Objective To gain the best cosmetic result and to avoid the manifest postoperative scar, bleeding and injury of the sensory nerves in the nipple and areola. Methods The gynecomastia was corrected under the endoscope through a small incision (2~3.5 cm) around the areola combined with the tumescent liposuction of the breast to individuals whose breast hyperplasia was mainly because of the fat tissue hyperplasia and the incised tissues were sent for pathological examinations. Results Since March 2000, 16 young men with normal men genitals appearance had undergone this operation, in which 4 cases were breast gland tissue hyperplasia, 3 cases of fat tissue hyperplasia and 9 cases of mixed fat and gland tissue hyperplasia. The results were satisfactory with normal men breast appearance and small areola incisions. No complications happened such as hematoma, abnormal feeling and necrosis in nipple and the breast. The incised tissue of the unilateral breast was 100~320g with average of 130g. The sunction lipectomy volume of the unilateral breast was 20~130ml with average of 68ml. The pathological examination revealed that the incised tissue were fat tissue and breast gland tissue. During 5 months to 3 years following up, no breast hyperplasia recurred. Conclusions The endoscopic operative technique is an ideal option to correct the gynecomastia because it minimizes the areolar incision and avoids the injury of the nipple and areola. It is also helpful to the distal part incision and remoulding of the breast.

ObjectiveTo explore a procedure to correct the multiple facial deformities by using the expanded frontal flap combined with the axial flaps.MethodsAccording to the face deformity we used the rectangle 100-350 ml expanders behind the frontal hairline,after finishing the tissue expanding,adopted two or three axial flaps based on the supraoribital,supratrochlear or temporal vessels. ResultsA total of 13 cases were treated with this approach.7 eases were nose and lip defect reconstruction after burn,in which temporal vessel-based flap was used in 2 cases and supraoribital or supratrochlear vessel-based flaps in 5 cases.The other 6 cases were nasal reconstruction combined with the frontal defect correction by using random flaps,including 2 cases of pigmented nevus,1 neurofibroma,and 3 burn scars.All the flaps survived and satisfactory appearance was obtained.Conclusions The expanded frontal flap combined with axial flap based on multiple vessels is a good approach to correct the multiple facial deformities.

AIM:To analyze the dissolved content of main constituents of Maxing Shigan Decoction(Herba Ephedrae,Semen Armeniacae amarum,Gypsum Fibrosum,etc.) and powder applied in experiment.The experiment was carried out simulantly in vitro;i.e.drug passed through metabolically man-made stomach liquid and stomach-intestine liquid. METHODS:The experiment of decoction and its powder of Maxing Shigan Decoction were carried out respectively.main ingredients of component drugs in compound Maxing Shigan Decoction were chosen to analyze the dissolved content by the aid of GC and Complexometry. RESULTS:There was a distinctive difference in dissolved content of main ingredients. CONCLUSION:The law of dissolved content change provides a quick and efficient scientific basis for clinical dosage and determination of quality standard.

Objective To study the efficacy of radical surgery for the invasion of chest wall by lung cancers and the different methods of chest wall reconstruction. Methods A retrospective analysis of clinical data was conducted in 27 cases of lung cancer with chest wall invasion in this hospital. 24 cases received lobectomy, 3 cases received pneumonectomy, and all cases received wall reconstruction. The size of chest wall defect after resection ranged from 6.5 cm × 5.4 cm × 5.0 cm to 15.5 cm × 12.5 cm ×10.0 cm. The number of rib resection for each patient ranged from 1 to 4. The reconstructive methods were as follows: using polyester fabric to reconstruct costal pleura, using plexiglass, stainless steel wire and grid-like titanium plate to reconstruct bone defect, and using nearby muscle flap and pedunculated muscle flap to reconstruct muscle defect. Results Pathologic diagnosis was non-small cell lung cancer,including 22 cases of squamous cell carcinomas and 5 adenocarcinomas. There were pulmonary infections in 6 cases, chest hemorrhage in 1 case and chest purulence in 1 case. One-year survival was 77. 9 %,3-yearsurvival was 58.3 %, and 5-year survival was 29. 1 %. Conclusion The lung cancer with chest wall invasion is advisable to make active use of radical surgery. The different methods and repair materials are chosen to reconstruct the chest wall defect, supplemented by comprehensive treatments.

Objective: To analyze the risk factors of acute kidney injury (AKI) after isolated heart valve prosthesis implantation (HVPI) in relevant patients. Methods: We retrospectively studied 400 patients who received isolated HVPI in our hospital. The demographic characteristics and pre-, intra-, post-operative information were collected to conduct uni- and multi-variantanalysis. Results: The pre-operative serum creatinine level in 400 patients was 85.0 (72.0, 98.0) μmol/L and post-operative level was 104.5 (80.0, 146.3) μmol/L, the elevation was 20.9% (1.6%, 57.9%),P<0.05. Multi Logistic regression analysis indicated that age>50years (OR=2.12, 95% CI 1.13-3.95),hypertension history (OR=4.07, 95% CI1.23-13.47), cardiopulmonary bypass time>180 minutes (OR=5.38, 95% CI 1.63-17.77), post-operative hemoglobin<70 g/L (OR=0.20, 95% CI 0.06=0.74), serum glutamic-pyruvic transaminase>100 u/L (OR=12.10, 95% CI 2.28-64.23), pleural fluid drainage at the day of operation> 500 ml (OR=2.12, 95% CI 1.13-3.95), extubation after 24 hours of operation (OR=3.94, 95% CI 2.07-7.52), combining low cardiac output syndrome (OR=4.64, 95% CI 1.06-20.29) were the independent risk factors for AKI occurrence in patients after HVPI, allP<0.05. Conclusion: Post-HVPI AKI was associated with many factors. At prior operation, it was mainly related to the age and hypertension; during theoperation, it was mainly related to cardiopulmonary bypass time; at post-operation, it was mainly related to delayed extubation, low cardiac outputsyndrome, anemia, increased pleural lfuid drainage and serum glutamic-pyruvic transaminase.

OBJECTIVEBased on the different physiological characteristics of the mastoid skin and soft tissue of Chinese congenital microtia malformation, the Nagata two-stage method was respectively applied for ear reconstruction, and the clinic experience were investigated in this study.

METHODAccording to the mastoid skin and soft tissue difference in the thickness and tightness, 280 patients diagnosed with congenital microtia were divided into four types: thin and tight, thin and loose, thick and tight, thick and loose type. 90 cases of thin and loose type accepted the Nagata method of ear reconstruction surgery.

RESULTSWith average 7.8 months follow up, 84.4% (76/90) cases using Nagata two-stage method were satisfied with the outcome of the reconstructed ear including three dimensional position and subunit appearance. There were no postoperative complication related to chest wall deformity or affected normal physical function.

CONCLUSIONSThe Nagata two-stage method is appropriate management choice for Chinese congenital microtia. Based on the different physiological characteristics of the mastoid skin and soft tissue, the selection of different operational should be beneficial to the ear reconstruction of Chinese congenital microtia malformation.

China ; Congenital Microtia ; surgery ; Ear, External ; surgery ; Humans ; Mastoid ; Otologic Surgical Procedures ; Reconstructive Surgical Procedures ; Skin ; Thoracic Wall

Objective: To observe the effect of moxibustion on the expressions of tumor necrosis factor-α (TNF-α) and nuclear transcription factor kappa B (NF-κB) proteins in ankle joints of rats with rheumatoid arthritis (RA), and to explore the anti-inflammatory mechanism of moxibustion in the treatment of RA.Methods: Adjuvant arthritis (AA) rat models were induced and used as rat models of RA. Rats were randomly divided into a normal group, a model group, a moxibustion group and a saline group. Rats in the normal and model groups were not treated; rats in the moxibustion group accepted treatment by moxibustion at Zusanli (ST 36) and Shenshu (BL 23) after modeling; rats in the saline group were injected with 0.15 mL saline to the bottom of the left hind paw and had no other treatments. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes of rats' ankle joints under light microscope. Immunohistochemistry was used to observe the expressions of TNF-α and NF-κB in ankle joints of rats.Results: Compared with the normal group, the rats' ankle joints in the model group showed disorganization, joint surface defect, and significantly increased mean optical density (MOD) of TNF-α and NF-κB (allP<0.05). After moxibustion treatment, rats in the moxibustion group showed repaired ankle tissues, smooth joint surface without defects, decreased MOD of TNF-α and NF-κB than those in the model group (allP<0.05). Rats in the saline group had no damage to ankle joints, while TNF-α and NF-κB were significantly different from those in the model group (P<0.05).Conclusion: Moxibustion could down-regulate the expressions of NF-κB and TNF-α protein in ankle joints of RA rats, and produce an anti-inflammatory effect to promote tissue repair.

Objective To explore the clinical application of irradiated homograft costal cartilage (IHCC) granule transplantation for the pyriform aperture sunken and deformity in the facial contour.Methods From August 2016 to November 2017,a total of 29 female patients were received IHCC transplantation to the face contour.The standardized photos were taken before and after the operation and then survey of patient satisfaction was conducted.Results In a total of 29 patients,the postoperative 21 patients were satisfied with the IHCC transplantation.After the operation,5 cases were slightly highlighted and obvious bundles could be touched in the deep.At the early stage of operation,the cartilage particles were smoothed by means of manipulation.3 cases were not satisfied with full effect postoperatively and satisfied after secondary transplantation.Conclusions The IHCC granule transplantation for pyriform aperture sunken and deformity can increase the overall sense of facial coordination and anti-aging,and is a safe and effective treatment.

OBJECTIVE: To analyze the impact of β-tubulin-III (TUBB3), thymidylate synthase (TS) and excision repair cross complementation group 1 (ERCC1) mRNA expression on chemoresponse and clinical outcome of patients with advanced gastric cancer treated with TXT/CDDP/FU (DCF) regimen chemotherapy. METHODS: The study population consisted of 48 patients with advanced gastric cancer. All patients were treated with DCF regimen palliative chemotherapy. The mRNA expressions of TUBB3, TS and ERCC1 of primary tumors were examined by multiplex branched-DNA liquid chip technology. RESULTS: The patients with low TUBB3 mRNA expression had higher response rate to chemotherapy than patients with high TUBB3 expression (P=0.011). There were no significant differences between response rate and TS or ERCC1 expression pattern. Median overall survival (OS) and median time to progression (TTP) were significantly longer in patients with low TUBB3 mRNA expression (P=0.002, P<0.001). TS or ERCC1 expression was not correlated with TTP and OS. In the combined analysis including TUBB3, TS and ERCC1, the patients with 0 or 1 high expression gene had better response rate, TTP and OS than the remaining patients (all P<0.001). Multivariate analysis revealed that ECOG (Eastern Cooperative Oncology Group)≥2 (HR=2.42, P=0.009) and TUBB3 (HR=2.34, P=0.036) mRNA expression significantly impacted on OS. CONCLUSION High TUBB3 mRNA expression is correlated with resistance to DCF regimen chemotherapy. TUBB3 might be a predictive and prognostic factor in patients with advanced gastric cancer treated with TXT-based chemotherapy. The combined evaluation of TUBB3, TS and ERCC1 expression can promote the individual treatment in advanced gastric cancer.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; metabolism ; DNA-Binding Proteins ; genetics ; metabolism ; Drug Resistance, Neoplasm ; Endonucleases ; genetics ; metabolism ; Humans ; RNA, Messenger ; genetics ; metabolism ; Stomach Neoplasms ; drug therapy ; genetics ; Thymidylate Synthase ; genetics ; metabolism ; Treatment Outcome ; Tubulin ; genetics ; metabolism

Objective:To explore the rejuvenation effect of SMAS (Superficial musculoaponeurotic system) multi-vector suspension in the face and neck.Methods:From December 2019 to March 2023, the Plastic Surgery Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences implemented 34 cases of cheek rhytidectomy and 10 cases of cheek andneck rhytidectomy. Following general anaesthesia, liposuction is performed on the cheek and mandibular margins, and incisions are made anterior and posterior to the ear. At the end of the subcutaneous dissection, the SMAS in the region of the parotid gland is separated, and the SMAS is then secured by purse string multi-vector suture suspension. Intheend, excess skin is removed and the incision is reduced in tension.Results:All patients underwent successful surgeries and were satisfied with the postoperative follow-up results. The sagging soft tissues were effectively repositioned, resulting in natural facial and neck lift. There were no serious complications such as facial nerve injury, subcutaneous hematoma, incision infection, or skin flap necrosis.Conclusions:The utilization of MAS multi-vector suspension can significantly improve the relaxation of cheek and neck tissue, with fewer complications and satisfactory rejuvenation effect.