OBJECTIVETo investigate the therapeutic effect of crescent flap with skin-grafting for the correction of cryptotia.

METHODSBetween the helix and scalp, we designed a crescent flap with the pedicle above the helix. Another affiliated triangular flap was formed below the crescent flap. Skin-grafting was performed after the transposition of two flaps.

RESULTSFrom Jan. 2008 to Mar. 2013, 16 cases with cryptotia (19 ears) were treated by this method. The ears were re-positioned to normal location with auriculocephalic sulcus. No vascular crisis was happened. The patients were followed-up for 3 months to 2 years with satisfactory result and no recurrence.

CONCLUSIONSThis method of crescent flap with skin-grafting is suitable for cryptotia at any grade. It is designed brilliantly with no inconspicuous scar.

Adolescent ; Adult ; Child ; Child, Preschool ; Ear, External ; abnormalities ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Young Adult

OBJECTIVETo discuss the feasibility of using free tissue flap for simultaneous tongue reconstruction after tongue cancer resection.

METHODRadial forearm flaps and anterolateral thigh flaps were used for simultaneous reconstruction of different defects after tongue cancer resection in 47 cases. The functional evaluation was assessed during the follow-up period of 3 months to 9 years.

RESULTSOnly one flap failed,giving a success rate of 97.7%. The 36 patient available for postoperative follow-up were all able to communicate in basic languages and eat normally. Among them, normal speech was found in 34, while slurred speech was found in two. 31 patients could eat normal diet ,while eight could eat soft diet and two could eat liquid diet.

CONCLUSIONSSimultaneous tongue reconstruction with free tissue flap is a reliable method with high successful rate. Flaps selection based on different tongue defects is the key point to achieve good functional and cosmetic results for the reconstruction tongue.

Adult ; Aged ; Female ; Free Tissue Flaps ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Tongue Neoplasms ; surgery

OBJECTIVETo assess the clinical features and therapeutic effect of free thin anterolateral thigh flap for the reconstruction of intraoral defects.

METHODSThe clinicopathologic data of 34 cases with oral carcinoma were obtained from Institute and Hospital of Stomatology, Nanjing University Medical School, from December 2008 to December 2011. These 34 patients underwent the simultaneous tumor resection and intraoral defects reconstruction with free thin anterolateral thigh flaps. The defects were located at tongue, buccal, mouth floor, and so on. The subcutaneous fat thickness of the flap at the site of the perforator is usually measured by ultrasound before the operation. If the thickness of the subcutaneous fat at the site of the perforator exceeded 1.5 cm, the patient was excluded from the study.

RESULTSThere were 16 male and 18 female patients. The mean age was 55.4 years. Among the 34 patients, 26 flaps with musculocutaneous perforators and 8 flaps with septo-cutaneous perforators were used. Partial flap necrosis occurred in 2 patients.

CONCLUSIONSThe free thin anterolateral thigh flap is the ideal soft tissue flap for the intraoral defects reconstruction. Satisfactory functional results can he achieved at recipient area with minimal morbidity at the donor site area.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Soft Tissue Injuries ; etiology ; surgery ; Surgical Flaps ; Thigh

OBJECTIVETo investigate the expression and significance of beta-receptor ( p-R) in infantile hemangioma.

METHODSThe expression of beta-R was detected by immunohistochemistry in infantile hemangioma (40 cases), venous malformation (20 cases) and normal skin (10 cases).

RESULTSThe positive expression rate of beta2-R was 70% (28/40) in infantile hemangioma, while no expression of beta2-R in venous malformation and normal skin. Among 28 cases with positive expression of beta2-R, 24 cases were in proliferative phase. The positive expression of beta2-R in infantile hemangioma was significantly higher than that in venous malformation and normal skin tissue. The positive expression of beta2-R in the proliferative hemangioma and non-proliferative hemangioma was also significantly different (P < 0.05).

CONCLUSIONSbeta2-R is specifically expressed in infantile hemangioma, especially in proliferative hemangioma.

Case-Control Studies ; Female ; Hemangioma ; metabolism ; Humans ; Immunohistochemistry ; Infant ; Male ; Receptors, Adrenergic, beta ; metabolism

OBJECTIVETo investigate the effect of 5-aza-2-deoxycytidine on the TGF-beta/smad signal transduction pathway in human keloid fibroblasts (KFSs).

METHODSFirstly, immunohistochemical method was used to detect the positive expression rate of phospho-smad2 and phospho-smad3 in the specimens of 15 cases of keloid and 15 cases of normal skin. The keloid fibroblasts were cultured in vitro with 5-aza-2-deoxycytidine(experimental group) or with DMEM (control group). The effect of 5-aza-2-deoxycytidine on the cell cycle and apoptosis of fibroblasts was analysed with flow cytometry ( FCM). Transforming growth factor (TGF)-beta1, Smad7, phospho-smad2 and phospho-smad3 were analyzed by Western Blot, and Immunofluorescence.

RESULTSIt was found that the positive expression of phospho-smad2 and phospho-smad3 in keloid were higher than those in normal skin. The FCM showed that the proportion of cells in G0/G1 stage was increased, and so does the proportion of apoptosis cells in keloid fibroblasts intervened by 5-aza-2-deoxycytidine. The expression of TGF-beta1, phospho-smad2 and phospho-smad3 protein were significantly suppressed while the expression of smad7 protein increased in keloid fibroblasts with 5-aza-2-deoxycytidine. In addition, 5-aza-2-deoxycytidine reversed phosphorylation and nuclear translocation of smad2 and smad3.

CONCLUSIONS5-aza-2-deoxycytidine, methylase inhibitors, inhibits cell proliferation and promotes apoptosis of KFSs, which may be associated with the suppression of TGF-beta/smad signal pathway.

Apoptosis ; drug effects ; Azacitidine ; analogs & derivatives ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Enzyme Inhibitors ; pharmacology ; Female ; Fibroblasts ; drug effects ; metabolism ; Humans ; Keloid ; metabolism ; pathology ; Male ; Signal Transduction ; drug effects ; Smad2 Protein ; metabolism ; Smad3 Protein ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo screen out related microRNAs in keloid tissue, and identify their effect on the proliferation of keloid fibroblasts.

METHODS8 cases of keloid tissue and 8 cases of normal skin tissue were collected as specimens. The differently expressed miRNA in keloid tissue from normal skin tissue were screened out with gene chip( Exiqon company), which was validated with quantitative real-time PCR. Then miRNA mimics was transfected into keloid fibroblasts line to stimulate high expression of mature miRNA in cells. The effect on the proliferation of fibroblasts in keloid was tested by Edu.

RESULTS(1) A total of 17 differently expressed microRNAs were found, including miR-199a-5p. (2) The expression of miR-199a-5p had been verified by qRT-PCR to be down-regulated in keloid, which was consistent with the result of array. (3) The positive rate of EdU in miR-199a-5p mimics transfected group and negative control group was (20.72 +/- 2.50)% and (27.68 +/- 4.92)%, respectively. The proliferative rate of keloid fibroblasts turned down in miR-199a-5p-transfected group (t = 2.183, P = 0.047). Besides that, the cell cycle changed after transfection. The percentage of S and G2/M phase in miR-199a-5p mimics transfected group was 33.93 +/- 1.30 and 10.87 +/- 0.80, respectively, while it was 31.39 +/- 0.79 and 9.27 +/- 0.46 in negative control group, and the difference was statistically significant.

CONCLUSIONS(1) The miRNA expression profile is different between keloid and normal skin; (2) The expression of miR-199a-5p is down-regulated in keloid and miR-199a-5p can affect the cell cycle and suppress proliferation of keloid fibroblasts. It indicateds that miR-199a-5p may be involved in regulating fibroblastic proliferation.

Cell Proliferation ; Cells, Cultured ; Down-Regulation ; Female ; Fibroblasts ; metabolism ; Gene Expression Profiling ; Humans ; Keloid ; genetics ; metabolism ; pathology ; Male ; MicroRNAs ; genetics ; metabolism

OBJECTIVETo explore the CD phenotypic, protein expression and pluripotent differentiation of human hypertrophic scar fibroblasts cultured in vitro, so as to study the mechanisms of scar formation.

METHODSFibroblasts were isolated and cultured from human hypertrophic scar of 3 cases. The cells morphology was observed by inverted microscope, and the growing state of the third passage was detected by the cell counting meter of Vi-CELL. The cell surface markers CD105, CD14, CD73, CD34, CD44, CD45 and CD90 were identified by flow cytometry. The expression of CK19, Oct-4, Nanog and vimentin was detected by immunocytochemistry, and the expression of alpha-smooth muscle actin(alpha-SMA) was tested by immunofluorescence. The differentiated potential of fibroblasts of the third passage into adipogenic, osteogenic and chondrogenic lineages was assayed.

RESULTSThe primary passage fibroblasts showed the shape of spindle shaped or irregular polygon with a radiated or circinate of growing arrangement. The growth curve showed the cells growth was slow on the first and second day, and quick during the third to fifth day, which reached platform stage on the sixth or seventh day. The fibroblasts highly expressed mesenchymal stem cell surface markers-CD73, CD105, CD44, CD90, but not expressed hematopoietic stem cell surface markers-CD14, CD34, CD45 by flow cytometry. And positive expression of vimentin, Oct-4 and negative expression of CK19 were detected by Immunocytochemistry. Positive expression of alpha-SMA was also detected by immunofluorescence. Multidirectional differentiation induction indicated that the third passage cells could differentiate into adipogenic, osteogenic and chondrogenic lineages.

CONCLUSIONSHuman hypertrophic scar-derived fibroblasts show the biologic characteristics of mesenchymal stem cells, which may play an important role in wound healing and hypertrophic scar formation.

Adolescent ; Antigens, CD ; metabolism ; Cell Differentiation ; physiology ; Cells, Cultured ; Cicatrix, Hypertrophic ; pathology ; Female ; Fibroblasts ; cytology ; metabolism ; Humans ; Male ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Phenotype ; Young Adult

OBJECTIVETo investigate the possibility of placenta mesenchymal stem cells (PMSCs) differentiation into dermal fibroblast, and the potency of PMSCs used in cutaneous wound healing and stored as seed cells.

METHODSEnzyme digestion method was used to obtain PMSCs, and PMSCs were amplified after culture in vitro. Flow cytometry assay, osteogenic and adipogenic differentiation were done for MSCs identification. The induction medium composed of DMEM/F12 + 50 microg/ml VC + 100 ng/ml connective tissue growth factor (CTGF) was added into the 24-well plate for 16 days induction period. Pictures were taken to record morphologic change. Immunofluorescence tests were performed to detect Vimentin, FSP-1, collagen I , collagen III, desmin and laminin expression before and after induction. At the same time osteogenic and adipogenic differentiation were used to assay the differentiation ability change after induction. The induced dermal fibroblasts were frozen in liquid nitrogen and recovery and trypan blue was used to detect cell viability.

RESULTSAfter CTGF induction, PMSCs got obvious fibroblasts morphology, the protein level of Vimentin, FSP-1, collagen I, collagen III and Laminin increased, PMSCs started to express Desmin, the dermal fibroblasts specific proteins, and osteogenic and adipogenic differentiation ability was diminished. PMSCs were successfully induced into dermal fibroblasts, and these induced cells could get a high cell viability ( more than 90% ) after recovery.

CONCLUSIONSPMSCs could be induced into dermal fibroblasts by CTGF in vitro. PMSCs have the potential application in skin wound healing, and can be used as seed cells of dermal fibroblasts.

Cell Differentiation ; drug effects ; Cells, Cultured ; Connective Tissue Growth Factor ; pharmacology ; Female ; Fibroblasts ; cytology ; drug effects ; Humans ; Mesenchymal Stromal Cells ; cytology ; drug effects ; Placenta ; cytology ; Pregnancy

OBJECTIVETo observe the effect of non-ablative fractional laser Lux1540nm in superficial scars therapy.

METHODSAccording to the Fitzpatrik skin type and scar appearances, appropriate laser energy and pulse width were selected for scar treatment. Therapeutic effect and side-effect was evaluated by preoperative photos and 6 months of postoperative photos.

RESULTSThe total effective rate was 78.12% (28/32). 7 cases (21.88%) showed ineffective results. The therapeutic effect was improved along the increase of treatments. Temporary hyperpigmentation was found in 3 cases (9.38%) and faded away within 3-6 months. Temporary erythema faded away within 4-24 hours.

CONCLUSIONThe treatment of non-ablative fractional laser Lux1540nm for superficial scar is effective with minimum side effect.

Adolescent ; Adult ; Cicatrix ; surgery ; Female ; Humans ; Laser Therapy ; methods ; Male ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the feasibility and therapeutic effect of thinned posterior tibial artery free perforator flap for the reconstruction of soft tissue defects at dorsum of hands.

METHODSSix fresh adult lower limbs specimens were injected with red latex via arterial cannula and dissected. The number, distribution, branches, and outer diameter of posterior tibia artery perforators were observed. Based on the anatomic study, the perforator flaps were designed to reconstruct soft tissue defects at dorsum of hands and wrists. The redundant fat on the flaps was removed, but preserving the nutrient vascular system. 11 flaps were used with the size ranging from 2 cm x 5 cm to 10 cm x 14 cm.

RESULTS43 skin perforators of posterior tibial artery were observed in six lower limbs, 29 perforators with the outer diameter is greater than 0.5 mm when they threading over the deep fascia plane, on average every 4.8 bundles of sides. The mean outside diameter of perforating artery is (1.8 +/- 0.5) mm, and the length is (44 +/- 15) mm. 6 perforators were founded both in the second and fifth zone which could be used for anastomosis for its better diameters. All flaps survived completely without any complication at donor sites. 7 cases were followed up for 3-12 months. Both satisfactory functional and cosmetic results were achieved with a soft and thinned appearance.

CONCLUSIONSThe thinned posterior tibial artery free perforator flap has a reliable blood supply and good appearance. It is very suitable for the reconstruction of small or medium-sized defects at the dorsum of hands and wrists.

Adolescent ; Adult ; Female ; Hand Injuries ; surgery ; Humans ; Lower Extremity ; anatomy & histology ; blood supply ; Male ; Middle Aged ; Perforator Flap ; blood supply ; Reconstructive Surgical Procedures ; methods ; Tibial Arteries ; anatomy & histology ; transplantation ; Young Adult