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Objective:To investigate feasibility and clinical effect of free anterolateral thigh flap(ALTF) with reversed arterial flow in repair of foot and ankle wounds in children.Methods:From October 2014 to February 2021, the free ALTF with reversed arterial flow was used to repair the wounds in 7 children with severe soft tissue injury and main blood vessel injury in the Department of Hand & Foot Surgery of the Second Affiliated Hospital of University of South China. Of the 7 injured children, 5 were caused by traffic accident, 1 by mechanical strangulation and 1 by heavy object. The size of wounds ranged from 6.0 cm×8.0 cm to 9.0 cm×11.0 cm. ALTF were designed to be anastomosed with the blood vessels at the recipient sites by retrograde blood supply. The size of flaps ranged from 6.0 cm×8.0 cm to 10.0 cm×11.0 cm. All flap donor sites were pulled together and directly sutured. Follow-ups were conducted through outpatient clinic visits, telephone call and WeChat reviews in the 1st, 3rd, 6th, 12th and 24th months after surgery. The major contents in follow-up were the shape, colour, texture, sensation of flap and function of ankles.Results:All donor sites healed at I stage. A total of 5 flaps survived successfully; One flap had venous occlusion after surgery, and the flap survived after surgical exploration; One flap had partial necrosis after surgery, and repaired with artificial dermis after further debridement. Postoperative follow-up lasted for 6-24 months, with an average of 10.5 months. All flaps appeared in similar colour and texture to the surrounding soft tissues. Two children underwent flap repair after half a year due to bloated flaps. The Ankle-hind foot Function Score of American Orthopedic Foot Ankle Society(AOFAS) was used to evaluate the ankle function. AOFAS achieved 84-94 points, with 5 children in excellent and 2 in good. The sensation recovered to S 3+ in 5 children, S 3 in 1 child and S 2 in 1 child, according to the standard of British Medical Research Council (BMRC). Conclusion:For the children with severe soft tissue injury combined with main vascular injury in foot and ankle, free ALTF with reversed arterial flow can repair the defect and effectively secure the blood supply. It is a feasible method for wound repair.
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Objective:To explore the advantages and value for clinical application of clavicle segment osteotomy approach with pectoralis major muscle pedicle in surgical resection of posterior brachial plexus tumour.Methods:From April 2010 to December 2020, 6 patients with brachial plexus tumour behind the clavicle were treated. Two patients had the tumour on the left brachial plexus and 4 on the right. Two patients had the tumours located in the upper trunk of brachial plexus, 2 in the middle trunk, 1 in the medial plexus and 1 in the posterior bundle. The neurological function evaluation were grade II in 3 cases and grade III in 1 case preoperatively. The tumours sized from 3.0 cm× 3.0 cm×2.0 cm to 11.0 cm×8.0 cm×6.0 cm. The clavicular segment osteotomy approach with the pedicle of the pectoralis major was applied in order to expose the surgical field and remove the nerve tumour. All patients underwent regular postoperative outpatient clinic follow-up to record the sensation of the affected limb and the recovery of muscle strength, tumour recurrence and fracture healing.Results:In the operation, it was found that there was still a little glial-like tissue in the nerve sheath after complete dissection of the tumours in 2 patients. Postoperative pathological examination reported that there were 4 schwannoma, 1 malignant peripheral schwannoma and 1 neurolipoma. The postoperative follow-up lasted for 6 to 34 months, with an average of 12.8 months. All patients showed no symptoms of brachial plexus injury or tumour recurrence. The clinical symptoms were relieved or disappeared. The neurological function evaluation reached grade III in 5 patients and grade IV in 1 case. At the same time, the internal fixation of the clavicle was satisfactory and achieved bone union in all cases. Fracture healing time was 2.5 to 4.5 months, with an average of 3.2 months. The internal fixation was removed from 3 patients after operation in 1 year. No obvious limb movement disorder and periarthritis of shoulder and other complications occurred.Conclusion:The transclavicular osteotomy approach with the pedicle of the pectoralis major can fully expose the anatomical alignment of the brachial plexus and the relationship adjacent and between the tumour and the surrounding tissues in the surgery for a brachial plexus tumour behind the clavicle, which is helpful for a complete tumour resection. It is a feasible method to treat brachial plexus tumour behind the clavicle by finding residual tumour-like tissue, reducing the risk of surgery and tumour recurrence, and providing excellent blood supply to the osteotomy segment of the clavicle to promote fracture healing.
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In order to standardize the management of fixed assets in basic medical research, and to solve the problem ofone equipment with more than one code , we discussed the fixed assets coding of instrument and equipment in this paper.The existing equipment classification of the Institute of Basic Medical Sciences of the Chinese Academy of Medical Sciences was analyzed.Depending on application of the experiment and the principle of equipment, the novel fixed assets encoding dictionary of instrument and equipment is generated, which fits in the application and development of basic medical research.The managers may find the corresponding code quickly with the standardized equipment name.The new encoding dictionary may facilitate the classification of basic medical experimental instruments, prevent multiple coding situations of equipment and improve the management.
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Objective To investigate whether the sodium arsenite inhibiting proliferation of hepatocellar carcinoma(HCC) cells and having a relation with the expression of promyelocytic leukemia (PML) protein .Methods The immunohistochemistry , Western blot analysis ,immunofluorescence assay and quantitative PCR were used to examine the PML gene and protein expression in HCC tissue and cells .Results The immunohis to chemical staining showed that the PML protein was expressed in nucleus of well‐differentiated ,moderately differentiated and poorly differentiated HCC tissues randomly selected from 15 cases of HCC under‐going hepatic resection .Western blot analysis showed that PML protein was expressed at varying levels in all 24 HCC tissue sam‐ples ,HuH7 ,HepG2 ,Hep3B ,SMMC‐7721 and L02 cells .The immunofluorescence assay demonstrated that PML protein grains were found in the nucleis of the HuH7 ,HepG2 ,Hep3B and SMCC‐7721 cells ,in which HuH7 and Hep3B expressed more PML proteins than HepG2 and SMMC‐7721 cells .24 HCC tissue samples ,Hep3B ,HepG2 ,SMCC‐7721 and HuH7 cells all expressed PML gene .Sodium arsenite not only down‐regulated the PML protein expressed in HuH7 and primary HCC cells ,but also inhibited the HCC cell growth of HepG2 ,Hep3B ,HuH7 and SMMC‐7721 ,with the exposure time extension ,the inhibiting effect of sodium arsenite on HCC cells was enhanced .Conclusion Both HCC cell lines and tissues generally express ther PML protein and gene , PML protein may serve as the molecular basis for the direct targeting effects of arsenical agents .
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Objective To study the expression and clinical significance of the SALL4 in human gastric carcinoma tissues. Methods The expression of SALL4 in 91 samples of gastric carcinoma and 37 samples of normal gastric tissues was detected by RT-PCR,Western blot and immunohistochemistry,and its relationship with the clinical data were analyzed statistically.Results The positive expression rate of SALL4 in gastric carcinoma(74.7%)was significantly higher than that(18.9%)in normal gastric mucosa tissues(P <0.05).Moreover,with the decreased with the differentiation of gastric carcinoma,the positive expression rate of SALL4 was increased.The expression of SALL4 mRNA and protein in gastric carcinoma tissues were significantly higher than that in normal gastric tissues(P <0.050).The expression levels of SALL4 were relevant to lymph node metastasis(P =0.001),infiltra-tion depth(P =0.029)and the differentiation degree of gastric carcinoma(P =0.050).Conclusion SALL4 was highly expressed in gastric cancer tissues and relevant to lymph node metastasis,infiltration depth and the differentiation degree,which may have play an important role in the development of gastric cancer.
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Objective To explore the prognosis related genes of pancreatic ductal adenocarcinoma (PDAC)and investigate the molecular regulation mechanism.Methods Gene expression data of 102 PDAC patients with complete clinical survival data were selected from gene expression database of National Center for Biotechnology Information.The 106 transcription regulation gene collection was collected from Transfac database.The 715 microRNA (miRNA)target regulation gene collection was selected according to PicTar and TargetScanS method.Biological pathway data obtained from the Kyoto Encyclopedia of Genes and Genomes (KEGG).The known cancer genes were collected from the cancer gene census (CGC) database.Univariate Cox proportional hazards model was used to analyze the correlation between gene expression data and survival time,then obtained survival related candidate genes from the whole genome. Then the enriched genes were analyzed by hypergeometric distribution algorithm from three databases. Multiple correction testing was performed by BH-FDR method (FDR < 0.05 ).Kaplan-Meier was performed for survival curve analysis of PDAC.Results The results of data of 102 PDAC patients analyzed by univariate Cox proportional hazards model indicated that 273 genes were significantly related to the survival time of patients (P <0.000 1 ).After 273 survival genes were enrichment analyzed in 106 transcription factor regulation gene collection,12 survival genes enriched transcription factor target gene sets were found.After 273 survival genes were enrichment analyzed in 715 miRNA target regulation gene collection,11 survival genes enriched miRNAs target sets were discovered.After 273 survival genes were enrichment analyzed in pathway data of KEGG,15 survival genes enriched pathways were obtained. Period circadian clock 2 (PER2 )was regulated by CCAAT/enhancer binding protein (CEBPA)at transcription level and regulated by miRNA-32 after transcription.The prognosis of PDAC was affected by circadian rhythm pathway.The 102 patients with PDAC were ranked according to the expression of PER2 from high to low,the first 51 cases were included in PER2 higher expression group and the left were included in PER2 lower expression group.Kaplan-Meier survival analysis indicated that PER2 was significantly correlated with prognosis of PDAC (P <0.01 ).Conclusion CEBPA/miRNA-32/PER2 and its related circadian clock pathway may be the target pathway in interfering the development of PDAC,and is correlated with the prognosis of PDAC.
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Objective To dynamically observe the plasma levels of MFG-E8 in mice with obstructive jaundice and the expression of MFG-E8 mRNA and protein in liver,spleen,lymph nodes and thymus,and to investigate their significance in obstructive jaun-dice.Methods The mice models of obstructive jaundice were established and divided into the sham operation group and the common bile duct ligation group.Western blot was adopted to detect plasma MFG-E8 protein expression in obstructive jaundice mice on 3,7, 14 d;the MFG-E8 mRNA expression changes in liver,spleen,lymph nodes and thymus tissue were detected by RT-PCR;the MFG-E8 protein expression in the above organizations was detected by Western blot.Results Plasma MFG-E8 protein levels at each time point in the obstructive jaundice mice were significantly lower than those in the control group (P<0.05);MFG-E8 mRNA expres-sion in liver,spleen,lymph nodes and thymus tissue was significantly decreased (P<0.05),meanwhile the MFG-E8 protein levels in liver,spleen,lymph nodes and thymus tissue were significantly decreased (P<0.05).Conclusion the expression of MFG-E8 in obstructive jaundice immune tissue is significantly decreased,which may have a significant impact on the clearance of apoptotic cells in obstructive jaundice.
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Objective To observe the protection effect of adrenomedullin(AM)and adrenomedullin binding protein-1 (AMBP-1) on the intestinal mucosal barrier after obstructive jaundice.Methods 24 male Sprague-Dawley rats were randomly divided into the Sham group,obstructive jaundice control group(Vehicle)and AM/AMBP-1 treatment group(n=8).Obstructive jaundice was in-duced in adult rats(180-220 g)by common bile duct ligation(CBDL).On 6 d after CBDL,the rats were administered through fem-oral vein with AM/AMBP-1(24/80μg/kg).Blood and tissue samples were collected at 24 h after administered AM/AMBP-1 for various measurements.The intestinal permeability of all rats was measured by fluorescein isothiocyanate-dextran(FITC-D).Serum concentration of TNF-αwas measured by enzyme-linked immunosorbent assay.The apoptosis of intestinal cells was detected by ter-minal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL).The expression of cleaved caspase-3 was measured by Western blot.The inj ury condition in the small intestinal mucosa was assessed by the Chiu′s scoring under microscope.Results Compared with the Sham group,the permeability of intestinal mucosa in the Vehicle group was increased (P<0.05)and serum TNF-αlevel was increased obviously (P<0.05).The expression of cleaved caspase-3 protein,the apoptosis index(AI)and the Chiu′s score were increased in the Vehicle control group(P<0.05).Compared with the Vehicle control group,the permeability of intestinal mucosa was significantly improved (P<0.05),serum TNF-αwas decreased in the AM/AMBP-1 group(P<0.05).The expression of cleaved caspase-3,the AI index and Chiu′s score were significantly decreased in the AM/AMBP-1 group(P<0.05). Conclusion AM and AMBP-1 can significantly improve the high permeability state of the intestinal mucosa in obstructive jaundice rat,reduce the apoptosis of the small intestinal tissue,alleviate the systemic inflammatory reaction and have the protective effect on the intestinal mucosal barrier.
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Cultivating clinical comprehensive ability is one of the core and main purposes for surgical clinical education.According to the characteristics in clinical teaching of hepatobiliary surgery,we combined basic theory with clinical practice and discussed on the problems of how to improve medical students' clinical comprehensive abilities including clinical operational ability,logical thinking ability,scientific research innovative ability and the doctor-patient communication ability and how to cultivate medical ethics and professional competence from aspects of basic clinical skills training,translational medicine concept,etc.
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AIM:To put forward three-level design(Box-Behnken design)for fitting response surfaces to optimize the extraction technology of total flavonoids from Hypericum ascyron L.METHODS:Four factors,including temperature,reflux time,concentration of ethanol,ratio of solvent to raw material were used to examine the yield of total flavonoids.Prediction was carried out through comparing the observed and predicted values.RESULTS:The results suggested that ethanol concentration and extraction temperature were two statistically significant factors.The optimum conditions of extraction process consisted of the ratio(mL:g)of solvent to material(13.3:1),ethanol concentration(53.2%),extraction temperature(78.7℃)and extraction time(2.3h).Regression coefficient of binomial fitting complex model was as high as 0.984 6.Bias between observed and predicted values was-4.01%.CONCLUSION:Box-Behnken design is success in optimizing the extaction in close agreement with the predicted values of the mathematic model.
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Objectives:To construct rGA antisense eukaryotic expression vector. Methods:Using molecular cloning technology, we subcloned rGA cDNA in its antisense orientations of the pcDNA 3.0 vector. Results:Cutting with Eco RⅠ and Hin D Ⅲ,antisense recombinant plasmid produce 2 bands. One was 0.28 kb fragment, the other was 5.5 kb fragment which corresponded to theoretical calculation. Conclusions:We succeeded in constructing rGA antisense eukaryotic expression vector.
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Objective To construct the recombinant plasmid carrying antisense GA cDNA, and evaluate the effect of antisense GA gene on the biological characteristics of colon cancer cells. Methods The recombinant plasmid pcDNA3.0/GA containing antisense GA gene was constructed by gene recombination technique. The recombinant plasmid was transfected into colon cancer cells by lipofectamine. The effect of antisene GA gene on the biological characteristics of colon cancer cell line DH52 was evaluated by MTT and electron microscopy. Results The recombinant plasmid pcDNA3.0/GA was successfully constructed. The growth rate of colon cancer cells decreased, and microstructure of the cells appeared typical apoptotic changes after transfection. Conclusion Antisense GA gene could inhibit the growth of colon cancer cells possibly by suppressing GA gene expression and decreasing GA activity in the colon cancer cells.
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AIM:To put forward three-level design(Box-Behnken design) for fitting response surfaces to optimize the extraction technology of total flavonoids from Hypericum ascyron L.METHODS:Four factors,including temperature,reflux time,concentration of ethanol,ratio of solvent to raw material were used to examine the yield of total flavonoids.Prediction was carried out through comparing the observed and predicted values.RESULTS:The results suggested that ethanol concentration and extraction temperature were two statistically significant factors.The optimum conditions of extraction process consisted of the ratio(mL:g)of solvent to material(13.3:1),ethanol concentration(53.2%),extraction temperature(78.7℃)and extraction time(2.3h).Regression coefficient of bino-mial fitting complex model was as high as 0.984 6.Bias between observed and predicted values was -4.01%.CONCLUSION:Box-Behnken design is success in optimizing the extaction in close agreement with the predicted values of the mathematic model.