Objective To investigate the application of the repeated expanded bilateral deltopectoral flap for resurfacing severe facial cervical scar, with review of relating articles to discuss issue of repeated expanding flap.Methods Nine patients suffered from hyperplastic facial and cervical scar.Two soft tissue expanders were implanted into the anterior chest region at both sides of sternum.The center of inner border of the expander was at the cross of second intercostal and parasternal line, and the lengthways axe of the expander was located at the ligature of the second intercostals and mammary areola.After two weeks when the expander was filled, expanded flap was transferred to cervical defect.The transferred flap was repeated expanded after half a year and transferred to resurface facial defect.Results In the first expansion stage, 600 or 800 ml expander were implanted in each side of sternum.In the second stage, 400 or 500 ml were used.The first stage of expanding process was smooth, and 2 of the expanding flaps were ruptured during the second expansion period.400-520 cm2 (average 440 cm2) additional expanded flap was acquired during two stages of expanding.Conclusions The repeated expanded bilateral deltopectoral flap gives us greater opportunity to repair severe facial-cervical scar.The best interval time of the two-stage expansion is over half a year.The speed of second expansion should be lower than that in the first stage, and protecting the expanding flap carefully from external force compression is needed during the second expasion.

Objective: This paper discusses a surgical method to improve the middle part of face and the temporal surface by using the patented technology of embedding guidance technology. Methods: On the basis of not removing the skin, the application of embedding guidance technology was applied to achieve the effect of facial lifting by placing a 2-0 polyester knitting line under the scalp with a minimally invasive incision(3-5 mm) , paving up to the skull periosteum and down to the hairline edge for compound fixation. Results: Among the 200 patients, 197 were female and 3 were male. Aging from 23-62 years old, all of the patients suffered from mild to moderate problem of saggy skin.Post-operation follow-up was kept from 3 months to 5 years after the treatment, which demonstrated that all of the patients showed different degrees of facial lifting after edema subsided at 3 months, including improvedfacial skin condition, shallower nasolabial groove, lifting of the lateral canthus and tightening of facial skin. The patients were satisfied with the effect. Conclusions The surgical method is an effective method to solve the problem of facial aging with advantages, such as simple execution, minimized wound, fast recovery, no post-operation bandage requirement and showing great result towards patients suffering from mild and moderate saggy facial skin problem.

Objective: To investigate the therapeuctic effect of one-stage reconstruction of distal urethra with free graft of tublar oral mucosa. Methods: Two strips of oral mucosa graft( 0.4—0.6 cm in width), were harvested and sutured around an oiled silk roll to form mucosa tube. The mucosa tube was used to reconstruct distal urethra. Postoperative pressure dressing and earlier urination were recommended. Results: From May 2007 to October 2015, 16 cases with distal urethra defect or stenosis were treated with this method. The urethra defect was 2—4 cm in length. Urethral fistula happened in 3 patients. All the other 13 cases healed primarily. 10 cases were followed up for 1—5 years by telephone with normal function. Conclusions One-stage reconstruction with free graft of bulbar oral mucosa is suitable and reliable for distal urethra defect less than 4 cm in length.

Objective:To investigate the clinical efficacy of the modified central short incision minimally invasive double eyelid surgery.Methods:A retrospective analysis was conducted on patients who underwent the modified procedure at Chengdu Badachu Medical Aesthetic Hospital from September 2018 to January 2023. The modification involved extending the traditional central short incision to retain the outer fascial membrane of the orbicularis oculi muscle through shallow layer dissection. At five marked points, the skin and muscle layers of both the upper and lower eyelids were fixed to the pre-tarsal fascia. The upper eyelid orbital septum was also repositioned, postoperative evaluations were performed by doctors, scoring the upper eyelid (0-8 points, with higher scores indicating greater satisfaction) and the incision was intermittently sutured. Patient satisfaction was investigated 3 months after surgery by outpatient questionnaires or telephone follow-up.Results:Ninety-four patients (147 eyelids, including 31 with ptosis) were included. There were 28 males (49 eyelids) and 66 females (98 eyelids), aged 20-41 years, with an average age of 29.7 years. Follow-up ranged from 6 to 36 months, averaging 14 months. All incisions healed without infection, scar hyperplasia, or corneal injuries. Two cases required revision surgery for shallow folds. The remaining patients had smooth, full eyelid folds with hidden, flat incisions. Doctors evaluated the postoperative effect: 141 cases were satisfied, 4 cases were general and 2 cases were dissatisfied. Patient satisfaction: 142 cases were satisfied and above, 3 cases were generally satisfied and 2 cases were dissatisfied.Conclusion:The modified central short incision minimally invasive double eyelid surgery fully exposes the surgical field, corrects ptosis, expands indications and is simple, minimally traumatic, quick to recover from, with minimal scarring and natural result.It is an optimal method for minimally invasive double eyelid surgery.

Objective:To investigate the clinical efficacy of the modified central short incision minimally invasive double eyelid surgery.Methods:A retrospective analysis was conducted on patients who underwent the modified procedure at Chengdu Badachu Medical Aesthetic Hospital from September 2018 to January 2023. The modification involved extending the traditional central short incision to retain the outer fascial membrane of the orbicularis oculi muscle through shallow layer dissection. At five marked points, the skin and muscle layers of both the upper and lower eyelids were fixed to the pre-tarsal fascia. The upper eyelid orbital septum was also repositioned, postoperative evaluations were performed by doctors, scoring the upper eyelid (0-8 points, with higher scores indicating greater satisfaction) and the incision was intermittently sutured. Patient satisfaction was investigated 3 months after surgery by outpatient questionnaires or telephone follow-up.Results:Ninety-four patients (147 eyelids, including 31 with ptosis) were included. There were 28 males (49 eyelids) and 66 females (98 eyelids), aged 20-41 years, with an average age of 29.7 years. Follow-up ranged from 6 to 36 months, averaging 14 months. All incisions healed without infection, scar hyperplasia, or corneal injuries. Two cases required revision surgery for shallow folds. The remaining patients had smooth, full eyelid folds with hidden, flat incisions. Doctors evaluated the postoperative effect: 141 cases were satisfied, 4 cases were general and 2 cases were dissatisfied. Patient satisfaction: 142 cases were satisfied and above, 3 cases were generally satisfied and 2 cases were dissatisfied.Conclusion:The modified central short incision minimally invasive double eyelid surgery fully exposes the surgical field, corrects ptosis, expands indications and is simple, minimally traumatic, quick to recover from, with minimal scarring and natural result.It is an optimal method for minimally invasive double eyelid surgery.

Objective: To investigate the effect of skin soft tissue expansion on repair of large area of scars on extremities. Methods: Twenty-five patients with large area of scars on extremities were admitted to our department from June 2007 to October 2014. There were 14 males and 11 females, aged 4 to 36 years. Operations were performed under local infiltration anesthesia or general anesthesia. In the first stage, 1 to 5 cylindrical expanders with capacities of 250 to 600 mL were placed at left or right sides or at upper or lower parts of the scars. In the second stage, scars of 21 patients were repaired with expanded transverse propulsive and lateral flaps, and scars of 4 patients were repaired with expanded perforator flaps whose pedicles were perforators of brachial artery, superior ulnar collateral artery, or posterior interosseous artery according to areas and shapes of the scars. The secondary wound areas ranged from 13 cm×7 cm to 34 cm×18 cm after dissolution or excision of scars. The areas of flaps ranged from 13 cm×7 cm to 20 cm×12 cm. The donor sites were sutured directly. The flaps after operation and follow-up of patients were observed and recorded. Results: All expanded flaps survived after operation. And the superficial distal part of flap whose pedicle was perforator of posterior interosseous artery in one patient was with necrosis, and other flaps survived well. During follow-up of 3 to 15 months after operation of the second stage, color and texture of flaps were similar to surrounding skin, while extremities of donor sites were thinner and auxiliary incisional scars formed after expansion. Conclusions Expanded flap is a good way to repair large area of scar on extremities. Bilateral skin of scar is the first choice of donor site of expanded flap. If there isn′t enough skin for expanding on bilateral sides, expanded perforator flap designed at upper or lower part of the scar is another choice to repair the scar.

OBJECTIVETo evaluate safety and immunogenicity of inactivated hepatitis A vaccine in HBsAg carriers and healthy children.

METHODSOne hundred and twenty-one healthy children and ten HBsAg carriers, aged 1-10 years HAV susceptible were enrolled in the study. The inactivated hepatitis A vaccine was produced by Tangshan Biogenetic Company. The dosage of the vaccine was 1000 U/Dosage and 500 U/Dosage. The vaccination schedule was six month apart for two injections. The serum anti-HAV level was detected with EIA at one month after first injection and at one and six month after the booster injection, respectively.

RESULTSThe anti-HAV appeared in all the children. One month after the booster injection, the serum anti-HAV level in children vaccinated 500 U/Dosage was 4684.9 mIU and 4535.6 mIU, respectively and in the children vaccinated 1000 U/Dosage, 5399.8 mIU and 7347.1 mIU, respectively. The anti-HAV level was not statistically different between the two groups of children. There was no adverse reaction after the vaccination. The anti-HAV level was still high one year after first injection.

CONCLUSIONSThe data indicated that the safety and immunogenicity of the domestic inactivated hepatitis A vaccine were excellent in both groups of children.

Child ; Child, Preschool ; Hepatitis A Antibodies ; blood ; Hepatitis A Vaccines ; immunology ; Hepatitis B Surface Antigens ; blood ; Humans ; Immunization ; Infant ; Vaccines, Inactivated ; immunology

A 26-year-old male presented with tremor of bilateral shoulders and hands as the major symptom and also had cognitive and emotional abnormalities for more than 1 year, who was diagnosed as cerebral hepatolenticular degeneration (HLD) in Tongji Hospital of Huazhong University of Science and Technology in October 2021. The serum ceruloplasmin and urine copper levels of the patient were 0.023 g/L and 3760.00 μg/24 h, respectively, and the Kayser-Fleischer (K-F) ring was seen in the cornea. Genetic testing revealed a homozygous mutation of ATP7B gene c.2975C>T (p.Pro992Leu), while transcranial sonography (TCS) showed lenticular nucleus hyper-echogenicity. The literature was searched using hepatolenticular degeneration and transcranial sonography as key words; and 9 articles involving 150 HLD cases were obtained. The lenticular nucleus hyper-echogenicity was presented in 76.9% HLD patients (150/195), while only in 12.7% healthy subjects (17/134) ( P<0.001), suggesting that advanced transcranial sonography can detect the metal deposition and may be used for diagnosis of cerebral HLD.