The complications associated with polyacrylamide hydrogel injection including tissue infection, nodular formation, and migration along tissue planes have been well-documented. Complete removal of injected material is seldom possible. Patients who underwent removal of injected material were significantly more likely to express interest in facelift. We provide an open surgical technique with facelift incision to deal with the removal of polyacrylamide hydrogel and complication due to volume deflation and tissue descent.

Background There is extensive literature on different face-lift techniques; however, few articles published in the English language address the particularities of the face-lift for Chinese patients. Because of differences in facial anatomy, facial aging, and patient expectations, facial rejuvenation procedures for Chinese patients can be quite different from those of White patients. Methods The study includes 1026 consecutive primary face-lift cases performed by the senior author (D.Y.) from 2006 to 2019. Of these, 1010 patients were female and 16 were male. The average age of the patient at the time of primary face-lift was 40.5 years. The face-lift procedures included midface lift in 108 cases, midface and lower-face lift in 882 cases, and midface and lower-face lift with brow lift in 36 cases. All patients received superficial musculoaponeurotic system (SMAS) treatment, in the form of lateral SMASectomy in 607 cases, high-SMAS technique in 84 cases, modified high-SMAS short-scar technique in 108 cases, minimal access cranial suspension technique in 38 cases, and modified minimal access cranial suspension technique in 189 cases. Photographs of patients were analyzed to assess persistent features of facial aging. Complications such as hematoma, skin slough, infection, and nerve injury were also reviewed. Results Most patients obtained consistently good results with minimal risk and complications. All surgical techniques discussed were safe and reproducible, providing various options for surgeons. Conclusions Special attention should be taken when planning a facial rejuvenation procedure for Chinese patients. Anatomic variations dictate a greater emphasis on the management of tissue ptosis, particularly regarding lateral brow descent and malar fat pad descent. In our practice, various face-lift techniques can produce excellent results. Surgeons must adopt a technique that serves patients well and is, ideally, safe, consistent, easily reproducible, and applicable to various anatomic problems. In addition, every surgery is customized to the patient's anatomy and concerns. Therefore, the surgeon must adopt individualized technique according to the needs and desires of each patient.

PURPOSE:To study the changes in the hair follicle cycle and related stem cells induced by photoaging to establish a mouse model of senescence in hair follicles.METHODS:There were 54 C57BL6/J mice randomly divided into three groups. The UVA group and the UVB group underwent photoaging induced by UV lamps for 8 weeks. Changes in skin and the hair follicle cycle were compared by physical signs, dermoscopy, and hematoxylin and eosin and Masson's staining in each group. Western blot, immunohistochemistry, and RT-qPCR were carried out to test canonical proteins and gene expression of the Wnt signaling pathway in the samples. Immunofluorescence was chosen to show variations in the stem cells related to the hair follicle cycle.RESULTS:There were more gray hairs in the UVA group than the other groups (P<0.05). Both diameter of the hair shaft and depth of hair root were significantly decreased in the UV groups (P<0.05). Stem cells and melanocytes of the hair follicles were reduced in the UVA group. UV, especially UVB, up-regulated the expression of the Wnt signaling pathway and prolonged anagen and telogen phases in the hair follicles, compared with the control group (P<0.05).CONCLUSION:By decreasing the number of stem cells related to hair follicles, UVA induces hair follicle photoaging characterized by hair follicle miniaturization and gray hairs. UV up-regulated the expression of the Wnt signaling pathway, and the hair follicle cycle was significantly prolonged by UVB.

BACKGROUND Important differences in facial anatomy and how faces age must be considered when performing facelifts in Asian populations. Few facelift methods are specifically designed for Asian patients. OBJECTIVE This study evaluated the efficacy of lateral superficial muscular aponeurotic system (SMAS)-stacking/SMAS-ectomy with orbicularis-malar fat repositioning. MATERIALS AND METHODS Between February 2013 and December 2016, 62 women underwent the evaluated technique and completed the follow-up (15 months, ranging from 3 to 38.5 months). Three blinded, independent observers graded wrinkles, laxity, nasolabial fold depth, malar prominence, and tear trough deformity using quantitative comprehensive grading scales. FACE-Q scale items were assessed, and complications were recorded. RESULTS The mean postoperative scores for wrinkles, laxity, nasolabial fold depth, malar prominence, and tear trough deformity decreased from 2.64, 2.62, 2.01, 2.06, and 2.40 to 1.48, 1.34, 0.93, 1.21, and 1.27, respectively. The preoperative and postoperative scores differed significantly for all parameters (p < .05). The FACE-Q results showed that the patients were highly satisfied with their appearance, quality of life, adverse effects, and care. CONCLUSION The authors' technique allows midfacial and periorbital rejuvenation and offers dual benefits by correcting individual facial asymmetries and reshaping the jowls and neck contour in Asian patients.

AIM:Tissue-specific extracellular matrix promotes tissue regeneration and repair. We aimed to identify the optimal decellularized matrices for tissue-engineered vascular graft (TEVG). METHODS:Decellularized aorta of fetal pigs (DAFP, n = 6, group A), decellularized aorta of adult pigs (DAAP, n = 6, group B), and decellularized carotid artery of adult pigs (DCAP, n = 6, group C) were prepared. Scaffolds were compared using histology and ultrastructure. Endothelial cell (EC) and myofibroblast (MFB) infiltration assessments were performed in vitro. Cell infiltration was measured in vivo. Biomechanical properties were also determined. RESULTS:Almost original cells were removed by the acellularization procedure, while the construction of the matrix basically remained. In vitro, monolayer ECs and multi-layer MFBs were formed onto the internal surface of the specimens after 3 weeks. In vivo, cell infiltration in group A significantly increased at the 6th and 8th week when compared with groups B and C (p < 0.01). The infiltrated cells were mainly MFBs and a few CD4+ T-lymphocytes/macrophages in the specimens. Groups A and B showed greater axial compliance than group C (p < 0.01). CONCLUSION:DAFP was the most suitable for use as a small-caliber vascular graft.

Background Skin is a dynamic organ that maintains homeostasis and provides protection against environmental stimuli and pathogens. However, constant solar ultraviolet (UV) radiation can induce photoaging and photocarcinogenesis, thus reducing skin barrier function by altering skin at the cellular and structural levels. Adipose-derived stem cells (ADSCs) ameliorate signs of skin photoaging, but their antiphotoaging mechanism remains elusive. In this study, we explored the mechanism by which ADSCs improve skin photoaging. Methods Female C57BL/6J mice were used as experimental subjects and were randomly divided into three groups. We used Western blot analysis, Real time-polymerase chain reaction, and immunofluorescence to analyze the expression of photoaging- and photocarcinogenesis-related inflammasomes, extracellular matrix components, and related factors. Results The results showed that ADSCs reduced the UVB irradiation-mediated increase in MMP2, MMP13, phospho-NF-kappa B p65, Nlrp3, and VCAM-1 mRNA expression. The TGF-beta 2 expression trend was opposite that of the above genes. ADSCs ameliorated the downregulation of alpha 6 integrin, CD34, and collagen I by UVB irradiation. Simultaneously, ADSCs reduced the overexpression of COX2 and TNF-alpha induced by UVB irradiation. Conclusion These results demonstrated that ADSCs could restore skin barrier function at the cellular and structural levels, enhance hair follicle stem cell (HFSCs) activity by regulating TGF-beta 2 and inhibit photoaging- and photocarcinogenesis-related inflammatory responses and extracellular matrix degradation.

重睑即"双眼皮",重睑成形术是指通过改变眼睑组织结构,重塑眼睑外形,形成新的上睑皱襞的手术,现已成为美容外科最普遍的手术之一.其术式种类繁多,以切开法、埋线法为主,其中切开法应用最多.采用这种术式可以使眼睛美化,更易于表达情感.眼睛被美学家称为美之窗,不仅是人体容貌中最显露、最醒目的 器官,也是容貌美的中心,单眼皮常给人以单调、冷漠的感觉,而双眼皮却体现出一种灵动、清秀之美;另一方面,轮廓清晰的重睑线也受到现代审美的推崇,这些是重睑成形术流行的原因.但由于求美者对手术效果要求较高,所以实施该手术时要注意围术期的处理,以减少不必要的纠纷.未来,应进一步探索更趋于完美的手术效果,最大限度减少并发症发生.

目的:细胞微环境在调控细胞定位、细胞行为和细胞分化等方面发挥重要作用.细胞外基质(Etracellular matrix,ECM)在塑造干细胞微环境中起着最关键的作用,与上皮干细胞接触,调节干细胞命运,其中整合素和胶原蛋白在干细胞的调节和维持中发挥重要作用.本研究中,笔者假设UVB照射通过改变ECM诱导皮肤光老化,并且应用脂肪干细胞(Adipose derived stem cells,ADSCs)可以逆转光老化.方法:将C57BL/6J小鼠作为研究对象,分为对照组、UVB组和UVB+ADSCs组.采用HE和Masson染色鉴定各组的组织学差异,应用免疫荧光分析和RT-PCR技术检测三组间ECM组分表达的差异性.评估整合素α2(Integrinα2),增殖细胞核抗原(Proliferating cell nuclear antigen,PCNA),抗凋亡蛋白Bcl-2在各组的表达情况.结果:HE和Masson染色结果显示UVB照射明显增加表皮厚度,应用ADSCs后表皮厚度与对照组接近.UVB组整合素α2、胶原蛋白Ⅲ和抗凋亡蛋白Bcl-2的表达水平均低于对照组,而UVB+ADSCs组各因子表达高于UVB组,与对照组接近(P<0.05).基质金属蛋白酶2(Matrix metalloproteinase 2,MMP 2)、基质金属蛋白酶9(Matrix metalloproteinase 9,MMP 9)和PCNA的表达趋势与上述相反.结论:笔者发现UVB照射通过改变ECM而导致典型的光老化征象,并且UVB抑制抗凋亡蛋白Bcl-2的表达和整合素α2的表达.Bcl-2和整合素α2有望成为抑制光老化的作用因子.

Massive facial damages extremely affect the facial appearance and function. In existing publications, the surgical flap transfer was still prior to other methods in repairing the facial injury. Among them, the prefabricated induced expanded skin flap seems more effective based on the facial specific features and damage range. In this study, a literature research was carried out in the database of PubMed. A total of 85 patients were included and all of them underwent the method of prefabricated expanded flap to reconstruct the massive facial defects. The prefabricated induced expanded skin flaps harvested from the neck and chest area have prominent advantage in resetting massive facial deformities. All the flaps survived demonstrated an excellent texture and color match with the facial defects areas. However, the unsolved problems are still existed in these flaps and further research is necessary to obtain a satisfactory outcome for both patients and surgeons.

To improve mechanical properties of fibrin gel-based scaffolds for tissue-engineered, small-diameter vascular grafts, we developed a completely biological composite scaffold using fibrin gel and decellularized canine carotid arteries. The hybrid scaffold was fabricated by spray-coating fibrin gel onto the outer surface (group A), inner surface (group B), or inner and outer surfaces (group C) of decellularized canine carotid arteries. Additionally, vascular grafts were constructed using the hybrid scaffold and porcine vascular cells (myofibroblasts and endothelial cells). Histological examination revealed that the fibrin gel was bound to the decellularized canine carotid artery. Scanning electron microscopy indicated that the decellularized canine carotid artery fibers were closely intertwined with the fibrin gel fibers Obtained vascular grafts consisted of three layers. Compared to fresh canine carotid arteries, completely biological hybrid scaffolds and the tissue-engineered vascular grafts exhibited similar burst strengths, ultimate tensile strengths, and radial compliances. Furthermore, the decellularized canine carotid arteries showed significantly lower radial compliance than other groups. The three different construction methods had no significant impact on the biomechanical properties of the completely biological hybrid scaffolds. Therefore, the completely biological hybrid scaffold, using fibrin gel and decellularized canine carotid artery, can serve as a scaffold for tissue-engineered, small-diameter vascular grafts.

Background/Aims: Skin photoaging is primarily caused by the functional attrition of skin stem cells. The skin stem cell niche plays an important role in maintaining stem cell survival and behaviour. In our study, we hypothesized that UVB irradiation induces skin photoaging by changing skin stem cell niches and that transferred adipose-derived stem cells (ADSCs) can remodel the niches by affecting the BMP signalling pathway and transdifferentiating into skin stem cells. Methods: Sixty-four C57BL/6J mice were divided into the following groups: a control group, the UVB group and the UVB+ADSCs group. Western blot assays, immunofluorescence analysis and real-time PCR were used to measure differences in the expression of niche components among the three groups. Furthermore, we tested whether transplanted ADSCs express skin stem cell markers, such as p63, α6-integrin and CD34. Results: The expression levels of Bmp4, its downstream factors Smad1 and MAPK1 and a regulatory factor of the niche, i.e., NFATc1, were lower in the UVB group than were those in the control group (P< 0.05) but higher in the UVB+ADSCs group than were those in the UVB group (P< 0.05). Compared with Bmp4, Nanog (a downstream factor of Bmp4), and MMP13 (a regulatory factor of the niche), ICAM-1 (a proinflammatory gene), p63 (a basal transcription factor), β1-integrin, Mtnr1a and Tyr (melanogenesis-related factors) showed the opposite expression trends (P< 0.05). Bmp2 and Collagen IV levels did not significantly change among the three groups (P> 0.05). Skin stem cell markers, such as p63, α6-integrin and CD34, were coexpressed in the ADSCs, which suggested the ADSCs may transdifferentiate into skin stem cells. Conclusion: We found that UVB irradiation results in typical photoaging signs by altering skin stem cell niches and that Bmp4 was a key factor in BMP signalling in hair follicles. ADSCs reversed these typical photoaging signs by remodelling skin stem cell niches through BMP4 pathway modulation and transdifferentiation into skin stem cells.

Purpose: Among multiple influential factors affecting facial symmetry, the role of soft tissue is often overlooked. Skin and skeletal differences between Asian and Caucasian people also require the adaptation of current techniques for Asian patients. This article aimed to explore the ability of individual facelift techniques to improve facial symmetry and reset youthful eye in Asian people, while a new method, called the grid method, was tried to evaluate the improvement in facial symmetry. Methods: The authors conducted a review of 58 consecutive facelifts, which were all performed by a single surgeon between April 2009 and December 2016 following institutional review board approval. Among them, 21 patients underwent lower eyelid blepharoplasty. The original frontal photograph of each patient was evaluated by the grid method. Five independent plastic surgeons reviewed the facial asymmetry of the images before and after the operations using a visual analog scale to analyze the facial asymmetry of the patients. Results: In the preoperative group evaluated by the grid, the mean facial asymmetry score was 4.11, while in the postoperative group, the mean score was 1.07, which was significantly lower than the mean score before the operation (p < 0.001). The change in mean scores illustrated that the technique was effective in improving facial symmetry in Asian people. A total of 8 patients experienced hematomas and recovered well without obvious sequelae. Conclusions: The individual facelift technique was effective for improving facial symmetry and reshaping youthful eye in Asian people.

MicroRNAs (miRNAs) have been extensively studied and play a regulatory role during adipogenesis. Specifically, many miRNAs participate in regulation of mesenchymal stem cell (MSC) differentiation into adipogenic and osteogenic lineages. However, the regulatory mechanisms of miR-135a-5p in the Hippo signaling pathway during adipogenesis need to be explored. In this study, we observed that miR-135a-5p promotes adipogenesis of human adipose-derived MSCs (hADMSCs). miR-135a-5p was overexpressed in adipocytes compared to hADMSCs and further upregulation of miR-135a-5p promoted proliferation and adipogenesis of hADMSCs. In contrast, miR-135a-5p reduction inhibited these processes. Luciferase activity detection and Western blotting confirmed that overexpressed miR-135a-5p had the ability to upregulate the HIPPO signaling pathway. Subsequently, we observed that miR-135a-5p is targeted to key negative regulators in the HIPPO signaling pathway, including MOB kinase activator 1B (MOB1B) and large tumor suppressor 1 (LATS1). Moreover, suppression of LATS1 and MOB1B upregulated the activity of TEAD. In conclusion, we have verified that miR-135a-5p plays an active role in adipogenesis by targeting LATS1 and MOB1B expression, thereby enhancing the HIPPO signaling pathway.

Objective To introduce a relatively minimally invasive operative method of middle facial rhytidetomy and analyze the effect of high-level SMAS combined with malar fat pad and orbicularis oculi muscle suspension.Methods High-level SMAS combined with malar fat pad and orbicularis oculi muscle suspension was carried out in 121 patients.The incision was designed along the hair borderin the temporal region,and then stripped along with the superficial SMAS in the range above the zygomatic arch.Drooping malar fat pad,SMAS and orbicularis oculi muscle were suspended in the deep temporal fascia,and excess skin tissue was removed.In this way,thesagging facial tissue can maintain along-term lifting effect.Results One hundred and twenty-one patients were followed up from 6 weeks to 1 year.All of them achieved satisfactory clinical results.The recovery time was shortand no complications such as facial nerve injury,subcutaneous hematoma or infection occurred.The postoperative incision scar is not obvious.Conclusion Restoration of high SMAS,malar fat pad and orbicularis oculi muscle was the key in middle facial rejuvenation.Injury of the facial nerve branches was avoided through the safe dissection of the subcutaneous layer.This method was relatively simple,surgically,and produced a significant and lasting effect.

Background: Tissue engineering has emerged as a promising alternative for small-diameter vascular grafts. The aim of this study was to determine the feasibility of using decellularized aortae of fetal pigs (DAFPs) to construct tissue-engineered, small-diameter vascular grafts and to test the performance and application of DAFPs as vascular tissue-engineered scaffolds in the canine arterial system. Methods: DAFPs were prepared by continuous enzymatic digestion. Canine vascular endothelial cells (ECs) were seeded onto DAFPs in vitro and then the vascular grafts were cultured in a custom-designed vascular bioreactor system for 7 days of dynamic culture following 3 days of static culture. The grafts were then transplanted into the common carotid artery of the same seven dogs from which ECs had been derived (two grafts were prepared for each dog with one as a backup; therefore, a total of 14 tissue-engineered blood vessels were prepared). At 1, 3, and 6 months post-transplantation, ultrasonography and contrast-enhanced computed tomography (CT) were used to check the patency of the grafts. Additionally, vascular grafts were sampled for histological and electron microscopic examination. Results: Tissue-engineered, small-diameter vascular grafts can be successfully constructed using DAFPs and canine vascular ECs. Ultrasonographic and CT test results confirmed that implanted vascular grafts displayed good patency with no obvious thrombi. Six months after implantation, the grafts had been remodeled and exhibited a similar structure to normal arteries. Immunohistochemical staining showed that cells had evenly infiltrated the tunica media and were identified as muscular fibroblasts. Scanning electron microscopy showed that the graft possessed a complete cell layer, and the internal cells of the graft were confirmed to be ECs by transmission electron microscopy. Conclusions: Tissue-engineered, small-diameter vascular grafts constructed using DAFPs and canine vascular ECs can be successfully transplanted to replace the canine common carotid artery. This investigation potentially paves the way for solving a problem of considerable clinical need, i.e., the requirement for small-diameter vascular grafts.

Recent advancements in cancer biology have identified a large number of lncRNAs that are dysregulated expression in the development and tumorigenesis of cancers, highlighting the importance of lncRNAs as a key player for human cancers. However, the prognostic value of lncRNAs still remains unclear and needs to be further investigated. In the present study, we aim to assess the prognostic value of lncRNAs in cutaneous melanoma by integrated lncRNA expression profiles from TCGA database and matched clinical information from a large cohort of patients with cutaneous melanoma. We finally identified a set of six lncRNAs that are significantly associated with survival of patients with cutaneous melanoma. A linear combination of six lncRNAs (LINC01260, HCP5, PIGBOS1, RP11-247L20.4, CTA-292E10.6 and CTB-113P19.5) was constructed as a six-lncRNA signature which classified patients of training cohort into the high-risk group and low-risk group with significantly different survival time. The prognostic value of the six-lncRNA signature was validated in both the validation cohort and entire TCGA cohort. Moreover, the six-lncRNA signature is independent of known clinic-pathological factors by multivariate Cox regression analysis and demonstrated good performance for predicting three-and five-year overall survival by time-dependent receiver operating characteristic (ROC) analysis. Our study provides novel insights into the molecular heterogeneity of cutaneous melanoma and also shows potentially important implications of lncRNAs for prognosis and therapy for cutaneous melanoma.

Keratinocyte differentiation plays a pivotal role in the function of epidermal barrier and can be triggered by extracellular calcium in vitro and in vivo, but the precise mechanism still need to be further investigated. On the other hand, it is known that microRNAs control multiple biological events including cellular proliferation and differentiation. The present study demonstrated that miR-203a expression was upregulated in calcium-induced HaCaT Cells in a dose-dependent manner, whereas the stemness-associated factors SNAI2 and ΔNp63 were downregulated. Furthermore, SNAI2 and ΔNp63 were identified as the targets of miR-203a by computational prediction and luciferase reporter assays. The protein levels of SNAI2 and ΔNp63 were suppressed by ectopic expression of miR-203a. Functionally, silencing of miR-203a or overexpression of SNAI2 and ΔNp63 attenuated cell cycle arrest induced by calcium without any changes in cellular apoptosis. Additionally, ectopic expression of SNAI2 inhibited miR-203a in calcium-induced HaCaT cells, by binding to the promoter region of miR-203a. In conclusion, our findings demonstrate that miR-203a plays an essential role in keratinocyte proliferation and differentiation caused by extracellular calcium by targeting the SNAI2 and ΔNp63 genes. Furthermore, SNAI2 was found to suppress the transcription of miR-203a. Our data highlights a coherent cross-talk between two transcription factors (SNAI2 and ΔNp63) and miR-203a in keratinocyte differentiation and epidermal development.

Fullerenol is similar to graphite in terms of structure. In the present study, the anti-aging effect of fullerenol on skin through derived stem cells in a mouse model was assessed and the potential mechanism of fullerenol was investigated. The anti-aging effect of fullerenol effectively inhibited the retention rate of transplanted adipose-derived stem cells and increased the thickness of the dermal portion of skin and collagen ratio in mice. The effect of fullerenol on the proliferation of stem cells was observed. Treatment with fullerenol effectively promoted the mRNA expression of Runt-related transcription factor 2, alkaline phosphatase and osteocalcin in a mouse model of skin aging induced by D-galactose. However, fullerenol treatment effectively suppressed the protein expression of peroxisome proliferator-activated receptor-γ (PPAR-γ) and increased forkhead box protein O1 (FoxO1) protein expression in the mice model of skin aging induced by D-galactose. These results demonstrate that the anti-aging effect of fullerenol on skin through derived stem cells may be mediated in mice via the PPAR-γ/FoxO1 signaling pathway.

Deregulation of microRNAs (miRNAs) has been implicated in drug resistance in various types of cancers, including malignant melanoma (MM). MiR-488-3p has been reported as a tumor suppressor in several cancers. However, the exact expression patterns of miR-488-3p and the precise molecular mechanisms underlying its role in MM remain largely unknown and require further investigation. In this study, we demonstrated that miR-488-3p is significantly downregulated in MM clinical specimens and cell lines. Ectopic expression of miR-488-3p resulted in markedly increased drug sensitivity of MM cells in vitro and in vivo. The DNA-activated, catalytic polypeptide (PRKDC), which encodes DNA-dependent protein kinase catalytic subunit (DNA-PKcs), was identified as a direct target of miR-488-3p using luciferase reporter assays, qRT-PCR, and western blotting analyses. PRKDC knockdown by small interfering RNA (siRNA) alone promoted sensitivity of MM cells to cisplatin (DDP) while overexpression of PRKDC partially rescued the miR-488-3p-mediated acceleration of sensitivity to DDP in MM cells. Taken together, our results indicate that miR-488-3p serves as a drug resistance sensitizer in MM, supporting its potential as a promising therapeutic candidate.