"Dog ear" deformity is a common skin tissue protrusion defect following surgical procedures. Persistent instances of "dog ear" deformity, which do not naturally resolve, may impact postoperative aesthetics and the quality of life for patients, necessitating a secondary corrective surgical intervention. A comprehensive understanding of the mechanisms contributing to the formation of " dog ear" deformities and the proficient application of suitable correction techniques are imperative for both plastic and dermatologic surgeons. This paper provides a summary of the mechanisms behind the formation of " dog ear" deformity and offers a detailed review of surgical treatment method and strategies. It categorizes the treatments and indications based on different types and locations of "dog ear" deformity and includes surgical diagrams for reference.

"Dog ear" deformity is a common skin tissue protrusion defect following surgical procedures. Persistent instances of "dog ear" deformity, which do not naturally resolve, may impact postoperative aesthetics and the quality of life for patients, necessitating a secondary corrective surgical intervention. A comprehensive understanding of the mechanisms contributing to the formation of " dog ear" deformities and the proficient application of suitable correction techniques are imperative for both plastic and dermatologic surgeons. This paper provides a summary of the mechanisms behind the formation of " dog ear" deformity and offers a detailed review of surgical treatment method and strategies. It categorizes the treatments and indications based on different types and locations of "dog ear" deformity and includes surgical diagrams for reference.

Objective To explore the effective constituents from Sonchus arvensis L. and the potential mechanism in treating sepsis by network pharmacology. Methods The chemical ingredients reported in the literature were taken as research objects and Swiss Target Prediction database was used to collect the identify the potential targets of those ingredients. The GeneCards, OMIM and TTD databases were applied to screen the sepsis related molecular targets. The cross targets were obtained and used to construct the active ingredient-disease target network. In addition, the targets were also imported into STRING database to construct a PPI network. Finally, GO and KEGG enrichment analysis were performed on the target genes to predict the mechanism via DAVID database. Results 71 components from S. arvensis L. were obtained, which corresponded to 579 potential drug targets. There were 3437 related targets of sepsis. S. arvensis L. and sepsis shared 272 common targets. The results showed that 1366 terms were found by GO function enrichment, including 245 molecular functions (MF), 1002 biological processes (BP), and 119 cell composition (CC), The KEGG enrichment analysis suggested that 166 signaling pathways were involved. Conclusion The study revealed that TNF, AKT1, IL-6, IL-1β, TP53 and some other targets might be affected by potentially active ingredients of S arvensis L. such as linoleic acid, linolenic acid and oleic acid to regulate the expression of steroids, sphingolipids hormones as well as epidermal factors and chemokines in treating sepsis.

The construction of a countywide community for medical and health services is designed to upgrade the service capacity of primary medical and health institutions, to promote resource sharing and collaborative services, and promote the hierarchical medical system. Huzhou of Zhejiang province has launched its initiative in building a countywide community for medical services since 2018. The authors summarized its main practices in promoting the integration of the management system and optimizing operating mechanism of countywide medical and health institutions, promoting the reform of the county medical and health governance system, as well as the achievements and shortcomings, with a view to providing reference for promoting the high-quality development of the countywide medical and health service system.

The etiology and pathogenesis of keloid are still not clear. It is believed that the formation of keloid is due to the joint action of many factors, during which process the external factor of fibroblast play an important role. Reprogramming of glucose metabolism in keloid fibroblasts is a new research direction. TGF-β 1 and its related TGF-β 1/Smad signalling pathway are considered to be the most closely related to the formation of keloid. This article reviews the research progress on extracellular factors, glucose metabolism and signaling pathways of keloids.

The etiology and pathogenesis of keloid are still not clear. It is believed that the formation of keloid is due to the joint action of many factors, during which process the external factor of fibroblast play an important role. Reprogramming of glucose metabolism in keloid fibroblasts is a new research direction. TGF-β 1 and its related TGF-β 1/Smad signalling pathway are considered to be the most closely related to the formation of keloid. This article reviews the research progress on extracellular factors, glucose metabolism and signaling pathways of keloids.

Objective:To explore whether there is Warburg effect in keloid fibroblasts (KFs) , hypertrophic scar fibroblasts (HSFs) and atrophic scar fibroblasts (ASFs).Methods:KFs, HSFs, ASFs and NFs were isolated and cultured, respectively, in vitro. Glucose consumption and lactate production of the cells in each group were tested and compared. The mRNA expression of key glycolytic enzymes was detected, including hexokinase 2 (HK2), fructose-2, 6-biphosphatase 3 (PFKFB3), pyruvate kinase isoform M 2 (PKM2) and lactate dehydrogenase A (LDHA). In addition, the effect of 2-deoxy-D-glucose(2-DG) on the proliferation of KFs and NFs were detected and compared.Results:Glucose consumption and lactate production in KFs were 45.5% and 38.1% higher than those in NFs respectively ( P<0.01), while there was no statistical difference in glucose consumption and lactate production between ASFs and NFs, HSFs and NFs ( P>0.05). The mRNA expression of HK2, PKM2 and LDHA genes in KFs were 4.7, 2.7 and 1.8 times higher than those in NFs ( P<0.05), respectively, while the gene expressions in ASFs and HSFs had no statistical differences from those in NFs ( P>0.05). Under the action of 2-DG, the cell proliferation activity in KF group and NF group were reduced by 37.5% and 27.0%, respectively, indicating that the inhibition effect of glycolysis inhibitor on the proliferation activity of KFs was significantly higher than that of NFs. Conclusions:There is Warburg effect in KFs and there are no similar phenomena in HSFs and ASFs.

Objective:To explore whether there is Warburg effect in keloid fibroblasts (KFs) , hypertrophic scar fibroblasts (HSFs) and atrophic scar fibroblasts (ASFs).Methods:KFs, HSFs, ASFs and NFs were isolated and cultured, respectively, in vitro. Glucose consumption and lactate production of the cells in each group were tested and compared. The mRNA expression of key glycolytic enzymes was detected, including hexokinase 2 (HK2), fructose-2, 6-biphosphatase 3 (PFKFB3), pyruvate kinase isoform M 2 (PKM2) and lactate dehydrogenase A (LDHA). In addition, the effect of 2-deoxy-D-glucose(2-DG) on the proliferation of KFs and NFs were detected and compared.Results:Glucose consumption and lactate production in KFs were 45.5% and 38.1% higher than those in NFs respectively ( P<0.01), while there was no statistical difference in glucose consumption and lactate production between ASFs and NFs, HSFs and NFs ( P>0.05). The mRNA expression of HK2, PKM2 and LDHA genes in KFs were 4.7, 2.7 and 1.8 times higher than those in NFs ( P<0.05), respectively, while the gene expressions in ASFs and HSFs had no statistical differences from those in NFs ( P>0.05). Under the action of 2-DG, the cell proliferation activity in KF group and NF group were reduced by 37.5% and 27.0%, respectively, indicating that the inhibition effect of glycolysis inhibitor on the proliferation activity of KFs was significantly higher than that of NFs. Conclusions:There is Warburg effect in KFs and there are no similar phenomena in HSFs and ASFs.

Objective: To introduce a reconstruction procedure of natural sideburn, with combined expanded retroauricular flap and scalp flap. Methods: A retrospective study was produced in Plastic Surgery Hospital, PUMC, from January 2014 to December 2017. Twenty patients (21 sides) underwent sideburn reconstruction with combined expanded retroauricular flap and scalp flap (double pedicled flap, n=3; single pedicled flap, n=17) were included in this study. There were 12 male (12 sides) and 8 female (9 sides), with the mean age of (23.8±3.2) years. The sideburn defect was caused by burn in 19 patients, and it was resulted from hemangioma in 1 patient. Results: The size of flaps ranges from 8 cm×12 cm to 10 cm×16 cm. Venous congestion at the distal end of the flap occurred in 1 patient, which was cured after dressing change, and the sideburn was not affected. The reconstructed sideburns are natural, symmetric, and without obvious scar. The follow-up time was 3-40 months. Fourteen patients were very satisfied with the reconstructed sideburn, and 6 patients were satisfied. No severe complication was observed during follow-up time. Conclusions The combined retroauricular flap and scalp flap is an alternative method for sideburn reconstruction, which provide natural hair distribution, inconspicuous scars and less complications.

Objective: To explore a surgical method for the reconstruction of naturally dynamic double eyelid by fully reserving orbicularis oculi muscle. Methods: Incisional double eyelid blepharoplasty were performed on 352 patients. Orbicularis oculi muscle in incisional and pretarsal area were completely preserved. Muscle was elevated from plate by resecting deep muscular myolemma and muscles to form pretarsal myocutaneous flap. Thereafter, the orbital septum was completely exposed. The free end of muscle flap was fixed to a higher position of the levator aponeurosis. The orbital septum was repaired at the same time. Results: From June 2009 to December 2017, 352 patients were performed double eyelid blepharoplasty using above technique. They are 337 females and 15 males. Fifty-two patients were followed up for 6-60 months, with the mean time of 27 months. All the incisions were uneventfully healed. The new double eyelid presented smooth appearance, and the so-called " sausage" phenomena were not noticed. There was no concave groove or step-like deformity when eyes closed. Forty-five patients were satisfied with the outcomes. Two patients had shallower supratarsal folds on one side, and 1 patient underwent secondary repair. Two patients complained about asymmetry. Two patients suffered from mild unilateral eyelash eversion (without need of reparation). Conclusions The combined application of deep and superficial myolemma release of the orbicularis oculi muscle, and orbital septum reset, could create a double eyelid with natural and dynamic appearance.