Objective:To explore the clinical effect of a new method for nipple reduction and shortening in nipple hypertrophy.Methods:A retrospective analysis was made with patients with nipple hypertrophy who were admitted to Shanghai Mylike Medical Cosmetic Hospital from January 2018 to December 2019. The optimal size of the postoperative nipple was determined according to the patient’s requirements at the un-erectile state. Two wedge-shaped tissues resection were designed at the two symmetrical edges of the nipple to determine the diameter of the new nipple, and two dual wing shaped flaps were designed at the top of the nipple to determine the height of the new nipple. After local anesthesia, the redundant skin and subcutaneous tissue were cut off, and the corresponding points were closed and sutured. The appearance of the nipple was observed after operation. The nipple sensation and erectile function were evaluated by touching the nipple with cotton swab.Results:A total of 22 patients with nipple hypertrophy, aged from 24 to 35 years old, were female patients after childbirth and lactation. No wound nonunion or infection occurred. The blood supply and sensation of the nipple were good, and the shape of the nipple was significantly improved. All patients were followed up for 3-9 months, and the nipple sensation and erectile function recovered completely. All patients were satisfied with the postoperative result.Conclusions:The reduction of nipple by wedge tissue resection and wing flap can correct both the diameter and height of the nipple, while the nipple sensation and erection function are not affected. The procedure is easily performed with satisfactory result.

Objective:To explore the clinical effect of a new method for nipple reduction and shortening in nipple hypertrophy.Methods:A retrospective analysis was made with patients with nipple hypertrophy who were admitted to Shanghai Mylike Medical Cosmetic Hospital from January 2018 to December 2019. The optimal size of the postoperative nipple was determined according to the patient’s requirements at the un-erectile state. Two wedge-shaped tissues resection were designed at the two symmetrical edges of the nipple to determine the diameter of the new nipple, and two dual wing shaped flaps were designed at the top of the nipple to determine the height of the new nipple. After local anesthesia, the redundant skin and subcutaneous tissue were cut off, and the corresponding points were closed and sutured. The appearance of the nipple was observed after operation. The nipple sensation and erectile function were evaluated by touching the nipple with cotton swab.Results:A total of 22 patients with nipple hypertrophy, aged from 24 to 35 years old, were female patients after childbirth and lactation. No wound nonunion or infection occurred. The blood supply and sensation of the nipple were good, and the shape of the nipple was significantly improved. All patients were followed up for 3-9 months, and the nipple sensation and erectile function recovered completely. All patients were satisfied with the postoperative result.Conclusions:The reduction of nipple by wedge tissue resection and wing flap can correct both the diameter and height of the nipple, while the nipple sensation and erection function are not affected. The procedure is easily performed with satisfactory result.

BACKGROUNDEndostar™ (rh-endostatin, YH-16) is a new recombinant human endostatin developed by Medgenn Bioengineering Co. Ltd., Yantai, Shandong, P.R.China. Pre-clinical study indicated that YH-16 could inhibit tumor endothelial cell proliferation, angiogenesis and tumor growth. Phase I and phase II studies revealed that YH-16 was effective as single agent with good tolerance in clinical use.The current study was to compare the response rate , median ti me to progression (TTP) ,clinical benefit andsafety in patients with advanced non-small cell lung cancer ( NSCLC) , who were treated with YH-16 plus vi-norelbine and cisplatin (NP) or placebo plus NP.

METHODSFour hundred and ninety-three histologically or cy-tologically confirmed stage IIIB and IV NSCLC patients , withlife expectancy > 3 months and ECOG perform-ance status 0-2 , were enrolledin a randomized ,double-blind ,placebo-controlled , multicenter trial ,either trialgroup : NP plus YH-16 (vinorelbine 25 mg/m² on day 1 and day 5 ,cisplatin 30mg/m² on days 2 to 4 , YH-167.5mg/m² on days 1 to 14) or control group : NP plus placebo (vinorelbine 25 mg/m² on day 1 and day 5 ,cis-platin 30 mg/m² on days 2 to 4 ,0.9% sodium-chloride 3 .75 ml on days 1 to 14) every 3 weeks for 2-6 cycles .The trial endpoints included response rate ,clinical benefit rate ,time to progression,quality of life and safety .

RESULTSOf 486 assessable patients , overall response rate was 35.4% in trial group and 19.5% in controlgroup (P=0 .0003) . The median TTP was 6 .3 months and 3 .6 months for trial group and control group respectively (P < 0 .001) . The clinical benefit rate was 73 .3 %in trial group and 64.0% in control group (P=0 .035) .In untreated patients of trial group and control group ,the response rate was 40 .0% and 23.9%(P=0 .003) ,the clinical benefit rate was 76 .5 % and 65 .0 % (P=0 .023) ,the median TTP was 6 .6 and 3 .7months (P=0 .0000) ,respectively .In pretreated patients of trial group and control group ,the response ratewas 23.9% and 8.5%(P=0 .034) ,the clinical benefit rate was 65.2% and 61.7%(P=0 .68) ,the median TTP was 5 .7 and 3 .2 months (P=0 .0002) ,respectively . The relief rate of clinical symptoms in trial groupwas higher than that of those in control group ,but no significance existed (P > 0 .05) . The score of quality oflife in trial group was significantly higher than that in control group (P=0 .0155) after treatment . There were no significant differences in incidence of hematologic and non-hematologic toxicity , moderate and severe sideeffects betweentrial group and control group .

CONCLUSIONSThe addition of YH-16 to NP regimen results in significantly and clinically meaningful improvement in response rate , median time to tumor progression,and clinical benefit rate compared with NP alone in advanced NSCLC patients . YH-16 in combination with chemotherapy shows a synergic activity and a favorable toxic profile in advanced cancer patients .