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Summary Background Volume restoration is no more a fresh theory for midfacial rejuvenation. However, lack of knowledge regarding the natural ageing process of fat compartments often leads to an insufficient or excessive clinical result. The aim of this study is to reveal the age-related changes in midfacial fat compartments and the correlation between midfacial grooves and the related fat compartments. Methods This study included 60 Asian females in defined age-based categories. The thickness of the infraorbital fat compartment, the nasolabial fat compartment, and the cheek fat compartments were measured using computed tomography (CT) images. Analysis of correlations between midfacial grooves and the related fat compartments was performed using the SPSS software. Results A tendency of thickening in the infraorbital fat and nasolabial fat compartments with age was observed. The superficial layer of cheek fat compartments was found to be thinner, and a similar tendency was observed in the medial part of deep medial cheek fat. However, it was thicker in the lateral part of deep medial cheek fat. There was a negative correlation between the fat thickness of deep medial cheek fat and both the severity of tear trough deformity and the nasolabial fold. A positive correlation between the lower third of the nasolabial fat compartment and the severity of the nasolabial fold was found as well. Conclusion Different midfacial fat compartments tended to undergo selective hypertrophy or atrophy with ageing. The findings of this study suggested that augmentation of the deflated fat compartment and liposuction of the hypertrophic fat compartment can provide a more natural effect in facial rejuvenation.

To investigate the potential role of stromal cell-derived factor-1α (SDF-1α)/CXCR4/CXCR7 axis in adipose-derived mesenchymal stem cells (ADSCs), quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was employed to screen the effective small interfering RNA against CXCR4 and CXCR7 in ADSCs. The messenger RNA (mRNA) and proteins abundances of AKT (p-AKT), ERK (p-ERK), JNK (p-JNK), and p38 (p-p38) in different groups were identified by qRT-PCR, western blot, and immunofluorescence staining method. Meanwhile, cell migration and cell proliferation with SDF-1 treated were examined by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and transwell permeable assay, respectively. Moreover, the interaction between CXCR4 and CXCR7 was examined by a GST pull-down assay. CXCR4 small interfering RNA3 (siRNA3) and CXCR7 siRNA3 have been proved to the most effective tools for knockdown CXCR4 and CXCR7 expressions. mRNA abundance of JNK and p38 could be affected by SDF-1α/CXCR4/CXCR7 axis. However, western blot analysis of p-AKT, p-ERK, p-JNK, and p-p38 in CXCR43-treated ADSCs was significantly higher than that in the control group. Moreover, the immunofluorescence staining analysis revealed that the expressions of p-ATK and p-JNK proteins were significantly higher in NC- and SDF-1-treated subgroups than that in the CXCR4 and CXCR7 groups. p-ATK and p-JNK proteins in CXCR4 group were similar to that in CXCR7 group. Cell migration analysis of CXCR4-treated ADSCs suggested that knockdown CXCR4 could effectively promote cell migration (p < .05). Moreover, CXCR4 could interact with CXCR7. The results in this study could provide a better understanding of SDF-1α/CXCR4/CXCR7 axis during ADSCs development.

BACKGROUND The current study was conducted to study the incidence of human papillomavirus (HPV)-associated nasopharyngeal carcinoma (NPC) in Southern China and the corresponding treatment outcome. METHODS A retrospective chart review with a level of evidence of 4 was performed. RESULTS Between 2000 and 2015, a total of 1328 patients with NPC were treated in 3 study institutes in Hong Kong and Foshan City in Guangdong Province, China. All tumors were undifferentiated, nonkeratinizing carcinoma, of which 91.9% were positive for the Epstein-Barr virus (EBV+) and 7.7% were positive for HPV/p16 (HPV+). Although coinfection with both viruses occurred only in 8 patients (0.6%), 94 patients had tumors that were EBV negative (EBV-) and HPV+. All patients were treated with intensity-modulated radiotherapy alone for American Joint Committee on Cancer stage I and II disease, and concurrent chemoradiotherapy for stage III and IV disease. With a median follow-up of 72.8 months, the authors found that the local recurrence rate was significantly lower for patients with tumors that were EBV-/HPV+ compared with patients with tumors that were EBV+/HPV- (6.4% vs 13.8%; P = .03). Similar trends were observed for the 5-year disease-free survival rate (89.8% vs 70.8%; P =.03) and 5-year overall survival rate (86% vs 72%; P =.03). CONCLUSIONS In regions that are endemic for NPC, the prevalence of EBV and HPV coinfection in patients with NPC is extremely low. Conversely, patients with EBV-/HPV+ NPC demonstrate significantly better local tumor control and survival after radiotherapy. Cancer 2017. © 2017 American Cancer Society.

Background: The latissimus dorsi (LD) flap procedure remains a popular and useful breast reconstruction tool in China and Western countries, and donor site seroma formation is the main complication. This study was conducted in Chinese patients to determine whether stable cases of seromas would resolve without treatment. Methods: A retrospective review of 45 consecutive cases of immediate breast reconstruction with LD flap from April 2012 to February 2017 was conducted. The scope of the seroma was demarcated with a marker pen, and cases that remained stable over time (i.e. the size of the seroma did not increase) were observed without treatment. The measured outcomes included the incidence of seromas, the volume and duration of postoperative wound drainage, and other demographic characteristics. Results: Twenty-four patients (53.3%) developed a seroma at the donor site. Of these, 21 patients (87.5%) did not require treatment, and the seroma resolved over time. The mean duration of a sustained seroma was 6.8 ± 1.4 weeks (range: 4–9 weeks). Conclusions: This study observed the scope and progression of the seromas and found that seromas at the LD donor sites resolved over time without treatment. Key words: Autologous Breast Reconstruction; Breast Reconstruction; Latissimus Dorsi Myocutaneous Flap; Observation; Seroma

Background Adipose-derived stem cells (ADSCs) were effective in treating wound. Stromal cell-derived factor-1 (SDF-1), a chemokine usually called CXCL12, is well known for its chemotaxis in induction of cell migration. However, little is known about the SDF-1responsible for the complex migration of ADSCs from residence to injured sites. Objective Herein, we firstly showed SDF-1 is a major regulator involved in migration of ADSCs during wound repair in vivo . Methods Trauma in rats was induced by surgical operation. The levels of SDF-1 in wounded tissue were assayed by ELISA. ADSCs were labeled with Green Fluorescent Protein (GFP), and then were transferred to injured rats by intracarotid injection. The plasma levels of ADSCs during wound healing were detected by flow cytometry, and ADSCs in injured tissue were evaluated by bioluminescence imaging in vivo and laser confocal microscopy (LCM), respectively. Results ADSCs were successfully labeled with GFP. SDF-1 level reached to the peak value on 24 h after injury and then decreased continuously. Additionally, levels of plasma ADSCs in SDF-1 treated rats reached to the peak value (12%) at d21 after medicine delivery, while those of normal and injured rats showed the peak values of 6.28% and 9.84% at d7 and d21, respectively. Finally, the results of LCM indicated treatment of ectogenic SDF-1 obviously enhanced GFP–ADSCs distribution in wounded tissues. Conclusion Our results indicated that SDF-1 treatment obviously promoted the migration and directed distribution of ADSCs in traumatic tissue.

Human adipose‑derived stem cells (ASCs) isolated from various body sites have been widely investigated in basic and clinical studies. However, ASCs derived from human breast tissue (hbASCs) have not been extensively investigated. In order to expand our understanding of hbASCs and examine their potential applications in stem cell research and cell‑based therapy, hbASCs were isolated from discarded surgical fat tissue following reduction mammoplasty and a comprehensive characterization of these hbASCs was performed, including analysis of their cellular morphology, growth features, cell surface protein markers and multilineage differentiation capacity. These hbASCs expressed cluster of differentiation (CD)44, CD49d, CD90 and CD105, but did not express CD31 and CD34. Subsequently, the hbASCs were differentiated into adipocytes, osteocytes and chondrocytes in vitro. In order to examine the potential applications of hbASCs in breast reconstruction, an approach to promote in vitro differentiation of hbASCs into mammary gland‑like epithelial cells (MGECs) was developed using activated autologous platelet‑rich plasma (PRP). A proliferation phase and a subsequent morphological conversion phase were observed during this differentiation process. PRP significantly promoted the growth of hbASCs in the proliferation phase and increased the eventual conversion rate of hbASCs into MGECs. Thus, to the best of our knowledge, the present study provided the first comprehensive characterization of hbASCs and validated their multipotency. Furthermore, it was revealed that activated autologous PRP was able to enhance the differentiation efficiency of hbASCs into MGECs. The present study and other studies of hbASCs may aid the development of improved breast reconstruction strategies.

The transdermal delivery system (TDS) is able to obtain a systemic therapeutic effect by administration through the skin, which has low side effects and is able to maintain a sustained blood concentration. However, due to the barrier presented by the stratum corneum, numerous drugs have poor percutaneous permeability. Therefore, the improvement of skin permeability is key to TDS. The main method of promoting transdermal absorption is through the usage of penetration enhancers. Dimethyl sulfoxide (DMSO) is a commonly used penetration enhancer, which has anti-inflammatory analgesic effects and is able to penetrate the skin. Retinoic acid (RA) and lipolanthionine peptide (LP) may also benefit the permeation efficiency of TDS. Therefore, the present study examined the function of DMSO, RA and LP as penetration enhancers in TDS. Firstly, the optimum concentration of DMSO was confirmed by detecting the expression of the LacZ gene in vitro. Secondly, different combinations of LP, RA and DMSO were applied to mouse skin to analyze the penetration enhancer combination with the greatest efficacy. All the animals were divided into five groups: The RA + LP + DMSO + pORF-LacZ group, the RA + DMSO + pORF-LacZ group, the LP + DMSO + pORF-LacZ group, the DMSO + pORF-LacZ group and the control group. Skin was soaked in combinations of LP, RA and DMSO for seven days and then the pORF-LacZ plasmids were daubed onto the skin once daily three days. On the 11th day, all the animals were sacrificed by cervical dislocation and the skin and blood samples were collected. The blood samples were used to detect the expression of the LacZ gene by quantitative polymerase chain reaction and the skin samples were used to detect the expression of claudin-4 and zonula occluden-1 (ZO-1) proteins by immunohistochemistry and western blot analysis. The results demonstrated that the combination of LP, RA and DMSO exhibited the greatest transdermal delivery efficiency, which verified that RA and LP were able to increase the penetration effects. Following treatment with LP, the symptoms of dermal edema were relieved and the capillaries contracted, which suggested that LP was a safe and effective penetration enhancer able to reduce the side-effects caused by DMSO. The present study provides a guideline for the synthesis of novel penetration enhancers.

Background: The main complication of autologous free fat tissue transplantation is fat resorption and calcification due to the ischemic necrosis of fat. The promotion of transplant neovascularization soon after autologous free fat grafts may reduce these outcomes. In adulthood, stromal cell-derived factor-1 (SDF-1) and its membrane receptor C-X-C chemokine receptor type 4 (CXCR4) are involved in the homing and migration of multiple stem cell types, neovascularization, and cell proliferation. We hypothesized that CXCR4 may improve the long-term survival of free fat tissue transplants by recruiting endothelial progenitor cells (EPCs) and may therefore improve graft revascularization. In this study, we aimed to determine the effect of human breast adipose-derived stem cells (HBASCs) transfected with the CXCR4 gene on the survival rate of human autologous free fat transplants in nude mice. Methods: Human breast adipose-derived stem cells (HBASCs) were expanded ex vivo for 3 passages, labeled with green fluorescent protein (GFP) and transfected with CXCR4 or left untransfected. Autologous fat tissues were mixed with the GFP-labeled, CXCR4-transfected HBASCs (group A), GFP-labeled HBASCs (group B), the known vascularization-promoting agent VEGF (group C), or medium (group D) and then injected subcutaneously into 32 nude mice at 4 spots in a random fashion. Six months later, the transplanted tissue volume and histology were evaluated, and neo-vascularization was quantified by counting the capillaries. CXCR4 and SDF-1α mRNA expression in the transplants was determined using real-time quantitative PCR analysis (qPCR). Results: The data revealed that the control (group D) transplant volume survival was 28.3 ± 4.5%. Mixing CXCR4-transfected (group A) and untransfected (group B) HBASCs significantly increased transplant volume survival (79.5 ± 8.3% and 67.2 ± 5.9%, respectively), whereas VEGF-transfected HBASCs (group C) were less effective (41.2 ± 5.1%). Histological analysis revealed that both types of HBASCs-treated transplants consisted predominantly of adipose tissue, unlike the control transplants, and also presented significantly less fat necrosis and fibrosis. The CXCR4-transfected HBASCs-treated transplants had a significantly higher capillary density than did the other transplants and showed GFP and CD31 double-positive cells (i.e., ASCs-derived endothelial cells). The mRNA expression of CXCR4 and SDF-1α was much higher in the CXCR4-transfected HBASCs transplants than in the other three transplants. Conclusions: Our data demonstrated that HBASCs can enhance the survival and quality of transplanted free fat tissues. Moreover, CXCR4 transfection of these HBASCs could augment this effect. Stimulation of angiogenesis and decreased fat cell apoptosis due to the recruitment of endothelial progenitor cells (EPCs) and an increase in graft revascularization are potential mechanisms underlying the improved long-term survival of free fat transplants following CXCR4-transfected HBASCs treatment.

Summary Background The creation of a superior palpebral crease has been the most popular plastic surgery procedure in Asians for several decades. The most important criterion for judging the success of this procedure is the achievement of the desired size and shape of this crease or the perfect crease width. However, the determinants of crease width remain unclear, which may account for the high rate of unsatisfactory results. Methods Standard images were used to study the anatomic parameters, including crease width, crease height, and upper eyelid movement distance (ULMD) at the midpupillary axis, of the inherent double eyelid crease in 32 Chinese women aged 19–26 years. The thickness of the eyelid tissue at 5, 7.5, 10, and 15 mm from the lid margin was measured in the oblique sagittal direction by magnetic resonance imaging (MRI) at the central axis of the optic nerve. Multiple linear regression was used to analyze the relationship between crease width and crease height, ULMD, and eyelid thickness. Results Multiple linear regression revealed that crease height, crease thickness, and ULMD were significantly associated with crease width (partial regression coefficients: 0.67, −0.33, and −0.29 respectively). The determination coefficient R 2 was 0.667 in the regression model, and the result of analysis of variance (ANOVA) showed that the regression model was significant ( F = 16.04, p = 0.000). Conclusions In performing upper blepharoplasty, it is important to consider eyelid thickness and movement distance of the upper eyelid margin rather than relying on crease height alone. Attention to these factors will help to achieve the desired size and shape of the crease.

To investigate whether activated autologous platelet-rich plasma (PRP) can promote proliferation and osteogenic differentiation of human adipose-derived stem cells (hASCs) in vitro. hASCs were isolated from lipo-aspirates, and characterized by specific cell markers and multilineage differentiation capacity after culturing to the 3(rd) passage. PRP was collected and activated from human peripheral blood of the same patient. Cultured hASCs were treated with normal osteogenic inductive media alone (group A, control) or osteogenic inductive media plus 5%, 10%, 20%, 40%PRP (group B, C, D, E, respectively). Cell proliferation was assessed by CCK-8 assay. mRNA expression of osteogenic marker genes including alkaline phosphatase (ALP), osteopontin (OPN), osteocalcin (OCN) and core binding factor alpha 1 (Cbfa1) were determined by Real-Time Quantitative PCR Analysis (qPCR). Data revealed that different concentrations of activated autologous PRP significantly promoted hASCs growth in the proliferation phase compared to the without PRP group and resulted in a dose-response relationship. At 7-d and 14-d time point of the osteogenic induced stage, ALP activity in PRP groups gradually increased with the increasing of concentrations of PRP and showed that dose-response relationship. At 21-d time point of the osteogenic induced stage, PRP groups make much more mineralization and mRNA relative expression of ALP, OPN, OCN and Cbfa1 than that without PRP groups and show that dose-response relationship. This study indicated that different concentrations of activated autologous PRP can promote cell proliferation at earlier stage and promote osteogenic differentiation at later stage of hASCs in vitro. Moreover, it displayed a dose-dependent effect of activated autologous PRP on cell proliferation and osteogenic differentiation of hASCs in vitro.

Aims: To investigate whether ginsenoside Rg1 can promote neural phenotype differentiation of human adipose-derived stem cells (hASCs) in vitro. Methods: hASCs were isolated from lipo-aspirates, and characterized by specific cell markers and multilineage differentiation capacity after culturing to the 3rd passage. Cultured hASCs were treated with neural inductive media alone (group A, control) or inductive media plus 10, 50, or 100 μg/mL ginsenoside Rg1 (groups B, C, and D, respectively). Cell proliferation was assessed by CCK-8 assay. Neuron specific enolase (NSE) and microtubule-associated protein-2 (MAP-2) levels were measured by Western blot. mRNA levels of growth associated protein-43 (GAP-43), neural cell adhesion molecule (NCAM), and synapsin-1 (SYN-1) were determined by real-time PCR. Results: Ginsenoside Rg1 promoted the proliferation of hASCs (groups B, C, and D) and resulted in higher expression of NSE and MAP-2 compared with the control group. Gene expression levels of GAP-43, NCAM, and SYN-1 in the test groups were higher than that in thw control. The results displayed a dose-dependent effect of ginsenoside Rg1 on cell proliferation and neural phenotype differentiation. Conclusion: This study indicated that ginsenoside Rg1 promotes cell proliferation and neural phenotype differentiation of hASCs in vitro, suggesting a potential use for hASCs in neural regeneration medicine.

The current study aimed to investigate adipose tissue-derived stem cells (ADSCs) in vivo by multimodality imaging following implantation for cellular therapy. The biological characteristics of ADSCs co-labeled with Molday ION Rhodamine B™ (MIRB) and green fluorescent protein (GFP) were studied in vitro. Following rat ADSC isolation and culture, a combined labeling strategy for ADSCs based on genetic modification of the reporter gene GFP with lentiviral vector expression enhancement and physical MIRB labeling was performed. Cell viability, proliferation, membrane-bound antigens and multiple differentiation ability were compared between the labeled and unlabeled ADSCs. The ADSCs were successfully labeled with GFP and MIRB, showing various fluorescent colors for marker identification. The fluorescence emitted by the GFP protein was sustained and exhibited stable expression, while MIRB fluorescence decreased with time. Compared with the unlabeled ADSCs, no significant differences were detected in cell viability, proliferation, membrane-bound antigens and multiple differentiation ability in the co-labeled samples (P>0.05). No significant effects on the biophysical properties of ADSCs were observed following co-labeling with lentiviral vectors encoding the gene for emerald green fluorescent protein and MIRB. The ADSCs were able to be efficiently tracked in vitro and in vivo by multimodality imaging thus, the co-labeling approach provides a novel strategy for therapeutic gene studies.

Nervous system injury causes severe medical and social problems worldwide, and doctors have not found any ultimate solutions to it until now. The regenerative medicine using stem cells is a promising technology to conquer this challenge. In this study, we explored the influence of platelet-rich plasma (PRP) on neural differentiation of adipose-derived stem cells (ASCs). Human ASCs (hASCs) were harvested and isolated from lipoaspirates of liposuction operations. They were cultured to the third passage and characterized by specific cell markers and multilineage differentiation capacities. Autologous PRP was isolated and prepared from venous blood of the same patient underwent liposuction. The cultured hASCs were treated with either neural inductive conditioned medium plus 10% PRP (experimental group) or neural inductive conditioned medium alone (control group). The supplement of autologous PRP into culture medium obviously promoted proliferation of hASCs. After two weeks of neurogenic induction, the hASCs treated with PRP displayed higher level of neuron-specific enolase and membrane-associated protein-2 compared with the control group. Gene expression level of growth associated protein-43 (GAP-43), neural cell adhesion molecule (NCAM), and synapsin 1 (SYN-1) in the PRP group was also higher than in the control group. These results indicate PRP is capable of promoting cell proliferation and neurogenic differentiation of hASCs in vitro. Addition of autologous PRP could facilitate the potential use of hASCs in nerve regeneration.

There are several surgical techniques for mandibuloplasty, for example, ostectomy of the lateral cortex around the mandibular angle, angle-splitting ostectomy, sagittal split ramus ostectomy, multistage osteotomy of the mandibular angle. These techniques all have achieved excellent aesthetic results, but they require a high level of skill and are time consuming. From July 1995 to June 2010, a total of 1006 patients underwent intraoral curved ostectomy for prominent mandibular angle by grinding, contiguous drilling, and chiseling in our department. A round bur was used to reduce the outer cortex thickness of the mandible body. The ostectomy line on the mandibular angle was penetrated contiguously using a long-shaft bur drill. A curved-headed chisel approximately 10 mm in width was hammered to separate the redundant mandibular angle. Concurrent procedures such as reduction malarplasty and genioplasty were performed in patients with protrusion of the malar bone and microgenia. A total of 992 patients were satisfied with the final facial contour. The square-shaped appearance was converted to an ovoid, slender, and feminine facial contour from the frontal view. Ninety-three patients underwent postoperative complications. Among the 93 cases, there were 14 patients who were unsatisfied with the final results. The average operative time was 42 minutes for ostectomy of prominent mandibular angle. Intraoral curved ostectomy for prominent mandibular angle by grinding, contiguous drilling, and chiseling is an appropriate technique for correcting lower facial contour. The surgical technique is not complex, and the ostectomy is easy to manipulate. The operation consumes less time. Complications of various degrees are relatively lower, and most of them can be treated effectively. Both surgeons and most of the patients are satisfied with the results.

The objective of this article was to explore the effect of paraorbital soft-tissue expansion before orbital osteotomies and medial translocation by combined intracranial-extracranial approach. Tissue expansion was implanted in the zygomatic and temporal region 3 weeks before traditional operation in 2 cases of severe orbital hypertelorism. The measurements of interorbital and intercanthal distance were studied preoperatively and postoperatively by three-dimensional computed tomography. The interorbital distance of the 2 patients decreased from 4.4 and 3.2 cm to 2.0 and 1.4 cm, respectively. The intercanthal distance decreased from 6.7 and 4.8 cm to 5.0 and 3.8 cm, respectively. The paraorbital soft-tissue-expansion technique may be an effective technique for the stability of the corrected orbital framework and the prevention of reoccurrence in severe cases of orbital hypertelorism.

To investigate the effect of Botulinum toxin type A (Botox) injection into the masseter muscle on mandibular development in rats.12 28-day-old Wistar rats were divided into two groups as Botox group (n= 6) and control group (n = 6) which received anesthesia only. In Botox group, Botox was injected into the right masseter muscle, while only sterile saline into the left muscle. When the rats were 75-day-old, CT scan and 3D reconstruction were performed for cephalometry. The masseter muscles at both sides were weighed. Histologic study of masseter muscle and mandible was also performed.The weight of right masseter muscle was (0.4575 +/- 0.0940) g in Botox group, and (0.8899 +/- 0.1030) g in control group (0.05). The mandibular height II and III was (10.8 +/- 0.8) mm and (9.5 +/- 0.6) mm in Botox group and (12.5 +/- 0.6) mm and (10.7 +/- 0.4) mm in control group, respectively (P0.05). The intergonial distance was (11.6 +/- 0.6) mm and (12.4 +/- 0. 6) mm in Botox and control group, respectively (P0.05).When the rats receive Botox injection into the masseter muscle at young age, the grown-up rats have a decreased mandibular height, but the mandibular length and intergonial distance are not affected.

To discuss the treatment and prevention of the complications resulted from intraoral mandibular angle reduction.From July 2002 to August 2008, 672 cases underwent intraoral mandibular angle reduction. The 59 cases with postoperative complications were treated and followed up.No severe complication happened. In 18 cases with asymmetry, 13 cases improved through soft tissue adjustment, 5 cases were reoperated with good results. Intraoperative precise osteotomy was needed to prevent asymmetry. 3 cases with infection healed with drainage and anti-inflammatory treatment. Intraoperative aseptic manipulation and adequate drainage were necessary to prevent infection. 20 cases with labial numbness recovered 3 - 6 weeks later. 5 cases with temporary facial nerve injury recovered 2 - 3 months later. 12 cases with bleeding and hematoma were treated by dressing with pressure and drainage and healed 3 weeks later. Skin necrosis resulted from tight dressing occurred in one case, which were treated with skin graft. Intraoperative protection of nerve and vessels, as well as the dressing were very important.Most of the complications can be treated and recovered well. Preoperative design, precise manipulation and postoperative reliable dressing are the key points to prevent complications.

To observe the effect of intense pulsed light (IPL) on transforming growth factor-beta1 mRNA (TGF-beta1 mRNA) expression in rat skin and explore the molecular mechanisms of photorejuvenation.Fifteen SD rats were exposed to IPL in 3 dermal regions with triple pulses (duration of 4, 5, and 6 ms) at the energy density of 34 J/cm2 and pulse delay of 20 or 25 ms. On days 1, 3, 5, 7, 15, and 30 after the treatment, skin specimens from the treated and non-treated areas were obtained to detect TGF-beta1 mRNA expression with in situ hybridization.In the UPL-exposed skin areas, TGF-beta1 mRNA expression was detected in the epidermal keratinocytes and dermal cells 1 day after the exposure, reaching the highest expression level on day 7 followed by gradual decrement since day 15, and till day 30, only weak expression was found in the dermal cells. In the non-exposed regions, the cells remained negative for TGF-beta1 mRNA.IPL can enhance TGF-beta1 mRNA expression in the skin, suggesting that TGF-beta1 plays an important role in dermal remodeling in photorejuvenation.

To introduce a method to reduce the volume of medial gastrocnemius for calf reduction.Tibial nerve and nerve branches were dissected and explored at popliteal region for morphometry in 20 cadaver-legs. The length, width and the origination position of the nerve to the medial gastrocnemius were measured and recorded. During surgery, the nerve to the medial gastrocnemius muscle were explored and cut off. The circumference and the shape of the leg were measured and recorded.The nerve innervating the medial gastrocnemius originates from the tibial nerve which lies in the fat tissue of popliteal space. In 8 cases (40%) there is only 1 branch to the medial gastrocnemius, and in 4 cases (30%) there are 2 branches. In other 4 cases (30%) the medial sural cutaneous nerve originate from the nerve to the medial gastrocnemius. The nerve to the medial gastrocnemius muscle branch off at (- 6.6 +/- 13.7) mm; the width is (2.3 +/- 0.4) mm; the length is (42 +/- 12) mm. Neurectomy of the nerve to the medial gastrocnemius was performed in 16 cases. After operation, the circumference of the leg was reduced (3.5 +/- 1.1) cm averagely and the curve of the medial line of the calf was reduced. There is no obvious swelling in these cases and the patients were able to walk immediately after operation. The function of the leg was not obviously influenced.Neurectomy of the nerve to the medial gastrocnemius muscle was a safe and effective method for calf reduction.

To study the technical refinements of intraoral reduction malarplasty to prevent postoperative drooping of the cheek.Twenty-four patients with prominent zygomatic complex underwent reduction malarplasty from January 2005 to January 2006. In all these cases, the osteotomized malar complex was repositioned superioposteriorly, and the perioral muscles and periosteum were redraped accordingly and fixed on deep temporal fascia.Symmetry between the left and right complexer were achieved, with a decreased midfacial width of 10.22-/+1.97 mm. During postoperative follow-up of 4 to 6 months, all the patients had satisfactory operative results, and reported no postoperative drooping of cheek.This method of superioposterior reduction of the perioral muscles and periosteum is simple and effective, but the long-term result needs to be observed.

To establish a rabbit model of orbital hypertelorism for plastic and reconstructive surgery and evaluate the surgical effects.Orbital osteotomies and medial translocation was performed in 16 New Zealand rabbits (4 to 6 months old) by combined intracranial-extracranial approach. The interorbital distance (IOD) and bone healing between the orbits were evaluated with gross measurement. X-ray and histological examinations were performed immediately and 12 weeks after the operation.The average IOD of the rabbits was 0.74 cm after completion of the operation, but increased to 0.96 cm 12 weeks after the operation, showing significant relapse of orbital hypertelorism (P0.01).The IOD can be decreased successfully in this rabbit model.

To investigate a new method of genioplasty for treatment of a prominent mandibular angle with mandibular malformation.According to the different types of the mandible, the prominent mandibular angle was grinded with the masseter muscle kept intact. Autologous micromorselized bone of the grinded mandibular angle was collected and implanted into the chin for augmentation mentoplasty, and the chin was fixed with gypsum after operation.Fifteen patients receiving the surgery were followed up for 6 -12 months, and satisfactory effects were achieved in 12 patients. One patient requested modification of the shape of the chin 10 days after the operation, and another two sustained chin distortion due to external forces and underwent subsequent shape adjustment of the chin.The procedure described avoids graft rejection and causes less complications for genioplasty with easy moulding and satisfactory outcome.

To find a new method for edge detection and modeling in frontal facial contour image.Searching circle-based edge detection algorithm was developed on the basis of Sobel edge detector. Apriori knowledge of the facial contour and searching limitations as the minimum curvature radius, concave-convex property, and maximum edge disconnected distance were used to detect the edge of frontal facial contour. The frontal facial contour model was established with least squares curve fitting methods, and the relationship between the model rank and model precision was analyzed.The edge detected by the new method was consistent with the actual edge of the facial contour and the irrelevant edge was well eliminated. Variation of the 2,4,10 time models from the actual image were compared, which identified the 10 time model as the best one.The effectiveness and practicability of this new method for edge detection and modeling has been tested, which provides a theoretic basis for designing facial contouring image system.

To study the effects of the superficial venous trunk (SVT) and its nourishing vessels on early revascularization of the reverse-flow random flap in order to provide theoretical evidences for clinical applications.The morphologic changes of micrangium of the reverse-flow random flap with SVT and without SVT were observed at different phases and compared by optical microscopy and stereological methods.The micrangium density of the flaps with SVT and without SVT showed a tendency of increasing at 3 days after the operation. At 5 to 10 days, the micrangium density of the flap with SVT was much higher than the flap without SVT. There was significant difference between the two groups, which was proved by the optical microscopy observation.This study suggests that SVT and its nourishing vessels could promote early revascularization of the flap after transplantation. The SVT can be of benefit to the survival of the reverse-flow random flap.

To observe the effect of intense pulsed light (IPL) on heat shock protein 70 (HSP70) expression in skin and elucidate the biological mechanisms of photorejuvenation.The skin of 15 SD rats was exposed to IPL in 3 regions at the energy density of 34 J/cm(2) in triple pulses with the duration of 4, 5 and 6 ms, respectively, and pulse delays of 20 and 25 ms. On days 1, 3, 5, 7, 15 and 30 after treatment, specimens of the treated and untreated skin were taken, respectively, for determination of HSP70 expression by immunohistochemistry.In treated regions, positive immunohistochemical staining was observed on day 1 in the epidermal keratinocytes, sebaceous gland cells and endothelial cells. The staining reached the highest intensity on day 7, gradually weakened on day 15, and disappeared on day 30. In the untreated areas, the cells were negative for immunohistochemical staining.Skin HSP70 expression can be enhanced by IPL, suggesting the role of HSP70 in photorejuvenation.

To investigate the mechanism of impeded wound healing by exogenous hyaluronan (HA).Wound healing models were established on 18 adult rabbit ears, which were randomly divided into 3 groups, the 2% HA treated-group (group A), the 1% HA treated-group(group B), and the PBS control group (group C). The process of wound healing was observed morphologically and histologically. The expression of alpha-smooth muscle actin in fibroblast was measured by immunohistochemical method.1. The mean values of wound healing time of groups A, B and C were (11.7 +/- 0.6), (11.3 +/- 0.6), and (10.8 +/- 1.0) days respectively. Wound contraction was greater in group C than in group A and group B. 2. Compared with PBS controls, the collagen fibril was slender and arrayed regularly in HA treated wound. 3. The expression of alpha-smooth muscle actin was greater in group C than in groups A and B.It is one of reasons of impeded wound healing that exogenous HA inhibits the expression of alpha-smooth muscle protein and wound contraction. There exists dose-dependent effect.