Objective:To construct a virtual-real interactive system HE-01 for the treatment of microtia based on HoloLens and verify the feasibility of applying HE-01 in ear reconstruction.Methods:Six volunteers (3 males and 3 females, average age: 20.5 years old) and six patients with microtia(3 males and 3 females, average age: 7.6 years old) were recruited from Plastic Surgery Hospital of Chinese Academy of Medical Sciences from August to September 2021. The Mimics Research 21.0 software and 3-matic research software were used to construct a virtual three-dimensional auricle model. Based on HoloLens and occlusal splint navigation marker device, the virtual-real interactive system HE-01 for the treatment of microtia was constructed. The registration accuracy, tracking delay and display effect of different colors (red, green, blue and skin color) of HE-01 were evaluated through repeated experiments of volunteers. The operation process was defined through repeated experiments of patients and the feasibility of applying HE-01 in auricular reconstruction was verified.Results:HE-01 was built successfully and the operation flow was clear. The experiment of six volunteers (12 ears) showed a high registration accuracy (average error rate 2.3%-2.4%, less than 2.7% of the bilateral auricle size difference of normal people), low tracking delay (six volunteers were all less than 0.1 s), and best green and red display effect of virtual auricle guide under different angles (-60°, -30°, 0°, 30°, 60°). Experiments of patients with microtia showed that HE-01 could be applied to auricular reconstruction, and there were no obvious complications in wearing the navigation marker device, which had repeatability and stability.Conclusion:This study has completed the conceptual design of augmented-reality assisted auricular reconstruction based on navigation device, CT data and HoloLens. HE-01 has good registration accuracy, tracking speed and display effect, laying a good foundation for further software development and clinical transformation.

Objective:To construct a virtual-real interactive system HE-01 for the treatment of microtia based on HoloLens and verify the feasibility of applying HE-01 in ear reconstruction.Methods:Six volunteers (3 males and 3 females, average age: 20.5 years old) and six patients with microtia(3 males and 3 females, average age: 7.6 years old) were recruited from Plastic Surgery Hospital of Chinese Academy of Medical Sciences from August to September 2021. The Mimics Research 21.0 software and 3-matic research software were used to construct a virtual three-dimensional auricle model. Based on HoloLens and occlusal splint navigation marker device, the virtual-real interactive system HE-01 for the treatment of microtia was constructed. The registration accuracy, tracking delay and display effect of different colors (red, green, blue and skin color) of HE-01 were evaluated through repeated experiments of volunteers. The operation process was defined through repeated experiments of patients and the feasibility of applying HE-01 in auricular reconstruction was verified.Results:HE-01 was built successfully and the operation flow was clear. The experiment of six volunteers (12 ears) showed a high registration accuracy (average error rate 2.3%-2.4%, less than 2.7% of the bilateral auricle size difference of normal people), low tracking delay (six volunteers were all less than 0.1 s), and best green and red display effect of virtual auricle guide under different angles (-60°, -30°, 0°, 30°, 60°). Experiments of patients with microtia showed that HE-01 could be applied to auricular reconstruction, and there were no obvious complications in wearing the navigation marker device, which had repeatability and stability.Conclusion:This study has completed the conceptual design of augmented-reality assisted auricular reconstruction based on navigation device, CT data and HoloLens. HE-01 has good registration accuracy, tracking speed and display effect, laying a good foundation for further software development and clinical transformation.

Objective:To analyze the characteristics of postoperative thoracic deformation in patients who underwent multi-rib autologous rib cartilage transplantation auricle reconstruction based on 3dMD imaging system.Methods:A retrospective study was conducted using 3dMD data of the thorax from patients who underwent auricle reconstruction surgery using multiple autologous costal cartilages at the First Department of Ear Reconstruction of the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from July to September 2019. The normal-side chest wall image was superimposed on the rib-harvested side chest wall for automatic registration and alignment, with distance numerical data presented in a Cartesian heat map through color mapping technology. By observing the areas where the rib-harvested side thorax had obvious deformation, the distance difference of the concave and convex peaks on the sagittal diameter was measured to judge the degree of thoracic deformation in children (≤10 mm as none; >10-20 mm as mild; >20-30 mm as moderate; >30 mm as severe).Results:A total of 42 children were included, with 27 males and 15 females, aged from 7 to 12 years old. The Cartesian heat map of thoracic deformation showed that the obvious concave area of the chest wall was located at the junction of the middle and inner one-third of the clavicle and the 7th rib, and the obvious convex area was located in the area from the nipple to the 5th rib. The measurement range of the protrusion peak in the upper chest nipple area was from -7.638 9 to -14.288 4 mm; the measurement range of the depression peak in the rib arch area was from 7.238 7 to 14.653 2 mm. The range of the distance difference between the concave and convex peaks was from 14.877 6 to 28.941 6 mm.The degree and incidence of thoracic deformation in children: mild in 5 cases; moderate in 37 cases.Conclusion:Based on the analysis with 3dMD photogrammetry, the overall characteristics of chest wall deformation in patients who underwent ear reconstruction with autologous rib cartilage grafts were the coexistence of protrusion in the upper chest nipple area and depression in the area where the rib cartilage was harvested, with changes occurring on the sagittal diameter.

The nomenclature of congenital auricular malformations is complex and confusing, which brings great inconvenience to clinical work and scientific research. This study comprehensively summarized and sorted out the existing Chinese and English names of congenital auricular malformations, providing reference basis for the scientific classification and clinical treatment of congenital auricular malformations. Sixty-seven papers on the topic of congenital auricle malformations were collected from databases such as CNKI, Wanfang Database, VIP Database, PubMed, Web of Science, and ScienceDirect by using the PRISMA method. The two core issues of morphological and anatomical naming and classification of congenital auricle malformations were sorted and summarized based on these articles. In this study, the existing Chinese and English names of congenital auricular malformations were summarized, and a preliminary classification was made at the morphological and anatomical levels, and the embryological origin of the external auricle and its substructures was elaborated. Based on the result of this study, a comprehensive analysis can be conducted on the malformations of the ear structures and their embryological origins in order to explore the etiology of congenital ear malformations. It is expected that scientific and standardized naming and classification method can be developed, and reasonable and effective standardized treatment can be formulated for congenital auricular malformations based on this study.

Objective:To analyze the characteristics of postoperative thoracic deformation in patients who underwent multi-rib autologous rib cartilage transplantation auricle reconstruction based on 3dMD imaging system.Methods:A retrospective study was conducted using 3dMD data of the thorax from patients who underwent auricle reconstruction surgery using multiple autologous costal cartilages at the First Department of Ear Reconstruction of the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from July to September 2019. The normal-side chest wall image was superimposed on the rib-harvested side chest wall for automatic registration and alignment, with distance numerical data presented in a Cartesian heat map through color mapping technology. By observing the areas where the rib-harvested side thorax had obvious deformation, the distance difference of the concave and convex peaks on the sagittal diameter was measured to judge the degree of thoracic deformation in children (≤10 mm as none; >10-20 mm as mild; >20-30 mm as moderate; >30 mm as severe).Results:A total of 42 children were included, with 27 males and 15 females, aged from 7 to 12 years old. The Cartesian heat map of thoracic deformation showed that the obvious concave area of the chest wall was located at the junction of the middle and inner one-third of the clavicle and the 7th rib, and the obvious convex area was located in the area from the nipple to the 5th rib. The measurement range of the protrusion peak in the upper chest nipple area was from -7.638 9 to -14.288 4 mm; the measurement range of the depression peak in the rib arch area was from 7.238 7 to 14.653 2 mm. The range of the distance difference between the concave and convex peaks was from 14.877 6 to 28.941 6 mm.The degree and incidence of thoracic deformation in children: mild in 5 cases; moderate in 37 cases.Conclusion:Based on the analysis with 3dMD photogrammetry, the overall characteristics of chest wall deformation in patients who underwent ear reconstruction with autologous rib cartilage grafts were the coexistence of protrusion in the upper chest nipple area and depression in the area where the rib cartilage was harvested, with changes occurring on the sagittal diameter.

The nomenclature of congenital auricular malformations is complex and confusing, which brings great inconvenience to clinical work and scientific research. This study comprehensively summarized and sorted out the existing Chinese and English names of congenital auricular malformations, providing reference basis for the scientific classification and clinical treatment of congenital auricular malformations. Sixty-seven papers on the topic of congenital auricle malformations were collected from databases such as CNKI, Wanfang Database, VIP Database, PubMed, Web of Science, and ScienceDirect by using the PRISMA method. The two core issues of morphological and anatomical naming and classification of congenital auricle malformations were sorted and summarized based on these articles. In this study, the existing Chinese and English names of congenital auricular malformations were summarized, and a preliminary classification was made at the morphological and anatomical levels, and the embryological origin of the external auricle and its substructures was elaborated. Based on the result of this study, a comprehensive analysis can be conducted on the malformations of the ear structures and their embryological origins in order to explore the etiology of congenital ear malformations. It is expected that scientific and standardized naming and classification method can be developed, and reasonable and effective standardized treatment can be formulated for congenital auricular malformations based on this study.

Objective:To explore the expression of hypoxia-inducible factor-1α (HIF-1α) in different types of congenital microtia chondrocytes and normal ear chondrocytes, and the relationship with oxygen concentrations.Methods:The experimental samples were from the patients with unilateral congenital microtia admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences during September 1st, 2021 to October 31st, 2022, including 6 cases of unilateral lobular type congenital microtia (experimental group 1), 6 cases of conchal type (experimental group 2), and 6 cases of normal ear cartilage (experimental group 3). And auricle chondrocytes of each group were extracted respectively. The chondrocytes of each group were cultured in an incubator with an oxygen concentrations of 21%, 10%, 5%, and 1% respectively. After 12 h, total RNA was collected and the expression of HIF-1α at the mRNA level was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). Immunofluorescence staining was used to detect the expression of HIF-1α protein in chondrocytes. Statistical analysis was performed using GraphPad Prism 8.0 software. One-way ANOVA was used for comparison between groups, and SNK test was used for pairwise comparison. P<0.05 was considered statistically significant. Results:RT-qPCR results showed the relative expression levels of HIF-1α mRNA in ear chondrocytes under 21%, 10%, 5%, and 1% oxygen concentrations. In experimental group 1 the relative expression levels of HIF-1α mRNA were 0.031 8±0.006 0, 0.043 4±0.001 0, 0.049 5±0.000 9, 0.030 5±0.001 0 respectively; experimental group 2, 0.036 9±0.000 6, 0.047 4±0.000 8, 0.054 1±0.000 4, 0.034 1±0.001 8 respectively; experimental group 3, 0.041 6±0.000 4, 0.055 6±0.000 6, 0.070 1±0.001 9, 0.077 2±0.000 9 respectively; the difference of relative expression of HIF-1α mRNA in the three groups was statistically significant under the condition of 21% and 5% oxygen concentration ( P<0.01). Immunofluorescence staining showed that the HIF-1α protein in experimental groups 1 and 2 was partially located in the nucleus and partially located in the cytoplasm, while in the experimental group 3 it was located in the nucleus at 5% oxygen concentration. Conclusion:HIF-1α is expressed in both types of lobular and conchal congenital microtia and normal ear chondrocytes, and the expression level is negatively correlated with the severity of the deformity. When oxygen concentration varied from 21% to 1%, the changing trend of HIF-1α mRNA in type lobular and type conchal microtia is similar, and the expression level is negatively correlated with the severity of the abnormality, and the peak value appeared at 5% oxygen concentration, decreased at 1% oxygen concentration, but continued to increase in normal ear chondrocytes. At 5% oxygen concentration, the location of HIF-1α protein in the nucleus of chondrocytes with microtia is different from normal chondrocytes.

This paper is a discussion about the article "the essential elements in the development of medical aesthetics: '未来Future Codes’ aesthetic system". The aesthetic judgment of body image, the technique and limitation of medical aesthetics were clarified herein.

Objective:To construct a system HE-01 for the treatment of microtia based on HoloLens and verify the feasibility the application of HE-01 in ear reconstruction.Methods:Six volunteers and six patients with microtia were recruited from Plastic Surgery Hospital of Chinese Academy of Medical Sciences from August to September 2021. Mimics Research and 3-matic research software were used to construct a virtual three-dimensional auricle model. Based on HoloLens and occlusal splint navigation marker device, the virtual-real interactive system HE-01 for the treatment of microtia was constructed. The registration accuracy, tracking delay and display effect of HE-01 were evaluated through repeated experiments of volunteers. The operation process was defined through repeated experiments of patients and the feasibility of applying HE-01 in auricular reconstruction was verified.Results:HE-01 was built successfully and the operation flow was clear. The experiment of volunteers showed that under different angles, the registration accuracy was high (less than 2.7% of the bilateral auricle size difference of normal people), the tracking delay was low (less than 0.1s), and the green and red display effect of virtual auricle guide was the best. Experiments of patients with microtia showed that HE-01 could be applied to auricular reconstruction, and there were no obvious complications in wearing the navigation marker device, which had repeatability and stability.Conclusion:This study has completed the conceptual design of augmented-reality assisted auricular reconstruction based on navigation device, CT data and HoloLens. HE-01 has good registration accuracy, tracking speed and display effect, laying a good foundation for further software development and clinical transformation.

Objective:To explore the expression of hypoxia-inducible factor-1α (HIF-1α) in different types of congenital microtia chondrocytes and normal ear chondrocytes, and the relationship with oxygen concentrations.Methods:The experimental samples were from the patients with unilateral congenital microtia admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences during September 1st, 2021 to October 31st, 2022, including 6 cases of unilateral lobular type congenital microtia (experimental group 1), 6 cases of conchal type (experimental group 2), and 6 cases of normal ear cartilage (experimental group 3). And auricle chondrocytes of each group were extracted respectively. The chondrocytes of each group were cultured in an incubator with an oxygen concentrations of 21%, 10%, 5%, and 1% respectively. After 12 h, total RNA was collected and the expression of HIF-1α at the mRNA level was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). Immunofluorescence staining was used to detect the expression of HIF-1α protein in chondrocytes. Statistical analysis was performed using GraphPad Prism 8.0 software. One-way ANOVA was used for comparison between groups, and SNK test was used for pairwise comparison. P<0.05 was considered statistically significant. Results:RT-qPCR results showed the relative expression levels of HIF-1α mRNA in ear chondrocytes under 21%, 10%, 5%, and 1% oxygen concentrations. In experimental group 1 the relative expression levels of HIF-1α mRNA were 0.031 8±0.006 0, 0.043 4±0.001 0, 0.049 5±0.000 9, 0.030 5±0.001 0 respectively; experimental group 2, 0.036 9±0.000 6, 0.047 4±0.000 8, 0.054 1±0.000 4, 0.034 1±0.001 8 respectively; experimental group 3, 0.041 6±0.000 4, 0.055 6±0.000 6, 0.070 1±0.001 9, 0.077 2±0.000 9 respectively; the difference of relative expression of HIF-1α mRNA in the three groups was statistically significant under the condition of 21% and 5% oxygen concentration ( P<0.01). Immunofluorescence staining showed that the HIF-1α protein in experimental groups 1 and 2 was partially located in the nucleus and partially located in the cytoplasm, while in the experimental group 3 it was located in the nucleus at 5% oxygen concentration. Conclusion:HIF-1α is expressed in both types of lobular and conchal congenital microtia and normal ear chondrocytes, and the expression level is negatively correlated with the severity of the deformity. When oxygen concentration varied from 21% to 1%, the changing trend of HIF-1α mRNA in type lobular and type conchal microtia is similar, and the expression level is negatively correlated with the severity of the abnormality, and the peak value appeared at 5% oxygen concentration, decreased at 1% oxygen concentration, but continued to increase in normal ear chondrocytes. At 5% oxygen concentration, the location of HIF-1α protein in the nucleus of chondrocytes with microtia is different from normal chondrocytes.