1.Clinical application of hair follicle-bearing microskin in the treatment of hypertrophic scars
Hanxiao CHENG ; Xifei QIAN ; Yanjiao MAO ; Jie LONG ; Weili XU ; Rui YAN ; Zhentao ZHOU ; Zhongxin SUN ; Jufang ZHANG ; Chunsheng HOU
Chinese Journal of Plastic Surgery 2025;41(4):340-347
Objective:To investigate the protocol and clinical efficacy of hair follicle-bearing microskin (HF-MS) transplantation in the treatment of hypertrophic scars.Methods:Prospective randomized controlled trial. From January to November 2024, patients with hypertrophic scars were recruited from the Medical Cosmetic Center of Affiliated Hangzhou First People’s Hospital with Westlake University School of Medicine and the Department of Plastic and Reconstructive Surgery of Ningbo Sixth Hospital. Patients were randomly divided into the observation group and the control group using a random number table. In the observation group, 1.0 mm punch decompression was performed on the hypertrophic scar area, followed by implantation of HF-MS extracted from the scalp donor site using follicular unit excision (FUE) into the decompression pores. The control group underwent only 1.0 mm punch decompression. Vancouver scar scale (VSS) scores (total score 0-15, higher scores indicating more severe scarring) were assessed preoperatively and at 1, 3, and 6 months postoperatively. Efficacy at 6 months, improvement in hypertrophic scar area, hair survival rate (observation group), adverse reactions, and patients’ satisfaction rates were evaluated. Categorical data were expressed as frequency (%) and analyzed using chi-square tests; normally distributed measurement data were expressed as Mean ± SD and analyzed using independent samples t-tests. Results:A total of 50 patients were included (25 per group), with 22 males and 28 females, aged 18-60 years (mean age: 33 years). The effective rate was 92% (23/25) in the observation group and 68% (17/25) in the control group, showing a statistically significant difference ( P<0.05). Preoperative VSS scores did not differ significantly between the observation and control groups [(6.67±3.19) vs. (7.12±2.89), P>0.05]. At 1, 3, and 6 months postoperatively, the observation group had VSS scores of (5.48±2.60), (4.64±2.39), and (3.80±2.10), respectively, compared to (6.36±2.53), (5.84±2.28), and (5.32±2.09) in the control group. The 6-month postoperative VSS scores differed significantly between groups ( P<0.05). Preoperative hypertrophic scar areas showed no significant difference [(5.75±2.83) cm 2 vs. (6.91±3.31) cm 2,P>0.05]. At 6 months postoperatively, the observation group had significantly smaller scar areas than the control group [(3.15±1.55) cm 2 vs. (5.37±2.93) cm 2,P<0.01]. The average hair survival rate in the observation group was 41% at 6 months. Adverse reactions occurred in 3 cases in the observation group (2 skin indurations, 1 hyperpigmentation) and 7 cases in the control group (4 hyperpigmentation, 2 skin atrophy, 1 skin induration). The observation group had a significantly lower adverse reaction rate [12% (3/25) vs. 28% (7/25), P<0.05]. Patient satisfaction rates were 88% (22/25) in the observation group and 64% (16/25) in the control group ( P<0.05). Conclusion:HF-MS transplantation demonstrates definitive clinical efficacy in treating hypertrophic scars, effectively improving scar morphology, clinical symptoms, and patient quality of life.
2.Clinical effect of microneedle combined with topical minoxidil in the treatment of male androgenetic alopecia
Chongxiang FAN ; Xifei QIAN ; Zhounan JIANG ; Hanxiao CHENG ; Jufang ZHANG
Chinese Journal of Plastic Surgery 2025;41(4):382-389
Objective:To investigate the efficacy of microneedling combined with topical 5% minoxidil tincture in the treatment of male androgenetic alopecia (AGA).Methods:This study was a prospective study. Male patients with newly diagnosed androgenetic alopecia at the Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital Westlake University School of Medicine, from April 2022 to April 2024 were selected. Age and BASP score were used as matching variables, and every 3 cases were matched as a group. In the study group, 1.0 mm microneedle combined with topical 5% minoxidil tincture was used for 2-3 times of acupuncture operation in the hair loss area, and then about 1 ml of 5% minoxidil tincture was applied to the scalp to promote absorption. From the second day, about 1 ml of 5% minoxidil tincture was evenly sprayed on the hair roots of the scalp in the hair loss area and massaged until absorption, once in the morning and evening every day. Control group 1 was evenly sprayed with 5% minoxidil tincture on the hair roots of the alopecia area, once a day in the morning and evening, about 1 ml each time. Patients in control group 2 received oral finasteride 1 mg once daily. The three groups were treated for 13 weeks, and adverse reactions were recorded during the treatment. Before and immediately after 13 weeks of treatment, the final hair density, velus hair density, hair follicle density, hair shaft average diameter, single hair follicle density and double hair follicle density of the three groups were measured by dermoscopy. Paired sample t-test was used for statistical analysis. After 13 weeks of treatment, the above measurement indexes of study group, control group 1 and control group 2 were analyzed by LSD multiple comparison method. Results:A total of 99 male patients were enrolled, with 33 in the study group [mean age: (31.6 ± 5.8) years, range: 18-45], 33 in control group 1[mean age: (31.7 ± 5.6) years, range: 20-44], and 33 in control group 2 [mean age: (32.2 ± 5.4 )years, range: 19-45].In the study group, three patients experienced transient pain in the treated areas during and after microneedling, which resolved spontaneously within two hours. Two patients developed scalp flaking three days post-treatment, which improved with increased washing frequency and targeted shampoo selection. No significant adverse reactions were observed in control groups 1 and 2.After 13 weeks of treatment, significant increases were observed in the study group compared to baseline for terminal hair density [(104.5 ± 29.6) hairs/cm 2 vs. (72.5 ± 27.9) hairs/cm 2], mean hair shaft diameter [(53.6 ± 11.4) μm vs. (45.7 ± 12.9) μm], follicular unit density [(71.4 ± 18.5) units/cm 2 vs. (57.8 ± 17.4) units/cm 2], and single-hair follicular unit density [(46.7 ± 11.1) units/cm 2 vs. (31.4 ± 12.3) units/cm 2], all with statistically significant differences ( P < 0.05). Control group 1 also showed significant increases in terminal hair density [(87.3 ± 24.5) hairs/cm 2 vs. (70.7 ± 26.0) hairs/cm 2], vellus hair density [(55.3 ± 13.9) hairs/cm 2 vs. (30.2 ± 8.8) hairs/cm 2], follicular unit density [(58.9 ± 17.1) units/cm 2 vs. (52.6 ± 15.5) units/cm 2], mean hair shaft diameter [(52.8 ± 15.7) μm vs. (50.1 ± 16.0) μm], and single-hair follicular unit density [(40.1 ± 11.1) units/cm 2 vs. (34.2 ± 12.0) units/cm 2], all with statistically significant differences ( P < 0.05).Control group 2 showed significant improvements in terminal hair density [(106.3 ± 22.5) hairs/cm 2 vs. (73.7 ± 26.9) hairs/cm 2], follicular unit density [(68.4 ± 18.1) units/cm 2 vs. (53.7 ± 15.4) units/cm 2], mean hair shaft diameter [(57.9 ± 16.2) μm vs. (50.6 ± 15.7) μm], single-hair follicular unit density [(48.1 ± 11.5) units/cm 2 vs. (34.2 ± 12.6) units/cm 2], and double-hair follicular unit density [(23.5 ± 6.4) units/cm 2 vs. (17.2 ± 6.8) units/cm 2], all with statistically significant differences ( P < 0.05). When comparing post-treatment outcomes, the study group exhibited significantly higher terminal hair density, vellus hair density, mean hair shaft diameter, follicular unit density, and single-hair follicular unit density than control group 1, while vellus hair density was significantly lower ( P < 0.05). The study group and control group 2 showed no statistically significant differences in most parameters except for double-hair follicular unit density, which was significantly lower in the study group ( P< 0.05). Conclusion:Microneedling combined with topical 5% minoxidil tincture is an effective treatment for male androgenetic alopecia, demonstrating significant improvements in hair density, follicular unit density, and hair shaft thickness.
3.Study on the Correlation between Serum ITG αMβ2,GSDMD Levels and Disease Severity,Prognostic Prediction in Patients with Severe Acute Pancreatitis Complicated with ARDS
Xia LIU ; Ziwei ZHOU ; Fei CHENG ; Hanxiao WANG ; Qianxiu LIAO
Journal of Modern Laboratory Medicine 2025;40(5):124-130
Objective To investigate the relationship between the expression levels of serum integrin αMβ2(ITG αMβ2)and gasdermin D(GSDMD)in patients with severe acute pancreatitis(SAP)complicated with acute respiratory distress syndrome(ARDS)and the severity of the disease and its value in predicting prognosis.Methods A total of 147 patients with SAP complicated with ARDS(ARDS group)admitted to the Department of Intensive Care Medicine of the Southwest Jiaotong University Affiliated Hospital(Chengdu Third People's Hospital)from August 2021 to October 2023 were selected.According to the oxygenation index(OI),they were divided into mild group(n=35),moderate group(n=46)and severe group(n=66).According to the 28-day prognosis,they were divided into death group(n=77)and survival group(n=70).Another 147 SAP patients without ARDS at the same time period were selected(non-ARDS group).The expression levels of serum ITG αMβ2 and GSDMD were detected by enzyme-linked immunosorbent assay.Spearman method was used to analyze the correlation between serum ITG αMβ2,GSDMD expression levels and OI in patients with SAP complicated with ARDS.Multivariate Logistic regression was used to analyze the factors of death in patients with SAP complicated with ARDS.Receiver operating characteristic(ROC)curve was used to analyze the value of serum ITG αMβ2,GSDMD expression levels in evaluating the death of patients with SAP complicated with ARDS.Results Compared with the non-ARDS group,the expression levels of serum ITG αMβ2(31.95±8.17 ng/L vs 53.33±12.22 ng/L)and GSDMD(2.25±0.55 ng/ml vs 4.39±1.18 ng/ml)in the ARDS group were increased,and the differences were statistically significant(t=17.637,19.899,all P<0.05).The expression levels of serum ITG αMβ2 and GSDMD in mild group,moderate group and severe group increased in turn,and the differences were statistically significant(F=163.069,194.028,all P<0.05).The expression levels of serum ITG αMβ2 and GSDMD were negatively correlated with OI in patients with SAP complicated with ARDS(r=-0.787,-0.778,all P<0.05).The 28-day mortality rate of 147 SAP patients with ARDS was 52.38%(77/147).Compared with the survival group,the expression levels of serum ITG αMβ2(46.96±10.28 ng/L vs 59.11±10.94 ng/L)and GSDMD(3.74±0.98 ng/ml vs 4.98±1.04 ng/ml)in the death group were increased,and the differences were statistically significant(t=6.920,7.415,all P<0.05).The number of extrapulmonary organ failure≥2,prolonged mechanical ventilation time,increased acute physiological and chronic health assessment II score,and increased ITG αMβ2.and GSDMD were independent risk factors for death in SAP patients complicated with ARDS(Wald χ2=4.297~13.536,all P<0.05),and increased OI was an independent protective factor(Wald χ2=8.346,P<0.05).The combined evaluation AUC of serum ITG αMβ2 and GSDMD expression levels results in a larger area under the curve(AUC)for mortality in SAP patients with ARDS compared to the individual evaluation of SAP complicated with ARDS,which was greater than serum ITG αMβ2 and GSDMD expression levels alone,and the differenes were statistically significant(Z=3.517,3.430,all P<0.05).Conclusion The increase of serum ITG αMβ2 and GSDMD expression levels is related to the progression and poor prognosis of patients with SAP complicated with ARDS.The combined monitoring of serum ITG αMβ2 and GSDMD expression levels has a high evaluation value for the risk of death in patients with SAP complicated with ARDS.
4.Efficacy and safety of a domestic hair follicle extraction system in extracting hair follicles from patients with androgenetic alopecia: a multicenter, prospective, randomized, self-controlled clinical trial
Kai YANG ; Jinran LIN ; Fei ZHU ; Suyun FENG ; Zheng LI ; Yue ZHANG ; Ruiming HU ; Hanxiao CHENG ; Zhentao ZHOU ; Yatong WU ; Dingquan YANG ; Jufang ZHANG ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):603-607
Objective:To compare the efficacy and safety of a domestic hair follicle extraction system versus traditional follicular unit excision (FUE) in extracting hair follicles for the treatment of androgenetic alopecia (AGA) .Methods:A multicenter, randomized, self-controlled clinical trial was conducted on AGA patients aged 18 - 59 years who were recruited from the Huashan Hospital, Fudan University, the Affiliated Hangzhou First People's Hospital, and the China-Japan Friendship Hospital between June 2023 and September 2024. Each patient's scalp was randomly divided into two sides (experimental side vs. control side) using an envelope method. The experimental side underwent robotic hair transplantation with a domestic hair follicle extraction system, and the control side underwent traditional FUE. Hair follicles were extracted from the safe donor area in the occipital region, and implanted into the ipsilateral hair loss area. The primary outcome was the hair transection rate which was calculated immediately after follicular extraction. The secondary outcomes included the hair follicle unit loss rate and the change in hair density at the recipient site on postoperative day 14. Safety was evaluated by assessing the incidence of folliculitis at the donor site on postoperative day 14 and the overall incidence of adverse events. Surgical outcomes were evaluated at 9 months after surgery. Comparisons of evaluation indicators among groups were performed by using a paired t test or Wilcoxon signed-rank test. Results:A total of 55 patients with AGA (51 males and 4 females, aged 32.71 ± 5.75 years) completed the hair follicle transplantation and postoperative follow-up. The hair transection rate ( M[ Q1, Q3]) was 6.65% (4.56%, 10.16%) in the experimental group and 5.28% (3.04%, 8.89%) in the control group (difference = 1.24%, 95% CI: -0.24%, 2.65%) . The hair follicle unit loss rate was 2.00% (1.00%, 3.50%) in the experimental group and 0.50% (0, 2.00%) in the control group, with a significant difference between the two groups ( P = 0.008) . On postoperative day 14, there was no significant difference in the hair density between the experimental group and control group (72.20 ± 25.95 per cm 2vs. 76.49 ± 30.84 per cm 2, P = 0.173) . At 9-month follow-up, both groups showed improvement in the investigator's overall score in the recipient areas. Seven adverse events occurred in 7 subjects (12.72%) in each group, and all were mild folliculitis. Conclusion:The domestic hair follicle extraction system demonstrated comparable efficacy and safety to the traditional FUE in hair transplantation.
5.Application experience of intraorbital margin drilling and midface lifting surgery combined with comprehensive blepharoplasty
Zhentao ZHOU ; Zhongxin SUN ; Hanxiao CHENG ; Fei ZHU ; Xifei QIAN ; Jufang ZHANG
Chinese Journal of Plastic Surgery 2025;41(9):945-950
Objective:To evaluate the clinical efficacy of infraorbital rim drilling midface lift combined with composite lower blepharoplasty.Methods:Retrospective analysis of clinical data from the patients who underwent combined midface lift and lower blepharoplasty at Department of Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medical, between January 2022 and February 2024.The infraorbital rim drilling midface lift combined with lower blepharoplasty was performed via a subciliary incision approach. Through a subciliary incision, the herniated orbital fat was excised, followed by fixation of the orbital septum to the infraorbital rim periosteum. Drill holes were created at the medial and lateral infraorbital rim, and arcuate suspension of the midface was performed using 2-0 absorbable sutures (SXPP1A405). Postoperative follow-up assessed midface lifting outcomes and complication rates. The wrinkle severity rating scale (WSRS) was used to grade nasolabial folds pre- and postoperatively (5-point scale: higher scores indicating more pronounced folds). Patient-reported outcomes were assessed using the Face-Q questionnaire, evaluating: (1) overall facial satisfaction, (2) satisfaction with surgical results, and (3) satisfaction with decision (scale 0-100; higher scores indicating greater satisfaction/less decisional regret). Descriptive statistical methods were employed for data analysis.Results:A total of 43 patients were enrolled, comprising 7 males and 36 females, with a mean age of (50.6±12.2) years (range: 32-73 years). Postoperative follow-up averaged (11.9±4.6)months. All patients demonstrated significant improvement in lower eyelid bags, tear trough deformity, midface elevation, and nasolabial folds. Surgical complications included: residual lower eyelid fat ( n=5), intermittent fixation point pain persisting >1 month ( n=4), mild residual tear trough deformity ( n=4), and hematoma ( n=1). Nasolabial fold WSRS scores decreased from ( 3.7±0.9 ) points to(2.9±0.6)points following surgery. In 38 patients, Face-Q scores demonstrated high satisfaction levels: appearance-related satisfaction scored (80.9 ± 10.3)points and satisfaction with decision scored (82.4 ± 8.9)points, indicating favorable patient-reported outcomes. Conclusion:The infraorbital rim drilling-assisted midface lift combined with comprehensive lower blepharoplasty effectively corrects midface ptosis while addressing lower eyelid bags. This technique provides reliable fixation points through drilling, resulting in stable and long-lasting lifting outcomes with high patient satisfaction.
6.Clinical application of hair follicle-bearing microskin transplantation in the treatment of subacute wounds
Zhongxin SUN ; Danya ZHOU ; Hanxiao CHENG ; Jiadong PAN ; Jufang ZHANG ; Xin WANG
Chinese Journal of Plastic Surgery 2025;41(10):1048-1054
Objective:To investigate the clinical efficacy of hair follicle-bearing microskin transplantation as a novel therapeutic approach for subacute wounds.Methods:A prospective randomized controlled trial was conducted from June to October 2024, involving patients with subacute wounds treated in the Department of Plastic and Reconstructive Surgery, Hand Microsurgery at Ningbo No.6 Hospital, and the Medical Aesthetics Center at Hangzhou First People’s Hospital. Participants were randomly assigned via a random number table into two groups: the observation group received hair follicle-bearing microskin transplantation, while the control group received conventional treatment including debridement, dressing changes, antimicrobial therapy, and local pressure relief. The observation endpoint was set at 6 weeks post-treatment. Outcome measures included time to complete wound healing, wound healing score (comprising five items: wound area, appearance, exudate, signs of infection, and condition of surrounding skin; total score 0-15, with a higher score indicating poorer healing), donor site recovery, adverse reactions, and patient satisfaction [rated on a 4-level scale: very satisfied, satisfied, basically satisfied, dissatisfied; satisfaction rate was calculated as (very satisfied + satisfied) cases/total cases×100%]. Data were analyzed using SPSS 25.0 software, with continuous variables expressed as Mean±SD and compared via t-test; enumeration data were expressed as cases (relative numbers) and analyzed using Fisher’s exact test. P<0.05 was considered statistically significant. Results:Sixteen patients were enrolled (8 per group), including 12 males and 4 females, with a mean age of 46 years (range: 41-71). No significant differences in baseline characteristics (gender, age, wound duration, and wound area) were observed between the two groups (all P>0.05). All procedures in the observation group were completed successfully without intraoperative or short-term postoperative complications. The donor site area was (28.2±11.8) cm 2 (9.0-50.0 cm 2). All wounds in the observation group healed completely within 2-5 weeks post-treatment, with a mean healing time of (26.2±5.0) d. The donor sites healed within two weeks, leaving only pinpoint scars. In contrast, only 4 cases in the control group achieved complete healing within the observation period (6 weeks post-treatment), with a mean healing time of (33.2±5.7) d. The other 4 patients showed no tendency to heal at 6 weeks and progressed to chronic wounds. Before treatment, no significant difference in wound healing scores was found between the two groups (9.6±2.6 vs. 9.1±2.0, t=0.43, P=0.676). At 6 weeks post-treatment, the observation group showed significantly lower wound healing scores than the control group (1.2±1.5 vs. 7.9±3.9, t=-4.48, P=0.001). At 6 weeks post-treatment, patient satisfaction in the observation group was significantly higher than that in the control group (8/8 vs. 4/8, P=0.006). Conclusion:Hair follicle-bearing microskin transplantation demonstrates significant clinical advantages in treating subacute wounds, including accelerated healing, improved aesthetic outcomes, minimal donor site morbidity, and rapid recovery.
7.Efficacy and safety of a domestic hair follicle extraction system in extracting hair follicles from patients with androgenetic alopecia: a multicenter, prospective, randomized, self-controlled clinical trial
Kai YANG ; Jinran LIN ; Fei ZHU ; Suyun FENG ; Zheng LI ; Yue ZHANG ; Ruiming HU ; Hanxiao CHENG ; Zhentao ZHOU ; Yatong WU ; Dingquan YANG ; Jufang ZHANG ; Wenyu WU
Chinese Journal of Dermatology 2025;58(7):603-607
Objective:To compare the efficacy and safety of a domestic hair follicle extraction system versus traditional follicular unit excision (FUE) in extracting hair follicles for the treatment of androgenetic alopecia (AGA) .Methods:A multicenter, randomized, self-controlled clinical trial was conducted on AGA patients aged 18 - 59 years who were recruited from the Huashan Hospital, Fudan University, the Affiliated Hangzhou First People's Hospital, and the China-Japan Friendship Hospital between June 2023 and September 2024. Each patient's scalp was randomly divided into two sides (experimental side vs. control side) using an envelope method. The experimental side underwent robotic hair transplantation with a domestic hair follicle extraction system, and the control side underwent traditional FUE. Hair follicles were extracted from the safe donor area in the occipital region, and implanted into the ipsilateral hair loss area. The primary outcome was the hair transection rate which was calculated immediately after follicular extraction. The secondary outcomes included the hair follicle unit loss rate and the change in hair density at the recipient site on postoperative day 14. Safety was evaluated by assessing the incidence of folliculitis at the donor site on postoperative day 14 and the overall incidence of adverse events. Surgical outcomes were evaluated at 9 months after surgery. Comparisons of evaluation indicators among groups were performed by using a paired t test or Wilcoxon signed-rank test. Results:A total of 55 patients with AGA (51 males and 4 females, aged 32.71 ± 5.75 years) completed the hair follicle transplantation and postoperative follow-up. The hair transection rate ( M[ Q1, Q3]) was 6.65% (4.56%, 10.16%) in the experimental group and 5.28% (3.04%, 8.89%) in the control group (difference = 1.24%, 95% CI: -0.24%, 2.65%) . The hair follicle unit loss rate was 2.00% (1.00%, 3.50%) in the experimental group and 0.50% (0, 2.00%) in the control group, with a significant difference between the two groups ( P = 0.008) . On postoperative day 14, there was no significant difference in the hair density between the experimental group and control group (72.20 ± 25.95 per cm 2vs. 76.49 ± 30.84 per cm 2, P = 0.173) . At 9-month follow-up, both groups showed improvement in the investigator's overall score in the recipient areas. Seven adverse events occurred in 7 subjects (12.72%) in each group, and all were mild folliculitis. Conclusion:The domestic hair follicle extraction system demonstrated comparable efficacy and safety to the traditional FUE in hair transplantation.
8.Study on the Correlation between Serum ITG αMβ2,GSDMD Levels and Disease Severity,Prognostic Prediction in Patients with Severe Acute Pancreatitis Complicated with ARDS
Xia LIU ; Ziwei ZHOU ; Fei CHENG ; Hanxiao WANG ; Qianxiu LIAO
Journal of Modern Laboratory Medicine 2025;40(5):124-130
Objective To investigate the relationship between the expression levels of serum integrin αMβ2(ITG αMβ2)and gasdermin D(GSDMD)in patients with severe acute pancreatitis(SAP)complicated with acute respiratory distress syndrome(ARDS)and the severity of the disease and its value in predicting prognosis.Methods A total of 147 patients with SAP complicated with ARDS(ARDS group)admitted to the Department of Intensive Care Medicine of the Southwest Jiaotong University Affiliated Hospital(Chengdu Third People's Hospital)from August 2021 to October 2023 were selected.According to the oxygenation index(OI),they were divided into mild group(n=35),moderate group(n=46)and severe group(n=66).According to the 28-day prognosis,they were divided into death group(n=77)and survival group(n=70).Another 147 SAP patients without ARDS at the same time period were selected(non-ARDS group).The expression levels of serum ITG αMβ2 and GSDMD were detected by enzyme-linked immunosorbent assay.Spearman method was used to analyze the correlation between serum ITG αMβ2,GSDMD expression levels and OI in patients with SAP complicated with ARDS.Multivariate Logistic regression was used to analyze the factors of death in patients with SAP complicated with ARDS.Receiver operating characteristic(ROC)curve was used to analyze the value of serum ITG αMβ2,GSDMD expression levels in evaluating the death of patients with SAP complicated with ARDS.Results Compared with the non-ARDS group,the expression levels of serum ITG αMβ2(31.95±8.17 ng/L vs 53.33±12.22 ng/L)and GSDMD(2.25±0.55 ng/ml vs 4.39±1.18 ng/ml)in the ARDS group were increased,and the differences were statistically significant(t=17.637,19.899,all P<0.05).The expression levels of serum ITG αMβ2 and GSDMD in mild group,moderate group and severe group increased in turn,and the differences were statistically significant(F=163.069,194.028,all P<0.05).The expression levels of serum ITG αMβ2 and GSDMD were negatively correlated with OI in patients with SAP complicated with ARDS(r=-0.787,-0.778,all P<0.05).The 28-day mortality rate of 147 SAP patients with ARDS was 52.38%(77/147).Compared with the survival group,the expression levels of serum ITG αMβ2(46.96±10.28 ng/L vs 59.11±10.94 ng/L)and GSDMD(3.74±0.98 ng/ml vs 4.98±1.04 ng/ml)in the death group were increased,and the differences were statistically significant(t=6.920,7.415,all P<0.05).The number of extrapulmonary organ failure≥2,prolonged mechanical ventilation time,increased acute physiological and chronic health assessment II score,and increased ITG αMβ2.and GSDMD were independent risk factors for death in SAP patients complicated with ARDS(Wald χ2=4.297~13.536,all P<0.05),and increased OI was an independent protective factor(Wald χ2=8.346,P<0.05).The combined evaluation AUC of serum ITG αMβ2 and GSDMD expression levels results in a larger area under the curve(AUC)for mortality in SAP patients with ARDS compared to the individual evaluation of SAP complicated with ARDS,which was greater than serum ITG αMβ2 and GSDMD expression levels alone,and the differenes were statistically significant(Z=3.517,3.430,all P<0.05).Conclusion The increase of serum ITG αMβ2 and GSDMD expression levels is related to the progression and poor prognosis of patients with SAP complicated with ARDS.The combined monitoring of serum ITG αMβ2 and GSDMD expression levels has a high evaluation value for the risk of death in patients with SAP complicated with ARDS.
9.Application experience of intraorbital margin drilling and midface lifting surgery combined with comprehensive blepharoplasty
Zhentao ZHOU ; Zhongxin SUN ; Hanxiao CHENG ; Fei ZHU ; Xifei QIAN ; Jufang ZHANG
Chinese Journal of Plastic Surgery 2025;41(9):945-950
Objective:To evaluate the clinical efficacy of infraorbital rim drilling midface lift combined with composite lower blepharoplasty.Methods:Retrospective analysis of clinical data from the patients who underwent combined midface lift and lower blepharoplasty at Department of Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital, Westlake University School of Medical, between January 2022 and February 2024.The infraorbital rim drilling midface lift combined with lower blepharoplasty was performed via a subciliary incision approach. Through a subciliary incision, the herniated orbital fat was excised, followed by fixation of the orbital septum to the infraorbital rim periosteum. Drill holes were created at the medial and lateral infraorbital rim, and arcuate suspension of the midface was performed using 2-0 absorbable sutures (SXPP1A405). Postoperative follow-up assessed midface lifting outcomes and complication rates. The wrinkle severity rating scale (WSRS) was used to grade nasolabial folds pre- and postoperatively (5-point scale: higher scores indicating more pronounced folds). Patient-reported outcomes were assessed using the Face-Q questionnaire, evaluating: (1) overall facial satisfaction, (2) satisfaction with surgical results, and (3) satisfaction with decision (scale 0-100; higher scores indicating greater satisfaction/less decisional regret). Descriptive statistical methods were employed for data analysis.Results:A total of 43 patients were enrolled, comprising 7 males and 36 females, with a mean age of (50.6±12.2) years (range: 32-73 years). Postoperative follow-up averaged (11.9±4.6)months. All patients demonstrated significant improvement in lower eyelid bags, tear trough deformity, midface elevation, and nasolabial folds. Surgical complications included: residual lower eyelid fat ( n=5), intermittent fixation point pain persisting >1 month ( n=4), mild residual tear trough deformity ( n=4), and hematoma ( n=1). Nasolabial fold WSRS scores decreased from ( 3.7±0.9 ) points to(2.9±0.6)points following surgery. In 38 patients, Face-Q scores demonstrated high satisfaction levels: appearance-related satisfaction scored (80.9 ± 10.3)points and satisfaction with decision scored (82.4 ± 8.9)points, indicating favorable patient-reported outcomes. Conclusion:The infraorbital rim drilling-assisted midface lift combined with comprehensive lower blepharoplasty effectively corrects midface ptosis while addressing lower eyelid bags. This technique provides reliable fixation points through drilling, resulting in stable and long-lasting lifting outcomes with high patient satisfaction.
10.Clinical application of hair follicle-bearing microskin transplantation in the treatment of subacute wounds
Zhongxin SUN ; Danya ZHOU ; Hanxiao CHENG ; Jiadong PAN ; Jufang ZHANG ; Xin WANG
Chinese Journal of Plastic Surgery 2025;41(10):1048-1054
Objective:To investigate the clinical efficacy of hair follicle-bearing microskin transplantation as a novel therapeutic approach for subacute wounds.Methods:A prospective randomized controlled trial was conducted from June to October 2024, involving patients with subacute wounds treated in the Department of Plastic and Reconstructive Surgery, Hand Microsurgery at Ningbo No.6 Hospital, and the Medical Aesthetics Center at Hangzhou First People’s Hospital. Participants were randomly assigned via a random number table into two groups: the observation group received hair follicle-bearing microskin transplantation, while the control group received conventional treatment including debridement, dressing changes, antimicrobial therapy, and local pressure relief. The observation endpoint was set at 6 weeks post-treatment. Outcome measures included time to complete wound healing, wound healing score (comprising five items: wound area, appearance, exudate, signs of infection, and condition of surrounding skin; total score 0-15, with a higher score indicating poorer healing), donor site recovery, adverse reactions, and patient satisfaction [rated on a 4-level scale: very satisfied, satisfied, basically satisfied, dissatisfied; satisfaction rate was calculated as (very satisfied + satisfied) cases/total cases×100%]. Data were analyzed using SPSS 25.0 software, with continuous variables expressed as Mean±SD and compared via t-test; enumeration data were expressed as cases (relative numbers) and analyzed using Fisher’s exact test. P<0.05 was considered statistically significant. Results:Sixteen patients were enrolled (8 per group), including 12 males and 4 females, with a mean age of 46 years (range: 41-71). No significant differences in baseline characteristics (gender, age, wound duration, and wound area) were observed between the two groups (all P>0.05). All procedures in the observation group were completed successfully without intraoperative or short-term postoperative complications. The donor site area was (28.2±11.8) cm 2 (9.0-50.0 cm 2). All wounds in the observation group healed completely within 2-5 weeks post-treatment, with a mean healing time of (26.2±5.0) d. The donor sites healed within two weeks, leaving only pinpoint scars. In contrast, only 4 cases in the control group achieved complete healing within the observation period (6 weeks post-treatment), with a mean healing time of (33.2±5.7) d. The other 4 patients showed no tendency to heal at 6 weeks and progressed to chronic wounds. Before treatment, no significant difference in wound healing scores was found between the two groups (9.6±2.6 vs. 9.1±2.0, t=0.43, P=0.676). At 6 weeks post-treatment, the observation group showed significantly lower wound healing scores than the control group (1.2±1.5 vs. 7.9±3.9, t=-4.48, P=0.001). At 6 weeks post-treatment, patient satisfaction in the observation group was significantly higher than that in the control group (8/8 vs. 4/8, P=0.006). Conclusion:Hair follicle-bearing microskin transplantation demonstrates significant clinical advantages in treating subacute wounds, including accelerated healing, improved aesthetic outcomes, minimal donor site morbidity, and rapid recovery.

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