A case of a 3-year-old child suffered with severe crush injury to the right forearm and right hand on June, 2017. A comprehensive treatment was conducted with limb salvage, free flap repair and the repair of nerve, vessel and tendon for functional reconstructions followed by rehabilitation therapies. The function and appearance of the injured limb and hand recovered well 3 years after surgery.

Objective: To investigate the effect of brucea javanica oil emulsion (BJOE) on the proliferation, collagen synthesis and ERK1/2 MAPK singaling pathway of hypertrophic scar fibroblasts (HSFs). Methods: The human hypertrophic scar tissues were collected, and HSFs were isolated, cultured and identified in vitro. Cells were treated with BJOE under the concentration of 0.5, 1, 5, 10, 20 and 50 mg/ml for 24 h respectively; the half inhibitory concentration(IC50)of 24 h was calculated. The experimental groups were treated for 24, 48, 72 h by BJOE at the IC50, the control group was conventionally cultured without BJOE. Cell proliferation was detected by CCK-8 assay and cell cycle was determined by flow cytometry (FCM). The morphological changes of cells treated with BJOE at a concentration of IC50 for 24 h were observed. The protein expression levels of collagen Ⅰ, vimentin, ERK1/2 and p-ERK1/2 were measured by Western blot. Results: The IC50 of BJOE was 1.176 mg/ml, so the concentration of 1 mg/ml was selected for the subsequent experiment. After 24, 48, 72 h treated with BJOE at a concentration of 1 mg/ml, the inhibition rates of BJOE on HSFs were (53.13±2.40)%, (75.07±2.67)%and (88.65±0.32)%, respectively. The difference was significant (P<0.05). Under the effect of BJOE, the number of HSFs significantly decreased, the interval between cells widened, cell protrusions were significantly shortened or even disappeared, and the cells became round. The percentage of cells decreased in S phase. Expression of type Ⅰ collagen, vimentin and p-ERK1/2 in HSF was significantly inhibited (P<0.05), while there was no significant difference in the expression of ERK1/2(P>0.05). Conclusions BJOE inhibites the proliferation of HSF and the synthesis of type Ⅰ collagen, and its mechanism is related to the inhibition of ERK1/2 phosphorylation and vimentin expression.

This article reports a case, happened in July 2019, of 9 severed segments of 2nd-5th fingers in left hand treated in the Department of Repair and Microsurgery, Zhengzhou Renji Hospital. Through the unified management before surgery, team surgery, three or four fixed-point mattress eversion suture and close observation after surgery. It can effectively prevent the occurrence of vascular compromise. All the replanted fingers survived after the surgery. And the function of the fingers recovered well at 2 years after surgery through early and continuous rehabilitation exercise.

Objective To investigate biomechanical properties of double eyelid surgery and its clinical application in upper blepharoplasty .Methods In the mild ptosis correction combined with double eyelid surgery ,the main force from levator was assigned to upper tarsus to open eyes .At the same time ,not only it could ensure the enough height of palpebral fissure ,but also had relatively sta-ble and persistent double eyelid .For those who had sunken upper eyelid ,were given fat transposition and/or autologous fat grafting .For those who had medial epicanthal fold ,to achieve a pleasing eye ap-pearance ,we performed epicanthoplasty .Results After 6 months to 2 years of follow-up ,15 cases had unsatisfactory results and underwent secondary surgery .The revision reason was as follows :7 pa-tients had asymmetry double eyelid width ,3 patients had insufficient correction for ptosis ,2 patients had shallower and narrower double eyelid line .In 3 cases ,the correction of the upper sunken was in-sufficient .The remaining 164 patients with mild ptosis were well corrected ,and the double eyelid was stable and natural ,and the results were satisfactory .There were no major complications .Conclusions During mild blepharoptosis correction combined with double eyelid surgery ,reasonable treatment of the biomechanical balance has certain clinical significance for avoiding postoperative complications and improving the effect of double eyelid surgery .

Cleft lip and/or palate (CLP) are the most common craniofacial malformations in humans. Speech problems often persist even after cleft repair, such that follow-up articulation training is usually required. However, the neural mechanism behind effective articulation training remains largely unknown. We used fMRI to investigate the differences in brain activation, functional connectivity, and effective connectivity across CLP patients with and without articulation training and matched normal participants. We found that training promoted task-related brain activation among the articulation-related brain networks, as well as the global attributes and nodal efficiency in the functional-connectivity-based graph of the network. Our results reveal the neural correlates of effective articulation training in CLP patients, and this could contribute to the future improvement of the post-repair articulation training program.
Brain/diagnostic imaging* ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Humans ; Magnetic Resonance Imaging ; Reading