Objective To investigate a myocutaneous flap method for eyelid baggy plasty conforming to the medical aesthetic requirements. Methods Before operation the amount of the lower eyelid skin excised should be determined. Asking the patient to look upward at supine position, the operator lifted properly the lower eyelid skin using fine forceps without teeth at the results of smooth superficialness at this region and slight ectropion. The incision lines were marked along the print pinched by forceps and the trace 2 to 3 mm below the ciliary margin. Intra-operatively severing soft issues to the inferior orbital fringe just on the sub-orbicularis level, the skin-muscle flap was made. Then the excessive muscle was removed in the light of the incision lines. The orbital fat teased out resected or filled up the concavity along the lower orbital edge. Results The tense and smooth appearance of lower eyelid was archived in 900 cases received in our hospital except 2 temporary ectropion cases and 2 temporary double vision cases. We repaired the 15 ectropions using adjacent skin flap, tarsal reduction, skin soft tissue expansion, or superficial temporary fascia sling suspension, eliminated 28 haematomaes and made the excision of scar and wound suture for a hypertrophic scar case in the 150 complications from other hospitals. The crow wrinkles were improved apparently. Conclusion The amount of skin excision determined pre-operatively, which not only successfully refrains interfering elements from blooding and swelling but also avoids giving rise to ectropion, is accurate than that performed during operation. Natural appearance after operation becomes better and lasting because of orbicularis raised which strengthens the anterior wall of orbital septum.

Objective To study the clinical effects of abdominoplasty using ultrasound assisted liposuction and dermolipectomy. Methods With the patient standing, the relative areas of maximal adipose fullness in the abdomen and waist were marked topographically. With the patient in the supine position, the "pinch test" was performed by surgical operator advancing the tissue in the infraumbilical area toward the pubic region in order to estimate how much skin needed to be resected before operation. Inter-operatively tumescent technique with the transduction of ultrasound into fatty areas was applied in the first place, following classic abdominoplasty including excessive skin and fat resection, musculoaponeurotic plication and umbilical transposition. Results Sixteen patients followed up from six months to two years were satisfied with aesthetic effects because of smoothness of the operated areas, good sensory recovery and obvious shrinkage of skin with fewer complications. There were no infection, skin necrosis, and wound dehiscence. Conclusion The excellent effects of abdominal profile sculpture can be reproduced with the new method using UAL in vivo and dermolipectomy.

Objective To explore the therapeutic effect of infrabrow excision blepharoplasty combined with botulinum toxin A (BTXA) injection on periorbital rejuvenation.Methods A total of 146 females were involved in this study.The incision was designed,hiding at the lower edge of the brow.Eye orbicularis was folded,eyelid lift and some of the skin removed during operation,and simultaneously the shape of eyebrow was better adjusted.After suture cutting,BTXA was injected at the glabella and the lateral of canthus.Results All the 146 cases were followed up for 3 to 12 months.The blepharotosis symptom was improved effectively,the periocular wrinkles were alleviated obviously and no complications occurred in these patients.Conclusions Combining Infrabrow excision blepharoplasty with BTXA injection in periocular treatment is safe,convenient and effective.It is a good clinical approach to make periorbital rejuvenation.

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 explore the effective measurements of integrated therapy for the ear keloids in the Oriental. Methods Surgical excision was performed for keloid, and the cut then sutured directly or with flap transfer. At early stage of surgery (within 24 hours), X-ray or electron-ray radiotherapy was used for 3-5 times once daily; and steroids injected after cutting lines at 7th day every two weeks and gradually ended. Results A total of 48 patients were treated, and followed, in which 12 patients were lost of follow-up. The total effective rate was 94. 4 % based on the data of follow-up in 36 patients for 1-3 years. Therefore, the curation rate was 83. 3 % (30 cases) and effective rate 11. 1 % (4 cases). Conclusions Surgical cutting combined with early radiotherapy and steroids injection is the effective integrated therapy for the ear keloids in the Oriental.

Objective To explore the methods and effects of improving facial appearance on volume defect and aging,and recovery of aesthetic looks by autologous fat granules graft.Methods We designed the filling areas according to gender,age,individual face characteristics and desire of the case before operation.By liposuction technology with low pressure from the trunk,fats were taken with cleaning and purifying.Then pure fats were injected to the marked areas of the face by multi-level and multi-tunnel injection.It was able to supply the facial volume for lost soft tissue,to improve the aging appearance and to achieve smooth facial contour.Results All cases were followed-up for 3 months to 2 years,facial appearances were satisfied or improved,without fat liquefaction,infection,scleroma and other complications.Only a few cases needed complementary transplantation.The overall results were satisfactory.Conclusions Autologous fat granules graft is a safe and effective facial soft tissue filling technology.It can effectively improve facial aging appearance,restore natural,young and beautiful looks,and be worth for clinical application.

Objective To investigate the correlation between human epidermal stem cell (hESCs) and hypertrophic scar or keloid. Methods Improved collagen Ⅳ-coated adhesion methods was used to isolate and culture the epidermal stem cells after neutral protease selectively digested the dermo-epidermal junctions. After the cells were cultured and expanded in vitro, and passage 3 hESCs were induced by different concentrations of TGF-β1 (0.1, 5.0, and 10.0 ng/ml). Morphological fea-tures and identification of these cells were meseasured by HE, Masson, immunohistochemical staining on the days 3 and 7, respectively. Results After induced by TGF-β1 for 3 and 7 days, the morpholo-gy of the epidermal stem cell (hESCs) was changed into fusiform shape, similar to fibroblasts. 70 % ofthe cell which was induced by TGF-β1 were blue stained in the cytoplasm by Masson stain, which is the distinctive method for collagen, suggesting collagen appeared or increased in the cells. The collagen concentrations in supernatants of hESCs were 0.4150±0.0014, 0.3380±0. 0020, and 0.3870±0.0020, much higher than that in control group (0.0780±0.0025) and normal skin fibro-blast group (0.15004±0.0051) (P<0.05). Immunohistochemical staining revealed that positive rates of these cells for anti-vimentin staining were more than (95.00±1.20)% in experiments and (5.70±0.20)% in control group. Conclusion The differentiantion of hESCs induced by TGF-β1 into fibro-blasts indicates that hESCs may play a role in the pathogenesis of hypetrophic scar and keloid.

Objective To investigate and design a coincidence detection system for an all-digital small animal PET scanner and evaluate its preliminary performance properties.Methods This coincidence module adopted a coincidence identification mode based on singles data in list-mode.Using digital signal processing technology,energy calibration,crystal identification,timing alignment and coincidence events extraction were performed on singles data in list-mode.The obtained data could be used for image reconstruction.Results The 13 × 13 crystal array was well recognized by the position histogram of one lutetium yttrium orthosilicate (LYSO) crystal block.In the coincidence timing histogram of the micro-Derenzo phantom,1.36 ns full width at half maximum was obtained.The rods with a diameter of 1.2 mm were clearly displayed in the reconstructed image of the micro-Derenzo phantom.Conclusion The coincidence module can provide satisfactory performance to meet the design needs of an all-digital small animal PET scanner.

Objective:To analyze the factors influencing dysphagia after an injury to the cervical spinal cord (CPCI) to provide a basis for clinical screening and intervention.Methods:A total of 110 CPCI patients with dysphagia were divided into a severe dysphagia group ( n=19), a mild dysphagia group ( n=35), and a control group ( n=56) according to their functional oral intake scale scores. Data on gender, age, level of injury, degree of damage, duration of injury, causes of injury, surgical mode, tracheotomy status, occurrence of pneumonia and pharynx swelling were collected. Univariate and multivariate logistic regressions were evaluated to identify factors affecting swallowing. Results:The regressions highlighted age, the severity of the spinal cord injury, tracheotomy status, and the occurrence of pneumonia and pharyngeal swelling during hospitalization as the best predictors of swallowing difficulties. Multifactoral logistic regression analysis revealed that undergoing tracheotomy and catching pneumonia during hospitalization were major risk factors for severe dysphagia.Conclusions:Tracheotomy and pneumonia during hospitalization are useful predictors of severe dysphagia after a cervical spinal cord injury.

To examine the molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) and investigate the horizontal transmission of blaKPC and blaNDM genes for the prevention and treatment of CRKP. A total of 49 clinically isolated CRKP strains were retrospectively analyzed from January to December 2022 at The First Hospital of Hunan University of Chinese Medicine. Phenotypic screening was performed using modified carbapenem inactivation assay (mCIM) and EDTA-carbapenem inactivation assay (eCIM). Polymerase chain reaction (PCR) was utilized to identify carbapenem resistance genes, β-lactamase resistance genes, and virulence genes, while multi-locus sequence analysis (MLST) was employed to assess the homology of CRKP strains. Conjugation experiments were conducted to infer the horizontal transmission mechanism of blaKPC and blaNDM genes. The results showed that the study included 49 CRKP strains, with 44 carrying blaKPC and 8 carrying blaNDM, Three strains were identified as blaKPC+ blaNDM-CRKP. In this study, 28 out of 49 CRKP strains (57.2%) were found to carry virulence genes. Additionally, one CRKP strain tested positive in the string test and was found to carry both Aerobactin and rmpA virulence genes. MLST results revealed a total of 5 ST types, with ST11 being predominant (41/49, 83.7%). Successful conjugation was observed in all 3 blaKPC-CRKP strains, while only 1 out of 3 blaNDM-CRKP strains showed successful conjugation. The transconjugant exhibited significantly reduced susceptibility to imipenem and cephalosporin antibiotics. In conclusion, the resistance mechanism of CRKP in this study is primarily attributed to the production of KPC enzymes, along with the presence of multiple β-lactamase resistance genes. Additionally, there is a local prevalence of hv-CRKP and blaKPC+ blaNDM-CRKP. blaKPC and blaNDM can be horizontally transmitted through plasmids, with varying efficiency among different strains.