OBJECTIVE To investigate the optimal surgical approach and compatible material for large nasal septal perforation.METHODS Operations were underwent via labiogingival groove approach under endoscope.Double layer of flaps were perichondrium of nasal septal cartilage,base of nasal cavity and inferior nasal meatus on the left and acellular dermal matrix (ADM) on the right and the two flaps were adhered with ear-cerebral glue (EC).RESULTS All of 36 cases were successfully repaired and no reperforation occurred after following-up for 3 months to 2 years.CONCLUSION Large mucosal flaps with wide pedicel and abundant blood supply and ADM of good biocompatibility provide a higher survival rate of the flaps.This method has the advantages of wide field of vision,less damage of the donated area and short time of operation.It is an optimal and practical method for repair of the large nasal septal perforation.

OBJECTIVETo investigate the application of medpor and split-thickness skin graft in formation of cranioauricular sulcus during auricular reconstruction with Nagata method.

METHODSThe first stage operation was fulfilled according to the Nagata two-stage method which involves fabrication and grafting of the costal cartilage framework. The second-stage ear elevation operation was undertaken 6 months later to form the cranioauricular sulcus. Split-thickness skin was taken from temporal and accipital area. After releasing the auricular framework and transplanting C shaped medpor at the rear side of framework, the temporaparietal fascia flap was transferred to cover postauricular medpor and framework. Then the split-thickness skin graft was implant on the fascia surface.

RESULTSFrom July 2010 to August 2012, 20 cases (22 ears) were treated. Partial necrosis of temporaparietal fascia flap and framework exposure happened in 1 case. Successful ear reconstruction was achieved in other cases with satisfactory cranioauricular sulcus during the follow-up period of 6-18 months (average, 13 months).

CONCLUSIONSThe application of medpor and split-thickness skin graft in the ear elevation of Nagata method for auricular reconstruction for microtia can achieve satisfactory results. It not only avoids the obvious scar in the donor site due to harvesting full-thickness and intermediate-thickness skin, but also reduces chest trauma due to harvesting costal cartilage.

Costal Cartilage ; transplantation ; Dermatologic Surgical Procedures ; methods ; Ear Auricle ; surgery ; Fascia ; Humans ; Polyethylenes ; therapeutic use ; Skin Transplantation ; Surgical Flaps ; transplantation

Objective:To investigate the therapeutic effect of Zhenju hypotensive tablet combined with nifedipine sustained-release tablet in the treatment of essential hypertension, and its influence on the vascular endothelial function, expression of cystatin C (CysC), homocysteine (Hcy) and hypersensitive C-reactive protein (hs-CRP).Methods:From September 2018 to September 2019, 182 patients with essential hypertension were enrolled in Zhuji Hospital of Traditional Chinese Medicine.They were divided into observation group (91 cases) and control group (91 cases) according to the random digital table method.The control group was given nifedipine sustained-release tablets, while the observation group received Zhenju hypotensive tablets on the basis of the control group.The course of treatment in both two groups was 12 weeks.After treatment, the changes of blood pressure, endothelial function, CysC, Hcy and hs-CRP levels and adverse reactions were compared.Results:The total effective rate of the observation group (91.21%) was higher than that of the control group (79.12%) (χ 2=5.262, P<0.05). The SBP and DBP in the two groups were decreased after treatment for 12 weeks ( tobservation group=29.054, 26.702, tcontrol grou P=27.449, 20.145, all P<0.05). The SBP and DBP in the observation group were lower than those in the control group ( t=12.704, 8.177, all P<0.05). After treatment for 12 weeks, the plasma level of ET-1 in the two groups were lower than those before treatment, and the level of NO the two groups were higher than those before treatment ( tobservation group=27.388, 18.644, tcontrol group=9.480, 9.657, all P<0.05). The plasma level of ET-1 in the observation group was lower than that in the control group, and the level of NO in the observation group was higher than that in the control group, the differences were statistically significant( t=22.384, 9.134, all P<0.05). The levels of CysC, Hcy and hs-CRP in the two groups after treatment for 12 weeks were lower than those before treatment ( tobservation group=31.586, 23.159, 29.776, tcontrol grou P=11.641, 13.649, 16.521, all P<0.05). The levels of CysC, Hcy and hs-CRP in the observation group were lower than those in the control group ( t=17.193, 10.554, 14.671, all P<0.05). The adverse reaction in the observation group was less than those in the control group (χ 2=7.959, P<0.05). Conclusion:Zhenju hypotensive tablet combined with nifedipine sustained-release tablet has good therapeutic effect in the treatment of essential hypertension.It can improve the vascular endothelial function, reduce the expression of CysC, Hcy and hs-CRP, and has fewer adverse reactions.