Objective To measure and compare the cerebral blood flow(CBF)of children with autism spectrum disorder(ASD),global developmental delay(GDD),and ASD with GDD groups via arterial spin labeling(ASL)technique,and to evaluate the diag-nostic value of CBF values.Methods ASL images of ASD,GDD,and ASD with GDD groups of children were firstly acquired,and the CBF values of frontal lobe,temporal lobe,parietal lobe,occipital lobe,striatum and thalamus region of interest(ROI)were fur-ther measured,respectively.One-way analysis of variance or Kruskal-Wallis H test was used to compare the differences in CBF values among these three groups,and the receiver operating characteristic(ROC)curve was used to analyze the efficacy of CBF values in distinguishing ASD with GDD from without GDD.Results ASD with GDD had significantly lower CBF values in the left and right frontal lobes than those with ASD or GDD alone,and the differences were statistically significant(P<0.05).The CBF values in the left and right frontal lobes effectively distinguished ASD with GDD from without GDD[area under the curve(AUC)>0.7].Conclusion ASL technique can noninvasively assess CBF in children with or without GDD,helping to understand the pathophysiology of ASD with GDD and improving diagnostic accuracy.

Purpose To observe the changes in the brain microstructure of children with global developmental delay(GDD)via MR diffusion kurtosis imaging(DKI).Materials and Methods A total of 34 children with GDD were included as the experimental group,and 34 children with normal development as the control group in the Third Affiliated Hospital of Zhengzhou University from September 2020 to March 2023,retrospectively.DKI and clinical data were collected.After post-processing,DKI parameters were obtained,including fraction anisotropy,mean kurtosis(MK),axial kurtosis and radial kurtosis(Kr).The differences in parameters in each region of interest of the two groups were analyzed,the correlation between DKI parameters and Gesell developmental scale was analyzed,and the receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of DKI parameters.Results Compared with the control group,the MK value of the centrum semiovale decreased(Z=-2.723,P<0.01),the MK value and Kr value of the thalamus decreased(t/Z=-3.220,-3.128,both P<0.01),the MK value and axial kurtosis value of the anterior and posterior limb of internal capsule decreased(t/Z=-2.958,-2.573,-2.085,-2.403,all P<0.05),the Kr value of the anterior limb of internal capsule decreased(t=-2.155,P<0.05),the MK value and Kr value of frontal white matter decreased(Z=-2.177,-2.711,both P<0.05).The correlation analysis showed that the MK and Kr value of the anterior limb of the internal capsule and the MK value of the posterior limb of the internal capsule were positively correlated with the score of the gross motor functional area(r=0.379,0.378,0.405,all P<0.05),and the MK value of the posterior limb of the internal capsule was positively correlated with the fine motor functional area(r=0.461,P=0.006).The Kr value of the thalamus had the largest area under the curve at 0.721 when diagnosing GDD.Conclusion Children with GDD have changes in brain microstructure,and DKI has a certain value for diagnosis.

As for the treatment of microtia, the status quo is as follows. The ear reconstruction with autologous costal cartilage has been generally accepted as the therapeutic strategy for type Ⅲ/Ⅳ patients with only small ear lobe remaining or complete absence of auricle, and the outcomes are improved steadily with the advances in technology; but for type Ⅰ/Ⅱ patients with larger remnant ear, there is insufficient evidence to be able to support any specific treatment methods as the potential unified approach for surgeons to choose from. Non-surgical treatment with appliance wearing may play an auxiliary role in the treatment of microtia, which is worthy of further research. The authors proposed a serialized treatment system based on their clinical practice and literature review. It is expected to be helpful for the treatment of microtia.

Objective:To introduce a suture anchor technique and its outcomes in the repair of lower eyelid malposition caused by previous blepharoplasty.Methods:Patients with lower eyelid malposition treated with this technique in Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2017 to January 2021 were enrolled. This series included patients with lower eyelid malposition caused by lower blepharoplasty, with or without revision surgery. The suture anchor technique was used to suspend the orbicularis oculi musculocutaneous flap under local infiltrative anesthesia with all patients.Results:A total of 47 patients (64 eyes) were enrolled in this study, including 11 lower eyelid retraction cases (12 eyes) and 36 ectropion cases (52 eyes). The age range was 27 to 61 years (average: 43 years). Thirty-seven patients had their revision surgery for the first time and 10 patients had their second operation more than once. Patients were followed up for 6-24 months. Forty-six patients (63 eyes, 98.4%) shown normal lower eyelid position with satisfied shape, without obvious ectopia, valgus deformity or eyelid exposure. One patient (1 eye, 1.6%) of postoperative anchored area infection was controlled after drainage and dressing changes. The surgical incisions were healed, and the lower eyelid malposition was improved with patient’s satisfactory.No recurrence was observed.Conclusions:The absorbable suture anchor technique is an effective, minimally invasive, and safe method for correcting post-blepharoplasty lower eyelid malposition.

Objective:To introduce a suture anchor technique and its outcomes in the repair of lower eyelid malposition caused by previous blepharoplasty.Methods:Patients with lower eyelid malposition treated with this technique in Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2017 to January 2021 were enrolled. This series included patients with lower eyelid malposition caused by lower blepharoplasty, with or without revision surgery. The suture anchor technique was used to suspend the orbicularis oculi musculocutaneous flap under local infiltrative anesthesia with all patients.Results:A total of 47 patients (64 eyes) were enrolled in this study, including 11 lower eyelid retraction cases (12 eyes) and 36 ectropion cases (52 eyes). The age range was 27 to 61 years (average: 43 years). Thirty-seven patients had their revision surgery for the first time and 10 patients had their second operation more than once. Patients were followed up for 6-24 months. Forty-six patients (63 eyes, 98.4%) shown normal lower eyelid position with satisfied shape, without obvious ectopia, valgus deformity or eyelid exposure. One patient (1 eye, 1.6%) of postoperative anchored area infection was controlled after drainage and dressing changes. The surgical incisions were healed, and the lower eyelid malposition was improved with patient’s satisfactory.No recurrence was observed.Conclusions:The absorbable suture anchor technique is an effective, minimally invasive, and safe method for correcting post-blepharoplasty lower eyelid malposition.

As for the treatment of microtia, the status quo is as follows. The ear reconstruction with autologous costal cartilage has been generally accepted as the therapeutic strategy for type Ⅲ/Ⅳ patients with only small ear lobe remaining or complete absence of auricle, and the outcomes are improved steadily with the advances in technology; but for type Ⅰ/Ⅱ patients with larger remnant ear, there is insufficient evidence to be able to support any specific treatment methods as the potential unified approach for surgeons to choose from. Non-surgical treatment with appliance wearing may play an auxiliary role in the treatment of microtia, which is worthy of further research. The authors proposed a serialized treatment system based on their clinical practice and literature review. It is expected to be helpful for the treatment of microtia.

Objective:To introduce a suture anchor technique and its outcomes in the repair of lower eyelid malposition caused by previous blepharoplasty.Methods:Patients with lower eyelid malposition treated with this technique in Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2017 to January 2021 were enrolled. This series included patients with lower eyelid malposition caused by lower blepharoplasty, with or without revision surgery. The suture anchor technique was used to suspend the orbicularis oculi musculocutaneous flap under local infiltrative anesthesia with all patients.Results:A total of 47 patients (64 eyes) were enrolled in this study, including 11 lower eyelid retraction cases (12 eyes) and 36 ectropion cases (52 eyes). The age range was 27 to 61 years (average: 43 years). Thirty-seven patients had their revision surgery for the first time and 10 patients had their second operation more than once. Patients were followed up for 6-24 months. Forty-six patients (63 eyes, 98.4%) shown normal lower eyelid position with satisfied shape, without obvious ectopia, valgus deformity or eyelid exposure. One patient (1 eye, 1.6%) of postoperative anchored area infection was controlled after drainage and dressing changes. The surgical incisions were healed, and the lower eyelid malposition was improved with patient’s satisfactory.No recurrence was observed.Conclusions:The absorbable suture anchor technique is an effective, minimally invasive, and safe method for correcting post-blepharoplasty lower eyelid malposition.

Objective:To introduce a suture anchor technique and its outcomes in the repair of lower eyelid malposition caused by previous blepharoplasty.Methods:Patients with lower eyelid malposition treated with this technique in Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2017 to January 2021 were enrolled. This series included patients with lower eyelid malposition caused by lower blepharoplasty, with or without revision surgery. The suture anchor technique was used to suspend the orbicularis oculi musculocutaneous flap under local infiltrative anesthesia with all patients.Results:A total of 47 patients (64 eyes) were enrolled in this study, including 11 lower eyelid retraction cases (12 eyes) and 36 ectropion cases (52 eyes). The age range was 27 to 61 years (average: 43 years). Thirty-seven patients had their revision surgery for the first time and 10 patients had their second operation more than once. Patients were followed up for 6-24 months. Forty-six patients (63 eyes, 98.4%) shown normal lower eyelid position with satisfied shape, without obvious ectopia, valgus deformity or eyelid exposure. One patient (1 eye, 1.6%) of postoperative anchored area infection was controlled after drainage and dressing changes. The surgical incisions were healed, and the lower eyelid malposition was improved with patient’s satisfactory.No recurrence was observed.Conclusions:The absorbable suture anchor technique is an effective, minimally invasive, and safe method for correcting post-blepharoplasty lower eyelid malposition.

Objective:To evaluate the role of de novo mutations (DNMs) in Chinese patients with non-syndromic congenital microtia by using whole exome sequencing in patient-parent trios and to detect the pathogenic DNMs, if there are any. Methods:Twenty-four Chinese trio families with congenital microtia were recruited from March 2017 to July 2018 at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences. The patients, aged from 6 to 10 years old, 15 males and 9 females, had unilateral microtia, including 15 on the left and 9 on the right. After informed consent, peripheral blood was collected from patients and their unaffected parents.Whole exome sequencing was performed on all patients and their parents. DNMs in the coding region and canonical splicing sites were detected, and the number of DNMs in each patient was obtained. Each DNM was classified according to the ACMG standards and guidelines for the interpretation of sequence variants. In-silico prediction was performed using different algorithms and databases considering both variant-and gene-level implications. ExAc database, VarCards, Human Splicing Finder 3.1 software were used to predict each variant’s pathogenicity, including loss of function variant, missense variant and nonsynonymous variant. Mouse genome information database was used to detect the expression of the homologous gene, and David 6.8 bioinformatics database was used for pathway enrichment analysis of candidate genes. The Online Mendelian Inheritance in Man database was used to query the correspondence between candidate genes and human diseases.Results:Twenty-three DNMs were detected in 24 microtia trios. In each patient, there was 0-3 DNMs with no significant difference in population. Twelve missense variants, eight synonymous variants, one nonsense, one start codon variant, and one inframe indel were detected. Among them, a nonsense LRP12 mutation was classified as pathogenic according to ACMG guidelines. However, none of the variants were considered disease-causing according to in-silico predictions.Conclusions:Increased number or mutational burden of DMNs are not observed in Chinese patients with microtia. DMNs is not the primary cause of microtia, although rare DNMs in responsible genes could occasionally lead to cases.

Objective:To evaluate the role of de novo mutations (DNMs) in Chinese patients with non-syndromic congenital microtia by using whole exome sequencing in patient-parent trios and to detect the pathogenic DNMs, if there are any. Methods:Twenty-four Chinese trio families with congenital microtia were recruited from March 2017 to July 2018 at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences. The patients, aged from 6 to 10 years old, 15 males and 9 females, had unilateral microtia, including 15 on the left and 9 on the right. After informed consent, peripheral blood was collected from patients and their unaffected parents.Whole exome sequencing was performed on all patients and their parents. DNMs in the coding region and canonical splicing sites were detected, and the number of DNMs in each patient was obtained. Each DNM was classified according to the ACMG standards and guidelines for the interpretation of sequence variants. In-silico prediction was performed using different algorithms and databases considering both variant-and gene-level implications. ExAc database, VarCards, Human Splicing Finder 3.1 software were used to predict each variant’s pathogenicity, including loss of function variant, missense variant and nonsynonymous variant. Mouse genome information database was used to detect the expression of the homologous gene, and David 6.8 bioinformatics database was used for pathway enrichment analysis of candidate genes. The Online Mendelian Inheritance in Man database was used to query the correspondence between candidate genes and human diseases.Results:Twenty-three DNMs were detected in 24 microtia trios. In each patient, there was 0-3 DNMs with no significant difference in population. Twelve missense variants, eight synonymous variants, one nonsense, one start codon variant, and one inframe indel were detected. Among them, a nonsense LRP12 mutation was classified as pathogenic according to ACMG guidelines. However, none of the variants were considered disease-causing according to in-silico predictions.Conclusions:Increased number or mutational burden of DMNs are not observed in Chinese patients with microtia. DMNs is not the primary cause of microtia, although rare DNMs in responsible genes could occasionally lead to cases.