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Lin G, Zhang X, Song Z, Xu Y, Wang H, Zheng R, Fan F, You J. Clinical Application of Botulinum Toxin A on Nasal Reconstruction with Expanded Forehead Flap for Asian Patients. Aesthetic Plast Surg 2024:10.1007/s00266-024-04033-x. [PMID: 38653821 DOI: 10.1007/s00266-024-04033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Because of its unique advantages, frontal expansion has become a common tool for Asian nasal reconstruction, but it has the limitations of prolonging the duration and pain in the expansion area. Based on the fact that the denervation effect of botulinum toxin type A (BTX-A) has been widely used in the reconstruction of superficial organs, we hypothesized that BTX-A would shorten the length of nasal reconstruction sequence and alleviate the discomfort of patients. METHODS A comparative retrospective study was conducted of consecutive patients underwent sequential treatment of nasal reconstruction between June 2010 and July 2012. Data on demographics, BTX-A injection plan and expansion duration were collected and analyzed. Phased pain intensity outcomes were evaluated by visual analogue scale (VAS). Photographs were collected during the follow-up period. RESULTS Thirty patients were enrolled in the study; 15 (50%) with and 15 (50%) without BTX-A pre-injection. Demographic data were homogeneous. The duration of the observation group (BTX-A pretreated) (133.87 ± 13.64 days) was significantly shortened versus the control group (164.27 ± 14.08 days, P<0.001). At the initial stage, no significant difference was found in the VAS scores (P=0.64). At the medium stage, the VAS score of the observation group (2.07 ± 0.80) was significantly lower than the control group (3.00 ± 0.53, P<0.01). At the terminal stage, the VAS score of the observation group (1.93 ± 0.59) was significantly lower than the control group (2.73 ± 0.70) but with a narrower disparity. CONCLUSION Pre-injection of BTX-A is effective in shortening the duration of the expansion phase, as well as relieving the pain associated with expansion. LEVEL OF EVIDENCE IV The journal asks authors to assign a level of evidence to each article. For a complete description of Evidence-Based Medicine ratings, see the Table of Contents or the online Instructions for Authors at www.springer.com/00266 .
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Affiliation(s)
- Guangxian Lin
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Xulong Zhang
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Zhen Song
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Yihao Xu
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Huan Wang
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Ruobing Zheng
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Fei Fan
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
| | - Jianjun You
- Center of Rhinoplasty, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
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Lin G, Yihao X, Zhang X, You J, Wang H, Zheng R, Tian L, Guo J, Song Z, Fan F. Tunneled Paranasal Augmentation Using Diced Autologous Costal Cartilage in Asian Rhinoplasty: A Comparative Study. Facial Plast Surg 2024. [PMID: 38547925 DOI: 10.1055/a-2296-3105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2024] Open
Abstract
Due to the prevalence of anterior maxilla dysplasia in Asian population, paranasal concavity is a common accompaniment to low nose, but its impact on facial harmonization is often underestimated. A retrospective comparative study was conducted on patients diagnosed as low nose with paranasal concavity between June 2017 and June 2021, with a total of 56 patients followed up successfully. The control and observation groups were established according to whether the paranasal augmentation was performed. Demographic data were collected. Cosmetic enhancement was quantitatively evaluated by sagittal planimetry, establishing related anatomical landmarks and measuring columella base prominence (CBP) and alar base prominence (ABP). Subjective evaluation concluded the patient-reported satisfaction (FACE-Q-Rhinoplasty Module and Facial Appearance Module) and the third-party physician assessment (Global Aesthetic Improvement Scale, GAIS).Significant improvements in CBP and ABP were reported both in the control and the observation group (p < 0.01). In postoperative intergroup comparisons, the observation group was superior to the control group regarding ABP values (2.5 ± 0.75 degrees, p < 0.01), FACE-Q-Facial scores (7.49 ± 3.70, p < 0.05), and GAIS scores (p < 0.05). However, no statistical difference was found in CBP values and FACE-Q-Rhinoplasty scores. Paranasal augmentation-related complications included asymmetry of alar bases (6.9%) and facial or intraoral foreign body sensation (34.5%). This study affirmed that paranasal augmentation using diced costal cartilage in rhinoplasty is a safe procedure effective in remedying paranasal concavity and improving facial satisfaction. LEVEL OF EVIDENCE:: IV.
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Affiliation(s)
- Guangxian Lin
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Xu Yihao
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Xulong Zhang
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Jianjun You
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Huan Wang
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Ruobing Zheng
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Le Tian
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Junsheng Guo
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Zhen Song
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
| | - Fei Fan
- Nasal Reconstruction Centre, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Shijingshan District, China
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Wu L, Wang H, Tian L, Ma H, Fan F, You J. The relay graft, a tailored supplement between the nasal hump and established tip in East Asian rhinoplasty. J Plast Reconstr Aesthet Surg 2024; 91:94-102. [PMID: 38402818 DOI: 10.1016/j.bjps.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/10/2023] [Accepted: 02/04/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND In East Asian individuals, the nasal bone already has sufficient height for an ideal dorsal profile, but the tip requires enhancement for a desired projection. Consequently, the gap between the intrinsic bony structure and the established nasal tip requires appropriate management. The options are either to reduce the keystone region to create a smooth bed for a conventional dorsal onlay graft or to preserve the original osseocartilaginous structures and then customize a supplementary graft. The aim of this study was to detail and validate the utilization of a relay graft, a transition graft that fills the structural gap between the upper dorsum and established tip graft. The proper application of this graft could prevent osteotomy and preserve the intrinsic dorsum. METHODS Relay grafts were applied during rib-based rhinoplasty in East Asian patients. Three-dimensional stereophotogrammetric evaluations of the patients were performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection improvement, radix elevation, and the angulation of kyphion and pronasale. RESULTS Fifteen female patients, ranging in age from 21 to 40 years (average 24.5 years), were included. In all cases, the relay graft was applied as one essential element for filling the structural gap. No crooked dorsal profile or visible graft was noted in all cases. Fifteen patients completed the pre- and postoperative stereophotogrammetric study. Postoperative analysis showed great improvement of tip position as well as a slight elevation of the radix, evidenced by the consistent change of kyphion/pronasale angulation and sellion elevation. CONCLUSIONS The relay graft effectively mitigates the necessity of a disruptive dorsal reduction. It is entirely possible for East Asians to achieve a smooth dorsal profile when only the lower half of the dorsum is transitioned to the proposed tip position. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Lehao Wu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Rd., Shijingshan District, Beijing 100144, PR China
| | - Huan Wang
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Rd., Shijingshan District, Beijing 100144, PR China
| | - Le Tian
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Rd., Shijingshan District, Beijing 100144, PR China
| | - Hengyuan Ma
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Rd., Shijingshan District, Beijing 100144, PR China
| | - Fei Fan
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Rd., Shijingshan District, Beijing 100144, PR China
| | - Jianjun You
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, No. 33 Badachu Rd., Shijingshan District, Beijing 100144, PR China.
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Zhang SQ, Wu ZQ, Huo BW, Xu HN, Zhao K, Jing CQ, Liu FL, Yu J, Li ZR, Zhang J, Zang L, Hao HK, Zheng CH, Li Y, Fan L, Huang H, Liang P, Wu B, Zhu JM, Niu ZJ, Zhu LH, Song W, You J, Yan S, Li ZY. [Incidence of postoperative complications in Chinese patients with gastric or colorectal cancer based on a national, multicenter, prospective, cohort study]. Zhonghua Wei Chang Wai Ke Za Zhi 2024; 27:247-260. [PMID: 38532587 DOI: 10.3760/cma.j.cn441530-20240218-00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Objective: To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications. Methods: This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression. Results: The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion: Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.
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Affiliation(s)
- S Q Zhang
- Department of Public Health, Qinghai University School of Medicine, Xining 810001, China
| | - Z Q Wu
- Gastrointestinal Cancer Center, Beijing Cancer Hospital, Beijing 100142, China
| | - B W Huo
- Department of Gastrointestinal (Oncology) Surgery, Affiliated Hospital of Qinghai University, Xining 810001, China
| | - H N Xu
- Department of Gastrointestinal (Oncology) Surgery, Affiliated Hospital of Qinghai University, Xining 810001, China
| | - K Zhao
- Department of Gastrointestinal (Oncology) Surgery, Affiliated Hospital of Qinghai University, Xining 810001, China
| | - C Q Jing
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Jinan 250021, China
| | - F L Liu
- Department of Gastric Surgery, Cancer Hospital, Fudan University, Shanghai 200025, China
| | - J Yu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Z R Li
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - J Zhang
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China
| | - L Zang
- Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China
| | - H K Hao
- Department of Gastrointestinal Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - C H Zheng
- Department of Gastroenterology, Union Hospital of Fujian Medical University, Fuzhou 350001, China
| | - Y Li
- Department of Gastrointestinal Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - L Fan
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - H Huang
- Department of Gastric Surgery, Cancer Hospital, Fudan University, Shanghai 200025, China
| | - P Liang
- Department of Gastrointestinal Surgery, the First Hospital of Dalian Medical University, Dalian 116011, China
| | - B Wu
- Department of Basic Surgery, Union Hospital of Peking Union Medical College, Beijing 100032, China
| | - J M Zhu
- Department of Gastrointestinal Oncology, the First Affiliated Hospital of China Medical University, Shenyang 110002, China
| | - Z J Niu
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - L H Zhu
- Department of Gastrointestinal Surgery, Run Run Shaw Hospital, Zhejiang University, Hangzhou 310009, China
| | - W Song
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, China
| | - J You
- Department of Gastrointestinal Oncology, the First Affiliated Hospital of Xiamen University, Xiamen 361003, China;Zhang Shuqin is now working at Department of Infection Management, Suqian Hospital, Xuzhou Medical University
| | - S Yan
- Department of Gastrointestinal (Oncology) Surgery, Affiliated Hospital of Qinghai University, Xining 810001, China
| | - Z Y Li
- Gastrointestinal Cancer Center, Beijing Cancer Hospital, Beijing 100142, China
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Zhang L, Xiao T, Zeng X, You J, He Z, Chen CX, Wang Q, Nafady A, Al-Enizi AM, Ma S. Isoreticular Contraction of Cage-like Metal-Organic Frameworks with Optimized Pore Space for Enhanced C 2H 2/CO 2 and C 2H 2/C 2H 4 Separations. J Am Chem Soc 2024; 146:7341-7351. [PMID: 38442250 DOI: 10.1021/jacs.3c12032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
The C2H2 separation from CO2 and C2H4 is of great importance yet highly challenging in the petrochemical industry, owing to their similar physical and chemical properties. Herein, the pore nanospace engineering of cage-like mixed-ligand MFOF-1 has been accomplished via contracting the size of the pyridine- and carboxylic acid-functionalized linkers and introducing a fluoride- and sulfate-bridging cobalt cluster, based on a reticular chemistry strategy. Compared with the prototypical MFOF-1, the constructed FJUT-1 with the same topology presents significantly improved C2H2 adsorption capacity, and selective C2H2 separation performance due to the reduced cage cavity size, functionalized pore surface, and appropriate pore volume. The introduction of fluoride- and sulfate-bridging cubane-type tetranuclear cobalt clusters bestows FJUT-1 with exceptional chemical stability under harsh conditions while providing multiple potential C2H2 binding sites, thus rendering the adequate ability for practical C2H2 separation application as confirmed by the dynamic breakthrough experiments under dry and humid conditions. Additionally, the distinct binding mechanism is suggested by theoretical calculations in which the multiple supramolecular interactions involving C-H···O, C-H···F, and other van der Waals forces play a critical role in the selective C2H2 separation.
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Affiliation(s)
- Lei Zhang
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Taotao Xiao
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Xiayun Zeng
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Jianjun You
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Ziyu He
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Cheng-Xia Chen
- MOE Laboratory of Bioinorganic and Synthetic Chemistry, Lehn Institute of Functional Materials, School of Chemistry, Sun Yat-Sen University, Guangzhou 510006, China
| | - Qianting Wang
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Ayman Nafady
- Department of Chemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdullah M Al-Enizi
- Department of Chemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Shengqian Ma
- Department of Chemistry, University of North Texas, Denton, Texas 76201, United States
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Song Z, Zhang X, Xu Y, You J, Wang H, Zheng R, Tian L, Guo J, Fan F. The Dynamic Changes in Hemodynamics of the Forehead Flap During Tissue Expansion. Facial Plast Surg Aesthet Med 2024; 26:135-140. [PMID: 37358573 DOI: 10.1089/fpsam.2023.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Background: The tissue expansion process brings changes in hemodynamics. Objective: To measure the change in vessel diameter, blood flow, and resistance in the blood vessels using ultrasound before, during, and after tissue expansion. Methods: Patients undergoing the embedment of a forehead expander from September 2021 to October 2022 were included. Hemodynamics parameters, including vessel diameter, blood flow velocity, and resistance index (RI) of the supraorbital artery (SOA), supratrochlear artery (STrA), and frontal branch of the superficial temporal artery (FBSTA), were measured with ultrasound before and 1, 2, 3, and 4 months after expansion. Results: Nine males and six females with ages ranging from 15 to 26 years (mean, 20 years) were included. After 4 months of expansion, the diameter of the STrA, SOA, and FBSTA increased significantly, the RI decreased significantly, and except the right SOA, peak systolic flow velocity increased significantly. Conclusion: The parameters of flap perfusion were significantly improved in the first 2 months of expansion and tended to stable values.
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Affiliation(s)
- Zhen Song
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Xulong Zhang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Yihao Xu
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Jianjun You
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Huan Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Ruobing Zheng
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Le Tian
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Junsheng Guo
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Fei Fan
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
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Wang X, Dong W, Song Z, Wang H, You J, Zheng R, Xu Y, Zhang X, Guo J, Tian L, Fan F. Comparing the Effectiveness of Betamethasone and Triamcinolone Acetonide in Multimodal Cocktail Intercostal Injection for Chest Pain After Harvesting Costal Cartilage: A Prospective, Double-Blind, Randomized Controlled Study. Aesthetic Plast Surg 2024; 48:1111-1117. [PMID: 37438661 DOI: 10.1007/s00266-023-03461-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/06/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND There has been no previous study on the availability of different glucocorticoid varieties used in the multimodal cocktail for harvesting autologous costal cartilage. This randomized controlled trial (RCT) was to compare the significance and complications of betamethasone and triamcinolone acetonide as a component of the cocktail for harvesting costal cartilage in patients. MATERIALS AND METHODS The patients were randomized to two groups. The group A used multimodal cocktail: ropivacaine, parecoxib sodium, epinephrine, and triamcinolone acetonide; group B used multimodal cocktail: ropivacaine, parecoxib sodium, epinephrine, and betamethasone. The primary outcomes were chest pain after surgery evaluated with a visual analog scale (VAS). The secondary outcomes evaluated the quality of recovery. The tertiary outcomes included rescue analgesic consumption, the first feeding time and the time to the first ambulation, and duration of hospital stay. RESULTS The VAS scores between the two groups was not considered clinically significant, but the groups achieved a VAS score of 3 or less. However, the time until the first rescue analgesia and the number were significantly longer and smaller for group A. Additionally, there were no significant differences between the two groups in the duration of hospital stay, first feeding time, the quality of recovery, and the first ambulation time. CONCLUSION Adding corticosteroids into the multimodal cocktails could improve pain relief after costal cartilage harvest. And the efficacy of Triamcinolone acetonide was better than betamethasone. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xin Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Wenfang Dong
- Department of Plastic and Reconstructive Surgery, Peking University third Hospital, 49 North Huayuan Road, Beijing, 100191, People's Republic of China
| | - Zhen Song
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Huan Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Jianjun You
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Ruobing Zheng
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Yihao Xu
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Xulong Zhang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Junsheng Guo
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Le Tian
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Fei Fan
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China.
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Song Z, Zhang X, Xu Y, You J, Wang H, Zheng R, Tian L, Guo J, Fan F. The Dynamic Changes in Skin Thickness of Forehead during Tissue Expansion. Facial Plast Surg 2024; 40:61-67. [PMID: 37023772 DOI: 10.1055/s-0043-1767769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
In addition to providing extra flap size, the tissue expansion process also brings changes in flap thickness. This study aims to identify the changes in the forehead flap thickness during the tissue expansion period. Patients undergoing forehead expander embedment from September 2021 to September 2022 were included. The thickness of the forehead skin and subcutaneous tissue were measured with ultrasound before and 1, 2, 3, and 4 months after expansion. Twelve patients were included. The average expansion period was 4.6 months, and the mean expansion volume was 657.1 mL. The thickness of skin and subcutaneous tissue in the central forehead changed from 1.09 ± 0.06 to 0.63 ± 0.05 mm and from 2.53 ± 0.25 to 0.71 ± 0.09 mm, respectively. In the left frontotemporal region, skin and subcutaneous tissue thickness changed from 1.03 ± 0.05 to 0.52 ± 0.05 mm and 2.02 ± 0.21 to 0.62 ± 0.08 mm. On the right side, skin and subcutaneous tissue thickness changed from 1.01 ± 0.05 to 0.50 ± 0.04 mm and 2.06 ± 0.21 to 0.50 ± 0.05 mm. This study measured the dynamic changes in the thickness of the forehead flap during expansion. The thickness of the forehead flap decreased the fastest in the first 2 months of expansion, and the changes in skin and subcutaneous thickness slowed down in the third and fourth months and tended to a minimum value. Additionally, the thickness of subcutaneous tissue decreased greater in magnitude than the dermal tissue.
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Affiliation(s)
- Zhen Song
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Xulong Zhang
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Yihao Xu
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Jianjun You
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Huan Wang
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Ruobing Zheng
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Le Tian
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Junsheng Guo
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
| | - Fei Fan
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, People's Republic of China
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Zhang X, Song Z, Xu Y, Zheng R, Guo J, Tian L, Wang H, You J, Fan F. Handheld Doppler Detection and Light Illumination for Vascular Mapping in Nasal Reconstruction. J Craniofac Surg 2024; 35:59-62. [PMID: 37702526 DOI: 10.1097/scs.0000000000009737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/31/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND The application of the expanded forehead flap in nasal reconstruction has the advantage of being able to provide a sufficient amount of flap and can provide good aesthetic results. For an expanded forehead flap to survive, there must be adequate arterial supply and venous return. Despite this, limited studies have been conducted on preoperative vascular mapping and the design of the expanded forehead flap for nasal reconstruction. In this article, the authors present a technique of hand-held Doppler detection with light illumination for vascular mapping. PATIENTS AND METHODS The study included patients who underwent total nasal reconstruction with expanded forehead flaps between May 2016 and April 2021. The design of the flap was based on the result of preoperative vascular detection by hand-held Doppler detection assisted by light illumination. RESULTS A total of 32 patients underwent total nasal reconstruction with an expanded forehead flap. The distal part of the flap became necrotic 1 week after the surgery in 2 patients. Following dressing changes and the administration of antibiotics, the distal flap in these patients survived well. No complications were reported in the long term. CONCLUSIONS Hand-held Doppler detection combined with light illumination is a convenient and effective preoperative design method for nasal reconstruction with an expanded forehead flap. All flaps survived well in the long term. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Xulong Zhang
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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10
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Li D, Wang X, Zhou J, Duan Z, Yang R, Liu Y, Chen Y, Zhang L, Liu H, Li W, You J. Analysis of Efficacy and Safety of Small-Volume-Plasma Artificial Liver Model in the Treatment of Acute-On-Chronic Liver Failure. Physiol Res 2023; 72:767-782. [PMID: 38215063 PMCID: PMC10805255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/11/2023] [Indexed: 01/14/2024] Open
Abstract
To explore the efficacy and safety of a small-volume-plasma artificial liver support system (ALSS) in the treatment of acute-on-chronic liver failure (ACLF). A retrospective analysis was performed. All ACLF patients received ALSS of plasma exchange & double plasma molecular absorb system (PE+DPMAS) treatment, and successfully completed this treatment. Patients were divided into small-volume and half-volume plasma groups. We compared the changes of the indicators on liver function, kidney function, blood coagulation function, and blood ammonia level before and after PE+DPMAS treatment; we compared the short-term and long-term curative effects between small-volume and half-volume plasma groups; and the factors influencing Week 4 and Week 12 mortality of ACLF patients were analyzed. The Week 4 improvement rates were 63.96 % and 66.86 % in the small-volume and half-volume plasma groups, respectively. The Week 12 survival rates in the small-volume-plasma and half-volume plasma groups were 66.72 % and 64.61 %, respectively. We found several risk factors affecting Week 4 and Week 12 mortality. Kaplan-Meier survival curves suggested no significant difference in Week 4 and Week 12 survival rates between the small-volume and half-volume plasma groups (P=0.34). The small-volume-plasma PE+DPMAS treatment could effectively reduce bilirubin and bile acids, and this was an approach with high safety and few complications, similar to the half-volume-plasma PE+DPMAS treatment. The small-volume-plasma PE+DPMAS has the advantage of greatly reducing the need for intraoperative plasma, which is especially of importance in times of shortage of plasma.
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Affiliation(s)
- D Li
- The First Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, China.
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You J, Ellis JL, Adams S, Sahar M, Jacobs M, Tulpan D. Comparison of imputation methods for missing production data of dairy cattle. Animal 2023; 17 Suppl 5:100921. [PMID: 37659911 DOI: 10.1016/j.animal.2023.100921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 09/04/2023] Open
Abstract
Nowadays, vast amounts of data representing feed intake, growth, and environmental impact of individual animals are being recorded in on-farm settings. Despite their apparent use, data collected in real-world applications often have missing values in one or several variables, due to reasons including human error, machine error, or sampling frequency misalignment across multiple variables. Since incomplete datasets are less valuable for downstream data analysis, it is important to address the missing value problem properly. One option may be to reduce the dataset to a subset that contains only complete data, but considerable data may be lost via this process. The current study aimed to compare imputation methods for the estimation of missing values in a raw dataset of dairy cattle including 454 553 records collected from 629 cows between 2009 and 2020. The dataset was subjected to a cleaning process that reduced its size to 437 075 observations corresponding to 512 cows. Missing values were present in four variables: concentrate DM intake (CDMI, missing percentage = 2.30%), forage DM intake (FDMI, 8.05%), milk yield (MY, 15.12%), and BW (64.33%). After removing all missing values, the resulting dataset (n = 129 353) was randomly sampled five times to create five independent subsets that exhibit the same missing data percentages as the cleaned dataset. Four univariate and nine multivariate imputation methods (eight machine learning methods and the MissForest method) were applied and evaluated on the five repeats, and average imputation performance was reported for each repeat. The results showed that Random Forest was overall the best imputation method for this type of data and had a lower mean squared prediction error and higher concordance correlation coefficient than the other imputation methods for all imputed variables. Random Forest performed particularly well for imputing CDMI, MY, and BW, compared to imputing FDMI.
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Affiliation(s)
- J You
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
| | - J L Ellis
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada.
| | - S Adams
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
| | - M Sahar
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
| | - M Jacobs
- Trouw Nutrition Innovation Department, Amersfoort, Netherlands
| | - D Tulpan
- Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada
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Leishman EM, You J, Ferreira NT, Adams SM, Tulpan D, Zuidhof MJ, Gous RM, Jacobs M, Ellis JL. Review: When worlds collide - poultry modeling in the 'Big Data' era. Animal 2023; 17 Suppl 5:100874. [PMID: 37394324 DOI: 10.1016/j.animal.2023.100874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Within poultry production systems, models have provided vital decision support, opportunity analysis, and performance optimization capabilities to nutritionists and producers for decades. In recent years, due to the advancement of digital and sensor technologies, 'Big Data' streams have emerged, optimally positioned to be analyzed by machine-learning (ML) modeling approaches, with strengths in forecasting and prediction. This review explores the evolution of empirical and mechanistic models in poultry production systems, and how these models may interact with new digital tools and technologies. This review will also examine the emergence of ML and Big Data in the poultry production sector, and the emergence of precision feeding and automation of poultry production systems. There are several promising directions for the field, including: (1) application of Big Data analytics (e.g., sensor-based technologies, precision feeding systems) and ML methodologies (e.g., unsupervised and supervised learning algorithms) to feed more precisely to production targets given a 'known' individual animal, and (2) combination and hybridization of data-driven and mechanistic modeling approaches to bridge decision support with improved forecasting capabilities.
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Affiliation(s)
- E M Leishman
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, Canada
| | - J You
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, Canada
| | - N T Ferreira
- Trouw Nutrition Canada, Puslinch, Ontario, Canada
| | - S M Adams
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, Canada
| | - D Tulpan
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, Canada
| | - M J Zuidhof
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - R M Gous
- School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - M Jacobs
- FR Analytics B.V., 7642 AP Wierden, The Netherlands
| | - J L Ellis
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, Canada.
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Zhang X, Song Z, Xu Y, Zheng R, Tian L, Guo J, Wang H, You J, Fan F. Rhinoplasty with Mortise-Tenon Cartilaginous Framework for Caudal Septal Cartilage Defects. Aesthetic Plast Surg 2023:10.1007/s00266-023-03733-0. [PMID: 37945758 DOI: 10.1007/s00266-023-03733-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Rhinoplasty for caudal septal cartilage defects is a challenge due to the difficulty of fixation of the grafts. OBJECTIVES This study presents an approach for correcting defects in caudal septal cartilage with the costal cartilaginous framework using a mortise-tenon technique. METHODS From May 2019 through May 2022, a retrospective analysis of patients with caudal septal cartilage defects underwent rhinoplasty using a mortise-tenon cartilaginous framework by a senior surgeon was performed. The surgical outcomes were evaluated both preoperatively and postoperatively. RESULTS This study involved 17 patients, ranging in age from 27 to 58 years. There were 22.4 months of follow-up on average. There was no long-term or short-term complication observed. The aesthetic outcome of all cases was satisfactory. The mean score for the patients of the perceptions of improvement in their noses was 8.11. CONCLUSION Correction of caudal septal cartilage defects with this costal cartilaginous framework using the mortise-tenon technique is feasible and effective. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xulong Zhang
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Zhen Song
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Yihao Xu
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Ruobing Zheng
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Le Tian
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Junsheng Guo
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Huan Wang
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Jianjun You
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China
| | - Fei Fan
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China.
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Xu Y, Fan F, You J, Zheng R, Wu L, Zhang X, Tian L, Guo J, Wang H. Application of Modified V-Y Advancement Flap in Alar Base Reduction. J Craniofac Surg 2023; 34:2522-2525. [PMID: 37702524 DOI: 10.1097/scs.0000000000009653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND A variety of techniques for alar base modification have been described in the literature. Limitations of these techniques include scars, recurrence, asymmetry, etc. An incorrect excision of the lateral alar wall can result in a tear-drop or Q-shaped deformity. OBJECTIVES In this study, a modified V-Y advancement flap will be introduced that will avoid the complications discussed above as well as adjust the positional relationship between the nasal alar and the columella using this technique. In addition, this method is reversible; once the nostril is narrow due to excessive advancement of the flap, the reverse V-Y advancement method can be used to enlarge the nostril. METHODS In this study, a retrospective review of wide nasal bases in the past 3 years was conducted. A blind analysis of anthropometric points was conducted. There were 3 outcome variables: the width of the alar base, the width of the flare, and the distance between the alar base and columellar base. RESULTS The alar base was reduced with a modified V-Y advancement flap on 65 female patients ranging from 18 to 45 years of age. In 10 cases, an "Inclined Y-arm flap" was used to narrow alar bases and adjust columella-alar positions. In the remaining cases, a "Horizontal Y-arm flap" was performed to narrow the simple nasal alar width. In all cases, the nasal base was reduced without distortion. In the postoperative period, all the effects were seen to persist for a long time, and patients were generally satisfied with the results of the procedure. CONCLUSION By using this modified V-Y advancement flap technique, the incision can be concealed as thoroughly as possible, thereby avoiding "tear-drop" or "Q" deformities as well as narrowing the nasal alar effectively. Furthermore, this method, in combination with rhinoplasty surgery, will greatly enhance the nasal appearance.
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Affiliation(s)
- Yihao Xu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
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15
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Song Z, Zhang X, Xu Y, You J, Wang H, Zheng R, Tian L, Guo J, Fan F. The Immediate Contraction of the Expanded Forehead Flap. J Craniofac Surg 2023; 34:2187-2190. [PMID: 37643073 DOI: 10.1097/scs.0000000000009689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Flaps contract immediately after harvest, which added difficulty to flap design. This study aims to investigate the immediate contraction rate of the expanded forehead flap used in nasal reconstruction. METHODS Patients undergoing nasal reconstruction with expanded forehead flaps from September 2021 to January 2023 were included. Objective measurements of the pedicle width, maximum width, maximum length, and flap size of the expanded forehead flap before and after harvest were conducted. RESULTS Fourteen patients, including 9 males and 5 females, were included. The average expansion period was 4.6 months, and the mean injection volume was 658.6 ml. The average retraction rate of pedicle width, maximum width, maximum length, and size of the flap after harvest were 16.15%, 30.26%, 26.86%, and 50.89%, respectively. CONCLUSION This study presents the contraction rate of the expanded forehead flap used for nasal reconstruction. The data from the measurement will help surgeons to design the expanded forehead flap. LEVEL OF EVIDENCE Level-Level IV.
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Affiliation(s)
- Zhen Song
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Xu Y, Song Z, Zhang X, Guo J, Tian L, Zheng R, Wang H, You J, Fan F. Modified Drilled Extended Spreader Grafts in Asian Rhinoplasty: Clinical Application and Histopathological Analysis. J Craniofac Surg 2023; 34:2177-2180. [PMID: 37370207 DOI: 10.1097/scs.0000000000009502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Extended Spreader Grafts (ESGs) are widely used for both esthetic and functional purpose in rhinoplasty. This study aims to examine the effects of drilling on ESGs in rhinoplasty and their clinical benefits, as well as to analyze their histologic characteristics. METHODS We conducted a retrospective review of patients undergoing esthetic rhinoplasty using drilled ESGs with autologous costal cartilage by a senior surgeon from January 2018 to April 2022. RESULTS A total of 80 patients were included, with a mean follow-up period of 26 months. Revision operations were performed on 4 patients. The phenomenon of tissue ingrowth from the septum mucoperichondrium to the septal cartilage through the holes of the drilled ESGs was observed in all 4 patients. Specimens of the ingrown tissue were taken from 3 patients during their revision surgeries. Vascular structures and connective tissue were observed in the specimens after fixation, paraffin embedding, and staining with hematoxylin-eosin. No other complications were observed except for 2 cases presenting cartilage warping after surgery. CONCLUSION Application of the drilled ESGs is a simple but effective approach, which has 3 significant advantages in rhinoplasty: enhancing the stability of the cartilaginous framework through connective tissue ingrowth, preserving the septal cartilage, and providing septum vitality by allowing the formation of vascular structures between the perichondrium and the septal cartilage; reducing the probability of warping in early stages through release the tension force of the cartilage itself. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Yihao Xu
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Guo J, Zhang X, Xu Y, Zheng R, You J, Fan F, Wang H. Learning Curve Analysis of Full-Length Costal Cartilage Harvesting by Plastic Surgery Residents: A Retrospective Study. J Craniofac Surg 2023; 34:e594-e598. [PMID: 37336485 DOI: 10.1097/scs.0000000000009489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 06/21/2023] Open
Abstract
ABSTRACT Costal cartilage harvesting (CCH) is a fundamental skill for plastic surgery residents to master. Understanding the learning process is essential for optimizing training programs and ensuring patient safety. Previous research on learning curves has been limited. A retrospective study was conducted on patients who underwent CCH between January 2018 and December 2022. The learning process of 14 inexperienced residents was analyzed using the curve-fitting method, with operative time (OT) and complication rates as outcome measured. Data were compared with 4 attending surgeons who also performed CCH. Resident OTs decreased as experience grew, with the bi-exponential model fitting best. After 10 to 20 cases, the average OT decreased to around 40 minutes. By extrapolation, novice residents require ~50 cases to achieve a plateau of OT similar to the attending surgeons, around 27 minutes. Most complications of the resident group occurred within the first 10 to 20 cases, and the complication rate of attending surgeons was <1%. Harvesting on the left side and a higher body mass index resulted in longer OTs for residents. Harvesting the seventh rib required significantly more time for both residents and attending surgeons. The learning curve for CCH shows that 10 to 20 cases are necessary for residents to perform safely and efficiently. Training should progress gradually, starting with longer incisions and leaner patients, then moving to smaller incisions and more challenging cases. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Junsheng Guo
- Rhinoplasty and Nasal Reconstruction Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
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Song Z, Xu Y, Zhang X, You J, Wang H, Zheng R, Tian L, Guo J, Fan F. Application of a Modified Costal Cartilaginous Framework in Correction of Severe Saddle Nose Deformity. Aesthet Surg J 2023; 43:830-839. [PMID: 36866401 DOI: 10.1136/bmj-2022-073481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Insufficient support of the nasal septum due to congenital or secondary deficiency leads to severe saddle nose deformity, which presents an unpleasant appearance. OBJECTIVES The purpose of this study is to present our approach to constructing a costal cartilaginous framework with autologous costal cartilage for correction of severe saddle nose deformities. METHODS A retrospective analysis was conducted of patients who underwent correction of severe saddle nose deformity (type 2 to type 4) by a senior surgeon from January 2018 to January 2022. Preoperative and postoperative measurements were conducted to evaluate the surgical outcomes. RESULTS A total of 41 patients ages 15 to 50 years completed the study. The average follow-up time was 20.6 months. No short-term complications were observed. Revisional operations were performed on 3 patients. All patients were satisfied with the aesthetic results. Analysis of objective measurements showed that the nasofrontal angle, columellar-labial angle, and tip projection improved significantly in type 2 cases, the nasofrontal angle and tip projection improved significantly in type 3 cases, and tip projection improved significantly in type 4 cases. CONCLUSIONS Application of this modified costal cartilaginous framework, which consists of a fairly stable foundation layer and an aesthetic contour layer of block costal cartilage, has achieved satisfactory results over the long term.
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Zhang X, Song Z, Xu Y, You J, Wang H, Zheng R, Tian L, Guo J, Fan F. Correction of Cleft Lip Nose Deformity With Circular Shape Alar Graft and Block Costal Cartilage. Ann Plast Surg 2023; 91:78-83. [PMID: 37450864 DOI: 10.1097/sap.0000000000003582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Secondary deformities of the cleft lip and nose are mainly caused by the long period of craniofacial development and the secondary scarring. Correction of the secondary cleft lip-nose deformity is a complex process that requires both the correction of the soft tissue and skeletal support. The purpose of this study was to present our experience in correcting the secondary unilateral cleft lip-nose deformities with autologous costal cartilage. METHODS A retrospective analysis of patients who underwent correction of unilateral cleft nasal deformity with simultaneous rhinoplasty by a senior surgeon from January 2015 to January 2022 was conducted. Preoperative and postoperative measurements of the columellar-labial angle and the inclination of nasal base were conducted to evaluate the surgical outcomes. RESULTS A total of 54 patients were included in this study according to the inclusion criteria. The mean follow-up period was 4 years (range, 1-7 years). The mean values of the columellar-labial angle were 91.1 ± 9.2 degrees preoperatively and 101.0 ± 5.9 degrees postoperatively. The mean values of the inclination of nasal base were 4.5 ± 1.2 degrees preoperatively and 0.9 ± 0.4 degrees postoperatively. There was a considerable increase in the columellar-labial angle after the surgery (9.9 ± 6.0 degrees; P < 0.01). The inclination of nasal base decreased significantly (3.6 ± 1.1 degrees; P < 0.01). CONCLUSIONS Our approach on correction the secondary clef lip nose through repositioning the muscles by Z-plasty and application of the block cartilage graft and circular shape alar graft has achieved long-term satisfactory results.
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Affiliation(s)
- Xulong Zhang
- From The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
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Zhang L, He Z, Liu Y, You J, Lin L, Jia J, Chen S, Hua N, Ma LA, Ye X, Liu Y, Chen CX, Wang Q. A Robust Squarate-Cobalt Metal-Organic Framework for CO 2/N 2 Separation. ACS Appl Mater Interfaces 2023. [PMID: 37327481 DOI: 10.1021/acsami.3c06530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The separation of CO2 from the industrial post-combustion flue gas is of great importance to reduce the increasingly serious greenhouse effect, yet highly challenging due to the extremely high stability, low cost, and high separation performance requirements for adsorbents under the practical operating conditions. Herein, we report a robust squarate-cobalt metal-organic framework (MOF), FJUT-3, featuring an ultra-small 1D square channel decorated with -OH groups, for CO2/N2 separation. Remarkably, FJUT-3 not only has excellent stability under harsh chemical conditions but also presents low-cost property for scale-up synthesis. Moreover, FJUT-3 shows excellent CO2 separation performance under various humid and temperature conditions confirmed by the transient breakthrough experiments, thus enabling FJUT-3 with adequate potentials for industrial CO2 capture and removal. The distinct CO2 adsorption mechanism is well elucidated by theoretical calculations, in which the hierarchical C···OCO2, C-O···CCO2, and O-H···OCO2 interactions play a vital synergistic role in the selective CO2 adsorption process.
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Affiliation(s)
- Lei Zhang
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Ziyu He
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Yupeng Liu
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Jianjun You
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Lang Lin
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Jihui Jia
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Song Chen
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Nengbin Hua
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Li-An Ma
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Xiaoyun Ye
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Yanrong Liu
- Beijing Key Laboratory of Ionic Liquids Clean Process, CAS Key Laboratory of Green Process and Engineering, State Key Laboratory of Multiphase Complex Systems, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Cheng-Xia Chen
- MOE Laboratory of Bioinorganic and Synthetic Chemistry, Lehn Institute of Functional Materials, School of Chemistry, Sun Yat-Sen University, Guangzhou 510275, China
| | - Qianting Wang
- Collaborative Innovation Center for Intelligent and Green Mold and Die of Fujian Province, College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
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Wu L, You J, Wang H, Tian L, Fan F. Introducing Saddle-Shaped Radix Graft, with a Second Look into the Classic. Plast Reconstr Surg 2023; Publish Ahead of Print:00006534-990000000-01903. [PMID: 37220389 DOI: 10.1097/prs.0000000000010722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND An enduringly stable tip graft is the key to achieve successful rhinoplasty cases. However, the intrinsic nature of rib graft warping renders major unpredictability for the long term outcome. The objective of this study was to detail and validate the utilization of a radix graft design that is characterized by the dual curved surfaces and beveled margin, which consequently renders a shape similar to a saddle. METHODS Twenty-three female patients, ranging in age from 22 to 31 years completed the study. In all cases, the saddle-shaped radix graft was applied as the essential element for enhancing radix region profile. The complications that arose were collected retrospectively. Three-dimensional stereophotogrammetric evaluations of patients were performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, radix height and the radius of curvature. RESULTS Postoperative analysis suggested significant improvement on the aesthetics of the radix region over time, evidenced by the significant increase of radix height (4.33±1.21 vs 7.08±1.00mm), as well as the reduction of radius of curvature at nasofrontal break over long term(22.63±2.24 vs 13.94±0.98). Other postoperative evaluations including radix height, tip projection and nasal length had significant improvement. CONCLUSIONS The Saddle-shaped radix graft effectively augments the radix area and creates an aesthetically pleasant nasofrontal break without causing the elevated radix deformity. It has the merits of anatomically compliance and flexibility when it comes to concomitantly improving the glabella-radix profile for those East Asians with extremely low radix.
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Affiliation(s)
- Lehao Wu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
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Zhang L, Lin S, Liu Y, Zeng X, You J, Xiao T, Feng Y, He Z, Chen S, Hua N, Ye X, Wei ZW, Chen CX. Optimized Pore Nanospace through the Construction of a Cagelike Metal-Organic Framework for CO 2/N 2 Separation. Inorg Chem 2023; 62:8058-8063. [PMID: 37172273 DOI: 10.1021/acs.inorgchem.3c01055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The development of metal-organic framework (MOF) adsorbents with a potential molecule sieving effect for CO2 capture and separation from flue gas is of critical importance for reducing the CO2 emissions to the atmosphere yet challenging. Herein, a cagelike MOF with a suitable cage window size falling between CO2 and N2 and the cavity has been constructed to evaluate its CO2/N2 separation performance. It is noteworthy that the introduction of coordinated dimethylamine (DMA) and N,N'-dimethylformamide (DMF) molecules not only significantly reduces the cage window size but also enhances the framework-CO2 interaction via C-H···O hydrogen bonds, as proven by molecular modeling, thus leading to an improved CO2 separation performance. Moreover, transient breakthrough experiments corroborate the efficient CO2/N2 separation, revealing that the introduction of DMA and DMF molecules plays a vital role in the separation of a CO2/N2 gas mixture.
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Affiliation(s)
- Lei Zhang
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Sihan Lin
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Yupeng Liu
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Xiayun Zeng
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Jianjun You
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Taotao Xiao
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Yongjie Feng
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Ziyu He
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Song Chen
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Nengbin Hua
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Xiaoyun Ye
- College of Materials Science and Engineering, Fujian University of Technology, Fuzhou, Fujian 350118, China
| | - Zhang-Wen Wei
- MOE Laboratory of Bioinorganic and Synthetic Chemistry, Lehn Institute of Functional Materials, School of Chemistry, Sun Yat-Sen University, Guangzhou 510275, China
| | - Cheng-Xia Chen
- MOE Laboratory of Bioinorganic and Synthetic Chemistry, Lehn Institute of Functional Materials, School of Chemistry, Sun Yat-Sen University, Guangzhou 510275, China
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Song Z, Zhang X, Wang H, You J, Zheng R, Xu Y, Guo J, Tian L, Fan F. Nasal reconstruction with the expanded forehead flap: Long-term follow-up of esthetic outcome and 12-year experience. J Plast Reconstr Aesthet Surg 2023; 83:109-116. [PMID: 37276728 DOI: 10.1016/j.bjps.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/20/2022] [Accepted: 04/11/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND The expanded forehead flap has its unique advantage in nasal reconstruction. The authors present their 12-year experience with nasal reconstruction with an expanded forehead flap. The esthetic and functional outcomes were assessed with long-term subjective and objective evaluations. METHODS A retrospective analysis was conducted of consecutive patients who underwent nasal reconstruction with the expanded forehead flap from 2009 to 2021 performed by the senior author (F.F.). Data were collected and analyzed regarding defect characteristics, processes of treatment, and complications. Subjective esthetic and functional outcomes were assessed through questionnaires FACE-Q (Face Questionnaire) and NOSE (Nasal Obstruction Symptom Evaluation). The objective esthetic outcome was assessed by a senior resident through the viewing of clinical photographs. RESULTS One hundred and fifty-five patients underwent nasal reconstruction with an expanded forehead flap. The average expansion period was 174 days, and the injection volume was 685.7 ml. There were 15 complications. One hundred and eight patients (69.6%) were satisfied, and 19 patients (12.2%) were very satisfied with the outcome. The differences between postoperative and preoperative scores of FACE-Q were statistically significant (p < 0.01). Sixty-nine percent of patients complained of bilateral eyebrow asymmetry, 27.1% of patients reported partial recovery of frontal deformity with dissatisfaction, and 2.6% of patients considered not recovered at all. The results of 78 patients (50.3%) were considered "satisfied," and 41 patients (26.5%) were considered "very satisfied" by objective evaluation. CONCLUSION Nasal reconstruction with an expanded forehead flap was a safe technique with good esthetic outcomes. Although problems with the asymmetry of the eyebrows and frontal deformation were presented, the influence was minimal and well-accepted by most patients.
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Affiliation(s)
- Zhen Song
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xulong Zhang
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan Wang
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianjun You
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ruobing Zheng
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yihao Xu
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junsheng Guo
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Tian
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Fan
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Shen K, You J, Wang Y, Wang X, Esfeh JM, Hashimoto K, McCurry K, Yun J, Budev M. A Single-Center Retrospective Study of Patients Undergoing Combined Liver-Lung Transplantation (LLT). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Chen Y, Yan B, You J. 120P Neoadjuvant immunochemotherapy of pembrolizumab plus chemotherapy in resectable non-small cell lung cancer. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00375-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Song Z, Xu Y, Zhang X, You J, Wang H, Zheng R, Tian L, Guo J, Fan F. Application of a Modified Costal Cartilaginous Framework in Correction of Severe Saddle Nose Deformity. Aesthet Surg J 2023. [PMID: 36866401 DOI: 10.1093/asj/sjad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Insufficient support of the nasal septum due to congenital or secondary deficiency leads to severe saddle nose deformity which presents an unpleasant appearance. OBJECTIVES The purpose of this study is to present our approach to constructing a costal cartilaginous framework to correct severe saddle nose deformities with autologous costal cartilage. METHODS A retrospective analysis was conducted of patients underwent correction of severe saddle nose deformity (Type II to Type IV) by a senior surgeon from January 2018 to January 2022. Preoperative and postoperative measurements were conducted to evaluate the surgical outcomes. RESULTS A total of 41 patients aged from 15 to 50 years completed the study. The average follow-up time was 20.6 months. No short-term complication was observed. Revision operations were performed on three patients. All cases were satisfied with the aesthetic results. Analysis of objective measurements showed nasofrontal angle, columellar-labial angle, and tip projection improved significantly in Type II cases, nasofrontal angle and tip projection improved significantly in Type III cases, and tip projection improved significantly in Type IV cases. CONCLUSIONS Application of this modified costal cartilaginous framework which consists of a fairly stable foundation layer and an aesthetic contour layer of block costal cartilage has achieved satisfactory results in the long-term, which focuses on the aesthetic outcome while correcting the saddle nose deformity.
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Affiliation(s)
- Zhen Song
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Yihao Xu
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Xulong Zhang
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Jianjun You
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Huan Wang
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Ruobing Zheng
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Le Tian
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Junsheng Guo
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
| | - Fei Fan
- The Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing, China
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Wu L, Wang H, You J. A New Supplement for Postoperative Management? Aesthet Surg J 2023; 43:NP229-NP230. [PMID: 36461939 DOI: 10.1093/asj/sjac315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- Lehao Wu
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, People's Republic of China
| | - Huan Wang
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, People's Republic of China
| | - Jianjun You
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, People's Republic of China
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Zheng R, Wang X, Wang H, You J, Xu Y, Zhang X, Guo J, Fan F. Improvement of Nasal Dorsal Onlay Graft Appearance after Augmentation Rhinoplasty with Costal Cartilage for Thin-Skinned Patients. Aesthetic Plast Surg 2023; 47:330-335. [PMID: 36071240 DOI: 10.1007/s00266-022-03082-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The camouflage of the nasal dorsum is very important for thin-skinned patients. In this study, the authors presented an improved method for these patients and evaluated the safety and efficacy of this method in augmentation rhinoplasty. METHODS Fifty-two thin-skinned nose Chinese patients, ranging in age from 18 to 42 years, who underwent open augmentation rhinoplasty with modified perichondrium on dorsal onlay graft were included in the study. Among these patients, 24 of them were primary cases, and the other cases were secondary. The Rhinoplasty Outcomes Evaluation (ROE) scale and Visual aid scoring (VAS) questionnaire were used to evaluate aesthetic outcomes. RESULTS During the long-term follow-up (ranging from 6 to 20 months), the ROE scores of each item before and after surgery were statistically significant in our study. The total scores of the preoperative and postoperative ROE scale of the study were 9.77 ± 3.18 and 20.65 ± 1.88, respectively, which indicated reasonably high satisfaction. According to the VAS questionnaire, patients' own evaluations of the nasal dorsal improvement rendered a high satisfaction rate. One case of fat liquefaction at the donor site and two cases of warping occurred and no other major complications were encountered. CONCLUSION Covering the two edges of the graft with perichondrium on the onlay dorsal graft seems a convenient and effective method for thin-skinned augmentation rhinoplasty, which was the best choice for camouflage of the nasal dorsum in our department. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ."
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Affiliation(s)
- Ruobing Zheng
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Xin Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Huan Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Jianjun You
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Yihao Xu
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Xulong Zhang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Junsheng Guo
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China
| | - Fei Fan
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, People's Republic of China.
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Xu Y, Zhang X, You J, Wang H, Zheng R, Wu L, Tian L, Guo J, Fan F. Analysis of the Cause of Cartilage Warping in the Rhinoplasty of Costal Cartilage and Application of Embed-In Graft in Revision Surgery. Aesthet Surg J 2023; 43:646-654. [PMID: 36656674 DOI: 10.1093/asj/sjad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND It is undeniable that costal cartilage is an excellent source of grafts, however it has some potential disadvantages, including the tendency to warp. There are very few studies that have examined how to resolve pre-existing cartilage warping during secondary revision surgery. OBJECTIVES The aim of this study was to examine the causes of cartilage warping other than the cartilage itself and ways to correct cartilage warping during revision surgery. METHODS During the present study, the cases of cartilage warping in the past 5 years were retrospectively reviewed, and the external factors of cartilage warping were evaluated in order to design new cartilage grafts that could be used to repair cartilage deformities. RESULTS A total of 29 females and 3 males between the ages of 18 and 60 years participated in the study (average age, 32.5 years). In all cases, embed-in grafts were used to correct warping. All patients satisfied with the results. As a result of our research, we found that another external cause of cartilage warping was the hump that was not removed completely during the initial surgery. CONCLUSIONS Incomplete removal of the hump is a major contributing external factor to cartilage warping, particularly in the sagittal plane. This embed-in graft is not intended to be used as a routine graft in normal circumstances, but rather as an immediate means of solving an unexpected situation. The graft is primarily used to repair severely warped cartilage.
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Affiliation(s)
- Yihao Xu
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Xulong Zhang
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Jianjun You
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Huan Wang
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Ruobing Zheng
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Lehao Wu
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Le Tian
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Junsheng Guo
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
| | - Fei Fan
- From the Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PRChina
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Wu L, You J, Wang H, Tian L, Xu Y, Zheng R, Zhang X, Guo J, Fan F. X-shaped Tip Graft: A Versatile Solution for Warping Correction in Rib Cartilage-Based Rhinoplasty. Aesthet Surg J 2023; 43:26-36. [PMID: 35748855 DOI: 10.1093/asj/sjac170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND An enduringly stable tip graft is the key to achieving successful rhinoplasty. However, the intrinsic tendency of rib grafts to warp renders the long-term outcome of cartilage-based rhinoplasty highly unpredictable. OBJECTIVES The aim of this study was to detail and validate the utilization of a tip graft that is characterized by a circumferential split on the tip graft, which creates a shape similar to the letter X. METHODS The counterrotating force applied intraoperatively and the complications that arose were examined retrospectively. Three-dimensional stereophotogrammetric evaluations of patients was performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, tip rotation, and the nasion-pronasale angulation. RESULTS Forty-five female patients, ranging in age from 18 to 41 years (average, 28.5 years) completed the study. In all cases, the X graft was applied as an essential element for enhancing tip projection. Postoperative analysis showed excellent maintenance of tip position over time, evidenced by insignificant changes in nasion-pronasale angulation. Other postoperative evaluations, including tip projection, nasal length, and nasolabial angle, showed significant improvement. The differences were not statistically different between short- and long-term follow-up. CONCLUSIONS The X graft effectively mitigates the negative impact of graft warping. It is the ultimate form for tip support and for elongating short noses. It has the merits of versatility and flexibility when used to create a strong and sustainable tip support in East Asian rhinoplasty. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Lehao Wu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Jianjun You
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Huan Wang
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Le Tian
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Yihao Xu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Ruobing Zheng
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Xulong Zhang
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Junsheng Guo
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Fei Fan
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College, Plastic Surgery Hospital and Institute, Beijing, PR China
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Wang X, Wang H, You J, Han R, Zheng R, Xu Y, Zhang X, Guo J, Fan F. A ten-year surgical experience in patients of Tessier No.0 cleft with a bifid nose. Int J Pediatr Otorhinolaryngol 2023; 164:111399. [PMID: 36455432 DOI: 10.1016/j.ijporl.2022.111399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/24/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Tessier No.0 cleft with a bifid nose is a rare malformation. Reconstruction of the nose is essential for children/adults to correct facial cosmetic defects and contribute to developing patients' mental health. The aim of the study was to present the 10-year clinical results using local flaps or expanded forehead flaps in bifid nose patients. METHODS A retrospective review was performed between January of 2010 and August of 2021 in our department. Sex, age at surgery, associated anomalies, and type of operation were reviewed. RESULTS A total of 33 patients were retained. The median duration of follow-up was 5.5 years. Fourteen patients underwent multi-stage nasal reconstruction using expanded forehead flap with costal cartilage as a framework, and 16 patients were operated with local skin flap with silicone while the other three were operated with local skin flap with costal cartilage. There were six cases (18.18%) of complications in our study. During follow-up, 28 patients (84.85%) had satisfactory outcomes, four patients (12.12%) had partially satisfactory results, and one patient (3.03%) had an unsatisfactory outcome. CONCLUSION Using local skin flap with silicone or costal cartilage rhinoplasty and nasal reconstruction using expanded forehead flap with costal cartilage for patients with a bifid nose of Tessier No.0 cleft showed that it was safe and effective, and had satisfying results in the long-term follow-up.
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Affiliation(s)
- Xin Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China
| | - Huan Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China
| | - Jianjun You
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China
| | - Ri Han
- Nanfang Hospital, Southern Medical University, No.1838 North Guangzhou Avenue, Baiyun District, Guangzhou, 510515, Guangdong Province, China
| | - Ruobing Zheng
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China
| | - Yihao Xu
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China
| | - Xulong Zhang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China
| | - Junsheng Guo
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China
| | - Fei Fan
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33, Badachu Road, Shijingshan, Beijing, 100730, China.
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Yan C, Hui Z, Wang Q, Xiao S, Pu Y, Wang Q, Wang T, You J, Ren X. OA09.03 Single Cell Analyses Reveal Effects of Immunosenescence Cells in Neoadjuvant Immunotherapy of Lung Squamous cell Carcinoma Patients. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Yang L, Wu JZ, You J, Fan L, Jing CQ, Wang Q, Yan S, Yu J, Zang L, Xing JD, Hu WQ, Liu F. [A multicenter retrospective study on the efficacy of different anti-reflux reconstruction methods after proximal gastrectomy for gastric cancer]. Zhonghua Wai Ke Za Zhi 2022; 60:838-845. [PMID: 36058710 DOI: 10.3760/cma.j.cn112139-20220418-00175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To examine the clinical efficacy of 3 anti-reflux methods of digestive tract reconstruction after proximal gastrectomy for gastric cancer. Methods: The clinical data and follow-up data of gastric cancer patients who underwent anti-reflux reconstruction after proximal gastrectomy in 11 medical centers of China from September 2016 to August 2021 were retrospectively collected, including 273 males and 65 females, aging of (63±10) years (range: 28 to 91 years). Among them, 159 cases were performed with gastric tube anastomosis (GTA), 107 cases with double tract reconstruction (DTR), and 72 cases with double-flap technique (DFT), respectively. The duration of operation, length of postoperative hospital stay and early postoperative complications (referring to Clavien-Dindo classification) of different anti-reflux reconstruction methods were assessed. Body mass index, hemoglobin and albumin were used to reflect postoperative nutritional status. Reflux esophagitis was graded according to Los Angeles criteria based on the routinely gastroscopy within 12 months after surgery. The postoperative quality of life (QoL) was evaluated by Visick score system. The ANOVA analysis, Kruskal-Wallis rank sum test, χ2 test and Fisher's exact test were used for comparison between multiple groups, and further comparison among groups were performed with LSD, Tamhane's test or Bonferroni corrected χ2 test. The mixed effect model was used to compare the trends of Body mass index, hemoglobin and albumin over time among different groups. Results: The operation time of DFT was significantly longer than that of GTA and DTR ((352±63) minutes vs. (221±66) minutes, (352±63) minutes vs. (234±61) minutes, both P<0.01). The incidence of early complications with Clavien-Dindo grade Ⅱ to Ⅴ in GTA, DFT and DTR groups was 17.0% (27/159), 9.7% (7/72) and 10.3% (11/107), respectively, without significant difference among these three groups (χ2=3.51, P=0.173). Body mass index decreased more significantly in GTA than DFT group at 6 and 12 months after surgery (mean difference=1.721 kg/m2, P<0.01; mean difference=2.429 kg/m2, P<0.01). body mass index decreased significantly in DTR compared with DFT at 12 months after surgery (mean difference=1.319 kg/m2, P=0.027). There was no significant difference in hemoglobin or albumin fluctuation between different reconstruction methods perioperative. The incidence of reflux esophagitis one year after surgery in DTR group was 12.9% (4/31), which was lower than that in DFT (45.9% (17/37), χ2=8.63, P=0.003). Follow-up of postoperative quality of life showed the incidence of Visick grade 2 to 4 in DFT group was lower than that in GTA group (10.4% (7/67) vs. 34.6% (27/78), χ2=11.70, P=0.018), while there was no significant difference between DFT and DTR group (10.4% (7/67) vs. 22.2% (8/36, P>0.05). Conclusions: Compared with GTA and DTR, DFT is more time-consuming, but there is no significant difference in early complications among three methods. DFT reconstruction is more conducive to maintain postoperative nutritional status and improve QoL, especially compared with GTA. The risk of reflux esophagitis after DTR reconstruction is lower than that of DFT.
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Affiliation(s)
- L Yang
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - J Z Wu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J You
- Department of Gastrointestinal Oncology Surgery, the First Affiliated Hospital, Xiamen University, Xiamen 361000, China
| | - L Fan
- Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - C Q Jing
- Department of General Surgery, Shandong Provincial Hospital, Jinan 250021, China
| | - Q Wang
- Department of General Surgery, the First Affiliated Hospital of Jilin University, Changchun 130061, China
| | - S Yan
- Department of Gastrointestinal Oncology Surgery, the Affiliated Hospital of Qinghai University, Xining 810001, China
| | - J Yu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L Zang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - J D Xing
- Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100143, China
| | - W Q Hu
- Department of General Surgery, Changzhi People's Hospital, Changzhi 046099, China
| | - Fenglin Liu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Zhou L, Chen X, Wang J, Liu ZY, You J, Lan S, Liu JF. [Predictive value of mismatch negativity and P3a combined with electroencephalogram reactivity for the prognosis of comatose patients after severe brain injury]. Zhonghua Yi Xue Za Zhi 2022; 102:2265-2271. [PMID: 35927057 DOI: 10.3760/cma.j.cn112137-20220413-00799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the clinical value of mismatch negativity and P3a combined with electroencephalogram (EEG) reactivity to predict the prognosis of patients after severe brain injury. Methods: The clinical data of patients with severe brain injury who were admitted to the neurosurgical intensive care unit of Xiangya Hospital of Central South University from October 2019 to July 2020 were retrospectively analyzed. All patients underwent evaluation of auditory mismatch negativity (MMN), P3a, and EEG reactivity (EEG-R) within 28 days after the onset of coma. Patients were divided into two groups using the 3-month Glasgow Outcome Scale (GOS) after coma onset, a GOS score of 3-5 was defined as a favorable outcome, and GOS grades 1-2 were defined as an unfavorable outcome. The correlation between clinical indicators and prognosis was analyzed, and the predictive values of statistically significant indicators and the cut-off values were determined using the receiver operating characteristic (ROC) curve. Results: A total of 48 patients were enrolled in the study, including 35 males and 13 females (age range:18-68 years old). Twenty-nine of the patients had a favorable outcome and 19 had an unfavorable outcome. The Glasgow Coma Scale (GCS), EEG-R, absolute amplitude of MMN at Fz (FzMMNA), and amplitude of P3a at Cz (CzP3aA) were significantly correlated with the prognosis of comatose patients (P<0.001). Multivariate logistic regression analysis revealed that only EEG-R, FzMMNA, and CzP3aA were independent predictors for the prognosis of comatose patients after severe brain injury (all P<0.05), with the area under the curve (AUC) of 0.757 (0.613-0.900), 0.912 (0.830-0.994) and 0.887 (0.793-0.981), respectively. The combination of FzMMNA and CzP3aA and the combinationof EEG-R, FzMMNA and CzP3aA increased the value of AUC to 0.942 (0.879-1.000) and 0.964 (0.920-1.000), respectively. Moreover, a cut-off value of 1.27 μV and 2.64 μV for FzMMNA and CzP3aA, respectively, yielded the best sensitivity and specificity for the prognosis prediction of patients with severe brain injury [FzMMNA: 89.66%(26/29) and 84.21%(16/19); CzP3aA:82.76%(24/29) and 84.21%(16/19)]. Conclusion: This study indicates that the combination of EEG-R, FzMMNA, and CzP3aA may serve as a favorable prognostic indicator for comatose patients after severe brain injury.
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Affiliation(s)
- L Zhou
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - X Chen
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - J Wang
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - Z Y Liu
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - J You
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - S Lan
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
| | - J F Liu
- Department of Neurosurgery, Xiangya Hospital Central South University, Changsha 410008, China
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Zheng XC, Huang HJ, You J, Lin XY, Chen DR, Zhong D. [Myxiod pleomorphic liposarcoma: a clinicopathological and molecular genetic analysis of six cases]. Zhonghua Bing Li Xue Za Zhi 2022; 51:738-742. [PMID: 35922164 DOI: 10.3760/cma.j.cn112151-20220524-00441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the clinicopathologic and molecular genetic characteristics of myxoid pleomorphic liposarcoma (MPLPS). Methods: Six cases of MPLPS diagnosed and consulted in Fujian Provincial Hospital from 2015 to 2021 were collected for histomorphological observation, immunohistochemistry, and fluorescence in situ hybridization (FISH) detection of DDIT3 (CHOP) gene translocation and MDM2/CDK4 gene amplification. Results: There were four males and two females, aged 26-74 years (mean 53.8 years). The tumor size was 3.8-16.0 cm (mean 11.8 cm). All six cases had similar histopathologic features, showing overlapping histologic morphology of myxoid liposarcoma and pleomorphic liposarcoma. Four cases (4/6) were positive for S-100 protein, and the Ki-67 index was 50%-95%. All cases (6/6) were negative for DDIT3 (CHOP) translocation and MDM2/CDK4 amplification by FISH. TP53 (p.R248w) germline mutation was found in one case. Conclusions: MPLPS is a rare subtype of liposarcoma, characterized by overlapping morphology of myxoid liposarcoma and pleomorphic liposarcoma. Genetically, a few of them have TP53 gene germline mutations, but they lack of DDIT3 (CHOP) translocation or MDM2/CDK4 amplification.
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Affiliation(s)
- X C Zheng
- Department of Pathology, Xiamen Third Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Xiamen 361100, China Department of Pathology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China
| | - H J Huang
- Department of Pathology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China
| | - J You
- Department of Pathology, Fujian Provincial Hospital South Branch, Fuzhou 350028, China
| | - X Y Lin
- Department of Pathology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China
| | - D R Chen
- Department of Pathology, Fujian Provincial Hospital, Fujian Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China
| | - Dingrong Zhong
- Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, China
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You J, Hao X, Falo L, Hao R, Zhang J, Carey C, You Z, Falo L. 057 Targeting keratinocytes to potentiate skin immunization. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Drozdz M, Doane A, Alkallas R, Desman G, Bareja R, Reilly M, Bang J, Yusupova M, You J, Wang J, Verma A, Aguirre K, Kang E, Watson I, Elemento O, Piskounova E, Merghoub T, Zippin J. 646 A nuclear cAMP microdomain suppresses tumor growth by hippo pathway inactivation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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You J, Bae S, Bae E. Assessing The Utility of D-Dimer Driven Anticoagulation Strategies In Severely Obese Patients With COVID-19. Eur J Cardiovasc Nurs 2022. [PMCID: PMC9384376 DOI: 10.1093/eurjcn/zvac060.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Background Many studies to date have documented significant inflammatory vascular sequelae in association with COVID-19. Current guidelines suggest an initial strategy of therapeutic-dose anticoagulation to non-critically ill, hospitalized patients requiring low-flow oxygen and a concurrent D-dimer level above the upper limit of normal. However, the utility of D-dimer values in predicting thrombosis in severely obese patients are equivocal to poor, with prior evidence suggesting falsely elevated levels with greater BMI. Given the weight-based dosing of heparin, these patients may also be inadvertently at elevated risk for major bleeds. Purpose To examine the utility of D-dimer levels in risk stratification and anticoagulation therapy in non-critically ill COVID-19 patients with severe obesity. Methods In this single-center, retrospective study, 32 severely obese patients (defined as BMI > 40) hospitalized with COVID-19 and requiring low flow oxygen delivery, without ICU level of care were analyzed. Clinical outcomes were compared between groups receiving therapeutic versus prophylactic doses of anticoagulation. All were treated with low molecular weight heparin (LMWH) per hospital protocol. The following data points were examined: length of hospitalization, mortality, anticoagulation therapy, initial d-dimer levels, thrombotic events, minor/major bleeds, and oxygen modality. Results In total, 78% of patients initially presented with a D-dimer level above the upper limit of normal, with 53% of patients meeting criteria for therapeutic anticoagulation. However, there were no significant differences in incidence of thrombotic events, mean length of hospitalization or overall mortality. Furthermore, despite utilization of appropriate therapeutic anticoagulation, it did not reduce the overall use of oxygen support requirements, including high flow oxygen or non-invasive ventilation, when compared to individuals receiving prophylactic dosing. Conclusion The clinical utility of D-dimer levels for guiding anticoagulation therapy in severely obese patients with COVID-19 may be limited. Here, we demonstrate that therapeutic dose approaches have nonsignificant differences in clinical outcomes when compared to prophylactic doses in this distinct population.
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Affiliation(s)
- J You
- Northwell Health , Manhasset , United States of America
| | - S Bae
- Northwell Health , Manhasset , United States of America
| | - E Bae
- Suny Downstate Medical Center, Department of Internal Medicine , Brooklyn , United States of America
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Wu L, Wang H, Tian L, Fan F, You J. The Necessity of Filling the Structural Gap, A Personal Take. Aesthet Surg J 2022; 42:NP600-NP601. [PMID: 35639804 DOI: 10.1093/asj/sjac134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lehao Wu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute , Beijing, PR China
| | - Huan Wang
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute , Beijing, PR China
| | - Le Tian
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute , Beijing, PR China
| | - Fei Fan
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute , Beijing, PR China
| | - Jianjun You
- Department of Plastic Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute , Beijing, PR China
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Wu L, Li B, You J, Wang H. The Promise of a New Strategy in Alar Surgery. Aesthet Surg J 2022; 42:NP443-NP444. [PMID: 34932798 DOI: 10.1093/asj/sjab424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lehao Wu
- Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Binghang Li
- Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Jianjun You
- Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Huan Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
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Dong W, Wang X, Wang H, You J, Zheng R, Xu Y, Zhang X, Guo J, Ruan J, Fan F. Comparison of Multimodal Cocktail to Ropivacaine Intercostal Nerve Block for Chest Pain After Costal Cartilage Harvest: A Randomized Controlled Trial. Facial Plast Surg Aesthet Med 2022; 24:102-108. [PMID: 35230140 DOI: 10.1089/fpsam.2021.0264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: To compare the effectiveness of an intercostal nerve block after costal cartilage harvest when a multimodal cocktail or ropivacaine plus patient-controlled analgesia is used, as measured by visual analog scale (VAS) scores, rescue analgesic consumption, and related complications. Materials and Methods: Eligible patients who underwent costal cartilage harvest were equally randomized to receive a multimodal cocktail (multimodal group) or ropivacaine plus patient-controlled analgesia (ropivacaine group). Results: Of 112 patients assessed, 12 (10.7%) patients were excluded and 100 (89.3%) patients were enrolled and assigned to multimodal group (n = 50) and ropivacaine group (n = 50). The VAS scores in the multimodal group were significantly lower than those in the ropivacaine group both at rest (0.924 ± 0.073 vs. 1.920 ± 0.073, p < 0.001) and during coughing (2.340 ± 0.083 vs. 3.944 ± 0.083, p < 0.001) in mixed-effects model analysis. Rescue analgesic consumption and rate of complications were significantly lower in the multimodal group compared with the ropivacaine group (all p < 0.05). Conclusions: Multimodal cocktail improved chest pain after costal cartilage harvest with less rescue analgesic consumption and complications compared with ropivacaine plus patient-controlled analgesia. Clinical Trial Registration: ChiCTR2100042445.
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Affiliation(s)
- Wenfang Dong
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Xin Wang
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Huan Wang
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Jianjun You
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Ruobing Zheng
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Yihao Xu
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Xulong Zhang
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Junsheng Guo
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Jingjing Ruan
- Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
| | - Fei Fan
- The Twelfth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan, Beijing, China
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Wu L, Wang H, Tian L, Fan F, You J. The Plug-in Graft, the Essential Supplement for a Stable Cartilaginous Framework in Rhinoplasty. Aesthet Surg J 2022; 42:862-870. [PMID: 35078208 DOI: 10.1093/asj/sjac009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A stable cartilaginous framework sets up the foundation for a successful rhinoplastic procedure. However, the curvature of the anterior septal angle usually does not match the added tip graft, leaving a structural gap that potentially causes postoperative rotation of the nasal tip. A supplementary graft is required to fill this gap, consolidating this structure at three dimensions. OBJECTIVES To detail and validate the utilization of a graft that fills the structural gap for a more stabilized framework and better-sustained tip position in the long term. METHODS Intraoperative counter-rotating Newton force and complications were retrospectively collected. Three-dimensional stereophotogrammetric evaluations were performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, the Goode ratio, and tip rotation. Results were compared statistically. RESULTS Thirty-one female patients, ranging in age from 18-41 years, finished the study. Intraoperative rotating measurement indicated an unequivocal stabilizing effect of the plug-in graft. Postoperative analysis showed great maintenance of tip position over time. Tip projection and nasolabial angle had a slight decrease over time, the differences were not statistically different. CONCLUSIONS The plug-in graft effectively consolidates the entire cartilaginous framework in rib-based rhinoplasty procedures. This anatomically integrated structure sets up the fundamental groundwork which provides uncompromising support for the tip graft, so as to achieve an aesthetically pleasing outcome that endures. When executed properly, this graft is effective in maintaining postoperative tip positions, which warrants the technical challenges and the prolonged operating time.
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Affiliation(s)
- Lehao Wu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Huan Wang
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Le Tian
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Fei Fan
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
| | - Jianjun You
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, PR China
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Wang X, Dong W, Wang H, You J, Zheng R, Xu Y, Fan F. Follow-up of extensive calcified costal cartilage-based rhinoplasty in Chinese People. J Cosmet Dermatol 2022; 21:3954-3961. [PMID: 35005832 DOI: 10.1111/jocd.14727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To the best of our knowledge, there is currently no such study in the area of extensive calcified costal cartilage rhinoplasty. The study evaluated patients' satisfaction with extensive calcified costal cartilage compared with no calcified costal cartilage. METHOD Thirty-five patients with extensive calcified costal cartilage underwent rhinoplasty at our institution between January 2018 and May 2020. We also used a control group of 35 patients with absent rib cartilage calcification to compare the outcomes. Satisfaction was evaluated by the photogrammetric measurements and Rhinoplasty Outcomes Evaluation (ROE) scale. RESULTS We found no significant difference in the nose measurement between the two groups before and after the operation. Besides, both groups had a significant difference in comparison with preoperative after surgery except for the nasofrontal angle. The difference between preoperative and postoperative ROE scores was statistically significant in both groups. We also compared the satisfaction of preoperative and postoperative outcomes between the two groups, where no difference was found between them. Each group had a patient who occurred an infection after surgery. CONCLUSION Autologous costal cartilage provides the most abundant source for graft fabrication. Patients with extensive calcified cartilage could undergo rhinoplasty and have satisfactory results instead of choosing an artificial implant.
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Affiliation(s)
- Xin Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenfang Dong
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianjun You
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ruobing Zheng
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yihao Xu
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Fan
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wang X, Wang H, You J, Zheng R, Xu Y, Fan F. Craniofacial development in patients of Tessier No.0 cleft with a bifid nose using 3D computed tomography. Front Pediatr 2022; 10:979345. [PMID: 36090555 PMCID: PMC9449123 DOI: 10.3389/fped.2022.979345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Considerable studies have focused mainly on the facial deformity of Tessier No.0 cleft with a bifid nose, but the deformity of the skull is not well understood. Therefore, our study aimed to explore the evolution of cranial dysmorphology and the chronology of Tessier No.0 cleft with a bifid nose, by three-dimensional measurements. METHODS Ninety-six non-surgical patients and computed tomographic scans were included (Tessier No.0 cleft with a bifid nose, n = 48; controls, n = 48) and divided into five age subgroups. Craniofacial cephalometric measurements were analyzed by Mimics software. RESULTS The widening of nasal bone was the most remarkable and persistent from 2 years old appropriately. The overall cranial base length in patients compared with controls increased 11.8% (p < 0.01) on average. The middle and posterior cranial fossa increasing accounted for most of this change. The cranial base angles also showed increased obviously. By analyzing the linear of the nasopharynx and respiratory tract, it was found that its development did not affect respiration. CONCLUSIONS The cranial base deformity of Tessier No.0 cleft with a bifid nose consists of the whole skull base and particularly the middle and posterior cranial base length increase. At the same time, there may be late closure of the spheno-occipital synchondrosis and sella displacement. We believe this study is unique in providing valuable data for elucidating the pathological and morphological abnormalities of skull base development in Tessier No.0 cleft with a bifid nose.
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Affiliation(s)
- Xin Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan Wang
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianjun You
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ruobing Zheng
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yihao Xu
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Fan
- Department of Rhinoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Chen Y, You J, Chen Y, Ma L, Chen H, Wei Z, Ye X, Zhang L. Low-crystalline nickel hydroxide nanosheets embedded with NiMoO4 nanoparticles on nickel foam for high-performance supercapacitor applications. CrystEngComm 2022. [DOI: 10.1039/d2ce00577h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Transition metal hybrid nanomaterials have attracted wide attention in the field of energy storage due to their rich redox activity and good conductivity and structural stability. In this work, low-crystalline...
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Wu L, Wang H, Xu Y, Zhang X, Fan F, You J. Bilateral Tip Add-On Grafts: Concept, Applications and Complications in East Asian Rhinoplasty. Aesthetic Plast Surg 2021; 45:2880-2885. [PMID: 34085104 DOI: 10.1007/s00266-021-02370-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND A solid tip support plays the fundamental role in augmentation rhinoplasty for East Asians. However, the soft tissue envelope is sometimes limited; the bilateral alae and mucosae cannot be transposed to consolidate the full course of the strut. A graft that serves for the ultimate purpose of elongating the valid length of the strut is therefore necessary. METHODS Forty-one female patients, ranging in age from 19 to 35 years (average 26.5 years), received augmentation rhinoplasty surgery that was supplemented by the applications of the bilateral accessory add-on tip grafts. The tip projection was established by columellar strut or septal extension grafts. These crescent-shaped grafts acted like a bridge between the alae and the strut, which aim to provide supplementary volume and surface area to help reduce tension and further define the width and shape of the nasal tip. RESULTS Patients' own evaluations on the overall improvements of the nose rendered high satisfaction rate. During the follow-up, six cases presented deviated columella and asymmetrical nostrils; three cases had deformed dorsal profile due to graft warping or resorption at 12 to 18-month period postoperatively, and were corrected during revision surgeries. No other major complications were encountered. CONCLUSIONS These accessory tip add-on grafts are intrinsically applicable for East Asians rhinoplasty surgeries. Instead of being utilized as a routine graft for normal circumstances, this pair of accessory tips is an expedient measure to solve a difficult situation. This graft will be particularly necessary in managing a severely short nose with interior soft tissue insufficiency. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Lehao Wu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33 Badachu Rd., Shijingshan District, Beijing, 100144, China
| | - Huan Wang
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33 Badachu Rd., Shijingshan District, Beijing, 100144, China
| | - Yihao Xu
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33 Badachu Rd., Shijingshan District, Beijing, 100144, China
| | - Xulong Zhang
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33 Badachu Rd., Shijingshan District, Beijing, 100144, China
| | - Fei Fan
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33 Badachu Rd., Shijingshan District, Beijing, 100144, China
| | - Jianjun You
- Department of Plastic Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33 Badachu Rd., Shijingshan District, Beijing, 100144, China.
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Dong W, Wang X, Wang H, You J, Zheng R, Xu Y, Zhang X, Guo J, Fan F. A Prospective Study of Multimodal Cocktail Intercostal Injection for Chest Pain Relief after Costal Cartilage Harvest for Rhinoplasty. Br J Oral Maxillofac Surg 2021; 60:841-846. [DOI: 10.1016/j.bjoms.2021.12.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 11/28/2022]
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Ren P, Fan F, Zheng R, Xu Y, You J, Wang H, Zhang X, Tian L, Lin G. [Application of autologous costal cartilage-based open rhinoplasty in secondary unilateral cleft lip nasal deformity]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021; 35:1021-1026. [PMID: 34387432 DOI: 10.7507/1002-1892.202012066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To evaluate the effectiveness of autologous costal cartilage-based open rhinoplasty in the correction of secondary unilateral cleft lip nasal deformity. Methods Between January 2013 and June 2020, 30 patients with secondary unilateral cleft lip nasal deformity were treated, including 13 males and 17 females; aged 14-41 years, with an average of 21.7 years. Among them, 18 cases were cleft lip, 9 cases were cleft lip and palate, and 3 cases were cleft lip and palate with cleft alveolar. The autologous costal cartilage-based open rhinoplasty was used for the treatment, and the alar annular graft was used to correct the collapsed alar of the affected side. Before operation and at 6-12 months after operation, photos were taken in the anteroposterior position, nasal base position, oblique position, and left and right lateral positions, and the following indicators were measured: rhinofacial angle, nasolabial angle, deviation angle of central axis of columella, nostril height to width ratio, and bilateral nasal symmetry index (including nostril height, nostril width, and nostril height to width ratio). Results The incisions healed by first intention after operation, and no complications such as acute infection occurred. All 30 patients were followed up 6 months to 2 years, with an average of 15.2 months. During the follow-up, the patients' nasal shape remained good, the tip of the nose and columella were basically centered, the back of the nose was raised, the collapse of the affected side of nasal alar and the movement of the feet outside the nasal alar were all lessened than preoperatively. The basement was elevated compared to the front, and no cartilage was exposed or infection occurred. None of the patients had obvious cartilage absorption and recurrence of drooping nose. Except for the bilateral nostril width symmetry index before and after operation, there was no significant difference ( t=1.950, P=0.061), the other indexes were significantly improved after operation when compared with preoperatively ( P<0.05). Eleven patients (36.7%) requested revision operation, and the results were satisfactory after revision. The rest of the patients' nasal deformities were greatly improved at one time, and they were satisfied with the effectiveness. Conclusion Autologous costal cartilage-based open rhinoplasty with the alar annular graft is a safe and effective treatment for secondary unilateral cleft lip nasal deformity.
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Affiliation(s)
- Pengjie Ren
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Fei Fan
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Ruobing Zheng
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Yihao Xu
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Jianjun You
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Huan Wang
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Xulong Zhang
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Le Tian
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
| | - Guangxian Lin
- Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China
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You J, Wang TH, Chen DH, Yu HD, Hong QQ. [Perirectal fascial anatomy and pelvic autonomic nerve preservation during the transanal total mesorectal excision]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:593-598. [PMID: 34289543 DOI: 10.3760/cma.j.cn.441530-20210509-00196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The difficulty of transanal total mesorectal excision (TME) is to find the correct dissection plane of perirectal space. As a complex new surgical procedure, the fascial anatomic landmarks of transanal approach operation are more likely to be ignored. It is often found that dissection plane is false after the secondary injury occurs during the operation, which results in the damage of pelvic autonomic nerves. Meanwhile, the mesorectum is easily damaged if the dissection plane is too close to the rectum. Thus, the safety of oncologic outcomes could be limited by difficulty achieving adequate TME quality. The promotion and development of the theory of perirectal fascial anatomy provides a new thought for researchers to design a precise approach for transanal endoscopic surgery. Transanal total mesorectal excision based on fascial anatomy offers a solution to identify the transanal anatomic landmarks precisely and achieves pelvic autonomic nerve preservation. In this paper, the authors focus on the surgical experience of transanal total mesorectal excision based on the theory of perirectal fascial anatomy, and discuss the feature of perirectal fascial anatomy dissection and technique of pelvic autonomic nerve preservation during transanal approach operation.
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Affiliation(s)
- J You
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Xiamen University, Xiamen 361003, China
| | - T H Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Xiamen University, Xiamen 361003, China
| | - D H Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Xiamen University, Xiamen 361003, China
| | - H D Yu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Xiamen University, Xiamen 361003, China
| | - Q Q Hong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Xiamen University, Xiamen 361003, China
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You J, Reilly M, Drozdz M, Bang J, Zippin J. 493 Determination of the critical sources of cAMP for Crisaborole activity in human keratinocytes. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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