Objective To evaluate the method for vaginal treconstruction with muscle sparing verti-cle rectus abdominis myocutaneous flap(MS-VRAM flap). Methods From September 2006 to April 2008, MS-VRAM flaps were used for vaginal reconstruction in 9 patients (20 to 35 years old), ancl all ca-ses were congenital absence of vagina. Before operation, the inferior epigastrie arteries were detected by the Doppler and the flaps based on the perforators ranged from 6 cm×20 cm. MS-VRAM flaps were ele-vated and then transferred to reconstruct the vagina. Results All 9 cases of MS-VRAM flaps survived completely. No complications occurred at donor site of abdominal wall. With 2-12 months' follow-up, the patients were satisfied with the results. Conclusion Despite technical difficulties in elevating the MS-VRAM flap, the flap is a good choice for vaginal reconstruction.

Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for bone meta-static cancer. Methods 71 cases with bone metastatic cancer were randomly divided into observation group (40 ca-ses) and control group (31 cases). The observation group was treated with zoledronic acid, 4 mg intravenously and local radiotherapy. The control group was treatd by radiotherapy alone. Results Pain relief was noted in 90% pa-tients in the observation group and 83.9% in the control group, respectively. The statistical difference was not signif-icant(P > 0.05). After the treatment had finished 3 months pain alleviation situation:Pain relief was noted in 87.5% patients in the observation group and 67.7% in the control group, respectively. The difference between the two groups was significant(χ2 =4.09, P =0.043). No serious radiotherapy and serious adverse drug reactions was found. Conclusion Zoledronic acid combined with radiotherapy was superior to radiotherapy alone for metastatic cancer bone pain relief, analgesic effect maintain a longer time.

BACKGROUND:It is convenient to fabricate porcelain veeners using chairside computer aided design/computer aided manufacture (CAD/CAM) system. However, the color of the restorations is not ideal when the veener is cemented immediately, so different surface treatments are needed. OBJECTIVE:To investigate the influence of different surface treatments on the color of chairside porcelain veneers made of CEREC Blocs and the color match between the porcelain veneers and teeth. METHODS:Five fresh extracted maxillary central incisors were selected and prepared. Twenty-five 0.6 mm porcelain veneer specimens were fabricated with Sirona CEREC Blocs by chairside CAD/CAM system, and then randomized into five groups. Untreated specimens served as control group. The other four groups were treated respectively by polishing, glazing, glazing after polishing or staining. The color parameters of specimens and the teeth were measured with ShadeEye NCC on the middle 1/3 region of labial surfaces, and color differences (ΔE) between the specimens and teeth were calculated. Data were analyzed by SPSS 19.0 software. RESULTS AND CONCLUSION:Compared with the control group, the L* value of the glazing, glazing after polishing and staining groups were significantly decreased (P<0.05). The L* value of the staining group was the lowest. The a* and b* values had no significant differences between groups (P>0.05). Compared with the control group, the ΔE values of glazing, glazing after polishing and staining groups were significantly decreased (P<0.05), and the ΔE value of the staining group was the lowest. The ΔL* values of glazing, glazing after polishing and staining groups were significantly lower than those of the control group (P<0.05), and the ΔL* value of the staining group was the lowest. Compared with the control group, only the Δb* value of staining group was decreased significantly (P<0.05). The Δa* values did not differ significantly between groups (P>0.05). These results suggest that the chairside porcelain veneers made of CEREC Blocs can obtain satisfactory aesthetic appearance by glazing and staining.

AIM: To investigate the changes of current and gene expression of acetylcholine sensitive K~+ channel (K_ ACh ) in chronic human atrial fibrillation (AF) and to evaluate the roles of K_ ACh expression in the occurring and maintenance of AF. METHODS: Acetylcholine sensitive K~+ currents (I_ KACh ) were recorded with the whole-cell patch clamp technique in single atrial myocyte of AF group and normal sinus rhythm group (SR group). The current densities-voltage relations were analyzed. The Kir3.4 mRNA was measured by reverse transcription-polymerase chain reaction. RESULTS: (1) Compared with SR group, acetylcholine sensitive K~+ current densities in AF group were reduced under testing potential between -80 mV and -120 mV . Acetylcholine sensitive K~+ current density was ( -11.665 ?1.027) pA/pF (n=11) in AF group vs ( -19.486 ?0.766) pA/pF (n=11) in SR group at -100 mV testing potential (P

Objective To investigate the possibility of using the results of breast ultrasound and Cohen-classification to determine the gynecomastia patients' subtype, and to evaluate the effectiveness of different surgical methods based on the classification. Methods In the past 3 years, 40 patients with gy-necomastia were treated in this hospital. The patients" age ranged from 18 to 50 years, with an average of 21.38. All the patients had the bilateral lesions, and their pathological diagnosis was gynecomastia. The mammary gland resected from each side weighted from 30 to 180 grams. The total fat volume liposucted ranged from 200 ml to 1 200 ml. As a routine, we performed breast ultrasound examination before the op-eration on each patient. According to the different echo, we marked the extent of breast gland on the chest walls and determine the Cohen classification of the patients. For breast tissue hyperplasia, we only resected the gland under the direction of the chest wall marks. For fat tissue hyperplasia, we just per-formed liposuction. For patients with mixed fat and gland hyperplasia, we combined these two methods rationally. If necessary, the procedures was repeated. Results With the help of breast ultrasound exami-nation, the operating procedure was more accurate and simple, as a result, our treatments had less injury and no severe complications. After a following-up of 6-36 months, satisfactory results were achieved, with normal male chest appearance and small obscure scar. Conclusions Male breast surgery is totally different from the females. The Cohen classification has been determined for each gynecomastia patient, based on the results of breast ultrasound examination, which helps choose the surgical methods and procedures and decrease surgical injuries and complications, with satisfactory results.

Objective To explore the clinical effect of the modified rhytidectomy technique with hidden temporal and buccal incision.Methods 26 cases of aging face were collected.The operation was performed with modified preauricular incision which was the leading edge of the cartilage of helix and hair line.Preauricular remporal fascia was modified as suspended vertically and SMAS superficial to parotic gland was suspended vertically to nasolabial sulcus.Results All the patients reported fine rejuvenescent effects,the satisfaction rate was 100％ without any severe complications,such as scar,hair loss on temperal incision.Conclusions This surgical technique may maintain natural configuration of preauricular area,result in invisable incision scar with no obvious baldness,and avoid important nerves or vessel injury.

Objective To explore the safety of fat reduction treated by non invasive focused ultrasound.Methods A randomized double-blind and negative control clinical trial was carried out on the excess fat of 40 subjects' abdomen by a JCS-01 non-invasive focused ultrasound device.Subjects received treatments with the device on day 1 and day 7.Observations on the area treated and inquiries on feelings were conducted during treatments.Before the first treatment and 14 days after the treatment,laboratory examinations were performed,including liver function,blood lipid tests,etc.Results 40 subjects participated in the trial and 36 subjects (18 each in both treatment and control groups) accomplished 2 times of treatments,all followed-up and laboratory examinations.During the process of treatments,4 subjects in the experimental group complained about feelings of tepidity or pricking.One subject on blood test of triglyceride showed slightly higher than her early normal result,which fell to the normal level at reexamination.Conclusions Subjects treated by non-invasive focused ultrasound at the area of no more than 500 cm2 every time and at an interval of 6 days manifest little changes on the blood test results,with slightly local reactions but no complaints during follow-up.

Objective To compare the perinipple round-block technique with the conventional periareolar round-block technique in areolar reduction operations.Methods A total of 37 patients who underwent areolar reduction operations in our department were randomly allocated into two groups:Group A (19 patients) received a conventional periareolar round-block technique,while group B (18 patients) through a new perinipple round-block technique.In the latter approach,an intraareolar donut of pigmented skin was deepithelialized,and the exposed areolar dermis was then telescoped inward and stretch-anchored to an imaginary circular line situated beneath the breast skin areola junction.The roundblock technique was then utilized to approximate the skin edges,resulting in a minimal scar,totally inconspicuous,confined to the immediate perinipple area.The operative time,perioperative complications,scars,absorption time of the skin folds,the sensation of the nipple-areolar complex and the patients' satisfaction were compared between the two groups.Results The mean operative time of group A and group B was 40.5 min and 45.8 min,respectively (P＜0.05).No perioperative complications were found in these two groups.No patient had experienced permanent nipple sensory changes.The skin folds absorption time of group A was 4.34 months,while the time of group B was 8.78 months (P＜0.01).The perinipple round-block technique produced a more inconspicuous scar with a better aesthetic results.Conclusions The traditional periareolar round-block technique leaves a sharply demarcated areola by a circular scar which has a totally unnatural and artificial look.As for the perinipple round-block technique,the incision as well as any residual cutaneous wrinkling or puckering is well concealed by the dome of the nipple and the areolar,but it needs a longer skin folds absorption time.

Objective To investigate the mechanism of liposome PGE1 on the survival of the expanded flap.Methods The minipigs were set up as an animal model.They were divided into 2 groups.The expanded flaps (8 cm ×2 cm) were designed and elevated on the back of an minipig.An image analysis technology was used to evaluate the survival rate of the expanded flap,while realtimePCR technique was used to investigate the molecular mechanism.Results The survival area of the expanded flap in the Lipo PGE1 group was significantly enlarged (P＜0.01) compared with the control group.The VEGF,iNOS and Ang-1 gene expression decreased,but TGF-β1 gene expression increased.But there was no significant difference between two groups (P＞0.05).Conclusions The Lipo PGE1 could promote survival rate of the expanded flap,but the mechanism does not involve the regulation of VEGF,iNOS,Ang-1 and TGF-β1 gene expression.

Objective To summarize the clinical characteristics of 15 cases of Poland's syndrome and to explore the suitable treatment strategies. Methods A retrospective study of 15 adult patients with Poland's syndrome was conducted and the related literature was reviewed. According to the development of pectoralis muscles and breast, chest deformities were classified into 2 grades: mild and severe. Mild form was limited to absence of partial pectoralis major muscle, with variable hypoplasia of other minor components (such as the size of breast and the size and position of the nipple-areola complex), leading to a mild chest wall asymmetry. Severe form was characterized by absence or severe hypoplasia of the pectoralis major muscle and mammary gland with an evident chest wall asymmetry. Combined with gender, adult patients were divided into 4 types: female mild, female severe, male mild, and male severe. Each type had its own treatment strategies based on its anatomic features: silicone implant insertion for female mild type;latissimus dorsi muscular flap transposition and silicone implant insertion for female severe type;fat injection for male mild type;latissimus dorsi muscular flap transposition for male severe type of the patients. From 2003 to 2008, 15 adult cases were admitted to our ward, aged from 16 to 34 years.The case number of each type was 6, 6, 2 and 1, respectively. One severe female patients rejected any surgical interventions;the others were all treated as the above. Results Follow-up periods ranged from 6 months to 4 years. This series had got satisfactory results with good breast symmetry and natural texture. All the latissimus dorsi muscular flaps survived well. No postoperative complications, such as implant capsular contracture or implant displacement, were observed. Conclusion The manifestations of Poland's syndrome are extremely varied. This classification method is simple but useful, which could effectively direct the individualized treatment for the complete and adequate rehabilitation. Latissimus dorsi muscular flap, pedicled or free transplanted, pulsing silicone implant in females, are the first choices for severe chest deformations of this syndrome.