Objective To sum up the experience of copper needle embolization for huge subcutaneous cavernous hemangioma. Methods Eighteen cases of huge hemangioma, located at the face and neck (3 cases), the upper limbs (5 cases), or the lower limbs and buttocks (10 cases), respectively, were treated from 1996 to 2003. Needles made from copper wire 1~3 mm in diameter were inserted into the lesions, through the skin directly or under the guidance of color Doppler ultrasonography. The copper needles were left in place for 1 week, with or without 4~6 V direct current circulated for 5~10 min twice. Results The therapeutic outcomes included: the shrinking and sclerotization of the hemangioma with the disappearance of postural changes (18 cases), the decrease of circumference of the involved limb (13 cases), the change of the lesion skin from blue-purple to light or normal in color (4 cases), the subsidence or disappearance of swelling and heavy feeling of the involved limb (5 cases), and the regression of the lesion and the reduction of blood flow under color ultrasonography (14 cases). Conclusions Copper needle embolization is a simple, effective and relatively less invasive method for the treatment of huge subcutaneous cavernous hemangioma that is difficult to be resected. It at times may be the only applicable option for children.

Objective To summarize clinical experience of reconstruction of breast suspensory structure in correction of mild-to-moderate breast ptosis.Methods Through a periareolar incision,the flabby deep layer of the superficial fascia beneath the upper breast gland was completely removed.Then the gland was lifted up to the normal position and the superior pole of the gland was fixed to the pectoral fascia at the second intercostal space.By using the dermal bra technique,an appropriate amount of skin was excised,and the dermis was fixed to the anterior surface of the breast gland. Or a monofilament polypropylene mesh was implanted and fixed to the anterior or posterior surface of the upper breast gland.Postoperatively,remarkable scar fibrosis reaction developed to form strong supporting structures just like natural ones.Glandular plication or implant augmentation was simultaneously employed to enhance the projection,if necessary.Results A total of 32 cases of mild-to-moderate breast ptosis was treated with this technique,including 10 cases of mastopexy only,20 cases of mastopexy with implant augmentation,and 2 cases of mastopexy using monofilament polypropylene mesh.The operation time was 90~150 min(mean,110 min).The intraoperative blood loss was 30~100 ml(mean,58 ml).No complications such as nipple or areola necrosis or sensory disturbance were found.Follow-up observations for 6~12 months(mean,11.3 months) showed a satisfactory rate of 90.6%(29/32).Conclusions Reconstruction of breast suspensory structure is a simple,safe,and effective method for correction of mild-to-moderate breast ptosis without hyperplasia of mammary glands.

Ojective To evaluate the effect of the collagen injection for skin defect correction. Methods The various kinds of skin defect were injected by medical cosmetic collagen. Results 103 cases of skin defect were treated by collagen injection. Short term therapentic effect inclnding "excellent" and "good" was 85.5%. no complication occurred. Conclusion It showed that the method of collagen injection for skin defect correction is safe, simply and effective.

The suppressive effect of anti-KDR antibody against VEGF on proliferation of hemangioma-derived vascular endothelial cells (HVECs) was investigated. HVECs from one case of hemangioma in proliferative phase were cultured. Both primary culture and sub-culture were conducted in M199 medium. The HVECs of passage 3 were divided into 4 groups based on the concentrations of anti-KDR antibody. Cell count was performed and inhibitory rate of HVECs was measured before and 9 days after interference. The results showed that the number of HVECs in the anti-KDR antibody-treated groups was significantly decreased and the inhibitory rate of HVECs by anti-KDR antibody (50, 10 and 2 microg/mL) was 84%, 63% and 39% respectively at 9th day after interference, with the difference being significant. In the control group, the number of HVECs was increased significantly. In was concluded that the anti-KDR antibody could suppress the activity of VEGF through blocking the KDR, indicating the potential clinical applications of anti-KDR antibody in the treatment of hemangioma.
Antibodies/*pharmacology ; Cell Proliferation/drug effects ; Endothelium, Vascular/*pathology ; Hemangioma/*pathology ; Tumor Cells, Cultured ; Vascular Endothelial Growth Factor Receptor-2/*immunology

Objective To explore a more efficient surgical method to cure axillary osmidrosis through a comparative study on results from two surgical treatments of axillary osmidrosis in the armpit area.Methods 72 patients were randomized into two groups,in which 36 patients (group A) with micro-incision simple liposuction and 36 patients (group B) with dissection and excision of subcutaneous tissue from axillary folds.The clinical outcomes in the two groups were comparatively analyzed,based on surgery time,effect,complications,scarring and recovery time.Results The total efficiency of axillary osmidrosis treatment was 100％ after 6-12 months clinical follow-up towards two groups.There was no significantly statistical difference on the effect of both groups.Micro-incision simple liposuction was obviously superior to dissection and excision of subcutaneous tissue from axillary folds based on surgery time,complications,recovery time,scarring and armpit hair survival rate.The two groups were significantly different (P＜0.05).Conclusions Minimally invasive simple liposuction,as a treatment for axillary osmidrosis is a method with more effectiveness and reliability.It is a more acceptable approach to patients in view of safety and convenience,smaller and invisible scarring,fewer complications,and less recovery time.

Objective To study arterial distribution of rectus abdominis musculocutaneous flap and to evaluate whether it can be divided into several units for reconstruction. Methods The arteries of the rectus abdominis musculocutaneous flap were studied on 60 sides of cadavers by dissection and angiography. Results The superior epigastric artery (SEA) and the inferior epigastric artery (IEA) continued in a longitudinal direction. Most of their branches took on a typical spiral configuration and communicated with each other within muscle above the level of umbilicus. Many perforating arteries penetrated through the anterior rectus sheath to get to the overlying skin, but the highest concentration of major perforators were in the paraumbilical area. The inferior epigastric artery was more significant than superior epigastric artery in supplying the skin of the musculocutaneous flap. Based on thefstudies of the vascular anatomy of muscles, we could classify arterial distribution into 3 types: type Ⅰ (SEA 26.5 %, IEA 34.6%) revealed a single main intramuscular artery: type Ⅱ (SEA 64.7 %, IEA 48.1%) had two major intramuscular branches; type Ⅲ (SEA 8.8%, IEA 17.3 %) revealed three intramuscular branches. Our anatomic studies showed that the superior and inferior epigastric artery bifurcated or divided into more than two main branches in the majority of cases (SEA 73.5%, IEA 65.4%). Conclusion The rectus abdominis musculocutaneous flap could often be divided into several regions for breast construction which is based on the distribution of each branch of the artery.

Objective To investigate the application of computer-aided 3D reconstruction and rapid prototyping(RP) technique in the correction of prominent mandibular angle.Methods Computer tomography scanning and 3D reconstruction were performed on 15 square face patients with prominent mandibular angles,then their actual mandible models were made by RP techniques.Surgical programs were made according to the model,including partial mandibular angle osteotomy,outer mandible table sagittal splitting osteotomy,chin augmentation with autogenous mandibule bones,and so on.In 15 cases,mandibular angle partial cutting was performed in 5 cases,sagittal splitting osteotomy in 6 cases,and mandibular angle partial cutting combined with splitting osteotomy in 4 cases.The autogenous mandibule bones were transplanted for chin augmentation in 3 chin microsomia patients.All the cases were treated according to the position and range set by the RP model.Results All the mandibular models produced by RP techniques were real and complete,which could directly and precisely show the state of the mandible.The operations completed smoothly and accomplished with the expected outcomes designed before operation.In all cases,the width of lower face was efficiently reduced and the face was symmetrical after operation.The follow-up period ranged from 3 months to 1 year in 12 patients,during which their facial appearances were in good condition and the results were satisfactory.Conclusion RP techniques is helpful in precise representation of the state of mandible,which providing ideal surgical models for accurate evaluation of prominent mandibular angle,design of surgical procedures as well as surgery instruction.It can provide good assistance to facial contour plastic surgery.

Objective To observe effects and mechanisms of insulin on reperfusion injury after cerebral ischemia.Methods Sixty-six male Wistar rats were used in this study.All rats were divided into 3 groups as treated group(A),control group(B) and random sham-operated group(C).Four-vessel occlusion was used to establish global cerebral ischemia reperfusion model in study groups.The treated group were divided into 5 groups(A1-A5) and intraperineally injected with biosynthetic human insulin 2 IU/(kg?d) and 50%glucose 2 g/(kg?d) for 7 days,the blood glucose was monitored in preoperative and postoperative 3,6,12,24 h,and the blood glucose was maintained between 3.5-6.5 mmol/L.These animals of control group were given with saline 2 mL/(kg?d) for 7 days in abdominal cavity.All the rats were killed in the seventh day,brain homogenate was collected for detection of neuron specific enolase(NSE)and nitric oxide(NO).The hippocampus was separated for observation of electronic microscope.Results Concentration of NSE in brain tissue in group C was significantly higher than that of group A and group B,while the level in group A was higher than that of group B.Concentration of NO in group C was lower than that of group A and group B while the level of NO in group A was significantly lower than that of group B.Electron microscope showed that the ultrastructure of sham-operated group was nearly normal,damage degree of hippocampal neuron and gliacyte and capillary was gradually worse from group A1,A2 to A4,the damage degree of group B1,B2 and B4 was serious and there was no difference among them.Conclusion Insulin can really promote recovery of the cerebral injury after ischemia reperfusion.

Objective To study the molecular regulation mechanism of VEGF in the model of ATRA induced differentiation in HL-60 cells,and to provide new targets for leukemia anti-angiogenic therapy.Methods The morphology was observed by Wright-Gimesa staining; HL-60 cells differentiation was detected by NBT reduction experiment.VEGF,STAT3,c-myc mRNAs were measured by reverse transcription-PCR;VEGF,STAT3 and c-myc proteins were determined by Western blot.Results The proliferation of HL-60 cells was inhibited obviously by ATRA(1 μmol/L) with the induction of differentiation,NBT positive rate was 82.59％ (t =-24.157,P ＜ 0.01) ; VEGF mRNA (t =7.339,P ＜ 0.05),STAT3 mRNA (t =3.667,P ＜0.05) and c-myc mRNA (t =6.858,P ＜ 0.05) were all down-regulated.VEGF protein (t =3.386,P ＜0.05),STAT3 protein(t =4.074,P ＜ 0.05) and c-myc protein (t =3.333,P ＜ 0.05) were all down-regulated.Conclusion VEGF expression level is reduced with the procession of differentiation of HL-60 cells,which may be largely correlated with the down regulation of STAT3 and c-myc.

Objective To discuss the methods and evaluate the effects of initial muscle-enclosing protection of large segment of exposed Achilles tendon and second stage repair of Achilles tendon rupture complicated with cuta-neous defect.Methods Among patients treated between August 2005 to April 2014 in our hospital,there were 32 patients,who were diagnosed with Achilles tendon rupture complicated with cutaneous defect.Of the 32 patients, there are 21 male and 11 female.Their ages range from 23 to 69,with an average age of 46.2 ±3.5.In all the patients described above,there are soft tissue contusion injuries and cutaneous defects on their posterior lower legs near the ankles,with the area of skin defects ranging from 3cm ×4cm to 5 ×12cm,and the Achilles tendons were ruptured, extracted,dissociated and completely uncovered.All patients were initially treated with triceps surae muscle-enclosing method to put aside and protect the large segment of exposed Achilles tendon.Later,the ruptured Achilles tendons were repaired,together with the transfer of skin flap to repair skin defects,at the second stage.The therapeutic effects were evaluated during postoperative follow-up periods.Results The mean follow-up period was 18 months,ranged from 11 to 32 months.According to the therapeutic effect evaluation standard of Arner-Lindholm,there were Excellent results in 22 patients,Good in 7 cases and Poor in 3 cases,with a combined excellent/good rate of 90.62%.Conclusion Initial muscle-enclosing protection of large segment of exposed Achilles tendon and second stage repair of Achilles tendon rupture complicated with cutaneous defect is advantageous to the function of patients with rapid recovery.