Objective　To search a simple, safe and effective osteotomy for hypertrophied mandibular angle.Methods　Hypertrophied mandibular angles were classified as lateral bulge, posteroinferior projection and combination based on their appearances. With local nerve blocking and infiltrating anesthesia, 162 cases with hypertrophied mandibular angel were respectively operated by intraoral approach with sagittal split, curved or combinative osteotomy method according to their types. Hypertrophied masseters were partially resected simutaneouly in 75 cases combined with masseter hypertrophy, and buccal fat pads were extracted in 52 cases associated with round faces.Results　Postoperative follow-up of 3～12 months to 60 cases of them showed 94.3 % of them were satisfactory.Conclusion　This operative method is simple and safe.It has minimal influence on the overall body of patients, and it is accord with the rules of aesthetic surgery.

Objective To investigate the different procedure effects in patients with modified sub-pectoral and subglandular breast augmentation. Methods Patients with modified subpectoral breast aug-mentation (10 cases) and subglandular breast augmentation (10 cases) were randomly selected, and satis-factory surveys to the procedures were conducted in the two groups of patients, including breast touch-feeling, dynamic change, as well as self-feeling and spouse-feeling. Results By the comparison of sub-glandular with subpectoral breast augmentation, touch-feeling was excellent in the former group, with breast spreading out to bilateral side in horizontal position. The breasts had different changes with differ-ent posture and natural movement. Spouse was more satisfactory to the former than the latter group. Conclusion Subglandular breast augmentation has natural shape, dynamic changes and fidelity of the re-al, especially in horizontal position, which is more conformable to the standards of patients and their spouse, and better than subpectoral breast augmentation.

Objective To investigate clinical therapeutic effects after a series of improvements of multi-site combination in the simple obese patient with tumescent liposuction. Methods Before tumescence anesthetization, short-acting benzo-diazepine was used as sedative inducer. The pressure and fluid velocity of short-acting benzodiazepine were regulated and injected into deeper level of fat at first, and all of these actions decreased the pain of patients, and promote the effect of the pain tolerance. The positions of the incisions were selected to hide from view and specifically protected, which could improve looks and decrease the scar formation after operation. In later stage of operation the flaps were pressurized and slid from outside, in order to make the flaps even and smooth and to keep their thickness according to the position of the flaps and the age of the patients. Opened draining was changed to block draining after operation. Results 73 cases were taken the follow-up for 6～24 months. All cases obtained satisfactory results, except that one cases was complicated by scar hypertrophy. The changes of the circumferences were as follows: the decrease of the maximum circumference of thigh was from 2 cm to 17cm, abdomen from 3 cm to 24 cm, and buttocks from 1 cm to 3 cm. Conclusions A series of improvement of key measures enhance the clinical therapeutic effects of multi-site combination in the simple obese patient with tumescent liposuction.

Objective To explore the treatment of capsular contr ac ture after augmentation mammaplasty with mammary prostheses. Method Through primary incision (axillary or inframammary) and minor capsu le incision, patients with capsular contracture after augmentation mammoplasty w ere treated by preserving the contractive capsule and repositing of the breast p rosthesis anterior to the primary capsule. Results Total ly 12 cases (14 breasts) of capsular contracture were achieved satisfactory res ults since 2001. Conclusion The method of capsule preser vation and reposting of the breast prosthesis anterior to the capsule present n umerous advantages: little trauma, less bleeding, simple surgical procedure, saf e, less possibility of recrudescence, and can be finished through a small primar y axillary incision. It is a preferable method to treat capsular contracture.

ObjectiveTo avoid the complications such as scar,alopecie,scalp numbness,hematoma etc,resulted from the conventional coronal incision rhytidectomy,and to explore and solve the issues about endoscopic frontal and temporal rhytidectomy.MethodsThrough 3-5 short incisions in hairline,we dissected under frontal periosteum or gales aponeurotica and in superficial layer of deep temporal fascia.The frontal and temporal cavitites were feedthrough at temporal crest.The corrugator supercilii muscle,superciliary depressor muscle,frontal muscle and orbicularis oculi were treated.Sufficient dissection was done under the periosteum of os orbitale.ResultsThis method had been applied in 186 patients with forehead lift.After operation,transient paralysis of facial nerve frontal branch were found in 3 patients.The depression of glabellum and lateral canthus were found in 5 patients.The depressions were corrected by autologous fat injection. Other 178 patients' results were satisfactory.ConclusionsEndoscopic frontal and temporal rhytidectomy has some advantages,such as minute invasion,less hemorrhage,few complications,and stable operation result,etc.Compared to the conventional coronal incision rhytidectomy,this method will be used more widely.

Objective In order to assess the value of Echinoccocus granulosus cyclophilin A (EgypA) in immune diagnosis,this novel gene was cloned and expressed.Methods By screening the EST library,the coding region of EgCypA was identified,and the PCR primers were designed based on this sequence.Bioinformatic tools were used to deduce the amino acid sequence of EgCypA and analyzed its biological characteristics.EgCypA was amplified from E.granulosus cDNA library by using PCR.Then,it was cloned into the prokaryotic expression vector pET28a and transformed into E.coli BL21.The recombinant protein was expressed in E.coli BL21 after IPTG induction.The immunogenicity of EgCypA was evaluated by Western blot using the Echinoccocus granulosus and other parasites infected animals' sera.Results Results of SDS-PAGE electrophoresis show that the recombinant BL21 expressed 18 400-25 000 protein,which was identical with the molecular weight calculated by bioinformatic analysis.Western blot shows that the recombinant protein only reacted with its immune serum and E.granulosus cystic fluid immune serum,and EgCypA immune serum could react with the excretion and secretion antigen from E.granulosus protoscolexes,and no cross-reaction between EgCypA and sera from other parasites infected animals.Conclusions Cloning and expression of EgCypA are successful.EgCypA has good immunologic activity and could be a candidate molecular for immune diagnosis of echinococcosis in early stage.

Objective To analyse risk factors for bile leakage after liver resection.Methods Between January 2011 and December 2012,469 patients underwent elective hepatectomy.We prospectively collected and retrospectively analyzed demographic data,pathological variables,and perioperative variables.Univariate analysis screened the related factors of bile leakage after liver resection.Multivariate analysis identified the independent risk factors of postoperative bile leakage.Results 469 patients were included in the analysis.The prevalence of bile leakage was 22.6％ (n =106).Univariate analysis identified the following risk factors as male gender,portal hypertension,steatosis,cirrhosis,ChildPugh grade,ascites,operative time,intraoperative transfusion,intraoperative blood loss,portal triad clamping,microwave solidification,lymphadenectomy,number of tumor,tumor margin,tumor capsular,diameter of tumor,portal vein invasion or portal branch thrombosis,number of abdominal drains.Multivariate analysis identified 4 independent risk factors for postoperative bile leakage:Cirrhosis [OR =13.2 (2.3,76.9),P =0.004],steatosis [OR =73.1 (17.7,301.5),P ＜ 0.001],infusion volume of the surgery day [OR=1.0 (1.0,1.0),P=0.019] and diameter of tumor [OR=1.2 (1.1,1.3),P=0.003].Conclusions Cirrhosis,steatosis,transfusion volume of the surgery day,and tumor size were risk factors for bile leakage after major liver resection.

Objective To explore the value of non-invasive prenatal test (NIPT) in pregnant women with intermediate risk after traditional Down syndrome screening. Methods From March 1 2015 to March 31 2016, a total of 2 949 pregnant women with intermediate risk after traditional Down syndrome screening who received NIPT as the second-line screening method at Shenzhen Maternity and Child Healthcare Hospital after informed consent were recruited for this study. Retrospective data analysis including the results of traditional Down syndrome screening, ultrasound, NIPT and invasive amniocentesis to fetal karyotype analysis were conducted, and pregnant outcomes were followed up. Results NIPT results were all obtained in 2 949 pregnant women with intermediate risk after traditional Down syndrome screening. Of 25 NIPT-positive cases, 24 cases received invasive amniocentesis to fetal karyotype analysis. Thirteen cases were confirmed with fetal chromosomal abnormalities including 5 cases of trisomy 21, 2 cases of trisomy 13, 4 cases of sex chromosomal abnormalities and 2 cases of other chromosomal abnormalities. In addition, 1 NIPT-positive case refused prenatal diagnosis was confirmed normal result after birth. The postnatal follow-up in NIPT-negative women did not find any newborn with chromosomal abnormality. The incidence of fetal chromosomal abnormalities in women with intermediate risk was 0.44% (13/2 949). Conclusion NIPT can be used as second-line screening method in pregnant women with intermediate risk after Down syndrome screening, which could lead to the prenatal detection of a higher proportion of fetal chromosomal abnormalities and a lower invasive-testing rate.

Objective To evaluate the results of prosthesis augmentation,relieve suffering patient experience,improve shape and touch of breast.Methods According to design,in dual-plane mammaplasty transaxillary approach with endoscopic assistance,we used soft-tissue expansion before prosthesis,saline volume in expander was the same as prosthesis size at beginning; adjusting expander volume and position,then determined prosthesis size according to expander volume lastly.after intraoperative sustained expansion for 30 to 60 minutes twice prosthes volume,replace expander with prosthesis.Results This method was applied in 120 patients,showing that pain significantly reduced after expansive without use of analgesia pump; complications included that 3 patients appeared seroma and absorbed soon; 2 patients had poor prosthese location,which was adjusted in reoperation; one capsular contracture was repaired later.After 6-months to 2-years follow-up,the results showed that breast was nature and dynamic; satisfactory rate reached to 95 ％.Conclusions In augmentation mammaplastic operation,pre-adoption of an expander can make it easy to adjust the location of prosthesis,to avoid being injured and to determine prosthesis volume by expander injection of saline volume,especially for patient with different size of both breasts.

Objective To explore a more efficient surgical method to cure axillary osmidrosis through a comparative study on results from two surgical treatments of axillary osmidrosis in the armpit area.Methods 72 patients were randomized into two groups,in which 36 patients (group A) with micro-incision simple liposuction and 36 patients (group B) with dissection and excision of subcutaneous tissue from axillary folds.The clinical outcomes in the two groups were comparatively analyzed,based on surgery time,effect,complications,scarring and recovery time.Results The total efficiency of axillary osmidrosis treatment was 100％ after 6-12 months clinical follow-up towards two groups.There was no significantly statistical difference on the effect of both groups.Micro-incision simple liposuction was obviously superior to dissection and excision of subcutaneous tissue from axillary folds based on surgery time,complications,recovery time,scarring and armpit hair survival rate.The two groups were significantly different (P＜0.05).Conclusions Minimally invasive simple liposuction,as a treatment for axillary osmidrosis is a method with more effectiveness and reliability.It is a more acceptable approach to patients in view of safety and convenience,smaller and invisible scarring,fewer complications,and less recovery time.