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
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
This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a...This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1. The both sides or one side of sponge was treated with ultraviolet (UV) irradiation for 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge showed very slow elution properties. On the other hand, the single-sided UV-irradiated sponge showed initially fast elution and subsequent very slow elution properties. Such initially fast elution of collagen molecules from the surface without UV-irradiation allows an adhesion of collagen sponge to the wound surface and results in hemostatic effect. In addition, the water absorption and retention properties of sponge were investigated by placing the hydrated sponge on a mesh for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge absorbed 81 times more water than own weight and showed a value of 45 times even after 7 days. The single-sided UV-irradiated sponge absorbed 80 times more water than own weight and showed a value of 39 times even after 7 days. The sponge with high water absorption and retention properties allows a wound healing effect because such sponge can absorb large amounts of blood plasma and exudates containing various cell growth factors. The double-sided UV-irradiated sponge is a good candidate for the wound dressing. On the other hand, the single-sided UV-irradiated sponge is a good candidate for the hemostatic material.展开更多
BACKGROUND As artificial intelligence(AI)continues to expand across medical specialties,its application in medical imaging within plastic and reconstructive surgery(PRS)remains limited in the literature.Imaging plays ...BACKGROUND As artificial intelligence(AI)continues to expand across medical specialties,its application in medical imaging within plastic and reconstructive surgery(PRS)remains limited in the literature.Imaging plays a critical role in surgical planning,intraoperative decision-making,and postoperative monitoring in PRS,presenting an opportunity for AI to enhance clinical outcomes.AIM To evaluate the current applications of AI in medical imaging for plastic surgery,with a focus on its use in preoperative planning,intraoperative guidance,and postoperative monitoring.METHODS A literature search was conducted using MEDLINE,EMBASE,ScienceDirect,and OVID up to February 2025.Studies were included based on relevance to AI use in plastic surgery imaging.Extracted data included AI modality,surgical context,outcomes,and limitations.The search followed PRISMA guidelines and was registered with PROSPERO(CRD420251008741).RESULTS AI tools have improved preoperative planning through three-dimensional vascular mapping,augmented reality,and thermographic imaging.Intraoperatively,AI-enabled navigation and robotic systems have increased surgical precision.Postoperative AI applications,including deep learning algorithms and sensorbased monitoring,support early complication detection and wound healing assessment.However,persistent barriers include data variability,model generalizability,surgeon unfamiliarity,and lack of regulatory standards.CONCLUSION AI-driven imaging technologies show promise in enhancing decision-making and outcomes in PRS.To ensure safe clinical integration,future efforts must focus on structured validation,standardization,and ethical oversight.展开更多
《Chinese Journal of Plastic and Reconstructive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编,编辑部设在上海交...《Chinese Journal of Plastic and Reconstructive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编,编辑部设在上海交通大学医学院附属第九人民医院整复外科。展开更多
《Chinese Journal of Plastic and Reconstructive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编,编辑部设在上海交...《Chinese Journal of Plastic and Reconstructive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编,编辑部设在上海交通大学医学院附属第九人民医院整复外科。本刊现已被Scopus、DOAJ、Science Direct,以及万方数据库、中国知网等数据库全文收录。展开更多
《Chinese Journal of Plastie and Reconstruetive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编.编辑部设在上海交...《Chinese Journal of Plastie and Reconstruetive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编.编辑部设在上海交通大学医学院附属第九人民医院整复外科。展开更多
Reconstructive defects of the human face pose unique challenges to even the most experienced surgeon given their myriad of presentations and the individuality of each patient’s anatomy,clinical presentation,and persp...Reconstructive defects of the human face pose unique challenges to even the most experienced surgeon given their myriad of presentations and the individuality of each patient’s anatomy,clinical presentation,and perspective or preferences.A robust armamentarium of reconstructive options must be cultivated for each facial subunit so that experience and artistry can be best utilized to rebuild the patient’s structure and function.This review will outline a subset of local rotation and transposition flaps that are most useful for facial reconstruction,organized by facial subunit.展开更多
<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most com...<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. <strong>Objectives: </strong>Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). <strong>Methods: </strong>A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. <strong>Results: </strong>A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. <strong>Conclusion:</strong> Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.展开更多
Myofibroblastic sarcoma(MS)is a rare malignant soft tissue tumor characterized by myofibroblasts.It most commonly arises in the head and neck region,especially the tongue,with rare occurrences in the limbs.MS exhibits...Myofibroblastic sarcoma(MS)is a rare malignant soft tissue tumor characterized by myofibroblasts.It most commonly arises in the head and neck region,especially the tongue,with rare occurrences in the limbs.MS exhibits varying histopathology,ranging from low-to high-grade,with diverse subtypes showing different clinical behaviors and prognoses.This article reports the first case of high-grade MS in the hand,adding to the limited documentation of this rare condition.Here,we present the case of a 30-year-old healthy female with a year-long history of progressive shortening,mobility loss,and weakness in the first finger of the left hand.Left-hand imaging revealed a lytic,cottony tumor involving the entire first metacarpal.Following surgical resection,which included metatarsal grafting and joint reconstruction,a diagnosis of high-grade MS was confirmed based on histological manifestations and immunohistochemical staining,which was further classified as grade 2 according to the French Federation of Cancer Centers Sarcoma Group system.Postoperative radiotherapy was administered and the patient experienced a successful recovery without graft osteonecrosis.The patient regained 90%mobility and strength,without shortening,after surgical resection and radiotherapy.Six months post-surgery,the patient reported full hand functionality.MS is a rare tumor that infrequently affects bones and is often misdiagnosed owing to its controversial characteristics.The initial treatment should focus on complete resection with negative margins,followed by reconstructive surgery to preserve function.Further case studies are needed to establish standardized surgical treatment protocols.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
Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several ele...Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several elective surgical procedures available for both conditions,such as neuroma excision followed by nerve reconstruction,nerve relocation,e.g.,surgically implanting a transected nerve into a muscle,nerve transfers in cases of associated paralysis,and most recently,regenerative peripheral nerve interface surgery.Whenever possible in the post-conflict phase,a coordinated effort between traveling humanitarian surgeons specializing in reconstructive microsurgery and local healthcare providers is essential for successfully treating phantom and chronic residual limb pain in post-conflict amputees.While providing a detailed logistical framework for global humanitarian missions is beyond the scope of this article,we provide a brief perspective on a topic of utmost importance for reconstructive surgeons worldwide:the high-quality care and treatment of refugees and those whose lives have been impacted by conflict,disaster,or displacement.展开更多
<strong>Introduction: </strong>Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of li...<strong>Introduction: </strong>Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. <strong>Objectives:</strong> To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years.<strong> Materials and Methods:</strong> Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. <strong>Results:</strong> 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. <strong>Conclusion:</strong> Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.展开更多
Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for ...Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for the temporary,definitive,or staged repair of these defects.A major advance in the field of plastic and other reconstructive surgery in this regard has been the introduction and successful use of acellular dermal matrices(ADMs).In recent years,not only the type of tissue from which ADMs are produced,product range,diversity and areas of use have increased,but their use in reconstructive fields,especially in post oncologic breast surgery,has become highly regarded and this has favored ADMs to be a potential cornerstone in specific and well-defined surgical fields in future.It is essential that reconstructive surgeons become familiar with some of the ADM’s as well as the advantages and limitations to their use.This review not only provides basic science and clinical evidence of the current use of ADMs in wide range of surgical fields but also targets to keep them as an important backdrop in the arma-mentarium of reconstructive surgeons.Brief considerations of possible future directions for ADMs are also conducted in the end.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
Purpose: Ablative options, beyond mastectomy, for large breasted patients with breast cancer include oncoplastic resection via reduction pattern and standard lumpectomy. Oncoplastic resection also entails a contralate...Purpose: Ablative options, beyond mastectomy, for large breasted patients with breast cancer include oncoplastic resection via reduction pattern and standard lumpectomy. Oncoplastic resection also entails a contralateral procedure for symmetry and the potential benefit of a superior cosmetic outcome. Our aim was to examine the cost-effectiveness of this treatment strategy comparing it to standard lumpectomy in treating breast cancer patients. Methods: A literature review was performed of the probabilities and outcomes related to treatment of unilateral breast cancer via oncoplastic resection or unilateral lumpectomy. Utility score surveys were used to estimate the quality adjusted life years (QALYs) associated with a successful procedure, additional margins excision and post-operative complications. A decision analysis tree was developed to highlight the more cost-effective strategy. An Incremental Cost-Utility Ratio (ICUR) was calculated. Sensitivity analysis was performed to check the robustness of our data. Results: Oncoplastic resection was associated with fewer positive margins relative to standard lumpectomy (10.0% versus 18%). In cases with positive margins, a greater percentage of oncoplastic resection patients chose a mastectomy compared to the lumpectomy patients (72% versus 19%). Utility scores for a successful operation favored oncoplastic resection (92.6 versus 86.55), but in instances of positive margins, favored the lumpectomy patients (74.2 versus 70.2). Decision tree analysis revealed that oncoplastic resection was more cost-effective with an ICUR of $2609.66/QALY gained. Conclusion: Oncoplastic resection represents a cost-effective strategy for the large breasted patient and provides the surgical team yet another reasonable option for the appropriate patient.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
Nail changes following upper extremity transplantation(UET)cannot be overlooked as they possess diagnostic and prognostic relevance in allotransplantation of upper limbs.This comprehensive review explores nail and nai...Nail changes following upper extremity transplantation(UET)cannot be overlooked as they possess diagnostic and prognostic relevance in allotransplantation of upper limbs.This comprehensive review explores nail and nail bed related changes encountered in UET recipients in the literature.The differential diagnosis of nail abnormalities in UET includes a wide range of systemic,local and iatrogenic conditions other than immune responses to the allograft.It requires interdisciplinary evaluation by primary transplant surgeons,pathologists,dermatologists and immunologists.The possible underlying mechanisms of nail pathology in UET and the management are discussed.It also underscores the importance of onychodystrophy and need for timely intervention and to improve outcomes in UET recipients.展开更多
Objectives: The current medical school curriculum offers scant exposure to plastic surgery. Medical students and junior doctors are often inadequately prepared for in-hospital placements which may impact on patient sa...Objectives: The current medical school curriculum offers scant exposure to plastic surgery. Medical students and junior doctors are often inadequately prepared for in-hospital placements which may impact on patient safety and quality of care. We aimed to deliver a one-day “hands-on” practical session on basic surgical skills and principles in plastic surgery, and to assess its effectiveness at improving confidence to the specialty among junior trainees. Methods: The one-day practical session covered knot tying, suturing, LA administration, skin lesion excision and local flaps, with short concurrent lectures on principles of plastic surgery. Self-assessment confidence scores were recorded before and after the course on seven domains: a) knowledge: wound assessment and management, suture selection, and concepts of flaps;b) practical skills: Handling of surgical instrument, suturing, LA administration, and skin lesion excision. Results: Thirty-five participants attended: Six core surgical trainees, fifteen foundation doctors, and fourteen medical students. The overall course satisfaction was 9.13/10. Self-assessment confidence scores in all domains significantly improved after the course (p < 0.0001). Suturing (58.6%) and skin lesion excision (74.5%) demonstrated the largest improvement. Qualitative feedback was extremely positive. Conclusions: The hands-on nature of the course offered participants great opportunities to acquire the necessary confidence and practical skills required for in-hospital placements. It is vital for students and doctors interested in a career in plastic surgery to prepare adequately for this diverse specialty, which is covered in limited depth in medical school. The need for more practical skills courses on plastic surgery for this demographic is intuitive.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
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This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1. The both sides or one side of sponge was treated with ultraviolet (UV) irradiation for 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge showed very slow elution properties. On the other hand, the single-sided UV-irradiated sponge showed initially fast elution and subsequent very slow elution properties. Such initially fast elution of collagen molecules from the surface without UV-irradiation allows an adhesion of collagen sponge to the wound surface and results in hemostatic effect. In addition, the water absorption and retention properties of sponge were investigated by placing the hydrated sponge on a mesh for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge absorbed 81 times more water than own weight and showed a value of 45 times even after 7 days. The single-sided UV-irradiated sponge absorbed 80 times more water than own weight and showed a value of 39 times even after 7 days. The sponge with high water absorption and retention properties allows a wound healing effect because such sponge can absorb large amounts of blood plasma and exudates containing various cell growth factors. The double-sided UV-irradiated sponge is a good candidate for the wound dressing. On the other hand, the single-sided UV-irradiated sponge is a good candidate for the hemostatic material.
文摘BACKGROUND As artificial intelligence(AI)continues to expand across medical specialties,its application in medical imaging within plastic and reconstructive surgery(PRS)remains limited in the literature.Imaging plays a critical role in surgical planning,intraoperative decision-making,and postoperative monitoring in PRS,presenting an opportunity for AI to enhance clinical outcomes.AIM To evaluate the current applications of AI in medical imaging for plastic surgery,with a focus on its use in preoperative planning,intraoperative guidance,and postoperative monitoring.METHODS A literature search was conducted using MEDLINE,EMBASE,ScienceDirect,and OVID up to February 2025.Studies were included based on relevance to AI use in plastic surgery imaging.Extracted data included AI modality,surgical context,outcomes,and limitations.The search followed PRISMA guidelines and was registered with PROSPERO(CRD420251008741).RESULTS AI tools have improved preoperative planning through three-dimensional vascular mapping,augmented reality,and thermographic imaging.Intraoperatively,AI-enabled navigation and robotic systems have increased surgical precision.Postoperative AI applications,including deep learning algorithms and sensorbased monitoring,support early complication detection and wound healing assessment.However,persistent barriers include data variability,model generalizability,surgeon unfamiliarity,and lack of regulatory standards.CONCLUSION AI-driven imaging technologies show promise in enhancing decision-making and outcomes in PRS.To ensure safe clinical integration,future efforts must focus on structured validation,standardization,and ethical oversight.
文摘《Chinese Journal of Plastic and Reconstructive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编,编辑部设在上海交通大学医学院附属第九人民医院整复外科。
文摘《Chinese Journal of Plastic and Reconstructive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编,编辑部设在上海交通大学医学院附属第九人民医院整复外科。本刊现已被Scopus、DOAJ、Science Direct,以及万方数据库、中国知网等数据库全文收录。
文摘《Chinese Journal of Plastie and Reconstruetive Surgery》(《CJPRS》)是我国整形外科和修复重建专业领域第1本正式获批的英文版学术期刊,于2019年正式出版发行。本刊由李青峰教授担任主编,林晓曦教授担任共同主编.编辑部设在上海交通大学医学院附属第九人民医院整复外科。
文摘Reconstructive defects of the human face pose unique challenges to even the most experienced surgeon given their myriad of presentations and the individuality of each patient’s anatomy,clinical presentation,and perspective or preferences.A robust armamentarium of reconstructive options must be cultivated for each facial subunit so that experience and artistry can be best utilized to rebuild the patient’s structure and function.This review will outline a subset of local rotation and transposition flaps that are most useful for facial reconstruction,organized by facial subunit.
文摘<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. <strong>Objectives: </strong>Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). <strong>Methods: </strong>A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. <strong>Results: </strong>A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. <strong>Conclusion:</strong> Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.
文摘Myofibroblastic sarcoma(MS)is a rare malignant soft tissue tumor characterized by myofibroblasts.It most commonly arises in the head and neck region,especially the tongue,with rare occurrences in the limbs.MS exhibits varying histopathology,ranging from low-to high-grade,with diverse subtypes showing different clinical behaviors and prognoses.This article reports the first case of high-grade MS in the hand,adding to the limited documentation of this rare condition.Here,we present the case of a 30-year-old healthy female with a year-long history of progressive shortening,mobility loss,and weakness in the first finger of the left hand.Left-hand imaging revealed a lytic,cottony tumor involving the entire first metacarpal.Following surgical resection,which included metatarsal grafting and joint reconstruction,a diagnosis of high-grade MS was confirmed based on histological manifestations and immunohistochemical staining,which was further classified as grade 2 according to the French Federation of Cancer Centers Sarcoma Group system.Postoperative radiotherapy was administered and the patient experienced a successful recovery without graft osteonecrosis.The patient regained 90%mobility and strength,without shortening,after surgical resection and radiotherapy.Six months post-surgery,the patient reported full hand functionality.MS is a rare tumor that infrequently affects bones and is often misdiagnosed owing to its controversial characteristics.The initial treatment should focus on complete resection with negative margins,followed by reconstructive surgery to preserve function.Further case studies are needed to establish standardized surgical treatment protocols.
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。
文摘Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several elective surgical procedures available for both conditions,such as neuroma excision followed by nerve reconstruction,nerve relocation,e.g.,surgically implanting a transected nerve into a muscle,nerve transfers in cases of associated paralysis,and most recently,regenerative peripheral nerve interface surgery.Whenever possible in the post-conflict phase,a coordinated effort between traveling humanitarian surgeons specializing in reconstructive microsurgery and local healthcare providers is essential for successfully treating phantom and chronic residual limb pain in post-conflict amputees.While providing a detailed logistical framework for global humanitarian missions is beyond the scope of this article,we provide a brief perspective on a topic of utmost importance for reconstructive surgeons worldwide:the high-quality care and treatment of refugees and those whose lives have been impacted by conflict,disaster,or displacement.
文摘<strong>Introduction: </strong>Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. <strong>Objectives:</strong> To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years.<strong> Materials and Methods:</strong> Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. <strong>Results:</strong> 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. <strong>Conclusion:</strong> Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.
文摘Large-scale defects of body in the reconstructive surgical practice,and the help-lessness of their repair with autologous tissues,have been an important factor in the development of artificial biological products for the temporary,definitive,or staged repair of these defects.A major advance in the field of plastic and other reconstructive surgery in this regard has been the introduction and successful use of acellular dermal matrices(ADMs).In recent years,not only the type of tissue from which ADMs are produced,product range,diversity and areas of use have increased,but their use in reconstructive fields,especially in post oncologic breast surgery,has become highly regarded and this has favored ADMs to be a potential cornerstone in specific and well-defined surgical fields in future.It is essential that reconstructive surgeons become familiar with some of the ADM’s as well as the advantages and limitations to their use.This review not only provides basic science and clinical evidence of the current use of ADMs in wide range of surgical fields but also targets to keep them as an important backdrop in the arma-mentarium of reconstructive surgeons.Brief considerations of possible future directions for ADMs are also conducted in the end.
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Purpose: Ablative options, beyond mastectomy, for large breasted patients with breast cancer include oncoplastic resection via reduction pattern and standard lumpectomy. Oncoplastic resection also entails a contralateral procedure for symmetry and the potential benefit of a superior cosmetic outcome. Our aim was to examine the cost-effectiveness of this treatment strategy comparing it to standard lumpectomy in treating breast cancer patients. Methods: A literature review was performed of the probabilities and outcomes related to treatment of unilateral breast cancer via oncoplastic resection or unilateral lumpectomy. Utility score surveys were used to estimate the quality adjusted life years (QALYs) associated with a successful procedure, additional margins excision and post-operative complications. A decision analysis tree was developed to highlight the more cost-effective strategy. An Incremental Cost-Utility Ratio (ICUR) was calculated. Sensitivity analysis was performed to check the robustness of our data. Results: Oncoplastic resection was associated with fewer positive margins relative to standard lumpectomy (10.0% versus 18%). In cases with positive margins, a greater percentage of oncoplastic resection patients chose a mastectomy compared to the lumpectomy patients (72% versus 19%). Utility scores for a successful operation favored oncoplastic resection (92.6 versus 86.55), but in instances of positive margins, favored the lumpectomy patients (74.2 versus 70.2). Decision tree analysis revealed that oncoplastic resection was more cost-effective with an ICUR of $2609.66/QALY gained. Conclusion: Oncoplastic resection represents a cost-effective strategy for the large breasted patient and provides the surgical team yet another reasonable option for the appropriate patient.
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.
文摘Nail changes following upper extremity transplantation(UET)cannot be overlooked as they possess diagnostic and prognostic relevance in allotransplantation of upper limbs.This comprehensive review explores nail and nail bed related changes encountered in UET recipients in the literature.The differential diagnosis of nail abnormalities in UET includes a wide range of systemic,local and iatrogenic conditions other than immune responses to the allograft.It requires interdisciplinary evaluation by primary transplant surgeons,pathologists,dermatologists and immunologists.The possible underlying mechanisms of nail pathology in UET and the management are discussed.It also underscores the importance of onychodystrophy and need for timely intervention and to improve outcomes in UET recipients.
文摘Objectives: The current medical school curriculum offers scant exposure to plastic surgery. Medical students and junior doctors are often inadequately prepared for in-hospital placements which may impact on patient safety and quality of care. We aimed to deliver a one-day “hands-on” practical session on basic surgical skills and principles in plastic surgery, and to assess its effectiveness at improving confidence to the specialty among junior trainees. Methods: The one-day practical session covered knot tying, suturing, LA administration, skin lesion excision and local flaps, with short concurrent lectures on principles of plastic surgery. Self-assessment confidence scores were recorded before and after the course on seven domains: a) knowledge: wound assessment and management, suture selection, and concepts of flaps;b) practical skills: Handling of surgical instrument, suturing, LA administration, and skin lesion excision. Results: Thirty-five participants attended: Six core surgical trainees, fifteen foundation doctors, and fourteen medical students. The overall course satisfaction was 9.13/10. Self-assessment confidence scores in all domains significantly improved after the course (p < 0.0001). Suturing (58.6%) and skin lesion excision (74.5%) demonstrated the largest improvement. Qualitative feedback was extremely positive. Conclusions: The hands-on nature of the course offered participants great opportunities to acquire the necessary confidence and practical skills required for in-hospital placements. It is vital for students and doctors interested in a career in plastic surgery to prepare adequately for this diverse specialty, which is covered in limited depth in medical school. The need for more practical skills courses on plastic surgery for this demographic is intuitive.
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.
