Effect of facial filling with autologous fat particles on facial contour reshaping / 中华医学美学美容杂志

Objective:To explore the effect of facial filling with autologous fat particles on the facial contour remodeling of patients with facial rejuvenation needs and its influence on the facial skin indicators of patients.Methods:From February 2019 to February 2020, 225 female patients, aged 25-52 years, with an average age of (42.5±5.2) years, received facial rejuvenation treatment in Zhengzhou Mylai Medical Beauty Hospital. They were divided into observation group (PPDO serrated line lifting combined with autologous fat granule filling), control group 1 (PPDO serrated line lifting alone) and control group 2 (simple autologous fat granule filling alone), with 75 cases in each group. After 6 months of follow-up, facial skin indexes, contour remodeling effect and adverse reactions after treatment were compared among the three groups.Results:At the last follow-up, the facial skin elasticity and moisture scores of the observation group (63.45±10.11, 56.71±9.38) were significantly higher than those of control group 1 (51.11±9.23, 43.69±7.65) and control group 2 (52.35±9.51, 42.47±7.53). The facial spots and lipid scores (41.31±7.24, 42.18±7.46) were significantly lower than those in control group 1 (48.67±9.15, 53.49±9.45) and control group 2 (48.26±9.21, 53.55±9.53) ( F=37.39, 68.98, 17.42, 40.91, P<0.001). At the last follow-up, the lower surface width of observation group (11.35±0.63) was lower than that of control group 1 (12.21±0.85) and control group 2 (12.38±0.65). The contour ratio of the lower part of the face (0.63±0.17) was higher than that of control group 1 (0.56±0.15) and control group 2 (0.57±0.15) ( F=44.49, 4.36, P<0.05). The change level of the ratio of lower facial area (0.12±0.03) was higher than that of control group 1 (0.07±0.02) and control group 2 (0.08±0.04) ( F=54.31, P<0.001). Conclusions:For patients who need facial rejuvenation treatment, the use of autologous fat granule facial filling therapy has good clinical effects, which can significantly improve the patient's facial skin elasticity, moisture, spots, and oil. The patient's facial contour reshaping effect is better, and the aesthetic score is significantly improved, and does not increase the risk of adverse reactions.

Analysis of the genomic landscape of primary central nervous system lymphoma using whole-genome sequencing in Chinese patients / 医学前沿

Primary central nervous system lymphoma (PCNSL) is an uncommon non-Hodgkin's lymphoma with poor prognosis. This study aimed to depict the genetic landscape of Chinese PCNSLs. Whole-genome sequencing was performed on 68 newly diagnosed Chinese PCNSL samples, whose genomic characteristics and clinicopathologic features were also analyzed. Structural variations were identified in all patients with a mean of 349, which did not significantly influence prognosis. Copy loss occurred in all samples, while gains were detected in 77.9% of the samples. The high level of copy number variations was significantly associated with poor progression-free survival (PFS) and overall survival (OS). A total of 263 genes mutated in coding regions were identified, including 6 newly discovered genes (ROBO2, KMT2C, CXCR4, MYOM2, BCLAF1, and NRXN3) detected in ⩾ 10% of the cases. CD79B mutation was significantly associated with lower PFS, TMSB4X mutation and high expression of TMSB4X protein was associated with lower OS. A prognostic risk scoring system was also established for PCNSL, which included Karnofsky performance status and six mutated genes (BRD4, EBF1, BTG1, CCND3, STAG2, and TMSB4X). Collectively, this study comprehensively reveals the genomic landscape of newly diagnosed Chinese PCNSLs, thereby enriching the present understanding of the genetic mechanisms of PCNSL.

Serum levels of sST2 and inflammatory factors in patients with acute left ventricular ejection fraction reduction heart failure treated with sacubitril/valsartan / 中华全科医师杂志

Objective:To investigate the serum levels of soluble growth stimulation expression gene 2 protein (sST2) and inflammatory factors in patients with acute left ventricular ejection fraction reduction heart failure (HFrEF) treated with sacubitril/valsartan.Methods:Ninety six patients with acute HFrEF admitted in The Affiliated Hospital of Qingdao University from March 2020 to March 2021 were enrolled. The patients were treated with sacubitril/valsartan,the dose was gradually increased from 50 mg b.i.d to the target dose of 200 mg b.i.d according to hemodynamics. After 12 weeks, the target dose was achieved in 72 cases (compliance group), and did not achieved in 24 cases (non-compliance group). The serum levels of sST2, IL-1β, IL-6, TNF-αand IL-10 were measured and compared between the two groups. The changes in left atrial anteroposterial diameter (LA), left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) values were assessed with echocardiography. The adverse reactions, readmission rate and all-cause death within 3 months after discharge were compared between the two groups.Results:A total of 96 patients with acute HFrEF completed the follow-up, including 72 patients (75.0%) in the compliance group and 24 (25.0%) in the non-compliance group; aged 50-75 (66.1±6.7) years old, and 68 (70.8%) males. After treatment, the serum levels of sST2, IL-1β, IL-6 and TNF-α were decreased, and the IL-10 level was increased in both groups ( P<0.05); while the improvement of serum indicators in the compliance group was more marked ( P<0.05). Echocardiography showed that the LA, LVDd, and LVEF were significantly increased after treatment ( P<0.05) in compliance group, while there was no significant changes before and after treatment in the non-compliance group. SST2, inflammatory factors and echocardiographic measurements of patients in the standard group had statistical significance before and after treatment ( P<0.05), and the difference showed a downward trend. No deterioration of renal function and angioedema were observed in both groups, and there was no significant difference in hyperkalemia (two in compliance group and one in non-compliance group), symptom hypotension (each in two groups) between the two groups (χ 2=0.12, 0.68; P>0.05). In the non-compliance group, 10 patients (41.7%) were readmitted due to heart failure, and 6 patients (25.0%) died; while there were no readmitted cases or fatal cases in compliance group (χ 2=33.49, 19.20; P<0.05). Conclusion:Early application of sacubitril and valsartan sodium in patients with acute HFrEF after hemodynamic stabilization can significantly improve left ventricular remodeling, for those with earlier escalation to the target dose, it is more beneficial. The changes of serum sST2 and inflammatory factor level after treatment may predict the efficacy of sacubitril/valsartan therapy.

Assessment of postoperative vital signs by nasal packing versus transseptal suturing techniques after septoplasty / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the affection to heart rate, blood pressure and breathing rate by nasal packing versus transseptal suturing techniques during patients undergone septoplasty. METHODS Eighty patients with deviation of nasal septum were included in this study. The patients were allocated into two groups: packing group and suturing group. The heart rates, blood pressure and breathing rates pre-and post-operations were collected, and the ascending range of these between two groups were assessed. The post-operative complications were observed. RESULTS The ascending range of the heart rates, blood pressure and breathing rates were smaller in suturing group than in packing group patients(P ＜0.05). There is no significant differences in post-operative complications between 2 groups. CONCLUSION Nasal suturing techniques during septoplasty might be a valid substitution for packing with more stable vital signs, smaller burden on the cardiovascular system and the same complication rates.

An extensive DeBakey type IIIb aortic dissection with massive right pleural effusion presenting as abdominal pain and acute anemia:particular case report / 老年心脏病学杂志（英文版）

We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.

Experimental Study on Acellular Dermal Matrix and Autologous Fat Injected into Rabbit Vocal Cords / 听力学及言语疾病杂志

Objective To evaluate the clinical application of autologous fat and acellular dermal matrix (ADM ) in vocal fold medialization .Methods A total of 16 New Zealand white rabbits of both sexes were divided into two study groups (8 rabbits in each group) ,after unilateral recurrent laryngeal nerve section ,autologous fat or ADM were injected into paralyzed vocal folds .Laryngoscopic exams were performed 2 ,4 ,8 ,and 12 weeks after implanta‐tion ;then larynx specimens were sampled and serially sectioned in axial plane from the false vocal fold to the sub ‐glottis .After section was stained with HE ,histologic behavior of the graft were evaluated by optical microscope , volume of remaining material were calculated by autoCAD software .Results The remaining volume of autologous fat and ADM reduced gradually ,there were no statistically significant differences between the 2 groups .In 2 weeks , fat cells survival was mass distribution ,as its necrosis and absorption ,intraimplant resulted in a plurality of cavitati‐on ,encapsulated by fibrous connective ,mixed with a little survival fat cells .In 12 weeks ,obvious capsule formation surrounded lipoma composed of fiber connective tissue .In the ADM group ,2 weeks after injection ,intra - implant fibroblast activity and neovascularization was noted ,later fibroblast infiltration increased gradually .In 12 weeks ,the implantation maintaun the basic outline and have compact organizational structure ,but not forming obvious bounda‐ries with the surrounding tissue .Conclusion Comparing degree of absorption ,there were no statistically significant differences between autologous fat and ADM in the study ,but histological outcome of ADM is closer to the original organization .In future ,ADM optimization or combination with other materials ,will have a larger development and clinical application value .

Analysis of risk factors affecting bleeding in percutaneous nephrolithotomy for treatment of kidney stones / 中华泌尿外科杂志

Objective The present study was designed to investigate the risk factors affecting bleeding during percutaneous nephrolithotomy. Methods The records of 218 patients with percutaneous nephrolithotomy procedure by a single surgeon were retrospectively reviewed.The mean age was 48 years ( range,19 -70).One hundred and forty six patients had staghore stones,and 7 patients had previous open or percutaneous nephrolithotomy histories.Forty-one patients had concomitant diabetes mellitus,and 89 cases had hypertension.The following factors including age,sex,BMI,diabetes status,hypertension status,stone type,calix of puncture,previous open or percutaneous nephrolithotomy history,number of accesses,size of accesses,operative time,and surgeon experience were analyzed.Univariate analysis and multivariate step regression analysis were used for statistical assessment. Results 207 procedures were successfully performed,and 11 patients failed because of difficulty to establish the accesses.Single-tract was used in 176 cases and multiple-tract was used in 31 cases.163 cases were performed via a 18 F access and 44 cases via a 24 F access.The mean operative time was 78.4 min.The overall blood transfusion rate was 7.7％,and stone type ( P =0.034),diabetes ( P =0.030),number of accesses ( P =0.019 ),size of accesses ( P =0.008) and operative time (P =0.001 ) were the risk factors affecting blood transfusion requirement.The average hemoglobin (Hb) drop after percutaneous nephrolithotomy procedures was 11.2 g/L,and stone type ( P ＜ 0.001 ),diabetes ( P =0.015 ),number of accesses ( P =0.016),size of accesses ( P ＜ 0.001 ) and operative time ( P ＜ 0.001 ) were the risk factors affecting Hb drop.The following covariates including Hb drop:age,sex,BMI,previous open or percutaneous nephrolithotomy history,hypertension status,calix of puncture and surgeon experience were not risk factors affecting blood transfusion requirement and Hb drop.Multivariate stepwise regression analysis showed that diabetes ( OR =1.75 ),stone type ( OR =1.92),number of accesses ( OR =2.45 ),size of accesses ( OR =1.32) and operative time ( OR =1.66) significantly increased risk of bleeding. Conclusions Stone type,diabetes,number of accesses,size of accesses and operative time were the risk factors affecting blood loss during percutaneous nephrolithotomy.

Diagnosis and treatment of breast implant rupture / 中华医学美学美容杂志

Objective To study the diagnosis, treatment and prognosis of the rupture of breast implant. Methods Physical examination, X-ray fluoroscopy, high frequency and color the Doppler ultrasonography were helpful to make a clear diagnosis, in exploring and removing the fiber envelope by inframammary or periareolar incision, repairing the anatomy structure of the breasts and performing augmentation mammaplasty again. Results In 32 patients, the breast shape was basically symmetrical, most of the incisions were healed by first intention except 2 cases with complication of subcutaneous fluid collection. A satisfactory therapeautic result could be achieved by taking out the breast implant which was rupture, exploring and removing the fiber envelope, and extending the lacuna. Conclusion A satisfactory therapeautic result can be achieved by extending the lacuna.