Recent studies of exosomes derived from mesenchymal stem cells (MSCs) have indicated high potential clinical applications in many diseases. However, the limited source of MSCs impedes their clinical research and application. Most recently, induced pluripotent stem cells (iPSCs) have become a promising source of MSCs. Exosome therapy based on iPSC-derived MSCs (iMSCs) is a novel technique with much of its therapeutic potential untapped. Compared to MSCs, iMSCs have proved superior in cell proliferation, immunomodulation, generation of exosomes capable of controlling the microenvironment, and bioactive paracrine factor secretion, while also theoretically eliminating the dependence on immunosuppression drugs. The therapeutic effects of iMSC-derived exosomes are explored in many diseases and are best studied in wound healing, cardiovascular disease, and musculoskeletal pathology. It is pertinent clinicians have a strong understanding of stem cell therapy and the latest advances that will eventually translate into clinical practice. In this review, we discuss the various applications of exosomes derived from iMSCs in clinical medicine.

Eyebrow lifting is a common surgical procedure used to correct the laxity of upper eyelid skin in middle-aged women, and there are many kinds of eyebrow lifting method including supra-brow blepharoplasty, sub-brow blepharoplasty, transbrow excision blepharoplasty, supra-brow combined with infra-brow blepharoplasty, as well as endoscopic brow lift. Different surgical method are suitable for different populations, and every procedure has its own advantages and disadvantages. In recent years, with the development of eyebrow lifting method , the effects of eyebrow lifting on the correction of upper eyelid skin laxity becomes more permanent, and there is a growing trend that eyebrow lifting method combined with other periorbital procedures will be used to realize periorbital rejuvenation.

Eyebrow lifting is a common surgical procedure used to correct the laxity of upper eyelid skin in middle-aged women, and there are many kinds of eyebrow lifting method including supra-brow blepharoplasty, sub-brow blepharoplasty, transbrow excision blepharoplasty, supra-brow combined with infra-brow blepharoplasty, as well as endoscopic brow lift. Different surgical method are suitable for different populations, and every procedure has its own advantages and disadvantages. In recent years, with the development of eyebrow lifting method , the effects of eyebrow lifting on the correction of upper eyelid skin laxity becomes more permanent, and there is a growing trend that eyebrow lifting method combined with other periorbital procedures will be used to realize periorbital rejuvenation.

Eyebrow lifting is a common surgical procedure used to correct the laxity of upper eyelid skin in middle-aged women, and there are many kinds of eyebrow lifting method including supra-brow blepharoplasty, sub-brow blepharoplasty, transbrow excision blepharoplasty, supra-brow combined with infra-brow blepharoplasty, as well as endoscopic brow lift. Different surgical method are suitable for different populations, and every procedure has its own advantages and disadvantages. In recent years, with the development of eyebrow lifting methods, the effects of eyebrow lifting on the correction of upper eyelid skin laxity becomes more permanent, and there is a growing trend that eyebrow lifting method combined with other periorbital procedures will be used for periorbital rejuvenation.

Eyebrow lifting is a common surgical procedure used to correct the laxity of upper eyelid skin in middle-aged women, and there are many kinds of eyebrow lifting method including supra-brow blepharoplasty, sub-brow blepharoplasty, transbrow excision blepharoplasty, supra-brow combined with infra-brow blepharoplasty, as well as endoscopic brow lift. Different surgical method are suitable for different populations, and every procedure has its own advantages and disadvantages. In recent years, with the development of eyebrow lifting methods, the effects of eyebrow lifting on the correction of upper eyelid skin laxity becomes more permanent, and there is a growing trend that eyebrow lifting method combined with other periorbital procedures will be used for periorbital rejuvenation.

Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2±0.3) h,

Objective:To compare and analyze the clinical appplication and therapeutic effect of applying three methods for correction of moderate and severe upper eyelid skin laxity.Methods:From January 2017 to March 2019, retrospective analysis was performed to evaluate the therapeutic effect of applying three methods by Department of Plastic Surgery at Xijing Hospital of Air Force Medical University to correct moderate and severe upper eyelid skin laxity, such as subbrow blepharoplasty(SBB), double eyelid surgery(DES) and combination of subbrow blepharoplasty and double eyelid surgery(CSD). Patients were divided into the SBB group, DES group, and CSD group according to the different surgical methods, inclusion and exclusion criteria. The 6 month postoperative improvement of upper eyelid skin laxity, including marginal reflex distance 1(MRD1), medial corneal margin-fold distance (MCMFD), middle pupil margin-fold distance (MPMFD), lateral canthus margin-fold distance (LCMFD), the improvement of upper eyelid wrinkles and patient and surgeon visual analog scores (VAS) were compared. Measurement data were expressed as mean ± standard deviation, comparison between groups was performed by ANOVA, pairwise comparison between groups was performed by LSD- t test, P<0.05 was considered statistically significant. Results:Ninety female patients were included in this study. Thirty patients in each group, patients were between 35 and 62 years old. There was no significant difference in gender, age, and degree of upper eyelid skin laxity among the three groups ( P>0.05). All patients were followed up for 6 to 24 months. Upper eyelid skin laxity and upper eyelid wrinkles were obviously improved in all cases after operation. With the exception of 2 cases of vomiting and 1 case of scalp numbness of CSD group. The improvement of MRD1 in SBB group, DES group and CSD group was (0.14±0.09) mm, (0.34±0.11) mm, (0.43±0.15) mm, showing significant difference between three groups ( F=34.537, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=6.418, 2.824, 9.236, P <0.001, 0.008, <0.001). The improvement of MCMFD in SBB group, DES group and CSD group was (0.32±0.15) mm, (0.92±0.21) mm, (0.97±0.24) mm, showing significant difference between three groups ( F=94.082, P <0.001). The differences between the SBB group and the DES group, the SBB group and the CSD group were statistically significant ( t=11.273, 12.404, P <0.001), and there was no significant difference between the DES group and the CSD group ( t=1.132, P=0.261). The improvement of MPMFD in SBB group, DES group and CSD group was (0.34±0.13) mm, (1.07±0.24) mm, (1.37±0.23) mm, showing significant difference between three groups ( F=193.935, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=13.531, 5.628, 19.159, P <0.001). The improvement of LCMFD in SBB group, DES group and CSD group was (0.54±0.17) mm, (1.58±0.37) mm, (1.97±0.48) mm, showing significant difference between three groups ( F=121.405, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=10.971, 4.097, 15.068, P <0.001). The improvement of upper eyelid wrinkles in SBB group, DES group and CSD group was 0.70±0.47, 0.50±0.51, 1.20±0.48, showing significant difference between three groups ( F=16.471, P <0.001). There was no significant difference between the SBB group and the DES group ( t=1.592, P=0.115), while the differences between the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.571, 3.979, P <0.001). The VAS patients score in SBB group, DES group and CSD group was 2.77±0.57, 2.17±0.38, 3.90±0.31, showing significant difference between three groups ( F=124.575, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.379, 15.541, 10.161, P <0.001). The VAS surgeons score was 2.80±0.61, 2.27±0.58, 4.07±0.45, showing significant difference between three groups ( F=84.085, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=3.740, 12.624, 8.883, P <0.001). Conclusions:Compared with subbrow blepharoplasty and double eyelid surgery, the combination of subbrow blepharoplasty and double eyelid surgery is an effective way to excise upper eyelid skin and reduce wrinkles, which has the best results in promoting upper eyelid rejuvenation. It should be considered as optimal method for correction of moderate and severe upper eyelid skin laxity.

Objective:To compare and analyze the clinical appplication and therapeutic effect of applying three methods for correction of moderate and severe upper eyelid skin laxity.Methods:From January 2017 to March 2019, retrospective analysis was performed to evaluate the therapeutic effect of applying three methods by Department of Plastic Surgery at Xijing Hospital of Air Force Medical University to correct moderate and severe upper eyelid skin laxity, such as subbrow blepharoplasty(SBB), double eyelid surgery(DES) and combination of subbrow blepharoplasty and double eyelid surgery(CSD). Patients were divided into the SBB group, DES group, and CSD group according to the different surgical methods, inclusion and exclusion criteria. The 6 month postoperative improvement of upper eyelid skin laxity, including marginal reflex distance 1(MRD1), medial corneal margin-fold distance (MCMFD), middle pupil margin-fold distance (MPMFD), lateral canthus margin-fold distance (LCMFD), the improvement of upper eyelid wrinkles and patient and surgeon visual analog scores (VAS) were compared. Measurement data were expressed as mean ± standard deviation, comparison between groups was performed by ANOVA, pairwise comparison between groups was performed by LSD- t test, P<0.05 was considered statistically significant. Results:Ninety female patients were included in this study. Thirty patients in each group, patients were between 35 and 62 years old. There was no significant difference in gender, age, and degree of upper eyelid skin laxity among the three groups ( P>0.05). All patients were followed up for 6 to 24 months. Upper eyelid skin laxity and upper eyelid wrinkles were obviously improved in all cases after operation. With the exception of 2 cases of vomiting and 1 case of scalp numbness of CSD group. The improvement of MRD1 in SBB group, DES group and CSD group was (0.14±0.09) mm, (0.34±0.11) mm, (0.43±0.15) mm, showing significant difference between three groups ( F=34.537, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=6.418, 2.824, 9.236, P <0.001, 0.008, <0.001). The improvement of MCMFD in SBB group, DES group and CSD group was (0.32±0.15) mm, (0.92±0.21) mm, (0.97±0.24) mm, showing significant difference between three groups ( F=94.082, P <0.001). The differences between the SBB group and the DES group, the SBB group and the CSD group were statistically significant ( t=11.273, 12.404, P <0.001), and there was no significant difference between the DES group and the CSD group ( t=1.132, P=0.261). The improvement of MPMFD in SBB group, DES group and CSD group was (0.34±0.13) mm, (1.07±0.24) mm, (1.37±0.23) mm, showing significant difference between three groups ( F=193.935, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=13.531, 5.628, 19.159, P <0.001). The improvement of LCMFD in SBB group, DES group and CSD group was (0.54±0.17) mm, (1.58±0.37) mm, (1.97±0.48) mm, showing significant difference between three groups ( F=121.405, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=10.971, 4.097, 15.068, P <0.001). The improvement of upper eyelid wrinkles in SBB group, DES group and CSD group was 0.70±0.47, 0.50±0.51, 1.20±0.48, showing significant difference between three groups ( F=16.471, P <0.001). There was no significant difference between the SBB group and the DES group ( t=1.592, P=0.115), while the differences between the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.571, 3.979, P <0.001). The VAS patients score in SBB group, DES group and CSD group was 2.77±0.57, 2.17±0.38, 3.90±0.31, showing significant difference between three groups ( F=124.575, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.379, 15.541, 10.161, P <0.001). The VAS surgeons score was 2.80±0.61, 2.27±0.58, 4.07±0.45, showing significant difference between three groups ( F=84.085, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=3.740, 12.624, 8.883, P <0.001). Conclusions:Compared with subbrow blepharoplasty and double eyelid surgery, the combination of subbrow blepharoplasty and double eyelid surgery is an effective way to excise upper eyelid skin and reduce wrinkles, which has the best results in promoting upper eyelid rejuvenation. It should be considered as optimal method for correction of moderate and severe upper eyelid skin laxity.

The lateral canthus is the junction of the upper and lower eyelids, which is located at the temporal side. The distance from the lateral orbit rim to the lateral canthal angle is 5-7 mm. Cosmetic lateral canthoplasty, as an important surgical method for the rejuvenation of the eyes, was developed in recent year. Along with the development of anatomic study of the lateral canthus, the cosmetic lateral canthoplasty was modified and improved. The purpose of this review is to summarize the anatomy of the lateral canthus, indications for cosmetic lateral canthoplasty and surgical procedures, so as to provide a useful reference for clinicians.

Objective To evaluate the value of modified calcofluor white fluorescent staining in the histopathological diagnosis of subcutaneous mycosis,in order to provide a new method for histopathological diagnosis of subcutaneous mycosis.Methods A total of 21 lesional skin tissues were collected from patients with subcutaneous mycosis in the Affiliated Hospital of Chengde Medical University between 1987 and 2017,and embedded in paraffin.Then,each paraffin-embedded tissue section was cut into 4 4-μm-thick serial sections,and subjected to modified calcofluor white fluorescent staining,hematoxylin and eosin (HE) staining,periodic acid Schiff (PAS) staining and Gomori methenamine silver nitrate (GMS) staining respectively.Positive rates and staining outcomes were compared among the above staining methods.Statistical analysis was carried out with SPSS 19.0 software by using chi-square test for comparing the positive rates among the above 4 staining methods.Results Of 21 patients with fungal infections,14 (66.67％) were positive for modified calcofluor white fluorescent staining,5 (23.80％) for HE staining,6 (28.57％) for PAS staining,and 11 (52.38％) for GMS staining.The positive rate by modified calcofluor white fluorescent staining was significantly higher than that by HE staining and PAS staining (x2 =6.718,5.200,respectively,both P ＜ 0.05),while no significant difference was observed between the modified calcofluor white fluorescent staining and GMS staining (x2 =0.693,P =0.530).Conclusion The modified calcofluor white fluorescent staining is an accurate method for detecting fungi,and has a certain application value in the histopathological diagnosis of subcutaneous mycosis.