Objective To explore the clinical technique and curative effect of tissue expansion in repairing soft tissue defects of eyelid.Methods Repair of eyelid defects with tissue expansion was performed in 21 patients(21 eyes)from Apr.2004 to Apr.2009,in whom there were 9 males and 12 females,aged 6-48 years(mean 29),in a course of 6 months to 23 years.Twelve defects were in upper eyelid and 9 in lower eyelid.The areas of eyelid scars ranged from 5mm?20mm to 30mm?50mm,and 10 patients were with ectropion of eyelid due to cicatrical contraction.Tissue expanders sized 30-100ml were implanted beneath the normal skin adjacent to lesions of eyelids,and normal saline solution was periodically injected for 3 to 4 months to slowly expand the overlying skin.Then the expanders were removed,and different sizes of adjacent expanded skin flaps were used with rotation to repair the eyelid defects and restore normal position of palpebral margins.Results Satisfactory wound healing was obtained in all the 21 patients with no complication.Sixteen patients were followed-up for 1 to 16 months(mean 10 months),in them the expanded flap survived nicely with acceptable cosmetic result,and the postoperative scar was not conspicuous.No recurrence of ectropion occurred except one with mild ectropion due to termination of expanding treatment by the patient.Conclusion Tissue expansion technique is a reconstructive option for eyelid defects.

Objective To evaluate the STR profiling availability of formalin-fixed tissues and the detectable time limit of intact STR profile.Methods The different human tissues were fixed with 10-fold diluted commercial 40%formalin fixative for different duration under 15～20℃,and then DNA was extracted using the method of QIAamp~(R)DNA and IQ~(TM) DNA System.The extracted DNA was quantified with QuantifilerTM kit and amplified by both AmpFSTR identifiler kit and AmpFSTR MiniFiler kit.The STR profile was analyzed by GeneMapper ID v3.2 on 3100-Avant.Resuls The STR profiling availability of formalin-fixed tissues was relevant to the formalin fixing duration mainly.as well as the type of tissues and the template concentration and protocol of DNA extracting.The optimal ranges of template concentration is 1～3ng/μL and the QIAamp extracting method was preferable.There are differences in the degradation rate between various types of tissues in the unbuffered formalin fixative,and the lung tissue showed the slowest rate and liver and intestine tissues the fastest.Intact miniSTR profile of all the tissues detected could be obtained within 15 days duration of formalin fixing while intact STR profile could be obtained within 4 days.Conclusion The major factor that impact the availability of STR profiling of formalin-fixed tissues is the fixing duration in unbuffered formalin,as well as the type of tissues,method of extraction,concentration of PCR template and the kinds of STR loci.

Objective To develop an in vitro model for cranial suture of neonatal SD rat. Methods The parietal hones with the sagittal suture were removed from SD rats (19-days old) for organ culture. In the experimental group, tensile force 3.92×10~(-3) N (0.4 g) was applied by helical springs, whereas no tension (0 N) was set in control group. These explants were observed under inverted microscope. At the end of the incubation period for 24 hours, general conditions were observed under inverted microscope and histological conditions were observed after hematoxylin and eosin stain. Results Under inverted micro-scope, sutures had no obvious changes in control group, whereas sutures were enlarged gradually in the experimental group. With histological observation, sutures developed normally in control group, but in experimental group, osteohlasts and capillary vessels proliferated actively in the suture. Conclusions In vitro model of cranial suture can be cultured and grown successively.

Objective To investigate the genetic data of 21 autosom al STR included in G oldeneyeTM DNA ID 22N CK it in Chinese H an nationality and to evaluate the forensic application. Methods B y detected 500 unrelated healthy individuals in Chinese H an nationality of East China w ith G oldeneyeTM DNA ID 22N CK it, allele frequencies, population genetics param eters and linkage disequilibrium inform ation of the 21 autosom al STR w ere statistically analyzed. Results In the 21 autosom al STR , no deviations from H ardy-W einberg equilibrium w ere detected and all loci w ere independent form each other. D P values of 21 au-tosom al STR w ere all above 0.85, and the com bined discrim ination pow er w as 1-3.616 5×10-26. Com bined m ean exclusion chance of this system in duo cases w as 1-2.786 81×10-6, in trio cases w as 1-8.545 82× 10-10. Conclusion Tw enty-one autosom al STR included in G oldeneyeTM DNA ID 22N CK it are highly polym orphic in the H an nationality. Com bined w ith G oldeneyeTM DNA ID 20A K it, the kit can satisfy the needs for full-sibling testing and facilitate the solution of this kind of case tools.

Objective To perform the validation and analysis of forensic param eters of G oldeneye?DNA ID 26Y system . Methods B ased on the validation rules of Scientific W orking G roup on DNA A nalysis M ethods (SW G D A M ),the kitwas assessed from several parts, as test of PCR system, reproducibility, ac-curacy, and sensitivity, etc. A nd Y-STR loci of 517 unrelated healthy individuals from E astern C hina were genotypes by this kit. The distribution and frequency of haplotype were calculated and forensic param e-ters of the kit were assessed. Results The com plete profiles can be obtained even when the PC R reac-tion volum e with 6.25μL . A nd correct profile was obtained with DNA down to 125 pg.No reproducible peaks were detected with the DNA of com m on anim als and m icroorganism with the kit. For the m ale-m ale m ixture testing, average 70% of the m inor alleles were obtained when the ratios of 1∶19 and 19∶1. For the m ale-fem ale m ixture testing, results showed that the sensitivity of the kit was no compromised with the addition of fem ale sam ples. Conclusion The validation studies dem onstrated that G oldeneye?DNA ID 26Y system has good sensitivity and specificity, and suitable for m ixture testing. The polym orphism of 26 Y-STR loci included in this kit are good for forensic application.

OBJECTIVETo explore an effective method to diagnose and treat the congenital recessive cleft palate.

METHODSFor the treatment of congenital recessive cleft palate, an operation was designed to recover the anatomic length and function mobility of the soft palate. The operation procedure includes incising vertically the midline mucous membrane of the soft palate, creating and pushing back the mucosal flap of the hard palate, making Z-plasty on the nasal mucosa, reconstructing the sling of the levator veli palatini muscle and repairing the palatal defects with the buccinator muscularis mucosae flap. 12 cases of congenital recessive cleft palate have treated with this method.

RESULTSAll of the 12 cases obtained good results. Their pronunciation improved obviously.

CONCLUSIONThe method is effective for diagnosis and treatment of congenital recessive palate, which is worthy of further application.

Adolescent ; Child ; Cleft Palate ; diagnosis ; surgery ; Female ; Humans ; Male

OBJECTIVETo classify the patients with cleft lip and palate who need orthognathic surgery and to propose the corresponding operations.

METHODSFrom January 2005 to May 2015, 121 patients with cleft lip and palate diagnosed as maxillary retrusion were treated by orthognathic surgery. Inclusion criteriar: (1) male aged over 16, female aged over 14; (2) diagnosed as non-syndromic cleft lip and palate without systemic disease and other genetic diseases; (3) without previous orthodontic and orthognathic treatment; (4) having no other craniofacial malformation. Maxillary features and repaired types were recorded.

RESULTS93 patients were included and divided into two categories depended on the dental crowding. Class I: the teeth quantity and bone quantity is coordinated, space analysis ≤ 4 mm (mild dental crowding). The forward distance of maxillary less than 6 mm was defined as Class I a (36 cases) more than 6 mm as Class I b (28 cases). Class II: the teeth quantity and bone quantity is not coordinated, space analysis > 4 mm ( moderate or severe dental crowding). After the simulation of distraction osteogenesis, the anterior crossbite was corrected defined as Class II a (23 cases), not corrected defined as Class II b (6 cases). Class I a were corrected by conventional orthognathic surgery. While Class I b were corrected by Le Fort I maxillary advancement using distraction osteogenesis. Class II a were repaired just by anterior maxillary distraction. While Class II b need to combine conventional orthognathic surgery with anterior maxillary distraction. All the patients were satisfied with the treatment effect.

CONCLUSIONSThe patients of cleft lip and palate with maxillary retrusion who need orthognathic surgery can be classified as the method mentioned above, and then choose the appropriate operations.

Adolescent ; Adult ; Cleft Lip ; complications ; Cleft Palate ; complications ; Female ; Humans ; Male ; Maxilla ; Osteogenesis, Distraction ; Osteotomy, Le Fort ; Retrognathia ; classification ; surgery

Objective To detect differentially expressed genes between human normal skin and photoaging skin, and to investigate the molecular and biological mechanisms of human skin photoaging at transcriptional level. Methods Full-thickness skin specimens were obtained during full-face rhytidectomy from sun-exposed (anterior ear skin) and sun-protected (retroauricular skin) sites of 6 patients with facial photoaging from 2007 to 2008. Genomic microarray analysis was conducted to identify differentially expressed genes between the two groups of specimens followed by gene-cluster analysis. Results The normalization of microarray data showed that the number of differentially expressed genes was 2163 between skin samples from sun-exposed and sun-protected sites in one patient, significantly higher than that in the other 5 patients (less than 200);therefore, the data from the patient with 2163 differentially expressed genes were excluded from further analysis.Totally, 172 differentially expressed genes were identified with Beadarray chip, including 99 up-regulated genes and 73 down-regulated genes. Based on Genebank research, 118 functionally classified genes werefound, which were associated with a series of biological processes, including cell adhesion, receptor regulation,signal transduction, metabolism, and so on. Conclusions There are a lot of differentially expressed genes between human photoaging skin and normal skin. Rhytidectomy may be associated with the differential expression of skin photoaging-related genes.

Objective According to the fine artery anatomy of the lower lip, we developed an innovative partial-thickness myocutaneous flap based on the vascular network of the submucosal and subcutaneous layers of the lower lip.We attempted to treat the secondary bilateral cleft lip deformities using this innovative cross-lip flap.Methods From July 2009 to June 2015, this new technique was used in 98 patients with secondary bilateral cleft lip deformities.The central defects usually occurred in these patients.The defects were reconstructed partially or completely according to the severities of the defects.The operative procedures were as follows: The split flap was elevated from the posterior portion of the oris orbicularis muscle after the inferior labial arteries were divided.Then the partial-thickness flap was rotated 180 degrees horizontally and inverted 180 degrees upward to the upper lip defect.Results All 98 musculomucosal pedicle flaps were viable.The upper lips were reconstructed according to the severities.Conclusions This myocutaneous cross-lip flap with musculomucosal-pedicle has a more reliable blood supply, better flexibility and plasticity.It is an effective method for aesthetic reconstruction for the secondary bilateral cleft lip deformities.

Objective To analyze the clinical manifestations,treatment and prognosis of adult medulloblastoma (MB).Methods A total of 163 cases of adult MB,confirmed by surgical and pathological diagnosis,were retrospectively analyzed about the clinical manifestations,imaging,treatment and prognosis.There are 108 males and 55 females in the group,whose average age was 28.6-year-old.Results The main clinical manifestations include headache,nausea,vomiting,dizziness,gait disturbance,hypopsia,diplopia,hearing loss and cerebellum crisis.Gross total resection was achieved in 90 cases,subtotal resection in 67 cases and biopsy in 6 cases.Survival time from surgery to progression or death or the last date of follow-up were measured and estimated by the Kaplan-Meier method.Among a total of 160 follow-up patients with MB,postoperative overall survival time was from 7 to 170 months,median survival time was (127±6) months (95％ CI 115.3-138.68).The 5-year overall survival time of adult MB patients was 73.1％ (120/163).The log-rank test was used to compare the significance of the following prognostic variables.Among all clinical factors,patients undergoing the craniospinal irradiation had a significantly better survival rate than those without this treatment (44 months vs 34 months,x2 =8.712,P =0.003).Conclusion Good therapeutic effect of MB be achieved by adopting surgical resection with early enough craniospinal irradiation.Recurrence and metastasis are the two main factors for bad prognosis in adult MB.