OBJECTIVETo explore the clinical effect of the method by using an expanded post-auricular skin flap combined with autologous rib cartilage framework for correction of concha-type microtia.

METHODSThe operation were performed in three stages. The expander was implanted under post-auricular skin at the first stage and expanded skin flap was formed. At the second stage, the expander was taken out and the expanded skin flap was transferred with autologous rib cartilage framework and skin graft for correction of microtia. At the third stage, the reconstructed ear was revised and new concha was formed.

RESULTSFrom August 2008 to August 2011, 108 cases with 113 concha-type microtia were corrected by this method. All patients healed primarily and were followed up for 6 months to 3 years. The reconstructed ears had a good appearance and position, and were symmetric to ear on the healthy sides.

CONCLUSIONSUsing expanded post-auricular skin flap combined with autologous rib cartilage framework is a reliable method for concha-type microtia.

Adolescent ; Adult ; Cartilage ; transplantation ; Child ; Child, Preschool ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

Objective To explore CT features of thin-wall cavity change of pulmonary metastases from renal clear cell carcinoma after molecular targeted treatment and its clinical significance.Methods Clinical and imaging data of 2 patients with thin-wall cavity of pulmonary metastases originating from renal clear cell carcinoma after molecular targeted drug Pazopanib were reported and analyzed retrospectively.Results After resection of primary renal tumors,multiple solid metastatic lesions in the lung were detected and the lesions showed ring enhancement on the post-contrast images.After 3-month Pazopanib treatment,most of the lesions presented thin-wall cavity change.Case 1 showed slowly disease progression while case 2 suffered from spontaneous pneumothorax and died 2 months later.Conclusion Necrosis of pulmonary metastases originated from renal carcinoma can be impelled by molecular targeted Pazopanib treatment,which helped to the formation of cystic thin-wall cavity,but the influence on the prognosis still remains uncertain.

Objective To find out the general status about the traditional Chinese medicine therapies that were included into medicare among the selected hospitals in the country's public hospital reform project, and to investigate the reasons for those not included and make recommendations.Methods Collecting relevant information through questionnaires, experts interviews and discussions.Results There are still some TCM therapies not included into the range of reimbursement.Most Of them are external treatment of traditional Chinese medicine, acupuncture, massage, special treatments of traditional Chinese medicine and comprehensive therapies of TCM.Conclusions The establishment of negotiations department about medicare in the field of traditional Chinese medicine was needed.Medicare should be in favor of TCM therapies, and traditional Chinese medicine hospitals should strengthen training of personnel and hiring.At the same time, a reasonable increase of the proportion of TCM experts involved in the making health insurance directory was needed.

Objective To analyze the consistency of individual examination diagnosis with terminologies expressed in the conclusion report of physical examinations by the chief inspection physician. Methods Based on the clinical classifications used in the Guidelines on Prevention and Treatment of Blood Lipid Abnormality for Chinese Adults, and related terminology descriptions of Dyslipidemias that were actually used in four-item blood lipid examinations diagnosis, a lexicon database of Hyperlipidemias was constructed with 39 terms used in the four-item blood lipid examination diagnosis and chief physician conclusions. Totally 11953 electronic chief physician inspection reports from 8 health check-up institutions were included. We investigated the terms of lexicon database using word frequency analysis method, calculated the positive rate in the diagnosis of four single examinations of serum lipid and the positive rate in the chief physician's conclusion. Consistency of chief physician's conclusion with single examination diagnosis was analyzed by Kappa test. Results (1) Among the 39 terms of lexicon database, there are 18 nonstandard terms used in single examination diagnosis, accounted for 46％ of all terms; (2) In word frequency analysis, there are only 1％ of terms that corresponded to clinical classifications of Hyperlipidemias accurately;(3) The positive rate of Hyperlipidemias in serum lipid four single examinations diagnosis was 47％, the positive rate of physician diagnosis was 35％. The consistency analysis of chief physician conclusions with single examination diagnosis showed Kappa=0.71(P<0.01). Conclusions Although the final conclusion written by the chief physician was not using standard terms strictly, most of synonymous terminology expressed in the physician conclusion is normative, which enabled the construction of lexicon database and text mining. Whether the single examination diagnosis are consistent with physician conclusions can be an evaluation indicator to assess the quality of chief physician conclusions for physical examinations. Kappa>0.75 may be suggested as a favorable value.

OBJECTIVETo investigate a novel method for the reconstruction of large vermilion defects.

METHODSBased on the size and shape of the defects, a buccinator myomucosal flap pedicled with the junction of buccinator and orbicularis oris in the oral commisure was designed and rotated to reconstruct the large vermilion defects. The upper bound of the flap is at least 1 cm away from the stensen's duct. The width is about 2.5-3.0 cm, and the length is as far as to arrive the raphe pterygomancibularis. The donate site is directly closed primarily. There is no need for secondary pedicle division.

RESULTSFrom July 2003 to April 2013, 14 cases with large vermilion defects was reconstructed with this method. No flap necrosis occurred with primary healing. 5 cases were followed up with an average follow up period of 1 year (0.5-3 years). The apprearance and function of the reconstructed vermilion were satisfactory without any apparent donor site defect. The patients were satisfied with both the functional and cosmetic results.

CONCLUSIONThe buccinator myomucosal flap is a simple and ideal method for reconstruction of large vermilion defects, especially for the defects closed to the commisure.

Adolescent ; Adult ; Child ; Facial Muscles ; surgery ; Female ; Follow-Up Studies ; Humans ; Lip ; surgery ; Male ; Mouth Mucosa ; surgery ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the characteristics and incidence of the thoracic deformities in patients with microtia.

METHODSIn Plastic Surgery Hospital, we conducted a retrospective study of the clinical and radiographical data of 300 patients with microtia from March 2013 to October 2014. Pearson χ2 test was used to analyze the relationship among deformities of ribs and spine, as well as microtia.

RESULTSA total of 78 (26.0%) patients were documented with rib deformities, 26 patients (8.7%) had spinal deformities, and 17 patients (5.7% )had both. The incidence of rib deformities in microtia I, II, and III was 7.1% (2/28), 26.7% (62/232) and 35.0% (14/40) respectively. The incidence of spinal deformities in microtia I, II, and III was 3.6% (1/28), 6.5% (15/232) and 25.0% (10/40 respectively. The patients with microtia III were found to have a higher incidence of ribs and spinal deformities than those with microtia II, patients with microtia II were found to have a higher incidence of ribs and spinal deformities than those with microtia I (P < 0.05).

CONCLUSIONSThe incidence of ribs and spinal deformities is high in patients with microtia. The poorer one auricle developed, the higher the incidence of thoracic deformities.

Biomedical Research ; Congenital Microtia ; epidemiology ; Humans ; Incidence ; Retrospective Studies ; Ribs ; abnormalities ; Spine ; abnormalities

Objective:To explore the technique of two-flap in ear reconstruction.Method:Quantitative tissue expansions were used in the mastoid area in the first stage.After the final injection,there was 1 month of sustaining time.Expanded skin flap and unexpanded fascia flap were designed in the second stage,so thetwo-flaptechnique was used in the ear reconstruction.From January 2004 to December 2008,1 427 patients of microtia were treated using two-flap technque.Result:The expanded skin flap could show the fine structures of the reconstructed ears.The reconstructed ears had vivid cranioauricular angle after using the unexpanded fascia flap.Conclusion: Two-flap method was easily manipulated and the complications were rare.The reconstructed ears had lucid and three-dimensional contour.

Parkinson's disease(PD)is the most common neurodegenerative disease in middle-aged and elderly people.Constipation is one of the most common non-motor symptoms of PD.Anorectal manometry can objectively reflect anorectal movement and sensory function,and is one of the necessary tests to check anorectal function,judge the type of constipation,and evaluate the effect of constipation treatment.This paper expounds the detection indicators and significance of anorectal manometry,and summarizes the characteristics of anorectal manometry in PD patients with constipation:decreased maximum anal systolic pressure,insufficient rectal propulsion,decreased rectal sensitivity,and the type of constipation in PD patients is mainly outlet obstruction with contradictory anal contraction or insufficient relaxation during defecation.

Objective: To understand current status of children s first permanent molar in Harbin, to investigate parental awareness regarding children s first permanent molar as well as Pit and Fissure sealant, and to provide new ideas for caries prevention in the first permanent molar and Pit and Fissure sealant. Methods: In October 2019, 11 540 children in the region were examined and their parents were given questionnaires. Results: The prevalence of dental caries was 37.72%. The DMFT was 1.11, the germination rate was 86.98%, and Pit and Fissure sealants rate was 36.93%. About 16.8% of the parents were aware of the eruption time of first permanent molar, and 35.33% didn t know first permanent molar, 19.39% of the parents had a clear understanding of Pit and Fissure sealants time and 32.77% of the parents were not aware of Pit and Fissure sealants. The prevalence of caries was higher in children (35.55%, 32.77%) whose parents did not know the first permanent molar and the pit and fissure sealants.High income level, high education level and urban parents had a higher degree of knowledge about fossa closure( χ 2=98.35, 192.16, 172.31, P <0.05). Conclusion Prevalence of dental caries is higher in children in Harbin, and the awareness of Pit and Fissure sealants is lower in parents. Relevant organizations should strengthen the publicity and education of oral health knowledge for parents.

Objective: To investigate the oral health service demands and utilization among school-age children in Xiangfang district of Harbin, and to explore the related influencing factors. Methods: A total of 7 944 children aged 6-11 were investigated for oral health status through questionnaire survey in Xiangfang District, Harbin. Descriptive analysis, Chi-square test, nonparametric test and Logistic regression were used to analyze the oral health service demands and utilization of school-age children. Results: The rate of caries, unfilled caries, malocclusion and traumatic dental injuries were 89.7%, 60.7%, 59.3% and 12.5%, respectively. In the past 12 months, 53.8% of children had toothache. The rate of seeking medical treatment in stomatology department was 31.6%, with the primary reason being treatment (47.6%), while the rate of preventive dental treatment was 15.6%. Multivariate analysis showed that girls, father s education being high school or technical secondary school, father s education higher or equal to junior college, poor oral health evaluation, high score on oral knowledge and oral attitude, brushing teeth once a day, brushing teeth twice a day or more, having attended oral health courses, having toothache experience, having dental trauma experience, suffering from dental caries were more likely to visit the oral clinics (OR=1.11，1.17，1.50，0.80，1.07，1.21，1.60，2.27，1.28，1.49，1.54，1.67, P<0.05). Conclusion In Xiangfang District of Harbin, there is a large demand for oral health services for school-age children, however, both of the utilization rate and the preventive medical treatment rate is low. Many factors affect the utilization of oral health services for children. It is suggested that targeted measures should be taken to improve the utilization level of school-age children s health resources.