In this report,we present the case of a 55-year-old woman with a 30-year history of multiple familial trichoe-pithelioma(MFT),with facial surface tumors that progressively worsened,causing ventilation disorders.In ord...In this report,we present the case of a 55-year-old woman with a 30-year history of multiple familial trichoe-pithelioma(MFT),with facial surface tumors that progressively worsened,causing ventilation disorders.In order to improve the patient’s appearance and functional impairment,we performed a two-step surgical excision and skin grafting procedure post diagnosis through genetic testing.The 18-month follow-up confirmed that the effect was satisfactory without obvious recurrence.Based on this outcome,we have developed a diagnosis and treat-ment process for patients with MFT,aiming to provide a reference for standardized treatment of this rare disease.展开更多
Nerve regeneration conditioned fluid is secreted by nerve stumps inside a nerve regeneration chamber.A better understanding of the proteinogram of nerve regeneration conditioned fluid can provide evidence for studying...Nerve regeneration conditioned fluid is secreted by nerve stumps inside a nerve regeneration chamber.A better understanding of the proteinogram of nerve regeneration conditioned fluid can provide evidence for studying the role of the microenvironment in peripheral nerve regeneration.In this study,we used cylindrical silicone tubes as the nerve regeneration chamber model for the repair of injured rat sciatic nerve.Isobaric tags for relative and absolute quantitation proteomics technology and western blot analysis confirmed that there were more than 10 complement components（complement factor I,C1q-A,C1q-B,C2,C3,C4,C5,C7,C8β and complement factor D） in the nerve regeneration conditioned fluid and each varied at different time points.These findings suggest that all these complement components have a functional role in nerve regeneration.展开更多
Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the l...Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery.The entire treatment period was divided into two stages,during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I,the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively;the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch;and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II,the chest scars were excised,and breast tissues were repositioned;the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery.Results From October 2010 to October 2019,21 patients(on 24 sides)underwent reconstructive procedures for extensive scar contractures on the anterior chest.All flaps survived,and their donor sites were sutured directly.During a follow-up of 3 months to 8 years,the flaps became soft and exhibited color similar to that of the adjacent tissues.The limited neck and shoulder movements improved,and postoperatively,all female patients were satisfied with the shape of their breasts.Additionally,neither apparent weakening on the adduction,internal rotation,or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed.Conclusion Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest.展开更多
Background:Use of internal filling ports in tissue expander–based reconstructions are advantageous because of easier self-care,lower infection rates,and fewer instances of capsule formation.The appearance of peripros...Background:Use of internal filling ports in tissue expander–based reconstructions are advantageous because of easier self-care,lower infection rates,and fewer instances of capsule formation.The appearance of periprosthetic fluid accumulation after internal-port tissue expander implantation is a common complication that warrants treatment.In this study,we introduced a noninvasive method using fine-needle aspiration(FNA)to remove fluids accumulated after implantation of a remote internal-port tissue expander.Methods:In this study,245 patients who underwent implantation of remote internal-port tissue expanders in our hospital from July 1,2012,to July 1,2019,were included and divided into two groups.In the control group,patients underwent tissue expander implantation before July 1,2016,and large quantities of fluids were removed with surgical aspiration procedures in most cases.In the FNA group,the patients underwent implantation after July 1,2016,and large quantities of fluids were removed first with the FNA procedure.Patients’demographic data,indications for FNA application,and related complications were collected and analyzed.Results:Overall,395 expanders were placed in 245 patients.Postoperative management was similar in both groups.Fluids were managed with 23 expanders in the control group and with 31 expanders in the FNA group.There was no difference in the fluid aspiration rate between the two groups.The surgical aspiration rate was 11.1%(23/208)in the control group.The success rate of FNA was 90.3%(28/31).In the FNA group,the surgical aspiration rate was 1.6%(3/187),which was significantly lower than that in the control group.There were no significant differences in complications between the two groups.Conclusion:FNA can be used for periprosthetic fluid removal after the implantation of a remote internal-port tissue expander in most cases.This method is more convenient and safer than surgical aspiration for the postoperative management of internal-port tissue expander implantation.展开更多
With advances in anatomical knowledge and technology,increased interest has been directed towards reconstruction with enhanced aesthetic and functional outcomes.A myriad of thinned perforator flap harvest approaches h...With advances in anatomical knowledge and technology,increased interest has been directed towards reconstruction with enhanced aesthetic and functional outcomes.A myriad of thinned perforator flap harvest approaches have been developed for this purpose;however,concerns about jeopardizing their vascularity remain.To ensure optimum reconstructive outcome without hampering the flap’s microcirculation,it is important to make good use of the existing advanced imaging modalities that can provide clear visualization of perforator branches,particularly in the adipose layer,and an accurate assessment of flap perfusion.Therefore,this review will highlight the imaging modalities that have been utilized for harvesting a thinned perforator flap from these two perspectives,along with future insights into creating both functionally and aesthetically satisfying,yet simultaneously safe,thinned perforator flaps for the best reconstructive outcomes for patients.展开更多
Numerous studies have shown that macrophages can orchestrate the microenvironment from the early stage of wound healing to the later stages of scar formation.However,few reviews have highlighted the significance of ma...Numerous studies have shown that macrophages can orchestrate the microenvironment from the early stage of wound healing to the later stages of scar formation.However,few reviews have highlighted the significance of macrophages during the formation of abnormal scars.The purpose of this reviewwas to outline the polarization of macrophages from early to late stage of pathological scar formation,focusing on spatiotemporal diversity of M1 and M2 macrophages.In this review,the role of macrophages in the formation of hypertrophic scars and keloids is summarized in detail.First,an increased number of M2 cells observed before injuries are significantly associated with susceptibility to abnormal scar pathogenesis.Second,decreased expression of M1 at the early stage and delayed expression of M2 at the late stage results in pathological scar formation.Third,M2 cells are highly expressed at both the margin and the superficial region,which is consistent with the invasive property of keloids.Finally,this review helps to characterize strategies for the prediction and prevention of pathological scar formation.展开更多
Background:Microsurgical replantation has become the most favorable treatment option for scalp avulsion.However,the accurate prediction of postoperative replant viability remains challenging.Case presentation:In this ...Background:Microsurgical replantation has become the most favorable treatment option for scalp avulsion.However,the accurate prediction of postoperative replant viability remains challenging.Case presentation:In this article,we showed that(indocyanine green angiography,ICGA)can provide a much more precise prediction of replant necrosis than conventional clinical assessment in a rare case of complete scalp avulsion with prolonged ischemia time.Conclusion:Clinical assessment of replant survival may be misleading in cases of complex tissue injuries and prolonged ischemic stress.This case provides insight into the promising utility of ICGA as an important adjuvant tool to better assess tissue perfusion and viability in scalp avulsion and possibly other types of replantation.展开更多
Pathological scars might cause a distorted appearance and restricted mobility,and the study of scar pathophysiology has been hindered by the absence of a reliable model.In this study,we introduce a model with a modifi...Pathological scars might cause a distorted appearance and restricted mobility,and the study of scar pathophysiology has been hindered by the absence of a reliable model.In this study,we introduce a model with a modified device to induce controlled tension on a wound healing by secondary intention to overcome the shortcomings of the model generated by Aarabi et al.We investigated and recommend an induction of 0.1 N/mm^(2) tension on day 7 for 14 days to mimic the characteristics of human scars.A 3.5-fold increase in scar tissue and a 2-fold increase in collagen production were induced by the modified model.Histologically,the modified method increased scar thickness.However,no significant difference was found in cell density between the two groups.This modified procedure significantly increased scar tissue,which could be used for further cellular and biomolecular research.The mechanical force applied to the wound became measurable and controllable.This method is more convenient for researchers to observe in realtime and for providing timely adjustments of the tension used in this modified model.展开更多
Architectural modeling and behavior analysis are two important concerns in the software development. They are often implemented separately, and specified by their own supporting notations. Architectural modeling helps...Architectural modeling and behavior analysis are two important concerns in the software development. They are often implemented separately, and specified by their own supporting notations. Architectural modeling helps to guarantee the system design to satisfy the requirement, and behavior analysis can ensure the interaction correctness. To improve the trustworthiness, methods trying to combine architectural modeling and behavior analysis notations together have been proposed, e.g., establishing a one-way mapping relation. However, the one-way relation cannot ensure updating one notation specifications in accordance with the other one, which results in inconsistency problems. In this paper, we present an approach to integrating behavior analysis into architectural modeling, which establishes the interoperability between architectural modeling notation and behavior analysis notation by a bidirectional mapping. The architecture is specified by the modeling language, architecture analysis and design language （AADL）, and then mapped to behavior analysis notation, Darwin/FSP （finite state process） through the bidirectional transformation. The bidirectional transformarion provides traceability, which makes behavior analysis result provided by a model checker can be traced and reflected back to the original AADL specifications. In this way, the behavior analysis is integrated into architectural modeling. The feasibility of our approach is shown by a control system example.展开更多
Bone drilling is a routine operation in surgeries,such as neurosurgery and orthopedics.However,the excessive drilling temperature may cause severe thermal damage to the bone tissue.Therefore,the drilling temperature d...Bone drilling is a routine operation in surgeries,such as neurosurgery and orthopedics.However,the excessive drilling temperature may cause severe thermal damage to the bone tissue.Therefore,the drilling temperature determination of bone tissue can reduce the harm caused by thermal damage.A time-varying temperature field simulation model of bone drilling was set up by ABAQUS software in this paper,based on the Johnson-Cook model.Then it was validated with experiments by drilling cortical bone of fresh bovine shaft of the femur.The relative error between the experimental values and the theoretical values within 7.67%showed a good consistency.Furthermore,the aging factor is also considered to evaluate the temperature field of bone drilling.The results showed that the drilling temperature near the bone-drill area increased significantly.The drilling temperature of cortical bone decreases sharply with the radial distance and exhibits a hysteresis lag in the axial distribution.The aging factor mainly affects the peak of drilling temperature.The peak of drilling temperature tends to increase with age.The peak drilling temperature in the elderly(70y)was up to 6.8%higher than that in the young(20y),indicating that the elderly is more prone to excessive drilling temperature.Therefore,special attention should be paid to the temperature control of elderly bone tissue.展开更多
This paper aims to analyze how China’s rise is perceived by minor powers in the world system.Taking Turkey as the case study,the paper focuses on major issue areas such as bilateral trade and business between Turkey ...This paper aims to analyze how China’s rise is perceived by minor powers in the world system.Taking Turkey as the case study,the paper focuses on major issue areas such as bilateral trade and business between Turkey and China,and the issue of Eastern Turkistan(Xinjiang problem).This research concludes that unbalanced trade relationships and fierce competition in textile exports between Turkey and China are causing uneasiness on the Turkish side.Nevertheless,this has not changed Turkey’s perception about China’s rise as an opportune chance.Politically,it is possible for Turkey to seek opportunities to cooperate with China in many aspects to promote Turkey’s interests.China should also realize that it is impossible for Turkey to be openly supportive of China’s anti-terrorist policies in Xinjiang,where most of the inhabitants are regarded as“fellowmen”by Turks.展开更多
基金supported by the National Natural Science Foundation of China(grant nos.82272264 and 82072177).
文摘In this report,we present the case of a 55-year-old woman with a 30-year history of multiple familial trichoe-pithelioma(MFT),with facial surface tumors that progressively worsened,causing ventilation disorders.In order to improve the patient’s appearance and functional impairment,we performed a two-step surgical excision and skin grafting procedure post diagnosis through genetic testing.The 18-month follow-up confirmed that the effect was satisfactory without obvious recurrence.Based on this outcome,we have developed a diagnosis and treat-ment process for patients with MFT,aiming to provide a reference for standardized treatment of this rare disease.
基金supported by grants from the National Natural Science Foundation of China,No.30925034,81101437
文摘Nerve regeneration conditioned fluid is secreted by nerve stumps inside a nerve regeneration chamber.A better understanding of the proteinogram of nerve regeneration conditioned fluid can provide evidence for studying the role of the microenvironment in peripheral nerve regeneration.In this study,we used cylindrical silicone tubes as the nerve regeneration chamber model for the repair of injured rat sciatic nerve.Isobaric tags for relative and absolute quantitation proteomics technology and western blot analysis confirmed that there were more than 10 complement components（complement factor I,C1q-A,C1q-B,C2,C3,C4,C5,C7,C8β and complement factor D） in the nerve regeneration conditioned fluid and each varied at different time points.These findings suggest that all these complement components have a functional role in nerve regeneration.
文摘Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest.Methods The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery.The entire treatment period was divided into two stages,during which segmental latissimus dorsi flaps were pre-expanded in stage I and anterior chest scar deformities were reconstructed in stage II.During stage I,the musculocutaneous perforators arising from the lateral branch of the thoracodorsal artery were determined by ultrasound preoperatively;the flap design included the anterior segment of the latissimus dorsi supplied by the musculocutaneous perforators from the lateral branch;and a tissue expander was placed following flap dissection and then infused with saline intermittently for 4–6 months.In stage II,the chest scars were excised,and breast tissues were repositioned;the continuity of the medial branch of the thoracodorsal nerve to the muscle was preserved when reconstruction was performed using the segmental latissimus dorsi flaps supplied by the main or lateral branch of the thoracodorsal artery.Results From October 2010 to October 2019,21 patients(on 24 sides)underwent reconstructive procedures for extensive scar contractures on the anterior chest.All flaps survived,and their donor sites were sutured directly.During a follow-up of 3 months to 8 years,the flaps became soft and exhibited color similar to that of the adjacent tissues.The limited neck and shoulder movements improved,and postoperatively,all female patients were satisfied with the shape of their breasts.Additionally,neither apparent weakening on the adduction,internal rotation,or extension strength of the shoulder joint on the affected side nor marked depression deformity in the back was observed.Conclusion Pre-expanded muscle-sparing latissimus dorsi flaps with blood supply from the main or lateral branch of the thoracodorsal artery proved to be a desirable option for the reconstruction of extensive scar contractures on the anterior chest.
基金the National Natural Science Foundation of China(81501668)Two-hundred Talent(20161424),Shanghai“Rising Stars of Medical Talent”Youth Development Program(Outstanding Youth Medical Talents),and Shanghai Jiao Tong University“Chenxing”Youth Development Program(Associate Professor Type A).
文摘Background:Use of internal filling ports in tissue expander–based reconstructions are advantageous because of easier self-care,lower infection rates,and fewer instances of capsule formation.The appearance of periprosthetic fluid accumulation after internal-port tissue expander implantation is a common complication that warrants treatment.In this study,we introduced a noninvasive method using fine-needle aspiration(FNA)to remove fluids accumulated after implantation of a remote internal-port tissue expander.Methods:In this study,245 patients who underwent implantation of remote internal-port tissue expanders in our hospital from July 1,2012,to July 1,2019,were included and divided into two groups.In the control group,patients underwent tissue expander implantation before July 1,2016,and large quantities of fluids were removed with surgical aspiration procedures in most cases.In the FNA group,the patients underwent implantation after July 1,2016,and large quantities of fluids were removed first with the FNA procedure.Patients’demographic data,indications for FNA application,and related complications were collected and analyzed.Results:Overall,395 expanders were placed in 245 patients.Postoperative management was similar in both groups.Fluids were managed with 23 expanders in the control group and with 31 expanders in the FNA group.There was no difference in the fluid aspiration rate between the two groups.The surgical aspiration rate was 11.1%(23/208)in the control group.The success rate of FNA was 90.3%(28/31).In the FNA group,the surgical aspiration rate was 1.6%(3/187),which was significantly lower than that in the control group.There were no significant differences in complications between the two groups.Conclusion:FNA can be used for periprosthetic fluid removal after the implantation of a remote internal-port tissue expander in most cases.This method is more convenient and safer than surgical aspiration for the postoperative management of internal-port tissue expander implantation.
基金supported by grants from National Natural Science Foundation of China(81772086,82072177),‘Two Hundred Talent’program,‘Outstanding Youth Medical Talents’Shanghai‘Rising Stars of Medical Talent’Youth Development Program and Shanghai Jiao Tong University‘Chenxing’Youth Development Program(Associate Profes-sor Type A).
文摘With advances in anatomical knowledge and technology,increased interest has been directed towards reconstruction with enhanced aesthetic and functional outcomes.A myriad of thinned perforator flap harvest approaches have been developed for this purpose;however,concerns about jeopardizing their vascularity remain.To ensure optimum reconstructive outcome without hampering the flap’s microcirculation,it is important to make good use of the existing advanced imaging modalities that can provide clear visualization of perforator branches,particularly in the adipose layer,and an accurate assessment of flap perfusion.Therefore,this review will highlight the imaging modalities that have been utilized for harvesting a thinned perforator flap from these two perspectives,along with future insights into creating both functionally and aesthetically satisfying,yet simultaneously safe,thinned perforator flaps for the best reconstructive outcomes for patients.
文摘Numerous studies have shown that macrophages can orchestrate the microenvironment from the early stage of wound healing to the later stages of scar formation.However,few reviews have highlighted the significance of macrophages during the formation of abnormal scars.The purpose of this reviewwas to outline the polarization of macrophages from early to late stage of pathological scar formation,focusing on spatiotemporal diversity of M1 and M2 macrophages.In this review,the role of macrophages in the formation of hypertrophic scars and keloids is summarized in detail.First,an increased number of M2 cells observed before injuries are significantly associated with susceptibility to abnormal scar pathogenesis.Second,decreased expression of M1 at the early stage and delayed expression of M2 at the late stage results in pathological scar formation.Third,M2 cells are highly expressed at both the margin and the superficial region,which is consistent with the invasive property of keloids.Finally,this review helps to characterize strategies for the prediction and prevention of pathological scar formation.
基金supported by grants from the National Natural Science Foundation of China(81772086,8170120)the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant(20161424)+1 种基金Shanghai Sailing Program(16YF1403500,17YF1401900)China Postdoctoral Science Foundation(2018 M630449).
文摘Background:Microsurgical replantation has become the most favorable treatment option for scalp avulsion.However,the accurate prediction of postoperative replant viability remains challenging.Case presentation:In this article,we showed that(indocyanine green angiography,ICGA)can provide a much more precise prediction of replant necrosis than conventional clinical assessment in a rare case of complete scalp avulsion with prolonged ischemia time.Conclusion:Clinical assessment of replant survival may be misleading in cases of complex tissue injuries and prolonged ischemic stress.This case provides insight into the promising utility of ICGA as an important adjuvant tool to better assess tissue perfusion and viability in scalp avulsion and possibly other types of replantation.
基金supported by grants from the National Natu-ral Science Foundation of China(81501668).
文摘Pathological scars might cause a distorted appearance and restricted mobility,and the study of scar pathophysiology has been hindered by the absence of a reliable model.In this study,we introduce a model with a modified device to induce controlled tension on a wound healing by secondary intention to overcome the shortcomings of the model generated by Aarabi et al.We investigated and recommend an induction of 0.1 N/mm^(2) tension on day 7 for 14 days to mimic the characteristics of human scars.A 3.5-fold increase in scar tissue and a 2-fold increase in collagen production were induced by the modified model.Histologically,the modified method increased scar thickness.However,no significant difference was found in cell density between the two groups.This modified procedure significantly increased scar tissue,which could be used for further cellular and biomolecular research.The mechanical force applied to the wound became measurable and controllable.This method is more convenient for researchers to observe in realtime and for providing timely adjustments of the tension used in this modified model.
基金The authors would like to thank anonymous reviewers for their helpful comments and suggestions. Special thanks to Raymond Cheng, Andrew Liu and Yuan Yao for their careful revisions. This work was supported by the National Natural Science Foundation of China under （Grant Nos. 91118004, 61232007）, and the Innovation Program of Shanghai Municipal Education Commission （13ZZ023）.
文摘Architectural modeling and behavior analysis are two important concerns in the software development. They are often implemented separately, and specified by their own supporting notations. Architectural modeling helps to guarantee the system design to satisfy the requirement, and behavior analysis can ensure the interaction correctness. To improve the trustworthiness, methods trying to combine architectural modeling and behavior analysis notations together have been proposed, e.g., establishing a one-way mapping relation. However, the one-way relation cannot ensure updating one notation specifications in accordance with the other one, which results in inconsistency problems. In this paper, we present an approach to integrating behavior analysis into architectural modeling, which establishes the interoperability between architectural modeling notation and behavior analysis notation by a bidirectional mapping. The architecture is specified by the modeling language, architecture analysis and design language （AADL）, and then mapped to behavior analysis notation, Darwin/FSP （finite state process） through the bidirectional transformation. The bidirectional transformarion provides traceability, which makes behavior analysis result provided by a model checker can be traced and reflected back to the original AADL specifications. In this way, the behavior analysis is integrated into architectural modeling. The feasibility of our approach is shown by a control system example.
基金National Natural Science Foundation of China(grant numbers:51875008 and 52105424)R&D Program of Beijing Municipal Education Commission(KM202210005033)+3 种基金Royal Society via an International Exchange programme(Grant No:IEC\NSFC\191,253)International Research Cooperation Seed Fund of Beijing University of Technology(grant number:2021A10)BJAST Innovation Cultivation Programes(No.11000022T000000446498)BJAST Budding Talent Program(BGS202210).
文摘Bone drilling is a routine operation in surgeries,such as neurosurgery and orthopedics.However,the excessive drilling temperature may cause severe thermal damage to the bone tissue.Therefore,the drilling temperature determination of bone tissue can reduce the harm caused by thermal damage.A time-varying temperature field simulation model of bone drilling was set up by ABAQUS software in this paper,based on the Johnson-Cook model.Then it was validated with experiments by drilling cortical bone of fresh bovine shaft of the femur.The relative error between the experimental values and the theoretical values within 7.67%showed a good consistency.Furthermore,the aging factor is also considered to evaluate the temperature field of bone drilling.The results showed that the drilling temperature near the bone-drill area increased significantly.The drilling temperature of cortical bone decreases sharply with the radial distance and exhibits a hysteresis lag in the axial distribution.The aging factor mainly affects the peak of drilling temperature.The peak of drilling temperature tends to increase with age.The peak drilling temperature in the elderly(70y)was up to 6.8%higher than that in the young(20y),indicating that the elderly is more prone to excessive drilling temperature.Therefore,special attention should be paid to the temperature control of elderly bone tissue.
文摘This paper aims to analyze how China’s rise is perceived by minor powers in the world system.Taking Turkey as the case study,the paper focuses on major issue areas such as bilateral trade and business between Turkey and China,and the issue of Eastern Turkistan(Xinjiang problem).This research concludes that unbalanced trade relationships and fierce competition in textile exports between Turkey and China are causing uneasiness on the Turkish side.Nevertheless,this has not changed Turkey’s perception about China’s rise as an opportune chance.Politically,it is possible for Turkey to seek opportunities to cooperate with China in many aspects to promote Turkey’s interests.China should also realize that it is impossible for Turkey to be openly supportive of China’s anti-terrorist policies in Xinjiang,where most of the inhabitants are regarded as“fellowmen”by Turks.
