Nasendoscopic comparison for cleft palate repair after velopharyngeal muscle reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To find out the nasendoscopic changes of velopharyngeal configuration and movement after palatoplasty with or without velopharyngeal muscle reconstruction.</p><p><b>METHODS</b>The nasendoscopy was taken in forty-one patients with palatoplasty, 22 repaired by velopharyngeal muscle reconstruction and 19 with modified von Langenbeck's procedure (non-reconstructive group).</p><p><b>RESULTS</b>In patients with velopharyngeal muscle reconstruction, the velopharyngeal ports are smooth and full with a definite reduction in size than patients without velopharyngeal muscle reconstruction. During phonation, the complete and marginal velopharyngeal competence rate in reconstructive group (90.91%) is higher than the group of non-reconstruction (37.31%) The major velopharyngeal closure is circular movement in reconstructive group, otherwise coronal closure in nonconstructive group.</p><p><b>CONCLUSIONS</b>Based the observation of nasendoscopy, the velopharyngeal muscle reconstruction in palatoplasty has more definite improvement to velopharyngeal closure than non-reconstructive procedure. Palatoplasty with velopharyngeal muscle reconstruction could reduce the size of velopharyngeal port and make the complete velopharyngeal closure easier.</p>

A preliminary approach of covering corrugator with rectangle periosteous flap in rhytidectomy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the aesthetic outcome after application of rectangle periosteous flap to cover corrugator.</p><p><b>METHODS</b>On the basis of regular rhytidectomy, a inter-eyebrow periosteous flap is applied to cover the fascia flap of corrugator by means of turnover. This manipulation helps to separate the skin from the muscle and prevent the re-adherence between the skin and muscle.</p><p><b>RESULTS</b>The approach was applied on 15 cases. The follow-up ranged from 6 months to 1 year. The results were satisfactory.</p><p><b>CONCLUSIONS</b>The method is effective in elimination of inter-eyebrow crease.</p>

The application of pedicled anterolateral thigh fasciocutaneous flaps for reconstruction of perineal and inguinal defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a method for the reconstruction of defects of perineum and groin with pedicled anterolateral thigh fasciocutaneous flaps.</p><p><b>METHODS</b>From July 2003 to February 2005, 12 pedicled anterolateral thigh fasciocutaneous flap based on the perforators of lateral circumflex femoral artery had been designed and transferred to the defects of perineum and groin.</p><p><b>RESULTS</b>Anterolateral thigh fasciocutaneous island flaps were performed in twelve patients. The size of the transferred flap ranged from 8 cm x 11 cm to 18 cm x 20 cm. Only one patient developed superficial cutaneous necrosis in the posterior aspect of the flap because of fecal contamination and infection. The wounds healed secondarily.</p><p><b>CONCLUSIONS</b>Despite variable vascular anatomy and technical difficulties in elevating the anterolateral thigh flap, the anterolateral thigh flap is a good choice for perineum and groin reconstruction.</p>

The involvement of ERK pathway in the cellular phenotype conversion in human mesenchymal stem cells cocultured with human sweat gland cells / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the cellular phenotype conversion of human mesenchymal stem cells (MSCs) cocultured with human sweat gland cells (SGCs) and the contribution of extracellular signal-regulated kinase (ERK) pathway in the process.</p><p><b>METHODS</b>MSC and SGC were isolated, amplified , and identified with two-step immunohistochemistry method. The primary SGCs were heat-shocked at 47 degrees C. Then the supernatants were collected immediately and 24hr later. The 3rd passage of MSCs were divided into control, SGC supernatant (cells were cultured in DMEM/F12 medium containing 30% SGC supernatant), SGC supernatant + EGF (cells were cultured in DMEM/F12 medium containing 30% SGC supernatant and 50 microg/L EGF), and SGC supernatant + PD98059 (cells were cultured in DMEM/F12 medium containing 30% SGC supernatant and 10 micromol/L PD98059) groups. The positive expression of CK7and CEA in MSCs were detected on the 7th post-stimulation day (PSD) by flow cytometry. The expression of ERK and phosphorylated ERK were determined with Western blotting.</p><p><b>RESULTS</b>The positive expression rate of CK7 and CEA was (5.76 +/-0.10)%, (2.01 +/- 0.09)% in SGC supernatant group; (7.31 +/- 0.21)% and (7.27 +/- 0.12)% in SGC supernatant + EGF group; and (1.63 +/- 0.11)%, (1.54 +/- 0.07)% in SGC supernatant + PD98059 group; they were all obviously higher than that in control group (P < 0.01). Moreover, ERK expression was observed in all groups. The expression of pERK in SGC supernatant + EGF group was higher than that in SGC supernatant group, but almost no expression of pERK was found in the SGC supernatant + PD98059 and control groups.</p><p><b>CONCLUSION</b>Indirect coculture of MSCs with SGCs can induce the phenotype conversion of MSCs through ERK pathway.</p>

The periareolar approach management of postoperative complications of breast augmentation by injected polyacrylamide hydrogel / 中华整形外科杂志

<p><b>OBJECTIVE</b>To analysis various complications of 30 patients of breast augmentation by injected polyacrylamide hydrogel and discuss the treatment through periareolar incision.</p><p><b>METHODS</b>All patients were classified according to the different complications. Open suction technique and partial mastectomies via periareolar incisions were performed in all patients, Only one patient had immediately breast reconstruction with prosthesis, five patients received secondarily breast prostheses implantation via a axillary incision.</p><p><b>RESULT</b>All the symptoms were relieved after remove of polyacrylamide hydrogel.</p><p><b>CONCLUSIONS</b>Polyacrylamide hydrogel should be prohibited for injected breast augmentation at present. A double-blinded randomized clinical study, controlled animal experiments and a large sample questionnaire survey for complications are necessary. The periareolar approach is valuable technique and can remove polyacrylamide hydrogel as completely as possible.</p>

The reverse first dorsal metatarsal artery flap for the defects of the distal foot / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore a new method to reconstruct the defect of the distal foot.</p><p><b>METHODS</b>A distally based dorsum pedis island flap pedicled with the first dorsal metatarsal artery was designed and transferred to the defect of the distal foot.</p><p><b>RESULTS</b>Five patients were treated with this flap, which ranged from 2 cm x 4 cm to 6 cm x 7 cm in size. Four flaps survived completely, one flap had marginal necrosis and healed after conservative therapy.</p><p><b>CONCLUSIONS</b>The reverse first dorsal metatarsal artery flap, with good blood circulation and easy manipulation, is a good option for the defects of the distal foot.</p>

A comparison of the velopharyngeal closure after palatoplasty between with or without velopharyngeal muscular reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of palatoplasty with or without velopharyngeal muscular reconstruction on the velopharyngeal closure under the lateral radiography.</p><p><b>METHODS</b>The lateral radiographs and cephalometric analysis were taken in sixty-two patients with cleft palate and velopharyngeal insufficiency, 32 repaired with velopharyngeal muscular reconstruction and 30 with modified von Langenbeck's procedure (non-reconstructive group).</p><p><b>RESULTS</b>In patients with velopharyngeal muscular reconstruction, the velopharyngeal competence, the reductive rate of nasopharynx, the distance reduction in lower part of the mobile nasopharynx during phonation and the distance in middle part of mobile nasopharyngo in rest were superior to that without velopharyngeal muscular reconstruction, and there were variform PPW eminence-soft palate contact in velopharyngeal closure. The patients with complete or good velopharyngeal closure had a definite reduction in nasopharynx, compared to the patients with velopharyngeal insufficiency in the non-reconstructive group.</p><p><b>CONCLUSIONS</b>The functional area for velopharyngeal closure after palatoplasty might be located in the middle part of mobile nasopharynx. The velopharyngeal muscular reconstruction in palatoplasty could reduce the size of nasopharynx and improve the coordination movement of velopharyngeal closure.</p>

Facial anatomic study and application in rhytidectomy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To find a procedure for facial rejuvenation which is simple, safe with lasting aesthetic results based on facial anatomic study.</p><p><b>METHODS</b>Anatomy study was performed on 12 sides from 6 head specimens. Observe the range and thickness of fat lateral to the nasolabial grooves. Observed the location of the skin retaining ligaments and reappraised their functions combining with clinical observations.</p><p><b>RESULTS</b>Skin and subcutis and SMAS (including mimic muscles) become slackening with aging, but the loosening degrees are different, especially in the region lateral to the nasolabial groove. So they should be handled respectively. The fat lateral to the nasolabial groove is thick and is mobile with aging . So the subcutaneous detachment need not beyond the anterior border of the masseter. In the past two years, we performed rhytidectomy on 100 patients by limited subcutaneous detachment and SMAS double-plication. Satisfactory results were obtained. There are no serious complications observed.</p><p><b>CONCLUSIONS</b>Rhytidectomy by limited subcutaneous detachment and SMAS double-plication is a simple and safe procedure with lasting aesthetic results.</p>

Re-growth of induced-osseous tissue encapsulated in muscular fasciae for prefabrication of an osteo-musculo-cutaneous flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To improve the survival of mesenchymal stem cells (MSCs) for prefabrication of an osteo-musculo-cutaneous flap.</p><p><b>METHODS</b>In a mouse model, the compound of MSCs and p(3HB-co-3HH) were embeded in the latissimus dorsi muscle as an experimental group and the muscle pocket of the buttock as the control. The examinations of the HE staining, hybridization in situ of osteonectin mRNA and Von kossa staining were used to evaluate the results.</p><p><b>RESULTS</b>The expression of osteonectin mRNA and the Von kossa staining showed that the latissimus dorsi muscle group was superior to the control in 2 weeks and 4 weeks after the surgery in vivo.</p><p><b>CONCLUSION</b>The results indicate that the above-mentioned technique may be a good alternative for the prefabrication of the osteo-musculo-cutaneous flap.</p>

The usage of inferior turbinate mucosal flap for repairing cleft lip / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a technique for decreasing the tension of the nasal floor during the procedures of repairing complete clef lip.</p><p><b>METHODS</b>With the designation of an inferior turbinate mucosal flap combined with an oral mucosal flap in the splitting side, the tension was effectively decreased and the nasal floor was closed easily. Eighteen patients was selected for the treatment with this technique since 2000. The follow-ups were 10 to 24 months.</p><p><b>RESULTS</b>All of the patients showed wound healing well with the significant improvement in the donor site.</p><p><b>CONCLUSION</b>The above mentioned technique may effectively decrease the tension and be used to close the nasal floor safely. It could also reduce the incidence of the complications.</p>

The investigation of behavior problem with secondary deformity of cleft lip / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the behaviors of the children suffered from the secondary deformity after the repair of the cleft lip.</p><p><b>METHODS</b>With the application of the PCPI, eighty patients with the secondary deformity after the repair of the cleft lip were selected in this study and 134 normal children was used for the control.</p><p><b>RESULTS</b>In the age between 6 and 11 years, there were no significant difference of the behaviors between the children suffered from secondary deformity of cleft lip and the normal children,but in the age from 12 to 16, the children with the deformity showed more behavior problems with the social withdraw and the poor social relationships, compared with the normal children.</p><p><b>CONCLUSION</b>The children with the secondary deformity after cleft lip repair in adolescence could have the tendency to suffer from the behavior problems, especially showing the social withdraw and the poor social relationships.</p>

Treatment of the complications of polyacrylamide hydrogel injection for augmentation mammaplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>The purpose of this study was to search for a perfect treatment for the complications after polyacrylamide hydrogel injection for augmentation mammaplasty.</p><p><b>METHODS</b>48 patients who accepted polyacrylamide hydrogel injection for augmentation mammaplasty were included in this study. Operations were performed for the complications of polyacrylamide hydrogel injection. The clinical data were analyzed and the experience in the treatment of the complications was summarized.</p><p><b>RESULTS</b>All patients were satisfied with the result of the operation. The B-ultrasonic examination showed that no visible polyacrylamide hydrogel remained in the cavity.</p><p><b>CONCLUSION</b>The best therapy for the complications of polyacrylamide hydrogel injection was removing of the polyacrylamide hydrogel and the pathologic tissue and irrigation of the cavity.</p>

Applications of autogenous outer table of the calvarial and mandibular bone in posttraumatic deformities of the nose / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the applications of bone grafts from the cranium or mandible in the repair of posttraumatic deformities of the nose.</p><p><b>METHODS</b>From 1997 to 2002, a total of 44 patients, who presented with secondary nose deformity as well as facial fractures, were reconstructed by autogeneous outer table grafts of the calvarial or mandibular bone after facial skeleton reposition. In this series, 32 cases used the calvarial bone, 12 cases used the mandible bone, which was harvested through a coronal incision and an oral approach respectively.</p><p><b>RESULTS</b>The surgical incisions healed primarily in all patients with minimal scar. The facial appearance was greatly improved. No implant infection, extrusion and shift were observed in the postoperative follow-up of 6 months to 2 years. There was not obvious bone resorption, nor donor site morbidity.</p><p><b>CONCLUSION</b>Autogeneous calvarial and mandibular bone was an ideal material of bone graft in reconstruction of severe posttraumatic deformities of the nose. Compared with other autogeneous and alloplastic materials, the outer table of the calvarial and mandibular bone produced less morbidity of the donor site, invisible scar, no rejection and less resorption.</p>

Experimental study of a polypropylene mesh for moulding and supporting a breast during a breast reduction procedure / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the polypropylene mesh acted for the moulding and support.</p><p><b>METHODS</b>Four mini-pigs were used in this experimental research. A polypropylene mesh was implanted under the skin on one side of each pig. An expander was thereafter placed in the deep layer to imitate the action of gravity to the skin and mesh. The specimens were collected in two different times for the biomechanics and histology examinations.</p><p><b>RESULTS</b>The biomechanical data were shown lower and the histological properties were found changeable in the expanded skin without the mesh support, compared with the normal skin. However, the changes did not occur in the expanded skin with the mesh support. Furthermore, the tensile strength and elastic modulus of the polypropylene mesh were significant less than the human skin.</p><p><b>CONCLUSION</b>The Polypropylene mesh could prevent the extended skin effectively and has moulding and support effects.</p>

Leptin as a survival enhanced-factor in grainy fat transplantation / 中华整形外科杂志

<p><b>OBJECTIVE</b>This experiment is to test the survival enhance effect of leptin in grainy fat transplantation.</p><p><b>METHODS</b>The 0.6 g grainy fat was obtained from the Wistar mouse subcutaneous tissue in the abdomen. It was then mixed with 0.9% NS and 20 ng/ml leptin and transplanted in the head subcutaneously. The transplanted tissue was taken out after 10, 20 and 40 days. After being weighed, the tissue was dyed with HE staining and VEGF staining. The data was analyzed with SPSS software.</p><p><b>RESULTS</b>The fibrous membrane around the tissue in leptin group was thin and there was less fat cell necrosis, compared with the control group. The remained-weight rate was 108.3%, 83.3% and 66.3% in 10, 20 and 40 days after the surgery. The differences were statistic significant between the leptin groups and the control (P < 0.05). The examinations of the HE and VEGF stain showed that there was the rich vascularization in leptin treated tissue.</p><p><b>CONCLUSION</b>Leptin could enhance the survival of the transplanted grainy fat due to its angiogenesis effect.</p>

The expression of the estrogen receptor within the mammary gland of the breast hypertrophy and hypogenesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of the estrogen receptors(ER) in breast hypertrophy and micromastia.</p><p><b>METHODS</b>The quantity of ER within breast tissue in 13 patients with mammary hypertrophy strictly elected was determined using DCC single dot test. The results were compared with that measured in 13 patients with micromastia.</p><p><b>RESULTS</b>The average of the quantity of the ER was respectively (5.33 +/- 5.70) fmol/mg and (1.17 +/- 0.86) fmol/mg in mammary hypertrophy ground and in the micromastia group. There was obvious significant between the two groups in a statistics basis (P < 0.05) .</p><p><b>CONCLUSIONS</b>The breast hypertrophy is related to the excessive expression of ER within breast tissue,while the micromastia and breast hypotrophy are related to the lower level or the expression inhibition of ER.</p>

Experimental study on inhibition of skin graft contraction with papaverine cream / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of exteral use of papaverine cream on enhancement of skin graft.</p><p><b>METHODS</b>Five mini-pigs were used for the study. 20 full-thickness wounds were created on the back of each animal. Along the midline of the abdomen, a 40 cm x 2 cm full-thickness skin graft was harvested and the wound sutured.The full-thickness graft was prepared and trimmed to 2 cm x 2 cm of 0.6 mm thickness split-skin grafts, which were transplanted to each wound with tie-over bolsters. The sutures were removed 2 weeks after the operation. Twelve pairs of 100%-survived skin grafts were selected and divided into group A (the left side) and group B (the right side), with each pair locating on the same and opposite position. From the day of suture removal, 2% papaverine cream was used to group A while plain cream was used to group B. The grafts were measured and observed for healing condition at the time of suture removal and the first, second, third, fourth, fifth, and sixth month. The surface area of the graft was measured and the shrinking ratio was calculated. After the animals were killed at the sixth month, samples of the skin grafts were taken and processed with 10% formalin, routine paraffin wax and Hematoxylin-eosin staining. The tissue structure was observed and the results were analyzed statistically.</p><p><b>RESULTS</b>The grafts in two groups did not have significant differences at the time of suture removal. Observations from the first to the sixth month showed that the two groups had significant differences in skin graft contracture and histological changes. HE stains demonstrated that the skin grafts in group A had less fibroblasts, more microvessels and orderly-arranged collagenous fibers.</p><p><b>CONCLUSIONS</b>External use of papaverine cream can inhabit the contraction of skin grafts. It is a safe, effective, simple, and reliable method,which has the advantages of easy delivery,cheapness, less injury and infection,and no side effects.</p>

Collagen changes of allografting an acellular dermal matrix / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the collagen changes of allografting an acellular dermal matrix (allo-ADM).</p><p><b>METHODS</b>The allo-ADM was grafted underneath the skin of SD rats. The content of collagen and the proportion of type I to III collagen was examined with a biochemical assay.</p><p><b>RESULT</b>The content of collagen and the proportion of type I to III collagen in the allo-ADM group showed no significant changes.</p><p><b>CONCLUSION</b>The allo-ADM could keep long time in the body and it may be an ideal material for soft tissue filling.</p>