Adaptability of bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection

Background:Several reconstructive techniques have been used to reconstruct scalp defects.Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage.In this study,we will assess the adaptability of a bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection.Methods:This study was performed at the Plastic Surgery Department,Fayoum University Hospital,on 20 patients with huge scalp tumors treated by adequate excision and reconstructed using a bipedicled scalp advancement flap from December 2021 to July 2023.Results:The study was conducted on 20 patients:16(80%)were men and 4(20%)were women presenting with large scalp tumors.The mean age was 57.4 years(33-68 years).The sites of the tumors were 10(50%)occipital,6(30%)parietal,and 4(20%)parieto-occipital.No major complications occurred postoperatively,and the bipedicled flaps survived well in all cases,with no necrosis.Conclusion:Huge scalp defects after tumor resection can be safely reconstructed with a large versatile bipedicled advancement scalp flap,either transversely or longitudinally oriented,with favorable functional results and accepted aesthetic results,apart from the alopecic area over the grafted donor site,which can be treated by tissue expansion if desired later.

Balancing Microbiome as a Promising Approach for Scalp Care——the Basic Concept and an in Vitro Proof

The human scalp harbors a diverse range of microbiome,much like other skin surfaces,where both beneficial and harmful microorganisms coexist.This study explores the possibility of balancing key scalp microorganisms,particularly Staphylococcus epidermidis,Staphylococcus aureus and Malassezia species.While Staphylococcus epidermidis plays a beneficial role in maintaining scalp health by producing antimicrobial proteins and supporting the skin barrier,Staphylococcus aureus is identified as a pathogen linked to skin infections and dandruff formation.Malassezia fungi degrade triglycerides in sebum into unsaturated fatty acids,exacerbating scalp conditions like dandruff.In order to promote the beneficial microbe while inhibit the harmful ones,we investigated the combination of 1.0 mM pyrrolidone carboxylate-zinc(PCA-Zn),0.2%malt oligosaccharides(MT:corn-derived oligosaccharide mainly containing maltotetraose)and 0.05 mM Hinokitiol on its microbial activity,which significantly enhanced the growth of Staphylococcus epidermidis while inhibiting both Staphylococcus aureus and Malassezia,offering insights into promising strategies for scalp care.

Giant Cerebriform Nevus Cell Nevus of the Scalp: A Case Report

Giant cerebriform nevus cell nevus of the scalp is an extremely rare form of congenital melanocytic nevus. Giant cerebriform nevus of the scalp has a major psychosocial impact because of its unsightly appearance with fetid maceration. We report the case of a 35-year-old woman who had a painless, malodorous swelling of the cerebriform scalp measuring 20 × 17 cm in diameter with a wide base of insertion at the occipital level adhering to the deep planes. The excision associated with a skin plasty was carried out. Histology concluded that there was a giant cerebriform naevo-cellular nevus of the scalp.

自体刃厚头皮回植修复中厚供皮区创面的安全有效性

背景:大面积深度烧伤创面愈合后多伴瘢痕增生,需要移植中厚皮进行修复,所取中厚皮片一般达到真皮乳头层以下,若处理不当容易出现供区皮创面愈合延迟、溃破和愈合后疼痛瘙痒等并发症,因此,供皮区创面修复应得到重视。目的:分析自体头皮修复深度烧伤和瘢痕患者供皮区的安全性和实用性。方法:选择2021年1月至2023年9月郑州市第一人民医院烧伤科收治的60例深度烧伤和瘢痕增生患者作为研究对象,均进行中厚皮移植修复,取皮部位为患者自身腿部或背部中厚皮,采用随机数字表法分为研究组(30例)、对照组(30例),研究组采用自体刃厚头皮回植修复中厚皮供皮区,对照组采用吸水敷料修复中厚皮供皮区。对比两组术后6 d的中厚皮供皮区创面愈合率、创面完全上皮化时间,术后3,6 d供皮区换药疼痛评分,以及术后6个月中厚皮供皮区瘢痕增生情况。结果与结论:①研究组中厚皮供皮区创面上皮化时间短于对照组(P<0.05),中厚皮供皮区创面愈合率高于对照组(P<0.05),术后3,6 d的中厚皮供皮区换药疼痛评分均低于对照组(P<0.05),术后6个月的中厚皮供皮区瘢痕增生率、瘢痕评分及瘙痒评分均低于对照组(P<0.05);②结果表明,自体头皮修复中厚皮供皮区具有加快创面愈合和减轻瘢痕增生的优点。

IMPACTS ON THE EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN ISCHEMIC BRAIN TISSUE TREATED WITH CLUSTER PUNC-TURE ON SCALP ACUPOINTS IN RATS

Objective To probe into the impacts on the expression of vascular endothelial growth factor （VEGF） in ischemic brain tissue treated with cluster puncture on scalp acupoints in rats, Methods 128 rats were randomized into pseudo-operation group, model group, scalp-needling group and cluster-needling group, In scalp-needling group, penetration method was used on the focal side from Bǎihuì （百会 GV20） to Qǔbīn （曲鬓 GB7）, and in cluster-needling group, penetration method was used on both sides from GV20 to GB7, and a common needling on GV 20. Needles were punctured 2 mm in depth, constantly rotated for 10min, retained for 2 h. Immunohistrochemical method was applied to determine VEGF expression and microvessel density （MVD）. Results With the intervention of cluster puncture on scalp acupoints, VEGF： expressions on every time-spot after ischemia were enhanced apparently, superior to those in scalp-needling group. On the three time-spots of the 7^th, 14^th and 21^st days, MVD was increased after cluster puncture on scale acupoints, superior to those in scalp-needling group. Conclusion Cluster puncture on scalp acupoints up-regulated VEGF expression and promoted regeneration of microvessel.

从阿帕奇到SCALP-EG/风暴前兆——欧洲防区外空对地导弹技术发展剖析

法国研制的阿帕奇导弹已正式服役了, 它是西欧第一种防区外发射的空对地导弹, 也是西欧隐身区外导弹的先驱.后来, 在它的基础上又发展了先进的SCALP-EG/风暴前兆导弹, 该导弹在今年3月的伊拉克战争中, 英国空军首次使用.

Modulatory effect of International standard Scalp Acupuncture on brain activation in the elderly as revealed by resting-state fMRI

The specific mechanisms by which acupuncture affects the central nervous system are unclear. In the International Standard Scalp Acupuncture system, acupuncture needles are applied at the middle line of the vertex, anterior parietal-temporal oblique line, and the posterior parietal-temporal oblique line. We conducted a single-arm prospective clinical trial in which seven healthy elderly volunteers (three men and four women;50–70 years old) received International Standard Scalp Acupuncture at MS5 (the mid-sagittal line between Baihui (DU20) and Qianding (DU21)), the left MS6 (line joining Sishencong (EX-HN1) and Xuanli (GB6)), and the left MS7 (line joining DU20 and Qubin (GB7)). After acupuncture, resting-state functional magnetic resonance imaging demonstrated changes in the fractional amplitude of low frequency fluctuations and regional homogeneity in various areas, showing remarkable enhancement of regional homogeneity in the bilateral anterior cingulate, left medial frontal gyrus, supramarginal gyrus, right middle frontal gyrus, and inferior frontal gyrus. Functional connectivity based on a seed region at the right middle frontal gyrus (42, 51, 9) decreased at the bilateral medial superior frontal gyrus. Our data preliminarily indicates that the international standard scalp acupuncture in healthy elderly participants specifcally enhances the correlation between the brain regions involved in cognition and implementation of the brain network regulation system and the surrounding adjacent brain regions. The study was approved by the Ethics Committee of the China-Japan Union Hospital at Jilin University, China, on July 18, 2016 (approval No. 2016ks043).

Angiosarcoma of the scalp diagnosed by the presence of neck inflammation:a case report

Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography （CT）, magnetic resonance image （MRI） and ultrasonography （US） were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel （DTX） treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

PRACTICE AND DEVELOPMENT ON ZHU'S AND CHAU'S SCALP ACUPUNCTURE

Zhu’s and Chau’s Scalp Acupuncture is one of the newly developed needling meth-ods which follows the "penetrating head acu-point needling" method. Through many years ofclinical experience, exploration and research in conjunction with the various advantages of differ-ent styles and sects of scalp acupuncture needling methods, a unique method of scalp acupuncturehas been developed. This method combines the modern medical theory and the traditional Chinesemedical theory. The region of head is divided into seven treatment areas: Shenting region (GV24), Touwei region (ST 8), Shuaigu region (GB 8), Baihui region (GV 2O), Qiangjian region(GV 18), Xinhui region (GV 22), Wangu region (GB 12). The manipulation is developed andcreated according to the Collection of Acupuncture and Moxibustion, Chouqi and Jinqi methods.In the process of the insertion of the needles, this method requires the cooperation of rapid andslow breathing by lifting, following and opposing the meridian course, including active and pas-sive

A CONTROL STUDY OF SCALP ACUPUNCTURE IN TREATING APHASIA AFTER ACUTE CEREBROVASCULAR DISEASES

A control study of clinical therapeutic effects of scalp acupuncture was made onforty-four Patients suffering from aphasia caused by acute cerebrovascular diseases,and was observedfor 4 weeks.The results revealed that the therapeutic effect in the scalp acupuncture group was betterthan that in the controlgroup.Aphasia was cured more rapidly in the scalpacupuncturegroug than inhe control group.The difference was of significance statistically.

The Use of “Scalp Block” in Pediatric Patients

Infiltration of the nerves of the scalp with local anesthetics is used in adults for a variety of head and neck procedures and craniotomies with many benefits, from hemodynamic stability to reduced postoperative pain. We here succinctly review the current evidence for “scalp block” in pediatric patients.

INFLUENCE OF LOCAL INFILITRATION ANESTHESIA OF SCALP-POINT ON ACUPUNCTURE INDUCED CHANGES OF CEREBRAL BLOOD PERFUSION DETECTED BY SPECT

Objective: To observe the influence of local infiltration anesthesia at the scalp point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 healthy volunteer subjects (8 males and 2 females) who were ordered to take a lying position on a specific bed with their heads keeping in a fixed position. Scalp point used was Motor Area (MS 6). The first syringe needle (gauge 5) was inserted into the scalp from the upper 1/5 of MS 6 and the second syringe needle inserted into the scalp from the middle 2/5 of MS 6 and advanced downward, with the two needles connected to a HAN’s Therapeutic Apparatus. Images of the brain were then taken before and after electroacupuncture (EA) stimulation, and after local injection of 1% lidocaine [mixed with epinephrine (1∶200,000, 3 mL)] plus EA by using Siemens ECAM/ICON Single Photo Emission Computed Tomography (SPECT). Intravenous injection of Ethyl cysteinate dimmer 555 MBq was performed before displaying cerebral images. Data of blood functional changing rat (BFCR%) were analyzed quantitatively using a mathematic model. Results: Before EA stimulation, the blood perfusion and function of cerebral cortex, thalamus, basal ganglion and cerebellum on both sides of the brain were basically symmetry. Following EA of MS 6, BFCR% of the contralateral thalamus, parietal lobe and the frontal lobe increased significantly. Following local infiltration anesthesia, BFCR% of the contralatral thalamus declined markedly (P<0.05). The results of quantitative analysis were in agreement with those of visual observation. Conclusion: Local infiltration anesthesia of the scalp point can significantly weaken or block EA stimulation induced changes of BFCR%.

Use of Flame Atomic Absorption Spectroscopy and Multivariate Analysis for the Determination of Trace Elements in Human Scalp

The analysis of trace elements in human hair for use as biomarkers continues to generate considerable interest in environmental and bioanalytical studies, medical diagnostics, and forensic science. This study investigated the concentrations of essential and toxic elements (Fe, Mg, Ca, Cu, Zn, Cr, Cd, and Pb) using flame atomic absorption spectroscopy (FAAS) in human scalp hair obtained from subjects living in Forsyth County, North Carolina, USA. The influence of age, sex, race, and smoking habits on the levels of trace elements in the hair samples were also investigated. Additionally, analyses were subjected to a statistical, regression, and principal component analysis to evaluate inter-elemental association and possible pattern recognition in hair samples. Furthermore, Ca/Mg and Zn/Cu ratios, which are often used to evaluate the degree of Ca and Cu utilization in humans and as markers for various health related issues including, atherosclerosis, hypertension, insulin sensitivity, and pancreatic cancer, were calculated. The overall mean concentrations of Fe (25 μg/g), Ca (710 μg/g), Mg (120 μg/g), Zn (190 μg/g), Cu (12 μg/g), and Cr (0.20 μg/g) were found in hair samples. The trace element concentrations varied widely in hair samples as demonstrated by large range of concentrations obtained for each element. However, levels of Cd and Pb elements of <0.030 μg/g were detected in hair sample. In general, the levels of the trace elements in hair samples were poorly correlated. However, significant correlations were found between Ca and Mg (r = 0.840, p = 0.05). The levels of Fe, Ca, Mg, Zn, Cu, and Cr in hair samples and the calculated Ca/Mg and Zn/Cu ratios were found to be largely correlated with age, race, sex, and smoking habits.

The Scalp Involvements in the Connective Tissue Diseases

Background: The involvements of the scalp over the connective tissue diseases (lupus, sclerodermia and dermatomyositis) are often the present complaint due to the disfigurement they cause. The aim of our study was to identify the various involvements of the scalp over the connective tissue diseases. Method: We conducted a descriptive study over a period of seven months of every instance of involvement of the scalp and hair during connective tissue diseases received in the department. A tensile test, a Trichogram and mycological sampling were performed. Results: 25/35 involvements of the scalp were noted (71.42%);all of them were female and the mean age was 32 years. It was a lupus in 17 cases, sclerodermia in 6 cases, dermatomyositis and a sclerodermatomyositis. They were the present complaint in 48% of cases within 3 years and preceding the other lesions in 32% of cases. We noted fragile and dry hair in 10 cases, straightened hair in 8 cases and hypochromic spots fleck in 5 cases. Conclusion: Connective tissue diseases cause severe injuries and often reveal a risk of permanent cicaticial alopecia and fungal superinfection. The cicatricial alopecia and straightened hair are secondary to immune disorders.

Ageing-Related Features of Hair and Scalp in Chinese Women by Clinical Evaluation Study

There are previous studies of ageing hair and scalp in Caucasians and some Asians, such as Koreans and Japanese. However, the characteristics of scalp and hair have not yet been studied in Chinese, the largest population in the world, especially in terms of ageing. The purpose of this study is to investigate ageing features in Chinese women’s hair and scalp. Methods: In total, 1343 women in China aged 20 to 65 participated in this research. Hair density and diameter were measured and analysed with Folliscope&reg. Hair color and scalp conditions such as dandruff and erythema were evaluated through microscopic images. Measuring equipment was also used to detect scalp water content, barrier function and sebum secretion. Results: Hair density decreased gradually with ageing, while hair diameter peaked at 40s. The color of hair became bright with ageing because of gray hair and color fading. The degree of scalp sebum and dandruff was higher at younger ages. Interestingly, scalp erythema became more severe with ageing. Conclusion: This study shows the physical and physiological changes of Chinese women’s hair and scalp. Most aging features (hair diameter, scalpsebum contents, dandruff and erythema) were noticeable in their 40s, but hair density began to decline in their 30s. This first study of aging hair and scalp in Chinese women would be helpful for understanding the ageing phenomenon and development of hair and scalp care products.

Mechanical stimulation of the scalp improves the extra-and intracranial blood circulation in humans and mice

Background:Scalp combing,as an ancient method of health care,has been used for thousands of years in traditional Chinese medicine.Although this method is considered to be beneficial for the blood circulation of the head,the underlying mechanisms remain unclear.Methods:Both human participants and mice were used in this study.In participants,the scalp was stimulated by combing continuously for 5 min,and the temperature was measured using infrared thermal imaging before and after stimulation.In mice,the temperature was determined before and at 5,15,and 30 min after a 5-min scalp mechanical stimulation(SMS).Additionally,the vasculature of the mice was labeled with retro-orbital fluorescein isothiocyanate-dextran injection,and the capillaries were observed directly under a confocal microscope.Using in vivo CLARITY imaging and the spectrofluorometric detection of Evans Blue dye extravasation,the bloodebrain barrier permeability was assessed.Results:SMS increased the temperature of the left ear significantly in human(P=.0247)while can slightly increase the temperature of the right ear and the face without significant difference(P>.05).Moreover,SMS can significantly slow the decrease in the temperature of the external auditory canal at 5 min(P=.0153)and in body temperature at 15 min(P=.0295)after SMS whereas no significant difference in body temperature at 30 min(P>.05)compared with control mice.Furthermore,capillaries of the ear with a diameter of less than 8 mm were significantly dilated(P=.0006)following SMS and the number of dextran dots was higher at 15 min(P>.05)and 30 min(F=10.98,P=.037)after SMS intervention compared with control mice.Conclusion:Our study provides strong evidence to support the notion that scalp combing can improve extra-and intracranial blood circulation under healthy conditions.

High Scalp Tension after Three-Dimensional Titanium Mesh Repair for Skull Defect: 2 Case Reports

Rationale: The three-dimensional (3D) computer-made titanium mesh is widely used in the skull repair for those patients receiving decompression of the bone flap. It can restore normal anatomy to a greater extent and make a better appearance. Case Presentation: We reported two cases of patients admitted to our hospital who have experienced high scalp tension after skull repair. At first, these two patients underwent decompression of the bone flap, and the physical examination results showed a defect of skull. No neurological symptoms and signs were found. The 3D computed tomography (CT) reconstruction of skull was performed, and then the skull repair with 3D titanium mesh was conducted. But because of high scalp tension, they underwent a second operation, during which we re-trimmed and reduce the arc of the titanium mesh. The scalp incision of both patients healed well and no titanium mesh was exposed. Both patients have a good prognosis. Lessons: We highlight that the high tension of scalp due to overstretching after 3D titanium mesh repair for skull defect should be paid much attention to. Trimming and reducing the arc of titanium mesh is an effective treatment for this situation.

Effect of cluster needling at scalp acupoints on differential protein expression in rat brain tissue after acute focal cerebral ischemia

Objective:To explore the function of cluster needling at scalp points therapy on regulating differential protein's expression at different time points in middle cerebral artery occlusion(MCAO)model rats.Methods:Fifty-four rats were divided into three groups randomly and 18 rats in each group.The groups respectively were the model group(group M,n=18),cluster needling at scalp points group(group C,n=18),false operation group(group F,n=18).Each group was then assigned in three subgroups,including 24-h,7-day,and 14-day subgroups.Six rats in each subgroup.Acupuncture at Baihui(GV20)and 2 points beside Baihui,which was 3 e4 mm away from the midline.Longa score was used to evaluated neurological effects.Proteomics methods were used to identify differentially expression proteins with a standard of fold change greater than 1.5 and P<.05 at different times.Results:1.Nerve function scoring:The nerve function scores at 7 and 14 days decreased in group C,which showed better neural function than group M(P<.05).2.Fold change in proteins:Group M showed932 differentially expressed proteins compared with group F,and among them,414 proteins showed significant changes in expression after acupuncture.The expression levels of Cdc42 and GFAP were increased,and Mag,Shank2,and MBP levels were decreased.In the Gene Ontology analysis,the cellular component consisted of the terms cytoplasm,cytoskeleton,lysosome,and plasma membrane.The main related biological processes were cellecell signaling,protein transport,aging,and cell adhesion.Many synaptic and metabolic pathways were found by KEGG analysis.Conclusion:Cluster needling at scalp acupoints can improve the nerve function score and improve dyskinesia in MCAO model rats.Cluster needling at scalp acupoints can regulate the expression of 414 proteins,including Cdc42,GFAP,Mag,Shank2,and MBP,which are related to cerebral ischemia.The differential proteins are major concentration in cytoplasm,cytoskeleton,lysosomes,and plasma membrane,participate in cellecell signaling,protein transport,aging,and cell adhesion,and act through multiple synaptic and metabolic pathways to exert their biological functions.

Combination therapy of scalp electro-acupuncture and medication for the treatment of Parkinson's disease: A systematic review and meta-analysis

Objective:To summarize the current clinical evidence related to the therapeutic effects and safety of adjuvant scalp electro-acupuncture (SEA) treatment for Parkinson's disease in China.Methods:Following the PRISMA statement,seven electronic databases were searched to retrieve randomized controlled clinical trials that used SEA combined with medication as the treatment intervention,and medication as the control.RevMan 5.3 was used to analyze outcomes,including the Unified Parkinson's Disease Rating Scale (UPDRS),Webster scale,effectiveness rate,and UPDRS III.Results:Nine randomized controlled trials,with certain methodological flaws and risks of bias,were included that involved 474 participants.SEA combined with medication was more effective than medication alone in overall therapeutic effects,as evidenced by total UPDRS scores (mean difference (MD):7.15,95% confidence interval [CI] 0.24 to 14.07,P =.04),Webster scores (MD:1.60,95% CI 0.20 to 2.99,P =.03),and effectiveness rate (risk ratio:1.35,95% CI 1.19 to 1.54,P <.001).In addition,there was significant improvement in pooled motor function results after adjuvant SEA treatment compared with medication alone (MD:5.75,95% Cl 4.18 to 7.32,P <.001).Conclusion:The combination of SEA and medication may be a promising intervention for patients with Parkinson's disease,especially to improve motor function.However,results were inconclusive,and additional studies with rigorous experimental design and larger sample sizes are needed to verify these results.