Objective To explore the methodology of suturing the upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap to the levator aponeurosis,simulating the mechanism of fibers from the levator aponeurosis to the dermis in natural double-eyelid in blepharoplasty.Methods Pretarsal orbicularis myocutaneous flap was harvested.Dissection between the orbital septum and the levator aponeurosis was performed originating from the upper margin of the tarsi until to the levator muscle.The upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap was sutured to the levator aponeurosis.The lower skin margin to the orbital septum to the upper skin margin was sutured interruptedly.Patients with medial epicanthus were performed epicanthoplasty at the same time.Results 136 eyes in 68 patients were performed with double-eyelid blepharoplasty using this method.62 patients were followed-up for 1 month and 53 patients were followed-up for 3 months.They all reported satisfactory aesthetic results.Conclusions Double-eyelid blepharoplasty using this method accords with the physiological mechanism in natural double-eyelid.Postoperative double-eyelid is natural with little tumefaction.This method can avoid double-eyelid fold retraction and multi-fold occurrence.

Objective To study the technology and the result of dual plane breast augmentation using nipple margin vertical incision of areola.Methods Totally 60 cases of augmentation mammaplasty were involved in this study.The nipple margin vertical incision of areola was applied obliquely into the breast through the pectoralis major fascia.The rib starting point of pectoralis major were cut off,medial to the side of the sternum.Under the pectoralis major the cavity was peeled according to the preoperative design range.Based on the different situation of the breast types Ⅰ,Ⅱ,Ⅲ,dual plane breast augmentations were stripped respectively.After implanting the breast prosthesis,the upper part of the prosthesis was under the pectoralis major and the lower part was under the mammary gland.Results The 60 patients were all after childbearing,20 of whom underwent type 2 dual plane breast augmentation,4 underwent type 3 double plane and the rest underwent type 1 double plane.After 3 months to 2 years follow-up,all cases got satisfactory results,except 1 case of postoperative hematoma and 1 case appeared capsular contracture.Conclusions The nipple margin vertical incision of areola can complete types Ⅰ,Ⅱ,Ⅲ dual plane breast augmentation operation,at the same time it can correct mild-to-moderate mastoptosis.

OBJECTIVETo investigate the dynamic changes of type I collagen, and the activity of metalloproteinases-1 (MMP-1) and tissue inhibitor of metalloproteinases-1 (TIMP-1) after angioplasty.

METHODSThe restenotic model of iliac arteries of domestic microswine was established with hypercholesterol feed plus two angioplasties. Angioplastied vessels were harvested at the end of 1, 2, 3 and 6 months after the second angioplasty. Immunohistochemistry, transmission electronic microscopy and image quantitative analysis techniques were employed to study neointimal proliferation, the phenotype of vascular smooth muscle cells (VSMC) and the expression of type I collagen, MMP-1 and TIMP-1.

RESULTSThe peak of vascular neointimal proliferation was at 3 months after angioplasty. The expression of type I collagen gradually increased from 1 to 6 months after angioplasty. For MMP-1, expression was lower in the early stage after angioplasty but increase to normal levels of control vessels at 6 months after angioplasty. Expression of TIMP-1 rapidly increased in the early phase after angioplasty, reached peak at 3 months and maintained the high level till 6 months after angioplasty. Meanwhile, the VSMC was predominantly the synthetic phenotype at the early stage and was transformed to the contractive phenotype at the late stage after angioplasty. The ratio of TIMP-1 and MMP-1 was positively related to the area of the neointima and the expression of type I collagen respectively (P < 0.01).

CONCLUSIONType I collagen increased gradually after angioplasty, which might be determined by the ratio of TIMP-1/MMP-1 and also related to the phenotype of VSMC.

Angioplasty ; Animals ; Arterial Occlusive Diseases ; metabolism ; surgery ; Collagen Type I ; metabolism ; Iliac Artery ; surgery ; Matrix Metalloproteinase 1 ; metabolism ; Muscle, Smooth, Vascular ; cytology ; metabolism ; Swine, Miniature ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism