The role of the expression of PPAR-gamma gene in the adipogenesis in hemangioma evolution / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the role of the expression of PPAR-gamma gene in the adipogenesis in hemangioma evolution.</p><p><b>METHODS</b>Routine immunohistochemistry staining of Perilipin A, the marker antigen of adipocytes, was performed to observe the adipogenesis in hemangioma. Immunofluorescence staining of PPAR-gamma, the important transcription factor in promoting adipogenesis, was carried out to observe its location in hemangioma tissue, with the co-staining of alpha-SMA and CD31. And RT-PCR was used to examine the expression of PPAR-gamma gene in hemangioma in different stages.</p><p><b>RESULTS</b>In the evolution of hemangioma, the number of adipocytes increased continuously. And the tumor was replaced by fibrofatty tissue finally. PPAR-gamma was located in the nuclei of perivascular cell in hemangioma tissue. The expression of PPAR-gamma gene in hemangioma increased in the evolution of hemangioma, but still was lower than that in normal fat tissue from children.</p><p><b>CONCLUSION</b>The expression of PPAR-gamma in the perivascular cells suggests that they may contribute to the adipogenesis in hemangioma involution.</p>

Orbicular oris muscle flap wrapped by acellular dermis for the treatment of upper lip atrophy in children / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the treatment of upper lip atrophy resulted by previous therapy.</p><p><b>METHODS</b>From Mar. 2008 to Mar. 2012, 4 cases with upper lip atrophy resulted by radiotherapy and sclerosing agent injection were treated with lower orbicularis oris muscle flap wrapped by acellular dermis. The thickness and height of upper lip were increased to improve the lip atrophy.</p><p><b>RESULTS</b>Primary wound healing was achieved in all the 4 cases. All the patients were followed up for 3 years with obvious improvement and inconspicuous scar.</p><p><b>CONCLUSION</b>The volume of lower lip in children is not sufficient as donor site. The lower orbicularis oris muscle flap wrapped by acellular dermis can effectively improve the lip thickness and vermilion portion of upper lip.</p>

Plagiocephaly resulted from frontosphenoidal synostosis and squamosal suture synostosis: a report of five cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and mapagement of plagiocephaly resulted from For frontosphenoidal synostosis, frontosphenoidal synostosis and squamosal suture synostosis.</p><p><b>METHODS</b>orthotic nolding therapy should be selected for patients under 3-month-old. If it can' t make effect after treatment for 3 months, transcranial surgery should be adopted with the horizontal advancement of orbitofrontal bar at the affected side. Patients with squamosal suture synostosis should receive prohotic molding From 2005 to 2012, five patients were therapy for six month, remolding the cap every month.</p><p><b>RESULTS</b>treated with satisfactory result, including 3 patients with frontosphenoidal synostosis who received surgery and 2 patiens with squamosal suture synostosis who receive orthotic molding therapy only.</p><p><b>CONCLUSIONS</b>Few patients with plagiocephaly are caused by frontosphenoidal synostosis and squamosal suture synostosis. The orthotic molding therapy should be selected at an early time, but mostly, surgery may be needed for</p>

Segmental monobloc osteotomy and bi-directional distraction for the treatment of Crouzon syndrome in an infant / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the segmental monobloc osteotomy and bi-directional distraction for the treatment of Crouzon syndrome in an infant.</p><p><b>METHODS</b>A 9-month-old female infant underwent monobloc osteotomy through combined intra- and extra-cranial way. The facial skull was divided into frontal, orbital and maxillary segments. The external distractor was used to move the frontal segment, orbital segment and midface forward. The internal distractor was used to move the maxilla downward. The consolidation lasted for 3 months after distraction.</p><p><b>RESULTS</b>The osteotomy and distraction were successfully completed. The distraction distance reached 18 mm, showing by distractor. The real distraction distance of facial bone was 12 mm, documented by 3-D image. The skull deformity and severe depression of midface improved a lot. The exophthalmos and underbite were corrected. The obstructive sleep apnea also improved markedly. However, the downward movement of maxilla was limited.</p><p><b>CONCLUSIONS</b>Monobloc osteotomy with external distractor, as well as maxillary distraction, could be used for Crouzon syndrome in infant. It is safe and effective method which can be performed in an early age for Crouzon syndrome with obstructive sleep apnea.</p>

Treatment of airway obstruction with mandibular distraction osteogenesis in Pierre Robin syndrome / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of mandibular distraction osteogenesis (MDO) in the treatment of airway obstruction in Pierre Robin syndrome (PRS).</p><p><b>METHODS</b>From 2007 to 2009, 8 newborns with PRS were treated with MDO. The mandibular distractors were fixed after bilateral oblique mandibular osteotomy. The distraction was started one day after operation, three times a day. The distraction distance was 1.2 mm per day until it reached about 12 -20 mm (mean 15 mm).</p><p><b>RESULTS</b>The distraction was successfully completed in 8 cases with no complication. The distraction distance reached 15 mm, as we expected. The discontinuity cyanosis, inspiratory dyspnea, dystithia were improved after distraction.</p><p><b>CONCLUSIONS</b>MDO is feasible and safe for the treatment of airway obstruction in PRS.</p>

Management of congenital scalp defects in infants / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the management of congenital scalp defects in infants.</p><p><b>METHODS</b>From 1996 to 2008, 6 infants with congenital scalp defects were treated with dressing change, flap transposition, or tissue expansion combined with skull defect reconstruction.</p><p><b>RESULTS</b>Parietal scalp defects in 6 cases were healed after treatment. 5 cases were followed up for 3 months to one year. 2 cases had scalp alopecia in some areas. The scar was inconspicuous in the other 3 cases.</p><p><b>CONCLUSIONS</b>Dressing change is suitable for small scalp defect, while flap transposition should be used for medium defect. For large full-thickness cranial defect, dressing change and tissue expansion should be performed at the first stage, followed by skull defect reconstruction and expanded flap transposition.</p>

Diagnosis and treatment of children sinus pericranii / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and treatment of children sinus pericranii (SP).</p><p><b>METHODS</b>From Jan. 2000 to Dec. 2008, 12 cases of SP were treated. The clinical data and CT results were studied. If the SP had no communication with the intracranial vessels, DSA was performed to know its venous drainage. The operation procedures included excision of bump, followed by hemostasis. Then the local flap was used to cover the cranial defect.</p><p><b>RESULTS</b>12 cases all had scalp bump whose size was changed with body position. Three-dimensional CT showed a crater-like depression and multiple honeycomb diploic holes in the skull. 6 cases with venous malformation received DSA. 12 patients were operated.</p><p><b>CONCLUSIONS</b>SP can be diagnosed with typical CT results and symptoms. DSA should be performed if the communication with the intracranial vessels is existed. The main methods include operation, embolization and reserved observation. Medicine injection is not recommended due to the high risk.</p>

3-Dimensional CT for preoperative measurement and postoperative assessment in craniosynostosis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the significance of 3-dimensional (3-D) CT for preoperative measurement and postoperative assessment in craniosynostosis.</p><p><b>METHODS</b>17 cases with craniosynostosis underwent 3-D CT reconstruction. The 3-D images were used to perform cephalometry. The cases included brachycephalic, caphocephalia, plagiocephaly. The CVAI must be measured for plagiocephaly. Measurement results were compared before and after operation in 9 cases.</p><p><b>RESULTS</b>The bone segments were advanced 1.5 - 3 cm in brachycephalic, retruded 2 - 4 cm in scaphocephalic, moved back and forth about 2 cm in plagiocephaly.</p><p><b>CONCLUSIONS</b>Preoperative 3-D CT reconstruction and measurement can be used to design the advancement distance of bone flap and orbito-frontal bone bridge, as well as to estimate the treatment results before operation.</p>

Skull plasty to correct congenital craniosynostosis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the technique of skull reconstruction for the congenital craniosynostosis.</p><p><b>METHODS</b>Many technique of skull plasty were adopted to correct the congenital craniosynostosis. We advanced fronto-orbital, reversal change of the frontal bone to correct the brachycephalic, hydrocephaly acrocephaly, which were supported by parietal bone. Plum-plasty of the calvaria was performed for sagittal synostosis; Fronto-orbital plasty correct the trigonocephaly; for single coronal synostosis, which result to frontal plagiocephaly,we reversed both frontal sides, advanced orbital strip and tilted the invalid side . The post plagiocephaly because of single Lambdoid synostosis, we performed of plum-plasty, reversal change of total occipital. Fronota-facial advancement cured the brachycephalic complicating with Apert or Crouzon which caused by coronal synostosis and cranial basal suture synostosis.</p><p><b>RESULTS</b>37 cases were recovery without complication. The figures were improved.</p><p><b>CONCLUSIONS</b>Big calvarial flap plasty is an optimal technique to correct the congenital craniosynostosis. But it is not substituted by bone lengthening and minimally invasive technique.</p>

Inhibiting effects of tetrandrine on capsular contraculture in rabbits / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the effects of tetrandrine on inhibition of capsular contracture in rabbits.</p><p><b>METHODS</b>12 female New Zealand white rabbits were randomly divided into two groups with 6 animals in each group. Four smooth silicone implants (15 ml each) were implanted beneath the panniculus carnosus muscle of each rabbit. 20 mg tetrandrine was given in side of the implant cavity in the experimental group intraoperatively. All animals were sacrificed 3 months after operation. Capsular tensility, wet weight, collagen content and capsular histological examinations were carried out. In addition, The expression of alpha-smooth muscle actin (a-SMA) were examined by immunohistochemistry.</p><p><b>RESULTS</b>Capsular tensility and capsular wet weight and capsular collagen content in the control group were significantly higher than that in the tetrandrine group (P < 0.01). alpha-SMA positive cell numbers in control group was obviously higher than that in the tetrandrine E group (P < 0.01). Capsular thickness were no statistical difference between 2 groups (P > 0.05). The capsular microstructure of control group was similar in two groups. The inner layer of capsule was smooth. The middle layer was lamellated fibrous tissue. The outer layer was loose connective tissue. Collagen fibres in control group was dense, the middle layer was thicker than that of the tetrandrine group. Typical myofibroblasts were found in both of 2 types of capsules. Myofibroblasts with swollen mitochondria and dilated rough and chromatin margination endoplasmic reticulum were found in the tetrandrine group.</p><p><b>CONCLUSIONS</b>This study verified the efficiency of tetrandrine in inhibiting the capsular contracture.</p>

Cranial vault reconstruction of plagiocephaly / 中华整形外科杂志

<p><b>OBJECTIVE</b>Treatments of unilateral lambdoid synostosis and unilateral coronal synostosis.</p><p><b>METHODS</b>Approach to coronal, double frontal flaps were rotated with orbit advancement and anteversion of the frontal to enlarge the volume of ante cranial fossa., and reconstruct the contour of orbit and the frontal. The gap was between the frontal and parietal to reconstruct the coronal suture after fixation and reconstruction of the frontal os. For post plagiocephaly, double rotated occipital flap and plum-plasty flap were performed to reconstruct the occiput. The gap between the parietal and occiput was to reconstruct the lambdoid suture.</p><p><b>RESULTS</b>Eight cases have favourable prognosis with satisfactory contour.</p><p><b>CONCLUSIONS</b>It is optimal to use frontal flap rotation, orbit advancement and frontal anteversion to correct the unilateral coronal synostosis. Bilateral rotated occipital-parietal crossing flap and plum-plasty were performed to reconstruct the occiput. Keeping the gap between the parietal and occiput for reconstruction of the lambdoid suture is suitable to infant.</p>

Surgical management of neonate lip and palate cleft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the security and feasibility in ambi-operation of the neonate lip and palate cleft correction.</p><p><b>METHODS</b>Using Ornizuka's and innovated Langenbeck's method to correct the lip and palate cleft in 30 cases with detailed program, the effect after operation was evaluated.</p><p><b>RESULTS</b>All physiological index were normal in the group of ambi-operation, which had no difference to other newborn. The effect is satisfactory. 5 of them have the fistula under the gingival.</p><p><b>CONCLUSIONS</b>Based on controlling on surgery indication, screening the well-developed newborn, it is secure and feasible to correct lip and palate in one stage, and it can get excellent effect.</p>

Total calvarial reconstruction for sagittal synostosis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the technique of total calvaria reconstruction for sagittal synostosis.</p><p><b>METHODS</b>11 children with sagittal synostosis were treated. The David II procedure was used to reconstruct the calvarial gap in 6 cases; Osteotomies with reversal change was performed on 2 cases; Plum-plasty of the calvaria was performed on 3 cases.</p><p><b>RESULTS</b>The 11 cases were cured with satisfactory head shape.</p><p><b>CONCLUSIONS</b>The David II procedure is applicable for patient of 1 approximately 3 months. The technique of floating skull flap plasty and plum-plasty of the calvaria can be performed on patients older than 3 months.</p>