The healing of skin wounds is a highly coordinated multi-step process that occurs after trauma including surgical incisions, thermal burns, and chronic ulcers. In this study, the authors investigated lncRNA FOXD2-AS1 function in adipose mesenchymal exosomes from ADMSCs that were successfully extracted. Highly expressed lncRNA FOXD2-AS1 in ADMSCs-exosomes accelerated HaCaT cell migration and proliferation. LncRNA FOXD2-AS1 negatively targeted miR-185-5p, and miR-185-5p negatively targeted ROCK2. Highly expressed lncRNA FOXD2-AS1 in ADMSCs-exosomes promoted HaCaT cell migration and proliferation via down-regulating miR-185-5p and further up-regulating ROCK2. In conclusion, LncRNA FOXD2-AS1 overexpression in ADMSCs derived exosomes might accelerate HaCaT cell migration and proliferation via modulating the miR-185-5p/ROCK2 axis.

目的 分析颏下肌皮瓣修复单侧扁桃体癌切除术后组织缺损的临床应用效果.方法 回顾性分析自 2017 年12 月至 2019年 12月,海军军医大学第三附属医院整形外科采用颏下肌皮瓣修复 17 例单侧扁桃体癌切除术后组织缺损患者.16 例为鳞状细胞癌,1 例为腺样囊性癌.参照国际抗癌联盟肿瘤及美国癌症联合委员会(American Joint Committee on Cancer,AJCC)分期标准,均为Ⅱ、Ⅲ、Ⅳ期.肿瘤大小为 2.0 cm×1.5 cm～5.0 cm×4.0 cm,4 例伴淋巴结转移.所有患者均采用颏下肌皮瓣进行术后组织缺损修复重建.结果 所有患者随访 2～5 年,15 例颏下肌皮瓣成活,切口一期愈合;1 例咽瘘(直径约 1.5 cm),皮瓣部分成活,经多次换药及剪除坏死组织后延期愈合;1 例皮瓣坏死,给予剪除,采用胸大肌皮瓣行咽瘘修复术.术后皮瓣成活良好,并发症较少,患者生存率较高.结论 颏下肌皮瓣修复单侧扁桃体癌切除术后组织缺损时取材相对容易,手术创伤较小,术后效果理想.

Objective To explore the causes of body image and the influencing factors of postoperative satisfaction of plastic and cosmetic patients. Methods From May 2017 to March 2018, 30 patients with plastic cosmetic surgery were investigated. Using qualitative research, in-depth interviews was conducted with cosmetic patients. Rrelevant data used t test. Results A significant difference was found between the four dimensions of appearance tendency, health assessment, disease tendency and self-classification (P＜0.05), there were no statistically significant differences in the six dimensions of appearance evaluation, comfort evaluation, comfort tendency, health tendency, body part satisfaction, and overweight (P＞0.05). The causes of the self-image of plastic and cosmetic patients are mainly summarized as personality, external factors, cognition, self-esteem and coping style. Postoperative satisfaction was related to expectation, personality and service quality. Conclusion The body image of plastic and cosmetic patients is affected by multiple factors. To improve the quality of service, reduce the unreasonable expectations of the recipient can improve satisfaction.

The incidence of cutaneous squamous cell carcinoma (cSCC) has been increasing in recent years. Meanwhile, microRNAs (miRNAs) have been found to play vital roles in various cancers, including cSCC. This study aimed to investigate the expression of microRNA-573 (miR-573) in cSCC, its relationship with long non-coding RNA PICSAR and analyze its biological role. The relationship between PICSAR and miR-573 was confirmed by dual-luciferase reporter assay and Pearson’s correlation coefficient analysis. The levels of PICSAR and miR-573 were measured using quantitative Real-Time PCR. Cell Counting Kit-8 assay was used to evaluate the cSCC cell proliferation ability. The migration and invasion abilities of cSCC cells were evaluated by Transwell assay. PICSAR expression was increased and miR-573 was decreased in tumor tissues and cSCC cell lines. PICSAR and miR-573 can bind directly, and miR-573 expression was downregulated by PICSAR in cSCC. Overexpression of miR-573 significantly inhibited the proliferation, migration and invasion abilities of A431 and SCC13 cells. Additionally, miR-573 overexpression reversed the promotion effects of PICSAR overexpression on cSCC cell proliferation, migration and invasion abilities. In conclusion, our findings indicated that miR-573 expression was decreased in tumor tissues and cSCC cells and was downregulated by PICSAR in cSCC. Additionally, miR-573 overexpression inhibited cSCC cell proliferation, migration and invasion, and reversed the promotion effects of PICSAR overexpression on cSCC cell biological functions. Thus, miR-573 might function as a tumor suppressor and might be involved in the regulatory effects of PICSAR on tumorigenesis in cSCC.

A photocrosslinking hydrogel technique facilitates articular cartilage repair in minimally invasive surgery.

Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare autosomal-dominant genetic disorder, and mutations in the forkhead box L2 (FOXL2) gene are one of the major genetic causes. As this study shows, there are many patients with BPES who do not have FOXL2 mutations, as the screening results in all family members were negative. Using whole-exome sequence analysis, we discovered another possible mutational cause of BPES in integrin subunit beta 5 (ITGB5). The ITGB5 mutation (c.608T>C, p.Ile203Thr) appears in the base sequence of all BPES+ patients in this family, and it appears to be a three-generation-inherited mutation. It can cause changes in base sequence and protein function, and there may be cosegregation of disease phenotypes. ITGB5 is located on the long arm of chromosome three (3q21.2) and is close to the known pathogenic gene FOXL2 (3q23). This study is the first to report ITGB5 mutations in BPES, and we speculate that it may be directly involved in the pathogenesis of BPES or indirectly through the regulation of FOXL2.

近年来,伴随着巨大的行业红利,过度整形美容的话题受到公众和社会的广泛关注.回顾整形美容行业的发展史和临床概况,指出行业发展中过度整形美容这一现象,从内因和外因两个层次多个角度深入剖析造成过度整形美容的原因,并从身心健康、异化现象、社会认同感、价值观等方面阐述过度整形美容的危害,最后从科学的政策和监管机制、正确的社会舆论导向、机构和医生的职业道德规范、求美者正确观念的树立四个方面提出了破除过度整形美容的举措.

Objective:To observe the application and clinical effect of stromal vascular fraction gel (SVF-gel) in local rhinoplasty.Methods:A total of 84 patients with mild nasal root and low bridge were divided into observation group and control group. In the observation group, liposuction with SVF gel extraction plus injection rhinoplasty was carried out; in the control group, liposuction plus injection rhinoplasty was carried out according to the height change of nasal root and bridge, the change of nasal frontal angle, the occurrence of complications and the satisfaction of patients after operation.Results:The 84 patients were followed up for 2 weeks to 24 months. The height of nasal root and bridge increased significantly and the lines were more harmonious. The absorption of the observation group was much lower than that of control group. Except 3 patients in the observation group and 8 patients in the control group, there were different degrees of absorption within 6 months after operation. All patients did not have complications such as fat liquefaction, necrosis, induration and infection in the injection area. Three patients in the observation group were satisfied with the results after reinjection, and one patient in the control group was satisfied with the results after reinjection, three patients were not satisfied with the results, and four patients were satisfied with the prosthesis augmentation rhinoplasty. In the observation group, there were 37 cases of excellent satisfaction, 5 cases of good satisfaction, and the overall satisfaction was 100%; in the control group, there were 20 cases of excellent satisfaction, 15 cases of good satisfaction, 7 cases of bad satisfaction, and the satisfaction was 83.3%. The former was better than the latter.Conclusions:In view of superiorities such as lower complications with long-lasting effect, high fat survival rate and high satisfaction in local augmentation rhinoplasty, SVF-gel injection is especially suitable for patients who cannot accept autologous bone, prosthesis and allograft tissue filler for augmentation rhinoplasty.

目的 探讨认知行为干预对美容整形就医者体像认识和自尊的影响.方法 选取2018年3月至2018年10月于本院接受整形美容者130人为研究对象,随机分为两组,每组65人.对照组采用常规医护干预,干预组采用认知行为干预.采用自制的一般情况调查表、多维自我体像调查问卷(MBSRQ)及自尊量表(SES)评估两组临床资料、体像水平及自尊水平.结果 两组临床资料比较差异无统计学意义.干预组相貌评估、舒适倾向、健康倾向、身体部位满意和超重5个维度评分均高于对照组(P<0.05);干预组自尊量表评分高于对照组(P<0.05).结论 认知行为干预可改善美容就医者的体像评分及自尊评分,值得临床推广应用.

背景:由于脐带间充质干细胞作为种子细胞具有来源广泛、取材方便、免疫原性低、成骨分化潜能及较强的增殖和自我更新能力等诸多优点,近年来关于其在骨组织工程中的应用研究越来越多.目的:对脐带间充质干细胞在分离培养、成骨诱导及其支架等方面进行综述.方法:由第一作者检索CNKI数据库和PubMed数据库的相关文章,检索词为"人脐带间充质干细胞,分离,培养,成骨分化,支架,骨组织工程""human umbilical cord stem cell,culture,isolation,osteogenic differentiation,scaffold,bone tissue engineering",查阅2004至2020年来有关的文献,最终纳入104篇文献.结果与结论:脐带间充质干细胞的分离、培养方法不一;无血清或动物血清替代物培养体系及细胞共培养技术取得了很大进展;3D培养系统将是未来发展的方向.脐带间充质干细胞成骨诱导分化机制仍不明确,需深入研究阐明.至今,开发取长补短、性能更优的复合支架仍是研究的焦点;生物打印技术突破了微米级精确调控支架内部复杂结构打造个体化支架的难题,为骨组织工程带来巨大希望;设计和制造出具有多方面理想组成(包括生物相容性、微观及宏观高孔隙率、机械性能和相关生物可吸收性等)及减少临床治疗不良反应的支架仍是骨组织工程中的重要挑战之一.

Tissue engineering technology provides a promising approach for external ear reconstruction. Although the first clinical breakthrough of tissue engineered auricular reconstruction has been achieved based on polymer scaffold, the discrepant clinical efficacy among different patients triggered by residual scaffold mediated aseptic inflammatory reaction seriously hinders its further clinical application. A proper natural scaffold with low inflammatory reaction is urgently required to address this problem. Among all the natural materials, acellular cartilage matrix (ACM) is considered to be the ideal cartilage-specific microenvironmental biomimetic scaffold. However, no breakthroughs have been achieved for the regeneration of human-ear-shaped cartilage based on ACM so far. The main challenge is how to prepare ACM into a three-dimensional (3D) porous scaffold with precise human-ear shape and proper mechanical strength. In this study, ACM powder, prepared by freezing pulverization and decellularization, was successfully prepared into 3D porous scaffolds using gelatin as an auxiliary crosslinker. By optimizing proportion and concentration of ACM and gelatin, the scaffolds presented proper pore structure and degradation rate as well as good mechanical strength and biocompatibility. Furthermore, ACM/Gelatin could be fabricated into porous scaffolds with precise human-ear shape and proper mechanical strength by integrating 3D printing, polycaprolactone (PCL) inner core designing, cast molding, and freeze-drying technologies. Finally, human-ear-shaped cartilage with good elasticity and cartilage-specific extracellular matrices was successfully regenerated using the ACM/Gelatin-PCL scaffolds and auricular chondrocytes (elastic cartilage). All of these results provide important support for the application and clinical translation of human-ear-shaped cartilage.

Adipose-derived stem cell (ADSC)-based therapeutic strategies are in fast-pace advancement in wound treatment due to their availability and the ability to self-renew, undergo multilineage differentiation and self-renewal. Existing studies have successfully explored ADSCs to facilitate scar-free healing of small wounds, but whether the healing of large-area wounds that exhibit over 50% of skin tissue loss in the entire body could be achieved remains controversial. This study sought to review the mechanism of physiological wound healing, and discuss the roles played by chemokines, biological factors and biomaterial scaffolds. The possibility of applying ADSC-conditioned medium or ADSC-released exosomes as 'off-the-shelf' tissue engineering products, integrated with biomaterial scaffolds to facilitate wound healing, was analyzed.

目的:探讨依据鼻部局部美学亚单位间不同的解剖特点,采用膨体聚四氟乙烯(Expanded polytetrafluoroethylene,e-PTFE)联合鼻中隔软骨及耳软骨在鼻综合整形术中对鼻部进行分段调整的效果.方法:2017年8月至2019年3月,应用该方法进行了32例手术,取鼻正中飞鸟形切口加双侧鼻翼缘切口,利用膨体聚四氟乙烯、鼻中隔软骨、耳软骨,对鼻背、鼻小柱、鼻尖等各个美学分区进行逐一调整,观察其效果.结果:本组29例获得随访,随访时间3～17个月,恢复都较满意,取得了较好效果,无慢性感染、假体歪斜、鼻尖皮肤变薄等并发症发生.结论:根据鼻部的美学分区,通过对鼻部美学亚单位分别修饰处理,可以达到鼻部外观和手感完美统一的效果.

OBJECTIVE:To explore the risk factors related to periprosthetic infection after breast augmentation, and to provide a basis for reducing the risk of postoperative infection. METHODS:A total of 1 056 female patients who underwent breast augmentation between January 2010 and January 2018 were analyzed retrospectively. The patients were 20 to 44 years old (mean, 31.6 years). The body mass index (BMI) was 19.0-31.1 kg/m 2, with an average of 24.47 kg/m 2. According to the periprosthetic infection standard of the United States Centers for Disease Control and Prevention (CDC), the patients were divided into infection group and non-infection group. Age, BMI, diabetes, previous history of immunosuppression, history of smoking, previous history of breast surgery, previous history of mastitis, combined with active dermatitis, surgical approach, the type and shape of breast prosthesis, implant in the different layers, combined with mastopexy, operation time, postoperative antibiotic time, postoperative breast crash, and postoperative potential infection surgery were analyzed by univariate analysis. The influencing factors of prosthetic infection were screened by logistic regression. RESULTS:Periprosthetic infection occurred in 60 cases after operation, and the infection rate was 5.68%. Among them, 11 cases were acute infection, 33 cases were subacute infection, 16 cases were delayed infection, and 20 cases were positive in bacterial culture. Postoperative breast crash occurred in 114 cases. Univariate analysis showed that diabetes, previous history of immunosuppression, history of smoking, previous history of mastitis, postoperative breast crash, postoperative potential infection surgery, and combined with breast suspension were the influencing factors of postoperative periprosthetic infection ( P<0.05). Multivariate analysis showed that diabetes, history of smoking, and postoperative breast crash were the risk factors of periprosthetic infection ( P<0.05). CONCLUSION:Diabetes, smoking, and postoperative breast crash are the risk factors of periprosthetic infection after breast augmentation.

目的 检测FOXL2基因的过表达及沉默对乳腺癌细胞系MCF-7细胞生长状况的影响.方法 培养乳腺正常细胞系HBL-100和乳腺癌细胞系MCF-7细胞,Trizol法提取两者总RNA,利用逆转录聚合酶链式反应(RT-PCR)技术分别检测FOXL2基因在这两种细胞中的表达水平.用FOXL2-pEGFP质粒和FOXL2-shRNA质粒转染MCF-7细胞,分别使其过表达或沉默FOXL2,并建立分组为过表达FOXL2(A组)及沉默FOXL2(B组)以及未作转染处理的MCF-7细胞(C组),Western blot检测3组FOXL2蛋白表达量,验证转染是否成功,MTT法测转染后3组细胞的增殖情况.结果 RT-PCR结果显示HBL-100和MCF-7细胞均可转录FOXL2的mRNA,且24-△△Ct值＞2,证明FOXL2在MCF-7细胞中表现为上调,且差异有统计学意义(P＜0.05).成功转染MCF-7细胞后,Western blot结果与C组相比,A组细胞中FOXL2蛋白表达量明显增加,B组细胞中FOXL2蛋白表达量明显减少,差异均有统计学意义(P＜0.05),可见模型构建成功.MTT法检测3组MCF-7细胞的OD值及细胞增殖率,A组FOXL2基因过表达,MCF-7细胞的增殖能力明显被抑制,而B组的细胞增殖能力增加,差异均有统计学意义(P＜0.05).结论 FOXL2基因在乳腺癌中高表达,且可以抑制乳腺癌细胞的增殖,可能为一个新的肿瘤抑制因子,但仍需要做进一步的研究.

The epicanthal fold is ordinary in the eyelids of Asians, and the aesthetic appearance of eyelid surgery could be reduced and undermined; thus, medial epicanthoplasty is commonly performed to eliminate the effect of the epicanthal fold with less scarring. At present, there are a lot of techniques that have been described for the treatment of epicanthal fold. The potential problems, however, such as visible scar or under correction in the medial canthus area are challenges to surgeons. The purpose of our study was to explore a novel and individualized design using a modified rectangle flap with acceptable functional and aesthetic outcomes. From January 2017 to January 2018, epicanthoplasty was performed for 40 patients by using a modified rectangle flap. All patients underwent double-eyelid surgery at the same time when they needed it. The evaluation criteria included the intercanthal distance (ICD), interpupillary distance (IPD), the ratio of ICD to IPD (ICD ratio), scar visibility, and cosmetic results. From January 2017 to January 2018, the modified rectangle flap method was carried out on 40 patients, who were evaluated at follow-up from 7 to 15 months. The average intercanthal length was 36.9 ± 2.2 mm preoperatively and decreased significantly to 31.5 ± 1.8 mm postoperatively, 7 months after the surgery (P < 0.01). The excellent cosmetic results, in terms of an open medial canthus, were observed during follow-up periods, with no definite recurrence, hypertrophic scar, or injury of the lacrimal apparatus. The inner canthus and lacrimal caruncle are fully exposed with an invisible scar. Both the patients and the surgeon judged that the aesthetic outcomes were excellent or good. This modified rectangular flap is an effective and personalized method of correcting the medial folds that leave no additional scar in the medial canthal area, and the procedure meets the patient’s aesthetic expectations. 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 .

糖尿病患者皮肤易受损伤,并因其复杂的异常病理生理学过程而愈合延迟或不愈合,降低了患者的生活质量,成为亟待解决的难点和热点.成纤维细胞(FB)是皮肤组织的重要细胞成分之一,是真皮层中分泌细胞外基质(ECM)的主要修复细胞,更是创伤愈合的关键与基础.近几年来,有关糖尿病对FB的影响以及对其改变的研究发展迅速.最新研究发现,糖尿病患者FB的改变在其创面难愈中起重要作用.该文就糖尿病创面愈合中糖尿病对FB的影响以及FB的变化作一综述,以了解其具体机制.

就整形美容外科中过度治疗的具体表现,其产生原因及应对策略进行综述与探讨.近年来,我国整形美容市场发展非常迅速,据国际美容外科学会公布的数据显示,中国已成为继美国和巴西之后的全球第三整容大国.随着医疗美容行业的快速发展,一系列的相关问题也暴露出来,其中整形美容过程中的过度治疗问题尤为突出.求美者自身的审美水平和心理状态不同,加之社会环境和媒体宣传等因素的影响,过度整形的具体表现也各不相同.