Objectives:To investigate the clinical efficacy of the distal tension-offloading cosmetic suture technique in reducing hypertrophic scar formation following open thyroidectomy.Methods:Clinical data and postoperative incision appearance of 138 patients undergoing open thyroidectomy at the Department of Thyroid and Neck Oncology of Tianjin Medical University Cancer Institute and Hospital, as well as the Department of Head and Neck Oncology of Tianjin Cancer Hospital Airport Hospital, from Aug 2023 to Jan 2024 was enrolled. Patients were devided into two groups based on the incision closure method: the distal tension-offloading cosmetic suture group (tension reduction group, 37 cases) and ordinary intradermal suture group (control group A, 55 cases evaluated 3 months post-surgery; control group B, 46 cases evaluated 6 months post-surgery). The Vancouver Scar Scale (VSS) was employed to assess the appearance of the wounds at 3 and 6 months post-surgery .Results:On 3 and 6 months post-surgery, the total VSS scores for patients in the tension reduction group were 2.8 ± 2.3 and 2.5 ± 2.5, respectively,while that in control group A on 3 months was 5.2 ± 3.0, and in group B on 6 months was 5.3 ± 3.4. The differences were statistically significant (all P<0.001). On 3 and 6 months post-surgery, the proportions of hypertrophic scars in the tension reduction group were 14% (5/37) and 11% (4/37), respectively , while in control group A it was 35% (19/55) , and in control group B was 35% (16/46) at 6 months, with differences being statistically significant ( P=0.024, 0.011 ). On 6 months post-surgery, 51 % (19/37) of patients in the tension reduction group achieved 'socially invisible aesthetic incisions', while only 15% (7/46) of patients in control group B achieved the same outcome ( P<0.01). Conclusion:Distal tension-offloading cosmetic suture significantly reduces the incidence of incision hypertrophic scars in open thyroid surgery.

Allogeneic haemopoietic stem cell transplantation (allo-HSCT)-related nephrotic syndrome is a rare complication, recognized as a clinical manifestation of chronic graft versus host disease (GVHD). T cell dysfunction is thought to play a significant role in the pathogenesis of allo-HSCT-related nephrotic syndrome, but the precise mechanism remains unclear. This paper reported a case of X-linked adrenoleukodystrophy (X-ALD) who had good control of the disease after allo-HSCT, but developed proteinuria and progressed to nephrotic syndrome after immunosuppressive therapy was tapered. Kidney biopsy revealed secondary membranous nephropathy, which responded well to treatment with glucocorticoids and tacrolimus. Limited literature exist on allo-HSCT-related nephrotic syndrome in children. This study provides a comprehensive summary of its mechanism, clinical features, pathology, diagnosis,and treatment, offering valuable insights for diagnosing and managing allo-HSCT-related nephrotic syndrome in pediatric patients.

Allogeneic haemopoietic stem cell transplantation (allo-HSCT)-related nephrotic syndrome is a rare complication, recognized as a clinical manifestation of chronic graft versus host disease (GVHD). T cell dysfunction is thought to play a significant role in the pathogenesis of allo-HSCT-related nephrotic syndrome, but the precise mechanism remains unclear. This paper reported a case of X-linked adrenoleukodystrophy (X-ALD) who had good control of the disease after allo-HSCT, but developed proteinuria and progressed to nephrotic syndrome after immunosuppressive therapy was tapered. Kidney biopsy revealed secondary membranous nephropathy, which responded well to treatment with glucocorticoids and tacrolimus. Limited literature exist on allo-HSCT-related nephrotic syndrome in children. This study provides a comprehensive summary of its mechanism, clinical features, pathology, diagnosis,and treatment, offering valuable insights for diagnosing and managing allo-HSCT-related nephrotic syndrome in pediatric patients.

Objectives:To investigate the clinical efficacy of the distal tension-offloading cosmetic suture technique in reducing hypertrophic scar formation following open thyroidectomy.Methods:Clinical data and postoperative incision appearance of 138 patients undergoing open thyroidectomy at the Department of Thyroid and Neck Oncology of Tianjin Medical University Cancer Institute and Hospital, as well as the Department of Head and Neck Oncology of Tianjin Cancer Hospital Airport Hospital, from Aug 2023 to Jan 2024 was enrolled. Patients were devided into two groups based on the incision closure method: the distal tension-offloading cosmetic suture group (tension reduction group, 37 cases) and ordinary intradermal suture group (control group A, 55 cases evaluated 3 months post-surgery; control group B, 46 cases evaluated 6 months post-surgery). The Vancouver Scar Scale (VSS) was employed to assess the appearance of the wounds at 3 and 6 months post-surgery .Results:On 3 and 6 months post-surgery, the total VSS scores for patients in the tension reduction group were 2.8 ± 2.3 and 2.5 ± 2.5, respectively,while that in control group A on 3 months was 5.2 ± 3.0, and in group B on 6 months was 5.3 ± 3.4. The differences were statistically significant (all P<0.001). On 3 and 6 months post-surgery, the proportions of hypertrophic scars in the tension reduction group were 14% (5/37) and 11% (4/37), respectively , while in control group A it was 35% (19/55) , and in control group B was 35% (16/46) at 6 months, with differences being statistically significant ( P=0.024, 0.011 ). On 6 months post-surgery, 51 % (19/37) of patients in the tension reduction group achieved 'socially invisible aesthetic incisions', while only 15% (7/46) of patients in control group B achieved the same outcome ( P<0.01). Conclusion:Distal tension-offloading cosmetic suture significantly reduces the incidence of incision hypertrophic scars in open thyroid surgery.