Therapeutic effect of modified frontal muscle flap transfer with facial nerve function fully preserved in the correction of severe blepharoptosis / 中华医学美学美容杂志

Objective:To study the therapeutic effect of modified frontal muscle flap with facial nerve function preserved in the treatment of severe blepharoptosis, and to observe its therapeutic effect and recurrence rate.Methods:From May 2005 to may 2019, 17 patients (26 eyes) with severe blepharoptosis were treated with modified triangular frontalis muscle flap. The curative effect and satisfaction were evaluated.Results:After 6 months to 10 years＇ follow-up, the patients with blepharoptosis were well corrected, and the function of opening and closing was restored to normal. 24 eyes in 26 eyes were cured, and 2 eyes were basically cured. No recurrence or retraction of the upper eyelid occurred. 14 patients were very satisfied with the treatment effect, 2 were basically satisfied, 1 was not satisfied.Conclusions:The transfer of the triangle frontalis flap in the upper part of the eyelid can correct the blepharoptosis effectively, and keep the function of facial nerve fully, then avoid the paralysis of frontalis flap caused by nerve conduction obstacle, which can reduce the recurrence rate.

The Application of a 2D Printing of Rib Cartilage in Personalized Ear Framework Fabrication / 中华整形外科杂志

Objective@#To explore a 1∶1 2D printing method of rib cartilage based on CT scanning in assisting ear framework fabrication for auricular reconstruction.@*Methods@#From January 2016 to January 2017, 73 cases of microtia aging from 5 to 7 referred to our department. A 1∶1 2D printing of rib cartilage based on CT scanning was applied in preoperative assessment and measurments of bilateral sixth, seventh and eighth costal cartilage were completed before the surgery. Personalized rib cartilage ear framework fabrication was determined by the measurements.@*Results@#Among the 73 cases, 58 cases received auricular reconstruction successfully. There were 15 patients whose rib cartilages did not meet the requirements and postponed the surgery. The patients who underwent auricular reconstruction were followed up for 6 to 12 months (average, 9 months). During the follow-up, 52 cases had satisfactory outcomes in size, shape, symmetry and details. No deformation of reconstructed ears or chest wall was found during the follow-up.@*Conclusions@#The 1∶1 2D printing based on CT scanning is a simple and timesaving way to evaluate the rib cartilage. It can be beneficial to save the amount of cartilage and improve the personalized ear framework fabrication.

Application of autologous fat grafting in breast reconstruction / 中华外科杂志

Objective@#To observe the outcome of breast reconstruction with autologous fat grafting in the patients following treatment for breast cancer.@*Methods@#The clinical data of 22 patients after breast cancer modified radical mastectomy with fat grafting for breast reconstruction from January 2012 to March 2015 at Department of Body Contouring and Liposuction Center of Plastic Surgery, Hospital of Peking Union Medical College were analyzed retrospectively. The age of 22 patients (all female) was 28 to 54 years. Fifteen patients were performed breast modified radical mastectomy 5 to 16 year ago without radiotherapy, 7 patients were performed breast modified radical mastectomy following regular radiotherapy 2 years ago. Low negative pressure liposuction technical was applied to harvest fat tissue for 400 to 800 ml which was filtrated and purified by cotton pad method in low temperature environment. Fat grafting was performed with multi-level and multi-tunnel and in multi-point injection ways. All patients were followed up by regular imaging evaluation with MRI or ultrasonography after operation every 3 months.@*Results@#All breast reconstruction were successfully performed in 22 patients, no severe complications occurred. Among 15 patients without radiotherapy, 12 patients were performed with autologous fat grafting for breast reconstruction, 3 patients with prosthetic implantation for breast augmentation after autologous fat grafting. Among 7 patients with radiotherapy, 6 patients were performed with autologous fat grafting for breast reconstruction, 1 patient with prosthetic implantation for breast augmentation after autologous fat grafting. The volume of fat grafting was 104 to 380 ml. It took 2.5 hours to finish the operation including 1.0 to 1.5 hours for liposuction and 40 minutes for fat grafting. Next fat grafting were performed after 3 months. The fat of the breast were survived well detecting by MRI, only 1 patient had a cystic nodule which had been resected during nipple reconstruction. Ultrasonography screened several cystic nodules with the major axis of 0.1 to 0.2 cm in the breast, which couldn′t be found by palpating in 18 patients. The patients were followed up for 18 to 36 months, the outcome were satisfactory.@*Conclusion@#Autologous fat grafting for breast reconstruction simplifies the operation program with satisfied results and avoids the complications of breast reconstruction with skin flap.

Argatroban in treatment of patients with transient ischemic attack / 中华全科医师杂志

Eighty-three patients with transient ischemic attack (TIA) were randomly divided into study group (n =42) and control group (n =41) from July,2011 to Mar,2015.Patients in both groups were given aspirin 100 mg/d ; in addition,patients in study group received intravenous infusion of argatroban 10 mg,q12h,for 7 days and those in control group received subcutaneous injection of low molecular weight heparin (LMWH) 2 050 AXa IU,b.i.d for 7 days.The cases with cure,significantly effectiveness and effectiveness in study group and control group were 10,14,16 and 6,12 16,respectively.Compared with the control group,argatroban shows superiority in treatment of TIA with higher safety and lower side effect.

Climical perception for 100 cases valvular heart disease operated at the basic level hospital / 中国基层医药

Objective To summarize the experience of surgical treatment for 100 patients with valvular heart disease.Methods 100 valve patients were operated on from June 2002 to July 2006.The heart function(NYHA) was class Ⅱ in 24,class Ⅲ in 54,class Ⅳ in 22 including 7 patients with sever cardiac failure.74 patients had rheumatic disease,19 congenital disease,2 cases with SBE.7 aortic vavle degenerative disease including 1 case with ascending aortic dissection aneurysm,61 atrial fibrillation,10 left atrium thrombus and 3 coronary heart disease.Results There were low output syndrome in 14,including 2 death,4 reoperation for postoperative bleeding and 1 gasembolism in brain stem.1 case needed reoperation for peri-prosthetic leak half a year after discharge.In the follow-up period,91 cases of these patients were in NYHA class Ⅰ,4 cases were class Ⅱ,5 cases were recovering.Conclusions Result of vavle replacement surgical treatment is satisfactory.Pay attention to preparation before operation,accurate protection for myocardium and correct repair.Tricuspid repair should be alse considered actively.Eliminating gas in left heart before re-beat is important.