Objective To observe the effects of secreted protein,acidic and rich in cysteine (SPARC) on the expression of TGF-β1 and collagen type Ⅰ in cultured human keloid fibroblasts by real-time fluorescence quantitative RT-PCR.Methods In vitro keloid fibroblasts were stimulated by different concentrations of recombinant human SPARC,and with the control group for comparison,real-time fluorescence quantitative RT-PCR to detect expression of TGFβ1 and collagen type Ⅰ.Results Compared with the control group,the expression of TGF-β1 and collagen type Ⅰ was significantly increased in the experimental group.Conclusions SPARC could enhance the expression of TGF-β1 and collagen type Ⅰ in keloid fibroblasts significantly.

Objective To investigate the application of the frontal branch of superficial temporal vessels pedicled flap in repairing lower eyelid ectropion.Methods Eight cases were collected from patients diagnosed with lower eyelid ectropion in our hospital from April 2012 to April 2015.In phase 1 of operation,the dilators were implanted into the frontal branch of superficial temporal vessels and fully expanded by normal saline injection;In phase 2,the scar of lower eyelid was incised,and the expanded forehead flaps were transferred to cover the wound after the lower eyelid released back to normal anatomy location;In phase 3,the flap delay operation was manipulated 3 weeks after phase 2,and the left wound after scar excision was finished by pedicle division 1 week later.Results All patients in the study showed a good appearance and function of lower eyelid.There were no complications such as flap congestion and necrosis occurred.Meantime there were no relapses observed according to the follow-ups ranging from 6 months to 1 year.Conclusions The application of the frontal branch of superficial temporal vessels pedicled flap shows a promising procedure in treatment of lower eyelid ectropion.

Objective: To explore a simple method of cryptotia correction with good effect. Methods: 7 patients and 10 ears were operated on, using a supra-auricular V-Y flap. The auricular muscles′ adhesion with cartilage was sufficiently released, and the scapha cartilage was remodeled by a reverse suture. The flap was rotated to post-auricular to close the wound, and deepenen the auriculocephalic angle. Results: All patients′ ears nearly had a normal appearance and an obvious crus of helix. Patients could wear glasses or respirator easily, as their supra-auricular part was free from the skull. Our technique ensured all scars were hidden behind the ear or in the hair. No patients required revisional surgery. Conclusions This technique is a simple method , which has a good result , covert scar and low recurrence. We can use it for majority of patients with cryptotia.

Objective: This study aimed to present our clinical experience using a novel method for autologus costal cartilage framework fabricationin fully expansion technique ear reconstruction without skin graft. Methods: During Steptember 2016 to Steptember 2017, autologus costal cartilage framework with expansion technique were performed for 63 patients with microtia. Autologous costal cartilage was stacked up to form the structure and height, the natural appearance of auriculocephalic angle was achieved at the same stage, so the second-stage elevation of ear and postauricular skin graft was unnecessary. The delicate structure of the reconstructed ear and ideal bilateral symmetry were achieved by the optimized cartilage stack-up. Results: Three patients out of total 63 patients had cartilage frame work exposure, and were treated with superficial temporal fascia transfer combined with skin graft. The rest 60 patients had satisfied results. Follow-up ranged from 8 months to 18 months and 12 months follow-up was on average. The novel frame work fabrication method was based on the sufficient full pre-expansion procedure. The ideal structure, bilateral symmetry, and excellent definition of the framework, as well as the natural dorsal appearance of the reconstructed auricular were achieved. Conclusions The cartilage " stack-up" method is essential for the full expansion without skin grafts ear reconstruction technique. The combination of the cartilage " stack-up" framework fabrication and full pre-expansion provide a well-defined, well-projected and bilateral symmetrical ear.

Objective: To investigate the clinical effect of conjoint fascial sheath (CFS) suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis. Methods: From February 2017 to April 2018, 19 severe blepharoptosis patients (21 eyelids) were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening, and repaired through the technology of CFS suspension. Results: There were 19 cases, 17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes, and the other 2 cases obtained satisfactory results though reoperation. There were no complications of exposure keratitis, ectropion and infection occurred. Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months. Conclusions The application of conjoint fascial sheath (CFS) suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.

Objective: To evaluate the application of the expanded free deltopectoral flap, pedicled with perforation of internal thoracic artery, in the repairment of middle to large facial skin and soft tissue defect. Methods: From June 2015 to December 2017, 11cases diagnosed with facial lesions were included in this study. The tissue defect of 10 cases were caused by burn, and 1 case by superficial tumor. In the first stage, the tissue expander was implanted into the internal thoracic artery supplying area. After the expander was fully expanded, the second surgery, i. e. the resection of facial lesion, was performed. The defect areas of patients, with the range of 9 cm×7 cm to 17 cm×10 cm, were repaired by expanded free deltopectoral flaps. Results: All flaps were survived, with no vascular crisis occurred. The size of flaps ranged from 10.0 cm×9.0 cm to 18.0 cm×11.5 cm. All the patients were satisfied with the outcomes, after 6 to 24 months follow-up. The color and texture of flaps was close to normal. The scars were acceptable. Conclusions The expanded free deltopectoral flap, pedicled with the perforator of internal thoracic artery, is a promising way to repair middle to large facial skin and soft tissue defect.

Objective To evaluate the clinical outcome of reduction plasty for labia minora hy-pertrophy with redundant praeputium clitoridis .Methods A total of 84 cases were included from June 2013 to December 2016 .Arc-shaped resection of labia minora and crescent resection of redundant pra-eputium clitoridis were the two essntial surgical procedure ,and 5-0 VICRYL Rapide was used for su-turing the incision .Results The 84 cases were operated with this mothod with satisfactory aesthetic result .Complications ,such as hematoma ,infection and poor wound healing ,were not observed .Ede-ma was resoluted after one to two weeks .After the reduction plasty of the labial labia ,the vagina and perineum were completely covered in the natural state ,without scar ,also the sensitivity of clitoris was improved due to the better expoure post-operationally .Conclusions The same-stage reduction plasty for labia minora hypertrophy with redundant praeputium clitoridis is a reliable and effective method . Both satisfactory aesthetic result and improved sexual sensitivity are achived ,without hematoma ,in-fection and poor wound healing .

Since it was introduced in the 1970s, skin and soft tissue expansion has been widely used in the field of plastic and reconstructive surgery, and has achieved good results. In the field of ear reconstruction, there are many related studies and reports available. The author reviewed and summarized the history and current progress of skin and soft tissue expansion and its application in auricular reconstruction, and offered author’s personal opinion on the classification and naming of ear reconstruction based on expansion technique.

Since it was introduced in the 1970s, skin and soft tissue expansion has been widely used in the field of plastic and reconstructive surgery, and has achieved good results. In the field of ear reconstruction, there are many related studies and reports available. The author reviewed and summarized the history and current progress of skin and soft tissue expansion and its application in auricular reconstruction, and offered author’s personal opinion on the classification and naming of ear reconstruction based on expansion technique.

Male infertility,a common condition in andrology,falls under the category of"no son"in traditional Chinese medicine(TCM).Unhealthy eating habits and excessive sexual activity,prevalent due to improved living standards,have contributed to the increasing incidence of male infertility.YE Tianshi proposed the theory of"maintaining with the sweet and restoring the body fluids",which emphasizes the importance of ample body fluid for the nourishment of the male essence chamber.Sufficient body fluid is crucial for normal sperm generation.In TCM,the primary pathogenesis of male infertility involves the loss of body fluids and insufficiency of yin essence.Sweet Chinese herbal medicinal is recommended as it nourishes yin,enriches essence,and replenishes male reproductive essence without producing phlegm and dampness.Therefore,when treating male infertility,attention should be given to the use of sweet Chinese herbal medicinal,adhering to the principle of"abundant body fluids nourish kidney yin,and abundant kidney yin supports semen production".Therapies such as purging fire to preserve body fluids with Zengye Decoction,nourishing yin to enrich essence with Guilu Erxian Decoction,benefiting qi to promote fluid production with Buzhong Yiqi Decoction,and warming yang and transporting fluids with Xianfu Shezi Decoction should be considered.Medication and dosage adjustments should be made based on the specific etiology,pathology,and related symptoms to improve the quality of male sperm and enhance the chances of conception.