Objective:To explore the clinical application effect of double eyelid plasty using the levator palpebrae superioris aponeurosis fiber flap.Methods:In March 2021, 3-mm-wide tissue strips were vertically harvested from the mid-upper eyelids from 5 adult Han cadavers with single eyelids, provided by the Anatomy Lab of Nanchang Vocational Health College, and then Masson staining was performed to track the levator aponeurosis fiber. A descriptive case series study was performed. From February 2021 to February 2022, eligible patients who were prospectively collected from the Outpatient Department of the First Affiliated Hospital of Nanchang University underwent double eyelid plasty. The levator palpebrae superioris aponeurosis fiber flap was dissected and repositioned between the orbicularis oculi muscles at the upper and lower edge of incision. The surgical site was closed by a three-layer multi-faceted suture fixation: the muscle of orbicularis oculi at lower edge of incision was sutured to the flap root and tarsal upper edge; the upper and the muscle of orbicularis oculi at the upper and lower edge were sutured to the flap end; the skin was sutured to the muscle of orbicularis oculi and flap end. Postoperatively, incision healing and complications were monitored. Twelve months after surgery, two independent attending plastic surgeons evaluated double eyelid height, curvature, symmetry, and incision scar. The patients were asked to evaluate the effect as satisfied, relatively satisfied, or dissatisfied.Results:Masson staining of 5 lateral upper eyelid specimens revealed that in single-eyelid cases, the levator palpebrae superioris aponeurosis diverged into fibers at the white line, penetrated the orbicularis oculi loosely, and extended to the eyelid margin. Fourty female patients with single or hidden double eyelids were included, aged 18-38 years. After 12 months’ follow-up, all patients had good incision healing without major complications. Twelve months after the operation, the result of doctor evaluation was as followed: 40 cases had proper line height and natural curvature; 38 cases had good line retention, 2 cases had shallower lines; 39 cases had good symmetry, 1 case had asymmetry; 40 cases had no sunken scar. The result of patient satisfaction was as satisfied (35 cases), relatively satisfied (2 cases), dissatisfied (3 cases), with a 92.5% (37/40) satisfaction rate.Conclusion:The levator palpebrae superioris aponeurosis fiber flap method can reconstruct upper eyelid tissue, with natural dynamic double eyelids with few complications and high patient satisfaction.

Objective:To validate the validity of the auricular cartilage fish-shaped framework in comprehensive rhinoplasty for Chinese Han females.Methods:The clinical data of Chinese Han female patients with short nose and saddle nasal deformity undergoing primary rhinoplasty at the Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, from August 2021 to October 2023, were retrospectively analyzed. Patients underwent comprehensive rhinoplasty, involving the implantation of an auricular cartilage fish-shaped framework at the nasal tip and a dorsal nasal implant on the nasal bridge.Postoperative follow-up monitored for complications. At 6-month postoperatively, a satisfaction survey was conducted among the patients, their family, or friends using a scale where: very satisfied with improvement=4, moderately satisfied with improvement=3, Slightly satisfied with improvement=2, No improvement=1. Additionally, two plastic surgeons evaluated the postoperative outcomes using a scale where: excellent=5, very good=4, good=3, fair=2, poor=1.Preoperative and 6-month postoperative photographs were processed using Image J software to measure the following parameters: nasolabial angle, nasofacial angle, nasofrontal angle, columellar lobular angle, nasal height, and nasal length. Paired t-tests were used for statistical analysis, with P < 0.05 considered statistically significant. Results:A total of 18 patients were included, with a mean age of (26.4 ± 7.2) years (range: 18-45 years). The mean postoperative follow-up duration was (23.0 ± 9.3) months (range: 6 months to 3 years). All patients recovered well, with no severe complications occurring.The mean patient satisfaction score regarding the postoperative outcome was 3.50 ± 0.62. The mean satisfaction score from family or friends was 3.33 ± 0.69. The two evaluating plastic surgeons rated the outcomes as 4.17 ± 0.85 and 3.94 ± 0.93, respectively, both falling between the excellent and very good categories on the assessment scale.Statistically significant differences (all P < 0.01) were found between preoperative and 6-month postoperative measurements for all assessed nasal parameters. Nasolabial angle: 99.68° ± 2.95° vs. 95.37° ± 1.09°; nasofacial angle: 29.47° ± 2.99° vs. 32.82° ± 2.23°; nasofrontal angle: 140.72° ± 5.18° vs. 133.79° ± 4.43°; columellar lobular angle: 44.86° ± 3.43° vs. 39.23° ± 6.44°; nasal height: (57.52 ± 0.60) mm vs. (58.41 ± 0.39) mm; nasal length: (50.08 ± 0.54) mm vs. (50.64 ± 0.31) mm. Conclusion:The use of the auricular cartilage fish-shaped framework combined with a prosthesis in rhinoplasty, requiring only unilateral or bilateral auricular cartilage, effectively improved low nose and short nose deformities in the majority of Chinese Han females. This validates the favorable outcome of this framework in comprehensive rhinoplasty for this population.

Objective To investigate the effectiveness of electro-ultrasound therapy in preventing postoperative re-adhesion in patients with moderate to severe intrauterine adhesion(IUA)who have undergone transcervical resection of adhesions(TCRA).Methods A total of 105 patients with IUA admitted to the Fifth Affiliated Hospital of Zhengzhou University from November 2022 to December 2023 were selected as the research objects.The subjects were divided into two groups based on whether they received electro-ultrasound therapy postoperatively:Control group(n=56)and electro-ultrasound group(n=49).Pre-and post-treatment conditions of endometrial thickness,uterine cavity volume,volumetric blood flow parameters and hemodynamic parameters of arteries in different parts of the uterus(uterine arteries,sub-endometrium,intra-endometrial)were compared between two groups,The pregnancy status of two groups within one year after the treatment was followed-up.Results After treatment,both groups showed significant improvement in endometrial thickness,uterine cavity volume,volumetric blood flow parameters,and hemodynamic parameters of arteries in different parts of the uterus(uterine arteries,sub-endometrium,intra-endometrial)compared to their pre-treatment values in the same group(P＜0.05),with electro-ultrasound group showing more pronounced improvement(P＜0.05).Within one year after treatment,the pregnancy rate of electro-ultrasound group was higher than that of control group(P＜0.05).Conclusion Electro-ultrasound therapy helps prevent re-adhesion following TCRA in patients with intrauterine adhesions,contributing positively to the improvement of clinical efficacy.

Objective:To evaluate the role of the TANK-binding kinase 1 (TBK1)/receptor-interacting protein kinase 1 (RIPK1) signaling pathway in postoperative cognitive dysfunction (POCD) in aged mice.Methods:Fifty SPF healthy male C57BL/6 mice, aged 18 months, weighing 20-25 g, were divided into 5 groups ( n=10 each) using a table of random numbers: control group (group C), POCD group, dimethyl sulfoxide group, GSK group and GSK+ Nec-1 group. A mouse model of POCD was established by the closed reduction internal fixation of the left tibial fracture in anesthetized animals. Dimethyl sulfoxide, TBK1 inhibitor GSK8612 and RIPK1 inhibitor Nec-1 (0.5 μl/side) were stereotactically injected into the hippocampal CA1 region at 30 min before operation. Cognitive function was assessed using the contextual fear conditioning test before operation and at 3 days after operation. The mice were then anesthetized and sacrificed, and the hippocampal tissues were obtained for determination of the expression of TBK1, RIPK1, interleukin-lbeta (IL-1β), tumor necrosis factor-alpha (TNF-α), activator protein 1 (AP-1) and Nestin (by Western blot), the expression of Bcl-2, Bax and caspase-3 mRNA (by fluorescent quantitative real-time polymerase chain reaction) and for examination of TBK1/RIPK1 molecular interactions and neural stem cell proliferation in the hippocampal dentate gyrus (DG) region (by immunofluorescent staining). Results:Compared with C group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, RIPK1, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in POCD group ( P<0.05 or 0.01). Compared with POCD group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in GSK group ( P<0.05 or 0.01). Compared with GSK group, the percentage of freezing time was significantly increased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was down-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was up-regulated, and the proliferation of neural stem cells in the hippocampal DG region was increased in GSK+ Nec-1 group ( P<0.05 or 0.01). Conclusions:The TBK1/RIPK1 signaling pathway is involved in the pathogenesis of POCD in aged mice.

The etiology of tumors is complex and influenced by multiple factors, including the host and environmental conditions. Allergy is primarily driven by the immune response of helper T cell 2 (Th2). Research has shown that the Th2 immune response is closely related to tumors, which is specifically manifested through Th2 antibodies, allergy-related effector cells and mediators within the tumors, as well as tumor immune-related functions. This internal interaction mechanism will increase the complexity and challenges associated with the clinical diagnosis and treatment of tumors and allergy. The formation of allergic constitution is shaped by both congenital and acquired factors, and its physical state is closely linked to the occurrence and progression of allergic diseases. Therefore, this paper aims to explore the relationship between tumors and allergic reactions from the perspective of traditional Chinese medicine (TCM) constitution theory. Based on the four basic principles of the TCM constitution, including endowment inheritance theory, environment constraint theory, body-spirit composition theory, and life process theory, this exploration will focus on four aspects: genetic factors and internal disease causes, inflammatory environments and functional regulation, psychological disorders and emotional pathogenesis, as well as age structure and disease risk. Furthermore, from the perspective of constitution-disease relation of chronic disease prevention, this paper will discuss the significant importance of adjusting allergic constitution to improve both subjective symptoms and objective indicators of allergic reactions in tumor patients.

Objective:To evaluate the role of the TANK-binding kinase 1 (TBK1)/receptor-interacting protein kinase 1 (RIPK1) signaling pathway in postoperative cognitive dysfunction (POCD) in aged mice.Methods:Fifty SPF healthy male C57BL/6 mice, aged 18 months, weighing 20-25 g, were divided into 5 groups ( n=10 each) using a table of random numbers: control group (group C), POCD group, dimethyl sulfoxide group, GSK group and GSK+ Nec-1 group. A mouse model of POCD was established by the closed reduction internal fixation of the left tibial fracture in anesthetized animals. Dimethyl sulfoxide, TBK1 inhibitor GSK8612 and RIPK1 inhibitor Nec-1 (0.5 μl/side) were stereotactically injected into the hippocampal CA1 region at 30 min before operation. Cognitive function was assessed using the contextual fear conditioning test before operation and at 3 days after operation. The mice were then anesthetized and sacrificed, and the hippocampal tissues were obtained for determination of the expression of TBK1, RIPK1, interleukin-lbeta (IL-1β), tumor necrosis factor-alpha (TNF-α), activator protein 1 (AP-1) and Nestin (by Western blot), the expression of Bcl-2, Bax and caspase-3 mRNA (by fluorescent quantitative real-time polymerase chain reaction) and for examination of TBK1/RIPK1 molecular interactions and neural stem cell proliferation in the hippocampal dentate gyrus (DG) region (by immunofluorescent staining). Results:Compared with C group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, RIPK1, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in POCD group ( P<0.05 or 0.01). Compared with POCD group, the percentage of freezing time was significantly decreased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was up-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was down-regulated, and the proliferation of neural stem cells in the hippocampal DG region was decreased in GSK group ( P<0.05 or 0.01). Compared with GSK group, the percentage of freezing time was significantly increased at 3 days after operation, the expression of Bax mRNA, caspase-3 mRNA, IL-1β, TNF-α and AP-1 was down-regulated, the expression of TBK1, Bcl-2 mRNA and Nestin was up-regulated, and the proliferation of neural stem cells in the hippocampal DG region was increased in GSK+ Nec-1 group ( P<0.05 or 0.01). Conclusions:The TBK1/RIPK1 signaling pathway is involved in the pathogenesis of POCD in aged mice.

Objective:To explore the clinical application effect of double eyelid plasty using the levator palpebrae superioris aponeurosis fiber flap.Methods:In March 2021, 3-mm-wide tissue strips were vertically harvested from the mid-upper eyelids from 5 adult Han cadavers with single eyelids, provided by the Anatomy Lab of Nanchang Vocational Health College, and then Masson staining was performed to track the levator aponeurosis fiber. A descriptive case series study was performed. From February 2021 to February 2022, eligible patients who were prospectively collected from the Outpatient Department of the First Affiliated Hospital of Nanchang University underwent double eyelid plasty. The levator palpebrae superioris aponeurosis fiber flap was dissected and repositioned between the orbicularis oculi muscles at the upper and lower edge of incision. The surgical site was closed by a three-layer multi-faceted suture fixation: the muscle of orbicularis oculi at lower edge of incision was sutured to the flap root and tarsal upper edge; the upper and the muscle of orbicularis oculi at the upper and lower edge were sutured to the flap end; the skin was sutured to the muscle of orbicularis oculi and flap end. Postoperatively, incision healing and complications were monitored. Twelve months after surgery, two independent attending plastic surgeons evaluated double eyelid height, curvature, symmetry, and incision scar. The patients were asked to evaluate the effect as satisfied, relatively satisfied, or dissatisfied.Results:Masson staining of 5 lateral upper eyelid specimens revealed that in single-eyelid cases, the levator palpebrae superioris aponeurosis diverged into fibers at the white line, penetrated the orbicularis oculi loosely, and extended to the eyelid margin. Fourty female patients with single or hidden double eyelids were included, aged 18-38 years. After 12 months’ follow-up, all patients had good incision healing without major complications. Twelve months after the operation, the result of doctor evaluation was as followed: 40 cases had proper line height and natural curvature; 38 cases had good line retention, 2 cases had shallower lines; 39 cases had good symmetry, 1 case had asymmetry; 40 cases had no sunken scar. The result of patient satisfaction was as satisfied (35 cases), relatively satisfied (2 cases), dissatisfied (3 cases), with a 92.5% (37/40) satisfaction rate.Conclusion:The levator palpebrae superioris aponeurosis fiber flap method can reconstruct upper eyelid tissue, with natural dynamic double eyelids with few complications and high patient satisfaction.

Objective:To validate the validity of the auricular cartilage fish-shaped framework in comprehensive rhinoplasty for Chinese Han females.Methods:The clinical data of Chinese Han female patients with short nose and saddle nasal deformity undergoing primary rhinoplasty at the Department of Plastic Surgery, the First Affiliated Hospital of Nanchang University, from August 2021 to October 2023, were retrospectively analyzed. Patients underwent comprehensive rhinoplasty, involving the implantation of an auricular cartilage fish-shaped framework at the nasal tip and a dorsal nasal implant on the nasal bridge.Postoperative follow-up monitored for complications. At 6-month postoperatively, a satisfaction survey was conducted among the patients, their family, or friends using a scale where: very satisfied with improvement=4, moderately satisfied with improvement=3, Slightly satisfied with improvement=2, No improvement=1. Additionally, two plastic surgeons evaluated the postoperative outcomes using a scale where: excellent=5, very good=4, good=3, fair=2, poor=1.Preoperative and 6-month postoperative photographs were processed using Image J software to measure the following parameters: nasolabial angle, nasofacial angle, nasofrontal angle, columellar lobular angle, nasal height, and nasal length. Paired t-tests were used for statistical analysis, with P < 0.05 considered statistically significant. Results:A total of 18 patients were included, with a mean age of (26.4 ± 7.2) years (range: 18-45 years). The mean postoperative follow-up duration was (23.0 ± 9.3) months (range: 6 months to 3 years). All patients recovered well, with no severe complications occurring.The mean patient satisfaction score regarding the postoperative outcome was 3.50 ± 0.62. The mean satisfaction score from family or friends was 3.33 ± 0.69. The two evaluating plastic surgeons rated the outcomes as 4.17 ± 0.85 and 3.94 ± 0.93, respectively, both falling between the excellent and very good categories on the assessment scale.Statistically significant differences (all P < 0.01) were found between preoperative and 6-month postoperative measurements for all assessed nasal parameters. Nasolabial angle: 99.68° ± 2.95° vs. 95.37° ± 1.09°; nasofacial angle: 29.47° ± 2.99° vs. 32.82° ± 2.23°; nasofrontal angle: 140.72° ± 5.18° vs. 133.79° ± 4.43°; columellar lobular angle: 44.86° ± 3.43° vs. 39.23° ± 6.44°; nasal height: (57.52 ± 0.60) mm vs. (58.41 ± 0.39) mm; nasal length: (50.08 ± 0.54) mm vs. (50.64 ± 0.31) mm. Conclusion:The use of the auricular cartilage fish-shaped framework combined with a prosthesis in rhinoplasty, requiring only unilateral or bilateral auricular cartilage, effectively improved low nose and short nose deformities in the majority of Chinese Han females. This validates the favorable outcome of this framework in comprehensive rhinoplasty for this population.

Objective To investigate the effectiveness of electro-ultrasound therapy in preventing postoperative re-adhesion in patients with moderate to severe intrauterine adhesion(IUA)who have undergone transcervical resection of adhesions(TCRA).Methods A total of 105 patients with IUA admitted to the Fifth Affiliated Hospital of Zhengzhou University from November 2022 to December 2023 were selected as the research objects.The subjects were divided into two groups based on whether they received electro-ultrasound therapy postoperatively:Control group(n=56)and electro-ultrasound group(n=49).Pre-and post-treatment conditions of endometrial thickness,uterine cavity volume,volumetric blood flow parameters and hemodynamic parameters of arteries in different parts of the uterus(uterine arteries,sub-endometrium,intra-endometrial)were compared between two groups,The pregnancy status of two groups within one year after the treatment was followed-up.Results After treatment,both groups showed significant improvement in endometrial thickness,uterine cavity volume,volumetric blood flow parameters,and hemodynamic parameters of arteries in different parts of the uterus(uterine arteries,sub-endometrium,intra-endometrial)compared to their pre-treatment values in the same group(P＜0.05),with electro-ultrasound group showing more pronounced improvement(P＜0.05).Within one year after treatment,the pregnancy rate of electro-ultrasound group was higher than that of control group(P＜0.05).Conclusion Electro-ultrasound therapy helps prevent re-adhesion following TCRA in patients with intrauterine adhesions,contributing positively to the improvement of clinical efficacy.

BACKGROUND:Patients with diabetes mellitus(DM)are vulnerable to community-acquired pneumonia(CAP),which have a high mortality rate.We aimed to investigate the value of heparin-binding protein(HBP)as a prognostic marker of mortality in patients with DM and CAP. METHODS:This retrospective study included CAP patients who were tested for HBP at intensive care unit(ICU)admission from January 2019 to April 2020.Patients were allocated to the DM or non-DM group and paired with propensity score matching.Baseline characteristics and clinical outcomes up to 90 days were evaluated.The primary outcome was the 10-day mortality.Receiver operating characteristic(ROC)curves,Kaplan-Meier analysis,and Cox regression were used for statistical analysis. RESULTS:Among 152 enrolled patients,60 pairs were successfully matched.There was no significant difference in 10-day mortality,while more patients in the DM group died within 28 d(P=0.024)and 90 d(P=0.008).In the DM group,HBP levels at ICU admission were higher in 10-day non-survivors than in 10-day survivors(median 182.21[IQR:55.43-300]ng/ml vs.median 66.40[IQR:34.13-107.85]ng/mL,P=0.019),and HBP levels could predict the 10-day mortality with an area under the ROC curve of 0.747.The cut-offvalue,sensitivity,and specificity were 160.6 ng/mL,66.7%,and 90.2%,respectively.Multivariate Cox regression analysis indicated that HBP was an independent prognostic factor for 10-day(HR 7.196,95%CI:1.596-32.455,P=0.01),28-day(HR 4.381,95%CI:1.449-13.245,P=0.009),and 90-day mortality(HR 4.581,95%CI:1.637-12.819,P=0.004)in patients with DM. CONCLUSION:Plasma HBP at ICU admission was associated with the 10-day,28-day,and 90-day mortality,and might be a prognostic factor in patients with DM and CAP.