A Scarless Method for Correcting Tanzer Group IIB-Constricted Ear Without Cartilage Grafting.

Tanzer group IIB-constricted ear is described as a deformity of the helix, antihelix, or scapha. Deficiency of the auricular skin and cartilage is a key point in the reconstruction of the cartilaginous framework. Traditionally, the treatment of a constricted ear mainly includes 2 aspects: correction of cartilage deformity and restoration of skin volume deficiency. By mimicking the suspension principle of a cable bridge, our technique only requires adjustment of the spatial directions and mechanical forces between the 2 flaps to achieve an aesthetic effect. The authors were able to avoid harvesting the costal cartilage. The desired ear shape was obtained immediately postoperatively. Therefore, Vaseline gauze was not applied and was modeled along the scapha and antihelix. Expansion of the ear was remarkable in both horizontal and vertical lengths. Our technique causes less damage, less scarring, shorter operation time, fewer complications, faster rehabilitation, and no delays.

Mechanism of vascular endothelial cell-derived exosomes modified with vascular endothelial growth factor in steroid-induced femoral head necrosis.

Steroid-induced avascular necrosis of the femoral head (SANFH) is an intractable orthopedic disease. This study investigated the regulatory effect and molecular mechanism of vascular endothelial cell (VEC)-derived exosomes (Exos) modified with vascular endothelial growth factor (VEGF) in osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in SANFH. VECs were culturedin vitroand transfected with adenovirus Adv-VEGF plasmids. Exos were extracted and identified.In vitro/vivoSANFH models were established and treated with VEGF-modified VEC-Exos (VEGF-VEC-Exos). The internalization of Exos by BMSCs, proliferation and osteogenic and adipogenic differentiation of BMSCs were determined by the uptake test, cell counting kit-8 (CCK-8) assay, alizarin red staining, and oil red O staining. Meanwhile, the mRNA level of VEGF, the appearance of the femoral head, and histological analysis were assessed by reverse transcription quantitative polymerase chain reaction and hematoxylin-eosin staining. Moreover, the protein levels of VEGF, osteogenic markers, adipogenic markers, and mitogen-activated protein kinase (MAPK)/extracellular regulated protein kinases (ERK) pathway-related indicators were examined by Western blotting, along with evaluation of the VEGF levels in femur tissues by immunohistochemistry. Glucocorticoid (GC) induced adipogenic differentiation of BMSCs and inhibited osteogenic differentiation. VEGF-VEC-Exos accelerated the osteogenic differentiation of GC-induced BMSCs and inhibited adipogenic differentiation. VEGF-VEC-Exos activated the MAPK/ERK pathway in GC-induced BMSCs. VEGF-VEC-Exos promoted osteoblast differentiation and suppressed adipogenic differentiation of BMSCs by activating the MAPK/ERK pathway. VEGF-VEC-Exos accelerated bone formation and restrained adipogenesis in SANFH rats. VEGF-VEC-Exos carried VEGF into BMSCs and motivated the MAPK/ERK pathway, thereby promoting osteoblast differentiation of BMSCs in SANFH, inhibiting adipogenic differentiation, and alleviating SANFH.

Application of Multimodal Fusion Technology in Image Analysis of Pretreatment Examination of Patients with Spinal Injury.

As one of the most common imaging screening techniques for spinal injuries, MRI is of great significance for the pretreatment examination of patients with spinal injuries. With rapid iterative update of imaging technology, imaging techniques such as diffusion weighted magnetic resonance imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and magnetic resonance spectroscopy are frequently used in the clinical diagnosis of spinal injuries. Multimodal medical image fusion technology can obtain richer lesion information by combining medical images in multiple modalities. Aiming at the two modalities of DCE-MRI and DWI images under MRI images of spinal injuries, by fusing the image data under the two modalities, more abundant lesion information can be obtained to diagnose spinal injuries. The research content includes the following: (1) A registration study based on DCE-MRI and DWI image data. To improve registration accuracy, a registration method is used, and VGG-16 network structure is selected as the basic registration network structure. An iterative VGG-16 network framework is proposed to realize the registration of DWI and DCE-MRI images. The experimental results show that the iterative VGG-16 network structure is more suitable for the registration of DWI and DCE-MRI image data. (2) Based on the fusion research of DCE-MRI and DWI image data. For the registered DCE-MRI and DWI images, this paper uses a fusion method combining feature level and decision level to classify spine images. The simple classifier decision tree, SVM, and KNN were used to predict the damage diagnosis classification of DCE-MRI and DWI images, respectively. By comparing and analyzing the classification results of the experiments, the performance of multimodal image fusion in the auxiliary diagnosis of spinal injuries was evaluated.

Finite-Element Biomechanical-Simulated Analysis of the Nasolabial Fold.

BACKGROUND: Nasolabial fold (NLF) is an important anatomic sign of facial aging. However, the dynamic biomechanical relationships between the facial mimetic muscles (FMMs) and the NLF remain unclear. OBJECTIVE: This study aimed to investigate the dynamic biomechanical relationships between the FMM and various NLF by finite-element analysis (FEA). METHODS: The 3-dimentional computer-aided design (3D CAD) model of the skin-muscle-maxillofacial bone in the NLF was established by using the engineering design module of the Computer-Aided 3-dimensional Interactive Application (CATIA) software. This CAD model was then imported into the Hypermesh software to set element type, mesh, and material properties. Finally, the 3D FEA model of the skin-muscle-maxillofacial bone in the NLF was generated, and then exported and uploaded into the Abaqus software with HM format for mechanical force loading and biomechanical analysis. RESULTS: A 3D FEA model of the skin-muscle-maxillofacial bone in the NLF was successfully established by using the Mimics, Geomagic Studio, CATIA, Hypermesh, and Abaqus softwares. This FEA model had a good geometrical resemblance and good biomechanical properties. This provided an ideal biomechanical model for the study of deformation and the biomechanics of soft tissues, such as the NLF. The FEA was applied to the biomechanical simulation of the NLF. We established five effective FEA models to study the dynamic biomechanical relationships between the NLF and the FMM. The dynamic biomechanical relationships between the NLF and the FMM were preliminarily determined by computer simulating different types of mechanical force loadings. CONCLUSION: The FEA is an effective method to simulate the dynamic biomechanical relationships between the NLF and the FMM. Through the FEA simulation described in this study, we could preliminarily conclude that the formation of different types of NLF is mainly due to the coordinated contraction of various FMM. Moreover, not all FMM are involved in all types of NLF. According to the results of the FEA simulations in this study, it is worthwhile considering investigating the role of botulinum toxin in improving the morphology of the NLF in the near future.

Removal of mercury(II), lead(II) and cadmium(II) from aqueous solutions using Rhodobacter sphaeroides SC01.

Microorganisms and microbial products can be highly efficient in uptaking soluble and particulate forms of heavy metals, particularly from solutions. In this study, the removal efficiency, oxidative damage, antioxidant system, and the possible removal mechanisms were investigated in Rhodobacter (R.) sphaeroides SC01 under mercury (Hg), lead (Pb) and cadmium (Cd) stress. The results showed that SC01 had the highest removal rates (98%) of Pb among three heavy metals. Compared with Hg and Cd stress, Pb stress resulted in a lower levels of reactive oxygen species (ROS) and cell death. In contrast, the activities of four antioxidant enzymes in SC01 under Pb stress was higher than that of Hg and Cd stress. Furthermore, the analysis from fourier transform infrared spectroscopy indicated that complexation of Pb with hydroxyl, amid and phosphate groups was found in SC01 under Pb stress. In addition, X-ray diffraction analysis showed that precipitate of lead phosphate hydroxide was produced on the cell surface in SC01 exposed to Pb stress. Therefore, these results suggested that SC01 had good Pb removal ability by biosorption and precipitation and will be potentially useful for removal of Pb in industrial effluents.

What Is the Skull Structure Influence of Squamosal Suture Synostosis in Nonsyndromic and Syndromic Crouzon Craniosynostosis?

BACKGROUND: The morphologic effect of squamosal synostosis has not been clarified, due to its low occurrence rate, and its inclination to be combined with premature closure of other major sutures, especially in syndromic synostosis. This study's goal is to explore the morphological influence of squamosal synostosis in both syndromic and nonsyndromic craniosynostosis patients. METHODS: Twenty-five computed tomography (CT) scans from nonsyndromic squamosal synostosis (NSS), Crouzon syndrome with squamosal synostosis (CSS), Crouzon syndrome without squamosal synostosis, and normal controls were included. Three-dimensional (3D) cephalometry, entire cranial volume and cranial fossa volume were measured using Materialise software. RESULTS: The entire cranial volume of all groups was similar. The NSS developed a gradual reduction in the severity of reduced segmental volume from the anterior cranial fossa, to the middle cranial fossa, and to the unaffected volume of posterior cranial fossa. The CSS developed the most severe volume reduction of middle cranial fossa (12608.30 ±â€Š2408.61 mm vs 26077.96 ±â€Š4465.74 mm, 52%), with proportionate volume reduction of the anterior (7312.21 ±â€Š2435.97 mm vs 10520.63 ±â€Š2400.43 mm, 30%) and posterior cranial fossa (33487.29 ±â€Š5598.93 mm vs 48325.04 ±â€Š14700.44 mm, 31%). The NSS developed a narrower anterior cranial fossa, a clockwise rotated Frankfort horizontal plane, and a retracted chin (pogonion). CONCLUSION: Squamosal synostosis may alter the development of cranial fossa volume, especially the volume of middle cranial fossa. However, the development of cranial base, and related facial features are determined largely by major vault sutures and associated syndromic conditions, rather than the squamosal suture alone. LEVEL OF EVIDENCE: II.

Progress on Botulinum Toxin Type A-Induced Pain Relief in the Field of Plastics.

OBJECTIVE: To retrospectively evaluate the effectiveness of Botulinum Toxin Type A (BTX-A) injections relieve pain in the field of plastic surgery and postoperative rehabilitation, and discuss the analgesic mechanism of BTX- A in plastics and related research progress. METHODS: From appearance to September 1, 2016, PUBMED, EMBASE, and Web of Science were searched, using the key words related to "Botulinum Toxin Type A" and "Pain." Furtherly, nonplastic surgery-related literature was excluded by manual screening. RESULTS: Eleven literatures met the inclusion criteria, including 6 prospective controlled cohorts, 4 patient series, and 1 retrospective cohort. These studies involved Lower Limb, Breast, Hallux, Amputees, and Temporomandibular joint disk disfigurement and enrolled 402 patients. Among the patients, 360 received intraoperative BTX-A injection at the time of the main surgical procedure, 16 injected postoperatively and 26 did not undergo surgery. And 85.32% reported pain alleviation and 69.96% got favorable side effects and no one occurred major adverse effects. But 1.83% accepted injections more than once. Mechanism analysis explained these studies' results and demonstrated the analgesic effectiveness of BTX-A in plastics with nociceptive pain, inflammatory pain, and neuropathic pain. CONCLUSION: The results suggest that BTX-A may induce postoperative pain associated with plastic surgeries relief. But the available data of outcome assessment involved in this review are inconsistent and failed to meet methodological rigor. And pain alleviations are influenced by many factors. So further randomized controlled clinical trials with large sample sizes are needed to support this practice, determine standard usage methods, and establish corresponding specification systems.