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    The effect of extracellular vesicles secreted by adipose-derived mesenchymal stem cells after being stimulated by ultrasound on the biological properties of adipose-derived mesenchymal stem cells

    LIU Zibo, WANG Yikai, ZHENG Yi, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 403-.  
    Abstract740)      PDF(pc) (5906KB)(26)       Save
    Objective To collect extracellular vesicles( EVs) secreted by adipose mesenchymal stem cells( ADSCs) after ultrasound stimulation, compare with EVs secreted by normal ADSCs, and to explore the effects of EVs secreted after ultrasound stimulation on the biological characteristics of ADSCs, including cell proliferation, migration, and adipogenic differentiation abilities. Methods Firstly, some ADSCs were treated with low-intensity ultrasound, cell culture supernatant was collected and extracellular vesicles (U-EVs) were extracted by ultrafiltration method. Some ADSCs were cultured normally and their extracellular vesicles( N-EVs) were also collected. The experiments were performed in the following three groups: PBS (blank control group), EVs secreted by untreated cells (N-EVs group), and EVs secreted by ultrasoundtreated cells (U-EVs group). The CCK-8 assay was used to assess the viability of ADSCs under treatment with EVs at different concentrations. The concentration that most strongly enhanced cell viability was selected. At this concentration, cell migration was detected by scratch test, cell proliferation was detected by EdU method, and adipogenic induction medium was used to induce and compare adipogenic differentiation ability of ADSCs. Results EVs secreted after ultrasound stimulation met the identification standards, and the optimal concentration for affecting ADSCs was about 150 µg/mL. At this concentration, the cell proliferation rate of the U-EVs group( 19.2%±1.8%) was significantly higher than that of the N-EVs group( 11.9%±3.4%), and the Oil Red O staining area of the U-EVs group was( 2.78±0.23) times that of the control group, significantly higher than (2.11±0.18) times of the N-EVs group. However, there was no significant difference in cell migration rates between the N-EVs (16.3%±2.0%) and U-EVs (21.5%±2.3%) groups. Conclusion  EVs secreted by ultrasound-stimulated ADSCs significantly enhance the vitality of ADSCs and improve their abilities in cell proliferation, migration, and adipogenic differentiation.
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    Application of head-mounted video system in the teaching of free flap reconstructive surgery
    ·CHENG Chen, CHENG Kaixiang, SHAO Jing, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 500-.  
    Abstract572)      PDF(pc) (941KB)(12)       Save
    Objective To evaluate the effect of head-mounted video system in the teaching of free flap reconstructive surgery. Methods A total of 45 surgeons with further study program in the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital from June 2022 to December 2023 were included and randomly divided into experimental group (n=23) and control group (n=22). Both groups were given lectures about basic theoretical knowledge and surgical procedure before operation. The experimental group observed the surgery by video system, and the video data was directly taken from the head-mounted video device of the operator and accompanied by explanation, while the control group was observed in the operation room. The basic theoretical assessment, surgical procedure assessment and teaching satisfaction rate were compared between the two groups. Results The scores of surgical procedure assessment and teaching satisfaction rate of experimental group were higher than those of control group, the difference was statistically significant( P<0.05), but there were no statistically significant difference in the basic theoretical assessment scores between the two groups (P>0.05).
    Conclusion The head-mounted video system can improve the teaching effect and teaching satisfaction of flap reconstructive surgery, which has certain promotion significance.
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    Hypodermic needle guided suturing for distant tension-offloading suture
    PAN Sida, WU Qinghua, PENG Qian, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 456-.  
    Abstract526)      PDF(pc) (1487KB)(16)       Save
    Distant tension-offloading suture is one of the solutions for tension impeded wound healing and scarring after surgery. In this paper, an innovated technique of achieving tension-offloading suturing using hypodermic needle guidance was introduced. Hypodermic needle guided suturing( HGS) technique makes high quality wound closure simple, with cheap and accessible equipment.
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    Advances in minimal-invasive blepharoplasty

    YANG Baofeng, LI Jie, MA Jiguang
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 491-.  
    Abstract516)      PDF(pc) (969KB)(18)       Save
    The application of minimal-invasive blepharoplasty has been increasing year by year because of its advantages such as invisible surgical scar, stable and natural double eyelid and short recovery period. This review summarized the advances of minimal-invasive blepharoplasty at home and abroad, and introduced the surgical procedure of minimal-invasive blepharoplasty and the advantages, disadvantages and complications, so as to provide reference for the clinical application of minimal-invasive blepharoplasty.
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    Progress in research methods of studying the neural crest

    JIANG Leheng, YIN Ningbei
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 469-.  
    Abstract474)      PDF(pc) (993KB)(108)       Save
    The neural crest is a migratory, multipotent stem cell population during vertebrate embryogenesis, and lineage tracing is the focus of its research. Over the 150 years since its first discovery, understanding of the neural crest has gone through a transition from morphological observations to single-cell level. In this paper, important approaches applied to study the neural crest were reviewed including radioisotope labeling, chimeras, vital dye labeling, in vitro clonal analysis, conditional genetic recombination and single-cell sequencing.
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    The incidence and risk factors of breast cancer-related lymphedema

    ZHANG Yingying, LI Hua, GUAN Jiaqin, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (3): 242-.  
    Abstract466)      PDF(pc) (1127KB)(1061)       Save
    Objective To explore the incidence rate, severity and risk factors of breast cancer-related lymphedema (BCRL)
    among breast cancer survivors. Methods Data collected from 128 patients underwent breast cancer operation during September
    1 to December 31, 2019. All the patients were female, aging (49.0±6.8) years (29-81 years). The Norman questionnaire and arm
    circumference measurement were used to evaluate the BCRL status and treatment status of breast cancer patients from subjective
    and objective perspectives at 6, 12, 24 and 36 months after surgery separately. The influence of the correlation factors on BRCL
    occurrence was analyzed by Logistic analysis. Results BRCL incidences were 9.4%, 25%, 23.4% and 23.4% at 6, 12, 24, 36
    months according to arm circumference measurement, while 12.5%, 26.6%, 25.0% and 25.0% by Norman questionnaire. Among the 128 patients, 30 were diagnosed with BCRL after breast cancer surgery, among which the incidence of stage Ⅰ
    lymphedema, stage Ⅱ lymphedema and stage Ⅲ lymphedema were 15.6%, 6.3% and 1.6%, respectively. Age, body mass index (BMI)  radiotherapy, the number of positive lymph nodes and surgery method showed differences between the the BCRL group and control group. Both CDT or LVA showed improvement for the BCRL patients. Conclusion BCRL is a common complication for
    breast cancer patients after surgery. It can be fairly diagnosed in the first year after surgery without the increasing incidence of
    BCRL over time throughout 3 years. BMI, radiotherapy were found to be independent risk factors in the development of BCRL in
    this study.
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    Analysis of the mechanism of fibroblast involvement in scarless healing of oral mucosa based on single cell transcriptome sequencing

    XUANYUAN Xinyang, XU Jiacheng, WANG Mengting, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (2): 115-.  
    Abstract463)      PDF(pc) (3654KB)(924)       Save
    Objective To explore the heterogeneity of human normal oral mucosa and skin fibroblasts and the mechanism of
    oral mucosal fibroblasts in promoting scarless wound healing. Methods Single-cell transcriptome sequencing data were obtained
    from the GEO database for 13 cases of oral mucosa and 8 cases of skin. The 64,633 cells were subjected to quality control, dimen sionality, clustering and cell annotation. Fibroblasts were extracted and annotated for subsets definition, differential gene enrichment
    and intercellular interactions analysis. Results Fibroblasts can be divided into 5 subsets: inflammatory, adipose, mesenchymal,
    contractile, and Wnt-inhibited. The proportion of inflammatory fibroblasts was significantly upregulated in the oral mucosa and
    was associated with immune cell recruitment. CXCL13, EEF1A1 and B2M genes were highly expressed in oral mucosa fibro
    blasts. Gene ontology (GO) functional analysis showed that scar healing-related pathways such as immune response and pro-in
    flammatory pathways were activated in oral fibroblasts. Cellular interaction analysis revealed that the interaction between fibro
    blast subsets was significantly changed, the information flow of oral mucosal COLLAGEN signaling pathway was upregulated, and
    the score of collagen degradation genes including MMP1 and MMP10 were also increased (P<0.05). Conclusion Fibroblasts
    in normal skin and oral mucosa differ significantly in their subpopulation and function. The stronger inflammatory characteristics
    and collagen metabolism of oral mucosal fibroblasts may drive the scarless wound healing.
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    Evaluation of facial injection filling materials for medical aesthetics
    ZHAO Chenyu, LI Chongchong, SUN Xue, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (5): 517-.  
    Abstract425)      PDF(pc) (874KB)(3300)       Save
    With economic development and technological progress, the demand for medical aesthetics has increased sig
    nificantly, and medical biomaterials are widely used. It is necessary to further improve the evaluation of their effectiveness and
    safety. At present, the evaluation of its physicochemical properties and biology is adopted in China. However, the clinical effec
    tiveness is a multi-faceted evaluation without unified criteria. Most of the evaluation mainly adopts objective indicators for quan
    titative analysis, while subjective feelings are secondary criteria. In this paper, the main facial fillers and the evaluation methods
    of their physicochemical properties were reviewed.
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    modRNA enhance the effect of cell therapy in tissue repairing and regeneration
    ·WANG Xiangying, FU Wei
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 465-.  
    Abstract420)      PDF(pc) (976KB)(21)       Save
     Cell therapy has been developed rapidly in recent years. However, the effect of cell therapy in tissue repairing and regeneration is ineffective. Therefore, a new strategy to enhance the therapeutic effect of cell therapy is urgently demanded. Some studies in recent years have found that the combination of mRNA with cell therapy, that is, transfect mRNA into transplanted cells, can promote the efficiency of tissue repairing and regeneration, which could further promote the repair and regeneration of multiple tissues such as cardiovascular, skin, bone and articulus. In this paper, the advantages of the combination of mRNA with cell therapy, other applications in tissue repairing and regeneration, and the difficulties of clinical transformation were all reviewed, aiming to provide new ideas for the tissue repairing and regeneration and the strategies of the clinical transformation.
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    New advances in the study of scaffold materials for cartilage tissue engineering
    YUE Guangren, WANG Ximei, LI Yu
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (4): 408-413.  
    Abstract405)      PDF(pc) (875KB)(1149)       Save
    Lacking blood vessels and nerve nourishment, cartilage has limited ability to repair and regenerate. Combining scaffolds, cells and active factors, tissue engineering has been considered as an important new direction for repairing cartilage injury. Scaffold plays an important role in the cartilage regeneration process, not only providing a support site for cell adhesion, but also improving the local microenvironment and affecting cell proliferation and differentiation. Many materials have been used to make biodegradable scaffolds: natural materials, synthetic materials and composite materials. In this paper, the materials that have been relatively widely used in cartilage tissue engineering were reviewed so as to provide valuable reference for researchers in this field.
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    Clinical effects and prognosis of oral sirolimus in the treatment of abdominal lymphatic malformations
    XU Zhenguo, CHEN Tao, TAI Maozhong, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 434-.  
    Abstract369)      PDF(pc) (9690KB)(13)       Save
    Objective  To observe the clinical effect and prognosis of oral sirolimus in the treatment of abdominal lymphatic malformations. Methods From March 2020 to August 2022, clinical data of 5 patients with abdominal lymphatic malformations treated with oral sirolimus were retrospectively analyzed. Results  All patients had abdominal pain before admission and were treated with oral sirolimus for 2 years. Subjective evaluation of clinical symptom improvement: Progress in 0 case, stability in 2 cases, improvement in 3 cases, cure in 0 case. Objective evaluation of lesion improvement: Grade Ⅰ(poor) in 2 cases, grade Ⅱ( medium) in 0 cases, grade Ⅲ( good) in 1 case, grade Ⅳ( excellent) in 2 cases. During the treatment, 2 patients developed oral ulcers and 1 patients developed mild anemia, all of which were improved after symptomatic treatment. All patients had no serious complication. After 1 year of follow-up, abdominal pain and other symptoms did not appear again, and the tumors of 3 cases (macrocystic lymphatic malformations) were significantly reduced, and 2 cases (microcystic lymphatic malformations) did not show significant tumor growth. Conclusion Sirolimus is safe and effective in the treatment of abdominal lymphatic malformations, and can significantly relieve abdominal discomfort symptoms, especially for macrocystic lymphatic malformations, with significant tumor size reduction and satisfactory results. 
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    Constructing a quality evaluation index system based on Donabedian theory for surgical care in plastic and reconstructive surgery specialties
    QIAN Fuwen, YANG Yuelai, ZHU Yonggan
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 447-.  
    Abstract329)      PDF(pc) (968KB)(44)       Save
    Objective To establish the evaluation index system of nursing quality of plastic and reconstructive surgery specialties based on Donabedian theory. Methods  Thirty five experts from Three-A hospitals in China in plastic and reconstructive surgery were consulted through email from April to June in 2023. The primary nursing quality evaluation index system of plastic and reconstructive surgery specialties was drawn up through literature research and qualitative interview methods. Two rounds of expert consultation were conducted by Delphi method to establish the nursing quality evaluation index system of plastic and reconstructive surgery specialties. Results The composition of experts in the two rounds of consultation was consistent, and the Cr of the experts was 0.777 1. In this study, the coefficient of variation of the secondary and tertiary indexes was 0.107-0.129, and the coefficient of variation was below 0.15, indicating that the two round consultations were credible and the coordination of the experts was good. Eventually, experts were consistant with each other in regard to all the indexes, the evaluation indexes of nursing quality in plastic and reconstructive surgery including 3 primary indexes, 10 secondary indexes and 47 tertiary indexes were determined through two round consultations by email. Conclusion  This study established a relatively scientific, rigorous and comprehensive evaluation index system for the quality of surgical care in plastic and reconstructive surgery, providing a theoretical basis for optimizing the quality of nursing care in plastic and reconstructive surgery and improving the satisfaction of patients and doctors.
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    Analysis of mutation type and clinical significance of congenital melanocytic nevi

    ZHAO Yifei, ZOU Yun, CHEN Hui, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (3): 258-.  
    Abstract324)      PDF(pc) (843KB)(1391)       Save
    Objective To explore the molecular characteristics of giant congenital melanocytic nevi (GCMN) and their
    clinical significance. Methods The samples of patients diagnosed with GCMN were subjected whole-exome sequencing and
    bio-information analysis to clarify the pathogenic genes and distribution patterns. Results In 50 samples (25 pairs of tissues
    and blood) from 25 patients, 21 patients had somatic mutations, including NRAS gene (19 cases) and BRAF gene (1 case). New
    mutations were detected in 2 patients’
    lesions and blood, and the mutant genes were MET gene and IDH1 gene. In addition,
    no causative mutation was detected in 4 patients. There was no statistic difference between GCMN genotype and phenotype.
    Conclusion NRAS somatic mutation is the most common mutation in GCMN, and BRAF gene has also been detected. Potential
    new mutated IDH1 and MET genes were also found.
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    Research progress of 3D bioprinting technology in dermal regeneration

    XU Pengqin, HAN Chunmao
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (3): 302-.  
    Abstract306)      PDF(pc) (973KB)(912)       Save
     Soft tissue defects of skin are common in clinical practice. The restoration of dermal damage, to a large ex
    tent, contributes to the repairing effects and scar formation of skin soft tissue defects. Three-dimensional (3D) bioprinting is an
    emerging technology that can accurately distribute biomaterials and living cells. It creates intricate stereoscopic structures which
    facilitates regenerative repair of dermal defects. Due to limitations of printing method, bio-ink, and seed cells, 3D bioprinting
    technology for skin is still in the lab stage. With the development of 3D bioprinting, especially in novel bio-ink exploitation and
    technical optimization, high resolution 3D bioprinting will enable us to customize elaborate functionalized skin models and even
    cutaneous appendages, providing new strategies in dermal regenerative repairment.
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     Overview of sensitive skin and treatment progress of aesthetic medicine

    LU Nan, WU Min, SONG Jiao, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (3): 323-.  
    Abstract303)      PDF(pc) (708KB)(1544)       Save
    敏感性皮肤 ; 机制 ; 诊断 ; 治疗 ; 光电治疗
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    Research progress of intramuscular fatty infiltration

    LU Baixue, GAO Weicheng
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 481-.  
    Abstract299)      PDF(pc) (970KB)(64)       Save
    Fat infiltration plays an important role in the pathological development of muscle related diseases, and is closely related to disease recurrence and poor prognosis. In recent years, the research on the potential mechanism of intramuscular fat infiltration has been highly popular at home and abroad, mainly focusing on the basic and clinical research related to skeletal muscle and myocardial fat infiltration. In this paper, the relevant literature on the pathogenesis of intramuscular fat infiltration in skeletal muscle and myocardium in recent years was reviewed, to provide assistance for the basic and clinical research of intramuscular fat infiltration related diseases.
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     Clinical observation of subcutaneous buried transverse mattress suture on reducing high-tension incision scar

    MENG Fanjun, WANG Li, WANG Qiang, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (3): 236-.  
    Abstract295)      PDF(pc) (2328KB)(323)       Save
    Objective To investigate the effect of subcutaneous buried transverse mattress suture on reducing high-tension
    incision scar. Methods Twelve patients with body surface pigmented nevus or local scar were selected, and the lesions were
    removed by outpatient operation. Then the superficial fascia layer was dissociated 1-1.5 cm to both sides of the incisal margin,
    and the incisions were sutured. The incisions were divided into modified suture group and traditional control group by self control
    method. In the modified suture group, subcutaneously buried transverse mattress suture was used to reduce tension and close
    the incision, while in the traditional suture group, subcutaneously buried vertical mattress suture was used to reduce tension and
    close the incision, and then interrupted suture was used to close the skin surface. Incision healing was observed during suture
    removal. Scar width was measured 6 months after operation, and the score of Vancouver scar scale was performed. Results
    Among the 12 patients, 10 patients completed the operation and incision healing observation. Scar measurement and evaluation
    were completed in 10 patients 6 months after the operation. Scar width in the modified suture group was (0.66±0.22) mm, smaller than the traditional control group [(0.98±0.24) mm], and the difference was significant (P<0.05). Vancouver scar scale score
    in the modified suture group was 1.70±0.55, also significantly lower than the traditional control group (3.07±0.97) with signif
    icant difference (P<0.05). Conclusion Subcutaneous buried transverse mattress suture can more fully relieve incision tension
    and reduce postoperative scarring than traditional tension-reducing suture method.
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    Clinical observation of the effect of JianpiQushi Fang on the treatment of keloid in patients with phlegm-damp/damp-heat TCM constitution
    TANG Renyan, XIA Lingling, CAO Zhengdong, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (4): 376-379.  
    Abstract293)      PDF(pc) (889KB)(311)       Save
    Objective To explore the clinical effect of Traditional Chinese Medicine (TCM) formula “JianpiQushi Fang” in the treatment of keloid in patients with phlegm-damp/damp-heat TCM constitution, and to provide preliminary clinical evidence for TCM systemic treatment of keloid. Methods Twenty-five keloid cases were diagnosed as phlegm-dampness/damp heat constitution by TCM constitution criteria. The patients were treated with“JianpiQushi” decoction with 1 dose daily (half dose twice a day) and continued for 4 weeks as a course of treatment. Physique score, local scar pain/pruritus symptoms, and Vancouver scar scale (VSS) score were compared before and after the treatment. Results Compared with before treatment, the physique score, scar local pain score and pruritus symptom score were significantly improved after treatment (P<0.05), while the scar VSS score had no significant change (P>0.05). Conclusion “JianpiQushi Fang” can effectively reduce the symptoms of keloid in patients with phlegm-damp/damp-heat TCM constitution, but its effect on improving the appearance and texture of scar is limited, suggesting that it should be combined with local surgical treatment.
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    Application of two-dimensional nanomaterial MXenes in tissue engineering
    ZHOU Hongling, WU Yeke, ZHAO Lixing
    Journal of Tissue Engineering and Reconstructive Surgery    2023, 19 (2): 178-.  
    Abstract289)      PDF(pc) (900KB)(867)       Save
    Owing to the advantages of high conductivity, hydrophilicity, high specific surface area, fascinating mechanical
    strength and photothermal conversion performance, transition metal carbides, nitrides or carbonitrides (MXenes), as a new kind
    of two-dimensional materials, have shown remarkable potential applications in the field of biomedicine, especially in tissue en
    gineering. In this paper, the research progress of biocompatibility of MXenes was briefly summarized, the application of MXenes
    in tissue engineering such as bone repair and skin regeneration was emphatically introduced, and finally the challenges and po
    tential research directions of MXenes in tissue engineering were prospected, aiming to provide some insights for the research and
    clinical application of MXenes in tissue engineering.
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    Neuroprotective effect of Liraglutide(LRG)on spinal cord injury(SCI)in rats by inhibiting ferroptosis
    DING Shuai, ZHANG Guangquan, GAO Kun, et al
    Journal of Tissue Engineering and Reconstructive Surgery    2024, 20 (4): 422-.  
    Abstract284)      PDF(pc) (2406KB)(26)       Save
    Objective To observe the neuroprotective effect of liraglutide( LRG) on spinal cord injury( SCI) rats, and to explore whether its mechanism is related to inhibiting ferroptosis. Methods A total of 90 female Wistar rats were randomly divided into sham group( n=30), SCI group( n=30) and LRG+SCI group( n=30). A rat model of SCI was established using the modified Allen’s method. For the SCI+LRG group, LRG (200 µg/kg) was administered immediately via subcutaneous injection( s.c.) following SCI, and then subsequently given once a day for the next ten days. Animals in both the sham and SCI group were administrated with equal volumes of sterile PBS. The iron content and glutathione( GSH) level in spinal cord were detected by the kit at 24, 48 and 72 h after operation. The expression levels of xCT and GPX4 protein were analyzed by Western blot. The BBB locomotion rating scale was used to investigate the hindlimb function 1, 3, 7, 14, 28 days after injury. HE staining and Nissl Staining were performed to evaluate the structural damage and surviving neurons around the injured area 28 days after operation, and the neuron apoptosis was detected by immunofluorescence staining. Results. Compared with the sham operation group, the iron content in SCI group was significantly increased within 3 days after injury (P<0.05), and GSH level was significantly decreased (P<0.05). LRG treatment effectively decreased the iron contents in injured spinal cords( P<0.05), and increased GSH level (P<0.05). In addition, LRG treatment significantly increased the expression levels of xCT and GPX4 in injured spinal cords( P<0.01). Compared with SCI group, the BBB score of LRG group was significantly higher at 7, 14 and 28 days after injury (P<0.05). HE staining and Nissl staining showed that cavity of damaged regions of LRG group was lower than that of SCI group (P<0.05), and the number of motoneurons in the spinal ventral horn of rat treated with LRG was higher than that of SCI group (P<0.05). Immunofluorescence staining showed that the ratio of cleaved-caspase 3-positive neurons was remarkably increased after SCI( P<0.05) and LRG significantly reduced the ratio of cleaved-caspase 3-positive neurons( P<0.05). Conclusion LRG treatment after SCI may promote SCI repair, protect damaged neurons and restore motor function through inhibiting ferroptosis in the microenvironment at the lesion site.
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