Objective To explore the clinical effect of inverted L-shaped incision combined with medial canthal tendon plication for moderate and severe epicanthus correction.Methods Improved method of inverted L-shaped incision combined with medial canthal tendon plication were performed in 42 cases of moderate and severe epicanthus.The epicanthus covered more than 50％ lacrimal caruncle with single-fold eyelids or unconspicuous double-fold eyelids.Among them,40 cases received doubleeyelid plasty simultaneously.Results The follow-up time of 38 cases ranged from 6 to 24 months.37 cases received double-eyelid plasty simultaneously.All the patients obtained satisfactory results aesthetically,the contours of two eyelid fissures and the double-eyelid radian looked more natural postoperatively.There was no reoccurrence of epicanthus.Mild scar proliferation was observed in all of the patients in the early 1-2 months of postoperative period and then would fade within three months.Conclusions It is effective to correct epicanthus by improved method of inverted L-shaped incision combined with medial canthal tendon placation.

Purpose To study clinical pathological characteristics,margin status and its influencing factors in different type of facial basal cell carcinoma (BCC).Methods The histopathological features,margin status of the first frozen section and influencing factors was retrospectively analyzed,with review of the relevant literature.The primary outcome variable was the rate of initially positive frozen section margins.Multivariable Logistic regression was used to study histologic subtype,surgical margins,tumor size,location and other factors influence on the rate of initially positive frozen section margins.Results The pathological subtype is the major risk factor,the infiltrative (OR =4.463,95％ CI =1.919-10.380,P ＜0.05) and morpheaform (OR=5.018,95％CI=2.025-16.623,P＜0.05) had higher risk on positive surgical margin compared with the nodular.The rate of initially positive frozen section margins of nodular and superficial BCC at different margins were observed but the difference were not significant (P ＞ 0.05).Conclusion The pathological subtype is the major risk factor.Surgical excision with a 3 mm margin can achieve ideal results for nodular and superficial BCC in facial area.

0.05) for children and young people, showing irrelevancy to age. Conclusions The X ray SRS is effective and safe for cerebral AVM, it gives high obliteration rate for AVM of volume

Objective To evaluate the effect of X-ray stereotactic radiotherapy(SRT)with two different methods in curing brain metastases.Methods 41 patients with brain metastases were treated by SRT,including 24 cases by SRT and 17 cases by SRT combined whole brain irradiation.78 lesions in 41 patients fall into two groups:small tumor(3 cm).All patients were followed for 2～19 months after treatment by CT scan.The effect,recurrent and complication were discussed.Results Following SRT,the effect rate was 92.9% in SRT group and 93.7% in SRT combined whole brain irradiation group.The effect rate was 97.4% for small lesions while 90% large lesions.The recurrent rate was much higher in SRT(17%) than that in SRT combined whole brain irradiation group(5.9%),the difference was statistically significant(?

Objective To investigate the value of 99Tcm-MDP imaging for the differential diagnosis between infection and aseptic loosening after total hip arthroplasty.Methods During February 2008 to August 2011,74 patients (32 males,42 females,average age (64.3±11.2) years) with hip pain after arthroplasty underwent 3-phase (blood flow,blood pool and bone phases) 99Tcm-MDP imaging.All patients had measurements of serum C reactive protein (CRP) and erythrocyte sedimentation rate (ESR).Joint infection was defined as either increased peri-prosthetic soft tissue activity during perfusion and blood pool phases or increased peri-prosthetic bone activity during uptake phase,or positive in all 3 phases.Aseptic loosening was defined as having negative 99Tcm-MDP in all 3 phases.Clinical diagnosis was chosen as the gold standard.The blood flow-pool imaging was compared with the serum examinations.x2 test was used for statistical analysis.Results There were 74 symptomatic joints in 74 patients,including 24 joint infections and 50 aseptic loosening.For the detection of peri-prosthetic infection,combined perfusion-blood-pool phase was more accurate than bone uptake phase (90.5％ (67/74) vs 55.4％ (41/74) ;x2=23.159,P＜0.001),with the sensitivity of 91.7％ (22/24)vs 70.8％ (17/24) and specificity of 90.0％ (45/50) vs 48.0％ (24/50),respectively.The blood flow-pool imaging was also more accurate than CRP (73.0％ (54/74) ;x2 =7.656,P＜0.05) and ESR (71.6％ (53/74) ; x2 =8.633,P＜0.05),respectively.Conclusion 99Tcm-MDP perfusion/blood flow-pool imaging is an accurate modality for differentiating peri-prosthetic infection from aseptic loosening in patients with hip pain after arthroplasty.

Objective:Setting up a queuing simulation model to study the allocation and usage of MRI in certain regional hospital in East China. To find out the causes and put forward suggestions. Methods: Statistical method was used for statistical analysis of MRI inspection time. Queuing simulation model was used to analyzing MRI allocation and used in 7 top hospitals. The waiting queue length, average queue length, sojourn time and waiting time was calculated.Results: The average MRI examination waiting time of the 7 top hospitals in the whole region is 0.403 h. The waiting time of 2 hospitals is more than 40 min while which is less than 20 min in 3 hospitals. The equipment utilization rate is higher in 2 hospitals (vacancy rate is 11.9%-16.4%) while which is lower in 2 other hospitals (vacancy rate is 52.3%-58.9%).Conclusion: The problem of health allocations of resources could be solved by establishing regional MRI examination center radiation regional around.

Objective To explore a new surgical treatment for severe inverted nipple and to reduce the possibility of recurrence. Methods Two opposite long six-side polygon de-epithelialized areas were designed within the range of areola on both sides of the nipple. The four sides in lateral portion were dissected and two wedge-shaped dermal and glandular tissue flaps were created, completely releasing the contractive fiber causing nipple retraction while reserving breast ducts. The flaps were reversed 180 degrees through the tunnel bilateral sides of breast ducts to support the nipple. It was tracted for 3-4 weeks by series 7 needle penetrating the nipple basis. Results All the 14 patients were followed up for 3-18 months, and they were satisfied with the appearance and the aesthesia of the nipple and no recurrence was observed, breast-feed function reserved in 2 cases after childbirth. Conclusions This operation is easy to perform with satisfying aesthetic outcome and breast-feed function remaining.It is an ideal method for correcting serious inverted nipple.

Objective:To observe the clinical efficacy of warm needling moxibustion plus tuina in treating knee osteoarthritis (KOA) due to cold-dampness blocking collaterals.
Methods:Forty-eight KOA patients were randomized into 2 groups by their visiting sequence, 24 cases in each group. The treatment group was intervened by warm needling moxibustion plus tuina, while the control group was treated with acupuncture plus tuina. The two groups were both treated once a day, 30 min for each session, 10 d as a treatment course, totally for 3 treatment courses. The visual analogue scale (VAS) and Lysholm knee scoring scale (LKSS) were observed before and after the treatment to evaluate the clinical efficacy.
Results:After 3 treatment courses, the VAS and LKSS scores were significantly changed in the two groups (P<0.01), and the between-group differences were also statistically significant (P<0.01). The markedly-effective rate was 83.3% in the treatment group versus 66.7% in the control group, and the difference was statistically significant (P<0.05).
Conclusion:Warm needling moxibustion plus tuina can produce a more significant efficacy than acupuncture plus tuina in treating KOA due to cold-dampness blocking collaterals.

Objective To evaluate medical chemistry adhesive in tension-free herniorrhaphy for inguinal hernia. Methods In this study, 100 patients with primary unilateral inguinal hernia were assigned to study group ( n = 50) and control group ( n = 50) during Jun. 2009 and Dec. 2009. Medical chemistry adhesive (n-butyl-2-cyanoacrylate, NBCA) was used in Lichtenstein tension-free hernia repair in study group and suture procedure was used in control group. Patient demographics, operation time,postoperative length of stay, visual analogue scale ( VAS ) score 24 hours after surgery, incidence of postoperative chronic pain and hematoma, recurrence rate, and other complications were compared between the two groups. Results The duration of follow-up ranged from 12 months to 18 months. There were no recurrences or wound infection in the two groups. In study group, no patient complained of chronic pain postoperatively, whereas in the control group, 6 patients ( 12% ) had a significant chronic pain. In study group, 2 patients (4%) had local hematoma after operation, whereas there were 8 ( 16% ) in the control group ( P ＜ 0. 05 ). There were no significant differences between the 2 groups in postoperative length of stay ( P ＞ 0. 05 ), but the operation time and postoperative VAS score in study group ( 38 ± 5 min and 2. 5 ± 0. 6)were lower than in the control group (42 ± 5 min and 2. 8 ± 0. 8 ), ( P ＜ 0. 05 ). Conclusions Application of medical chemistry adhesive in tension-free herniorrhaphy for inguinal hernia is associated with less postoperative pain, lower incidence of hematoma, less postoperative chronic pain and shorter operation time.

Objective To study the characteristics of plasma adiponectin levels exhibiting in gestation women and newborns, as well as the relationships between adiponectin levels and fetal birth weight. Methods Totally 98 subjects have been considered in this study, in-cluding venous blood samples of 36 healthy non-pregnant women (control group), 31 uncomplicated pregnant women (pregnancies group) and the cord blood samples taken at delivery of their singleton infants born at term (newborns group). The concentrations of adiponectin and insulin were determined by radioimmunoassay technique. And SPSS was used for statistical analyses. Results The adiponectin level in women of late period of gestation (WLPG) (11.10±5.72)g/ml was lower than that of other two groups, and the newborns average cord plasma level of adiponectin was (30.71±12.77) g/ml significantly higher than that of the control group (16.52±6.87) g/ml. The adipone-ctin level for WLPG was correlated with FINS and HOMA-IR (r = -0.411, -0.393, P <0.05). The adiponectin level in cord plasma was positively correlated with birth weight(r = 0.416, P < 0.05). The adiponectin level in WLPG was correlated neither with the adiponec-tin level nor body weights of their newborns. Conclusions The average cord plasma adiponectin level of newboms is significantly higher than that of the control group and WLPG. It is positively correlated with birth weight, which suggests that adiponectin may be involved in reg-ulating fetal growth. The adiponectin level in WLPG is correlated neither with the adiponectin level nor body weights of their newborns.