The significance of beta-receptor expression in infantile hemangiomas / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of beta-receptor ( p-R) in infantile hemangioma.</p><p><b>METHODS</b>The expression of beta-R was detected by immunohistochemistry in infantile hemangioma (40 cases), venous malformation (20 cases) and normal skin (10 cases).</p><p><b>RESULTS</b>The positive expression rate of beta2-R was 70% (28/40) in infantile hemangioma, while no expression of beta2-R in venous malformation and normal skin. Among 28 cases with positive expression of beta2-R, 24 cases were in proliferative phase. The positive expression of beta2-R in infantile hemangioma was significantly higher than that in venous malformation and normal skin tissue. The positive expression of beta2-R in the proliferative hemangioma and non-proliferative hemangioma was also significantly different (P < 0.05).</p><p><b>CONCLUSIONS</b>beta2-R is specifically expressed in infantile hemangioma, especially in proliferative hemangioma.</p>

Reduction mammaplasty with central gland pedicle based on Würinger's horizontal septum / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the method and efficacy of reduction mammaplasty with central gland pedicle based on Würinger' s horizontal septum in the treatment of female breast hypertrophy.</p><p><b>METHODS</b>From Mar. 2009 to Sept. 2011, a series of 21 consecutive patients with mild and moderate hypermastia underwent reduction mammaplasty with central gland pedicle. Only the mammary gland located at cranial portion of septum was resected and the mammary gland located at caudal portion of septum was preserved.</p><p><b>RESULTS</b>In our series, the mean resection weight per breast was (327.8 +/- 148.6) g, the mean nipple-to clavicle midpoint was 20.0 cm (range, 18.0-22.0 cm) and the mean nipple-to-sternal-notch distance was 21.0 cm (range, 19.5-22.5 cm) postoperatively. Nipple was moved upward 6.5 cm on average (range, 4.0-10.0 cm). There was no hematoma and nipple-areolar complex (NAC) necrosis. Minimal wound dehiscence occurred in one case and healed by dressing change. 17 cases were followed up for 3 months to 2 years. Satisfactory breast shape was achieved with good NAC sensibility.</p><p><b>CONCLUSIONS</b>The reduction mammaplasty with central gland pedicle based on Würinger' s horizontal septum is a safe and reliable technique for mild and moderate hypermastia. Satisfactory breast contour, as well as NAC viability and sensibility, could be achieved with lower occurrence of hematoma or seroma.</p>

Auricular reconstruction by soft tissue expansion techniques without skin grafting / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate a method of auricular reconstruction by soft tissue expansion techniques without skin grafting.</p><p><b>METHODS</b>Two tissue expanders (50 ml and 70 ml) were implanted under the skin of mastoid in 15 patients with grade II or III microtia. One big expander (100 ml) were implanted under the skin of mastoid in 13 patients with grade I microtia and 3 patients with grade II or III microtia. After skin expansion, the expanders were taken out. The autologous rib cartilage or Medpor scaffolds were implanted. The superior expanded skin flap was used to cover the frontal surface and the upper part of the back surface of the framework. The inferior expanded skin flap was transplanted to cover the lower part of the back surface of the framework. The remained expanded skin flap was transplanted to cover the wound in the lateral of head.</p><p><b>RESULTS</b>No skin graft was needed in all the patients. Epidermis blister occurred at the distal part of flap in one case. No other complication was happened. A follow-up of 6 to 12 months (mean 10.9 months) was carried out in all patients with good cosmetic result when the reconstructed ear underwent second-stage operation. The scar size on the dornor site was (5.2 +/- 0.6) cm2 The satisfactory rate was 90% (28/31).</p><p><b>CONCLUSIONS</b>The expanded skin with this new method is enough for auricular reconstruction without skin grafting, leaving less complication and less scar at donor site.</p>

Auricular reconstruction and correction of mild hemifacial microsomia with dermal fat graft in one stage / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of auricular reconstruction and correction of mild hemifacial microsomia with dermal fat graft in one stage.</p><p><b>METHODS</b>28 cases with microtia and grade I and II hemifacial microsomia were treated. The tissue expander was implanted under the skin of mastoid at the first stage. At the second stage, the auricular reconstruction was performed with autologous rib cartilage framework. The remained dermal fat tissue from the donor site was inserted subcutaneously to correct the asymmetric face of microsomia. 20 cases, who underwent auricular reconstruction only, were used as control group.</p><p><b>RESULTS</b>The facial asymmetry was greatly improved after operation in the 28 cases. The complications happened in 7% (2/28) of the patients, including one case of infection and one case of framework exposure. While it was 5% (1/20) in control group, showing no significant difference between the two groups (P > 0.05). The satisfactory rate was 93% (26/28) in one-staged group and 80% (16/20) in control group (P < 0.05).</p><p><b>CONCLUSIONS</b>The dermal fat graft which should be abandoned in the traditional auricular reconstructions could be used to correct mild hemifacial microsomia with satisfactory appearance improvement.</p>

Radiofrequency ablation combined with transarterial chemoembolization for unresectable primary liver cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Radiofrequency ablation (RFA) followed by transarterial chemoembolization (TACE) for unresectable primary liver cancer (PLC) has not been widely discussed. In this study, the outcome of the combination of RFA with TACE was retrospectively evaluated.</p><p><b>METHODS</b>From May 2003 to March 2008, 127 consecutive PLC patients with a median age of 56.4 +/- 8.8 years underwent RFA plus TACE. All patients were deemed to have unresectable PLC based on their tumor characteristics. The maximal diameter of the tumor was between 1.5 cm and 10.0 cm. Twenty-six cases with small (<or= 3.0 cm), 33 with medium (3.1 - 5.0 cm), and 68 with large (> 5.0 cm) tumors were included in this study. RFA was performed using a RITA Medical Systems expandable electrode device, which was followed by first-time TACE administration one to two months later.</p><p><b>RESULTS</b>Technical success of RFA was achieved in all 127 patients with no severe treatment-related complications. RFA was performed percutaneously in 16 (13.5%) cases, by laparoscopic approach in 19 (15.7%), and through laparotomy in the remaining 92 (72.4%). RFA response was classified as complete ablation in 48 cases, nearly complete ablation in 28, and partial ablation in 51. The total 1-, 2-, and 3-year survival rates after RFA were 83.1%, 55.7%, and 43.7%, respectively. The survival rates at 3 years were 78.6%, 28.1%, and 0 for complete ablation, nearly complete ablation, or partial ablation groups, respectively. Three-year disease-free survival rates for the complete ablation and nearly complete ablation groups were 50.3% and 21.3%, respectively. RFA response and liver function were significant variables influencing survival time as analyzed using the Cox regression model.</p><p><b>CONCLUSION</b>RFA could be the first-line exterminate treatment for unresectable PLC, and TACE following RFA may assist in eradicating the peripheral viable tissue and micro-metastasis.</p>

Auricular reconstruction with overlapping tissue expansion techniques / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate a method of auricular reconstruction with overlapping tissue expansion techniques and without skin graft.</p><p><b>METHODS</b>Two tissue expanders were implanted subcutaneously at the mastoid. 6 patients with microtia (overlapping group) were treated. After completion of skin expansion, the expanders were removed. The autologous rib cartilage or Medpor scaffolds were implanted. The flap A made by the upper expanded flap was used to cover the upper part of the front and the back of the framework. The flap B made by lower expanded flap was transplanted to cover the lower part of the back of frameworks. The remaining expanded skin was designed to cover the postauricular wound. The other thirteen microtia patients who treated by the traditional auricular reconstruction were selected as control(traditional group).</p><p><b>RESULTS</b>Skin graft was not necessary in the patients of overlapping groups. The appearance of the reconstructed ear was very satisfactory. Epidermal necrosis of 0.5 cm x 0.5 cm happened at the distal end of postauricular flap in one case. All the other cases had no complication of infection or framework exposure. The patients were followed up for 3-6 months. Compared with the traditional group, the scar in the costal donor site was inconspicuous in overlapping group (P < 0.05). The complication rate was lower and satisfactory rate was higher in overlapping group (P < 0.01 and P < 0.05). But there was hair growth in the helix of reconstructed ear in overlapping group.</p><p><b>CONCLUSIONS</b>The overlapping expansion can provide enough skin for ear reconstruction. The skin graft is not necessary, resulting less donor site scar and low complications.</p>

Analysis of the complications following the periareolar reduction mammaplasty using polypropylene mesh as suspension device / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the cause and the prophylactic measures for the complication following the periareolar reduction mammaplasty using polypropylene mesh as suspension device.</p><p><b>METHODS</b>From Dec. 1999 to Dec. 2005, 78 patients who underwent periareolar reduction mammaplasty using polypropylene mesh as suspension device were analysed. Among them, 47 cases were followed-up for 6 months to 5 years, and their long-term effect was evaluated.</p><p><b>RESULTS</b>Early after operation, complications included seroma (3 cases), infection (3 cases), delayed wound healing (3 cases), and paraesthesia of nipple-areolar complex (1 case). The 47 followed-up patients presented abnormal wave-like skin appearance in superior polar of breast (7 cases), palpable cord-like mammary content in peripheral region of breast (3 cases), widening of periareolar scar and secondary ptosis (2 cases) and paraesthesia of nipple-areolar complex (1 case). All other patients acquired good appearance and felt satisfactory. 2 patients could lactate after operation. 5 patients underwent mammary X-ray radiography after operation. No mesh shadow or calcification was revealed.</p><p><b>CONCLUSIONS</b>Although polypropylene mesh is a good suspension device in reduction mammaplasty, the long-term complication is relatively high because of the hardness of the tissue. More soft tissue is necessary as alternative device for clinical application.</p>

Surgical treatment of 475 patients with periampullary carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare of the outcome of all patients who received surgical treatment in one institute for periampullary carcinoma during different intervals over the past 40 years.</p><p><b>METHODS</b>Retrospective review of 475 patients suffering from periampullary carcinoma in intervals 1958 approximately 1976, 1977 approximately 1987, 1988 approximately 1998 and 1999 approximately 2003 is presented.</p><p><b>RESULTS</b>In interval 1958 approximately 1976, for 128 patients, the tumor resection rate was: pancreatic carcinoma (PC) 26.6% (21/79), ampullary carcinoma (AC) 86.2% (25/29), distal bile duct cancer (DBDC) 38.5% (5/13), and duodenal cancer (DC) 57.1% (4/7). In interval 1977 approximately 1987, for 70 patients, the tumor resection rate was: PC 26.7% (16/60), AC 66.7% (4/6), DBDC 100% (1/1), and DC 66.7% (2/3). In interval 1988 approximately 1998, for 147 patients, the tumor resection rate was: PC 20.2% (22/109), AC 75.0% (12/16), DBDC 50.0% (2/4), and DC 66.7% (12/18). In interval 1999 approximately 2003, for 130 patients, the tumor resection rate was: PC 20.4% (20/98), AC 100% (4/4), DBDC 75.0% (12/16), and DB 83.3% (10/12). Cumulatively, from 1958 to 2003, the incidence of DBDC has become significantly higher, and the average of total bilirubin level (TBIL) has gradually been going downward, the average of blood transfusion during operation and the diameter of resected tumor has been becoming smaller. From 1999 to 2003, none of the 130 periampullary carcinoma patients had received biliary drainage before operation.</p><p><b>CONCLUSION</b>Mortality and complication have become significantly lower because of effective improvement in the perioperative preparation and the care after surgery of periampullary cancer in the recent years. Even though the accurate diagnosis has become increasing earlier than before, the resection rate and prognosis of periampullary carcinoma remain poor.</p>

The expression and interaction of cyclin D1 and p16 in fibroblasts of pathologic scars / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of cyclin D1, p16, AR and ER in fibroblasts of scars for further understanding the interaction of these factors and the roles that they play in scar development.</p><p><b>METHODS</b>Thirty samples of mature scar, hypertrophic scar and keloid were detected with immunohistochemical method (SP technique) and compared with normal skin.</p><p><b>RESULTS</b>There were on positive results in normal skin and mature scars. The expression of cyclin D1, p16 and AR was higher in hypertrophic scars and keloids than in normal skin with significant difference (P < 0.05). The expression of cyclin D1 in keloids was higher than in hypertrophic scars (P < 0.05). Though the expression of p16 was higher in keloids than in hypertrophic scars, the difference was not significant. There was significant correlation between the expression of cyclin D1 and AR in the pathologic scar.</p><p><b>CONCLUSION</b>The AR played an important role in scar formation and displayed its function through cyclin D1. The expression of p16 could suppress the excessive proliferation of cells to some extent. If the effect was not enough to resist the function of cyclin D1, long-term proliferation of cells would occur and lead to keloid formation. As the expression of cyclin D1 and p16 in hypertrophic scars was in a state of relative equilibrium, the cell proliferation showed a tendency of self-restriction.</p>