Objective To study the function of hypoxia mimics of different exposure time of deferasirox in improving the growth of micrangium in a narrow pedicle flap.Methods Fourty male SD rats were divided into 2 groups:experimental group was fed with deferasirox 100 mg/kg per day from 1d,3d,5d and 7d,respectively,before the surgery of transferring the narrow pedicle flap,while control group just fed with saline.After 7 days,the immunohistochemistry,Western blot and quantitative reverse transcription-PCR (qPCR) were performed to examine the expression of CD34.qPCR was used to examine the expression of HIF-1α,VEGF in order to investigate the regulatory effect of deferasirox in improving the growth of micrangium and the distinction among the different exposed time of deferasirox in the narrow pedicle flap.Results The deferasirox group exhibited a marked improvement in flap healing time,and with the increasing administration time of deferasirox,the expression of MVD,HIF-1α and VEGF was improved in each treated group (P＜0.05).Conclusions Deferasirox can induce HIF-1α secretion and increase CD34 expression,and so deferasirox can protect endothelial cells from hypoxic and ischaemic injury.

Objective To investigate the effect of deferasirox on DLL4 expression and angiogenesis in a narrow pedicle and random flap in rats.Methods Twenty SD rats were randomly divided into the deferagirox group and control group.Rats were subjected to deferagirox of 100 mg · kg-1 · d-1 inthe experimental groups,respectively and the same dose saline in the control group for 1 week. In each group,flap were created in the bilateral back of each rats.Ratio of length to width of tissue in the pedicle portion and the flap portion was 1 cm × 1 cm and 3 cm × 3 cm,respectively.The tissue samples were taken from the pedicle and the middle portions of the flap.The DLL4 and CD105 expression was also detected with immunohistochemistry (SABC).Results Compared with control group,whatever in the pedicle portion or the middle portion,there was a significant increase of microvessels marked by CD105 and a significant decrease of flap microvessels stained by DLL4 in the deferagirox group.In both groups,compared with the pedicle portion,there was a significant increase of microvessels marked by CD105 and DLL4 in the the middle portion.Conclusions Deferasirox can in crease the CD105 expression and angiogenesis of the slender narrow pedicle random flap.This process might be related to the inhibition of DLL4 protein expression,which is significant in the notch signaling pathway.

Objective To evaluate the effectiveness and safety of long-pulsed laser for hair removal in different colour of skin. Methods Hair removal was performed in 607 hirsute patients with two long-pulsed lasers. Results Although the effectiveness rates of hair removal in upper lip and full bread were not different, their complications were different by using two long-pulsed lasers. Also there were signifi-cant decreases of effectiveness and complication in the lighter skin and thc darker skin (P<0.01). Con-clusion The 755 nm wavelength has more effectiveness and lower complication in the lighter skin. How-ever, the 1 064 nm wavelength has more effectiveness and lower complication in the darker skin.

Objective To explore the anatomical basis for clinical application of the compound flap pedicled with arterial arch of palpebral margin by observing eyelid blood supply and anatomical structure and to prove that it is an ideal method of repairing the eyelid defect for clinical application. Methods 15 adult cadavers (30 eyelids) were dissected. The origin, course, branches, diameters and vessel networks of palpebral margin arterial arch were observed particularly. 30 cases of eyelid marginal defect were reviewed and the therapeutic effect of this method evaluated. Results Eyelid was constituted by 5 layers: skin, subcutaneous tissue, muscle, tarsal plate and conjunctival layers. Most eyelid vessels were mutually anastomosed to form a constant vessel network. Palpebral margin arterial arch and peripheral arterial arch were formed by dorsal nasal artery branches and lacrimal artery branches, both of which nourished the eyelid tissue. All the compound flaps of 30 cases survived completely without any complications. All cases obtained satisfactory results functionally and esthetically. Conclusions The arterial arch of palpebral margin is constant and the blood supply of the compound flap is reliable. It can repair full eyelid defect with the same kind of tissue, and obtain satisfactory appearance. It is an ideal method of repairing the eyelid defect.

Objective To investigate the effect of recombinant human growth hormone on the PingPang Racket flap survival.Methods Every two PingPang Racket flaps were designed on the both sides of 40 adult SD rats's back.The pedicle size was 1.0 cm × 1.0 cm,while the flap size was 3.0 cm in diameter circular.Longitudinal axis of flap was perpendicular to the center line of the rats back,to which the distance from proximal pedicle was about 1 cm.The flaps on the left side served as Ⅰ group,and the other side served as Ⅱ group,which were subdivided into Ⅰa and Ⅰb,Ⅱa and Ⅱb,respectively.And there were 20 rats in each subgroup.On the flap surfaces in group Ⅰ,it was 6 uniform injection poinsts,subcutaneously injecting with rhGF (the dose was 0.1IU · Kg-1 · d-1) for 7 days from the beginning of operation,that were designed.It goes the same way to the group Ⅱ,while normal saline was instead of rhGF.In subgroup Ⅰa and Ⅱa,the flaps were generally observed every day.The percentage of the flap survival area was determinated 7 days after operation.In subgroup Ⅰb and Ⅱb,specimens were collected at the distal end of flap at intraoperative(before injecting rhGF)and 1 st,3rd,5th,7th day after operation.Immunohistochemistry and enzyme-linked immunosorbent were applied to examine the expression of TGF-β1 and CD34,and the microvessel density of the flaps was calculated.Results According to the 7 days' observation after the surgery,the flap survival area percentage of subgroup Ⅰa was (97.00 + 2.12) ％,which was significantly higher (P ＜ 0.05) than that of subgroup Ⅱ a,whose was (81.00 +3.43)％.On 1st,3rd,5th and 7th day postoperatively,the expression of TGF-β1,CD34 in both subgroup Ⅰb and Ⅱb were elevated and reached peak on the 5th day.Content of GF-β1 and CD34 in Ⅰb were 1571.40 ± 13.32 pg/ml and 60.40 ±0.32 pg/ml,respectively,and in Ⅱb were 691.43 ± 11.06 pg/ml and 20.43 ± 0.06 pg/ml.At the same point of time,the expression of TGF-β1,CD34 were significant higher in Ⅰb subgroup than that in Ⅱb (P ＜ 0.05).In subgroup Ⅰb and Ⅱb,the number of microvessels increased on postoperative 1 st,3rd,5th and 7th day,especially on 3rd,5th and tended to be stable at 7th day.At the same point of time,the number of microvessels in Ⅰb was always higher than that in Ⅱb (P ＜ 0.05).Conclusion Subcutaneous injection of rhGH on flaps can enhance the expression of TGF-β1,CD34,promote microvascular generation of the flap tissue directly or indirectly,and also improve the survival of PingPang Racket flaps.

Objective To detect the expression of SDF-1 and CD34,and MVD changes at slen der narrow pedicle flap of hypoxia and ischemia during the survival process,and to investigate the role of SDF-1 at flap neovascularization.Methods The slender narrow pedicle flaps,which pedicle's length-breadth ratio were 4 ∶ 2,and the flap size of each took an area of 2 cm × 2 cm (group A),3 cm ×3 cm (group B),4 cm × 4 cm (group C),5 cm × 5 cm (group D) and 6 cm × 6 cm (group E),were designed and elevated on each pigs' double dorsum.The flaps were served as a hypoxia/ischemia flap model.The survival area,histologic analysis,SDF-1 and CD34 enzyme-linked immunosorbent assay at the distal flap were evaluated at days 0,3,5,7,and 14 after operation,respectively.Results In the each group of flaps,the expression of SDF-1,CD34 and MVD increased with time,reached the plateau level after 5 days (maximal values of SDF-1:124.80 ± 4.05 ingroup A,137.85 ±3.03 in group B,166.53 ± 2.98 in group C,72.80 ± 2.63 in group D and 62.79 ± 2.20 in group E),7 days ( maximal values of CD34:16.76 ± 0.62,17.60 ± 0.72,18.48 ± 0.55,12.70 ± 0.60,and 11.51 ± 0.70,each group),and 7 days (maximal values of MVD:52.45 ± 2.78,59.34 ± 3.12,61.14 ± 3.35,25.25 ± 3.78,and 24.46 ± 7.46,each group),and then gradually decreased.In the different groups of flaps,when the flap area increased,the expression of SDF-1,CD34 and MVD increased,but the parameters decreased at the area of 5 cm × 5 cm,and the flaps were partial necrosis.Conclusions SDF-1 may play an adjusted role in the survival process of the slender narrow pedicle flap.

Objective To discuss the effect of early application of vacuum sealing drainage (VSD) on the small vessels and microthrombus of congested flap.Methods 56 SD rats were randomly divided into 7 groups after operation:one-hour group,four-hour group,one-day group,two-day group,three-day group,four-day group and seven-day group.A flap was designed and put on either side of a rat's back.The flaps were randomly arranged into control group and the flaps on the other side served as the experiment group.The equipment of VSD was fixed to each experiment flap.We observed and measured the flap,survival area,the expression of HIF-1α and vascular endothelial cell and microthrombus on the flap at different time.Results Firstly,the damage of vascular endothelial cell and microthrombus in the experiment flaps was less than the control group of flaps at the same time,so as the expression of HIF-1α.Secondly,the trend of expression of HIF-1α did not rise obviously in first 3 days and rose obviously from the 4th day in the experiment flaps; but in the control flaps,when time-lapse,the expression of HIF-1α increased,reached the plateau level at 6th day.Thirdly,the congestion of experimental flap was mitigated as compared with those under control,and the survival area was bigger,and it reached the top on the third day.Conclusions The application of VSD early to flap can aspirate detained blood initiatively,reduce the ischemic and hypoxic status of the tissue of flaps,and so it can lessen the damage of vascular endothelial cell and the formation of microthrombus of flap,beneficial for the survival of flap.

Objective To probe into the application of vacuum sealing drainage (VSD) in flap with slender narrow pedicle and to observe the survival,the shaping of blood vessel,congested edema and the expression of CD34 in the flap,and to analyze the underlying mechanism of VSD on the flap survival.Methods 64 SD rats were randomly divided into 8 groups:4-hour group,8-hour group,1-day group,2-day group,3-day group,4-day group,and 6-day group.A flap was designed and put on either side of a rat's back.The both width and length of the flap were 0.8 cm and the pedicle sized in the diameter of 3.5 cm.Both sides of the flaps on the rats' backs were randomly arranged into control side and experimental side.VSD was fixed sideways to each group after the shaping of flaps.Each of the equipments was dismantled respectively in the corresponding time after the operation.Afterwards the color and swelling degree of the flaps were observed,a sample was cut and the flap survival area was measured altogether on the 7th day.Flap histology and the expression of CD34 were observed mainly through HE dyeing and immunohistochemistry.The statistical data were treated to figure out the flap survival rate and to determine whether statistical differences existed in the microvessel density (MVD).Results As the time of the negative pressure suction went on,the survival area of the experimental side flap was increasing day by day and came to the maximum on the third day (95±4)％,but no statistical difference was discerned between on the third day and on the sixth day (P＞0.05).As the time of the negative pressure suction went on,the MVD in the flap was also increasing.Statistical differences (P＜0.05) existed between the experimental side of the instant group,4-hour group and the 8-hour group and those of 3-day group,4-day group,and 6-day group.Conclusions The application of VSD can advance the survival of the flap,whose survival area can reach its maximum within 3 days under application.Besides,it can promote the increase of MVD in the flap.

Objective To investigate the value of the new method with bilateral lip mueosa flaps for central defect reconstruction of upper-lip vermilion. Methods On both sides of the central defect of upper lip vermilion, reverse triangular flaps was designed below the junction between vermilion and mucosal. These two flaps had the common pedicle of vermilion depression site. Incisions of "(λ)" shape were de-signed below the defect area and the flaps included mucosa and submucous tissue. This mueosa flaps were raised and orbicularis otis muscles under the flaps were free moderately. Bilateral orbicularis oris muscles were sutured under the common pedicle of the two mucosa flaps. Then the bilateral mucosa flaps were ro-tated down 90° and inserted into the " (λ)" shape incisions to increase the tissue volume of the middle upper lip and deepen the labiogingival sulcus. The common pediele of the bilateral mucosa flaps was formed to the vermilion tubercle and then the incisions were sutured layer by layer. Results The technique was per-formed on 26 patients including 18 cases of upper-lip vermilion defect after repair of bilateral cleft lip,4 ca-ses of upper-lip vermilion defect after repair of unilateral cleft lip and 4 cases of congenital malformation. All the lip mucosa flaps survived completely without any complications. The vermilion, tubercle and shape of the lips were satisfactory after all cases were repaired and all incision scars were concealed. Con-clusions Using the lip mucosa flaps transfer to repair vermilion defect with the same tissue can obtain satisfactory appearance. The lip mucosa flaps are ideal for repairing of the lip vermilion defect and recove-ring of the profile of labial arch and vermilion tubercle. It can be used widely in any cases with the central defect of upper lip vermilion.

Objective To introduce a new and practical method of treating blepharoptosis with direct suspension of the frontal muscle-fascia improvement. Methods 22 cases of blepharoptosis were corrected by direct suspension of the frontal muscle-fascia in which the dynamia still came from frontal muscle.Through double-fold eyelid incision, the frontal muscle-fascia was dissected from the subcutaneous tissue and a 1.5 cm length incision of the frontal muscle-fascia was cut under the supraorbital margin. And through the incision, the frontal muscle-fascia on the superficies of periosteum was dissected 1.5 cm to the upper margin of orbital, and then the frontal muscle-fascia was pulled down and fixed to the levator muscle aponeurosis directly by mattress sutures, with the tension being adjusted to a moderate degree. Results 22 cases of blepharoptosis were cured by primary healing with this method. The patients were followed up for 3 to 6 months with satisfactory results and no recurrence. Conclusion Compared with the traditional methods,this one may decrease the damage to the upper lid and frontalis area, leaving no risk of damaging the vessels or nerves. The technique is simple and the curative effect is affirmed. It can be used to treat any blepharoptosis patient with normal frontal muscle function.