The refinement of nasal tip rotation and projection is a critical step in tip sculpting in augmentation rhinoplasty. Autologous cartilage material is widely used in rhinoplasty due to its good histocompatibility and support. However, in clinical work, the profile of the nasal tip after autologous cartilage rhinoplasty often changes over time, with the phenomenon of downward rotation of the nasal tip and reduced tip projection. Thus, how to construct a stable nasal tip cartilage framework is a common problem for clinicians. This review encompasses the relevant content of nasal tip dynamics and measurement, the recent approaches to constructing the nasal tip cartilage framework, the factors influencing tip rotation and projection after rhinoplasty, the dynamic changes in nasal tip morphology after surgery, and summarizes the method to mitigate the downward rotation of the nasal tip and variations in nasal tip projection, with the aim to guide intraoperative adjustment of nasal tip morphology.

Objective:To investigate the regulatory role and underlying mechanism of hepatic complement factor D(CFD) in obesity and adipose tissue metabolic disorders in high-fat diet(HFD)-induced obese mice.Methods:C57BL/6J mice were fed a HFD to induce obesity and subjected to tail vein or targeted virus injections to establish tissue-specific CFD overexpression or knockdown models. HE staining of adipose tissue was performed to evaluate adipocyte size and number. Immunohistochemical staining was used to evaluate uncoupling protein 1(UCP1) protein expression. qPCR and Western blot were conducted to detect the expression of genes related to lipid synthesis, thermogenesis, and downstream signaling pathway proteins in adipose tissue. In vitro, differentiated 3T3-L1 cells and primary stromal vascular fractions(SVF) from brown adipose tissue were treated with recombinant CFD protein combined with pathway inhibitors to verify the regulatory mechanism.Results:Liver-specific overexpression of CFD in mice led to increased adipose tissue mass ratio and aggravated insulin resistance under HFD conditions, accompanied by more severe fat accumulation and decreased energy expenditure compared with control mice. Conversely, liver-specific knockdown of CFD improved these metabolic abnormalities. Mechanistically, CFD exerted its metabolic regulatory effects by activating the C5aR-AKT signaling pathway in adipocytes. Furthermore, targeted knockdown of C5aR in adipose tissue attenuated the adverse metabolic effects induced by hepatic CFD overexpression.Conclusion:Hepatic CFD plays a critical role in the development of obesity and related metabolic disorders. These findings provide a potential novel therapeutic target for the management of obesity-associated metabolic diseases.

Objective:To investigate the regulatory role and underlying mechanism of hepatic complement factor D(CFD) in obesity and adipose tissue metabolic disorders in high-fat diet(HFD)-induced obese mice.Methods:C57BL/6J mice were fed a HFD to induce obesity and subjected to tail vein or targeted virus injections to establish tissue-specific CFD overexpression or knockdown models. HE staining of adipose tissue was performed to evaluate adipocyte size and number. Immunohistochemical staining was used to evaluate uncoupling protein 1(UCP1) protein expression. qPCR and Western blot were conducted to detect the expression of genes related to lipid synthesis, thermogenesis, and downstream signaling pathway proteins in adipose tissue. In vitro, differentiated 3T3-L1 cells and primary stromal vascular fractions(SVF) from brown adipose tissue were treated with recombinant CFD protein combined with pathway inhibitors to verify the regulatory mechanism.Results:Liver-specific overexpression of CFD in mice led to increased adipose tissue mass ratio and aggravated insulin resistance under HFD conditions, accompanied by more severe fat accumulation and decreased energy expenditure compared with control mice. Conversely, liver-specific knockdown of CFD improved these metabolic abnormalities. Mechanistically, CFD exerted its metabolic regulatory effects by activating the C5aR-AKT signaling pathway in adipocytes. Furthermore, targeted knockdown of C5aR in adipose tissue attenuated the adverse metabolic effects induced by hepatic CFD overexpression.Conclusion:Hepatic CFD plays a critical role in the development of obesity and related metabolic disorders. These findings provide a potential novel therapeutic target for the management of obesity-associated metabolic diseases.

The refinement of nasal tip rotation and projection is a critical step in tip sculpting in augmentation rhinoplasty. Autologous cartilage material is widely used in rhinoplasty due to its good histocompatibility and support. However, in clinical work, the profile of the nasal tip after autologous cartilage rhinoplasty often changes over time, with the phenomenon of downward rotation of the nasal tip and reduced tip projection. Thus, how to construct a stable nasal tip cartilage framework is a common problem for clinicians. This review encompasses the relevant content of nasal tip dynamics and measurement, the recent approaches to constructing the nasal tip cartilage framework, the factors influencing tip rotation and projection after rhinoplasty, the dynamic changes in nasal tip morphology after surgery, and summarizes the method to mitigate the downward rotation of the nasal tip and variations in nasal tip projection, with the aim to guide intraoperative adjustment of nasal tip morphology.

The problem of single educational origin structure generally existed in affiliated hospitals of universities, which could not only affect the academic vitality and scientific research innovation ability of the hospital, but also may lead to restricted discipline development. Through measures such as reforming the hospital-retention policy, expanding recruitment channels, strengthening talent cultivation and formulating supporting policies, Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology has successfully increased the proportion of doctors graduated from other hospitals, promoted the diversification of educational origin structure. The author suggested that affiliated hospitals of universities should establish a diversified human resources allocation system during the recruitment stage, give support policies to employees graduated from other hospitals, pay attention to the balanced development of sub-specialties, and expand the educational origin of existing employees, so as to promote the healthy development of clinical disciplines.

The problem of single educational origin structure generally existed in affiliated hospitals of universities, which could not only affect the academic vitality and scientific research innovation ability of the hospital, but also may lead to restricted discipline development. Through measures such as reforming the hospital-retention policy, expanding recruitment channels, strengthening talent cultivation and formulating supporting policies, Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology has successfully increased the proportion of doctors graduated from other hospitals, promoted the diversification of educational origin structure. The author suggested that affiliated hospitals of universities should establish a diversified human resources allocation system during the recruitment stage, give support policies to employees graduated from other hospitals, pay attention to the balanced development of sub-specialties, and expand the educational origin of existing employees, so as to promote the healthy development of clinical disciplines.

Squamous cell carcinoma, which originates from squamous epithelium or tissue that undergoes squamous epithelial metaplasia, is one of the most common pathological types of solid human carcinoma. Although squamous cell carcinoma can occur in different anatomical locations, its pathogenesis has commonalities and distinctive features. Genetic mutations and abnormal expression of squamous differentiation markers, epigenetic modifications regulating target gene expression, and tumor microenvironment inducing immune escape of cancer cells are all involved in the development of squamous cell carcinoma. At present, great progress has been made in the research on the pathogenesis of squamous cell carcinoma. This article, combined with relevant research in recent years, reviews the pathogenesis of squamous cell carcinoma in terms of genome changes, epigenetic changes, non coding RNA regulation, tumor microenvironment changes and risk factor induction, so as to provide reference for the prevention and treatment of squamous cell carcinoma.

How to promote high-quality wound healing is a common problem for plastic surgery and burn physicians. In recent years, numerous animal studies have demonstrated that mesenchymal stem cell-derived exosomes promote wound repair through multiple mechanisms and are promising cell-free therapeutic agents with broad prospect of application. How to enhance the therapeutic efficacy of exosomes, optimize their drug delivery strategy, and improve their biological properties are the challenges to be overcome in order to move from basic research to clinical application of exosome therapy for wound repair. This article focuses on methods to improve the wound repair potential of mesenchymal stem cell-derived exosomes, and reviews the recent research advances on improving the therapeutic efficacy of mesenchymal stem cell-derived exosomes in wound repair from three aspects, including pretreatment of parental mesenchymal stem cells, hydrogel bio-scaffold loaded with exosomes, and engineered exosomes, to provide a reference for further clinical studies.

The role of the subchondral bone in the pathophysiological processes of knee osteoarthritis(KOA)is receiving increasing attention.During the early stages of KOA,micro-fractures due to stress occurr with increased subchondral bone remodeling and decreased subchondral bone structural parameters,promoting the development of local microcirculatory disorders and atypical bone marrow lesions(BMLs).The micro-pores in cartilage provide pathways for blood vessel invasion into the deep layers of articular cartilage and subsequently bring in cartilage-degrading enzymes.With the pathogenesis of KOA,the loss of proteoglycans,which resist pressure to maintain the integrity of articular cartilage,results in stress overloading and then metabolic imbalances,leading to decreased bone resorption and increased bone formation.In the late stages of KOA,significant subchondral bone sclerosis further obstructs local blood microcirculation,which manifests as extended BMLs or increased signal intensity and even subchondral bone cysts.The acidic local environment impairs osteoblast function and erodes bone strength,contributing to subchondral bone collapse.Consequently,there is continued loss of the attached articular cartilage because of the positive feedback.Drug or surgical treatment aimed at cartilage protection should focus on functional modulation of osteoblasts and/or osteoclasts in the subchondral bone and the internal environment at different stages,instead of merely on the protection of articular cartilage.

Objective To investigate the X-ray gray scale changes of calcium sulfate and evaluate its clini-cal effect in traumatic fracture treatment. Methods 23 traumatic fracture cases were treated from September 2014 to January 2016 in our hospital. The degradation rate of calcium sulfate was evaluated by X ray assay. Results Af-ter surgery,about 69%remnants at 1 week,53%remnants at 2 weeks,26%remnants at 4 weeks,7%remnants at 6 weeks were observed,while no remnants were found at 8 weeks after surgery. The initial time window of callus appearance was 3 to 9 weeks and the mean time was(6.5 ± 1.6)weeks. The fracture union time was 8 to 24 weeks and the mean time was(15.0 ± 5.2)weeks. One patient with distal humeral comminuted fracture had non-infec-tious delayed healing wound.One case of hemolytic staphylococcus in incision was cultured. Conclusion Calcium sulfate degrades rapidly,cautions should be taken for the application in the superficial bone.