Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical intervention remains the most effective therapeutic approach for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive procedures combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Objective To investigate the effect of extracorporeal diaphragmatic pacing(EDP)on wea-ning patients undergoing mechanical ventilation after acute Stanford type A aortic dissection(ATAAD)sur-gery.Methods A total of 80 patients who underwent ATAAD surgery and required mechanical ventilation in the cardiac intensive care unit(CCU)of our hospital from October 2023 to October 2024 were selected as the study subjects.They were randomly divided into a control group and an intervention group using a random number table method,with 40 patients in each group.Both groups of patients received conventional clinical drug therapy,mechanical ventilation support,and rehabilitation exercises after surgery.The intervention group additionally underwent EDP therapy on this basis.The clinical data,mechanical ventilation time,weaning out-comes,oxygenation index,tidal volume,and changes in diaphragm function parameters were compared be-tween two groups of patients.Results Compared with the control group,the intervention group had a shorter mechanical ventilation time[77.00(59.00,133.63)h]vs.54.50(49.00,105.25)h],offline success rate(72.5％vs.90.0％),oxygenation index[202.90(178.63,240.05)mmHg vs.236.50(196.00,293.75)mm-Hg],higher tidal volume[(496.00±111.95)mL vs.(563.23±133.98)mL],with a statistically significant difference(P＜0.05).Compared with the control group,diaphragmatic excursion(DE)of both sides[11.90(8.50,16.50)mm vs.15.30(12.20,19.80)mm;12.60(10.80,14.90)mm vs.14.70(11.43,19.20)mm]and diaphragmatic thickening fraction(DTF)of left and right side[21.75％(17.53％,27.13％)vs.26.30％(21.10％,32.40％);24.00％(17.68％,29.35％)vs.28.30％(22.43％,33.40％)]of the intervention group were higher,and the differences were statistically significant(P＜0.05).Conclusion EDP can enhance the function of the diaphragm in patients,shorten the duration of mechanical ventilation,improve the success rate of wea-ning,and improve the weaning outcomes of mechanically ventilated patients after ATAAD surgery.

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical intervention remains the most effective therapeutic approach for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive procedures combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Objective:To investigate the effect of laboratory indicators on hair loss in patients with female pattern hair loss (FPHL).Methods:Patients with FPHL who visited the Outpatient Clinic of the Department of Medical Aesthetics in Hangzhou First People’s Hospital from November 2022 to November 2023 were selected as the study group, and healthy women who matched the age of the study group in the physical examination center during the same period were selected as the control group. The general information of the patient was recorded, and was also tested by trichoscopy to rule out other patterns of alopecia. Representative indicators including testosterone, dehydroepiandrosterone sulfate(DHEA-S), thyroid-stimulating hormone, 25-hydroxyvitamin D, and serum ferritin were selected from laboratory tests for further analysis. Otherwise, the proportion of deficiency in vitamin D(<20 ng/ml) was calculated based on 25-hydroxyvitamin D levels (number of deficiency cases/total number of cases in each group×100%). Count data were presented as samples (percentages), and chi-square test was used for comparison between groups. Normally distributed continuous data were presented with Mean±SD, independent samples t-test was used for comparison between groups, M( Q1, Q3) was used for non-normally distributed continuous data, and Wilcoxon rank-sum test was used for comparison between groups. Multivariate logistic regression was used to analyze the influencing factors of FPHL. P<0.05 was statistically significant. Results:A total of 37 patients were selected in both groups. The mean age was (28.8±1.3) years in the study group and (29.6±0.9) years in the control group ( t=0.49, P=0.625). The body mass index was (22.8±0.4) kg/m 2 in the study group, and (23.5±0.3) kg/m 2 in the control group ( t=1.26, P=0.211). The testosterone level was 0.58 (0.49, 0.79) nmol/L in the study group, and 0.54 (0.50, 0.78) nmol/L in the control group( Z=1.42, P=0.157). The level of DHEA-S was 6.21 (5.18, 9.60) μmol/L in the study group, and 6.20 (5.20, 9.34) μmol/L in the control group ( Z=2.75, P=0.006). The level of thyroid-stimulating hormone was 2.56 (1.55, 3.66) mU/L in the study group and 1.49 (1.05, 2.65) mU/L in the control group ( Z=2.51, P=0.012). The level of 25-hydroxyvitamin D was 15.44 (11.80, 21.20) ng/ml in the study group, and the level of 25-hydroxyvitamin D was 20.32 (12.07, 21.20) ng/ml in the control group ( Z=2.30, P=0.021), and the proportion of 25-hydroxyvitamin D deficiency in the study group was 64.9% (24/37), which was higher than that in the control group [40.5% (15/37)] ( χ2=4.39, P=0.036). The serum ferritin level was 64.44 (39.47, 133.45) μg/L in the study group and 67.75 (52.63, 143.83) μg/L in the control group ( Z=0.70, P=0.484). The results of multivariate logistic regression analysis showed that the risk of FPHL was increased by the high level of DHEA-S and thyroid-stimulating hormone, and the low level of 25-hydroxyvitamin D (all P<0.05). Conclusion:Abnormal level of DHEA-S, thyroid-stimulating hormone, and 25-hydroxyvitamin D may be risk factors for FPHL.

Objective:To study the effect of bridge orbicularis oculi muscle flap blepharoptosis in the treatment of post-burn scar contracture ectropion.Methods:The clinical data of patients wih post-burn cicatricial ectropion treated with bridge orbicularis oculi muscle flap from April 2006 to September 2020 of Department of Plastic Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University were analyzed retrospectively. For patients with severe eyelid scar contracture caused by head and face burns, after releasing the scar and resetting the eyelid margin, orbicularis oculi muscle flaps were made at the base of the upper and lower eyelid release incision, crossed the muscle flap over the eyelid adhesion point of the eye fissure, by performed bridge cross transfer, and fixed to the orbicularis oculi muscle at the base of the release incision to form eyelid adhesion. H-shaped full-thickness skin graft or medium-thickness skin graft was performed on the defect wound during the operation. Tie-over dressing fixation in the skin graft area. One year after the operation, it was confirmed that the skin graft was stable and there was no recurrence of ectropion, and then cut the adhesion. Follow-up for more than one year after the operation, foreign body sensation, conjunctival sac pusc, skin graft survival, success rate of eyelid adhesion, anti-stretching effect of muscle flap, skin retraction rate and complications were observed. The distances between eyelid margins preoperative and after incision of eyelid adhesion were measured. SPSS 25.0 software was used for data statistics, measurement data was represented by M ( Q1, Q3), and counting data was represented by cases. Results:Fourteen patients (23 eyes) were included in this study, including 11 males and 3 females, aged 41.5 (32.5, 47.0) years, and the time from burn to this treatment was 13.5 (10, 24) months. 5 cases (7 eyes) were not treated with skin grafting or blepharoptosis after burn, and 9 cases (16 eyes) were treated with blepharoptosis and/or skin transplantation. The area of skin graft during operation was 37 mm ×18 mm to 52 mm ×39 mm. Before operation, the distance between the upper and lower eyelid margins was 14 (12, 14) mm when eyes were open, and 6 (5, 9) mm when eyes were closed. After eyelid adhesion surgery, the patient had no foreign body sensation and infection, and all the skin grafts survived. The success rate of blepharoptosis was 100%, and there was no accidental rupture or elongation. The eyelid adhesions contracted synchronously when the patients closed their eyes, and the muscle flap had good anti-stretching effect. The duration of blepharoptosis was 13(12, 24) months, during which no complications or adverse reactions occurred. The average skin graft retraction rate was 9% (5%, 10%) in half a year. After incision of the orbicularis oculi muscle flap, the distance between the upper and lower eyelid margins was 9 (8, 9) mm when the eyes were open, and 0 (0, 0) mm when the eyes were closed.Conclusion:Bridge orbicularis oculi muscle flap tarsorrhaphy can provide long-term tarsorrhaphy, effectively reduce skin contracture after eyelid skin grafting, and has a stable therapeutic effect on postburn ectropion.

Objective:To investigate the effect of laboratory indicators on hair loss in patients with female pattern hair loss (FPHL).Methods:Patients with FPHL who visited the Outpatient Clinic of the Department of Medical Aesthetics in Hangzhou First People’s Hospital from November 2022 to November 2023 were selected as the study group, and healthy women who matched the age of the study group in the physical examination center during the same period were selected as the control group. The general information of the patient was recorded, and was also tested by trichoscopy to rule out other patterns of alopecia. Representative indicators including testosterone, dehydroepiandrosterone sulfate(DHEA-S), thyroid-stimulating hormone, 25-hydroxyvitamin D, and serum ferritin were selected from laboratory tests for further analysis. Otherwise, the proportion of deficiency in vitamin D(<20 ng/ml) was calculated based on 25-hydroxyvitamin D levels (number of deficiency cases/total number of cases in each group×100%). Count data were presented as samples (percentages), and chi-square test was used for comparison between groups. Normally distributed continuous data were presented with Mean±SD, independent samples t-test was used for comparison between groups, M( Q1, Q3) was used for non-normally distributed continuous data, and Wilcoxon rank-sum test was used for comparison between groups. Multivariate logistic regression was used to analyze the influencing factors of FPHL. P<0.05 was statistically significant. Results:A total of 37 patients were selected in both groups. The mean age was (28.8±1.3) years in the study group and (29.6±0.9) years in the control group ( t=0.49, P=0.625). The body mass index was (22.8±0.4) kg/m 2 in the study group, and (23.5±0.3) kg/m 2 in the control group ( t=1.26, P=0.211). The testosterone level was 0.58 (0.49, 0.79) nmol/L in the study group, and 0.54 (0.50, 0.78) nmol/L in the control group( Z=1.42, P=0.157). The level of DHEA-S was 6.21 (5.18, 9.60) μmol/L in the study group, and 6.20 (5.20, 9.34) μmol/L in the control group ( Z=2.75, P=0.006). The level of thyroid-stimulating hormone was 2.56 (1.55, 3.66) mU/L in the study group and 1.49 (1.05, 2.65) mU/L in the control group ( Z=2.51, P=0.012). The level of 25-hydroxyvitamin D was 15.44 (11.80, 21.20) ng/ml in the study group, and the level of 25-hydroxyvitamin D was 20.32 (12.07, 21.20) ng/ml in the control group ( Z=2.30, P=0.021), and the proportion of 25-hydroxyvitamin D deficiency in the study group was 64.9% (24/37), which was higher than that in the control group [40.5% (15/37)] ( χ2=4.39, P=0.036). The serum ferritin level was 64.44 (39.47, 133.45) μg/L in the study group and 67.75 (52.63, 143.83) μg/L in the control group ( Z=0.70, P=0.484). The results of multivariate logistic regression analysis showed that the risk of FPHL was increased by the high level of DHEA-S and thyroid-stimulating hormone, and the low level of 25-hydroxyvitamin D (all P<0.05). Conclusion:Abnormal level of DHEA-S, thyroid-stimulating hormone, and 25-hydroxyvitamin D may be risk factors for FPHL.

Objective:To study the effect of bridge orbicularis oculi muscle flap blepharoptosis in the treatment of post-burn scar contracture ectropion.Methods:The clinical data of patients wih post-burn cicatricial ectropion treated with bridge orbicularis oculi muscle flap from April 2006 to September 2020 of Department of Plastic Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University were analyzed retrospectively. For patients with severe eyelid scar contracture caused by head and face burns, after releasing the scar and resetting the eyelid margin, orbicularis oculi muscle flaps were made at the base of the upper and lower eyelid release incision, crossed the muscle flap over the eyelid adhesion point of the eye fissure, by performed bridge cross transfer, and fixed to the orbicularis oculi muscle at the base of the release incision to form eyelid adhesion. H-shaped full-thickness skin graft or medium-thickness skin graft was performed on the defect wound during the operation. Tie-over dressing fixation in the skin graft area. One year after the operation, it was confirmed that the skin graft was stable and there was no recurrence of ectropion, and then cut the adhesion. Follow-up for more than one year after the operation, foreign body sensation, conjunctival sac pusc, skin graft survival, success rate of eyelid adhesion, anti-stretching effect of muscle flap, skin retraction rate and complications were observed. The distances between eyelid margins preoperative and after incision of eyelid adhesion were measured. SPSS 25.0 software was used for data statistics, measurement data was represented by M ( Q1, Q3), and counting data was represented by cases. Results:Fourteen patients (23 eyes) were included in this study, including 11 males and 3 females, aged 41.5 (32.5, 47.0) years, and the time from burn to this treatment was 13.5 (10, 24) months. 5 cases (7 eyes) were not treated with skin grafting or blepharoptosis after burn, and 9 cases (16 eyes) were treated with blepharoptosis and/or skin transplantation. The area of skin graft during operation was 37 mm ×18 mm to 52 mm ×39 mm. Before operation, the distance between the upper and lower eyelid margins was 14 (12, 14) mm when eyes were open, and 6 (5, 9) mm when eyes were closed. After eyelid adhesion surgery, the patient had no foreign body sensation and infection, and all the skin grafts survived. The success rate of blepharoptosis was 100%, and there was no accidental rupture or elongation. The eyelid adhesions contracted synchronously when the patients closed their eyes, and the muscle flap had good anti-stretching effect. The duration of blepharoptosis was 13(12, 24) months, during which no complications or adverse reactions occurred. The average skin graft retraction rate was 9% (5%, 10%) in half a year. After incision of the orbicularis oculi muscle flap, the distance between the upper and lower eyelid margins was 9 (8, 9) mm when the eyes were open, and 0 (0, 0) mm when the eyes were closed.Conclusion:Bridge orbicularis oculi muscle flap tarsorrhaphy can provide long-term tarsorrhaphy, effectively reduce skin contracture after eyelid skin grafting, and has a stable therapeutic effect on postburn ectropion.

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical treatment is currently the best solution for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical treatment is currently the best solution for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Objective:To explore the applicability of the distance between facial marks classification in evaluating the severity of androgenic alopecia in men.Methods:From June to December 2019, the male Chinese with diagnosis of androgenic alopecia were evaluated in the specific clinic of alopecia of Hangzhou First People’s Hospital according to the distance between facial marks and BASP(basic and specific) classification. The classification based on the distance between facial marks measures the distance from the facial marks of the anterior hairline to the horizontal line of the eyebrow and the longest radius of hair loss in the hair rotation center, the hair recession of the patient’s forehead (F), temporal (M) and vertex (V) parts. The hair loss in each region is rated as 0-3 grade from light to heavy, and the final hair loss grading is expressed as FnMnVn, such as F1M2V0. The highest grade of hair loss in F, M and V is the overall grade of hair loss. SPSS 25.0 software was used to statistically analyze the general data of patients, and Kappa test was used to evaluate the consistency between the results of the distance classification and BASP classification. The repeatability of the distance classification was tested by the repetition rate of three hair loss specialists. When two or more specialists gave the same evaluation among the three hair loss specialists, the result was regarded as the standard result. The ease of use of the distance between facial marks classification was tested by the consistency rate between the grading results of two temporary trained general doctors and the standard results.Results:A total of 150 male patients, aged (32.8±7.9) years (19-58 years), were included, of which 99 patients were 24-35 years old, accounting for 66.00%. It can be observed that the onset age was earlier. As assessed in this classification, the patients who participated in the study were graded as mild in 65 cases(43.33%), severe in 58 cases(38.67%), and moderate, which was consistency with the results obtained by BASP classification ( κ=0.573, P<0.001). Three experienced alopecia specialists evaluated 150 patients through the distance between facial marks. The results showed that the repetition rates of frontal, temporal and parietal classification results were 98.00%(147/150), 97.33%(146/150) and 96.00%(144/150), respectively. The repetition rate of the final alopecia classification was 92.00%(138/150), and the repetition rate of the overall alopecia classification was 98.00%(147/150). The consistency rate between the overall alopecia classification results of two temporary trained general doctors and the standard results was 95.92%(141/147) and 96.60%(142/147), respectively, and the consistency rate of the other results was higher than 90.00% except for one general doctor who was 89.86%(124/138) in the final classification. Conclusion:The distance between facial marks classification is a comparatively accurate and easy-to-learn grading method designed for Chinese male androgenic hair loss patients based on objective measurement data.