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Objectives: With the increase in aging population in China, elderly Crohn's disease (CD) patients need to receive more attention. This study aims to explore the clinical characteristics and disease process of elderly onset CD (EOCD) patients in a single center., Methods: From January 2002 to January 2022, a total of 221 patients with CD from the Seventh Medical Center of Chinese PLA General Hospital were enrolled. According to the Montreal CD classification standard, the patients were further divided into 4 groups: an EOCD group (≥60 years old, n =25), a middle age onset CD (MOCD) group (40-59 years old, n =46), a young onset CD (YOCD) group (17-40 years old, n =131), and a childhood onset CD (COCD) group (6-16 years old, n =19). We compared the clinical characteristics and long-term prognosis among them., Results: Females were predominant in the EOCD group (15/25, 60%). The number of people without smoking in the EOCD group (80%) was lower than that in COCD group (100%), higher than that in the YOCD group (70.2%) and the MOCD group (69.6%) (all P <0.05). Patients with perianal diseases at diagnosis were rare in the EOCD group (0%), lower than that in the COCD group (21.1%) and the YOVD group (19.8%) (all P <0.05). Stenosis was the most common disease behavior in the EOCD group (63.0%), significantly higher than that in the COCD group (15.8%), the YOCD group (36.6%) and the MOCD group (43.5%) (all P <0.05). The EOCD group was easier to be misdiagnosed as tumor (24%), higher than that in the COCD group (0%), the YOCD group (6.9%) and the MOCD group (19.6%) (all P <0.05). The EOCD group was prone to comorbidities (52%), and 20% of them were complicated with multiple comorbidities ( P <0.05). During the follow-up, the all-cause mortality of EOCD was 12%, and the CD-related mortality was 8%, which was significantly higher than the other groups (all P <0.05). The use of immunosuppressants in the EOCD group (4.8%) was lower than that in the COCD group (12.8%), the YOCD group (16.8%) and the MOCD group (16.1%), but there was no statistical significance among the 4 groups ( P =0.467). In addition, there was no significant difference in the rate of intestinal resection among the 4 groups ( P =0.062)., Conclusions: In EOCD patients, females were predominant, smoking was less common, and they were prone to comorbidity. At the initial stage of diagnosis, it is easy to be misdiagnosed as tumor, and the disease behavior mainly showed stricture type, less complicated with perianal diseases. During the follow-up, all-cause mortality and CD-related mortality of EOCD patients were significantly higher than those of the non-elderly onset CD patients.

Objective: To detect potential mutations of the spastic ataxia of Charlevoix-Saguenay (SACS) gene in a pedigree affected with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS)., Methods: Genomic DNA was extracted from peripheral blood samples of the proband and her family members. All exons and flanking sequences of the SACS gene were analyzed by high-throughput sequencing. Suspected mutations were verified with Sanger sequencing., Results: Next generation sequencing revealed novel compound heterozygous mutations of the SACS gene, namely c.13085T to G (p.I4362R) and c.5236dupA (p.T1746fs), in the proband, which were respectively derived from her parents. The mutations were confirmed by Sanger sequencing., Conclusion: The c.5236dupA (p.T1746fs) and c.13085T to G (p.I4362R) mutations of the SACS gene probably underlie the ocular symptoms and hearing loss in the proband.

Objective: To explore a new method to correct the whistle deformity in bilateral cleft lip., Methods: A lower lip bipedicle orbicularis oris musculomucosal island flap was designed to repair the upper vermilion defect.The pedicle of this flap was deepidermidalized and then embedded into the upper lip. The dry lip in the central was reserved to reconstruct the vermilion tubercle., Results: From Aug.2013 to Aug.2015,10 cases were treated successfully with primary healing. With the follow-up period of 5-17 months, the appearance of upper lip was greatly improved with a balanced proportion and full lip tubercle., Conclusions: This lower lip bipedicle orbicularis oris musculomucosal island flap is an ideal method for the correction of whistle deformity in bilateral cleft lip.

This case report describes a male patient, 5 years old, with recurrent nose congestion and fetid discharge from the right nasal cavity. The suspected clinical diagnosis of a supernumerary nasal tooth was confirmed by computed tomography (CT). Laboratory examination showed normal. After endoscopic removal in general anesthesia, the tooth was examined by pathological examination. A literature search identified 22 supernumerary nasal teeth in 21 patients.

Objective: To introduce a modified penile elongation method and observe its postoperative complications., Methods: From January 1993 to December 2007, 130 patients with congenital short and small penis were divided into 2 groups: the routine group and the modified group, with 65 patients in each group. In the routine group, the patients were 18-55 years old (39.6 on average), and the penile length during erection was (4.9 +/- 1.4) cm. In the modified group, the patients were 20-56 years old (35.4 on average), and the penile length during erection was (5.0 +/- 1.5) cm. There was no significant difference between the two groups (P > 0.05). On the basis of scrotal flap which was transferred to cover the prolonged cavernous body of penis, the "+" shaped incision at the root of the penis was made in the routine group, and the incision was shifted upward by 1.5 cm in the modified group. And V-Y incision was made for the penises with more than 4 cm prolonged length. In order to compare the conditions in the two groups, no physical therapy was applied in 30 days after the operation., Results: All the 130 patients' incisions obtained healing by the first intention, and all flaps survived successfully. Postoperative hydrophallus appeared differently between both groups. In the routine group, obvious hydrophallus appeared on the 3rd day after the operation and lasted for (15.11 +/- 2.71) days, with 3 cases (4.62%) suffering from refractory hydrophallus. In the modified group, hydrophallus appeared on the 3rd day after the operation and lasted for (6.65 +/- 0.29) days without any refractory hydrophallus. There was significant difference between the two groups in the duration of hydrophallus (P < 0.05). All patients were followed up for 6-8 months. After the operation, the shape and function of the penis were found good. The prolonged length was (4.9 +/- 1.4) cm in the routine group and (5.0 +/- 1.5) cm in the modified group. There was no significant difference between the two groups (P > 0.05). The satisfaction rate (according to the patients' self-rating) was 95% and 98% in the routine group and the modified group, respectively., Conclusion: The method using the scrotal flap transferred to cover the prolonged cavernous body of the penis is safe and of low complication rate. The modified method is more effective to abate postoperative hydrophallus.

Objective: To explore the role of collagen degradation and scar morphology and structure in the formation of hypertrophic scar., Methods: SDS-PAGE (sodium dodecyl sulfate polyacrylamide gel electrophoresis) plus collagen substrate electrophoresis, amino acid analysis and compound staining were employed to observe the collagenase activity within hypertrophic scar, collagen degradation and the tissue morphology of the scar., Results: There exhibited deranged collagen fibres within hypertrophic scar, and large amounts of acid mucopolysaccharide closely surrounded the collagen fibres. All these led to an obvious decrease in collagenase activity and reduction of collagen degradation., Conclusion: The decrease of collagen degradation and the formation of hypertrophic scar might be closely related to the decrease in collagenase activity and the inhibiting activity of acid mucopolysaccharide on collagenase.