OBJECTIVE To investigate the mechanism of Huangqin decoction in improving ulcerative colitis （UC） through the gut microbiota-tryptophan metabolism-aryl hydrocarbon receptor （AhR） axis. METHODS Mice were randomly divided into normal group （normal saline）， model group （normal saline）， microbiota depletion-model group （normal saline）， microbiota depletion-Huangqin decoction group （9.1 g/kg， by crude drug， similarly hereinafter）， Huangqin decoction group and mesalazine group （positive control group， 0.4 g/kg）， with 6 mice in each group. Microbiota depletion was achieved by providing free access to a mixed antibiotics for 10 days. The UC model was induced by administering 2.5% dextran sulfate sodium solution for 7 days. After successful modeling， each treatment group received corresponding drugs or normal saline intragastrically once daily for 10 days. After the final administration， body weight change ratio， disease activity index （DAI） score， and colon length were evaluated； colon pathological changes were observed； serum levels of interleukin-6 （IL-6）， IL-10， IL-22， and tumor necrosis factor-α （TNF-α） were measured； the expressions of Occludin， zonula occluden-1 （ZO-1）， and AhR in colon tissue were detected； fecal samples were subjected to high-throughput sequencing to analyze targeted tryptophan metabolomics. RESULTS Compared with the model group， Huangqin decoction group showed reduced infiltration of inflammatory cells in the colon tissue and restoration of the intestinal mucosal structure. Body weight change ratio， colon length， serum content of IL-10， the expressions of Occludin， ZO-1 and AhR in colon tissue and the contents of tryptophan metabolites indole-3-propionic acid （IPA）， N -acetylserotonin （NAS） and indole-3-acetic acid （IAA） were all significantly increased （ P ＜0.05）； DAI score， serum levels of IL-6， TNF-α， and IL-22 and the content of tryptophan metabolite indole-3-ethanol were significantly decreased （ P ＜0.05）； gut microbiota structure was improved， with increased relative abundances of beneficial bacteria such as Lactobacillus ， and decreased relative abundances of pathogenic bacteria such as Escherichia-Shigella . However， after antibiotic-induced microbiota depletion， although Huangqin decoction significantly increased the content of NAS in the feces of mice， the expression of AhR protein in colon tissue did not increase concurrently. CONCLUSIONS Huangqin decoction can repair the intestinal mucosal barrier in UC mice by regulating the gut microbiota and promoting the production of IPA and IAA， thereby activating AhR. This suggests that an intact gut microbiota is an important prerequisite for Huangqin decoction to exert its AhR-regulating effects.

Objective:To explore the effect of combined orbicularis muscle double stitch operated on blepharoplasty.Methods:A total of 90 patients, 79 females and 11 males, aged 18-49 years, were treated by using combined orbicularis muscle double stitch procedure, that is, to fix upper lifting muscle, to remove partial fat, and to perform blepharoplasty.Results:All 90 cases＇ incisions were healed at the first phase, no obvious swelling and bleeding. Within 3-24 months follow up, all patients＇ upper eyelids were significantly improved. The skin was smoothy when closing eyes, and eyelash was up when opening eyes, and arc was natural and satisfactory.Conclusions:This method can improve the shape of the upper eyelid swelling and get long-lasting and stable physiological eyelid.

Objective: To explorea long-term effect of in situ artificial anal reconstruction using five-combined-operation technique after lower rectal cancer resection. Methods: After miles operation, 60 patients suffered with lower rectal cancers underwent in situ artificial anal reconstruction using five-combined-operation technique, which included internal and external anal sphincter, rectal flap, rectal angle, and anoperineal reconstruction. Results: All cases in this study were performed successfully, with primary healing in the wounds. Awareness of defecation had reoccurred in all cases since 1 week postoperatively and self-control of defecation had been regained since 3 weeks postoperatively with formed stool excreted once or twice a day. Long-term follow-ups: ①In 95% cases, rectal controlled discharge time was longer than 2 minutes, which was significantly higher than that of sphincter reconstruction group as a control(P<0.05). ② Five-year survival rate reached to 88%, which was significantly higher than that of the control group(P<0.05). Conclusions Anal reconstruction using five-combined operation method after Miles operation could be a safe and effective surgical procedure, which could completely cure tumor, and improve patients′ life quality and long-term survival rate.

Objective To discuss the correction of lower baggy eyelid with severe tear trough and eyelid sulcus (groove deformity) and its therapeutic effect.Methods Through incision at the lower eyelid margin,the dissection was performed at the deep surface of the orbicularis muscle to expose the orbital septum and inferior orbital rim periosteum.The orbital fat which was released from orbital septum was repositioned at the inferior orbital rim and fixed on periosteum.If the depression was not completely corrected,the extra orbicularis fixed with periosteum.If the depression was not completely corrected,the extra orbicularis muscle was designed as muscle flap with interior pedicle to further correct the groove deformity.Results 60 cases were treated with no depression or unsmooth deformity.All the cases were followed up for 3-12 months with satisfactory aesthetic effect.Conclusions Orbicularis flap combined with orbital fat reposition is a simple and effective method for correction of tear trough and eyelid sulcus deformity.

Objective To discuss the correction of lower baggy eyelid with severe tear trough and eyelid sulcus (groove deformity) and its therapeutic effect.Methods Through incision at the lower eyelid margin,the dissection was performed at the deep surface of the orbicularis muscle to expose the orbital septum and inferior orbital rim periosteum.The orbital fat which was released from orbital septum was repositioned at the inferior orbital rim and fixed on periosteum.If the depression was not completely corrected,the extra orbicularis fixed with periosteum.If the depression was not completely corrected,the extra orbicularis muscle was designed as muscle flap with interior pedicle to further correct the groove deformity.Results 60 cases were treated with no depression or unsmooth deformity.All the cases were followed up for 3-12 months with satisfactory aesthetic effect.Conclusions Orbicularis flap combined with orbital fat reposition is a simple and effective method for correction of tear trough and eyelid sulcus deformity.

Objective To study the methods and clinical effects of joint expansion of double fascia flaps wrapping the Medpor to perform full-ear reconstruction on congenital microtia deformity.Methods 60 patients with congenital microtia deformity were selected.including 22 left ears and 38 right ears.Majority had loss of ear auricle or only partial earlobe.Phase Ⅰ procedures included:temporal-parietal branch was used for the vascular pedicle,and mastoid area behind the ear was moved and expanded for fascia flap.Phase Ⅱ included:the joint expansion of double fascia flap wrapped Medpor to do full-ear reconstruction.Results Flaps survived and no complications for all 60 patients.Reconstructed ears had lifelike appearance and clear anatomical structures.Auriculocephalic angulars positions and sizes were consistent with the healthy ears.None of them had exposed prosthesis and scar contraction.Three-dimensional shapes were good.Conclusions Joint expansion of double fascia flap wrapping Medpor could avoid the chest wall deformity and exposed prosthesis.The fine structure of the reconstructed ear is satisfactory.

Objective To investigate the clinical indication and effect of instant reconstruction of breast after removal of polyacrylamide hydrogel injection for breast augmentation.Methods Patients had breast ultrasound,MRI check before operation,to define the distribution and level of the injections and tissue infiltration.Depending on tissue degree,capsule integrity and breast degeneration situation,three different methods were chosen,including implantation of silicone gel underneath the breast,pectoralis major or dual-plane.Results 56 patients' incision healed well.Follow-up for 6 months to 3 years showed that breast shapes were good without scars,prosthetic herniapsular,capsular contracture and other complications.Conclusions Instant reconstruction of the breast after removal of polyacrylamide hydrogel injection can improve breast shape and get satisfied effects.

Objective To explore the methodology of skin flap muscle flap (double flaps) and and effect of the double flaps on eyelid bag blepharoplasty.Methods Through lower eyelid incision,skin flap and muscle flap were formed,orbicularis muscle and orbital septum separated between the skin and flaps,direct access to the inferior orbital rim depression.Arcuate edge of the orbicularis muscle was fully stripped and released,especially the orbicularis muscle at the inferior orbital rim periosteal surface.The orbital fat was released,sutured below the inferior orbital rim periosteal surface.The orbicularis muscle flap was designed,lift and fixed to enhance midface to achieve the rejuvenation effect in the lower eyelid region.Results The 36 patients treated had no hematoma and flinch in the lower eyelid.Within 3 to 18 months follow-up,there were no ectropion,and facial nerve damage and other complications.Conclusions Double-flap is a feasible method as it can effectively enhance midface rejuvenation and correct eyelid bags deformity.

Objective To investigate the reconstructive effect and method on breast deformation after polyacrylamide hydrogel injection for breast augmentation.Methods Sixty patients underwent B type ultrasonic and MRI examination for confirmation of breast deformation after removal of polyacrylamide hydrogel injection and clear distribution level of the injection material and surrounding tissue infiltration.According to skin elasticity,breast subcutaneous layer,glandular layer and pectoral muscle layer,then placed in the suction apparatus with injection of normal saline and completely sucked out and clear the injection material.Based on the wishes of patients and tissue damage,divided into Ⅰ or Ⅱ prostheses implanted and provided appropriate treatment Results Within 3 months to 3 years visiting,breast shape was good.Prosthesis had no herniation,without infection.Bilateral breasts were symmetry without capsular contracture.Conclusions Reconstruction of breast deformation after polyacrylamide hydrogel injection for breast augmentation can improve breast shape and achieve satisfactory effects.

Objective To observe the clinical effect on cervicogenic headache (CEH) of pulsed radiofrequency stimulation (PRF) applied to the C2 dorsal root ganglion combined with nerve block.Methods A total of 78 cases diagnosed as CEH were randomly divided into a combined treatment group,a PRF treatment group and a nerve block group.The combined treatment group was given both PRF applied to the C2 dorsal root ganglion and blocking therapy.The other two groups were given only one treatment or the other.All the treatments were once weekly for 3 weeks.Before treatment and 1,3 and 6 months after treatment,all of the patients' headaches were evaluated using a visual analogue scale (VAS).Results At 1,3 and 6 months after treatment,the average VAS scores of all three groups had decreased significantly.The VAS ratings dropped the most in the combined treatment group,followed by the PRF group and then the nerve block group.All the intergroup differences were statistically significant.The combined treatment group's cure rate (88％) was significantly better than that of the PRF group (81％),which was significantly better than that of the nerve block group (54％).Conclusion Combining PRF applied to the C2dorsal root ganglion with nerve block therapy has a synergistic effect on CEH.The curative effect of the combined treatment was better than either PRF or blocking alone.