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OBJECTIVE@#To review the research progress of the principle and clinical application of keloid core excision technique.@*METHODS@#The literature on keloid core excision technique at home and abroad in recent years was extensively reviewed, and the principle, development history, indications, advantages and disadvantages of this technique were summarized, and the existing controversies were analyzed.@*RESULTS@#Keloid core excision is a technique to remove the inner fibrous core from the keloid and cover the defect with the keloidal flap. It reduces the wound tension, yields good aesthetic results in the treatment of ear keloids, and reduces the recurrence rate of keloids combining with adjuvant therapies.@*CONCLUSION@#The keloid core excision technique has specific advantages, yet its overall efficacy remains controversial. Further studies are imperative to explore the mechanisms regarding keloid recurrence and the vascular supply principles of the keloidal flap. It is also necessary to define appropriate surgical indications and safety protocols of this technique.
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Humans , Keloid/pathology , Recurrence , Surgical Flaps/pathology , Plastic Surgery Procedures , Treatment OutcomeABSTRACT
OBJECTIVE@#To explore the feasibility of using indocyanine green angiography in mapping the superficial temporal vessels and assisting design and harvesting of the superficial temporal artery based forehead flap.@*METHODS@#A clinical data of 14 patients with facial soft tissue defects repaired with superficial temporal artery based forehead flaps between October 2015 and November 2022 was retrospectively analyzed. There were 9 males and 5 females with a median age of 9.5 years (range, 3-38 years). The forehead flaps were used to reconstruct facial soft tissue defects following excision of facial scar (8 cases) or congenital melanocyte nevus (6 cases). The size of defects ranged from 3 cm×2 cm to 24 cm×9 cm. Before operation, the indocyanine green angiography was used to map the superficial temporal artery and vein, and to analyze the relationship of the arteries and veins. The forehead flaps with unilateral superficial temporal fascia as the pedicle was transferred to repair the small facial defect in 2 cases. The facial pedicle contained the frontal branch of the superficial temporal artery and 2 cm of the superficial temporal fascia around the vessel, and the tiny accompanying vein of the frontal branch of the superficial temporal artery was used as the outflow of the flap. The forehead flaps with the skin pedicle including bilateral or unilateral superficial temporal fascia and the overlying skin was pre-expanded and transferred to repair the large facial defect in 12 cases. The skin pedicle contained the frontal branch of superficial temporal artery and one of main branches of superficial temporal vein. Among the 12 cases, the frontal branch of superficial temporal vein was used as the outflow in 4 cases, and the parietal branch was used as the outflow in 8 cases. The size of the flaps ranged from 3 cm×2 cm to 30 cm×13 cm. The skin pedicles were divided at 3 weeks after the flap transfer.@*RESULTS@#Indocyanine green angiography could clearly showed the course and branching of the superficial temporal artery and vein. Individual differences existed in the location where the frontal branch of the superficial temporal artery entered the forehead. The superficial temporal vein had great variability and did not follow the artery. One patient had expander-related complication, which resulted in 3-cm flap necrosis. The necrotic tissue was debrided and repaired with skin grafting. The other flaps totally survived and the incisions healed by first intention. All patients were followed up 2-24 months, with a median of 11.5 months. The color, texture, and thickness of the flaps matched well with those of recipient sites. Hypertrophic scar was not observed in recipient or donor site. All patients were satisfied with the reconstructive outcomes.@*CONCLUSION@#Indocyanine green angiography can clearly visualize the course and the branches of the superficial temporal arteries and veins, which can help surgeons understand the position, distribution, and concomitant relationship of the superficial temporal vessels, and make a rational surgical plan of the forehead flap.
Subject(s)
Male , Female , Humans , Child, Preschool , Child , Adolescent , Young Adult , Adult , Temporal Arteries/surgery , Indocyanine Green , Forehead/surgery , Retrospective Studies , Skin Transplantation , Angiography , Soft Tissue Injuries/surgery , Perforator Flap/blood supply , Treatment OutcomeABSTRACT
Objective:To explore the clinicopathological characteristics of the primary hepatic adenosquamous carcinoma(ASC).Methods:A retrospective analysis was performed on the clinical data of 5 ASC patients admitted to the First Affiliated Hospital of Anhui Medical University from 2006 to 2019 who underwent surgical resection and were pathologically confirmed.Results:Among the 5 ASC cases, there were 4 males and 1 female. The age ranged from 48 to 73 years. As for the initial symptoms, there were 5 cases complaining upper abdominal pain, 2 cases presenting fever, 1 case presenting weight loss and 1 case presenting jaundice. CA19-9 was significantly higher than normal in 4 cases, while AFP was normal in all. None had definite preoperative diagnosis.All the 5 patients underwent surgical resection with pathology proved primary hepatic ASC. Lymph node metastasis was found in 4 cases and nerve invasion in 2 cases. There were 4 cases at TNM stage ⅣA, one at stage ⅠB. The median disease-free survival (DFS) was 5 months and the overall survival (OS) was 9 months.Conclusions:Primary hepatic adenosquamous carcinoma is a rare type of liver malignant tumor with an extremely poor prognosis. Surgical resection helps little in improving the prognosis.
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Intrahepatic cholangiocarcinoma (ICC) is a group of adenocarcinoma that derives from epithelium of the subbranches of intrahepatic bile ducts, which is characterized by difficulty in early diagnosis, high malignancy and poor prognosis. ICC is relatively rare, but it is the second most common in primary liver cancer, and its incidence has gradually increased worldwide. Radical resection is recognized as the only treatment that can bring better long-term survival currently. However, many surgery-related problems, such as lymph node dissection and major vascular resection and reconstruction, are still controversial. Adjuvant therapy, including chemotherapy, regional therapy, targeted therapy and immunotherapy, has received increasing attention in recent years. Although there is no uniform standard, a large number of related studies have supported its efficacy. In this article, the authors have reviewed the molecular pathogenesis of ICC and advances in treatment.
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Objective@#To study the expression of TNF-α and PCNA in human breast tissue with polyacrylamide hydrogel(PAHG) injection, and to provide the initial theory basis for its prognosis and clinical treatment.@*Methods@#Immunohistochemistry was used to measure the expression of tumor necrosis factor α(TNF-α)and proliferating cell nuclear antigen (PCNA) in 20 normal breast tissues and 40 cases with PAHG injection, analysis was also done by HE staining.@*Results@#①HE staining showed that there were a large number of homogeneous amorphous gel-like injections under optical microscope. Around PAHG there were different degrees of fibrous tissue hyperplasia with or without fibrous degeneration and lots of inflammatory cells. Local foreign body giant cell reaction and ductal dilatation also can be seen around PAHG. ②The IA levels of TNF-α and PCNA in the experimental group were 3.9± 0.3 and 3.2 ± 0.2, the IA levels of TNF-α and PCNA in the control group were 1.0 ± 0.1 and 1.3 ± 0.3, the IA level in the experimental group was significantly higher than that in the control group (P=0.000). The difference was statistically significant. The positive rates of TNF-α and PCNA in the experimental group were 90% (36/40)and 85% (34/40)respectively; the positive rates of TNF-α and PCNA in the control group were 30% (6/20), 40% (8/20). The positive expression rate in the experimental group was significantly higher than that in the control group (P=0.000). The difference was statistically significant. TNF-α and PCNA has Pearson positive relevance in the changes(r=0.3, P=0.040), the difference was statistically significant.@*Conclusions@#TNF-α and PCNA are involved in the immunoreaction of mammalian breast tissue injected with polyacrylamide hydrogel, which may induce the aseptic inflammation, fibrous tissue hyperplasia and related issues through mutual influence.
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BACKGROUND:Hyperbaric oxygen (HBO) therapy can aleviate the skin flap congestion by improving the angiogenesis and increasing the oxygen content of blood in skin flaps. Although the HBO therapy ability to increase flap survival has been wel described, the research on the application of HBO pretreatment in skin flap transplantation does not arouse adequate concern. OBJECTIVE: To investigate the effect of HBO pretreatment on early-stage flap congestion in the rat model of over-length dorsal random skin flaps. METHODS: Thirty-six SD rats were randomly divided into control group (n=12), HBO pretreatment group (n=12) and HBO treatment group (n=12). Rats in the HBO pretreatment group received 4 days of HBO therapy prior to transplantation, once a day. Rats in the HBO treatment group received 4 days of HBO therapy after transplantation. Rats in the control group were raised in the normal conditions after flap transplantation. At postoperative days 3 and 5, rats were sacrificed and the samples were colected. The inflammation of flap tissues was detected using hematoxylin-eosin staining. The expression of vascular endothelial growth factor and transforming growth factor-β was analyzed by immunohistochemistry staining. The flap survival rate was calculated at postoperative day 5. RESULTS AND CONCLUSION:The flap survival area of the HBO pretreatment group and HBO treatment group was larger than that of the control group (P 0.05). HBO pretreatment can increase the expression of vascular endothelial growth factor and transforming growth factor-β and promotes angiogenesis in random pattern flaps,thereby improving skin flap survival.
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As one of famous shrubs in China, Buxus microphylla is considered as the important wattle. However, the constituents of Buxus microphylla stem extracts aren't used effectively. Therefore, the molecules of stem extracts in Buxus microphylla are analyzed to further utilize the resources. The results show that the optimal extraction time of ethanol/methanol extraction, petroleum ether/ benzene extraction, and benzene/alcohol extraction are 7h, 7h, and 5h, respectively. The HK-61, HK-63, HK-73, HK-81, HK-82 stem extracts are obtained 1, 9, 1, 27, and 1 components, respectively. The stem extracts of Buxus microphylla is rich in drug and biomedical activities. Buxus microphylla stem is fit to extract 1,5-hexadien-3-yne, squalene, and dibutyl phthalate
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ObjectiveTo investigate the expression and activity of p38 mitogen-activated protein kinase (p38 MAPK)in hippocampus CA1 and CA3 area of rats with conditioned fear.Methods 24 h after rat model of conditioned fear was established,rats were sacrificed,then expression of p38 MAPK and phosphorylated p38 MAPK (Thr180/Tyr182) in hippocampus CA1 and CA3 area of rats were detected by western blot.ResultsCompared with control group ( ratios of value of gray scale were 1.0 ± 0.1 and 1.0 ± 0.2,respectively),expression of p38 MAPK and phosphorylated p38 MAPK (Thr180/Tyr182) in hippocarpus CA1 area of rats with conditioned fear (9.4 ± 2.6 and 7.8 ± 2.1,respectively) were significantly increased ( n =9,P ＜ 0.05 ).Compared with control group ( 2.1 ± 0.5 and 1.4 ± 0.5,respectively),expression of p38 MAPK and phosphorylated p38 MAPK (Thr180/Tyr182 ) in hippocampus CA3 area of rats with conditioned fear (6.2 ± 3.3 and 2.6 ± 0.6,respectively)were also significantly increased ( n =9,P ＜ 0.05 ).Conclusionp38 MAPK may play important role in the formation of long term memory of conditioned fear.