Objective To analyse the clinical features,predisposing risk factors and treatment of hematologic diseases complicated by pulmonary fungal infection(PFI).Methods The medical records of 97 cases of PFI were retrospectively analyzed.Results Totally 201 fungal strains were obtained from 97 cases of hematologic diseases.The candida strains were 147(73.1%).Two-fungal infection was 17.5%,and secondary bacterial infection was 71.8%;relative death rate was 23.4%.Cure rate of Amphotericin B deoxycholate and Itraconazole was 67.7% and 63.7%.Conclusion Fungal infection is one of the main pathogens in hematologic diseases complicated by infection.Early diagnosis and treatment is the key to beneficial release and long time survival.Amphotericin B deoxycholate and Itraconazole were effective medicines for treated fungal infection.

Objective To analyze the incidence and the risk factors of retinopathy of prematurity (ROP) among the multiple and single gestations births.Methods A prospective control study was applied to the research.The preterm infants were selected that from September 2013 to December 2015 in neonatology department of our hospital.They were divided into multiple gestations group (52 cases) and single birth infants group (600 cases).RetCam Ⅲl retina camera and binocular indirect ophthalmoscope video were used to screening the ocular fundus.The cure rate of the two groups was compared with chi-square test.Results The incidence of ROP in multiple gestations group (32.69％) was higher than single birth infants group (20.83％) (P =0.047).There was significant difference about the multiple and single gestations births in ≤ 30 weeks (P =0.040),and there was no statistically significant difference in ＞ 30 weeks (all P ＞0.05).With the increase of birth weight,the ROP detection rate of two groupa was reduced.There was no statistically significant difference about different birth weight among the two groups (all P ＞ 0.05).The oxygen usage of ＞ 5 days ROP detection rate was higher than 5 days or less in the two groups (P =0.025,0.001).There was no significant difference in ROP detection rate between two groups with ≤5 d oxygen usage.There was significant difference about the multiple and single gestations births in oxygen usage of ＞ 5 days (P =0.020).Multivariate analysis found that multiple gestations and small gestational age were risk factors for ROP.Conclusion The smaller gestational age,the lower birth weight,and the longer oxygen therapy with the preterm infants,the higher the incidence of ROP.The number of different gestational is also the influences factors of ROP.Multiple gestations overall incidence of ROP is higher than the single birth infants.The smaller the gestational age and the longer oxygen usage,multiple gestations incidence of ROP is higher than single gestation in different births.However,there is no relationship in different birth weight among the multiple and single gestations.

AIM:To investigate atrial natriuretic peptide(ANP) circadian in the encapsulated human ANP(hANP) cDNA transfected cells,to alter the ANP circadian by artificial control to achieve the objective of effectively treat hypertension or congestive heart failure(CHF). METHODS:ANP cDNA was transfected into Chinese hamster ovary(CHO) cells,which were encapsulated in polycarprolactone(PCL) tubes.The longterm survival of transfected CHO cells and the levels of ANP secreted were detected.Circadian rhythm of ANP secreted by encapsulated transfected cells was also studied,which was regulated by melatonin. RESULTS:During culturing,the ANP level secreted by transfected CHO cells in 2 mL of culture medium within 24 hours could reach 210.3 ng/L in a 20 mm-long and 2 mm-diameter PCL tube.The section of ANP displayed a circadian variation:higher in daytime,but lower at night.The acrophase of circadian rhythm was 4:15 but could be shifted to 7:55 after melatonin management. CONCLUSION:ANP cDNA transfected CHO cells that encapsulated into PCL tube can secret ANP,which might be suitable for the future implantation into human body.Our research provides a new approach in the treatment of hypertension and CHF by ANP.

Objective:To investigate the validity of a simple technique of drilling nasal spine in costal cartilage based rhinoplasty.Methods:From August 2018 to October 2020, the clinical data of patients whom received costal cartilage rhinoplasty in Plastic Surgery Hospital of Chinese Academy of Medical Sciences were retrospectively analyzed. During the operation, the towel clamp was slid into the space of the nasal spine, with minor adjustments of its position, slowly and steadily, the towel clamps were tightened until the bilateral tips were met, and the perforation procedure was successful. Then, based on this aperture, the columellar strut was firmly fixed to the nasal spine, and the cartilage framework was established. Postoperative follow-up was conducted to investigate the satisfaction of the patients, as well as a third-party plastic surgeon was introduced to evaluate the pre-and post-operative photos of the patients by the observer’s overall cosmetic improvement score (IGAIS).Results:A total of 35 female patients with the age of (27.7±2.3) years (22-37 years old) were included. All patients presented low tip and dorsum, with flat, flaring alae. There were no significant short-term complications such as infection, mucosal perforation and graft exposure. The patients were followed up for 6 to 24 months. Two cases presented cartilage warping, and was corrected after revision surgery. The appearance of the nose was significantly improved, and the subjective satisfaction was 97.1% (34/35). The third-party physician evaluation results were: in 35 cases, 33 cases achieved significant improvement, 2 cases achieved moderate improvement, 100% (35/35) of the patients reached the improvement, and the improvement score was 1.08±0.28.Conclusions:The drilling technique of utilizing a towel forcep is simple and practical which facilitates stable fixation of nasal columellar support graft, and renders a good outcome in the clinical application of autologous costal cartilage rhinoplasty.

Objective:To introduce a new method of lateral nasal osteotomy. The key of this method is to fully dissect the tissue around the piriform foramen to achieve nasal osteotomy under direct vision. The osteotomy line in the whole process can be seen, which provides a more reliable control for the degree of osteotomy during the operation, and also makes the postoperative outcome more predictable.Methods:Patients whom were treated with open external osteotomy combined with autologous costal cartilage implantation for augmentation rhinoplasty (with 24 cases of hump nose correction) from October 2018 to October 2020. During the surgery, the whole nasal dorsum was exposed, the superior lateral cartilage was separated from the nasal septum, and the whole process was carried out through the mucosa from the intranasal approach under direct view. The osteotomy line was evaluated at the same time.Results:A total of 33 female patients were retrospectively analyzed. All the operations were successful, and the local swelling occurred after operation. The follow-up time was 3-18 months. After 3 months, the nasal contour and dorsal curves were smooth. Severe infections, major injuries like nasolacrimal duct, lacrimal sac, medial canthus ligament, nerve branches were not noticed in all patients. During the long-term follow-up, two patients exhibited slightly widened nasal bone, but did not require surgical intervention. The shape of nose was greatly improved. Patients were satisfied with the result . The subjective evaluation had "very satisfactory" in 24 cases (72.7%) and "satisfactory" in 9 cases (27.3%). The IGAIS evaluation were also positive: the average score of 33 patients was 1.26±0.34, including 30 cases (90.9%) scoring 1 point and 3 cases (9.1%) scoring 2 points.Conclusions:The open osteotomy technique has better control than that of conventional blind operation. It is more reliable, safer for the surgeons who are new to rhinoplasty and the experienced ones.

Objective:To investigate subalar change after rhinoplasty with costal cartilage.Methods:A retrospective study was performed on patients who received cartilaginous rhinoplasty at the Rhinoplasty Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences from May 2019 to August 2020. The facial three-dimensional(3D) and CT scanning data of young female cases was analyzed. Pre-operative and more than 6 months follow-up data was matched. The 3D facial coordinate system was established. Preoperative and postoperative location of the subnasale and the lateral point of nasal-facial junction, the angle between endocanthion-alare and coronal plane and the nasolabial angle were analyzed with paired samples t-test. The volume of subalar area was analyzed with one-sample t-test. Results:Eighteen female cases aged (27.30±4.41) years were enrolled in the study with (10.61±3.53) months follow-up. One case (5.6%) suffered from nostril asymmetry one month after the surgery. The subnasale moved forward from (74.30±1.97) mm to (77.67±2.37) mm [average difference (3.36±0.96) mm]. The lateral point of nasal-facial junction moved forward from (65.51±2.45) mm to (68.05±2.52) mm [average difference (2.53±1.50) mm]. Nasolabial angle was (88.79±11.21) degree preoperatively and (101.37±5.53) degree postoperatively [average difference (12.57±7.57) degree]. Angle between endocanthion-alare and coronal plane increased from (9.01±3.24) degree to (12.73±3.27) degree [average difference (3.72±2.22) degree]. The differences between pre- and post-operative data were statistically significant ( P<0.01). The volume of subalar area increased by (282.59±103.22) mm 3. The difference was statistically significant ( P<0.01). Conclusions:Rhinoplasty with costal cartilage could make subalar area move forward.

Objective:To investigate the clinical application of a cartilage graft fixation method in the context of rib-based rhinoplasty.Methods:The clinical data of patients who underwent costal cartilage based rhinoplasty in the Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2020 to January 2022 were retrospectively analyzed. A 20 ml syringe needle was used to drill several micropores about 1 mm in diameter on the surface of the cartilage grafts prior to its placement. "septal extension grafts with micropores" were prepared, and the preparation of the remaining grafts was conventional.Results:A total of 30 female patients aged 21-45 years, with an average age of 36 years underwent primary or repaired autogenous costal cartilage rhinoplasty without severe damage to the nasal septum cartilage (at least retention of L-shaped scaffolds larger than 10 mm) were enrolled. All operations were successful, the cartilage scaffold was stable and durable. There were no serious complications such as infection, septal hematoma and cartilage exposure. Postoperative patients were followed up for a duration of 6-24 months. Two out of 30 patients were not satisfied with the postoperative appearance. During the revision surgery, the septal perichondrium was separated, mucosal tissue had grown into the bilateral holes which further verified of the feasibility of drilling. The other patients were satisfactied with the results.Conclusion:Nasal septum extension graft based on drilling technique is beneficial to maintain the long-term stability of cartilage scaffold after comprehensive costal cartilage nasal surgery, which justifies its application in comprehensive nasal plastic surgery.

Objective:To investigate the clinical effect of jujube core-shaped tissue resection technique in the treatment of alar reduction.Methods:A retrospective analysis was performed for the clinical data of patients who underwent alar reduction from February 2019 to June 2022. A spindle-shaped incision line was designed along the outer edge of the base of the nasal lobule, with a width of 4-5 mm and a length of 8-12 mm. The incision line was 1-2 mm away from the alar groove, and the inner side of the design line was extended to the inside of the nasal vestibule. After the incision was made, the subcutaneous tissue was undermining dissected with curved sharp scissors, and the shape of the extended excision tissue was similar to that of jujube core. After reduction, the incision was closed with vertical mattress suture. The surgical effect and complications were followed up after surgery, and an independent attending plastic surgeon evaluated the outcome and scarring based on photos before and at the last postoperative follow-up using the global aesthetic improvement scale (GAIS) and the Vancouver scar scale (VSS). GAIS is graded as 1, 2, 3, 4, and 5 points, and the lower the score, the better the improvement(≤3 points as effective improvement). VSS includes four parameters: color (0-3 points), thickness (0-4 points), vascular distribution (0-3 points), and softness (0-5 points). The higher the score, the more significant the scar is.Results:A total of 20 patients were enrolled, including 6 males and 14 females, aged 20 to 33 years, with an average age of 24.9 years. Before the operation, there were different degrees of alar flare and alar hypertrophy. After surgery, 13 patients had mild swelling, ecchymosis, which resolved after 3 days. There were no major complications as infection, incision dehiscence, and delayed healing. After 3 to 16 months of postoperative follow-up, 2 patients gradually developed cartilage deformation and affected the appearance of the nostrils 6 to 9 months after surgery due to the combination of rib-based rhinoplasty, and the satisfactory results were obtained after revision surgery. The symmetry of the nostrils was significantly improved. The GAIS score of 20 patients was (1.20±0.41) points, of which, 16 patients were rated as 1 point and 4 patients were rated as 2 points, all of which met the improvement criteria, and the VSS score was (1.45±0.60) points, in which the average score for color, thickness, vasculature and compliance are 0.60, 0.05, 0.55 and 0.30 points respectively.Conclusion:The application of jujube core-shaped tissue resection technique for alar reduction can increase the amount of tissue removal with the same incision width, which can not only fully narrow the alar effectively but also correct the hypertrophy of the alar tissue.

Objective:To investigate the validity of a simple technique of drilling nasal spine in costal cartilage based rhinoplasty.Methods:From August 2018 to October 2020, the clinical data of patients whom received costal cartilage rhinoplasty in Plastic Surgery Hospital of Chinese Academy of Medical Sciences were retrospectively analyzed. During the operation, the towel clamp was slid into the space of the nasal spine, with minor adjustments of its position, slowly and steadily, the towel clamps were tightened until the bilateral tips were met, and the perforation procedure was successful. Then, based on this aperture, the columellar strut was firmly fixed to the nasal spine, and the cartilage framework was established. Postoperative follow-up was conducted to investigate the satisfaction of the patients, as well as a third-party plastic surgeon was introduced to evaluate the pre-and post-operative photos of the patients by the observer’s overall cosmetic improvement score (IGAIS).Results:A total of 35 female patients with the age of (27.7±2.3) years (22-37 years old) were included. All patients presented low tip and dorsum, with flat, flaring alae. There were no significant short-term complications such as infection, mucosal perforation and graft exposure. The patients were followed up for 6 to 24 months. Two cases presented cartilage warping, and was corrected after revision surgery. The appearance of the nose was significantly improved, and the subjective satisfaction was 97.1% (34/35). The third-party physician evaluation results were: in 35 cases, 33 cases achieved significant improvement, 2 cases achieved moderate improvement, 100% (35/35) of the patients reached the improvement, and the improvement score was 1.08±0.28.Conclusions:The drilling technique of utilizing a towel forcep is simple and practical which facilitates stable fixation of nasal columellar support graft, and renders a good outcome in the clinical application of autologous costal cartilage rhinoplasty.

Objective:To introduce a new method of lateral nasal osteotomy. The key of this method is to fully dissect the tissue around the piriform foramen to achieve nasal osteotomy under direct vision. The osteotomy line in the whole process can be seen, which provides a more reliable control for the degree of osteotomy during the operation, and also makes the postoperative outcome more predictable.Methods:Patients whom were treated with open external osteotomy combined with autologous costal cartilage implantation for augmentation rhinoplasty (with 24 cases of hump nose correction) from October 2018 to October 2020. During the surgery, the whole nasal dorsum was exposed, the superior lateral cartilage was separated from the nasal septum, and the whole process was carried out through the mucosa from the intranasal approach under direct view. The osteotomy line was evaluated at the same time.Results:A total of 33 female patients were retrospectively analyzed. All the operations were successful, and the local swelling occurred after operation. The follow-up time was 3-18 months. After 3 months, the nasal contour and dorsal curves were smooth. Severe infections, major injuries like nasolacrimal duct, lacrimal sac, medial canthus ligament, nerve branches were not noticed in all patients. During the long-term follow-up, two patients exhibited slightly widened nasal bone, but did not require surgical intervention. The shape of nose was greatly improved. Patients were satisfied with the result . The subjective evaluation had "very satisfactory" in 24 cases (72.7%) and "satisfactory" in 9 cases (27.3%). The IGAIS evaluation were also positive: the average score of 33 patients was 1.26±0.34, including 30 cases (90.9%) scoring 1 point and 3 cases (9.1%) scoring 2 points.Conclusions:The open osteotomy technique has better control than that of conventional blind operation. It is more reliable, safer for the surgeons who are new to rhinoplasty and the experienced ones.