Adolescent ; Adult ; Child ; Ear Auricle ; surgery ; Female ; Humans ; Male ; Postoperative Complications ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Young Adult

Adolescent ; Adult ; Child ; Congenital Abnormalities ; surgery ; Congenital Microtia ; Ear ; abnormalities ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective:To explore whether hyperuricemia was an independent risk factor for all-cause mortality in patients with atrial fibrillation.Methods:Patients with atrial fibrillation who were confirmed by 12-lead electrocardiogram in 11 hospitals of Kailuan Group from 2006 to 2007 were selected as the research objects.All patients were followed up by prospective cohort study, and all-cause deaths were observed.The last follow-up time was December 31, 2013.Kaplan-Meier curve and Cox proportional hazards model were used to analyze and compare the risk of all-cause mortality in patients with atrial fibrillation in the hyperuricemia group compared with the normal uric acid group.Results:A total of 388 community-based patients with atrial fibrillation were included in the final statistical analysis, with 136 all-cause deaths occurred during an average follow-up period of 6.93 years.The incidence of all-cause mortality was 9.24% per year(36/390)in the hyperuricemia group, whereas 5.16% per year(100/1 937) in the normal uric acid group.In the univariate Cox proportional risk model analysis, the risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in the hyperuricemia group (95% CI) was 1.84(1.26-2.69) times that in the normal uric acid group ( P<0.01). After adjusting for potential confounding variables, the adjusted risk ratio (95% CI) of all-cause death in patients with atrial fibrillation in hyperuricemia group was still 1.94(1.32-2.85) times of that in normal uric acid group ( P<0.01). After adjustment for potential confounding variables, for each 0.01 g/L increase in uric acid (1 g/L=5 950 μmol/L), the risk of all-cause death in patients with atrial fibrillation increased by 1.15 (1.05-1.26) times ( P<0.01). Conclusion:Hyperuricemia was an independent risk factor for all-cause death in patients with atrial fibrillation in community.

OBJECTIVETo study the difference of histologic examination and type II collagen expression in the rib cartilage of patients at different age.

METHODSThe patients were divided into three groups, as children group (5 to 10 years old), teenager group (11 to 17 years old), and adult group (18 to 29 years old). Histologic examination of rib cartilage and quantitative analysis of type II collagen with immunohistochemical stain were carried out in the three groups. Motic Med 6.0 A system was used to quantitate immunohistochemical image through measurement of mean photodensity. The results were statistically analyzed.

RESULTSAmong the three groups, the children's rib cartilage had the most blood vessels, the most chondrocytes, well-distributed stain of matrixes, and the type II collagen was expressed actively and highest in photodensity. The rib cartilage of teenager group had less blood vessels, unhomogeny distributed stain of matrixes, the enlarged and separated cartilage lacunae. The rib cartilage in adult group showed the least blood vessels, the least chondrocytes, the hyalinization of perichondrium, the most deposition of calcium salt, and the type II collagen was expressed at the lowest level in photodensity. Statistical analysis showed significant differences among the three groups (P < 0.01).

CONCLUSIONSHistologic structure in human rib cartilage changes during the aging process and the type II collagen is decreased with the increase of age.

Adolescent ; Adult ; Aging ; physiology ; Child ; Child, Preschool ; Chondrocytes ; metabolism ; Collagen Type II ; metabolism ; Female ; Humans ; Male ; Ribs ; anatomy & histology ; metabolism ; Young Adult

OBJECTIVEA simple and effective therapy for single side constricted ear.

METHODSTransplanting normal side free composite auricular grafts to constricted ear (15 patients and 15 sides), then lengthening the helix, exposing the scapha, correcting deformity.

RESULTSThe 15 patients composite grafts all survived. The helix has been lengthened, the scapha exposed, the normal ear reduced, the constricted ear augmented and two sides ear have become symmetry.

CONCLUSIONThis method is simple and results are satisfied.

Adolescent ; Child ; Ear, External ; abnormalities ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Transplants ; Treatment Outcome

OBJECTIVETo further explore the effects of substance P on the proliferation and apoptosis of fibroblasts obtained from pathological scars in vitro.

METHODSFibroblasts from keloid (KSF) , hypertrophic scar (HSF) and normal dermis (NDF) of 12 burn patients were cultured in vitro and divided into control, SP (with 1 x 10 (-6) mol/L SP added to the culture medium) , and SP + spantide( with 1 x 10 (-6) mol/L SP and 3 x 10 (-5) mol/L spantide added to the culture medium) groups. MTT method or flow cytometry assay was used for the determination of the proliferative activities or apoptotic rate of fibroblasts obtained from KSF, HSF and NDF with SP or Spantide. And then the fibroblasts in SP group were subdivided into 1 x 10( -9) -1 x 10 (-5) mol/L groups to examine the time-or dose-effect of SP to fibroblasts from different sources.

RESULTSIn control group, different types of fibroblasts exhibited similar proliferative activities and apoptotic rates. But there was significant difference in these indices between control and SP group (the proliferative activity of KSF, HSF, NDF was 0. 656+/-0. 071, 0. 525 +/-0. 064, 0. 404+/-0. 063, respectively; and the apoptotic rate of KSF, HSF, NDF was [( 1.5+/-0.3) % , (4.0+/-0.5) % , (5.5+/-0.7) % , respectively],( P < 0. 05). SP had stronger effect on KSF than it did to HSF, as well as it had stronger effect on HSF than it did to NDF. In SP + spantide group, the effect of SP on KSF was partially inhibited, while it was completely inhibited in cultures of HSF and NDF. KSF was more sensitive to SP and the effect was longer when compared with HSF.

CONCLUSIONSP may play an important role in the process of pathological scar formation due to its diverse effects on fibroblasts from different sources.

Adolescent ; Adult ; Apoptosis ; Burns ; pathology ; Cell Division ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix, Hypertrophic ; pathology ; Fas Ligand Protein ; Female ; Fibroblasts ; cytology ; drug effects ; Flow Cytometry ; Humans ; Male ; Middle Aged ; Substance P ; pharmacology

OBJECTIVETo explore an ideal method for repairing the skin-soft tissue defects according to the different anatomical units of cheek, and find reasonable design principles to transfer the expanded flaps.

METHODSAccording to the location of the defect, we placed 1-3 appropriate expanders nearby, when the flap expanded enough we adopted advanced skin flaps, rotation-advanced skin flaps or transposition skin flaps to repair the defect. In this group of 269 cases, the defects were secondary to hemangioma, various scars, nevus or nevus excision.

RESULTSIn all 269 cheek defects, 305 expanded flaps were developed which included 145 rotation-advanced flaps, 121 advanced skin flaps and 39 transposition skin flaps. 52 of them generated complications, including blood circulation disorder of the distal part of flaps, hematoma, infection, injection, lower eyelid ectropion, expander extrusion and capsule contracture. Mostly, these complications didn't affect the final results.

CONCLUSIONSThe principles presented in this article are the guidelines to treat the skin-soft tissue defect of check with tissue expansion. The satisfied results come from the reasonable flap designs.

Adolescent ; Adult ; Cheek ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Young Adult

OBJECTIVETo analyze the sectional anatomical features of auricular and middle ear malformation in patients with microtia so as to improve the clinical classification and the instruction of surgery.

METHODSFrom Jun. to Dec. 2009, 36 cases with microtia were selected in the center of auricular reconstruction in Plastic Surgery Hospital, including 22 cases of unilateral microtia and 14 cases of bilateral microtia. 22 patients with unilateral microtia were studied with the contralateral healthy ears as controls. Spiral CT was performed for high-resolution scan of the temporal bone. The coronal, sagittal and 3D reconstruction images were created with Mimic software. Several distances and degrees were measured.

RESULTSThe patients were classified by Max classification. The anteroposterior diameter and the vertical diameter of tympanic cavity were (7.75 +/- 1.92) mm and (14.66 +/- 4.75) mm for type I; (6.17 +/- 2.56) mm and(14.35 +/- 5.12) mm for type II; (6.31 +/- 3.40) mm and (9.97 +/- 4.36) mm for type III (P = 0.001). The mastoid pneumatization degree for type I, II, III were 13.33%, 13.64%, 30.77% in sclerotic type, 13.33%, 18.18%, 7.69% in diploe type, 0, 9.09%, 38.46% in composite type, 73.33%, 59.09%, 23.08% in pneumatic type (chi2 = 24.11, P = 0.002). The cover of fenestra vestibuli by facial nerve was 21.43%, 47.62%, 54.55% (chi2 = 23.44, P = 0.002) for type I, II, III. There was a statistical difference between the microtia group and the control group.

CONCLUSIONSAccording to the Max classification, the middle ear malformation changed along the auricular malformation. The anatomical variations was complicated in type II microtia, which should be sub-classified.

Adolescent ; Adult ; Anatomy, Cross-Sectional ; Child ; Child, Preschool ; Ear ; abnormalities ; diagnostic imaging ; Ear, External ; abnormalities ; diagnostic imaging ; Ear, Middle ; abnormalities ; diagnostic imaging ; Female ; Humans ; Male ; Tomography, Spiral Computed ; Young Adult

OBJECTIVETo investigate the chest contour deformities after harvesting of costal cartilage for total ear reconstruction, so as to prevent donor site morbidity.

METHODS107 cases of microtia who underwent ear reconstruction with costal cartilage during the period from 1994 to 2003, were retrospectively studied. Both the chest depression deformity and the costal arch deformity were evaluated. The possible related factors to the chest contour deformities were analyzed statistically with Stata software.

RESULTSThe incidence of chest depression was 54.55% (48/88), including 35 cases of mild depression (39.77%) and 13 cases of severe depression (14.77% ). The incidence of costal arch deformity was 52.77% (46/88), including 33 cases of mild deformity (37.50%) and 13 cases of severe deformity (14.77%). The incidence of both deformities was significantly different at different age (P < 0.01), but not at different follow-up period (P = 0.294 and P = 0.225, respectively). Gender was related to the incidence of chest depression (P < 0.01), but not to the costal arch contour deformity (P = 0.619). Comparing resection of the 6th and 7th rib cartilage with resection of 7th and 8th rib cartilage, the incidence of costal arch deformity was significantly different (P < 0.01), but the incidence of depression deformity was not (P = 0.657).

CONCLUSIONSThe incidence of chest deformities increases with early operation time (< 13 years old). The male patients have higher incidence of depression deformity than female. The arch deformity is higher when the 6th and 7th rib cartilage were resected. The follow-up period is not related to the chest deformities.

Adolescent ; Adult ; Child ; Child, Preschool ; Ear, External ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Postoperative Complications ; Reconstructive Surgical Procedures ; adverse effects ; Retrospective Studies ; Ribs ; abnormalities ; transplantation ; Sex Factors ; Thorax ; abnormalities ; Young Adult

OBJECTIVETo evaluate the development of the chest wall after costal cartilage harvesting in children.

METHODSThirty-nine patients, who underwent microtia reconstruction with costal cartilage grafts, were examined in the donor-site with physical examination and radiography. Forty normal children were selected as control.

RESULTSThere were no significant differences in size between the bilateral chests, and compared to the control. The rib deformity in each donor site was not observed on the radiography.

CONCLUSIONSThe costal cartilage harvesting in children has no significant evidence to influence the development of the chest wall.

Adolescent ; Adult ; Cartilage ; surgery ; transplantation ; Child ; Female ; Humans ; Male ; Postoperative Care ; Postoperative Period ; Radiography, Thoracic ; Reconstructive Surgical Procedures ; Thorax ; metabolism ; physiopathology