Background and purpose:Radiofrequency ablation (RFA) was one of the best combined treatments for hepatocarcinoma. CT was commonly used to evaluate treatment response and recurrent disease. However it was diffi cult to evaluate treatment effectiveness of RFA and to detect recurrent nodule especially the size below 1cm. Digital subtraction arteriography(DSA) may provide fi nal diagnosis of recurrent nodule after RFA for hepatocarcinoma. Our purpose was to analyze the signs of DSA after RFA for hepatocarcinoma in order to provide possible reference for treatment effectiveness and the imaging follow-up methods. Methods:17 patients with primary liver cancer (n=15) or hepatic metastasis(n=2) were enrolled in this study. Common hepatic arteriography or super-selective angiography of suspicious tumor area were performed on all patients. Results:On DSA, most ablated regions presented as round or ovoid low density areas with no stain. At the peripheral zone of the lesion, fi ve signs after RFA could be found: Stain of localized granulation tissue, arterio-portal fi stula, hemorrhage, recurrence and no abnormal fi ndings. Local or intrahepatic recurrence occurred in 9 cases. Conclusion:Hepatic DSA has great value in detecting local recurrence of hepatic tumor after RFA treatment. DSA is superior to CT in detecting marginal or intrahepatic recurrent nodule below 1 cm.

Objective To discuss the clinical effect of medial canthal skin defects reparation with nasofacial sulcus reversed fascio-cutaneous flaps.Methods Medial canthal skin defects in 10 patients were repaired with nasofacial sulcus reversed fascio-cutaneous flaps in the hospital.These patients included 3 cases of pigmented nevus,6 cases of skin tumors,1 case of scar.The size of defects varied from 0.8 cm× 1.0 cm to 1.8 cm×2.2 cm.Results In these 10 cases,the maximum area of fascio-cutaneous flaps was 2.0 cm×3.0 cm,and the minimum area was 1.2 cm× 1.5 cm.All the flaps survived with primary healing postoperatively.Incision line scar was inconspicuous and the color and texture of flaps were similar to those of surrounding tissues.Conclusions To maintain and restore the integrity of medial canthal by using nasofacial sulcus reversed fascio-cutaneous flaps would lead to a good aesthetic effects.

Objective:To explore the clinical application of orbital septum fat reset for tear though deformity and palpbromalar groove in the lower blepharoplasty.Methods:From March 2015 to March 2018, 72 cases of lower eye baggy deformity with tear though deformity and palabromalar groove were treated with the procedures of orbital septum fat reset, relaxing the tears ligament and orbicularis retaining ligament; the orbital fat that was released from orbital septum was repositioned at the inferior orbital and fixed on periosteum.Results:The incisions of 72 cases were healed successfully, the shape of the eyes was naturally symmetrical, the palpebral and buccal parts were excessive, and the contour lines formed a monoconvexcurve, with no obvious scar. All the cases were available for 6 to 24 months follow-up. 66 cases (91.67%) were satisfied with the cosmetic results.Conclusions:Orbital septum fat reposition is an effective method for correction of tear though and eyelid sulcus deformity.

Objective:To investigate the clinical and gene variant characteristics of PCDH19 gene related epilepsy, and improve the ability of clinicians in early disease identification. Methods:The clinical data of 3 PCDH19 gene related epilepsy patients admitted to Children′s Hospital Affiliated to Zhengzhou University from October 2018 to August 2023 diagnosed by gene detection were reviewed and analyzed. Results:All the patients are female, and the onset age of seizure ranged in their infancy. Seizures in clusters and fever sensitivity were observed in all patients, and were very hard to control by single-drug treatment. Proband 1 was seizure-free after 2 kinds of anti-epileptic drug treatment, but with mild degree of intellectual disability. Proband 2 had refractory epilepsy with severe degree of intellectual disability. Proband 3 was seizure-free after 2 kinds of anti-epileptic drug treatment and without intellectual disability. In the first family, the proband carried heterozygous c.369C>G variant in the PCDH19 gene which was identified as de novo after parental validation. In the second family, the proband carried c.1652T>A variant inherited from her mother. In the third family, the proband carried c.278G>A variant inherited from her father. The 3 mutations had not been reported in the Human Gene Mutation Database. Conclusions:PCDH19 gene related epilepsy is one special kind of X-linked inherited epilepsy syndrome characterized by seizures in clusters and sensitivity to fever. And gene detection can help with early diagnosis and make rational clinical strategies in time. The variants c.369C>G, c.1652T>A and c.278G>A have enriched the gene variant spectrum of PCDH19.