Lipedema is secondary to local fat deposition, a disease characterized by the symmetric thickening of lower limbs, mostly occurs in women, especially in adolescence and pregnancy. In its early stage, it could be easily confused with lymphedema. Extensive literature review on primary fat edema in recent years, as well as a summary of the clinical symptoms and signs and diagnosis and treatment of lipedema were conducted, so as to provide a useful reference for clinicians.

Objective:To explore the clinical application of peroneal artery pedicled with lateral calf muscle wear skin flap in repair of foot and ankle soft tissue defect.Methods:From February 2017 to May 2019, the peroneal artery pedicled with lateral calf muscle wear foot and ankle soft tissue defect was used with skin flap in 20 cases, which included car accident injuries in 11 cases, 3 cases of heavy injuries, skin ulcer in 4 cases, and 2 cases of bone scars. All of the affected limb wounds presented with the exposure of deep tissue such as bone or tendons. The flap cut ranged from 5.0 cm×4.0 cm~7.0 cm×5.0 cm. The donor area was closely sutured in 5 cases, and inguinal full thickness skin pack was used with skin grafting in 15 cases.Results:20 cases of postoperative skin flap survived of all, healing of wounds and cuts for phase I. After follow-up of 5~18 months, the flap had good shape and wear-resistant quality, without feeling bloated. The two points of flap were different within 3~5 mm; the functional activity of the ankle joint was good in the affected limb, with satisfactory results.Conclusions:It is a convenient and reliable procedure, with smaller surgical trauma, which is an ideal skin flap for repair of soft tissue defect in foot and ankle.

Objective: To explore the effect of the modified suture suspension by annular ligaturing the frontalis muscle to treat severe congenital blepharoptosis in children (age≤3). Methods: From October 2016 to October 2017, 11 patients (16 eyes) with severe blepharoptosis were treated using the modified suture suspension in the Affiliated Hospital of Weifang Medical University. There were 7 males and 4 females, aged from 1 to 3 years old, with the average of 26.3 months. Three suture lines were used in three directions respectively. One end was fixed to the upper edge of the tarsus, the other end was fixed to the frontalis muscle by annular ligation. The operation effect and complications were evaluated 1 week and 6 months after the operation. Results: All the incisions healed well. Hypophasis was observed in 1 eye. The exposed palpebral fissure was less than 3 mm when the eye was closed. No corneal exposure was observed in other cases. One week after surgery, the blepharoptosis of 5 patients were fully corrected (6 eyes, 37.5 %). Blepharoptosis in 5 patients were basically corrected (9 eyes, 56.2 %). One patients was over corrected (1 eyes, 6.3%). Six months after surgery, the blepharoptosis of 5 patients were fully corrected (5 eyes, 31.2 %). Blepharoptosis in 5 patients were basically corrected (9 eyes, 56.3%). However, the blepharoptosis of 1 patient was under corrected (2 eyes, 12.5%). Conclusions This modified suture suspension by annular ligature the frontalis muscle has the advantages of simple operation, low cost, stable effect, small wound, and satisfactory clinical effect.