Objective:To investigate the safety and efficiency of depilation with intense pulsed light (IPL) in congenital microtia patients during different phase of reconstruction treatment sessions.Methods:The hairy skin was treated with the M22TM system (Lumenis, German) using a filter of 695-1 200 mm. A three pluses mode of the radiant setting with a pulse width of 3.5 ms, a delay of 60 ms, and an energy density of 16-18 mJ/cm 2 was applied in the expanded patients. Depilation efficacy was evaluated as follows: excellent (hair density reduction >75%), good (50%-75%), fair (25%-50%), and poor (<25%). The depilation effect was compared between different phases. And the adverse effect was observed. Results:A total of 131 cases were included. There was no difference of the hair density reduction between patients with different expander volume after same IPL depilation treatments [15 (13-19) vs. 16 (15-19) root/cm 2, Wilcoxon rank analysis]. The hair density reduction in the expansion group was lower than the non-expansion group after two IPL depilation treatments [15 (13-19) vs. 17 (15-21) root/cm 2, P<0.05, Wilcoxon rank analysis]. The depilation efficacy was highly related with the numbers of IPL depilation treatments the patients received [Kendall′ stat b=0.74 (95% CI: 0.71-0.77), P<0.05]. There were 3 cases of folliculitis, 2 cases of blisters occurred in this study, and no expander exposure and cartilage absorption were observed. Conclusions:Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander. The volume of the expander does not significantly affect the hair removal efficiency. Depilation in the expansion phase is more efficient than that in the non-expansion phase, and the ideal result of " hair-free" or " less hairy" reconstructed ears can be achieved in 5 treatments, with suboptimal results in 3 treatments.

ObjectiveTo investigate the effect of Stemona tuberosa alkaloids （STA） on apoptosis and phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） and c-Jun N-terminal kinase/p38 mitogen-activated protein kinase （JNK/p38 MAPK） signaling pathways in human lung cancer A549 cells. MethodA549 cells were classified into blank group and STA groups （100， 150， 200， 250， 300 mg⋅L^-1）. Thiazole blue （MTT） assay and colony formation assay were used to evaluate the proliferation of A549 cells. Apoptosis was observed based on Hoechst 33258 staining， flow cytometry， and Annexin V-FITC/PI staining. Western blot was employed to detect the expression of apoptosis-related proteins cysteine-aspartic acid protease-3 （Caspase-3）， B-cell lymphoma-2 （Bcl-2）-associated X protein （Bax）， and Bcl-2， and the expression of PI3K， phosphorylated （p）-PI3K， Akt， p-Akt， JNK， p-JNK， p38 MAPK， and p-p38 MAPK. ResultCompared with the blank group， STA groups （150， 200， 250， 300 mg⋅L^-1） demonstrated the increase in inhibition rate of cell proliferation （P<0.01） and cell clone inhibition rate， and decrease in cell clone formation rate （P<0.01）. In comparison with the blank group， STA groups showed typical characteristics of apoptosis， such as chromatin condensation and enhanced fluorescence reaction. The apoptosis rate of STA groups was significantly higher than that of the blank group （P<0.01）. Compared with the blank group， STA （150， 200， 250， 300 mg⋅L^-1） significantly up-regulated the protein expression of Caspase-3 and Bax （P<0.05， P<0.01） and down-regulated the expression of Bcl-2 protein （P<0.01）. Compared with the blank group， STA had no significant influence on the total protein expression of PI3K， Akt， JNK， and p38 MAPK. However， STA （150， 200， 250， 300 mg⋅L^-1） significantly decreased the levels of p-PI3K and p-Akt （P<0.05， P<0.01） and increased the level of p-p38 MAPK （P<0.05， P<0.01）. Compared with the blank group， STA （200， 250， 300 mg⋅L^-1） significantly raised the level of p-JNK （P<0.05， P<0.01）. ConclusionSTA can inhibit the proliferation and induce the apoptosis of A549 cells by inhibiting PI3K/Akt signaling pathway and activating JNK/p38 MAPK signaling pathway.

ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.

OBJECTIVE Histamine is a conserved neuromodulator in mammalian brains and critically involved in many physiological functions.Understanding the precise structure of histaminergic network is the cor-nerstone in elucidating its function.METHODS Herein,using novel HDC-CreERT2 mice and genetic labeling strategies,we reconstructed a whole brain 3D structure of histaminergic neurons and their outputs at 0.32×0.32×2 μm3 pixel resolution with a cutting-edge fluorescence micro-optical sectioning tomography system(fMOST).And we dissect an appetite control circuit originating from the TMN to medial septal nucleus(MS)using fiber photometry,optogenetics,and chemogenetics interfer-ence.RESULTS We quantified the fluorescence density of all brain areas and found that histaminergic fiber density varied significantly among brain regions.The density of histaminergic fiber was positively correlated with the amount of histamine release induced by optogenetic stim-ulation or physiological aversive stimulation.Moreover,we reconstructed fine morphological structure of 60 hista-minergic neurons via sparse labeling,and uncovered the largely heterogeneous projection pattern of individual his-taminergic neuron.Lastly,we found that MS-projecting histaminergic circuit is functionally inhibited during food consumption,and bidirectionally modulates feeding behavior via downstream H2,but not H1,receptors on MS glutamatergic neurons.CONCLUSION Collectively,this study reveals an unprecedented whole-brain quanti-tative analysis of histaminergic projections at the meso-scopic level,providing a foundation for future functional histaminergic study.And we also demonstrate that this MS-projecting histaminergic circuit is critically involved in feeding,and H2Rs in MS glutamatergic neurons is a promising target for treating body weight problems.

ObjectiveTo study the effect of apigenin on the proliferation and apoptosis of human colon cancer CL187 cells and the underlying mechanisms. MethodHuman colorectal cancer CL187 cells were treated with different concentrations of apigenin （0， 30， 45， 60 mg·L^-1） according to the results of the preliminary experiment. The proliferation of CL187 cells was detected by methyl thiazolyl tetrazolium （MTT） and colony formation assays， and the apoptosis was observed via Hoechst 33258 staining. Real-time fluorescence quantitative PCR was conducted to determine the mRNA levels of cysteine protease-3 （Caspase-3）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax） in the CL187 cells treated with apigenin. Western blot was employed to measure the protein levels of Caspase-3， Bcl-2， and Bax associated with apoptosis， protein kinase B （Akt） and phosphorylated Akt （p-Akt） in phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） pathway， and extracellular signal-regulated kinases 1/2 （ERK1/2）， p-ERK1/2， c-Jun N-terminal kinase （JNK）， p-JNK， p38 mitogen-activated protein kinase （MAPK）， and p-p38 MAPK protein in MAPK pathway. ResultCompared with the blank group， the apigenin groups had low cell survival rates and high inhibition rates on cell proliferation （P<0.01）. Apigenin decreased the cell clone number and clone formation rate， and increased the inhibition rate on clone formation （P<0.01）. After CL187 cells were treated with different concentrations of apigenin for 48 h， typical apoptosis characteristics such as nuclear pyknosis， chromatin condensation， and enhanced fluorescence reaction were observed. Compared with blank group， 45， 60 mg·L^-1 apigenin treatments down-regulated the mRNA level of anti-apoptotic gene Bcl-2 （P<0.01） and all the apigenin treatments up-regulated those of the pro-apoptotic genes Bax and Caspase-3 （P<0.05， P<0.01）. Similarly， apigenin treatments down-regulated the protein level of Bcl-2 （P<0.05， P<0.01） and up-regulated those of Caspase-3 （P<0.05， P<0.01） and Bax （P<0.01， 45， 60 mg·L^-1）. The blank group had higher protein level of Akt than the 60 mg·L^-1 apigenin group （P<0.01）， higher protein levels of p-Akt， ERK1/2， and p-ERK1/2 than the 45， 60 mg·L^-1 apigenin groups （P<0.01）， and higher protein levels of JNK and p-JNK than the apigenin groups （P<0.05， P<0.01）. Compared with blank group， 60 mg·L^-1 apigenin up-regulated the protein level of p38 MAPK （P<0.05）， and all the apigenin groups up-regulated that of p-p38 MAPK （P<0.01）. Furthermore， apigenin lowered the p-Akt/Akt ratio （P<0.05， P<0.01） and p-ERK1/2/ERK1/2 ratio （P<0.01）， while it increased the p-JNK/JNK ratio （45， 60 mg·L^-1； P<0.05， P<0.01） and p-p38 MAPK/p38 MAPK ratio （P<0.05， P<0.01）. ConclusionApigenin can inhibit the proliferation and promote the apoptosis of CL187 cells by inhibiting the PI3K/Akt signaling pathway and regulating the expression of proteins in the MAPK signaling pathway.

Piperine is a kind of amide alkaloids presenting in Piper nigrum L.，which has the pharmacological action such as protecting cardiovascular system ，regulating glucose and lipid metabolism ，anti-tumor，improving nervous system diseases ， anti-inflammation and so on. This paper summarized the pharmacological action and mechanisms of piperine in recent years and found that piperine ，as the main active ingredient of P. nigrum ，could protect the cardiovascular system by reducing inflammation and oxidative stress ；improve mitochondrial function through anti-inflammatory and antioxidant effects ，thereby regulate glucose and lipid metabolism ；play an anti-tumor role by mediating the signaling pathways of Wnt/β-catenin，NF-κB/Nrf-2/KeAP-1/HO-1， PI3K/Akt，TGF-β1/Smad2/ERK1/2；improve neurological diseases by inhibiting autophagy ，relieving inflammation ，improving antioxidant，inhibiting neuronal apoptosis and regulating the expression of related proteins in neurons ；play an anti-inflammatory effect by inhibiting the activity of NF-κB and other signaling pathways and reducing the expression of inflammation-related proteins. However，the mechanism of action of piperine is not perfect ，and most of the studies have been confined to the pharmacological level or a certain signaling pathway and a certain target ，without being able to elucidate the interconnection between the relevant signaling pathway and the specific target from a holistic perspective. In the follow-up ，the specific targets of piperine can be identified and clinical trials can be carried out to provide support for the clinical application of piperine.

Objective:To evaluate the clinical effect of total-model fractional CO 2 laser in the treatment of atrophic acne scar. Methods:A retrospective analysis was performed on the clinical data of patients with atrophic acne scar treated by total-model fractional CO 2 laser(Deep FX+ Active FX+ CW) in Laser Aesthetic Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2017 to September 2019. CW mode and/or Active FX mode was used to fine grinding of the scar edge, and Active FX mode and Deep FX mode were used to scan the whole area acne scar involved. The treatment was performed 3-5 times with an interval of more than 3 months. Two attending physicians who were not involved in the study evaluated the photos of patients before treatment and 3-5 times after treatment with the Global Aesthetic Improvement Scale (GAIS) and the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA). Acne scar and overall facial skin quality were assessed with GAIS, a total score of 1 to 3, with a score 1 indicating deterioration and a score 3 indicating significant improvement. The severity and density of acne scarring were assessed with ECCA, with the higher the score, the more severe it is. The international numeric rating scale (NRS) was used to rate the pain immediately after treatment (0-10 points), with 0 indicating no pain and 10 indicating extreme pain. Side effects such as the occurrence of crusts, erythema, pigmentation and acne-like rash were observed. SPSS 24.0 was used for statistical analysis, and the measurement data were expressed by Mean±SD. Paired t-test was used for ECCA scores before and after treatment, and P<0.05 was considered as statistically significant difference. Results:A total of 75 patients were included in this study, including 16 males and 59 females, aged 27.2±6.2 years (19-49 years). Among them, the improvement in acne scar and overall facial skin quality were excellent in 12 cases, significant in 34 cases, median in 24 cases and poor in 5 cases. GAIS score was 1.62±0.77. The ECCA score was 157.20±18.89 before treatment and 138.93±23.62 after treatment, showing significant difference ( t=9.41, P<0.001). The pain score was 4.65±1.52 and disappeared spontaneously about 2-4 hours after operation. The scab stage was 6.65±0.89 days, and the erythema stage was 3.09±0.70 weeks. The post-inflammatory hyperpigmentation case occurred in 1.3% (1/75) and lasted for 4 months. Acne-like rash occurred in 16.0% (12/75), which relieved by external smear of fusidic acid. No blisters, hypopigmentation, bacterial or viral infection, scar formation and other adverse reactions happened. Conclusions:The total-mode fractional CO 2 laser is effective and safe in the treatment of facial atrophic acne scar.

Objective:To evaluate the clinical effect of total-model fractional CO 2 laser in the treatment of atrophic acne scar. Methods:A retrospective analysis was performed on the clinical data of patients with atrophic acne scar treated by total-model fractional CO 2 laser(Deep FX+ Active FX+ CW) in Laser Aesthetic Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2017 to September 2019. CW mode and/or Active FX mode was used to fine grinding of the scar edge, and Active FX mode and Deep FX mode were used to scan the whole area acne scar involved. The treatment was performed 3-5 times with an interval of more than 3 months. Two attending physicians who were not involved in the study evaluated the photos of patients before treatment and 3-5 times after treatment with the Global Aesthetic Improvement Scale (GAIS) and the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA). Acne scar and overall facial skin quality were assessed with GAIS, a total score of 1 to 3, with a score 1 indicating deterioration and a score 3 indicating significant improvement. The severity and density of acne scarring were assessed with ECCA, with the higher the score, the more severe it is. The international numeric rating scale (NRS) was used to rate the pain immediately after treatment (0-10 points), with 0 indicating no pain and 10 indicating extreme pain. Side effects such as the occurrence of crusts, erythema, pigmentation and acne-like rash were observed. SPSS 24.0 was used for statistical analysis, and the measurement data were expressed by Mean±SD. Paired t-test was used for ECCA scores before and after treatment, and P<0.05 was considered as statistically significant difference. Results:A total of 75 patients were included in this study, including 16 males and 59 females, aged 27.2±6.2 years (19-49 years). Among them, the improvement in acne scar and overall facial skin quality were excellent in 12 cases, significant in 34 cases, median in 24 cases and poor in 5 cases. GAIS score was 1.62±0.77. The ECCA score was 157.20±18.89 before treatment and 138.93±23.62 after treatment, showing significant difference ( t=9.41, P<0.001). The pain score was 4.65±1.52 and disappeared spontaneously about 2-4 hours after operation. The scab stage was 6.65±0.89 days, and the erythema stage was 3.09±0.70 weeks. The post-inflammatory hyperpigmentation case occurred in 1.3% (1/75) and lasted for 4 months. Acne-like rash occurred in 16.0% (12/75), which relieved by external smear of fusidic acid. No blisters, hypopigmentation, bacterial or viral infection, scar formation and other adverse reactions happened. Conclusions:The total-mode fractional CO 2 laser is effective and safe in the treatment of facial atrophic acne scar.

Objective:To explore the clinical effect of the second toenail flap with the dorsal bone of the phalange in repairing the defect of fingernail bed.Methods:From January, 2012 to June, 2019, 10 patients with large area of fingernail bed defect were treated by the second toenail flap with bone on the back of the phalanx. The survival of the flap was observed after the operation, and the fracture healing, the shape of the nail and the flexion and extension function of the finger joint were observed in the outpatient follow-up.Results:All flaps of the second toenail survived. The average follow-up period was 8 (4-12) months. The fractured ends of 10 patients' phalanges healed well without nonunion, good appearance of toenail and deformity of toenail. The recovery of hand function was evaluated according to the evaluation standard of upper limb function of Hand Surgery Society of Chinese Medical Association, 9 cases were excellent, and 1 case was good.Conclusion:The second toenail flap with dorsal bone of the phalanx preserved is easy to cut, simple to operate, and has good clinical effect. It is a good method to repair the defect of the fingernail bed.

Objective:To analyze the complications of vacuum-assisted microwave in the treatment of axillary hyperhidrosis and bromhidrosis.Methods:The clinical data of patients with axillary hyperhidrosis and axillary bromhidrosis admitted to the Laser Aesthetic Center of Plastic Surgery Hospital of Chinese Academy of Medical Sciences from April 2018 to May 2019 were retrospectively analyzed. All patients received vacuum-assisted microwave therapy under tumescent anesthesia. The template with appropriate size was selected for transfer printing, and then microwave treatment was carried out according to the marked points. The energy level was 1-5. The hyperhidrosis severity scale (HDSS) was used to grade the hyperhidrosis severity score, and the changes of grading before and after operation were compared to evaluate the curative effect.Results:In the 103 cases, there were 16 males and 87 females, aged from 18 to 62 years. The HDSS scores at 3 months(1.28±0.29)and 12 months(1.70±0.62) after treatment were significantly lower than those before treatment(3.13±0.27) ( P<0.01). In the 103 cases, 99 cases had no postoperative complications and had definite postoperative effect, 4 cases had postoperative complications, including 1 case of infection with local skin necrosis, 1 case of blister and skin scald and 2 cases hematomas(3 sides). Among the 2 cases of hematomas, 1 case had severe necrosis of subcutaneous tissue and fat liquefaction. The incidence of complications was about 3.88% (4/103). Conclusions:Vaccum-assisted microwave is effective in the treatment of hyperhidrosis and bromhidrosis, and the incidence of complications is low. The correct operation and proper treatment of complications can achieve satisfactory result.