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Table of Content

    01 August 2024, Volume 20 Issue 4 Previous Issue   
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    Experimental study of human umbilical cord mesenchymal stem cells on recovery of cavernosum nerve function in a rat model of diabetic-induced erectile dysfunction
    YANG Yang, LIU Fang, LI Shuaixiu, et al
    2024, 20 (4):  395. 
    Abstract ( 168 )   PDF (6071KB) ( 31 )  
    Objective  To explore the restoration effects of human umbilical cord mesenchymal stem cells on erectile function in rats by repairing and regenerating cavernous nerve. Methods Umbilical cords of healthy full-term newborns were collected, human umbilical cord mesenchymal stem cells( hUCMSC) were isolated and cell surface markers were identified. The rat model of diabetes-induced erection dysfunction (DIED) was established by intra-abdominal streptozotocin (STZ) injection in combination with high-fat diet, and an apomorphine( APO) test was performed to screen diabetic rat model with erectile dysfunction after 10 weeks. Eight weeks after the transplantation of hUCMSC, erectile function was evaluated by APO test and maximum intracavernous pressure/mean arterial pressure (ICP/MAP) ratio. The levels of neuronal nitric oxide synthase (nNOS) in corpus cavernosum tissues of rats were analyzed by immunohistochemistry analysis. In addition, the expression levels of neurotrophic growth factors including BDNF, NGF, VEGF, and IGF-1 in the corpus cavernosum tissues of SD rats were detected by ELISA. Results  The hUCMSC was successfully isolated from human umbilical cords, and results of flow cytometry showed that CD73, CD90 and CD105 were highly expressed while CD11b, CD19, CD34, CD45 and HLA-DR were low expressed on the surface of P4 hUCMSC. The rat model of diabetic-induced erectile dysfunction was successfully established. After 8 weeks of hUCMSC therapy, the results of APO test showed that hUCMSC enhanced the erectile function of DIED rats, as evidenced by an increase in the number of complete erection. Compared with the negative group, the blood flow in the penis was improved as indicated by obvious increases in ICP/MAP ratio values in medium-dose and high-dose groups of hUCMSC treatment. Immunohistochemistry results suggested that after the treatment of hUCMSC in medium and high doses, hUCMSC treatment significantly elevated the expression level of nNOS in the corpus cavernosum tissue of DIED rats, then induced penile erection in rats. Furthermore, ELISA test results indicated that the expression levels of BDNF, NGF, VEGF and IGF-1 could be restored in different degrees after treatment with medium- and high-dose of hUCMSC. Conclusion hUCMSC is a kind of adult pluripotent stem cells, which is effective and dose-dependent in the treatment of DIED rats induced by high fat diet combined with STZ following intracavernosal transplantation. The mechanism of hUCMSC treatment is related to neuroprotective and regenerative repair effects provided by upregulation of the expression levels of BDNF, NGF, VEGF and IGF-1.
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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
    2024, 20 (4):  403. 
    Abstract ( 740 )   PDF (5906KB) ( 26 )  
    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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    Clinical study on the combined application of autologous epidermal cell suspension and meshed autologous split thickness skin graft in the treatment of deep partial thickness burns

    YANG Huizhong, XU Zhenpeng, YUAN Bo, et al
    2024, 20 (4):  411. 
    Abstract ( 175 )   PDF (5183KB) ( 27 )  
    Objective To evaluate the effect of autologous epidermal cell suspension combined with mesh skin graft in deep II-degree burn wounds. Methods Patients with deep partial thickness burns were selected as the research subjects and randomly divided into two groups, control group and experimental group, according to the random table method. Control group received split-thickness mesh skin graft( n=8), and experimental group received autologous epidermal cell suspension combined with split-thickness mesh skin graft( n=8). The epidermal cell suspension was prepared from autologous donor skin by cell separator. The wound healing time, wound healing rate on first week after treatment, and scar score (Vancouver scale) on 8th week after surgery were statistically analyzed in the two groups. At the same time, the concentration and viability of epidermal cells in the cell suspension were detected. Results The healing time of experimental group was (10.2±0.3) days, compared with( 12.1±0.6) days in control group( P<0.05). The healing rates of control group and experimental group were 76.97%±10.68% vs. 94.85%±10.01% (P<0.05) one week after treatment, and the Vancouver scar scores of control group and experimental group were 6.13±3.44 vs. 2.92±1.07 (P<0.05) at 8 weeks after surgery. The concentration of cell suspension was( 1.77±0.11)×106 cells per cm² skin sample, and the cell viability was 87.85%±4%. Conclusion This study preliminarily confirmed that autologous epidermal cell suspension combined with mesh skin transplantation in the treatment of deep partial thickness burns can promote skin grafting healing time, reduce donor area, and improve postoperative scar hyperplasia.
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    Biocompatibility of PCL/RGO nerve duct basement membrane prepared by electrospinning
    ·YE Kai, HUANG Xiaoxia, WU Boyu, et al
    2024, 20 (4):  416. 
    Abstract ( 128 )   PDF (5581KB) ( 14 )  
    Objective  To explore the in vitro biocompatibility of five different contents of polycaprolactone/reduced graphene oxide (PCL/RGO) nerve duct basement membrane materials with PC12 cells. Methods Five kinds of PCL/RGO nerve duct basement membrane materials with different RGO contents were prepared by electrospinning technique and cocultured with PC12 cells. The proliferation of PC12 cells was determined by CCK-8 method, the adhesion and reproduction of PC12 cells were observed by scanning electron microscopy, and the cell activity was observed by Live/Dead fluorescence staining. Results The cell proliferation rate of the five groups was different, but the toxicity grade was 0( no cytotoxicity), and the cell proliferation of 0.75%RGO/PCL group was the best. After 5 groups of materials were cultured for 7 days, the cell adhesion growth was significantly increased under electron microscope compared with 1 day and 3 days, and the surface of the materials was fully coated. The Live/Dead fluorescence staining results showed that the survival rate of cells in all groups was above 90%. Conclusion Five kinds of PCL/RGO composites with different RGO contents all have good biocompatibility, and the composite materials with 0.75%RGO/PCL ratio have a relatively large advantage in promoting cell proliferation and adhesion.
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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
    2024, 20 (4):  422. 
    Abstract ( 284 )   PDF (2406KB) ( 26 )  
    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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    Selection of vascular anastomosis methods for breast reconstruction using lobed free lower abdominal flap transplantation
    SONG Dajiang, ZHANG Tianyi, WANG Zhiyuan, et al
    2024, 20 (4):  428. 
    Abstract ( 218 )   PDF (9081KB) ( 19 )  
    Objective To summarize the indications and vascular anastomosis methods selection for the transplantation of lobed free lower abdominal flap for breast reconstruction. Methods  From October 2019 to June 2023, 17 female breast cancer patients received lobulated free lower abdominal flap transfer for breast reconstruction, including 10 cases of immediate breast reconstruction and 7 cases of delayed breast reconstruction. All the cases were completed by transplantation of lobulated free lower abdominal flaps, including 20 M1 type free rectus abdominis skin flaps, 6 M2 types, and 8 M3 types. The specific vascular anastomosis methods include supercharge in 9 cases and turbocharge in 8 cases. The recipient vessels include 14 sides of the proximal end of the internal mammary vessels, 10 sides of the main trunk of the thoracodorsal vessels, 3 sides of the serratus anterior branches, 2 cases of the lateral thoracic artery and vein, and 5 sides of the distal end of the internal mammary vessels. Results  Each side flap had a length of (14.2±0.4) cm, a width of (11.5±1.0) cm, and a thickness of( 4.9±0.3) cm. All flaps had good blood circulation and all survived smoothly. All patients were followed up for 6 to 38 months (20.7 months on average), no recurrence was noted. The reconstructed breasts had good appearance, satisfactory texture, no flap contracture and deformation, and was basically symmetrical with the healthy breast. The flap donor site and breast recipient area only had linear scars left, and there was no significant impact on abdominal wall function.Conclusion The lobed free lower abdominal flap is suitable for breast reconstruction with large base and sagging convexity. Choosing a reasonable vascular anastomosis method can ensure the free placement of the flap and satisfactory breast shaping.
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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
    2024, 20 (4):  434. 
    Abstract ( 369 )   PDF (9690KB) ( 13 )  
    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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    Surgical management of soft tissue arteriovenous malformations:A retrospective study in one center
    WANG Qian, WANG Min, CHEN Yong, et al
    2024, 20 (4):  440. 
    Abstract ( 127 )   PDF (17715KB) ( 15 )  
    Objective  To evaluate the surgical management of patients with soft tissue arteriovenous malformations.Methods Data of 43 AVM patients who underwent surgical treatment in our department from January 2007 to December 2022 were retrospectively analyzed, including 23 males and 20 females, aged 8-62 years, with an average age of 27.3 years. The lesion sites included head and neck( n=29), trunk( n=5), upper limbs( n=4) and lower limbs( n=5). The situation of these patients was evaluated according to the Schobinger staging system and Yakes classification. The strategy of surgical management was summarized based on the methods and outcomes of the above cases. Results A total of 43 patients were included in the study. According to the Schobinger staging system, there were 8 stage Ⅰ, 21 stage Ⅱ, 13 stage Ⅲ and 1 stage Ⅳ patients. Based on the Yakes classification, the lesions included 5 Yakes type Ⅰ, 13 type Ⅱ, 7 type Ⅲ, and 17 type Ⅳ. One of the patients could not be classified with Yakes classification due to lack of vascular imaging results. Simple surgical resection was performed in 29 patients, combined preoperative superselective embolization with surgical resection was performed in 5 patients, two-stage surgical resection with application of tissue expanders was performed in 6 patients, amputation was performed in 3 patients. As for wound repair, primary linear closure was performed in 14 patients, skin grafting in 15 patients, expanded flaps in 6 patients, and local flaps in 8 patients. The incisions healed primarily. Skin grafts and flaps survived well. During the follow-up of 6-112 months( 33.7 months on average), 37 patients were cured( 84%) and 6 improved. Conclusion  Based on the site, anatomy, clinical staging and Yakes classification, combined with interventional embolization and expanders, personalized surgical treatment can obtain satisfactory short-term and long-term 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
    2024, 20 (4):  447. 
    Abstract ( 329 )   PDF (968KB) ( 44 )  
    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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    Design of hospital drug delivery box and its application in botulinum toxin Type A drug delivery process
    JIANG Wenjun, XU Min
    2024, 20 (4):  453. 
    Abstract ( 143 )   PDF (1770KB) ( 19 )  
    Objective  To evaluate the application effect of hospital drug delivery box (incubator) in short-term transportation of botulinum toxin type A drugs in hospital. Methods Botulinum toxin type A was transported in an incubator from the 1st to the 15th of each month from September to December 2021, and was set as the intervention group. From the 16th to the 30th of each month, the drug was transported in ordinary cartons and was set as the control group. The effects of two different transport vehicles on maintaining the temperature stability of botulinum toxin type A drugs in the box, the occurrence of the average rate of drug package damage and the use satisfaction of nursing staff were all evaluated. Results The intervention group was significantly better than the control group in the above three aspects, the difference was statistically significant (P<0.05). Conclusion The hospital drug delivery box can meet the temperature control demand of special drugs requiring cold chain transportation in the hospital, and the stability is good, can reduce or avoid drug damage, and improve the satisfaction of nursing staff.
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    Hypodermic needle guided suturing for distant tension-offloading suture
    PAN Sida, WU Qinghua, PENG Qian, et al
    2024, 20 (4):  456. 
    Abstract ( 526 )   PDF (1487KB) ( 16 )  
    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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    Successful repair of skin tissue expansion devices implantation with partial exposure of dilated sac Two cases repor·t

    WU Weimin, LAN Tianyao, ZHENG Huarong, et al
    2024, 20 (4):  460. 
    Abstract ( 75 )   PDF (9569KB) ( 40 )  
    From September 2023 to December 2023, two patients with burn scar formation were admitted. The skin and soft tissue expander was implanted in stage I, and part of the expander balloon was exposed after surgery. In one case, the exposed area was about 5 cm×5 cm and the volume was about 50 mL, accounting for 20% of the total water injection. The exposed area of the other case is about 3 cm×2 cm, and the volume is about 20 mL, accounting for 5% of the total water injection. The causes of the exposed expander balloon were analyzed, and dressing change was given. At the same time, water injection and pressure bandaging were used to save the exposed expander balloon. In the end, 270 mL and 360 mL water were successfully injected, accounting for about 67% and 90% of the rated capacity of the skin soft tissue expander. Postoperative scar repair results were good in 2 patients, no necrosis of expanded flap, no motor and sensory dysfunction, and the patients were satisfied. The reasons for the partial exposure of the expansion balloon after the implantation of the skin and soft tissue expander are as follows: 1. Scar expansion is limited and the surrounding conditions are not sufficient, and the wound is easy to split; 2. Too long electric coagulation time leads to local full-layer necrosis of the flap, which easily leads to the exposure of the expander. The experience in the treatment of such complications: prevention and treatment of infection, external bandaging and fixation to reduce the tension of local exposed balloon. In addition, negative pressure closure and drainage can promote wound healing.
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    modRNA enhance the effect of cell therapy in tissue repairing and regeneration
    ·WANG Xiangying, FU Wei
    2024, 20 (4):  465. 
    Abstract ( 420 )   PDF (976KB) ( 21 )  
     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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    Progress in research methods of studying the neural crest

    JIANG Leheng, YIN Ningbei
    2024, 20 (4):  469. 
    Abstract ( 474 )   PDF (993KB) ( 108 )  
    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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    Application and development of fluorescence-guided surgery in reconstructive surgery
    SHI Chenchen, XU Heng, ZHANG Yixin
    2024, 20 (4):  469. 
    Abstract ( 51 )   PDF (1009KB) ( 25 )  
    Fluorescence-guided surgery( FGS) uses fluorescent contrast agents to visualize the target tissue and provide real-time dynamic images. Its temporal resolution, spatial resolution and application mode are superior to magnetic resonance imaging, computed tomography and ultrasound, and it is mainly used in tumor resection. Currently in reconstructive surgery, surgeons are often involved in the localization and discrimination of blood vessels, lymph vessels, and nerves. In this paper, the application status of FGS in flap surgery, lymphatic and nerve reconstruction from the above three aspects, and the development progress of related fluorescent contrast agents and imaging system were all reviewed.
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    Research progress of intramuscular fatty infiltration

    LU Baixue, GAO Weicheng
    2024, 20 (4):  481. 
    Abstract ( 299 )   PDF (970KB) ( 64 )  
    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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    Advancements of fractional photoelectric technology in periorbital rejuvenation
    YAN Li, CHEN Xiaoying, PAN Meng
    2024, 20 (4):  486. 
    Abstract ( 261 )   PDF (981KB) ( 12 )  
    The periorbital region is one of the earliest areas to show signs of aging, and its aging process can effectively reflect a person's level of aging. Periorbital aging involves various issues such as dark circles, wrinkles, tear troughs, and under-eye bags, which can give people a tired, depressed, or angry appearance. Fractional photoelectric technology is widely used in periorbital rejuvenation as it adopts the principle of fractional photothermolysis, which can form dozens of microscopic treatment zones, stimulating collagen regeneration and enabling rapid repair of the surrounding normal skin tissues. In this paper, the application of fractional photoelectric technology in periorbital rejuvenation was reviewed, aiming to provide references for clinical practice.
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    Advances in minimal-invasive blepharoplasty

    YANG Baofeng, LI Jie, MA Jiguang
    2024, 20 (4):  491. 
    Abstract ( 516 )   PDF (969KB) ( 18 )  
    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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    The application and thinking of problem enriched instruction in clinical teaching of dermatology and venereology based on psychology of learning
    ·HUANG Linting, LIU Lanjun, WANG Xue, et al
    2024, 20 (4):  496. 
    Abstract ( 264 )   PDF (967KB) ( 20 )  
    Based on psychology of learning, this study analyzed the conditions and levels of problem enriched instruction from the perspective of learning condition theory and problems, summarized the characteristics of various problems, and the teaching design of the chapters of“ herpes zoster” in the textbook of dermatology and venereology was performed, aiming to broaden students’ understanding of herpes zoster, and try to improve students’ understanding through multiple dimensions such as the clinical professional competence, medical exploration and medical ideological and political education through the layer-by-layer analysis based on the minimum problem unit.
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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
    2024, 20 (4):  500. 
    Abstract ( 572 )   PDF (941KB) ( 12 )  
    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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