Objective To study and solve the repairing and reconstruction characteristic for chronic radioactivity ulceration on chest wall.Methods Using transverse rectus abdominis musculocutaneous flaps (TRAM) to repair and reconstruct 12 cases serious chronic radioactivity ulceration after radical operation of mastocarcinoma.Including 6 cases using single pedicle TRAM flaps, 6 cases using double pedicle TRAM flaps.Results All 12 cases were applied successfully with 100% survived and were followed-up for 1 to 4 years.There were better colour, texture, elasticity on flap and obviously improvement for cicatricial tissue round ulceration.Conclusion It is better choice for repairing chronic radioactivity ulceration on chest wall with transverse rectus abdominis musculocutaneous flaps and it is also reliable method for flap circulation using double pedicle TRAM flaps by vascular anastomosis.

Objective To investigate the expression of specific marker molecules in hair-inducing activity of long-term cultured human dermal papilla cells (HDPCs) in vitro.Methods After dissected and cultured the HDPCs in vitro,the cells of passages 1 to 8 were used for experiments.The growth appearances of HDPCs in different passages were observed under inverted microscope.To detect the expression of specific marker molecules of long-term cultured HDPCs,the alkaline phosphatase (ALP) activity of the HDPCs was examined,and the specific genes ALP and insulin-like growth factor-1 (IGF-1) expression levels of HDPCs were determined by real-time quantitative PCR.Results After long-term cultured in vitro,the ALP and IGF-1 expression levels of HDPCs gradually decreased in different passages,as well as the display of the aggregated and cartouche growth.The ALP and IGF-1 expression levels of HDPCs in passage 1 was the highest,they were almost about 6.8-fold and 3.5-fold higher than the HDPCs in passage 8.The ALP staining of the HDPCs in passage 1 and passage 2 were evident,but the cells' ALP staining gradually became much weaker than the cells in the previous passages after the long-term cultured in vitro.Conclusions The expression levels of specific marker molecules ALP and IGF-1 of the HDPCs decrease gradually after long-term cultured in vitro,and the higher passage HDPCs lost the special aggregated and cartouche growth appearance,and hence lead to the loss of hair-inducing activity of HDPCs.

Objective To compare the efficacy of endovenous laser treatment combined with transilluminated powered phlebectomy and traditional surgical treatment for great saphenous varicosity. Methods From January 2014 to January 2015,77 patients diagnosed as great saphenous varicosity were enrolled. They were randomly divided into two groups, 37 patients received endovenous laser treatment combined with transilluminated powered phlebectomy and the other 40 patients underwent traditional surgical treatment. The related indicators were compared.Results The mean operation time,average bleeding volume,operative incisionquantity and average hospitalization time of EVLT+ TIPP group were (66.1±14.7) min,(24.4±10.5) ml,5.7±1.7,(5.6±1.4) d respectively,of control group were (84.3±18.5) min,(59.0±15.6) ml,8.0±1.8,(10.1±3.1) d respectively,there were significant differences between the two groups(t =-4.749,-11.460,-5.714;P<0.001) .There were no significant complications in the two groups.In the EVLT+ TIPP group,6 patientsoccurred patsubcutaneous induration, 5 patients occurred subcutaneous hematoma and 7 patients had skinparesthesias.In the traditional operation group,2 cases occurred patsubcutaneous induration,3 cases occurredsubcutaneous hematoma and 2 cases had skin paresthesias.The EVLT+ TIPP group was slightly higher than thetraditional operation group in the complications, but there were no significant differences between them ( P>0.05).During a mean follow?up time of (18±7) months(12 months to 24 months),1 patient recurrence in theEVLT+ TIPP group,2 cases recurrence in the traditional operation group.The recurrence rates of the two groupswere similar,the difference was not significant between them(P=1.000) .Conclusion Endovenous lasertreatment combined with transilluminated powered phlebectomy for great saphenous varicosity is effective andsafe.It also has the advanta and better cosmetic results.

Objective To introduce a modified vertical scar method (Hall-Findlay method) and its improved technique.Methods From May 2009 to May 2018,128 cases of female mammoplasty were completed in the Department of Plastic Surgery,Nanfang Hospital of Southern Medical University,aged 22 to 49 years,with an average of 38.3 years.56 cases underwent breast reduction surgery and 72 cases underwent breast suspension surgery.The surgical incision was designed according to the Hall Findlay method.Firstly,the inner skin of the design line was shaved to form a leather cap,the breast tissue was removed,the upper or inner pedicle was preserved,and the Würinger's horizontal septum structure was arranged to ensure the blood supply and innervation of the nipple areolar complex.The partially enlarged basal mammary gland tissue was removed,and the remaining mammary tissue was fixed upward at the second rib level.The redundant skin of the breast was fully reduced and sutured.For patients with obvious breast hypertrophy,intraoperative combined aspiration of fat was used,mainly to reduce the subcutaneous fat of the lateral and lateral chest of the breast gland.Results A total of 128 cases of breast disease and simple breast sagging were treated with this method.Only 1 case showed nipple areolar complex ischemia in the early postoperative period.After 3 months to 6 months follow-up,the breast shape was good and the satisfactory rate was over 95％.Conclusions This procedure is modified from the Lejour method of vertical scar mammoplasty.The full thickness of the pedicle is preserved compared with the Lejour method.The anatomical structure of the horizontal septum is preserved during the operation to reduce the postoperative nipple-areolar complex dysfunction and poor blood supply.The probability of occurrence and the long-term effect are good,the shape of the breast is straight,and it is worth promoting.

Objective:To investigate the value of paraspinal approach and intraperative neuromonitoring in surperior laryngeal nerve (SLN) protection during thyroidectomy.Methods:214 cases of thyroid cancer admitted in our hospital from Jun. 2017 to Feb. 2018 were randomly divided into 2 groups. Patients in control group used the neck white line approach, while patients in observation group used paraspinal approach and intraperative neuromonitoring on the basis of the control group. Operation time, blood loss and SLN injury were compared between the two groups.Results:Operations were successfully performed in 214 cases. The amount of blood loss was (16.64±4.10) ml in the control group and (16.58±3.90) ml in the observation group ( t=0.086, P=0.931) . The operation time was (74.52±17.94) and (72.06±15.31) min ( t=0.792, P=0.430) . There was no significant difference in intraoperative blood loss or operation time between the two groups ( P>0.05) . SLN was seen in 134 (74.44%) of 180 nerves and 98 (89.09%) of 110 nerves, showing significant differences between the two groups ( Z=-3.02, P=0.003) . Temporary SLN injury occurred to 6 cases (4.65%) in the control group after operation, while it didn’t occurred to any one in the observation group ( Z=-2.012, P=0.044) . Conclusion:Application of paraspinal approach and intraperative neuromonitoring can improve the efficiency and safety of thyroidectomy, and is significant for SLN protection during thyroidectomy.

Objective To investigate the application value of split type tubercle on the surgical treatment of unilateral thyroid benign nodules.Methods 180 cases of unilateral benign thyroid nodules were selected,and they were randomly divided into split type tubercle resection group(group A,n =90) and hemithyroidectomy group(group B,n =90) according to the digital table.The clinical effects were compared in the two groups.Results There was no complication such as hypocalcaemia and postoperative hemorrhage.1 case of group A and 2 cases of group B had transient vocal cord palsy,there was no statistically significant difference (P ＞ 0.05).There were 6 cases postoperative nodule recurrences in group A,and 5 cases in group B during 6 months to 5 years follow-up,there was no statistically significant difference(P ＞0.05).The thyroid stimulating hormone(TSH) levels of the two groups showed no statistically significant difference before operation (P ＞ 0.05).However,the TSH level of group A (2.76 ± 1.34)IU/mL was lower than (4.31 ± 2.01)IU/mL of group B 1 year after operation,and the difference was significant between the two groups (t =9.235,P ＜ 0.05).Conclusion The split type tubercle resection is worthy to properly applied in surgical treatment of unilateral benign thyroid nodules.

Objective:To study the expression of FOXP3 in gastric cancer and its prognostic significance.Methods:One hundred and six specimens of gastric adenocarcinoma confirmed by pathology from the Department of Gastrointestinal Surgery of the Second People′s Hospital of Lianyungang in Jan. 2005 to Dec. 2015 were selected as the observation group and 85 normal para-cancer tissues as the control group. The expression of FOXP3 in 106 cases of gastric cancer was detected by tissue microarray and immunohistochemical technology. Cox regression model was used to analyze the correlation between survival data and prognosis, and Kaplan-Meiers was used to analyze the relationship between FOXP3 expression and the prognosis of gastric cancer patients.Results:The positive rate of FOXP3 expression was 53.8% (57/106) in gastric cancer tissues and 28.2% (24/85) in paraneoplastic tissues, and the difference was statistically significant ( χ2=12.597, P<0.001). The level of FOXP3 expression in gastric cancer tissues was significantly correlated with the TNM stage of patients′ tumors ( χ2=4.402, P<0.05). Single-factor Cox survival analysis showed that age, tumor pathological grade, tumor size, whether it invaded lymph nodes, TNM stage, FOXP3 expression level and prognosis were correlated.Kaplan-Meier survival analysis showed that the survival rate of tumor cell FOXP3-positive group was lower than that of FOXP3-negative group; in the subgroup type, among the subgroups, any age group, any sex group, stage Ⅲ and Ⅳ tumor cell subgroups, low- and undifferentiated groups, tumor size <16 cm 3 group, and tumor cell FOXP3 expression-positive group invading lymph nodes had lower survival than tumor cell FOXP3 expression-negative group. Conclusions:The expression of FOXP3 is up-regulated in gastric cancer. The expression of FOXP3 in gastric cancer may be a prognostic factor, and the positive expression of FOXP3 may indicate a worse prognosis.

Objective:To establish silicone cartilage models of donor-sites for the microtia patients by using digital technology, and to explore the application of surgical simulation in auricular reconstruction.Methods:From June 2018 to October 2019, 19 congenital microtia patients underwent thoracic CT scans and following three-dimensional costal cartilage imaging with Mimics software at the Nanfang Hospital, Southern Medical University. Among these patients, 16 were males and 3 were females. The mean age of patients was 16 years (range 8 to 35 years). Silicon cartilage models were produced by 3D printing and used for surgical planning and preoperative simulation in ear framework fabrication. Cartilaginous framework was sculptured according to the simulation during operation. Patients were followed up for a minimum of six months to evaluate the size, outline, height and auriculocephalic angle of the reconstructed ear. The satisfactory outcomes of the patients were scored according to a 5-point Likert scale.Results:All the patients received the surgical simulation and sculpture training with silicone cartilage models before operation. Auricular reconstruction was completed successfully according to the simulation. The duration of sculpture was shortened to 1-1.5 hours. There were no serious complications, such as hematoma, inflammation, skin necrosis and framework exposure. The contour of reconstructed ear was natural and clear over a 6 months follow-up, and all the patients were satisfied with their surgical outcomes.Conclusions:With the application of digital technology and silicone cartilage models by 3D printing to the surgical planning and training in microtia patients, patient-specific framework is fabricated with precisely assembling, which not only shortens the operation time, but also provides the unexperienced surgeons with a safe and effective training of ear framework fabrication.

Objective:To investigate the application of three-dimensional digital technique in customized ear framework fabrication for auricular reconstruction.Methods:From July 2018 to October 2019, the patients with microtia who underwent ear reconstruction in the Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University were enrolled. Each patient with unilateral microtia underwent auricular CT scan and preoperative analysis and ear framework design were carried out with Mimics software 18.0. The two-dimension(2D) ear films and three-dimension(3D) silicon models were produced by 1∶1 2D printing and 3D printing, respectively. Microtia reconstruction was performed according to the guide of the models, patients were followed up over a six-month period to evaluate the size, outline, height and auriculocephalic angle of the reconstructed ear. The satisfactory outcomes of the patients were scored according to a 5-point Likert scale.Results:A total of 15 patients were included in this study, including 11 males and 4 females, aged 8-27 years, with an average of 15.5 years old. All the 15 patients completed the surgical planning and ear reconstruction successfully, without major complications, such as hematomas, inflammation, skin necrosis and framework exposure. The costal cartilage frameworks were very similar to the printed 3D models in size and contour. Comparison between the two sides was made at six months postoperatively. The reconstructed ear was much the same as that of contralateral side, and all patients were satisfied with their reconstructed ear outcomes with average score of 4.4.Conclusions:With the application of digital technique for pre-surgical planning in microtia reconstruction patients, ear templates were produced from 2D to 3D, and the correction of microtia was changed from standard auricular reconstruction to personalized auricular reconstruction, with a great improvement of the precision in ear framework fabrication.

Objective:To investigate the application of three-dimensional digital technique in customized ear framework fabrication for auricular reconstruction.Methods:From July 2018 to October 2019, the patients with microtia who underwent ear reconstruction in the Department of Plastic and Aesthetic Surgery, Nanfang Hospital, Southern Medical University were enrolled. Each patient with unilateral microtia underwent auricular CT scan and preoperative analysis and ear framework design were carried out with Mimics software 18.0. The two-dimension(2D) ear films and three-dimension(3D) silicon models were produced by 1∶1 2D printing and 3D printing, respectively. Microtia reconstruction was performed according to the guide of the models, patients were followed up over a six-month period to evaluate the size, outline, height and auriculocephalic angle of the reconstructed ear. The satisfactory outcomes of the patients were scored according to a 5-point Likert scale.Results:A total of 15 patients were included in this study, including 11 males and 4 females, aged 8-27 years, with an average of 15.5 years old. All the 15 patients completed the surgical planning and ear reconstruction successfully, without major complications, such as hematomas, inflammation, skin necrosis and framework exposure. The costal cartilage frameworks were very similar to the printed 3D models in size and contour. Comparison between the two sides was made at six months postoperatively. The reconstructed ear was much the same as that of contralateral side, and all patients were satisfied with their reconstructed ear outcomes with average score of 4.4.Conclusions:With the application of digital technique for pre-surgical planning in microtia reconstruction patients, ear templates were produced from 2D to 3D, and the correction of microtia was changed from standard auricular reconstruction to personalized auricular reconstruction, with a great improvement of the precision in ear framework fabrication.