Objective:To introduce a novel method to repair bottoming-out and double-bubble deformity after augmentation mammaplasty with a hammock-shaped capsular flap, and to evaluate its clinical effect of the related complications.Methods:From 2015 to 2019, a total of 16 patients (aged range from 23 to years, with average age of 33.4 years) were treated in the Department of Plastic Surgery, Shanghai Mylike Cosmetic Hospital. We performed a novel hammock-shaped capsular flap with periareolar incision. First of all, the periprosthetic capsule was widely separated from the lower pole of the breasts. Then the inframammary folds were anchored to the chest wall to eliminate the excess the cavity. Finally, the capsular flaps were raised up from both anterior and posterior leaf and resutured by fold tile shaped suture, in order to elevate the inframammary folds in aesthetic revision.Results:Only one case showed mild hematoma and healed after treatment. After 6 months follow-up, all the inframammary folds were elevated to the ideal position, and the double-bubble deformity was corrected with concealed scars and satisfactory shape and symmetry. Meanwhile, recurrent cases and capsule contraction were not observed.Conclusions:For patients with bottoming-out and double-bubble complications after augmentation mammaplasty, the use of hammock-shaped capsular flap can effectively revise the deformation. This technical refinement seems to afford stable outcomes with convenient operation and minor injury and produce satisfactorily clinical effects with fewer complications.

Intensive cancer treatment with drug combination is widely exploited in the clinic but suffers from inconsistent pharmacokinetics among different therapeutic agents.To overcome it,the emerging nanomedicine offers an unparalleled opportunity for encapsulating multiple drugs in a nano-carrier.Herein,a two-step super-assembled strategy was performed to unify the pharmacokinetics of a pep-tide and a small molecular compound.In this proof-of-concept study,the bioinformatics analysis firstly revealed the potential synergies towards hepatoma therapy for the associative inhibition of exportin 1(XPO1)and ataxia telangiectasia mutated-Rad3-related(ATR),and then a super-assembled nano-pill(gold nano drug carrier loaded AZD6738 and 97-110 amino acids of apoptin(AP)(AA@G))was con-structed through camouflaging AZD6738(ATR small-molecule inhibitor)-binding human serum albumin onto the AP-Au supramolecular nanoparticle.As expected,both in vitro and in vivo experiment results verified that the AA@G possessed extraordinary biocompatibility and enhanced therapeutic effect through inducing cell cycle arrest,promoting DNA damage and inhibiting DNA repair of hepatoma cell.This work not only provides a co-delivery strategy for intensive liver cancer treatment with the clinical translational potential,but develops a common approach to unify the pharmacokinetics of peptide and small-molecular compounds,thereby extending the scope of drugs for developing the advanced com-bination therapy.

One-compartment lumped-parameter models of respiratory mechanics, representing the airflow resistance of the tracheobronchial tree with a linear or nonlinear resistor, are not able to describe the mechanical property of airways in different generations. Therefore, based on the anatomic structure of tracheobronchial tree and the mechanical property of airways in each generation, this study classified the human airways into three segments: the upper airway segment, the collapsible airway segment, and the small airway segment. Finally, a nonlinear, multi-compartment lumped-parameter model of respiratory mechanics with three airway segments was established. With the respiratory muscle effort as driving pressure, the model was used to simulate the tidal breathing of healthy adults. The results were consistent with the physiological data and the previously published results, suggesting that this model could be used for pathophysiological research of respiratory system.

Objective: To investigate the correlation between mandibular condyle volume and external ear volume in M2a type of hemifacial microsomia. Methods: 19 patients with M2a type of hemifacial microsomia diagnosed by CT scan in the Shanghai Ninth People′s Hospital from August 2017 to December 2018 were included, and the head CT data were obtained. At the same time, 19 healthy people were recruited as volunteers and obtain CT data of their heads as control. The Mimics 15.0 software was used for 3D reconstruction of CT data, measure the volume of mandibular condyle and external ear. SPSS 25.0 software was used to analyze the correlation between mandibular volume and external ear volume, as well as the difference between bilateral mandibular condyle volume (healthy side mandibular condyle volume-affected side mandibular condyle volume) and bilateral external ear volume difference (healthy side external ear volume-affected side external ear volume), and the correlation was obtained by spearman correlation coefficient analysis. P<0.05 indicates that the difference was statistically significant. Results: The data of 19 cases of M2a type of hemifacial microsomia and 19 healthy volunteers were analyzed. The left and right volume of bilateral mandibular condyle in healthy volunteers was (1 309.23±420.63) mm^3, (1 325.93±425.60) mm³(P=0.904), the left and right volume of external ear was (7 854.18±2 005.77) mm³, (7 862.63±1 994.02) mm³(P=0.990), bilateral development was synchronous, there was no statistical difference. There was a significant positive correlation between mandibular condyle volume and external ear volume in healthy volunteers (P=0.004, rs=0.772). The volume of healthy and affected mandibular condyle in the patients with M2a type of hemifacial microsomia was (1 160.89±549.07) mm^3, (509.55±303.88) mm³ (P=0.006), and the volume of healthy and affected external ear was (7 418.19±2 434.93) mm³and (2 029.99±1 080.37) mm³ (P=0.007). The development is not synchronized in the mandibular condyle and external ear in M2a type of hemifacial microsomia, but the mandibular condyle volume is significantly positively correlated with the external ear volume(healthy side: P=0.008, rs=0.740; affected side: P=0.004, rs=0.709), and the affected part of the mandibular condyle and the external ear development (the volume difference between the mandibular condyle or the external ear volume) also has the same performance(P=0.006, rs=0.753). Conclusions There is a significant positive correlation between mandibular condyle volume and external ear volume in patients with M2a type of hemifacial microsomia.

Mechanical ventilation is an importmant life-sustaining treatment for patients with acute respiratory distress syndrome. Its clinical outcomes depend on patients' characteristics of lung recruitment. Estimation of lung recruitment characteristics is valuable for the determination of ventilatory maneurvers and ventilator parameters. There is no easily-used, bedside method to assess lung recruitment characteristics. The present paper proposed a method to estimate lung recruitment characteristics from the static pressure-volume curve of lungs. The method was evaluated by comparing with published experimental data. Results of lung recruitment derived from the presented method were in high agreement with the published data, suggesting that the proposed method is capable to estimate lung recruitment characteristics. Since some advanced ventilators are capable to measure the static pressure-volume curve automatedly, the presented method is potential to be used at bedside, and it is helpful for clinicians to individualize ventilatory manuevers and the correpsonding ventilator parameters.
Humans ; Lung ; Positive-Pressure Respiration ; Respiration, Artificial ; Respiratory Distress Syndrome ; Ventilators, Mechanical