Embryo-fetal developmental toxicity and toxicokinetics of carenoprazan hydrochloride in rabbits / 中国药理学与毒理学杂志

OBJECTIVE To investigate the embryo-fetal developmental toxicity (EFDT) of careno?prazan hydrochloride (KFP-H008) in rabbits. METHODS Pregnant rabbits were given by gavage KFP-H008 at 5, 15 and 50 mg·kg-1 during the organogenetic period (gestation days 6-18, GD 6-18). Rabbits in positive control group were treated with cyclophosphamide (CP) 10 mg·kg-1 by iv. Maternal body mass and food consumption during gestation were recorded. Pregnant dams were euthanized on GD 29. The numbers of live/dead fetuses, resorptions, implantations, corpora lutea, and gravid uterus mass, placenta mass, fetal gender ratios, body mass, and skeletal development were evaluated. Moreover, the toxicokinetic parameters including AUC and C0-t, and tissue distributions were determined. RESULTS From GD 13, the maternal body mass and the food consumption in KFP-H00815 and 50 mg · kg-1 groups were lower than in the normal control group (P<0.05). Also, the reduced fetal crown rump length and mass, skeletal malformations/variations were observed in KFP-H00815 and 50 mg · kg-1 groups (P<0.05). KFP-H008 was rapidly eliminated, and became undetectable in the maternal plasma after a single administration. Following multiple KFP-H00850 mg · kg-1 treatment, both KFP-H008 and its metabolites were detectable in various tissues of the maternal and fetus, which might be the evidence for carenoprazan-induced developmental toxicity. In KFP-H00815 mg · kg-1 group, KFP-H008 and its metabolites were undetectable in most of maternal and fetal tissues. CONCLUSION The no observed adverse effect level (NOAEL) of KFP-H008 for maternal and fetal rabbits is about 5 mg·kg-1.

Interference mechanism of liposome PGE1 on survival of expanded flap / 中华医学美学美容杂志

Objective To investigate the mechanism of liposome PGE1 on the survival of the expanded flap.Methods The minipigs were set up as an animal model.They were divided into 2 groups.The expanded flaps (8 cm ×2 cm) were designed and elevated on the back of an minipig.An image analysis technology was used to evaluate the survival rate of the expanded flap,while realtimePCR technique was used to investigate the molecular mechanism.Results The survival area of the expanded flap in the Lipo PGE1 group was significantly enlarged (P＜0.01) compared with the control group.The VEGF,iNOS and Ang-1 gene expression decreased,but TGF-β1 gene expression increased.But there was no significant difference between two groups (P＞0.05).Conclusions The Lipo PGE1 could promote survival rate of the expanded flap,but the mechanism does not involve the regulation of VEGF,iNOS,Ang-1 and TGF-β1 gene expression.

Reservation of pretarsal orbicularis muscle in double-eyelid blepharoplasty / 中华医学美学美容杂志

Objective To explore the methodology of suturing the upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap to the levator aponeurosis,simulating the mechanism of fibers from the levator aponeurosis to the dermis in natural double-eyelid in blepharoplasty.Methods Pretarsal orbicularis myocutaneous flap was harvested.Dissection between the orbital septum and the levator aponeurosis was performed originating from the upper margin of the tarsi until to the levator muscle.The upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap was sutured to the levator aponeurosis.The lower skin margin to the orbital septum to the upper skin margin was sutured interruptedly.Patients with medial epicanthus were performed epicanthoplasty at the same time.Results 136 eyes in 68 patients were performed with double-eyelid blepharoplasty using this method.62 patients were followed-up for 1 month and 53 patients were followed-up for 3 months.They all reported satisfactory aesthetic results.Conclusions Double-eyelid blepharoplasty using this method accords with the physiological mechanism in natural double-eyelid.Postoperative double-eyelid is natural with little tumefaction.This method can avoid double-eyelid fold retraction and multi-fold occurrence.

Influence of liposome PGE1 on ischemia-reperfusion injury of expanded flap / 中华医学美学美容杂志

Objective To investigate the influence of the liposome PGE1 on the ischemia-reperfusion injury of the expanded flap.Methods The minipigs were set up as an animal model.They were divided into 2 groups.The expanded flaps (8 cm × 2 cm ) was designed and elevated on the back of the minipigs.An image analysis technology was used to evaluate the survival rate of the expanded flap,while a biochemistry method was used to detect the concentrations of malondialdehyde (MDA),myeloperoxidase (MPO) and microvessel density (MVD) in the tissue.Skin tempreture was measured after the drug administration.Results The survival area of the expanded flap in the Lipo PGE1 group was significantly enlarged (P＜0.05),compared with the control group.The MPO and MDA concen tration in the tissue was statistically different between two groups (P＜ 0.05),but there was no difference of the MVD concentration between two groups.The skin temperature was higher in the Lipo PGE1 group.Conclusions The Lipo PGE1 could promote survival rate in the expanded flap and protect it from ischemic injury.

Application of melanocytes and bone marrow mesenchymal stem cells in tissue engineered skin construction / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the method of constructing tissue-engineered skin using melanocytes and bone marrow mesenchymal stem cells (BMSCs) in vivo.</p><p><b>METHODS</b>Melanocytes were isolated from human foreskin. BMSCs were isolated from human bone marrow. Both of them were co-cultured at a ratio of 1:10, and then were implanted into the collagen membrane to construct the tissue-engineered skin, which was applied for wound repair in nude mice. The effectiveness of wound repair and the distribution of melanocytes were evaluated by morphological observation, in vivo 4,6-diamidino-2-phenylindole, dihydrochloride (DAPI) fluorescent staining tracing, HE staining, S-100 immunohistochemistry, and transmission electron microscopy.</p><p><b>RESULTS</b>The wounds were satisfactorily repaired among the nude mice. The melanocytes were distributed in the skin with normal structure, as confirmed by DAPI fluorescent staining tracing, HE staining, S-100 immunohistochemistry, and transmission electron microscopy.</p><p><b>CONCLUSION</b>Melanocytes and BMSCs, after proper in vitro culture at an appropriate ratio, can construct the tissue-engineered skin with I type collagen membrane.</p>

Clinical classification and surgical management of palpebral bags / 中华医学美学美容杂志

Objective To investigate the classification and surgical management of patients with palpebral bags. Methods A total of 200 cases with palpebral bags who underwent surgical treatment between May 2003 to August 2008 were retrospectively analyzed. The palpebral bags were classified according to skin flaccidness, bulging of excessive orbital septum fat and tarsus relaxation. The postoperative cosmetic results were also assessed. Results Of the 200 treated cases, the postoperative cosmetic results were assessed as very satisfactory in 178 (89 % ) cases, as satisfactory in 18 (9 % ) cases, and as dissatisfactory in4 (2 % ) cases. Conclusion Patients with palpebral bags should be treated with different surgical methods according to their different types.

Biocompatiblity of various polypropylene meshes in breast ptosis correction / 中华医学美学美容杂志

Objective Implanting surgical meshes to support breast in periareoler mammaplasty shows an excellent prospect.But shrinking of the mesh and the adhesion formation affected the postoperative shape and palpation of the breast.The aim of this study was to compare biocompatible properties of four different polypropylene meshes (Prolene(R) ; Vypro Ⅱ(R) ; Premilene Mesh (R) and Premilene Mesh LP(R)) and to discuss the inclusion criteria of meshes in this technique.Methods The study was carried out in pigs.Four different polypropylene meshes were implanted subcutaneously in belly.90 days after implantation the mesh samples were explanted,and complications,foreign-body reaction,collagen fiber and elastic fiber formation were observed,as well as ultrastructures for the biocompatible properties.Results The biocompatible properties of each mesh were different.The foreign-body reactions determined the biocompatible properties,and affected the postoperative shape greatly.Conclusions Premilene Mesh LP o as a newer low-weight polypropylene mesh,has superior properties to the others.

Poland's syndrome: clinical analyses of 15 cases with review of literature / 中华医学美学美容杂志

Objective To summarize the clinical characteristics of 15 cases of Poland's syndrome and to explore the suitable treatment strategies. Methods A retrospective study of 15 adult patients with Poland's syndrome was conducted and the related literature was reviewed. According to the development of pectoralis muscles and breast, chest deformities were classified into 2 grades: mild and severe. Mild form was limited to absence of partial pectoralis major muscle, with variable hypoplasia of other minor components (such as the size of breast and the size and position of the nipple-areola complex), leading to a mild chest wall asymmetry. Severe form was characterized by absence or severe hypoplasia of the pectoralis major muscle and mammary gland with an evident chest wall asymmetry. Combined with gender, adult patients were divided into 4 types: female mild, female severe, male mild, and male severe. Each type had its own treatment strategies based on its anatomic features: silicone implant insertion for female mild type;latissimus dorsi muscular flap transposition and silicone implant insertion for female severe type;fat injection for male mild type;latissimus dorsi muscular flap transposition for male severe type of the patients. From 2003 to 2008, 15 adult cases were admitted to our ward, aged from 16 to 34 years.The case number of each type was 6, 6, 2 and 1, respectively. One severe female patients rejected any surgical interventions;the others were all treated as the above. Results Follow-up periods ranged from 6 months to 4 years. This series had got satisfactory results with good breast symmetry and natural texture. All the latissimus dorsi muscular flaps survived well. No postoperative complications, such as implant capsular contracture or implant displacement, were observed. Conclusion The manifestations of Poland's syndrome are extremely varied. This classification method is simple but useful, which could effectively direct the individualized treatment for the complete and adequate rehabilitation. Latissimus dorsi muscular flap, pedicled or free transplanted, pulsing silicone implant in females, are the first choices for severe chest deformations of this syndrome.

Acellular cadaveric dermis-assisted immediate breast reconstruction: the preliminary experience / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and therapeutic effect of acellular cadaveric dermis (ACD)-assisted immediate breast reconstruction.</p><p><b>METHODS</b>From Sep. 2009 to May 2010, 10 cases received ACD-assisted immediate breast reconstruction. During the operation, the ACD was used to cover inferior and lateral portion of the implants in 2 cases and expanders in 8 cases.</p><p><b>RESULTS</b>The patients were followed up for an average period of 4 months with satisfactory breast appearance. The complications included infection in 2 cases and dehiscence in 2 cases. But no implant or expander was taken out.</p><p><b>CONCLUSIONS</b>The ACD-assisted immediate breast reconstruction is a technically simple procedure with minimal morbidity. Satisfactory clinical outcome can be achieved with appropriate candidates.</p>

The technique of periorbital defects reconstruction with island orbicularis oculi myocutaneous flap in orbital zone / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the technique of periorbital defects reconstruction with island orbicularis oculi myocutaneous flap in orbital zone.</p><p><b>METHODS</b>The upper or lower eyelid island orbicularis oculi myocutaneous flap,medially based,were used for the defects of the periorbital area, according to the position,shape and size of the defects. The donor site was closed directly.</p><p><b>RESULTS</b>From July 2003 to October 2009, 24 patients were treated in this method, the flaps survived totally. The flap proved to be flexible, safe, relatively simple, and provided good functional and aesthetic results with follow up 6 to 24 months. Complications were minimal.</p><p><b>CONCLUSIONS</b>The upper eyelid or lower eyelid island orbicularis oculi myocutaneous flap, medially based, is a satisfied method in repairing periorbital defects in one stage with good blood supply, excellent color texture matching and inconspicuous donor scar and deformity.</p>

Application of ultrasonography in the detection of nasal interdomal fat pad / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the application of ultrasonography in the detection of nasal interdomal fat pad (IFP).</p><p><b>METHODS</b>Thirty-eight patients who underwent open rhinoplasty and other surgeries in our hospital were enrolled in this study. All patients were studied by ultrasonography to evaluate the shape, structure, size, and location of IFP. The results of ultrasonography were compared with intraoperative findings.</p><p><b>RESULTS</b>The boundaries between IFP and the subcutaneous fat were clear under ultrasonography in 32 patients (84.2%), but were not clear in 6 patients (15.8%) who had undergone injection rhinoplasty (n=2) or augmentation rhinoplasty (n=4). As shown by ultrasonography,the average length,width,and height of IFP were (11.81∓1.28) mm, (2.49∓0.57) mm, and (1.90∓0.61) mm, respectively,which were not significantly different between male and female patients (P>0.05). In addition, the length, width, and height of IFP were significantly larger in nasorostral hypertrophy group than in normal group (P0.05).</p><p><b>CONCLUSION</b>Ultrasonography can accurately evaluate the size and morphology of IFP pre-operatively, and therefore is helpful to ensure the success of rhinoplasty.</p>

The design and technique of one stage treatment of eyelid divided nevus with island skin flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the design and technique of the one stage treatment of eyelid divided nevus with adjacent and distant island skin flap.</p><p><b>METHODS</b>Under local or general anesthesia, the divided nevus on the upper and lower eyelid were excised totally or partially. According to the location, shape and size of the defect, orbicularis oculi musculocutaneous flap, postauricular SMAS-pedicled flap or reversal superficial temporal artery flap was chosen to repair the defect in one stage. The donor site was closed directly.</p><p><b>RESULTS</b>Since 2003, 16 patients were treated in this group, with 10 orbicularis oculi musculocutaneous flaps, 3 postauricular SMAS-pedicled flaps, and 3 reversal superficial temporal artery flaps. The largest size of the nevus on the upper and lower eyelid were 2.5 cm x 2.0 cm and 4.0 cm x 3.0 cm, respectively. One postauricular SMAS-pedicled flap and 1 reversal superficial temporal artery flap showed distal venous refluence obstruction and epidermal necrosis in early postoperative stage, which healed through dressing. The other flaps survived completely.</p><p><b>CONCLUSIONS</b>Treating eyelid divided defects with adjacent or distant island skin flap is a suitable method with satisfactory result and less morbidity in donor sites.</p>

Application of four-dimensional computed tomography angiography in the study of vascular structure of the deep inferior epigastric artery perforator / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the vascular structure of the deep inferior epigastric artery perforator with the four-dimensional computed tomography (CT) angiography.</p><p><b>METHODS</b>10 abdominal specimens harvested from fresh cadavers were cannulated with trocar and injected with contrast medium in the deep inferior epigastric artery at different levels, including the deep inferior epigastric artery, its bifurcations, the lateral or medial large perforators. During the perfusion of the contrast medium in the flap, the flap was scanned by three-dimensional CT (four-dimensional defined as three dimensional CT plus time). The CT data were sent to CT workstation and the images were processed and reformatted.</p><p><b>RESULTS</b>The deep inferior epigastric artery perforator terminates in the subdermal vascular plexus, with bifurcating superior to the Scarpa fascia and under the skin. The anastomosis in the abdominal midline occurs in the subdermal vascular plexus. The blood flow distributes in two ways, one is the subdermal vascular plexus, the other is the existed vascular structure. The zone overlying the rectus muscle in the pedicle side has the best blood supply, the other adjacent zone on the ipsilateral side of the abdomen, the zone overlying the contralateral rectus muscle and the zone lateral to the contralateral rectus muscle has declining perfusion.</p><p><b>CONCLUSIONS</b>The four-dimensional CT is a useful method to study the vascular structure of the deep inferior epigastric artery perforator in the superficial fascia.</p>

The reconstruction of large chest wall defect for 6 patients / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the management of large chest wall defect.</p><p><b>METHODS</b>From Oct. 2005 to Jun. 2009, 6 patients with large chest wall defects were reconstructed by latissimus dorsi muscle flap and titanium mesh in one case, reverse latissimus dorsi muscle flap and polypropylene mesh in one case, free lateral anterior thigh flap in one case, bilateral pectoralis muscle flap in one case, and vertical rectum abdominal muscle flaps in two cases.</p><p><b>RESULTS</b>The patients were followed up for 1-24 months with good cosmetic and functional results. The flaps survived completely. One case of chest wall fistula and one case of sinus occurred, which healed after debridement.</p><p><b>CONCLUSIONS</b>Every layers of chest wall defects should be reconstructed, respectively. The chest wall defects should be reconstructed by titanium mesh and polypropylene mesh first. The soft tissue defect should be covered with different flaps according to the location, area and the degree of the defects. Latissimus dorsi muscle flap can be as the first-line treatment with the advantages of good blood supply, flexible movement and abundant tissue volume.</p>

Mammaplasty after polyacrylamide hydrophilic gel removal from breast / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between mammaplasty and results after polyacrylamide hydrophilic gel (PAHG) removal from breast.</p><p><b>METHODS</b>From Feb. 2003 to Aug. 2009, 130 patients with bilateral breast augmentation by PAHG injection were treated. Preoperative ultrasound examination and MRI were performed to know the distribution of PAHG and infiltration at the surrounding tissue. According to the conditions after removal, the patients were received implant augmentation immediately, or at the second stage, or no implant.</p><p><b>RESULTS</b>The patients were followed up for 3 months at the most with a very satisfactory rate of 63.84% (83/120), a satisfactory rate of 31.53% (41/120) and a unsatisfactory rate of 4.63% (6/120). Slight capsular contracture (Baker I) occurred in 5 cases with 6 breasts in satisfactory group. All the patients in unsatisfactory groups who selected unsuitable implants by themselves were re-operated to take out the implants. 3 cases with much residue PAHG insisted to receive breast implants. Among them, 2 cases achieved acceptable results even the surface of the breasts were not smooth. No other complication happened.</p><p><b>CONCLUSIONS</b>The breast reaugmentation after PAHG removal should be performed based on the deformity and condition of breast. Both cosmetic result and psychological relief could be obtained after mammaplasty.</p>

Application of computed tomography angiography in preoperative design of deep inferior epigastric artery perforator flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the application of computed tomography angiography (CTA) in preoperative design of deep inferior epigastric artery perforator (DIEAP) flap.</p><p><b>METHODS</b>From Jan, 2007 to Mar, 2008, preoperative CTA of deep inferior epigastric artery was performed in 13 patients, including 5 patients with congenital absence of the vagina, 4 patients with penile and scrotal Paget's disease and 4 patients after mastectomy. The images were analyzed, including multiple planar reformation (MPR), maximum intensity projection (MIP) and volume rendering (VR). Then the distributions, branches and locations of perforators of deep inferior epigastric artery were measured. The images from CTA were compared with intraoperative observation.</p><p><b>RESULTS</b>The images demonstrated the distributions of deep inferior epigastric artery and locations of its perforators, which were proved to be true by intraoperative observation.</p><p><b>CONCLUSIONS</b>The preoperative CTA of deep inferior epigastric artery is very useful for preoperative design of DIEAP flaps.</p>

Vaginal reconstruction with pedicled deep inferior epigastric perforator flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore a new surgical procedure for vaginal reconstruction with pedicled deep inferior epigastric perforator (DIEP) flap.</p><p><b>METHODS</b>Since June 2007, 6 cases underwent vaginal reconstruction, including five congenital vaginal absence and one immediately after total vaginal resection due to carcinoma. Intensive CT scans were performed preoperatively for perforator selection. The DIEP flaps were designed vertically on the anterior abdominal wall and transferred for vaginal reconstruction.</p><p><b>RESULTS</b>All the patients recovered uneventfully with no flap loss and other complication. The patients were followed up for 1 to 8 months (mean, 4 months) with satisfactory results.</p><p><b>CONCLUSION</b>Vaginal reconstruction with vertical DIEP flaps is a safe and reliable method.</p>

The effect of macrophage and granulocyte macrophage colony-stimulating factor on the survival of rat abdominal wall flap / 中华普通外科杂志

Objective To study the effect of macrophage, its stimulating factor, granulocyte macrophage colony-stimulating factor (GM-CSF), the combination of GM-CSF and macrophage on the survival of rat deep epigastric perforator flap (DEP). Methods The stable animal model of DEP flap in Sprague-Dawley rat mimicing human deep inferior epigastric perforator flap in breast reconstruction was established. The rats were treated with subcutaneous injection of recombined rat GM-CSF or rat peritoneal macrophages, respectively, or combination of GM-CSF/ Macrophages. Normal saline was used as parallel negative control. The rats were sacrificed and flap specimens were harvested on day 7 after operation, the flaps survival area were measured by the method of rubbings and the survival proportion of flaps were calculated, Von Will brand factor were detected by immunohistochemistry and microvessel density (MVD), and were calculated with microscopic study, and collagen were stained and quantified by Masson staining. Results Survival proportion of flaps in group GM-CSF (53.08% ± 8. 76% ) was not different with that in macrophages group (47. 95% ± 4. 92% ), and both of these two groups were significantly higher than parallel negative control group (43.28% ± 5.27% ) but significantly lower than combination GM-CSF/ macrophages group ( 61.68% ± 6. 60% ). For MVD, flap in GM-CSF group ( 24. 82 ± 4. 18 ) was not significantly different with macrophages group (24.30 ± 3.02 ), and both of these two groups were significantly higher than group parallel negative control (21.37 ± 2.65 ) but significantly lower than combination GM-CSF/macrophages group ( 29. 82 ± 4. 74). Collagen deposition in the flaps in GM-CSF group (17. 25% ± 2. 85% ) were significantly higher than parallel negative control group (14.41% ± 2. 89% ), macrophages group ( 12. 69% ± 3.55% ) were lower than parallel negative control group but there was no significant difference. That in combination GM-CSF/macrophages group (20.31% ± 3.01% )was significantly higher than GM-CSF group ( P < 0. 05 ). Conclusion Treatment with rat GM-CSF or macrophage can significantly promote the survival of the flaps. Combined application of GM-CSF and macrophage could synergetically promote the survival of the flaps, the vasculogenesis and the collagen deposition.

The clinical application of parotid fascia-SMAS-platysma flap in the lifting of lower face and neck / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the technique of lower face and neck lifting with parotid fascia-SMAS-platysma flap.</p><p><b>METHODS</b>To improve the lifting strength of SMAS and the cosmetic result, the traditional SMAS-platysma flap was modified as parotid fascia-SMAS-platysma flap. The modified flap was folded and suspended step by step to lift the lower face and neck.</p><p><b>RESULTS</b>From Oct. 2004 to Oct. 2008, 78 patients were treated with this method. The patients' age ranged from 40 to 65 years old. There were 2 cases of male and 76 cases of female. All the patients were followed up for 6 months to 4 year with satisfactory results.</p><p><b>CONCLUSIONS</b>Folding and suspension of the parotid fascia-SMAS-platysma flap step by step can effectively lift the saggy tissue of lower face and neck.</p>

Correction of secondary breast deformities after removement of injected polyacrylamide hydrophilic gel / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the correction of secondary breast deformities after removement of injected polyacrylamide hydrophilic gel (PAHG).</p><p><b>METHODS</b>From March 2003 to March 2008, 100 patients with bilateral breast augmentation with injected PAHG underwent operation to remove the PAHG. The age of patients ranged from 35 to 50 years. Ultrasound and MRI were performed before operation to show the distribution of PAHG and the muscle infiltration around the PAHG. According to the PAHG distribution, muscle infiltration, skin elasticity, infection and PAHG residue, the patients were treated respectively with breast implants at the same stage or at the second stage, or without implants.</p><p><b>RESULTS</b>The patients were followed up for 3 months to 3 years. The percentage of satisfactory, median satisfactory and dissatisfactory was 90%, 9%, and 1%. In the median satisfactory group, 3 breasts in 3 cases showed slight capsular contracture (Baker II), 8 implants in 6 cases were palpable on the lower pole of the breasts. The middle-aged patient in dissatisfactory group was not satisfied with the high-projected implants shape which were chosen by herself and placed at the second stage. Then implants were removed. There was no complication of implant hernia, infection, wound disruption, or asymmetry.</p><p><b>CONCLUSIONS</b>The secondary breast deformities could be corrected by breast augmentation with implants. Both breast appearance and the psychological affection can be improved.</p>