Hematologic abnormalities as the first manifestation of systemic lupus erythematosus (SLE) are broadly in line with the amount of PAIgG, which is also related to the severity of the disease. ① The level of serum immune complexes correlates inversely with the number of platelets. Cellular immunity mediated by platelets or platelet membrane lymphocytes leads to lymphocyte release and macrophage accumulation around the platelets, making them easily swallowed or destroyed directly by natural killer cells. In this paper, two cases improved after splenectomy. Most scholars believe that splenectomy can be used in ITP but should not promote the occurrence of SLE. If you really want to perform a splenectomy, medication cannot be abandoned, which may delay the onset of SLE. Clinical work on ITP must closely observe regular serological tests for SLE. This data shows that SLE can also present with superficial lymph node involvement. Pathologically, the lymph node follicular structure is unclear, cellular proliferation and changes should alert to the possibility of SLE, especially when associated with fever, leukopenia, and increased serum γ-globulin, which should highly suggest the presence of SLE. Reports describe Kikuchi's necrotizing lymphadenitis (lymph node pathology showing tablet-like necrosis with groups of histiocyte hyperplasia), as described in three cases in Liaoning DW Journal 1989, Volume 3, where two patients were eventually diagnosed with SLE. This article suggests that even without typical skin lesions, LBT still has diagnostic value. We realize that in laboratory tests for SLE, one or more blood cell lines reduced, elevated ESR, increased serum γ-globulin and IgG levels aid in diagnosis, while anti-nuclear antibody (ANA), anti-dsDNA antibody, and anti-Sm antibodies are significant for diagnosis. LE cell test results vary due to the proficiency and seriousness of the examiner, resulting in a significantly lower positive rate than ANA and consuming more blood, so this test is diminishing in foreign countries. ANA testing in SLE is highly sensitive and worth promoting. Ear cartilage (profile) instead of meibomian gland reconstruction is an important procedure in ophthalmology, protecting vital ocular structures. Various surgical techniques have been developed by many scholars, but the results are less than ideal. The focus of the study is selecting eyelid and meibomian alternatives intraoperatively. Sclera, costal cartilage, or frozen dura mater can replace damaged tissues. Our department successfully reconstructed the eyelid using autologous auricle cartilage under non-institutional conditions. Hereby, we report as follows.
Before tumor resection surgery, under sterile conditions, ear cartilage was taken and wrapped with saline-soaked gauze. After removing the barrier and mass, conjunctival separation risk was assessed according to defect size; generally, conjunctiva separation can pull the seal into the cartilage appropriate for the lower eyelid. A pedicle flap was taken from the corresponding storm eyelid on the same side, both ends of the graft sutured to the tarsus stump or adjacent ligament, then the far end of the flap was sutured to the lower eyelid skin, and finally the conjunctiva was sutured to the palpebral side of the flap. Stitches were removed after 8-10 days, and the pedicle was cut after 15 days. Case 1: Female patient, aged 63. In October 1986, a black painless mass was found on the right lower eyelid growing slowly. It rapidly increased in February 1987, and in March of the same year, our department treated her. The patient's general condition was good, visual acuity 1.0, and the right upper eyelid was normal. A cauliflower-like mass, 7x12mm in size with central rupture and Mu-edge invasion, was seen centrally. Local anesthesia was used for ear cartilage replacement of meibomian eyelid reconstruction, and the tumor caused a lower eyelid skin defect (about 2/3 of the lower eyelid). A skin pedicle flap from the same side was used for repair. Pathological diagnosis of the tumor was squamous cell carcinoma. Follow-up for a year and a half showed no recurrence. Case 2: Female patient, aged 20. In 1980, she underwent surgery at a local hospital for a left lower eyelid tumor. Due to tumor recurrence and growth, she visited us in November 1986. The patient was in good condition. The left eye had a visual acuity of 0.9, and a semi-circular mass about 10×nmm in size was visible on the left lower eyelid. Tumor resection and repair were performed simultaneously in January 1987. Pathological diagnosis was mackerel-like epithelial cancer. Patients were followed up for over a year with no tumor recurrence, except for slight valgus of the pupil.
Discussion: Eyelid reconstruction requires fine surgical operation, ensuring beautiful postoperative eyelid shape and physiological requirements. The tarsus substitute uses auricle cartilage, avoiding rejection from leaf tissue. Generally, removing the tarsal plate does not affect the normal development of the ear or its function and appearance. This surgical procedure is simple, easy to operate, and easy to master, suitable for primary hospitals. Generally, appearance and physiological function return to normal within about three months, with satisfactory results.