1.Contralateral mandibular outer cortex "sandwich" bone grafting for correcting lower facial asymmetry with normal occlusal relationship
Guoping WU ; Tong LU ; Yuming QU ; Sheng GAO ; Zhiyang XIE ; Kaili YAN ; Chongxu QIAO ; Shunchao YAN ; Shu WANG ; Wensong SHANGGUAN
Chinese Journal of Plastic Surgery 2024;40(10):1049-1058
Objective:To investigate the clinical outcomes of using autologous mandibular outer cortex "sandwich" grafting to augment mandible for correcting lower facial asymmetry with normal occlusal relationships.Methods:A retrospective analysis was conducted on the clinical data of patients with lower facial asymmetry treated at the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2016 to December 2019. Preoperative cone-beam CT (CBCT) scans of the maxillofacial region were obtained to acquire three-dimensional data of the maxillofacial skeleton. Computer-aided design was used to determine the osteotomy range of the mandibular outer cortex and design osteotomy guide template. The outer cortex of the larger mandibular side (donor site) was harvested according to the osteotomy guide template and sectioned. The segmented mandibular outer cortex was then contoured to match the arc of the recipient side’s mandibular outer cortex and fixed to the inner side of the recipient mandibular outer cortex, thus increasing the width and thickness of the expanded mandible. Follow-up was conducted at 7th day and 6 months postoperatively, CBCT scan was performed to measure the changes in ramus height (Co-Go), mandibular body length (Go-Me), and mandibular outer cortex thickness, and volume, and the patient satisfaction with facial appearance (1 to 5 points, with higher scores indicating higher satisfaction), were assessed to evaluate surgical outcomes. Statistical analysis was performed using SPSS 12.0 software. Paired t-tests were used to compare patient satisfaction scores preoperatively and six months postoperatively. Repeated measurement ANOVA was used to compare Co-Go and Go-Me measurements preoperatively, 7th day, and 6 months postoperatively. If a statistically significant difference is found, further analysis using post-hoc testing(Tukey’s HSD test) will be conducted to examine the data. Results:Sixteen patients with lower facial asymmetry were included, comprising of 5 males and 11 females, aged 18 to 40 years, with an average age of 25.2 years. Surgical method included contralateral mandibular outer cortex "sandwich" grafting to the expanded mandible in 9 cases and simultaneous genioplasty in 7 cases. Follow-up ranged from 6 months to 5 years, with an average follow-up of 18.6 months. All patients experienced numbness of the lower lip postoperatively, which resolved within six months, and no severe complications occurred. The symmetry of lower facial contour improved significantly and remained stable. Patient satisfaction score for facial appearance increased from (1.63±0.62) points preoperatively to (4.19±0.75) points six months postoperatively( P<0.01). The differences in Co-Go on the donor side and Go-Me on the recipient side across the three time points(preoperatively, 7th day and 6 months postoperatively) were not statistically significant(all P>0.05). However, the differences in Go-Me on the donor side and Co-Go on the recipient side across the three time points were statistically significant(all P<0.05). On the donor side, the mandibular outer cortex thickness decreased by a maximum of 6 mm on 7th day postoperatively and increased by a maximum of 2 mm at 6 months postoperatively compared to 7th day. On the recipient side, mandibular outer cortex thickness increased by a maximum of 6 mm on 7th day postoperatively and decreased by a maximum of 2 mm at six months postoperatively compared to 7th day. The volume of the mandibular outer cortex on the recipient side increased by (4 415.94±1 017.21)mm 3 at 7th day postoperatively compared to preoperatively, and decreased by (202.63±300.85)mm 3 at 6 months postoperatively. Conclusion:For lower facial asymmetrical with normal occlusal relationships and no occlusal plane deviation, contralateral mandibular outer cortex "sandwich" bone grafting can effectively increase the width and volume of the mandible on the grafted side, achieving favorable clinical outcomes.
2.Effectiveness of rotational filling of an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision on breast ptosis
Kaili YAN ; Chongxu QIAO ; Shunchao YAN ; Zai SHI ; Jingyi XU ; Yuming QU ; Shu WANG ; Wensong SHANGGUAN ; Guoping WU
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(6):582-587
Objective:To evaluate the effectiveness of correcting breast ptosis using the rotational filling of an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision.Methods:A retrospective study was conducted on 34 female patients (68 breasts) with breast ptosis treated at the Department of Plastic Surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2016 to June 2023. The patients' ages ranged from 23 to 53 years, with an average of (37.4±7.9) years. All patients underwent correction of breast ptosis using an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision. Pre-operative and post-operative measurements were taken to assess the corrective outcomes, including mammary base width (MBW), areola diameter (AD), nipple-to-nipple distance (NN), suprasternal notch-to-nipple distance (SSN-N), nipple-to-inframammary fold distance (N-IMF), and thoracic circumference at the nipple level (TN). Patients' satisfaction was assessed using the BREAST-questionnaire (BREAST-Q) module.Results:Postoperative first-stage wound healing was achieved in all 34 patients without complications such as hematoma, infection, or nipple necrosis. The follow-up period ranged from 6 to 60 months, with a median of 12 months. Early postoperative observations showed periareolar folds, which disappeared within 3 to 6 months in 31 cases, while mild periareolar folds, persisted for up to 12 months in 3 cases. Four patients reported reduced nipple sensation postoperatively. Measurements showed a statistically significant increase in TN and a reduction in NN, SSN-N, AD, N-IMF, and MBW compared to preoperative values (all P<0.001). BREAST-Q scores indicated significant improvements in satisfaction with breasts, psychosocial well-being and physical well-being, with preoperative scores of (21.6±8.9), (42.4±11.9) and (49.7±12.9) scores increasing to (82.3±8.5), (81.9±8.1) and (81.2±8.3) scores, respectively (all P<0.001). Conclusions:The double periareolar incision technique with rotational filling of an inferolaterally pedicled tongue-shaped glandular flap is a safe and effective method for correcting breast ptosis.
3.Contralateral mandibular outer cortex "sandwich" bone grafting for correcting lower facial asymmetry with normal occlusal relationship
Guoping WU ; Tong LU ; Yuming QU ; Sheng GAO ; Zhiyang XIE ; Kaili YAN ; Chongxu QIAO ; Shunchao YAN ; Shu WANG ; Wensong SHANGGUAN
Chinese Journal of Plastic Surgery 2024;40(10):1049-1058
Objective:To investigate the clinical outcomes of using autologous mandibular outer cortex "sandwich" grafting to augment mandible for correcting lower facial asymmetry with normal occlusal relationships.Methods:A retrospective analysis was conducted on the clinical data of patients with lower facial asymmetry treated at the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2016 to December 2019. Preoperative cone-beam CT (CBCT) scans of the maxillofacial region were obtained to acquire three-dimensional data of the maxillofacial skeleton. Computer-aided design was used to determine the osteotomy range of the mandibular outer cortex and design osteotomy guide template. The outer cortex of the larger mandibular side (donor site) was harvested according to the osteotomy guide template and sectioned. The segmented mandibular outer cortex was then contoured to match the arc of the recipient side’s mandibular outer cortex and fixed to the inner side of the recipient mandibular outer cortex, thus increasing the width and thickness of the expanded mandible. Follow-up was conducted at 7th day and 6 months postoperatively, CBCT scan was performed to measure the changes in ramus height (Co-Go), mandibular body length (Go-Me), and mandibular outer cortex thickness, and volume, and the patient satisfaction with facial appearance (1 to 5 points, with higher scores indicating higher satisfaction), were assessed to evaluate surgical outcomes. Statistical analysis was performed using SPSS 12.0 software. Paired t-tests were used to compare patient satisfaction scores preoperatively and six months postoperatively. Repeated measurement ANOVA was used to compare Co-Go and Go-Me measurements preoperatively, 7th day, and 6 months postoperatively. If a statistically significant difference is found, further analysis using post-hoc testing(Tukey’s HSD test) will be conducted to examine the data. Results:Sixteen patients with lower facial asymmetry were included, comprising of 5 males and 11 females, aged 18 to 40 years, with an average age of 25.2 years. Surgical method included contralateral mandibular outer cortex "sandwich" grafting to the expanded mandible in 9 cases and simultaneous genioplasty in 7 cases. Follow-up ranged from 6 months to 5 years, with an average follow-up of 18.6 months. All patients experienced numbness of the lower lip postoperatively, which resolved within six months, and no severe complications occurred. The symmetry of lower facial contour improved significantly and remained stable. Patient satisfaction score for facial appearance increased from (1.63±0.62) points preoperatively to (4.19±0.75) points six months postoperatively( P<0.01). The differences in Co-Go on the donor side and Go-Me on the recipient side across the three time points(preoperatively, 7th day and 6 months postoperatively) were not statistically significant(all P>0.05). However, the differences in Go-Me on the donor side and Co-Go on the recipient side across the three time points were statistically significant(all P<0.05). On the donor side, the mandibular outer cortex thickness decreased by a maximum of 6 mm on 7th day postoperatively and increased by a maximum of 2 mm at 6 months postoperatively compared to 7th day. On the recipient side, mandibular outer cortex thickness increased by a maximum of 6 mm on 7th day postoperatively and decreased by a maximum of 2 mm at six months postoperatively compared to 7th day. The volume of the mandibular outer cortex on the recipient side increased by (4 415.94±1 017.21)mm 3 at 7th day postoperatively compared to preoperatively, and decreased by (202.63±300.85)mm 3 at 6 months postoperatively. Conclusion:For lower facial asymmetrical with normal occlusal relationships and no occlusal plane deviation, contralateral mandibular outer cortex "sandwich" bone grafting can effectively increase the width and volume of the mandible on the grafted side, achieving favorable clinical outcomes.
4.Preliminary study of effect of erythropoietin pretreatment on enhancing directional homing ability of bone marrow mesenchymal stem cells in rats
Yuming QIAO ; Song ZHOU ; Ya ZHANG ; Yongguang LIU ; Ming ZHAO
Organ Transplantation 2021;12(1):57-
Objective To evaluate the effect of erythropoietin (EPO) on the proliferation and migration of bone marrow mesenchymal stem cell (BMSC) in rats. Methods The 5th generation BMSCs were divided into the control (without EPO) and 10, 100, 500, 1 000 IU/mL EPO groups. After 24 h and 48 h of culture, the proliferation rate, migration ability and the expression levels of CXCR4 of BMSCs were detected in each group. The 5th generation BMSCs were further divided into BMSC and EPO-BMSC groups. After 48 h of culture, the effect of EPO upon surface markers, directional differentiation and cytoskeleton morphology of BMSCs were evaluated in both groups. Results After theco-culture of EPO and BMSCs for 48 h, the proliferation rate and migration ability of BMSCs were significantly enhanced, and the expression level of CXCR4 protein was significantly up-regulated in the 100 IU/mL and 500 IU/mL EPO groups compared with those in the control group (all
5.Treatment for Post-polio Syndrome (review)
Yuming WANG ; Huiming GONG ; Junyi ZHANG ; Aimin ZHANG ; Qing SUN ; Xue BAI ; Jiali QIAO
Chinese Journal of Rehabilitation Theory and Practice 2017;23(5):510-513
There is no specific treatment for post-polio syndrome. The common applied therapies include mediciation, exercise, cogni-tive behavioural therapy, physiotherapy, occupational therapy, Traditional Chinese Medicine, assistive technology, psychological and social factors adjustment, interdisciplinary comprehensive rehabilitation, and so on.
6.Progress on the relationship between preeclampsia and long-term cardiovascular disease among women
Haiyang YAN ; Wei CAI ; Shengkai SUN ; Yanan QIAO ; Zhihong WANG ; Yuming LI
Clinical Medicine of China 2017;33(4):377-380
Preeclampsia(PE) is a unique disease to pregnancy women,and women who had a history of preeclampsia significantly increased the risk of cardiovascular disease.Preeclampsia etiology and pathogenesis is not clear yet,it may have common pathophysiology with cardiovascular disease(CVD),such as oxidative stress,endothelial injury,insulin resistance,lipid metabolic disorder and so on.The article reviewed the relationship between preeclampsia and long-term cardiovascular disease among women,especially discussed the disease such as coronary heart disease,hypertension and stroke,to find the association and to explore the potential risk management options for these high-risk women.To block,intervene,and prevent cardiovascular disease starting with preeclampsia,it is of significance to the cardiovascular health of over 300 million women worldwide.

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