Objective To summarize and explore the clinical effect of auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap.Methods The procedure involved three stages.The first stage was the delay procedure of postauricular skin flap.The second stage was the auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap about 3 weeks after the delay procedure.The third stage involved construction of tragus and conchal cavity and other local correction 6 months or longer after the second stage surgery.The clinical effect,patients' satisfaction and complication were observed.Results This method was used in 28 patients,31 ears of congenital microtia.23 cases completed auricular reconstruction with three stages,the other 8 cases completed only two stages.All auricular reconstruction were successful.The location,size and shape of reconstructive ears were good.The complications were few.The patients or their relatives were basically satisfactory.Conclusions Auricular reconstruction with autologous costal cartilage grafts and delaying postauricular skin flap is a safe and effective method.

To investigate the effects of Yiguanjian Decoction, a compound traditional Chinese herbal medicine, on rats with cirrhosis based on the method of differential proteomics.

OBJECTIVETo explore the reasonable therapeutic strategy for different types of epicanthus.

METHODSPatients with epicanthus were classificated according to the shape, extent and inner canthal distance and treated with different methods appropriately. Modified asymmetric Z plasty with two curve method was used in lower eyelid type epicanthus, inner canthus type epicanthus and severe upper eyelid type epicanthus. Moderate upper epicanthus underwent '-' shape method. Mild Upper epicanthus in two conditions which underwent nasal augumentation and double eyelid formation with normal inner canthal distance need no correction surgery. The other mild epicanthus underwent '-' shape method.

RESULTSA total of 66 cases underwent the classification and the appropriate treatment. All wounds healed well. During 3 to 12 months follow-up period, all epicanthus were corrected completely with natural contour and unconspicuous scars. All patients were satisfied with the results.

CONCLUSIONSClassification of epicanthus hosed on the shape, extent and inner canthal distance and correction with appropriate methods is a reasonable therapeutic strategy.

Blepharoplasty ; methods ; Cicatrix ; Eyelids ; anatomy & histology ; surgery ; Humans ; Nose ; surgery

OBJECTIVETo explore the therapeutic effect of the temporal rotation flap combined with cartilage plasty for cryptotia correction.

METHODSFrom January 2009 to June 2012, 8 cases with cryptotia (10 ears) were treated. After complete dissection of the cartilage adhesion, the cartilage was reshaped by suture to restore its appearance. Then the temporal triangular rotation flap was transferred to cover the wound.

RESULTSNo hematoma, infection or flap necrosis happened. The follow-up period ranged from 3 months to 1 year, with an average of (6.88 +/- 2.85) months. The ear appearance kept stable with no recurrence and inconspicuous scar. Satisfactory result was achieved.

CONCLUSIONTemporal rotation flap combined with cartilage plasty is a good option for correction of mild or moderate cryptotia.

Adolescent ; Child ; Ear Cartilage ; surgery ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Rotation ; Skin Transplantation ; Surgical Flaps

Objective: To observe the role of Qudu medicinal granules (祛毒冲剂) on enterogenous endotoxemia . Methods: Sixty-one cases with enterogenous endotoxemia were randomly divided into two groups:Qudu medicinal granule group (n=30) that was treated with Qudu medicinal granules combined with western medicine, and smecta group which was treated with smecta and western medicine (n=31). Changes of symptoms and signs were observed before treatment and 1, 3, 7 days after treatment. Blood samples were collected in the morning to measure the white blood cell (WBC), plasma lipopolysaccharide (LPS) and tumor necrosis factor (TNF) levels. Results: Recovery speed of WBC count in Qudu medicinal granule group was faster than that of the smecta group, there was significant difference on the third day after treatment (P

Objective To explore the expression and clinical significance of phosphoenolpyruvate carboxykinase (PCK) and plaminogen activator inhibitor-1 (PAI-1) in pleomorphic adenoma and adjacent tumor tissues of parotid gland. Methods Immunohistoehemistry was used to detect the expression of PCK and PAI-1 in10 cases of normal parotid glands, 38 cases of pleomorphic adenoma (0 cm) , adjacent tumor tissues (0.5, 1.0, 1.5, 2.0 cm from the pleomorphic adenoma). Results PCK expressed in all cases of normal parotid glands and adjacent tumor tissues, while PAI-1 expressed in 4 cases of normal parotid glands. Except 18 samples of 2.0 cm apart from pleomorphic adenoma, PAI-1 was expressed in the other adjacent tumor tissues. There was no obvious difference of PCK expression among normal, pleomorphic adenoma and adjacent tumor tissues of parotid glands (P> 0.05). The difference of PAI-1 expression was detected between pleomorphic adenoma (0 cm) and normal parotid glands and adjacent tumor tissues (2.0 cm from the tumor, P < 0.05). Conclusion During the development of pleomorphic adenoma, the expression level of PAI-1 is progressively increased while no change of PCK expression is found. It is rather remarkable that translocation of PAI-1 and PCK expression from cytoplasm and plasma membrane to nucleus occurs. The results mentioned above suggest that PCK and PAI-1 might play important roles in the progress of pleomorphic adenoma.

Objective To investigate the expression of mitochondrial autophagy-associated protein PINK1 and Parkin in parotid pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma(CA-EX-PA). Methods The expression of PINK1 and Parkin were detected by immunohistochemistry in 24 cases of normal parotid gland tissues, 32 cases of PA tissues and 42 cases of CA-EX-PA tissues. The correlations of PINK1 and Parkin expression with the clinicopathologic characteristics of CA-EX-PA patients were analyzed. Results The positive rates of PINK1 in normal parotid gland, PA and CA-EX-PA tissues were 100%, 91% and 67% respectively; and those of Parkin were 100%, 88% and 52% respectively. The expression rates of PINK1 and Parkin in PA and CA-EX-PA tissues were significantly lower than those in normal tissues (P < 0.05). The expression of PINK1 and Parkin protein were positively correlated in CA-EX-PA tissues (r=0.877, P < 0.01). In CA-EX-PA tissues, the expression of PINK1 and Parkin were associated with tumor invasion, lymph node metastasis and TNM stage (P < 0.05). Conclusion The expression of PINK1 and Parkin are decreased in PA and CA-EX-PA tissues. The decrease of mitochondrial autophagy activity might play important roles in the development, invasion and metastasis of parotid gland tumors.

Objective:To evaluate the effect of mild hypothermia on inositol requiring enzyme 1-X-box binding protein 1 (IRE1-XBP1) signaling pathway in endoplasmic reticulum in cortex in a rat model of focal cerebral ischemia-reperfusion (I/R).Methods:Fifty-four clean-grade healthy male Sprague-Dawley rats, aged 8-10 weeks, weighing 200-230 g, were divided into 3 groups ( n=18 each) using a random number table method: sham operation group (group S), cerebral I/R group (group I) and mild hypothermia group (group T). Cerebral I/R was induced by inserting a nylon thread with rounded tip into the internal carotid artery which was occluded for 2 h and then released for reperfusion.The surface cooling was started immediately after reperfusion, and the rectal temperature was maintained at 32-34 ℃ for 3 h in group T. Blood vessels were only exposed, without occlusion in group S. The neurologic deficit was assessed and scored at 24 h of reperfusion.The animals were then sacrificed and the ischemic area of the cerebral cortex was removed for examination of the ultrastructure of the cells (with a transmission electron microscope), for determination of nerve cell apoptosis (using TUNEL), for detection of the expression of IRE1 and XBP1 (by Western blot) and for determination of the expression of IRE1 and XBP1 protein mRNA (using quantitative real-time polymerase chain reaction). Results:Compared with group S, the neurologic deficit scores were significantly increased, nerve cell apoptosis in the ischemic area of the cerebral cortex was increased, the expression of IRE1, XBP1 protein and mRNA was up-regulated ( P<0.05), the neuronal nuclei was degenerated and swollen, the nuclear membrane was fragmented and defective, the chromatin was pyknotic and marginalized, and the endoplasmic reticulum was dilated and cisternal in group I and group T. Compared with group I, the neurologic deficit scores were significantly decreased, nerve cell apoptosis in the ischemic area of the cerebral cortex was decreased, the expression of IRE1, XBP1 protein and mRNA was up-regulated ( P<0.05), and the damage to the ultrastructure of nerve cells was reduced in group T. Conclusion:The mechanism by which mild hypothermia alleviates focal cerebral I/R injury is associated with further activation of neuronal IRE1-XBP1 signaling pathway and alleviation of endoplasmic reticulum stress response in rats.

Objective: To explore a good method for locating reconstructed auricle. Methods: An X-ray film ear template was modelled with the opposite healthy ear, then the template was reversely placed on the malformed side. The position of template was adjusted according to the observation at a standard frontal view and the relations with local anatomic landmarks until bilateral auricular symmetry was reached. At that time the position of template was fixed, and three points were marked. The first point was the most front point of helix, that is in front of the junction of helix and inferion crura of antihelix. The second point was the junction of superior edge of earlobe and tragus. The third point was the junction of inferior edge of the earlobe and face.After marking the three points, the template was placed in flat based on the three points, and the shape of auricle was drawn.Whether the remnant earlobe was dislocated was decided by the difference between the position of remnant earlobe and the marked points. Results: In this study, 118 cases had completed the three stages of ear reconstruction. In the first stage of the operation, 28 cases were residual earlobe moved, 1 case had hematoma postoperatively, and no case had serious complications such as infection and skin flap necrosis.In the second stage of the operation, the position of reconstructed ears were nearly symmetrical to the opposite sides. There were partial necrosis of grafted skins in 2 cases and partial necrosis of skin flaps in 3 cases, which were repaired with simple skin grafting or skin grafting after coverage of superficial temporal fascia flap. In the third stage of the operation, the position of reconstructed auricles was mostly symmetrical to the opposite side, and the wound were healed primarily.The satisfaction rate was 81.4%. Conclusions Triple-point Marking at a standard frontal view is a simple and practical method for locating reconstructed auricle in ear reconstruction.

Objective To explore the clinical effect of three-point double eyelid blepharoplasty combined with correcting epicanthal folds by using asymmetric Z-plasty with a two curve design.Methods We retrospectively reviewed the application and effect of three-point double eyelid blepharoplasty combined with correcting epicanthal folds by using asymmetric Z-plasty with a two curve design between January 2015 and June 2016.There were 36 cases of severe epicanthus in this group,including 20 cases of thin eyelid,13 cases of mild swollen eye and 3 cases of moderate swollen eye.Results Follow-up by telephone or WeChat,satisfactory for the 26 cases,the basic satisfaction of 9 cases,1 case of dissatisfaction,moderate swollen eye and severe epicanthus.Conclusions In the case of severe epicanthus with a single eyelid and a mild swollen eyelid without thinning of the eyelid,the use of three-point double eyelid blepharoplasty combined with correcting epicanthal folds by using asymmet ric Z-plasty with a two curve design is one of good choices of methods for the correction of epicanthus.