Objective To introduce a modified surgical technique for repairing palate fistulae.Methods Based on the clinical categories of palate fistulae,local mucosal flap was designed,if possible,to reduce the area of the fistulae and reshape the fistulae.Then the thin tongue flap with anterior pedicle was designed for repairing the palate fistulae,without much limitation of tongue movement and excessive tension of tongue flap pedicle short lingual frenulum correction was performed firstly to release the motion of tongue,if necessary.The donor site was closed directly.Three weeks later division of the tongue flap,as well as detailed appearance correction of tongue,was carried out at the same time.Results 12 cases were treated,and followed up for 6-12 months.For all the cases,the defect of fistulae was totally repaired,while aesthetics appearance of tongue was satisfactory,and no interference with speech with the use of tongue as donor site.Oral hygiene and mastication were unimpaired.No patient described disability of sensory or gustatory postoperatively.Conclusions Tongue flap has sufficient blood supply,while impairment of donor site is minimal.The planning and procedure of surgery are relatively simple.It is an ideal flap in treatment of palate fistulae.

Objective To evaluate the safety and reliability of laparoscopic in treatment of gastric gastric stromal tumor (GST).Methods 48 GST patients were selected for laparoscopic operation who had no distant metastases,adjacent organ invasion and non-cardia and pylorus infiltration confirmed by preoperative examination.The postoperative treatment,follow-up and the effect was observed.Results 48 patients included 22 males and 26 females,and mean age was 56 years old.The tumor diameter was 0.6-10.0 cm,in which 36 cases had tumor size ≥ 2 cm.12 cases of tumor occurred in gastric antrum,12 cases in gastric fundus,16 cases in anterior wall of gastric body,8 cases in posterior wall of gastric body.The mean operative time was 85 min,the mean operation blood loss was 65 ml,the postoperative average start eating time was 3 d,and the mean postoperative in-patient time was 7 d.All patients were followed up for 12-36 months.There were no local recurrence and distant metastasis and tumor-related deaths.Conclusions For the GST patients who have no distant metastases,adjacent organ invasion and non-cardia and pylorus infiltration,laparoscopic operation is safe and effective,which is not only applied to less than 2 cm diameter GST,but also to larger diameter tumor.

Objective To study the fouling mechanism during the filtration of traditional Chinese medicine decoction by inorganic ceramic membrane so as to make a valuable exploration both on membrane fouling prevention and the industrialization of membrane separation technology in the field of Chinese materia medica. Methods Micro-filtrating Qingluo Tongbi Decoction using alumina ceramic membrane, researching the applicability of the membrane with different pore sizes, observing the fouling on membrane surface by scanning electron microscopy, studying the resistance distribution of membrane in filtration process, analyzing the fouling existence shape, position, and forming rule. Results In this system, alumina membrane with the pore size of 0.2 ?m was most suitable, which had the biggest permeating flux and reservation rate of effective component with less fouling. Among the alumina membranes with three different pore sizes, auto resistance and pore block resistance made up inferior percentage in total resistance, fouling resistance distribution mainly consisted of the reversible resistance, such as concentration polarization and gel layer resistance. Conclusion Optimizing parameters of the techniques in membrane process, using suitable pretreatment method and cleaning method can reduce membrance fouling and make the memberane property recover.

Objective To investigate expressions of STAT3 and phosphorylated STAT3(p-STAT3)in cutaneous malignant melanoma(CMM)lesions, and to explore their significance. Methods The expressions of STAT3 and p-STAT3 were detected with an immunohistochemical method using polymer enzyme-labeled secondary antibodies in skin specimens from 22 CMM lesions and 23 pigmented nevus lesions. The effects of STAT3 and p-STAT3 expressions on lymph node metastasis of CMM were evaluated. Results The expression rate of STAT3 was significantly higher in CMM lesions than in pigmented nevus lesions (95.5% vs. 56.5%, χ2 = 9.23, P < 0.05), so was that of p-STAT3 (90.9% vs. 43.5%, χ2 =11.38, P < 0.05). STAT3 expression in CMM lesions had no obvious effects on lymph node metastasis of CMM (P > 0.05), while the elevated expression of p-STAT3 in CMM lesions was a predictive factor for lymph node metastasis in CMM (OR = 1.88, 95% CI: 1.05 - 3.38, P < 0.05). Conclusion Increased expression of STAT3 and p-STAT3 in CMM may play important roles in the pathogenesis of CMM, and elevated p-STAT3 expression may contribute to invasion and metastasis of CMM.

Objective To investigate the effects of all -trans retinoic acid (ATRA),acitretin and tazarotene on apoptosis and active caspase-3 of human melanoma cells A375 and to discuss the relevant significance.Methods The effects of retinoids on apoptosis and active caspase-3 of A375 cells were examined in vitro.Early apoptosis analysis by double staining with annexin V-FITC and PI,and active caspase 3 analysis by the staining of FITC conjugated monoclonal rabbit anti active caspase-3 antibody were measured by flow cytometer.Results ATRA and acitretin induced apoptosis of A375 cells (both P＜0.05),but tazarotene was not effective (P＞0.05).ATRA and acitretin elevated the cell population with detectable active caspase-3 (both P＜0.05),but tazarotene was not effective either (P＞0.05).Acitretin played a most prominent role among the retinoids. Early apoptosis ratio was significantly and positively correlated with active caspase-3 percentage in both ATRA and acitretin (P＜0.05).Conclusions Acitretin and ATRA induce apoptosis of A375 cells in which caspase is critical.Retinoids are prospectively applied as an assisting alternative for treating melanoma.

Objective To determine the pattern and incidence of congenital coronary anomalies (CCA) in adults undergoing coronary angiography. Methods The diagnostic angiographic data collected from October 2000 to October 2006 were reviewed, from which congenital coronary anomalies were found, and their angiographic features were studied. Results Among 1520 adults undergone coronary angiography, anomalous coronary arteries were found in 58 cases (3.82%). Depending on the anatomic characteristics of anomalous coronary arteries, these 58 cases were classified as following. Anomalies of origin and distribution were found in 26 cases (1.71%), among them separated origin of left anterior descending and left circumflex from left coronary sinus were found in 14 cases, left main trunk and left circumflex arising from right coronary sinus in 1 case for each, single left coronary artery in 2 cases, right coronary arteries arising from ascending aorta in 4 cases, from left coronary sinus in 3 cases, and from posterior coronary sinus in 1 case, respectively. Anomalies of coronary termination were observed in 11 cases (0.72%), and all of them were coronary artery fistulas. Anomalies of intrinsic coronary arterial anatomy in 21 cases (1.38%), among them myocardial bridge in 18 cases, hypoplasia of left circumflex artery in 2 cases, and sinus node artery arising from left posterior ventricular branch in 1 case. No anomalous collateral vessels were found. Conclusion Coronary angiography is one of the important methods of detecting anomalous coronary arteries. Classification based on the anatomic characteristics can help clarify the pattern and incidence of congenital anomalies of coronary arteries in adalts.

Objective To evaluate the effectiveness and safety of autologous granular fat graft applied for penile lengthening and augmentation.Methods After all the superficial ligment and 1/3-2/ 3 part of the deep suspensory-ligament had been cut off for penile lengthening,local pedicaled fasciaadipose flap was designed to fill the depression,the pre-centrifuged autologous granular fat was injected into the space beneath Buck's fascia for penile augmentation.Normal length,pulling penis length,diameter,circumference and complications were evaluated.Results 34 cases were performed and followed up for 3-18 months,both ideal length and diameter increase of penis were achieved.The differences of nomal length,pulling-length,the diameter and circumference were (2.8±0.1) cm,(2.1±0.2) cm,(0.9 ± 0.1) cm,(2.8 ± 0.1) cm,respectively.The common complications included poor wound healing in 4 cases,preputial edema and subcutaneous scleroma in 8 cases for 3 months.Conclusions Autologous granular fat graft for penile augmentation during the lengthening surgery is a reliable and effective method and easy procedure.Detail processing can decrease the complications.

Objective To investigate the treatment methods of tissue defects in nose and lower eyelid area.Methods Based on the impaired area,combined pre-expansion of forehead and facial region was adopted.The volume of soft tissue expander was determined.150-170 ml expander was implanted between frontalis muscle and periosteum of forehead,while at the facial region,and the volume of expander should be determined by the normal skin area as large as possible.The excision of impaired tissue was performed after sufficient expansion,and then skin flap or transposition skin flap were advanced at the facial region.At forehead,ortho-position skin flap based on supratrochlear vessels was designed for repairing the nose and palpebra inferior region.Three weeks later division of the ortho-position skin flap was carried out.With the flattened pedicle,the rest part of impaired area was replaced.Results Six cases were performed with this method.For all the cases,the survival rate of flap was 100％.Esthetic appearance and satisfying color-match were achieved,without appearance of lower eyelid ectropion.Conclusions Combined pre-expansion of forehead and facial region is an ideal method in treatment of the defects in nose and lower eyelid area.

OBJECTIVETo investigate the clinical application of expanded flap based on cutaneous branch of transverse cervical artery for reconstruction of cervical cicatricial contracture.

METHODSBased on the clinical anatomy of cutaneous branch of transverse cervical artery flap, we design the corresponding subclavicular area for expansion. The incision was usually located at the anterior axillary fold, 5-8 cm in length. The expander was implanted under the deep fascial layer, without injury of the vascular pedicle. Fixation sutures were put about 1 cm apart from the incision to prevent the expander from transposition and exposure. After expansion, the cervical cicatricial contracture was excised and released. According to the defect, the expanded flap based on the cutaneous branch of transverse cervical artery was designed, with the pedicle located at the posterior margin of sternocleidomastoid and 1. 8 cm above median point of clavicle. "S" shape incision was made at the location of vascular pedicle. Subcutaneous dissection was performed 1.5 cm in width along the incision on both sides. Then the flap was harvested under the deep fascial layer and rotated to cover defect without tension. It was not necessary to dissect the vascular pedicle further. The defect at donor site was closed directly.

RESULTS17 cases were treated with the island flap. The contracture of the cervical scar was corrected completely with aesthetic appearance.

CONCLUSIONSExpanded flap based on cutaneous branch of transverse cervical artery has reliable blood supply. It' s an ideal flap for the treatment of cervical cicatricial contracture.

Arteries ; Cicatrix ; surgery ; Clavicle ; Contracture ; surgery ; Dissection ; methods ; Fasciotomy ; Humans ; Neck ; blood supply ; Neck Muscles ; anatomy & histology ; Surgical Flaps ; blood supply

Objective:To investigate the application value of real-time ultrasound elastography in the treatment of fibroids radiofrequency ablation (RFA).Methods:Transvaginal ultrasonography,Real-time ultrasound elastography (RTE) and contrast-enhanced ultrasonography (CEUS) were performed on 34 patients with a total of 38 uterine fibroids who had the treatment of RFA before,1 hour and 3 months after the treatment of RFA.Detected the diameters of the lesions with the three methods of CEUS,RTE and 2D.Analysed the elastic image features and divided into groups,Measured the elastic strain ratio and compared the E/E0 in and between the group.The difference of lesion diameter between 2D,RTE and CEUS was compared.When the image of lesions showed blue and green was taken as the cirterion of incomplete ablation after RFA,conpared with CEUS,analysed the consistency of RTE and CEUS in evaluating the degree of ablation.Results:The lesions were divided into 3 groups according to the preoperative elastic image,with 8 (21.1％) in the blue group,20 (52.6％) in blue-based and 10 (26.3％) in green-based group.The difference was obvious in E/E0 between the 3 groups before RFA.There was no significant difference in E/E0 between 1 hour and 3 months after RFA (P ＞ 0.05).In each group the E/E0 of lesions were significantly increased at 1 hour and 3 months after the treatment of FRA,and the hardness of 3 months after RFA was harder than that of 1 hour after RFA(P＜0.05).The diameter measured by RTE was larger than that by 2D and CEUS before RFA(P＞0.05).The diameter measured by 2D was larger than that by RTE and CEUS at 1 hour after RFA (P＜0.05).No statistically significant difference was found in the lesion diameters among the three methods of2D,RTE and CEUS at 3 months after the treatment ofRFA (P＞0.05).CEUS and RTE had the basic consistent in the evaluation of lesions ablation degree at 1 hour (kappa=0.46) and 3 months (kappa=0.54) after the treatment of RFA.Conclusions:After RFA,the myoma gradually hardens,and RTE can reflect the change of the hardness,RTE can clearly show the boundary of uterine ftbroids especially after the treatment of RFA,can be used in the prediction of lesions ablation degree,so there was a certain application value of RTE used in RFA.