Chinese Journal of Plastic and Reconstructive Surgery最新文献

Background

Ears play an important role in facial profiles. Lying ears are not perceived favorably in Asian cultures; therefore, surgical procedures are implemented to adjust this defect. However, surgery has complications and requires recovery time. We introduced a hyaluronic acid (HA) injection technique to aesthetically improve ear prominence.

Methods

This retrospective study examined 25 Chinese patients aged 20–47 years with congenital lying ears who received HA injections in the auricular base at Shanghai Ninth People’s Hospital and Hangzhou Yijie Medical Cosmetology Clinic between November 2019 and December 2022. The average injection volume was 6.32 ​± ​1.22 mL in the auricular base unilaterally, and the follow-up time ranged from 6 to 24 months. Morphological measurement data were recorded. Two-dimensional (2D) and three-dimensional (3D) images were obtained to evaluate the effects.

Results

All patients showed improvements in ear prominence. The cranioauricular angle (CAA) increased from 22.24° ​± ​4.53° to 65.90° ​± ​5.38° immediately post-injection and was maintained at 49.18° ​± ​4.74° 6 months later. The ear projection (EP) increased from 14.75 ​± ​2.72 mm to 26.26 ​± ​2.94 mm immediately post-injection and was 22.51 ​± ​2.68 mm after 6 months. No serious complications were noted.

Conclusion

HA injection in the auricular base effectively corrected the lying ears and aesthetically optimized the facial profile. It also had a face-lift effect that made the face look younger and more compact. The injection procedure was minimally invasive and required no recovery period. The effect was maintained for a long time and was satisfactory.

Background

Skin lesions on the nose are common. Multiple surgical techniques have been used for nasal reconstruction. These options may be autogenous or alloplastic and can be performed in single or multiple stages. The choice of coverage depends on the nature of the lesion, location on the nose, and available donor sites. This study aimed to evaluate the surgical outcomes of using locoregional flaps for nasal reconstruction.

Methods

A total of 27 patients underwent surgery. There were 9 men and 18 women, aged 7 months to 93 years. Four patients presented with involuting hemangioma, five patients with ischemic necrosis of the columella, and five patients with congenital nevus; the remaining 13 patients were previously diagnosed with basal cell carcinoma. Six techniques have been described for nasal reconstruction at our institution from 2016 to 2020. Most patients had basal cell carcinoma (n=13). Locoregional flaps and primary sutures were used for nasal reconstruction.

Results

The complications were minimal. One patient had a superficial infection and one experienced postoperative bleeding. No recurrence was observed, and none of the patients asked for a second opinion.

Conclusion

Radical excision of tumors combined with analysis of nasal defects and nearby donor sites is essential for nasal reconstruction. The use of locoregional flaps leads to consistent and good aesthetic outcomes.

Background

Chondrosarcoma (CS) is the second most common primary bone tumor, accounting for approximately 30% of all malignant bone tumors. Unfortunately, the efficacy of currently available drug therapies is limited. Therefore, this study aimed to explore drug therapies for CS using novel computational methods.

Methods

In this study, text mining, GeneCodis STRING, and Cytoscape were used to identify genes closely related to CS, and the Drug Gene Interaction Database (DGIdb) was used to select drugs targeting the genes. Drug-target interaction prediction was performed using DeepPurpose, to finally obtain candidate drugs with the highest predicted binding affinities.

Results

Text-mining searches identified 168 genes related to CS. Gene enrichment and protein-protein interaction analysis generated 14 genes representing 10 pathways using GeneCodis, STRING, and Cytoscape. Seventy drugs targeting genes closely related to CS were analyzed using DGIdb. DeepPurpose recommended 25 drugs, including integrin beta 3 inhibitors, hypoxia-inducible factor 1 alpha inhibitors, E1A binding protein P300 inhibitors, vascular endothelial growth factor A inhibitors, AKT1 inhibitors, tumor necrosis factor inhibitors, transforming growth factor beta 1 inhibitors, interleukin 6 inhibitors, mitogen-activated protein kinase 1 inhibitors, and protein tyrosine kinase inhibitors.

Conclusion

Drug discovery using in silico text mining and DeepPurpose may be an effective method to explore drugs targeting genes related to CS.

A review of the literature in commonly used retrieval systems generally yields minimal or no pertinent information on the early works of Chinese doctors. Herein, the early works in rhinoplasty by pioneers Dr. Maolian Hu (胡懋廉) and Dr. PC Nyi (倪葆春) were retrieved from the database of Chinese Medical Journal published before 1949 that overseas doctors could not gain access to online possibly due to the language barrier in collecting and processing those old professional data by main retrieval systyems. They published original articles on costal cartilage applications for correction of saddle noses in as early as 1939 and 1949, respectively, which represent the earliest attempts of treating nasal deformities with costal cartilages in China as well as in Asia. The private cosmetic surgical practices in rhinoplasty from the 1930s to the 1940s were recovered and briefly reviewed, and some of the most important clinical cases were presented. Other important events related to rhinoplasty, such as the establishment of the first national society of rhinoplasty in Chengdu, China in 2011 and the successful performance of the first national congress on rhinoplasty in Shanghai, China in 2012, were included.

Background

Although oral health-related quality of life (OHRQoL) in orthodontic patients has been assessed in the past, to date, no study has compared the OHRQoL between two nations. We aimed to compare the OHRQoL between Chinese and American orthodontic patients.

Methods

We conducted a two-center questionnaire-based cross-sectional study among patients who underwent orthodontic treatments at the Chinese PLA General Hospital (PLAGH) in Beijing, China and Massachusetts General Hospital (MGH) in Boston, Massachusetts, United States. Candidate variables included the participating center, patients’' age, sex, Angle’s classification of malocclusion, evaluation stage, and appliances used. The primary outcome was patients’ OHRQoL assessed with the Oral Health Impact Profile-14 (OHIP-14). Descriptive statistics, stratification, and univariate and multivariate analyses were performed.

Results

The average age was lower for PLAGH patients than for MGH patients (21.1 ​± ​7.9 vs. 33.1 ​± ​14.6 years, P<0.001). The most common type of malocclusion was Angle’s Class III malocclusion at PLAGH (39%) and Class I malocclusion at MGH (59.5%). Clear aligners were used in 34.1% and 2.7% of the patients at MGH and PLAGH, respectively. OHIP-14 scores were lower for PLAGH patients than for MGH patients (18.4 ​± ​4.7 vs. 22.3 ​± ​7.4, P<0.001), particularly in functional limitation, psychological discomfort/disability, and handicap. Univariate regression analysis demonstrated that participating center, age, Class I malocclusion, and the use of clear aligners were significantly associated with overall OHIP-14 scores. Multivariate regression analysis demonstrated that patients at PLAGH were associated with lower OHIP-14 scores (coefficient: −3; 95% CI: −5, −1.3; P=0.001), and age was positively associated with OHIP-14 scores (coefficient: 0.1; 95% CI: 0.004, 0.13; P=0.038).

Conclusion

Chinese orthodontic patients had lower OHIP-14 scores, indicating a higher OHRQoL than American patients. In addition to the younger age, this difference may be attributed to the different ethical, cultural, educational, and socioeconomic background of Chinese and American orthodontic patients.

Background

The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.

Methods

In this report, we describe an alar spiral advancement flap with a subcutaneous pedicle combined with postoperative nasal stent therapy for the repair of alar defects.

Results

All cases showed slight asymmetry immediately after surgery, but at a median follow-up of 24 months, no cases of dissatisfaction with the nose shape or abnormal respiratory function were found. Almost all incision scars subsided within 12 months. In addition, all flaps that were dissected and rotated during the surgeries healed, and no signs of necrosis or development of vascular compromise were observed.

Conclusion

Our preliminary experience suggests that the alar spiral flap followed by nasal stent therapy provides stable recovery of appearance and function for alar defects during follow-ups and shows promise for future therapies.

Background

Chronic venous ulcers are a serious problem for both patients and physicians. The CEAP classification (clinical manifestations (C), etiologic factors (E), anatomic distribution of disease (A), and underlying pathophysiologic findings (P)) for chronic venous disorders (CVD) was developed in 1994. Published papers on CVD use all or part of the CEAP. Micropunch grafts, which are a variation of skin grafts, have been used with great success in plastic surgery for both esthetic and reconstructive purposes. This study aimed to assess the outcomes of micropunch grafting in the treatment of chronic refractory venous ulcers.

Methods

Patients with chronic venous ulcers who did not respond to conservative treatment for more than 6 months were included in the study. All patients underwent ulcer coverage by micropunch skin grafts using a micrometer. The patients were discharged on the same day as the surgery. Micropunch skin grafts were manually counted per square centimeter intraoperatively and during follow-up using Dermlite Dermatoschope™ II Pro HR. Patient satisfaction was assessed by using a questionnaire.

Results

Twenty patients underwent the surgery. Most of the patients were middle-aged males. The ulcers were predominantly small- and medium-sized. The mean operation time was 167.00 ​± ​86.01 ​min. After 6 months, the survival rate of the planted micrografts was 84%. Three ulcers had graft loss and two patients had an infection at the ulcer site, which was managed conservatively. The patients were followed-up for 14 months.

Conclusion

Micropunch grafting is a useful and convenient method for the treatment of difficult venous ulcers and can be performed on an outpatient basis.

The pathogenesis of striae distensae (SD) is complicated and has not yet been fully elucidated. Hormonal changes, overstretched skin, and structural and functional changes in the skin may be crucial factors in the development of SD. Therapy aims to stimulate dermal collagen synthesis and improve skin texture. Mainstream treatments include topical medications, chemical peeling, laser and radiofrequency therapy, microdermabrasion, microneedle therapy, and filler injection therapy. In the present review, we summarize current perspectives on the pathogenesis and clinical therapy of SD.

Polydeoxyribonucleotide (PDRN) consists of DNA fragments with molecular weights ranging from 50 to 1 500 ​kDa, which are mainly extracted from the sperm cells of salmon trout or chum salmon. Many preclinical and clinical studies have demonstrated the properties of PDRN. These include anti-inflammatory, anti-apoptotic, anti-osteoporotic, anti-melanogenetic, anti-allodynic, anti-osteonecrotic, bone regenerative, tissue damage preventive, anti-ulcerative, and wound healing properties, which are mediated by the activation of the adenosine A_2A receptor and salvage pathways. Moreover, PDRN promotes angiogenesis, cellular activity, collagen synthesis, soft tissue regeneration, and skin priming and revitalization and can be used to treat hyperpigmentation. Therefore, this review assessed the potential use of PDRN as an anti-aging agent for the skin.