bined w ith G oldeneyeTM DNA ID 20A K it, the kit can satisfy the needs for full-sibling testing and facilitate the solution of this kind of case tools.
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Objective To perform the validation and analysis of forensic param eters of G oldeneye?DNA ID 26Y system . Methods B ased on the validation rules of Scientific W orking G roup on DNA A nalysis M ethods (SW G D A M ),the kitwas assessed from several parts, as test of PCR system, reproducibility, ac-curacy, and sensitivity, etc. A nd Y-STR loci of 517 unrelated healthy individuals from E astern C hina were genotypes by this kit. The distribution and frequency of haplotype were calculated and forensic param e-ters of the kit were assessed. Results The com plete profiles can be obtained even when the PC R reac-tion volum e with 6.25μL . A nd correct profile was obtained with DNA down to 125 pg.No reproducible peaks were detected with the DNA of com m on anim als and m icroorganism with the kit. For the m ale-m ale m ixture testing, average 70% of the m inor alleles were obtained when the ratios of 1∶19 and 19∶1. For the m ale-fem ale m ixture testing, results showed that the sensitivity of the kit was no compromised with the addition of fem ale sam ples. Conclusion The validation studies dem onstrated that G oldeneye?DNA ID 26Y system has good sensitivity and specificity, and suitable for m ixture testing. The polym orphism of 26 Y-STR loci included in this kit are good for forensic application.
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<p><b>BACKGROUND</b>Maxillary anterior segmental distraction osteogenesis (MASDO) is a recently used method for correction of severe maxillary retrusion in cleft lip and palate (CLP) patients. In this article, we evaluated the feasibility of MASDO using rigid external distraction (RED) and rapid orthodontic tooth movement to correct severe maxillary retrusion in CLP patients.</p><p><b>METHODS</b>Fourteen male and five female complete CLP patients between the ages of 18 and 22 years (mean age 19.7 years) at the time of distraction, with severe maxillary retrusion, were treated with the rigid external distraction (RED) device after maxillary anterior osteotomy. Rapid orthodontic tooth movement was started one week after the MASDO. Standard profile photographic, cephalometric films were obtained preoperatively and after therapy. Sella-nasion-point A (SNA) and Sella-nasion-point B (SNB) angles were measured to reflect changes in maxillary and mandibular position, and the distance between anterior nasal spine and posterior nasal spine (ANS-PNS) was measured to represent the maxillary dental arch length.</p><p><b>RESULTS</b>The SNA angle increased from an average of 74.6° (range 73.0°-78.0°), preoperatively, to 83.4° (range 78.6°-88.0°) after the RED was removed (P < 0.01). All cases of severe maxillary retrusion were improved. Nine patients' profiles became harmonious after therapy. One patient had a bimaxillary protrusion deformity and needed further surgery. The regenerate alveolar crest and edentulous space on both segments was almost completely eliminated after rapid orthodontic tooth movement.</p><p><b>CONCLUSION</b>MASDO with the RED system and rapid orthodontic tooth movement is a successful way of correcting severe maxillary retrusion in CLP patients.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Cleft Lip , General Surgery , Cleft Palate , General Surgery , Osteogenesis, Distraction , Methods , Tooth Movement TechniquesABSTRACT
<p><b>OBJECTIVE</b>Estrogens play an important role in intrinsic skin aging. The associated changes in global gene expression are poorly understood.</p><p><b>METHODS</b>We used the Illumina microarray platform to obtain comprehensive gene expression profiles in female Chinese Han skin, and confirmed the data by quantitative real-time PCR (Q-RT-PCR).</p><p><b>RESULTS</b>We found 244 genes significantly related to estrogen-associated intrinsic skin aging, and some of these genes were confirmed by Q-RT-PCR. We also performed functional analysis by both Gene Ontology annotation and enrichment of the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways database. The functional analysis revealed 11 biological pathways (including the KEGG pathways, the mitogen-activated protein kinase signaling pathway and metabolic pathways), that were associated with multiple cellular functions which may be involved in intrinsic skin aging.</p><p><b>CONCLUSION</b>This study suggests that estrogen-associated intrinsic skin aging is a complicated biological process involving many genes and pathways.</p>
Subject(s)
Female , Humans , Middle Aged , Aging , Physiology , China , Ethnology , Estrogens , Metabolism , Gene Expression Profiling , Gene Expression Regulation , Physiology , Menopause , Oligonucleotide Array Sequence Analysis , Methods , RNA , Genetics , Metabolism , Skin , MetabolismABSTRACT
Objective To detect differentially expressed genes between human normal skin and photoaging skin, and to investigate the molecular and biological mechanisms of human skin photoaging at transcriptional level. Methods Full-thickness skin specimens were obtained during full-face rhytidectomy from sun-exposed (anterior ear skin) and sun-protected (retroauricular skin) sites of 6 patients with facial photoaging from 2007 to 2008. Genomic microarray analysis was conducted to identify differentially expressed genes between the two groups of specimens followed by gene-cluster analysis. Results The normalization of microarray data showed that the number of differentially expressed genes was 2163 between skin samples from sun-exposed and sun-protected sites in one patient, significantly higher than that in the other 5 patients (less than 200);therefore, the data from the patient with 2163 differentially expressed genes were excluded from further analysis.Totally, 172 differentially expressed genes were identified with Beadarray chip, including 99 up-regulated genes and 73 down-regulated genes. Based on Genebank research, 118 functionally classified genes werefound, which were associated with a series of biological processes, including cell adhesion, receptor regulation,signal transduction, metabolism, and so on. Conclusions There are a lot of differentially expressed genes between human photoaging skin and normal skin. Rhytidectomy may be associated with the differential expression of skin photoaging-related genes.
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Objective To evaluate the STR profiling availability of formalin-fixed tissues and the detectable time limit of intact STR profile.Methods The different human tissues were fixed with 10-fold diluted commercial 40%formalin fixative for different duration under 15～20℃,and then DNA was extracted using the method of QIAamp~(R)DNA and IQ~(TM) DNA System.The extracted DNA was quantified with QuantifilerTM kit and amplified by both AmpFSTR identifiler kit and AmpFSTR MiniFiler kit.The STR profile was analyzed by GeneMapper ID v3.2 on 3100-Avant.Resuls The STR profiling availability of formalin-fixed tissues was relevant to the formalin fixing duration mainly.as well as the type of tissues and the template concentration and protocol of DNA extracting.The optimal ranges of template concentration is 1～3ng/μL and the QIAamp extracting method was preferable.There are differences in the degradation rate between various types of tissues in the unbuffered formalin fixative,and the lung tissue showed the slowest rate and liver and intestine tissues the fastest.Intact miniSTR profile of all the tissues detected could be obtained within 15 days duration of formalin fixing while intact STR profile could be obtained within 4 days.Conclusion The major factor that impact the availability of STR profiling of formalin-fixed tissues is the fixing duration in unbuffered formalin,as well as the type of tissues,method of extraction,concentration of PCR template and the kinds of STR loci.
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Objective To investigate a new method which could not only avoid the extrusion of the silicon implant, but also be benefit for the reconstruction of nasal tip and alar during nasal augmen-tation procedure. Methods Folded lower lateral cartilage flap combined with silicon implant was ap-plied for nasal dorsal augmentation and reconstruction of nasal tip and alar with its unique character at the same time. Results 12 cases were all primary healing, without infection, extrusion of implant and other complications. One month after operation, the projection of nasal tip was increased, which had better delicate and definite shape, natural appearing tip adding contour and height to nasal tip, pleas-ant definition. Conclusions Folded lower lateral cartilage flap combined with silicon implant is an ef-fective method to decrease the incidence of extrusion, when we want to have a little over-projected na-sal tip with prosthesis. It is also helpful for reconstructing the nasal tip and alar with its unique char-acter.
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Objective To develop an in vitro model for cranial suture of neonatal SD rat. Methods The parietal hones with the sagittal suture were removed from SD rats (19-days old) for organ culture. In the experimental group, tensile force 3.92×10~(-3) N (0.4 g) was applied by helical springs, whereas no tension (0 N) was set in control group. These explants were observed under inverted microscope. At the end of the incubation period for 24 hours, general conditions were observed under inverted microscope and histological conditions were observed after hematoxylin and eosin stain. Results Under inverted micro-scope, sutures had no obvious changes in control group, whereas sutures were enlarged gradually in the experimental group. With histological observation, sutures developed normally in control group, but in experimental group, osteohlasts and capillary vessels proliferated actively in the suture. Conclusions In vitro model of cranial suture can be cultured and grown successively.
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OBJECTIVE@#ABO genotyping for forensic identification by oligonucleotide chip.@*METHODS@#Oligonucleotide microarrays which could detect 3 different SNPs in exon 6 and exon 7 for ABO genotyping were used. Population studies on ABO was carried out in a sample of 115 unrelated Chinese Han individuals. The method was also applied to cases.@*RESULTS@#The technique could identify 6 genotypes of ABO system. According to the results of population studies, no significant deviations from Hardy-Weinberg equilibrium could be found. The observed and expected heterozygosities were 0.591 and 0.616 respectively. The polymorphic information content was 0.544. The average exclusion probabilities in buos and trios was 0.188 and 0.344 respectively. The discrimination power is 0.777.@*CONCLUSION@#The data and case application demonstrated that ABO typing by oligonucleotide probe arrays was a useful technique for paternity testing and individual identification.
Subject(s)
Female , Humans , ABO Blood-Group System/genetics , Blood Stains , DNA/blood , DNA Primers , Forensic Medicine , Genotype , Hair/chemistry , Oligonucleotide Array Sequence AnalysisABSTRACT
<p><b>OBJECTIVE</b>To provide ideal materials for resurfacing penile ventral wounds.</p><p><b>METHODS</b>For hypospadias with scrotal fissure and penile-scrotal transposition, scrotal skin flaps based on lateral branches of posterior scrotal arteries were utilized to resurface penile ventral wounds when urethral reconstruction were finished.</p><p><b>RESULTS</b>9 cases of hypospadias of different types have been treated with the method mentioned above. All flaps survived and good results achieved.</p><p><b>CONCLUSION</b>For hypospadias with scrotal fissure and penile-scrotal transposition, scrotal skin flaps pedicled on lateral branches of posterior scrotal arteries can not only resurface penile ventral wounds, but also correct scrotal fissure and penile-scrotal transposition simultaneously.</p>