Objective:To introduce a new technique of double eyelid blepharoplasty by manipulating the relocation and reconnection of aponeurotic flap with tarsus (Bridge Technique), which can achieve physiological, dynamic, natural-looking and minimal-scar double eyelids.Methods:From September 2018 to January 2020, subjects from the Han ethnicity who received double eyelid blepharoplasty using our "Bridge Technique" in the Department of Plastic and Reconstructive Surgery, the Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, were included. The overall aesthetic outcomes were comprehensively graded as good, moderate and poor both by doctors and patients regarding on palpebral fissure, the smoothness of eyelid margin and double eyelid, evenness of incision, symmetry and relapse rate, respectively.Results:151 subjects, including 127 female and 24 male, were included. Their age ranged from 18-41 years old (mean, 27.1 years). At the follow-up of 6-month post-surgery, 90.7% (137 cases), 7.3% (11 cases) and 2.0% (3 cases) of their aesthetic outcomes were graded as good, moderate and poor by three single-blinded doctors, respectively. 86.1% (130 cases), 11.9% (18 cases) and 2.0% (3 cases) were graded as good, moderate and poor by the patients themselves. The overall follow-up period ranged from 6-18 months (mean, 12.7 months). The long-term outcomes were achieved to be stable without any complications.Conclusions:The "Bridge Technique" , which is the tarsal-fixation with aponeurotic flap linkage in blepharoplasty, has been proven as an effective technique for creating dynamic, stable, natural-looking and physiological double eyelids. In addition, it can also effectively avoid unsatisfactory corneal exposure rate which might be caused by the mild ptosis with poor levator function.

Objective:To introduce a new technique of double eyelid blepharoplasty by manipulating the relocation and reconnection of aponeurotic flap with tarsus (Bridge Technique), which can achieve physiological, dynamic, natural-looking and minimal-scar double eyelids.Methods:From September 2018 to January 2020, subjects from the Han ethnicity who received double eyelid blepharoplasty using our "Bridge Technique" in the Department of Plastic and Reconstructive Surgery, the Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, were included. The overall aesthetic outcomes were comprehensively graded as good, moderate and poor both by doctors and patients regarding on palpebral fissure, the smoothness of eyelid margin and double eyelid, evenness of incision, symmetry and relapse rate, respectively.Results:151 subjects, including 127 female and 24 male, were included. Their age ranged from 18-41 years old (mean, 27.1 years). At the follow-up of 6-month post-surgery, 90.7% (137 cases), 7.3% (11 cases) and 2.0% (3 cases) of their aesthetic outcomes were graded as good, moderate and poor by three single-blinded doctors, respectively. 86.1% (130 cases), 11.9% (18 cases) and 2.0% (3 cases) were graded as good, moderate and poor by the patients themselves. The overall follow-up period ranged from 6-18 months (mean, 12.7 months). The long-term outcomes were achieved to be stable without any complications.Conclusions:The "Bridge Technique" , which is the tarsal-fixation with aponeurotic flap linkage in blepharoplasty, has been proven as an effective technique for creating dynamic, stable, natural-looking and physiological double eyelids. In addition, it can also effectively avoid unsatisfactory corneal exposure rate which might be caused by the mild ptosis with poor levator function.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.