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Objective:To establish silicone cartilage models of donor-sites for the microtia patients by using digital technology, and to explore the application of surgical simulation in auricular reconstruction.Methods:From June 2018 to October 2019, 19 congenital microtia patients underwent thoracic CT scans and following three-dimensional costal cartilage imaging with Mimics software at the Nanfang Hospital, Southern Medical University. Among these patients, 16 were males and 3 were females. The mean age of patients was 16 years (range 8 to 35 years). Silicon cartilage models were produced by 3D printing and used for surgical planning and preoperative simulation in ear framework fabrication. Cartilaginous framework was sculptured according to the simulation during operation. Patients were followed up for a minimum of six months to evaluate the size, outline, height and auriculocephalic angle of the reconstructed ear. The satisfactory outcomes of the patients were scored according to a 5-point Likert scale.Results:All the patients received the surgical simulation and sculpture training with silicone cartilage models before operation. Auricular reconstruction was completed successfully according to the simulation. The duration of sculpture was shortened to 1-1.5 hours. There were no serious complications, such as hematoma, inflammation, skin necrosis and framework exposure. The contour of reconstructed ear was natural and clear over a 6 months follow-up, and all the patients were satisfied with their surgical outcomes.Conclusions:With the application of digital technology and silicone cartilage models by 3D printing to the surgical planning and training in microtia patients, patient-specific framework is fabricated with precisely assembling, which not only shortens the operation time, but also provides the unexperienced surgeons with a safe and effective training of ear framework fabrication.
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【Objective】 To investigate the clinical efficacy and safety of low-dose rituximab combined with dexamethasone in the treatment of refractory ITP (RITP) in children. 【Methods】 A total of 31 RITP children, admitted to the Hematology Department of Kunming Children′s Hospital from January 2016 to December 2019 and agreed to receive low-dose rituximab (100 mg/ time, once a week, for 4 successive weeks) combined with dexamethasone (0.6 mg/kg, once a day, for 4 successive days) were enrolled and studied. Blood routine was monitored every other day during treatment, and adverse drug reactions were recorded. The influence of gender, disease course and age on prognosis was compared by χ2 test. 【Results】 1) Among the 31 cases, 11 (35.5%) had platelets >100×109/L after 4 weeks and had no recurrence in 6 months; 9 (29%) had platelets >30×109/L but <100×109/L and had no recurrence in 6 months; 11 (35.5%) showed no recovery of platelets, which were consistently lower than 30×109/L. 2) Rituximab was used in 4 cases (12.9%), 1 case (3.2%) presented with severe drug-induced rashes; Headache, vomiting and elevated blood pressure occurred in 2 cases (6.4%). 1 case (3.2%) presented with laryngeal edema. 3) There was no difference in the total effective rate among different gender, age and disease course (P >0.05). 【Conclusion】 The total effective rate of low-dose rituximab combined with dexamethasone for children with refractory ITP in 6 months is 64.5%, and the adverse reactions are tolerable, so it can be used as a treatment option for children with refractory ITP.
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Objective@#To explore the clinical and genetic characteristics of infantile nephrotic syndrome caused by COQ2 variants.@*Methods@#The clinical and genetic data of a patient with nephrotic syndrome caused by COQ2 variants diagnosed at pediatric department of Peking University First Hospital from February 2018 to March 2018 were retrospectively analyzed. Related literature retrieved from PubMed, CNKI and Wanfang databases were searched to date (up to July 2018) with "COQ2 gene" or "primary coenzyme Q10 deficiency" and "nephrotic syndrome" or "nephropathy" as key words.@*Results@#A 14-month-old male, presented to local hospital at 11 months of age with edema and severe proteinuria, without hematuria, hypertension or renal dysfunction. He did not have infection or seizure in the course of the disease. He had no response to a more than four-week full-dose prednisone treatment. He had normal birth, mild motor development retardation and moderate language retardation. He was born to non-consanguineous healthy parents. He had two unaffected older sisters and one older sister died of "nephropathy" at one year of age. Genetic testing identified compound heterozygous variants in COQ2 gene: c.518G>A and c.973A>G, both could be predicted by in silico tools to be deleterious in protein function. These variants are not single nucleotide polymorphism and rare in normal populations. Both variants have previously been reported as pathogenic. These missense mutations were inherited from parents in autosomal recessive manner tested by Sanger sequencing. The patient was supplemented with high-dose of coenzyme Q10, at 30 mg/(kg·day) and glucocorticoid was withdrawn. Within three weeks of high dose coenzyme Q10 treatment, the edema disappeared. After seven weeks of high dose coenzyme Q10 treatment, the patient had decreased proteinuria and improved serum albumin levels. The urine protein to creatinine ratio decreased from 22.87 mg/mg to 1.98 mg/mg; Serum albumin increased from 14.2 g/L to 39.9 g/L, with normal kidney function and improved motor development. Primary CoQ10 deficiency is reported to be a rare autosomal recessive mitochondrial disorder with heterogeneous renal, neurologic, and muscular manifestations. To date, COQ2 variants have been reported in 14 children with glomerular involvement. Their age at onset ranged from neonatal period to 10-year-old (8 patients within the first year of life). Steroid resistant nephrotic syndrome (SRNS) is the most common phenotype. Some of these children also had progressing encephalopathy and myopathy, and seizures. Patients with COQ2 variants might show clinical improvement with early high-dose oral CoQ10 supplementation. Literature review revealed two Chinese articles, mainly about adults with neurologic symptoms. SRNS was previously not reported in Chinese pediatric patients.@*Conclusions@#It is necessary to carry out genetic testing for infant with SRNS. The coexistence of some degree of encephalomyopathy, such as development retardation, should raise suspicion of a mitochondrial defect caused by COQ2 variants. Timely diagnostic genetic testing and early high dose of coenzyme Q10 supplement could significantly improve their prognosis.
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Objective@#To design a method of mandibular division for plastic surgery.@*Methods@#From January 2009 to June 2017, 118 patients who underwent mandibular plastic surgery were observed, measured and analyzed. Combined with clinical experience, a new method of mandibular division was designed. The mandible was divided into right and left sides and each side was subdivided into five subunits (A, B, C, D, E). Area A is mandibular ramus upper 1/2 and mandibular coracoid area; Area B is mandibular lower 1/2 area; Area C is mandibular body area; Area D is chin area; Area E is mandibular angle.@*Results@#The mandibles of 118 patients were divided according to the new method to obtain the characteristics of mandibular deformities and guide the design of the surgical plan.@*Conclusions@#The new method of mandibular division is concise and scientific, which is in favor of the diagnosis and surgical design of plastic surgery.
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Objective@#To design the aesthetic new gonion and osteotomy line for patients with prominent mandibular angle patients using computer-aided techniques, and to investigate the application of three-dimensional digital planning in gonioplasty.@*Methods@#From April 2016 to April 2017, 14 female patients with prominent mandibular angle underwent preoperative surgical design and surgical simulation using digital technology. Gonioplasty was performed under the guide of surgical templates, preoperative, surgical simulation and postoperative data were measured including bilateral mandibular angles, the height of ramus(Co-Go) and the length of mandibular body(Go-Me). Paired t test was used to compare the differences between surgical simulation and postoperative measurements.@*Results@#Gonioplasty was performed in 14 patients successfully, and all were satisfied with their facial outcomes. The mandibular angle was improved from 113.86°±4.11° to 124.52°±1.26° on the left side, and 114.30°±4.01° to 124.29°±1.24° on the right side respectively. The average ratio of Go-Me/Co-Go was 2.011 on both sides after operation, which was very close to surgical planning. No significant differences were found between surgical planning and postoperative measurements with respect to mandibular angle or the ratio of Go-Me/Co-Go on both sides(P>0.05). The deviations between them were 1.00°±0.68° and 0.058±0.038 on the left side, and 0.85°±0.63° and 0.072±0.053 on the right side respectively.@*Conclusions@#Computer-assisted gonioplasty could improve the efficiency and accuracy of surgery, reduce the risk of surgical complications, and attain higher patients′ satisfaction.
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Objective To explore the relationship of two loci (rs2293152, rs9579700) gene polymorphisms of signal transduction and transcription factor-3 (STAT3) with susceptibility to Henoch-Scho. .nlein purpura (HSP) and HSP nephritis (HSPN). Methods From September 2013 to September 2015, 180 children with HSP (group HSP) and 205 healthy children (control group) were enrolled in this study. Single nucleotide polymorphism (SNP) of intron 11 rs2293152C/G and intron 23 rs957970C/T of STAT3 gene was detected by sequence specific primer polymerase chain reaction (SSP-PCR). Results The frequency of CC genotype in STAT3 gene intron 11 rs2293152 in HSP group (26.1％) was significantly higher than that in control group (8.8％), and the frequency of allele gene of rs2293152C in HSP group (48.6％) was significantly higher than that in control group (32.7％) (P=0.013, 0.025). There were no differences in distribution of genotype and allele in rs957970C/T loci of intron 23 of STAT3 gene between two groups (P>0.05). The frequencies of genotype and allele of the two loci of STAT3 gene were no difference between HSPN and non HSPN groups (P>0.05). Conclusions The allele gene C of intron 11 rs2293152C/G of STAT3 gene may be a susceptible gene of HSP, while there was no association of 23 rs957970C/T polymorphism to HSP and there was no association of the two loci polymorphisms to HSPN.
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OBJECTIVE To investigate the proliferation effect of di(2-ethylhexyl) phthalate (DEHP) on prostate in aged rats at the environmental exposure dose and the possible mechanism.METHODS Thirty-two male Sprague-Dawley rats,aged 1.5 years,were randomly divided into 4 groups (8 rats per group) and treated with DEHP (30,90 and 270 μg· kg-1,ig) and vehicle once daily respectively for 4 weeks.All the animals were anesthetized with pentobarbital sodium and sacrificed on the day subsequent to the last treatment.① Abdominal aortic blood samples were collected,and serum estradiol (E2),testosterone (T) and prolactin (PRL) levels were assayed by ELISA.② The prostate tissues were dissected and categorized into different lobes,weighed and measured.The prostate relative mass was calculated.③ The morphological changes were detected by HE staining and prostate epithelial height was analyzed with microscopic image analysis software.RESULTS Compared with vehicle control group,the prostate relative mass,dorsolateral prostate mass,and dorsolateral prostate index in DEHP 270 μg· kg-1 group were significantly higher (P＜0.05).The height of the ventral prostate epithelium in DEHP 30,90 and 270 μg· kg-1 groups was increased significantly (P＜0.01),so was the height of dorsal prostate epithelium in DEHP 270 μg· kg-1 group (P＜0.01).There were no significant changes in levels of E2,PRL or T in DEHP 30,90 and 270 μg· kg-1 groups,but the ratios of E2/T in DEHP 30 and 270 μμg· kg-1 groups were increased significantly (P＜0.05).CONCLUSION Low-dose DEHP could promote the proliferation of prostatic hyperplasia in the aged rats,which might be associated with the relative levels of endogenous hormone.
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Objective To aesthetically evaluate the mandible,to position the gonion landmark of the aesthetic female with digital techniques and to establish three-dimensional mandibular measurements database of the aesthetic female.Methods 14 aesthetic volunteers were chosen by plastic surgeons and ordinary people based on the identical view of esthetic mandible.The heads were scanned by a spiral CT scanner,and the data were imported into Mimics 18.0 to generate the 3D skull images.Distance,angle and ratio measurements,which could represented the aesthetic characters of the mandible,were made on the images.All the data were transferred into the SPSS 22.0 software to perform statistical analysis.A two-tailed t test was used to compare the symmetry of bilateral mandibles.Dynamic database of aesthetic mandibles was established.The mean,standard deviation,standard error and 95％ confidence interval of data were calculated by statistical software automatically.Results The results suggested that the mean of aesthetic mandibular angle was 123.91°,and the mean of mandibular plane angle was 27.03°.The ratio between the mandibular body and ramus approximated to 2 ∶ 1,and the ratio of the distance between gonion and mental foramen to ramus was close to 1.4.Conclusions The study of mandibular esthetics contributes to positioning the new gonion accurately for patients with prominent mandibular angle and gonion reconstruction,and it can assist surgeons in surgical designing,simulating and performing.
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Objective To explore the correlation between the serum levels of interferon (IFN)-γ,interleukin (IL)-18,IL-10 and recurrent spontaneous abortion (RSA).Methods Enzyme-linked immunosorbent assay was used to detect the serum levels of IFN-γ,IL-18 and IL-10.There were 40 patients with RSA (RSA group) and 40 normal early pregnant women (control group) enrolled in this study.After 2 months,those serum cytokines in two groups of non-pregnant state were detected again.Results Compared to control group,the serum levels of IFN-γ and IL-18 of RSA group were significantly higher (P ＜0.01),the serum level of IL-10 was significantly lower (P ＜ 0.01).Two months after termination of pregnancy,there was no significant difference in the serum levels of IFN-γ and IL-10 between the two groups.The serum level of IL-18 maintained a high level in the RSA group after termination of pregnancy.Conclusions In patients with RSA,the serum levels of IFN-γ and IL-18 were elevated,the serum level of IL-10 was decreased.The serum levels of IFN-γ,IL-18 and IL-10 were closely related with RSA.
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Objective To investigate the pretreatment and post-treatment effect of reduced glutathione (GSH) on acute ischemia-reperfusion injury (IRI) of rat kidney. Methods Fifty adult SD rats were divided into 5 groups: control group (Sham group), ischemia reperfusion group (I/R group), GSH pretreatment group (pre-treatment group), and GSH post-processing group (post-treatment group), with ten rates in each group. Animals in pre-treatment group were injected 4% GSH 100 mg/kg intraperitoneally at 24th , 16th , 8th hour and 45th minute before surgery. Animals in post-treatment group were administrated GSH with the same dosage at 45th minute, 6th, 12th and 18th hour after surgery. Creatinine (Cr), urea nitrogen (BUN) level, the total superox-ide dismutase (T-SOD) activity, malondialdehyde (MDA) and nitric oxide (NO) levels in serum were measured at 24th hour after surgery. Histopathological changes were checked by H. E staining. Results Damage on kid-ney structure of animals in pre-treatment group was less than that in I/R group. There was little pathological change on kidney of those in pre-treatment group. Serum Cr, BUN, MDA and NO levels were all decreased but T-SOD activity increased in pre-treatment and post-treatment group when compared with those in I/R group (P <0.05), (P < 0.05). T - SOD activity in post-treatment group was higher than that in pre-treatment group (P <0.05). Conclusion GSH can protect rats against acute renal ischemia-reperfusion injury within 24 hours before and after kidney ischemia-reperfusion , especially after ischemia-reperfusion.
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The association of the serum phospholipid fatty acid components with lipid profiles in patients with newly-diagnosed type 2 diabetes mellitus was investigated.Saturated fatty acid in patients with newly diagnosed type 2 diabetes mellitus was increased(48.79±1.55 vs 42.58±1.96,P<0.01),whereas monounsaturated fatty acid and polyunsaturated fatty acid were decreased(10.72±1.53 vs 12.09±1.32,33.41±2. 16 vs 35.79±2.41.6.08±1.66 vs 9.54±1.54,all P<O.01).
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Objective To investigate the effects and mechanisms of 5-aza-2'-deoxycytidine (5-Aza-CdR) on endometrial cancer cell.Methods In vitro experiments of 5-Aza-CdR were done using human endometrial cancer cell line HEC-1B.Evaluation of cellular proliferation and apoptosis was ascertained respectively using trypan blue exclusion and flow cytometry.RT-PCR and methylation specific PCR(MSP) was done to detect the expression of RASSF1 A mRNA and methylation status of RASSF1 A promoter of HEC-1B cell line.Results (1) The status of cellular growth and apeptosis of HEC-1 B cell line:the growth inhibition effects of 5-Aza-CdR on HEC-1B cell line were both concentration-dependent (P ＜ 0.01) and time-dependent(P ＜0.01),as well as the apoptosis rate of HBC-1-B cell line depended on the dose of 5-Aza-CdR obviously(P ＜0.01).(2)The expression of RASSF1A mRNA of HEC-1B cell line:RASSF1A mRNA was expressed in HEC-1B cell after 5-Aza-CdR treatment,but it was undetectable before the treatment.In the groups with different concentration of 5-Aza-CdR (0.05,0.1,1,5,10 nmol/ml),the expression of RASSF1A mRNA was respectively 0.074±0.004,0.105±0.004,0.167±0.006,0.334±0.005,0.484±0.007,which were remarkably different from the group without 5-Aza-CdR(the expression of RASSF1A mRNA was 0;P ＜ 0.01).(3) The hypermethylation of RASSF1A promoter of HEC-1B cell line:the hypermethylation of RASSF1A promoter was detected in HEC-1B cell line.The status of hypermethylation was decreased after treatment with 5-Aza-CdR of 0.05,0.1,1,5 nmol/ml,meanwhile,both methylation bands and demethylation bands were observed by methylation specific PCR.After the treatment with 5-Aza-CdR of 10 nmol/ml the hypermethylation was absent absolutely.Conclusions (1) In HEC-1B cell line,5-Aza-CdR can inhibit cell proliferation and induce cell apopotosis.(2) 5-Aza-CdR can renew the expression of RASSF1A mRNA of HEC-1B cell line and reverse the hypermethylation of RASSF1A promoter.
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Angiostatin(AS) and endostatin(ES) are both potent endogenous angiogenesis inhibitors, and the combination of AS and ES has been shown to have synergistic antiangiogenic effects. Here we report the fusion protein AS-ES expressed in E. coli which has antiangiogenic effects. At first, AS and ES genes were cloned respectively through RT-PCR, then fusion gene was made through gene splicing ,finally pET-42 (b)/AS-ES expression plasmid was constructed and transduced in E. coli BL21 (DE3). Target protein was in form of inclusion body,the rate of expression was about 14%, and MW about 65KD. Western blotting assay showed expressed protein had specific immune reaction to both the antibodies of AS and ES. The expressed protein which was refolded and purified through heparin affinity chromatography had antiangiogenic effect to vessels on chicken embryo chorioallantoic membrane. The results show that fusion protein AS-ES was expressed successfully in E. coli, and the expressed protein,which was renatured and purified, had immuno-reactivity to anti-AS and anti-ES in Western blotting and angiogenesis inhibition activity.