Liposuction abdominoplasty is a prevalent procedure in plastic surgery, with common complications including infection and bleeding. However, cases leading to intestinal rupture accompanied by extensive abdominal wall infection are extremely infrequent. One such case was reported in this article. The patient was a 37-year-old female who developed symptoms of abdominal pain, vomiting, and fever after undergoing liposuction abdominoplasty at another hospital. She was admitted to the First Affiliated Hospital of Wenzhou Medical University on October 27, 2023. CT scan revealed a right lower abdominal wall hernia, intestinal obstruction, and abdominal wall infection. Intra-operative exploration demonstrated that a portion of the ileum had herniated subcutaneously, with multiple small perforations. There was also widespread soft-tissue infection in the subcutaneous area, along with partial skin necrosis. Emergency surgery was performed to repair the ruptured intestine. Biological dressing were used to cover and protect the exposed intestinal wall and the defective abdominal wall. Multiple debridement procedures and vacuum sealing drainage were performed for the extensive subcutaneous soft-tissue infection. Bacterial culture of the drainage fluid indicated Escherichia coli infection, and imipenem-cilastatin was administered for anti-infective treatment. After the infection was controlled, the wound was repaired with local flaps and fascia lata. During the six-month follow-up after discharge, the patient’s general condition remained satisfactory, with normal dietary intake and a well-healed wound. This case report particularly highlights that for patients with a prior history of abdominal surgery should undergo preoperative abdominal CT and other relevant examinations before liposuction to exclude potential risk factors such as incisional hernias and ensure patient safety.

Objectives:To compare the intraoperative neurophysiological monitoring(IONM)results during 3-column osteotomy surgery in severe congenital scoliosis(CS)patients with or without intraspinal anomalies,and to explore the effect of intraspinal anomaly on the incidence of IONM alarm events and postoperative out-comes in CS patients.Methods:Clinical data of patients with severe CS who underwent 3-column osteotomy surgery in our hospital from September 2020 to May 2023 were retrospectively analyzed.The patients were divided into two groups according to whether combined with intraspinal anomalies.The basic information,the latency and amplitude of somatosensory evoked potentials(SSEPs)of both lower extremities,amplitude of tran-scranial electric motor evoked potentials(TCeMEPs),as well as the sensitivity and specificity of multimodal IONM were compared between the two groups.The incidence of IONM alarm events and postoperative out-comes were analyzed.Results:A total of 37 patients who met the criteria were included in the study,of which 14 patients combined with intraspinal anomalies,including 8 cases of syringomyelia,2 case of tethered cord,1 case of diastematomyelia,1 case of diastematomyelia combined with tethered cord,and 2 cases of sy-ringomyelia combined with tethered cord.The latency of SSEPs-P3 7 in the concave side lower extremity of CS patients with intraspinal anomalies was significantly longer than that of CS patients without intraspinal anomalies(40.9±3.3ms vs 38.0±3.7ms,P=0.03).In addition,the sensitivity and specificity of multimodal IONM were comparable between the two groups.There was no significant difference in the incidence of abnormal SSEPs,the incidence of IONM alarm events and the incidence of postoperative neurological symptoms between the two groups(P＞0.05).Conclusions:Multimodal IONM provides excellent monitoring effects in severe CS paitents undergoing 3-column osteotomy surgery.The latency of SSEPs-P37 in the concave side lower ex-tremity of CS patients with intraspinal anomalies was significantly longer than that of CS patients without in-traspinal anomalies.Intraspinal anomalies don't increase the incidence of intraoperative IONM alarm events or the incidence of postoperative neurological complications.

Objectives:To assess the midterm efficacy of distal subapical vertebra posterior shift combined with rotational osteotomy for severe angular kyphosis correction.Methods:A retrospective analysis was con-ducted on the clinical data of 35 patients with severe spinal angular kyphosis who underwent posterior shift combined with rotational osteotomy at distal subapical vertebra in our department from October 2016 to May 2022.There were 23 males and 12 females,the average age was 30.8±12.4 years(15-61 years),with 13 cas-es combined with nerve damage.Follow-up duration ranged from 2 to 6 years(mean 3.5 years).Full-length anteroposterior and lateral X-ray examination of the spine in a standing position was performed before opera-tion,immediately after orthopedic surgery,and at 2-year follow-up,and the kyphotic angle,sagittal vertical axis(SVA),as well as sagittal apex deviation were measured and evaluated.The recovery of neurological func-tion was evaluated by the Frankel classification of neurological function before operation,and at 2 weeks and 6 months after operation.Results:All 35 patients successfully underwent the surgery,resulting in a signifi-cant decrease in the kyphotic Cobb angle from 104.6°±13.2° preoperatively to 32.1°±18.4° postoperatively(P＜0.05),with an improvement rate of 69.3％.Additionally,the SVA decreased from 4.9±4.4cm before surgery to 2.6±1.5cm after surgery immediately(P＜0.05),and the sagittal apex deviation decreased from 10.9±2.0cm to 5.5±1.4cm(P＜0.05).Furthermore,12 out of the 13 patients with nerve damage showed improvement at the fi-nal follow-up assessment,1 case showed no change compared with that before operation.Conclusions:Poste-rior shift combined with rotational osteotomy at distal subapical vertebra in the management of severe angular kyphosis can yield favorable orthopedic outcomes,which serves as a novel surgical option for managing severe angular spinal kyphosis.

Objectives:To compare the intraoperative neurophysiological monitoring(IONM)results during 3-column osteotomy surgery in severe congenital scoliosis(CS)patients with or without intraspinal anomalies,and to explore the effect of intraspinal anomaly on the incidence of IONM alarm events and postoperative out-comes in CS patients.Methods:Clinical data of patients with severe CS who underwent 3-column osteotomy surgery in our hospital from September 2020 to May 2023 were retrospectively analyzed.The patients were divided into two groups according to whether combined with intraspinal anomalies.The basic information,the latency and amplitude of somatosensory evoked potentials(SSEPs)of both lower extremities,amplitude of tran-scranial electric motor evoked potentials(TCeMEPs),as well as the sensitivity and specificity of multimodal IONM were compared between the two groups.The incidence of IONM alarm events and postoperative out-comes were analyzed.Results:A total of 37 patients who met the criteria were included in the study,of which 14 patients combined with intraspinal anomalies,including 8 cases of syringomyelia,2 case of tethered cord,1 case of diastematomyelia,1 case of diastematomyelia combined with tethered cord,and 2 cases of sy-ringomyelia combined with tethered cord.The latency of SSEPs-P3 7 in the concave side lower extremity of CS patients with intraspinal anomalies was significantly longer than that of CS patients without intraspinal anomalies(40.9±3.3ms vs 38.0±3.7ms,P=0.03).In addition,the sensitivity and specificity of multimodal IONM were comparable between the two groups.There was no significant difference in the incidence of abnormal SSEPs,the incidence of IONM alarm events and the incidence of postoperative neurological symptoms between the two groups(P＞0.05).Conclusions:Multimodal IONM provides excellent monitoring effects in severe CS paitents undergoing 3-column osteotomy surgery.The latency of SSEPs-P37 in the concave side lower ex-tremity of CS patients with intraspinal anomalies was significantly longer than that of CS patients without in-traspinal anomalies.Intraspinal anomalies don't increase the incidence of intraoperative IONM alarm events or the incidence of postoperative neurological complications.

Liposuction abdominoplasty is a prevalent procedure in plastic surgery, with common complications including infection and bleeding. However, cases leading to intestinal rupture accompanied by extensive abdominal wall infection are extremely infrequent. One such case was reported in this article. The patient was a 37-year-old female who developed symptoms of abdominal pain, vomiting, and fever after undergoing liposuction abdominoplasty at another hospital. She was admitted to the First Affiliated Hospital of Wenzhou Medical University on October 27, 2023. CT scan revealed a right lower abdominal wall hernia, intestinal obstruction, and abdominal wall infection. Intra-operative exploration demonstrated that a portion of the ileum had herniated subcutaneously, with multiple small perforations. There was also widespread soft-tissue infection in the subcutaneous area, along with partial skin necrosis. Emergency surgery was performed to repair the ruptured intestine. Biological dressing were used to cover and protect the exposed intestinal wall and the defective abdominal wall. Multiple debridement procedures and vacuum sealing drainage were performed for the extensive subcutaneous soft-tissue infection. Bacterial culture of the drainage fluid indicated Escherichia coli infection, and imipenem-cilastatin was administered for anti-infective treatment. After the infection was controlled, the wound was repaired with local flaps and fascia lata. During the six-month follow-up after discharge, the patient’s general condition remained satisfactory, with normal dietary intake and a well-healed wound. This case report particularly highlights that for patients with a prior history of abdominal surgery should undergo preoperative abdominal CT and other relevant examinations before liposuction to exclude potential risk factors such as incisional hernias and ensure patient safety.

Objectives:To assess the midterm efficacy of distal subapical vertebra posterior shift combined with rotational osteotomy for severe angular kyphosis correction.Methods:A retrospective analysis was con-ducted on the clinical data of 35 patients with severe spinal angular kyphosis who underwent posterior shift combined with rotational osteotomy at distal subapical vertebra in our department from October 2016 to May 2022.There were 23 males and 12 females,the average age was 30.8±12.4 years(15-61 years),with 13 cas-es combined with nerve damage.Follow-up duration ranged from 2 to 6 years(mean 3.5 years).Full-length anteroposterior and lateral X-ray examination of the spine in a standing position was performed before opera-tion,immediately after orthopedic surgery,and at 2-year follow-up,and the kyphotic angle,sagittal vertical axis(SVA),as well as sagittal apex deviation were measured and evaluated.The recovery of neurological func-tion was evaluated by the Frankel classification of neurological function before operation,and at 2 weeks and 6 months after operation.Results:All 35 patients successfully underwent the surgery,resulting in a signifi-cant decrease in the kyphotic Cobb angle from 104.6°±13.2° preoperatively to 32.1°±18.4° postoperatively(P＜0.05),with an improvement rate of 69.3％.Additionally,the SVA decreased from 4.9±4.4cm before surgery to 2.6±1.5cm after surgery immediately(P＜0.05),and the sagittal apex deviation decreased from 10.9±2.0cm to 5.5±1.4cm(P＜0.05).Furthermore,12 out of the 13 patients with nerve damage showed improvement at the fi-nal follow-up assessment,1 case showed no change compared with that before operation.Conclusions:Poste-rior shift combined with rotational osteotomy at distal subapical vertebra in the management of severe angular kyphosis can yield favorable orthopedic outcomes,which serves as a novel surgical option for managing severe angular spinal kyphosis.

The oral and maxillofacial region comprises a variety of organs made up of multiple soft and hard tissue, which are anatomically vulnerable to the pathogenic factors of trauma, inflammation, and cancer. The studies of this intricate entity have been long-termly challenged by a lack of versatile preclinical models. Recently, the advancements in the organoid industry have provided novel strategies to break through this dilemma. Here, we summarize the existing biological and engineering approaches that were employed to generate oral and maxillofacial organoids. Then, we detail the use of modified co-culture methods, such as cell cluster co-inoculation and air-liquid interface culture technology to reconstitute the vascular network and immune microenvironment in assembled organoids. We further retrospect the existing oral and maxillofacial assembled organoids and their potential to recapitulate the homeostasis in parental tissues such as tooth, salivary gland, and mucosa. Finally, we discuss how the next-generation organoids may benefit to regenerative and precision medicine for treatment of oral-maxillofacial illness.
Organoids ; Humans ; Tissue Engineering/methods* ; Coculture Techniques ; Regenerative Medicine ; Mouth

A decline in mucosal vascularity is a histological hallmark of oral submucous fibrosis(OSF),a premalignant disease that is largely induced by betel quid chewing.However,the lack of available models has challenged studies of angiogenesis in OSF.Here,we found that the expression of thrombospondin 1(THBS1),an endogenous angiostatic protein,was elevated in the stroma of tissues with OSF.Using a fibroblast-attached organoid(FAO)model,the overexpression of THBS1 in OSF was stably recapitulated in vitro.In the FAO model,treatment with arecoline,a major pathogenic component in areca nuts,enhanced the secretion of transforming growth factor(TGF)-β1 by epithelial cells,which then promoted the expression of THBS1 in fibroblasts.Furthermore,human umbilical vein endothelial cells(HUVECs)were incorporated into the FAO to mimic the vascularized component.Overexpression of THBS1 in fibroblasts drastically suppressed the sprouting ability of endothelial cells in vascularized FAOs(vFAOs).Consistently,treatment with arecoline reduced the expression of CD31 in vFAOs,and this effect was attenuated when the endothelial cells were preincubated with neutralizing antibody of CD36,a receptor of THBS1.Finally,in an arecoline-induced rat OSF model,THBS1 inhibition alleviated collagen deposition and the decline in vascularity in vivo.Overall,we exploited an assembled organoid model to study OSF pathogenesis and provide a rationale for targeting THBS1.

Objective:To design a medical big data center based on data warehouse(DW)and data service platform,to integrate information resources between different information systems and organizational structures,to build a secure channel for data sharing,and to meet the needs of clinical application data.Methods:Based on data flow direction,and according to hospital clinical services,operation management,and scientific research development,a top-down data application layer,data service layer,DW layer,and operational data storage(ODS)layer design architecture was adopted to design a medical big data center based on DW and data service platform.Guided by hospital data and business,according to the"object-event-report"data splitting logic,the activities corresponding to the roles in each subject domain were disassembled and sorted out to facilitate quick invocation in clinical applications.Results:The medical big data center was equipped with basic modules for patient master index management and master data management,covering 16 major business subject domains and 52 business subdomains,including hospital's clinical services,hospital management,and patient identification.The medical big data center application included clinical data center,operation data center and scientific research data center,and clearly defined the correlation logic between major categories of information,centrally managed the whole life cycle of service application program interfaces,combined master data information,comprehensively managed medical data,realized the normalization of hospital data,and established high-quality data assets and flexible DW models with the help of big data technology.Conclusion:The medical big data center based on DW and data service platform can integrate different information systems of the hospital with data within the hospital,realize the convenient invocation of interface services and the standardized and persistent management of hospital data,and ensure the data applications needs of clinical application,operational decision-making,and scientific research analysis.