ObjectiveRepeated implantation failure (RIF) in in vitro fertilization-embryo transfer (IVF-ET) remains a challenging clinical issue. Although acupuncture is increasingly used as an adjunctive therapy for RIF patients, robust evidence supporting its efficacy in improving pregnancy outcomes is still lacking. This pilot study therefore aims to estimate effect sizes to inform sample size calculations for future definitive trials and to assess key feasibility parameters.Design and methodsThis single-center, two-arm, single-blind, randomized sham-controlled trial will enroll 100 women (50 per group) with RIF aged 25~40 years. Using a parallel-group design, participants will be randomized to receive either conventional Western medicine treatment combined with acupuncture (experimental group) or the same conventional Western medicine treatment combined with sham acupuncture (control group). Acupuncture or sham acupuncture will be administered twice weekly from day 5 of the menstrual cycle until the day before embryo transfer, with a minimum of three completed sessions, targeting acupoints with standardized techniques. The primary outcome will be embryo implantation rate, and secondary outcomes will include clinical pregnancy rate and serum biomarkers (β-human chorionic gonadotropin, luteinizing hormone, progesterone, and estradiol). Safety will be monitored through adverse event reporting.DiscussionThe findings of this study will provide preliminary data to guide the design of future large-scale, multicenter randomized controlled trials. Such trials would in turn generate more definitive evidence on the efficacy of acupuncture for improving pregnancy outcomes in RIF patients undergoing IVF-ET.Clinical trial registrationhttps://itmctr.ccebtcm.org.cn/, identifier ITMCTR2025000838

To study the clinical efficacy of Wenyang Lishui Formula (WYLSF) in preventing ovarian hyperstimulation syndrome (OHSS) and explore the suitable range of estradiol (E2) on the human chorionic gonadotropin (HCG) day in patients with OHSS using WYLSF. Part I: eligible patients at high risk for OHSS undergoing ovulation induction between January and December, 2023 were randomized into 2 groups based on the actual treatment. The treatment group received 200 mL WYLSF formula twice daily for 5 days after oocyte retrieval in a combination of lifestyle coaching (LC) intervention including regular diet and exercise, whereas the LC group received LC intervention alone. The incidence of OHSS, OHSS self-assessment scales, changes in E2 levels on HCG day and 5 days after oocyte retrieval, ovarian morphology changes, and menstrual recovery were compared between the two groups. Part II: patients at high risk for OHSS treated with WYLSF were studied. The optimal E2 threshold on the HCG day was determined using the maximum selection test, and a multivariate analysis was adopted to compare the relationship between different E2 levels on HCG day and hospitalization rate, incidence of moderate to severe OHSS, and self-assessment scales, to explore the preventive effect of WYLSF on OHSS in patients with varying E2 levels. A total of 120 patients were included in the Part I analysis. The treatment group (60 cases) showed a significant reduction in the incidence, duration, and severity of abdominal distension, as well as the incidence of vomiting compared with the LC group (P<0.05). The post-retrieval E2 levels in the treatment group decreased significantly more (P=0.032). Among 1,652 patients treated with WYLSF in the Part II, 90 patients with ⩽ 10092 pmol/L, 159 with >31074 pmol/L, and 1,403 in the middle range group were formed based on E2 levels on HCG day in Part two analysis. Univariate and regression analyses showed that patients with E2 levels >31073 pmol/L had a significantly higher incidence of moderate to severe OHSS compared to those with E2 levels ⩽ 10092 pmol/L (P<0.05). WYLSF can effectively reduce specific symptoms in high-risk OHSS patients after ovulation induction and significantly lower E2 levels. It may be more suitable for high-risk OHSS patients with E2 levels <31073 pmol/L on HCG day. (Registration No. MR-11-23-032493, https://www.medicalresearch.org.cn/login )

Background: Uterus ageing is a crucial factor contributing to decreased fertility in older women and is also implicated in menstrual disorders, endometritis, and adenomyosis. Bushen Jianpi Tiaoxue Decoction (BJTD) is a traditional Chinese medicine formulation used to ameliorate endocrine disorders in the female reproductive system and finds extensive application in ageing-related endometrial diseases. However, the mechanisms underlying its improvement of uterus ageing have not been thoroughly investigated. Purpose: To explore the potential components and mechanisms of BJTD in ameliorating uterus ageing through network pharmacology, in vivo, and in vitro experiments. Methods: Morphological changes were observed using hematoxylin and eosin staining, collagen deposition was assessed using Masson staining, and apoptotic-related molecules were detected using Western blot. After determining the modeling doses, BJTD intervention was administered at two doses, and the expression of oxidative stress and apoptosis-related genes and proteins was measured. The levels of cellular apoptosis were evaluated using the TUNEL assay kit and Annexin V/FITC-PI assay kit. The main components of BJTD were determined by UPLC-MS, and the potential targets and mechanisms of BJTD action were explored using network pharmacology and molecular docking. BJTD-Containing Serum (BJTD-S) was extracted and applied in vitro experiments using human endometrial stroma cells (hESC) to preliminarily identify the pathways affected. Results: We demonstrated that modeling with 600 mg/kg/day D-Gal for 5 weeks significantly increased collagen deposition in uterine tissues, particularly in the glands and stroma. Additionally, it significantly elevated the levels of TNF-alpha and IL-1 beta and increased the expression of p53 and BAX while decreasing BCL-2 expression. BJTD significantly reduced the increased levels of TNF-alpha and IL-1 beta induced by D-Gal, and modulated oxidative stress markers such as SOD, MDA, GSH-Px, and T-AOC. BJTD also inhibited the cascade activation of apoptosis induced by D-Gal, suppressing the expression of cleaved-Caspase 8, cleaved-Caspase 3, and BAX. SIRT1 is a potential target of BJTD action. In vitro experiments showed that BJTD-S significantly improved D-Gal-induced apoptosis in hESC cells, and the expression levels of SIRT1, NRF2, and HO-1 were significantly decreased in D-Gal-induced hESC, and BJTD-S significantly increased their expression. Conclusion: BJTD can ameliorate oxidative stress and cell apoptosis levels in D-Gal-induced uterine aging, and its active ingredients can activate the SIRT1/NRF2 pathway to exert its effects. Importantly, our study provides novel insights into the molecular mechanisms by which traditional Chinese medicine influence uterus ageing. By specifically targeting the SIRT1/NRF2 pathway, BJTD presents a unique therapeutic approach that has not been extensively explored in previous studies, marking a significant advancement in the treatment of uterus ageing.

Background:Polycystic ovary syndrome (PCOS) is interrelated with obesity. Lifestyle intervention, mainly focusing on weight loss, has emerged as promising strategies to improve fertility outcomes in women with obesity. Acupuncture can aid in weight loss through metabolic regulation. However, evaluating the effectiveness of lifestyle and acupuncture in improving symptoms of polycystic ovary syndrome is still lacking. Results:This study aims to evaluate the efficacy of long-term lifestyle and acupuncture treatment on PCOS and elucidate the lipidomic features of these interventions in patients with overweight/obese PCOS, and identify potential therapeutic targets. Thirty-one women with PCOS and twenty-eight age and BMI matched controls were recruited. The participants with PCOS were randomly assigned to either lifestyle and acupuncture intervention group (A&L) or Lifestyle and sham acupuncture group (SA&L) for 4 months. The patients were followed up for an additional 4 months. Clinical indices indicating hyperandrogenism, homeostasis and quality of life was collected to evaluate the effectiveness of treatments. Comprehensive lipidomic analyses by utilizing mass spectrometry were conducted to profile the lipidomic signatures of participants with PCOS before and after treatment. After the A&L intervention, the BMI of participants with PCOS was significantly reduced. Assessments of insulin resistance (HbA1c, HOMA-IR, ISI), hyperandrogenism (SHBG, FAI), physical activity, and β-endorphin showed significant improvement. Lipidomic analysis revealed a panel of lipid species that effectively distinguished participants with PCOS from those without PCOS (AUC = 0.9747). Serum 18:0 Lyso PI, involved in intracellular insulin signaling pathways, was specifically associated with the A&L regimen. The co-regulation of 18:0 Lyso PI and 16:0 SM (d18:1/16:0) were associated with the A&L regimen. Conclusion:18:0 Lyso PI may be a potential biomarker for A&L therapy in PCOS patients.

Postoperative ileus (POI) remains a prevalent and significant challenge following abdominal surgeries, precipitating patient distress, prolonged hospital stays, and escalated medical expenditures. Conventionally addressed via pharmacological interventions, POI is increasingly being explored through adjunctive therapeutic strategies, with acupuncture gaining recognition as a promising option. Acupuncture has demonstrated encouraging potential in promoting gastrointestinal motility in patients with POI. Moreover, recent research has shed light on the therapeutic mechanisms underlying its efficacy. This article aims to present a comprehensive overview of acupuncture as a treatment for POI, highlighting advancements in clinical research and recent elucidations of its mechanistic underpinnings. It aspires to contribute a pivotal reference point for scholars and enthusiasts keen on garnering a deeper understanding of acupuncture's role in managing POI.

BACKGROUND:Individuals with chin retrusion may seek chin and lower jawline aesthetic enhancement. OBJECTIVES:To evaluate VYC-25L (Juvéderm Volux XC; Allergan Aesthetics, an AbbVie company), a lidocaine-containing injectable hyaluronic acid dermal filler, for chin retrusion correction. METHODS:In this prospective, Phase 3, multicenter study (NCT04559984), Chinese adults with moderate-to-severe chin retrusion on the China (Allergan) Chin Retrusion Scale (CACRS) and glabella-subnasale-pogonion (G-Sn-Pog) angle <172.5° were randomized 2:1 to VYC-25L (treatment plus optional touch-up 4 weeks later) or no treatment (control). The primary endpoint was change from baseline (CFB) in G-Sn-Pog angle at Week 24. Secondary endpoints included CACRS response (≥1-point improvement), Global Aesthetic Improvement Scale (GAIS) response (improved/much improved), and FACE-Q Satisfaction with Chin score. Procedural pain was rated (0 = none to 10 = worst imaginable); injection-site responses (ISRs) were recorded daily for ≤28 days. RESULTS:The mean age of the patient (VYC-25L, n = 97; control, n = 51) was 31.2 years (range, 20-52 years). Mean CFB in G-Sn-Pog angle at Week 24 was 2.97° (VYC-25L) vs 0.09° (control; between-group difference, 3.08° [P < .0001]); improvement was maintained to Week 52. At Week 24, VYC-25L achieved higher responses vs control for CACRS (78.7% vs 18.8%, respectively; rate difference, 60.0%; P < .0001) and GAIS (92.6% vs 4.2%, respectively; rate difference, 88.4%; P < .0001); mean overall FACE-Q Satisfaction with Chin score was 70.4 vs 34.9, respectively. Mean (standard deviation) procedural pain was 2.6 (1.6); most ISRs were mild (41.8%) or moderate (50.0%) in severity. CONCLUSIONS:In Chinese adults, VYC-25L safely and effectively corrected chin retrusion for at least 1 year. LEVEL OF EVIDENCE: 2 (THERAPEUTIC):

Background:Lip augmentation has become increasingly accepted and popular. However, there are still a few approved lip fillers that are versatile, biocompatible, suitable for lip enhancement, and backed by large-scale clinical trials. Objectives:To assess the safety and effectiveness of Janlane LIPs (Shanghai Qisheng Biopharmaceutical Co., Ltd, Shanghai, China), a new hyaluronic acid filler for lip augmentation. Methods:This prospective, multicenter, randomized, controlled study randomized subjects to the treatment group or the concurrent no-treatment control group that received delayed treatment. The level of Lip Fullness Grading Scale (LFS) was evaluated by the blinded evaluator, and the Global Aesthetic Improvement Scale (GAIS) was evaluated by the blinded evaluator and the subjects at pre-injection and after injection. Adverse reactions were recorded. Statistical analysis of subject satisfaction was performed. Results:A total of 176 subjects were enrolled. The scores of LFS after injection were higher than those before injection; the degree of GAIS evaluated by the evaluator and subjects improved significantly. Local redness, swelling, etc. occurred after injection, most of which resolved within 1 week. The patient satisfaction was high and statistically significant. Conclusions:Janlane LIPs showed long-term aesthetic improvement and safety for lip augmentation, high patient satisfaction, and are worthy of clinical promotion. Level of Evidence 2 Therapeutic:

Objective This study aims to investigate the effects of natural products on animal models of premature ovarian failure (POF). Methods We conducted comprehensive literature searches and identified relevant studies that examined the protective effects of natural products on experimental POF. We extracted quantitative data on various aspects such as follicular development, ovarian function, physical indicators, oxidative stress markers, inflammatory factors, and protein changes. The data was analyzed using random-effects meta-analyses, calculating pooled standardized mean differences and 95% confidence intervals. Heterogeneity was assessed using the I 2 statistic, and bias was estimated using the SYRCLE tool. Results Among the 879 reviewed records, 25 articles met our inclusion criteria. These findings demonstrate that treatment with different phytochemicals and marine natural products (flavonoids, phenols, peptides, and alkaloids, etc.) significantly improved various aspects of ovarian function compared to control groups. The treatment led to an increase in follicle count at different stages, elevated levels of key hormones, and a decrease in atretic follicles and hormone levels associated with POF. This therapy also reduced oxidative stress (specifically polyphenols, resveratrol) and apoptotic cell death (particularly flavonoids, chrysin) in ovarian granulosa cells, although it showed no significant impact on inflammatory responses. The certainty of evidence supporting these findings ranged from low to moderate. Conclusions Phytochemicals and marine natural product therapy (explicitly flavonoids, phenols, peptides, and alkaloids) has shown potential in enhancing folliculogenesis and improving ovarian function in animal models of POF. These findings provide promising strategies to protect ovarian reserve and reproductive health. Targeting oxidative stress and apoptosis pathways may be the underlying mechanism.

Purpose: During reduction malarplasty using both intraoral and preauricular incisions, the operative exposure of the preauricular incision can result in injury of the temporal branch of the facial nerve, a potentially serious complication. The purpose of this study was to determine the relative frequency of this injury and investigate potential methods of prevention by analyzing the related anatomic and functional details of the patients that sustained temporal branch injury. Methods: The study comprised a retrospective review of 93 patients who underwent L-shaped reduction malarplasty with osteotomy using intraoral and preauricular incisions between December 2018 and February 2021. Specifically, this included all patients with transient dysfunction of the temporal branch of the facial nerve 1 week postoperatively, which recovered with conservative treatment. Results: In 4 of the 93 operated cases, the postoperative evaluation revealed that the forehead lines disappeared, there was a failure of eyebrow lifting, double eyelids remained unchanged in 3 cases and narrowed in 1, but eye closure was not affected. However, using only conservative treatment, the symptoms of all patients improved and recovered. Conclusions: To avoid the temporal branch of facial nerve injury during reduction malarplasty with intraoral and preauricular incisions, surgeons need to be especially familiar with the anatomy of the temporal branch of the facial nerve and proceed with precise, atraumatic dissection. However, if facial paralysis is diagnosed postoperatively, active treatment should be undertaken as soon as possible. Level of Evidence: Level IV

BackgroundThe application of nasolabial perforator flap for nasal reconstruction has been reported previously with satisfactory outcomes, but the outcomes and risk factors of postoperative adverse events have been unclear to plastic surgeons.AimsTo statistically analyze the effectiveness of the nasolabial perforator flap in nasal reconstruction and the risk factor of postoperative complications and re-operation.Patients/MethodsThis retrospective study evaluated 58 Chinese patients who underwent nasal reconstruction with the nasolabial perforator flap from 2009 to 2021. The esthetic and blood supply outcomes were measured by plastic surgeons on a 5-point Likert scale. Binary logistic regression was used to determine the risk factors associated with postoperative complications and re-operation.ResultsThe mean age of the cohort was 66.4 +/- 2.0 years. The defect size ranged from 6.5 x 5.5 mm2 to 40 x 70 mm2, and 48.3% of defects covered more than one nasal subunit. Venous congestion occurred in 4.9% of flaps, and the immediate overall postoperative score was 7.72/10. More than one nasal subunit of involvement was the risk factor associated with re-operation (p = 0.004), but no risk factor was associated with complications.ConclusionsThe nasolabial perforator flap is reliable for nasal reconstruction with good esthetic outcomes and fewer complications. However, a large number of involved subunits may lead to multiple surgeries for flap trimming in easterners.

Bushen Tiaoxue Granules (BTG) is an empirical Chinese herbal formula that has been used for the treatment of subfertility. The protective effect of BTG on controlled ovarian hyperstimulation (COH)-induced impaired endometrial receptivity has been reported in our previous study. This study aims to explore the mechanisms of BTG on ameliorating abnormal morphology of endometrium based on network pharmacology. Active compounds of BTG were identified via the traditional Chinese medicine systems pharmacology and UPLC-MS technology. The SwissTargetPrediction platform and HERB database were used to screen out the putative targets of BTG. Potential targets of endometrial dysfunction caused by COH were obtained from three GEO databases. Through the STRING database, the protein–protein interaction was carried out according to the cross-common targets of diseases and drugs. GO terms and KEGG pathways enrichment analyses were conducted via the Metascape database. AutoDock Vina was used for docking validation of the affinity between active compounds and potential targets. Finally, in vivo experiments were used to verify the potential mechanisms derived from network pharmacology study. A total of 141 effective ingredients were obtained from TCMSP and nine of which were verified in UPLC-MS. Six genes were selected through the intersection of 534 disease related genes and 165 drug potential targets. Enrichment analyses showed that BTG might reverse endometrial dysfunction by regulating adherens junction and arachidonic acid metabolism. Hematoxylin–eosin staining revealed that BTG ameliorated the loose and edematous status of endometrial epithelium caused by COH. The protein expression of FOXO1A, β-Catenin and COX-2 was decreased in the COH group, and was up-regulated by BTG. BTG significantly alleviates the edema of endometrial epithelium caused by COH. The mechanisms may be related to adheren junctions and activation of arachidonic acid metabolism. The potential active compounds quercetin, taxifolin, kaempferol, eriodictyol, and isorhamnetin identified from the BTG exhibit marginal cytotoxicity. Both high and low concentrations of kaempferol, eriodictyol, and taxifolin are capable of effectively ameliorating impaired hESC cellular activity.

Objective To investigate how body fat influences glucose metabolism and hormone profiles in women with polycystic ovary syndrome (PCOS), compared to women without PCOS. Methods We conducted a cross-sectional study of 166 women with PCOS and 139 age-matched control women at Peking University Third Hospital (Beijing, China) from March 2016 to December 2021. All participants underwent bioimpedance rate assessment of clinical, anthropometric, hormonal, and metabolic features. In particular, body composition parameters were assessed, based on the methods used in a previous study. Homeostasis model assessment-insulin resistance (HOMA-IR) and other indices calculated from fasting glucose and insulin were used to measure insulin resistance. The hormonal profiles [follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), prolactin (PRL), total testosterone (T), and androstenedione (A2)] were assessed by using biochemical methods. Two subgroup analyses were conducted according to waist-to-hip ratio (WHR; < 0.85, non-central obesity and ≥ 0.85, central obesity) and body fat percentage (BFP; < 35% for lean and ≥35% for obesity). The indices above were analyzed using a two-sided t-test or Wilcoxon rank sum test. Linear regression was used to investigate the effects of body composition on metabolism and sex hormones in the PCOS and control groups. Results Compared to women without PCOS, women with PCOS and central obesity ( P =0.021), PCOS and noncentral obesity ( P <0.001), PCOS and high BFP ( P <0.001), and PCOS and low BFP ( P <0.001) had more severe glucose metabolism evaluated with HOMA-IR. Women with PCOS experienced greater insulin sensitivity impairment than did the normal population for every equal increase in BFP. LH, LH/FSH, total testosterone, and androstenedione were significantly higher in patients with PCOS than in healthy controls, regardless of WHR and BFP stratification. However, negative correlations existed between body fat indices (i.e., BFP and body mass index) and hormone indices (i.e., LH and androstenedione) in the PCOS group, but were absent in the control group. Conclusions Obese and non-obese women with PCOS have more severe insulin resistance and sex-hormone disorders than women without PCOS. The effect of body fat on sex-hormone disorders is only exist in women with PCOS. These findings suggested that PCOS clinical guidelines should be more specific to body fat. Clinical trial registration https://clinicaltrials.gov/ , Registration No. NCT04264832.

潮热多汗是围绝经期最突出的临床表现之一,属于中医"汗证"范畴.文章围绕围绝经期汗证治疗中"阴阳辨识"的难点,引入郑钦安先生"阳主阴从"的学术思想和"阴火"理论,提出临证中应仔细辨识"神、色、舌、脉",多汗若见神疲乏力、困倦思睡、少气懒言、面色暗沉、舌淡胖、苔润滑、脉沉或缓,则属阳虚阴盛所致"阴火".治疗以扶阳固摄为主,并提出围绝经期汗证属"阴火"者可选用潜阳丹和封髓丹.最后通过临床病案分析,加深对围绝经期汗证扶阳辨治思路的理解.

Background: Exploratory studies have shown that remote ischemic conditioning (RIC) has the potential to lower blood pressure (BP). We investigated whether chronic RIC reduces BP for hypertension. Methods: This is a multicenter, randomized, double-blind, parallel-controlled trial. Patients with an office BP of 130/80 to 160/100 mm Hg and a 24-hour average BP ≥125/75 mm Hg not on antihypertensive medications were recruited. After a 1-week compliance screening phase, they were randomly assigned in a 1:1 ratio to receive RIC or sham RIC twice daily for 4 weeks. The primary efficacy outcome was the change in 24-hour average systolic BP from baseline to 4 weeks. Safety events were assessed over the study period. Results: Ninety-five participants were randomly allocated to the RIC (n=49) and sham RIC (n=46) groups. In the intention-to-treat analysis, the reduction in 24-hour average systolic BP was greater in the RIC group than the sham RIC group (−4.6±9.5 versus −0.9±6.8 mm Hg; baseline-adjusted between-group mean difference: −3.6 mm Hg [95% CI, −6.9 to −0.3 mm Hg]; adjusted P =0.035). The per-protocol analysis showed that 24-hour average systolic BP reduced −5.9±8.6 mm Hg in the RIC group and −0.7±6.7 mm Hg in the sham RIC group (baseline-adjusted between-group mean difference: −5.2 mm Hg [95% CI, −8.5 to −1.9 mm Hg]; adjusted P =0.002). No major adverse events were reported in both groups. Conclusions: RIC is safe in patients with mild hypertension and may lower BP in the absence of antihypertensive medications. However, the effects of RIC on clinical outcomes in these patients require further investigation. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04915313.

目的 探讨基于结构式鼻整形亚单位原理进行自体肋软骨联合膨体聚四氟乙烯(expanded polytetrafluoroethylene,e-PTFE)在单侧唇裂继发鼻畸形整复中的治疗效果.方法 自 2016 年 8 月至 2022 年 12 月,北京大学第三医院成形外科收治25 例单侧唇裂继发鼻畸形患者,采用自体肋软骨联合PTFE矫正单侧唇裂继发鼻畸形.采用Face-Q量表评估患者手术前后鼻部美学的满意度以及鼻塞症状评估(nasal obstruction symptom evaluation,NOSE)量表评估术后鼻塞通气功能情况,同时记录患者术后并发症的发生情况.结果 25 例患者术后切口均一期愈合.术后获随访 3 个月至 6 年,鼻部形态良好,鼻尖及鼻小柱基本居中,鼻背较术前增高,鼻翼塌陷较术前减轻,双侧鼻孔间差异缩小,患侧鼻基底较术前抬高,无感染、鼻中隔偏曲、移植物外露等并发症发生.Face-Q量表评估结果提示,患者术后鼻部美学满意度明显提升;NOSE量表结果表明,患者通气功能在术后得到改善,评分差异具有统计学意义(P<0.05).结论 基于结构式鼻整形亚单位原理采用自体肋软骨联合e-PTFE修复单侧唇裂继发鼻畸形可以获得良好的术后效果.

目的 比较三维立体成像系统与传统二维摄影在歪鼻测量中的可靠性.方法 获取自 2018 年 1 月至 2022 年1月,于北京大学第三医院成形外科就诊的30例歪鼻患者的Vectra XT 3D图像和 2D标准化摄影图像,通过 2 名测评者对 13 个测量指标进行测量比较测评者间及测评者内可靠性.结果 3D立体成像测量的组内相关系数(intraclass correlation coefficient,ICC)略优于 2D标准化摄影测量(测评者内ICC分别为 0.93±0.43 和 0.83±0.77,P＜0.05;测评者间ICC分别为 0.92±0.61 和0.85±0.85,P=0.003),测量技术误差(technical error of measurement,TEM)、相对TEM(relative TEM,rTEM)在组内及组间评估差异均有统计学意义,相对误差测量(relative error measurement,REM)在组间评估差异具有统计学意义(P＜0.05).结论 与 2D标准化摄影测量相比,3D立体成像测量在歪鼻评价中具有更为优异的可靠性.

There is a deviation of scientific research methodology, the prevalence of reductionism and the decline of systematology, in the scientific research and clinical practice of TCM. This deviation is influenced by the strong reductionist methodology of western medicine, and also has its own reasons for insufficient understanding of the system, neglecting of self-advantages, and lacking of philosophical methodology. By analyzing the characteristics of the great deviation between reductionism and systematology of TCM, this article gives some countermeasures, including encirclement based on constitution,focusing on systematic research and speculation, inheriting the criticism of ancient academic heritage, and establishing a unified discourse system of Chinese and Western medicine.

The paranasal depression is a common facial feature of Oriental populations. One of the most wildly used method to improve it was paranasal augmentation using expanded polytetrafluoroethylene (ePTFE). The effectiveness of it should be tested by three-dimensional morphological measurements. Patients who underwent paranasal augmentation using ePTFE between January 2017 and December 2022 were recruited in the study. The preoperative and postoperative clinical variables and three-dimensional measurement of patients were also collected. The satisfaction outcome were assessed. By establishing a coordinate system based on the Frankfurt plane, 16 landmarks including nasal alar crest, subnasal point, upper lip, pogonion, glabella, sub-cheek, orbitale, tragion in left and right side of faces were marked. Five segments, 4 ratios, and 3 angles were measured based on it. The significant increase of segments, ratios, and angles indicated that paranasal augmentation could increase the protrusion of paranasal area, both in absolute value and relative proportion. The significant decrease of other data indicated that the protrusion difference between paranasal base and upper lip, forehead, and chin, respectively, were shortened after surgery. The average size of implant was 6.54 ± 1.02 mm, and the average increase of paranasal height was 4.38 ± 1.04 mm postoperatively. This indicates that two-thirds of its height will ultimately be reflected effectively in the sagittal elevation of the paranasal base. Paranasal augmentation using ePTFE could effectively increase paranasal height and improve subunits relationships, and the ePTFE prosthesis should be designed and carve considering the 1/3 loss of height after implantation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Midface is located in the central area of the facial region and plays a crucial role in the esthetic evaluation of one's appearance. The East Asian, especially the Chinese, has wide and flat midfacial bone structure, low piriform aperture area compared with the prominent zygomatic and oral region, which results in an unpleasant appearance. 1 Jin H.R. Won T.B. Rhinoplasty in the Asian patient. Clin Plast Surg. 2016; 43: 265-279 Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar In contrast to the patients' surging demand of midface filling surgery, there is a lack of evaluation standard for midfacial depression, nor quantitative and objective grading system for midface morphology. In the current study, we collected the three-dimensional (3D) facial information of Chinese Han Youth and summarized the morphological characteristics of their midface, focusing on the concavity and convexity from the sagittal plane.

This article reviewed our experience of Chinese nasal reconstruction over 12 years and evaluated the effect of expanded forehead flap both aesthetically and functionally. The special skin type and other anatomic features of Chinese patients was understood thoroughly during the treatment. This article thus catered for the need of multiracial nasal reconstruction. We analyzed existing clinical data and demonstrated a typical case in detail. The postoperative result supported our strategy which advocated the extensive application of expanded forehead flap, together with flip scar flap as the internal lining. The features of Chinese patients also prompted the use of costal and auricular cartilage. Emerging technology like 3D-printing would benefit nasal reconstruction from more aspects.