Objective To investigate the operative technique and outcome of the expanded flap to repair the full thickness defects of nose and upper lip simultaneously.Methods Three kinds of ex panded flaps were chosen to reconstruct the full thickness defects of nose and upper lip.They were designed according to the location and the size of the defects,and also the circumstances of the donor site.Treatment effectiveness were observed by long-term follow-up.Results 7 patients were treated with the expanded flap.All cases received satisfactory results with no complications such as flap necrosis.And for male patients,the frontal expanded flap could reconstruct upper lip and beard simultaneously that reached better shape.Conclusions It is an ideal approach of repairing nasal-lip defects by the tissue expanded flap.

Objective:To assess the efficacy and intervention time of sequential laser treatments for early stage of facial post-traumatic scars which were managed by plastic surgeons.Methods:212 patients in our department with facial post-traumatic scar which were managed by plastic surgeons within 2-12 weeks received 3-session of sequential 595 nm and CO 2 ablative fractional lasertreatments at 8 weeks intervals. They were divided into four groups in this retrospective study. Traumatic scars were first treated by 595 nm pulsed dye laser at 2 weeks (group A), 4 weeks (group B), 8 weeks (group C), 12 weeks (group D) post-operation respectively. Until the vascularity scores of Vancouver scar scale (VSS) fell below 2 points, then scars were treated with CO 2 ablative fractional laser. During the study, all cases were treated with standard silicone gel. Photographs taken before and after each treatment session were independently evaluated and scored by two uninvolved doctors with Vancouver scar rating scale (VSS). Friedman test and Mann-Whitney U test were used for intragroup and intergroup comparison of the difference before and after each session treatment. Patients, self-satisfactory (on 0-100%) and adverse effects were recorded and Chi-square and Fisher’s exact test were used to compare the differences between groups. Results:All 4 groups of patients completed 3-session laser treatments. The VSS score of A/B/C/D group was 3.0 (3.00-5.00) /4.0(3.00-4.00) /6.0 (5.00-6.00) /6.5 (6.00-7.75) at baseline, and significantly decreased to 2(2.00-3.00)/2(2.00-3.00)/4(3.00-4.00)/4(4.00-4.75) at 2 months after 3-session treatment ( P<0.001) respectively. Compared VSS score intergroup, there was no statistically difference between group A and B before ( P>0.05) or after ( P>0.05) treatment. In contrast, compared with group C or D, VSS score of group A or B was significantly lower at baseline ( P<0.001) and final follow-up ( P<0.001). And the excellent rate of patients, self-satisfaction were significantly different for group A(80.77%) vs. group C(56.41%) or D(47.50%), and group B(75.61%) vs. group C or D( P<0.05). No significant adverse effects were reported except for 3 patients with mild transient vesicles, and amonge the 3 cases, hyperpigmentation was observed in 2 cases which was faded within 6 months. Conclusions:A combination of 595 nm pulsed dye laser and CO 2 ablative fractional laser for facial traumatic scars starting from 2 weeks to 1 month post-operation could reach better clinical outcome by attenuating scar formation effectively and with higher patients, self-satisfaction than that from 2-3 months post-operation.

Objective:To assess the efficacy and intervention time of sequential laser treatments for early stage of facial post-traumatic scars which were managed by plastic surgeons.Methods:212 patients in our department with facial post-traumatic scar which were managed by plastic surgeons within 2-12 weeks received 3-session of sequential 595 nm and CO 2 ablative fractional lasertreatments at 8 weeks intervals. They were divided into four groups in this retrospective study. Traumatic scars were first treated by 595 nm pulsed dye laser at 2 weeks (group A), 4 weeks (group B), 8 weeks (group C), 12 weeks (group D) post-operation respectively. Until the vascularity scores of Vancouver scar scale (VSS) fell below 2 points, then scars were treated with CO 2 ablative fractional laser. During the study, all cases were treated with standard silicone gel. Photographs taken before and after each treatment session were independently evaluated and scored by two uninvolved doctors with Vancouver scar rating scale (VSS). Friedman test and Mann-Whitney U test were used for intragroup and intergroup comparison of the difference before and after each session treatment. Patients, self-satisfactory (on 0-100%) and adverse effects were recorded and Chi-square and Fisher’s exact test were used to compare the differences between groups. Results:All 4 groups of patients completed 3-session laser treatments. The VSS score of A/B/C/D group was 3.0 (3.00-5.00) /4.0(3.00-4.00) /6.0 (5.00-6.00) /6.5 (6.00-7.75) at baseline, and significantly decreased to 2(2.00-3.00)/2(2.00-3.00)/4(3.00-4.00)/4(4.00-4.75) at 2 months after 3-session treatment ( P<0.001) respectively. Compared VSS score intergroup, there was no statistically difference between group A and B before ( P>0.05) or after ( P>0.05) treatment. In contrast, compared with group C or D, VSS score of group A or B was significantly lower at baseline ( P<0.001) and final follow-up ( P<0.001). And the excellent rate of patients, self-satisfaction were significantly different for group A(80.77%) vs. group C(56.41%) or D(47.50%), and group B(75.61%) vs. group C or D( P<0.05). No significant adverse effects were reported except for 3 patients with mild transient vesicles, and amonge the 3 cases, hyperpigmentation was observed in 2 cases which was faded within 6 months. Conclusions:A combination of 595 nm pulsed dye laser and CO 2 ablative fractional laser for facial traumatic scars starting from 2 weeks to 1 month post-operation could reach better clinical outcome by attenuating scar formation effectively and with higher patients, self-satisfaction than that from 2-3 months post-operation.

Objective:To investigate the correlation between three-dimensional histogram analysis of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and Gleason score(GS)in prostate cancer(Pca)from two hospital, and its diagnostic efficacy for discriminating low-grade from high-grade Pca.Methods:A total of 102 pathologically confirmed Pca patients in the First Affiliated Hospital of Zhejiang Chinese Medical University and Hangzhou Traditional Chinese Medical Hospital(TCM Hospital)Affiliated to Zhejiang Chinese Medical University from January 2017 to October 2020 were retrospectively analyzed.The quantitative parameters of Pca, including transport constant(K trans), rate constant(K ep), percent volume of the extravascular extracellular space(V e)and fraction of the Intraplasmic contrast volume(V p), were obtained by manually layer by layer delineating of interested regions of all lesions on the original DCE-MRI imaging.Then the three-dimensional histogram analysis of the above parameters were performed to obtain the minimum, maximum, median, mean, area, 10 thpercentile, 25 thpercentile, 75 thpercentile and 90 thpercentile.The correlations between quantitative parameters and GS, and diagnostic efficiencies were analyzed. Results:102 Pca patients were divided into low-grade prostate cancer group(GS≤3+ 4)(n=44)and high-grade Pca group(GS≥4+ 3)(n=58). There were no statistically significant differences in age and location of lesions between the two groups( P>0.05), but there were statistically significant differences in Gleason score, PSA level and lesion diameter between the two groups( U=0.000, 730.000, 711.000, all P<0.05). The median, mean, 10 thpercentile, 25 thpercentile, 75 thpercentile, 90 thpercentile derived from K trans, and K ep(median, mean, 10%, 25%, 75%, 90%)together with maximum of K transand mean for V e were positively correlated with GS( r=0.405 to 0.583, P<0.05), in which mean of K transhad the highest positive correlation( r=0.583, P=0.000). The histogram parameters derived from V pwere negatively correlated with GS( r=-0.301 to 0.341, P<0.05). The area under ROC of 75th percentile derived from K transwas the highest(0.832). When the cut-off value of 75 thpercentile derived from K transwas ≥0.680/min, its Youden index, sensitivity, and specificity were 0.594, 0.776, 0.818, respectively. Conclusions:The three-dimensional histogram of DCE-MRI quantitative parameters has correlation with GS in Pca patients, can be used to discriminate low-grade from high-grade Pca.