Objective To investigate the approach and clinical efficacy of second repair surgery according to the nose and mouth contour design of unilateral cleft lip.Methods Based on the characteristics of anatomy,mechanics and deformity of the cleft lip,we designed a surgical incision of nasolabial contour lines with reference to the horizontal and central vertical lines and the contour.After careful investigation of classic procedures and clinical practice,unilateral cleft lip was repaired by overall stage Ⅱ surgical procedures.Results Application of this surgical method with satisfactory clinical efficacy had been achieved.Conclusions The second stage repair personalized surgical methods of unilateral cleft lip designed according to the nose and mouth contour can achieve maximal correction of malformation and beautiful appearance.

Objective To explore the effect of botulinum toxin type A(BTXA)in the treatment of early hypertrophic scars(HTS).Methods BTXA was injected into and around the eady HTS,and then the modal and histological changes of the scars as well as the clinical reaction were observed in the patient.BTXA was also injected into muscle around the incision and effect on the cicatrization observed.Results Injection of BTXA could obviously alleviate ache and pruritus of eady HTS and could impel the atrophy and inteneration of eady HTS.Changes were found in paraffin-embedded tissue section by the hemetoxylin and eosin(HE)staining.Injection of BTXA into muscle around the cut could can reduce occurrence of HTS.Conclusion BTXA can help prevent the early HTS to a certain extent.The mechanism underlying this effect may be related to the reducing the tension around scars and proliferative activity,interfering with the signal transduction of small nerves,affecting the proliferation and apoptosis of fibroblasts and subsequently decreasing the collagen synthesis.

Objective To compare the clinical efficacy of minimally invasive removal of intracranial hematomas and medical con-servative treatment for hypertensive cerebral hemorrhage .Methods A total of 75 patients with hypertensive cerebral hemorrhage were collected and randomly divided into two groups according to the treatments :38 patients treated with conservative medicine and 37 patients treated with minimally invasive removal of intracranial hematomas based on standard drug therapy .Neurological impair-ment and recovery of self-care ability of patients in both groups before and after three weeks and six weeks of treatment were scored by National Institute of Health Stroke Scale (NIHSS) .Changes of diffusion tensor imaging before treatment and after two weeks of treatment were evaluated by fractional anisotropy value (FA) .Results There was no significant difference between neurological im-pairments of the patients in two groups before treatment .But the recovery degree of functional impairment and muscle nerve in min-imally traumatic treatment group was more significant than those in the conservative medical treatment group after treatments . There was significant difference between two groups (P< 0 .05) .Conclusion Minimally traumatic of hematomas is an effective method of treating hypertensive intracerebral hemorrhage .

Objective To compare the effect of different gastrointestinal motility drugs on capsule endoscopy. Methods Seventy-one patients with suspected small bowel disease were randomly divided into metoclopramide group (24 patients), mosapride group(25 patients) and control group (22 group). The patients in metoclopramide group swallowed capsule endoscopy immediately after intramuscularly injecting 10 mg metoclopramide, the patients in mosapride group swallowed capsule endoscopy 15 min after taking 5 mg mosapride, and the patients in control group did not take any of the gastrointestinal motility drugs. Three groups had the same bowel preparation before checking. The finishing rate of small bowel examinations, stomach and small intestinal transit time, intestinal cleanliness and the detection rates of lesions in three groups were compared. Results The total small bowel examination finishing rate was 94.4%(67/71). The small bowel examination finishing rate in metoclopramide group, mosapride group, and control group was 95.8%(23/24), 96.0%(24/25), and 90.9% (20/22), and there was no significant difference(P>0.05). The stomach transit time in metoclopramide group, mosapride group and control group was(27.5 ± 20.7), (28.1 ± 20.9) and (52.3 ± 33.5) min. The stomach transit time in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly lower than that in control group (P<0.05). The small intestinal transit time in three groups had no significant difference (P>0.05). The image class scores in metoclopramide group, mosapride group and control group was (2.5 ± 0.4), (2.7 ± 0.4) and (1.7 ± 0.3) scores.The scores in metoclopramide group and mosapride group had no significant difference (P>0.05), but they were significantly higher than that in control group (P<0.05). The detection rate of lesions in metoclopramide group, mosapride group and control group was 45.8%(11/24), 56.0%(14/25) and 18.2%(4/22). The detection rate of lesions in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly higher than that in control group (P<0.05). Conclusions The use of gastrointestinal motility drugs before capsule endoscopy can improve the quality of inspection, and metoclopramide and mosapride shows no significant difference.

Objective To establish the anti-infective tissue engineered bones (TEBs) and evaluate the anti-infective and osteogenic effects of the infection-prevention TEBs on femoral large bone defects in goats.Methods Based on the controlledrelease antibiotic system fibrin gel-coated vancomycin alginate beads (FG-Vanco-AB),the infection-prevention TEBs were established and evaluated.They were transplanted into the critical-size defects in the right femurs of goats.TEBs without the controlled-release antibiotic system were used as controls and transplanted into the left femoral defects.The breakpoint sensitivity of vancomycin (5 mg/mL) for S.aureus was used as a standard concentration.Postoperatively,the vancomycin concentrations in the lesion site,in the adjacent site and in the circulation,as well as the anti-infective effects of the infection-prevention TEBs were evaluated by High-performance liquid chromatography (HPLC).Bone hcaling was assessed by histology,CT and ECT.The results were used to evaluate the osteogenic effect of the infection-prevention TEBs.Results Results from ESM,CLSM and in vivo tracing showed that the in vitro and in vivo survival conditions of seeded cells were analogous to those of TEBs.The effective concentration (over the bactericidal concentration) of vancomycin in bilateral defects and in blood lasted for 28 days,2 days and 7 days,respectively.The concentration of vancomycin in the femur decreased gradually from the grafted site to both ends.At 28 and 56 days postoperatively,the ECT results showed no significant difference between the right and left femurs.CT and histology demonstrated that at 14,28 and 112 days after surgery,bone defects in the bilateral femurs were repaired synchronously,and were completely covered by new bone tissue after 112 days.Conclusion The anti-infective TEBs were successfully established.FG-Vanco -AB in the transplanted sites provided the local bone tissues with anti-infective capability whilst not interfered the process of bone reconstnction and wound healing.

Objective To discuss the measurement of bone tumor volume on the basis of three dimensional images segmentation technology. Methods Twenty patients with lacunar bone tumor from Tianjin hospital and Tongji hospital were included in the study from January 2010 to August 2010. There were 11 males and 9 females. Each patient was exposed to spiral CT preoperatively. Then these primitive CT dates were imported into digital orthopedics clinical research platform (SuperImage orthopedics edition 1.1, Cybermed Ltd). The volume and maximum diameter of bone tumor were measured before operation by three-dimensional reconstruction technology. The actual tumor volume was measured during the operation. The tumor volume was also calculated from plain X-rays and CT scans as ellipsoidal or cylindrical depending on the tumor configuration and presence or absence of a soft tissue component. Results The tumor volume was measured to be (14.92±7.34) mm3, (16.65±6.95) mm3 and (34.29±15.70) mm3 using three-dimensional reconstruction technology, intraoperative elevation, and traditional radiograph measurement separately. It was found that there was no difference regarding the outcomes of measurement between three-dimensional reconstruction technology and gross intraoperative measurement. But obvious difference was detected between gross intraoperative measurement and traditional radiograph measurement. Coefficient of correlation between diameter and volume of bone tumor was 0.325 (P=0.162). Conclusion Digital measurement is a precise, efficient,convenient and repeatable method for bone tumor measurement.

Objective To explore surgical procedure of combined anterior-lateral and lateral approach for the treatment of bone tumors of femoral neck. Methods Forty patients with bone tumors of femoral neck treated in Tianjin Hospital were included from July 2005 to August 2009. Of the patients, 12 who were treated with curettage and bone graft through combined anterior-lateral and lateral incision were analyzed in this study. There were 7 males and 5 females with an average age of 34 years ranging from 17 to 68 years. 4 patients were diagnosed as chondroblastoma, 2 giant cell tumor, 3 fibrous dysplasia, and 3 single bone cysts. 7 patients suffered from pathologic fractures, and 5 had presented thin cortical bone because of tumor involvement. There were 1 tumor located in H1 zone, 4 in H2 zone and 7 in H1,2 zone according to ISOLS femoral neck classification. All patients were treated by curettage and bone graft via anterior-lateral approach, 10 cases underwent internal fixation with anatomical plate, and 2 cases with canulated screws with lateral approach. Results The follow-up time ranged from 10 to 68 months with an average of 35 months.Pain disappeared in all patients, and there were not recurrence of tumor, pathologic fractures and avascular necrosis. One case had complained of lateral femoral skin numbness which may be caused by injures of femoral lateral nerves. One case had difficulties in the valgus of hip joint. The mean MSTS score was 29.2 points ranging from 27 to 30 points. Conclusion Anterior approaches of "SP" incision is helpful to thorough curettage which decrease the risk of recurrence due to good visualization and intemal fixation is easy to perform via lateral approaches. The result suggested that combined anterior-lateral "SP" and lateral incision is liable option in treatment of bone tumors of femoral neck.

Background and purpose: It has been reported that some low dose chemotherapy drugs have antiangiogenetic effects. The purpose of this study was to investigate the effect of inhibiting angiogenesis by low dose hydroxycamptothecin on H22 hepatoma transplantation tumor mouse models. Methods: H22 transplantation tumor mouse models were established, CTX was administrated in abdominal cavities as positive control group. 0.9%NaC1 solution was administrated as negative control group. Intra abdominal cyclophosphamide and hydroxycamptothecin (0.2 and 0.4 mg/kg) were injected for 10 days continuously. The growth of tumor were observed and measured. The tumor inhibitory rates were tested in animal tumor model with experimental treatment. The expression of VEGF and CD34 were measured by means of immunohistochemistry. Results: Hydroxycamptothecin had effect on tumor growth. Tumor weight inhibitory rates of hydroxycamptothecin with 0.2 and 0.4 mg/kg were 23.53% and 43.25% respectively. The difference was significant when compared with the negative control group (P<0.05). The expression of VEGF and MVD can be suppressed significantly than negative control group in vivo (P<0.05). Conclusion:Hydroxycamptothecin have inhibitory effect on tumor growth and the expression of VEGF and MVD with H22 hepatoma transplantation tumor mouse models in low dose. The mechanism possibly involved inhibiting the angiogenesis.

Objective To investigate the methods of rectifying the excessive width of fold line and conglutination of the upper eyelid following blepharoplasty. Methods The width of double eyelid was redesigned, ranging from 6 mm to 8 mm. Then the scar of upper eyelid was excised about 1 mm to 2 mm, and the orbital septum fat flap, orbicularis oculi flap, infraorbicularis oculi fat flap and injection of lipochondria were utilized to fill the depression of upper eyelid. Results In our series, there were 20 eyelids of 16 cases receiving rectification. Orbital septum fat flap was used to correct 2 eye-lids, orbicularis oculi flap 4 eyelids, infraorbicularis oculi fat flap 10 eyelids and injection of lipochon-dria 4 cases. Among 12 eases of following-up, 10 of them were satisfied with the postoperative effects. The results were acceptable in other 2 cases. Conclusion It is a good approach to correct the excessive width of fold line and conglutination of the upper eyelid with local flaps, including the orbital septum fat flap, orbicularis oculi flap, infraorbicularis oculi fat flap and injection of lipochondria.

Objective To investigate the changes of the masseter muscle following osteotomy of the prominent mandibular angle and to provide guidance for the resection of mandibular angle. Methods Ten goats were equally divided into two groups. In group A we performed unilateral curved osteotomy of the mandibular angle, and in group B we performed unilateral dissection of the masseter muscle. The cross section area (CSA) and the sarcomere length of masseter muscle were measured beore and after operation. Results (1) Cross section area (CSA) of masseter muscle fiber in curved ostectomy group decreased at 1,2, 3 and 6 months after operation in different extent. Comparing with the control group, the difference was statistically significant (P<0.01). CSA of masseter muscle fiber in dissection group decreased 1 month postoperatively, which had significantly statistic difference with control group (P<0.01). But, they had no significant difference with control group at 2, 3, and 6 months after operation (P>0.01). (2) Sarcomere length of masseter muscle in curved ostectomy group decreased in 1 week, 1 and 2 months after operation, which had significantly statistic difference with control group (P<0.01). At 3 months after operation, sarcomere length recovered to normal. In dissection group, sarcomere length decreased in 1 week and 1 month after operation, which had significantly statistic difference with control group (P<0.01). At 2 month after operation, it recovered to normal. Conclusion Certain extent of atrophy does happen to masseter muscle after mandibular angle ostectomy. Meanwhile, these changes do not significantly impair the function of masseter muscle. According to this, we suggest a simple mandibular angle ostectomy without partial resection of masseter muscle in case of mild to morderate mandibular angle hypertrophy. Doing so, we can not only achieve the cosmetic effect but also reduce the implications.