Crack-induced abrupt capacity degradation in commercial LiNi0.8Co0.1Mn0.1O2 (NCM811)/SiO x -graphite pouch batteries.

Reasons for abrupt capacity fading in commercial LiNi0.8Co0.1Mn0.1O2 (NCM811)/SiO x -graphite pouch batteries were evaluated using electrochemical methods. These approaches consist of charge and discharge curves, differential curves and electrochemical impedance spectroscopy (EIS), and some advanced verification techniques constituting scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD). The predominance testament concerning capacity attenuation through experimental verification after the battery is disassembled proves that the silicon-based anode material deteriorates further, bringing about a significant number of cracks with the progression of cycles. In addition, electrolyte enters into the cracks, generating the excessive growth of the solid electrolyte interface (SEI) and the expansion of impedance, which eventually causes the failure of conductive networks, dilemma of ion transmission and increment in polarization, ultimately contributing to lithium dendrites.

Characterization of Canine Gingival-Derived Mesenchymal Stem Cells and Their Exosomes.

Mesenchymal stem cells (MSCs) can be isolated from numerous tissues and have the potential for self-renewal and multidirectional differentiation. Evidence is accumulating which suggests that MSCs are also present in the gingival tissue. This study aimed to evaluate the feasibility of collecting, purifying, and amplifying gingival-derived MSCs (GMSCs) from canine gingiva and to obtain GMSC-derived exosomes (GMSC-exo). GMSCs were isolated and cultured; furthermore, cellular immunofluorescence demonstrated that GMSCs possess characteristic MSC markers, and in vitro differentiation was induced, indicating that GMSCs can differentiate into multiple lineages. GMSC-exo was successfully extracted from GMSCs supernatant and found that they exhibit the typical characteristics of exosomes as analyzed by transmission electron microscopy, nanoflow analysis, and western blotting. GMSC-exo promoted the proliferation and migration of Madin-Darby canine kidney cells. It was concluded that canine gingiva is a good source of MSCs. Additionally, GMSC-exo is a potentially promising cell-free therapeutic tool for the treatment of canine gingival diseases.

The gut-to-brain axis for toxin-induced defensive responses.

After ingestion of toxin-contaminated food, the brain initiates a series of defensive responses (e.g., nausea, retching, and vomiting). How the brain detects ingested toxin and coordinates diverse defensive responses remains poorly understood. Here, we developed a mouse-based paradigm to study defensive responses induced by bacterial toxins. Using this paradigm, we identified a set of molecularly defined gut-to-brain and brain circuits that jointly mediate toxin-induced defensive responses. The gut-to-brain circuit consists of a subset of Htr3a+ vagal sensory neurons that transmit toxin-related signals from intestinal enterochromaffin cells to Tac1+ neurons in the dorsal vagal complex (DVC). Tac1+ DVC neurons drive retching-like behavior and conditioned flavor avoidance via divergent projections to the rostral ventral respiratory group and lateral parabrachial nucleus, respectively. Manipulating these circuits also interferes with defensive responses induced by the chemotherapeutic drug doxorubicin. These results suggest that food poisoning and chemotherapy recruit similar circuit modules to initiate defensive responses.

BSA­seq and genetic mapping identified candidate genes for branching habit in peanut.

KEY MESSAGE: The candidate gene AhLBA1 controlling lateral branch angel of peanut was fine-mapped to a 136.65-kb physical region on chromosome 15 using the BSA-seq and QTL mapping. Lateral branch angel (LBA) is an important plant architecture trait of peanut, which plays key role in lodging, peg soil penetration and pod yield. However, there are few reports of fine mapping and quantitative trait loci (QTLs)/cloned genes for LBA in peanut. In this project, a mapping population was constructed using a spreading variety Tifrunner and the erect variety Fuhuasheng. Through bulked segregant analysis sequencing (BSA-seq), a major gene related to LBA, named as AhLBA1, was preliminarily mapped at the region of Chr.15: 150-160 Mb. Then, using traditional QTL approach, AhLBA1 was narrowed to a 1.12 cM region, corresponding to a 136.65-kb physical interval of the reference genome. Of the nine genes housed in this region, three of them were involved in hormone metabolism and regulation, including one "F-box protein" and two "2-oxoglutarate (2OG) and Fe(II)-dependent oxygenase (2OG oxygenase)" encoding genes. In addition, we found that the level of some classes of cytokinin (CK), auxin and ethylene showed significant differences between spreading and erect peanuts at the junction of main stem and lateral branch. These findings will aid further elucidation of the genetic mechanism of LBA in peanut and facilitating marker-assisted selection (MAS) in the future breeding program.

Ca2+ -independent transmission at the central synapse formed between dorsal root ganglion and dorsal horn neurons.

A central principle of synaptic transmission is that action potential-induced presynaptic neurotransmitter release occurs exclusively via Ca2+ -dependent secretion (CDS). The discovery and mechanistic investigations of Ca2+ -independent but voltage-dependent secretion (CiVDS) have demonstrated that the action potential per se is sufficient to trigger neurotransmission in the somata of primary sensory and sympathetic neurons in mammals. One key question remains, however, whether CiVDS contributes to central synaptic transmission. Here, we report, in the central transmission from presynaptic (dorsal root ganglion) to postsynaptic (spinal dorsal horn) neurons in vitro, (i) excitatory postsynaptic currents (EPSCs) are mediated by glutamate transmission through both CiVDS (up to 87%) and CDS; (ii) CiVDS-mediated EPSCs are independent of extracellular and intracellular Ca2+ ; (iii) CiVDS is faster than CDS in vesicle recycling with much less short-term depression; (iv) the fusion machinery of CiVDS includes Cav2.2 (voltage sensor) and SNARE (fusion pore). Together, an essential component of activity-induced EPSCs is mediated by CiVDS in a central synapse.

High-Density Genetic Variation Map Reveals Key Candidate Loci and Genes Associated With Important Agronomic Traits in Peanut.

Peanut is one of the most important cash crops with high quality oil, high protein content, and many other nutritional elements, and grown globally. Cultivated peanut (Arachis hypogaea L.) is allotetraploid with a narrow genetic base, and its genetics and molecular mechanisms controlling the agronomic traits are poorly understood. Here, we report a comprehensive genome variation map based on the genotyping of a panel of 178 peanut cultivars using Axiom_Arachis2 SNP array, including 163 representative varieties of different provinces in China, and 15 cultivars from 9 other countries. According to principal component analysis (PCA) and phylogenetic analysis, the peanut varieties were divided into 7 groups, notable genetic divergences between the different areas were shaped by environment and domestication. Using genome-wide association study (GWAS) analysis, we identified several marker-trait associations (MTAs) and candidate genes potentially involved in regulating several agronomic traits of peanut, including one MTA related with hundred seed weight, one MTA related with total number of branches, and 14 MTAs related with pod shape. This study outlines the genetic basis of these peanut cultivars and provides 13,125 polymorphic SNP markers for further distinguishing and utility of these elite cultivars. In addition, the candidate loci and genes provide valuable information for further fine mapping of QTLs and improving the quality and yield of peanut using a genomic-assisted breeding method.

Divided Eyelid Nevus: Surgical Repair Discussion and Case Reports From Northwestern China.

Currently, due to the lack of long-term postoperative follow-up outcomes of the congenital divided eyelid nevus, we described our surgical approaches and presented the functional and cosmetic results of 13 patients with an average of 5-year follow-up. Based on the surgical treatments and the follow-ups, the selection of total or subtotal excision depends on the lesion location and the use of blepharoplasty approaches is determined by defect size. The CO2 laser may be a useful second-stage procedure to ablate remnant lesions, but long-term monitoring is required.

Étant donné le peu de suivi postopératoire à long terme sur les résultats cliniques de la réparation du nævus palpébral congénital en miroir, les chercheurs décrivent les méthodes chirurgicales utilisées et présentent les résultats fonctionnels et esthétiques chez 13 patients, suivis sur une période moyenne de cinq ans. D'après les traitements chirurgicaux et les suivis, le choix d'une excision totale ou partielle dépend du foyer de la lésion, et le mode de blépharoplastie repose sur la dimension de l'anomalie. Le laser CO2 peut être utilisé en deuxième phase pour faire disparaître les vestiges des lésions, mais une surveillance à long terme s'impose.

Exploration of Factors Influencing Nurse Competence Through Nursing Profile Analysis.

BACKGROUND: Nurse competence is a combination of knowledge, performance, skills, and attitudes that are required in fulfilling one's role as a nurse. So far, few comprehensive studies have explored the influencing factors of nurse competence. METHOD: The competence levels of 160 RNs in a Chinese hospital were evaluated using a questionnaire method, and the relationship between competence results and nursing characteristics was analyzed. RESULTS: The competence of participating nurses was at a medium level. Among all the characteristics, education and staffing levels were two main factors influencing nurse competence. CONCLUSION: Quantity of nurses and quality of nursing service are two main issues facing the modern nursing system. The findings from this study provide useful information and suggestions on how to improve nurse competence to nurse industry personnel, including nurses, nursing employers, educators, and students. [J Contin Educ Nurs. 2019;50(12):572-580.].

Reinstatement of the corticioid genus Leifia (Hymenochaetales, Basidiomycota) with a new species L.brevispora from Hubei, Central China.

The monotypic genus Leifia was previously considered to be a later synonym of Odonticium. With the morphological and phylogenetic evidence provided by an additional four East Asian specimens, we propose to reinstate Leifia as an independent genus in Hymenochaetales. Leifia morphologically differs from Odonticium by its grandinioid hymenophore with hyphal strands, numerous thick-walled cystidia with an invaginated apical end and narrowly and thick-walled basidia. The phylogeny generated from the current data set of ITS and 28S regions indicates that Leifia forms a sister clade to Odonticium. Besides the generic type Leifiaflabelliradiata in the Leifia clade, two specimens, collected from Hubei, Central China, are newly introduced as Leifiabrevispora. This new species is the second species of Leifia and differs from the generic type by its shorter basidiospores and distribution in warm-temperate to subtropical areas in East Asia. The additional two specimens, collected from Da Lat, Viet Nam, differ morphologically, both from each other and from known species of Leifia, but more samples need to be examined before further taxonomic decisions can be made.

The Endotoxin Delivery Protein HMGB1 Mediates Caspase-11-Dependent Lethality in Sepsis.

Caspase-11, a cytosolic endotoxin (lipopolysaccharide: LPS) receptor, mediates pyroptosis, a lytic form of cell death. Caspase-11-dependent pyroptosis mediates lethality in endotoxemia, but it is unclear how LPS is delivered into the cytosol for the activation of caspase-11. Here we discovered that hepatocyte-released high mobility group box 1 (HMGB1) was required for caspase-11-dependent pyroptosis and lethality in endotoxemia and bacterial sepsis. Mechanistically, hepatocyte-released HMGB1 bound LPS and targeted its internalization into the lysosomes of macrophages and endothelial cells via the receptor for advanced glycation end-products (RAGE). Subsequently, HMGB1 permeabilized the phospholipid bilayer in the acidic environment of lysosomes. This resulted in LPS leakage into the cytosol and caspase-11 activation. Depletion of hepatocyte HMGB1, inhibition of hepatocyte HMGB1 release, neutralizing extracellular HMGB1, or RAGE deficiency prevented caspase-11-dependent pyroptosis and death in endotoxemia and bacterial sepsis. These findings indicate that HMGB1 interacts with LPS to mediate caspase-11-dependent pyroptosis in lethal sepsis.

Stearoyl Lysophosphatidylcholine Inhibits Endotoxin-Induced Caspase-11 Activation.

Stearoyl lysophosphatidylcholine (LPC) exerts protective effect during endotoxemia and in experimental sepsis, but the underlying mechanism is unclear. Here, we demonstrated that stearoyl LPC could block caspase-11-mediated macrophage pyroptosis. In vitro, stearoyl LPC significantly decreased caspase-11 activation and pyroptosis induced by lipopolysaccharide (LPS) plus cholera toxin subunit B independent of the receptor G2A. Stearoyl LPC did not affect LPS uptake by mouse peritoneal macrophages but did significantly inhibit the interaction between LPS and caspase-11. Moreover, stearoyl LPC treatment conferred significant protection against lethal endotoxemia and significantly reduced the release of IL-1α and IL-1ß. These findings identify stearoyl LPC as an inhibitor of LPS-mediated caspase-11 activation. This mechanism could explain the protective action of stearoyl LPC in experimental sepsis and endotoxemia.

A promising tool for surgical lipotransfer: a constant pressure and quantity injection device in facial fat grafting.

BACKGROUND: The purpose of this study was to preliminarily assess a constant pressure and quantity fat granule injection device for minimal invasive properties in clinic. METHODS: A retrospective controlled study was carried out, from October 2013 to January 2015, on 76 female healthy patients aged between 26 and 53 years at the General Hospital of Lanzhou Military Command, China. To achieve small volume, high thrust, and precision requirements of facial fat grafting, an integrated handheld controller and motor design was adopted, reducing the volume and weight of the fat transplantation injection device. The 76 patients underwent 90 procedures each side of the face; each patient was treated with the aforementioned device on the face's left side, while a conventional hand-push injection device was used on the right side as control. The outcome was assessed on pre- and postoperative images, with 6-24 months follow-up. RESULTS: The current device consistently allowed deposition of fat threads at about 55 µL/cm after cannula withdrawal; the volume of fat injected could be precisely adjusted to 0.04 mL/s. This device had the advantages of small-volume injection and convenient operation. The patients exhibited a good, stable shape and a smooth contour line in both sides. The long term satisfaction was higher for the left side than for the right one. Nodules and unevenness occurred only on the right side. Ecchymosis occurred significantly less frequent on the left side than the right one. Intraoperative pain was significantly lower for the left side than the right one. CONCLUSIONS: This device offered superior control compared with the conventional one and constitutes a promising tool for surgeons practicing lipotransfer.

Human Basic Fibroblast Growth Factor Inhibits Tau Phosphorylation via the PI3K/Akt-GSK3ß Signaling Pathway in a 6-Hydroxydopamine-Induced Model of Parkinson's Disease.

BACKGROUND: Basic fibroblast growth factor (bFGF) has been increasingly investigated due to its neuroprotection in neurodegenerative disorders. Because there are still no cures for any of these disorders, it is crucial to identify new therapeutic targets and screen potential drugs. The increased phosphorylation of tau at Ser396 leads to intracellular tau accumulation, which forms neurofibrillary tangles in Parkinson's disease (PD). In this study, neuroprotection by bFGF was observed, and the mechanisms related to its regulation of phosphorylated tau were investigated. METHODS: bFGF-loaded liposome carriers were intranasally administered to rats. The neuroprotective effects of bFGF were assessed in a PD model induced by 6-hydroxydopamine (6-OHDA) in vivo and in vitro. The phosphorylation of tau was measured, and the PI3K/Akt-GSK3ß signaling pathway was investigated. RESULTS: Our study demonstrated that liposomes markedly assisted in the delivery of bFGF to the striatum and substantia nigra of rats and enhanced the neuroprotective effects of bFGF on dopaminergic neurons. bFGF treatment significantly ameliorated the behavioral deficits induced by 6-OHDA, rescued the loss of tyrosine hydroxylase-positive neurons and increased the number of Nissl bodies. bFGF reduced the phosphorylation of tau and GSK3ß and increased the phosphorylation of PI3K/Akt. CONCLUSION: Liposomes markedly assisted in the delivery of bFGF to the brain and enhanced the neuroprotective effects of bFGF by inhibiting the phosphorylation of tau. bFGF down-regulated the phosphorylation of tau by increasing the phosphorylation of GSK3ß via the PI3K/Akt signaling pathway. These findings provide a new vision of bFGF as a potential therapy for PD.

Two cases of macrodactyly of the foot: relevance in pediatric orthopedics.

Congenital enlargement of one or several digits of the foot, known as macrodactyly, is a rare malformation. Macrodactyly impedes foot development and affects function and gait. Here, we describe a surgical technique used to correct macrodactyly in two pediatric patients. We performed amputation of the enlarged phalanx and debulking of the soft tissues to construct a normal-sized digit. This precise technique involves a simple surgical plan that preserves the metatarsus and cuneiform and does not result in a wide plantapedis. Both patients subsequently showed improved gait and were able to wear normal shoes.

[EFFECTIVENESS EVALUATION OF FACIAL METICULOUS FAT GRAFTING BY FAT GRANULES INJECTION ASISTOR].

OBJECTIVE: To study the effectiveness of facial meticulous fat grafting by fat granules injection asistor. METHODS: Between January and August 2015, 46 patients received facial autologous fat grafting for rejuvenation. There were 7 males and 39 females, aged 21-65 years (mean, 34 years). Firstly, the faces were divided into 10 cosmetic zonations according to facial aesthetic criteria, then autologous fat grafting was carried out by fat granules injection asistor. The autologous fat was filled into 1, 2, 3, 4, 5, 6, 7, 8, and 9 cosmetic zonations in 3, 7, 5, 3, 8, 4, 2, 10, and 4 cases respectively; the injected fat amount was 2-110 mL (mean, 47 mL). RESULTS: The swelling period was from 5 to 15 days after operation (mean, 7 days), and there were no complications of infection, cyst, introvascular thrombogenesis, and so on. They were followed up 1-7 months (mean, 3 months). The effect of face rejuvenation was satisfactory. CONCLUSIONS: Cosmetic zonation of face is helpful for preoperative evaluation of autologous fat grafting, and the fat granules injection asistor is beneficial to reach better effect of face rejuvenation.

Loss of KLF14 triggers centrosome amplification and tumorigenesis.

Centrosome amplification is frequent in cancer, but the underlying mechanisms remain unclear. Here we report that disruption of the Kruppel-like factor 14 (KLF14) gene in mice causes centrosome amplification, aneuploidy and spontaneous tumorigenesis. Molecularly, KLF14 functions as a transcriptional repressor of Plk4, a polo-like kinase whose overexpression induces centrosome overduplication. Transient knockdown of KLF14 is sufficient to induce Plk4-directed centrosome amplification. Clinically, KLF14 transcription is significantly downregulated, whereas Plk4 transcription is upregulated in multiple types of cancers, and there exists an inverse correlation between KLF14 and Plk4 protein expression in human breast and colon cancers. Moreover, KLF14 depletion promotes AOM/DSS-induced colon tumorigenesis. Our findings reveal that KLF14 reduction serves as a mechanism leading to centrosome amplification and tumorigenesis. On the other hand, forced expression of KLF14 leads to mitotic catastrophe. Collectively, our findings identify KLF14 as a tumour suppressor and highlight its potential as biomarker and therapeutic target for cancer.

The development and clinical application of facial minimally invasive fat granules injection device with controlled pressure and quantity / 中华整形外科杂志

<p><b>OBJECTIVE</b>To develop and evaluate the application of the facial minimally invasive fat granules injection device with controlled pressure and quantity.</p><p><b>METHODS</b>Due to the requirement of facial fat grafting (small volume, precision, high pressure), we developed the integrated device with handheld controller and motor. From Nov. 2013 to Mar. 2015, 50 cases who underwent facial fat transplantation were selected to receive facial fat grafting with the device on the right side and with conventional syringe on the left side as control. The clinical effect was assessed by patients, surgeon and one from the third party. The intraoperative pain, injection difficulty, postoperative swelling and hruising, complications and overall satisfactory were recorded. Pain intensity was assessed using digital classification method ( NRS). Therapeutic effect was evaluated using Likert 5 points scoring method. Chi-square test, Wilcoxon test and one-way ANOVA were used for statistical analysis.</p><p><b>RESULTS</b>The device has the advantages of minimal designed and easily handling. The injection speed is 7.2 mm/s with the fat injection volume as precise as 0.04 ml/s (0.0056 m/mm). Among the 50 cases, the excellent and good effect were achieved in 90% (45/50) on the right face, and 78% (39/50) on the left face (Z = -4.285, P < 0.01). Local nodes happened in 7 cases on left face, while none on the right face (χ² = 6.57, P < 0.05). Petechiae occurred in 21 cases on right face and 45 cases on left face (χ² = 5.37, P < 0.05). Pain was assessed as 3.7 ± 1.1 points on the right sides, and 5.2 ± 0.7 points on the left sides (F = 17.405, P < 0.01).</p><p><b>CONCLUSIONS</b>The facial minimally invasive fat granules injection device with controlled pressure and quantity has the advantages of easily handling, precisely controlled quantity with hotter effect, less pain and complication.</p>

[Clinical characteristics and surgical management of 17 patients with pressure sore of sinus type].

OBJECTIVE: To sum up the clinical characteristics, surgical management, and effectiveness of pressure sore of sinus type. METHODS: Between January 2009 and April 2013, 17 patients with 19 pressure sores of sinus type after traumatic paraplegia were treated, and the clinical data were analyzed retrospectively. There were 11 males and 6 females with an average age of 27.4 years (range, 17-49 years). The median disease duration was 1.5 years (range, 6 months to 7 years). Of 17 cases, there were 14 primary cases and 3 recurrent cases; 10 focuses of 8 cases were classified as simple sinus type, and 9 focuses of 9 cases as complex sinus type, which had a false synovial sheath complicated with one to four "second sinus". The pressure sore of sinus type majorly located at the ischial tuberosity. The size of pressure sore ranged from 1.5 cm x 1.0 cm to 3.0 cm X 2.0 cm, and the length of "second sinus" ranged from 8 to 32 cm with an average of 17 cm. After the false synovial sheath was totally excised, the wound was repaired by local sliding or rhombus flaps at the first or second stage in patients with simple sinus type pressure sore. On the basis of excising the false synovial sheath, the "second sinus" was totally removed in the patients with complex sinus type pressure sore. RESULTS: Wound dehiscence occurred in 1 case of simple sinus type pressure sore at 4 days, which was cured after it was sutured again. Wound infection occurred at 9, 17, and 23 days respectively in 3 cases of complex sinus type pressure sore, which was cured after second debridement and necrosis tissues removal. The other wounds healed by first intention, and the flaps totally survived. All patients were followed up 6-12 months (mean, 9.3 months). No recurrence was observed. CONCLUSION: According to the clinical characteristics, pressure sore of sinus type could be divided into simple sinus type and complex sinus type. The key of successful treatment is to thoroughly excise false synovial sheath and "second sinus".

[Opportune time and method of reconstruction of penile defects caused by devastating electrical burn].

OBJECTIVE: To explore the timing and suitable method of reconstructing penile defects caused by devastating electrical burn. METHODS: Thirteen patients with penile defects after devastating electrical burn, hospitalized from September 1998 to August 2013, were included in this study. After the necrotic tissues in the wounds were removed by dressing changes, a local or a hinge-like flap constructed from scrotum or abdominal wall, a prelaminated hinge-like flap from forearm, or a free forearm flap was selected, according to the injury degree of the penis, for the repair of the defect or reconstruction of penis respectively. RESULTS: The flaps survived and the wounds healed well in 2 patients repaired with local flaps from scrotum or abdominal wall. Urethritis occurred in 2 patients 6 to 9 months after the transplantation of hinge-like flaps from scrotum, and they were cured by appropriate drugs. Functions of urination and erection of penis were recovered in these 4 patients. All flaps survived in the 5 patients repaired with hinge-like flaps from abdominal wall or prelaminated flaps from forearm. The wounds in 2 patients healed; wound dehiscence occurred in the other 3 patients in different degrees, and they healed after suturing for 2 or 3 times. The function of erection of penis recovered in these 5 patients, but with discontinuity of urinary stream during urination. Among them, 3 married patients enjoyed satisfactory sexual life. All free forearm flaps survived and the wounds healed well in 4 patients. Urinary fistula occurred in 1 patient, and it was repaired by a secondary operation. These 4 patients experienced normal urination function, but only 2 patients in whom corpus spongiosum partially remained retained the function of erection of penis to certain degree. All these 4 patients could not perform normal sexual intercourse. All patients were followed up for 6 to 13 months after surgery. Under ordinary state, the length of penis was 5.9-9.3 cm, and the circumference of penis was 8.4-10.0 cm. Wound scar was not obvious in all cases. Nine patients reported a restricted erection. CONCLUSIONS: Penile defect caused by devastating electrical burn should be repaired with a suitable flap after necrotic tissues are removed with dressing change. To repair affected penis with necrosis of a small part of cavernous body and/or corpus spongiosum, or combined with urethra defects, local flaps from scrotum or abdominal wall or hinge-like flap from scrotum should be employed. To repair those with necrosis of a large part or the whole of corpus spongiosum combined with urethra defects, hinge-like skin flaps from abdominal wall or prelaminated flaps from forearm should be employed. In patients with necrosis of a large part of cavernous body and corpus spongiosum combined with urethra defect, or total loss of penis, free forearm flaps should be employed to reconstruct penis.

Our preferred surgical approach to cicatricial cryptotia.

BACKGROUND: Adhesions between the auricle and retroauricular cranial wall and mastoid occur after burns to this area due to cicatricial contracture, leading to the distortion of the otocranial angle and obscuring the remnant auricle in the scar. A definition of cicatricial cryptotia was devised to describe the ear deformity after burn by the authors, and a novel surgical approach to cicatricial cryptotia was employed to reconstruct the auricle. PATIENTS AND METHODS: A total of 33 ears in 26 adult patients were operated upon. As many as 19 cases of cicatricial cryptotia were unilateral, seven cases bilateral. The patients' age ranged from 19 to 31 years. Because of a lack of normal tissues surrounding the remnant ear, a periauricular cicatricial flap was designed to repair the helix and antihelix defect and a horizontal bifoliate skin flap for earlobe reconstruction. Two triangular cicatricial flaps located at the cephalic or caudal direction of the survival ear were used for shaping the otocranial angle and auriculotemporal sulci, combined with zoned transplantation of a full-thickness skin graft. RESULTS: All cicatricial flaps demonstrated nearly 100% survival and the take rate of transplanted skin grafts was approximately 95%. The main structures were visible and cosmetically acceptable; the otocranial angle and auriculotemporal sulci were acceptably restored. The function of wearing eye glasses or a mask was regained. The patients were followed up from 3 months to 6 years after surgery; the mean follow-up period was 3.2 years. The contour of the reconstructed auricle was maintained well, and the scar contracture was acceptable. CONCLUSION: Periauricular cicatricial flaps combined with skin grafting is a new approach to cicatricial cryptotia when auricle reconstruction after burn is limited by a scarcity of supple, elastic local skin and fascia.