Objective To investigate the application of auricular cartilage in nasal plastic surgery and its clinical effects of the different tip graft and reconstructed domal graft (RDG).Methods From October 2009 to May 2015,the surgical procedure was performed on 286 patients,through the application of cymba and conchae cartilages into various tip graft and RDG in nasal tip plasty.Results A total of 286 patients were followed up post-operatively for 3 months to 5 years,245 patients (85.7％ achieved expected stability tip,the tip down to 1-2 mm after one year.Tip skin thinning was observed in 10 patients after one year,nasal tip down occurred in 89 patients;the columella skew and asymmetric nostrils occurred in 31 patients.Conclusions The ear cartilage can be made into various tip graft for rhinoplasty,with satisfactory clinical outcomes.

Objective To compare the difference between bone marrow stomal cell (BMSC) and adipose-derived stem cell (ADSC) of liver fibrosis in rats.Methods BMSC and ADSC of Sprague-Dawley (SD) rats were isolated and purified.The stem cell markers were detected with flow cytometry.The coculture system was set up with 0.4 μm Transwell insert semipermeable membrane.ADSC or BMSC were co-cultured with hepatic stellate cells (HSC).Normal hepatocyte cell line of rat (BRL) was co-cultured with HSC as negative control group and HSC cultured alone was blank control group.After cultured for 72 hours,the proliferation of HSC was determined by cell counting kit-8 (CCK-8) method.The expression of α-smooth muscle actin (α-SMA) of HSC was detected by Western blotting.The apoptosis of HSC was examined by flow cytometry.After BMSC,ADSC and BRL cultured alone for 72 hours,expression level vascular endothelial growth factor (VEGF),interleukin-10 (IL-10),nerve growth factor (NGF) and transforming growth factor-β1 (TGF-β1) in the culture medium were detected by enzymelinked immunosorbent assay (ELISA) method.The rats model of liver fibrosis were established.The rats were divided into BMSC treatment group,ADSC treatment group,BRL group and culture medium group,six rats in each group,which were injected with 1.5 mL BMSC,ADSC and BRL cells suspension (5 × 106) through portal vein,respectively,and same volume of culture medium was injected to the rate of culture medium group,once every two weeks for four weeks.The pathological changes of liver tissue sections were observed and liver fibrosis markers were tested.T test was performed for comparison between two samples and analysis of variance was used for comparison among multiple groups.Results BMSC and ADSC were successfully isolated and cultured.The phenotype of BMSC and ADSC was similar.Compared with blank control group and negative control group,both ADSC and BMSC could inhibit the proliferation of HSC and promote apoptosis (proliferation,2.43±0.27,2.39±0.33,1.92±0.38 and 2.18±0.31,FBMSC =25.61,FADSC =38.63,both P＜0.05 ;apoptosis rate,(5.59 ± 0.40)％,(6.82±0.57)％,(8.31± 1.03) ％ and (9.36 ± 0.54) ％,FBMSC =73.69,FADSC =97.41,both P＜ 0.05).The effects of ADSC were more significant than those of BMSC (t=5.76 and 5.18,both P＜0.05).There was difference in the cytokine levels secreted by ADSC and BMSC (NGF,(7.46 ± 0.54) pg/mL vs (3.95 ± 0.71) pg/mL,t =10.92,P＜0.05; TGF-β1,(8.79 ±0.93) pg/mL vs (6.36±0.85) pg/mL,t=7.58,P＜0.05).The cell transplantation experiment indicated that both BMSC and ADSC had significant inhibitory effect on liver fibrosis.The activity index of inflammation and degree of fibrosis in BMSC treatment group and ADSCs treatment group were 9.87±2.07,4.17 ± 0.94 and 10.13 ± 1.81,3.98 ± 0.82,which were significantly lower than those in blank control group (13.78±2.53 and 5.09±1.15)and negative control group (13.34± 1.89 and 4.95± 1.22,FBMSC=51.26 and 32.29,P＜0.05; FADSC =46.73 and 40.94,P＜0.05).The level of hyaluronic acid ((191.5±33.2) μg/L and (178.8±28.2) μg/L),type Ⅲ collagen ((19.9±5.1) μg/L and (21.7± 3.3) μg/L) and hydroxyproline ((312.6±38.8) μg/g and (325.8±28.2) μg/g) of BMSC treatment group and ADSC treatment group were significantly lower than those of negative control group and blank control group (hyaluronic acid,(282.3 ± 18.7) μg/L and (287.5 ± 26.7) μg/L),F =73.51 ; type Ⅲ collagen,(35.3± 3.3) μg/L and (32.5±4.3) μg/L,F=76.19; hydroxyproline,(458.4 ± 38.1) μg/g and (473.9 ± 63.7) μg/g,F=60.37,all P＜0.05).However,there was no difference between BMSC treatment group and ADSC treatment (all P＜0.05).Conclusions ADSC and BMSC had similar stem cell characteristics.There was difference in inhibiting the activation of HSC between ADSC and BMSC.But there was no significant difference in inhibiting liver fibrosis of rats in vivo.

ObjectiveTo investigate the hemostatic effect of fibrin sealant (FS) powder on severe wound surface and find out the minimum effective dosage.Methods1 cm2 round wound surface was made on the liver of New Zealand white rabbits. Different dosages of FS powder were administrated on the wound surface. Bleeding time and bleeding volume were examined to find out optimized dosage. Hemostatic effect of FS powder was observed and compared with chitin cotton, gelfoam and normal gauze.ResultsBleeding time (0.57±0.21 min)and bleeding volume (0.35±0.29 ml)of FS 10 mg/cm2 group were obviously different from FS 8 mg/cm2 group (P<0.05), not significantly different from FS 12 mg/cm2 group. FS 10 mg/cm2 group got the shortest bleeding time and the lowest bleeding volume, which was obviously different from chitin cotton, gelfoam and gauze groups (P<0.05～0.01).ConclusionThe hemostatic effect of FS powder is better than gelfoam, chitin cotton and gauze and its optimized dosage is 10 mg/cm2.

Objective:To investigate the effectiveness of a modified upper lip lifting technique with retaining the nasal columellar base incision.Methods:From Jun. 2019 to Jun. 2020, 24 cosmetic patients (aged from 18 to 36 years, with mean 26.5 years) underwent upper lip lifting with skin flap resection of bilateral upper lip flaps and retained the nasal columellar base in Chengdu High-Tech Zone Xinyuerong Medical Aesthetic Clinic. These factors were analyzed, including postoperative complications, improvement of nasolabial angle, effectiveness of upper lip lifting and overall satisfaction.Results:In the 24 patients, 2 patients had numbness in the upper lip after surgery, and returned to normal after 4 months. The concealed scar was effective to improve the linear scar and scar contracture of traditional upper lip lifting. All patients were followed up for 3 months to 1 year. The satisfactory lifting effectiveness was obtained in 24 cases. As for overall satisfaction, 22 cases were very satisfied (91.7%) and 2 cases were satisfied (8.3%).Conclusions:This upper lip lifting surgical procedure of upper lip flaps with retaining the nasal columellar base incision has changed the traditional method to avoid the upper lip horizontal line scar, nasolabial angle contracture, while ensuring the columellar base blood supply is not damaged, with minimized and concealed scar. This surgical procedure is a safe and effective method and worth clinical application.

Objective:To investigate the clinical effectiveness and significance of special fixing cartilaginous support structure on nasal tip to prevent and correct alar rim retraction.Methods:Special shaped tip extension support structure was composed of two parts of type Ⅲ of septum extension graft (SEG) and two pieces of wedge graft fixed on either side of the cephalic end near the top of support structure. After the alar cartilage vault was fixed to the nasal tip cartilage support structure, the lower lateral cartilage (LLC) cephalic was fixed to both sides of this nasal tip support structure. The LLC received support from the cartilaginous support structure to counter and correct the lower lateral cartilage cephalic retraction. From January 2017 to January 2020, this surgical procedure was used in 34 patients (aged from 20 to 46 years, with mean 32.6 years) with rhinoplasty who had a nasal tip support structure but still had a space between the LLC and the stent intraoperativly. Preoperativly, 4 cases had normal relation of alar columella and alar rim, 18 cases had mild alar rim retraction, and 12 cases had moderate alar rim retraction. The patients were followed up for 6 to 18 months to observe the correction effect and patient satisfaction.Results:Among the 34 patients, 8 patients received alar edge graft, 2 patients received lateral foot support graft, and 2 patients received alar rim graft combined with lateral foot support graft. All patients were followed up for 6-18 months, 30 patients with alar rim retraction were completely corrected, and 4 patients with normal alar and nasal columella relationship did not have alar rim retraction after surgery. No complications such as infection, necrosis, contracture or respiratory dysfunction were found in all patients. 28 cases (82.4%) were very satisfied; 6 cases (17.6%) were satisfied; the satisfactory rate was 100%.Conclusions:The special shaped nasal tip cartilage support structure combined with type Ⅲ SEG and its cephalic wedge grafts could achieve satisfactory clinical results in the prevention and correction of alar rim retraction.

Objective:To explore the feasibility and advantages of integrated prosthesis of expanded polytetra-fluoroethylene (e-PTFE) in eyebrow arch augmentation.Methods:The clinical data of 45 patients with low or flat brow arch and glabellar zone from June 2019 to October 2020 in Chengdu High-tech Zone Xinyuerong Medical Aesthetic Clinic were analyzed retrospectively, in which it included 45 women, whose ages ranged from 20 to 39 years with average 29.8 years. Forty-three cases underwent primary surgery, and 2 cases underwent repair. The e-PTFE was sculpted to be personalized integrated prosthesis according to the shape of the patient's eyebrow arch and glabellar zone. The incision was designed on the medial and lateral sides of the lower margin of the bilateral eyebrow to avoid the supraorbital foramen, and the lacunae were striped under the frontal periosteum, and the two sides were connected to cover the glabellar zone and inverted triangle area between the eyebrows. The carved e-PTFE was implanted into one side and pulled out from the other side. The prosthesis was smoothed by Venn pliers of the ventral and dorsal sides.Results:The 45 patients in this group were followed up for 6-18 months. The incisions of all the patients were healed Ⅰ/A, and the scar of the incisions was concealed. Slight scalp numbness occurred in 4 patients and returned to normal 3 months later. The prosthesis in the glabellar zone appeared in 1 case 3 months after operation and returned to normal after reoperation. The symmetry, radian, fullness, convexity and tactility of bilateral eyebrow arch were all satisfactory in 45 cases. 39 cases were very satisfied, accounting for 86.7%; 6 cases (13.3%) were satisfactory. The sagittal distance of the anterior surface of the cornea to the soft tissues overlying the supraorbital rims was (2.02±1.72) mm preoperatively and (6.5±1.19) mm in the last follow-up. The difference was statistically significant ( t=14.49, P<0.01). Conclusions:This design of integral e-PTFE in eyebrow arch augmentation is safe, effective and easy to operate. It can significantly increase the bony beauty and stereoscopic sense of the eyebrow arch and glabellar zone, effectively deepen the eye socket, improve the eye protrusion, and reduce the risk of asymmetry and prosthesis displacement, and therefore it is one of the ideal methods for eyebrow arch augmentation.

Objective:To investigate the effect of ship-shaped expanded polytetrafluoroethylene (e-PTFE) nasal prosthesis in rhinoplasty.Methods:From February 2016 to June 2021, 86 patients, including 9 males and 77 females, aged 18-47 (24±5) years old, were admitted to Chengdu High-tech Zone Xinyuerong Medical Aesthetic Clinic for cosmetic treatment of rhinoplasty. All patients underwent rhinoplasty with the application of ship-shaped e-PTFE and autologous cartilage. The postoperative complications, glabellar fullness, inverted brow triangle, nasal polygon aesthetic shape and patient satisfaction were evaluated. These data were measured and analyzed, including the nasal length, nasal tip height, nasal frontal angle and nasal facial angle before and after the operation.Results:In 86 patients, the incision healed in one stage after surgery, and 8 cases had nasal vestibular scar hyperplasia. All patients were followed up for 1-5 years: 84 cases obtained satisfactory nasal morphology, and 2 cases recovered naturally after adjusting and lowering the prosthesis height half a year after surgery because the interbrow area was too full. 74 patients (86%) were very satisfied, 10 cases (11.6%) were satisfied. The nasal length was (4.07±0.20) cm, the nasal tip height was (2.66±0.36) cm, the nasal frontal angle was (106.42±8.04)°, and the nasal face angle was (15.90±0.85)°before operation. The nasal length was (4.23±0.20) cm, the nasal tip height was (2.59±0.26) cm, the naso-frontal angle was (113.69±6.34)°, and the naso-facial angle was (21.57±0.78)° at eighteen months after operation. There were statistically significant differences in nasal length, naso-frontal angle and naso-facial angle ( t=-5.51, -5.96, -52.31, P<0.01), but no statistically significant differences in nasal tip height ( t=1.47, P=0.146). Conclusions:The ship-shaped e-PTFE can be shaped to reflect the aesthetic of the nose dorsum, which is similar to the anatomical structure of the nose dorsum, increase the stability and authenticity of the prosthesis, and is worthy of clinical application.