Objective To investigate the safety and efficacy of CO2 fractional laser combined with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) for the treatment of refractory flat wart.Methods The 80 patients with facial flat wart were randomly divided into observation group (40 cases) and control group (40 cases).The observation group was treated with CO2 fractional laser combined with 5-ALA-PDT,and the control group was treated with 5-ALA-PDT only.Those with residual lesions after the first treatment were treated with the second or third times.The interval duration between treatments was 2 weeks.The efficacy and the adverse reaction were evaluated after the 2-week,4-week and 6-month after the last treatment.Results Compared with prior treatment,the facial lesions achieved complete response and improvement.The total effective rate of the observation group were 90.0％ (36/40) and 72.5％ (29/40) for the control group,the difference was statistically significant (P＜0.05).There were 2 cases of pigmentation occurred in observation group and 3 cases in control group.The complications including infection and hypertrophic scar were seldom occurred in the two groups.Conclusions The safety and efficacy of CO2 fractional laser combined with ALA-PDT are better than that with ALA-PDT only in the treatment of refractory flat wart.

Objective To explore the risk factors of surgical treatment for children’ s tethered cord syndrome. Methods Retrospective-ly analyzed the clinical data of 43 tethered cord syndrome children who had undergone surgical treatment from January 2007 to December 2009,and to evaluate the efficacy of the surgical treatment. Meanwhile,The Cox proportional hazards regression model was adopted to evaluate the surgical efficacy. Results 28 children received effctive curative effect after the surgical treatment in 43children with tethered cord syn-drome,the total effective rate was 65. 12%. Cox medol showed that tight filum terminale(P<0. 05), operation methods (P<0. 05)and the duration of the disease(P<0. 05)were independent risk factors of surgical treatment for children’s tethered cord syndrome. Conclusion The operativeefficacy of children’ s tethered cord syndrome were influence by the tight filum terminale,operation methods and the duration of the disease.

Objective To observe the efficacy and safety of topical 2％ propranolol cream for strawberry hemangiomas in proliferative phase.Methods Sixty infants with strawberry hemangiomas in proliferative phase were included in this study.There were 18 males and 42 females aged 30 days to 12 months.The lesions were located in head and neck (n=30),trunk (n=19) and extremities (n =11).All the infants received the 2％ propranolol cream treatment three times per day.The infants were required a regular return visit every month.The changes of tumor size,texture and color were monitored and recorded.The adverse effects after medication were observed and managed accordingly.The short-term results were evaluated using a 4-grade system.Results All the infants were followed up for 12 months.Among 60 infants,the Ⅰ,Ⅱ,Ⅲ and Ⅳ grade curative effects were 2,17,33 and 8 cases,respectively.All the infants had no drug adverse reaction.Conclusions The effect of topical 2％ propranolol cream for strawberry hemangiomas in proliferative phase is reliable,with little side effects.It will be popularized in clinical application.

Objective To study antihypertensive effect of comprehensive intervention in elderly patients with hypertension.Methods A total of 80 patients in our hospital were randomly divided into intervention group (n =41) and control group (n =39).The control group received antihypertensive drug treatment and basic nursing including blood pressure monitoring,prevention of complications and so on.Base on the control group,the intervention group was given exercise intervention,dietary intervention and health education,etc.according the patient's situation.Antihypertensive effect,blood pressure changes,the incidence of stroke events and adverse reactions before and after intervention were observed.Results Both the systolic blood pressure and diastolic blood pressure were decreased after intervention in the two groups.The difference in systolic blood pressure and diastolic blood pressure of two groups was statistically significant (P ＜ 0.05).The response rate of intervention group was 90.24％,which was significantly higher than 66.67％ of the control group (P ＜ 0.05).The incidence of stroke in the intervention group was 4.88％,which was lower than 20.51％ in the control group (P ＜ 0.05).Conclusion The comprehensive intervention could effectively improve the clinical effect,control the blood pressure level,improve the quality of life and reduce the incidence of adverse events in elderly patients with hypertension.So it is worth to be popularized.

Objective To study antihypertensive effect of comprehensive intervention in elderly patients with hypertension.Methods A total of 80 patients in our hospital were randomly divided into intervention group (n =41) and control group (n =39).The control group received antihypertensive drug treatment and basic nursing including blood pressure monitoring,prevention of complications and so on.Base on the control group,the intervention group was given exercise intervention,dietary intervention and health education,etc.according the patient's situation.Antihypertensive effect,blood pressure changes,the incidence of stroke events and adverse reactions before and after intervention were observed.Results Both the systolic blood pressure and diastolic blood pressure were decreased after intervention in the two groups.The difference in systolic blood pressure and diastolic blood pressure of two groups was statistically significant (P ＜ 0.05).The response rate of intervention group was 90.24％,which was significantly higher than 66.67％ of the control group (P ＜ 0.05).The incidence of stroke in the intervention group was 4.88％,which was lower than 20.51％ in the control group (P ＜ 0.05).Conclusion The comprehensive intervention could effectively improve the clinical effect,control the blood pressure level,improve the quality of life and reduce the incidence of adverse events in elderly patients with hypertension.So it is worth to be popularized.

Objective:To explore the training methods to improve the cosmetic suture technique of junior surgeons.Methods:The training course of cosmetic suture techniques was carried out for junior residents such as plastic surgery professional graduate students and standardized training residents, through the study of the basic knowledge of cosmetic suture and the practical training of minimally invasive principles, to help them master cosmetic suture techniques systematically for the need of future clinical practice. Compared with the level of operation skills before and after cosmetic suture training in different groups (graduate students of plastic surgery and other majors, standardized training residents of plastic surgery and other majors), the residents' performance had been significantly improved. The incisions healing after half a year follow-up in cases they sutured were observed.Results:After cosmetic suture training, the suture skills of the students were significantly improved, and there was a significant correlation with the time of clinical practice. The incidence of incisions inflammation and postoperative scar formation in the cases sutured by the students with practice for 6 months was significantly lower than those for 1 month (6.42% vs 21.67%, 1.13% vs 5.56% respectively).Conclusions:The training of cosmetic suture techniques is very important to improve the professional ability of junior residents in plastic and cosmetic surgery, and it needs a long time practice to master the suture skills.

This study introduces that we have established a clinical case database of scar prevention and treatment with medical histories, diagnosis and treatment ideas, and case expansion according to the scar diseases that professional postgraduates of plastic surgery need to master, and applied it to the practical teaching for plastic surgery postgraduates. Through the comprehensive evaluation from three aspects of mastering basic knowledge, applying knowledge and developing discipline, it's suggested that the professional postgraduates can better grasp the knowledge of scar prevention and treatments after learning from the clinical scar database, and the application of the teaching case database has further improved students' teaching and learning participations and innovative thinking abilities.

Objective:To investigate the clinical effect of botulinum toxin type A injection in the prevention and treatment of frontal traumatic scars immediately after operation.Methods:From January 2016 to January 2018, among the 152 patients with frontal trauma admitted to the Department of Plastic Surgery, Daping Hospital, Army Military Medical University, patients with wounds almost perpendicular to the Langer line were selected. Immediately after debridement and suture, botulinum toxin type A was injected with a concentration of 2 U botulinum toxin per 0.10 ml of solution, 0.05 to 0.10 ml (1 to 2 U) per 1 cm was injected into the frontal muscle according to frontal muscle strength.With reference to the observer scar assessment scale and Vancouver scar scale, the color, width, texture, thickness, pain, and itching of the postoperative scar of the frontal wound were evaluated at follow-up.Results:A total of 44 patients were included, 22 males and 22 females, aged (31.5 ± 8.4) years old, with a wound length of 1-12 cm(average, 3.5 cm) and a Botox injection volume around wounds of 0.10-0.90 ml (2-18 U) . The patients were followed up for 6 to 24 months. One patient had mild to moderate ptosis, which completely disappeared within one month. Within 6 weeks after operation, the scars in 44 patients were pink and hard. 3-6 months later, the scars gradually became soft, narrow and flat with similiar skin color, no pain and itching left in 42 patients. The satisfaction rate was 95.5% (42/44). Two patients were dissatisfied because of scar pigmentation and width.Conclusions:Immediate injection of botulinum toxin type A after debridement and suture of the frontal trauma wound can effectively prevent and improve scar appearance with a high rate of satisfaction.

Objective:To investigate the clinical effect of botulinum toxin type A injection in the prevention and treatment of frontal traumatic scars immediately after operation.Methods:From January 2016 to January 2018, among the 152 patients with frontal trauma admitted to the Department of Plastic Surgery, Daping Hospital, Army Military Medical University, patients with wounds almost perpendicular to the Langer line were selected. Immediately after debridement and suture, botulinum toxin type A was injected with a concentration of 2 U botulinum toxin per 0.10 ml of solution, 0.05 to 0.10 ml (1 to 2 U) per 1 cm was injected into the frontal muscle according to frontal muscle strength.With reference to the observer scar assessment scale and Vancouver scar scale, the color, width, texture, thickness, pain, and itching of the postoperative scar of the frontal wound were evaluated at follow-up.Results:A total of 44 patients were included, 22 males and 22 females, aged (31.5 ± 8.4) years old, with a wound length of 1-12 cm(average, 3.5 cm) and a Botox injection volume around wounds of 0.10-0.90 ml (2-18 U) . The patients were followed up for 6 to 24 months. One patient had mild to moderate ptosis, which completely disappeared within one month. Within 6 weeks after operation, the scars in 44 patients were pink and hard. 3-6 months later, the scars gradually became soft, narrow and flat with similiar skin color, no pain and itching left in 42 patients. The satisfaction rate was 95.5% (42/44). Two patients were dissatisfied because of scar pigmentation and width.Conclusions:Immediate injection of botulinum toxin type A after debridement and suture of the frontal trauma wound can effectively prevent and improve scar appearance with a high rate of satisfaction.

Objective To investigate the clinical application and effect of pick-stab skill in eyebrow embroidery.Methods From July 2015 to January 2016,36 cases were selected to receive eyebrow embroidery with pick-stab skill in our department,including 1 male and 35 females.The cosmetic outcomes,complications and satisfaction rate were observed in these cases.Results In these 36 cases,14 cases were colored in one time,19 cases were colored twice,and 3 cases were more than 3 times.All patients were followed up for 6 months.The color of the eyebrow was natural,and the blue color was not existed.Conclusions The pick-stab skill in eyebrow embroidery is worthy in clinic with better cosmetic effect,higher success rate and safety.