Objective:To study the clinical effects of modified surgical method with H-uvulopalatopharyngoplasty(H-UPPP)and traditional surgical method in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods:The clini-cal data of 364 pediatric patients with OSAHS were retrospectively analyzed.The patients were divided into 2 groups and treated by low-temperature plasma knife radio frequency ablation for bilateral tonsil removal combined with H-UPPP(group A,n=204)and low-temperature plasma knife radio frequency ablation only(group B,n=160)respectively.The operative time,intraoperative bleed-ing,postoperative secondary bleeding,VAS of pain following operation,postoperative traumatic white film shedding time,OAH1,LSaO2,ESS scores and complications of the 2 groups were compared.Results:In group A the operative time,intraoperative bleed-ing,VAS,OAHI and ESS scores were lower than those in group B(P＜0.05),wile postoperative traumatic white film detachment time and LSaO2 were higher(P＜0.05).No statistically significant difference in terms of the number of cases of postoperative seconda-ry bleeding and complications was observed between the 2 groups(P＞0.05).Conclusion:The combination of low-temperature plas-ma radio frequency ablation and H-UPPP for the treatment of OSAHS may provide clear intraoperative view,and may improve the treatment effects.

Objective To evaluate the value of different surgical methods in the repair of huge chest wall defect after breast malignant tumor operation.Methods The clinical data of 22 patients with chest wall defect after chest operation were retrospectively analyzed.All patients received one-stage repair for the chest wall defect with different surgical methods.Of the patients,9 cases got repair with latissimus dorsi myocutaneous flap,4 cases received repairment with internal mammary perforator flap of contralateral breast,and the others received dermatoplasty.Results All the 22 cases were successfully repaired.Two cases of dermatoplasty got mild edema who was healed after acitive dressing change.No one got effusion,infection or necrosis.No recurrence or distant metastasis happened except one case of liver metastasis in the follow-up of 6 to 24 months.Conclusions Application of different surgical methods in repair for the chest wall defect can improve patients' life quality.It is easy,safe and effective.We should choose the most suitable surgical method according to individual situation.

Objective To investigate the clinical efficacy of comprehensive hyperbaric oxygen (HBO) in the treatment of the patients with sudden hearing loss .Methods Totally, 80 patients with sudden hearing loss who were admitted into our hospital for treatment from June 2015 to March 2017 were selected as research subjects, and were divided into the observation group (n =40) and the control group (n =40), in accordance with the sequence of admission.The control group was given volume expansion to improve hemorheology , vasodilator to improve microcirculation, glucocorticoids, neurotrophic drugs and ginkgo biloba extract dripping pills, while the observation group received HBO in addition to the treatment received by the control group .One course of treatment for all patients in the 2 groups was 10 days, and following 3 courses of treatment, changes in hearing and clinical efficacy before and after treatment for the patients of the 2 groups were compared between the 2 groups.Results Following treatment for 3 courses for the observation group , 4 cases were cured, 21 cases were markedly effective , 10 cases were effective and 5 cases were ineffective, with a total effective rate of 87.5％, while for the control group, no cases were cured, 5 cases were markedly effective, 22 cases were effective and 13 cases were ineffective, with a total effective rate of 67.5％.Statistical significance could be seen, when comparisons were made between the observation group and the control group (P <0.05).Before treatment, there was no significant differences in full frequency hearing loss for the patients of 2 groups (P >0.05).After 2 courses of treatment, the value of low frequency hearing for the observation group increased more significantly, as compared with that of the control group [(37.39 ±5.77) vs (23.91 ±4.08) dB,P <0.05], however, there were no statistical differences in the increased values of high frequency hearing , when comparisons were made between the 2 groups (P >0.05).After 3 courses of treatment, the increased values of both low frequency and high frequency hearing for the patients of the observation group were all significantly better than those of the control group [ low frequency: (45.99 ±5.98) vs (36.79 ±5.72) dB; high frequency:(19.63 ±3.94) vs (9.70 ±2.17)dB, P <0.05].Conclusions Comprehensive HBO treatment could effectively improve the hearing level of the patients with full frequency sudden hearing loss , which was worth further clinical popularization .

Objective To investigate the clinical efficacy of comprehensive hyperbaric oxygen (HBO) in the treatment of the patients with sudden hearing loss .Methods Totally, 80 patients with sudden hearing loss who were admitted into our hospital for treatment from June 2015 to March 2017 were selected as research subjects, and were divided into the observation group (n =40) and the control group (n =40), in accordance with the sequence of admission.The control group was given volume expansion to improve hemorheology , vasodilator to improve microcirculation, glucocorticoids, neurotrophic drugs and ginkgo biloba extract dripping pills, while the observation group received HBO in addition to the treatment received by the control group .One course of treatment for all patients in the 2 groups was 10 days, and following 3 courses of treatment, changes in hearing and clinical efficacy before and after treatment for the patients of the 2 groups were compared between the 2 groups.Results Following treatment for 3 courses for the observation group , 4 cases were cured, 21 cases were markedly effective , 10 cases were effective and 5 cases were ineffective, with a total effective rate of 87.5％, while for the control group, no cases were cured, 5 cases were markedly effective, 22 cases were effective and 13 cases were ineffective, with a total effective rate of 67.5％.Statistical significance could be seen, when comparisons were made between the observation group and the control group (P <0.05).Before treatment, there was no significant differences in full frequency hearing loss for the patients of 2 groups (P >0.05).After 2 courses of treatment, the value of low frequency hearing for the observation group increased more significantly, as compared with that of the control group [(37.39 ±5.77) vs (23.91 ±4.08) dB,P <0.05], however, there were no statistical differences in the increased values of high frequency hearing , when comparisons were made between the 2 groups (P >0.05).After 3 courses of treatment, the increased values of both low frequency and high frequency hearing for the patients of the observation group were all significantly better than those of the control group [ low frequency: (45.99 ±5.98) vs (36.79 ±5.72) dB; high frequency:(19.63 ±3.94) vs (9.70 ±2.17)dB, P <0.05].Conclusions Comprehensive HBO treatment could effectively improve the hearing level of the patients with full frequency sudden hearing loss , which was worth further clinical popularization .

Objective To study the safety and availability of extended resection,gland reconstruction and mammary gland lavage in treatment of mammary duct expansion.Methods 41 patients with duct expansion admitted from Mar.2012 to Jan.2015 were studied and they were randomly divided into two groups.15 patients in the control group received normal surgical treatment,and 26 patients in the observation group received extended resection,gland reconstruction and mammary gland lavage treatment.Results The operation time,intraoperatve blood loss,length of hospital stay and degree of satisfaction of the observation group were superior to those of the control group while the recurrence rate was lower than that of control group.The gland expanded resection reduced the recurrence rate,the shape of the breast was improved,and the continuous irrigation was the guarantee for the immediate formation of the gland.The three kinds of surgical procedures were organically combined and complement each other.Conclusion The surgical methord of extended resection,gland reconstruction and mammary gland lavage is worth of further exploring due to its advantages of easy to operate,good cosmetic effect and low recurrence rate.

Objective To explore the feasibility of using contralateral breast as the donor for immediately breast reconstruction or chest wall defect repair after mastectomy in breast cancer patients. Methods From Jul. 2013 to Mar. 2016, contralateral breast fat flap was used as the donor for 8 breast cancer patients with immediate autologous non-microsurgical breast reconstruction or chest wall defect repair after mastectomy. All participants in this study received preoperative oncological screening with ultrasound, mammography, and magnetic resonance imaging which revealed the absence of pathological abnormalities in the donor breast. Results Among the 8 pa-tients, 4 patients underwent immediate breast reconstruction and 4 received chest wall defect repair. Only 1 pa-tient undergoing breast reconstruction had minor complications with little or no effect on the final outcome. No patient undergoing chest wall defect repair had postoperative complications. The functional and aesthetic out-comes were very satisfactory. Regular follow-ups were from 3 to 34 months with no recurrence found up to the present. Conclusions This article presents the first case for immediately breast reconstruction or chest wall de-fect repair using contralateral breast as the donor. The surgical method has some complications but with good aesthetic outcomes, which can be an option for breast cancer patients with hypertrophic and ptotic breast.

Objective To evaluate intraoperative tracing of sentinel lymph nodes ( SLNs) by fluorescence imaging combined with carbon nanoparticles .Methods 112 breast cancer patients eligible for sentinel lymph node biopsy were randomly assigned to the combination group (56 cases)receiving indocyanine green (ICG)and carbon nanoparticles as the lymphatic mapping tracers and ICG alone group (56 cases).Intraoperative frozen sec-tion was performed , followed by conventional histopathology .Results In the combination group , subcutaneous lymphatic vessels were successfully visualized in 53 patients and the detection rate was 94.6%(53/56).The flu-orescence SLNs were successfully detected in 54 patients and the detection rate was 96.4%(54/56)in ICG alone group.In the combination group , SLNs were successfully identified in 54 patients by fluorescence and 52 patients by black dyed, and the SLNs detection rate was 100%(56/56).While in the ICG alone group, the SLNs were found in 52 patients and the detection rate was 92.9%(52/56)(χ2 =2.3, P>0.050).The average number of detected SLNs was 3.7 ±1.5 ( 205/56 ) in combination group vs 2.5 ±1.4 ( 130/52 ) in ICG alone group ( t =-3.5, P=0.001).17 metastatic SLNs were found in 10 patients in the combination group vs 12 metastatic SLNs in 9 patients in ICG alone group .Conclusion Combination of ICG and carbon nanoparticles for mapping sentinel lymph nodes in breast cancer patients can increase the number of SLNs detected and the detection rate , reducing the rate of misdiagnosis and false negative rate .

Objective To determine the quality of life of patients treated with one of three different types of surgery for breast cancer.Methods This was a cross-sectional study using a questionnaire survey completed by Chinese patients without active disease after at least 2 years of follow-up after breast cancer surgery.Results This study totally included 139 breast cancer patients:44 ( 31.6%) had undergone modified radical mastectomy with reconstruction, 41(29.5%)had a quadrantectomy with axillary lymph node dissection, and 54(38.9%)had a modified radical mastectomy without reconstruction.The EORTC QLQ-C30 and EORTC QLQ-BR23 question-naires were used;their reliability was>0.82.Global health status(94.30 ±12.04, P=0.028)and role functio-ning(85.16 ±17.23, P=0.138)were highest in the quadrantectomy group.Pain score was highest in the modi-fied radical mastectomy with reconstruction group(26.13 ±30.15, P =0.042).The breast symptom score (22.56 ±22.30, P=0.009)and body image perception(85.56 ±19.72, P=0.025)were highest in the conser-vative treatment group.The overall health of patients given modified radical mastectomy without reconstruction was lower(72.61 ±20.89, P=0.014) in women older than 50 years compared with younger women.Conclu-sions The quadrantectomy with axillary lymph node dissection procedure had better acceptance, but the overall health status did not differ between groups.Overall health status is lower in women older than 50 years receiving a modified radical mastectomy without reconstruction.

Objective To investigate the effect of overexpression of miRNA-4465 on invasion and metastasis of breast cancer MDA-MB-231 cells and its mechanism.Methods MiRNA-4465 minics was transfected into the MDA-MB-231 cells,and real-time PCR was used to detect the expression of miRNA-4465.Transwell assay was used to investigate the migration and invasion capability of cells after being transfected.Bioinformatics analysis were performed to predict the potential targets of miRNA-4465,and finally,luciferase reporter plasmids assay and west-ern blot was used to confirm the potential target of miRNA-4465.Results Comparing with negative control group, the expression of miRNA-4465 in miRNA-4465 minics group was increased significantly.Transwell migration assay showed that migration capability of cells in miRNA-4465 minics group was decreased(P =0.001);transwell inva-sion assay showed that invasion capability of cells in miRNA-4465 minics group was decreased(P =0.010).Lucif-erase reporter plasmids assay showed that comparing with the negative control +psiCHECK2-EZH2 3’UTR(wild type),the fluorescence activity of miRNA-4465 minics +psiCHECK2-EZH2 3’UTR(wild type)was decreased by 66%(P =0.001).Moreover,comparing with the negative control group,the expression of EZH2 protein was de-creased after transfecting miRNA-4465 minics into MDA-MB-231 cells.Conclusion MiRNA-4465 can suppress the invasion and metastasis of breast cancer MDA-MB-231 cells,which may be related to the regulation of EZH2.

OBJECTIVETo explore an ideal surgical method for nipple hypertrophy correction.

METHODSFrom July 2008 to June 2011, 44 nipple reductions were performed for 22 women (44 sides) by using the modified Z-shaped incision technique. The incision consists of two circles, one quadrangle and one triangle located on the top, body and base of the nipple. The nipple's height was decreased and the nipple diameter and base area were reduced. Bilateral nipples were designed symmetrically.

RESULTS22 cases(44 sides) were treated with primary healing. The mean diameter of the nipple was reduced to (9.8 +/- 1.6) mm from (17.6 +/- 3.4) mm, the average height from (18.8 +/- 3.6) mm to (8.2 +/- 1.4) mm, with the patient supine. All the patients were followed up for 14 months to 4 years with satisfactory results. No nipple necrosis, infection and numb happened. 20 patients completed the self-designed survey scale 1 year after operation, of which 4 cases achieved normal lactation, and the remaining patients didn't have childbirth and breastfeeding yet.

CONCLUSIONSThe modified Z-shaped incision technique could reduce the height, diameter, and most importantly, reduce the basal shape of all types of hypertrophic nipple to create a desired new cylindrical nipple without affection of nipple sensation and function.

Adolescent ; Adult ; Female ; Humans ; Hypertrophy ; Mammaplasty ; methods ; Nipples ; pathology ; surgery ; Treatment Outcome ; Young Adult