Neurofibromatosis type 1 (NF1) presents with a diverse range of symptoms that can affect the skin, bones, eyes, central nervous system, and other organs. This article reports the diagnosis and treatment process of a patient with NF1 complicated by bilateral severe-to-profound sensorineural hearing loss. Genetic testing revealed a heterozygous variant of NF1 NM_ 000267.3: c.4054_ 4058del(p.Ser1352LeufsTer20, supporting the diagnosis of NF1. After thorough evaluation, a right cochlear implantation was performed, yielding satisfactory postoperative results. This case suggests that NF1 patients may exhibit phenotypic heterogeneity and atypicality, providing a reference for clinicians in the diagnosis and treatment of such patients.

In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

In recent years, the number of patients with vaginal relaxation has increased year by year, and the minimally invasive vaginal contraction has been carried out more and more widely in clinical practice, but the treatment normalization and safety have not been thoroughly studied. We summarized six cases of characteristics and treatment measures for patients with various complications after minimally invasive vaginal contraction surgery from September 2021 to December 2023 at Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital. The patients' age ranged from 26 to 44 years. Two cases accepted vaginal contraction with embedded vaginal thread, and four accepted vaginal contraction with acellular allogenic dermis. One patient showed vaginal hyper-tightness, one patient showed subcutaneous suture nodules, two patients showed explosion of acellular allogenic dermis, and three patients showed vaginal infection symptoms such as yellow leucorrhea and peculiar smell. All patients had sexual pain and discomfort. One patient underwent vaginal orifice dilation, one patient underwent suture extraction and secondary vaginal contraction, one patient underwent acellular allogenic dermis extraction and immediate vaginal contraction, two patients underwent acellular allogenic dermis extraction and secondary vaginal contraction, and one patient underwent secondary vaginal contraction. The symptoms of all six patients were relieved after treatment. Despite the short operation time and fast postoperative recovery of minimally invasive vaginal contraction, there are still complications after surgery, causing physical and mental damage to patients. Plastic surgeons, therefore, should be cautious in the treatment process to avoid collateral damage, so that patients get the best treatment effect.

Objective To investigate the optimal target and prognostic significance of SBP in hospi-talized octogenarian male patients with heart failure with preserved ejection fraction(HFpEF).Methods A total of 952 male HFpEF inpatients aged ≥80 years admitted in Department of Car-diovascular Diseases of Second Medical Center of Chinese PLA General Hospital from July 2012 to June 2023 were recruited.According to their SBP value at discharge(1 mm Hg=0.133 kPa),they were divided into＜100 mm Hg group(29 cases),100-150 mm Hg group(677 cases),and＞150 mm Hg group(246 cases).General clinical data of all patients were collected,and all-cause mortality rate was regarded as the endpoint event.Results The mortality rate was 82.8％(24/29),63.5％(430/677)and 55.7％(137/246)in the SBP＜100,100-150 and＞150 mm Hg groups,respectively,and statistical difference was observed in the rate among the three groups(P=0.006).The mortality rate of patients with SBP＜100 mm Hg was significantly higher than that of the other two groups(x2=22.70,Plog-rank＜0.01).The patients with SBP 100-150 and＞150 mm Hg had notably lower risk for mortality than those with SBP＜100 mm Hg(P=0.015).Conclusion SBP＜100 mm Hg is closely associated with an increased risk of all-cause mortality in octogenarian male HFpEF inpatients.

Objective:To improve and optimize the modified surgical strategies for patents with Simon Ⅰ and Simon Ⅱ type of gynecomastia, based on their magnetic resonance imaging (MRI) features.Methods:Clinical data of 190 patients aged 12 to 56 years (mean age 26.7±8.6) with gynecomastia who underwent modified surgeries in the Department of Plastic Surgery of Peking Union Medical College Hospital from January 2017 to January 2023 were retrospectively analyzed. The study measured breast MRI images of 44 male patients to calculate the area ratio of the glands on the transverse plane via nipple. This provided insight into the physiological structure and the tissue distribution of gynecomastia for improving the modified surgical strategies. All 190 patients were treated with enhanced liposuction and " Pull-Through and Bottom-Up" techniques. The duration of operation, amount of liposuction and amount of glandular resection, postoperative complications were recorded, and postoperative satisfaction was investigated by questionnaire surveys.Results:MRI images of the 87-side male breast showed that the average area ratio of the glands on the transverse plane via nipple was (10.9±12.5) %. The most prevalent subtype of gynecomastia was branch pattern, accounting for 46.0%. The median surgical duration of 190 patients was 95 (65-210) minutes, the median liposuction volume was 300 (50-1 400) ml, and the median glandular removal was 19.9 (1.5-157.0) g. Eighty-eight patients (46.3%) went through followed up for more than 6 months post-posterative with an overall satisfaction score of 4.68±0.53. Postoperative complications occurred in 19 sides (5.1%), and the reoperation rate was 1.3%.Conclusions:The MRI imaging of gynecomastia shows that the component of patients′ breasts are mainly fat, with a small amount of glandular tissue and the dominant subtype is branch pattern. Enhanced liposuction combined with " Pull-Through and Bottom-Up" stab incision technique can be an effective treatment for Simon grades Ⅰ and Ⅱ gynecomastia. The method results in high patient satisfaction with fewer postoperative complications.

Objective:To evaluate the differences and aesthetic meaning of stable vitiligo treatment in the face and neck region using suction blister transplantation or noncultured autologous suspension of epidermal cells.Methods:Sixty-four stable vitiligo patients (25 males and 39 females with age ranges from 10 to 46 years, average 25 years) in the face and neck region were randomly divided into two groups (32 patients in each group): one group received suction blister transplantation, while other group received noncultured autologous suspension of epidermal cells. Patients′treatment effectiveness, pigmentation and piecing deformity were evaluated in postoperative 3 months and 6 months.Results:In the postoperative 3 months and 6 months, the effectiveness of suction blister transplantation group was 68.75% (22/32) and 90.63% (29/32), respectively, while the effectiveness of noncultured autologous suspension of epidermal cells group was 59.37% (19/32) and 87.50% (28/32), respectively, in which no significant differences were found between two groups ( P>0.05). No obvious pigmentation and piecing deformity were found in noncultured autologous suspension of epidermal cells group, which were much better than the suction blister transplantation group in postoperative 3 months and 6 months. Conclusions:Both suction blister transplantation and noncultured autologous suspension of epidermal cells could bring good treatment effectiveness for patients of stable vitiligo in the face and neck region. Compared with suction blister transplantation, noncultured autologous suspension of epidermal cells could offer better aesthetic appearance.

Objective:To summarize the clinical diagnosis and treatment process of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) in symptomatic patients with textured breast implants in Peking Union Medical College Hospital in order to provide reference for the management of such patients in China.Methods:From January 2019 to September 2021, 23 symptomatic patients with textured breast implants were admitted to the Peking Union Medical College Hospital, aged 29-52 years, with an average of 36.2 years. All patients agreed to remove the prosthesis by surgery, and accepted cytology, flow cytometry, and immunohistochemical examination of the fluid around the implants and capsule tissue before or during the operation to complete the BIA-ALCL screening process.Results:All 23 patients presented with unilateral periprosthetic fluid accumulation, with fluid volume ranging from 20 to 130 ml, of which 7 cases were combined with periprosthetic contracture. No tumor cells were found in the pathological findings of effusion and the capsule tissue, and the BIA-ALCL pathologic screening results (CD 30 and ALK) were all negative. No bleeding, infection, wound dehiscence and other complications occurred after the operation.Conclusions:A personalized clinical process should be developed for symptomatic patients with textured breast implants. Attention should be paid to imaging and pathological examinations.

Targeted therapy is one of the conventional treatments for advanced hepato-cellular carcinoma (HCC). In recent years, immunotherapy has created a new era of HCC treatment. The combination of targeted therapy and immunotherapy has synergistic effects, which taking survival benefits to patients with advanced HCC. Local therapy, represented by interventional treatment, can rapidly control the development of tumor and promote the expression and releasing of tumor antigen. On the basis of local therapy and combination of immunotherapy plus targeted therapy, it can offer the possibility to prolong the survival of patients, and even obtain the chance of cure. The authors introduce the diagnosis and treatment of an advanced HCC patient with inter-ventional treatment combined with immunotherapy plus anti-angiogenesis targeted therapy. Results show that patient achieving pathological complete response and undergoing resection after conver-sion therapy. The patient has a good prognosis with a better quality of live.

Hepatocellular carcinoma is one of the common causes of tumor-related death, and it has high morbidity and mortality rates in China. Recent studies have shown that platelets are closely associated with the development of hepatocellular carcinoma. Literature review shows that platelets not only participate in hemostasis, but also act on liver cells and tumor microenvironment, promote the formation of new blood vessels, and participate in the development and progression of hepatocellular carcinoma as a cell mediator through immune response and other pathways. In addition, platelets and their derivatives can be used as potential therapeutic targets for hepatocellular carcinoma. Therefore, antiplatelet therapy is expected to become a new adjuvant strategy for the treatment of hepatocellular carcinoma, which has important clinical significance.

Objective:To investigate the safety and efficacy of indignant jejunostomy tube in radical resection of gastric carcinoma.Methods:Using "radical gastrectomy, esophagectomy, jejunostomy, enteral nutrition" as the Chinese search terms and "gastrectomy, esophagectomy, jejunostomy, jejunostomies, enteral nutrition" as the English search terms searched Pubmed, MEDLINE, EMbase, Web of Science, Cochrane Library, CNKI, VIP, Wanfang and CBMdisc. The Chinese and English literatures published at home and abroad on indwelling and non-indwelling jejunostomy tubes after radical resection of gastric carcinoma from January 2010 to December 2020 were collected, including randomized controlled trial and cohort studies. The main outcome measure was the length of hospital stay; the secondary outcome measure was the overall postoperative complication rate, postoperative pulmonary infection rate, intestinal obstruction rate, and body weight changes at 3 and 6 months after radical gastrectomy. Meta-analysis was conducted using RevMan 5.2 software.Results:Finally, 12 articles with a total of 2 173 patients were included. Compared with the non-indwelling jejunostomy tube group, the patients in the indwelling group had a longer hospital stay ( WMD=2.05, P=0.01) and a higher incidence of intestinal obstruction ( OR=11.67, P<0.001). The incidence of overall postoperative complications ( OR=1.24, P=0.31), the incidence of postoperative pulmonary infection ( OR=1.43, P=0.13) and 3 months after radical gastrectomy ( WMD=0.58, P=0.24), 6 months ( P>0.05), the difference were not statistically significant. Conclusions:Indwelling jejunostomy tube placement after radical gastrectomy of gastric carcinoma did not show more therapeutic advantages, but prolonged the length of hospital stay and the probability of intestinal obstruction. Therefore, selective jejunostomy tube placement rather than routine jejunostomy placement should be required.