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Objective To evaluate the effect of retroauricular skin expansion forthe purpose of ear reconstruction.Methods In this technique called three-stage method:1st soft tissue expander implantation under the skin close to the microtic ear,2nd the autogenous rib cartilage is harvested,the ear framework is prepared and covered with expanded skin.3rd the pseudomeatus,tragus and lobule are formed.Results 50 patients out of 55 patients were satisfied with their result and patients were followed up from 6 months to 2 years and no complain were received,There were few case with minor complication of (Exposure of expander,Deflation or Infection,Exposure of framework,Steel wire extrusion,Hypertrophic scar,Chest wall deformities) and the complications were treated accurately and carefully and patients were discharged after recoveries.Conclusion The three-stage method is very useful in microtia by using costal autogenous rib cartilage.
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Objective To explore the role of apoptosis in the development of acute lung injury (ALI) after severe acute pancreatitis (SAP) and its mechanism via Notch/Hes signal transduction pathway in the pathologic process.Methods Fifty healthy male Sprague Dawley rats were randomly divided into,sham group (n=8) and model group (n=42).Tissue samples of model group were collected randomly at 3 (n=10),6 (n=10),12 (n=10) and 24h (n=12) after model establishment.Tissue collection of Sham group was conducted at 3h.Left lung wet/dry weight ratio (W/D) was calculated;Histological scores of pancreatic and lung tissues were assessed under microscope;myeloperoxidase (MPO) and tumor necrosis factor-α (TNF-α) of lung tissues were determined by enzymatic-chemical method and radioimmunoassay method respectively.Apoptosis of lung cells was evaluated by TUNEL assay followed by calculation of apoptosis index.Protein levels of Notch-l,Hes-1 and Hes-5 were also detected semi-quantitatively by Western blotting.Results The lung tissue W/D of model rats exhibited a gradual increment at the prior 12 hours,and the ratio was significantly higher than that of sham group at each time point (P＜0.01) while it reached the peak at 12h time point.Pancreatic and lung pathological scores of model groups were increased at all time points and significantly higher than sham group (P＜0.01).Lung pathological scores of model groups achieved a peak at 12h.Meanwhile,lung MPO and TNF-α of model groups showed the same increment trend at each time points.The apoptosis index (AI) of lung cells in model groups were higher than that in sham group (P＜0.01).Compared with sham group,the model groups showed lower protein expression levels of Notch-1,especially at 3,6 and 12h (P＜0.05).Notch-1 protein expression level of 12h group was lower than that of 3,6 and 24h groups (P＜0.01).Correlation analysis found that apoptosis of lung cells was significantly negatively related to histopathological scores (r=-0.834,P＜0.01).The Notch-1 protein expression showed positive correlation with AI (r=0.515,P=0.004),but significantly negative correlation with W/D (r=-0.593,P=0.001),histological scores (r=-0.306,P=0.002),MPO (r=-0.687,P＜0.01) and TNF-α (r=-0.574,P=0.001) in the lung tissue.Conclusions Lung cell apoptosis,which is negatively correlated to tissue injury levels,may play an important role in the development of ALI after SAP.Inhibitory state of Notch-1 signaling transduction can aggravate ALI in the pathologic process.