| Background:Hair is one of the important characteristics of mammals, with the evolution of human hair (mainly hair) in human social life has gradually become health and beauty of the external representation, and its social and psychological significance are far beyond the physiological significance of their own. Hair would be an obvious impact on the situation of patients with self-evaluation, social relations and quality of life. Soft, glossy, healthy and beautiful hair style usually becomes superiority at the social activities. Alopecia is a common symptom on clinical, give patients psychological stress and inconvenience of living, therefore, baldness has become a more and more modern concerned problem.The clinical classification of alopecia as follows: seborrheic alopecia, nerve alopecia, scarring alopecia, disease alopecia, hereditary baldness, acquired alopecia. Many of the causes of baldness are complex, such as: mental or physical factors, androgen-induced hair loss, drug factors, food and nutrition metabolism factors, congenital factors, physical and chemical factors, endocrine disorders factors, disorder function of the immune system. Among those causes of alopecia, androgen-induced hair loss is the highest and the most common incidence of the alopecia.The clinical treatments for baldness include: drug treatment, surgical treatment and use of beauty technology to cover up the alopecia areas.Drug therapyAt present, there are two drugs commonly used for the treatment of alopecia effectively: regaine minoxidil and propecia finasteride. Regaine minoxidil can increase the vascular endothelial growth factor called mRNA of dermal papilla cells expression, and the vascular endothelial growth factor of dermal papilla cells has played an important role in the regulation on hair growth cycle; through the above-mentioned cytokines to stimulate ,maintain and extend the hair follicle growth progress so that can increase the hair follicle development and the promotion of angiogenesis in dermal papilla, to play an important role in the treatment of hair loss. Propecia finasteride have the function of reducing 5-αinhibit isoenzyme, thereby inhibiting reduction of testosterone to DHT (Dihydrotestosterone, DHT), lower the levels of DHT in the serum and scalp. The male hormones would not to inhibit the hair growth, so as to effectively reverse the process of baldness, alopecia and promote hair re-growth. The use of these two drugs can effectively prevent hair loss caused by a variety of reasons, it take long time to promote parts of bald or sparse hair regeneration.But when stop using the drug the level of weight and quantity of the hair make downward trend, indicating that the drug can not be fundamentally change the genetic quality in patients with alopecia, and can cause side effects such as hirsutism and sexual dysfunction.Surgical TreatmentIn 1939, a doctor named Okuda in Japan used a technology which was called "Punch" to take the patient's occipital skin tissue with hair follicle in order to reconstruct the severely burned scalp with a hair transplant surgery.The results of transplantation at the site can see new hairs grown, opened up the modern hair transplantation as a new chapter in surgical technology, the development has been nearly 70 years. For the treatment of alopecia on the clinical surgical techniques including the following methods: flap transfer, scalp reduction surgery, scalp tissue expansion, scalp autologous transplantation and so on.But because of the existence of the donor site scars and hair transplantation uneven growth patterns, the operation cycle length, and the impact of patients with issues such as life and work, those methods failed to achieve satisfactory results. Entered in the late 90's, Dr. Seager in Canada and the doctor Rassman in the United States proposed "the concept of follicular unit" and "follicular units grafting under the microscope " technology, so that transplantation of autologous hair follicle to promote a wide range of technology. This transplanting technique not only greatly improved the survival rate of the hair follicle after transplantation and the hair transplantation more natural growth pattern, also its lasting effects had been welcomed by patients obviously and widely. Autologous transplantation of hair follicle in patients with the requirements of the hair follicle must have adequate funding for the district, however, too large for baldness, and even complete loss of hair of patients with cicatricial alopecia, or the whole of head generally sparse and the top of the scarcity of women with androgenetic alopecia patients, for the donor district or because of poor condition of the recipient site, the source of the shortage of hair follicles and the survival rate instability of the hair follicles after transplantation, also the appearance of hair density and can not achieve satisfactory results after operation. So, for how to solve the apparent shortage of resources of hair follicle, it become clinical questions that need to be resolved in the hair restoration surgery.Cosmetology TechnologyThe psychological suffering and the mental burden of patients with hair loss, as well as gradual loss of confidence in treatment, it is bound to cause symptoms increased. In such cases, patients may choose to wear a wig or weaving hairs; in that case it can reduce the mental burden, and can have the therapeutic alliance with drug treatment or surgery. While the wig or weaving hairs can cover a certain area of the alopecia and achieve certain cosmetic effect, patients can gate the psychological comfort, but there are three disadvantages of those two methods: for the first, the structure is not strong and easy to fall off by the external force; second the patients feel too hot to wear, airtight, and the use of short duration; thirdly, the wig are chaotic, combing inconveniently, the appearance are not natural.In conclusion,the wig should not fundamentally ease the psychological stress of patients.Both internal and external researchers are trying to find the treatments of alopecia in the new methods through experimental studies. The current hair tissue engineering through reconstruction of the hair follicles in vitro, hair follicle allograft transplantation and gene therapy that seek some breakthrough. Carried out through vitro tissue engineering of autologous hair follicle cells amplifies the quantity, you can theoretically solve the problem. Abroad have been conducted allogeneic transplantation of hair follicle cells in the laboratory and the success of the reports: researchers transplanted healthy adult hair follicle epithelial cells into another healthy adults'forearm showed that epithelial and stromal reaction, producing a new hair follicle cells. However, these studies are still at the experimental stage, from the clinical application of the road is still long.To sum up, for the district for autologous hair of alopecia in patients with inadequate resources, regardless of clinical drug treatment, surgical treatment, beauty treatment, or basic laboratory research, both internal and external researchers at this stage have not been able to find practical, satisfactory treatment. Yi Bin and Hu Zhiqi had invented a portable wig through experiments, and had registered the national patent. Each of the wigs included one hair which connected to the cylindrical polypropylene with barbs, to provide a new way for the treatment in alopecia which is obviously insufficient resources in the hair follicles. However, the shortcoming of the wig is: Since each portable wig had only one hair, the appearance after the hair transplantation wasn't natural.Our experiment about wig grafts research an improved structure and make animal experiments to observe the appearance of histocompatibility and simulation results, to explore the possibility of its clinical application , so it can better provide a more new and practical of clinical method to solve the sources of the autologous hair alopecia problem of insufficient resources.Part I : The Design and Improvement of the portable wig structureObjective: To improve the structure methodology of portable wig, and designed the best structure for the follow-up to lay the foundation for the experimental animals.Methods: 1, portable wig base production: the polypropylene powder was injected into a diameter of 1mm, stainless steel material cylindrical mold, putted the above-mentioned experimental mold into the blast drying oven with digital display, in the premise which the polypropylene does not change the chemical nature, the polypropylene powder can change the glass state into the viscous flow under the heating condition, and form corresponding to the mold 1mm diameter of the cylinder.2, the connection of hair fibers and the wig base stump: the composition of 8 hair fibers with the length of 5.0cm will be inserted into the mold, the hair bundles root is connected firmly with the polypropylene which is still in the viscous flow, in that case the hair bundles will be buried at the base with the polypropylene base stump.At room temperature, the cylindrical mold molding polypropylene base glass into the glass state,and then stripping it so it can form the hair fibers with polypropylene base. Use the 11th blades to carve up a number of jagged barbs at the polypropylene graft wig base through the binocular stereo anatomy microscope. The wig graft polypropylene base stump surface can show multi-serrated appearance. Results: The polypropylene is the common medical polymer material, at a certain temperature it has stable chemical properties, and the organization has a good biocompatibility.In this experiment we use of the physical and chemical properties of the polypropylene, and designed it to be portable wig with the cylindrical base stump, the top use of hot-melt method and compaginate the hair fibers with it. At the base stump there are multi-row array of jagged barbed, so that the implantation into the subcutaneous has a good stationary effect.Conclusion: 1, the portability graft wig is based on polypropylene materials, it has a good histocompatibility, it is a recognized by clinical long-term retention in the body of the medical materials to ensure the safety of clinical application. 2,Improved portable wig can be more firmly anchored under the skin, and the hair which compaginate polypropylene base stump have been increased in the number,it will be more natural look. 3, to lay the foundation for the follow-up animal experiments.Part II: The implantation of portable wig into the rabbit subcutaneous and the observation of tissue histocompatibility and the appearanceeffect.Objective: To implant the improved portable wig into the rabbit neck subcutaneous, and through animal experiments to observe the tissue histocompatibility and the appearance of hair transplantation simulation effect, to explore the possibility of clinical use.Methods: We chosed 10 New Zealand White rabbits (Offered by Southern Medical University animal experiment center), transplanted 40 sheafs of portable wig into the neck subcutaneous of each rabbit through the hair follicle units transplantation technology. Each hair bundle include 8 hairs, 10 rabbits were transplanted 400 sheafs.The 10 rabbits were randomly divided into two groups: general observation and histology observation groups ,each group included five rabbtis.The general observation group is used to calculate the number of graft loss within 1 year; The histology observation observe the histocompatibility results through HE staining and scanning electron microscopy in 1 week ,2 weeks and every month in 1 year after the transplantation, each rabbit fractionated collection included 4-sheaf graft full skin organizations in sterile condition.Results:①The morphological observations of the portable wig HE staining: 1 week after transplantation, around the portable wig basal stump there were limitations of a very small amount of tissue infiltration of inflammatory cells, the capillary were mild congestive expansion, and a small amount of lymphocytic infiltration can be seen around that,the inflammation is mild; 2 weeks after transplantation, there has a large number of collagen fiber formation around the portable wig base stump, the number of inflammatory cells and perivascular lymphocytic infiltration are significant decrease ;between the base stump and the barb there had a lot collagen fibers ingrowed. One month after transplantation, there were a large number of collagen fibers around the portable wig base stump and surrounding tissue without inflammatory reaction, it could helped to fix the wig so that the wig should not shift and loss; two months to 1 year after transplantation, there were not significant adverse reactions surrounding the tissue can be observed.②The portable wig SEM morphological observations: We can see the polypropylene base stump which was implanted into the rabbit skin were close connection with the surrounding tissue, no necrosis, rejection, etc. Polypropylene base can be observed as homogeneous, smooth, translucent medical polymer materials. One week after the hair transplantation, it can be seen there were more tissur reaction cells gathered around the base stump, vascular mild congestive expansion. Two weeks after transplantation, collagen fibres ingrowed between the base stump and the barb, the tissue reaction cells were significantly reduced; 1 month after transplantation, the tissue inflammatory reaction is not observed surrounding the base stump, a large number of collagen fibers wrapped around the base stump, and ingrow the barb, that can help to fix the portable wig; 2 months to 1 year after transplantation, graft have good biocompatibility with the surrounding tissue, no adverse reactions observed.③The appearance observation results of wig: 5 rabbits were transplanted 200 sheafs graft wig under the neck skin, each sheaf including 8 human hairs, for a total of 1600 human hairs. After transplantation the portable wig on the early period should be paid attention to the protection of the wound to prevent graft-traction, so that can improve the stability of portable wig. The observation of portable wig base stump expulsion rate: 1 week after transplantation the number of base stump expulsion ws seven, the expulsion rate was 3.5%; 2 weeks after transplantation the number of base stump expulsion was five, the expulsion rate was 2.6%; The first 3 weeks to 12 months after transplantation the number of base stump expulsion was four, the expulsion rate was 0.5%; the total of expulsion rate of wig graft base stump in 1 year was 6.5%. The observation of Portable hair fiber wig expulsion rate: 1 week after transplantation the number of hair fibers expulsion ws 77, the expulsion rate was 4.8%; 2 weeks after transplantation the number of hair fibers expulsion ws 56, the expulsion rate was 3.7%; The first 3 weeks to 12 months after transplantation the number of hair fibers expulsion was 9, the expulsion rate was 0.6%; the total of expulsion rate of wig graft hair fibers in 1 year was 8.8%. The first 1～2 weeks after transplantation, the wound is not completely healed, pulled and dragged and scraped by the White Rabbit, it can be easily lead the wig graft base stump to expuls off the skin, therefore, it is necessary to pay more attention to the protection of early graft surgery area in order to prevent the graft be dragged. In the extension of the latter period, a large number of collagen fibers around the base stump hyperplasy, and parcels, wrapped around the base stump, and is conducive to t firmly anchored the graf base stump in the organization, significantly reduced the expulsion rate.Conclusion: 1, the improved portable wig can firmly anchored under the rabbit skin, polypropylene portable wig base stump have a good histocompatibility with the rabbit subcutaneous tissue, there was no adverse reactions happened. 2, the improved portable wig are more natural appearance of the simulation results. 3, to solve the problem of insufficient sources of clinical donor hair follicles. 4, we had carried out a one-year experiment in the vivo animal studies confirmed that the clinical relevance of portable wig, it had laid the foundation for the follow-up clinical trials.
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