Two hundred and twenty five children aged 4-12 years with phimosis were treated by flexible dilatation combined with topical betamethasone cream from January 2003 to January 2015.Two hundred and eight cases (92.44％) were completely cured and penile edema and urination were returned to normal 7 d after a single operation;while,17 children received 2-3 additional flexible expansion.During follow-up of 2-24 months,221 children achieved the cure standards with an overall cure rate of 98.22％.Flexible dilatation combined with topical betamethasone cream is effective modality for phimosis in children,with less surgical trauma and low complication rate.

Objective To understand the variation rules of schistosomiasis endemic situation before and after schistosomia-sis transmission controlled or interrupted,so as to provide the evidence for the consolidation of control achievements. Meth-ods In Anhui Province,3 counties reaching the criteria of schistosomiasis transmission controlled or interrupted were selected and their historical endemic data were collected and analyzed statistically from 10 years before the schistosomiasis transmission controlled to 2008. Results In Tianchang City,the Oncomelania hupensis snail area was 3.54 hm2 in a part of the lake marsh-land in the year reaching the criteria of transmission controlled(1998),and no snails were found in the year of transmission in-terrupted(2008). No stool-test-positive resident was detected except there were 58 acute schistosomiasis cases in 1993,and the sero-test-positive rate of local residents remained at low levels(0-1.55%). In Taihu County,the snail area was 0.84 hm2 account-ing for 0.06%of its historical accumulative snail areas in the year of transmission controlled(1971),and no snails were found three years before the transmission interrupted (1983). However,the schistosomiasis endemic rebounded 12 years later (1995),there was an outbreak of acute schistosome infections(73 cases),and the snail area increased again to 133.7 hm2 ac-counting for 2.91%of historical accumulative snail areas. After that,the snail area kept on rising and the infection rates of resi-dents and bovine remained higher than 1%. In Guangde County,the snail area was 32.4 hm2 accounting for 1.90%of its histori-cal accumulative snail areas in the year of transmission controlled(1995). After that,the snail area increased progressively, and the schistosomiasis endemic rebounded and there were acute schistosome infections 5 years later. The Spearman tests showed that the sero-test-positive rate(Tianchang City)and the stool-test-positive rates of residents and bovine(Taihu County)had positive correlations with the snail areas(r=0.582,0.401,0.596,all P<0.05). Conclusion The snail status is a key for the consolidation of schistosomiasis transmission controlled and interrupted. Therefore,a valid surveillance system of snail situa-tion should be established as quickly as possible.

Objective To compare the influences of lumbar anesthesia and general anesthesia on the percutaneous nephroscopic surgical treatment of kidney stones. Methods Sixty patients with kidney stones who received percutaneous nephroscopic treatment in our hospital from June 2010 to September 2014 were analyzed retrospectively and randomly divided into two groups. Thirty patients received surgery under lumbar anesthesia with the intrathecal administration of 15-20 mg of 0.5% bupivacaine and 0.01-0.02 mg of midazolam; Thirty patients received surgery under general anes-thesia with the intrathecal administration of 1-2 μg/kg of fentanyl and 0.01-0.02 mg/kg of midazolam and the intra-venous injection of 100 μg/(kg·min) of propofol and 0.5 mg/kg of atracurium. The systolic blood pressure, diastolic blood pressure and pulse rates of the two groups of patients were monitored continuously and each group of data were recorded. And the patients' operative time, anesthesia time, recovery time, blood loss and changes in systolic blood pressure, diastolic blood pressure and pulse rates were compared. Results In the lumbar anesthesia group, the patients' preoperative mean blood pressure and pulse rate compared with the intraoperative 90-minute blood pressure and pulse rate, with no statistically significant differences (P>0.05). In the general anesthesia group, the patients' preoperative mean blood pressure compared with the intraoperative 90-minute blood pressure, with statistically significant differences (P<0.05). The operative time, anesthesia time and blood loss in the general anesthesia group and the lumbar anesthesia group were(112.2±18.3) vs (99.3±21.1) minutes, (112.2±18.3) vs (101.3±22.0) mintues, and (331.7±151.1) vs (211.0±89.6) mL respectively, with the general anesthesia group were significantly higher than the lumbar anesthesia group (P<0.05). Conclusion In the process of lumbar anesthesia, percutaneous nephroscopic surgery enables stable hemodynamics, causes less blood loss and consumes shorter surgical and anesthesia time, thereby worthy of clinical application.

OBJECTIVETo investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture.

METHODSAt the first stage, the joint cicatricial contracture was released completely with protection of vessels, nerves and tendons. The wound was covered with allogenetic skin or biomaterials. After skin traction for 7-14 days, the joint could reach the extension position. Then the skin graft was performed on the wound. 25 cases were treated from Mar. 2000 to May. 2013.

RESULTSPrimary healing was achieved at the second stage in all the cases. The skin graft had a satisfactory color and elasticity. Joint function was normal. All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse, except for one case who didn' t have enough active exercise on shoulder joint.

CONCLUSIONDelayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.

Biocompatible Materials ; therapeutic use ; Cicatrix, Hypertrophic ; Combined Modality Therapy ; methods ; Contracture ; surgery ; Female ; Humans ; Male ; Recovery of Function ; Recurrence ; Skin Transplantation ; methods ; Tendons ; Traction ; methods ; Wound Healing

Objective To introduce an operative method of rhytidectomy with W-incision and fewer complications for facial rejuvenation.Methods A total of 84 patients were treated with rhytidectomy by multi-methods and followed up from January 2007 to December 2012.The rhytidectomy was done along the temporal hairline edge through the combined procedures,including sharp and blunt separation,liposuction and filling with autologous fat,tighting and fixing the fascial flap of superficial musculoaponeurotic system,as well as the suspension of the zygomatic cheek fiber fat pad.Results Follow-up for 3 moths to 2 years after surgery in 84 patients showed that the wound was healing with good concealment and without complications such as facial nerve injury or local uneven.All the cases achieved good results in facelift with high satisfaction rate after the combined operations.Conclusions This combined rhytidectomy is safe,effective,simple and easy.And it is a good and ideal approach of facial rejuvenation worthy of clinical application.

Obiective: To explore the method and clinical effect of epicanthal plasty. Methods: Transverse incision of epicanthus was applied on the horizontal line of the epicanthus to separate and release the orbicularis oculi muscle and the fibrous tissue and moderately remove the abnormal orbicularis oculi muscle. The redundant triangular flap under the incision was removed, and the superficial ligament of epicanthus was sutured and fixed to the dorsal nasal fascia with 1 stitch, so as to achieve correcting the epicanthus. Results: The epicanthus of the 121 patients was corrected after the surgery with their lacrimal caruncle exposed. The appearance of the endocanthion is pleasing, the skin of the endocanthion is smooth, the scar is invisible, and the oculi rimae is lengthened 1 to 3 mm. Conclusions The operation has achieved a satisfactory effect. Therefore, the horizontal transection to remove the triangular flap is applicable for most epicanthus due to its simplicity and practicality, as well as the invisible scar and simultaneous manipulation with other operations. These features might be significant for a wider clinical application.

ObjectiveCongenital heart disease （CHD） is a common birth defect in children， with its incidence increasing annually. Because of their special health status， the vaccination situation for children with CHD has become a focal point of attention. This paper systematically reviews the current status of vaccination among children with CHD in China to identify existing issues in vaccination efforts for children with CHD， provide guidance for increasing vaccination rates among children with CHD， reduce the incidence of vaccine-preventable diseases， and provide ideas for subsequent research. MethodsLiterature on the vaccination of children with CHD in China was searched in both Chinese and English databases， including CNKI， Wanfang Data Knowledge Service Platform， VIP， Chinese Biomedical and Web of Science， PubMed， EmBase， and the Cochrane Library. Relevant literature was identified based on inclusion and exclusion criteria， and data extraction was carried out to summarize the research results. ResultsA total of 15 studies were included. Three articles focusing on expert consensus （guideline recommendations） for vaccination of children with CHD in China all agreed that vaccination is both feasible and necessary for children with CHD. Systematic analysis found that the overall timely vaccination rate for children with CHD was between 34% and 50%， with a notable delay in vaccination. However， after professional outpatient assessment， the vast majority of children with CHD were advised to be vaccinated according to the national recommended schedule， with only about 2% of them being advised to delay vaccination. The proportion of children with CHD who reported suspected adverse events following immunization （AEFI） was low and not significantly different from that of healthy/control children. ConclusionThe safety of vaccinations for children with CHD in China is relatively high， but the total timely vaccination rate is currently low. In order to improve the coverage and timeliness of vaccination in children with CHD， it is recommended that relevant departments provide vaccination policy support. There is a lack of research on the effectiveness of vaccination in children with CHD， so further studies are urgently needed to further improve the vaccination strategy for children with CHD in China.