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Objective: To investigate the feasibility and safety of auricle reconstruction combined with Bonebridge implantation for bilateral aural atresia patients. Methods: A retrospective analysis was conducted for 36 cases(72 ears) who underwent Bonebridge implantation combined with bilateral auricle reconstruction from February 1, 2017 to January 15, 2020. All cases were bilateral congenital aural atresia and underwent Nagata auricle reconstruction for both sides simultaneously. Bonebridge implantations were performed during the second stage of auricle reconstruction. Results: All 36 patients healed well and had no surgical complications when discharged. The preoperative average bone conduction threshold of the patients was(8.5±5.8) dB HL and postoperative bone conduction threshold was (8.4±5.2) dB HL. There was no significant change after the implantation (P=0.724). The preoperative average air conduction threshold of was(64.9±7.4)dB HL and postoperative air conduction threshold was (24.0±5.3) dB HL, which had a significant change after the implantation (P<0.001). The hearing threshold with Bonebridge significantly decreased by 40.9 dB HL compared with the preoperative air conduction threshold(P<0.001). The speech recognition rate of monosyllable words, disyllabic words and short sentences in quiet environment increased by 62.5%, 63.5% and 72.2% respectively. The differences were statistically significant (P<0.001). The speech recognition rate of monosyllabic words, disyllabic words and short sentences in noise environment were significantly increased by 55.9%, 58.9% and 69.9% respectively (P<0.001). After a follow-up of 18.3 months in average, the hearing results were stable and the aesthetic outcomes were satisfied. One patient had implant rupture and healed after revision surgery. Conclusions: With an integrated surgical procedure, patients with bilateral congenital aural atresia can complete bilateral auricle reconstruction and hearing implantation within six months. This integrated surgical procedure is safe and efficient, with a stable hearing improvement and good appearance.
Subject(s)
Humans , Bone Conduction , Ear, External , Hearing Aids , Hearing Loss, Conductive , Retrospective Studies , Treatment OutcomeABSTRACT
Objective: To investigate the curative effect of rib cartilage framework supporting combined with local flap grafting for correction of cryptotia. Methods: Fourteen cases (nineteen ears) were corrected by rib cartilage framework supporting combined with local flap grafting method from January 2017 to March 2019. Part of the 7th rib cartilage was carved into a scalloped cartilage piece, which was implanted on the retroauricular cartilage to release and expand the deformed cartilage. A "M" incision was designed on the retroauricular skin to make the local flap grafting. Results: All corrected auricles were followed up for four months to three year and abtained satisfactory and stable appearance. In one case, the edge of the helix was broken two weeks after the operation, and well healed after repairing. Conclusions: The rib cartilage framework supporting combined with local flap grafting method can fully correct the deformity of cryptotia, and the long-term effect is satisfied. It can be an important complement to the classic methods.
Subject(s)
Humans , Cartilage , Ear, External/surgery , Plastic Surgery Procedures , Ribs , Surgical FlapsABSTRACT
Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis. Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children's Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L<TSB peak <427.5 μmol/L), very severe NHB group (TSB peak range 427.5-513.0 μmol/L), and fatal NHB group (TSB peak >513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up. Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up. Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.
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Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis. Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children's Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L<TSB peak <427.5 μmol/L), very severe NHB group (TSB peak range 427.5-513.0 μmol/L), and fatal NHB group (TSB peak >513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up. Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up. Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.
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<p><b>OBJECTIVE</b>To investigate the imbalance of Tc1/Tc2,Th1/Th2 and Tc/Th in patients with systemic lupus erythematosus(SLE) and its relationship with the clinical stages of SLE.</p><p><b>METHODS</b>The full blood culture and flow cytometry with fluorescence-labelled T lymphocytes were used to detect the levels of T-lymphocyte subsets and its intracellular factors IFN-γ and IL-4 in peripheral blood from SLP patients in active, inactive stages and normal healthy persons as controls, to compare the changes of Tc1,Tc2; Th1,Th2 levels and Tc/Th ratio in SLP patients in active and inactive stages, and to analyze their relationship with SLEDAI staging.</p><p><b>RESULTS</b>Compared with healthy controls, the levels of CD4/CD8in active SLE patients were significantly lower, but the levels of Tc1,Th1 in active SLE patients were higher than those in inactive SLE patients and normal controls. The ratio of Tc1/Tc2 and Th1/Th2 in the active SLE was higher than that in inactive SLE and normal controls(P<0.05), but the difference between inactive SLE patients and controls was not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>The Tc/Th imbalances and change of Tc and Th cells to Tc1 and Th1 cells play an important role in the pathogenesis of SLE.</p>
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Objective To evaluate the gender differences in dose-response curve with cisatra-curium in epileptics.Methods Eighty ASA grade Ⅰ or Ⅱ epileptics were enrolled in this study.All patients were divided into male and the female groups and received the method of single dose injection under midazolam-fentanyl intravenous anesthesia.Each patient received intravenous bolus of 20,30, 40,50μg/kg of cisatracurium respectively.The neuromuscular block was measured by Neuromuscular Transmission Monitor and the responses were defined in terms of the percentages of maximum sup-pression in T1 of TOF of the adductor pollicis muscle.According to log-probit transformation of the data of dose and response,the dose-response curve of cisatracurium was established through linear re-gression.The onset time of cisatracurium was also observed.Results The ED50 ,ED75 ,ED90 ,ED95 values of cisatracurium in male epilepsy patients were 37.2±9.7,48.1±11.3,60.4±12.8,69.3± 14.0 μg/kg and that of female epilepsy patients were 36.6±4.3,47.5±7.7,60.5±14.0,70.1± 19.4 μg/kg.There was no significant difference between the two gender groups.No significant change in onset time was observed among 4 dose groups.Conclusion No gender differences are ob-served in dose-response curve of cisatracurium in epileptics.
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<p><b>OBJECTIVE</b>To investigate the feasibility of Brent I methods for total auricular reconstruction when expanded flap ulceration happened.</p><p><b>METHODS</b>The expanded flaps in the retroauricular region ulcerated during total auricular reconstruction in 8 patients with microtia. Then the expanders were removed and autologous rib cartilage frameworks were implanted. Brent I techniques for the total auricular reconstruction were employed.</p><p><b>RESULTS</b>All the wounds in 8 patients with microtia healed primarily. The expanded flaps survived completely. The reconstructed ears had good shape and appearance with little hair. The size, shape and position of reconstructed ears were coordinated with the face.</p><p><b>CONCLUSIONS</b>Brent I technique is an alternative method for total auricular reconstruction when the expanded flap ulceration occurs during total ear reconstruction.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Ear Auricle , General Surgery , Ear, External , Plastic Surgery Procedures , Methods , Skin Transplantation , Surgical Flaps , Tissue Expansion , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To construct pGPU6/GFP/Neo-shRNA expression vector targeting human AMPKα2 gene and evaluate its silencing effect in SH-SY5Y cell line.</p><p><b>METHODS</b>The oligonucleotides designed by Ambion online CAD software targeting AMPKα2 were cloned into the pGPU6/GFP/Neo vector. After confirmation by DNA sequencing and enzyme digestion analysis, the recombinant vectors were transfected into the SH-SY5Y cell line via lipofectamine and the positive clones were selected using G418. The expression levels of AMPKα2 mRNA and protein in the transfected cells were detected by RT-PCR and Western blotting, respectively.</p><p><b>RESULTS</b>Four shRNA vectors were successfully constructed as confirmed by DNA sequencing and the enzyme digestion analysis. Among the 4 recombinant vectors, pGPU6/GFP/Neo-shRNA AMPKα2(3) showed the strongest gene silencing effect and down-regulated the protein expression of AMPKα2 by 63% in the transfected cells.</p><p><b>CONCLUSION</b>Transfection with pGPU6/GFP/Neo-shRNA AMPKα2(3) results in effective inhibition of AMPKα2 gene expression in SH-SY5Y cells, which provide a means for studying AMPK-mediated cell injury.</p>
Subject(s)
Humans , AMP-Activated Protein Kinases , Genetics , Cell Line , Gene Targeting , Methods , Genetic Vectors , Genetics , RNA Interference , RNA, Small Interfering , Genetics , Metabolism , TransfectionABSTRACT
<p><b>OBJECTIVE</b>To explore the relationship between nonsyndromic cleft lip with or without cleft palate (NSCL/P) and genetic polymorphism of MTHFR C677T and A1298C in Chinese population.</p><p><b>METHODS</b>Case-control study design was employed. MTHFR genotypes were determined by polymerase chain reaction and restriction fragment length polymorphism techniques (PCR-RFLP).</p><p><b>RESULTS</b>As to MTHFR C677T, 48 heterozygous parents with an affected child were analyzed through case-parental control study using TDT (chi2 = 0. 02, P > 0.05). The genotype frequency and allele frequency of 76 NSCL/P cases and 60 controls were analyzed through case-control study (chi2 = 9.91, P < 0.05). As to MTHFR A1298C, 27 heterozygous parents with an affected child were analyzed through case-parental control study using TDT (chi2 = 4.00, P < 0.05). The genotype frequency and allele frequency of 76 NSCL/P cases and 60 controls were analyzed through case-control study (chi2 = 4.42, P < 0.05).</p><p><b>CONCLUSIONS</b>The genetic polymorphism of MTHFR C677T is associated with the development of NSCL/P, and the genetic polymorphism of MTHFR A1298C is a risk factor for NSCL/P in the Chinese population.</p>
Subject(s)
Humans , Asian People , Genetics , Case-Control Studies , Cleft Lip , Genetics , Gene Frequency , Genotype , Methylenetetrahydrofolate Reductase (NADPH2) , Genetics , Polymorphism, GeneticABSTRACT
<p><b>OBJECTIVE</b>To explore the role of transforming growth factor beta (TGF beta) and their receptors (TGF beta-R) in the pathogenesis of hypertrophic scar.</p><p><b>METHODS</b>Specimens of normal skin and hypertrophic scar were harvested and the distribution and the expression of the TGF beta and TGF beta-R were determined by immunohistochemistry and in situ hybridization method.</p><p><b>RESULTS</b>The expressions of TGF beta and TGF beta-RII in normal skin were higher than the expression of TGF beta 1, TGF beta 2 and TGF-RI. But in hypertrophic scar the results were on the contrary. The mRNA expressions of TGF beta 1, TGF beta 2 and TGFRI were evidently increased with decreased mRNA expression of TGF-beta 3 and TGFR II in the hypertrophic scar when compared with those in the normal skin.</p><p><b>CONCLUSION</b>The expression of TGF-beta (beta 1, beta 2, beta 3) and their receptors in different levels during the process of wound healing might be related to the formation of hypertrophic scars.</p>
Subject(s)
Humans , Cicatrix, Hypertrophic , Genetics , Metabolism , Immunohistochemistry , In Situ Hybridization , RNA, Messenger , Genetics , Metabolism , Receptors, Transforming Growth Factor beta , Genetics , Metabolism , Skin , Metabolism , Pathology , Transforming Growth Factor beta , Genetics , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the role of recombinant human transforming growth factor beta3 (rhTGFbeta3) on fibroblast and its possible mechanism.</p><p><b>METHODS</b>Normal skin fibroblast (NSFb) and hypertrophic scar fibroblast (HSFb) were cultured in vitro, and were processed by different concentrations of rhTGFbeta3. NSFb and HSFb in DMEM solution without rhTGFbeta3 were employed as control. The changes in the protein and mRNA expression of type I and III collagen in NSFb and HSFb were observed.</p><p><b>RESULTS</b>(1) The expression of type I and III procollagen in NSFb was evidently different from that of HSFb (2) The synthesis of type I and III procollagen in all test groups was increased obviously after rhTGFbeta3 process (P < 0.001) while the ratio of type I to III procollagen was decreased when compared with that in control group. (3) The effects of rhTGFbeta3 on the biological behavior exhibited an obvious dose- effects relationship. The contents of type I to III procollagen in HSFb were higher than those in NSFb when the dose of rhTGFbeta3 was same.</p><p><b>CONCLUSION</b>rhTGFbeta3 could effectively promote the synthesis of type I and III procollagen, especially type III procollagen in fibroblasts. This might be beneficial to the accelerate of wound healing and to inhibit or prevent scar formation.</p>
Subject(s)
Humans , Cicatrix, Hypertrophic , Metabolism , Collagen Type I , Collagen Type III , Fibroblasts , Metabolism , In Vitro Techniques , Recombinant Proteins , Pharmacology , Transforming Growth Factor beta3 , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the inhibiting action of transforming growth factor-beta type R II receptor(TGF-beta R II) antibody to fibroblasts.</p><p><b>METHODS</b>Four groups of cultured skin fibroblasts were treated with different dosages of TGF-beta R II antibody. Examinations were performed with HYP, MTT, microscope, and flow cytometry techniques.</p><p><b>RESULTS</b>TGF-beta R II antibody resulted in significant inhibition of fibroblasts(P < 0.01).</p><p><b>CONCLUSION</b>TGF-beta R II antibody has inhibiting effects on the proliferation of skin fibroblasts and with a dose-dependent manner.</p>
Subject(s)
Adolescent , Child , Humans , Antibodies, Monoclonal , Pharmacology , Cell Division , Cells, Cultured , Fibroblasts , Cell Biology , Flow Cytometry , Microscopy, Electron , Protein Serine-Threonine Kinases , Receptors, Transforming Growth Factor beta , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To explore a method for reconstruction of Poland's chest wall deformity.</p><p><b>METHODS</b>The customized, textured silicone prosthesis was fabricated from a soft silicone polymer that approximated to the softness of the pectoralis major muscle. A lateral incision of 6 cm on the affected chest was made. After a subcutaneous pocket above the ribs was created through the incision, the prosthesis was placed in the pocket.</p><p><b>RESULTS</b>Since October 2000, chest wall reconstruction for Poland's syndrome deformity has been performed in 7 male patients (18 to 45 years) with the customized soft silicone prosthesis. Follow-up for 3 to 17 months showed that all patients were satisfied with the aesthetical results. Seroma occurred in 2 patients, and needle aspiration was used to solve the problem.</p><p><b>CONCLUSION</b>This method is simple and less traumatic. The reconstructed chest wall approximates to the softness and appearance of the contralateral pectoralis muscle.</p>