Objective:To observe the application and clinical effect of stromal vascular fraction gel (SVF-gel) in local rhinoplasty.Methods:A total of 84 patients with mild nasal root and low bridge were divided into observation group and control group. In the observation group, liposuction with SVF gel extraction plus injection rhinoplasty was carried out; in the control group, liposuction plus injection rhinoplasty was carried out according to the height change of nasal root and bridge, the change of nasal frontal angle, the occurrence of complications and the satisfaction of patients after operation.Results:The 84 patients were followed up for 2 weeks to 24 months. The height of nasal root and bridge increased significantly and the lines were more harmonious. The absorption of the observation group was much lower than that of control group. Except 3 patients in the observation group and 8 patients in the control group, there were different degrees of absorption within 6 months after operation. All patients did not have complications such as fat liquefaction, necrosis, induration and infection in the injection area. Three patients in the observation group were satisfied with the results after reinjection, and one patient in the control group was satisfied with the results after reinjection, three patients were not satisfied with the results, and four patients were satisfied with the prosthesis augmentation rhinoplasty. In the observation group, there were 37 cases of excellent satisfaction, 5 cases of good satisfaction, and the overall satisfaction was 100%; in the control group, there were 20 cases of excellent satisfaction, 15 cases of good satisfaction, 7 cases of bad satisfaction, and the satisfaction was 83.3%. The former was better than the latter.Conclusions:In view of superiorities such as lower complications with long-lasting effect, high fat survival rate and high satisfaction in local augmentation rhinoplasty, SVF-gel injection is especially suitable for patients who cannot accept autologous bone, prosthesis and allograft tissue filler for augmentation rhinoplasty.

Objective: To discuss and analyze the respective clinical effects of autologous fat filling for facial rejuvenation in the same period of three months after incisions. Methods: From June 2015 to January 2018, 117 patients with facial rejuvenation admitted to the Plastic Surgery Hospital of Weifang Medical College were randomly divided into A, B and C groups. Group A (39 cases, male 3 cases, female 36 cases, age 44-67 years old) received simple rhytidectomy. Group B (39 cases, male 4 cases, female 35 cases, age 45-67 years old) underwent rhytidectomy and autologous fat filling at the same time. Group C (39 cases, male 3 cases, female 36 cases, age 45-65 years old) received autologous fat filling 3 months after rhytidectomy. We compared the improvement of facial depression (nasolabial groove and mouth angle), the effect of facial rejuvenation after fat filling in three groups and the incidence of complications in group B and C. Results: 15 cases in group A, 12 cases in group B and 2 cases in group C had no obvious improvement in facial atrophy, the remaining 88 cases had obvious improvement compared with before operation, and achieved the effect of facial rejuvenation. The incidence of complications in group C (7.69%) was significantly lower than that in group B (35.90%), the excellent or good rate of facial improvement and the nasolabial groove and peri-oral depression improvement in group C (87.18%, 92.31%) was significantly higher than that in group B (64.10%, 64.10%) and group A (33.33%, 17.95%) (P<0.05). Conclusions Comparative analysis of fat filling after 3 months of wrinkle removal to improve facial soft tissue atrophy and collapse is more obvious and more permanent in effect than fat filling, which is worthy of clinical promotion.

Lipedema is secondary to local fat deposition, a disease characterized by the symmetric thickening of lower limbs, mostly occurs in women, especially in adolescence and pregnancy. In its early stage, it could be easily confused with lymphedema. Extensive literature review on primary fat edema in recent years, as well as a summary of the clinical symptoms and signs and diagnosis and treatment of lipedema were conducted, so as to provide a useful reference for clinicians.

Objective: To explore the biological characteristics of synovial fluid-derived mesenchymal stem cells (SF-MSCs) cultured in serum-free medium and the ability of in vitro reconstruction of three-dimensional cartilage combined with scaffold material. Methods: Human SF-MSCs were cultured in serum medium and mesenchymal stem cells medium-serum free (MSCM-sf) respectively, then the proliferative ability and morphology of SF-MSCs were compared; The third passage SF-MSCs cultured in MSCM-sf were identified by flow cytometry, three-way(chondrogenic, osteogenic, adipogenic)differentiation assay and induced for chondrogenic differentiation when combined with polyglycolic acid/polylactic acid (PGA/PLA). Results: SF-MSCs cultured in MSCM-sf had better morphology and proliferative ability than that cultured in serum medium. The expression levels of positive markers of the third passage SF-MSCs cultured in MSCM-sf, such as CD73 (99.5%), CD90 (98.9%) and CD105 (96.5%), were more than 95%. However, the overall negative markers (CD34, HLA-DR and CD11b) expressed less than 2%. Three-way differentiation staining was positive. The combination of SF-MSCs and PGA / PLA can be induced into cartilage in vitro. Conclusions SF-MSCs cultured in MSCM-sf can be amplified under the condition of maintaining the stem cell characteristics, and can be combined with PGA/PLA scaffold to construct three-dimensional cartilage in vitro.

Objective To compare the results of thrombelastography (TEG) and the conventional coagulability test in patients with sepsis, and to discuss the value of TEG in monitoring blood coagulation dysfunction in patients with sepsis. Methods The clinical data of 92 adult patients with sepsis admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The patients were divided into sequential organ failure assessment (SOFA) score ≥ 12 group (n = 47) and SOFA < 12 group (n = 45). Thirty-five non-sepsis adult patients with normal coagulation function served as control group. The venous blood was collected for conventional blood coagulation test and routine examination of blood, D-dimer, procalcitonin (PCT), and TEG, and the differences were compared among three groups. Correlations between SOFA and various indexes of patients with sepsis were analyzed by Spearman rank correlation method. Results As shown in the results of the conventional blood coagulation test, D-dimer was gradually increased with the aggravation of the disease, the values in non-sepsis, SOFA < 12, and SOFA ≥ 12 groups were 0.523 (0.273, 0.928), 0.863 (0.673, 4.221), and 4.118 (2.420, 5.653) mg/L respectively (Z = 25.163, P = 0.000). Platelet count (PLT) in SOFA ≥ 12 group was significantly lower than that of the SOFA < 12 group and non-sepsis group [×109/L: 28.6 (12.8, 48.9) vs. 257.3 (152.6, 339.8), 182.0 (118.0, 229.0), both P < 0.01]. There was no significant difference in prothrombin time (PT) and international normalized ratio (INR) among three groups, and it indicated that the conventional blood coagulation test might not respond quickly to the change in coagulation status of sepsis patients. As shown in the results of TEG, the values of reaction time (R value) and kinetics time (K value) in SOFA < 12 group were lower than those of the non-sepsis group [R value (minutes): 4.4 (3.6, 6.1) vs. 6.3 (6.0, 6.7), P < 0.01; K value (minutes): 1.1 (1.0, 1.5) vs. 1.5 (1.3, 1.8), P < 0.05], while they were higher in SOFA ≥ 12 group than those of the non-sepsis group [R value (minutes): 7.0 (5.7, 8.7) vs. 6.3 (6.0, 6.7), P > 0.05; K value (minutes): 4.2 (3.4, 7.1) vs. 1.5 (1.3, 1.8), P < 0.01]. The α angle, maximum amplitude (MA) and coagulation index (CI) in SOFA < 12 group were higher than those of the non-sepsis group [α angle (° ): 73.3 (68.5, 74.7) vs. 66.8 (62.2, 69.0), P < 0.01; MA (mm): 71.7 (61.9, 73.3) vs. 60.3 (58.2, 63.8), P < 0.01; CI: 3.1 (-0.1, 3.9) vs. 0.9 (-0.4, 1.3), P < 0.05], while they were lower in SOFA ≥ 12 group than those of the non-sepsis group [α angle (° ): 48.1 (36.6, 53.0) vs. 66.8 (62.2, 69.0), P < 0.01; MA (mm): 37.8 (30.0, 45.7) vs. 60.3 (58.2, 63.8), P < 0.01; CI: -5.6 (-8.4, -3.6) vs. 0.9 (-0.4, 1.3), P < 0.01]. The above results indicated that TEG could distinguish quickly the hypercoagulability and hypocoagulability status in septic patients. PCT in non-sepsis, SOFA < 12, and SOFA ≥ 12 groups were 0.27 (0.05, 1.80), 0.68 (0.10, 10.00), 41.10 (4.24, 100.00) μg/L respectively (Z = 195.475, P = 0.000), which indicate the severity of infectious disease. Correlation analysis results showed that SOFA score was negatively correlated with PLT, α angle, MA, and CI (r value was -0.853, -0.833, -0.881, and -0.859, respectively, all P = 0.000), and it was positively correlated with activated partial thromboplastin time (APTT), D-dimer, R value, K value, and PCT (r value was 0.381, 0.561, 0.587, 0.831, 0.775, respectively, P < 0.05 or P < 0.01), and non correlations was founded with PT, fibrinogen (FBG), and INR (r1 = 0.211, P1 = 0.233; r2 = -0.252, P2 = 0.142; r3 = 0.248, P3 = 0.148). Conclusions TEG can effectively monitor the change in coagulation in patients with sepsis, and distinguish the hypercoagulable and hypocoagulable state. TEG may be a valuable tool to evaluate degree and risk of sepsis objectively.

Background Studies showed that activation of microglia-derived nicotinamide adenine dinucleotide phosphate (NADPH) oxidase plays a key role in the neurodegenerative diseases and neural cell death in central nervous system.The effect of NADPH on cone degeneration have been determined in rd rats,its role in rod degeneration is relatively less studied.Objective This study was to study the expression of NADPH oxidase in the retinal degenerative process in rd mice and further explore its role in the photoreceptor degeneration.Methods rd Mice at postnatal day 8 (P8),P10,P12,P14,P16 and P18 were collected.The mice were sacrificed,and retinal sections,RNAs and proteins were prepared in above-mentioned time points.The expressions of the gp91 phox,a major subunit of NADPH oxidase,in transcript level and protein level in the retinas were semi-quantitatively detected by real-time PCR and Western blot respectively.Expression of gp91phox was localized in the rd retinas as ageing by immunohistochemstry,and the co-expression of gp91phox with CD11b,a specific marker of microglial cells,was assayed by immunofluorescent double labeling.The C57BL/6N mice were served as controls.The use and care of the animals complied with the Guideline of ARVO.Results Real-time PCR showed that gp91phox mRNA was not expressed in the retinas of C57BL/6N mice.Gp91phox mRNA was found to have less expressed in retinas of P8 rd mice.With aging,the expression level of gp91phox mRNA (gp91phox mRNA/β-actin) in rd mouse retinas was gradually increased with the highest level in P14 mice(1.136±0.370).A significant difference was seen in the gp91 phox mRNA expression among various groups of mice (F=17.81,P =0.00),and gp91phox mRNA expression was significantly elevated in P10,P12,P14,P16 and P18 rd mice compared with P8 rd mice(all at P＜0.05).The expression level of gp91phox protein (A value) in the retinas presented with a similar trend in the rd mice,with a significant difference among the various ages of rd mice and C57BL/6N mice (F =354.00,P＜0.01).The expression level of gp91 phox protein was increased in the rd mice in comparison with the C57BL/6N mice (all at P＜0.05).Immunochemistry revealed that the positive response cells for gp91phox increased in the inner layers of retinas in P10 rd mice and peaked in P14 mice.Immunofluorescent double labeling exhibited that gp91phox were seen to present a co-expression with CD11b,showing an orange fluorescence.Conclusions Expression of NADPH oxidase in the rctinas in the rd mice up-regulates and is parallels to the microglial activation and photoreceptor degeneration,suggesting that NADPH oxidase plays a role in the retinal dystrophy associated with microglial activation.

Objective To compare the curative effects of two different approaches in the surgical treatmentof small breast.Methods Fourty-seven patients with small breast were treated at our department.Twenty-eight sides of patients adopted an approach of prosthesis while the nineteen sides of patients were treated in the approach of autologous fat granules injection.Clinical assessment was done by analyzing operation time,blood loss volume,hospitalization duration and recent and long-term complications in breasts.All the pa-tients were followed up for thirty-two months on average.Results During follow-up period the appearance ofbreast was satisfied.Silicone gel breast prosthesis was well tolerated and the whole operation time was about (35±5 )min,the amount of blood loss was (35±5 ) mL,hospitalization duration was (2±1 ) days,during thefollow-up period prosthesis capsular contracture after hematoma occurred in one patient.The use of autolo-gous fat granules injection to breast augmentation was found limited,and the whole operate time was about (35±5 ) rain,the amount of blood loss was (15±5 ) mL,hospitalization duration was (1±1 ) days.With in-jection(2±l)times.During the follow-up period,one patient had infection,one patient liquefied fat,andone patient the induration.Conclusion Each treatment approach has its own advantages and disadvanta-ges.The approprite one should be selected according to the special situation of patients.

AIM:To observe the postoperative effect of the application of expanded artery island skin flap on the treatment of injuries of face.METHODS:Totally 20 patients,who were treated with expanded artery island flap transplantation for face injury at Cosmetic and Plastic Institute,Weifang Medical College,were selected between January 1997 and September 2004.Patients knew the trial and agreed to participate in it.All patients received two phases operation:During the first period of the treatment,according to the different characteristics and requirements of the patients,suitable expander was implanted and water was input regularly.During the second period,the expanded island skin flap was used to cure the injuries on the face or do organ reconstruction.The skin flap was 2.5 cm? 3.5 cm-5.0 cm?7.5 cm,and vessel pedicle was 12.5 cm at most.Follow up was done regularly after operation.RESULTS:A total of 20 patients were involved in the result analysis,no drop out.Follow-up was done for 6-24 months in 20 patients.There were 4 cases of at least 6 months and less than 12 months,7 cases of at least 12 months and less than 18 months,9 cases of at least 18 months and less than 24 months.After expandor implantation in the first period,the expanded skin received skin repair or organ reconstruction in the second period.The healing of the injuries was good and scars of the skin and organ displacement were not clearly seen.Their function was recovered well and shape was ameliorated.CONCLUSION:The expanded island skin flap can provide comparatively large-region flap and long vessel pedicle to increase the angle and flexibility of flap rotation,and make the repair looks closer to the normal area.

0.05).[Conclusion]The technique of double-tunnel with double-bundle of TE for reconstruction of anterior cruciate ligament(ACL) can improve the knee stability at the different flexion degree(0?～90?) and is more efficiently than the technique of single-tunnel with single-bundle.

BACKGROUND:At present, there is still lack of related reports about the aging process of in vitro cultured epidermal cells, since epidermal cells are seed cells necessary for the construction of tissue engineered skin, this articleis is aimed to investigate the biological property of normal human epidermal cells during aging process so as to provide a foundation for the selection of seed cells for tissue engineered skin OBJECTIVE: To observe the in vitro proliferation and aging property of human epidermal cells in order to provide a foundation for the proper selection of seed cells for tissue engineered skin.DESIGN: A self-comparative experiment.SETTING: Orthopedic Surgery Research Instioute of Weifang Medical College and the General Surgery Department of Weifang Medical College Affiliated Hospital.MATERIALS: This experiment was carried out at the Orthopedic Surgery Research Institute of Weifang Medical College, between September 2000and September 2002. Healthy foreskin tissue was obtained from 20 normal boys of 6-8 years old who received peritomy at the General Surgery Department of Weifang Medical College Affiliated Hospital.METHODS: Epidermal cells were obtained from normal young people for subculture. Cells were collected from different culture passages and taken as subjects, and their aging characteristics were assessed through morphological observation, population doubling time (PDT), immune cytochemistry and beta-galactosidase staining. MAIN OUTCOME MEASURES: ① The changes of the epidermal cell growth characteristics. ② The morphological changes of the epidermal cells. ③ The epidermal cell phenotypic changes. RESULTS: ① The clanges of the epidermal cell growth characteristics: Cells were in vitro cultured by monolayer for 9 passages, and PDT of P2 was the shortest. The cells showed strong proliferation in the first 5 passages.From P6, PDT was obviously prolonged, but the cells from P8 did not proliferate any longer. ② The morphological changes of epidermal cells: The primary cultured cells began to proliferate 3 days later, which accelerated 4 days later. The cells became approximately fused in about 1 week. The growth of epidermal cells was identified with a microscope and the immuno histological techniques. ③ The epidermal cell phenotypic changes: Along with the consecutive subculture, histological expression of beta-galactosidase was found to show an increasing tendency from weak expression (occupying 9% of the young cells) to strong expression (occupying 65% of aging cells), and the positive expression rate of beta-galactosidase was found to be remarkably correlated with cell passage age (r=0.87, P ＜ 0.01). CONCLUSION: ① Compared with young cells, aging cells displayed more obvious aging morphology and enzyme cyto-chemical characteristics.During the cell aging process, the PDT of cells showed an increasing tendency. ②Compared with young cells, the expression of beta-galactosidase in aging cells was remarkably increased, and this increase paralleled with the appearance of cell aging phenotype and the loss of cell proliferation capability, and reflects the aging degree of cells. ③ The in vitro cultured normal human epidermal cell aging model was established in this experiment. The results of this experiment indicated that epidermal cells from the 1st -5th passage (donators aged 16-18 years old) can be taken as the optimal seed cells for tissue engineered skin construction.