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01 December 2022, Volume 18 Issue 6 Previous Issue   

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The "seed and soil" theory in tissue and organ ageing ZHANG Wenjie 2022, 18 (6):  465.  Abstract ( 150 )   PDF (510KB) ( 122 )   Population ageing has become a global concern. Reducing the occurrence of ageing-related diseases is a major challenge in preventive medicine. The establishment of a scientific ageing theory will provide an important basis for the formulation of effective anti-ageing strategies. Drawing on the research experience in tissue engineering, the "seed and soil" theory in tissue and organ senescence was proposed: "seed" represents the stem cells, and "soil" represents the tissue microenvironment. The depletion of "seed " and deterioration of "soil" play a key role in tissue and organ senescence. Based on these characteristic changes of senescent tissue, a comprehensive anti-ageing strategy called "weeding, fertilizing and seeding" was proposed: removing senescent cells, improving tissue microenvironment, and replenishing stem cells. The existing anti-ageing technologies were further re-classified based on this strategy. Related Articles | Metrics

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Resection, repair and reconstruction of huge tumor in chest wall DAI Zhibing, Maierdanjiang·Maihemuti, SUN Yachao, et al 2022, 18 (6):  470.  Abstract ( 102 )   PDF (1570KB) ( 51 )   Objective　To explore the methods and effects of resection, repair and reconstruction of huge chest wall tumors. Methods　The data of 4 patients with huge chest wall tumors from July 2015 to January 2020 were retrospectively analyzed, including chondrosarcoma in 2 cases, giant cell tumor in 1 case, and metastasis of breast cancer in 1 case. All patients underwent extensive tumor resection and thoracic cavity was exposed after tumor resection. Two patients were reconstructed with patch and titanium mesh, and the incision was closed directly. One patient was repaired with patch and latissimus dorsi flap. One patient was reconstructed with patch, titanium mesh and latissimus dorsi flap. Results　One case of postoperative incision infection improved after debridement. All patients were followed up for 2-6 years, no tumor recurrence and metastasis were found. All patients had no abnormal breathing, dyspnea and other discomfort. Conclusion　It is difficult to resect the huge tumor in the chest wall. It is more reasonable and safe to choose the reconstruction method of patch and titanium mesh. The latissimus dorsi flap can achieve good results in repairing soft tissue defects. Paying attention to perioperative management and multidisciplinary participation can make patients achieve better curative effect. Related Articles | Metrics

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Pre-dilated flap design based on subunit principles in repairing facial scars ZHAO Han, ZHANG Zhi, LI Gang, et al 2022, 18 (6):  476.  Abstract ( 122 )   PDF (1570KB) ( 51 )   Objective　To explore the clinical efficacy of pre-dilated flaps designed according to subunit principles in repairing facial scars. Methods　 A retrospective analysis was conducted on 8 patients with facial scars admitted from May 2018 to September 2020, including 5 males and 3 females, aged from 6 to 47 years old, with an average age of 21 years old, and scar size of 4 cm×7 cm-12 cm×9 cm. According to the design of facial subunit divisions, head or neck dilator implantation was performed in stage I, and water injection was performed for 2-3 months. After water injection, facial scar resection and dilated flap repair were performed in stage Ⅱ, and the donor flap area was directly closed and sutured. Results　All the 8 cases of dilated flaps survived and the wound healing was good. The color and texture of the dilated flaps were similar to those of the face, and the facial morphology and function were satisfactory after 6-12 months of follow-up. Morphological and functional scores were higher after repair, and the difference was statistically significant (P<0.05). Conclusion　Pre-dilated flaps designed according to the subunit principle are recommended for repairing facial scar, and the shape, contour and function can be improved. Related Articles | Metrics

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The diagnosis and management of Bockenheimer disease: 7 case reports and literature review GAO Dinghui, CHEN Yong, WANG Qian, et al 2022, 18 (6):  480.  Abstract ( 149 )   PDF (1038KB) ( 58 )   Objective　Bockenheimer disease is a rare and diffuse venous malformation. Seven typical cases of Bockenheimer disease were reported and the related literature was reviewed. Methods　The general information, coagulation tests, radiographic results and treatment of 7 patients with Bockenheimer disease from April 2013 to July 2021 were retrospectively analyzed. And the related literature was reviewed to summarize the diagnostic criteria and management of Bockenheimer disease. Results　Seven patients with Bockenheimer disease were enrolled into this study, including 3 males and 4 females, aged from 14 to 62 years. The lesions were almost first noted at birth or childhood with slow progression, and appeared as extensive phlebectasia of the limb. Symptoms included pain, swelling, loss of function and so on. Coagulation tests revealed localized intravascular coagulopathy (LIC). MRI, CTV and plain radiograph demonstrated diffuse vein malformation under the skin and soft tissue of the affected limbs, which can involve in muscles and bones. Thromboses and phleboliths were common. The treatments included sclerotherapy, intralesional copper wire retention, and surgery. Symptoms and signs were relieved after treatment. Conclusion　Bockenheimer disease has typical appearance, symptoms, and radiographic features. The lesion is progressive and diffuse which requires early intervention and comprehensive treatment. Related Articles | Metrics

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Study on the effect of external application of Jiuyi Dan on the wound cavity repair after operation of refractory non-puerperal mastitis DAI Qiuying, CHEN Yifan, YIN Yulian, et al 2022, 18 (6):  485.  Abstract ( 142 )   PDF (1009KB) ( 40 )   Objective　To explore the clinical effect and safety of Jiuyi Dan on the wound repair of refractory non-puerperal mastitis (RNPM). Methods　Patients with RNPM who were treated with incision and debridement from December 2020 to December 2021 were divided into observation group and control group according to the postoperative treatment method. The control group was given routine dressing change, and the observation group was given the traditional Chinese medicine preparation Jiuyi Dan for external use on the basis of the control group. The effect and safety of the two groups on the postoperative wound cavity repair of patients with RNPM were retrospectively analyzed. Results　A total of 78 patients were included, including 38 cases in the observation group and 40 cases in the control group. There was no significant difference in wound volume between the two groups at 1 and 3 weeks after operation (P>0.05). Compared with 1 week after operation, the volume reduction of wound cavity at 3 weeks after operation was (23.59±14.19) mL and (16.96±10.78) mL in the observation group and the control group, respectively, and the difference between the two groups was statistically significant (t=2.06, P<0.05). The volume of wound cavity decreased more significantly in the observation group (F=4.22, P=0.04, partial η2=0.07). The wound healing time ≤2 months accounted for 68.42% (26/38) and 40% (16/40) in the observation group and the control group, respectively, and the wound healing time >2 months accounted for 31.58%(12/38) and 60%(24/ 40) in the observation group and the control group, respectively, with a statistically significant difference (χ2=6.33, P=0.01). The score of breast shape 6 months after operation in the observation group was 4.55±2.31, which was higher than that in the control group (3.38±1.98), and the difference between the two groups was statistically significant (t=2.17, P=0.03). There was no significant difference in liver and kidney function between the two groups before and after treatment(P>0.05). Conclusion　The external application of Jiuyi Dan can effectively promote the repair of wound cavity tissue after operation of RNPM, protect the appearance of breast, and has a certain safety. Related Articles | Metrics

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Study of photothermal coating on titanium surface with antibacterial and cell adhesive properties LU Jun, ZENG Deliang 2022, 18 (6):  490.  Abstract ( 101 )   PDF (1119KB) ( 72 )   Objective　To construct a photothermal coating on a titanium surface with antibacterial cell adhesive properties, and to discuss its potential for clinical application. Methods　Photothermal polydopamine nanoparticle (PDA-NP) coatings were smeared on the surface of titanium-based biomaterials that required tissue integration to control infection. The antibacterial effect and cell adhesion of PDA-NP coating on titanium surfaces were evaluated by bacterial and cell co-culture models. Results　In vitro results showed that PDA-NP coating significantly enhanced cell adhesion and was conducive to cell proliferation. The adhered Staphylococcus aureus (S. aureus) on the titanium surface with PDA-NP coating could be killed by near-infrared (NIR) irradiation in 3 minutes. Besides, when MC3T3-E1 osteoblasts were inoculated on the titanium surface with PDA-NP coating after contaminated with S. aureus, the bacteria could be effectively killed after about 3 minutes of NIR irradiation with nearly no impairment to the cell adhesion behavior of MC3T3-E1. Conclusion　The PDA-NP photothermal coatings on the surface of titanium implants are significantly antimicrobial to control infection and promote cell adhesion, thereby promoting tissue integration and preventing collateral damage to the surrounding tissue at the site of infection. Related Articles | Metrics

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Clinical application of Yan tension-free suture in skin incision of cesarean section FENG Hengchao, JI Pengpeng, SHEN Qi, et al 2022, 18 (6):  495.  Abstract ( 128 )   PDF (560KB) ( 49 )   Objective　To explore the clinical application of Yan tension-free suture in skin incision of cesarean section. Methods　From July 2021 to October 2021, 29 qualified pregnant women who underwent two or multiple cesarean sections were selected. All of them were treated with Yan tension-free suture to close the wound margin. Regular follow-up was performed after operation and the scar hyperplasia was evaluated and compared with that before operation. Results　All incisions were healed in 29 cases, and the scar healed in a linear manner. Conclusion　Yan tension-free suture can achieve precise anastomosis and tension-free suture by reasonable trimming and anchoring dermis twice. It has remarkable effect in controlling scar hyperplasia and is worth popularizing. Related Articles | Metrics

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Clinical experience of applying botulinum toxin type A in the treatment of hemi-facial spasm CHEN Fengchao, HOU Junjie 2022, 18 (6):  498.  Abstract ( 132 )   PDF (678KB) ( 29 )   Objective　To discuss the application of botulinum toxin type A in the treatment of hemi-facial spasm. Methods　Twelve patients who underwent botulinum toxin type A treatment for hemi-facial spasm from June 2016 to August 2020 were enrolled. The dosage, injection method, therapeutic effect and complications of botulinum toxin type A applied to each enrolled patient were summarized and analyzed. Results　After local injection of botulinum toxin type A, the symptoms of lateral muscle spasms were obviously controlled. Among them, 4 patients had no recurrence during the follow-up period, 6 patients received additional injection once, and 2 patients with severe symptoms received additional injection twice. The spasm of the affected side was well controlled, and no recurrence was observed during the follow-up period. No adverse reactions occurred in the enrolled patients. Conclusion　Botulinum toxin type A injection can well control hemi-facial spasm, and has the advantages of simple treatment, little pain and quick effect. The specific injection dose and site selection need to be adjusted accordingly after a comprehensive assessment of the patient's gender, degree of hemi-facial spasm and other factors. Related Articles | Metrics

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Clinical effect of Botox microdrop injection on improving the skin of lower face contour and neck LIU Bin, GU Yichun, MAO Lu, et al 2022, 18 (6):  502.  Abstract ( 429 )   PDF (733KB) ( 134 )   Objective　To explore the clinical effect of Botox microdrop injection on improving the skin of lower face contour and neck. Methods　From June 2018 to December 2019, a total of 115 beauty seekers (111 female and 4 male, aged 20-65 years) were treated with Botox microdrop injection. The diluted Botox (1 mL normal saline containing 20 units of botulinum toxin A) was injected into the subcutaneous or superficial layer of the marginal area of the mandible and neck by microdrop method, and the lifting and tightening effect of Botox on the skin in this area was observed. Results　After one month of injection, the skin sagging of the lower face contour was improved, the contour line of the mandibular margin became clearer, the loose skin of the neck became tight, and the neck lines became shallower. The effect was satisfactory in 108 beauty seekers. Conclusion　Botox microdrop injection has a good therapeutic effect on the aging, relaxation and sagging of the lower face contour and neck skin. Related Articles | Metrics

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Clinical application of self-made TPE drainage tube in minimally  invasive treatment of patients with stage Ⅳ bedsore  of ischial tuberosity LIU Bing, CAO Wei, FAN Chunhai 2022, 18 (6):  506.  Abstract ( 126 )   PDF (733KB) ( 25 )   Objective　To explore the clinical effect of self-made thermoplastic elastomer (TPE) drainage tube in minimally invasive treatment of patients with stage Ⅳ bedsore of ischial tuberosity. Methods　A total of 45 patients with stage Ⅳ bedsore of ischial tuberosity were enrolled between June 2020 and June 2021. According to random number table method, patients were divided into observation group (n=23) and control group (n=22). The control group was given routine treatment and nursing, while observation group was given self-made TPE drainage tube in minimally invasive treatment. The cure rate, wound healing time, hospital stay, medical cost and nursing satisfaction between the two groups were compared. Results　The cure rate in observation group was higher than that in control group (86.96% vs 59.09%, P<0.05). The wound healing time, hospital stay and medical cost in observation group were lower than those in control group (P<0.05), and scores of nursing technique and nursing attitude were higher than those in control group (P<0.05). Conclusion　The self-made TPE drainage tube is conducive to wound healing in patients with stage Ⅳ bedsore of ischial tuberosity, which can shorten wound healing time and hospital stay, and reduce medical cost, with high nursing satisfaction. It is worthy of clinical promotion in primary hospitals. Related Articles | Metrics

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Clinical application of self-made TPE drainage tube in minimally  invasive treatment of patients with stage Ⅳ bedsore  of ischial tuberosity LIU Bing, CAO Wei, FAN Chunhai 2022, 18 (6):  506.  Abstract ( 49 )   PDF (733KB) ( 100 )   Objective　To explore the clinical effect of self-made thermoplastic elastomer (TPE) drainage tube in minimally invasive treatment of patients with stage Ⅳ bedsore of ischial tuberosity. Methods　A total of 45 patients with stage Ⅳ bedsore of ischial tuberosity were enrolled between June 2020 and June 2021. According to random number table method, patients were divided into observation group (n=23) and control group (n=22). The control group was given routine treatment and nursing, while observation group was given self-made TPE drainage tube in minimally invasive treatment. The cure rate, wound healing time, hospital stay, medical cost and nursing satisfaction between the two groups were compared. Results　The cure rate in observation group was higher than that in control group (86.96% vs 59.09%, P<0.05). The wound healing time, hospital stay and medical cost in observation group were lower than those in control group (P<0.05), and scores of nursing technique and nursing attitude were higher than those in control group (P<0.05). Conclusion　The self-made TPE drainage tube is conducive to wound healing in patients with stage Ⅳ bedsore of ischial tuberosity, which can shorten wound healing time and hospital stay, and reduce medical cost, with high nursing satisfaction. It is worthy of clinical promotion in primary hospitals. Related Articles | Metrics

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A case report of ectropion repair by using scrotal skin after extensive deep burn SIMA Chao, CHEN Bin, ZHANG Xuhui, et al 2022, 18 (6):  510.  Abstract ( 124 )   PDF (730KB) ( 21 )   In October 2019, a patient with 95% total body surface area (TBSA) burns of grade Ⅲ was admitted, with severe eyelid burns. In the early stage, the remaining skin was used repeatedly to cover the wound with thick skin, saving lives. There was no excess normal full thickness skin for eyelid wounds, resulting in a severe ectropion deformity that exposed the cornea and bulbar conjunctiva. In order to avoid further deterioration of the condition, resulting in serious complications such as corneal perforation, scrotal skin was selected as the donor site to repair ectropion deformity. After surgery, eyelid could be closed normally, keratitis gradually improved, scrotal suture healed well. Related Articles | Metrics

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Misdiagnosed desmoid-type fibromatoses: Case report and literature review WANG Wenjing, LIU Boce, HUO Ran 2022, 18 (6):  513.  Abstract ( 111 )   PDF (747KB) ( 64 )   Desmoid-type fibromatosis (DTF) is a rare benign soft-tissue tumor originating in fibroblasts or myofibroblasts in fascia or muscle, tendon tissue, characterized by infiltrative growth, tendency to local relapse but no distant metastasis. Patients with DTF should be treated as early as possible, and complete surgical resection supplemented by radiation therapy or chemotherapy may reduce DTF recurrence rate. In this paper, a patient with DTF who was misdiagnosed as elastofibroma was reported. After complete surgical resection, the patient was discharged from hospital， and no recurrence was observed during follow-up. Related Articles | Metrics

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Research progress of temporomandibular joint disc tissue regeneration XIANG Chaoli, YU Lüfeng 2022, 18 (6):  516.  Abstract ( 162 )   PDF (973KB) ( 88 )   Temporomandibular joint disc perforation is one of the severe structural disorder in temporomandibular disorders (TMD). The main clinical manifestations are pain, sound and mandibular dyskinesias. At present, the prognosis of clinical treatment is poor, and it is difficult to restore the normal anatomical morphology and function of the articular disc. The development of tissue engineering technology has made it possible to regenerate the articular disc. It has been found that by seeding mesenchymal stem cells on a strong biodegradable scaffold, fibrocartilage differentiation is achieved under the stimulation of growth factors, and collagen fibers and glycosaminoglycans are secreted. Eventually, the scaffold is replaced by healthy tissue and the joint disc is regenerated. In this paper, the research progress of tissue engineering technology in articular disc regeneration was reviewed. Related Articles | Metrics

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Advances of clinical application of three-dimensional optical surface imaging system ZHONG Yehong, YANG Bin 2022, 18 (6):  524.  Abstract ( 129 )   PDF (431KB) ( 77 )   Accurate and effective anthropometric method is essential to plastic surgery. However, direct anthropometry and two-dimensional photogrammetry have no longer meet the standard of evidence-based medicine due to their low accuracy and low repeatability. Nowadays, with the developments of optical technology, three-dimensional optical surface imagining systems have gradually applied in clinical fields and become a necessary quantitative analyzing method for facial tissue. In this paper, the development, technical principle, imaging accuracy, application and future prospects of three-dimensional optical surface imagining systems were reviewed to provide new ideas and reference for further broadening the application field.  Related Articles | Metrics

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Research progress of mediating factors affecting the formation of foreign body giant cell LIU Yu, WANG Rui, LI Shijie, et al 2022, 18 (6):  527.  Abstract ( 380 )   PDF (453KB) ( 200 )   Foreign body giant cell (Foreign body giant cell, FBGC) is a prominent cell type formed after the implantation of biomedical materials. It is formed by the fusion of macrophages. It is a hallmark histological feature in chronic inflammation caused by persistent microbial infection or non-phagocytosis of foreign bodies. FBGC is related to the degradation and failure of implanted biomaterials, and is the key cell of foreign body reaction. Controlling the formation of FBGC is considered the key to preventing implantation failure. Therefore, FBGC has always been a research hotspot. Although the molecular mechanism that promotes the adhesion and development of macrophages and supports the formation of FBGC has not yet been elucidated, many mediating factors affecting its formation have also been discovered. In this paper, the relevant domestic and foreign literatures from the three aspects of FBGC formation process, structure and function, and influencing factors were summarized to further understand the mechanism of foreign body giant cell formation and provide enlightenment for finding other possible mediating factors. Related Articles | Metrics

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Research status on the divided nevus of the eyelid LU Xiaozhao, LI Yangqun 2022, 18 (6):  531.  Abstract ( 159 )   PDF (629KB) ( 54 )   Divided nevus, also known as "kissing nevus", "split ocular nevus" or "panda nevus", is a rare congenital dermatological abnormality that occurs at opposite margins of the upper and lower eyelids. There is paucity of literature on this rare congenital skin abnormality, and most knowledge of the disease process comes from isolated case reports and few series reports. The purpose of this review is to summarize the timing and basic treatment of divided nevus of eyelid. Most mitotic nevi reported in the literature are of medium-size intradermal melanocyte type. Majority of divided nevi included in this review were medium sized and of the melanocytic intradermal type. Malignant transformation occurred in 6 of all the cases read. A number of reconstruction approaches have been described in the literature, including one-stage reconstruction and multi-stage sequential reconstruction. In this review, a basic approach to reconstructing these complex defects was proposed, although ultimately individuation treatment depends on the surgeon's own choice. Related Articles | Metrics

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Midfacial fat compartments and their application in facial rejuvenation GAO Yuan, LI Jie, MA Jiguang 2022, 18 (6):  536.  Abstract ( 138 )   PDF (421KB) ( 78 )   Research on facial fat compartments has renewed the recognition of facial anatomy and aging process. Both descent and volumetric shift of facial fat compartments occur in the process of aging. Fat-compartment-targeted lipofilling and facelift have achieved satisfactory results. In this paper, the anatomy of midfacial fat compartments, the volume and position changes in the process of aging, and the clinical outcomes of facelift and lipofilling targeting on midfacial fat compartments were all reviewed, the drawbacks of current studies were summarized and the future research direction was prospected. Related Articles | Metrics

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Application of teaching mode based on BOPPPS model in microsurgical training of plastic surgeons WEI Siming, SONG Baoqiang 2022, 18 (6):  539.  Abstract ( 98 )   PDF (251KB) ( 61 )   Objective　To explore the application effect of teaching mode based on BOPPPS model in microsurgical training of plastic surgeons. Methods　From March 2019 to March 2020, 60 advanced orthopedic surgeons were selected and randomly divided into study group and control group (30 cases in each group). The control group adopted the traditional teaching method, and the research group adopted the teaching method based on BOPPPS model. At the end of the teaching, the scores of microsurgery theory and skills assessment and teaching satisfaction of the two groups were compared. Results　The scores of microsurgery theory and skills in the study group were higher than those in the control group (P<0.05). The students' satisfaction with teaching in the study group was higher than that in the control group (100% vs 80%, P<0.05). Conclusion　The BOPPPS teaching mode can effectively improve the microsurgical skills of the trainee physicians, and the teaching satisfaction is high.  Related Articles | Metrics

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Demand analysis of training system for specialist nurses of Plastic and Reconstructive Surgery YANG Jiafei, BIAN Weiwei, HUAN Ying, et al 2022, 18 (6):  541.  Abstract ( 119 )   PDF (491KB) ( 55 )   Objective　To understand the demand of training system for specialist nurses of Plastic and Reconstructive Surgery. Methods　A self-designed questionnaire was used to survey 104 plastic surgery specialist nurses in terms of general information, training status, training contents and training methods. Results　Most of the specialist nurses in plastic surgery had not been exposed to relevant knowledge training before work (86.54%), and most of them were trained in the post-service department. The knowledge requirements of different levels of nurses in the core competence of plastic surgery (including the ideological and moral character, theoretical knowledge, professional skills, comprehensive practical ability and professional development ability) were compared. Low-level nurses tended to master basic knowledge, while high-level nurses tended to cultivate comprehensive practical ability and professional development ability (P<0.05). Most of the training methods chose to participate in the intra-department professional learning (27.88%), followed by the orthopaedic surgery forum (20.19%). Conclusion　According to the demand of different levels of plastic surgery specialist nurses, the training plan should be arranged reasonably in order to improve the training effect and improve the professional quality, skill level and post competence of nurses. Related Articles | Metrics