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Transcriptomic and machine learning analyses identify hub genes of metabolism and host immune response that are associated with the progression of breast capsular contracture

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Genes & Diseases 2024年第3期11卷 427-437页

作者： Yukun Mao Xueying Hou Su Fu Jie Luan Breast plastic and reconstructive surgery Center Plastic Surgery HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100144China

Capsular contracture is a prevalent and severe complication that affects the post-operative outcomes of patients who receive silicone breast *** present,prosthesis replacement is the major treatment for capsular contracture after both breast augmentation procedures and breast reconstruction following breast cancer ***,the mecha-nism(s)underlying breast capsular contracture remains *** study aimed to identify the biological features of breast capsular contracture and reveal the potential underlying mechanism using RNA *** tissues from 12 female patients(15 breast capsules)were divided into low capsular contracture(LCC)and high capsular contracture(HCC)groups based on the Baker ***,41 lipid metabolism-related genes were identified through enrichment analysis,and three of these genes were identified as candidate genes by SVM-RFE and LASSO *** then compared the proportions of the 22 types of im-mune cells between the LCC and HCC groups using a CIBERSORT analysis and explored the Cor-relation between the candidate hub features and immune ***,PRKAR2B was positively correlated with the differentially clustered immune cells,which were M1 macro-phages and follicular helper T cells(area under the ROC=0.786).In addition,the expression of PRKAR2B at the mRNA or protein level was lower in the HCC group than in the LCC *** molecular mechanisms were identified based on the expression levels in the high and low PRKAR2B *** findings indicate that PRKAR2B is a novel diagnostic biomarker for breast capsular contracture and might also influence the grade and progression of capsularcontracture.

关键词： Biomarker Breastcapsular contracture Immune infiltration Machinelearning algorithms PRKAR2B

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A long-term histological research on human frontalis muscle flap specimens from recurrent blepharoptosis patients

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1161-1163页

作者： Lu Zhou Yu-Cheng Yan Jin-Cai Fan Department of plastic and reconstructive surgery Plastic Surgery HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100144China

Dear Editor,We present two patients with recurrent severe blepharoptosis after frontalis muscle(FM)flap *** we describe long-term histological changes of the FM flaps observed in revision *** flap suspension is widely applied in treating severe ptosis with poor levator function(surgery flaps which could reflect trends of morphological changes within the functioning FM flaps to some extent.

关键词： patients histological surgery

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Malignant triton tumor in the abdominal wall:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1467-1473页

作者： Ho Jik Yang Donghyun Kim Won Suk Lee Sang-Ha Oh Department of plastic and reconstructive surgery Chungnam National University Sejong HospitalSejong 30099South Korea Department of plastic and reconstructive surgery Chungnam National University HospitalDaejeon 35015South Korea Department of Emergency Eulji University HospitalDaejeon 35233South Korea Department of plastic and reconstructive surgery Chungnam National University College of MedicineDaejeon 35015South Korea

BACKGROUND Malignant triton tumors(MTTs)comprise a subgroup of malignant peripheral nerve sheath tumors(MPNSTs)that exhibits rhabdomyosarcomatous differen-tiation and follow an aggressive *** are primarily located along peripheral *** of MTTs in the abdominal wall have not been *** has a poorer prognosis than classic MPNSTs,and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis *** for MTTs mirrors that for MPNSTs and is predominantly *** SUMMARY A 49-year-old woman presented with a subcutaneous mass in her lower abdo-minal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the *** had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the *** computed tomography(CT)showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis *** was no sign of metastasis(T1N0M0).An incisional biopsy identified sporadic MTT of the lower abdomen.A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was ***-quently,the general surgeon utilized an approach akin to the open peritoneal onlay mesh *** patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin *** complications arose,and annual follow-up CTs did not show signs of recurrence or *** An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction,eliminating the need for postoperative radiotherapy.

关键词： Malignant triton tumor Abdominal wall Surgical excision Reconstruction Case report

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reconstructive surgery for phantom and residual limb pain in post-conflict settings

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Chinese Journal of plastic and reconstructive surgery 2024年第1期6卷 54-55页

作者： Damián Palafox plastic and reconstructive surgery Department Hospital Angeles PueblaPuebla 72190Mexico

Traumatic amputations remain one of the most frequent and disturbing wounds of armed *** this scenario,most amputees develop residual and phantom limb pain,impacting their quality of *** 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 *** 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 *** 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.

关键词： Residual limb pain Phantom limb pain Refugees reconstructive surgery Microsurgery Amputees

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Ultrasound-assisted isolation:A new method to isolate stromal vascular fraction

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Chinese Journal of plastic and reconstructive surgery 2024年第1期6卷 8-15页

作者： Yiming Gao Xiaojie Zhang Poh-Ching Tan Yun Xie Peiqi Zhang Tianyu Zhang Qingfeng Li Shuangbai Zhou Department of plastic and reconstructive surgery Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai200011China Department of burns and plastic surgery Shanghai Changzheng HospitalShanghai200003China College of Life Sciences Shanghai Normal UniversityShanghai200233China

Background:The stromal vascular fraction(SVF),a cluster of stem and progenitor cells isolated from adipose tissue,holds significant promise for application in regenerative ***,the existing methods for SVF isolation are time-consuming and ***,in this study,we explored a new method of SVF extrac-tion-ultrasound-assisted SVF isolation(USASI)-and compared the viability and characteristics of SVF isolated using different ***:SVF extraction methods using different combinations of ultrasound power,ultrasound time,collagenase dosage,and collagenase digestion time were compared with those of the control group(collagenase digestion method).The cell yield and vitality of the SVF were evaluated via cell counting and trypan blue *** cell components and immunophenotypes of freshly isolated SVF were analyzed using flow *** prolifer-ative capacity and differentiation potential of the SVF were also ***:Ultrasonication at 95 W-20 kHz for 30 s followed by digestion with 0.15%collagenase for 30 min was identified as the most suitable parameter for the USASI method in isolating SVF,as recommended based on the evaluation of various tested *** USASI method significantly reduced the collagenase dosage and shortened the digestion *** to the collagenase digestion method,the USASI method had a higher cell yield and cell viability,with no adverse effects on cell components,proliferative capacity,or multipotential differentiation ***:With reduced processing time,lower collagenase dosage,and increased cell yield without impairing the viability and characteristics of SVF,USASI holds the potential to emerge as a time-saving and cost-effective method for future clinical applications.

关键词： Stromal vascular fractions SVF isolation Mechanical force Ultrasound

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Reconstruction of cervical necrotizing fasciitis defect with the modified keystone flap technique:Two case reports

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World Journal of Clinical Cases 2024年第7期12卷 1305-1312页

作者： Wonseok Cho Eun A Jang Kyu Nam Kim Department of plastic and reconstructive surgery Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoul 03181South Korea

BACKGROUND Cervical necrotizing fasciitis(CNF)is a rare,aggressive form of deep neck space infection with significant morbidity and mortality *** surgical debridement acts as the cornerstone of CNF treatment;however,it often results in defects requiring complex *** SUMMARY We report two cases in which the keystone flap(KF)was used for CNF defect coverage:Case 1,an 85-year-old patient with CNF in the anterior neck,and Case 2,a 54-year-old patient with CNF in the posterior *** patients received empirical intravenous antibiotic therapy and underwent serial debridement,enabling adequate wound preparation and *** final defect size measured 5.5 cm×12 cm in Case 1 and 6 cm×11 cm in Case *** defect coverage,we employed an 8 cm×19 cm type II KF based on perforators from the superior thyroid artery in Case 1 and a 9 cm×18 cm type II KF based on perforators from the transverse cervical artery in Case *** flaps showed complete *** postoperative complications occurred in both cases,and favorable outcomes were observed at 7-and 6-month follow-ups in case 1 and 2,*** We effectively treated CNF-associated defects using the KF technique;KF is viable for covering CNF defects in carefully selected cases.

关键词： Fasciitis Necrotizing Debridement plastic surgery Dermatologic surgical procedures Case report

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Piezoelectric film promotes skin wound healing with enhanced collagen deposition and vessels regeneration via upregulation of PI3K/AKT

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Nano Research 2024年第8期17卷 7461-7478页

作者： Qi Xu Wufei Dai Peizhe Li Qinglin Li Zhen Gao Xiaoli Wu Wei Liu Wenbo Wang Department of plastic and reconstructive surgery Shanghai Key Laboratory of Tissue EngineeringShanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200011China Research Institute of plastic surgery Shandong Second Medical UniversityWeifang 261000China Department of surgery Air Force Medical CenterPLABeijing 100142China

Skin wounds are common in accidental injuries,and the intricacies of wound repair are closely linked to endogenous electric *** stimulation plays a pivotal role in the restorative processes of skin injuries,encompassing collagen deposition,angiogenesis,inflammation,and *** electrical stimulation therapy replicates and enhances the effects of endogenous wound electric fields by applying an external electric field to the wound site,thereby promoting skin wound *** this study,we developed a self-powered repetitive mechanical impacts-electrical stimulation(RMI-ES)system utilizing a BaTiO_(3)/polydimethylsiloxane(PDMS)piezoelectric composite *** to conventional electrical stimulation devices,the fabricated piezoelectric composite film efficiently harvests energy from the pressure applied by the stimulation device and the tensile force occurring during natural rat *** results demonstrated that piezoelectric stimulation generated by the composite membrane expedited the cell cycle,promoting fibroblast ***,piezoelectric stimulation induced favorable changes in fibroblast gene expression,including increased expression of transforming growth factor-β1(TGF-β1),connective tissue growth factor(CTGF),collagen 1,collagen 3,vascular endothelial growth factor(VEGF),and alpha-smooth muscle actin(α-SMA),while reducing interleukin-6(IL-6)*** analysis revealed that piezoelectric stimulation may induce fibroblast migration,proliferation,and collagen expression by influencing PI3K/AKT serine/threonine kinase(AKT)*** confirmation through the addition of the PI3K inhibitor LY294002 validated that piezoelectric stimulation can regulate the repair process after skin injury through the ***,in vivo results demonstrated that the electric field at the wound site effectively promoted wound healing,reduced inflammation,and stimulated collagen deposition and ne

关键词： BaTiO3/polydimethylsiloxane(PDMS)nano-composite membrane piezoelectrical stimulation skin wound healing collagen deposition PI3K/AKT serine/threonine kinase(AKT)signaling pathway

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Pedicled abdominal flap using deep inferior epigastric artery perforators for forearm reconstruction: A case report

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World Journal of Clinical Cases 2024年第4期12卷 828-834页

作者： Jae Hyung Jeon Kyung Wook Kim Hong Bae Jeon Department of plastic and reconstructive surgery Dankook University HospitalCheonan 31116ChungnamSouth Korea Department of Orthopaedic surgery Dankook University HospitalDankook University College of MedicineCheonan 31116ChungnamSouth Korea Department of plastic and reconstructive surgery Dankook University HospitalDankook University College of MedicineCheonan 31116ChungnamSouth Korea

BACKGROUND Pedicled abdominal flaps are a widely used surgical technique for forearm reconstruction in patients with soft tissue ***,some drawbacks include restricted flap size,partial flap loss,and donor-site *** address these concerns,we present a case of a pedicled abdominal flap using the deep inferior epigastric artery perforators(DIEP)for forearm reconstruction in a patient with a large soft tissue *** SUMMARY A 46-year-old male patient was admitted to our hospital with forearm injury caused by a pressing machine.A 15 cm×10 cm soft tissue defect with complete rupture of the ulnar side structures of the forearm was *** week after orthopedic management of the neurovascular injury and fractures using the first stage of Masquelet technique,the patient was referred to the plastic and recon-structive surgery department for wound *** debridement and negative-pressure wound therapy revealed a 20 cm×15 cm soft tissue defect.A pedicle abdominal flap with the DIEP was used to cover the *** weeks later,the flap was detached from the abdomen,and the abdominal defect was directly ***,the second stage of Masquelet technique was performed at the fracture site at week ***,all donor and recipient sites healed without complications,such as flap dehiscence,infection,hematoma,or *** site osteosynthesis was achieved without *** Pedicled abdominal flap using the DIEP provides a reliable option for forearm reconstruction in patients with large soft tissue defects.

关键词： Forearm injury Open fracture reduction Perforator flap Deep inferior epigastric artery perforators Case report

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Dual innervation method to preserve erectile function following prostatectomy

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Chinese Journal of plastic and reconstructive surgery 2024年第3期6卷 159-160页

作者： Nadia Hui Shan Sim Allen Sim Dayna Sim Bien-Keem Tan Allen Wei-Jiat Wong plastic Reconstructive and Aesthetic Surgery ServiceSengkang General Hospital544886Singapore Department of Urology Mount Alvernia Hospital Singapore574623Singapore Department of General surgery Sengkang General Hospital544886Singapore Department of plastic Reconstructive and Aesthetic SurgerySingapore General Hospital169608Singapore

Prostate cancer is the second most prevalent cancer in ***-assisted radical prostatectomy(RARP)has altered the landscape of prostate cancer *** the excellent oncological outcomes associated with RARP,the rate of erectile dysfunction(ED)remains *** repair of disrupted cavernous nerves with interpositional nerve grafts has been described;however,the outcomes have been *** hypothesize that this is attributed to Schwann cell atrophy and axonal regeneration limitations caused by long nerve *** proposed the use of nerve transfer to support axonal regrowth via an inter-positional graft with additional donor axons.A cadaveric study was performed to evaluate the anatomical feasibility of a vastus lateralis nerve(VLN)transfer to the distal recipient cavernous nerve *** VLN is long with multiple branching patterns that allow tension-free coaptation of the cavernous *** postulate that a dual innervation method using VLN nerve transfer together with interpositional nerve graft repair of the transacted cavernous nerves may improve the outcomes of ED post-RARP.

关键词： Erectile dysfunction Prostatectomy Interposition nerve graft Nerve transfer Vastus lateralis nerve

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Vascularized lymph node transfer using axilla as recipient site restores lymphatic flow in upper limb lymphedema:Evidence from magnetic resonance lymphangiography

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Chinese Journal of plastic and reconstructive surgery 2024年第1期6卷 1-7页

作者： Zhaohua Jiang Ziyou Yu Shengli Li Department of plastic and reconstructive surgery Shanghai Ninth People’s HospitalShanghai Jiao Tong UniversityShanghai200011China

Background:Lymphedema is a debilitating condition that frequently occurs after breast cancer ***-cularized lymph node transfer(VLNT)is a promising approach to reduce *** study used magnetic resonance lymphangiography(MRL)to assess lymphatic reconnections post-VLNT in patients with breast cancer-related lymphedema(BCRL).Methods:The clinical records of six female patients with unilateral upper limb BCRL who underwent VLNT(4 cases)or VLNT combined with breast reconstruction(2 cases)were retrospectively *** patients were examined using MRL preoperatively and at the 1-year *** morphological characteristics of the lymphatic network,dermal backflow patterns,and architecture of the lymph nodes were *** outcomes,patient satisfaction,and complications were ***:At the 1-year follow-up,reduction in tissue edema and limb circumference was achieved in all six *** MRL,the implanted lymph nodes in the axillary region of the affected upper arm were enhanced and visualized in all six *** lymphatic vessels in the subcutaneous tissue associated with the implanted lymph nodes were observed in four *** dermal backflow and lymphatic vessel dilation of the affected limbs were observed in all six *** disruption of the lymph flow in the donor area was ***:This is the first study to provide direct imaging evidence for the reconnection of afferent lymphatic channels between implanted lymph nodes and the recipient lymphatic system in patients with ***,our study demonstrates the mechanism and efficacy of VLNT in reducing lymphedema.

关键词： Magnetic resonance lymphangiography Vascularized lymph node transfer Breast cancer Lymphedema

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