Objective To investigate reconstructive repair methods of a large scalp defect with the granulation tissue wounds and skull exposure caused by the trauma.Methods Skin and soft tissue expansion technique was used to repair eight patients with a large scalp defect with the granulation tissue wounds and skull exposure caused by the trauma.The skin and soft tissue expanders were embedded under normal epicranial aponeurosis after the formation of fresh granulation tissue wound.Strict aseptic technique as well as water injection was done in the expansion process and moderate expansion to maintain rich blood circulation in the expansive parts.Results 12 skin and soft tissue expanders were implanted in 8 patients and the scalp wounds were completely repaired.No infection was detected after surgery and injection expansion process.Conclusions The skin and soft tissue expansion can be used to reconstruct post-traumatic scalp defect with granulation tissue wound and skull exposure.

Abnormal savda munziq could be used as an effective drug for treatment of hypertrophic scar.

OBJECTIVETo investigate the clinical effect of steroids on reducing postoperative edema in rhinoplasty.

METHODSCochrane, Medline data, Pubmed date, were searched and updated on October 2013. Randomized controlled trials(RCTS) studies were included to assess the efficacy of steroids on decreasing postoperative edema after rhinoplasty. The methodological quality of the included studies was evaluated, and date analyses were performed using the Cochrane Collaboration's software RevMan 5.2.

RESULTSA total of 4 RCTS involved 172 patients with rhinoplasty, including 87 patients in the experimental group( steroid) and 85 paitents in control group (placebo). Meta analysis results showed the edema in experimental group was significantly less than that in the control group on postoperative day 1 and 3 (P < 0.01), while the difference was not significant on postoperative day 7 (P = 0.19).

CONCLUSIONSPerioperative application of steroid in rhinoplasty can significantly reduce periorbital edema in the first postoperative day. The edema can completely be relieved after application of steroid for 3 days. It is a safe and effective way to reduce the postoperative edema.

Objective To investigate the validity of selecting subclones of human breast cancer cells with high-and low-metastatic potentiality,based on their different ability of penetrating the matrigel in vitro,and analyze their biological characteristics.Methods Continuous in vitro invasion assays in matrigel were applied to screen two subclones of human breast cancer cell line MDA-MB-435s,characterized by high-and low-metastatic potentiality.Cell growth curve assay,invasion assay,adhesion assay and angiopoiesis-promoting assay were conducted to explore the different biological properties of these two subclone cells.Results Two subclones of MDA-MB-435s,of high-and low-metastatic potentiality respectively,were obtained through continuous in vitro invasion assay,manifesting significant difference in growth rate,invasion ability,adhesion ability and angiopoiesis-promoting ability.Conclusion It is feasible to obtain subclones of human breast cancer cells of high-and low-metastatic potentiality by utilizing their difference in penetrating the matrigel in vitro.

Objective To explore the clinical efficacy of early surgery combined with electron linac therapy on keloid.Methods The keloid patients with stable phase were selected;complete resection of keloid and relaxation suture were performed;after the surgery within 24 hours 6 MeV with Varian 2300CD radiotherapy was given,each measuring 4 Gy,total dose of 20 Gy.Results 860 cases of patients were colected for a period of 3 months to 36 months of regular follow-up,which recovered in 802 cases (cure rate was 93.26％),effective results were observed in 41 cases (effective rate of 4.77％),including 17 cases of recurrence (recurrence rate 1.98％),the total efficiency (cure plus effective) was 98.02％.Conclusions More accurately immediate radiotherapy after surgery can effectively reduce the recurrence rate,which is a safe and effective method in the treatment of keloids.

Objective To summarize the early experience of thymectomy by robot-assisted thoracoscopic surgery (RATS) with the da Vinci S Surgical System.Methods A total of 16 patients was underwent thymectomy from October 2016 to May 2017 by RATS.Among them,there were 10 cases of thymic hyperplasia,5 cases of thymoma and 1 case of thymic small cell carcinoma,including 11 cases of myasthenia gravis (MG).The Osserman types were as follows:type Ⅰ (5),type ⅡA (3),type ⅡB (2),and type Ⅲ (1).Clinical data were collected and analyzed.Results The operations were successfully accomplished by RATS in all the 16 patients without any conversion to open surgery and major complication.The docking time was 2-45 (11.69 ± 11.03) min.The operation time was 47-152 (84.06 ± 25.67) min.The blood loss was 0-150 (57.50 ± 37.32) ml.The diameter of thymus or tumor was 4-19.5 cm and (8.22 ± 3.64) cm.Fourteen cases were removed tracheal intubation in the operation day,and the other 2 cases taked off in 6th and 8th days.One case occurred myasthenia gravis crisis after surgery.All patients were followed up for 2-7 months after discharge without MG recurrence.Conclusions The da Vinci S Surgical System can be safely,accurately and stably used for thymectomy.

Objective Describes the changes of arterial blood gas analysis and pulmonary functions of emphysematous rabbits after unilateral and bilateral lung volume reduction surgery.Methods Sixty rabbits were randomly and equally divided into 6 groups:control group(A),emphysema group( B),unilateral sham operation group(C),unilateral lung volume reduction surgery group( D),bilateral sham operation group( E ) and bilateral lung volume reduction surgery group(F).Obstructive emphysema was induced with somg and papain in tie rabbits of the remaining groups except the control one.Eight weeks later,arterial blood gas analysis and pulmonary functions were detected.Results Compared with group B,pH,PaO2,PaCO2,SaO2,forced expirratory volume in 0.5 s,froced expiratory capacity,functional residual capacity,total lung capacity,dynamic compliance,and resistance in expiartory phase could be improved in group D ( P ＜ 0.05 ).The amelioration of those results were more obvious in group F ( P ＜0.05).Two rabbits in group F died after opertation.Conclusion Bilateral lung volume reduction surgery could more markedly improve the arterial blood gas analysis and pulmonary functions of emphysematous rabbits than unilateral operation.

Objective To investigate the promotion effect of human transcriptional positive cofactor 4 (PC4) overexpression on lymphatic metastasis in lung adenocarcinoma .Methods 96 samples of lung adenocarcinoma tissue were collected .The immuno‐histochemistry(IHC) and real‐time quantitative polymerase chain reaction (qRT‐PCR) were adopted for detecting the expression levels of PC4 protein and mRNA .The correlation of PC4 expression with lymphatic metastasis and TNM stage was analyzed .Re‐sults The expression of PC4 protein was positively correlated mRNA in lung adenocarcinoma (r=0 .63 ,P<0 .01);the expression of PC4 protein was positively correlated with lymph node metastasis (χ2 =8 .29 ,P<0 .01) and TNM stage (χ2 =4 .71 ,P<0 .05);the expression of PC4 mRNA was also positively correlated with lymph node metastasis (χ2 = 8 .40 ,P< 0 .01) and TNM stage (χ2 =5 .10 ,P<0 .05) .Conclusion PC4 overexpression is found to be closely associated with the lymph node metastasis and TNM stage .PC4 may facilitate the lymph node metastasis of lung adenocarcinoma .

Objective To investigate whether EGFR gene mutations are correlated with the gene expression of ERCC1 and TYMS in non-small-cell lung cancer .Methods Collected February to December 2013 of non-small cell lung cancer(NSCLC) pa-tients eligible for enrolled 97 patients ,tumor tissue specimens obtained by intraoperative cut or puncture ,Gene expression of ERCC1 and TYMS were determined by branched-DNA liquid chip ,while somatic mutations in EGFR(E18 ,E19 ,E20 ,E21) gene were detec-ted by xTAG-liquid chip;And analysis of EGFR gene mutation associated with ERCC1 ,TYMS mRNA expression .Results Totally 29 cases of EGFR mutation were detected in all 97 specimens ,with a mutation rate of 30% (29/97) ,and a relatively high detection rate was observed in female ,adenocarcinoma and non-smoking patients(P<0 .05) .EGFR mutation was relevant to the expression of ERCC1(χ2 =4 .088 ,P<0 .05) ,EGFR mutation was irrelevant to the expression of TYMS(χ2 =0 .265 ,P>0 .05) .Conclusion In NSCLC tissues ,EGFR mutation is relevant to the expression of ERCC1 but irrelevant to the expression of TYMS .

Objective To assess the value of fuorine-18-fluom deoxy glucose positron emission tomography /computer tomography (18F-FDG PET/CT) in diagnosis of lymph node metastasis in the cases with non-small cell lung cancer ( NSCLC) .Methods From March 2012 to March 2015,167 patients underwent 18F-FDG PET/CT and contrast enhanced CT inspection within 10 days prior to the surgery and were pathologically diagnosed as non-small cell lung cancer(NSCLC) after surgery.With regard to estimation of the lymphatic metastasis,we com-pared the sensitivity,specificity,accuracy,positive and negative predictive value ,and Youden index between the PET/CT and contrast en-hanced CT.Results There were 731 lymph node stations from the 167 patients.Referred to the final pathological results ,PET/CT has screened 143 lymph node stations in true positive set ,26 lymph node stations in false positive set ,61 lymph node stations in false negative set , and 501 lymph node stations in true negative set .Furthermore,the sensitivity,specificity,the positive and negative forecast values ,and Youden index of PET/CT and CT was 70.10%vs.54.19%(P<0.05),95.07%vs.92.23%(P<0.05),88.10%vs.81.67%(P<0.05),84.62%vs.72.85%(P<0.05),89.15%vs.81.67%(P<0.05) and 0.65 vs.0.46 (P<0.05),respectively.Conclusion It is more effective to to precisely validate lymphatic metastasis of NSCLC by using PET /CT than using contrast enhanced CT inspection .Additionally,PET/CT can provide more information for the preoperative diagnosis , staging and the follow-up treatment of lung cancer .