Objective To observe the surgical effect of nipple retractor to inverted nipples.Methods Between January 2001 and January 2014,this nipple retractor to inverted nipples was used to correct 604 inverted nipples of 322 patients.The follow-up period ranged from 6 to 24 months.The clinical results and complications were evaluated.Results Excellent nipple morphology and patient satisfaction were achieved in 211 cases (93.8 ％),basically normal nipple morphology and patient satisfaction were achieved in 12 cases (5.3％),and recurrent nipple inversion occurred in three cases (1.3％).The latter three patients had experienced failed open correction for their inverted nipples,and some degree of nipple inversion occurred after removal of the frame.In this study,28 patients (12.4 ％) experienced successful pregnancy and breast-feeding.No loss of nipple sensation occurred in 225 cases.Nipple erection was observed after stimulation in 215 cases (95.6％).Conclusions The described technique is minimally invasive,simple,safe,and reliable.Satisfying aesthetic results can be achieved without destroying breast feeding function and nipple sensation.

Objective To observe the clinical effects of autologous fat injection augmentation with external tissue expander.Methods 26 cases wore the Brava device,a bra-like vacuum-based external tissue expander for 4 weeks before autologous fat injection augmentation.Patients resumed Brava wear for 14 more days after fat injection.Results 26 women had a mean augmentation volume at 3 months of 76 ml per breast after single fat injection.Follow-up ranged from 1 month to 12 months.There were no complications such as nodules,masses,or cysts occurred.Patient satisfaction was as sessed:25 cases (95.6 ％) were satisfied with the cosmetic results.Conclusions The addition of Brava expansion before autologous fat grafting leads to significantly larger breast augmentations,with more fat graft placement,higher graft survival rates,and minimal graft necrosis or complications,demonstrating high safety and efficacy for the procedure.

Objective When implantation of a prosthesis is performed for patients with a local defect of the breast after the removal of polyacrylamide hydrogel,incomplete coverage of the surface of the prosthesis occurs in these cases.The aim of this study was to explore the effectiveness of acellular allogeneic dermis in the repair of defects after prosthesis implantation.Methods Breast prosthesis implantation together with acellular allogeneic dermis repair was performed in 46 cases.Acellular allogeneic dermis was applied to cover the surface of the prosthesis,and interrupted suture was used between the margin of the dermis and the incisional margin of the gland,while appropriate tension was maintained.Results There were no complications occurred postoperatively.Correction of local depression in the breast was excellent in all cases.Histological examination showed the implanted acellular allogeneic dermis was integrated into the peripheral tissue.Conclusions Acellular allogeneic dermis can be used for repairing breast and muscle defects,in order to cover the prosthesis.Although it cannot significantly increase the thickness of the subcutaneous tissue,it can maintain the integrity of the peripheral tension around the prosthesis.In this way,it can avoid bulging of the prosthesis caused by a sudden reduction of local tension.Moreover,donor site injury is avoided.Acellular allogeneic dermis is an effective method for the repair of local breast defects.

Objective To establish a preoperative evaluation system for breast reconstruction,and to simplify the selection of surgical methods for breast reconstruction in a standard way.Methods We investigated respectively 192 successful cases that underwent breast reconstruction from July 2003 to July 2009.The factors influencing selection of methods for breast reconstruction were studied.The results presented in more than 50 ％ were collected.Results A special table of the preoperative evaluation system for breast reconstruction was established by analyzing statistical results. Conclusions The selection of methods for breast reconstruction is simplified according to this preoperative evaluation system.

Objective To evaluate the implication and necessity of deepithelialization in mastopexy.Methods A total of 124 patients with mastoptosis were randomly divided into 2 groups:group Ⅰ and group Ⅱ,62 cases each.A double-circle incision technique was used for all the patients.In group Ⅰ,full thickness skin around nipple-areola was resected.While in group Ⅱ,deepithelialization was performed and the peri nipple-areola dermis was preserved.Results The average full skin resection time was 4.5 minute per side in group Ⅰ and the skin deepithelialization time was 15.8 minute per side in group Ⅱ.Postoperative follow-up was carried out for all the 124 patients with duration of 2 weeks to 4 years.In group Ⅱ,sebaceous cysts,epidermal inclusion cyst and suture knot exclusion were found at the incision site in 8 patients (12.9 ％) at 3 weeks to 1.5 years after operation.Conclusions The blood supply to the nipple-areola complex is not affected by full-thickness skin removal during mastopexy,while the incidence of complication at the incision site decreases significantly.We conclude that deepithelialization has not much clinical significance in mastopexy.

Objective To analyze factors of volume maintenance percentage after autologous fat grafting breast augmentation.Methods From March 2011 to December 2014,39 patients were included.Age,BMI,donor site,breast preoperative volume,whether or not application of Brava and water-jet-assisted liposuction were collected as variables.We performed multivariate regression and univariate regression analyses in a general linear regression model and multilevel linear regression model to identify significant factors.Results The mean percentage of volume maintenance was (34± 12) ％.In univariate regression analysis,rate of volume maintenace was decreased 3.3％ as increase of age per 5 years;Brava application increased volume maintenace,compared with donor sites of the back and abdomen 8.4％ (40.7％ vs 32.3％,P＜0.05),application of leg fat increased by 9.6％ of volume maintenace (39.1％ vs 29.5％,P＜0.05).In the multivariate regression analysis,Brava use increased volume maintenance of 6.2％ (P＜0.05);use of leg fat increased by 6.0 ％ of volume maintenace as compared with donor sites of the back and abdomen (P＜0.05).Conclusions The age,Brava,and donor site are significant impact factors to percentage volume maintenance in autologous fat graft breast augmentation.

Breast cancer-related lymphedema is a chronic, progressive disease that occurs following axillary lymph node dissection. Treatment includes nonsurgical, surgical and biological engineering strategies. Conservative method are mainly used for prevention and in cases of subclinical lymphedema. Surgical options can be divided into two categories: reductive surgery and physiologic surgery. Biological engineering strategies use tissue engineering, stem cells and growth factors to automatically restore the lymphatic vessels. All the aforementioned techniques are not curative and, consequently, further research is imperative to establish a better regiman in management of lymphedema.

Objective To identify the prevalence and profile of psychological difficulties in a sample of women seeking the breast reconstruction, and to study the effect of the reconstructive surgery on their psychology. Methods Before and after the breast reconstruction, 50 breast-loss women were tested with the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), the self-esteem scale (SES),the self- rating body dysmorphic disorder scale (SBDDS), and the Eysenck personality questionnaire (EPQ), respectively. The proportion of the abnormally psychological patients was counted, their personality characters were analyzed, and the postoperative psychological changes were obverved. Results It was found that the 64 percent of the breast-loss patients were in anxiety, 30 percent were in depression, and 18 percent were in body dysmorphic disorder. The characteristics of their personality were more extravert, sociable and easily emotional agitation. The scores in SES of the preoperative patients were 27.46±8.95, and those of the postoperative patients were 33.05±6.12 (P＜0.05). The scores in SBDDS of the preoperative patients were 25.74±13.23, and those of the postoperative patients were 18.22±8.08 (P＜0.05).Conclusion The proportion of the anxiety, depression and BDD is high in the breast-loss women, and the postoperative psychology of esteem and body dysmorphic disorder is improved effectively.

OBJECTIVE: To study the meaning of expressions of ENO1 in the nasopharyngeal cancer tissue. METHOD: By using SP immunohistochemical methods. RESULT: The positive expressions for ENO1 were 60.0% in the nasopharyngeal cancer tissues,significantly higher than that (27.5%, 11/40) of in inflammatory nasopharyngeal mucosa (P<0.05). The positive expression rate of ENO1 protein in stage T1 + T2 + T3 was higher than that of in patients with T4 (chi2 = 11.424, P<0.05). But there was no significant relationship between expression of ENO1 and lymph node metastasis and postradiotherapy distant metastasis (P>0.05). CONCLUSION The results show that ENO1 over expression may play a important role in cell proliferation and canceration of nasopharyngeal cancer.
Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma ; Case-Control Studies ; DNA-Binding Proteins ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Neoplasm Invasiveness ; pathology ; Neoplasm Staging ; Phosphopyruvate Hydratase ; metabolism ; Tumor Suppressor Proteins ; metabolism ; Young Adult

Objective: To investigate the application and therapeutic effect of external tissue expansion-assisted autologous fat grafting for delayed breast reconstruction. Methods: Patients began wearing the BRAVA negative pressure system 8 hours a day for recipient tissue expansion for one month before the fat grafting procedure. After fat grafting, BRAVA was recommended to be worn 8 hours a day from postoperative 48 hours to one month. The interval of each fat grafting procedure was 2.5 to 3.0 months. The procedures were repeated until the completion of breast reconstruction. Water-jet assisted liposuction and subcutaneous release of scars were also performed during surgery. Results: From January 2013 to November 2016, 29 patients were followed up for 12 to 58 months, with average of 31.6 months. 28 patients completed the external tissue expansion-assisted autologous fat grafting breast reconstruction. Completion required 1 to 6 procedures, with average of 3.4 procedures. The total initial fat fill volume for each breast was ranged from 200 to 1 000 ml, with average of 583.7 ml. The initial fat fill volume for each breast was ranged from 92.5 to 243.7 ml per operation, with average of 173.8 ml. One patient underwent latissimus dorsi myocutaneous flap breast reconstruction after 3 fat grafting procedures. 8 patients completed the inframammary fold reconstruction, 3 patients underwent breast lift, 1 patient underwent lipofilling augmentation for the contralateral side. Postoperative satisfaction rate was 82.8% in patients and 75.9% in surgeon. Complication statistics: 5 cases of palpable nodules which recognized as fat necrosis (17.2%), one case of nontuberculous mycobacterial infection (3.4%) and one case of locoregional cancer recurrence (3.4%). Conclusions External tissue expansion-assisted autologous fat grafting is a minimally invasive procedure for breast reconstruction. Satisfactory results could be obtained for most of the patients who would like to choose fat grafting and have enough fat deposit in other parts of the body.