Pathogenic Genes for Congenital Microtia: A Bioinformatics Analysis.

OBJECTIVE: The purpose of this study is to accurately find the pathogenic genes of congenital microtia, so as to lay a theoretical foundation for genetic screening, diagnosis, and gene therapy of congenital microtia in the further stage. METHODS: In this study, the authors used public data from the Mouse Genome Informatics database. The authors used the String database ( https://string-db.org/ ) to construct the Protein-Protein Interaction network. Then Gene Ontology classification and Kyoto Encyclopedia of Genes and Genomes pathway analysis were performed for the pathogenic genes. RESULTS: The authors searched the Mouse Genome Informatics database and found 84 pathogenic genes of congenital microtia. The Protein-Protein Interaction network for pathogenic genes was constructed, which contained 81 nodes and 148 lines with MCM5, CDT1, POLA1, CDC45, CDC6, EFTUD2, ORC1, ORC4, ORC6, and TCOF1 . The authors conducted a Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis on pathogenic genes, and the results showed that pathogenic genes were involved in O-mannan biosynthesis, cell cycle, RNA polymerase, and other signaling pathways. CONCLUSIONS: The authors' results indicated that the occurrence of congenital microtia is attributed to a variety of genes. Furthermore, the interactions of pathogenic genes were further elucidated by using a bioinformatics approach. This study will help to reveal the pathogenesis of congenital microtia and lay the foundation for accurate diagnosis and treatment of congenital microtia in the future.

An ear-shaped film with a "leg".

Background: The reconstructed auricle projection is an essential element of ear reconstruction. The novel use of an ear-shaped film with one or two "legs" can successfully provide a healthy auricular contour, length, and width, hence improving the three-dimensional (3D) contour of the reconstructed auricle. Methods: Sixty-one patients (31 men and 30 women) with unilateral ear reconstruction (22 on the left and 39 on the right side) who underwent auricular reconstruction using the novel ear-shaped film at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences between February 2021 and June 2022 were enrolled in this retrospective study. Results: Using the Jarque-Bera and paired t-test, we found no statistically significant differences between the reconstructive and healthy ears in terms of length (5.93±0.56 vs. 5.89±0.49 cm, P=0.208), width (3.15±0.31 vs. 3.13±0.30 cm, P=0.224), height (2.48±0.33 vs. 2.51±0.36 cm, P=0.079), and perimeter (10.83±1.06 vs. 10.69±0.95 cm, P=0.164), using the novel ear-shaped film. The reconstructed auricle location was deemed satisfactory for all patients and their families. Conclusions: The novel ear-shaped film may reflect the structure and height of the auricle during ear reconstruction surgery. Implementing this method is easy, and its impact is significant. This technique can be widely used in all types of otoplasties.

Subtractive thinking: A novel combined application of antihelix reconstruction and outer helix reconstruction to treat mild cases of type I to II conchal microtia.

BACKGROUND: The management of mild cases of type Ⅰ to Ⅱ conchal microtia involves grafting cartilage to the affected ear to increase the cartilaginous area and transfer more skin to cover the larger cartilage. Herein, we performed a novel combined surgical procedure based on "subtractive thinking" that included antihelix reconstruction and outer helix reconstruction that was successful in patients with mild type I to II conchal microtia. METHODS: From January 2018 to September 2022, 65 patients with mild, unilateral, type I to II conchal microtia were enrolled in this study. All patients were treated with a novel method at the Plastic Surgery Hospital of Peking Union Medical College. The perimeters, widths, and lengths of the healthy and affected ears were measured both preoperatively and postoperatively. Patients' levels of satisfaction were determined based on postoperative results. RESULTS: The mean postoperative follow-up duration was 14.9 ± 2.65 months. All patients experienced no complications. Analysis revealed that our surgical method could effectively treat mild type I to II concha microtia irrespective of the auricular perimeter, width, and length (p < 0.0001). Furthermore, the patient satisfaction rate was 100%. CONCLUSION: The combined surgical procedure, which includes antihelix and outer helix reconstructions, is a viable method of reconstructing type I to II auricular concha microtia.

Exosomes from adipose-derived stem cells and application to skin wound healing.

Skin wound healing is an intractable problem that represents an urgent clinical need. To solve this problem, a large number of studies have focused on the use of exosomes (EXOs) derived from adipose-derived stem cells (ADSCs). This review describes the mechanisms whereby ADSCs-EXOs regulate wound healing and their clinical application. In the wound, ADSCs-EXOs modulate immune responses and inflammation. They also promote angiogenesis, accelerate proliferation and re-epithelization of skin cells, and regulate collagen remodelling which inhibits scar hyperplasia. Compared with ADSCs therapeutics, ADSCs-EXOs have highly stability and are easily stored. Additionally, they are not rejected by the immune system and have a homing effect and their dosage can be easily controlled. ADSCs-EXOs can improve fat grafting and promote wound healing in patients with diabetes mellitus. They can also act as a carrier and combined scaffold for treatment, leading to scarless cutaneous repair. Overall, ADSCs-EXOs have the potential to be used in the clinic to promote wound healing.

Comparing the Efficacy and Safety of Intralesional Verapamil With Intralesional Triamcinolone Acetonide in Treatment of Hypertrophic Scars and Keloids: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Clinical treatment of hypertrophic scars (HSs) and keloids is often unsatisfactory. Intralesional injections of triamcinolone acetonide (TAC) and verapamil are widely used to treat HSs and keloids, but their efficacy and safety are controversial. OBJECTIVES: The aim of this study was to conduct a meta-analysis of the effectiveness and safety of verapamil and TAC in the treatment of HSs and keloids. METHODS: Embase, Google Scholar, and PubMed were searched for randomized controlled trials (RCTs) from inception to February 2020. RCTs that evaluated treatment effects with the Vancouver Scar Scale or reported adverse effects were included. The continuous data and the dichotomous variables were analyzed as mean difference (MD) and relative risk (RR), respectively. RESULTS: Seven RCTs (461 patients) were included. Compared with verapamil, TAC rapidly changed the ∆height (MD = 0.07; P < 0.05) and ∆pliability (MD = 0.23; P < 0.05) after the first session, but subsequent treatments resulted in no significant differences in the ∆height, ∆pigmentation, ∆vascularity, and ∆pliability. Although total adverse effects (RR = 0.42; P = 0.1) were not significantly different, in the subgroup analysis the incidence of telangiectasia (RR = 0.04; P < 0.05) and skin atrophy (RR = 0.10; P < 0.05), but not pain (RR = 1.27; P = 0.77), was significantly lower with verapamil than with TAC. CONCLUSIONS: Verapamil may be an effective substitute for TAC. Although total adverse effects did not change, the incidence of telangiectasia and skin atrophy was lower with verapamil than with TAC.

Human Adipose Tissue Cryopreservation: Impact of Different Calf Serum Concentrations on Tissue Viability.

Adipose tissue, which is harvested in large quantities during liposuction, has no blood supply and becomes necrotic within a few hours, if not immediately transplanted. Cryopreservation of adipose tissue allows these samples to be stored and used in diverse fundamental experiments, especially in fat-grafting animal tests that could provide a theoretical basis for clinical applications. Traditionally, fetal bovine serum (FBS) has been added as a cryoprotectant (CPA) to maintain the maximum viability of different tissues after freezing and thawing. Calf serum (CS) comes from the same species as FBS but is more economical compared with FBS-containing medium. The optimal concentration of CS in CPA for banking adipose tissue has not been studied. Here, we studied the cell survival rate, cell viability, tissue structural integrity, number of adipose-derived stem cells and blood vessels, and survival after transplantation into nude mice via ultrastructural evaluation of adipose tissue cryopreserved for 6 months in condition A (60% CS, 15% dimethyl sulfoxide [DMSO], 25% Dulbecco's modified Eagle's medium [DMEM]) and condition B (30% CS, 15% DMSO, 55% DMEM). Our results indicate that CS in addition to CPA results in adequate preservation of adipose tissue, especially when a higher concentration of CS (60%) is used in the CPA.

Efficacy and safety of topical nitroglycerin in the prevention of mastectomy flap necrosis: a systematic review and meta-analysis.

Flap necrosis is a common complication after mastectomy, and nitroglycerin (NTG) ointment has been used successfully to treat it. However, it is not clear whether topical NTG can completely prevent the occurrence of flap necrosis after breast cancer surgery, and it is also unclear whether this treatment may cause side effects. Three randomized controlled trials (RCTs) and two retrospective cohort studies (RCSs) were included in our investigation. This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We found that NTG significantly reduced the rates of mastectomy flap necrosis, full-thickness flap necrosis, and debridement as well as the rate of early complications other than flap necrosis. However, there was no significant difference in drug-related adverse reactions, explantation, superficial flap necrosis, infection, hematoma or seroma between the NTG and placebo groups.

Open Reduction and Internal Fixation and Intraoperative Exploration of the Superior Retinacular Arterial System in Young Adults Garden III Femoral Neck Fracture: A 10 Case Report.

At present, there is no uniform standard for the treatment of femoral neck fractures (FNFs) in young adults, and the current strategy is inclined to the native hip joint preservation. Femoral neck fractures in young adult are mostly caused by high-energy violence, and the blood supply of femoral head is severely damaged, which is prone to secondary femoral head avascular necrosis. In this article, we report 10 cases of young adult Garden III FNF treated with open reduction and internal fixation (ORIF) and microsurgical exploration of the superior retinacular vessels from 2015 to 2018, to more intuitively understand the involvement of superior retinacular vessels after displaced FNF in young adults. The results show that the SRA injury of Garden III FNF could be categorized into 3 types (type A-C), type A (6/10): the SRA vessels were kept intact, while they were pulled or compressed by displaced fracture fragment and could be revascularized by reduction; type B (3/10): the SRA vessels were avulsed with the superior retinaculum attachment avulsion fracture and could not be revascularized by reduction; and type C (1/10): the SRA vessels were ruptured, and the remnant of the vessel is present, which can be revascularized by vascular anastomosis. The previously mentioned results showed that the vascular damage of femoral head in Garden III FNF is quite complicated and might have the potential for being further classified into several subtypes.

Clinical characteristics of malignant melanoma in central China and predictors of metastasis.

Cutaneous malignant melanoma (MM) is the most malignant type of all skin neoplasms. There is wide variability in the characteristics of MM between patients of different races. The aim of the present study was to investigate the clinicopathological characteristics of patients with MM in central China and to assess the value of specific hematological and biochemical indices for predicting metastasis. The data of 167 patients with MM from the First Affiliated Hospital of Zhengzhou University (Henan, China) were retrospectively analyzed and compared with the data of patients with MM available from cBioPortal for Cancer Genomics. Following analysis of the clinicopathological characteristics of the 167 patients, the median overall survival time was 50 months, and the median disease-free survival time was 35 months. Albumin/D-dimer prognosis score (ADPS), lactate dehydrogenase, sex, T stage, tumor-node-metastasis stage, Breslow thickness, Clark level, histological type, growth phase, ulceration and metastasis were all significantly associated with prognosis. An ADPS of <341.01 was identified as an independent predictor of metastasis. The trial registration no. is 2018-LW-037 and this clinical trial was registered in the First Affiliated Hospital of Zhengzhou University Clinical Trial Registry in March 1, 2018.