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, Volume 19 Issue 6   

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In vivo and vitro phenotype identification of miR-148a-3p regulating angiogenesis HUANG Jin, HAN Wenqing, LI Xin, et al 2023, 19 (6):  525.  Abstract ( 58 )   PDF (2301KB) ( 103 )   Objective　To identify the phenotype of miR-148a-3p in regulating angiogenesis. Methods　The primary tissues of miR-148a knock-out mice were extracted and immunohistochemical staining was used to investigate the effect of miR-148a knockout on angiogenesis. By means of miRNA Mimic transfection, miR-148a-3p was overexpressed in human umbilical vein endothelial cells (hUVECs). Thereafter, the influence of miR-148a-3p overexpression on angiogenesis was studied in aspects of Matrigel-based tube forming assay, cell proliferation, cell migration, qPCR, etc. The effects of miR-148a- 3p on angiogenesis were clarified in terms of knock-out and overexpression. Results　Compared with heterozygous littermates, the miR-148a knock-out mice had an abnormal distribution of type-H vessels in the bone tissue. The ex-vivo fetal metatarsal experiments further confirmed the enhanced angiogenesis ability in absence of miR-148a. The expression level of miR-148a- 3p was overexpressed by miR-148a-3p mimic in vascular endothelial cells. It was found that the overexpression of miR-148a- 3p did not affect the proliferation ability of hUVECs, but could interfere with angiogenesis by inhibiting its migration ability, and affect the formation of lamellipodia and tubes. Conclusion　miR-148a-3p can inhibit angiogenesis both in-vivo and in-vitro, including sprouting, migration, and tube formation. Related Articles | Metrics

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Correcting cryptotia by overturning constricted cartilage LI Yiyuan, ZHANG Qun, XU Zhicheng, et al 2023, 19 (6):  530.  Abstract ( 44 )   PDF (1548KB) ( 67 )   Objective To explore a new method of correcting cryptotia by overturning constricted cartilage. By this method, the mechanical direction of cartilage is changed. Methods Thirty cryptotia patients were treated from 2010 to 2022. The retroauricular skin flap was elevated to expose the posterior aspect of the upper auricular cartilage. The abnormal insertion of the auricular intrinsic muscles was detached. Cut and overturned the sharp antihelical cartilage, and the scalp skin flap was undermined and advanced toward the postauricular sulcus. The edge of the retroauricular scalp flap was fixed on the mastoid periosteum to release tension of the incision. Results The 22 unilateral and 8 bilateral cryptotia patients were followed up for 6-48 months. Favorable results maintained without skin necrosis or other complications. No case needed revision surgery. Conclusion This new method of overturning the cartilage flap is generally applicable to moderate and severe patients with cryptotia, and its innovative point is to completely change the mechanical direction of constricted cartilage in the region of the antihelix Related Articles | Metrics

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Venous malformation of glans penis: Classification and long-pluse 1 064 nm Nd:YAG laser therapy DUAN Qiong, HU Li, LIN Xiaoxi, et al 2023, 19 (6):  535.  Abstract ( 45 )   PDF (2176KB) ( 36 )   Objective　To propose a classification system for venous malformations of glans penis (GPVM) and evaluate the efficacy and safety of long-pulse 1 064 nm Nd : YAG (LP-Nd:YAG) laser therapy for GPVM. Methods　Twenty-six patients with GPVM were included in this study. They were classified into three types according to involved area and erectile function: Solitary type (Type Ⅰ ), extensive type (Type Ⅱ ), and full glans penis type without (Type Ⅲ a) or with (Type Ⅲ b) erectile dysfunction. Twenty-five of them were treated by LP-Nd : YAG laser, and the outcomes were converted into a five grading scales. The major and minor complications were recorded after each session. Results　Twenty-four patients completed LP-Nd : YAG laser treatment. Four patients (16.7%) achieved“excellent (clear rate 75%-90%)” results and 20 patients (83.3%) achieved “nearly cured (clear rate>90%)”  after an average of 2.4±1.1 sessions (1-5 sessions) of treatment. All treated patients were followed up for 6-14 months [average (9.0±2.6) months], and no recurrence was observed. The minor complications included mucosa texture change (n=8), temporary hyperpigmentation (n=4), blister and thin scab (n=2), temporary fibrous nodules (n=2), temporary hypopigmentation (n=1), superficial scar (n=1), slight hypoesthesia (n=1). And the minor complications included tissue defect and local depression (n=1) and permanent fibrous nodules (n=2). Conclusion　LP-Nd : YAG laser has rather high  clearance rate of GPVM and major complications are rare. This classification system is valuable to predict outcomes and safety of laser therapy to a certain degree. Different type of GPVM is likely to be related to different complications. Related Articles | Metrics

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The effectiveness of free anterolateral thigh flap on repairing soft tissue defects in the plantar load-bearing area SHI Lingling, WU Jin, GUO Zhimin, et al 2023, 19 (6):  541.  Abstract ( 40 )   PDF (1065KB) ( 37 )   Objective　To explore the clinical effect of free anterolateral thigh flap (ALTF) for repairing soft tissue defects in the plantar load-bearing area. Methods　From March 2020 to March 2021, 12 patients with soft tissue defects in the plantar weight-bearing area were selected, the soft tissue defect ranged from 8 cm×6 cm to 26 cm×16 cm. After emergency debridement, ALTF was used to repair soft tissue defects, and the donor site wounds were directly sutured or grafted with full thickness skin. Results　All 12 flaps survived in this group, with 2 cases showing slight exudation at the edge of the flap and accompanied by non healing of the wounds. The wounds self-healed after dressing change, debridement, anti-inflammatory treatment, and other treatments. All 12 patients were followed up for 6-12 months after operation, and the skin flap texture was relatively soft and the appearance recovery was good. After operation, physical therapy and functional rehabilitation training were carried out under the guidance of medical staff, and the range of foot movement and strength were basically restored. At the last follow-up, all patients returned to normal gait. During the final follow-up, there was 1 case with S1 grade sensory function in the plantar area (8.33%), 3 cases with S2 grade (25.00%), 6 cases with S3 grade (50.00%), and 2 cases with S4 grade (16.67%). The postoperative foot function scores at week 1, month 3, and month 6 were 46.25±5.27, 73.14±8.42 and 88.74±10.51, respectively. Statistics showed that Maryland’s foot function score in the 6th month>3rd month>1st week (P<0.05). Conclusion The use of free ALTF technology for repairing soft tissue defects in the plantar load-bearing area of patients has shown good clinical results and is worth promoting and applying in clinical practice. Related Articles | Metrics

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fficacy analysis and patient satisfaction study of postoperative elect beam radiotherapy for refractory keloid ZHAO Min, LI Li, ZHAO Ruidong, et al 2023, 19 (6):  544.  Abstract ( 66 )   PDF (1162KB) ( 68 )   Objective　To explore the therapeutic effect of postoperative electron beam radiotherapy for intractable keloid and the influencing factors of recurrence, and to evaluate patients’ satisfaction with the therapeutic effect. Methods　From 2019 to 2021, 37 patients with refractory keloids, including 40 keloids, were treated with electron beam irradiation after operation. The radiotherapy was conducted with 6-9 MeV electron beam irradiation from the skin, and the irradiation dose was 20 Gy/5 Gy/4 F. The general clinical data of patients were collected and followed up regularly after operation. After the observation, questionnaires were distributed to all patients to evaluate their satisfaction. The treatment effect and adverse reactions of patients were analyzed, and the factors affecting recurrence were analyzed by Logistic regression. Results　Among the 40 scars, 4 cases (10%) recurred after treatment, and 5 cases (12.5%) had no obvious change after treatment, and the effective rate was 77.5%. The main adverse reactions were skin pigmentation and incision expansion. Univariate analysis showed that sex, past history, time interval from operation to radiotherapy, continuous irradiation and plasma fibrinogen content were related to recurrence. Multivariate analysis showed that the interval between operation and radiotherapy for more than 24 hours was an independent risk factor for recurrence, and continuous irradiation was an independent protective factor. Recurrence, incision expansion and pigmentation were the main reasons for patients’ dissatisfaction. Conclusion　Surgery combined with electron beam radiotherapy is an effective method for the treatment of refractory keloid. The time from operation to radiotherapy and continuous irradiation are independent prognostic factors affecting the recurrence of keloid, and the subjective evaluation of patients is not completely consistent with their clinical manifestations and examinations. Related Articles | Metrics

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Application of 3D imaging technology in the measurement and evaluation of rhinoplasty as quality control YIN Weimin, ZHANG Zhanying, SU Quanxin, et al 2023, 19 (6):  549.  Abstract ( 47 )   PDF (1156KB) ( 68 )   Objective To explore the application effect of 3D imaging technology in the measurement and evaluation of rhinoplasty. Methods Before operation, facial images of beauty seekers were collected by 3D scanner and three-dimensional imaging was performed. The surgical plan was formulated by 3D design scheme and measurement data, and the intraoperative prosthesis carving was guided and the operation was completed. The 3D measurement was performed again during the operation to ensure that the immediate postoperative effect was highly consistent with the preoperative design effect. 3D measurements were taken again 1 to 6 months after operation. Seven aesthetic landmarks were selected, and the intraoperative and postoperative 3D scanning data were compared with the preoperative 3D simulation data, and statistical analysis was carried out. Results A total of 31 cases of cosmetic rhinoplasty were selected in this group, of which 30 cases were satisfied with the postoperative results, and 1 case had implant deflection after operation, and the result was satisfied after the second stage of surgical repair. By analyzing the sample confidence level of the data of 7 aesthetic landmarks in the nose, the error range between the sample statistical value and the overall parameter value was obtained, which was used to judge the degree of coincidence between the intraoperative, postoperative effects and the preoperative simulation effects, that is, the eligibility criteria. The intraoperative and postoperative monitoring data of all cases were within the error range of the confidence level of the sample statistics, which met the standard of preoperative simulation effect. Conclusion The application of 3D scanning technology in surgery ensures that the postoperative effect is consistent with the preoperative simulation effect, which is very effective for the quality control of rhinoplasty. Related Articles | Metrics

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Research on reasonableness of allogeneic blood transfusion in patients with autologous blood transfusion and preventive nursing efficacy of massive transfusion in orthopedic surgery for craniofacial deformity WANG Ying, WANG Ye, ZHI Yankang 2023, 19 (6):  553.  Abstract ( 33 )   PDF (796KB) ( 18 )   Objective　To understand the allogeneic red blood cell infusion in patients with autologous blood transfusion and evaluate the reasonableness of allogeneic blood transfusion in orthopedic surgery for craniofacial deformity; To explore the risk factors for unreasonable blood transfusion; To establish a decision-making model for reasonable allogeneic red blood cell infusion in this type of surgery; And to assess the preventive nursing efficacy of massive transfusion. Methods　The patients who received extensive operations on craniofacial deformity and autologous blood transfusion were selected as research objects. The theoretical hemoglobin value after the completion of intraoperative salvaged autologous blood transfusion at the end of operations was estimated, and unreasonable blood transfusion was defined as being greater than 100 g/L and receiving allogeneic red blood cell infusion. The differences in various clinical indexes between unreasonable blood transfusion patients and other patients were compared, and the risk factors related to unreasonable blood transfusion were analyzed via the regression model. Artificial intelligence neural network algorithm was used to establish a decision-making model for reasonable allogeneic red blood cell infusion in this type of surgery. The preventive nursing efficacy of massive transfusion was assessed by reviewing adverse reactions in perioperative blood transfusion. Results　A total of 63 patients with intraoperative autologous blood transfusion  were included in this study, of which the allogeneic red blood cell infusion rate was 96.83% (61/63) and the unreasonable allogeneic red blood cell infusion rate was 36.07% (22/61). The regression model did not find relatively independent risk factors that lead to unreasonable allogeneic blood transfusion. The area under the ROC curve in the decision-making model for reasonable allogeneic red blood cell infusion was close to 100%. After using a lot of preventive nursing measures for blood transfusion in this type of surgery, no serious complications related to blood transfusion occurred. Conclusion　There are many unreasonable allogeneic red blood cell infusion phenomena in patients with autologous blood transfusion in orthopedic surgery for craniofacial deformity. It’s suggested that the model in this study should be used to evaluate the necessity of allogeneic red blood cell infusion at any time according to the changes of blood loss and autologous blood transfusion volume, so as to avoid unreasonable allogeneic blood transfusion. The efficacy of preventive nursing measures for massive transfusion is definite in this type of surgery Related Articles | Metrics

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Effect of strengthening proprioception training and isokinetic muscle strength training on rehabilitation of patients undergoing anterior cruciate ligament reconstruction#br# XU Longfei, GAO Piming, LUO Jingting, et al 2023, 19 (6):  558.  Abstract ( 44 )   PDF (808KB) ( 113 )   Objective　To explore the effect of strengthening proprioception training and isokinetic muscle strength training on the rehabilitation of patients undergoing anterior cruciate ligament (ACL) reconstruction. Methods　From January 2020 to December 2022, 82 patients with ACL reconstruction were randomly divided into two groups: 41 cases in the control group and 41 cases in the research group. The control group was given routine training, while the study group was given intensive proprioception training and isokinetic muscle strength training. The knee proprioception function, isokinetic muscle strength, joint pain degree, knee stability, and rehabilitation effect were compared between the two groups before and after training. Results　After training, the 15 ° recurrence difference, 45 ° recurrence difference, and 75 ° recurrence difference on the affected side of the two groups decreased compared to before training (P<0.05), and the study group was significantly lower than the control group (P<0.05). After training, the relative peak torque of knee extension and flexion (PT/BW), peak torque of knee flexion (PT), PT of knee extension, and the ratio of hamstring muscle strength to quadriceps strength (H/Q) of the two groups were higher than those before training (P<0.05), and the study group was significantly higher than the control group (P<0.05). After training, both visual analogue scale (VAS) scores and Lachman test tibia anterior displacement decreased compared to before training (P<0.05), and the study group was significantly lower than the control group (P<0.05). The excellent and good rehabilitation rate of the research group was 90.24%, which was significantly higher than the 73.17% of the control group (P<0.05). Conclusion　The application of enhanced proprioception training and isokinetic muscle strength training in patients undergoing ACL reconstruction can effectively improve the proprioception function and isokinetic muscle strength of the knee joint, reduce the degree of joint pain, and improve the stability and rehabilitation effect of the knee joint Related Articles | Metrics

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Mediating effects of self-esteem between social support and psychological resilience in adolescent patients with alveolar cleft LIU Ting, WANG Xudong, LI Li, et al 2023, 19 (6):  564.  Abstract ( 37 )   PDF (876KB) ( 43 )   lveolar cleft, to explore the relationship between social support and mental toughness and the mediating role of self-esteem in social support and mental toughness, and ultimately to provide a theoretical basis for psychological support in comprehensive sequential therapy. Methods　A series of questionnaires consisting of general information, Self-esteem Scale, Child and Adolescent Social Support Scale, and Resilience Scale for Chinese Adolescent were used to investigate 161 adolescent patients with alveolar cleft in a tertiary care hospital in Shanghai using convenience sampling method. Pearson correlation analysis was used to explore the correlation between social support, mental toughness and self-esteem; Bootstrap with Process macro program was used to analyze and verify the mediation effect. Results　The social support, mental toughness, and selfesteem scores of adolescent patients with alveolar cleft were 74.54±10.02, 102.03±15.09, and 31.32±5.17 respectively, which were at an intermediate level. Mental toughness scores were statistically different among different ages, places of residence and  household income levels (P<0.05). Both social support and self-esteem scores were positively correlated with mental toughness score (r=0.67, 0.63, both P<0.01), and social support was also positively correlated with self-esteem (r=0.37, P<0.01). Social support directly affected mental toughness (β=0.735, 95% CI: 0.575-0.910), and indirectly affected mental toughness through a partial mediating effect of self-esteem (β=0.242, 95% CI: 0.143-0.360), with the mediating effect accounting for 24.78% of the total effect. Conclusion　Self-esteem has a mediating effect between social support and mental toughness in adolescent patients with alveolar cleft, and patients’mental toughness level increases with the increase of self-esteem and social support levels. The patients’age, residence and family income were all influencing factors of mental toughness. Therefore, medical and nursing staff, family members of patients, and social institutions should work together to improve the patient’s self-esteem level, thereby increasing his or her mental toughness level and providing security for the effective implementation of sequence therapy. Related Articles | Metrics

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Bibliometric Analysis of Journal of Tissue Engineering and Reconstructive Surgery from 2019 to 2022 PAN Xian, XU Qi 2023, 19 (6):  570.  Abstract ( 61 )   PDF (840KB) ( 347 )   Objective　To analyze the change of the main bibliometrics indexes of Journal of Tissue Engineering and Reconstructive Surgery in recent 4 years, and to compare with other journals of cosmetic and plastic surgery. Methods　Based on the statistical data from the Chinese S&T Journal Citation Reports (Core Version), the main bibliometric indicators of Tissue Engineering and Reconstructive Surgery, including total cites, impact factor, fund paper ratio, other-citing rate and other citing indexes, were statistically and longitudinal analyzed, and horizontal comparisons were made with 5 cosmetic and plastic surgery journals with similar publication backgrounds. Results　In the past four years, the total cites and published article numbers in Tissue Engineering and Reconstructive Surgery increased steadily, while the impact factor, fund paper ratio, and comprehensive evaluation scores showed a downward trend, and the other-citing rate remained at about 0.9. Compared with other journals of cosmetic and plastic surgery, the total cites, impact factor and published article numbers of our journal ranked at the bottom, but the other-citing rate, fund paper ratio, and comprehensive evaluation scores ranked at the top. Conclusion　The short-term goal and direction of the journal is to organize high-quality papers and enhance the scope of the journal. Related Articles | Metrics

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Percutaneous vertebroplasty for pathological fracture of cervical fifth vertebral hemangioma complicated with bone cement leakage: A case report LI Luyao, MA Rui, TENG Yong 2023, 19 (6):  576.  Abstract ( 39 )   PDF (1254KB) ( 55 )   　In July 2018, a patient with cervical fifth vertebral hemangioma accompanied by pathological fracture and symptoms of nerve irritation was admitted. Transcervical anterior puncture cervical five-vertebra biopsy and percutaneous vertebroplasty were performed in the first operation. Postoperative physical examination and imaging findings showed nerve compression caused by bone cement leakage. In order to alleviate the patient’s symptoms, posterior cervical fifth left lamina fenestration and bone cement removal, right pedicle puncture and cement injection were performed for the second time. The symptoms of nerve stimulation were gradually improved. After 2 years of follow-up, the patient’s neurological function was completely recovered and good clinical results were obtained Related Articles | Metrics

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Strategy and research advances of vascularization of tissue engineered skin LIU Jian, WANG Zhenxing, SUN Jiaming 2023, 19 (6):  579.  Abstract ( 61 )   PDF (809KB) ( 135 )   As an alternative solution for skin defect treatment, the core idea of tissue engineered skin is to use scaffold, cells or bioactive molecules to promote skin repair and reconstruction. Over the past decades, the field has developed tremendously, and various strategies to improve skin regeneration have emerged. However, although many tissue engineered skin products have been produced and approved for clinical use, there are still many problems that need to be further studied. Among these limitations, the vascularization of tissue engineered skin is one of the key challenges. At present, a large number of basic researches have been devoted to solving the problem of vascularization. In general, these solutions can be divided into two catagories: 1. Angiogenesis promotion strategies based on various growth factors, cells or active nanoparticles; 2. In vitro or in vivo pre-vascularization strategy based on tissue engineered skin scaffolds. In this paper, the advantages and disadvantages of the above two methods were reviewed, and the latest progress in vascularization strategies for skin tissue engineering was introduced Related Articles | Metrics

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Progress of skin aging-related biomarkers and their mechanisms WANG Jue, WANG Jiaqi, CHEN Heng, et al 2023, 19 (6):  586.  Abstract ( 73 )   PDF (794KB) ( 252 )   　Skin aging is a direct manifestation of human aging, which is the result of the joint action of genetic and environmental factors, and is manifested by cumulative changes in skin structure, function and appearance, such as increased wrinkles, laxity, elastosis, telangiectasia, and skin pigmentation abnormalities, etc. It is of great significance to delay skin aging in order to safeguard people’s mental health and the normal physiological function of the skin. Skin aging is a highly complex and not yet fully understood process, and it is not yet possible to definitively detect and assess aging based on a single biomarker. In this paper, aging-related biomarkers and their mechanisms of action were described in detail. Related Articles | Metrics

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Research progress on the treatment strategy of diabetic foot ulcers based on antibiotic bone cement LIU Chenxiaoxiao, JAN Yang, ZHANG Yanji, et al 2023, 19 (6):  591.  Abstract ( 51 )   PDF (836KB) ( 255 )   　Diabetic foot ulceration (DFU) is a common complication in diabetic patients and an important cause of deterioration, amputation and even death. Thorough debridement, infection control, re-establishment of blood flow and timely repair of the wound are the mainstays of treatment for DFU. Antibiotic bone cement has been used to treat DFU wounds with satisfactory results. In this paper, the available literature was analyzed and found that the common strategy for the use of antibiotic bone cement in DFU is to cover the wound with antibiotic bone cement to control infection and promote induction membrane production after complete debridement in phase 1, and to repair the wound with skin grafting, flap grafting and Ilizarov technique in phase 2. In addition, the relevant adjuvant treatments were listed based on antibiotic bone cement materials to provide a variety of options for clinical treatment. Related Articles | Metrics

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Research progress of inhibiting cell aging in the treatment of cartilage regeneration in osteoarthritis YE Qicheng, NIE Ping 2023, 19 (6):  597.  Abstract ( 36 )   PDF (789KB) ( 98 )   In recent years, the role of cellular aging in the occurrence and development of osteoarthritis has become a research hotspot. The existing evidence has basically confirmed that abnormal cartilage repair and the occurrence and development of osteoarthritis (OA) have a causal relationship with chondrocyte aging and mesenchymal cells (MSCs) aging. Targeted elimination of aging cells and promotion of the rejuvenation of stem cells can effectively delay OA. In this paper, the pathological role of cellular aging in the occurrence and development of OA and potential therapeutic targets were reviewed. Cell senescence is an important biological phenomenon and potential therapeutic target in the occurrence and development of OA. Further study of its biological mechanism is helpful for the early prevention and treatment of OA. Related Articles | Metrics

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Research progress of probiotics in chronic wound healing LIN Weiyi, GE Chengwang, TANG Xiaowei, et al 2023, 19 (6):  602.  Abstract ( 77 )   PDF (799KB) ( 132 )   　The incidence of chronic wounds is high and wound healing is difficult, which usually requires comprehensive treatment. Existing studies have found that the application of some probiotics and their metabolites can resist infection, promote wound cell  proliferation, regulate inflammation and thus promote chronic wound healing, which proves the great potential of probiotics in chronic wound healing. In this paper, the current application methods of probiotics in promoting chronic wound healing and their interactions with various tissues and cells were reviewed, providing a new direction for the comprehensive treatment of chronic wounds. Related Articles | Metrics

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The application of problem-driven interactive discussion model in laser medicine course for postgraduate students WU Pinru, SUN Qilin, LIU YANG, et al 2023, 19 (6):  608.  Abstract ( 38 )   PDF (747KB) ( 44 )   Objective　To explore the effect of using PBL method combined with the seminar mode on graduate students’ laser medicine teaching. Methods　Sixty graduate students majoring in clinical medicine of Shanghai Jiao Tong University School of Medicine from grade 2020 to 2021 were selected. The students were randomly divided into two groups,with 30 members in each group. The experimental group adopted PBL-seminar combining teaching mode, while the control group adopted conventional teaching method. A questionnaire was designed to investigate students’ satisfaction with teaching effect and study interest. The assessment results (knowledge level and classroom performance) of the two groups were compared after teaching. Results　The majority (93%, 28/30) of graduate students have a good level of satisfaction with the PBL-seminar combining teaching mode and agree that it can help them increase their study interest and enhance their self-learning ability. The knowledge level and classroom observation results of the students in the combining teaching group were significantly better than those in the traditional teaching group, with a statistically significant difference (P<0.05). Conclusion　The application of PBL seminar combining teaching mode in teaching laser medicine to graduate students can stimulate students’ interest in learning, tap into their thinking potential, and help improve their knowledge level and self-learning ability. Students are highly satisfied with this teaching mode. Related Articles | Metrics