Objective To discuss the significance of region Ⅵ lymph nodes dissection in treatment of patients with clinical cervical nodes negative(cN0)papillary thyroid carcinoma(PTC).Methods Clinical data of 38 cases of cN0 PTC treated with region Ⅵ lymph nodes dissection were retrospectively analyzed.The related literature was reviewed.The cervical nodes dissection scope and the key operation points in treatment of cN0 PTC were discussed.Results No permanent recurrent laryngeal nerve injury or parathyroid damage happened.14 cases(36.84％)had occult lymph node metastasis to region Ⅵ lymph nodes.After more than 5 years of follow-up,all the cases had excellent life quality.3 cases(7.89％)were found lymph node metastasis to lateral cervical region and they were given functional neck dissection.No recurrence or metastasis occurred to the 3 cases during more than 2 years of follow-up.Conclusion Region Ⅵ lymph node dissection in treatment of cN0 PTC is safe,reliable,and with less complications.

OBJECTIVEAugmentation rhinoplasty is a commonly procedure in clinical work for a plastic surgeon. Autologous costal cartilage is widely used in aesthetic rhinoplasy because of the abundant in quality. However, the cartilage may warp, and it is not easy-handling for inexperienced plastic surgeons. We-used diced cartilage combined with thin strips as columellar struts, which can be easily shaped, and reduce the warping incidence.

METHODSFrom July 2012 to March 2014, 61 patients were performed diced costal cartilage for nasal augmentation via endonasal approach. Standardized photographs are obtained before and after surgery. Postoperative outcome is graded by patient's self-evaluation of the nasal appearance with a satisfaction scale.

RESULTSAmong the 61 cases, 25 were revision cases. The follow-up time was no less than 6 months, with an average time of 10.9 months. 28 patients reported improved or better nasal appearance. One patient required revision surgery because of overcorrection. Supratip step-off was observed in one patient and corrected by external reshaping. No warping, infection, irregularity, absorption, airway obstruction, or donor-site morbidity were observed. All patients were satisfied with the final appearance.

CONCLUSIONSDiced costal cartilage is a reliable option for nasal augmentation and revision rhinoplasty. Good outcomes can be achieved postoperatively, with aesthetically pleasing appearance and simple procedure.

Costal Cartilage ; transplantation ; Esthetics ; Humans ; Nasal Septum ; Reoperation ; Retrospective Studies ; Rhinoplasty ; methods

Objective To investigate the expression of discoidin CUB and LCCL domain containing 2(DCBLD2)and mitogen activated protein kinase kinase kinase kinase 3(MAP4K3)in thyroid cancer and their relationship with clinico-pathological features and prognosis.Methods A total of 92 patients with thyroid cancer diagnosed and treated in Xinghua People's Hospital Affiliated to Yangzhou University from January 2016 to June 2020 were selected.Immunohistochemistry(IHC)was used to detect the expression of DCBLD2 and MAP4K3 in thyroid cancer tissues and adjacent tissues.The expression differences of DCBLD2 and MAP4K3 in thyroid cancer patients with different clinicopathological features were compared.Kaplan-Meier curve analysis was used to analyze differences in the progression-free survival prognosis of patients with different DCBLD2 and MAP4K3 expressions.Multivariate COX analysis was used to analyze the risk factors affecting the progression-free survival prognosis of thyroid cancer.Results The positive rates of DCBLD2(67.39%)and MAP4K3(65.22%)in thyroid cancer tissues were higher than those in adjacent tissues(5.43%,6.52%),and the differences were statistically significant(χ2=76.262,68.894,all P<0.05).The expression of DCBLD2 was positively correlated with MAP4K3(r=0.742,P<0.001).The positive rates of DCBLD2 and MAP4K3 in stage Ⅲ～Ⅳ(87.18%,84.62%)and lymph node metastatic cancer tissues(93.75%,90.63%)were higher than those in stage Ⅰ～Ⅱ(52.83%,50.94%)and non lymph node metastatic cancer tissues(53.33%,51.67%),with statistically significant differences(χ2=11.230～15.513,all P<0.05).The 3-year progression-free survival rates of DCBLD2-positive and DCBLD2-negative patients were 74.19%(46/62)and 93.33%(28/30),respectively.The 3-year progression-free survival rates of MAP4K3 positive and negative patients were 75.00%(45/60)and 90.63%(29/32),respectively.The 3-year cumulative progression-free survival rate of DCBLD2 positive group and MAP4K3 positive group was lower than that of DCBLD2 negative group and MAP4K3 negative group,and the differences were statistically significant(χ2=4.533,4.138,P=0.033,0.046).DCBLD2 positive(OR=1.659,P=0.001),MAP4K3 positive(OR=1.606,P=0.001),tumor TNM stage Ⅲ～Ⅳ(OR=1.766,P=0.001)and combined lymph node metastasis(OR=1.868,P=0.001)were independent risk factors for the progression-free survival prognosis of thyroid cancer patients.Conclusion The expressions of DCBLD2 and MAP4K3 were increased in thyroid cancer tissue.They are involved in the occurrence and development of thyroid cancer,which may help evaluate the progression-free survival prognosis of thyroid cancer patients.

Objective: To investigate the clinical outcome of autologous thin split thickness skin graft with melanocytes for the treatment of large scar with depigmentation, caused by extensive burn. Methods: From August 2016 to June 2018, autologous thin split thickness skin graft with melanocytes was used on 19 patients, who had depigmented extensive burn scar. They include 15 males and 4 females, aged 19-54 years. The operation was performed under general anesthesia or local anesthesia. Local mechanical abrasion was carried out at the depigmented surface of the scar, until the superficial dermis. The thin split thickness skin graft with melanocytes was transplanted to the wound at recipient site, followed by package and fixation. The package was kept for two weeks. Results: After a follow-up period of 3-6 months, all the grafts survived well with satisfactory appearance. The defects at donor site healed well too. Conclusions Satisfactory outcome can be achieved with autologous thin split thickness skin graft with melanocytes for the treatment of depigmented scar caused by extensive burn.

Objective: To explore the clinical effect of cervico-acromial fasciocutaneous flap based on the supraclavicular artery as a method for face and neck reconstruction. Methods: From Oct 1990 to June 2014, 17 patients, with the age range of 7 to 51 years, suffering from cicatricle contractures of neck or facial defect, were treated with cervico-acromial fascicutaneous flaps. 29 flaps were used in 12 patients bilaterally or multiply. The donor sites of 2 patients were closed by skin graft; while in the rest 15 patients, the donor sites were closed by expanded flaps. Results: All the 29 flaps were survived, with satisfactory color and texture. Hematoma occurred in 1 case after tissue expander implantation, but the flap was successfully expanded after evacuation of hematoma. The size of flaps ranged from 15 cm×7 cm to 35 cm×15 cm. 10 patients completed 6 months follow-up, and presented with satisfactory appearance and better functional results. Conclusions Cervico-acromial fascicutaneous flap based on the supraclavicular artery is an good choice for reconstruction of neck and facial defects.

Objective: To introduce a reconstruction procedure of natural sideburn, with combined expanded retroauricular flap and scalp flap. Methods: A retrospective study was produced in Plastic Surgery Hospital, PUMC, from January 2014 to December 2017. Twenty patients (21 sides) underwent sideburn reconstruction with combined expanded retroauricular flap and scalp flap (double pedicled flap, n=3; single pedicled flap, n=17) were included in this study. There were 12 male (12 sides) and 8 female (9 sides), with the mean age of (23.8±3.2) years. The sideburn defect was caused by burn in 19 patients, and it was resulted from hemangioma in 1 patient. Results: The size of flaps ranges from 8 cm×12 cm to 10 cm×16 cm. Venous congestion at the distal end of the flap occurred in 1 patient, which was cured after dressing change, and the sideburn was not affected. The reconstructed sideburns are natural, symmetric, and without obvious scar. The follow-up time was 3-40 months. Fourteen patients were very satisfied with the reconstructed sideburn, and 6 patients were satisfied. No severe complication was observed during follow-up time. Conclusions The combined retroauricular flap and scalp flap is an alternative method for sideburn reconstruction, which provide natural hair distribution, inconspicuous scars and less complications.

Objective: To explore a surgical method for the reconstruction of naturally dynamic double eyelid by fully reserving orbicularis oculi muscle. Methods: Incisional double eyelid blepharoplasty were performed on 352 patients. Orbicularis oculi muscle in incisional and pretarsal area were completely preserved. Muscle was elevated from plate by resecting deep muscular myolemma and muscles to form pretarsal myocutaneous flap. Thereafter, the orbital septum was completely exposed. The free end of muscle flap was fixed to a higher position of the levator aponeurosis. The orbital septum was repaired at the same time. Results: From June 2009 to December 2017, 352 patients were performed double eyelid blepharoplasty using above technique. They are 337 females and 15 males. Fifty-two patients were followed up for 6-60 months, with the mean time of 27 months. All the incisions were uneventfully healed. The new double eyelid presented smooth appearance, and the so-called " sausage" phenomena were not noticed. There was no concave groove or step-like deformity when eyes closed. Forty-five patients were satisfied with the outcomes. Two patients had shallower supratarsal folds on one side, and 1 patient underwent secondary repair. Two patients complained about asymmetry. Two patients suffered from mild unilateral eyelash eversion (without need of reparation). Conclusions The combined application of deep and superficial myolemma release of the orbicularis oculi muscle, and orbital septum reset, could create a double eyelid with natural and dynamic appearance.

Reynoutria japonica Houtt., belonging to Polygoneae of Polygonaceae, is a Chinese medicinal herb with the functions of draining dampness and relieving jaundice, clearing heat and detoxifying, dispersing blood stasis and relieving pain, and relieving cough and resolving phlegm. In this study, we carried out high-throughput sequencing for the chloroplast genome sequences of five cultivars of R. japonica and analyzed the genome structure and variations. The chloroplast genomes of the five R. japonica cultivars had two sizes (163 376 bp and 163 371 bp) and a typical circular tetrad structure composed of a large single-copy (LSC) region of 85 784 bp, a small single-copy (SSC) region of 18 616 bp, and a pair of inverted repeat (IR) regions (IRa/IRb) which are spaced apart. A total of 161 genes were obtained by annotation, which consisted of 106 protein-coding genes, 10 rRNA-coding genes, and 45 tRNA-coding genes. The total GC content was 36.7%. Specifically, the GC content in the LSC, SSC, and IR regions were 34.8%, 30.7%, and 42.7%, respectively. Comparison of the whole chloroplast genome among the five cultivars showed that trnk-UUU, rpoC1, petD, rpl16, ndhA, and rpl12 in coding regions had sequence variations. In the phylogenetic tree constructed for the 11 samples of Polygoneae, the five cultivars of R. japonica clustered into one clade near the root and was a sister group of Fallopia multiflora (Thunb.).
Base Composition ; Genome, Chloroplast/genetics* ; Open Reading Frames ; Phylogeny ; Reynoutria