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Objective To investigate the accuracy of surgical pleth index (SPI) in monitoring patients with nociceptive stimulation and its predictability for cardiovascular response to nociceptive stimulation in total intravenous anesthesia (TIVA). Methods A total of 102 patients (aged 18 to 65 years, ASAⅠtoⅡ, and BMI of 18.5 to 30 kg/㎡) who underwent elective thyroid surgery in our hospital from February to June 2022 were enrolled in this study. Each patient was induced by intravenous anesthesia, maintained by target-controlled infusion of propofol and remifentanil, and monitored by SPI for analgesia depth. The absolute values of SPI, heart rate (HR) and mean arterical pressure (MAP) of patients 2 min before and during nociceptive stimulation and the maximum values of SPI, HR and MAP within 2 min after nociceptive stimulation were recorded. Receiver operating characteristic (ROC) curve was used to analyze the accuracy of SPI, HR and MAP in monitoring nociceptive stimulation and the predictability of SPI in cardiovascular response to nociceptive stimulation. Results ROC curve analysis indicated that SPI (AUC=0.931, Cutoff value=30) was superior to HR (AUC=0.804, Cutoff value=68) and MAP (AUC=0.759, Cutoff value=80) in monitoring accuracy of tracheal intubation stimulation, ΔSPI (AUC=0.990, Cutoff value=4) was better than ΔHR (AUC=0.972, Cutoff value=3) and ΔMAP (AUC=0.854, Cutoff value=3), ΔSPI was better than SPI, ΔHR was better than HR, and ΔMAP was better than MAP, with their AUC values statistically different (P < 0.05). In terms of monitoring the accuracy of skin incisions, SPI (AUC=0.925, Cutoff value=43) was superior to HR (AUC=0.587, Cutoff value=65) and MAP (AUC=0.804, Cutoff value=76), ΔSPI (AUC=0.998, Cutoff value=7) was better than ΔHR (AUC=0.833, Cutoff value=1) and ΔMAP (AUC=0.943, Cutoff value=3), ΔSPI was better than SPI, ΔHR was better than HR, and ΔMAP was better than MAP, and the above AUC differences were statistically significant (P < 0.05); SPI had predictive value for the cardiovascular response stimulated by tracheal intubation (AUC=0.662, Cutoff value=17, P < 0.05), but had no predictive significance for the cardiovascular response stimulated by skin incisions (P>0.05). Conclusion The absolute value and change of SPI are better than the traditional hemodynamic indexes HR and MAP in monitoring the accuracy of nociceptive stimulation, which can accurately monitor nociceptive stimulation during operation. SPI has predictive value for the cardiovascular response stimulated by intubation stimulation, and has important clinical significance for judging the appropriate timing of intubation.

W‐plasty is a very popular scar excisional revision technique. The core of the technique is to break up the scar margins into small triangular components, so as to cause light scattering and make the scar less noticeable. However, due to skin tension, facial incision scars tend to spread. Applying W‐plasty alone cannot achieve the ideal repair effect of facial scars. In this study, we proposed a scar revision technique combined W‐plasty with continuous tension‐reduction (CTR) technique to improve the appearance of facial scars. Sixty patients with facial scar were comprised in this retrospective study. Scars were assessed independently using the scar scale before and at 12‐month follow‐up. Clinical results showed a significant difference in scar appearance between different groups at 12‐month follow‐up. Vancouver scar scale (VSS), visual analogue scale (VAS) scores, and patient satisfaction were significant better in W‐plasty and CTR than other groups at 12‐month follow‐up. No severe complications were reported. The application of the tension offloading device provides an environment where the tension is continuously reduced, which could greatly decrease tension on the surgical incision. Combined with W‐plasty, this technique could significantly improve the scar's aesthetic appearance. [ABSTRACT FROM AUTHOR]

Tendon development requires the coordinated interaction of muscles and tendons. Muscle-derived cells (MDCs), a mixed cell population containing both myogenic and fibroblastic cell subsets, have been found to be ideal seed cells for tendon regeneration. However, the necessity of these cell types for tendon regeneration has not yet been tested. In this study, we aim to explore the possible synergistic effects of myogenic cells and fibroblasts in engineered tendon regeneration. MDCs were separated into rapidly adhering cell (RAC; fibroblasts) and slowly adhering cell (SAC; myogenic cells) populations. Myogenic- and tenogenic-related molecules were analyzed by immunofluorescent staining, RT-PCR and real-time PCR. The proliferative abilities of MDCs, RACs and SACs were also evaluated. Cell-scaffold constructs were implanted into nude mice, and subsequently evaluated for their histologic, ultrastructure, gene expression, and biomechanical characteristics. MDCs have better proliferative activity than RAC and SAC population. RACs could express higher levels of tenogenic-related molecules tenomodulin (TNMD) and scleraxis (SCX) than SACs. Whereas SACs only expressed myogenic-related molecules MyoD. In contrast to the tendons engineered using RACs and SACs, the tendons engineered using MDCs exhibited a relatively more mature and well-organized tissue structure and ultrastructure as well as better mechanical properties. Fibroblasts in muscle may be the primary cell population involved in tendon regeneration and that myogenic cells are an important component of the niche and control the fibroblast activity during tendon regeneration. The synergistic effects between fibroblasts and myogenic cells significantly contribute to efficient and effective regeneration of engineered tendons. [ABSTRACT FROM AUTHOR]

Objective: To observe the clinical effect of micro-plasma radio frequency treatment of facial post-burn hyperpigmentation., Methods: From June 2012 to August 2013, a total of 25 cases with facial post-burn hyperpigmentation were treated with micro-plasma treatment for 3-5 times. The roller tip was used with setting of 60-90 watts and 3-4 passes were performed in different directions. Treatments were repeated at an interval of 8 weeks., Results: All patients tolerated the pain. After treatment, the facial hyperpigmentation improved. Complete recovery was achieved in 4 cases; significant improvement in 11 cases; moderate in 7 cases and no effect in 3 cases. No hyperpigmentation, depigmentation and scar formation was observed., Conclusion: Micro-plasma radio frequency treatment is an ideal treatment for post-burn hyperpigmentation with lower side effect.