ObjectiveTo explore the clinical results of endoscopic resection of the frontal benign tumors.MethodsNineteen cases of benign tumors in the frontal area were rcsected using endo scopic techniques.The tumors were diagnosed as benign according to complaint,history and physical examination.ResultsAll 19 tumors were totally resected.The pathological examination revealed 11cases of lipoma,3 cases of sebaceous cyst,3 cases of sebaceous cyst and 2 cases of dermoid cyst.During 6 months to 2 years of follow-up,no tumor recurred.Local concavity was noticed in all patients but all resolved within 6 months except 2 patients.They received granular fat graft of the concavities 6months late and were satisfied with the results.ConclusionsBenign tumors near eyebrows and in glabella area can be treated by minimally invasive endoscopic technique.Compared with traditional surgery,this technique offers inconspicuous scar and fast recovery.

Intracranial artery dissection is rare in the clinic, but could account for a large proportion of young patients with intracranial vascular diseases. High-resolution magnetic resonance imaging is a direct method of vessel wall imaging and widely used in clinical practice due to advantages including high spatial resolution, high signal-to-noise ratio and strong reproducibility. The article briefly introduces the typical findings of intracranial artery dissection in high-resolution magnetic resonance imaging and the unique advantages of features such as intimal flap, double-lumen, lumen diameter change and intramural hematoma. It makes up for the deficiency of traditional lumen imaging in the diagnosis and differential diagnosis of intracranial artery dissection, providing a strong basis for the diagnosis and intervention of intracranial vascular dissection.

In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

OBJECTIVETo improve the results of the soft tissue expansion technique.

METHODSTwo expanders were buried in the same soft tissue pocket in an overlapping pattern. The inflation process was carried out routinely.

RESULTS19 cases of various tissue defects were treated with the overlapping tissue expansion technique since March 1999. Good results have been achieved.

CONCLUSIONThe overlapping tissue expansion technique can provide much more expanded tissue and reduce complications compared with the traditional expansion technique. It is especially suitable for repair of the defects at the facial and cervical region.

Adolescent ; Adult ; Burns ; surgery ; Child ; Dermatologic Surgical Procedures ; Female ; Humans ; Male ; Skin ; injuries ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; methods

OBJECTIVETo analyze potential mutations of NOTCH3 gene in a Chinese family featuring cerebral autosomal dominant arteriopathy with subcortical infarct and leucoencephalopathy (CADASIL) in order to facilitate genetic counseling and prenatal diagnosis.

METHODSThe proband and related family members and 100 healthy controls were recruited. The NOTCH3 gene was screened for mutations by polymerase chain reaction and direct DNA sequencing. PolyPhen-2 and SIFT software were used to predict the protein function.

RESULTSThe proband and two affected individuals from the family were adult-onset, with main clinical manifestations including recurrent transient ischemic attacks and(or) strokes, cognitive impairment, memory decline, and depression. MRI findings suggested multiple cerebral infarcts and severe leukoencephalopathy. A novel heterozygous missense mutation c.3043T> A (p.Cys1015Ser) located in exon 19 of NOTCH3 gene was identified not only in the proband and two patients, but also in an asymptomatic relative from the family. The same mutation was detected in none of the 100 unrelated healthy controls. Function analysis suggested that this mutation can severely affect the functions of this protein. Multiple sequence alignment revealed that the mutation site was extremely conserved in various species.

CONCLUSIONA novel heterozygous Cys1015Ser mutations in exon 19 of the NOTCH3 gene probably underlies the CADASIL in this family.

Adult ; Aged ; Amino Acid Sequence ; Base Sequence ; CADASIL ; complications ; genetics ; DNA Mutational Analysis ; Exons ; genetics ; Family Health ; Female ; Heterozygote ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation, Missense ; Pedigree ; Polymerase Chain Reaction ; Receptor, Notch3 ; Receptors, Notch ; genetics ; Sequence Homology, Amino Acid

Objective: To investigate the feasibility and technical tips of repairing facial defects with pre-expanded propeller flap based on the perforators of the supratrochlear artery or the supraorbital artery. Methods: In the first-stage operation, a tissue expander was buried underneath the frontalis muscle. The second-stage operation was conducted using pre-expanded supratrochlear artery or the supraorbital artery based propeller flap to repair facial defect. Results: From July 2010 to July 2016, this method was used in 8 patients. 5 flaps were based on the supratrochlear artery, and 3 flaps based on the supraorbital artery. Expander size was ranged from 150 ml to 300 ml. The size of propeller flaps was from 10 cm × 6 cm to 15 cm × 13 cm. All the flaps survived without any major complications. Follow-up period ranged from 3 to 36 months. Eyebrow replacement, flap thinning and scar revision were performed in 6 cases. All patients were satisfied with the final aesthetic result. Conclusions The pre-expanded propeller flap based on the supratrochlear artery or the supraorbital artery is an alternative option to repair the facial defect in appropriate cases.

Ischemic stroke is one of the most important causes of death and disability in humans,but the effective methods for treating brain injury after stroke are quite limited.Sphingosine 1-phosphate (S1P) is a pleiotropic lipid.There is certain interdependence between its metabolism and regulation and the molecular mechanisms involved in important biological events following cerebral ischemia.Membrane lipid therapy with S1P as the core may be an effective neuroprotective strategy of ischemic stroke.

Objective: To analyze dermoscopic features of blue nevi. Methods: Clinical and dermoscopic data were collected from patients with confirmed blue nevi in the Department of Dermatology and Venereology, Wuxi People′s Hospital from January 2008 to May 2018, and analyzed retrospectively. Chi-square test was used to analyze differences between groups. Results: Totally, 65 patients with 66 skin lesions were enrolled into this study. A total of 23 skin lesions were subjected to dermoscopy, which showed homogeneous pattern in 20 (87.0%) lesions, pseudo-pigment network pattern in 2 (8.7%) lesions, and cerebriform pattern in 1 (4.3%) lesion, and the homogeneous pattern was more common than the other patterns (χ² = 8.79, P < 0.05) . Under the dermoscope, 10 lesions were monochromatic (43.5%) , 11 were dichromatic (47.8%) , and 2 were multichromatic (8.7%) . Scar-like hypopigmentation was observed in 4 lesions (17.4%) , and vascular structures were observed in 5 (21.7%) , including punctate vessels in 4 (17.4%) and linear irregular vessels in 1 (4.3%) . Papillary hyperplasia was observed in 2 lesions (8.7%) . Additionally, pigmentation around lesions, white streaks, dots/globules, blotches, comedo-like openings were observed in 1 lesion (4.3%) each. Conclusions Blue homogeneous pattern is the most common dermoscopic feature of blue nevi. Pseudo-pigment network pattern, cerebriform pattern, scar-like hypopigmentation, multiple vascular patterns, papillary hyperplasia, white streaks, dots/globules, blotches, comedo-like openings can also be observed in blue nevus lesions.

Objective To investigate the impact of SARS-CoV-2 infection on male semen quality through meta-analysis and retrospec-tive study.Methods Literature retrieval was conducted in PubMed,CNKI,Wanfang Database and CBM database.Meta-analysis was performed using Stata 15.0.The male patients meeting the inclusion criteria from our hospital were enrolled as study subjects.General demographic data and semen parameters were collected.Single factor analysis of variance and graphing of semen parameters were con-ducted using GraphPad Prism 9.5.1.The test level was set at 0.05.Results A total of 9 studies involving 267 patients were included in the meta-analysis.There were no significant differences in sperm concentration and survival rate before and after SARS-CoV-2 infec-tion(P＞0.05).Semen volume and percentage of normal morphology significantly increased during 1-3 months after infection(P=0.005,P=0.010),with semen volume recovering to pre-infection level＞3 months later(P＞0.05).Sperm motility and progressive mo-tility increased＞3 months after infection(P=0.046,P=0.045),recovering to pre-infection levels(P=0.099,P=0.098).Sperm DNA fragmentation index may be temporarily elevated within 3 months after infection but gradually decreased＞3 months later.In the retrospective study of 8 cases,there were no statistical differences in semen parameters at different stages compared with pre-infection(P＞0.05),but semen parameters showed a negative trend during＜1 month after infection and recovered to pre-infection levels＞3 months later.Conclusion The results of this laboratory study are basically consistent with the meta-analysis.SARS-CoV-2 infection in males only caused short-term negative effects on sperm morphology,vitality and DNA integrity,but generally recovered to pre-infection levels＞3 months after infection.Due to the limitations of study subjects and sample size,the impact of SARS-CoV-2 infection on male semen quality needs to be further confirmed by long-term large-scale prospective studies.

Objective: To investigate the distribution of the septocutaneous perforators in the medial arm and its clinical applications. Methods: Between March 2014 and August 2018, 39 patients (45 arms) were included in the study. A coordinate system originating at the medial epicondyle was established, with the y-axis running to the axillary apex and expressed in relative value. The y-axis was trisected and each third from proximal to distal were designated as A, B, and C, respectively. Based on this, the medial arm flap was used to reconstruct defects in the head and neck, hand, axilla, elbow and chest wall. Results: An average of 4.6 perforators were identified along the medial intermuscular septum of the arm, located at 0.87±0.08, 0.50±0.09 and 0.20±0.06 on the y-axis, with a prevalence of 95.6%, 100% and 86.7%, respectively. Among the 45 flaps, 30 were used as pedicled distant flaps and 15 as perforator-based propeller flaps, with an average size of 18.7 cm×8.1 cm. The average length of the perforator pedicle was 3.1 cm. One pedicled distant flap developed hematoma after pedicle division but recovered with hematoma removal. One perforator-based propeller flap had partial loss of the distal third, requiring surgical debridement followed by a local flap transfer. Two perforator-based propeller flaps had venous congestion but survived completely with conservative therapy. The remaining flaps healed uneventfully. Donor-site morbidity was minimal. The patients were followed up for 6 months to 3 years (average 12.6 months) with satisfactory aesthetic appearance, greatly improved function and no tumor recurrence. Conclusions The constant perforators could be found in each third of the medial arm. The perforator-based medial arm flap could be used for various soft-tissue defect reconstructions.