Remnant ear utilized for the inferior part and lobule reconstruction in microtia patient with fully pre-expansion ear reconstruction technique / 中华整形外科杂志

Objective@#This study aimed to present our clinical experience of the utilization of remnant ear for the inferior part and lobule reconstruction in microtia patient with the fully pre-expansion ear reconstruction technique.@*Methods@#During 2017.01—2018.12, 156 cases of unilateral ear reconstruction were performed. The operation was divided into three stages. Six months after the ear reconstruction, the third stage of the remnant ear utilization was performed. The surgery was planned according to the microtia classification and the remnant morphology.@*Results@#All the patients had no complications. Follow-up period ranged from 7—24 months, and ten months on average. All the patients with typeⅠmicrotia had satisfying results of the inferior part and lobule reconstruction. Sixteen cases of types Ⅱand Ⅲ microtia patients had unfortunate outcomes, because the residual ears were too small to reconstruct the earlobe, and the incisure appeared when remnant and reconstructed ear was connected in cases of severe remnant malposition. The rest of patients were satisfied with the reconstruction.@*Conclusions@#The utilization of the remnant ear based on the types of microtia and the remnant morphology could achieve the satisfying result of reconstruction for most of the microtia patients.

Repair of extremity scar contracture by expanded local flaps / 中华医学美学美容杂志

Objective To investigate the application of expanded local flap in repairing extremity scars.Methods Thirty patients with extremity scars contracture as a result of trauma,surgery or infection during July 2000 and March 2013 were included.There were 11 male and 19 female patients with age ranging from 11 to 34 years.Tissue expansion,scar resection,flap transfer and scar management were involved in this process.Results There 24 patients suffered from upper extremity scars and 6 patients suffered from lower extremity scars.Expander exposure was noted in 3 patients,and 3 patients suffered from infection during the expansion.During the 6-month to 1-year follow-up,all patients satisfied with the results in terms of the skin texture,color,flexibility after the treatment with expanded local skin flap.Conclusions The expanded local flaps are suitable for the repair of the longitudinal and oblique scars in the extremities.

A novel method for costal cartilage framework fabrication in full expansion ear reconstruction technique without skin grafts / 中华整形外科杂志

Objective@#This study aimed to present our clinical experience using a novel method for autologus costal cartilage framework fabricationin fully expansion technique ear reconstruction without skin graft.@*Methods@#During Steptember 2016 to Steptember 2017, autologus costal cartilage framework with expansion technique were performed for 63 patients with microtia. Autologous costal cartilage was stacked up to form the structure and height, the natural appearance of auriculocephalic angle was achieved at the same stage, so the second-stage elevation of ear and postauricular skin graft was unnecessary. The delicate structure of the reconstructed ear and ideal bilateral symmetry were achieved by the optimized cartilage stack-up.@*Results@#Three patients out of total 63 patients had cartilage frame work exposure, and were treated with superficial temporal fascia transfer combined with skin graft. The rest 60 patients had satisfied results. Follow-up ranged from 8 months to 18 months and 12 months follow-up was on average. The novel frame work fabrication method was based on the sufficient full pre-expansion procedure. The ideal structure, bilateral symmetry, and excellent definition of the framework, as well as the natural dorsal appearance of the reconstructed auricular were achieved.@*Conclusions@#The cartilage " stack-up" method is essential for the full expansion without skin grafts ear reconstruction technique. The combination of the cartilage " stack-up" framework fabrication and full pre-expansion provide a well-defined, well-projected and bilateral symmetrical ear.

The same-stage reduction plasty for labia minora hypertrophy with redundant praeputium clitoridis / 中华医学美学美容杂志

Objective To evaluate the clinical outcome of reduction plasty for labia minora hy-pertrophy with redundant praeputium clitoridis .Methods A total of 84 cases were included from June 2013 to December 2016 .Arc-shaped resection of labia minora and crescent resection of redundant pra-eputium clitoridis were the two essntial surgical procedure ,and 5-0 VICRYL Rapide was used for su-turing the incision .Results The 84 cases were operated with this mothod with satisfactory aesthetic result .Complications ,such as hematoma ,infection and poor wound healing ,were not observed .Ede-ma was resoluted after one to two weeks .After the reduction plasty of the labial labia ,the vagina and perineum were completely covered in the natural state ,without scar ,also the sensitivity of clitoris was improved due to the better expoure post-operationally .Conclusions The same-stage reduction plasty for labia minora hypertrophy with redundant praeputium clitoridis is a reliable and effective method . Both satisfactory aesthetic result and improved sexual sensitivity are achived ,without hematoma ,in-fection and poor wound healing .

Supra-auricular flap and stretch of scapha cartilage: a method of cryptotia′s treatment / 中华整形外科杂志

Objective@#To explore a simple method of cryptotia correction with good effect.@*Methods@#7 patients and 10 ears were operated on, using a supra-auricular V-Y flap. The auricular muscles′ adhesion with cartilage was sufficiently released, and the scapha cartilage was remodeled by a reverse suture. The flap was rotated to post-auricular to close the wound, and deepenen the auriculocephalic angle.@*Results@#All patients′ ears nearly had a normal appearance and an obvious crus of helix. Patients could wear glasses or respirator easily, as their supra-auricular part was free from the skull. Our technique ensured all scars were hidden behind the ear or in the hair. No patients required revisional surgery.@*Conclusions@#This technique is a simple method , which has a good result , covert scar and low recurrence. We can use it for majority of patients with cryptotia.

Clinical features of patients with massive transfusion during plastic surgery / 中华医学美学美容杂志

Objective To review the clinical features of the patients received massive transfusion (MT) in plastic surgery department.Methods Ten cases were reviewed.The reason of massive transfusion,the type and dosage of transfusion,the reaction of patients were included.For all the patients,consultation of related department preoperatively was necessary.Based on the through and detailed analysis of the patients' condition,necessary blood product should be prepared ahead of operation.During the therapy,adjustment of treatment plan was made from time to time,according to the patient's condition.Therefore efficient and prompt therapeutic result was achieved.Results In all the 10 MT cases suffered from acute blood loss,2 of them were in hemorrhagic shock before administration.Coagulation disorders happened in 2 patients,and recovered after appropriate treatment.RBC,which was 58.3％ of total amount of transfusion,used most commonly;the second was fresh frozen plasma (FFP),which was 38.6％ according to the total amount.All the patients had satisfactory recovery,without hemolysis or any other functional disorder.Conclusions For MT patients in the Department of Plastic Surgery,the main proposes are to restore and maintain an effective circulatory blood volume,while preventing the coagulation disorder.Also,detailed analysis,through consultation and timely adjustment are of great importance for the MT patients.It is also the essential of an effective perioperative management.

Tongue flap combined with local mucosal flap for repairing palate fistulae / 中华医学美学美容杂志

Objective To introduce a modified surgical technique for repairing palate fistulae.Methods Based on the clinical categories of palate fistulae,local mucosal flap was designed,if possible,to reduce the area of the fistulae and reshape the fistulae.Then the thin tongue flap with anterior pedicle was designed for repairing the palate fistulae,without much limitation of tongue movement and excessive tension of tongue flap pedicle short lingual frenulum correction was performed firstly to release the motion of tongue,if necessary.The donor site was closed directly.Three weeks later division of the tongue flap,as well as detailed appearance correction of tongue,was carried out at the same time.Results 12 cases were treated,and followed up for 6-12 months.For all the cases,the defect of fistulae was totally repaired,while aesthetics appearance of tongue was satisfactory,and no interference with speech with the use of tongue as donor site.Oral hygiene and mastication were unimpaired.No patient described disability of sensory or gustatory postoperatively.Conclusions Tongue flap has sufficient blood supply,while impairment of donor site is minimal.The planning and procedure of surgery are relatively simple.It is an ideal flap in treatment of palate fistulae.

Clinical effect of penile lengthening and augmentation with autologous granular fat graft on short penis / 中华医学美学美容杂志

Objective To evaluate the effectiveness and safety of autologous granular fat graft applied for penile lengthening and augmentation.Methods After all the superficial ligment and 1/3-2/ 3 part of the deep suspensory-ligament had been cut off for penile lengthening,local pedicaled fasciaadipose flap was designed to fill the depression,the pre-centrifuged autologous granular fat was injected into the space beneath Buck's fascia for penile augmentation.Normal length,pulling penis length,diameter,circumference and complications were evaluated.Results 34 cases were performed and followed up for 3-18 months,both ideal length and diameter increase of penis were achieved.The differences of nomal length,pulling-length,the diameter and circumference were (2.8±0.1) cm,(2.1±0.2) cm,(0.9 ± 0.1) cm,(2.8 ± 0.1) cm,respectively.The common complications included poor wound healing in 4 cases,preputial edema and subcutaneous scleroma in 8 cases for 3 months.Conclusions Autologous granular fat graft for penile augmentation during the lengthening surgery is a reliable and effective method and easy procedure.Detail processing can decrease the complications.

Combined pre-expansion of forehead and facial region for repairing tissue defects after removal of lesions in nose and facial area / 中华医学美学美容杂志

Objective To investigate the treatment methods of tissue defects in nose and lower eyelid area.Methods Based on the impaired area,combined pre-expansion of forehead and facial region was adopted.The volume of soft tissue expander was determined.150-170 ml expander was implanted between frontalis muscle and periosteum of forehead,while at the facial region,and the volume of expander should be determined by the normal skin area as large as possible.The excision of impaired tissue was performed after sufficient expansion,and then skin flap or transposition skin flap were advanced at the facial region.At forehead,ortho-position skin flap based on supratrochlear vessels was designed for repairing the nose and palpebra inferior region.Three weeks later division of the ortho-position skin flap was carried out.With the flattened pedicle,the rest part of impaired area was replaced.Results Six cases were performed with this method.For all the cases,the survival rate of flap was 100％.Esthetic appearance and satisfying color-match were achieved,without appearance of lower eyelid ectropion.Conclusions Combined pre-expansion of forehead and facial region is an ideal method in treatment of the defects in nose and lower eyelid area.

Expanded deltopectoral skin flap for repair of wounds after excision of facial benign tumor / 中华医学美学美容杂志

Objective To explore the repair method for wounds after excision of facial benign tumors.Methods Unilateral or bilateral deltopectoral skin flaps were expanded depending on the area of the facial benign tumor.Expander was implanted underneath deltopectoral flap region through an incision inferior to the clavicle.When expansion was completed,all or part of the benign tumor was excised before designing the flap according to the area of the skin defect.The area of the skin flap should be more than that of skin defect with 10％ to 15％.The pedicle wound could be sealed by rolling it around to form a tube or a hinge using the benign tumor and pedicle.The flap was delayed three weeks later and the pedicle was divided one week after flap delaying.Results All 20 cases got the satisfactory results with treatment of pedicled expanded deltopectoral skin flaps for repair of wounds after excision of facial benign tumor.Conclusions It is a better option to repair a large area wound after excision of facial benign tumor with an expanded deltopectoral skin flap.

Comparison of assessments with digital tomosynthesis and MSCT in diagnosis of odontogenic cystic lesions of the jaws / 实用医学杂志

Objective To evaluate the value of digital tomosynthesis (TOMOS)in diagnosis of odontogenic cystic lesions of the jaws with oral fixed metal dentures, and compared with multi-slice spiral CT (MSCT). Methods The imaging findings of 40 cases with fixed metal dentures pathologically proved odontogenic cystic lesions of the jaws jn retrospective were retrospectively analyzed.All cases were performed by MSCT and TOMOS scanning,and 13 cases enhanced at the same time. The characteristics of the imaging findings in TOMOS and MSCT were compared. The diagnosis merits and disadvantages, especially their ability to detect the lesions and adjacent structures,were assessed. Results There were no significant difference (consistency check Kappa value>0.4) in evaluating the structure characteristics of the lesions, the relationgship between the lesions and cortex ,and the relationship between the lesions and surrounding organs. TOMOS is superior to MSCT in displaying apical change, the same in pure cystic and cystic-solid lesions interfered by artifacts.However, it is inferior to MSCT in detection of soft tissue invasion. Conclusion There is similar assessment value of TOMOS and MSCT in displaying odontogenic cystic lesions of the jaws. TOMOS can be chosen when the imaging findings of the lesions are interfered by metal artifacts.

Expanded random forearm flap for total nasal reconstruction in patients with cicatricial nasal deformity / 中华医学美学美容杂志

Objective To explore the method of total nasal reconstruction when the forehead skin for expanding is unavailable.Methods According to the principle of total nasal reconstruction,total nasal scar and deformity were repaired with expanded random forearm falp.All the expanders were placed in flexor side of forearm.The incision sides were placed in proximal,distal,or lateral part of the forearm according to different pedicles.After expansion,the nares were enlarged,eversion of ala nasi corrected,the contracture scars sufficiently released,and the size and shape of the reconstructive nose designed according to face size.The scar of nasal dorsum and capsule of the expanded flap could be used for reconstructing nasal dorsum.Donor sides could be sutured directly,the pedicle could be cut 3 weeks later.Results All the flaps survived with good appearances,and 3 of the 15 cases with proximal,11 with distal,and 1 with lateral pedicle.The effect of distal pedicle group was better than that in proximal and lateral pedicle group because of comfortable posture longer pedicle,and providing more tissue for reconstruction.Conclusions Total nasal reconstruction with expanded random forearm flap is an option when the forehead skin for expanding is unavailable.

The role of endotoxin in the pathogenesis of gastric mucosal damage in cirrhotic rats with portal hypertensive gastropathy

OBJECTIVE@#To study the role and the mechanism of endotoxin in the pathogenesis of gastric mucosa during portal vein hypertension gastrography (PHG) in the rats with cirrhosis.@*METHODS@#Rat model for PHG was established by injection of tetrachloride. The animals were injected with endotoxin i.p. at 3 mg/kg and endotoxin antagonist BPI21 i.v. at 2.0 mg/kg. The plasma level of endotoxin as well as the gastric mucosal level of tumor necrosis factor alpha (TNF-α) was measured with azobenzene and ELISA respectively. Furthermore, the pathological changes of the gastric mucosa were studied with HE stainning.@*RESULTS@#In rats with PHG, increased endotoxin and TNF-α as well as the gastric pathological lesion were observed. Injection of endotoxin remarkably increased plasma level of endotoxin as well as the gastric mucosal level of tumor necrosis TNF-α and induced more serious gastric lesion. Animals injected with endotoxin antagonist BPI21 showed improved gastric mucosal lesion, accompanied by the declining TNF-α level.@*CONCLUSIONS@#Our results suggestes that endotoxin may play a pathogenetic role in PHG by inducing the expression of TNF-α.

Effects of flavones extracted from Portulaca oleracea on ability of hypoxia tolerance in mice and its mechanism / 中西医结合学报

OBJECTIVE: To identify anti-hypoxia ingredients extracted from Portulaca oleracea and to find out the possible mechanism of its anti-hypoxia actions. METHODS: Seventy mice were randomly divided into seven groups which were untreated (normal saline), ginsenosides-treated, polysaccharide-treated, acidic components-treated, basic components-treated, alkaloids-treated and flavones-treated groups, and the ingredients of polysaccharide, acidic components, basic components, alkaloids and flavones were extracted from Portulaca olerace. The mice in each group were fed with corresponding ingredients for one week respectively. Then the survival time of mice in hypoxic conditions was observed. Another 90 mice were divided into 3 groups: untreated (normal saline), ginsenosides-treated and flavones-treated groups. The mice in each of these 3 groups were divided into 3 subgroups according to 12-, 24- and 36-hour exposure to hypoxia (10% oxygen and 90% nitrogen), respectively. After exposure to hypoxia, the red blood cell count (RBC), hemoglobin (Hb) concentration and hematocrit (HCT) in mice were determined. The plasma erythropoietin (EPO) levels of mice were detected by enzyme-linked immunosorbent assay (ELISA) and the relative values of EPO mRNA in renal tissue and pallium of mice were determined by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: The survival time of mice in hypoxic conditions in flavones-treated group was significantly longer than that in the untreated group. The RBC, Hb concentration, HCT, plasma EPO level and the relative values of EPO mRNA in renal tissue and pallium of mice were significantly higher in the flavones-treated group than those in the untreated group. CONCLUSION: The anti-hypoxia ingredients extracted from Portulaca oleracea are flavones and the anti-hypoxia effects may be obtained by improving the expression level of EPO and accelerating the generations of erythrocyte and Hb.

Effect of rehabilitation with early occupational therapy on unilateral spatial neglect caused by stroke / 中华物理医学与康复杂志

Objective To observe the effect of early occupational therapy intervention on unilateral spatial neglect caused by stroke.Methods A total of 92 patients with unilateral spatial neglect caused by stroke were ran- domly divided into a treatment group(46 cases)and a control group(46 cases).The cases of the control group were treated by routine clinical treatment plus positioning on the bed,passive joint motion,bridging movement,facilitation techniques,balance training in sitting and standing positions,gait training immediately after the patients' conditions got stable.The patients in the treatment group were treated with activities of daily living(ADL)training in addition to the interventions employed in the control group.Results Effect of the treatment group are superior to that of the control group as reflected by the scores with Fug1-Meyer scale and Barthel Index(P