Objective To analyze the clinical efficacy of PRF-mixed autogenous fat granules transplantation for facial contour modification,and to discuss the methodology for improving fat preservation rate after facial fat transplantation.Methods 60 cases were divided randomly into two groups with 30 cases each:mixed treatment group of PRF and autologous fat granules (mixed group),and simple autologous fat granules transplantation group (control group).According to the different defect parts of facial contour,the mixture of proper amount of autologous fat granules and PRF harvested from venous blood via once centrifugation separation autologous transplanted to the cases in mixed group,PRF not added to the cases in control group,then the recent and long-term effect,complications,safety,and patient satisfaction were observed.Results The facial shape was stable 6 months after operation,the face of all cases was more full,and facial proportion was more harmonious than before operation.12 months of follow-up study was performed in all 60 cases,there was no fat embolism,infection,necrosis and other complications.The satisfaction rate was 96.7％ in mixed group and 80％ in control group after primary operation respectively.There were significant differences between the two groups.Conclusions Autologous transplantation of fat granule mixed with PRF has important application value in facial contour modification and facial rejuvenation.It is easy to be operated,and can achieve high fat preservation rate,stable long term effect and no obvious complication;the cases performed sufficient amount mixture of transplantation can get ideal cosmetic effect.

Objective To evaluate the clinical efficacy of topical fat redistribution in combination with shortening of upper eyelid levator muscle in patients with excessively wide palpebral fissure after double-eyelid operation.Methods Twenty patients with excessively wide palpebral fissure after undergoing double-eyelid operation were selected.The double-eyelid line was aesthetically re-designed,the skin or incisional scar between the original and new double-eyelid lines was excised,and the scarring adhesion among different tissues was fully isolated.The fat tissues within the orbital septum,deep orbit and anterior orbital septum combined with ROOF reconstruction were performed to block the adhesion tissues,shortening of levator muscle of the upper eyelid was equally conducted to enhance the cosmetic effect.Results Seventeen patients were satisfied with the cosmetic appearance following once double-eyelid operation.Two cases underwent twice operations due to different height between bilateral papebral fissures.One patient was unsatisfied with the cosmetic appearance.Conclusions Fat redistribution in combination with shortening of levator muscle of the upper eyelid can not only repair excessively wide palpebral fissure complicated with ptosis and upper eyelid depression,but also enhance the exposure rate of the cornea and increase the cosmetic appearance,which is consistent with contem porary aesthetic perception.

Objective To summarize the clinical features of patients with ovarian tumor associated anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis,and to explore the influence of operation patterns on the prognosis.Methods The clinical data of ovarian tumors with anti-NMDAR encephalitis in the Third Affiliated Hospital of Sun Yat-sen University from January 2009 to December 2018 were collected,and the clinical characteristics,treatment and prognosis were analyzed.Results A total of 110 patients with ovarian tumors and anti-NMDAR encephalitis were collected.All patients were positive for anti-NMDAR antibodies in serum and/or cerebrospinal fluid.The age of onset ranged from 10 to 35 years (24.6 ±5.7).About 60.9％ patients'initial symptom was psychosis.The main clinical features were psychosis (97.3％),seizures (83.6％),conscious disturbance (72.7％),autonomic dysfunction (64.5％),dyskinesia (64.5％),central hypoventilation (54.5％) and impaired memory (31.8％).Most patients'symptoms were relieved after surgery and immunotherapy.Postoperative pathological results revealed that ovarian teratoma accounted for 97.8％ of the ovarian tumor.The prognosis of patients with surgery was better than the patients without surgery,with statistically significant difference (P ＜ 0.05).The prognosis of patients with adnexectomy was better than the patients with ovarian tumor excision,with statistically significant difference (P ＜ 0.05).Conclusions Anti-NMDAR encephalitis,with psycho-neurological symptoms as dominant manifestation,is usually associated with ovarian tumor.For young female patients with psychosis,clinicians should be alert to the possibility of anti-NMDAR encephalitis and screen for tumor.Patients with adnexectomy and immunotherapy can get a better prognosis.

Objective To explore the value of 3D-ASL parameters for predicting glioma grade before operation and the relationship between the expression of Ki-67 and microvessel density(MVD).Methods 3DASL images of 50 patients with pathologically proven gliomas (high grade:n=20,1ow grade:n 30) were analyzed retrospectively.The mean maximum relative cerebral blood flow was obtained by the hot spot method.The Ki-67 labeling index and MVD of surgical specimen were measured.The results were analyzed statistically.Results The mean rCBF,Ki-67 and MVD of low grade gliomas (n=30) were 1.69±1.27,3.73％±3.01％,25.43±13.03,while the high grade gliomas (n=20) were 3.18± 1.46,49.25％ ±20.15％,58.69±20.39 respectively.The difference between the two groups was statistically significant (P＜0.01),which was positively correlated with the grade(r=0.620,0.871,0.698,P＜0.01).rCBF was positively correlated with Ki-67 and MVD (r =0.535,0.723,P ＜0.01).Ki 67 labeling index was positively correlated with MVD (r=0.629,P＜0.01).Conclusion The rCBF value is useful for predicting glioma grade before operation and related to tumor MVD and cell proliferation.The biologic behavior of glioma can be predicted to a certain extent.

Objective:To examine the clinical value of combining indocyanine green (ICG) fluorescence navigation with blue dye in sen-tinel lymph node biopsy (SLNB) for patients with breast cancer. Methods:A total of 89 patients with early-stage breast cancer who met the inclusion criteria were admitted at Shantou Central Hospital, Guangdong from May 2013 to April 2014. In phase one, ICG and blue dye were applied in all 53 patients, and then SLNB and axillary lymph node dissection (ALND) were performed based on fluores-cence signal or visual sense of the lymph nodes. In phase two, 36 patients with early-stage breast cancer were included. ALND was omitted when sentinel lymph nodes were frozen showing negative result. Rates of detection, accuracy, and false-negative were calcu-lated. Results:A total of 89 patients were monitored, of which the total rate of SLNB detection was 96.6%(86/89). In the validation pe-riod, the rates of detection, accuracy, and false-negative were 94.3%(50/53) 98.0%(49/50), and 2.6%(1/38), respectively. In the alter-ative period, the rates of detection reached 100%. Of the 196 sentinel lymph nodes, 179 showed fluorescence signal, 142 exhibited blue dying, 54 only demonstrated fluorescence signals, and 45 demonstrated metastasis with five signaling fluorescence. About 24.7%of patients were diagnosed with SLN metastasis (22/89), where SLNB in two patients showed fluorescence signal but without blue dye. No ipsilateral lymph node relapsed were observed during a median follow up of 25 months. Conclusion:Combination of ICG fluores-cence navigation with blue dye in SLNB is safe for patients with breast cancer.

Objective To analyze the clinical efficacy and safety of the silkworm eroded dissolving method induced by micro-needle (the combined therapy of traditional Chinese and Western medicines including micro-needle guiding,external application of herbal membrane and anti-scar cream) for treatment of facial small area scar in early stage,and to explore a simple and effective therapy for facial scar.Methods Total 100 patients with facial small hyperplastic scar within 6 months after acute trauma healing were divided randomly into two groups with 50 cases each.The cases in treatment group were micro-needle acpunctured densely into scar,and then herbal membrane and anti-scar cream were applied.The cases in control group were treated similar to the treatment group except acpuncture.All cases in the two groups were treated for 3 months and followed-up for 6 months.Short-term efficacy,long-term efficacy,complications,safety and patient satisfaction were analyzed.Results There was no significant difference between treatment group and control group after treatment for one month,and significant difference was found after treatment for 2,3 months (P＜0.05).The earlier treatment after wound healing,the better efficacy.After treatment for three months most of scar showed no longer hyperplasia,and became soft gradully.Conclusions The combined therapy of micro-needle guiding,external application of herbal membrane and anti-scar cream for treatment of early facial small area scar demonstrates stable effects and high satisfactory rate of patients,the scar softens rapidly,and no obvious side effect occurs.

Objective To explore an operative method which can adequately enlarge the inner canthus with inconspicuous scar and perfect shape based on the transverse incision for epicanthus correction,and to evaluate the short-term results and long-term effects comprehensively.Methods The surface projection of tears port medial point was designed as a new inner canthal point,the full thickness skin from new inner canthal point was cut to the free edge of epicanthus,and an outward prolonged incision was made along the lower eyelid edge,separating the subcutanous dissociation or cutting off part of displaced orbicularis,so to relieve the skin tension of inner canthal and reset skin,suturing the new inner canthal point and lower eyelid edge.Results 120 cases were followed up for more than one year,the complication rate at different postoperative time points and patient satisfactory rate one year after operation were compared.12 cases had mild scar formation,from six months to one year after operation,the scar gradually became softened and then inconspicuous.22 cases had a little skin fold at the inner canthal in postoperational one month.2 cases were unsatisfied with the shape of inner canthal,Others were satisfied with therapeutic efficacy,the correction was sufficient with inconspicuous scar and 1ess recrudescence.Conclusions Epicanthus correction by subciliary incision epicanthoplasty is a simple and effective method and suitable for all types of epicanthic fold,and it has the advantages of sufficient enlarged inner canthus,inconspicuous scar and 1ess recrudescence.

Objective To discuss the efficacy and advantage of dolabriform flap in repairing periorbital skin and soft tissue defects.Methods 21 patients with periorbital skin disease were treated by radical resection,and then the adjacent or distant dolabriform flaps were designed for the one stage repair of skin and soft tissue defects in these cases according to the defect location,size,shape and neighborous skin conditions.The largest defect size was 3.5 cm × 4.5 cm,The smallest defect size was 1.2 cm × 1.5 cm.The largest ratio of hatchet pedicle width to axe handle length reached 1 ∶ 5,and the largest ratio of hatchet pedicle width to hatchet edge length was 1 ∶ 4.Results All of these dolabriform flaps in 21 patients survived well with primary incision healing.18 cases had been followed up for 3 to 12 months,showing that there was no deformation found on eyelids,eyebrow and nose,the colour of these flaps were similiar to that of the normal skin,without being fat and clumsy,all scars were almost invisible,and the cosmetic results were satisfactory.Conclusions Larger diameter of skin and soft tissue defect in different periorbital parts could be repaired individually with dolabriform flap according to the characters of natural lines,and it is a simple and flexible method for repairing periorbital skin defects,and can achieve satisfactory functional and cosmetic results.

Objective To analyze the clinical efficacy and safety of combined therapy of traditional Chinese and Western medicine (heparin sodium cream massage, induced treatment by micro-needle, and external application of herbal membrane) and micro-explosion method for facial pigmentation after trauma, and to explore an effective and safety therapy for skin-whitening and anti-freckle. Methods A total of 100 cases with pigmentation on face were divided randomly into two groups with 50 cases each: the cases in treatment group were massaged with heparin sodium cream, needled skin pigmentation spot densely by micro-needle and applied with herbal membrane; the cases in control group only were massaged with heparin sodium cream, and applied with herbal membrane, without needling on skin. Short-term efficacy, long-term efficacy, safety and satisfaction of patients were observed. Results These cases were followed-up for 3-6 months. There was no significant difference between treatment group and control group after treatment for 15 days, and then significant difference was found after 1, 2 and 3 months (P<0. 05). There was no side effect after treatment for 6 months, and all cases were satisfactory. Conclusions There is rapid regression of pigmentation, with stable effect and without recurrence and obvious side effect, and the satisfactory rate of patients is high after treated by combined therapy of herbal membrane external application, heparin sodium cream massage and induced treatment by micro-needle.

Objective To explore the effect and mechanisms of intense pulsed light (IPL) in treating hypertrophic scars on rabbit ear.Methods Thirty New Zealand white rabbits were incruited in this study.Two hypertrophic scar models were made in the ventral surface of the rabbit ears with two lesions on each ear.The rabbits were divided randomly into two groups:the treatment group and the control group.Rabbits in the treatment groups were treated by IPL at the 3rd,5th,7th week after operation.Rabbits in the control groups were untreated.Morphological appearances of the hypertrophic scar were observed,and biopsies of scar were taken for HE stain and immunohistochemistry for the expression of vascular endothelial growth factor (VEGF),proliferating cell nuclear antigen (PCNA) and α-SMA,microvessel density was calculated by the expression of α-SMA at the 3rd,5th,7th,9th week after operation.At the 9th week after the operation,the ventral surface skin from two normally-fed rabbits were collected to undergo the same examination above.Results Comparing with the control group,the height of scars was reduced significantly in the IPL treatment group.The scars becaming soften and completely flat needed less time in the IPL treatment group.Comparing with the control group,the level of α-SMA,MVD,VEGF and PCNA expression in the treatment group obviously decreased over the same period (P＜0.05).Conclusions IPL is of great therapeutic effect on treating hypertrophic scar of rabbit ear.