Objective:To investigate changes in psychological status before and after sequential therapy in patients with skin circulatory disorders following hyaluronic acid injection.Methods:A retrospective study was conducted on 17 female patients, with a mean age of 28-54 (39.5±1.2) years, admitted to the Fourth Medical Center of PLA General Hospital from December 2021 to July 2022. Patients received ultrasound-guided percutaneous arterial puncture or digital subtraction angiography (DSA) guided catheter intervention for hyaluronidase injection, alongside corticosteroid pulse therapy, diuretic administration, neurotrophic support, wound protection, and laser therapy. Psychological assessments, including the Minnesota multiphasic personality inventory (MMPI) and symptom check list-90 (SCL-90), were performed at admission and 30-45 days post-discharge. Changes in assessment scores and patient satisfaction were analyzed.Results:Two patients failed to complete all assessments, leaving 15 cases for final analysis. Affected anatomical regions included the nose/perinasal area (13 cases), temporal region (3 cases), lips (3 cases), and forehead (7 cases). MMPI scores for hypochondriasis, depression, hysteria, psychopathic deviation, paranoia, psychasthenia, and hypomania showed statistically significant reductions compared to baseline (all P<0.05). SCL-90 scores for somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and sleep/appetite disturbances also demonstrated significant decreases (all P<0.05). Among the 15 patients, 7 patients reported being very satisfied, 6 patients were satisfied, and 2 patients were moderately satisfied, with no dissatisfaction reported. Conclusion:Sequential therapy is associated with improved psychological outcomes in patients with skin circulatory disorders secondary to hyaluronic acid injection.

Objective:To explore the risk factors for complications of facial autologous fat transplantation.Methods:A total of 51 female patients (case group) with moderate to severe complications following facial autologous fat transplantation at the Fourth Medical Center of Chinese PLA General Hospital from November 2016 to October 2022 were included in this retrospective study. The median age was 31.0 (27.0, 40.0) years. After age and surgical date were matched with ratio of 1∶1, a total of 51 female patients who received autologous fat transplants at several official medical facilities and experienced no complications within a year after the procedure made up the control group. The median age of the control group was 32.0 (26.0, 41.0) years. The clinical characteristics of the two groups were compared, and the factors for complications of facial autologous fat transplantation were examined using a multivariate logistic regression model.Results:In the case group, complications included facial artery embolism (7 cases), ophthalmic artery embolism (19 cases), infection (19 cases), and fat necrosis (6 cases), with 26 severe and 25 moderate cases. No significant differences were found between the two groups in age, body mass index (BMI), marital status, history of hypertension, infectious diseases, allergies, smoking, or alcohol consumption (all P>0.05). However, significant differences were observed in a history of facial surgery, perimenstrual phase, surgical site, and fat donor site (all P<0.05). Multivariate logistic regression analysis revealed that a history of facial surgery ( OR=17.289, 95% CI: 4.851-61.616, P<0.001) and the surgical site being a clinic/outpatient department (compared to a hospital, OR=7.708, 95% CI: 2.482-23.939, P<0.001) were risk factors for postoperative complications after facial autologous fat transplantation. Conclusion:A history of facial surgery and the surgical site being a clinic/outpatient department (compared to a hospital) are risk factors for complications of facial autologous fat transplantation.

Objective:To investigate changes in psychological status before and after sequential therapy in patients with skin circulatory disorders following hyaluronic acid injection.Methods:A retrospective study was conducted on 17 female patients, with a mean age of 28-54 (39.5±1.2) years, admitted to the Fourth Medical Center of PLA General Hospital from December 2021 to July 2022. Patients received ultrasound-guided percutaneous arterial puncture or digital subtraction angiography (DSA) guided catheter intervention for hyaluronidase injection, alongside corticosteroid pulse therapy, diuretic administration, neurotrophic support, wound protection, and laser therapy. Psychological assessments, including the Minnesota multiphasic personality inventory (MMPI) and symptom check list-90 (SCL-90), were performed at admission and 30-45 days post-discharge. Changes in assessment scores and patient satisfaction were analyzed.Results:Two patients failed to complete all assessments, leaving 15 cases for final analysis. Affected anatomical regions included the nose/perinasal area (13 cases), temporal region (3 cases), lips (3 cases), and forehead (7 cases). MMPI scores for hypochondriasis, depression, hysteria, psychopathic deviation, paranoia, psychasthenia, and hypomania showed statistically significant reductions compared to baseline (all P<0.05). SCL-90 scores for somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and sleep/appetite disturbances also demonstrated significant decreases (all P<0.05). Among the 15 patients, 7 patients reported being very satisfied, 6 patients were satisfied, and 2 patients were moderately satisfied, with no dissatisfaction reported. Conclusion:Sequential therapy is associated with improved psychological outcomes in patients with skin circulatory disorders secondary to hyaluronic acid injection.

Objective:To explore the risk factors for complications of facial autologous fat transplantation.Methods:A total of 51 female patients (case group) with moderate to severe complications following facial autologous fat transplantation at the Fourth Medical Center of Chinese PLA General Hospital from November 2016 to October 2022 were included in this retrospective study. The median age was 31.0 (27.0, 40.0) years. After age and surgical date were matched with ratio of 1∶1, a total of 51 female patients who received autologous fat transplants at several official medical facilities and experienced no complications within a year after the procedure made up the control group. The median age of the control group was 32.0 (26.0, 41.0) years. The clinical characteristics of the two groups were compared, and the factors for complications of facial autologous fat transplantation were examined using a multivariate logistic regression model.Results:In the case group, complications included facial artery embolism (7 cases), ophthalmic artery embolism (19 cases), infection (19 cases), and fat necrosis (6 cases), with 26 severe and 25 moderate cases. No significant differences were found between the two groups in age, body mass index (BMI), marital status, history of hypertension, infectious diseases, allergies, smoking, or alcohol consumption (all P>0.05). However, significant differences were observed in a history of facial surgery, perimenstrual phase, surgical site, and fat donor site (all P<0.05). Multivariate logistic regression analysis revealed that a history of facial surgery ( OR=17.289, 95% CI: 4.851-61.616, P<0.001) and the surgical site being a clinic/outpatient department (compared to a hospital, OR=7.708, 95% CI: 2.482-23.939, P<0.001) were risk factors for postoperative complications after facial autologous fat transplantation. Conclusion:A history of facial surgery and the surgical site being a clinic/outpatient department (compared to a hospital) are risk factors for complications of facial autologous fat transplantation.

During the coronavirus disease 2019(COVID-19)pandemic season, cosmetic procedures have been hit hard. Cosmetic techniques must now change its emphasis from infection prevention to safe restart in response to patient desire generally. A key component of the approach is comprehending how COVID-19 affects invasive cosmetic techniques. This paper reviewed the relationship between COVID-19 and invasive cosmetic techniques and proposed coping strategies during the recovery period to increase awareness of COVID-19 among practitioners and patients, and to reduce the incidence of adverse events.

During the coronavirus disease 2019(COVID-19)pandemic season, cosmetic procedures have been hit hard. Cosmetic techniques must now change its emphasis from infection prevention to safe restart in response to patient desire generally. A key component of the approach is comprehending how COVID-19 affects invasive cosmetic techniques. This paper reviewed the relationship between COVID-19 and invasive cosmetic techniques and proposed coping strategies during the recovery period to increase awareness of COVID-19 among practitioners and patients, and to reduce the incidence of adverse events.

Objective:To conduct a network meta-analysis comparing the efficacy and safety of various drug injections for treating keloids.Methods:The search terms of "triamcinolone acetonide, 5-fluorouracil, verapamil, botulinum toxin, platelet rich plasma, keloid, scar, drug injection" were retrieved in PubMed, Embase, Web of Science, CNKI and Wanfang database to obtain the publicly published randomized controlled trials comparing single or combined drug injection for treating keloid from January 2010 to February 2023. The outcome index was the effective proportion of treatment, incidence proportion of adverse reactions, and recurrence proportion. NoteExpress, RevMan 5.4, and Stata 16.0 statistical software were utilized to perform a network meta-analysis of eligible studies that met the inclusion and exclusion criteria.Results:A total of 1 679 patients were enrolled in 21 studies that evaluated nine treatment modalities: triamcinolone (TAC), 5-fluorouracil (5-FU), botulinum toxin type A (BTA), platelet-rich plasma (PRP), Verapamil, BTA+ 5-FU, TAC+ 5-FU, TAC+ BTA, and TAC+ PRP. The network diagram revealed that there were 36 pairwise comparisons among the 9 treatment measures, with direct comparisons in 13 of them. The funnel plot demonstrated a symmetrical distribution of effect size points, and both Beggs test and Eggers test yielded P values greater than 0.05, indicating a low likelihood of publication bias. Nine treatment measures formed five closed loops with good consistency. The result of the network meta-analysis indicated that BTA+ 5-FU was more effective than TAC, 5-FU, or PRP alone; TAC+ 5-FU was more effective than TAC, 5-FU, or PRP alone; TAC+ BTA was more effective than TAC, 5-FU, BTA, or PRP alone; Verapamil was more effective than 5-FU and BTA was more effective than 5-FU. All result were found to be statistically significant ( P<0.05). A surface under the cumulative ranking area (SUCRA) map was generated, displaying the efficacy ranking and corresponding SUCRA values for each treatment: BTA+ 5-FU (85.6%)>TAC+ 5-FU (84.8%)>BTA+ TAC (76.7%)>Verapamil (48.9%)>BTA (45.0%)>TAC+ PRP (43.8%)>PRP (32.1%)>TAC (24.7%)>5-FU(8.3%). In terms of recurrence rate, the incidence of recurrence was higher with 5-FU compared to BTA or TAC+ 5-FU, and the incidence of recurrence was higher with TAC compared to TAC+ 5-FU; these differences were statistically significant ( P<0.05). A SUCRA map was generated with the ranking and SUCRA value for each treatment as follows: 5-FU (80.4%)>TAC (73.5%)>Verapamil (65.7%)>TAC+ BTA (52.5%)>PRP (34.8%)>BTA+ 5-FU (33.7%)>TAC+ 5-FU (30.2%)>BTA (29.3%). The qualitative analysis revealed a significantly lower incidence of systemic and local adverse reactions following combined drug injection compared to single drug injection. Conclusion:In the treatment of keloids using drug injection, combination therapy utilizing multiple drugs has demonstrated superior efficacy, lower recurrence rates, and fewer adverse reactions in comparison to single-drug therapy. Notably, the utilization of BAT, 5-FU, and TAC in combination may yield the most favorable outcomes.

Objective:To conduct a network meta-analysis comparing the efficacy and safety of various drug injections for treating keloids.Methods:The search terms of "triamcinolone acetonide, 5-fluorouracil, verapamil, botulinum toxin, platelet rich plasma, keloid, scar, drug injection" were retrieved in PubMed, Embase, Web of Science, CNKI and Wanfang database to obtain the publicly published randomized controlled trials comparing single or combined drug injection for treating keloid from January 2010 to February 2023. The outcome index was the effective proportion of treatment, incidence proportion of adverse reactions, and recurrence proportion. NoteExpress, RevMan 5.4, and Stata 16.0 statistical software were utilized to perform a network meta-analysis of eligible studies that met the inclusion and exclusion criteria.Results:A total of 1 679 patients were enrolled in 21 studies that evaluated nine treatment modalities: triamcinolone (TAC), 5-fluorouracil (5-FU), botulinum toxin type A (BTA), platelet-rich plasma (PRP), Verapamil, BTA+ 5-FU, TAC+ 5-FU, TAC+ BTA, and TAC+ PRP. The network diagram revealed that there were 36 pairwise comparisons among the 9 treatment measures, with direct comparisons in 13 of them. The funnel plot demonstrated a symmetrical distribution of effect size points, and both Beggs test and Eggers test yielded P values greater than 0.05, indicating a low likelihood of publication bias. Nine treatment measures formed five closed loops with good consistency. The result of the network meta-analysis indicated that BTA+ 5-FU was more effective than TAC, 5-FU, or PRP alone; TAC+ 5-FU was more effective than TAC, 5-FU, or PRP alone; TAC+ BTA was more effective than TAC, 5-FU, BTA, or PRP alone; Verapamil was more effective than 5-FU and BTA was more effective than 5-FU. All result were found to be statistically significant ( P<0.05). A surface under the cumulative ranking area (SUCRA) map was generated, displaying the efficacy ranking and corresponding SUCRA values for each treatment: BTA+ 5-FU (85.6%)>TAC+ 5-FU (84.8%)>BTA+ TAC (76.7%)>Verapamil (48.9%)>BTA (45.0%)>TAC+ PRP (43.8%)>PRP (32.1%)>TAC (24.7%)>5-FU(8.3%). In terms of recurrence rate, the incidence of recurrence was higher with 5-FU compared to BTA or TAC+ 5-FU, and the incidence of recurrence was higher with TAC compared to TAC+ 5-FU; these differences were statistically significant ( P<0.05). A SUCRA map was generated with the ranking and SUCRA value for each treatment as follows: 5-FU (80.4%)>TAC (73.5%)>Verapamil (65.7%)>TAC+ BTA (52.5%)>PRP (34.8%)>BTA+ 5-FU (33.7%)>TAC+ 5-FU (30.2%)>BTA (29.3%). The qualitative analysis revealed a significantly lower incidence of systemic and local adverse reactions following combined drug injection compared to single drug injection. Conclusion:In the treatment of keloids using drug injection, combination therapy utilizing multiple drugs has demonstrated superior efficacy, lower recurrence rates, and fewer adverse reactions in comparison to single-drug therapy. Notably, the utilization of BAT, 5-FU, and TAC in combination may yield the most favorable outcomes.

Objective To investigate and analyze the epidemiological and pathogenic characteristics on a case of human Streptococcus suis type 2 infection in Minhang District, Shanghai, and to provide evidence for early warning and prevention and control measures of rare and imported zoonotic acute infectious diseases in Shanghai. Methods By inquiring the patient medical history and epidemiological history and on-site environmental investigation, the infection route and source of the case were examined. The pathogenic culture of cerebrospinal fluid (CSF) was used to isolate Streptococcus suis, and Vitek2GP was used to identify the isolated strains. The PCR technique was used to detect species specific genes and virulence genes. Results The clinical manifestations of the patient were high fever with headache, nausea, vomiting and stiff neck. Blood tests showed a significant increase in c-reactive protein, an increase in lymphocyte percentage, and a decrease in platelet count. Head CT examination showed bilateral ethmoidal sinus and bilateral maxillary sinus inflammation, and significantly increased CSF white blood cell count and immunoglobulin. The case's CSF sample was positive for species specific genes (16SrRNA) and 2 virulence genes (cps-2j and ef). Conclusion This case was human Streptococcus suis type 2 with meningitis symptoms. Good prognosis was associated with timely diagnosis and treatment as well as the types of virulence factors. Medical institutions should identify early infection and take timely treatment as soon as possible to avoid severe illness and death cases. Departments of agriculture, health, market management, and others should consummate the reporting mechanism of animal epidemic situation, and establish necessary active sentinel monitoring.

Objective: To explore the effectiveness of keystone flap in repairing skin and soft tissue defects around joint. Methods: Between March 2013 and December 2017, 10 patients of skin and soft tissue defects around the joint were repaired with keystone flaps. There were 6 males and 4 females. The age ranged from 17 to 72 years, with an average age of 57.5 years. The skin and soft tissue defects located around the joints, including 2 cases of hip joints, 4 cases of knee joints, 3 cases of elbow joints, and 1 case of wrist joint. The cause of skin and soft tissue defects included scar contracture in 3 cases, basal cell carcinoma in 3 cases, squamous-cell carcinoma in 3 cases, and dermatofibrosarcoma protuberant in 1 case. The area of defects ranged from 4 cm×3 cm to 11 cm×11 cm. The keystone flap was designed beside the wound, and the V-shaped flap was designed at the longer side of the fan-shaped flap. The area of flap ranged from 7 cm×3 cm to 35 cm×10 cm. The flap was constantly compressed by vacuum assisted closure after operation for 3-6 days. Results: Primary wound healing was achieved and the flaps survived. All patients were followed up 6-24 months (mean, 15 months). The texture and color of flap was similar to the adjacent area. The appearance and function of joint were satisfactory. Conclusion: The keystone flap is a feasible and efficient way to repair the wound around joint. Furthermore, the skin color and texture is similar to the surrounding tissue after healing.