Background:This study explored the value of integrating problem-based learning(PBL)and team-based learning(TBL)methods into plastic and reconstructive surgery clinical practice.By addressing the challenges faced in tr...Background:This study explored the value of integrating problem-based learning(PBL)and team-based learning(TBL)methods into plastic and reconstructive surgery clinical practice.By addressing the challenges faced in traditional teachings,this study aimed to enhance educational outcomes and prepare students for real-world surgical scenarios,thereby improving patient care in this specialized field.Methods:Fifty undergraduate students majoring in clinical medicine at the Shanghai Jiao Tong University School of Medicine were selected as research subjects.They were randomly divided into experimental and control groups.The experimental group received the combined PBL-TBL teaching method,whereas the control group received the traditional teaching.The teaching effect was evaluated based on student satisfaction and academic performance.Results:The student satisfaction in the experimental group was higher than that of the control group(P<0.05).Subjective scoring for academic performance by instructors was higher in the experimental group than in the control group(P<0.05).Conclusion:The PBL and TBL combination had a significant effect when applied in plastic and reconstructive surgery clinical practice.展开更多
Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery...Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.展开更多
Objectives:The eukaryotic initiation factor 4F(eIF4F)translation initiation complex inhibitors(eIF4Fi)were recently found to hyperactivate extracellular signal-regulated kinases 1/2(ERK1/2)signals,which contribute to ...Objectives:The eukaryotic initiation factor 4F(eIF4F)translation initiation complex inhibitors(eIF4Fi)were recently found to hyperactivate extracellular signal-regulated kinases 1/2(ERK1/2)signals,which contribute to acquired resistance to BRAF(B-Raf proto-oncogene,serine/threonine kinase)inhibitors in melanoma.This present study aims to elucidate how to overcome the resistance of the eIF4Fi in BRAFV600E mutant melanoma cells and explore the underlying mechanisms.Methods:Melanoma A375(vemurafenib[VEM]-sensitive)and A375R(VEM-resistant)cells were exposed to eIF4Fi RocA at varying doses and durations in vitro.We investigated the impact of RocA on the activity of ERK1/2,AKT serine/threonine kinase 1(AKT1),eIF4E,and enhancer of zeste homolog 2(EZH2).We then examined the impact of RocA on pro-apoptotic BH3-only proteins and proliferative proteins.We subsequently determined the effect of combined eIF4Fi,AKT1 inhibitor,EZH2 inhibitor or VEM on tumor growth in vitro and in vivo.Results:RocA inhibited proliferation and induced apoptosis in A375 cells,but inhibited proliferation in A375R cells.RocA rapidly reactivated ERK1/2 at 3 h and returned to baseline levels at 48 h.However,eIF4E and AKT1 activation began at 12 h and peaked at 48 h.ERK1/2 positively regulated EZH2 and EZH2-dependent expression of c-Fos and EGR1,while AKT1 negatively regulated c-Myc,c-Jun,and BMF,but positively regulated eIF4E.RocA downregulated ERK1/2(or EZH2,AKT1,and eIF4E)independent bcl-2 and Mcl-1 expression.AKT1i enhanced RocA-induced cell apoptosis,while EZH2i reduced RocA-induced cell proliferation.Combined CR-1-31-B,EZH2i,and AKT1i effectively overcame resistance to RocA and VEM resistance both in vitro and in vivo.Conclusion:The eIF4F complex inhibitor reactivates ERK1/2-EZH2 and AKT1 signaling pathways,resulting in resistance to both eIF4Fi and VEM.Combined administration of an eIF4Fi with EZH2 and AKT1 inhibitors effectively enhances sensitivity to both eIF4F complex and BRAF inhibitors.展开更多
Diabetes mellitus is an escalating global health issue,with 463 million adults affected in 2019.Without intervention,this number is projected to increase to 578 million by 2030 and 700 million by 2045[1].Diabetic woun...Diabetes mellitus is an escalating global health issue,with 463 million adults affected in 2019.Without intervention,this number is projected to increase to 578 million by 2030 and 700 million by 2045[1].Diabetic wound,a significant complication,is characterized by delayed healing,high disability rates,and elevated mortality[2].The challenges of wound healing in diabetic patients,compounded by their high morbidity and mortality rates,have drawn growing attention in biomedical research.展开更多
A three dimensional rate-dependent crystal plasticity model is applied to study the influence of crystal orientation and grain boundary on the void growth and coalescence. The 3D computational model is a unit cell inc...A three dimensional rate-dependent crystal plasticity model is applied to study the influence of crystal orientation and grain boundary on the void growth and coalescence. The 3D computational model is a unit cell including one sphere void or two sphere voids. The results of three different orientations for single crystal and bicrystals are compared. It is found that crystallographic orientation has noticeable influences on the void growth directionvoid shape, and void coalescence of single crystal. The void growth rate of bicrystals depends on the crystallographic orientations and grain boundary direction.展开更多
Microplastic pollution represents a side-effect stemming from a global plastic waste mismanagement problem and includes degraded particles or mass produced plastic particles less than 5 mm in largest dimension.The sma...Microplastic pollution represents a side-effect stemming from a global plastic waste mismanagement problem and includes degraded particles or mass produced plastic particles less than 5 mm in largest dimension.The small nature of microplastics gives this area of pollution different environmental concerns than general plastic waste in the environment.The biological toxicity of particles,their internal components,and their surface level changes all present opportunities for these particles to adversely affect the environment around them.Thus,it is necessary to review the current literature surrounding this topic and identify areas where the study of microplastic can be pushed forward.Here we present current methods in studying microplastics,some of the ways by which microplastics affect the environment and attempt to shed light on how this research can continue.In addition,we review current recycling methods developing for the processing of mixed-plastic waste.These methods,including hydrothermal processing and solvent extraction,provide a unique opportunity to separate plastic waste and improve the viability of the plastics recycling industry.展开更多
The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the re...The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the reconstructive techniques in oncoplastic breast cancer surgery successfully can be applied to the treatment of these rare benign tumours improving the cosmetic and functional outcome.展开更多
BACKGROUND The high prevalence of human papillomavirus(HPV)infection in oropharyngeal squamous cell carcinoma(SCC)is well established,and p16 expression is a strong predictor.HPV-related tumors exhibit unique mechanis...BACKGROUND The high prevalence of human papillomavirus(HPV)infection in oropharyngeal squamous cell carcinoma(SCC)is well established,and p16 expression is a strong predictor.HPV-related tumors exhibit unique mechanisms that target p16 and p53 proteins.However,research on HPV prevalence and the combined predictive value of p16 and p53 expression in head and neck cutaneous SCC(HNCSCC),particularly in Asian populations,remains limited.This retrospective study surveyed 62 patients with HNSCC(2011-2020),excluding those with facial warts or other skin cancer.AIM To explore the prevalence of HPV and the predictive value of p16 and p53 expression in HNCSCC in Asian populations.METHODS All patients underwent wide excision and biopsy.Immunohistochemical staining for HPV,p16,and p53 yielded positive and negative results.The relevance of each marker was investigated by categorizing the tumor locations into high-risk and middle-risk zones based on recurrence frequency.RESULTS Of the 62 patients,20(32.26%)were male,with an average age of 82.27 years(range 26-103 years).High-risk included 19 cases(30.65%),with the eyelid and lip being the most common sites(five cases,8.06%).Middle-risk included 43 cases(69.35%),with the cheek being the most common(29 cases,46.77%).The p16 expression was detected in 24 patients(38.71%),p53 expression in 42 patients(72.58%),and HPV in five patients(8.06%).No significant association was found between p16 expression and the presence of HPV(P>0.99),with a positive predictive value of 8.33%.CONCLUSION This study revealed that p16,a surrogate HPV marker in oropharyngeal SCC,is not reliable in HNCSCC,providing valuable insights for further research in Asian populations.展开更多
The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs diff...The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs differ in many ways,including the surgical exposure of undergraduate studies,the structure,curriculum,and operative requirements of residency training.In general,Hong Kong has a single pathway of residency training with more early clinical exposure in an undergraduate study.On the contrary,Shanghai has multiple pathways of residency training that are heavily emphasized in academic research.Both Hong Kong and Shanghai should complement each other to modify their plastic surgery training programs that will eventually benefit the field of plastic surgery education。展开更多
BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy,but metastasis to the abdominal wall is extremely rare.Therefore,an appropriate treatment approach for large metastatic lesions with infection rema...BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy,but metastasis to the abdominal wall is extremely rare.Therefore,an appropriate treatment approach for large metastatic lesions with infection remains a great challenge.CASE SUMMARY We report the case of a 65-year-old woman who developed abdominal metastasis of endometrioid adenocarcinoma,as defined by International Obstetrics and Gynecology stage II,in which the lesion was complicated by infection.A right hemicolectomy was performed for colon metastasis in relation to her initial gynecological cancer 3 years ago.When admitted to our department,a complete resection of the giant abdominal wall lesion was performed,and a Bard composite mesh was used to reconstruct the abdominal wall.A local flap was used to close the resultant large defect in the external covering of the abdomen.The patient underwent chemotherapy following cytoreductive surgery.Pathology revealed metastasis of EC,and molecular subtyping showed copy number high of TP53 mutation,implying a poor prognosis.CONCLUSION When EC patients develop giant abdominal wall metastasis,a plastic surgeon should be included before contemplating resection of tumors.展开更多
On March 23,2024,at the 23rd Shanghai International Congress of Plastic and Reconstructive Surgery,a Neurofibromatosis Type 1 and Skin and Soft-Tissue Tumors Forum was unveiled.This forum aimed to foster multidiscipli...On March 23,2024,at the 23rd Shanghai International Congress of Plastic and Reconstructive Surgery,a Neurofibromatosis Type 1 and Skin and Soft-Tissue Tumors Forum was unveiled.This forum aimed to foster multidisciplinary cooperation to standardize the diagnosis and treatment of neurofibromatosis and skin and soft-tissue tumors,attracting leading experts and scholars from across the nation.It served as a pivotal platform for sharing advancements in pathology,clinical practices,and surgical techniques related to these conditions,alongside discussions on standardized care and precision medicine,marking a significant step forward in the field.展开更多
<em>Aloe vera</em> has been used for centuries for medicinal purposes. Clinical and experimental evidence indicates usefulness for skin moisturization, promoting wound healing, thermal skin injury, frostbi...<em>Aloe vera</em> has been used for centuries for medicinal purposes. Clinical and experimental evidence indicates usefulness for skin moisturization, promoting wound healing, thermal skin injury, frostbite, and ischemic skin insults. <em>Aloe vera</em> has anti-inflammatory, vasodilatory, antimicrobial, and proliferative actions, which have been investigated in various experimental models and in various in vitro studies. This extensive literature review of the properties and actions of <em>Aloe vera</em> finds substantial evidence for the reported and also likely clinical usefulness for <em>Aloe vera</em> in Plastic Surgery and in wound care and wound healing. Though further clinical investigation is warranted, Aloe vera use may likely be indicated in situations where its effects could positively influence outcomes, such as wound healing, flap vascularity, and inflammatory skin pathologies.展开更多
Background Traditional lecture-based teaching(TLT)has long been the primary method of teaching plastic suturing techniques and even surgical education.It has been challenging to adapt this approach to fit the educatio...Background Traditional lecture-based teaching(TLT)has long been the primary method of teaching plastic suturing techniques and even surgical education.It has been challenging to adapt this approach to fit the educational objectives of plastic surgery,which is a very practical science.Additionally,it is mainly teacher-led,and the course content is teacher-driven,which has disadvantages such as difficulty in motivating students and disconnection from clinical practice.Therefore,we developed a video point-to-point teaching(VPT)method and teamwork-based teaching(TBT)to study the effect of the new teaching model on fine cosmetic suturing operation(FCSO)and training outcomes for plastic surgeons.Methods We selected 30 junior doctors from the Department of Plastic and Reconstructive Surgery of the Chinese PLA General Hospital.All trainees were randomly assigned to three groups:TLT,VPT,and TBT.All trainees had their performances photographed,and a senior attending physician was appointed as a rater.We rated the process and results of FCSO according to a uniform rubric following the double-blind principle to compare the effects of different teaching modes on the trainees’FCSO and differences in training outcomes.Results There was no significant effect of video recording on trainees’FCSO(P>0.05).The total scores of the first suturing in the three groups were as follows:TLT group(13.18±1.66),VPT group(13.63±1.97),and TBT group(13.50±2.26),with no significant difference among the groups(P>0.05),indicating that the starting level of the trainees in the three groups was basically the same.There was no significant difference(P>0.05)between the VPT(20.30±2.17)and TBT(20.38±2.29)groups,but both of these groups were significantly better than the TLT group(16.43±1.86,P<0.01).Conclusion The TBT and VPT methods are significantly better than TLT.However,the TBT method is more economical and optimal for teachers and better utilizes students’initiative in learning and operation,which improves the teaching level and training efficiency.展开更多
July 20 and 21,2022,witnessed the highlight of the 21st Shanghai International Conference of Plastic and Aesthetic Surgery,a successful vascular anomalies workshop titled“Advancements in the Management of Vascular An...July 20 and 21,2022,witnessed the highlight of the 21st Shanghai International Conference of Plastic and Aesthetic Surgery,a successful vascular anomalies workshop titled“Advancements in the Management of Vascular Anomalies”at Shanghai Ninth People’s Hospital.The conference was graced by many renowned specialists and scholars from China and abroad who presented lectures and panels on cutting-edge debated concepts and technological progress in the field.Amid the coronavirus disease 2019(COVID-19)pandemic,specialists from numerous fields have delivered rich content in person and virtually to participants across China.Prof.Xiaoxi Lin’s team from Shanghai Ninth People’s Hospital,a leading center in the field of infantile hemangioma and vascular malformation in China,collaborated with colleagues on new developments using teaching and discussion.展开更多
Recently,the 11th Shanghai Plastic Surgery Forum and the 21st Shanghai International Plastic and Aesthetic Surgery Conference were successfully held in Shanghai.Among them,the Neurofibromatosis Forum was held on July ...Recently,the 11th Shanghai Plastic Surgery Forum and the 21st Shanghai International Plastic and Aesthetic Surgery Conference were successfully held in Shanghai.Among them,the Neurofibromatosis Forum was held on July 23,attracting thousands of experts and scholars,patients and their families,news media,and other stakeholders in China.The conference,hosted by the Ti-Sheng Chang’s Plastic Surgery Development Foundation and co-organized by Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.展开更多
An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it...An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it an extremely promising agent for plastic surgery.In this review,we summarize the positive roles of P188 in autologous fat grafting,wound healing,and cartilage transplantation.These roles include improving the survival rate of fat grafts and chondrocytes,stimulating the metabolic activity of adipocytes,promoting wound healing,and contributing to cartilage formation.Although further research is still needed,it is clear that P188 has great potential and application value in the field of plastic surgery.展开更多
BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few stu...BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few studies have explored the relationship between anxiety,depression,and pain in DFUs,as well as the associated risk factors.AIM To analyze the correlation between anxiety,depression,and pain in patients with DFUs and to identify the associated risk factors.METHODS This study included 106 patients diagnosed with DFUs who were admitted to Tiantai County People’s Hospital between March 2022 and March 2024.The patients’anxiety levels were evaluated using Zung’s self-rating anxiety scale(SAS),depression status was assessed using Zung’s self-rating depression scale(SDS),and pain intensity was assessed using the visual analog scale(VAS).Subsequently,correlations between SAS,SDS,and VAS scores were analyzed.Univariate and multivariate analyses were conducted to explore the risk factors that contributed to anxiety and depression in patients with DFUs.RESULTS Among the 106 patients,39.62%exhibited anxiety and 43.40%presented with depression.Most patients experiencing anxiety or depression exhibited mild symptoms,with no severe cases observed.Compared with asymptomatic patients,those with anxiety or depression had significantly higher VAS scores.Correlation analysis indicated a significant positive relationship between both SAS and SDS scores and the VAS score.Univariate analysis identified sex,age,Wagner’s grade,presence of other complications,and smoking history as factors significantly associated with anxiety and depression.Multivariate analysis further confirmed that younger age,higher Wagner’s grade,and higher VAS scores were independent predictors of anxiety and depression.CONCLUSION This study reveals a significant positive correlation between anxiety,depression,and pain in patients with DFUs.This finding suggests that timely and effective pain intervention may be beneficial in alleviating negative emotions such as anxiety and depression.In addition,younger age(<50 years),higher Wagner’s grade,and higher VAS scores increase the risk of developing anxiety and depression in this patient population.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide ...BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide a comprehensive meta-analysis of the role of NPWT in the manage-ment of DFUs.METHODS A systematic review was performed based on Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses guidelines,searching databases like PubMed,Embase,Web of Science,and the Cochrane Library.Randomized clinical trials(RCTs)were included to compare NPWT to other dressings for DFUs.Outcomes measured were wound healing time and rate,granulation tissue formation time,amputation rate,and adverse events.Study quality was evaluated using Coch-rane's risk of bias tool.Analyses utilizedχ2,I2,fixed or random-effects models via Stata v17.RESULTS Of the 1101 identified articles,9 RCTs were selected for meta-analysis.Studies spanned from 2005 to 2020 and originated from countries including the United States,Chile,Pakistan,Italy,India,and Germany.Meta-analysis demonstrated a significant improvement in wound healing rate[risk ratio(RR)=1.46,95%CI:1.22-1.76,P<0.01]and a reduction in amputation rate(RR=0.69,95%CI:0.50-0.96,P=0.006)with NPWT.Furthermore,the time for granulation tissue formation was significantly reduced by an average of 19.54 days.However,the incidence of adverse events did not significantly differ between NPWT and control treatments.CONCLUSION NPWT significantly improves wound healing rates and reduces amputation rates in DFUs.It also hastens the formation of granulation tissue.However,the therapy does not significantly alter the risk of adverse events compared to alternate treatments.展开更多
Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Vario...Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.展开更多
BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram...BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram(ECG)during resting conditions and physical exertion in individuals diagnosed with IHD and those without the condition using vasodilator-induced stress computed tomography(CT)myocardial perfusion imaging as the diagnostic reference standard.METHODS This single center observational study included 80 participants.The participants were aged≥40 years and given an informed written consent to participate in the study.Both groups,G1(n=31)with and G2(n=49)without post stress induced myocardial perfusion defect,passed cardiologist consultation,anthropometric measurements,blood pressure and pulse rate measurement,echocardiography,cardio-ankle vascular index,bicycle ergometry,recording 3-min single-lead ECG(Cardio-Qvark)before and just after bicycle ergometry followed by performing CT myocardial perfusion.The LASSO regression with nested cross-validation was used to find the association between Cardio-Qvark parameters and the existence of the perfusion defect.Statistical processing was performed with the R programming language v4.2,Python v.3.10[^R],and Statistica 12 program.RESULTS Bicycle ergometry yielded an area under the receiver operating characteristic curve of 50.7%[95%confidence interval(CI):0.388-0.625],specificity of 53.1%(95%CI:0.392-0.673),and sensitivity of 48.4%(95%CI:0.306-0.657).In contrast,the Cardio-Qvark test performed notably better with an area under the receiver operating characteristic curve of 67%(95%CI:0.530-0.801),specificity of 75.5%(95%CI:0.628-0.88),and sensitivity of 51.6%(95%CI:0.333-0.695).CONCLUSION The single-lead ECG has a relatively higher diagnostic accuracy compared with bicycle ergometry by using machine learning models,but the difference was not statistically significant.However,further investigations are required to uncover the hidden capabilities of single-lead ECG in IHD diagnosis.展开更多
基金supported by grants from the National Natural Science Foundation of China(grant nos.82472554 and 82202449)the Fund for Excellent Young Scholars of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(grant no.JYYQ006).
文摘Background:This study explored the value of integrating problem-based learning(PBL)and team-based learning(TBL)methods into plastic and reconstructive surgery clinical practice.By addressing the challenges faced in traditional teachings,this study aimed to enhance educational outcomes and prepare students for real-world surgical scenarios,thereby improving patient care in this specialized field.Methods:Fifty undergraduate students majoring in clinical medicine at the Shanghai Jiao Tong University School of Medicine were selected as research subjects.They were randomly divided into experimental and control groups.The experimental group received the combined PBL-TBL teaching method,whereas the control group received the traditional teaching.The teaching effect was evaluated based on student satisfaction and academic performance.Results:The student satisfaction in the experimental group was higher than that of the control group(P<0.05).Subjective scoring for academic performance by instructors was higher in the experimental group than in the control group(P<0.05).Conclusion:The PBL and TBL combination had a significant effect when applied in plastic and reconstructive surgery clinical practice.
文摘Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.
文摘Objectives:The eukaryotic initiation factor 4F(eIF4F)translation initiation complex inhibitors(eIF4Fi)were recently found to hyperactivate extracellular signal-regulated kinases 1/2(ERK1/2)signals,which contribute to acquired resistance to BRAF(B-Raf proto-oncogene,serine/threonine kinase)inhibitors in melanoma.This present study aims to elucidate how to overcome the resistance of the eIF4Fi in BRAFV600E mutant melanoma cells and explore the underlying mechanisms.Methods:Melanoma A375(vemurafenib[VEM]-sensitive)and A375R(VEM-resistant)cells were exposed to eIF4Fi RocA at varying doses and durations in vitro.We investigated the impact of RocA on the activity of ERK1/2,AKT serine/threonine kinase 1(AKT1),eIF4E,and enhancer of zeste homolog 2(EZH2).We then examined the impact of RocA on pro-apoptotic BH3-only proteins and proliferative proteins.We subsequently determined the effect of combined eIF4Fi,AKT1 inhibitor,EZH2 inhibitor or VEM on tumor growth in vitro and in vivo.Results:RocA inhibited proliferation and induced apoptosis in A375 cells,but inhibited proliferation in A375R cells.RocA rapidly reactivated ERK1/2 at 3 h and returned to baseline levels at 48 h.However,eIF4E and AKT1 activation began at 12 h and peaked at 48 h.ERK1/2 positively regulated EZH2 and EZH2-dependent expression of c-Fos and EGR1,while AKT1 negatively regulated c-Myc,c-Jun,and BMF,but positively regulated eIF4E.RocA downregulated ERK1/2(or EZH2,AKT1,and eIF4E)independent bcl-2 and Mcl-1 expression.AKT1i enhanced RocA-induced cell apoptosis,while EZH2i reduced RocA-induced cell proliferation.Combined CR-1-31-B,EZH2i,and AKT1i effectively overcame resistance to RocA and VEM resistance both in vitro and in vivo.Conclusion:The eIF4F complex inhibitor reactivates ERK1/2-EZH2 and AKT1 signaling pathways,resulting in resistance to both eIF4Fi and VEM.Combined administration of an eIF4Fi with EZH2 and AKT1 inhibitors effectively enhances sensitivity to both eIF4F complex and BRAF inhibitors.
基金supported by a grant from General Scientific Research Project of Zhejiang Provincial Department of Education(No.Y202455614).
文摘Diabetes mellitus is an escalating global health issue,with 463 million adults affected in 2019.Without intervention,this number is projected to increase to 578 million by 2030 and 700 million by 2045[1].Diabetic wound,a significant complication,is characterized by delayed healing,high disability rates,and elevated mortality[2].The challenges of wound healing in diabetic patients,compounded by their high morbidity and mortality rates,have drawn growing attention in biomedical research.
基金supported by National Natural Science Foundation of China(No.50575143)the Research Fund for the Doctoral Program of Higher Educa-tion (No.20040248005)
文摘A three dimensional rate-dependent crystal plasticity model is applied to study the influence of crystal orientation and grain boundary on the void growth and coalescence. The 3D computational model is a unit cell including one sphere void or two sphere voids. The results of three different orientations for single crystal and bicrystals are compared. It is found that crystallographic orientation has noticeable influences on the void growth directionvoid shape, and void coalescence of single crystal. The void growth rate of bicrystals depends on the crystallographic orientations and grain boundary direction.
文摘Microplastic pollution represents a side-effect stemming from a global plastic waste mismanagement problem and includes degraded particles or mass produced plastic particles less than 5 mm in largest dimension.The small nature of microplastics gives this area of pollution different environmental concerns than general plastic waste in the environment.The biological toxicity of particles,their internal components,and their surface level changes all present opportunities for these particles to adversely affect the environment around them.Thus,it is necessary to review the current literature surrounding this topic and identify areas where the study of microplastic can be pushed forward.Here we present current methods in studying microplastics,some of the ways by which microplastics affect the environment and attempt to shed light on how this research can continue.In addition,we review current recycling methods developing for the processing of mixed-plastic waste.These methods,including hydrothermal processing and solvent extraction,provide a unique opportunity to separate plastic waste and improve the viability of the plastics recycling industry.
文摘The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the reconstructive techniques in oncoplastic breast cancer surgery successfully can be applied to the treatment of these rare benign tumours improving the cosmetic and functional outcome.
基金Supported by the National Research Foundation of Korea,No.2020R1A2C1100891Soonchunhyang University Research Fund,No.2024-05-014.
文摘BACKGROUND The high prevalence of human papillomavirus(HPV)infection in oropharyngeal squamous cell carcinoma(SCC)is well established,and p16 expression is a strong predictor.HPV-related tumors exhibit unique mechanisms that target p16 and p53 proteins.However,research on HPV prevalence and the combined predictive value of p16 and p53 expression in head and neck cutaneous SCC(HNCSCC),particularly in Asian populations,remains limited.This retrospective study surveyed 62 patients with HNSCC(2011-2020),excluding those with facial warts or other skin cancer.AIM To explore the prevalence of HPV and the predictive value of p16 and p53 expression in HNCSCC in Asian populations.METHODS All patients underwent wide excision and biopsy.Immunohistochemical staining for HPV,p16,and p53 yielded positive and negative results.The relevance of each marker was investigated by categorizing the tumor locations into high-risk and middle-risk zones based on recurrence frequency.RESULTS Of the 62 patients,20(32.26%)were male,with an average age of 82.27 years(range 26-103 years).High-risk included 19 cases(30.65%),with the eyelid and lip being the most common sites(five cases,8.06%).Middle-risk included 43 cases(69.35%),with the cheek being the most common(29 cases,46.77%).The p16 expression was detected in 24 patients(38.71%),p53 expression in 42 patients(72.58%),and HPV in five patients(8.06%).No significant association was found between p16 expression and the presence of HPV(P>0.99),with a positive predictive value of 8.33%.CONCLUSION This study revealed that p16,a surrogate HPV marker in oropharyngeal SCC,is not reliable in HNCSCC,providing valuable insights for further research in Asian populations.
基金supported by grants from the Youth Doctor Collaborative Innovation Team Project(QC201803)of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicinethe Project of Biobank(NO.YBKA201901)from Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine+1 种基金the Shanghai Youth Top-Notch Talent Program(201809004)“Chenguang Program”supported by Shanghai Education Development Foundation and Shanghai Municipal Education Commission(19CG18)and Science and Technology Commission of Shanghai Municipality(19JC1413),Shanghai Rising-Star Program(20QA1405600).
文摘The field of plastic surgery has developed rapidly in the last couple of decades in Hong Kong and Shanghai,China.Both cities have their own educational system for training plastic surgeons.Their training programs differ in many ways,including the surgical exposure of undergraduate studies,the structure,curriculum,and operative requirements of residency training.In general,Hong Kong has a single pathway of residency training with more early clinical exposure in an undergraduate study.On the contrary,Shanghai has multiple pathways of residency training that are heavily emphasized in academic research.Both Hong Kong and Shanghai should complement each other to modify their plastic surgery training programs that will eventually benefit the field of plastic surgery education。
基金the National Key Technology R&D Program of China,No.2019YFC1005200,and No.2019YFC1005201the Natural Science Foundation of Beijing,No.7202213+1 种基金the National Natural Science Foundation of ChinaNo. 82072861, 81672571, and 81874108.
文摘BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy,but metastasis to the abdominal wall is extremely rare.Therefore,an appropriate treatment approach for large metastatic lesions with infection remains a great challenge.CASE SUMMARY We report the case of a 65-year-old woman who developed abdominal metastasis of endometrioid adenocarcinoma,as defined by International Obstetrics and Gynecology stage II,in which the lesion was complicated by infection.A right hemicolectomy was performed for colon metastasis in relation to her initial gynecological cancer 3 years ago.When admitted to our department,a complete resection of the giant abdominal wall lesion was performed,and a Bard composite mesh was used to reconstruct the abdominal wall.A local flap was used to close the resultant large defect in the external covering of the abdomen.The patient underwent chemotherapy following cytoreductive surgery.Pathology revealed metastasis of EC,and molecular subtyping showed copy number high of TP53 mutation,implying a poor prognosis.CONCLUSION When EC patients develop giant abdominal wall metastasis,a plastic surgeon should be included before contemplating resection of tumors.
文摘On March 23,2024,at the 23rd Shanghai International Congress of Plastic and Reconstructive Surgery,a Neurofibromatosis Type 1 and Skin and Soft-Tissue Tumors Forum was unveiled.This forum aimed to foster multidisciplinary cooperation to standardize the diagnosis and treatment of neurofibromatosis and skin and soft-tissue tumors,attracting leading experts and scholars from across the nation.It served as a pivotal platform for sharing advancements in pathology,clinical practices,and surgical techniques related to these conditions,alongside discussions on standardized care and precision medicine,marking a significant step forward in the field.
文摘<em>Aloe vera</em> has been used for centuries for medicinal purposes. Clinical and experimental evidence indicates usefulness for skin moisturization, promoting wound healing, thermal skin injury, frostbite, and ischemic skin insults. <em>Aloe vera</em> has anti-inflammatory, vasodilatory, antimicrobial, and proliferative actions, which have been investigated in various experimental models and in various in vitro studies. This extensive literature review of the properties and actions of <em>Aloe vera</em> finds substantial evidence for the reported and also likely clinical usefulness for <em>Aloe vera</em> in Plastic Surgery and in wound care and wound healing. Though further clinical investigation is warranted, Aloe vera use may likely be indicated in situations where its effects could positively influence outcomes, such as wound healing, flap vascularity, and inflammatory skin pathologies.
文摘Background Traditional lecture-based teaching(TLT)has long been the primary method of teaching plastic suturing techniques and even surgical education.It has been challenging to adapt this approach to fit the educational objectives of plastic surgery,which is a very practical science.Additionally,it is mainly teacher-led,and the course content is teacher-driven,which has disadvantages such as difficulty in motivating students and disconnection from clinical practice.Therefore,we developed a video point-to-point teaching(VPT)method and teamwork-based teaching(TBT)to study the effect of the new teaching model on fine cosmetic suturing operation(FCSO)and training outcomes for plastic surgeons.Methods We selected 30 junior doctors from the Department of Plastic and Reconstructive Surgery of the Chinese PLA General Hospital.All trainees were randomly assigned to three groups:TLT,VPT,and TBT.All trainees had their performances photographed,and a senior attending physician was appointed as a rater.We rated the process and results of FCSO according to a uniform rubric following the double-blind principle to compare the effects of different teaching modes on the trainees’FCSO and differences in training outcomes.Results There was no significant effect of video recording on trainees’FCSO(P>0.05).The total scores of the first suturing in the three groups were as follows:TLT group(13.18±1.66),VPT group(13.63±1.97),and TBT group(13.50±2.26),with no significant difference among the groups(P>0.05),indicating that the starting level of the trainees in the three groups was basically the same.There was no significant difference(P>0.05)between the VPT(20.30±2.17)and TBT(20.38±2.29)groups,but both of these groups were significantly better than the TLT group(16.43±1.86,P<0.01).Conclusion The TBT and VPT methods are significantly better than TLT.However,the TBT method is more economical and optimal for teachers and better utilizes students’initiative in learning and operation,which improves the teaching level and training efficiency.
文摘July 20 and 21,2022,witnessed the highlight of the 21st Shanghai International Conference of Plastic and Aesthetic Surgery,a successful vascular anomalies workshop titled“Advancements in the Management of Vascular Anomalies”at Shanghai Ninth People’s Hospital.The conference was graced by many renowned specialists and scholars from China and abroad who presented lectures and panels on cutting-edge debated concepts and technological progress in the field.Amid the coronavirus disease 2019(COVID-19)pandemic,specialists from numerous fields have delivered rich content in person and virtually to participants across China.Prof.Xiaoxi Lin’s team from Shanghai Ninth People’s Hospital,a leading center in the field of infantile hemangioma and vascular malformation in China,collaborated with colleagues on new developments using teaching and discussion.
文摘Recently,the 11th Shanghai Plastic Surgery Forum and the 21st Shanghai International Plastic and Aesthetic Surgery Conference were successfully held in Shanghai.Among them,the Neurofibromatosis Forum was held on July 23,attracting thousands of experts and scholars,patients and their families,news media,and other stakeholders in China.The conference,hosted by the Ti-Sheng Chang’s Plastic Surgery Development Foundation and co-organized by Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
基金The study was supported by the Scientific Research Staring Foundation for the Returned Overseas Chinese Scholars of the Peking University Third Hospital(grant no.BYSYLXHG2019001).
文摘An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it an extremely promising agent for plastic surgery.In this review,we summarize the positive roles of P188 in autologous fat grafting,wound healing,and cartilage transplantation.These roles include improving the survival rate of fat grafts and chondrocytes,stimulating the metabolic activity of adipocytes,promoting wound healing,and contributing to cartilage formation.Although further research is still needed,it is clear that P188 has great potential and application value in the field of plastic surgery.
文摘BACKGROUND Pain often predisposes patients with diabetic foot ulcers(DFUs)to negative emotional states,such as anxiety and depression,which can significantly impair treatment outcomes and recovery.However,very few studies have explored the relationship between anxiety,depression,and pain in DFUs,as well as the associated risk factors.AIM To analyze the correlation between anxiety,depression,and pain in patients with DFUs and to identify the associated risk factors.METHODS This study included 106 patients diagnosed with DFUs who were admitted to Tiantai County People’s Hospital between March 2022 and March 2024.The patients’anxiety levels were evaluated using Zung’s self-rating anxiety scale(SAS),depression status was assessed using Zung’s self-rating depression scale(SDS),and pain intensity was assessed using the visual analog scale(VAS).Subsequently,correlations between SAS,SDS,and VAS scores were analyzed.Univariate and multivariate analyses were conducted to explore the risk factors that contributed to anxiety and depression in patients with DFUs.RESULTS Among the 106 patients,39.62%exhibited anxiety and 43.40%presented with depression.Most patients experiencing anxiety or depression exhibited mild symptoms,with no severe cases observed.Compared with asymptomatic patients,those with anxiety or depression had significantly higher VAS scores.Correlation analysis indicated a significant positive relationship between both SAS and SDS scores and the VAS score.Univariate analysis identified sex,age,Wagner’s grade,presence of other complications,and smoking history as factors significantly associated with anxiety and depression.Multivariate analysis further confirmed that younger age,higher Wagner’s grade,and higher VAS scores were independent predictors of anxiety and depression.CONCLUSION This study reveals a significant positive correlation between anxiety,depression,and pain in patients with DFUs.This finding suggests that timely and effective pain intervention may be beneficial in alleviating negative emotions such as anxiety and depression.In addition,younger age(<50 years),higher Wagner’s grade,and higher VAS scores increase the risk of developing anxiety and depression in this patient population.
基金Supported by the National Natural Science Foundation of China,No.82202454 and No.81873934the Wang Zhengguo Trauma Medicine Fund(Growth Factor Revival Plan)No.SZYZ-TR-09+1 种基金the Shandong Provincial Natural Science Foundation Youth Fund,No.ZR2020QH168the Jinan Science and Technology Plan Project,No.202225065。
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide a comprehensive meta-analysis of the role of NPWT in the manage-ment of DFUs.METHODS A systematic review was performed based on Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses guidelines,searching databases like PubMed,Embase,Web of Science,and the Cochrane Library.Randomized clinical trials(RCTs)were included to compare NPWT to other dressings for DFUs.Outcomes measured were wound healing time and rate,granulation tissue formation time,amputation rate,and adverse events.Study quality was evaluated using Coch-rane's risk of bias tool.Analyses utilizedχ2,I2,fixed or random-effects models via Stata v17.RESULTS Of the 1101 identified articles,9 RCTs were selected for meta-analysis.Studies spanned from 2005 to 2020 and originated from countries including the United States,Chile,Pakistan,Italy,India,and Germany.Meta-analysis demonstrated a significant improvement in wound healing rate[risk ratio(RR)=1.46,95%CI:1.22-1.76,P<0.01]and a reduction in amputation rate(RR=0.69,95%CI:0.50-0.96,P=0.006)with NPWT.Furthermore,the time for granulation tissue formation was significantly reduced by an average of 19.54 days.However,the incidence of adverse events did not significantly differ between NPWT and control treatments.CONCLUSION NPWT significantly improves wound healing rates and reduces amputation rates in DFUs.It also hastens the formation of granulation tissue.However,the therapy does not significantly alter the risk of adverse events compared to alternate treatments.
文摘Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.
基金Supported by Government Assignment,No.1023022600020-6RSF Grant,No.24-15-00549Ministry of Science and Higher Education of the Russian Federation within the Framework of State Support for the Creation and Development of World-Class Research Center,No.075-15-2022-304.
文摘BACKGROUND Ischemic heart disease(IHD)impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.AIM To compare variations in the parameters of the single-lead electrocardiogram(ECG)during resting conditions and physical exertion in individuals diagnosed with IHD and those without the condition using vasodilator-induced stress computed tomography(CT)myocardial perfusion imaging as the diagnostic reference standard.METHODS This single center observational study included 80 participants.The participants were aged≥40 years and given an informed written consent to participate in the study.Both groups,G1(n=31)with and G2(n=49)without post stress induced myocardial perfusion defect,passed cardiologist consultation,anthropometric measurements,blood pressure and pulse rate measurement,echocardiography,cardio-ankle vascular index,bicycle ergometry,recording 3-min single-lead ECG(Cardio-Qvark)before and just after bicycle ergometry followed by performing CT myocardial perfusion.The LASSO regression with nested cross-validation was used to find the association between Cardio-Qvark parameters and the existence of the perfusion defect.Statistical processing was performed with the R programming language v4.2,Python v.3.10[^R],and Statistica 12 program.RESULTS Bicycle ergometry yielded an area under the receiver operating characteristic curve of 50.7%[95%confidence interval(CI):0.388-0.625],specificity of 53.1%(95%CI:0.392-0.673),and sensitivity of 48.4%(95%CI:0.306-0.657).In contrast,the Cardio-Qvark test performed notably better with an area under the receiver operating characteristic curve of 67%(95%CI:0.530-0.801),specificity of 75.5%(95%CI:0.628-0.88),and sensitivity of 51.6%(95%CI:0.333-0.695).CONCLUSION The single-lead ECG has a relatively higher diagnostic accuracy compared with bicycle ergometry by using machine learning models,but the difference was not statistically significant.However,further investigations are required to uncover the hidden capabilities of single-lead ECG in IHD diagnosis.
