Objective To analyze the clinical efficacy and safety of combined therapy of traditional Chinese and Western medicine (heparin sodium cream massage, induced treatment by micro-needle, and external application of herbal membrane) and micro-explosion method for facial pigmentation after trauma, and to explore an effective and safety therapy for skin-whitening and anti-freckle. Methods A total of 100 cases with pigmentation on face were divided randomly into two groups with 50 cases each: the cases in treatment group were massaged with heparin sodium cream, needled skin pigmentation spot densely by micro-needle and applied with herbal membrane; the cases in control group only were massaged with heparin sodium cream, and applied with herbal membrane, without needling on skin. Short-term efficacy, long-term efficacy, safety and satisfaction of patients were observed. Results These cases were followed-up for 3-6 months. There was no significant difference between treatment group and control group after treatment for 15 days, and then significant difference was found after 1, 2 and 3 months (P<0. 05). There was no side effect after treatment for 6 months, and all cases were satisfactory. Conclusions There is rapid regression of pigmentation, with stable effect and without recurrence and obvious side effect, and the satisfactory rate of patients is high after treated by combined therapy of herbal membrane external application, heparin sodium cream massage and induced treatment by micro-needle.

Objective To explore an operative method which can adequately enlarge the inner canthus with inconspicuous scar and perfect shape based on the transverse incision for epicanthus correction,and to evaluate the short-term results and long-term effects comprehensively.Methods The surface projection of tears port medial point was designed as a new inner canthal point,the full thickness skin from new inner canthal point was cut to the free edge of epicanthus,and an outward prolonged incision was made along the lower eyelid edge,separating the subcutanous dissociation or cutting off part of displaced orbicularis,so to relieve the skin tension of inner canthal and reset skin,suturing the new inner canthal point and lower eyelid edge.Results 120 cases were followed up for more than one year,the complication rate at different postoperative time points and patient satisfactory rate one year after operation were compared.12 cases had mild scar formation,from six months to one year after operation,the scar gradually became softened and then inconspicuous.22 cases had a little skin fold at the inner canthal in postoperational one month.2 cases were unsatisfied with the shape of inner canthal,Others were satisfied with therapeutic efficacy,the correction was sufficient with inconspicuous scar and 1ess recrudescence.Conclusions Epicanthus correction by subciliary incision epicanthoplasty is a simple and effective method and suitable for all types of epicanthic fold,and it has the advantages of sufficient enlarged inner canthus,inconspicuous scar and 1ess recrudescence.

Objective To discuss the efficacy and advantage of dolabriform flap in repairing periorbital skin and soft tissue defects.Methods 21 patients with periorbital skin disease were treated by radical resection,and then the adjacent or distant dolabriform flaps were designed for the one stage repair of skin and soft tissue defects in these cases according to the defect location,size,shape and neighborous skin conditions.The largest defect size was 3.5 cm × 4.5 cm,The smallest defect size was 1.2 cm × 1.5 cm.The largest ratio of hatchet pedicle width to axe handle length reached 1 ∶ 5,and the largest ratio of hatchet pedicle width to hatchet edge length was 1 ∶ 4.Results All of these dolabriform flaps in 21 patients survived well with primary incision healing.18 cases had been followed up for 3 to 12 months,showing that there was no deformation found on eyelids,eyebrow and nose,the colour of these flaps were similiar to that of the normal skin,without being fat and clumsy,all scars were almost invisible,and the cosmetic results were satisfactory.Conclusions Larger diameter of skin and soft tissue defect in different periorbital parts could be repaired individually with dolabriform flap according to the characters of natural lines,and it is a simple and flexible method for repairing periorbital skin defects,and can achieve satisfactory functional and cosmetic results.

Objective To explore a simple and effective epicanthoplasty.Methods A total of 65 cases were corrected by incising the epicanthus levelly,extending the incision along the lower palpebral margin,separating the skin about 1 cm×1 cm scope below incision,cutting off part of the orbicularis and epicanthus ligament,fixing epicanthus angle to nasal aponeurosis,and suturing the incision without tension.Results All the cases corrected by the transverse-one's procedure were followup one month to one year,and satisfactory results obtained.Conclusion This method is a simple and effective epicanthoplasty with less tissue damage and good appearance.

Objective To analyze the clinical efficacy and safety of the silkworm eroded dissolving method induced by micro-needle (the combined therapy of traditional Chinese and Western medicines including micro-needle guiding,external application of herbal membrane and anti-scar cream) for treatment of facial small area scar in early stage,and to explore a simple and effective therapy for facial scar.Methods Total 100 patients with facial small hyperplastic scar within 6 months after acute trauma healing were divided randomly into two groups with 50 cases each.The cases in treatment group were micro-needle acpunctured densely into scar,and then herbal membrane and anti-scar cream were applied.The cases in control group were treated similar to the treatment group except acpuncture.All cases in the two groups were treated for 3 months and followed-up for 6 months.Short-term efficacy,long-term efficacy,complications,safety and patient satisfaction were analyzed.Results There was no significant difference between treatment group and control group after treatment for one month,and significant difference was found after treatment for 2,3 months (P＜0.05).The earlier treatment after wound healing,the better efficacy.After treatment for three months most of scar showed no longer hyperplasia,and became soft gradully.Conclusions The combined therapy of micro-needle guiding,external application of herbal membrane and anti-scar cream for treatment of early facial small area scar demonstrates stable effects and high satisfactory rate of patients,the scar softens rapidly,and no obvious side effect occurs.

Objective:To examine the clinical value of combining indocyanine green (ICG) fluorescence navigation with blue dye in sen-tinel lymph node biopsy (SLNB) for patients with breast cancer. Methods:A total of 89 patients with early-stage breast cancer who met the inclusion criteria were admitted at Shantou Central Hospital, Guangdong from May 2013 to April 2014. In phase one, ICG and blue dye were applied in all 53 patients, and then SLNB and axillary lymph node dissection (ALND) were performed based on fluores-cence signal or visual sense of the lymph nodes. In phase two, 36 patients with early-stage breast cancer were included. ALND was omitted when sentinel lymph nodes were frozen showing negative result. Rates of detection, accuracy, and false-negative were calcu-lated. Results:A total of 89 patients were monitored, of which the total rate of SLNB detection was 96.6%(86/89). In the validation pe-riod, the rates of detection, accuracy, and false-negative were 94.3%(50/53) 98.0%(49/50), and 2.6%(1/38), respectively. In the alter-ative period, the rates of detection reached 100%. Of the 196 sentinel lymph nodes, 179 showed fluorescence signal, 142 exhibited blue dying, 54 only demonstrated fluorescence signals, and 45 demonstrated metastasis with five signaling fluorescence. About 24.7%of patients were diagnosed with SLN metastasis (22/89), where SLNB in two patients showed fluorescence signal but without blue dye. No ipsilateral lymph node relapsed were observed during a median follow up of 25 months. Conclusion:Combination of ICG fluores-cence navigation with blue dye in SLNB is safe for patients with breast cancer.

Objective To analyse the clinical efficacy of combined therapy of super-pulsed CO2 laser and traditional Chinese medicine on the prevention and treatment of post-traumatic hypertrophic scar, and to discuss effective comprehensive therapy for hypertrophic scars. Methods 108 cases of early post-traumatic hypertrophic scar were divided randomly into three groups with 36 cases each: combined treatment group of super-pulsed CO2 laser and traditional Chinese medicine (combined group), Chinese medicine treatment group (Chinese medicine group) and simple laser-treated group (laser group). They were regularly treated for 6 months and followed up for longer than 1 year. Clinical effects were evaluated according to scar property and subjective symptoms in patients. Results The total effective rate was 97.2 % and 86.1% in combined group and Chinese medicine group that were higher than 61.1 % in laser group. Obviously effective rate of the three methods were 55. 6 %, 27.8 % and 11. 1 %, respectively, and the difference of obviously effective rate between combined group and other two groups was significally different. Conclusion The method combined with super-pulsed CO2 laser and traditional Chinese medicine for prevention and treatment of post-traumatic hypertrophic scar has advantages of high obviously effective rate, long-term and stable effects, less complication, and it can achieve satisfactory cosmetic effects.

Objective To explore a surgical method which can not only remove the enormous breast tumor entirely, but also maintain the breast function and obtain satisfactory shape.Methods On the basis of traditional round block technique, we designed different form's outer ring and breast lateral Sshaped incision line according to the size of breast tumor and the degree of the papillae ptosis, trimmed away the epidermis between the two circles, a S-shape skin incision along lateral border of breast was made; after reaching to the capsule of tumor, we stripped off the tumor entirely along capsule surface, a large breast cavus subdermalis remained, and then made full use of the dermal-fat flap or dermal-fat breast flap to fill the cavity after tumor removal so that the shape of breast was reconstructed. Results All of the 5 cases maintained the breast function and satisfactory shape after surgery, no sensory obstacle and necrosis occurred in the papillae and areola, and the wound reached good healing. Up to 2 years of follow-up there was no recurrence of tumor was found. Conclusions The modified round block' technique is an i-deal method for removal of a huge breast tumor. The design is nimble and simple, and postoperative breast shape is satisfactory with light scar formation.

Background Given the increasing number of patients who require dual antiplatelet (DAP) therapy and electrophysiological device (EPD) placement, perioperative antiplatelet management is a current challenge. In this study, we investigated the incidence of pocket hema-toma formation after EPD placement in patients undergoing DAP therapy or an alternative low-molecular-weight heparin (LMWH) regimen. Methods This clinical observational study was performed from July 2010 to July 2012. In total, 171 patients were enrolled in the analysis after meeting the inclusion criteria. These patients were divided into two groups: 86 patients were treated with DAP therapy at the time of device implantation, and the DAP therapy was discontinued for 5 to 7 days and replaced with enoxaparin before device implantation in the other 85 patients. Adenosine phosphate (ADP)-mediated platelet aggregation and arachidonic acid-induced platelet aggregation were tested preoperatively. We compared the incidence of pocket hematoma between the two groups and the association of pocket hematoma develop-ment with ADP-mediated platelet aggregation and arachidonic acid-induced platelet aggregation.Results The incidence of pocket hema-toma in the patients who continued DAP was lower than that in the patients who replaced the dual antiplatelet regimen with LMWH (3.49%vs. 16.47%, respectively;X2 = 6.66,P < 0.01). Among the patients who continued DAP therapies, the rate of ADP-mediated platelet aggre-gation inhibition in patients with pocket hematomas was higher than that in patients without pocket hematomas. None of the patients under-going DAP or enoxaparin therapy developed pocket infection, thromboembolic events, or other serious complications. Multiple logistic re-gression analysis revealed that LMWH therapy was an independent risk factor for the development of pocket hematoma (RR = 0.054, 95%CI = 0.012-0.251). Furthermore, patients undergoing LMWH therapy were 5.1-fold more likely to develop pocket hematomas than were DAP-treated individuals.Conclusion Continuance of DAP therapy does not increase the risk of pocket hematoma formation after EPD placement.

Objective To evaluate the clinical efficacy of topical fat redistribution in combination with shortening of upper eyelid levator muscle in patients with excessively wide palpebral fissure after double-eyelid operation.Methods Twenty patients with excessively wide palpebral fissure after undergoing double-eyelid operation were selected.The double-eyelid line was aesthetically re-designed,the skin or incisional scar between the original and new double-eyelid lines was excised,and the scarring adhesion among different tissues was fully isolated.The fat tissues within the orbital septum,deep orbit and anterior orbital septum combined with ROOF reconstruction were performed to block the adhesion tissues,shortening of levator muscle of the upper eyelid was equally conducted to enhance the cosmetic effect.Results Seventeen patients were satisfied with the cosmetic appearance following once double-eyelid operation.Two cases underwent twice operations due to different height between bilateral papebral fissures.One patient was unsatisfied with the cosmetic appearance.Conclusions Fat redistribution in combination with shortening of levator muscle of the upper eyelid can not only repair excessively wide palpebral fissure complicated with ptosis and upper eyelid depression,but also enhance the exposure rate of the cornea and increase the cosmetic appearance,which is consistent with contem porary aesthetic perception.