1.Advances in the application of optical coherence tomography angiography in normal tension glaucoma
Yangyang JIN ; Lurun GU ; Youchen WUDENG ; Qiuyang ZHANG ; Guofan CAO
International Eye Science 2025;25(9):1448-1454
Normal tension glaucoma(NTG)is a chronic optic neuropathy characterized by progressive damage to the optic nerve and visual field defects, with its pathophysiology closely linked to genetic, immune-inflammatory and vascular factors. Optical coherence tomography angiography(OCTA)is a noninvasive imaging technique that provides real-time, quantitative assessment of retinal microvascular perfusion. In recent years, OCTA has been increasingly applied in NTG studies, demonstrating significant potential in early diagnosis, disease monitoring and management. This systematic review summarizes the latest advancements in the application of OCTA for NTG, with a focus on vascular parameters in the optic nerve head and macular regions. Its diagnostic value and monitoring management are further summarized. Moreover, the current limitations of OCTA technology and the challenges related to its clinical application are critically evaluated, while exploring its future developments. These insights aim to provide a theoretical foundation for further research on NTG-related microvascular pathology and the broader clinical application of OCTA.
2.Ilizorov technique in the treatment of limb contracture secondary to venous malformation
Youchen XIA ; Jianxun MA ; Jiancheng ZANG ; Xin ZHANG ; Xinwei WANG ; Zhenmin ZHAO ; Sihe QIN
Chinese Journal of Plastic Surgery 2020;36(4):403-408
Objective:To summarize the effect of Ilizarov technique in the treatment of limb contracture secondary to venous malformation.Methods:From January 2015 to June 2019, nine cases of limb contracture secondary to venous malformation, from Peking University Third Hospital and Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids, were treated with Ilizarov technique, including four males and five females, aged 9 to 35 years, with an average age of 19.5 years. There were two cases of flexion of the hip and knee, four cases of flexion of the knee, two cases of flexion of the knee with talipes equinovarus, and one case of flexion of the wrist. Ilizarov technique was used for treatment after the evaluation of the multi-disciplinary treatment team. According to the safe zone of wire fixation and the limbs deformities character, the preassembled external fixator was connected to the relevant deformed limbs, and the tendons were released at the same time. Limbs deformities were corrected gradually by adjusting the external fixator. For patients with severe pain or rapid development of the affected area, it is appropriate to perform ultrasound-guided injection of lauromacrogol and physical therapy to promote the function of joints.Results:During the treatment, there were no neurovascular injury, peripheral blood circulation disorder, infection event of injection channel and incision, or deep vein thrombosis. The follow-up were 6 to 40 months, with an average of 30.5 months. All the contractures of the hip and knee joints, most of the deformities of the wrist and ankle joints were corrected and the pain disappeared.Conclusions:Ilizarov technique is a minimally invasive, safe and effective method for the treatment of limb contracture secondary to venous malformation.
3.Application of tissue expansion in post-mastectomy breast reconstruction
Jianxun MA ; Bi LI ; Youchen XIA ; Jie ZHANG ; Xin YANG ; Weitao YOU ; Bailin PAN
Chinese Journal of Plastic Surgery 2020;36(11):1194-1200
Objective:To investigate the application value and clinical effect of tissue expansion in post-mastectomy breast reconstruction.Methods:From January 2013 to May 2019, 173 patients (38.2±8.0 years old) with body mass index (BMI) of (21.5±2.1) kg/m 2 were treated in Peking University Third Hospital. There were 76 cases on the right side and 97 cases on the left side; 8 cases underwent nipple sparing mastectomy, and 165 cases underwent modified radical mastectomy; 150 cases received chemotherapy and 9 cases received radiotherapy. In the first stage, immediate or delayed chest wall soft tissue expansion was performed. In the second stage, implant replacement, autologous tissue transplantation, or the combination of these two methods was performed to complete the breast reconstruction. All patients were followed up and the clinical effect was evaluated by Harris evaluation method. Results:Among 173 cases, 95 cases were provided immediate reconstruction, and 78 cases were applied delayed reconstruction. The period of tissue expansion was (7.7±3.2) months. During the second stage of reconstruction, implant exchange was conducted in 105 cases, 48 cases received implant exchange with autologous fat injection, 17 cases were performed implant exchange with endoscopy-assisted latissimus dorsi muscle transfer, and 3 cases were applied deep inferior epigastric perforator flap (DIEP) transplantation. The average follow-up time was 12.6 months (3.5-41.0 months). One patient had local tumor recurrence, and the implant was finally removed. The reconstruction effects were evaluated by Harris method, which showed that 23 cases had excellent appearance, 129 cases were good, 13 cases were fair, 7 cases were poor, and 88.4% (152/172) patients were good or above.Conclusions:Tissue expansion plays an important role as a transfer station in post-mastectomy breast reconstruction. In the second stage, the breast reconstruction method can be flexibly selected. Tissue expansion has a wide range of indications, and is especially suitable for immediate post-mastectomy breast reconstruction. Good result can be obtained by using this technique.
4.Ilizorov technique in the treatment of limb contracture secondary to venous malformation
Youchen XIA ; Jianxun MA ; Jiancheng ZANG ; Xin ZHANG ; Xinwei WANG ; Zhenmin ZHAO ; Sihe QIN
Chinese Journal of Plastic Surgery 2020;36(4):403-408
Objective:To summarize the effect of Ilizarov technique in the treatment of limb contracture secondary to venous malformation.Methods:From January 2015 to June 2019, nine cases of limb contracture secondary to venous malformation, from Peking University Third Hospital and Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids, were treated with Ilizarov technique, including four males and five females, aged 9 to 35 years, with an average age of 19.5 years. There were two cases of flexion of the hip and knee, four cases of flexion of the knee, two cases of flexion of the knee with talipes equinovarus, and one case of flexion of the wrist. Ilizarov technique was used for treatment after the evaluation of the multi-disciplinary treatment team. According to the safe zone of wire fixation and the limbs deformities character, the preassembled external fixator was connected to the relevant deformed limbs, and the tendons were released at the same time. Limbs deformities were corrected gradually by adjusting the external fixator. For patients with severe pain or rapid development of the affected area, it is appropriate to perform ultrasound-guided injection of lauromacrogol and physical therapy to promote the function of joints.Results:During the treatment, there were no neurovascular injury, peripheral blood circulation disorder, infection event of injection channel and incision, or deep vein thrombosis. The follow-up were 6 to 40 months, with an average of 30.5 months. All the contractures of the hip and knee joints, most of the deformities of the wrist and ankle joints were corrected and the pain disappeared.Conclusions:Ilizarov technique is a minimally invasive, safe and effective method for the treatment of limb contracture secondary to venous malformation.
5.Application of tissue expansion in post-mastectomy breast reconstruction
Jianxun MA ; Bi LI ; Youchen XIA ; Jie ZHANG ; Xin YANG ; Weitao YOU ; Bailin PAN
Chinese Journal of Plastic Surgery 2020;36(11):1194-1200
Objective:To investigate the application value and clinical effect of tissue expansion in post-mastectomy breast reconstruction.Methods:From January 2013 to May 2019, 173 patients (38.2±8.0 years old) with body mass index (BMI) of (21.5±2.1) kg/m 2 were treated in Peking University Third Hospital. There were 76 cases on the right side and 97 cases on the left side; 8 cases underwent nipple sparing mastectomy, and 165 cases underwent modified radical mastectomy; 150 cases received chemotherapy and 9 cases received radiotherapy. In the first stage, immediate or delayed chest wall soft tissue expansion was performed. In the second stage, implant replacement, autologous tissue transplantation, or the combination of these two methods was performed to complete the breast reconstruction. All patients were followed up and the clinical effect was evaluated by Harris evaluation method. Results:Among 173 cases, 95 cases were provided immediate reconstruction, and 78 cases were applied delayed reconstruction. The period of tissue expansion was (7.7±3.2) months. During the second stage of reconstruction, implant exchange was conducted in 105 cases, 48 cases received implant exchange with autologous fat injection, 17 cases were performed implant exchange with endoscopy-assisted latissimus dorsi muscle transfer, and 3 cases were applied deep inferior epigastric perforator flap (DIEP) transplantation. The average follow-up time was 12.6 months (3.5-41.0 months). One patient had local tumor recurrence, and the implant was finally removed. The reconstruction effects were evaluated by Harris method, which showed that 23 cases had excellent appearance, 129 cases were good, 13 cases were fair, 7 cases were poor, and 88.4% (152/172) patients were good or above.Conclusions:Tissue expansion plays an important role as a transfer station in post-mastectomy breast reconstruction. In the second stage, the breast reconstruction method can be flexibly selected. Tissue expansion has a wide range of indications, and is especially suitable for immediate post-mastectomy breast reconstruction. Good result can be obtained by using this technique.
6.Effectiveness of circumvertical mastopexy with internal shaping using inferior dermal-glandular flap for correction of breast ptosis
Yue LANG ; Bi LI ; Jianxun MA ; Youchen XIA ; Jie ZHANG ; Weitao YOU
Chinese Journal of Medical Aesthetics and Cosmetology 2019;25(5):392-395
Objective To evaluate the clinical effect of circumvertical mastopexy with internal shaping using inferior dermal-glandular flap for correction of breast ptosis.Methods From April 2010 to November 2017,33 cases of breast ptosis were treated in our department.The patients required nipple elevation of 3-6 cm and had unpleasing result after circumareolar mastopexy were treated with the technique of circumvertical lift with breast suspension and internal shaping with inferior dermal-glandular flap which pedicle was on the inframammary crease and tack technique for removing excessive skin precisely.Results 33 cases had their drainage tubes removed at the 2~3 days and suture removed at the 12~14 days postoperatively.All had primary healing of incision and no complications such as necrosis of NAC and dehiscence of incision occurred.Elastic bra was asked to wear for three to six months and then stable shape was achieved.Follow-up lasted for 6-60 months.All cases were satisfied with their new breast shape.Conclusions Circumvertical mastopexy with internal shaping using inferior dermal-glandular flap is a simple and effective method with relatively short scar and good shape for correction of the medium grade breast ptosis.
7.Survey and Analysis of Social Factors of Health among Staff of Urban Workers in Liaoning Province
Hui CHANG ; Youchen ZHANG ; Qing LI ; Hong LI ; Shiyang SHAN
Journal of China Medical University 2018;47(1):48-52,57
Objective To explore the social factors of health among staff of urban workers in Liaoning province and to provide scientific evidence for preparing propagation strategies. Methods Two thousand five hundred urban workers were surveyed using stratified, random sampling in Dandong city and Yingkou city of Liaoning province. The participants were investigated through questionnaires. Results Two thousand four hundred forty eight valid questionnaires were obtained. The self-rated health score of the respondents was 84.37 ± 13.72. The results of multiple linear reason showed that those with low family income satisfaction (B = -2.923,P = 0.019,95% CI:-5.360——0.485),many working hours per day (B = -3.749,P = 0.023,95% CI:-6.98——0.518),poor leadership (B = -3.688,P =0.014,95% CI:-6.608——0.768),and low job satisfaction (B = -2.012,P = 0.034,95% CI:-3.869——0.156) had lower self-rated health scores. However,those with more harmonious families (B = 3.105,P = 0.017,95% CI:0.565-5.645) and types of social support (B = 2.684,P = 0.003,95% CI:0.926-4.442) had higher self-rated health scores. Conclusion Social factors affecting health among staff of urban workers in Liaoning province are family income satisfaction,working hours per day,leadership approval degree,job satisfaction, social support and others.
8.Pathological changes of breast tissue after long-term polyacrylamide hydrogel injection for augmentation mammoplasty
Fangfei NIE ; Bi LI ; Youchen XIA ; Jianxun MA ; Jie ZHANG
Chinese Journal of Medical Aesthetics and Cosmetology 2018;24(5):328-331
Objective To study the pathological mechanism of aseptic necrosis of breast tissue after long-term breast augmentation injected with polyacrylamide hydrogel (PAHG).Methods We included patients who had no obvious clinical symptoms and underwent surgical removal of the PAHG in our hospital,excluding patients with a history of breast prosthesis implantation.Extracts were collected,and then underwent a careful gross observation and serial sections followed by HE,Mallory,and toluidine blue staining,to observe the histological structure of collagen fibers and inflammatory cells.Immunohistochemistry for CD31 and a-smooth muscle actin (a-SMA) antibody was used to further identify vascular endothelial cells and vascular smooth muscle cells,respectively.Analysis of the correlation between injection time and the incidence of different pathological changes were done.Results We included 22 females (mean age 39.14 years,range 22-55 years) who requested surgical removal of the PAHG.The mean duration of PAHG injection was 9.27 years (range 4-14 years).They had no clinical symptoms or only had induration,deformation and displacement.The basic pathological changes of local tissue included foreign body reaction and chronic inflammation,fibrosis and tissue necrosis;and half of the tissue had also histological changes,such as small vascular smooth muscle layer thickening,lumen stenosis,etc.No significant correlation was found between the pathological changes and the duration of the disease and the clinical symptoms.Conclusions Patients with PAHG injection for augmentation mammoplasty can histopathological changes of local tissues even without experiencing discomfort.The tissue necrosis in some patients may be caused by foreign body reaction and inflammatory reaction.It may also be due to local ischemia caused by small vascular smooth muscle hyperplasia,luminal stenosis etc.
9.Reconstruction of breast suspensory structure for correction of breast ptosis
Bi LI ; Youchen XIA ; Jie ZHANG
Chinese Journal of Minimally Invasive Surgery 2005;0(10):-
Objective To summarize clinical experience of reconstruction of breast suspensory structure in correction of mild-to-moderate breast ptosis.Methods Through a periareolar incision,the flabby deep layer of the superficial fascia beneath the upper breast gland was completely removed.Then the gland was lifted up to the normal position and the superior pole of the gland was fixed to the pectoral fascia at the second intercostal space.By using the dermal bra technique,an appropriate amount of skin was excised,and the dermis was fixed to the anterior surface of the breast gland. Or a monofilament polypropylene mesh was implanted and fixed to the anterior or posterior surface of the upper breast gland.Postoperatively,remarkable scar fibrosis reaction developed to form strong supporting structures just like natural ones.Glandular plication or implant augmentation was simultaneously employed to enhance the projection,if necessary.Results A total of 32 cases of mild-to-moderate breast ptosis was treated with this technique,including 10 cases of mastopexy only,20 cases of mastopexy with implant augmentation,and 2 cases of mastopexy using monofilament polypropylene mesh.The operation time was 90~150 min(mean,110 min).The intraoperative blood loss was 30~100 ml(mean,58 ml).No complications such as nipple or areola necrosis or sensory disturbance were found.Follow-up observations for 6~12 months(mean,11.3 months) showed a satisfactory rate of 90.6%(29/32).Conclusions Reconstruction of breast suspensory structure is a simple,safe,and effective method for correction of mild-to-moderate breast ptosis without hyperplasia of mammary glands.
10.Effects of radiation on the osteoinductive activity of recombinant human bone morphogenetic protein 2
Youchen LI ; Baoxing LI ; Yumin ZHANG
Chinese Journal of Orthopaedics 2001;0(03):-
Objective To study the effects of various doses of ionizing radiation on the osteoinductive activity of recombinant human bone morphogenetic protein 2 (rhBMP-2) and the role of collagen carrier. Methods BMP complex was prepared with rhBMP-2 and collagen sponge as a carrier. The osteoinductive activity of rhBMP-2 was evaluated by heterotopic bone formation. According to the conditions of gamma irradiation, the experiments were divided into 4 groups: (Ⅰ) non-irradiated complex as control; (Ⅱ) irradiated complex with 15, 20, 25 or 50 kGy; (Ⅲ) irradiated carrier: collagen sponge was irradiated with 50 kGy and then mixed with non-irradiated rhBMP-2; (Ⅳ) irradiated BMP: only rhBMP-2 was irradiated with 25 or 50 kGy and then mixed with non-irradiated collagen sponge. The BMP complexes were implanted into thigh muscle pouches in 34 Wistar rats, respectively. All collagen mass in muscle pouches were procured two or four weeks after implantation and examined macroscopically, radiographically and histologically. Quantitative analyses of heterotopic bone formation were evaluated by histomorphometry. Results Two weeks after implantation, collagen mass procured from muscle of irradiated complexes with 15, 20, 25 kGy are almost the same with that of control in size, shape and new bone formation, which are composed with richly vascularized connective tissue and immatured woven bone, but only the quantity of new bone in the group of 25 kGy reduced significantly(P

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