In this experiment we investigated the reestablishment of microcirculation and perfusion ways in venous flaps by means of rabbit ear chambers, image processing system, and composing video picture techniques, within 7 days after the operation. The results showed that the microcirculation of venous flaps, within two days after operation, was reestablished by two kinds of perfusion ways: (1)Diversion of blood flow perfused the capillaries through the "to-and-fro" movement of venous blood. (2) The venous blood flowed into arterial vessels through arteriovenous anastomoses and perfused the capillaries. Later the second way replaced the first one within the 48 hours, since it could normally perfuse tissues and guarantee the venous flap blood supply for the rest of time.

BACKGROUND: Intra-oral, extra-oral, and combination of intraoral and extra-oral incisions often use in mandibular angle contouring surgery. Minimally invasive incision at auriculocephalic sulcus in mandibular angle osteotomy is a new approach, but its report is rare. OBJECTIVE: To observe the anatomical structure of the mandibular angle and its related blood vessels and nerves, and to provide the anatomical basis for the minimally invasive incision at auriculocephalic sulcus in mandibular angle osteotomy. DESIGN, TIME AND SETTING: A single sample observational experiment was performed at Department of Anatomy in the Second Military Medical University from February to May in 2008. MATERIALS: A total of 15 adult skull specimens (30 laterals), including 11 female and 4 male, and 15 adult mandible (30 laterals) were used in the experiment. METHODS: Anatomical study was performed on 30 laterals of 15 skull specimens, observing distributions and arrangement of blood vessels and nerves as well as their position relation with mandibular angle. After sawing the mandible bones along mark lines, the distances from the mental foramen, mandibular foramen, and each section of mandibular canal to the edge, internal wall and external wall of the mandible bone were measured. The results were expressed as Mean?SD. MAIN OUTCOME MEASURES: The anatomical level, blood vessels, nerves and mandibular canals of mandibular angle region were observed. RESULTS: The distances from great auricular nerve, external jugular vein, cervical branch of facial nerve, facial artery and facial vein to the mandibular angle were (19.48?6.45), (13.84?3.78), (9.58?3.05), (22.62?7.16) and (20.08?6.45) mm, respectively. The distance from the location of marginal mandibular branch of facial nerve running out of the parotid gland to the mandibular angle was (7.79?2.57) mm. The distance from the location of mandibular canal at outer margin of third molar to the mandibular angle was (16.97?2.24) mm. CONCLUSION: The anatomical structure of the mandibular angle region is complex, and there are many important blood vessels and nerves. Minimally invasive incision at auriculocephalic sulcus is relatively safe in anatomy.

To explore an ideal way of small vessel anastomosis in microsurgery. Anastomosis of both carotid arteries were performed in 20 rabbits. The artery on one side was anastomosed with anastomotic clips,with the contralateral artery,which was anastomosed with sutures,for comparison. The vessels were harvested 1 and 14 days after the operation and were evaluated with operating microscopy, light microscopy and electronic microscopy. The average anastomosis time for suturing was about 15 min, while for clipping was 2～5min. There was no difference in patency between the two techniques. Endothelialization at the anastomotic sites were both completed 14 days postoperatively. However, when anastomotic clips were used, there were no endothelial damage and foreign bodies inside the vessels.This experiment has confirmed that anastomosis with clips provides a very safe and easy way to perform anastomosis and could reduce the incidence of thrombosis.

Objective:To assess the clinical outcome of autologous fat injection in treatment of hemifacial atrophy,so as to search for an ideal treatment of hemifacial atrophy.Methods: Autologous fat granules were obtained by tumescent liposuction.After purification,the fat granules were injected in a multi-strata,multi-tunnel,and multi-spot manner to repair facial introcession abnormality.Patients whose introcession was not improved after the stabilization of the fillings were re-injected with autologous fat granules twice or more until satisfactory outcomes were achieved.Results: All the 7 patients in this study obtained satisfactory outcomes after fat injection and basically reached symmetry.The follow-up result was good after 2 years.Conclusion: Local injection transplantation of autologous fat granules is effective for the treatment of facial depression and hemifacial atrophy,with slight trauma,little complication,and satisfactory outcome.

Objective:To investigate the anatomic characteristics of the pudendal-thigh flap and provide anatomic basis for clinical design and application. Methods: The perineal regions of 15 male cadavers were anatomized. The flap was designed on the cadavers and the blood vessels/nerves contained in the flap were studied. Based on the above anatomic findings, we designed the flaps in our operation. The axial arteries were isolated according to the designing and the tissue adjacent to the vessel pedicles was preserved. The flaps were transferred to the recipient site. The incision of donor site was directly sutured; skin graft was transplanted when the incision could not be directly sutured. Results: The perineal regions had rich and constant blood supply and had stable nerve innervation. The blood supplies of the perineal region included external pudendal artery, anterior cutaneous branches of obturator artery, lateral branch of posterior labial or scrotum arteries. The location of the above vessels was comparatively constant, especially external pudendal arteries and posterior scrotum arteries. Three groups of blood vessels went through the lower, middle and upper parts, and there were 4 groups of major nerves responsible for the innervation of the pudendal region. We have used 23 cases of pudenal-thigh flaps, with the largest flap being 17 cm X 9 cm and the smallest being 8 cm X 5 cm, and satisfactory outcomes were achieved in all the cases. Conclusion: The pudenal thigh flap has rich blood supply, convenient incision, and covert donor site. It has satisfactory outcome (morphologic and sensory) in repairing and reconstructing male perineal region and is worth popularizing.

Objective To explore an effective treatment for benign prostatic hyperplasia complicated with bladder stones.Methods Swiss LithoClast Master and transurethral resection of the prostate(TURP)were performed on 33 patients with benign prostatic hyperplasia complicated with bladder stones.Results The operations were completed successfully in all the cases with a mean lithoclasty time of 35 min(15-65 min),and mean TURP time of 85 min(50-110 min).No blood transfusion,TUR syndrome,bladder perforation,or residual stone occurred during and after the operations.Urethral catheter was withdrawn 5 days postoperation,none of the patients had urinary incontinence or dysuria.The diagnosis of benign prostatic hyperplasia was confirmed by pathology examination.Three months after the operations,IPSS decreased from 23.4?5.2 to 7.4?1.2(t=3.732,P=0.000);maximum urinary flow rate increased from(5.4?1.5)ml/s to(18.6?3.2)ml/s(t=2.491,P=0.015);and QOL decreased from 3.9?1.2 to 2.0?0.7(t=2.454,P=0.014).Conclusions EMS LithoClast Master combined with TURP is an effective treatment for benign prostatic hyperplasia complicated with bladder stones.

AIM: Recombinant adenovirus possesses high transfection efficiency and wide host range. This study was designed to construct the recombinant adenovirus vector containing human vascular endothelial growth factor 165 (VEGF165), so as to lay a foundation for the subsequent gene transfection, microencapsulated genetically engineered cells and animal experiments. METHODS: The experiment was conducted in the Laboratory of Cardiothoracic Surgery (the National Key Laboratory), Changhai Hospital of The Second Military Medical University of Chinese PLA from January to May in 2007. Experiment materials: pAxCAwt.VEGF165 was provided by Institute of Cardiothoracic Surgery of Changhai Hospital. pAxCAwt.VEGF165 and DNA-TPC were cotransfected into human embryonic kidney 293 cells by lipofection method. Being propagated, recombinant replication-deficient adenovirus named Ad.VEGF165 was obtained. The target gene of recombinant adenovirus was identified by polymerase chain reaction (PCR) and restriction enzyme digestion. The titer of virus was detected by 50% tissue culture infective dose method. RESULTS: Construction of recombinant adenovirus Ad.VEGF165: The pAxCAwt.VEGF165 and DNA-TPC were successfully cotransfected into human embryonic kidney 293 cells by lipofection method, and replication-deficient adenovirus vectors coding for VEGF165 gene were generated. Identification of recombinant adenovirus Ad.VEGF165: Two fragments of PCR products (597 bp and 146 bp) were obtained by NcoI restriction enzyme. The result was consistent with that calculated with Gene Tool software. The virus titers was 2.2?1015 pfu/L. CONCLUSION: DNA-TPC and pAxCAwt.VEGF165 can be used to construct replication-deficient recombinant adenovirus Ad.VEGF165 in a high titer, low toxicity, high efficiency and safe transfection in vitro.

Objective To study epicanthus anatomy in cadavers in order to explore a more ideal technique for the correction of epicanthus. Methods On the basis of epicanthus anatomic dissection in 6 adult cadavers, canthoplasty and a new fixation technique for correcting epicanthus was performed clinically in the following procedures: incising the epicanthal fold and partial inner canthus ligament, pulling the new canthus medially and fixing it on the lateral nasal aponeurosis. Results Anatomic dissection showed that the epicanthus was caused by malposition of the orbicularis oculi muscule. More than 200 patients with epicanthus had been operated on by this technique and 165 of them were available for postoperative follow up for 6 months to 4 years with better cosmetic results. Conclusions This technique has less tissue damage and more favorable postoperative scar. It is a simple and reliable surgical approach for correction of epicanthus.

Objective To analysis the scanning electron microscopic (SFM) results of the anastomosis site performed by nitinol clip in rabbits Methods The nitinol clip technique for microvascular anastomosis was tested experimentally and compared with the conventional 9 0 end to end suturing technique Ten carotid arteries on one side of 10 rabbits were ananstomosised using nonpenetrating microclips made of nitinol, and the other 10 carotid arteries on one side of 10 rabbits were ananstomosised. using nonpenetrating microclips made of nitinol,and the other 10 carotid arteries on the other side were sutured in a conventional way with 9 0 monofilament nylon Biopsy was performed in two groups of rabbits at different time intervals postoperatively, and the specimens were examined under scanning electron microscopy Results Twenty microvascular anastomoses were patent SEM examination of the anastomotic site revealed major differences between sutured and stapled groups Conclusion Stapled microvacular anastomosis technique is fast and reliable

Objective Using STI and WMSI to evaluate the change of the heart sarcomere local systolic function which suffered from coronary heart disease (CHD), to evaluate the improvement of ischemic heart sarcomere local systolic function after PCI. Methods There are 40 CHD patients after PCI called the treatment group and 40 healthy persons called the control group. Echocardiogram was used to evaluate the change of ventricular wall motion score in the treatment group which was before and 1 week after PCI , compared with the control group. STI is used to get the SLs, GSL and SrLe of the left ventricle six walls in basal segment,middle segmentand apical segment systole. Results The ventricular wall motion index of the left ventricular myocardium obviously rose in CHD patients which was after PCI, compared with the control group (P < 0.05). And it obviously reduced in CHD patients after PCI, compared with CHD patients before PCI(P < 0.05). The results of SLs,GSL and SrLe are reduced in myocardial ischemia segment of CHD patients before PCI,compared with the control group (P < 0.05). But they are significantly improved in the the treatment group 1 week after PCI, compared to which is before PCI(P < 0.05). Conclusion STI and WMS can be used to evaluate the abnormal of regional and global function of myocardium which is caused to coronary artery stenosis the effect of PCI. The left ventricular motion function of CHD is decreased, but the left ventricle regional systolic function of hypokinetic segments in patients with CHD after PCI is significantly increased.