Transconjunctival lower eyelid blepharoplasty with "super released" orbital fat in correction of tear trough and palpebromalar groove depression / 中国修复重建外科杂志

OBJECTIVE@#To investigate effectiveness of transconjunctival lower eyelid blepharoplasty with "super released" orbital fat in correction of lower eyelid pouch protrusion and tear trough and palpebromalar groove depression.@*METHODS@#A clinical data of 82 patients (164 sides) with lower eyelid pouch protrusion and tear trough and palpebromalar groove depression, who met the selection criteria between September 2021 and May 2022, was retrospectively analyzed. Of the included patients, 3 were males and 79 were females, with an average age of 34.5 years (range, 22-46 years). All patients had varying degrees of eyelid pouch protrusion and tear trough and palpebromalar groove depression. The deformities were graded by the Barton grading system as gradeⅠ in 64 sides, grade Ⅱ in 72 sides, and grade Ⅲ in 28 sides. The orbital fat transpositions were performed through the lower eyelid conjunctival approach. The membrane surrounding the orbital fat was completely released, allowing the orbital fat to fully herniate until the herniated orbital fat did not retract significantly in a resting and relaxed state, which is regarded as the "super released" standard. The released fat strip was spread into the anterior zygomatic space and the anterior maxillary space, and percutaneous fixed to the middle face. The suture that penetrates the skin was externally fixed by adhesive tape pasting without knotted.@*RESULTS@#There were 3 sides with chemosis after operation, 1 side with facial skin numbness, 1 side with mild lower eyelid retraction at the early stage after operation, and 5 sides with slight pouch residue. No hematoma, infection, or diplopia occurred. All patients were followed up 4-8 months, with an average of 6.2 months. The eyelid pouch protrusion, tear trough, and palpebromalar groove depression were significantly corrected. At last follow-up, the deformity was graded by Barton grading system as grade 0 in 158 sides and grade Ⅰ in 6 sides, with a significant difference compared to the preoperative score ( P<0.001). Patient's self-evaluation satisfaction reached very satisfied in 67 cases (81.7%), satisfied in 10 cases (12.2%), generally satisfied in 4 cases (4.8%), and dissatisfied in 1 case (1.2%).@*CONCLUSION@#The "super released" orbital fat can effectively prevent the retraction of orbital fat, reduce the probability of residual or recurrence of eyelid pouches, and improve the correction effect.

Risk factors associated with the progression from keloids to severe keloids / 中华医学杂志(英文版)

BACKGROUND@#Keloids are benign fibrous growths that are caused by excessive tissue build-up. Severe keloids exert more significant effects on patients' quality of life than do mild keloids. We aimed to identify factors associated with the progression from mild keloids to severe keloids, as distinct from those associated with the formation of keloids.@*METHODS@#In this retrospective case-control study, 251 patients diagnosed with keloids at West China Hospital between November 2018 and April 2021 were grouped according to the severity of lesions (mild [n = 162] or severe [n = 89]). We collected their basic characteristics, living habits, incomes, comorbidities, and keloid characteristics from Electronic Medical Records in the hospital and the patients' interviews. Conditional multivariable regression was performed to identify the independent risk factors for the progression of keloids.@*RESULTS@#Eighty-nine patients (35.5%) were classified as having severe keloids. We found the distribution of severe keloids varied with sex, age, excessive scrubbing of keloids, family income, the comorbidity of rheumatism, disease duration, characteristics of the location, location in sites of high-stretch tension, the severity and frequency of pain, the severity of pruritus, and infection. Multivariable analysis revealed significant associations between severe keloids and infection (odds ratio [OR], 3.55; P = 0.005), excessive scrubbing of keloids (OR, 8.65; P = 0.001), low or middle family income (OR, 13.44; P = 0.021), comorbidity of rheumatism (OR, 18.97; P = 0.021), multiple keloids located at multiple sites (OR, 3.18; P = 0.033), and disease duration > 15 years (OR, 2.98; P = 0.046).@*CONCLUSION@#Doctors should implement more active and thorough measures to minimize the progression of mild keloids in patients who have any of the following risk factors: infection, excessive scrubbing of keloids, low or middle family income, comorbidity of rheumatism, multiple keloids located at multiple sites, and disease duration > 15 years.

Clinical application of thoracodorsal artery perforator flap in repair of serious scar contracture of opisthenar / 中国修复重建外科杂志

Objective: To investigate the feasibility and effectiveness of thoracodorsal artery perforator (TDAP) flap for repairing serious scar contracture of the opisthenar. Methods: Between March 2015 and June 2017, 7 cases of serious scar contracture of opisthenar were repaired with TDAP flaps. There were 5 males and 2 females with an average age of 31 years (range, 11-48 years). The time from injury to operation was 8-67 months, with an average of 42 months. After the relocation of the joint and release of the scar, the size of soft tissue defect ranged from 5 cm×4 cm to 10 cm×8 cm. The size of TDAP flap ranged from 5.5 cm×5.0 cm to 10.5 cm×9.0 cm. Results: All flaps survived completely with primary healing at both donor site and recipient site. The flaps of 3 patients were bulky and underwent second-stage skin flap thinning at 3 months after operation. All 7 patients were followed up 6-32 months, with an average of 15 months. The skin flaps were soft and elastic. According to the upper limb function evaluation system recommended by Chinese Society of Hand Surgery, sensory function was classified as S3+ in 2 cases, S3+ in 1 case, S2+ in 3 cases, and S11+ in 1 case. The hand function was excellent in 2 cases, good in 4 cases, and fair in 1 case. There was no significant effect on shoulder movement. Conclusion: The TDAP flap is an ideal method for serious scar contracture of opisthenar.

Study on the Chemical Constituents in Antioxidant Activity Part of Semiaquilegia adoxoides / 中国药房

OBJECTIVE:To study the chemical constituents in antioxidant activity part of Semiaquilegia adoxoides. METH-ODS:The antioxidant activity part of S. adoxoides were isolated and purified by chromatography on silicagel and Sephadex LH-20 column,and compound structures were identified physicochemical properties and spectral data analysis. RESULTS:Nine com-pounds were isolated from the antioxidant activity part of S. adoxoides,namely magnoflorine (1),griffonilide (2),salidroside (3),ferulic acid(4),genistein(5),2,4-dihydroxybenzoic acid(6),chlorogenic acid(7),caffeic acid(8)and p-coumaric acid (9). CONCLUSIONS:The study confirms the active material basis in antioxidant activity part of S. adoxoides for the first time.

Repair of fingertip defects with lateral flaps of finger based on digital artery perforator / 中华显微外科杂志

ObjectiveTo analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. MethodsFrom October 2008 to August 2010,nine patients with twelve fingertip defects,including 5 thumbs,2 index fingers,3 middle fingers,2 ring fingers,underwent repair with lateral homodigital flaps based on digital artery perforator.The size of the flaps ranged from 2.7 cm× 1.4 cm to 3.1 cm× 1.8 cm.The donor site were covered by skin graft. ResultsEleven flaps survived.One case met with partial necrosis.The follow-up time ranged from 3 to 6 months(average of 4.5 months).The finges had good appearance.Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation.ConclusionUsing the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects.

Comparison of minimally invasive percutaneous iliosacral screw and reconstruction plate fixation in treating unstable pelvic fractures / 中华骨科杂志

ObjectiveTo compare the clinical effect of percutaneous iliosacral screws osteosynthesis (PISO) and open reduction internal reconstruction plate fixation in treating unstable pelvic fractures combined with sacroiliac joint dislocation,and evaluate their safety and practicality.MethodsFrom March 2004 to October 2010,37 patients with vertical unstable pelvic fractures were admitted to our department.Twenty cases were treated with percutaneous sacroiliac screw fixation and 17 cases were performed opened reduction and internal reconstruction plate fixation under C-arm X-ray's guide.The perioperative parameters and postoperative imaging indexes were compared and analyzed.ResultsAll patients were followed up for 6 months to 26 months,with an average of 15 months.There were statistical significances between the PISO group and open reduction internal fixation group in operation time,blood loss,postoperative pain,mean fever time and hospital stay.The two groups showed no significant difference on postoperative X-evaluation of reduction effect.The average healing time was 3.2 months and the difference was not statistically significant between two groups.PISO group had no complications such as infection,bent nails or broken nails.ConclusionThrough compared and analyzed the two groups in treating unstable pelvic fractures,the percutaneous sacroiliac screw fixation has been proved for a kind of ideal minimally invasive surgery method because of locating exactly,less damage and blood loss,milder pain and quicker recovery.But it demands higher operation techniques.Adequate preoperative preparation and postoperative patients' cooperation can reduce complications incidence.The second group of anterior reconstruction plate or T-shape plate to fix vertically unstable pelvic fractures at same time shows a good result of stabilization.

Tissue engineering cbondrogenesis :an experiment study of bone mesenchymal stem cells / 中国矫形外科杂志

[Objective]To investigate the chondrogenic ability and feasibility of bone mesenchymal stem cells(BMSCs) in three kinds of cellular carrier.[Method]BMSCs were separated and cultured into the third generation,which were cultivated in three knids of carriers by multi-point injection into and dropping on the surface of carriers(fibrin collagen sponge,group A;fibrin collagen sponge and FGF,group B and gelatin sponge,group C).All samples were analyzed after four weeks.[Result]There were a few chondrogenic cells in group A,much more chondrogenic cells in group B,and no cells in group C.According to analysis with SPSS 10.0 software,There were more cartilage cells(92.75?10.57) in group B than in group A(36.45?8.34).It was statistical different(P

Intravenous laser treatment of varicose great saphenous veins: Report of 126 cases / 中国微创外科杂志

Objective To evaluate the efficacy of intravenous laser treatment for varicose great saphenous veins of lower limbs. Methods .Intravenous laser treatment in combination with surgical procedure was used to treat 126 cases of varicose great saphenous vein (150 limbs) in this hospital between July 2002 and May 2004. Results .The operation time was 30~50 min (mean, 45 min). A follow-up for 3~19 months (mean, 6 months) in 120 cases (142 limbs) was carried out. Out of the 142 limbs, symptoms of soreness and lacking in strength completely disappeared in 134 limbs (94.4%) and partially subsided in 8 limbs (5.6%). A complete disappearance of symptoms of skin pigmentation and swelling was achieved in 45 limbs (90.0%, 45/50) and 97 limbs (96.4%, 97/101), respectively. The varicose superficial veins vanished in all the limbs without recurrence. Complications included skin burn on the medial malleolus (2 cases) or anterior shank (2 cases), numbness and hypoesthesia on the medial shank (3 cases), and subcutaneous cord-like hard tubercles (32 cases, which were completely softened and absorbed 3 months later). Conclusions .Intravenous laser treatment is a reliable method in the treatment of varicose great saphenous veins, with simplicity of performance, good safety, little influence of normal activities, and excellent cosmetic results.