OBJECTIVETo explore the curative effect of Z-plasty without skin grafting for correction of cryptotia.

METHODSTwenty-five cases (29 ears) with cryototia were corrected by Z-plasty without skin grafting in our department from June 2009 to January 2014. A Z-shaped incision with one arm on the back of antihelix and the other arm on the edge of hair was made on the back of ear and scalp. The adhesion on the back of antihelix cartilage was dissected and the cartilage framework was lifted and re-positioned. The postauricular flap was transferred to cover the wound on the back of antihelix. The other flap was transferred to cover the remnant wound and correct the malformation of cryptotia.

RESULTSAll the patients were followed up from 6 months to 1 year with stable and symmetric appearance.

CONCLUSIONSThe shape of auricle is natural after operation without skin grafting. It is a simple and ideal method for the treatment of cryptotia.

Ear Cartilage ; abnormalities ; surgery ; Ear, External ; abnormalities ; surgery ; Humans ; Skin Transplantation

Objective To analyze the clinical outcomes of using double-circle incision combined with the dermal bra technique for the correction of simple breast ptosis.Methods From March 2010 to December 2014,88 patients underwent breast ptosis correction using the technique,among which 52 cases were classified into mild ptosis,27 moderate ptosis,and 9 severe ptosis.According to the extent of ptosis,varying size of the dermal bra were designed,and the mammary glandular flap was rotated,suspended and fixed onto the pectoralis fascia.For patients with insufficient size of the dermal bra,the polypropylene mesh was used to assist glandular suspension and fixation.Follow-up duration was between 3 to 24 months,and the surgical effect was evaluated from the following aspects:wound healing,breast sensory,shape,and texture,etc.Results The 4 cases (4.5％) had hematoma,and 3 cases (3.4％) suffered from poor wound healing.No case of fat liquefaction,necrosis of the nipple and areola complex,sensory disorder of NAC,or secondary ptosis was examined.Mammary contour was slightly rigid in the early postoperative period but gradually becoming natural with soft texture 3 months postoperatively.Conclusions Double-circle incision combined with the dermal technique is worth spreading in the clinical practice of breast ptosis correction for its satisfactory outcomes and low incidence of complications.

OBJECTIVETo explore the feasibility of the transdiferentiation of human breast adipose-derived stem cells (hbASCs) into mammary epithelial-like cells after co-culturing in Transwell in vitro.

METHODSThe third passage hbASC and the HBL-100 cell line were co-cultured in a Transwell culture system for 15 days. The hbASCs were observed and identified by inverted phase contrast microscope and transmission electron microscopy, and immunocytochemistry staining in the induced and control groups.

RESULTSBoth the third passage hbASCs and the HBL-100 cell line cells could adhere and grow rapidly after co-culture in the Transwell system. After co-culture for 15 days, the morphology of some induced hbASCs changed into epithelial-like cells. Some induced hbASCs showed positive expression of CK18, CK19 by immunocytochemistry staining, and typical epithelium cells with microvilli, desmosomes and tonofilaments observed under TEM. The positive rate of CK18 and CK19 was (24.4 +/- 12.0)% and (21.6 +/- 16.4)% in experimental group, and (1.8 +/- 1.7)% and (1.1 +/- 0.6)% in control group.

CONCLUSIONThe data suggests that hbASCs may have the potential to transdifferentiate into human mammary epithelial-like cells after co-culturing in Transwell in vitro.

Adipose Tissue ; cytology ; Breast ; cytology ; Cell Differentiation ; Cells, Cultured ; Coculture Techniques ; Epithelial Cells ; cytology ; Female ; Humans ; Stem Cells ; cytology

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

Objective To review the clinical data of reduction mammoplasty by central pedicle technique,and to summarize all kinds of the complications to modify the technique for improvement of long term aesthetic effects.Methods The postoperative complications were analyzd and then an approach was used to investigate the pattern of the blood supply and the nerve distribution of breast.Based on the anatomical study,a modified double-circle reduction mammoplasty technique was designed to treat patients with hypertrophical breasts. Results With a follow-up for 3 months to 3 years,the patients who underwent this modified central pedicle technique,had an invisible scar,good projection,the better shape of breast and preserved their sensation of nipple-areola complex.Conclusions Modified central pedicle technique is a safe and reliable technique,especially ideal for Chinese women.The blood supply is rich and the sensation of nipple-areola complex is preserved.The fixation of the gland tissue is more important than the dermal-bra.

Objeetive To discuss a reasonable postoperative management of breast augmentation by polyacrylamide hydrogel (PAHG) injection.Methods The retrospective study was used to analyze 157 cases which received breast augmentation by PAHG injection.MRI was used in all of cases preoperatively.Among these patients,23 were located by three-dimensional (3D) reconstruction,the content of mono acrylamide in the serum of 71 cases were examined in the hydrogel of 23 cases and in the tissue around the hydrogel of 12 cases,respectively.The silicone gel implants were planted after the removal of PAHG in 7 cases.Results MRI-3D could show the injectants location,scope,layer and integrality more intuitional and more detailed.The momo acrylamide was found in the serum with 7 cases,in the hydrogel with 5 cases,in the tissue around the hydrogel with 3 cases.131 cases gained satisfactory results.All the cases received 3 to 6 months follow-up.The scleroma was not found after the palpation of breast.In the 7 cases that were planted with the silicone gel implants immediately,the shape and texture of the breast were both great.Conclusions The preoperative MRI examination is a first-choice,and if possible,3D reconstruction is better.With the detecting methods so far,there is no strong evidence to support the possibility of PAHG resolving into poisonous acrylamide inside the human body.During the operation,the injectant,the integument around the hydrogel and degenerative tissue should be orthoptically cleared-up as much as possible.Sucking the injectant blindly is not commended.The silicon gel prosthesis is planted to reconstruct the shape of breast immediately,but the prerequisite is that the patients have this demand and that the muscle is intact without inflammation.

Objective To investigate the efficacy and safety of Minilase-S on patients with dyspepsia.Methods A randomized,placebo-controlled,double blind and multicenter study was conducted.Two hundred and forty patients with dyspepsia symptoms(anorexia,fullness,abdominal discomfort and distension)were collected according to total symptom scores over 20 with visual analog scales.Each patient was randomly received either Minilase-S(2 capsules t.i.d)or placebo(2 capsules t.i.d)for 2 weeks.The symptoms scores were evaluated at treatment week 1,week 2,and 1 week after discontinued therapy.Results Two hundred and sixteen patients(105 patients in Minilase group and 111 patients in placebo group)finished the study.There was no difference in demographic data,anorexia,fullness,discomfort and distension score and the total symptom score between two groups.However,at treatment week 1,week 2 and 1 week after discontinued therapy,symptoms and total symptom score were significantly decreased in Minilase-S group compared to placebo group(all P value＜0.05).The total effective rates in treatment week 1,week 2 and 1 week after discontinued therapy were 64.76%,77.05%and 66.99%,respectinely,which were higer that those in placebo group(27.93%,37.84% and 29.36%,respectively)(P＜0.05).There was no severe side effects in both Minilase-S and placebo groups.Conclusions Minilase-S can significantly improve symptoms in patients with dyspepsia,which may be as one choice in the management of dyspepsia or in combined therapy.

Objective To increase the understanding in protein-losing enteropathy (PLE).Methods Sixty-one PLE patients were enrolled in the study and the clinical characteristics, complicated disease, diagnosis and treatment were analyzed. Results The age of the patients was 16-77 (40±15)years, and the gender ratio was 35:26 (female: male). The main clinical manifestations were bilateral lower limb edema in 51 cases, ascites in 41 cases, bilateral pleural effusion in 23 cases, pericardial effusion in 13cases, abdominal pain in 16 cases and diarrhea in 33 cases. The prominent abnormality in laboratory examinations was hypoalbuminemia. The underlying diseases include systemic lupus erythematosus (SLE) in 28 cases, intestinal lymphangiectasia in 12 cases, hepatic cirrhosis in 5 cases, heart diseases in 5 cases,Crohn's disease in 3 cases, membranous nephropathy in 2 cases, Budd-Chiari syndrome in 1 case. Four cases happened after abdominal operation and 1 case after radiation therapy of gastric cardia cancer. Thirtyseven cases were diagnosed by 99Tcm-labelled human serum albumin scintigraphy and 24 cases were diagnosed clinically. Treatment was focused on underlying diseases. The clinical manifestations in 21 cases of SLE improved after SLE was controlled. In 2 cases of intestinal lymphangiectasia and one with Crohn's disease, the clinical manifestations improved after surgery. The other patients had no improvement.Conclusions PLE was not uncommon in clinical practice. Its predominant characteristics were severe hypoalbuminemia, edema and dropsy of serous cavity. PLE can complicate other diseases such as SLE,intestinal lymphangiectasia. Treatment should be focused on primary disease.

A target molecule affinity-ultrafiltration liquid chromatography-electrospray ionization tandem mass spectrometric (LC-ESI-MSn) method was established for rapid screening acetylcholinesterase (AChE) inhibitors from total alkaloids of fibraurea recisa Pierre.A total of 12 potential inhibitors were screened from Fibraurea recisa Pierre.and 6 compounds were identified including palmatine,berberine,jatrorrhizine,palmatrubine,7,8-dihydro-8-hydroxyberberine and groenlandicine.The AChE inhibitory activity of these 6 compounds was validated in vitro.Palmatine showed the strongest inhibitory activity for AChE,which was stronger than that of donepezil hydrochloride,demonstrating the potential of palmatine as anti-Alzheimer's drug.This method is simple,rapid,and accurate for directly screening active ingredients which can inhibit AChE from complex extract of traditional Chinese medicines.

The flap surgery is evolving towards precision and digitization. With clinical application of the true perforator flap technique, the supermicrosurgery, the real-time imaging of flap perfusion technique and vascularized lymph node flap technique, better reconstructive outcome with minimal damage of donor site has been achieved.