Humans ; Perforator Flap

Objective To introduce an improved technique of periareolar incision mammoplasty using gland flap suspending and contour line circum-contraction suturing. Methods Through the periareolar incision, dissection was conducted between the subcutaneous tissue and the glandular tissue to detach the skin flap tent from the gland cone. A vertical glandular flap was formed in the upper portion to suspend the gland, with the gland tissue partially excised medial and lateral to the vertical glandular flap. Continuous contour line circum-contraction suturing was made for 2～3 rounds step by step from the cone bottom to the plateau, i.e. the nipple areola level. The suturing proceeded alternately from the flap tent to the glandular cone. Finally, the skin was sutured along the areolar incision. Results Sixteen breasts of eight patients were operated on using the present technique, including 10 cases of macromastia and 6 of breast ptosis. Satisfactory results were achieved with pretty breast shape and inconspicuous periareolar scar. Conclusion The contour line circum-contraction suturing periareolar incision mammoplasty is an optimal choice for moderate macromastia and breast ptosis.

Objective To elucidate the deleterious diabetogenic effect of tacrolimus on Chinese Han people.Methods According to patients' whole blood trough levels,the concentration of tacroli- mus was 5,15 and 25?g/L.Human islet cells cultured in vitro were exposed to various concentra- tions of tacrolimus for 72 h respectively,then stimulated by glucose at low (2.8 mmol/L) and high (16.7 mmol/L) levels.Glucose-stimulating insulin secretion during subsequent static incubation was measured using the ultrasensitive human insulin ELISA kit.The assessment of islet cell viability was studied with acridine orange (AO)-propidium iodide (PI).According to fasting plasma glucose,461 subjects were divided into normal glucosetolerance group (FPG＜5.55 mmol/L),impaired fasting glu- cose group (5.55 mmol/L＜FPG＜6.88 mmol/L) and posttransplant diabetes mellitus group (FPG≥6.89 mmol/L).A retrospective review of 461 non-diabetic kidney recipients completing at least 12 months of follow-up was performed to determine risk factors,incidence,and characteristics of post- transplant diabetes mellitus (PTDM).Results In vitro,lower tacrolimus concentration had not dele- terious effect on insulin secretion and viability of islet;high tacrolimus impaired?-cell survival as well as insulin secretion.Of the 461 patients with no history of diabetes at transplantation over the study period of 12 months,123 received tacrolimus and 338 received cyclosporine A (CsA).For patients receiving tacrolimus the cumulative incidence of PTDM was 13.8%,compared with 7.7% for pa- tients receiving CsA,showing no significant difference between them.The reduced tacrolimus level within the therapeutic window resulted in an increase in better glucose metabolism.Older age,family history of diabetes,acute rejection episodes and pre-transplant impaired fasting glucose were identified as risk factors for PTDM.Conclusion The diabetogenic effect of TAC is dose-dependent,and in the majority is reversible.Low initial doses,more rapidly tapering and lower maintenance levels of tacroli- mus decrease the incidence of PTDM in patients receiving tacrolimus.

Objective: To construct attenuated salmonella typhimurium haboring an eukaryotic co-expression plasmid encoding TIP30 and human IFN-? gene and observing its effect on the growth of adenoid cystic carcinoma. Methods: The TIP30 and human IFN-? genes were amplified by PCR and inserted into eukaryotic expression vector pCI-neofor the construction of expression plasmids pCI-TIP30 and pCI-IFN, respectively. A co-expression plasmid pCI-TIP30/IFN was constructed by linking TIP30 and human IFN-? gene using the sequence of internal ribosome binding sequence (IRES). Three recombinant expression plasmids were transformed into an attenuated AroA'autotrophic mutant of salmonella typhimurium SL7207, the resultant bacteria were used to infected murine macrophage in vitro and the expressed products were detected by Western blot and ELISA, respectively. Tumor growth was observed by oral administration of the recombinant salmonella typhimuriums to the nude mouse with adenoid cystic carcinoma. Results: Murine macrophage infected with recombinant salmonella transformed with both plasmids pCI-TIP30 and pCI-TIP30/IFN could express TIP30 protein, and murine macrophage infected with recombinant salmonella transformed with pCI-IFN or pCI-TIP30/IFN could secret human IFN-? in the culture supernatant. Attenuated salmonella typhimurium and three constructed recombinant salmonella typhimuriums all had evident inhibition onthe tumor growth in nude mouse with adenoid cystic carcinoma. Conclusion: The recombinant attenuated salmonella typhimuriums haboring plasmid pCI-TIP30, plasmidpCI-IFN and co-expressing plasmidp-CI-TIP30/IFN were successfully constructed, which could inhibit the growth of adenoid cystic carcinoma in nude mouse.

Objective To investigate the effects of multiple doses of propefol on long-term cognitive function in neonatal rats.Methods Twenty-four 7-day old SD rats weighing 12-16 g were randomly divided into 3 groups(n=8 each):group Ⅰ control(C)received intraperitoneal(IP)normal saline(NS)7.5 ml/kg once a day × 7 days:groupⅡ propofol 1(P1)received NS 7.5 ml/kg IP once a day×6 days+propofol 75 mg/kg IP on the 7 th day and group Ⅲ propofol 2(P2)received propefol 75 mg/kg IP once a day × 7 days.Learning and memory function were assessed using Morris water maze when the rats were 4 weeks old.The animals were decapitated immediately after the tests.The cortex and hippocampus were isolated for determination of aspartate (Asp),glutamic acid(Glu),glycine(Gly)and γ-aminobutyric acid(GABA)contents using high performance liquid chromatography(HPLC).Results Long-term learning and memory function significantly declined in group P2 as compared with group C and P1.The content of Asp in hippocampus and the Glu content and Glu/GABA ratio in cortex and hippocampus were significantly lower in group P2 than in group C and P1.There was no significant difference in Gly and GABA content in cortex and hippocampus among the 3 groups.Conclusion Multiple doses of propefol decreases long-term cognitive function by decreasing the levels of excitatory amino acid transmitters in the brain in neonatal rats.

OBJECTIVETo assess the outcome of large facial defect reconstruction with "partition" pre-expanded cervico-scapulo-dorsal flaps (CSDF) based on the superficial cervical artery (SCA).

METHODSSurgical course consisted of 3 stages. In stage I, a skin flap was designed along the axis of SCA according to the facial defect and an expander was implanted in the cervico-scapulo-dorsal region by means of "partition" expansion. The expanders were implanted beside the flap axis and beneath the posterior half of flaps so as to expand only half area of the flap. During the stage II, expanders were injected with saline regularly for continuous expansion. In stage III, the pre-expanded CSDFs were transferred to cover the facial defect of which the CSDFs included about half of non-expanded area.

RESULTSFrom November of 2008 to December of 2013, 15 patients with facial hypertrophic scar or scar contracture were reconstructed with pre-expanded CSDF based on the SCA. The expansion lasted for 3 to 4 months, and the expanded volume varied from 680 to 960 ml. One case of 4.0 cm x 1.5 cm epidermal flap necrosis occurred and healed subsequently with superficial scar; and another case of blister formation in the distal part of flap was found, which recovered without scar; the other 13 flaps survived without complications. After a follow-up for 12 to 38 months( average 26. 2 months), patients regained satisfactory appearance of face, with no obvious hypertrophic scar in the donor site.

CONCLUSIONSPartition preexpanded CSDF based on the SCA is a good choice for large facial defect reconstruction, and the partition expansion is an effective strategy for prevention of venous congestion.

Arteries ; Back ; Cicatrix, Hypertrophic ; surgery ; Face ; blood supply ; surgery ; Humans ; Hyperemia ; prevention & control ; Surgical Flaps ; blood supply ; transplantation ; Tissue Expansion

Objective To develop a CAD system for breast augmentation in order to improve the effect and raise patients' satisfaction.Methods 3D data of breast were collected by computer-aided projecting fringe measurement,and a CAD software system for breast surface 3D reconstruction and breast augmentation was developed under AutoCAD.Results A CAD system for breast augmentation was developed.Conclusion The system,which can provide a visual direction for the design of breast augmentation,has many advantages such as non-contact,speediness,accuracy,direct-view,etc.

Objective To investigate the feasibility and safety,and short-term therapeutic effect of laparoscopic azygoportal disconnection without splenectomy for cirrhotic portal hypertension (PLT count ＞ 50 × 109/L).Methods Clinical data of 48 patients with bleeding portal hypertension and secondary hypersplenism (PLT count ＞ 50 × 109/L) undergoing laparoscopic splenectomy and azygoportal disconnection (LSD,n =26) vs.laparoscopic azygoportal disconnection (LD,n =22) between January 2014 and August 2015 were analyzed.Results Operative time (82 ± 29) min,intraoperative blood loss 20(10-50) ml,days of postoperative fever 0(0-3) d,rate of postoperative fever 10/22,postoperative hospital stay (7.0 ± 1.3) d,and WBC counts (3.8 ± 1.6) × 109/L,PLT counts 64 (49-88) × 109/L,and the incidence of portal vein thrombosis on POD 7 (14％),were significantly less in LD group than in LSD group [(180±41) min,80(20-500) ml,2(0-4) d,(22/26),(10.8 ±3.0) d,(9.1 ±3.1) × 109/L,156 (78-630) × 109/L,(42％)],(t =9.637,Z =-4.746,Z =-2.314,x2 =8.224,t =5.794,t =7.785,Z=-5.508,x2 =4.742,all P ＜ 0.05).Immune function was better in LD group than in splenectomy group at postoperative month 3.The serum proportion of CD4 + (58 ± 11) and the CD4 +/CD8 + ratio (1.9 ±0.7) at postoperative month 3 were significantly higher after LD than after LSD [(43 ± 14),(1.2 ± 0.9)],(t =-3.755,t =-2.509,all P ＜ 0.05).Conclusion Laparoscopic azygoportal disconnection without splenectomy is safe and effective for esophagogastric variceal hemorrhage and moderate hypersplenism (PLT ＞ 50 × 109/L) secondary to portal hypertension.

Objective: To observe the expression of proteins Rb and P 53 in leukoplakia (LK) and squamous cell carcinoma (SCC) of oral muco sa. Methods: The expression of proteins Rb and P 53 was determined by immunohistochemical S-P method. Paraffin sections of 33 s amples of SCC and 20 of LK were immunohistochemically stained and analyzed. Results: (1)The expression of Rb in OLK, OSCC was not si gnificantly different from that in normal oral mucosa ;(2)the overexpression of mutant P 53 were found in OLK and its expression was increasing with dysp hasia degree (P

Objective To evaluate modified laparoscopic hepatic hemangioma extraction methods during laparoscopic hepatectomy.Methods From May 2009 to June 2013, 25 hepatic hemangioma patients were admitted for laparoscopic hepatectomy.Patients were divided into modified laparoscopic group with modified laparoscopic hepatic hemangioma extraction methods (MLH, n =11) and traditional laparoscopic group (TLH, n =14).Perioperative clinical parameters were compared between the two groups.Results Operative time (148.6 ± 18.0) min, time to removal of the HCH (15.7 ±4.6) min, visual analog scale pain score on the first postoperative day (2.3 ± 0.9), time to off-bed activity (2.5 ± 0.8) d, and postoperative hospital stay (8.5 ± 2.6)d in the MLH group were all less than those in the TLH group [(163.9±13.2)min, (33.9±3.1)min, (3.4±0.9), (3.1±0.8)d, (10.6±1.9)d] (t=-2.451,t =-11.800, t =-2.931, t =-2.156, t =-2.338,P ＜ 0.05).There were one in the MLH group and two cases in the TLH group developing postoperative complications (P =1.000).Conclusions Modified laparoscopic hepatic hemangioma extraction methods during laparoscopic hepatectomy for hepatic hemangioma is safe, feasible and of good therapeutic effect.