Reconstruction of anterior auricular defect with postauricular island / 中华医学美学美容杂志

Objective:To investigate the clinical effect of postauricular island flap in reconstruction of anterior auricular defect.Methods:Twelve patients with auricular tumors were retrospectively analyzed in the Department of Aesthetic Plastic and Craniofacial Surgery, the First Affiliated Hospital of Xi'an Jiaotong University. After the tumors were completely removed, the skin defects were repaired with retroauricular island flaps, and the clinical results of the flaps were observed.Results:All the twelve postauricular island flaps were survived postoperatively. One of the flaps had the disorder of blood supply. After puncture with the needle, the congestion was drained out and the flap survived finally. During 1 to 2 years' follow-up, all patients were well satisfied with the surgical results.Conclusions:The posterior auricular island flap in reconstruction of anterior auricular defect has the advantages of simple and easy operation, high survival rate, small scar in the donor area and good aesthetic effect, which is worthy of clinical promotion.

Risk factors of contrast-induced nephropathy after carotid artery stenting / 国际外科学杂志

Objective:To investigate the risk factors related to the contrast-induced nephropathy(CIN)occurring after carotid artery stenting(CAS)in patients with carotid artery stenosis.Methods:The clinical data of 137 patients with carotid artery stenosis, who were treated with CAS at Xuanwu Hospital, Capital Medical University during the period from January to Decmber 2021 were retrospectively analyzed. Record demographic characteristics (age, gender, height, weight), history of underlying diseases (hypertension, diabetes, kidney disease, etc.), history of medications, etc. Observe the clinical parameters such as creatinine, blood urea nitrogen, albumin, hemoglobin, hematocrit, degree of stenosis and estimated glomerular filtration rate (eGFR). Measurement data conforming to the normal distribution were expressed as the mean±standard deviation( ± s), and the t-test was used for comparison between groups; the measurement data that does not conform to the normal distribution were expressed as the median (interquartile range) [ M( Q1, Q3)], and the Rank-sum test was used for comparison between groups; the Chi-square test or Fisher exact test was used for comparison of count data between groups. Relevant variables were subjected to univariate analysis, and statistically significant indicators were selected according to the results of univariate analysis to be included in the multivariate Logistic regression analysis. Results:After CAS, a total of 29 patients (21.2%) among the 137 patients developed CIN. Univariate analysis indicated that bilateral carotid artery stenosis, uncontrolled hypertension before surgery, history of angiotensin converting enzyme inhibitor drugs, diabetes mellitus, history of insulin drugs, eGFR<45 mL/(min·1.73 m 2), body weight were the influencing factors associated with the occurrence of CIN after CAS in patients with carotid artery stenting; multivariate regression analysis revealed that the presence of bilateral carotid artery stenosis( OR=4.724, 95% CI: 1.455-15.338, P=0.010), diabetes mellitus( OR=3.451, 95% CI: 1.345-8.858, P=0.010) and eGFR <45 mL/(min·1.73 m 2)( OR=4.582, 95% CI: 1.001-20.971, P=0.050) were the independent risk factors related to the CIN after CAS. Conclusion:Patients with the presence of bilateral carotid artery stenosis, diabetes mellitus or eGFR <45 mL/(min·1.73 m 2) are more likely to develop CIN after CAS.

Risk factors of hemodynamic instability after carotid artery stenting in elderly patients / 国际外科学杂志

Objective:To investigate the risk factors related to the hemodynamic instability occurring after carotid artery stenting(CAS) in elderly patients with carotid artery stenosis.Methods:The clinical data of 80 patients with carotid artery stenosis, who were treated with CAS at Xuanwu Hospital, Capital Medical University during the period from January 2018 to Decmber 2018, were retrospectively analyzed. Record demographic characteristics (age, gender, height, weight), history of underlying diseases (hypertension, diabetes, kidney disease, heart failure, etc.), history of medications, etc. Observe the clinical parameters such as creatinine, blood urea nitrogen (BUN), urine volume, input and output, albumin, hemoglobin, location of stenosis, and degree of stenosis. Measurement data conforming to the normal distribution were expressed as the mean ± standard deviation ( Mean± SD), and the t-test was used for comparison between groups; the measurement data that does not conform to the normal distribution were expressed as the median (interquartile range) [ M( P25, P75)] indicates that the rank sum test was used for comparison between groups; the Chi-square test was used for comparison of count data between groups. Relevant variables were subjected to single factor analysis, and statistically significant indicators were selected according to the results of single factor analysis to be included in the multivariate Logistic regression analysis. Results:After CAS, a total of 37 patients among the 80 patients developed hemodynamic instability, the incidence rate was 46.25%. Univariate analysis indicated that the factors associated with the occurrence of postoperative hemodynamic instability included height , platelet count, ulceration plaque and the fluid intake in the first 24 hours after surgery; Multivariate regression analysis revealed that the presence of ulceration plaque ( OR=11.559, 95% CI: 1.232-108.495) and the fluid intake in the first 24 hours after surgery( OR=1.001, 95% CI: 1.000-1.001) were the independent risk factors related to the hemodynamic instability after CAS. Conclusion:Elderly patients with the presence of ulceration plaque before surgery are more likely to develop hemodynamic instability after CAS, and within 24 hours after surgery is a high-risk time period for hemodynamic instability.

Clinical efficacy of novel ‘umbrella’ autogenous graft in secondary cleft rhinoplasty / 中华医学美学美容杂志

Objective To observe the effects of a novel type ‘umbrella’ graft in secondary cleft rhinoplasty.Methods 38 secondary cleft patients with moderate to severe nasal deformity that were older than 16 years in our department from September 2013 to March 2016 were received rhinoplasty with novel type ‘umbrella’ graft.Nasal augmentation and piriformaperture filling with autologous rib cartilage was applied in patients with saddle nose or nasal base depression.The appearance and patient's satisfaction were assessed at 6 months after surgery.Results There were no complications such as infection,hematoma and graft exposure in all 38 patients with rhinoplasty.The nasal tip,dorsum,nostril and nasal base were improved significantly 6 months after surgery.Especially the nasal tip and nostril,most of them,became almost normal.The patients' self-evaluation of the appearance and function were satisfying.Conclusions The novel type ‘umbrella’ graft can improve the deformity of cleft nose significantly,especially the appearance of the nose tip and nostril,which is a reliable method.

Surgical treatment of pediatric mandibular fractures / 中华医学美学美容杂志

Objective To explore the effectiveness of the individualized surgical fixation for the treatment of mandibular fractures in children.Methods The individualized mandibular fixation methods were used to treat mandibular fractures in 85 children in Department of Plastic and Reconstructive Surgery in Xijing Hospital from April 2010 to July 2015.Depending on the fracture types and 3D pre simulation with stress and tension band fixation,six methods of treatment were used,including titanium plate,titanium plate-dental arch bars,biodegradable plate-dentalarch bars,biodegradable plate-occlusal splint,occlusal splint,and anchorage devices.Postoperative occlusal relationship,mouth opening and masticatory function were evaluated.Results Fixation of titanium plate was used in 10 cases,titanium plate-dental arch bars in 25 cases,biodegradable plate-dentalarch bars in 20 cases,biodegradable plate-occlusal splint 15 cases,individualized occlusal splint in 3 cases and anchorage devices in 12 cases.The treatment outcomes were good in the combined methods of open reduction with personalized fixation for children with mandibular fractures,and the reduction was satisfactory.Occlusal relationship had a good recovery after operation.Eating and functional training started earlier in these pediatric patients after operation.Conclusions For pediatric mandibular fractures,open reduction and fixation with appropriate methods can lead to favorable anatomic morphology and occlusion relationship.The application of 3D imaging technology in analyzing the fracture and showing tooth germ in the jaw helps the improvement of surgical efficiency and avoidance of unwanted tooth germ injuries.Personalized dental arch bar and splint provide good strength for external fixation or assist fixation on strain band.