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.

Objective:To discuss the role of changes of serum total bile acid(TBA)levels induced by long-term high-fat diet in the occurrence of supraventricular arrhythmia(SVA)in the apolipoprotein E knockout(ApoE-/-)mice,and to clarify its mechanism.Methods:Twenty ApoE-/-mice were randomly divided into normal diet group and high-fat diet(HFD)group(n=10);after 20 weeks of feeding,surface electrocardiogram was used to detect cardiac electrophysiology of the mice in various groups;echocardiography was used to detect cardiac systolic function and structure in the mice in various groups;enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of blood lipids,total bile acid(TBA)and inflammatory factors in the mice in various groups;hematoxylin-eosin(HE)staining was used to detect cardiac inflammatory response in the mice in various groups;Masson staining was used to observe myocardial fibrosis degree in the mice in various groups.Results:Compared with normal diet group,4 cases of junctional premature beat(JPB)/junctional tachycardia(JT),1 case of premature atrial contraction(PAC)and 1 case of premature ventricular contraction(PVC)were found in HFD group,while only 1 case of JPB/JT and 1 case of PAC were found in normal diet group.Compared with normal diet group,the heart rate of the mice in HFD group was significantly decreased(P<0.05);the QRS and QT intervals were significantly prolonged(P<0.05);the ejection fraction(EF)and fractional shortening(FS)were significantly decreased(P<0.05);the end-diastolic volume(EDV)was increased(P<0.05),but there was no significant difference in end-systolic volume(ESV)between groups(P>0.05);the left ventricular internal diameter at end-diastole(LVIDd)and left ventricular internal diameter at end-systole(LVIDs)were significantly increased(P<0.05).There were no significant differences in plasma total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-c)and low-density lipoprotein(LDL-c)levels and body weight between normal diet group and HFD group(P>0.05).Compared with normal diet group,the TBA level of the mice in HFD group was significantly increased(P<0.05).There were no significant differences in interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1),and C-X-C motif chemokine ligand 1(CXCL-1)levels between HFD group and normal diet group.Compared with normal diet group,the interleukin-1β(IL-1β)level in HFD group showed an increasing trend,but there was no significant difference between groups(P>0.05).The HE staining results showed that the inflammatory cell infiltration was similar between HFD group and normal diet group.The Masson staining results showed that compared with normal diet group,the fibrosis of the mice in HFD group showed an increasing trend,but there was no significant difference in myocardial fibrosis area between groups(P>0.05).Conclusion:Long-term high-fat diet may increase serum TBA level in ApoE-/-mice,which may induce SVA.

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.

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.

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.

Objective:To evaluate the detection performance of left ventricular ejection fraction (LVEF) in patients with chronic renal failure (CRF) by an artificial intelligence (AI) model based on yolox framework integrating left ventricular segmentation and critical point detection.Methods:From January 2019 to June 2023, a total of 4 284 echocardiographic images of 2 000 adults aged 18-80 years without segmental wall motion abnormalities, structural heart disease, cardiac surgery or cardiomyopathy were collected in Henan Provincial People′s Hospital to delineate the endocardial membrane, as a training set, an AI model based on yolox framework integrating left ventricular segmentation and critical point detection was established. The images were divided into the training set( n=1 675) and the test set( n=325) in a ratio of about 5∶1. All 228 echocardiographic images of 100 normal adult volunteers who were treated in Henan Provincial Chest Hospital from May 2020 to May 2021 were collected as external test set validation. All 792 echocardiographic images of 204 patients treated in Henan Provincial People′s Hospital from April 2019 to June 2023 were continuously enrolled to evaluate the measurement efficiency of AI model. Spearman correlation statistical method was used to analyze the consistency of AI model measurement with manual measurement and TomTec software measurement methods of 3 senior echocardiographic professionals. Subjects were divided into clear image group, unclear image group, normal LVEF group and reduced LVEF group, the differences of general data between the two groups were compared. The correlation coefficient(ICC) within the group was calculated to analyze the consistency, so as to evaluate the model performance. Results:LVEF measured by AI model was significantly correlated with both manual measurement and TomTec model measurement ( rs=0.834, 0.826; all P<0.01). ICC values of the clear image group and the unclear image group were 0.96 and 0.97, respectively. ICC values for all subjects, normal LVEF group and reduced LVEF group were 0.96, 0.90 and 0.96, respectively. Conclusions:The AI model based on yolox framework integrating left ventricular segmentation and critical point detection has good diagnostic performance in the automatic measurement of LVEF in patients with CRF.

Objective:To summarize the clinical characteristics in of different antibody subtypes in of patients with antisynthetase syndrome (ASS) complicated with interstitial lung disease (ILD).Methods:A retrospective analysis was conducted on 132 ASS-ILD patients at the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial People′s Hospital), encompassing a period from December 2019 to June 2023. The data included were basic demographic information, clinical features, laboratory test results, chest computed tomography (CT) scans, and pulmonary lung function tests. Patients were categorized into distinct subtypes based on anti-aminoacyl tRNA synthetase (ARS) antibodies. Statistical analysis was performed using a t-test for comparing means between two samples with equal variance, the Mann-Whitney U test for non-normally distributed continuous data, and the chi-square ( χ2) test or Fisher′s exact test for categorical variables. Results:The most prevalent subtype of anti-synthetase antibody was anti-histidine antibody (Jo-1), accounting for 60 of 132 cases (45.5%), followed by anti-glycine-based tRNA synthetase antibody (EJ) (33/132, 2 5.0%), anti-tRNA synthase antibody (PL-7) (26/132, 19.7%), anti-alanine-based tRNA synthetase antibody (PL-12) (7.6%, 10/132), anti-isoleucine-tRNA synthase antibody (OJ) (3/132, 2.2%). The presence of anti-Ro-52 antibodies was significantly associated with rapidly progressive ILD. In patients with different subtypes of ASS-ILD, the presence of anti-Jo-1 antibodies is was positive in 28 cases (46.7%), and the combination of infection is was more common than in other groups ( χ2=0.15, P=0.047). The group with positive anti-EJ antibodies has had a significant decline in lung function, and cough is was more common in 31 cases (93.9%) than in other groups ( P<0.05); the group with positive anti-PL-12 antibodies has had a more pronounced decline in lung function than other groups ( P<0.05), and fever (7 cases, 70.0%) wais more common than in other groups ( χ2=0.02, P=0.022). Conclusion:Anti-Jo-1, Anti-PL-7, and Anti-PL-12 antibodies were are observed more frequently in patients with ILD. Furthermore, a significant deterioration in lung function was is observed in patients testing positive for anti-PL-12 and anti-EJ antibodies.

Objective:To observe the attention processing characteristics of the pilots experiencing black hole illusion, and to provide quantitative data references for flight simulation training guided by eye movement fixation based on the eye movement mode of the pilots with high flight performance score.Methods:The pilots who underwent the transformation training were selected by cluster sampling. Their original flight performance scores were converted into percentile grades. The top 10 and bottom 10 pilots were assigned as high and low score groups. Their eye movement data were recorded when they were completing the night approach and landing task on the flight illusion simulator. The correlation between eye movement data and flight performance in the simulation task were analyzed, and the eye movement patterns of pilots with different flight performance were compared.Results:Thirty-six valid subjects were selected. A total of 12 eye movement indexes were correlated with flight performance ( r=0.334-0.398, all P<0.05). Three eye movement indexes, including peak velocity of exit saccade from attitude indicator of head-up display (HUD), the percentage of total duration of fixations on airspeed indicator of HUD to the total task duration and average duration of whole fixations on attitude indicator could establish a linear regression model with flight performance ( R2=0.422, F=7.77, P<0.001). The percentage of total duration of whole fixations on airspeed indicator of HUD to the total task duration in high score group [(4.38±3.48)%] was higher than that in low score group [(1.72±1.32)%], and the difference was statistically significant ( t=2.25, P=0.045). And the average peak velocity of exit saccade from attitude indicator of HUD in high score group [(358.85±171.40)°/s] was higher than that in low score group [(221.14±92.60)°/s], and the difference was statistically significant ( t=2.24, P=0.038). Conclusions:Eye movement index in the night approach and landing task can be used as an evaluation index of attention ability of pilots in black hole illusion simulation and experience task.

Objective:To observe the attention processing characteristics of the pilots experiencing black hole illusion, and to provide quantitative data references for flight simulation training guided by eye movement fixation based on the eye movement mode of the pilots with high flight performance score.Methods:The pilots who underwent the transformation training were selected by cluster sampling. Their original flight performance scores were converted into percentile grades. The top 10 and bottom 10 pilots were assigned as high and low score groups. Their eye movement data were recorded when they were completing the night approach and landing task on the flight illusion simulator. The correlation between eye movement data and flight performance in the simulation task were analyzed, and the eye movement patterns of pilots with different flight performance were compared.Results:Thirty-six valid subjects were selected. A total of 12 eye movement indexes were correlated with flight performance ( r=0.334-0.398, all P<0.05). Three eye movement indexes, including peak velocity of exit saccade from attitude indicator of head-up display (HUD), the percentage of total duration of fixations on airspeed indicator of HUD to the total task duration and average duration of whole fixations on attitude indicator could establish a linear regression model with flight performance ( R2=0.422, F=7.77, P<0.001). The percentage of total duration of whole fixations on airspeed indicator of HUD to the total task duration in high score group [(4.38±3.48)%] was higher than that in low score group [(1.72±1.32)%], and the difference was statistically significant ( t=2.25, P=0.045). And the average peak velocity of exit saccade from attitude indicator of HUD in high score group [(358.85±171.40)°/s] was higher than that in low score group [(221.14±92.60)°/s], and the difference was statistically significant ( t=2.24, P=0.038). Conclusions:Eye movement index in the night approach and landing task can be used as an evaluation index of attention ability of pilots in black hole illusion simulation and experience task.

Objective:To investigate the efficacy of internal fixation maintenance after fracture-related infection (FRI).Methods:Retrospectively analyzed were the data of 81 patients with deep FRI after 6 weeks of internal fixation who had been treated with hardware maintenance at Department of Orthopedics, The Second Hospital Affiliated to School of Medicine, Zhejiang University between 2013 and 2021. They were 61 males and 20 females, aged from 11 to 73 years (average, 11 years). After admission, the patients received bacterial culture, thorough debridement, negative pressure suction, soft tissue repair, and local and intravenous antibiotics. If a joint was affected by FRI, its cavity was cleaned and drained. Infection control and fracture healing were regularly observed in all patients. A treatment was considered successful when the internal fixation was maintained until fracture union, and considered as unsuccessful when the internal fixation was removed before fracture union. Risk factors associated with treatment failure were identified from gender, age, smoking, diabetes, fracture type, methicillin-resistant Staphylococcus aureus (MRSA) infection, methicillin-susceptible staphylococcus (MSSA) infection, Pseudomonas aeruginosa infection, Escherichia coli infection, infection by two kinds of bacteria, negative bacterial culture, early infection (within 2 weeks) and local use of antibiotics.Results:All patients were followed up for an average of 30 months (from 6 to 84 months). Fracture union was achieved in 62 (76.5%) patients with infection control and internal fixation retained. Masquelet technique was used to treat bone defects in 2 patients; a muscle flap or skin flap was used to reconstruct soft tissue coverage in 11 cases; fracture union was achieved by antibiotics and dressing changes in 2 patients with sinus tract. Amputation was performed in one unsuccessful case due to uncontrollable infection, and internal fixation was changed to external fixation in the other 18 unsuccessful cases, of which 3 achieved final bone union after application of Masquelet technique, 7 achieved final bone union after application of bone transfer technique, and 3 achieved soft tissue coverage after reconstruction with flap technique. Pseudomonas aeruginosa infection, open fractures and FRI for more than 2 weeks were high risk factors for failure in internal fixation maintenance ( P<0.05). Conclusions:If internal fixation is still stable and effective, hardware maintenance should be tried first in the patients with FRI within 6 weeks after fracture internal fixation. Muscle flap or skin flap surgery should be performed as soon as possible to effectively control infection and promote fracture union in the patients with soft tissue defects after thorough and effective debridement. History of open fracture, Pseudomonas aeruginosa infection, and FRI for over 2 weeks may be risk factors for failure in internal fixation maintenance.