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Objective@#To investigate the clinical effect of conjoint fascial sheath (CFS) suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis.@*Methods@#From February 2017 to April 2018, 19 severe blepharoptosis patients (21 eyelids) were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening, and repaired through the technology of CFS suspension.@*Results@#There were 19 cases, 17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes, and the other 2 cases obtained satisfactory results though reoperation. There were no complications of exposure keratitis, ectropion and infection occurred. Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months.@*Conclusions@#The application of conjoint fascial sheath (CFS) suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.
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Objective@#To explore the clinical effects of expanded forehead flaps in repairing midfacial defects.@*Methods@#From January 2003 to December 2018, 19 patients with midfacial defects were admitted to our unit, including 8 males and 11 females, aged 7 to 52 years. One cylindrical expander with rated capacity ranged from 100 to 170 mL was placed in the forehead of patients in the first stage of expansion, and the total water injection volume was about 2 times of the rated capacity of the expander during 1 to 2 months. The area of midfacial defects was 4 cm×2 cm to 9 cm×5 cm after resection in the second stage surgery. Expanded forehead flaps with vascular pedicle of supratrochlear vessels or frontal branch of superficial temporal vessels were used to repair the midfacial defects, with flap size ranging from 5 cm×2 cm to 16 cm×6 cm. The donor sites were closed by direct suturing. Three weeks later, the pedicle was divided. The complications, blood supply after flap transfer and pedicle division, and the treatment effects during follow-up were observed.@*Results@#Among the patients, flaps of 11 patients had vascular pedicle of supratrochlear vessels; flaps of 8 patients had vascular pedicle of frontal branch of superficial temporal vessels. All the flaps survived with no complications and good blood supply after flap transfer and pedicle division. During the follow-up of 6 to 12 months after the third stage surgery of pedicle division of 12 patients, no lower eyelid ectropion occurred, the appearance of the flaps was similar to the surrounding tissue with no swelling.@*Conclusions@#The application of expanded forehead flaps can not only repair the defects but also effectively avoid the complication of lower eyelid ectropion, which is a promising method in repairing midfacial defects.
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Objective@#To study the mRNA expressions of various CD97 isoforms in colorectal carcinoma tissues and their clinical significances.@*Methods@#A total of 50 colon cancer patients in the First Affiliated Hospital of Wenzhou Medical University from December 2013 to May 2014 and human colon cancer cell lines SW480 and SW620 were enrolled. The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expressions of CD97 human epidermal growth factor (EGF) (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in colon cancer tissues, adjacent tissues, normal colon tissues, SW480 cells and SW620 cells. The relationship between the mRNA expression of CD97EGF (1, 2, 5) and the clinicopathological factors was analyzed.@*Results@#Compared with those low expressions in adjacent tissues and normal tissues, the mRNA expressions of CD97 isoforms CD97EGF (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in cancer tissues were highest, and the differences were statistically significant (0.71±0.20 vs. 0.40±0.09 vs. 0.35±0.07, F = 107.642, P < 0.01; 0.45±0.11 vs. 0.26±0.05 vs. 0.27±0.06, F = 94.231, P < 0.01; 0.41±0.10 vs. 0.21±0.05 vs. 0.19±0.03, F = 165.672, P < 0.01). In addition, the mRNA expression of CD97EGF (1, 2, 5) in colon cancer patients was associated with tumor infiltration depth (T1-T2 and T3-T4), clinical stages (Ⅰ-Ⅱ and Ⅲ-Ⅳ), and the differences were statistically significant (t = -2.582, P = 0.013; t = -5.062, P < 0.01). The mRNA expression of CD97EGF (1, 2, 5) in SW620 cells was higher than that in SW480 cells.@*Conclusions@#CD97 isoforms are highly expressed in colon cancer tissues, and CD97EGF (1, 2, 5) may play an important role in the development and invasion of colon cancer. The CD97 isoforms may be new markers in the treatment of colon cancer.
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Objective To study the mRNA expressions of various CD97 isoforms in colorectal carcinoma tissues and their clinical significances. Methods A total of 50 colon cancer patients in the First Affiliated Hospital of Wenzhou Medical University from December 2013 to May 2014 and human colon cancer cell lines SW480 and SW620 were enrolled. The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expressions of CD97 human epidermal growth factor (EGF) (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in colon cancer tissues, adjacent tissues, normal colon tissues, SW480 cells and SW620 cells. The relationship between the mRNA expression of CD97EGF (1, 2, 5) and the clinicopathological factors was analyzed. Results Compared with those low expressions in adjacent tissues and normal tissues, the mRNA expressions of CD97 isoforms CD97EGF (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in cancer tissues were highest, and the differences were statistically significant (0.71±0.20 vs. 0.40±0.09 vs. 0.35±0.07, F=107.642, P<0.01;0.45±0.11 vs. 0.26±0.05 vs. 0.27±0.06, F=94.231, P< 0.01; 0.41±0.10 vs. 0.21±0.05 vs. 0.19±0.03, F= 165.672, P< 0.01). In addition, the mRNA expression of CD97EGF (1, 2, 5) in colon cancer patients was associated with tumor infiltration depth (T1-T2 and T3-T4), clinical stages (Ⅰ-Ⅱ and Ⅲ-Ⅳ), and the differences were statistically significant (t= -2.582, P= 0.013; t= -5.062, P< 0.01). The mRNA expression of CD97EGF (1, 2, 5) in SW620 cells was higher than that in SW480 cells. Conclusions CD97 isoforms are highly expressed in colon cancer tissues, and CD97EGF (1, 2, 5) may play an important role in the development and invasion of colon cancer. The CD97 isoforms may be new markers in the treatment of colon cancer.
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Objective: To evaluate 3D imaging technology in the preoperative evaluation of breast conserving surgery. Methods: A ret-rospective analysis was conducted using clinical data from 38 patients who underwent breast conserving surgery that was assisted by 3D imaging technology in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from April 2017 to January 2019. All 38 patients underwent 3.0-T breast magnetic resonance imaging (MRI) examination before surgery, and 3D reconstruction of virtu-al images was constructed through 3D modeling of medical digital imaging and communication (DICOM) data. The predicted resected tissue volume was compared with the volume of the actual resected specimen, and the surgical margin and postoperative aesthetics of the breast conserving surgery were evaluated. Results: The reconstructed 3D model clearly displayed the anatomical structures of the breast, tumor, gland, and blood vessels, and their relationship in 3D spaces. The goodness of fit of the 3D model to the practical sit-uation was 97.4% (37/38). In terms of the resection tissue volume, there was no significant difference between the predicted results (PRTV) and actual results (ARTV) [(61.7 ± 20.1) mL vs. (65.1 ± 20.7) mL, P>0.05]. There was a strong positive correlation between ARTV and PRTV (P<0.01). One patient underwent supplementary secondary surgery, resulting in an incidence of 2.6% (1/38). The postopera-tive satisfaction for breast conserving surgery was 100% (38/38). Conclusions: 3D imaging technology clearly displays the anatomical relationship between breast tumor and surrounding tissues, and correctly assesses breast volume, guiding surgical resection.
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Objective@#To evaluate the application of the expanded free deltopectoral flap, pedicled with perforation of internal thoracic artery, in the repairment of middle to large facial skin and soft tissue defect.@*Methods@#From June 2015 to December 2017, 11cases diagnosed with facial lesions were included in this study. The tissue defect of 10 cases were caused by burn, and 1 case by superficial tumor. In the first stage, the tissue expander was implanted into the internal thoracic artery supplying area. After the expander was fully expanded, the second surgery, i. e. the resection of facial lesion, was performed. The defect areas of patients, with the range of 9 cm×7 cm to 17 cm×10 cm, were repaired by expanded free deltopectoral flaps.@*Results@#All flaps were survived, with no vascular crisis occurred. The size of flaps ranged from 10.0 cm×9.0 cm to 18.0 cm×11.5 cm. All the patients were satisfied with the outcomes, after 6 to 24 months follow-up. The color and texture of flaps was close to normal. The scars were acceptable.@*Conclusions@#The expanded free deltopectoral flap, pedicled with the perforator of internal thoracic artery, is a promising way to repair middle to large facial skin and soft tissue defect.
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Objective To study whether ferulic acid can promote healing on chronic ischemic wounds and its possible mechanisms.Methods 40 male New Zealand white rabbits were randomly divided into 4 groups:vaseline group,ischemic control group,5％ ferulic acid group and recombinant bovine basic fibroblast growth factor for external use (rb-bFGF) group.Gross wounds were carefully observed and HE staining was used to observe the wound healing and immumohistochemical staining to observe the expression of the VEGF and CD31.The RNA was extracted to detect the expression of VEGF and HIF-1a by real-time PCR.Results The general observation and the HE staining of each specimen 11 days after operation all indicated that the duration of wound healing of the 5 ％ ferulic acid group was similar to that of the rb-bFGF group and markedly shorter than the ischemic control group and the vaseline smear group.The result of the immunohistochemical staining indicated that the content of the VEGF and CD31 expression of the 5 ％ ferulic acid groups and the rb-bFGF group made lit tle difference,but there was markedly less VEGF and CD31 in ischemic control group and the vaseline smear group.The result of the PCR showed that expression level of VEGF and HIF-1α in the 5 ％ fer ulic acid group was similar to that in the rb bFGF group and the vaseline smear group,but was obviously more than that of the ischemic control group and the vaseline smear group (P ＜ 0.05).Conclusions Ferulic acid can promote angiogenesis by increasing VEGF and HIF-1α which are closely related to angiogenesis and then promote the healing of chronic wounds.
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Objective:To investigate the clinical significance of the expression of Fas and FasL in breast cancer tissue and their relationship with the prognosis of breast cancer.Methods:Immunohistochemical technique was used to detect protein expression proportion and the level of Fas and FasL in 60 cases of breast cancer and 10 cases of benign breast tumor tissues.the experimental data were analyzed using semi-quantitative count and SPSS22.Results:The positive rate of Fas,FasL in breast cancer and benign breast tumor tissues were 78.33％ (47/60),80％ (8/10) and 95％ (57/60),70％(7/10),the positive rate of Fas protein in breast cancer tissues was higher than that of benign breast tumors,the positive rate of FasL protein in breast cancer was lower than that in benign breast tumor tissue.Fas、FasL protein expression were no significantly correlated with that of breast cancer staging,age,molecular typing,HER-2 and axillary lymph node status.but The strong expression of Fas,FasL protein were significantly correlated with that of the axillary lymph node status and the expression of ki-67.Conclusion:The strong expression of Fas,FasL protein may be associated with breast cancer metastasis and progress,and they could be as indicators of the evaluation of prognosis of breast cancer.
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Objective To investigate the cosmetic outcome of treatments for mentalis scars with expanded skin flaps.Methods From the experiences of past 26 cases in our department,we summarised the technique for treating the mentalis scars with expanded skin flaps.For simple mentalis scars or localized inferior facial scars,the mentalis,bottom jaw or facial skin were expanded and the expander kept superior to the neck-jaw angle.Otherwise the expander would only fill the angle and the expanding efficiency was reduced.For severe mentalis,neck or facial scars without extra normal treating skin,expanded deltopectoral flaps were chosen to cover the wound after cicatrectomy with pedicles which were cut 3 weeks later.Results All the local ordistant expanded flaps survived successfully in the 26 cases with optimistic outcomes.Conclusions Application of local or distant expanded flaps is a useful technique for mentalis scars treatment.
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Objective To develop new repairing techniques for acquired inferior palpebral region defects. Methods Expanded forehead flaps were used to reconstruct the inferior palpebral defects or post-excision wound surface and the flaps were pedicled with supra-trochlea vessels or ramus frontalis arteriae temporalis superficialis. As for supra-trochlea vessels, contralateral ones were prior to the homolateral ones. The incision site located in the scalp and the major axis of the expander parallel to the forehead. Firstly, the leisions were cut and the subcutaneous tissues loosed to regain the anatomy position of inferior palpebra. Secondly, the expanded flaps were transfered onto the defects by the wound sizes with the supra-trochlea vessels as their pedicles. At last, the pedicles were cut 3 weeks later.For ramus frontalis arteriae temporalis superficialis, the flap was transfered with a subdermal pedicle and the donor site was closed directly. Results There were 10 cases in the present group, 6 for supratrochlea vessels and the 4 others for ramus frontalis arteriae temporalis superficialis. All the flaps survived successfully. 3 cases returned with optimistic outcomes 6 months later. Conclusion The expanded forehead flaps are fit for repairing the inferior palpebral defects, which can successfully avoid ectropion. This technique is very useful for reconstructing the texture of the site of defects.
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<p><b>OBJECTIVE</b>To investigate the application of expanded deltopectoral flaps for treatment of cervical cicatricial contracture.</p><p><b>METHODS</b>The cervical cicatricial contracture was corrected in 18 cases with unilateral expanded deltopectoral flaps and 2 cases with bilateral expanded deltopectoral flaps. The size of scar ranged from 8 cm x 5 cm to 12 cm x 13 cm. The size of the unilateral expanded deltopectoral flaps ranged from 9 cm x 16 cm to 12 cm x 18 cm. The defects in donor sites were closed directly. The infraclavicula incision was designed. The flaps were delayed 3 weeks after flap transfer. The pedicle was cut off 4 weeks later.</p><p><b>RESULTS</b>From 2007 to 2009, 20 cases with cervical cicatricial contracture were treated with expanded deltopectoral flaps. All the flaps were survived. 6 cases were followed up for 6 months with satisfactory results in 5 cases and conspicuous scar in 1 case.</p><p><b>CONCLUSIONS</b>Expanded deltopectoral flap is very suitable for large size of cervical cicatricial contracture.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Young Adult , Cicatrix , General Surgery , Dilatation , Methods , Neck , Plastic Surgery Procedures , Methods , Skin Transplantation , Surgical Flaps , ThoraxABSTRACT
<p><b>OBJECTIVE</b>To investigate suitable treatment method for contracture of inframammary scars.</p><p><b>METHODS</b>Nine female patients with contracture of inframammary sear hospitalized in our hospital from July 2000 to July 2007 were subjected to skin expansion around the breast. The sites of incisions were mainly located on the inframammary scars. The expanders were placed around the breast and middle chest near the sternum. On the lateral side of chest, the expander should be inserted at the site parallel to upper level of the breast. The expanders should be placed under deep fascia and superficial to the gland. At II stage of operation, the scars were excised and the subcutaneous tissues should be thoroughly loosened to assure that the soft tissue and mammary gland would be restored to its anatomical position. Expanded skin was then designed as advancement or transposition flaps to repair the defects, or effects were closed with suturing.</p><p><b>RESULTS</b>Blood circulation disturbance occurred at the tip of a flap in one patient, with the size of 4.0 cm x 3.0 cm, and the resulting wound healed after skin grafting. Flaps in the other 8 patients survived, and the wounds healed satisfactorily. Nipples and mammary areola were successfully restored to the anatomical positions. Three patients were followed up for 6 months to 2 years, and the result was satisfactory.</p><p><b>CONCLUSIONS</b>Expanded flap is feasible for repairing contracture of inframammary scar and with good result.</p>
Subject(s)
Adolescent , Child , Female , Humans , Young Adult , Breast , Cicatrix , General Surgery , Plastic Surgery Procedures , Methods , Surgical Flaps , Tissue Expansion , MethodsABSTRACT
Objective To investigate the possibility of performing epicanthoplasty with same stage small incision blepharoplasty. Methods At the same stage of designing small incision blepharo-plasty, modified "Z" plasty without flap transposition was designed. The upper lid incisive line of epi-canthoplasty was bided in the double eyelid fold, while the lower eyelid incision located at the edge of eyelid. Results A series of 56 patients were treated with this method. Satisfactory esthctical result of double eyelid fold and inner canthus shape was achieved. Conclusion This modified method including epicanthoplasty combined with same stage small incision blepharoplasty has the advantages of minimal scar formation, easy to design perform and in accordance with physiology.
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<p><b>OBJECTIVE</b>To investigate the effect of METH1 gene transfection on fibroblast proliferation and I, III collagen synthesis in rabbit ear scar.</p><p><b>METHODS</b>The hypertrophic scar model on the rabbit ears was reproduced. 10 days after epithelization, Ad-METH1 was injected into the scar tissue. 30 days later, the effect of METH1 gene transfection on the angiogenesis, fibroblast proliferation and the ratio of collagen I/III in the scar tissue was detected by microcirculation microscope, AgNOR particle count and collagen dyeing.</p><p><b>RESULTS</b>30 days after injection of Ad-METH1, angiogenesis, fibroblast proliferation and the ratio of collagen I/III in the scar tissue were obviously suppressed.</p><p><b>CONCLUSION</b>Early application of Ad-METH1 after epithelization can markedly inhibit the formation of the hypertrophic scar.</p>
Subject(s)
Animals , Female , Male , Rabbits , ADAM Proteins , Genetics , Angiogenesis Inhibitors , Genetics , Cicatrix, Hypertrophic , Genetics , Pathology , Disease Models, Animal , Ear , Pathology , Ear, External , Pathology , Microcirculation , Neovascularization, Pathologic , Transfection , Wound HealingABSTRACT
<p><b>OBJECTIVE</b>To explore the method to repair large scalp and face scars.</p><p><b>METHODS</b>1-3 expanders under the scalp were needed for repair the scalp scar. The expanded deltopectoral flaps were transferred to repair the face scar.</p><p><b>RESULTS</b>12 cases were treated with satisfactory results. All the flaps survived and the donor sites were closed primarily. 2 cases had expander exposure which didn't affect the treatment results. Atrophic cutaneous striae was occurred because of overexpansion.</p><p><b>CONCLUSIONS</b>Skin expansion is a good method for large scalp and face scar.</p>
Subject(s)
Adolescent , Adult , Humans , Young Adult , Cicatrix , General Surgery , Scalp Dermatoses , General Surgery , Skin Transplantation , Surgical Flaps , Tissue Expansion , MethodsABSTRACT
BACKGROUND:Recent studies have demonstrated that growth factor, as a molecular signal, regulates cellular proliferation, differentiation, immigration and metabolism. Its expression and regulation play an important role in the chronic wound healing.OBJECTrVE: To observe the effect of vascular endothelial growth factor (VEGF) on the expression of VEGF receptor (VEGFR), basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) mRNA in wound tissue, and elucidate the mechanism of VEGF in promoting wound healing.DESrGN: Controlled animal experiment.SETTING: Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA. MATERIALS: Six New Zealand rabbits, aged 48-60 months, were involved in the experiment. Nanosphere-coated recombinant plasmid DNA eukaryotic expression vector pcDNA3.1/myc-hisA-VEGF166 was donated by Master Jia Ning, who was from Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA. METHODS: This experiment was carried out in the laboratory of Department of Plastic Surgery, Xijing Hospital from October 2004 to June 2005. ①VEGF (VEGF165) was taken as target gene to construct eukaryotic expression vector pcDNA3.1/myc-hisA- VEGF165. Nanosphere- VEGF165 complex was used. Three round excisional wounds, 6 mm in diameter, were created over the ventral surface of ears of anesthetized rabbits, and cartilage was exposed. Gelatin sponge thin slice dipping 100 μL nanosphere-VEGF165 complex was spread on unilateral wounds of each rabbit, and aseptic sealing membrane was spread on outer layer, serving as VEGF group; Gelatin sponge thin slice dipping 100 μL nanosphere without plasmid load was spread on contralateral wound, serving as control group; Skin of rabbit ear subterminal to circumcise region served as normal group. ② At postoperative 14 days, reverse transcription-polymerase chain reaction (RT-PCR) was used to observe the changes in the expression of VEGFR, bFGF and PDGF mRNA in wound tissue. ③ At postoperative 14 days, wound was took as center, and square tissue mass with size of 1 cm×1 cm (full-thickness rabbit ear included) was excised and prepared into sample, then which was stained by haematoxylin & eosin (HE). Under the optical microscope, the growth of newly regenerated granulation tissue was observed. MAIN OUTCOME MEASURES: Expression of VEGFR, bFGF and PDGF mRNA in wound tissue. RESULTS: ①HE staining results showed the growth speeds of granulation tissue and epithelium tissue in VEGF group were obviously faster than those in the control group. ②RT-PCR detected a significantly higher expression of VEGFR, bFGF and PDGF mRNA in the wound tissues in VEGF group than that in the control group (P ＜ 0.05) and normal group (P＜ 0.01).CONCLUSION: Exogenous VEGF up-regulates the expression of VEGFR, bFGF and PDGF mRNA in wound tissue. VEGF may act on its receptor and play an important role in promoting wound healing through its interaction with other cytokines.
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<p><b>OBJECTIVE</b>To investigate the possibility to fabricate a blood vessel scaffold with a combined polymer for tissue engineering.</p><p><b>METHODS</b>A blood vessel scaffold was designed with a combined polymer composed of rabbit vascular smooth muscle cells(VSMCs), collagen and a non-spinning fabric mesh of polyglycolic acid (PGA). VSMCs were implanted into collagen gel and their growth was observed. The mixed solution of VSMCs and collagen was dropped into the tubular scaffold, followed by 7-day culturing.</p><p><b>RESULTS</b>VSMCs formed many prominences after culturing in gelatinous collagen for 3-4 hours. With cells extending, some cells became shuttle- or spindle-shaped. After VSMCs-collagen complex was implanted into the PGA mesh, most of VSMCs remained in the pore of PGA mesh with the formation of gelation. VSMCs could adhere to and grow on the PGA fiber.</p><p><b>CONCLUSION</b>The non-spinning PGA porous biodegradable material coated with collagen is a good carrier for VSMCs to adhere and grow.</p>