Donor-Site Morbidity Following Harvest of Autologous Costal Cartilage in Microtia Reconstruction

Objectives: The objective of this study is to evaluate donor-site morbidity after costal cartilage harvest for microtia reconstruction. Methods: A total of 70 patients who underwent autologous costal cartilage harvest for microtia reconstruction from March 2008-March 2009 were included. Anterior chest wall deformity was evaluated with chest topography, and scar quality at baseline and at 6-months follow-up, and final outcomes analyzed with SPSS. Results: In 70 patients, 52 (74%) were male, 18 (26%) were female, and altogether 40 (57%) patients developed deformity. At 6-month follow-up, the incidence of anterior chest wall deformity was highest at 80% in Block-III, and least at 0% in Block-I. The 6 - 10 years age group was the largest group at 84% (21), and also with highest incidence of deformity in association to Block-IV harvest at 83%. The incidence of donor-site deformity was higher in female gender at 66%, and 54% in males. But in the sub-group, male had higher incidence of deformity at 75% in both Block-III, and Block-IV when compared to the respective females. The 120 - 135 cm height group had the highest deformity at 67% with Block-IV costal cartilages harvested. At the three measurement points: 1) xiphisternum, 2) intersecting points between PSL and LCM, and 3) intersecting points between MCL and LCM, significant differences (mean) were observed in chest circumference from baseline to 6-month follow-up, and between the left and right chest hemi-circumference (postoperatively). Acceptable donor-site scar was observed in all but 3% (2) developed hypertrophic scar. Conclusion: The development of chest wall deformity was observed when more than one costal cartilage was harvested, particularly the 6th (complete), 7th, 8th block. Therefore, to minimize the deformity, we recommend harvesting only the necessary amount of cartilage, and at the lowest level possible to avoid injury of costochondral junction. Additionally, age, height, gender and chest development are equally important factors which influence donor-site deformity in microtia reconstruction.

The application of the strip-shaped cymba conchae orthosis in the nonsurgical correction of complex auricular deformity

Objective: This study aims to evaluate the efficacy and safety of using a strip-shaped cymba conchae orthosis for the nonsurgical correction of complex auricular deformities. Methods: Clinical data were collected from 2020 to 2021 for 6 patients who underwent correction using a stripshaped cymba conchae orthosis. The indications, corrective effects, and complications associated with use of the orthosis were analyzed. Results: There were four indications for treatment: cryptotia with helix adhesion;cryptotia with grade I microtia;cryptotia with excessive helix thickness;and auricular deformity beyond the treatment time window(≥6 months). Excellent corrective effects were observed in all 6 patients. Complications occurred in one patient, who recovered after symptomatic treatment. Conclusion: The use of a strip-shaped cymba conchae orthosis alone or combined with a U-shaped helix orthosis presents a feasible approach for correcting complex auricular deformities or deformities beyond the treatment time window in pediatric patients.

RAPD analysis of genetic diversity of nine strains of Auricularia auricular cultivated in Heilongjiang Province

Polymorphism of nine strains （CF05, CF09, 29, 916, AU9, Chang10, Chang7, 8808 and AU. Japanese） of A. auricular cultivated in Heilongjiang Province were analyzed by RAPD （Random Amplication polymorphic DNA）. Thirteen primers were selected from forty PCR primers with 10bp long random primer. The results showed that nine strains of A. auricular have a high level of genetic diversity and the percentage of DNA polymorphic was 96.05. The genotypes of 9 strains of Auricularia auricular were identified by the fingerprints from primer 27 and primer 46 by RAPD analysis. The results are helpful for quickly identifying strains of A. auricular in its early breeding time, and also provides a powerful theoretic basis to differentiate strains （Auricularia auricular） whose morphology is very similar in breeding programs of edible fungus.

Ear keloid and epidermal cyst following auricular cartilage harvest for rhinoplasty:A case report

BACKGROUND This case report highlights a rare instance of concurrent keloid and epidermal cyst development at an ear cartilage harvest site following rhinoplasty in a 25-year-old woman.Both conditions,which typically stem from skin trauma,seldom occur together,demonstrating the exceptional characteristics of this case.CASE SUMMARY The patient underwent successful surgical removal of both the keloid and the epidermal cyst.Postoperative treatment included the use of silicone sheets,gel,and oral tranilast to reduce scarring.No recurrence was observed over a 6-mo follow-up period,indicating effective management of the condition.CONCLUSION The effective management of complex skin trauma cases underscores the need for individualized treatment strategies in plastic surgery.

Application of an electrophysiological technique combined with auricular acupuncture in gynecological perioperative gastrointestinal dysfunction

Objective:This study aimed to evaluate the effectiveness and safety of combining low-frequency pulsed electrophysiological techniques with auricular acupuncture(a fusion of traditional Chinese and Western medicine)for patients experiencing perioperative gastrointestinal dysfunction(POGD)following gynecological surgery.Methods:Eighty patients undergoing gynecological surgery were randomly assigned to an experimental group and a control group.Both groups received enhanced recovery after surgery(ERAS)care,with the experimental group receiving additional treatment combining electrophysiology and auricular acupuncture.Postoperative recovery indicators,including bowel sound recovery time,time to first exhaust and defecation,duration and incidence of abdominal pain and distension,nausea and vomiting,and specific gastrointestinal markers(HSP70,I-FABP,DAO,D-lactate),were monitored and compared between the two groups.Results:After treatment,the postoperative bowel sound recovery time,first postoperative exhaust time,duration of abdominal pain,and duration of abdominal distension were shorter in the experimental group than in the control group(P<0.05).The 6-hour and 48-hour integral values of the experimental group were significantly lower than those of the control group.In the experimental group,60%of the patients were completely cured of gastrointestinal function after surgery,whereas only 32.5%of the patients in the control group were cured.The main symptom scores(abdominal pain,abdominal distension,nausea and vomiting)on the third postoperative day and the total symptom scores on the third postoperative day were significantly lower in the experimental group than in the control group(P<0.05).The values of HSP70,I-FABP,DAO,and D-lactate in the experimental group on postoperative day one were significantly lower than those in the control group(P<0.05).Conclusion:The combination of the Chinese and Western medicine ERAS programs of low-frequency pulse electrophysiology technology plus auricular acupuncture can accelerate local gastrointestinal blood circulation during the perioperative period of gynecology,promote the recovery of gastrointestinal function,promote anal exhaustion,and prevent the occurrence of postoperative abdominal pain and bloating.The combination of Chinese and Western medicine ERAS can increase gastrointestinal fluid secretion,increase gastrointestinal hormone and blood flow values,increase gastrointestinal electrophysiological detection values,and change the indicators of gastrointestinal dysfunction.

Effect of Head Meridian Massage Combined with Auricular Acupoint Plaster on Patients with Insomnia

Objective:To study the effect of head meridian massage combined with auricular acupoint plasters on patients with insomnia.Methods:The sample consisted of 50 cases,and all of them were admitted to Yixing Hospital of Traditional Chinese Medicine from January 2022 to December 2023.The patients were divided into an observation group and a control group,with 25 cases in each group.The observation group was treated with a combination of head meridian massage and auricular acupoint plaster while the control group underwent conventional nursing care.The improvement of sleep quality and nursing effect were used as evaluation criteria to compare the clinical effects of the nursing programs.Results:After nursing intervention,the Pittsburgh sleep quality index(PSQI)score of the observation group,which was 7.17±1.41 points was lower than that of the control group(9.04±1.96 points),(t=3.8724,P<0.05).The total efficacy was 96.00%for the observation group and 76.00%for the control group(2=4.1528,P<0.05).Conclusion:Head meridian massage combined with auricular acupoint can improve the sleep quality of patients with insomnia.

Evaluation of the Efficacy of Auricular Acupoint Pressure Patch Combined with Modified Huangqi Decoction in Treating Diabetic Nephropathy

Objective:To explore the efficacy of auricular acupoint pressure patch combined with modified Huangqi Decoction in treating diabetic nephropathy.Methods:60 patients with diabetic nephropathy treated in our hospital from January 2021 to December 2022 were selected for this study.The patients were randomly divided into two groups using the random number table method,with 30 patients in each group.Among them,the control group was treated with conventional Western medicine,while the experimental group was treated with auricular acupoint pressure patches combined with modified Huangqi Decoction.The patients’fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),urinary protein quantification,urea nitrogen(BUN),serum creatinine(SCr),and other indicators were detected and recorded before and after treatment.Results:Before treatment,there was no statistically significant difference in the FPG,the 2hPG,and the HbA1c between the two groups of patients(P>0.05);after treatment,the FPG,the 2hPG,and the HbA1c of the patients in the experimental group were significantly lower than those in the control group(P<0.05).Before treatment,there was no statistically significant difference in the urinary protein quantification,the BUN,and the SCr between the two groups of patients(P>0.05);after treatment,the urinary protein quantification,BUN,and SCr of the patients in the experimental group were significantly lower than those in the control group(P<0.05).The experimental group showed better improvement in symptoms such as fatigue,backache,and frequency of nocturia(P<0.05).Conclusion:Auricular acupoint pressure patch combined with modified Huangqi Decoction effectively treats diabetic nephropathy and it helps control blood sugar and renal function indicators and improve clinical symptoms,therefore improving the patients’quality of life.

Cloning and Sequence Analysis of ras Promoter from Auricuralia auricular Strain YBS-3

[Objective] The ras promoters were cloned from genomic DNA of Auricuralia auricular so as to provide promoters for breeding better species by genetic technology. [Method] PCR was used to clone promoters with the genomic DNA of A. auricular strain YBS-3 as template,and then the sequences of four ras promoters were obtained. The analysis of promoter sequences was made by three promoter analysis software：Promoter prediction,Place and TFSEARCH ver.1.3. [Result] Four fragments contained core elements of promoter including TATA-box and CAAT-box,and many other important cis-elements such as GATA BOX,GCGC BOX,CCAAT BOX1,etc. At the same time,there was at least one transcriptional start site in these sequences. And several transcription factor binding sites were detected in these sequences. [Conclusion] Four promoter fragments all had promoter function theoretically.

Self-experience of buried seeds at auricular points in depressive patients with sleep disorder: a qualitative research

Objective To explore the self-experience of burying seeds at auricular points in depressive patients with sleep disorder,so as to seek possible approaches to improve the quality of care.Methods Eleven patients involved in a three-week randomized controlled clinical trial were purposefully interviewed by the experienced,qualified counselor.The process of thematic analysis was applied in this study,the self-experience was discussed and recorded,transcribed,and analyzed accordingly.Results Four themes related to self-experience were extracted,these included the deficiency in relevant support,passive acceptance,distrust,expectation and further advice.Conclusion There was an urgent demand of humane care and emotional support,which might improve compliance of the treatment to some extent in terms of health education.Additionally,medical practitioners should provide the patient with comprehensive support,professional health education,as well as standardize training program for TCM operator and control the operation’s quality.

STUDY ON THE THERAPEUTIC EFFECT AND MECHANISMS OF AURICULAR ACUPUNCTURE FOR TREATMENT OF EXPERIMENTAL DIABETES MELLITUS IN THE RABBIT

In the present study, fasting blood glucose (FBG) concentration and serum insulin concentration and changes of the ultramicrostructure of the pancreatic islet cells are used as the indexes to evaluate the therapeutic effect of auricular acupuncture in the treatment of experimental diabetes mellitus (DM) and to analyze its mechanisms in the rabbit. Thirty-two rabbits are randomly divided into control, model, acupuncture and medication groups with 8 cases being in each group. DM model is established by intravenous injection of 4% Alloxan (150 mg/kg). Otopoints used are low-resistance points of Yidan (MA-SC 6), Neifenmi (MA-IC 3), Jiaogan (MA-AH 7), Fei (MA-IC 1), Wei (MA-IC), Shen (MA-SC), etc.. In medication group, the animals are fed with glybenzcyclamide, (1.25 mg/kg/day). The treatment of both groups is given once daily, 20 sessions altogether. Results display that after 2 courses of treatment (20 sessions), in comparison with pre-treatment and model group, FBG contents in acupuncture and medication groups decreased significantly (P<0.01), while insulin contents of acupuncture and medication groups increased remarkably (P<0.05). No significant differences between acupuncture and medication groups in FBG and insulin contents. Accordingly, electron microscopic observation shows some improvements in partial organells as lysosome being fewer, reduction of the nucleolar swelling, etc. in both acupuncture group and medication group. It shows that restoration of the structure of islet β-cells of the pancreas, increase of the synthesis and release of insulin as well as the activity of insulin may contribute to the effect of auricular acupuncture in lowering blood glucose level in DM rabbits.

Extraction,Physiochemical Properties and Antibacterial Activities of Polysaccharides from Auricularia auricular

[Objective] To explore the optimal conditions for extracting polysaccharide from Auricularia auricular, and to study its physiochemical properties and antibacterial activities. [ Method] The extraction conditions for Auricularia auricular polysaccharides were optimized by orthogonal test, and its physiochemical characteristics and antagonistic activities on bacteria and molds were tested. I-Result] The optimized condition was with sample to liquid ratio of 1 ： 50, temperature of 90 ℃ and extraction time of 2.5 h. Under the optimized condition, the yield of pelysaccharide was 7.3%, with polysaccharide content of 77.81%. Containing aldose and amylase, the polysaccharides of Auncu/aria auricular was soluble in water. The inhibitory effect on bacteria was significantly stronger than on molds that the minimum diameter of inhibition zone for bacteria is 12.7 mm, while 7.9 mm for the molds. [ Conclusion] This study provides scientific basis for the development and utilization of Auricularia auricular polysaccharides.

Antibacterial and antibiofi lm activity of peptide PvGBP2 against pathogenic bacteria that contaminate Auricularia auricular culture bags

Bacteria contamination in Auricularia auricular culture bags reduces yield and increases the risk of food safety.In this study,5 species of bacteria,mainly gram-positive bacteria including three species of Bacillus spp.,Arthrobacter arilaitensis and Staphylococcus warneri,were isolated and identifi ed from bacteria-contaminated A.auricular culture bags.An in silico predicted antimicrobial peptide from theβ-1,3-glucan-binding protein sequence of Penaeus vannamei,designated Pv GBP2(FLKLGRKSRYGMLKL),was screened and its antibacterial effect and mechanism of action on the isolated Bacillus spp.explored.The minimal inhibitory concentrations(MIC)of Pv GBP2 on Bacillus spp.were 15.6–31.25μg/m L.Peptide Pv GBP2 could inhibit Bacillus subtilis in A.auricular culture bags to maintain growth and yield of A.auricular.Transmission electron microscopy(TEM)revealed that Pv GBP2 kills bacteria by perforating the cell wall,destroying membrane integrity and resulting in the leakage of intracellular solutes.In addition,Pv GBP2 inhibits biofi lm formation by B.subtilis by 90.6%at 1×MIC.Thus,peptide Pv GBP2 could be potentially applied as an antibacterial agent to control bacterial infection of A.auricular cultivation and the spread of foodborne pathogens.

Effects of electroacupuncture at auricular concha area on the circadian rhythm of melatonin secretion in p-chlorophenylalanine-induced insomnia rats

Backgroud:The electroacupuncture of auricular concha area(EA-ACR)proved to have a good regulatory effect on insomnia and the release of melatonin,which is most closely related to sleep.However,there is little research to demonstrate the relationship between EA-ACR and melatonin.The objective of present study is to observe the effects of EA-ACR on the circadian rhythm of melatonin secretion in p-chlorophenylalanine(PCPA)-induced insomnia rats.Methods:The study divided 36 male Sprague-Dawley rats randomly into three groups:12 in blank group,12 in model group,and 12 in EA-ACR group.By using PCPA intraperitoneal injection for 2 days,insomnia model was established.EA-ACR group was treated for 28 days.We observed the effects of EA-ACR on the rats'behavioral changes,open-field test and weight during the experiment.After the experiment,the rat tail and heart blood were collected,and the melatonin was detected by enzyme-linked immunosorbent assay.Results:Compared with the blank group,28–30 hours after PCPA intraperitoneal injection,the circadian rhythm of sleep and the total sleep time of model rats decreased.Compared with the model group,electrical stimulation in the ear concha region could effectively reverse the behavioral changes of rats,and increase the trend of weight growth(P=0.010),the crossing score(P=0.014),vertical motion score(P=0.015)and the level of plasma melatonin secretion(P=0.020)with the trend showing a rhythmic pattern(0–60 minutes upward,60–120 minutes downward,120–150 minutes upward).Conclusion:EA-ACR can improve the quality of life(weight),ameliorate exploring irritable and anxiety behaviors in PCPA-induced insomnia rats.The underlying effects of EA-ACR may be excited on the circadian rhythm of melatonin secretion in PCPA-induced insomnia rats.

Treatment of microtia:past,present and future

The purpose of this review article is to review the reconstructive method available for the treatment of microtia and highlight the recent advances.The well established technique developed by Brent and Nagata are still must widely performed procedure for microtia reconstruction.Various modification of this technique has been reported in the literature.Synthetic framework is seen as an alternative to autogenous costal cartilage framework because of ease of the procedure.More recently,tissue engineering is seen as the most promising treatment.This article gives an overview of the current practice in the field of microtia reconstruction and summarizes the recent surgical developments and relevant tissue engineering research.

Contemporary solutions for patients with microtia and congenital aural atresia-Hong Kong experience

Managing microtia patients is always a challenge. Multidisciplinary approach, good family support, well established doctorepatient rela-tionship and well organised patient-support groups are the essential elements for success. With the advancement of implantable hearing devices, more options will be available for the microtia patients. Otologists play a leading role in the whole management process. They not only provide proper guidance to the patients in choosing the correct path of the treatment, but also play a key role in organising and maintaining a cost-effective multidisciplinary rehabilitation team for the microtia patients.

Clinical Study on Suanzaoren Decoction (酸枣仁汤) Combined with Auricular Points Pressing Beans in Treating Insomnia

Objective:To study the curative effect of oral Suanzaoren Decoction(酸枣仁汤)combined with pressing beans at auricular points on insomnia.Methods:80 patients with insomnia were randomly divided into observation group and control group with 40 cases in each group.The control group was treated by auricular points pressing beans therapy,while the observation group was treated with oral Suanzaoren Decoction combined with auricular points pressing beans therapy.Adjust auricular points pressing beans and decoction once a week,4 times as a course of treatment,totaling 2 courses of treatment.The time of falling asleep,the time of sleeping and the number of awakening before and after treatment were compared in the two groups,and the total effective rate of sleep quality between the two groups was compared.Results:After treatment,the quality of sleep in both groups was better than that before treatment(P<0.05 or P<0.01),and the total effective rate of grade I sleep quality in the observation group was higher than that in the control group(P<0.01).Conclusion:Oral Suanzaoren Decoction combined with pressing beans at auricular points has a significant effect on insomnia,which is superior to pressing beans at auricular points alone.

Optimization of Extraction Technology of Auricularia auricula Polysaccharide

[Objective]This experiment aimed to study the extraction technology of Auricularia auricula polysaccharide（APS）.[Method] Polysaccharide yield was regarded as studying target.Based on the single factor experiment results,orthogonal experiment design was applied to study the effect of liquid-solid ratio,extraction time,extraction temperature on polysaccharide yield.[Result]The results showed that extraction temperature was an important factor that affects the yield of crude polysaccharide,the optimal technology condition of water extraction way was liquid-solid ratio of 1：70（g：ml）,4-hour extraction time with temperature at 100 ℃.[Conclusion] The yield of Auricularia auricular polysaccharide was 42.56% under the above mentioned condition.

Temporoparietal Fascia Flaps for Surgical Treatment of Cartilage Exposure After the First-Stage Microtia Reconstruction

Significant improvements have been achieved in microtia reconstruction using an autogenous costal cartilage framework.However,complications such as skin necrosis and cartilage exposure often destroy the final contour of the reconstructed auricle.Local fascia flaps are commonly used in salvage surgery because of their reliability and satisfactory results.Here,we report the case of a 26-year-old woman with multiple skin necroses and cartilage exposure on day 21 after the first-stage microtia reconstruction.The exposure area was covered by a temporoparietal fascia flap as a single-stage procedure.The most essential subunits survived,and the esthetic concours were harmonious and natural at 12 months postoperatively.Temporoparietal fascia flaps are recommended as the surgical treatment for multiple skin necroses and cartilage exposure in microtia reconstruction.The axial-pattern temporoparietal fascia flap is reliable for salvage auricular reconstruction and ensures satisfactory results at long-term follow-up.

Application of Autologous Costal Cartilage Scaffold in Reconstruction of Microtia Ear

Objective To investigate the application effect and manufacturing skills of autologous costal cartilage scaffold in ear reconstruction for microtia.Methods From January 2016 to January 2019,41 patients with microtia reconstruction in our hospital were selected,all of whom were type II or type III pediatric deformities.All patients underwent auricle reconstruction and retroauricular skin expansion and autologous costal cartilage stent.The first stage of the operation is to insert a skin dilator behind the residual ear and inject water to expand.The second stage of the operation is to carve and repair the soft ribs(usually 6 or 7 ribs)from the body,make a three-dimensional auricle support for auricle reconstruction,place a negative pressure drainage tube,and follow up for 3 to 6 months to observe the three-dimensional shape of the reconstructed auricle and the formation of cranioauricular angle.Results 41 patients with microtia had good three-dimensional shape of auricle reconstruction,normal auricle position,moderate cranioauricular angle,good helix and triangular fossa structure,and good bilateral symmetry.Patients and their families were satisfied with the effect of auricle reconstruction.Conclusion Autologous costal cartilage is a good scaffold for auricle reconstruction.It is through efficient and elaborate carving and splicing that a good three-dimensional auricle structure can be formed.Combined with early flap expansion,a good postoperative appearance effect can be obtained,which is the appropriate method for auricle reconstruction at present.