Objective To establish a preoperative evaluation system for breast reconstruction,and to simplify the selection of surgical methods for breast reconstruction in a standard way.Methods We investigated respectively 192 successful cases that underwent breast reconstruction from July 2003 to July 2009.The factors influencing selection of methods for breast reconstruction were studied.The results presented in more than 50 ％ were collected.Results A special table of the preoperative evaluation system for breast reconstruction was established by analyzing statistical results. Conclusions The selection of methods for breast reconstruction is simplified according to this preoperative evaluation system.

Objective To present a method for breast reconstruction with the superficial inferior epigastric artery (S1EA) flap and to summarize the operative experiences. Methods The diameter and distribution were evaluated with multipledetector-row computed tomography (MDCT) angiography and doppler perfusion flowmeter. Bipedicle superficial inferior epigastric artery flap was designed below umbilicus. Superficial inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2007, we have used the superficial inferior epigastric artery flap in 4 cases of breast reconstruction. Four flaps survived completely. With the follow-up of 6-12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal hernia, bulge and weakness in donor sites. Conclusions Breast reconstruction using the superficial inferior epigastric artery flaps can not only preserve the advantages of the traditional method using the deep inferior epigastric perforator flaps, but also retain the maximal function of the fascia and the rectus abdominal muscle and prevent the occurrence of abdominal weakness and hernia. It is an ideal alternative method of breast reconstruction on condition that definitive preoperative assessment of vessels and skilled surgical technique are provided.

Objective To evaluate the methods of correction for secondary deformity after removal of polyacrylamide hydrogel in breast.Methods From June 2006 to December 2007,the Center of Breast Plastic and Reconstruction at Chinese Academy of Medical Sciences admitted and treated 36 patients who experienced deformity after polyacrylamide hydrogel remoral in breasts.The average age of the patients was 27.5 years,and the time of consultation for the correction was from 6 months postoperatively.The patients who had preoperative MRI examinations showed that no visible polyacrylamide hydrogel remained in the breast were included in the study.The patients were classified according to the deformity of the breast and the chest wall tissue.Autologous fat injection grafting,silicon gel implant augmentation,and dermis grafting were performed for treating the deformity of the breasts after polyacrylamide hydrogel removal.Results During 3 to 18 months follow-up,the shape of the breast was improved and no complications such as infection,the sclerotic nodules,implant exposure occurred.35(97.2%) patients were satisfied with the result of the operations.Conclusions The correction for secondary deformity of breast after removal of PAHG should be performed at least 6 months after removal of polyacrylamide hydrogel.The optimal and nature contour of the breast may be recovered by combination of various surgical methods which are carefully selected according to the individual situation.

Objective To set up a method of three-dimensional breast volume measurement, to observe the effect of the artificial influencing factors on the final data, which are used for 3-D reconstruction of breast volume. Methods The CT data were used to reconstruct a digital prototype of the breast implant and the chest. The 3-D models were established firstly, and then the model was reasonablly cut to get single breast volume, breast implant volume, differences of the both sides of chest and breast volume. These methods were put up by the repeated test when the reference frame and the ranges were fixed. And the analysis of the artificial influencing factors was performed on 10 women whose breasts were unsym-metrical. The effects of the artificial influencing factors were analyzed by moving the coordinate axis, revolving the chest around the coordinate axis and changing the selected area. Results The repeatable test showed that the error was less than 4. 08 ml. The average volume differences between both sides of the breast before and after the given influencing factors were set, were 10. 339 ml and 7. 73 ml, as moved ± 4mm along the axis X; as revolving ±2° along the axis Z, that were 8. 654 ml and 7. 971 ml; as increasing or decreasing of the selected diameter of ± 4 mm, that were 6. 764 ml and 4. 267 ml, respectively. Conclusion Using the 3-D reconstruction technique for breast volume measurement is more simple, accurate and repeatable.

Objective To observe the clinical effects of autologous fat injection augmentation with external tissue expander.Methods 26 cases wore the Brava device,a bra-like vacuum-based external tissue expander for 4 weeks before autologous fat injection augmentation.Patients resumed Brava wear for 14 more days after fat injection.Results 26 women had a mean augmentation volume at 3 months of 76 ml per breast after single fat injection.Follow-up ranged from 1 month to 12 months.There were no complications such as nodules,masses,or cysts occurred.Patient satisfaction was as sessed:25 cases (95.6 ％) were satisfied with the cosmetic results.Conclusions The addition of Brava expansion before autologous fat grafting leads to significantly larger breast augmentations,with more fat graft placement,higher graft survival rates,and minimal graft necrosis or complications,demonstrating high safety and efficacy for the procedure.

Objective When implantation of a prosthesis is performed for patients with a local defect of the breast after the removal of polyacrylamide hydrogel,incomplete coverage of the surface of the prosthesis occurs in these cases.The aim of this study was to explore the effectiveness of acellular allogeneic dermis in the repair of defects after prosthesis implantation.Methods Breast prosthesis implantation together with acellular allogeneic dermis repair was performed in 46 cases.Acellular allogeneic dermis was applied to cover the surface of the prosthesis,and interrupted suture was used between the margin of the dermis and the incisional margin of the gland,while appropriate tension was maintained.Results There were no complications occurred postoperatively.Correction of local depression in the breast was excellent in all cases.Histological examination showed the implanted acellular allogeneic dermis was integrated into the peripheral tissue.Conclusions Acellular allogeneic dermis can be used for repairing breast and muscle defects,in order to cover the prosthesis.Although it cannot significantly increase the thickness of the subcutaneous tissue,it can maintain the integrity of the peripheral tension around the prosthesis.In this way,it can avoid bulging of the prosthesis caused by a sudden reduction of local tension.Moreover,donor site injury is avoided.Acellular allogeneic dermis is an effective method for the repair of local breast defects.

Objective:Use ligustrazin and salvia miltiorrhiza to treat idiopathic pulmonary fibrosis,for the experimental result was perfect in animal modal.Method:These two drugs combined with prednisone in 15 patients as treated group,prednisone in 10 patients as control group.Result:At 1,6 months followed up,the dyspnea and cough improved markedly.Chest radiograph and pulmonary function improved slightly.There were no differences between two groups.After 24 month the combined group 13(73%) stabilized,4(27%) relapse or deterioration,no death.Control group 6(60%) stabilized,3(30%) relapse or deterioration,1(10%) death,Conclusion:Combined group was better then control group.Ligustrazin and salvia miltorrhiza could decrease alveolitis and inhibit the formation of procollagen.It also improve the patient's immunity.

Objective To elucidate the effect of Ge-132 on the growth of melanocytes. Mothods Melanocyes from epidermis were cultured and purified ;the second generation of the cell was used for study ;the cells were divided into two groups randomly,to group A, Ge-132 was added to the media at 0.04mg/L ;to group B ,common culturing method was used without Ge-132. After 5d, the cells were seperated by digestion for study by transmission electronic micro- scope. ResultsCompared to group B, the vacuioes of the cells were increased,mitochondria distended, endoplasmic reticulum dilated and the number of melanosome declined in the group A. Conclusion Ge-132 can inhibit the melanocyte＇s growth at a certain concentration and might be used for treating pigmented diseases.

Objective To analyze of the influencing factors of mental health status and social disability for hashimoto thyroiditis(HT) patients.Methods The research employed Symptom Checklist 90 (SCL-90) and Social Disability Screening Schedule (SDSS) to evaluate the change and the influencing factors of mental health status and social disability of Hashimoto Thyroiditis patients.Result The scores of SCL-90 share,body symptom,sensitiveness relationship,depression,anxiety and social disability [(1.7±0.6),(2.0±0.7),(1.9±0.6),(2.0±0.60),(1.8±0.5) and (5.2±0.9),respective] in HT were increased compared with normal group[(1.4±O.4),(1.3±O.5),(1.6±O.5),(1.5±0.6),(1.4±0.4),(1.3±0.8) respective](P<0.01).In HT subjecte receiving levothyroxine(L-T4) therapy for 3 months,the scores of SCL-90 share score,body symptom,sensitiveness relationship.depression,anxiety and social disability were reduced respectively by(1.3±0.5),(1.5±0.5),(1.6±0.4),(1.6±0.4),(1.4±0.6) and(1.8±0.3)(all P<0.01).At the same time,the score of social disabilitv after therapy was increased compared with normal group (t=5.78,P<0.01).With the Logistic analyses.the score of social disability(F=1.16,P<0.01),TSH (F=2.05,P<0.01) and TP0(F=3.48.P<0.01)were risk factors of SCL-90 share score in HT subjects.Conclusion There were psychological health symptoms and social disability in HT case.TSH and TPO were risk factors of psychological health.L-T4Wag good for returning to normal mood.

Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of small renal cell carcinoma (SRCC) and renal angiomyolipoma (AML) with minimal fat.Methods The images and data of conventional ultrasound (US) and CEUS were retrospectively reviewed in 47 cases of small renal cell carcinoma and 8 cases of AML with minimal fat (d ＜ 30mm),which were confirmed by operation and pathologicall study,including 39 males and 16 females.The mean age of the patients was (54.8 ± 9.8) years old,ranged from 31 to 73 years old.The size,echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were observed,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results On contrast-enhanced sonography,fast wash-in and wash-off were observed in most of SRCC,while slow wash-off were observed in most of RAML with minimal fat.The statistically significant differences were found between SRCC and RAML with minimal fat in the values of TFP (time a to peak) and PI (peak-intensity).The occurrence of round pseudo-capsule and contrast-enhancement characteristics in SRCC was far more often than RAML with minimal fat.Conclusions Contrast-enhanced sonography combined with time-intensity analysis provides more useful information for the diagnosis of SRCC and AML with minimal fat.