Objective:To explore McGregor′s patch surface anatomy parameters and correlation with demographic characteristics.Methods:A retrospective analysis of 134 volunteers [33 males and 101 females, aged (32.9±13.4) years], screened from the hospital information system of Zhejiang Provincial People′s Hospital via a random formula in excel. All subjects were divided into young group (18-40 years) and elderly group (>40 years) according to age; thin group [body mass index (BMI) <18.5 kg/m 2], moderate group (BMI 18.5-24.0 kg/m 2), and obese group (BMI >24.0 kg/m 2) according to BMI. Subjects were photographed under the same standard circumstances, and the rate of McGregor′s patch and its correlation with demographic characteristics were analyzed. The surface anatomy parameters of the McGregor′s patch were also measured. The relationship between associated ligamentous structures and the McGregor′s patch was investigated by fine dissection. Results:The rate of McGregor′s patch was 46.3% (62/134). The rate of McGregor′s patch was 39.4% (13/33) in males and 48.5% (49/101) in females, with no statistically significant difference ( P=0.362). The prevalence of McGregor′s patch was 48.9% (45/92) in the young group and 40.5% (17/42) in the elderly group, with no statistically significant difference ( P=0.364). The prevalence of McGregor′s patch was 51.4% (19/37) in the thin group, 45.9% (34/74) in the moderate group, and 39.1% (9/23) in the obese group, with no statistically significant difference ( P=0.651). The center of the McGregor′s patch was at a distance of (5.7±0.3) cm from the point of the lateral canthal point and (5.1±0.3) cm from the tragion. A detailed autopsy revealed that the zygomatic arch ligament and the occlusal cutaneous ligament appeared at a constant level above and on the deep side of this depression, and the two ligaments had their termination points in the dermis in the area of the depression. Conclusions:The center of the McGregor's patch is（5.7±0.3）cm from lateral canthal point and（5.1±0.3）cm from the tragion. There is no correlation between the rate of McGregor's patch and age or BMI.

Objective To explore the effectiveness of MACE rehabilitation system based on international classification of functioning,disability and health for children and youth(ICF-CY)in improving the function of children with cerebral palsy,and to provide a more targeted comprehensive plan for rehabilitation of children with cerebral palsy.Methods Sixty-six children with cerebral palsy admitted to the Second Affiliated Hospital of Wenzhou Medical University from October 2022 to December 2023 were selected as the research objects and randomly divided into experimental group and control group,with 33 cases in each group.The experimental group received comprehensive rehabilitation intervention based on the MACE rehabilitation system of ICF-CY,and control group received traditional rehabilitation treatment.Modified Ashworth scale score,knee joint range of motion,functional independence measure for children(WeeFIM)score,gross motor function measure(GMFM)and fine motor function measure(FMFM)score of two groups of children after intervention were evaluated and compared.Results After intervention,the modified Ashworth scale scores of two groups of children were significantly lower than those before intervention in this group,the range of motion of knee joint was significantly better than that before intervention in this group,and the WeeFIM score,GMFM score and FMFM score were significantly higher than those before intervention in this group(P＜0.05).The modified Ashworth scale score of children in experimental group was significantly lower than that of children in control group,the range of motion of knee joint was significantly better than that of children in control group,and the WeeFIM score,GMFM score and FMFM score were all significantly higher than those of children in control group(P＜0.05).Conclusion The MACE rehabilitation system based on ICF-CY can effectively improve the muscle tone and joint range of motion of children with cerebral palsy,and enhance functional independence and motor function.

Objective To explore the effectiveness of MACE rehabilitation system based on international classification of functioning,disability and health for children and youth(ICF-CY)in improving the function of children with cerebral palsy,and to provide a more targeted comprehensive plan for rehabilitation of children with cerebral palsy.Methods Sixty-six children with cerebral palsy admitted to the Second Affiliated Hospital of Wenzhou Medical University from October 2022 to December 2023 were selected as the research objects and randomly divided into experimental group and control group,with 33 cases in each group.The experimental group received comprehensive rehabilitation intervention based on the MACE rehabilitation system of ICF-CY,and control group received traditional rehabilitation treatment.Modified Ashworth scale score,knee joint range of motion,functional independence measure for children(WeeFIM)score,gross motor function measure(GMFM)and fine motor function measure(FMFM)score of two groups of children after intervention were evaluated and compared.Results After intervention,the modified Ashworth scale scores of two groups of children were significantly lower than those before intervention in this group,the range of motion of knee joint was significantly better than that before intervention in this group,and the WeeFIM score,GMFM score and FMFM score were significantly higher than those before intervention in this group(P＜0.05).The modified Ashworth scale score of children in experimental group was significantly lower than that of children in control group,the range of motion of knee joint was significantly better than that of children in control group,and the WeeFIM score,GMFM score and FMFM score were all significantly higher than those of children in control group(P＜0.05).Conclusion The MACE rehabilitation system based on ICF-CY can effectively improve the muscle tone and joint range of motion of children with cerebral palsy,and enhance functional independence and motor function.

Objective:To explore McGregor′s patch surface anatomy parameters and correlation with demographic characteristics.Methods:A retrospective analysis of 134 volunteers [33 males and 101 females, aged (32.9±13.4) years], screened from the hospital information system of Zhejiang Provincial People′s Hospital via a random formula in excel. All subjects were divided into young group (18-40 years) and elderly group (>40 years) according to age; thin group [body mass index (BMI) <18.5 kg/m 2], moderate group (BMI 18.5-24.0 kg/m 2), and obese group (BMI >24.0 kg/m 2) according to BMI. Subjects were photographed under the same standard circumstances, and the rate of McGregor′s patch and its correlation with demographic characteristics were analyzed. The surface anatomy parameters of the McGregor′s patch were also measured. The relationship between associated ligamentous structures and the McGregor′s patch was investigated by fine dissection. Results:The rate of McGregor′s patch was 46.3% (62/134). The rate of McGregor′s patch was 39.4% (13/33) in males and 48.5% (49/101) in females, with no statistically significant difference ( P=0.362). The prevalence of McGregor′s patch was 48.9% (45/92) in the young group and 40.5% (17/42) in the elderly group, with no statistically significant difference ( P=0.364). The prevalence of McGregor′s patch was 51.4% (19/37) in the thin group, 45.9% (34/74) in the moderate group, and 39.1% (9/23) in the obese group, with no statistically significant difference ( P=0.651). The center of the McGregor′s patch was at a distance of (5.7±0.3) cm from the point of the lateral canthal point and (5.1±0.3) cm from the tragion. A detailed autopsy revealed that the zygomatic arch ligament and the occlusal cutaneous ligament appeared at a constant level above and on the deep side of this depression, and the two ligaments had their termination points in the dermis in the area of the depression. Conclusions:The center of the McGregor's patch is（5.7±0.3）cm from lateral canthal point and（5.1±0.3）cm from the tragion. There is no correlation between the rate of McGregor's patch and age or BMI.

Objective:To compare the efficacy of the injection of collagen, hyaluronic acid and their combined application in the treatment of lacrimal depression.Methods:From July 2022 to January 2023, 60 female patients with lacrimal depression, aged 19-49 years with an average age of 33.6 years, were treated by injection in Xi′an Rongyao FRESKIN Medical Cosmetology Clinic. There were 20 cases in the collagen injection group, 20 cases in the hyaluronic acid injection group, and 20 cases in the combined hyaluronic acid and collagen injection group. Preoperative, immediate, 1 month and 6 months after surgery, lacrimal groove deformity rating scale score and patient satisfaction at 1 month and 6 months after surgery were evaluated.Results:One month after operation, the satisfactory rate of patients in collagen group was 90%, that of hyaluronic acid group was 80%, and that of the combined treatment group was 90%. 6 months after operation, the satisfactory rate of patients in the collagen group was 80%, that of hyaluronic acid was 80%, and that of the combined treatment group was 90%. Postoperative follow-up showed no serious complications such as infection, embolism or visual loss in the 3 groups. Pigmentation occurred in 2 cases in the hyaluronic acid group and 1 case in the collagen group. No pigmentation occurred in the combined treatment group. Overall, all the three treatment methods were effective and safe.Conclusions:All three treatment methods can be used to improve lacrimal depression without serious complications.

Objective:To investigate the anatomic mechanism and risk factors of intracranial embolism caused by injection at temporal region.Methods:(1) Latex perfusion was performed on the vessels of 8 cranial specimens. The vessels from the superficial temporal artery to the carotid artery were dissected to measure the length, the diameter of starting point and ending point and the volume of vessels (drainage method). (2) Cranial CT angiography of 20 patients (excluding patients with cervical diseases) were obtained from the database of Zhejiang Provincial People’s Hospital from January 2021 to December 2022. The length, the diameter of starting point and ending point, and the volume of vessels were measured. (3) 5 plastic surgeons used pressure simulation measuring equipment to vigorously press the temporal region of the real skull model according to the clinical practice and maintain 2 s to obtain the maximum pressure value. The additional pressure on the temporal region was obtained by subtracting the common carotid artery base pressure [set at 90, 120, 150 and 200 mmHg (1 mmHg = 0.133 kPa)] from the maximum pressure.Results:(1) 8 arteries were collected from 4 skull specimens. The length of vessels was (169.5±7.2) mm, the diameter of the starting point of vessel was (4.29±0.28) mm, the diameter of the ending point of vessel was (1.31±0.15) mm, and the volume was (1.56±0.21) ml. (2) There were 11 males and 9 females among 20 patients aged 23-53 years. The length of vessels was (172.2±7.6) mm, the diameter of the starting point of vessel was (5.63±0.43) mm, the diameter of the ending point of vessel was (1.77±0.16) mm, and the volume was (1.59±0.23) ml. (3) The mean value of additional pressure generated by local pressure on the temporal region by 5 physicians was (127.2±10.1) mmHg (113.8-138.6 mmHg).Conclusion:When the injection volume into the superficial temporal artery was more than 1.6 ml, the artery was damaged, and the temporal area was pressed strongly (the local pressure was more than 110 mmHg above the basic pressure), the injection material might flow into the intracranial from the junction of the common carotid artery and into the internal carotid artery, which was the possible mechanism of the temporal filling leading to intracranial embolism.

Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.

Objective:To investigate the anatomic mechanism and risk factors of intracranial embolism caused by injection at temporal region.Methods:(1) Latex perfusion was performed on the vessels of 8 cranial specimens. The vessels from the superficial temporal artery to the carotid artery were dissected to measure the length, the diameter of starting point and ending point and the volume of vessels (drainage method). (2) Cranial CT angiography of 20 patients (excluding patients with cervical diseases) were obtained from the database of Zhejiang Provincial People’s Hospital from January 2021 to December 2022. The length, the diameter of starting point and ending point, and the volume of vessels were measured. (3) 5 plastic surgeons used pressure simulation measuring equipment to vigorously press the temporal region of the real skull model according to the clinical practice and maintain 2 s to obtain the maximum pressure value. The additional pressure on the temporal region was obtained by subtracting the common carotid artery base pressure [set at 90, 120, 150 and 200 mmHg (1 mmHg = 0.133 kPa)] from the maximum pressure.Results:(1) 8 arteries were collected from 4 skull specimens. The length of vessels was (169.5±7.2) mm, the diameter of the starting point of vessel was (4.29±0.28) mm, the diameter of the ending point of vessel was (1.31±0.15) mm, and the volume was (1.56±0.21) ml. (2) There were 11 males and 9 females among 20 patients aged 23-53 years. The length of vessels was (172.2±7.6) mm, the diameter of the starting point of vessel was (5.63±0.43) mm, the diameter of the ending point of vessel was (1.77±0.16) mm, and the volume was (1.59±0.23) ml. (3) The mean value of additional pressure generated by local pressure on the temporal region by 5 physicians was (127.2±10.1) mmHg (113.8-138.6 mmHg).Conclusion:When the injection volume into the superficial temporal artery was more than 1.6 ml, the artery was damaged, and the temporal area was pressed strongly (the local pressure was more than 110 mmHg above the basic pressure), the injection material might flow into the intracranial from the junction of the common carotid artery and into the internal carotid artery, which was the possible mechanism of the temporal filling leading to intracranial embolism.

Hyaluronic acid (HA) injections have already been one of most popular cosmetic procedures for around 18 years. However, blindness is one of the most serious complications caused by HA injections. There is still no consensus on the treatment for vision recovery. The efficacy and safety of different delivery administration of hyaluronidase such as retrobulbar injection and endovascular intervention are still controversial so far. Based on current status, prevention is prior to treatment, which is widely recognized in the world. The pathogenic mechanism of blindness induced by filler injection is still not clear, and there exist several theories including the artery embolism, ischaemia, artery spasm and venous involvement, which are all related to the ophthalmic artery and its branches. Therefore, acquiring anatomic knowledge and the relevant parameters will help us prevent to damage the ophthalmic artery and its branches during HA injections. The mechanism, treatment progress and prognosis of blindness caused by HA injections in recent years were analyzed and summarized in this article. We hope it will help the clinician to improve the relevant knowledge about vision loss caused by HA injection, as well as to promote the safety of filler injection.

Objective:To explore the benefit finding and influencing factors of primary caregivers of children with cerebral palsy.Methods:This study adopted the method of random sampling, 158 primary caregivers of children with cerebral palsy in the outpatient and inpatient wards of the Children′s Rehabilitation Department of the Second Affiliated Hospital of Wenzhou Medical University from November 2020 to January 2021 were selected as the research objects. The basic data questionnaire, Chinese version of benefit finding scale, simple coping style questionnaire and perceived social support scale were used to do investigation. The influencing factors of benefit finding of main caregivers of children with cerebral palsy were investigated by single factor analysis, Pearson correlation analysis and multiple linear regression analysis.Results:The score of benefit finding of the main caregivers of children with cerebral palsy was (62.4±7.0),which was above the middle level. The years of diagnosis, the payment method of medical expenses, the place of residence and the length of caring for children had a significant impact on the benefit finding of the main caregivers of children with cerebral palsy ( F=3.45, 3.75, 3.97, 6.60, all P<0.05). The main caregivers′ sense of benefit finding was positively correlated with positive coping style, family support, friend support, others′ support and perceived social support ( r=0.43, 0.20, 0.32, 0.24, 0.30, all P<0.05), and negatively correlated with negative coping style ( r=-0.36, P<0.01).The importance of those factors influencing the benefit finding of the main caregivers of children with cerebral palsy was as follows: positive coping style, place of residence and length of caring for children (standardized regression coefficients were 0.33, 0.22, -0.32, all P<0.05). Conclusions:The main caregivers of children with cerebral palsy have a good sense of benefit finding. The main factors affecting the benefit finding of the main caregivers are the children′s residence, the length of care and coping style.