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23 July 2020, Volume 14 Issue 4 Previous Issue    Next Issue

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Integrative Mechanism for Keloid Origination and Development LIU Wei 2018, 14 (4):  181-183.  DOI: 10.3969/j.issn.1673-0364.2018.04.001 Abstract ( 397 )   Keloid is usually defined as a localized fibrotic disease limited to human skin in the medical field and the past research literatures also focused on keloid cells. However, keloid only forms in human being and lacks proper animal models. In addition, keloid is difficult to heal with high rate of recurrence. These characteristics suggest that the current strategy of keloid research is needed to change. Based on clinical manifestation and literature reports, this expert eonunent proposes that an integrative strategy- should be adapted to investigate the mechanism of keloid origination and development, and keloid might be a systemic disease with its manifestation at human skin. Meanwhile, future keloid research should also been evolved from abnormality of local skin tissue to the contribution of systemic factors and the interaction between systemic factors and local skin cells. Related Articles | Metrics

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Advances in Treatment of Pathological Scars by Radiotherapy Technique YAO Hui,WANG Jiehua,LI Li,WANG Yun,GU Peihua,YIN Chao,HUAGN Bin,OU Yonggang 2018, 14 (4):  184-187.  DOI: 10.3969/j.issn.1673-0364.2018.04.002 Abstract ( 385 )   Radiotherapy technique is an effective way to treat pathological scars. Great progress has been made on thetreatment of scars with surgery and radiotherapy in recent years. From the aspect of the treatment principle of radiotherapy, selection of common radiation sources and methods, applications of electron ray and X ray radiotherapy technologies, adverse reactions and corresponding measures, the clinical research and development of radiotherapy technique for pathological scars were reviewed. Related Articles | Metrics

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The Inhibition Effect of AMPK Agonist on the Formation of Keloid CAI Haifeng,YIN Jiafei,WANG Chen,ZHOU Renpeng,WANG Zejian,WANG Danru 2018, 14 (4):  188-193.  DOI: 10.3969/j.issn.1673-0364.2018.04.003 Abstract ( 343 )   Objective To explore the interference effect of AMPK agonist on the formation of keloid, and to provide new ideas for the clinical treatment of keloid. Methods In vitro culture conditions of skin fibroblasts phenotype to the keloid phenotype transformation were established by hypoxia and different concentrations （0, 2.5, 5, 10, 20 ng/mL） of TGF-β1, and confirmed by cell morphology and Western blot. Subsequently, different doses （2.5, 5, 10, 20 μmol） of AMPK agonist （A769662） were added to observe its effect on the phenotypic transformation of skin fibroblast to keloid. The reserve effect was confirmed by cell morphology, the expression of related markers （E-cadherin, Vimentin, ACTA2, Collagen I , IRS-1, Glut4, p-H2AX/H2AX2, NANOG, OCT4） detected by Western blot and the expression of IL-6 and VEGF detected by ELISA. Results The spindle shape of skin fibroblasts lost under hypoxia and inflammation induction by TGF-β1. In the process of increasing TGF-β1 concentration to 10 ng/mL, TGF-β1 stimulated the transformation of phenotype of fibroblasts into keloid associated phenotype. As the concentration continued to increase, the effects were arrested and slightly reversed. At the same concentration （10 ng/mL） induced by TGF-β1, the process of cell transformation was gradually intervened with the increasing dose of AMPK agonists added. Under hypoxia condition, the expression of VEGF and IL-6 in skin fibroblasts was significantly increased. Under the induction of TGF-β1, the expression of VEGF and IL-6 was further increased. And with the addition of AMPK agonists, the expression of VEGF and IL-6 was progressively reduced. Conclusion AMPK agonists can inhibit the transformation of fibroblast to keloid associated phenotype induced by hypoxia and inflammation. Related Articles | Metrics

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Clinical Efficacy of Injection and Nursing in Treating 900 Cases of Keloid by 5-Fluorouracil Combined with Lidocaine and Triamcinolone RUAN Jing,LI Zhuoya,CHEN Ping,LIU Wei,BIAN Weiwei 2018, 14 (4):  194-237.  DOI: 10.3969/j.issn.1673-0364.2018.04.004 Abstract ( 530 )   Objective To summarize the experience of injection and nursing in treating 900 cases of keloid by 5- fluorouracil combined with lidocaine and triamcinolone, and to analyze the key points of treatment. Methods From 2002, 900 patients with keloid were selected, 5-FU combined with lidocaine and triamcinolone were injected into the scar. The changes of keloid were observed before and after treatment. Results Of 900 cases, 2 patients had adverse drug reactions, 30 patients were not effective, other 868 patients were significantly improved and no recurrence was observed in one year follow-up. Conclusion 5 -fluorouracil combined with lidocaine and triamcinolone can be used in treating keloid, it is simple and effective. At the same time, strengthen the nursing before and after injection is beneficial to improve the effect. Related Articles | Metrics

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Humanized Nursing in the Treatment of Facial Acne Scars by CO2 Dot Laser HE Ying,LU Wenting,BIAN Weiwei,CHEN Ping. 2018, 14 (4):  197-199.  DOI: 10.3969/j.issn.1673-0364.2018.04.005 Abstract ( 399 )   Objective To explore the humanized nursing effect in the treatment of facial acne sears by CO2 dot laser. Methods From January 2015 to January 2017, 128 cases with facial acne scars were included. According to the order and willingness of the patients, the patients were divided into two groups： control group and study group. All the patients were treated with CO2 dot laser. Patients in the control group was given routine preoperative and postoperative nursing, while patients in the study group was given humanized nursing on the basis of routine nursing,that is to increase the evaluation of the psychological status of patients and the psychological evaluation of the operation effect. The therapeutic effects of the two groups were compared. Results The total effective rate of the study group was 96.39], obviously higher than that of the control group （84.44%） （P〈0.05）. The VAS score of the study group was significantly lower than that of the control group （P〈0.05）. The incidence of postoperative complications of the control group and study group was 17.78] and 3.61] respectively, the difference was statistically significant （P〈0.05）. Conclusion Humanized nursing in the treatment of facial acne scars by CO2 dot laser can reduce the surgical pain and the incidence of postoperative complications, and improve the therapeutic effect. Related Articles | Metrics

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Treatment of Keloid Using Light-, Laser-and Energy-Based Devices PENG Yinbo,GUO Qige,SONG Chenlu,YAO Min 2018, 14 (4):  200-202.  DOI: 10.3969/j.issn.1673-0364.2018.04.006 Abstract ( 533 )   Keloid is a hyperplastic skin disease characterized by excessive proliferation of fibroblasts, large amount of extracellular matrix deposition and abnormal epidermal structure. Keloid has an unclear etiology, and lack of specific treatment in clinic. The common treatments include surgical operation, cryotherapy, compression therapy, local injection of drugs （corticosteroids, 5-Fu, etc.）, but the effects are not satisfactory. In recent years, the use of light-, laser- and energy- based devices for treatment of multiple dermatological conditions has become more widespread, with treatment of keloids proving no exception. IPD/DPL, PDL, which can selectively absorbed by the hemoglobin in the capillary of keloid, can damage the vascular endothelial cells, thus causing the blood tube occlusion and the scar tissue shrink. Combined with other scar treatments, IPD/DPL, PDL have a synergistic effect on anti -keloids. Other phototherapeutic treatments are not recommended for clinical use due to the risk of further scarring of keloids. Related Articles | Metrics

Original article

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The Preliminary App lication of Hollow Tissue Reconstruction with 3D Bioprinting PI Qingmeng,WANG Xiaolei,ZHANG Zhiliang,ZHOU Biyu,REN Xiaoyun,LU Yi,HUANG Yixiong,FU Mingang,FAN Zhihong 2018, 14 (4):  203-207.  DOI: 10.3969/j.issn.1673-0364.2018.04.007 Abstract ( 323 )   Objective To investigate the feasibility of building complex hollow tissue in one-step by using the technique of 3D bioprinting. Methods New blends were combined GelMA with Alginate on different concentration, and tested by mechanical examination to explore the feasibility of printable. After bioprinting of hollow tissue with double-layer loading with cells, cell viability assay and perfusion test of printed tissue with microbeads were used. Results Compared with pure group of GelMA （2.38±0.69）×10^-3 MPa and alginate （0.83 ±0.24）×10^-3 MPa, the Young]s mold of combined bioink was （8.78±1.73）×10^-3 MPa.There were significant statistical differences. Based on the combined hydrogel, double-layerd hollow fiber could be printed with the thickness of （62.06 ±0.45）μm of inner wall and （93.78 ±10.25）μm of outer wall. Diameter of inner and outer was （663.66 ±51.74）μm and （976.84±63.44）μm relatively. There were significant differences between inner and outer layer tracked by microbeads with different color. After loading with 3T3 mouse fibroblast cells in inner layer and outer layer in process of bioprinting, live-dead test showed the viability of cells in hollow fibers on day 1 （88.50%±5.8%）,day 3 （85.57%±6.22%） and day 7 （96.29%±2.64%）. Perfused with orange microbeads in 3T3 printed hollow tissue showed good integrity of the wall, and no obvious liquid exudation was observed. Conclusion Using such combined bioinks could fabricate complex hollow tissue with certain perfusion function, in which cells can survive. Related Articles | Metrics

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Effectiveness of 3D Print Individual Model on the Treatment of Complex Ankle Fracture LI Rensong,WANG Na 2018, 14 (4):  208-211.  DOI: 10.3969/j.issn.1673-0364.2018.04.008 Abstract ( 304 )   Objective To explore the effects of 3D printed individual model on the treatment of complex ankle fractures.Methods From June 2014 to February 2017, 78 patients with complex ankle fracture were selected and divided into observation group （n =39） and control group （n=39） in accordance with the principle of random draw envelope. Operative design by X -ray was used in control group, while individualized 3D printing model was used in observation group for operative design. The two groups were both operated by minimally invasive approach. Results All patients had finished the operation and there were no serious complications in the two groups. The incision length and operative time had no significant difference between the two groups （P〉0.05）. The blood loss, postoperative hospitalization time, fracture healing time in the observation group were significantly less than in the control group （P〈0.05）. Three months after operation, the incidence of complications such as nail tunnel infection, deep vein thrombosis and wound infection in the observation group were significantly lower than that in the control group （5.1% vs. 25.6%, P〈0.05）, and the total effective rate in the observation group was significantly higher than that in the control group （97.4% vs. 74.4%, P〈0.05）. Conclusion The application of 3D print individual model in the treatment of complex ankle fracture can provide safe, effective and personalized treatments, reduce the incidence of postoperative complications, promote the rehabilitation of patients and improve the prognosis of patients. Related Articles | Metrics

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Wrist Transverse Free Flap with Palmaris Longus Tendon in the Repair of Finger Complex Tissue Defect CHEN Deguang,WANG Jin,WANG Xueshan,SHI Xinxi,ZHAO Lianmin 2018, 14 (4):  212-214.  DOI: 10.3969/j.issn.1673-0364.2018.04.009 Abstract ( 445 )   Objective To explore the effect of wrist transverse free flap with palmaris longus tendon in the repair of finger complex tissue defect. Methods From January 2015 to January 2017, a total of 7 cases with composite tissue defects of fingers were concluded in this retrospective study. The finger complex tissue defect was repaired by free wrist transverse flaps with palmaris longus tendon and palmar cutaneous branch of the median nerve in emergency or in secondary stage. The incision of donor sites was closed primarily. Results All flaps were survived. The wounds of the donor site healed by first intention. The patients were followed up for 6 -12 months, the flap was soft with good color and no significant flap bloated appearance, and the static two point discrimination was 3 -5 mm. According to the upper extremity functional evaluation criteria of the Chinese Medical Association of Hand Surgery, 6 cases were excellent, 1 case was good, and the excellent and good rate was 100R. Conclusion This method can not only repair skin and tendon defects in one stage, but also reconstruct the motion and sensory function of the fingers. It can offer good appearance and skin texture, which is recommended to repair finger composite tissue defects. Related Articles | Metrics

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Comparative Analysis of Two Different Surgical Approaches for Humeral Intercondylar Fracture WEI Zhantu,WANG Xiaoping,HU Shiqiang,WU Weiwei,CHEN Luyao,HUANG Jian,TU Yumin,FENG Weili 2018, 14 (4):  215-218.  DOI: 10.3969/j.issn.1673-0364.2018.04.010 Abstract ( 412 )   Objective To compare and analyze the therapeutic effect of two surgical approaches in the treatment of humeral intercondylar fracture. Methods From May 2015 to May 2017, a total of 72 patients with humeral intercondylar fracture were treated. According to the method of approach, the patients were divided into 2 groups： olecranon osteotomy approach group （group A, n=36） and medial-lateral approach group （group B, n=36）. The operating time, X-ray exposure time, complications and elbow function assessment were observed and compared between the 2 groups. Results The operating time and X-ray exposure time in the group A were less than those in the group B （P〈0.05）. The incidence of complications in the group A was lower than that in the group B （P〈0.05）. The functional evaluation of the elbow joint in the group A was significantly higher than that in the group B （P〈0.05）. Conclusion The olecranon osteotomy approach in the treatment of humeral intercondylar fracture is superior to the medial -lateral approach with less operating time, X -ray exposure time, complications, and better elbow function recovery. Related Articles | Metrics

Review

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Application of Exosome Derived from Adipose Derived Stem Cells in Promoting Tissue Repair CHEN Chuhsin,ZHOU Shuangbai,LI Qingfeng 2018, 14 (4):  219-222.  DOI: 10.3969/j.issn.1673-0364.2018.04.011 Abstract ( 562 )   Adipose-derived stem cells have the effect of promoting tissue repair and regeneration, and its mechanism of action is inseparable from its paracrine role. Exosomes are extracellular vesicle secreted by cells and are a new mechanism for communication between cells. In recent studies, it has been found that stem cell-derived exosomes are a major means of paracrine activity of stem cells and mediate their role in promoting tissue regeneration. The application of exosomes provides a new strategy for tissue repair. In this paper, the application of exosomes derived from adipose-derived stem cells in tissue regeneration was reviewed. Related Articles | Metrics

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The Paracrine Effects of Mesenchymal Stem Cells on the Functional Recovery of Injured Exocrine Glands CAO Lu,WANG Shuai,ZHANG Nini,HUANG Guilin 2018, 14 (4):  223-226.  DOI: 10.3969/j.issn.1673-0364.2018.04.012 Abstract ( 399 )   A variety of physical, mechanical, chemical and pathogenic microbial stimuli may cause damage to the exocrine glands, resulting in decreased secretion. The effect of drug therapy is limited, the risk of organ transplantation is high with limited donor. The mesenchymal stem cells provide a new idea for the repair of various exocrine glandular damages because of its strong proliferation ability, multi-differentiation ability and paracrine/autocrine effects. In this paper, the application and research progress of paracrine effects of mesenchymal stem cells in exocrine tissue engineering were reviewed. Related Articles | Metrics

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Research Progress on the Chondrogenic Differentiation Related Activity Factors of Mesenchymal Stem Cells after Targeted Induction CHEN Jinfu,GENG Yiyun,WANG Daping 2018, 14 (4):  227-230.  DOI: 10.3969/j.issn.1673-0364.2018.04.013 Abstract ( 507 )   The damage or loss of articular cartilage leads to progressive disease such as arthritis, which seriously affects people＇s quality of life. The potential for self-healing is extremely low due to the lack of neural control, vascular supply, and the poor proliferative capacity of chondrocytes. The limitation and complexity of autologous chondrocyte transplantation has hindered the wide application of this technique. Mesenchymal stem cells have enormous proliferative capacity and retain the potential of differentiation. However, the potential of targeted chondrogenic differentiation requires external factors such as cytokines, scaffold materials, media, etc. In recent years, it is an important research direction to find the suitable active factor to induce chondrogenic differentiation. In this paper, the research progress on the chondrogenic differentiation related activity factors of mesenchymal stem cells was reviewed. Related Articles | Metrics

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Research Progress of Treatment Modalities of Port Wine Stains CHEN Yijie,YU Wenxin,LIN Xiaoxi 2018, 14 (4):  231-240.  DOI: 10.3969/j.issn.1673-0364.2018.04.014 Abstract ( 605 )   Port-wine stain is the most common vascular malformation and the incidence is about 0.3% to 0.5% in the infants. So far the international gold standard for PWS treatment is pulsed dye laser. In this paper, several ongoing trials on treating vascular malformation were introduced, including photodynamic therapy, angiogenesis inhibitors, site -specific pharmaco-laser therapy and hypobaric pressure therapy. Related Articles | Metrics

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PEEK and Modifications for Dental Prosthetics and Implants LIU Liming,CAO Wenrui,LU Shoutao,ZHANG Haijun 2018, 14 (4):  234-237.  DOI: 10.3969/j.issn.1673-0364.2018.04.015 Abstract ( 411 )   PEEK and its composite materials have been used in many areas of dental prosthetics and implants with excellent mechanical properties and good biocompatibility, especially the elastic modulus close to human cortical bone and the color close to the natural color. In this paper, the recent progress of PEEK in material modification and application for dental prosthetics and implants were reviewed to provide innovation for future researches. Related Articles | Metrics

Teaching

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Virtual Reality and A New Educational Pattern of Plastic Surgery XU Xiangwen,HUANG Xin,ZAN Tao 2018, 14 (4):  238-240.  DOI: 10.3969/j.issn.1673-0364.2018.04.016 Abstract ( 464 )   In the current situation of plastic surgery education, because of the complexity of the diseases and the specificity of the patients, the education of disease treatment lacks reproducibility. Virtual reality technology provides a three-dimensional and riskless operating environment that allows learners to perform exercises before a formal operation and try to operate independently. However, purely apply virtual reality technology is still insufficient. VR technology couldn’t completely modulate the complexity of guts or hemodynamics. Adding VR simulation technology in the traditional learning cycle, can supply the shortcomings of long learning curve and difficulty in grasping complex operative methods by simulating surgical environment, and form a new pattern of circular learning model of “observation, thinking, experience, action and teaching”. This new learning pattern can break through the traditional learning platform from classroom to operation table, so that more professional doctors can be trained quickly and with high quality in plastic surgery field. Related Articles | Metrics