ObjectiveTo investigate application of exercise stress test after acute myocardial infarction(AMI). Methods32 patients with AMI performed exercise stress test adopted the Bruce protocol in 16 days-8weeks after onset, at the same time cardiac functional capacity was measured.ResultsThe stress test was positive in 17 cases, whose cardiac functional capacity was 1.5-7 METs,and it was negative in 15 cases, whose cardiac functional capacity is 4-12 METs.Conclusions①Second class amount limited exercise stress test is safe to adaptive AMI patients. ②Cardiac functional capacity measurement is benefit to instruct patient rehabilitation exercise. ③Exercise stress test is valuable to estimate prognosis of AMI.

Objective To study the clinical therapeutic effects of early rehabilitation training combined with acupuncture on dysphagia after acute cerebral infarction.Methods One hundred patients with dysphagia caused by acute cerebral infarction were randomly divided into 4 groups:a comprehensive treatment group(25 cases,received rehabilitation training,acupuncture and routine medication),a routine drug group(25 cases,routine medication),a rehabilitation group(25 cases,received comprehensive rehabilitation training and routine mediciation)and an acu-puncture group(25 cases,received acupuncture therapy and routine medication).Dysphagia was evaluated with videofluoroscopic swallowing study(VFSS),and the incidence of pneumonia was observed before treatment and at the 14th day after daily treatment. Results After treatment,the VFSS scores of the 4 groups were significantly higher than before treatment,and VFSS scores in the comprehensive treatment group were significantly higher than those in the other groups.The effectiveness rate in the comprehensive treatment group was significantly higher than that in the other three groups.and the incidence of pneumonia was significantly lower.Conclusions Early rehabilitation com-bined with acupuncture can improve swallowing and reduce the incidence of aspiration pneumonia in acute stroke pa-tients.

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 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 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.

AIM: To develope a reversed-phase high performance liquid chromatographic method for the quantitative determination of chlorogenic acid and caffeic acid in Shegan Kangbingdu Injection. METHODS: The operation was carried out in the Kromasil ODS column with the mobile phase consisting of a mixture of water-methanol-acetonitril aceti acid(95∶10∶5∶2,v/v),in which the flow rate of 1.0 mL/min and UV detection wavelength at 326 nm were set to determine the contents of chlorogenic acid and caffeic acid. RESULTS: There were good linear relations between the concentrations and the peak-areas of chlorogenic acid and caffeic acid.The relative standard deviation of peak areas for chlorogenic acid or caffeic acid were 0.60%,0.32%,respectively.The two kinds of standard solutions were both stable in 16 h(RSD=0.54% for CGA,0.11% for CFA).The average recovery was 100.1%,99.6% for CGA,CFA,repectively.The detectable limit(S/N=3)was 0.012,0.020 mg/L,and the quantitative limit (S/N=10) was 0.037,0.052 mg/L,repectively. CONCLUSION:The method is simple,sensitive,rapid and accurate,and can be used for the quality control of Shegan Kangbingdu Injection

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.

Objective To evaluate the efficacy and safety in the treatment for gravitation wrinkles and unsatisfied shape with raonopolar and bipolar radiofrequency (RF) technique. Methods 28 patients were enrolled in this study. Every patient was treated for four times with an interval of 14 days by Accent Pro radiofrequency electric device (Alma Lasers Ltd). The clinical photographs were taken before and after the treatment, and the parameters were recorded during the treatment. The clinical efficacy and safety was evaluated 1 month after the treatment by comparing photographs and patients' satisfaction. Results Satisfactory rates were as follows: 85 % in doctor side, and 90 % in patients' side. No blister, scald, pigmentation and scar were observed during the treatment. Conclusion High frequency electric technique can be effective for the treatment of gravitation wrinkles and skin tightening by heating tissue deeply and non-invasively. Our clinical study shows that RF is an effective, non-invasive treatment with less pain and low side effects.