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Objective:To investigate the efficacy of the nutrient vessel of medial and lateral sural subcutaneous nerve chimeric tissue flap based on posterior perforating branch of peroneal artery to repair the composite tissue defect in the Achilles tendon area.Methods:From January 2016 to June 2021, 12 patients suffering from infectious wound with defect of Achilles tendon were treated in the Department of Trauma and Microscopic Orthopaedics, 988th Hospital of the Joint Logistics Support Force of PLA. The area of soft tissue defect around Achilles tendon was 2.5 cm× 4.5 cm-8.0 cm×12.5 cm, and the length of the defect of Achilles tendon was 3.0-7.0 cm. The defect around the Achilles tendon were repaired with the nutrient vessel of medial and lateral sural subcutaneous nerve chimeric Achilles tendon flap (ATF) and the posterior perforating branch of peroneal artery was used as the vessel of blood supply. The size of flap was 3.0 cm×5.0 cm-9.0 cm×13.0 cm, and the size of the ATF was 3.0 cm×4.0 cm-3.0 cm×8.0 cm. The donor sites were sutured directly (8 cases) or repaired with skin graft (4 cases). External fixation were put on for 6 weeks after surgery. Then the external fixation was removed and the functional exercise gradually started. Outpatient clinic follow-ups were carried out regularly. Thermann Achilles tendon function assessment system was used to evaluate the last follow-up.Results:The chimeric ATF was harvested and the blood supply of each flap was good during the operation. There was no vascular crisis after surgery. The flaps survived smoothly and the wound achieved grade A healing. All patients were entered follow-up that lasted for 10-24 months. There was good appearance of flaps with minor bloating, and the colour of flaps was similar to the skin around the receiving site. The texture was soft with normal function of the lower legs and ankle. Tendon function was evaluated by Thermann Achilles tendon function assessment system, the result were 8 cases in excellent and 4 cases in good.Conclusion:The nutrient vessel of medial and lateral sural subcutaneous nerve chimeric tissue flap based on posterior perforating branch of peroneal artery can accurately repair a composite tissue defect in the Achilles tendon area, and it is one of the effective methods for the repair of a composite soft tissue wound with Achilles tendon defect.
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Objective:To explore a surgical technique and treatment outcomes of the segmentle bridging reconstruction for severed fingers with single segmentle defect by using the free second toe bone-joint composite tissue combined with the great toe flap.Methods:From June 2010 to September 2017, 5 patients suffered from severed segmental defect of finger were treated. According to the defects of bone-joints, blood vessels, nerves, tendons and other soft tissues, the reconstruction surgery was designed to create a Flow-through bridging composite flap pedicled with the first dorsal metatarsal artery or the plantar artery. The blood vessles carried by the pedicle were anastomosed with the vessels in the finger to restore the blood supply to the distal finger while having the defected finger segment reconstructed. A Flow-through bridging composite flap was created by taking the second toe bone-joint composite tissue combined with a C-shaped or half-moon shaped flap from the fibular side of the great toe. Skin graft, retrograde lateral tarsal flap or free perforator flaps were used in 3 cases to repair the donor sites of the great and second toes. Iliac strip was implanted in 2 cases for toe salvage. Kirschner wires were removed 4-6 weeks after surgery followed by functional exercise.Results:All of the 5 reconstructed distal segments of the fingers survived with the healing of fractures in 8-12 week after surgery. The postoperative follow-up lasted 6-36 months and all the patients had the follow-ups at the outpatient clinic. It was found that the maximum flexion of the reconstructed interphalangel joint was 60 degrees together with dorsiflezion. According to the evaluation standard of the reconstructed function for thumb and finger issued by the Hand Surgery Society of the Chinese Medical Association, 3 fingers were in excellent and 2 in good. No obviouse affect on walking was found in all the patients.Conclusion:The free second toe joint composite tissue together with the great toe flap can be used to bridge the single segmental defect of a finger. It restores the blood supply to as well as the appearance of the distal finger, helps the recovery of the reconstructed distal finger. It is an ideal technique in the treatment of a severed distal segment of the finger.
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Objective:To investigate the surgical method and clinical effect of repairing the forefoot soft tissue defect by the retrograded lateral tarsal artery perforator flap pedicled with the anterior branch.Methods:From March, 2015 to October, 2018, 9 patients with soft tissue defects in forefoot were repaired by the retrograded lateral tarsal artery perforator flap pedicled with anterior branch. One patient received an emergency repair and 8 received secondary repair. The wounds were all located in the forefoot. Area of defects were 3.0 cm×2.0 cm-5.0 cm×4.0 cm; flap areas were 3.5 cm×3.0 cm-6.0 cm×4.5 cm. The donor sites of flap were repaired with full thickness skin graft. All patients received postoperative followed-up through the visits of outpatient clinics, WeChat or telephone reviews.Results:Eight flaps survived successfully and the wounds healed by first intention; One flap had venous crisis 2 days after surgery and after having removed stitches of the pedicle of flap, only distal skin necrosis occurred. And healed after changing treatment. All the skin graft in donor sites of flaps survived well. All patients were entered 3 to 18 months postoperative follow-up. The shape of flaps had good textures and were not bloated. The sensation of flaps partially recovered. In the last followed-up, 8 flaps were assessed by the American Orthopaedic Foot and Ankle Society (AOFAS) middle foot scoring standard. The results were excellent in 5 cases, good in 2 cases and poor in 1 case, with the good and excellent rate of 87.5%.Conclusion:The retrograde lateral tarsal artery perforator flap pedicled with the anterior branch is one of the effective methods to repair the soft tissue defect in forefoot without damaging the main trunk of dorsal pedal artery. It features a reliable blood supply to the flap and a relatively simple surgical procedure.
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Objective To explore the clinical effect of repairing the large area of soft tissue defect of the calf by the retrograde anterolateral thigh flap with single high cutaneous perforator. Methods From January, 2014 to July, 2017, 9 cases of large area of soft tissue defects were repaired by the retrograde anterolateral thigh flap with sin-gle high cutaneous perforator.There were 7 males and 2 females, aged 24-48 years.Soft tissue defects area of the calf was 10.0 cm×7.0 cm to 35.0 cm×15.0 cm, including skin grafting and skin stretch to repair the area. The perforating point of the high cutaneous artery branches was designed at the proximal end of the flap, which was used as the single nutrient vessel of the flap. The rotation point of the flap was moved upward to the proximal thigh, which not only in-creased the blood supply of the flap, but also made the flap repair range to the distal calf. The flap range was 15.0 cm×10.0 cm to 22.0 cm×12.0 cm. Results All flaps were cut smoothly, and no vascular crisis occurred. All flaps survived smoothly.All patients were followed-up for 6-12 months. The appearance of flaps was plump, slightly bloat-ed, and their color was similar to the recipient area. The texture was soft, and no active disorder in the donor site. Conclusion The retrograde anterolateral thigh flap with single high cutaneous perforator can be designed at a high rotation point.By increasing the number and caliber of the anastomotic branch between the pedicle and lateral superi-or genicular artery, the blood supply and reflux of flap can be improved, and the survival rate is not affected. Com-pared with the traditional anterolateral thigh flap, it has great advantages.
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CD70/CD27 pathway plays an important role in human immune regulation.The role of CD70/CD27 pathway in immune regulation is mainly to promote the activation and proliferation of T cells,induce the differentiation and formation of effector T cells and memory T cells,and interfere with regulatory T cells.In addition,the high level of CD70 expression in some tumor cells provides a new way for tumor immunotherapy.
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Objective To explore the surgical technique and treatment outcomes of the big toe wrap-around flap combination of the second phalange with the metatarsal to reconstruct the thumb. Methods From June,2014 to December, 2016, 6 patients of the thumb defects onⅤdegree, we took the big toe wrap-around flap with the second toe and the metatarsal to reconstruct the thumb. The metatarsal head was truncated nearby the metatarsophalangeal joint,and the metatarsal head was turned 70°-80° from the dorsal side to the plantar side, then recombinated the metatarsal after dealed with the fracture, so it can rebuild the metacarpophalangeal joints and the metacarpal. 6 cases were followed up. Results All cases survived,and they were followed up duing 4 to 24 months after operation. The shape was similar with uninjured sides and the two-point discrimination was 1.0-2.0 cm.The function recovered satis-factorily and the maximum flexion of the metacarpophalangeal joints can reach 50 degrees,at the same time,it has the function of dorsiflexion. They were got bone healing and there was no bone absorption and joint degeneration. The donor foot has no ulceration,and walking without the pain and lameness. According to the Upper Extremity Functional functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association,there were excellent in 3 cases and good in 3 cases. Conclusion Combined the big toe wrap-around flap with the second toe and the metatarsal to reconstruct the thumb, it can rebuild the metacarpophalangeal joints and metacarpal, we can get the thumb which have the physiological curvature and the suitable length,the configuration and the function were satisfac-tory.It is an effective method for reconstruction of the thumb defect onⅤdegree.
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Objective To investigate the methods and effects of anterolateral thigh flap reconstruction of the complicated hip decubitus.Methods The study contained 24 cases of grade Ⅳ hip decubitus reconstructed with anterograde pedicled anterolateral thigh flaps through May 2010 to July 2014.There were 13 males and 11 females,aged 26-64 years (mean 54 years).Defects ranged in size from 12 cm×6 cm to 24 cm× 12 cm.Dimensions of flaps harvested were 14 cm ×8 cm to 30 cm× 14 cm.Eighteen cases of the donor sites were directly sutured and six covered with full thickness skin.Results Twenty-two flaps survived completely,and wound was healed by the first intension.Two flaps developed partial distal necrosis,and wound was healed after dressing treatment.Period of follow-up was 6 months to 2 years.Shape,texture and color of the flaps were well matched with the recipient area.Conclusion The anterolateral thigh flap transplantation has advantages of similarity to the recipient area,large enough flap area and sound expected effective and is a good method for repair of hip decubitus.
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OBJECTIVE@#To evaluate the expressions of chemokine receptor 6 (CCR6), chemokine receptor 7 (CCR7) and their ligands (CCL20, CCL19/CCL21) in laryngeal squamous cell carcinoma (LSCC), and then explore their correlation with the clinicopathological features of LSCC.@*METHOD@#Blood samples, fresh specimens of LSCC and paired adjacent tissues were collected. The expressions of CCR6, CCR7 and their ligands CCL20, CCL19/ CCL21 mRNA as well as the protein CCR6, CCR7 were detected by real-time qRT-PCR and IHC respectively. Flow cytometry was also used to investigate CCR6, CCR7 expressed on PBMC.@*RESULT@#The relative expression levels of CCR6, CCR7, CCL19 and CCL21 mRNA in tumor tissue was significantly higher than that of adjacent tissues (P < 0.05), while the relative expression level of CCL20 mRNA in tumor tissue were significantly lower than that of adjacent tissues (P < 0.05). IHC confirmed the expression of protein CCR6 and CCR7 in both tumor tissue and metastatic ILN and the expression levels of protein CCR6, CCR7 were higher in the cases with lymphatic metastasis than that of those without lymphatic metastasis (P < 0.05). FCM showed the percentage of CD4+ CCR6+ T cells of LSCC was significantly higher than that of normal control (P < 0.05), while that of CD4+ CCR7+ T cells was significantly lower (P < 0.05).@*CONCLUSION@#CCR6 and CCR7 are expressed in tumor situ, metastatic LN and PBMC,and might exert a potential role in LSCC development.
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Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Carcinoma, Squamous Cell , Metabolism , Pathology , Chemokine CCL19 , Metabolism , Chemokine CCL20 , Metabolism , Chemokine CCL21 , Metabolism , Laryngeal Neoplasms , Metabolism , Pathology , Lymphatic Metastasis , Receptors, CCR6 , Metabolism , Receptors, CCR7 , MetabolismABSTRACT
OBJECTIVE@#To investigate the clinicopathological features, diagnosis and treatment of giant cell granuloma outside the jaw.@*METHOD@#The clinical and pathological datas of 3 cases in nasopharynx, temporal bone and maxillary sinus were analyzed retrospectively. The relevant literatures were also reviewed.@*RESULT@#The patients presented with local painless mass, part of which were aggressive. Histopathological feature was, replacement of the normal bone structure with proliferating fibrous tissue containing numerous giant cells was shown.@*CONCLUSION@#Giant cell granuloma outside the jaw was a non-neoplastic lesion, and extremely rare. It was somewhat difficult to make a correct diagnosis. Combining the clinical data and pathological feature were more helpful to the diagnosis. Total surgical resection was an effective therapeutic method.
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Adolescent , Adult , Female , Humans , Male , Young Adult , Granuloma, Giant Cell , Pathology , Jaw , Maxillary Sinus , Pathology , Nasopharynx , Pathology , Temporal Bone , PathologyABSTRACT
Objective To study the effect of angiotensin converting enzyme inhibitory peptides (ACEIP) on blood pressure of spontaneously hypertensive rats.Methods One hundred and four spontaneously hypertensive rats(SHR) were randomized to thirteen groups (n= 8,each group) and received one of following approaches:saline,captopril (10 mg/kg),low-dose (200 ?g/kg),medium-dose(400 ?g/kg) and high-dose (800 ?g/kg) of the three ACEIPs:VLPVP,KVLPVP,VLPVPR respectively.Thirty-two WKY rats were randomized to 4 groups(n=8 in each group),VLPVP,KVLPVP,VLPVPR (800 ?g/kg by gavage) and saline were administrated.The systolic blood pressure was measured before and after the administration of ACEIP.Results Compared with the control group,medium-dose and high-dose of VLPVP,KVLPVP and VLPVPR reduce blood pressure in hypertensive rats and the effect can last for above 6 hours [decline of blood pressure:high-dose:(40.9?15.7),(38.0?21.3) and (43.2?12.6) mmHg;medium-dose:(28.3?23.0),(24.7?21.5) and (26.2?9.9);control:(8.5?5.1),(6.2?4.1) and (7.1?5.5)mmHg;all P0.05].Conclusion Recombinant ACEIP acutely reduce high blood pressure in SHR,the antihypertensive effects persist for at least 6 hours,with no effect on normotensive WKY rats.
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Extranodal NK/T cell lymphoma(nasal type) is a common,high malignant degree and poor prognosis entity of the nasal lymphoma.It is the most important to understand its genesis,development,clinical manifestation,pathologic diagnosis,therapy and prognosis.
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Objective To present the clinical effect of dorsal carpometacarpal island flap with fascia, vessel and nerve to repair soft tissue defected. Methods The island flap was designed with root of fascia, dorsal metalcarpals artery and nerve.The flap to soft tissue defected in the nearby area was applied, including 30 cases in the last segment of thumb, 4 cases in the first segment of thumb, 1 case in the IP articulation of thumb, 1 case in the first segment of middle finger, 1 case in the carpometacarpal dorsal area and 1 case in the back of index finger. Results Thirty-eight cases were survived. All cases obtained good appearance and sensory recovery approach normally with little affection in supply area. Conclusions This method has advantage of simple, practical, high survive rate, low impairment, sensible and good appearance.
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BACKGROUND: As a kind of polypeptide, angiotensin-converting enzyme (ACE) inhibitory peptide can lower the blood pressure of human body through restraining the formation of angiotensin Ⅱ.OBJECTIVE: To investigate the influence of AGE inhibitory peptide on endothelial cell proliferation and endothelin expression in cultured human umbilical vein cells based on cellular and molecular levels in order to provide the experimental evidences for ACE inhibitory peptide to be the potential blood pressure-lowering health food.DESIGN: Repeated measures design.SETTING: School of Bioscience and Bioengineering, South China University of Technology; School of Applied Chemistry and Biological Technology,Shenzhen Polytechnic.MATERIALS: The experiment was carried out in the Institute of Applied Chemistry and Biological Technology, Shenzhen Polytechnic from September 2004 to March 2005. The AGE inhibitory peptide was provided by the Institute of Applied Chemistry and Biological Technology, Shenzhen Polytechnic. Under certain circumstance, 15 μ mol/L of the inhibitor was needed to decrease half of the AGE activity. The human umbilical vein endothelial cells of the 4th generation were cultured randomly in 7 groups with different concentrations: medium group, 150, 300 and 600 mg/L ACE inhibitory peptide groups, captopril group, norepinephrine(NE) group, and ACE inhibitory peptide+NE group.METHODS: ①The endothelial cells were cultured as recommended. The medium was M199+FBS(0.15, v/v)+penicillin(10 000 U/mL)+streptomycin (100 mg/L). After cellular fusion, the cells were carried on the passage with the ratio of 1:2. The 4th generation cells were used for experiment. ②M199(0.15, v/v) was contained in each group. ACE inhibitory peptides were added to make the final concentration 150, 300 and 600 mg/L in the 150, 300 and 600 mg/L ACE inhibitory peptide groups respectively. Captopril was added to make the final concentration 10-5 mol/L in the captopril group. NE was added to make the final concentration 100 μg/L in the NE group. ACE inhibitory peptide and NE were added to make the final concentration 300 mg/L and 100 μg/L in the ACE inhibitory peptide+NE group respectively. ③The state of cell growth was determined with cytometry. The contents of endothelial cells in the medium with different culture times were determined with radioimmunoassay. The expression of endothe lin mRNA was determined with reverse transcriptase-polymerase chain reaction. The expression of cellular endothelin protein was determined with immunohistochemical method.MAIN OUTCOME MEASURES: ①The influence of ACE inhibitory peptide on endothelial cell proliferation. ②The influence of ACE inhibitory peptide on the endothelin mRNA and endothelin protein.RESULTS: ①The influence of ACE inhibitory peptide on endothelial cell proliferation and endothelin secretion: Compared with the medium group,in the captopril and 150, 300, 600 mg/L ACE inhibitory peptide groups,the growth of endothelial cells was restrained and the endothelin content in the medium was lowered(P ＜ 0.01 or 0.05). NE could promote the growth of endothelial cells and the secretion of endothelin, but the cell density and endothelin content after treatment with ACE inhibitory peptide were similar to those in the medium group (P ＞ 0.05). ②The influence of ACE inhibitory peptide on the expressions of endothelin mRNA and protein in endothelial cells: Compared with the medium group, the expressions of endothelin mRNA and protein might be lowered in the captopril and 150,300, 600 mg/L ACE inhibitory peptide groups(P ＜ 0.01 or 0.05). The expressions of endothelin mRNA and protein could be up-regulated by NE.The gene expression after treatment with ACE inhibitory peptide was similar to that in the medium group(P ＞ 0.05).CONCLUSION: The ACE inhibitory peptides of different dosages can all restrain the growth of endothelial cells, lower the endothelin content, decrease the expression of endothelin gene and resist NE improved growth and secretion of endothelial cells in umbilical vein cell effectively.
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Purpose:To study the clinicopathological features of otolaryngeal mucoepidermoid carcinoma, and to elucidate its diagnosis and differential diagnosis. Methods:The clinical data were reviewed retrospectively and immunohistochemical stains were performed in 15 cases of mucoepidermiod carcinoma.Results:The 15 patients were all male with average age of 55 years. Two histological types were found: well differentiated (14 cases), poorly differentiated (1 case). The tumor cells were positive for CK,CK8,EMA,CEA.Conclusions:Mucoepidermoid carcinoma of otolaryngeal tumor is a rare tumor. It can be differentiated from other otolaryngeal tumors based on the histopathologic features and immunohistochemical findings. Histological type of the tumor is important for clinical therapy and prognostic evaluation.
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Objective and Method: To study the influence of angiotensin converting enzyme inhibitory peptides (ACEIP) on the expression of eNOS, iNOS, ET-1 mRNA in cultured human umbilical vein endothelial cells by semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR) method and then investigate its mechanism. Results: Campared with the control, the expression of ET-1 and iNOS was lower and the expression of eNOS was higer in different ACEIP groups. Conclusion: The antihyertensive function of ACEIP partly depended on the its effect to lessen the expression of ET-1,iNOS and induce the expression of eNOS in cultured human umbilical vascular endothelial cells.
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Ocular signs and serum vitamin A concentration are commonly used tor the diagnosis of vitamin A deficiency. Recently, impression cytology was suggested as a method for early detection of vitamin A status. Twenty patients with normal eyes and digestive disease, and 111 children with normal eyes were evaluated by serum vitamin A concentration, relative-dose-response and conjunctival impression cytology test. About 90% of the patients with normal conjunctival impression cytology has normal vitamin A status. About 70% of the patients with abnormal conjunctival impression cytology has abnormal vitamin A status despite their seemingly normal clinical ocular examination, and so did the children. These results suggest that impression cytology can identify individuals with preclinical vitamin A deficiency.
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Serum calcium, magnesium, zinc, and copper were determined in 117 healthy pregnant women and their infants. Maternal and cord blood were collected at delivery and assayed by flame atomic absorption spectropho-tometry, and the data obtained were evaluated by regression analysis.The results suggested that the serum concentrations of calcium, magnesium, and zinc of maternal blood were significantly lower than that of cord blood. The concentrations of serum calcium and magnesium between maternal and cord blood were highly correlated, but not of serum zinc. The serum concentration of copper in maternal blood was significantly higher than that in cord blood, but there was nos ignificant correlation between them. The serum calcium of infants always maintained over 2.0mmol/L(8mg/dl), even when the serum calcium of pregnant women was lower than 2.0mmol/L (8mg/dl). This fact indicates that the fetus draw much calcium from mother for development, despite calcium in the mother being depleted.
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Objective To study the absorption mechanism of the antihypertensive peptide,Val-Leu-Pro-Pro-Val(VLPVP) in Caco-2 cell model. Method Caco-2 cell model was used in vitro to investigate the effects of time,pH,drug concentration,enhancers and inhibitors on the absorption of VLPVP. VLPVP concentration was measured by HPLC. Results The transport rate of VLPVP reached the maximal level at pH7.4,and was positively correlated to transport time and drug concentration. The peptide transporter inhibitors(Gly-Pro,arphamenine A) ,the endocytosis inhibitor(phenyl arsenoxide) didn’t influence the transport of VLPVP,while the paracellular transport enhancer(sodium deoxycholate) ,the inhibitor of multi-drug resistant protein(MK-571) and the energy inhibitor(sodium azide) enhanced it from apical to basolateral side significantly,but the latter two didn’t influence the transport from basolateral to apical side. Conclusion Paracellular diffusion was suggested to have been the main mechanism for the absorption of intact VLPVP and MRP2 had strong eflux effect on the transepithelial transport of VLPVP.