Ojective To evaluate the effect of implatation of prosthesis under the periosteum via oral incision on mentoplasty. Methods The buccal morphology and structure of cadaver was studied with topographic methods. 43 cases of mentoplasty was treated by implatation of prosthesis under the periosteum via oral incision. Results The mandibular shape of all cases treated by mentoplasty were improved with successful and satisfactory effects. No complication occurred. Conclusions It suggested that the implatation of prosthesis under the periosteum via oral incision was a safe, effective procedure for mentoplasty.

Objective To evaluate the effect of intratumor injection of Pingyangmycin for the treatment of superficial hemangioma and venous malformation.Methods From May 2005 to March 2008,42 patients with superficial hemangioma or venous malformation,including 17 men and 25 women(aged 3 months to 51 years)were treated in our hospital by injecting pingyangmycin intratumorally.Among the patients,18 had hemangioma,20 had venous malformation,and 4 had the both.The injection consisted of a mixture of Pingyangmycin(8 mg),2% lidocaine(2 ml),normal saline(2 ml),and dexamethasone(2.5 mg).The volume of the tumor was evaluated before the injection.And then the mixture was injected intratumorally at a density of 0.5 mg/cm2(0.3 mg/cm2 for the patients with ulcers in the skin or mouth).For the patients who had residual tumor after the first injection,a second treatment was performed in 10 days to 3 weeks or longer.The maximum dosage of Pingyangmycin for a single injection was 8 mg,and the maximum total dosage was 70 mg.Results One year after the treatment,85.5%(47/55)of the patients were cured,and 12.7%(7/55)were improved.The total effective rate was 98.2%(54/55).Conclusions Injection of Pingyangmycin is an effective and safe method for superficial hemangioma and venous malformation with low blood flow.The maximum injection density is 0.5mg/cm2.

Ojective To evaluate the effect of the collagen injection for skin defect correction. Methods The various kinds of skin defect were injected by medical cosmetic collagen. Results 103 cases of skin defect were treated by collagen injection. Short term therapentic effect inclnding "excellent" and "good" was 85.5%. no complication occurred. Conclusion It showed that the method of collagen injection for skin defect correction is safe, simply and effective.

Objective To summarize clinical experience of reconstruction of breast suspensory structure in correction of mild-to-moderate breast ptosis.Methods Through a periareolar incision,the flabby deep layer of the superficial fascia beneath the upper breast gland was completely removed.Then the gland was lifted up to the normal position and the superior pole of the gland was fixed to the pectoral fascia at the second intercostal space.By using the dermal bra technique,an appropriate amount of skin was excised,and the dermis was fixed to the anterior surface of the breast gland. Or a monofilament polypropylene mesh was implanted and fixed to the anterior or posterior surface of the upper breast gland.Postoperatively,remarkable scar fibrosis reaction developed to form strong supporting structures just like natural ones.Glandular plication or implant augmentation was simultaneously employed to enhance the projection,if necessary.Results A total of 32 cases of mild-to-moderate breast ptosis was treated with this technique,including 10 cases of mastopexy only,20 cases of mastopexy with implant augmentation,and 2 cases of mastopexy using monofilament polypropylene mesh.The operation time was 90~150 min(mean,110 min).The intraoperative blood loss was 30~100 ml(mean,58 ml).No complications such as nipple or areola necrosis or sensory disturbance were found.Follow-up observations for 6~12 months(mean,11.3 months) showed a satisfactory rate of 90.6%(29/32).Conclusions Reconstruction of breast suspensory structure is a simple,safe,and effective method for correction of mild-to-moderate breast ptosis without hyperplasia of mammary glands.

Objective To improve the implatation of silicone prosthesis for rhinoplasty.Methods Forty one nasal specimens of cadavers were studied with anatomical and histological methods. And 213 cases of rhinoplasty via the retrofasial space (RFS) of dorsum nasi were performed.Results The upper extremity of RFS looked like bifurcation shape. Such surgery was performed for implatation by silicone prosthesis with V shape notch, and the rhinoplasty was successful with satisfactory effects.Conclusion Improved implatation of silicone prosthesis is an effective method for rhinoplasty.

Objective To sum up the experience of copper needle embolization for huge subcutaneous cavernous hemangioma. Methods Eighteen cases of huge hemangioma, located at the face and neck (3 cases), the upper limbs (5 cases), or the lower limbs and buttocks (10 cases), respectively, were treated from 1996 to 2003. Needles made from copper wire 1~3 mm in diameter were inserted into the lesions, through the skin directly or under the guidance of color Doppler ultrasonography. The copper needles were left in place for 1 week, with or without 4~6 V direct current circulated for 5~10 min twice. Results The therapeutic outcomes included: the shrinking and sclerotization of the hemangioma with the disappearance of postural changes (18 cases), the decrease of circumference of the involved limb (13 cases), the change of the lesion skin from blue-purple to light or normal in color (4 cases), the subsidence or disappearance of swelling and heavy feeling of the involved limb (5 cases), and the regression of the lesion and the reduction of blood flow under color ultrasonography (14 cases). Conclusions Copper needle embolization is a simple, effective and relatively less invasive method for the treatment of huge subcutaneous cavernous hemangioma that is difficult to be resected. It at times may be the only applicable option for children.

Objective To study arterial distribution of rectus abdominis musculocutaneous flap and to evaluate whether it can be divided into several units for reconstruction. Methods The arteries of the rectus abdominis musculocutaneous flap were studied on 60 sides of cadavers by dissection and angiography. Results The superior epigastric artery (SEA) and the inferior epigastric artery (IEA) continued in a longitudinal direction. Most of their branches took on a typical spiral configuration and communicated with each other within muscle above the level of umbilicus. Many perforating arteries penetrated through the anterior rectus sheath to get to the overlying skin, but the highest concentration of major perforators were in the paraumbilical area. The inferior epigastric artery was more significant than superior epigastric artery in supplying the skin of the musculocutaneous flap. Based on thefstudies of the vascular anatomy of muscles, we could classify arterial distribution into 3 types: type Ⅰ (SEA 26.5 %, IEA 34.6%) revealed a single main intramuscular artery: type Ⅱ (SEA 64.7 %, IEA 48.1%) had two major intramuscular branches; type Ⅲ (SEA 8.8%, IEA 17.3 %) revealed three intramuscular branches. Our anatomic studies showed that the superior and inferior epigastric artery bifurcated or divided into more than two main branches in the majority of cases (SEA 73.5%, IEA 65.4%). Conclusion The rectus abdominis musculocutaneous flap could often be divided into several regions for breast construction which is based on the distribution of each branch of the artery.

Background: Currently, many problems are still controversial on performing out of digestive tract operation through endoscopic submucosal tunnel. Aims: To evaluate the feasibility and safety of endoscopic mediastinal exploration via esophageal submucosal tunnel. Methods: Endoscopic mediastinal exploration was performed via esophageal submucosal tunnel in two healthy swine. A 5 cm submucosal tunnel was created with blunt dissection. The mucosal incision was closed by hemostatic clips, and penicillin was used prophylactically. Two weeks later, after reexamined by gastroscopy, the animals were sacrificed and the esophagus was obtained for macropathology and histopathology. The survival rate, wound healing and complications were observed. Results: The mediastinal organs such as aorta, trachea, and pericardium were identified clearly during exploration. All the animals survived with no obvious complications. Gastroscopy and histopathology showed good wound healing two weeks after operation. Taking autopsy as standard, the anatomical structures were accurately identified under endoscopy. Conclusions: Animal experiment revealed that mediastinal exploration via transesophageal endoscopic submucosal tunnel is feasible and relatively safe.

Objective: To investigate the clinical effect and safety of tramadol hydrochloride sustained-release tablets for subcutaneous venous malformation polidocanol sclerotherapy. Methods: The experimentation was designed in block randomization. 106 patients with subcutaneous venous malformations from May 2016 to November 2017, which in line with the inclusion criteria, were randomly divided into experimental group and control group, with 53 cases in each group. Experimental group patients took 100 mg tramadol hydrochloride sustained-release tablet 1 hour before operation, while control group patients took nothing. Both group underwent polidocanol foam injection therapy guided by the color ultrasound, to observe the effect of operative analgesia, postoperative analgesia (VAS grade) and complications. The data was analyzed by SPSS 19.0 software. Comparison between two groups was done with independent sample t test and P<0.05 was considered statistically significant. Results: The pain sensation(VAS grade) in surgery in experimental group(3.02±1.118)were significantly reduced than control group(6.30±1.514) (t=-12.701, P=0.000). 2 hours after operation the pain sensations decreased in both groups, but experimental group(0.23±0.577)were still better than which in control group(0.60±0.987)(t=-2.403, P=0.018). Three patients of experimental group(5.7%) felt mild nausea, and no other severe complications nor adverse effects occured. Conclusions Oral tramadol hydrochloride sustained-release tablets is one of safe, simple and effective way to achieve satisfactory preemptive analgesia for venous malformation polidocanol foam sclerotherapy.

Hemorrhagic anaemia caused by chronic gastrointestinal bleeding is a common complication of BRBNS that has the greatest impact on the patient′s quality of life, even life-threatening. Traditional treatments cannot slow down the overall progress of the disease. The curative effect is limited and has certain limitations. Sirolimus can effectively treat vascular malformations of the soft tissues, and it can control gastrointestinal lesions to correct iron deficiency anemia caused by bleeding, improve quality of life, and can inhibit disease progression and improve prognosis. This new emerging medication may become one of the powerful treatments for BRBNS in the future.