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Objective To present our experience and techniques with the use of autologous costal cartilage grafts in Asian rhinoplasty,and to report the surgical results and complications in 86 consecutive rhinoplasty cases.Methods All operations were performed by the first author (Liu AT) with open approach,costal cartilages and perichondrium were used to reconstruct the nasal tip projection according to the tripod theory in rhinoplasty,after removing the previous injection material,L-shaped implant or hypertrophic scar tissue in the tip.Medical charts and operative records were reviewed retrospectively to summary the complications.Nasal dorsum augmentation was done by costal cartilage or I-shaped allograft,sometimes with anterior sheath of rectus abdominis.Patients' subjective satisfaction of the postoperative nasal appearance was self-evaluated with grading (1 worse,2 no change,3 improved,and 4 much improved).Results From September 2015 to March 2017,86 patients underwent rhinoplasty at our hospital.The postoperative follow-up duration was 6 to 20 months.Overall,functional and aesthetic outcome was satisfactory in most patients,and the mean score by the patients' self-evaluation was 3.3 ± 0.6.Graft exposure,mobility,or significant resorption,pneumothorax or significant donor-site pain were not observed.Conclusions Even with minimal complications and morbidities,autologous costal cartilage grafts in Asian rhinoplasty is a versatile and reliable graft material for nasal tip surgery in severe short or saddle nose,contracted nose due to previous L-shaped augmentation and revision rhinoplasty in which the septal cartilage has already been harvested.
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Objective To investigate the feasibility of urethral prefabrication with vaginal mucosa in female-to-male transsexuals and to compare the urologic complications after penile reconstruction in female-to-male transsexuals between prefabrication group and forearm group.Methods Prefabrication of the neourethra with tubed vaginal mucosal graft was performed for 22 female-to-male transsexual patients from 2007 to 2016,while radial forearm flap,known as the traditional tube-within-tube method,was used to construct the neourethra for other 31 cases.Results All of the reconstructed penises survived completely and allowed the patients to urinate while standing in the prefabrication group.Phalloplasty by using the vaginal mucosal graft for urethroplasty significantly decreased the donor scar,the duration of the second operation and the incidence rates of urologic strictures,comparing with the forearm group (P＜0.05).Conclusions It is reliable to use the prefabrication of the neourethra with tubed vaginal mucosal graft in phalloplasty female-to-male transsexual patients.
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Objective To investigate the clinical efficacy of bromhidrosis with botulinum toxin A by needle free injection.Methods A total of 40 patients with bromhidrosis were collected and divided into needle free group and needle group.A comparative study was carried out in those subjects.Patients in needle free group received needle free injection of botulinum toxin A by INJEX30;Needle group received traditional injection by 26 G needles.Results In needle free group,16 cases were cured,3 cases were effective,1 case was ineffective,no significant pain,hematomas or necrosis were found.In needle group,15 cases were cured,4 cases were effective,and 1 case was ineffective;localized hematoma occurred in 2 cases.And cases in group needle experienced pain more intensely than cases in needle free group.Conclusions The INJEX30 improves the security,comfort and therapy compliance of botulinum toxin A injection in the bromhidrosis patients,with similar efficacy with traditional injection.
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Objective To explore the effect of application of SimMan human body simulator in nursing teaching experiments on emergency and critical care. Methods Forty undergraduate nursing students in 2012 were assigned as the experiment group, where nursing teaching experiments on emergency and critical care were conducted based on SimMan human body simulator. Forty undergraduate nursing students in 2011 were assigned as the control group, where the traditional teaching method was employed. The emergency ability of the nursing students in the two groups was evaluated, and the nursing students′ attitudes towards two teaching methods were investigated. Results The emergency ability was higher in the experiment group than that of the control group (P<0.05). The satisfaction level with teaching method in the experiment group was significantly higher than that of the control group (P<0.05). Conclusions SimMan human body simulator is effective in improving emergency ability of nursing students in nursing teaching experiments of emergency and critical care. It is worth popularizing and applying.
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ObjectiveTo study the inhibiting effects on the invasion and metastasis of melanoma by CXCR4 gene silence in nude mice.MethodsThe CXCR4 specific recombinant plasmid vector was constructed and transfected into the cultured MV3 cell line with lipofectamine.The models of subcutaneous melanoma in nude mice were established with MV3 cells.The nude mouse model of lung metastasis was established by injection of MV3 cells into the tail vein.The animals were sacrificed at 8weeks after the melanoma cells injection.CXCR4-shRNA plasmid vectors were discontinuously injected directly into the established tumor and vein.The changes of weight and size of the tumors and the mice body weight during the therapy were calculated respectively.Histological observation was performed to evaluate the presence and number of metastatic tumors.ResultsThe subcutaneous melanoma tumors in nude mice were established successfully.The growth of tumors in the CXCR4-shRNA injected nude mice was inhibitted obviously through tumor growth curve. There were significant differences between negative shRNA control nude mice and blank control nude mice (P＜0.01).Melanoma cells with CXCR4 shRNA permanent transfection had a much lower lung and brain and liver metastatic potential in nude mice than control cells and mock control cells in vivo.ConclusionsCXCR4 gene silencing mediated by shRNA significantly suppresses the growth of MV3 cell in vitro.Silencing of CXCR4 mediated by shRNA can also effectively decrease the metastatic potential of lung and liver and brain.
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The students are consciously taught how to think the surgery and how to analyze and solve problems in the animal surgery curriculum.
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Objective To investigate the changes at the motor end-plate (i. e. neuromuscular junction) following the free neurovascular muscle transfer. Methods Light and electron microscopy were used to study serially during 30 weeks the changes at the neuromuscular junction after free muscle transfer of the gracilis muscle in the adult Wistar rat. Results Under light microscopy, after staining with acetylthocholine the neuromuscular junction showed changes of degeneration with withdrawal of the innervating axon terminal followed by regeneration and reconstitution of the neuromuscular junction. With the electron microscope, mitochondrial sweelling and clumping of the synaptic vesicles were followed by withdrawal of the axon terminal from the muscle membrane on denervation. The infolding of the muscle membrane at the neuromuscular junction became less prominent. With reinnervation the ulatrastructure of the junction was only partially reestablishied with poorly reconstituted primary and secondary folds of the muscle membrane. The newly formed neuromuscular junction still lacked the structural detail seen in the control neuromuscular junction, even after 30 weeks. Conclusion The persistent weakness following free neurovascular muscle transfer may be attributed to the failure of full recovery of the intricate ultrastructure of the neuromuscular junction.
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Objective:To establish an experimental phalloplasty model with sensory restoration in rabbits and to explore a new surgical technique to improve the postoperative sensory function in phallic reconstruction. Methods: Adult male New Zealand white rabbit was used. Penile reconstruction was performed with superficial epigastric faciovascular pedicle flap. Free saphenous nerve graft was dissected, embedded in the flap, and end-to-end anastomosed to dorsal nerve of penis. Postoperatively, H-E staining and CGRP immunohistochemical staining were applied to observe the morphology of the regenerated nerves in the reconstructed penis at different stages. Results:Only a few CGRP-positive fibers scattered in deep corium in the reconstructed penis 1 month after surgery, while the quantity of CGRP nerve fibers increased markedly and the CGRP-positive fibers appeared in both superficial corium and papillae corii after 3 months. Six months postoperatively, the positive nerve fibers were also observed around the cutaneous accessories and in the epidermis-corium boundary layer. Conclusion: This rabbit model demonstrates the possibility of a new method for phalloplasty with sensory recovery, which may redound to clinical application.
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Nicotinic acetylcholine receptors concentrate on the postsynaptic membrane in the neuromuscular junction and participate in the neuromuscular transmission,which is of great importance to normal muscle function. The nicotinic acetylcholine receptor is a kind of pentamer.There are 2 types of nicotinic acetylcholine receptor due to the different subunit:fetal type ?-AChR (? 2???) and adult type ?-AChR(? 2???). This article reviews the difference of 2 types of nAChR in expression period,distribution,regulation mechanism and physiological significance.