Objective To investigate the clinical effect of type A botulinum toxin and nipple retractor in correcting severe inverted nipples.Methods All the patients with bilateral severe inverted nipples that sought consulting in the Plastic and Reconstructive Surgery Center of Peking Union Medical College Hospital were included in this study and the patients were randomized into different treatment group with nipple retractor only or BTX-A (Lanzhou,China) combined with nipple retractor.In the combined therapy group,50 u BTX-A was injected into the bottom of each nipple.2 weeks later,nipple retractor was placed and kept wearing for 6 months.For the retractor only group,no BTX-A was used.All the patients were followed up at 1 month,3 months and 6 months after the operation.Nipple projection was measured according to the profile view of pre-and post-operation.Effectiveness and complication rate were compared between the two groups.Results 20 patients were included in this study.Average nipple projection in the combined therapy group was (1.12±0.13) cm,(0.95± 0.10) cm and (0.73±0.11) cm (3 months,6 months and 12 months post-operation,respectively),which had a significant difference from that of the retractor group [(0.81±0.10) cm,(0.72±0.12) cm and (0.53±0.10) cm].Total complication rate of combined group was also lower than that of retractor group.The complications of the combined therapy group included hypopigmentation (1 case),without skin ulcer or wire dislocation.However in the retractor group,complications included skin ulcer (2 cases),hypopigmentation (1 case) and dislocation (1 case).No severe complications such as nipple necrosis happened in both groups.Conclusions BTX-A combined with nipple retractor is an effective method in correcting severe inverted nipple with low complication rate.

Objective To explore a new method for improving healing of skin graft donor sites.Methods A total of 40 patients who needed intermediate thickness skin graft from thigh,from January 2014 to December 2015,were randomly devided into experiment group and control group.Skin graft donor sites of the experiment group were covered with Physiotulle Ag and Allevyn foam dressing,while donor sites of the control group were covered with petrolatum impregnated gauze,sterile gauze,and compression bandage.Postoperative infection rate,pain scoring during the first dressing change,time of dressing change between operation and complete healing,duration for complete healing,and the area of non-healing two weeks after operation were compared and statistical analysis was performed with SPSS17.0.Results There was no infection in the experiment group.Two patients developed infection in the control group,with wound exudate culture positive for pseudomonas aeruginosa,and the wounds healed after dressing change.The experiment group was significantly better than that of the control group in pain scoring during the first dressing change,time of dressing change between operation and complete healing,duration of complete healing (U=81.5,P=0.001;U=109.5,P=0.011;t=0.769,P＜0.001).Conclusions The Physiotulle Ag combined with Allevyn foam dressing can enhance healing of skin graft donor sites,alleviate pain of the patient,and reduce dressing change.This method is easy to perform,and skin graft donor sites heal well in two weeks,which may lead a prospected application.

To explore the ideal pretarsal shows and morphological characteristics of double eyelids in Chinese populations through a morphometric analysis.

To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control.

Objective: To introduce the experience in skin defect reconstruction with keystone design perforator flap. Methods: From January 2012 to December 2012, 26 patients with different types of skin defect were repaired with keystone design perforator flaps, including 21 classic keystone design perforator flaps, 3 short incision keystone design perforator flaps, and 2 Omega variant keystone design perforator flaps. Results: One patient suffered partial flap loss and healed secondarily. All other patients recovered smoothly without complications. Conclusions Keystone design perforator flap offers a versatile technique for skin defect reconstruction except for scalp.

Objective: The purpose of this study is to systematically review the literature about surgical management of lymphedema, to provide recomendations for the surgical treatment plan of the disease. Methods: Cochrane Library and EMBASE databases were searched from January 1st, 2007 to October 1st, 2017 for the literature related to the surgical treatment of lymphedema. Data were extracted from clinical studies matching our inclusion criteria. Meta-analysis was performed with R 3.4.2. Results: 71 studies were included, out of which 4 studies described were excision, 9 were liposuction, 33 were lymphvenous anastomosis(LVA), 23 were vascularized lymph node transfer(VLNT) and 5 were combined therapy. The excess volume reduction were averaged 96.86%(95%CI: 87.38%—106.33%, I²=0%)for liposuction, 34.64%(95%CI: 19.80%—49.47%, I²=72%)for LVA, 36.85%(95%CI: 12.40%—61.30%, I²=81%) for VLNT. Conclusions With further understanding of the pathophysiology of lymphedema and development of radiologic and surgical technique, surgical treatment has the potential to play an important role in lymphedema complex management.

Objective:To evaluate facial asymmetry among Chinese young population via three-dimensional photogrammetry.Methods:Young subjects were recruited in Beijing from May to December in 2017. Three-dimensional facial images were obtained by VECTRA H1 camera. The images were exported to Geomagic Wrap 2017. Soft tissue landmarks were identified, and a coordinate system was built on every image. The face was divided into upper, middle, and lower part by the horizontal plane passing the exocanthion and the horizontal plane passing the cheilion. On the coronal plane, the distances between the midsagittal plane and the homogeneous landmarks located on the right and left hemifaces as well as bilateral palpebral fissure height were computed. In terms of facial depth, facial depth parameters located on the right and the left hemifaces were computed. There was a total of 13 parameters. Parameters on one hemiface were compared with those on the other hemiface using paired t-test. Mean absolute difference (MAD) and asymmetric rate (AR) were computed. Finally, we compared the result on men to the result on women via t-test. P<0.05 was considered statistically significant. Results:There was a total of 122 young subjects, 60 men (25.1±3.8 years old) and 62 women (27.3±4.3 years old). (1) On coronal plane, among males, the difference between bilateral tragion and midsagittal plane and the difference between bilateral cheilion and midsagittal plane were statistically significant( P<0.05); among females, the difference between bilateral exocanthion and midsagittal plane, the difference between bilateral palpebrale superius and midsagittal plane, and the difference between bilateral tragion and midsagittal plane were statistically significant ( P<0.05). Among bilateral landmarks (except for palpebral fissure height), the MAD of the distance between bilateral exocanthion and midsagittal plane was the smallest, (1.00±0.88) mm (AR=2.1%) and (1.08±0.79) mm (AR=2.4%) among men and women, respectively ( t=0.541, P=0.589). The MAD of the distance between lateral tragion and midsagittal plane was the largest, (3.45±2.54) mm (AR=4.6%) and (2.89±2.86) mm (AR=4.1%) among men and women, respectively ( t=-1.149, P=0.253). (2) In terms of facial depth, among both males and females, the difference between all bilateral facial depth parameters was statistically significant ( P<0.05). The MAD of the distance between the pogonion and bilateral tragion was the largest, (2.62±1.69) mm (AR=1.8%) and (2.45±1.69) mm (AR=1.8%) among men and women, respectively ( t=-0.491, P=0.625); the MAD of the distance between the glabella and bilateral tragion was the smallest, (1.77±1.25) mm (AR=1.4%) and (1.91±1.54) mm (AR=1.6%) among men and women, respectively ( t=0.587, P=0.558). Conclusions:Facial asymmetry is universal among Chinese young population. The MAD does not exceed 3.5 mm. Upper one-third face has higher symmetry while lower one-third face has lower symmetry.

Objective:To explore the regulatory effect of exosomes derived from healthy human adipose stem cells (ADSC) on the fibrosis of localized scleroderma fibroblasts (LSFs) in vitro. Methods:From January 2021 to January 2022, fat from 10 healthy donors in Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences was collected by liposuction. Adipose stem cells were isolated and cultured in vitro, and exosomes (ADSC-Exo) were collected. Fibroblasts were isolated from skin tissue of 15 patients with localized scleroderma during the same period and cultured in vitro. Induced differentiation and staining, nanoparticle tracking analysis, transmission electron microscopy, PKH26 staining and Western blotting were used to identify ADSC and their exosomes. The effect of ADSC on the expression of fibrosis markers [collagen Ⅰ, collagen Ⅲ, α-smooth muscle actin (α-SMA)] in LSFs through its exosomes was examined by extracellular vesicle secretion inhibition assay. The proliferation and migration abilities of LSFs treated with ADSC-Exo were tested by CCK-8 method and scratch test. Real-time quantitative PCR, immunofluorescence staining and Western blotting were used to detect the expression levels of collagen Ⅰ, collagen Ⅲ, α-SMA, transforming growth factor β (TGF-β) and p-Smad2/3 in LSFs. Independent sample t-test was used to compare between the two groups. One-way ANOVA was used for multi-group comparison, and SNK- q test was used for pairwise comparison. Results:ADSC and LSFs were successfully isolated and cultured in vitro, and ADSC-Exo was extracted. Extracellular vesicle secretion inhibition assay demonstrated that ADSC decreased fibrotic markers of LSFs by secreting extracellular vesicles. Results of CCK-8 and scratch test showed that the proliferation and migration ability of LSFs was decreased by ADSC-Exo treatment. The results of real-time quantitative PCR, immunofluorescence staining and Western blotting showed that compared with the control group, the expressions of collagen Ⅰ, α-SMA, TGF-β and p-Smad 2/3 in the ADSC-Exo treatment group were significantly decreased. Conclusion:In vitro, ADSC-Exo can affect the biological behavior and reduce the expression of fibrosis markers in LSFs by inhibiting the TGF-β/Smad pathway.

The management of chronic wounds presents significant challenges, characterized by a low rate of healing and substantial impairment of patients’ quality of life, while also exerting a considerable strain on healthcare resources. Wound healing is a multifactorial and dynamic process, necessitating close monitoring of wound changes and timely, appropriate interventions. Smart bandage/dressing, an innovative approach born from interdisciplinary research, offers a new generation of wound care. It enables dynamic quantitative monitoring of wound conditions, facilitates transdermal drug release and physical mode therapeutics, and adjusts interventions in real time based on monitoring outcomes. In comparison to traditional wound dressings, smart bandages exhibit attributes such as real-time responsiveness, precision, and convenience. They not only simplify wound management but also enhance patient comfort and compliance, showcasing potential as a safe and effective new treatment modality. Smart bandages hold promise for elevating the efficiency of managing chronic wounds, reducing morbidity rates, alleviating the burden of disease, and ultimately improving patients’ quality of life. This paper summarized the recent research progress of smart bandages and provide insights into novel wound care strategies.

Objective:To evaluate facial asymmetry among Chinese young population via three-dimensional photogrammetry.Methods:Young subjects were recruited in Beijing from May to December in 2017. Three-dimensional facial images were obtained by VECTRA H1 camera. The images were exported to Geomagic Wrap 2017. Soft tissue landmarks were identified, and a coordinate system was built on every image. The face was divided into upper, middle, and lower part by the horizontal plane passing the exocanthion and the horizontal plane passing the cheilion. On the coronal plane, the distances between the midsagittal plane and the homogeneous landmarks located on the right and left hemifaces as well as bilateral palpebral fissure height were computed. In terms of facial depth, facial depth parameters located on the right and the left hemifaces were computed. There was a total of 13 parameters. Parameters on one hemiface were compared with those on the other hemiface using paired t-test. Mean absolute difference (MAD) and asymmetric rate (AR) were computed. Finally, we compared the result on men to the result on women via t-test. P<0.05 was considered statistically significant. Results:There was a total of 122 young subjects, 60 men (25.1±3.8 years old) and 62 women (27.3±4.3 years old). (1) On coronal plane, among males, the difference between bilateral tragion and midsagittal plane and the difference between bilateral cheilion and midsagittal plane were statistically significant( P<0.05); among females, the difference between bilateral exocanthion and midsagittal plane, the difference between bilateral palpebrale superius and midsagittal plane, and the difference between bilateral tragion and midsagittal plane were statistically significant ( P<0.05). Among bilateral landmarks (except for palpebral fissure height), the MAD of the distance between bilateral exocanthion and midsagittal plane was the smallest, (1.00±0.88) mm (AR=2.1%) and (1.08±0.79) mm (AR=2.4%) among men and women, respectively ( t=0.541, P=0.589). The MAD of the distance between lateral tragion and midsagittal plane was the largest, (3.45±2.54) mm (AR=4.6%) and (2.89±2.86) mm (AR=4.1%) among men and women, respectively ( t=-1.149, P=0.253). (2) In terms of facial depth, among both males and females, the difference between all bilateral facial depth parameters was statistically significant ( P<0.05). The MAD of the distance between the pogonion and bilateral tragion was the largest, (2.62±1.69) mm (AR=1.8%) and (2.45±1.69) mm (AR=1.8%) among men and women, respectively ( t=-0.491, P=0.625); the MAD of the distance between the glabella and bilateral tragion was the smallest, (1.77±1.25) mm (AR=1.4%) and (1.91±1.54) mm (AR=1.6%) among men and women, respectively ( t=0.587, P=0.558). Conclusions:Facial asymmetry is universal among Chinese young population. The MAD does not exceed 3.5 mm. Upper one-third face has higher symmetry while lower one-third face has lower symmetry.