1.HLA-E siRNA silence expression of HLA-E gene in hepatocarcinomal cells
Tianling FANG ; Hua LI ; Tong ZHANG ; Xiancheng ZENG ; Guihua CHEN
Chinese Pharmacological Bulletin 2010;26(1):29-32
Aim According to various target sites of HLA-E mRNA,to design and synthesize 3 pieces of HLA-E siRNA chain,to compare quantitatively their efficiency of silencing gene in BEL-7402 with HLA-E(+)in order to select the dominant siRNA.Methods The hepatocarcinomal BEL-7402 cells,induced by 5×10~5 IU·L~(-1) IFN-γ,expressed HLA-E(+) and was pured by flow cytometry selecting as target cells for research.3 pieces of specific siRNA(A,B,C group)were designed and chemically synthesized,then the concentration of which(0.1 mmol·L~(-1))was respectively transfected through Lipofectamin 2000 into target cells.After 48 h,the gene silent effect on HLA-E gene in A,B and C groups was quantitatively observed by cytoimmunofluorence,flow cytometery,Western blot and real-time PCR,as well as on NK cytotoxicity to target cells tested by NK killing rate.Results Compared with those of control or non-specific siRNA group,HLA-E antigen,protein product,HLA-E mRNA and HLA-E molecule on cell surface were statistically down-regulated in A,B,and C group(P<0.01),whose were silenced more (above 90%) in B or C group than in A group (P<0.01).The NK killing rate in A,B and C groups was dominantly improved(P<0.01),which in B or C group was higher than in A group (P<0.01).Conclusion The targeted siRNA can specifically and high-efficiently silence HLA-E expression in hepatocarcinomal cells,and may keep them from immunoescape through non-classic HLAⅠ pathway to imply new strategy for hepatocarcinomal gene-immunotherapy.
2.Prevention of acute renal failure in obstructive jaundice patients in perioperative period
Dong DAI ; Xiaoyu TAN ; Xiancheng ZENG ; Songtao DU
Chinese Journal of General Surgery 2001;0(08):-
ObjectiveTo investigate the protection of renal function and the prevention of acute renal failue(ARF) in perioperative period in obstructive jaundice(OJ) patients. Methods In experimantal group, short time parenteral nutrition(PN) was given preoperatirely.Small dosage of dopamine was intravenously dripped.and rapid infusion of 20% mannitol periodically was done.In control group routine treatment was done. Postoperative blood BUN and Cr dynamic changes were examined and occurrence rate of ARF were recorded. Results No ARF occurred in the experimental group;but ARF occurred in 5 cases(29.4%)and 2 cases(17.6%) died (P
3. The application of diced cartilage in postoperative nasal deformity of cleft lip surgery
Ying LIANG ; Xiancheng WANG ; Yang SUN ; Xiang XIONG ; Xianxi MENG ; Fanglin ZENG ; Yuanming YANG ; Jinyuan CHANG ; Yiming HU ; Conghang JIANG ; Xiaofang LI ; Borong FANG
Chinese Journal of Plastic Surgery 2020;36(1):49-52
Objective:
To investigate the clinical effect of diced cartilage in correcting nasal alar base depression after cleft lip surgery.
Methods:
A retrospective study was conducted in 15 patients of nasal deformity after lip surgery from January 2018 to January 2019. All the patients were taken from autologous costal cartilage to reconstruct the outline of nasal malformation, and the remaining autologous costal cartilage was cut into 0.5-1.0 mm pieces and filled into the basilar lacunar space of the nasal alar by the 1 ml syringe whose anterior needle nipples was removed. The effects of visual images before and after operation were compared and analyzed by Adobe Photoshop CS6 software. The patients were followed up for 6-15 months (mean 10months). The satisfaction and complications of the patients were investigated.
Results:
The nasal alar base was significantly elevated and the outline of the nasal deformity was improved in 15 patients after operation. The overall effect was satisfactory and no obvious complications were found. No obvious absorption was found in the follow-up.
Conclusions
The application of diced cartilage to correct the nasal alar base depression after cleft lip surgery was a feasible method with important clinical value. It advanced in taking good use of the remaining cartilage and reducing the damage to both the donor and recipient area.
4.Application of local free-style perforator flap in repairing gluteal bedsores
Yuanming YANG ; Xiancheng WANG ; Xiang XIONG ; Yang SUN ; Xianxi MENG ; Ying LIANG ; Wenbo LI ; Xiaofang LI ; Fanglin ZENG ; Yiming HU ; Jinyuan CHANG
Chinese Journal of Plastic Surgery 2020;36(5):531-535
Objective:To investigate the application of local free-style perforator flap in repairing gluteal bedsores.Methods:A retrospective study was performed. Date from 35 patients(20 males and 15 females, mean age 46 years old, range from 24-71) with gluteal bedsores between June 2017 and June 2019 were retrieved and reviewed by the Department of Burn and Plastic Surgery, Second Xiangya Hospital of Central South University. Among these cases, 13 were paraplegia after trauma, 6 were paralysis after cerebral hemorrhage, 13 were chronic infection, and 3 were poor wound healing after tumor resection. The average defect size was 5.6 cm×5.0 cm(range from 2.0 cm×3.0 cm to 10.0 cm×5.0 cm). By following the concept of free-style perforator flap, the flap was designed near the wound according to the perforator location detected by Doppler before surgery, and the defects were recovered by the flaps by rotation or other method such as rotation. Or the perforator flap can be modified into dermis-fat flap and flipped 180° to recover the wound. After the surgery, the survival of the flap or the dermis-fat flap, wound healing, as well as the sense and motion function of buttock and lower limbs were observed and recorded.Results:21 cases were repaired by perforator flap and 14 cases were repaired by modified dermis-fat flap. The size of flap range from 3.0 cm×3.0 cm to 10.0 cm×7.0 cm. The follow-up time was 3-22 months(mean, 12 months). All perforator flaps and dermis-fat flaps survived. The appearance of buttock was pleasant and no recurrence of bedsores. The patients without paraplegia had no major sensory loss and pain. The function of gluteus maximus was basically normal, and the motor function of lower limb was also generally satisfactory.Conclusions:The local free-style perforator flap or modified dermis-fat flap has advantages including simple design and operation, reliable blood supply and minimal damage to the donor site. It is a better way to repair gluteal bedsores.
5.Bilateral endonasal incision combined with umbrella-like graft apply in autologous costal cartilage rhinoplasty
Fanglin ZENG ; Xiancheng WANG ; Yang SUN ; Xiang XIONG ; Xianxi MENG ; Wenbo LI ; Borong FANG ; Xiaofang LI
Chinese Journal of Plastic Surgery 2020;36(7):770-775
Objective:To introduce a surgical technique applied in autologous costal cartilage rhinoplasty described as the endonasal incision combined with umbrella-like graft.Methods:From February 2018 to May 2019, a total of 52 patients (48 females and 4 males) were enrolled and underwent rhinoplasty operation with bilateral intranasal incision for the construction of umbrellal scaffolds in Department of Burn and Plastic Surgery of the Second Xiangya Hospital. During the operation, bilateral inferior lateral cartilages were fully separated and septal cartilages were exposed. Umbrellal-like scaffolds were built to correct nasal aesthetic defects such as nasal columellar shrinkage and insufficient nasal tip protrusion. During the process of follow-up, all the patients were photographed and were asked to complete the the postoperative satisfaction survey by means of an online link or over the phone.Results:The preoperative nasal aesthetic defection was greatly improved. There is no the temporary complications including infection and bleeding. 30 patients who completed follow-up for 6 months at least and completed postoperative satisfaction survey were included in the case series. The measurements (average): The nasofrontal angle was measured as 141.29°±5.61°preoperation and 137.67°±5.27°postoperation. The nasolabial angle was measured as 89.53°±10.56°preoperation and 94.90°±5.88°postoperation , The nasal tip angle was measured as 86.60°±7.09°preoperation and 80.42°±5.47° postoperation, Columellar-lobular angle was measured as 48.82°±7.32°preoperation and 44.63°±2.51°postoperation , The tip projection-nasal length index was measured as 0.48±0.07 preoperation and 0.54±0.07 postoperation. Columellar-lobular length index was measured as 1.74±0.36 preoperation and 1.22±0.21 postoperation, There were significantly statistical differences between preoperative and postoperative measures. The photograph showed the location and reflection of nasal tip have remained stable, no upward or twist trend occurred. According to questionaire results, postsurgical swelling relieved in all cases within the first 3 to 6 weeks. No prolonged functional sequelae occured, Most of patients were satisfied with the aesthetic and functional results.Conclusions:Endonasal incision combined with umbrella-shape graft facilitates the operation, Bilateral endonasal incision allowed us to evaluate the reestablished nasal tip directly and adjust tip projection with convenience, there’s no columella scar left.
6.Surgical techniques for pollybeak deformity correction
Hongli ZHAO ; Xiancheng WANG ; Yang SUN ; Xiang XIONG ; Xianxi MENG ; Wenbo LI ; Zhihua QIAO ; Kai YANG ; Weiliang ZENG ; Yi TIAN
Chinese Journal of Plastic Surgery 2024;40(2):156-162
Objective:To evaluate the effectiveness of surgical methods for correcting pollybeak deformity in Chinese rhinoplasty.Methods:A retrospective chart review was conducted for patients who underwent pollybeak correction between January 2021 and December 2022 at the Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University. Individualized correction was tailored based on the etiology and severity of the nasal deformity of each patient, involving techniques such as resection of the anterior part of the nasal septum, reconstruction of nasal tip support, reconstruction of the middle part of the nasal vault, and excision of skin in the upper region of the nasal tip. A modified classification system for pollybeak deformity, the supratip fullness rating scale (SFRS), was developed to evaluate supratip fullness (0-3 points, with higher scores indicating more apparent deformity). The patients aesthetic outcomes were assessed by surgeons using the visual analogue scale (VAS) (0-10 points, with higher scores indicating more apparent deformity), and patient self-assessed using the rhinoplasty outcome evaluation (ROE) questionnaire (0-100 points, with higher scores indicating higher satisfaction). The measurement data of normal distribution was expressed as Mean±SD and analyzed by paired t-test; the measurement data of non-normal distribution was expressed as M( Q1, Q3) and analyzed by Wilcoxon signed rank test. Results:In a cohort study of 53 rhinoplasty patients (7 male, 46 female; age range 19-45 years, mean 29 years), comprising 15 primary and 38 secondary surgeries, nasal tip deformities were evaluated. Deformities were classified as mild (5 cases), moderate (25 cases), and severe (23 cases). Over a follow-up period of 6-17 months (mean 9.5 months), significant aesthetic improvements in the nasal tip region were observed. The SFRS scores decreased from 2(2, 3) preoperatively to 0(0, 0) postoperatively ( Z = -6.58, P < 0.001), and VAS scores decreased from 7.47±1.73 to 1.79±1.67 ( t = -25.61, P < 0.001). High patient satisfaction was indicated by a mean ROE score of 82.45±11.55. No significant complications, such as nasal tip ptosis, skin necrosis, or scar hyperplasia, were reported. Conclusion:Selecting an appropriate surgical method based on the severity and cause of pollybeak deformity can achieve satisfactory outcomes. Post-operative patients exhibit significant aesthetic improvement in the upper nasal tip area, resulting in high patient satisfaction.
7.A retrospective study of pedicled upper lip mucosal flap in repairing nasal septal mucosa defect after rhinoplasty
Yiwen DENG ; Xiancheng WANG ; Hongli ZHAO ; Zhihua QIAO ; Yi TIAN ; Weiliang ZENG ; Kai YANG ; Chunjie LI ; Quanding YAN ; Yang SUN
Chinese Journal of Plastic Surgery 2024;40(8):838-845
Objective:To investigate the surgical effect of pedicled upper lip mucosal flap in repairing nasal septal mucosal defects after rhinoplasty.Methods:A retrospective analysis was performed from January 2016 to October 2022, the clinical data of patients with nasal septal mucosal defects after rhinoplasty were collected in the Department of Plastic and Aesthetic (Burn) Surgery at the Second Xiangya Hospital of Central South University. The pedicled upper lip mucosal flap was utilized for repair based on the patient’s medical history and wound condition. The pedicle of the flap was designed 1 cm adjacent to the frenulum of the upper lip, and an appropriate flap was incised based on the size of the wound, with dissection performed up to the superficial layer of the orbicularis oris muscle. The dissection establishes an upper lip tunnel that connects the gingival-buccal groove to the nasal cavity. The pedicled upper lip mucosal flap was elevated and transposed into the nasal cavity via the upper lip tunnel. The position of the flap was adjusted to ensure complete coverage and fixation of the nasal septal defect wound using 5-0 absorbable suture. The visual analogue scale (VAS) and the nasal obstruction symptom evaluation (NOSE) scale were utilized to facilitate patients’ satisfaction evaluation and assessment of nasal obstruction symptoms before surgery and at 6 months post-surgery. The VAS total score was 10 points, with higher scores indicating greater levels of patient satisfaction. The NOSE scale comprises of 5 items, each assigned a score ranging from 0 to 4, denoting absence of symptoms, very mild presence, moderate intensity, relatively severe manifestation, and highly severe indication respectively. The measurement data of VAS and NOSE scores before surgery and at 6 months post-surgery was expressed by Mean±SD, using paired t-test. The score distribution of the NOSE scale was represented by the number of cases, using Mann-Whitney U test. Results:The study included a total of 15 female patients, with an average age of (27.6±2.9) years (ranging from 23 to 33 years). Eleven cases presented with preoperative cartilage exposure, and the size of tissue defect ranged from 0.9 cm×0.5 cm to 1.5 cm×0.7 cm. Nine patients had a history of smoking. Skin grafting was performed in 9 patients, while nasal mucosal metastasis was observed in 8 patients. The dimensions of the flap varied from 4.0 cm×1.2 cm to 7.0 cm×1.5 cm. The postoperative recovery was satisfactory, with successful survival of the skin flaps and no occurrences of infection, hematoma, wound dehiscence, or flap necrosis. The average duration of follow-up was (8.2±2.1) months (ranging from 6 to 12 months). The postoperative VAS score (7.73±0.88) was significantly higher compared to the preoperative score (1.86±0.74) ( P<0.01). Additionally, the postoperative NOSE score (4.66±1.71) showed a significant decrease from the preoperative score (10.73±2.68), with a statistically significant difference ( P<0.01). Among them, after surgery items of stuffy or unbreathable nose (2 cases vs. 15 cases), nasal obstruction (1 case vs. 14 cases), and feeling that the nose was not enough to breathe during exercise or exertion (4 cases vs. 14 cases) scored≥2 points were significantly less than those before operation (all P<0.01). Conclusion:The utilization of pedicled upper lip mucosal flap in the reconstruction of severe nasal septal mucosal defects following rhinoplasty has proven to be highly effective. The postoperative satisfaction of patients is remarkably high, the ventilation function exhibits significant improvement, and no severe complications are observed.
8.Surgical techniques for pollybeak deformity correction
Hongli ZHAO ; Xiancheng WANG ; Yang SUN ; Xiang XIONG ; Xianxi MENG ; Wenbo LI ; Zhihua QIAO ; Kai YANG ; Weiliang ZENG ; Yi TIAN
Chinese Journal of Plastic Surgery 2024;40(2):156-162
Objective:To evaluate the effectiveness of surgical methods for correcting pollybeak deformity in Chinese rhinoplasty.Methods:A retrospective chart review was conducted for patients who underwent pollybeak correction between January 2021 and December 2022 at the Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University. Individualized correction was tailored based on the etiology and severity of the nasal deformity of each patient, involving techniques such as resection of the anterior part of the nasal septum, reconstruction of nasal tip support, reconstruction of the middle part of the nasal vault, and excision of skin in the upper region of the nasal tip. A modified classification system for pollybeak deformity, the supratip fullness rating scale (SFRS), was developed to evaluate supratip fullness (0-3 points, with higher scores indicating more apparent deformity). The patients aesthetic outcomes were assessed by surgeons using the visual analogue scale (VAS) (0-10 points, with higher scores indicating more apparent deformity), and patient self-assessed using the rhinoplasty outcome evaluation (ROE) questionnaire (0-100 points, with higher scores indicating higher satisfaction). The measurement data of normal distribution was expressed as Mean±SD and analyzed by paired t-test; the measurement data of non-normal distribution was expressed as M( Q1, Q3) and analyzed by Wilcoxon signed rank test. Results:In a cohort study of 53 rhinoplasty patients (7 male, 46 female; age range 19-45 years, mean 29 years), comprising 15 primary and 38 secondary surgeries, nasal tip deformities were evaluated. Deformities were classified as mild (5 cases), moderate (25 cases), and severe (23 cases). Over a follow-up period of 6-17 months (mean 9.5 months), significant aesthetic improvements in the nasal tip region were observed. The SFRS scores decreased from 2(2, 3) preoperatively to 0(0, 0) postoperatively ( Z = -6.58, P < 0.001), and VAS scores decreased from 7.47±1.73 to 1.79±1.67 ( t = -25.61, P < 0.001). High patient satisfaction was indicated by a mean ROE score of 82.45±11.55. No significant complications, such as nasal tip ptosis, skin necrosis, or scar hyperplasia, were reported. Conclusion:Selecting an appropriate surgical method based on the severity and cause of pollybeak deformity can achieve satisfactory outcomes. Post-operative patients exhibit significant aesthetic improvement in the upper nasal tip area, resulting in high patient satisfaction.
9.A retrospective study of pedicled upper lip mucosal flap in repairing nasal septal mucosa defect after rhinoplasty
Yiwen DENG ; Xiancheng WANG ; Hongli ZHAO ; Zhihua QIAO ; Yi TIAN ; Weiliang ZENG ; Kai YANG ; Chunjie LI ; Quanding YAN ; Yang SUN
Chinese Journal of Plastic Surgery 2024;40(8):838-845
Objective:To investigate the surgical effect of pedicled upper lip mucosal flap in repairing nasal septal mucosal defects after rhinoplasty.Methods:A retrospective analysis was performed from January 2016 to October 2022, the clinical data of patients with nasal septal mucosal defects after rhinoplasty were collected in the Department of Plastic and Aesthetic (Burn) Surgery at the Second Xiangya Hospital of Central South University. The pedicled upper lip mucosal flap was utilized for repair based on the patient’s medical history and wound condition. The pedicle of the flap was designed 1 cm adjacent to the frenulum of the upper lip, and an appropriate flap was incised based on the size of the wound, with dissection performed up to the superficial layer of the orbicularis oris muscle. The dissection establishes an upper lip tunnel that connects the gingival-buccal groove to the nasal cavity. The pedicled upper lip mucosal flap was elevated and transposed into the nasal cavity via the upper lip tunnel. The position of the flap was adjusted to ensure complete coverage and fixation of the nasal septal defect wound using 5-0 absorbable suture. The visual analogue scale (VAS) and the nasal obstruction symptom evaluation (NOSE) scale were utilized to facilitate patients’ satisfaction evaluation and assessment of nasal obstruction symptoms before surgery and at 6 months post-surgery. The VAS total score was 10 points, with higher scores indicating greater levels of patient satisfaction. The NOSE scale comprises of 5 items, each assigned a score ranging from 0 to 4, denoting absence of symptoms, very mild presence, moderate intensity, relatively severe manifestation, and highly severe indication respectively. The measurement data of VAS and NOSE scores before surgery and at 6 months post-surgery was expressed by Mean±SD, using paired t-test. The score distribution of the NOSE scale was represented by the number of cases, using Mann-Whitney U test. Results:The study included a total of 15 female patients, with an average age of (27.6±2.9) years (ranging from 23 to 33 years). Eleven cases presented with preoperative cartilage exposure, and the size of tissue defect ranged from 0.9 cm×0.5 cm to 1.5 cm×0.7 cm. Nine patients had a history of smoking. Skin grafting was performed in 9 patients, while nasal mucosal metastasis was observed in 8 patients. The dimensions of the flap varied from 4.0 cm×1.2 cm to 7.0 cm×1.5 cm. The postoperative recovery was satisfactory, with successful survival of the skin flaps and no occurrences of infection, hematoma, wound dehiscence, or flap necrosis. The average duration of follow-up was (8.2±2.1) months (ranging from 6 to 12 months). The postoperative VAS score (7.73±0.88) was significantly higher compared to the preoperative score (1.86±0.74) ( P<0.01). Additionally, the postoperative NOSE score (4.66±1.71) showed a significant decrease from the preoperative score (10.73±2.68), with a statistically significant difference ( P<0.01). Among them, after surgery items of stuffy or unbreathable nose (2 cases vs. 15 cases), nasal obstruction (1 case vs. 14 cases), and feeling that the nose was not enough to breathe during exercise or exertion (4 cases vs. 14 cases) scored≥2 points were significantly less than those before operation (all P<0.01). Conclusion:The utilization of pedicled upper lip mucosal flap in the reconstruction of severe nasal septal mucosal defects following rhinoplasty has proven to be highly effective. The postoperative satisfaction of patients is remarkably high, the ventilation function exhibits significant improvement, and no severe complications are observed.
10.Application of local free-style perforator flap in repairing gluteal bedsores
Yuanming YANG ; Xiancheng WANG ; Xiang XIONG ; Yang SUN ; Xianxi MENG ; Ying LIANG ; Wenbo LI ; Xiaofang LI ; Fanglin ZENG ; Yiming HU ; Jinyuan CHANG
Chinese Journal of Plastic Surgery 2020;36(5):531-535
Objective:To investigate the application of local free-style perforator flap in repairing gluteal bedsores.Methods:A retrospective study was performed. Date from 35 patients(20 males and 15 females, mean age 46 years old, range from 24-71) with gluteal bedsores between June 2017 and June 2019 were retrieved and reviewed by the Department of Burn and Plastic Surgery, Second Xiangya Hospital of Central South University. Among these cases, 13 were paraplegia after trauma, 6 were paralysis after cerebral hemorrhage, 13 were chronic infection, and 3 were poor wound healing after tumor resection. The average defect size was 5.6 cm×5.0 cm(range from 2.0 cm×3.0 cm to 10.0 cm×5.0 cm). By following the concept of free-style perforator flap, the flap was designed near the wound according to the perforator location detected by Doppler before surgery, and the defects were recovered by the flaps by rotation or other method such as rotation. Or the perforator flap can be modified into dermis-fat flap and flipped 180° to recover the wound. After the surgery, the survival of the flap or the dermis-fat flap, wound healing, as well as the sense and motion function of buttock and lower limbs were observed and recorded.Results:21 cases were repaired by perforator flap and 14 cases were repaired by modified dermis-fat flap. The size of flap range from 3.0 cm×3.0 cm to 10.0 cm×7.0 cm. The follow-up time was 3-22 months(mean, 12 months). All perforator flaps and dermis-fat flaps survived. The appearance of buttock was pleasant and no recurrence of bedsores. The patients without paraplegia had no major sensory loss and pain. The function of gluteus maximus was basically normal, and the motor function of lower limb was also generally satisfactory.Conclusions:The local free-style perforator flap or modified dermis-fat flap has advantages including simple design and operation, reliable blood supply and minimal damage to the donor site. It is a better way to repair gluteal bedsores.