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Objective:To compare the pros and cons of harvesting ear cartilage through anterior and posterior auricular approaches during rhinoplasty.Methods:From January 2017 to December 2018, 63 patients with otochondral rhinoplasty in our hospital were enrolled in this study, 60 were female and 3 were male; the average age was 31.6 years (range, 18 to 43) . They were randomly divided into anterior auricular approach group with 32 cases (64 sides) and posterior auricular approach group with 31 cases (62 sides). Surgical duration, complications and postoperative scar of the two methods were analyzed.Results:The average time for harvesting the ear cartilage through posterior auricular approach and anterior auricular approach was (20.8±1.7) min and (12.6±1.1) min, respectively ( P<0.01). The overall complication rate was 15.6% for posterior auricular approach group and 4.8% for anterior auricular approach group. The wound healed well in both groups, and there was no significant difference in postoperative scar between the two groups during an average 13 months follow-up period. Conclusions:While both the anterior and the posterior auricular approaches present with similar inconspicuous scarring, the use of anterior auricular approach alone to harvest ear cartilage during rhinoplasty provides both the surgeons and the patients with easier access, shorter surgical duration, and fewer complications. Hence, we believe that the anterior auricular approach possesses greater advantages than the posterior auricular approach.
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Objective@#The purpose of this study is to systematically review the literature about surgical management of lymphedema, to provide recomendations for the surgical treatment plan of the disease.@*Methods@#Cochrane Library and EMBASE databases were searched from January 1st, 2007 to October 1st, 2017 for the literature related to the surgical treatment of lymphedema. Data were extracted from clinical studies matching our inclusion criteria. Meta-analysis was performed with R 3.4.2.@*Results@#71 studies were included, out of which 4 studies described were excision, 9 were liposuction, 33 were lymphvenous anastomosis(LVA), 23 were vascularized lymph node transfer(VLNT) and 5 were combined therapy. The excess volume reduction were averaged 96.86%(95%CI: 87.38%—106.33%, I2=0%)for liposuction, 34.64%(95%CI: 19.80%—49.47%, I2=72%)for LVA, 36.85%(95%CI: 12.40%—61.30%, I2=81%) for VLNT.@*Conclusions@#With further understanding of the pathophysiology of lymphedema and development of radiologic and surgical technique, surgical treatment has the potential to play an important role in lymphedema complex management.
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Objective To evaluate the efficacy and safety of Chushizhiyang ointment for the treatment of mild atopic dermatitis in infants.Methods A multicenter,randomized,open,active-controlled clinical trial was conducted.A total of 204 infants with atopic dermatitis were enrolled and randomly divided into 2 groups to be topically treated with Chushizhiyang ointment (test group,n =103) and hydrocortisone butyrate cream (control group,n =101),respectively,for 2 weeks.The improvement of eczema area and severity index (EASI) scores and quality of life was evaluated at 7 days and 14 days after the treatment,so was the incidence of adverse events and adverse reactions.Results Ninety-eight infants in the test group and 101 in the control group were included in the full analysis set,which revealed that the disease severity significantly decreased after the treatment in both groups.The EASI scores at the baseline and on days 7 and 14 were 2.47 ± 4.04,0.92 ± 1.25 and 0.39 ± 1.04 respectively in the test group,as well as 2.13 ± 2.01,0.85 ± 1.58 and 0.45 ± 1.65 respectively in the control group.Furthermore,the test group and control group both showed that EASI scores on days 7 and 14 significantly decreased compared with those at the baseline (the test group:T =-1 666,-1 793,respectively,both P ＜ 0.001;the control group:T =-1 951,-1 941,respectively,both P ＜ 0.001).No significant differences in EASI scores at the baseline or on days 7 and 14 were observed between the test group and control group (all P ＞ 0.05).The response rates in the test group and control group were 47.96％ (47/98) and 55.44％ (56/101) respectively on day 7,as well as 79.59％ (78/98) and 84.16％ (85/101) respectively on day 14,and there were also no significant differences between the two groups (both P ＞ 0.05).The adverse reactions mainly manifested as erythema,itching and scaling in the test group,as well as hypopigmentation,telangiectasia,scaling and hyperpigmentation in the control group.No significant difference in the incidence of adverse events was found between the test group (2.9％,3/103) and control group (6.9％,7/101).Conclusion Chushizhiyang ointment shows definite efficacy for mild atopic dermatitis in infants with good safety and tolerability,and can be a teatment option for mild atopic dermatitis in infants.
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Objective To estimate effects of Qingpeng ointment on skin barrier function,and to explore their potential mechanisms.Methods A total of 12 female volunteers with xerosis on the extensor surfaces of legs were enrolled into this study.All the volunteers were topically treated with Qingpeng ointment on the right leg (Qingpeng side) and its vehicle on the left leg (vehicle side) twice daily for 7 consecutive days.Skin barrier function-associated indexes including transepidermal water loss (TEWL) and the water content of the stratum corneum were measured before the treatment,after 3-and 7-day treatment separately.Thirty-six BALB/c female mice were randomly and equally divided into 6 groups:a blank control group receiving no induction or treatment,a model group induced by 2,4-dinitrofluorobenzene (DNFB) on the back for 5 consecutive weeks,3 Qingpeng groups and a vehicle group induced by DNFB on the back for 5 consecutive weeks followed by topical treatment with different concentrations (50％,75％,100％) of Qingpeng ointment or its vehicle twice a day for 2 consecutive weeks.At the end of treatment,skin appearance of mice was observed with naked eyes,skinfold thickness and TEWL were measured.Then,all the mice were sacrificed,and skin tissue specimens were resected from the back of mice followed by histopathologic examination and immunohistochemical staining for the detection of filaggrin (FLG),involucrin (IVL) and kallikrein 7 (KLK7) expressions in the epidermis.Results After start of treatment,both the Qingpeng side and vehicle side showed significantly decreased TEWL on day 3 (t =2.651,2.996,respectively,both P＜ 0.05) and 7 (t =3.615,3.586,respectively,both P＜ 0.05),but increased water content of the stratum corneum on day 3 (t=9.029,5.830,respectively,both P＜ 0.001) and 7 (t =13.842,11.299,respectively,both P ＜ 0.001) compared with those before the treatment.However,no significant differences were observed in TEWL or the water content of the stratum corneum between the Qingpeng side and vehicle side at any of the time points (all P ＞ 0.05).In addition,there were no marked differences in mouse skin appearance,skinfold thickness or histopathologic manifestations between the vehicle group and model group,while the manifestations of dermatitis were attenuated to different extents in the three Qingpeng groups compared with the model group.Both TEWL and KLK7 expression levels were significantly decreased in the vehicle group and three Qingpeng groups compared with the model group (all P ＜ 0.05),but similar between the vehicle and Qingpeng groups (all P ＞ 0.05).Conclusion The vehicle of Qingpeng ointment can improve skin barrier function.