Application of digital technology and three-dimensional silicone cartilage models in auricular reconstruction surgery / 中华医学美学美容杂志

Objective:To establish silicone cartilage models of donor-sites for the microtia patients by using digital technology, and to explore the application of surgical simulation in auricular reconstruction.Methods:From June 2018 to October 2019, 19 congenital microtia patients underwent thoracic CT scans and following three-dimensional costal cartilage imaging with Mimics software at the Nanfang Hospital, Southern Medical University. Among these patients, 16 were males and 3 were females. The mean age of patients was 16 years (range 8 to 35 years). Silicon cartilage models were produced by 3D printing and used for surgical planning and preoperative simulation in ear framework fabrication. Cartilaginous framework was sculptured according to the simulation during operation. Patients were followed up for a minimum of six months to evaluate the size, outline, height and auriculocephalic angle of the reconstructed ear. The satisfactory outcomes of the patients were scored according to a 5-point Likert scale.Results:All the patients received the surgical simulation and sculpture training with silicone cartilage models before operation. Auricular reconstruction was completed successfully according to the simulation. The duration of sculpture was shortened to 1-1.5 hours. There were no serious complications, such as hematoma, inflammation, skin necrosis and framework exposure. The contour of reconstructed ear was natural and clear over a 6 months follow-up, and all the patients were satisfied with their surgical outcomes.Conclusions:With the application of digital technology and silicone cartilage models by 3D printing to the surgical planning and training in microtia patients, patient-specific framework is fabricated with precisely assembling, which not only shortens the operation time, but also provides the unexperienced surgeons with a safe and effective training of ear framework fabrication.

The application of platelet-rich plasma in cosmetology / 中华整形外科杂志

Platelet-rich plasma (PRP), the concentration of platelet and plasma, is rich of a variety of growth factors.It plays an important role in anti-inflammatory and tissue regeneration, and has gradually been used in cosmetology in the recent years.This paper introduces the application of PRP in facial rejuvenation, acne and alopecia treatment, as well as improving the survival rate of autologous fat transplantation. The side effects and prospectives of PRP application in cosmetology were also summarized.

Large facial defect reconstruction with partition pre-expanded cervico-scapulo-dorsal flaps based on the superficial cervical artery / 中华整形外科杂志

<p><b>OBJECTIVE</b>To assess the outcome of large facial defect reconstruction with "partition" pre-expanded cervico-scapulo-dorsal flaps (CSDF) based on the superficial cervical artery (SCA).</p><p><b>METHODS</b>Surgical course consisted of 3 stages. In stage I, a skin flap was designed along the axis of SCA according to the facial defect and an expander was implanted in the cervico-scapulo-dorsal region by means of "partition" expansion. The expanders were implanted beside the flap axis and beneath the posterior half of flaps so as to expand only half area of the flap. During the stage II, expanders were injected with saline regularly for continuous expansion. In stage III, the pre-expanded CSDFs were transferred to cover the facial defect of which the CSDFs included about half of non-expanded area.</p><p><b>RESULTS</b>From November of 2008 to December of 2013, 15 patients with facial hypertrophic scar or scar contracture were reconstructed with pre-expanded CSDF based on the SCA. The expansion lasted for 3 to 4 months, and the expanded volume varied from 680 to 960 ml. One case of 4.0 cm x 1.5 cm epidermal flap necrosis occurred and healed subsequently with superficial scar; and another case of blister formation in the distal part of flap was found, which recovered without scar; the other 13 flaps survived without complications. After a follow-up for 12 to 38 months( average 26. 2 months), patients regained satisfactory appearance of face, with no obvious hypertrophic scar in the donor site.</p><p><b>CONCLUSIONS</b>Partition preexpanded CSDF based on the SCA is a good choice for large facial defect reconstruction, and the partition expansion is an effective strategy for prevention of venous congestion.</p>

Expression of specific marker molecules of long-term cultured human dermal papilla cells in vitro / 中华医学美学美容杂志

Objective To investigate the expression of specific marker molecules in hair-inducing activity of long-term cultured human dermal papilla cells (HDPCs) in vitro.Methods After dissected and cultured the HDPCs in vitro,the cells of passages 1 to 8 were used for experiments.The growth appearances of HDPCs in different passages were observed under inverted microscope.To detect the expression of specific marker molecules of long-term cultured HDPCs,the alkaline phosphatase (ALP) activity of the HDPCs was examined,and the specific genes ALP and insulin-like growth factor-1 (IGF-1) expression levels of HDPCs were determined by real-time quantitative PCR.Results After long-term cultured in vitro,the ALP and IGF-1 expression levels of HDPCs gradually decreased in different passages,as well as the display of the aggregated and cartouche growth.The ALP and IGF-1 expression levels of HDPCs in passage 1 was the highest,they were almost about 6.8-fold and 3.5-fold higher than the HDPCs in passage 8.The ALP staining of the HDPCs in passage 1 and passage 2 were evident,but the cells' ALP staining gradually became much weaker than the cells in the previous passages after the long-term cultured in vitro.Conclusions The expression levels of specific marker molecules ALP and IGF-1 of the HDPCs decrease gradually after long-term cultured in vitro,and the higher passage HDPCs lost the special aggregated and cartouche growth appearance,and hence lead to the loss of hair-inducing activity of HDPCs.

Study on applied anatomy of temporalis / 重庆医学

Objective To investigate the architectural features of temporalis and offer anatomic basis for the clinical application . Methods In eight cadavers ,the gross anatomy ,muscular architecture study of temporalis were performed on anterior ,middle and posterior portion .Results The wet muscle weight of the above portions was (13 .17 ± 3 .41) ,(12 .30 ± 3 .59) ,(9 .68 ± 2 .50)g ;their muscle length was (91 .28 ± 5 .93) ,(100 .15 ± 3 .64) ,(110 .53 ± 6 .18)mm ;and their physiological cross-sectional area in muscle was (485 .90 ± 124 .36) ,(396 .59 ± 110 .05) ,(313 .31 ± 75 .72)mm2 ,respectively .Conclusion These results indicated that the anterior portion of temporalis muscle is designed for tension production ,but the posterior and middle for velocity production .Posterior and middle portion of temporalis muscle could quantifying transfer for the dynamic correction of facial paralysis according to the physio-logical cross-sectional area .

Effect of topical tacrolimus on xenogeneic hair follicle transplantation / 中华医学美学美容杂志

Objective To study the effect of topical tacrolimus (FK506) on the survival of the xenogeneic transplanted hair follicles from human scalp to Wistar rats. Methods In our study, Wistar rats were used as recipients and human as donor. The black hair follicles of human scalp were harvested, and then the xenogeneic grafts were transplanted to white Wistar rats on the back. 20 couples of rats were divided in 2 groups: topical tacrolimus group (group A), and blank control group (group B). After operaton, we compared the survival time of hair follicles and their histologic outcomes in order to verify the practicability of xenogeneic transplantion of hair follicles, and the topical application of tacrolimus results.Results The mean survival time of group A was longer [(49. 9 ±7. 1) days] as compared to group B [(13. 1±1. 2) days]. The longest survival time was 65 days in group A and 14 days in group B, respectively. By comparison of the results we found that topical tacrolimus prolonged the survival time of the xenotransplanted hair follicles significantly and that tropical medication could not avoid rejection. Conclusions The immune privilege function dependent on the hair follicle anagen and axillary topical tacrolimus, can prolong the survival time of the xenogeneic transplanted hair follicles in rats significantly.

Establishment of rat skin organ culture model and initiation of hair follicular morphogenesis with its correlative dynamic expression of Wnt10 b/β-catenin / 中华医学美学美容杂志

Objective To establish a rat skin organ culture model to study the initiation of hair follicle morphogenesis, and the dynamic expression of Wnt10b/β-catenin in the developing hair follicle. Methods The dorsal skins of SD rat at embryos 14-17 (E14-E17) were cultured on a gelatin sponge-supported tissue culture system at the air/liquid interface of DMEM with 10 % fetal bovine serum (FBS) for 3-6 days, some of which removed from El5 were cultured in DMEM with FBS of different concentrations. HE staining and fluoroimmunoassay were adopted. Results The model we established allowed skin tissues isolated from E14-E15 to develop in a manner that was histologically and temporarily similar to the process in vivo. However, the developing hair follicle ceased to continue when their morphogenetic process reached the forth stage, and the concentration of FBS did not show any significant effect on the development of hair follicle. Expression of Wnt10b/β-catenin was induced in culture, as it also occurred in vivo,but grew weak till it disappeared in culture for 6 days, which was accompanied by development halt of hair follicle. Conclusions A rat skin organ culture model is established in which the morphogenesis of hair follicle takes place in a manner similar to in vivo, and Wnt10b/β-catenin probably has a close connection with the early morphogenesis of hair follicle.

Repairing and reconstruction of microsurgical flap in leg serious defection / 中华显微外科杂志

@#Objective To explore and solve the repairing and reconstruction in leg serious damage.Methods Using microsurgical technique to reconstruct 9 cases leg serious defection,especially free combining flap with two area flap were applied in 4 cases,two set of vessel were anastomosised to repair the tremendous defection with deep tissue including in tendon, vessel, nerve injury and exposure. Another 5 cases were repaired with paraumbilical flap with opposite lateral vessel anastomosis. Results All 9 cases were applied successfully with 100%survived and were followed-up for one month to four vears. all flaps were good and appearance was excellent,and there were satisfied function recovery. Conclusion It is better choice for repairing complex tissue defection in leg by combining giant free flap transplantation and it is also reliable method for flap circulation by opposite lateral vessel anastomosis.

A comparative study on external ultrasonic, internal ultrasonic and simple negative pressure liposuction operations under tumescent anesthesia / 中华整形外科杂志

<p><b>OBJECTIVE</b>To compare the effects of the external ultrasonic, the internal ultrasonic and simple negative pressure liposuction operations under tumescent anesthesia.</p><p><b>METHODS</b>The fat volume, operative time, complications and other indexes of liposuction in 276 cases were collected and compared.</p><p><b>RESULTS</b>External ultrasonic liposuction rapidly emulsified the fat with the least complication. The effects of the internal ultrasonic liposuction was next to the external ultrasonic method while the simple negative pressure liposuction had the poorest effects.</p><p><b>CONCLUSION</b>The external ultrasonic liposuction operation is a safe and effective method for local overweight reduction.</p>

Surgical treatment of congenital muscular torticollis: comparison of two operative methods / 中华医学美学美容杂志

Objective To evaluate the therapeutic efficacy of congenital muscular torticollis (CMT) by two different methods. Methods A total of 86 patients with congenital muscular torticollis in recent 7 years were involved in this study, including 69 cases under 12 years old and 17 cases over 12. Two different operation methods, incision of inferior extremity of sternocleidomastoid muscle and incision of amphi-sternocleidomastoid muscle with post-operative traction, were alternatively chosen according to the ages and deformed degrees of the patients. Results 72 patients were followed-up for 1 to 7 years (averaged 4.5 years). Based on the effect of function and cosmetology in the group of 57 cases under 12 years old, there were 52 cases (91.2 %) excellent, 5 cases (8.8 %) good and no case with side-effects. Meanwhile, in the group of 15 cases over 12 years old, there were 11 cases (73.3 %) excellent, 4 cases (26.7 %) good and no case with side-effects. The effect was satisfactory. Conclusion Different patients with congenital muscular torticollis should be treated with different therapeutic methods.

Comprehensive correction of secondary lip-nasal deformities after operation of unilateral cleft lip / 中华医学美学美容杂志

Objective To introduce a method of comprehension correction for secondary lip-nasal deformities after operation of the completely unilateral cleft lip. Methods The correction consisted of the following procedures: reposition of the columella and nasal alar crus by one tractional suture with nostril base narrowing; modification of flat nostril by a MT-plasty at the edge of naris; arising of the nasal alar and nasal dorsor by ePTFE implantation; reconstruction of the Cupid's bow by M type incision and vermilion advancement; repair of the vermilion deficit with the hinge mucosal flap and bipedicle mucosal flaps of the lower lip. Results Twenty-one cases with secondary lip-nasal deformities were successfully corrected by these comprehensive methods. Ten of them were followed-up for three months to 1 year with satisfactory effects. Conclusion The comprehensive methods can be used to correct satisfactorily the secondary lip-nasal deformities after operation of the completely unilateral cleft lip.

Preparation and application of the tumescent solution in the ultrosonic liposuction / 中华医学美学美容杂志

Objective To explore the application and formulas of the tumescent technique in the ultrosonic liposuction for better and more predictable reseults. Methods The tumescent technique formulas were present and analysed through 318 cases of ultrosonic liposuction. Results The following regimen was recommended as a result of the above studies: Lactated Ringer's solution or nosmal sodium was the fluid of choice; Lidocaine (500 mg/l) was a reference anesthetic. The maximal safe dose recommended for liposuction was 35 mg/kg body weight and total dose of epinephrine was 2～3 mg/l. But its concentation should be lower than 1:1 000 000. Concentration of sodium bicarbonate was 500 mg/l, and higer doses were of no value but harmless. Conclusions Safer formulas are provided for the tumescent technique administration in the ultrosonic liposuction. The tumescent technique may reduce potential complications related to ultrosonic liposuction

Anatomy study of blood vessel and nerve bunch of temporal muscle to repair the deformed of later facial paralysis / 中华显微外科杂志

Objective To evaluate the clinical anatomy for repair the deformed of later facial paralysis in power by grouped human specimen of the blood vessel and nerve bunch of temporal muscle Methods Materials consisted of 20 fresh human temporalis muscle specimens Divided to four groups in random Vascular infusion was by either solution of lead oxide,methylmethacrylate or Zhonghua ink,and stained the microdissection of nerve All the images were made photograph,and overlaped by computer To form the bunches of vascular and nerve Results Temporal muscle have three bunches to utilize independently,and the blood vessel and nerve formed a dense interlacing network Conclusion To power correct deformed in eye,nose and mouth of later facial paralysis,we can accomplish once a time with the corresponding temporal muscle bunches of vascular and nerve