Repairing of lower eyelid ectropion with expanded flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of reconstruction of lower eyelid ectropion with expanded flap.</p><p><b>METHODS</b>Fourty patients with lower eyelid ectropion were reconstructed using tissue expander. The volume of the smallest expander was 30 ml, and that of the biggest one was 150 ml. The expand time was from 2-months to 3-months, then advancement or transposition flaps were created and employed in the defected lesion where the scar was removed just in one operation.</p><p><b>RESULTS</b>All patients have been followed up for 2-year with satisfactory results and no recurrences was appearance.</p><p><b>CONCLUSIONS</b>Application of expander reasonable may get satisfactory result in reconstruction of lower eyelid ectropion. The incision in donor site is hidden and the symptom seldom recurs.</p>

Laparoscopic small intestinal flap colpopoiesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the possibility of Laparoscopic reconstruction of vagina using pedicled ileal autograft and provide a new procedure of colpopoiesis.</p><p><b>METHODS</b>The abdominal and perineal approaches were performed simultaneously under a sufficiently deep general anaesthesia. Laparoscopically, a 15-18 cm segment of the ileum on its vascular pedicle, ileal branches of the superior mesenteric artery and its concomitant veins, was selected and isolated for transplantation using ultrasonically-powered instruments. The distal of the transferred ileal segment was 15cm apart from the ileocecal junction. The ileum continuity was restored immediately by end-to-end anastomosis and the distal oral of the transplant was closed using a curved intraluminal stapler. Meanwhile, a neovaginal tract was completed to dissect from the perineum into the peritoneum and the tract widened laterally. Then the ileum transplant was reversed to reach the perineum through the peritoneal incision at the top of the neovaginal tract without subjecting the mesenteric neurovascular pedicle to undue tension and subsequent necrosis. The oral edge of the ileum transplant was sutured to the perineal skin.</p><p><b>RESULTS</b>Followed up for over 1-53 months postoperatively, 36 patients who received laparoscopic vaginoplasty by transferring ileal segment flaps got satisfactory neovaginal function similar to a normal vagina with mucus and moistness.</p><p><b>CONCLUSIONS</b>The advantages of using a laparoscopic ileum colpopoiesis are that (1) satisfactory neovaginal function similar to a normal vagina with mucus and moistness, (2) no disturbance of bowel function, (minimal scarring in abdominal wall and less secondary deformity in perineum and (3) no need for frequent dilation or stent wearing to the reconstructed vagina. And so laparoscopic vaginoplasty was a preferable alternative of vaginoplasty.</p>

Differential display of homeobox gene expressions in the normal, wounded human fetal and adult skins by DNA microarray / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the differential expression of homeobox genes in the normal, wounded human fetal and adult skins and its significance in fetal scarless healing.</p><p><b>METHODS</b>Gene chips containing 14 000 human genes were used to investigate homeobox gene expressions of the normal, wounded human fetal and adult skins.</p><p><b>RESULTS</b>There were significant differences between the expression of homeobox genes, especially for PRX-2, HOXB13, HOXB6 and HOXB7.</p><p><b>CONCLUSIONS</b>The homeobox gene is in close relation to developmental biology. The different expressions and changes of homeobox genes in the normal, wounded human fetal and adult skin may be a primary cause of different wound healing between fetal and adult skin.</p>

The role of tyrosine phosphorylation proteins in procollagen gene expression of fibroblasts in wound healing / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the role of adhesion between fibronectin and fibroblasts in wound healing as well as tyrosine phosphorylation proteins in procollagen mRNA expression.</p><p><b>METHODS</b>The level of proalpha1 (I) mRNA and tyrosine phosphorylation protein were detected employing the techniques of RT-PCR and immunoblotting. After inhibition of tyrosine kinases, herbimycin A was added to the medium to block the pathway of tyrosine phosphorylation, the changes of procollagen mRNA and tyrosine phosphorylation proteins were further investigated.</p><p><b>RESULTS</b>The adhesion between fibroblasts and fibronectin in wound healing not only induced the production of 98kd and 65kd tyrosine phosphorylation protein, but also enhanced obviously the expression of procollagen alpha1 (I) mRNA. When the pathway of tyrosine phosphorylation was blocked, the level of procollagen alpha1 (I) mRNA lowered remarkably, accompanied by the decrease of 98kd, 65kd tyrosine phosphorylation proteins.</p><p><b>CONCLUSION</b>The adhesion between fibronectin and fibroblasts plays an important role in expression increase of procollagen mRNA during wound healing, in the process of which tyrosine phosphorylation is a key step.</p>

The significance and the expression of homeobox genes during human burn wound healing / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the expression of several homeobox genes during the wound healing in fetal and adult skin and their roles in fetal scarless wound healing.</p><p><b>METHODS</b>The expressions of PRX-2, HOXB13, HOX2.2 and HOX2.3 during wound healing in fetal and adult skin were determined with in situ hybridization.</p><p><b>RESULTS</b>(1) PRX-2 positive expression could be identified in normal fetal and adult skin, especially in the fetus. But there was difference in location sites of the genes. The positive expression in normal fetal skin was mainly found in the peripheral cells at the hair shafts within dermal papilla layers and was also found in the epithelium. Nevertheless, weak positive expression of PRX-2 was found in the epithelial basal layer cells in normal adult skin but not in dermal tissue. There was strong positive expression of the PRX-2 in the tissue around the wound in fetus but not of that in adults except the epithelial basal layers. (2) Positive expression of HOXB13 could be identified in both normal fetal and adult skins. And the expression was concentrated mainly in hair follicle cells in the dermis and in the basal layer cells in the epithelium. Furthermore, the expression became weak after trauma, especially in fetal skin. (3) The positive expression of HOX2.2 and HOX2.3 in normal fetal skin was observed mainly in the whole layer of the epithelium and especially in the epithelial basal layers. Weak positive expression could be found in the dermis and strong expression found in the tissue near the wound. But there was no positive expression of the HOX genes in normal adult skin and wounds.</p><p><b>CONCLUSION</b>The difference in the HOX expression in fetal and adult skin wound healing might be the key factor leading to different wound healing. Homeobox genes might be closely related with the developmental biology.</p>

A comparative study of PDGF and EGF expression in skin wound healing between human fetal and adult / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the differences of PDGF and EGF expression in the wound healing between fatal and adult.</p><p><b>METHODS</b>With the established animal model of fetal scarless healing and the adult samples, an immunohistochemical technique was used to evaluate the expression of PDGF and EGF in the normal adult skin, normal fetal skin, and the process of their wound healing.</p><p><b>RESULTS</b>1. The expression of the PDGF was not found in the fetal skin, but a mild amount of the PDGF was shown in the epidermis and the upper dermal layer 12 hours and 1 day after the wounding process. In the normal adult skin, expression of PDGF was shown in the dermal fibroblasts, macrophagocytes and blood capillaries, and a strong expression was presented during its wound healing process. 2. In the fetal skin, the expression of the EGF was seen in the epidermis, hair follicles, sebaceous glands and sweat glands, but there were no markedly changes during the wound healing. In the adult skin, a positive stain of the EGF was shown in the basal layer of the epidermis while the mild stain in hair follicles and sweat glands. The level of the expression became gradually decreasing with the time going in the wounded adult skin.</p><p><b>CONCLUSION</b>The different expression of growth factors between fetal and adult skin in wound healing may be one of the important reasons that the fetal wound could produce scarless healing.</p>