Application of decellularization-recellularization technique in plastic and reconstructive surgery / 中华医学杂志(英文版)

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.

Combining Diced Cartilage with Chondrocyte Spheroids in GelMA Hydrogel: An Animal Study in Diced Cartilage Grafting Technique

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.

The Application of Cartilage Tissue Engineering with Cell-Laden Hydrogel in Plastic Surgery: A Systematic Review

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.

Short- and long-term outcomes of comprehensive facial rhytidectomy using FACE-Q scales / 中华医学美学美容杂志

Objective:To explore the technique procedure for comprehensive facial rhytidectomy, and to evaluate the surgical outcome.Methods:A total of 126 patient received comprehensive facial rhytidectomy were involved in this study and the outcomes were evaluated by using 14 FACE-Q scales.Results:Totally 44 patients completed the FACE-Q scales, with the follow-up of 6 to 86 months, with an average of 27.9 months. The overall satisfaction was 87.30±10.79 (mean±standard deviation), satisfaction with forehead and brow was 92.16±10.12, satisfaction with cheekbones was 93.30±6.95, satisfaction with cheek was 91.20±10.17, and satisfaction with neck was 87.16±9.65; appraisal of overall lines was 87.57±9.71, appraisal of forehead lines was 91.80±10.23, appraisal of glabella lines was 90.43±10.76, appraisal of nasolabial fold was 88.25±12.10, and appraisal of crow＇s feet was 91.52±13.66; social function scores were 88.70±9.40, psychological function scores 88.77±10.49, surgical decision satisfaction scores 90.86±9.06, and surgical outcome satisfaction scores 90.03±10.61. Self-evaluation was 8.33±3.15 years younger. There was no statistically significant difference in the scale results between the age groups of <40 years, 40-50 years, and >50 years.Conclusions:Comprehensive facial rhytidectomy is a systematic and thorough surgical solution for rejuvenation. This procedure is proved to be of high satisfactory degree in short and long-term follow-up by FACE-Q scales.

Endoscopic forehead lift with frontalis muscle resection by parallel incision / 中华医学美学美容杂志

Objective:To introduce a novel method of endoscopic forehead lift and its follow-up results.Methods:In the past 7 years, 119 patients underwent endoscopic forehead lift. The parallel incisions were made on the frontalis muscle to relieve the wrinkles of the forehead. Glabella muscles were partially bluntly bitten by minimally invasive forceps. No fixator or suture was applied during the operation. Postoperative FACE-Q scales were issued to patients, and the changes of eyebrow position before and after operation were measured.Results:One week postoperatively, glabella frown and forehead wrinkles were relieved or eliminated as the swell gone. The eyebrow measurement outcome showed that the eyebrows of the patients were definitely raised after the operation. The results of FACE-Q scales showed that patients were highly satisfied with the improvement of frontal wrinkles and glabella frown wrinkles, and with the surgical outcomes and decisions. The patients thought they were averagely 7 years younger after operation. The most common complication was temporary frontal skin numbness, followed by hairline regression.Conclusions:The endoscopic forehead lift can effectively improve the forehead wrinkles and the glabella frown wrinkles which meets the demands of Chinese patients.

Three-dimensional facial morphological features of young Han Chinese women: A preliminary study / 中华医学美学美容杂志

Objective To explore the feasibility of our method on assessing the three-dimensional facial morphological features based on three-dimensional surface imaging techniques.Methods According to the admission criteria,three-dimensional facial images of 34 attractive young Chinese women and 172 healthy reference young women were selected from the three-dimensional facial images database of our department.For those images,anthropometric facial measurements including facial height,width,the degree of convexity and concavity were computed using three-dimensional surface imaging techniques combined with three-dimensional coordinate system.The variance between attractive group and reference group was analyzed and the facial morphological features of each group were preliminarily summarized.Results Both groups met the criteria of mesoprosopy,not the "vertical facial trisection and rule of fifths".The attractive group had a relatively narrow anterior facial frame,a more rounded and full upper face compared with the reference group.They also had smaller intercan thai width compared with the reference group.Moreover,the attractive group showed more prominent nose,more full and prominent medial cheek.In addition,the attractive group shared less protruded upper lips and less retruded chin compared with the reference group.Conclusions Assessing facial morphology using three-dimensional surface imaging techniques is a convenient and feasible method.The evaluation of sagittal facial convexity and concavity is an indispensable part of facial morphology features assessment.

Primary retroperitoneal leiomyosarcoma: a clinical and pathological study of 11 cases / 中华泌尿外科杂志

Objective To analyze the clinical characteristics,pathology,CT characteristics and targeted therapy of primary retroperitoneal leiomyosarcoma treated at our institution during the past 20 years.Methods A retrospective review was performed among 11 patients of this disease.The main performances were hematuria,abdominal mass and abdominal pain.Non-enhanced CT scanning showed soft tissue density in all cases.Tri-phase enhanced scanning showed reinforcement in different degrees.Pathology results showed tissue necrosis.The pathology featured by routine HE and immumohistochemical staining.Results Surgical treatment was performed in all 11 patients.Postoperative pathology showed that median tumor diameter was 14.40cm.Spindle cell,cellular abnormity and mitotic figures could be seen through light microscope.During follow-up,3 cases recurrenced after 2 months,3 years and 5 years respectively.Conclusions Primary retroperitoneal leiomyosarcoma might have a high fatality rate and high recurrence rate.The clinical and CT features are unapparent.Pathology diagnosis is reliable,surgery is necessary to prolong life and cure disease.