Objective To investigate the possibility of auricle reconstruction assisted by an expander using porous silicon auricle frame.Methods An adult male with average sized,normal ears was selected.The spiral CT scan was used to acquire primitive data of his external ear.Mimics 8.1 and Geomagic studio 12 were used for 3D reconstruction and image processing.Three-dimensional model of auricle 1.4 mm in thickness was created according to the anterior auricular surface data.Finally,a metal model was made according to the 3D model of auricle.By the extrusion method,silicon auricle frame was formed from the metal model.Multiple perforations,1 mm in diameter and 1 mm internal from each other,were then made by a puncher.50 ml kidney tissue expanders were implanted between the panniculus carnosus and the fascia through an incision on the backs of 10 New Zealand white rabbits.The expander was inflated with 20 ml saline weekly,to a total of 160 ml.Maintenance of expansion lasted for a month.The expander was then removed through an incision along the expander near the back.Silicon auricle frame was inserted into the pocket.The reconstructed ears were observed for 6 months postoperation.Whether there were deformations,contractures and extrusions were observed.Results The reconstructed ears were elastic and compressible.No deformation,contracture or extrusion were observed 6 months postoperation.Scaphoid fossa,triangular fossa,helix,antihelix were legible.Conclusions The silicon frame,1.4 mm in thickness manufacted by computer aided design,could stand up to contraction of the overlying expanded flap,and it thus is possible to be used for auricle reconstruction assisted by the expander.

The result regarding the application of McAbs against PwMJ-SAg in the detection of the circulating antigens(CAg) in sera from the patients (early stage and nonpulmonary type) with paragonimiasis westermani was reported in this paper. CAg in the sera from 35 patients in the early stage and 15 nonpulmonary type of patients was 100% positive by using McAb IB1 and JB4 out of 8 McAbs against PwMJ-SAg. Furthermore, these two McAbs didnot react crossly with the sera from 25 normal subjects, 15 patients with clonorchiasis, 15 patients with fasciolopsiasis, 15 patients with schistosomiasis japonica, 16 patients with Brugian filariasis or 10 patients with pulmonary tuberculosis. However, they crossly reacted with 8 samples of sera from 15 patients (53.3%) with pagumogonimiasis skrjabini. The McAb IB1 and IB4, threfore, are appropriate as the reagents to diagnose paragonimiasis westermani (early stage or nonpulmonary type). Moreover, they are also valuable, to a certain degree, to diagnose pagumogonimiasis skrjabini.The projet was supported by NNSFC Department of parasitology .Anhni Medical University, Hefei

Objective To investigate experience in adult inguinal hernia treated with the open preperitoneal herniorrhaphy.Methods Eight hundred and twenty-six cases were retrospectively analyzed from February 2004 to December 2011 in our hospital.The effect of operative methods and treatment were observed simultaneously.Results All the patients were cured completely without special complications; Followed up for 12 months,some negative factors such as incision infection,recurrence,special discomfort,and chronic pain have not been appeared.Conclusions The open preperitoneal herniorrhaphy under local anesthesia for adult inguinal hernia is safe,reliable and effective.

Objective To detect the levels of MBP and IL 16 in cerebrospinal fluid(CSF) and serum, investigate the correlation between them and the role in multiple sclerosis attacking process.Methods The levels of MBP and IL 16 of cerebral fluid and serum of 31 patients with MS were detected by ELISA and compared with those of 24 cases of inflammatory demyelinating polyneuropathy or 22 cases of healthy persons.Results CSF and serum levels of MBP were found increaed significantly in MS patients compared with those in IDP and in healthy controls(HC)(all P 0.05).The concentrations of MBP in CSF of MS significantly correlated with that of IL 16 in CSF( r =0.468, P 0.05).The concentration of MBP in CSF of MS significantly correlated with CSF that in serum( r =0.505, P 0.05).Conclusion MBP is one of the autoantigens that induce MS,IL 16 may be mainly produced in CNS due to MBP stimulation; IL 16 may act within CNS.

Objective To build three-dimensional (3-D) finite element models for local advancement skin flap, by which the post-operative local strain and local stress of skin were figured out to assist in the design of skin flap in clinic. Methods The biomechanical parameters of human forehead skin were obtained in vitro from biomechanical experiments. The 3-D finite element model of local advancement skin flap was set up by MSC Marc/Mentat 2005 (3-D finite element software). Six models were built with the same flap but different skin defects, to simulate post-operative local strain of skin and local stress of skin in different models. Results Post-operative local stress of skin increased with the skin flaps stretching, but the relationship between increase and stretching did not meet the linear rule. Skin flap was able to stretch to 40 % of its initial length in theory if we did not consider blood supply of it. When the skin flap stretched over 40 % of its initial length, the maximal stress could exceed the yield limit. Conclusion It is an effective and workable way to simulate local advancement skin flap using 3-Dfinite element model and biomechanical parameters of human skin. The stretch ratio of local advancement skin flap should be not over 40% for safety.

Objective To study the clinical efficacy of recombinant human epidermal growth factor (rhEGF) in the treatment of sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after appling rhEGF to reinforce wound bed preparation (WBP). Methods From January 2007 to October 2009, 60 patients with sacrococcygeal decubitus ulcers Grade Ⅲ, were divided into control group and treatment group. The ulcer size was 3 cm × 4 cm to 10 cm × 12 cm and all ulcers were infected for 15-70 d. Treatment group received traditional dressing change and appling rhEGF to reinforce wound bed preparation. Control group received traditional dressing change only. The operative technique that we used in two groups was direct polymerizing suture. Cure rate of stage Ⅰ and complication morbidities were analyzed. Results Cure rate of stage Ⅰ was 87% in treatment group and 70% in control group. Complication morbidities were 13% in treatment group and 30% in control group. The difference between these two groups was statistically significant (P ＜ 0.05). Conclusion Appling rhEGF to reinforce wound bed preparation before operation could make subsequent treatment more effective and improve the cure ratio of operation with decreasing complications and morbidities. And more, dissecting under fascia possesses the advantages of easiness to perform and rich blood supply.The method of appling rhEGF with direct polymerizing suture is a simple, high efficient approach for the first repairment of sacrococcygeal decubitus ulcers grade Ⅲ, especially desirable for the elderly.

Objective To evaluate the efficacy of self-disigned long-thick silicone prothesis in the treatment of severe microgenia.Methods A long-thick silicone prothesis was designed according to the measurement results gained by a coordinate caliper.The designed long-thick silicone prothesis was sterilized by uperization.The procedure commenced under local anesthesia for all patients.The prothesis was placed through an intraoral incision.The digital photographs were taken at the pretreatment visits and 3 months and 12 months after treatment follow-up to observe the change of the chin projection.Results 20 cases of severe microgenia were treated with this technique.All wounds healed primarily.There was no infection,extrusion and rejective reaction.The profiles of chins were improved obviously and reached aesthetic standard.Only one implant required adjustment 3 months after first operation because of displacement.After 12 months follow-up the reshaping contour of the chins were satisfied.Locations of silicone prothesis were stable.No differences of the chin projection were observed.All patients were satisfied with their cosmetic results.Conclusions Implanting long-thick silicone prothesis to correct severe microgenia is safe,effective,simply,cheap and less invasive.

OBJECTIVE:To observe the amount of thoracic cavity drainage24h after using highdose reptilase during in?tracardiac surgery.METHODS:32patients undergoing operation were randomly divided into group R(reptilase group,n=17)and group C(control group,n=15).In group R,reptilase2KU was injected before opening the thoracic cavity,reptilase1KU was added to prefilling fluid of extracorporeal circulation machine and reptilase2KU was intravenoulsy dripped after stopping machine until the end of operation.RESULTS:Compared with group C,the amount of thoracic cavity drainage reduced by35%(P

Objective To explore the methodology of suturing the upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap to the levator aponeurosis,simulating the mechanism of fibers from the levator aponeurosis to the dermis in natural double-eyelid in blepharoplasty.Methods Pretarsal orbicularis myocutaneous flap was harvested.Dissection between the orbital septum and the levator aponeurosis was performed originating from the upper margin of the tarsi until to the levator muscle.The upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap was sutured to the levator aponeurosis.The lower skin margin to the orbital septum to the upper skin margin was sutured interruptedly.Patients with medial epicanthus were performed epicanthoplasty at the same time.Results 136 eyes in 68 patients were performed with double-eyelid blepharoplasty using this method.62 patients were followed-up for 1 month and 53 patients were followed-up for 3 months.They all reported satisfactory aesthetic results.Conclusions Double-eyelid blepharoplasty using this method accords with the physiological mechanism in natural double-eyelid.Postoperative double-eyelid is natural with little tumefaction.This method can avoid double-eyelid fold retraction and multi-fold occurrence.

Four patients with coexistence of sarcoidosis and primary Sj(o)gren syndrome (pSS) were retrospectively analyzed.All patients were female,who were referred to our department mainly because of respiratory symptoms.Positive antinuclear antibody (ANA) was detected in 2 patients and anti-Sj(o)grens syndrome A (SSA) antibody positive in 1 patient.All patients presented specific histologic patterns of both sarcoidosis and pSS.Publications related to coexistence of these two diseases were reviewed.Forty-one patients were finally included in the analysis,among whom 37 confirmed patients were from literature search.There were 37 women and 4 men.The main clinical features presentation were xerophthalmia in 40,xerostomia in 38,hilaradenopathies in 28,interstitial lung disease in 15,respiratory symptoms in 13.The main immunologic data were positive ANA in 23,SSA antibody in 19,anti-Sj(o)grens syndrome B antibody in 10 and rheumatoid factor in 12.All patients presented specific histologic patterns of both diseases.Patients with both sarcoidosis and pSS of ten represent multisystemic involvement and positive immunologic parameters,as well as the dual expression of specific histologic characteristics.