EGFL7 affects the migration of epidermal stem cells in refractory diabetic wounds by regulating Notch signaling pathway.

Aim: This study aimed to explore the role of EGFL7 in the healing process of refractory diabetic wounds. Methods: Epidermal stem cells (ESCs) were isolated from healthy mice and diabetic mice, identified by immunofluorescence, transfected with EGFL7 overexpression and silencing lentiviral vectors, and treated with Notch pathway inhibitor (DAPT). Results: SiEGFL7 significantly inhibited the proliferation, invasion and migration of ESCs of healthy mice. DAPT prominently inhibited the expressions of Notch1, Notch2, Hes1 and Jag1 in ESCs of healthy mice induced by overexpressed EGFL7. Overexpressed EGFL7 promoted wound healing in diabetic mice with refractory wounds. Conclusion: EGFL7 affects the proliferation and migration of ESCs in refractory diabetic wounds by regulating the Notch signaling pathway.

EGFL7 silencing inhibited the proliferation, invasion and migration of ESCs of healthy mice, which was reversed by Notch signaling inhibition. Overexpressed EGFL7 promoted wound healing in diabetic mice with refractory wounds, providing a promising potential for the treatment of diabetic wound.

Closed Rhinoplasty with a Mushroom-Shaped Costal Cartilage Graft in East Asian Patients.

BACKGROUND: The most challenging part of rhinoplasty is nasal tip management. For East Asian patients with a bulbous under projected nasal tip with thick skin, autologous cartilage is considered the gold-standard graft material to provide strong support to the nasal tip and effectively increase tip projection. The present study aimed to evaluate the outcomes of closed rhinoplasty with a mushroom-shaped costal cartilage graft in East Asian patients. METHODS: From February 2018 to May 2019, 52 patients underwent rhinoplasty with a mushroom-shaped costal cartilage graft in our institution. Rhinoplasty was performed through a bilateral endonasal incision. Postoperatively, all patients were photographed and asked to complete a satisfaction survey online or by telephone. RESULTS: The mean follow-up period was 15.8 months (range 12-21 months). Twenty-four of 52 patients agreed to participate in this study. Postoperatively, the mean nasofrontal angle was 137.7 ± 3.7°, mean nasolabial angle was 94.1 ± 6.2°, mean nasal tip angle was 79.4 ± 5.2°, and mean columellar/lobular angle was 44.7 ± 2.4°. The mean tip projection/nasal length index was 0.53 ± 0.07, and the mean columellar/lobular length index was 1.21 ± 0.22. There were no prolonged functional complications. Most patients (23/24; 95.8%) were satisfied with the aesthetic results. CONCLUSION: The present results suggest that the mushroom-shaped costal cartilage graft in closed rhinoplasty is a good choice for the correction of a bulbous under projected nasal tip. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

miR-203 Acts as an Inhibitor for Epithelial-Mesenchymal Transition Process in Diabetic Foot Ulcers via Targeting Interleukin-8.

OBJECTIVES: As a complication of diabetes mellitus (DM), one of the leading causes for death and disability for DM patients is diabetic foot ulcers (DFUs). Epithelial to mesenchymal transition (EMT) plays a critical role in wound healing of DFUs. miR-203 is specifically enriched in keratinocytes and has been shown to target interleukin 8 (IL-8), which acts as an activator for the EMT process. In this study, we explored the interaction between miR-203 and IL-8 in DFU rat models and human keratinocyte cells, underlying the mechanism of miR-203's function in DFUs progression. METHODS: DFU rat models were used to test gene expression in DFU progression. Diabetic keratinocyte cell lines were used to validate in vitro. Wound healing and Transwell assays were applied to evaluate cell migration and invasion abilities. The EMT process was estimated by testing expression of E-cadherin, Vimentin and Slug. The interaction between miR-203 and IL-8 was determined by Luciferase assay. RESULTS: Our results demonstrated that the wound-healing process had been slowed in DFUs, and the advanced glycation end products (AGEs) and the receptor for advanced glycation end products (RAGEs) in wound tissue were of a higher expression than those in normal rat. miR-203 was increased in skin tissues from DFU rat models, while IL-8 was decreased. Through knock-down of miR-203 in AGE-treated keratinocyte cells, it had been shown that the downregulation of miR-203 could promote cell proliferation and migration, and facilitate the EMT process. Meanwhile, Luciferase assay proved that miR-203 could directly target and inhibit IL-8. The repression of IL-8 could rescue the outcomes brought about by miR-203 inhibition. CONCLUSIONS: The upregulation of miR-203 in DFU tissues impaired wound healing by the repress EMT process. Specific knock-down of miR-203 could promote wound healing through the reactivation of its target gene IL-8 and the downstream IL-8/AKT pathway.

[Research progress in thin flap and flap thinning technique].

OBJECTIVE: To review the historical origin and development of thin flap and flap thinning technique. METHODS: A wide range of domestic and foreign literatures on thin flaps and flap thinning technique were reviewed. The background, definition, methods, problems, challenges, and future development of thin flap and flap thinning technique were summarized and analysed. RESULTS: Thin flap and flap thinning technique play an important role in the development of flap surgery, leading flap surgery towards a more rational and refined direction. CONCLUSION: Thin flap and flap thinning technique are still hot topics in the future. With the development of thin flap and flap thinning technique, clinicians will have more "free" choices.