Anatomic study of intramuscular nerve and blood vessel in forearm muscles: an anatomical study / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the distribution of intramuscular nerve and blood vessels in forearm muscles and to discuss the possibility of dividing the forearm muscles into independent functional units.</p><p><b>METHODS</b>(1) The muscles were dissected in 10 forearms from 5 fresh adult human cadavers and stained with the Sihler's nerve staining; (2) The blood vessels were studied in eight forearm muscles from 4 fresh adult human cadavers with irrigation of a mixture of 30% barium sulfate and gelatin from brachial artery and then X-photographed. All pictures were compared to study the intramuscular distribution of nerve and blood vessels.</p><p><b>RESULTS</b>The intramuscular nerve branches were stained purple-black and visualized clearly. The muscles were classified into three types according to the distribution characters of intramuscular nerve and blood vessels. And the types of muscles could be further subdivided into a and b subtypes.</p><p><b>CONCLUSION</b>According to the neurovascular distribution, the forearm muscles in type II a and type III a can be divided into independent function units for muscle functional transplantation.</p>

Laparoscopic small intestinal flap colpopoiesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the possibility of Laparoscopic reconstruction of vagina using pedicled ileal autograft and provide a new procedure of colpopoiesis.</p><p><b>METHODS</b>The abdominal and perineal approaches were performed simultaneously under a sufficiently deep general anaesthesia. Laparoscopically, a 15-18 cm segment of the ileum on its vascular pedicle, ileal branches of the superior mesenteric artery and its concomitant veins, was selected and isolated for transplantation using ultrasonically-powered instruments. The distal of the transferred ileal segment was 15cm apart from the ileocecal junction. The ileum continuity was restored immediately by end-to-end anastomosis and the distal oral of the transplant was closed using a curved intraluminal stapler. Meanwhile, a neovaginal tract was completed to dissect from the perineum into the peritoneum and the tract widened laterally. Then the ileum transplant was reversed to reach the perineum through the peritoneal incision at the top of the neovaginal tract without subjecting the mesenteric neurovascular pedicle to undue tension and subsequent necrosis. The oral edge of the ileum transplant was sutured to the perineal skin.</p><p><b>RESULTS</b>Followed up for over 1-53 months postoperatively, 36 patients who received laparoscopic vaginoplasty by transferring ileal segment flaps got satisfactory neovaginal function similar to a normal vagina with mucus and moistness.</p><p><b>CONCLUSIONS</b>The advantages of using a laparoscopic ileum colpopoiesis are that (1) satisfactory neovaginal function similar to a normal vagina with mucus and moistness, (2) no disturbance of bowel function, (minimal scarring in abdominal wall and less secondary deformity in perineum and (3) no need for frequent dilation or stent wearing to the reconstructed vagina. And so laparoscopic vaginoplasty was a preferable alternative of vaginoplasty.</p>

Transfection of agrin gene on the recovery of muscle function after free neurovascular muscle transfer / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of transfection of agrin gene on the recovery of muscle function after a free neurovascular muscle transfer.</p><p><b>METHODS</b>The electrical gene transfection was performed when the gracilis muscle of the SD rat was completed free neurovascular transfer. The experimental group was treated with pCS2+ -agrin, the group with plasmid pCS2+ as the negative control and the group with normal saline as the frank control. The muscle function, expression of neural agrin and the junctional nAChR number was measured after the operation.</p><p><b>RESULTS</b>At 4, 5 and 10 weeks postoperatively, the pCS2+ -agrin group was significantly better than the control groups in muscle function (P < 0.05 ). The immunohistochemical staining showed an increasing deposition of the agrin protein near the endplate at 1 and 5 weeks after the operation, but decreasing remarkably to the level of control groups at 10 weeks postoperatively. The pCS2+ -agrin group was significantly more than the control groups in junctional nAChR number at every points of the time postoperatively.</p><p><b>CONCLUSIONS</b>Transfection of agrin gene in the transferred muscle may increase the early recovery of muscle function.</p>

Observation of the grafting of platelet-derived growth factor gene-modified artificial composite skin on rat wounds / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effects of the grafting of a platelet-derived growth factor gene-modified artificial composite skin on rat wounds with full thickness defect.</p><p><b>METHODS</b>Platelet derived growth factor-B (PDGF-B) eukaryotic expression plasmid was constructed, and the fibroblasts were transfected with it by liposome mediation. Artificial composite skins 1 and 2 were constructed respectively. The skin1 was composed of keratinocyte, porcine acellular dermal matrix and PDGF-B gene-transfected fibroblasts while the skin 2 contained keratinocyte, porcine acellular dermal matrix and fibroblasts. The two kinds of composite skin were grafted onto wounds on the rat back to form composite skin group 1 (C1) and 2 (C2), respectively, with 18 rats in each group. Eight rats with wounds without treatment served as control (C) group. The survival rate of the composite skin was observed at 2 post-operative weeks (POWs). The rat wounds were examined grossly on 2, 4 and 6 POWs for the calculation of wound contraction rate. Wound tissue samples were harvested for histological examination.</p><p><b>RESULTS</b>(1) Up to 2 POWs, 14 grafts in C1 group survived completely, 3 with partial survival and 1 failure. In C2 group, 10 skin grafts survived completely, 4 with partial survival and 4 failures. (2) A scab was formed in the wound at 2 POW in C group. The surface of the grafted skin in C1 group was smooth, elastic, and showed good anti-friction properly, and it was better in quality compared with that in other two groups at 6 POW. (3) The wound contraction rate of the grafts in C group of rats was higher than that in C1 and C2 groups at 2, 4 and 6 POWs, while that in C1 was lower than that in C2 group. (4) Capillary formation was more intense in the grafted skins in C1 group at 2 POWs, and the epithelia differentiated well into 7 to 10 layers of epithelial cells with compact and orderly arrangement and evenly distributed fibrous tissue at 6 POWs.</p><p><b>CONCLUSION</b>Repair of the wound with artificial composite skin containing PDGF-B gene could improve the quality of wound healing.</p>

Differential display of homeobox gene expressions in the normal, wounded human fetal and adult skins by DNA microarray / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the differential expression of homeobox genes in the normal, wounded human fetal and adult skins and its significance in fetal scarless healing.</p><p><b>METHODS</b>Gene chips containing 14 000 human genes were used to investigate homeobox gene expressions of the normal, wounded human fetal and adult skins.</p><p><b>RESULTS</b>There were significant differences between the expression of homeobox genes, especially for PRX-2, HOXB13, HOXB6 and HOXB7.</p><p><b>CONCLUSIONS</b>The homeobox gene is in close relation to developmental biology. The different expressions and changes of homeobox genes in the normal, wounded human fetal and adult skin may be a primary cause of different wound healing between fetal and adult skin.</p>

Effect of expression of platelet-derived growth factor B gene on blood vessel reconstruction after tissue engineering skin grafting / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the effect of PDGF on dermal blood vessel reconstruction by transplanted tissue-engineering skin containing PDGF-B gene to rats.</p><p><b>METHODS</b>The recombined eukaryotic expression vector, pcDNA3.1-hPDGF-B, was constructed and transfected into fibroblasts mediated by LipofectAMINE. Keratinocytes + acellular dermal matrix (group A), keratinocytes + acellular dermal matrix + fibroblasts (group B), keratinocytes + acellular dermal matrix + fibroblasts with PDGF gene (group C) were recombined respectively, then transplanted them to rat dorsum and evaluated the reconstruction of blood vessels in the dermis after 2, 4, 6 week postoperation.</p><p><b>RESULTS</b>In 2-4 weeks after skin grafting the vascularization rate in group C was higher than that of group B and group A. The vascularization rates in all groups had no significant differences in six weeks (P > 0.05).</p><p><b>CONCLUSION</b>PDGF-B gene plays an important role in reconstruction of blood vessels in the dermis at early tissue-engineering skin grafting, which ensures the take of grafted tissue-engineering skin.</p>

The dynamic expression of TNF-alpha mRNA of hypertrophic scars and its roles / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the role of tumor necrosis factor alpha: TNF-alpha in the hypertrophic scar and find a valid way to treat the hypertrophic scars with gene therapy.</p><p><b>METHODS</b>TNF-alpha mRNA expression was tested with a semiquantitative reverse polymerase chain reation (RT-PCR) method in the different period of a hypertrophic scar.</p><p><b>RESULTS</b>There was a significant increase of TNF-alpha mRNA as the hypertrophic scar was getting mature (P < 0.01). However, the ratios of TNF-alpha mRNA was significantly in a lower level than the normal scar.</p><p><b>CONCLUSIONS</b>The results suggest that TNF-alpha may play an important role in normal would healing, but the hypertrophic scar may result from the shortage of the TNF-alpha. This indicates that to increase the TNF-alpha with gene therapy may be a good way to treat the hyphertrophic scar.</p>

One-stage reconstruction of postburn whole auricle defect with MEDPOR ear scaffold covered with superficial temporoparietal fascia flap / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the effect and the key points in the operative procedure of the one-stage reconstruction of postburn whole auricle defect with medpor car scaffold covered with superficial temporoparietal fascia (TPF) flap.</p><p><b>METHODS</b>Medpor car scaffold was embedded under the superficial temporal (TFP) fascia. Razor-thin skin was grafted onto the surface of the fascia flap.</p><p><b>RESULTS</b>Fifteen patients with postburn whole auricle defect were treated by one-stage reconstruction with Medpor ear scaffold during the last four years. It was successful in all the patients with satisfactory appearance of the reconstructed ears.</p><p><b>CONCLUSION</b>Medpor possessed friendly biological compatibility. The reconstruction gave satisfactory results, and its advantages consisted of short operational time, easy manipulation, less injury to patients and good auricular contour.</p>

Preparation of porcine acellular dermal matrix by low concentration of trypsin digestion and repeated freeze-thaw cycles / 中华烧伤杂志

<p><b>OBJECTIVE</b>To establish a new method for the preparation of porcine acellular dermal matrix.</p><p><b>METHODS</b>The antigenicity of the porcine dermis was weakened by removing epidermal and dermal cells from the porcine skin through the digestion with low-concentration trypsin and repeated freeze-thaw cycles. Split thickness porcine skin was treated with 0.05% trypsin to remove the cells from the epidermis and dermis. Repeated freeze-thaw cycles were employed to further weed out the residual cells within the dermis. The prepared acellular dermis was then examined grossly, as well as histologically, and also by immunohistochemical method.</p><p><b>RESULTS</b>No cell could be identified in the prepared porcine acellular dermal matrix. The integral basement membrane was preserved on the surface of dermal matrix with compact dermal matrix collagen structure.</p><p><b>CONCLUSION</b>Low concentration trypsinization and repeated freeze-thaw cycles seemed to be a simple and effective method for the preparation of xenogeneic acellular dermal matrix.</p>

Experimental study on p53 gene mutation in keloid fibroblasts / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the significance and the role of the p53 gene mutation in the exon 4 to 8 in keloid fibroblasts.</p><p><b>METHODS</b>Tissue samples from twelve patients with keloid and twelve hyperplastic scar respectively were harvested for in vitro culture of fibroblasts, and normal skin samples from the same patients were employed as the control. Polymerase chain reaction-based single-strained conformational polymorphism (PCR-SSCP) and DNA sequencing were employed to detect p53 gene mutations of the fibroblasts.</p><p><b>RESULTS</b>The points and frameshift mutations in the exon 4, 5, 6, 7 of p53 gene were identified in 9 of the 12 keloid tissue samples. No p53 gene mutation was detected in all hyperplastic scar and normal skin samples.</p><p><b>CONCLUSION</b>p53 gene mutation might play an important role in the formation and development of keloids.</p>

A comparative study of PDGF and EGF expression in skin wound healing between human fetal and adult / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the differences of PDGF and EGF expression in the wound healing between fatal and adult.</p><p><b>METHODS</b>With the established animal model of fetal scarless healing and the adult samples, an immunohistochemical technique was used to evaluate the expression of PDGF and EGF in the normal adult skin, normal fetal skin, and the process of their wound healing.</p><p><b>RESULTS</b>1. The expression of the PDGF was not found in the fetal skin, but a mild amount of the PDGF was shown in the epidermis and the upper dermal layer 12 hours and 1 day after the wounding process. In the normal adult skin, expression of PDGF was shown in the dermal fibroblasts, macrophagocytes and blood capillaries, and a strong expression was presented during its wound healing process. 2. In the fetal skin, the expression of the EGF was seen in the epidermis, hair follicles, sebaceous glands and sweat glands, but there were no markedly changes during the wound healing. In the adult skin, a positive stain of the EGF was shown in the basal layer of the epidermis while the mild stain in hair follicles and sweat glands. The level of the expression became gradually decreasing with the time going in the wounded adult skin.</p><p><b>CONCLUSION</b>The different expression of growth factors between fetal and adult skin in wound healing may be one of the important reasons that the fetal wound could produce scarless healing.</p>

Effects of catecholamines on human preadipocyte proliferation and differentiation / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the effects of catecholamines on human preadipocyte proliferation and differentiation.</p><p><b>METHODS</b>Catecholamines (epinephrine, isoprenaline and noradrenaline) were added to the culture media of human preadipocytes. The proliferation of cells, the expression of GPDH and lipid droplet accumulation in cytoplasm were observed and recorded. The functions of alpha and beta receptors were examined with adding alpha and beta receptor blockers.</p><p><b>RESULTS</b>Epinephrine and isoprenaline stimulated human preadipocyte proliferation and inhibited GPDH up-regulation during differentiation. The three types of catecholamines inhibited lipid accumulation in cell differentiation. The beta-adrenoceptors played a key role during the process.</p><p><b>CONCLUSION</b>Human preadipocytes responded to catecholamine characteristically. The result would be applicable in the study of drugs for obesity.</p>

An experimental study of cultured keratinocytes on the acellular xenodermis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To culture the keratinocytes on the acellular pig dermis and establish a composite skin in vitro.</p><p><b>METHODS</b>Full thickness skin taken from neonatal SD rats of approximate 24-hour-old was cultivated in asepsis condition, which was then separated into epidermal and dermal layers with low-temperature enzyme digestion. The basal lamina cells between the two layers were scraped off and the pure keratinocytes were obtained using gradient density centrifugation. In the experimental group, the keratinocytes were cultured on acellular xenodermis(AX) as the three-dimensional frames. In the control, the keratinocytes were cultured without any trophoblast. The air-liquid interface(ALI) culture continued after the primary culture. Routine histological HE staining and assay of Pancytokeratin and Laminin with strepavidin-biotin-peroxidase complex (SABC) method were used to study the morphology of CK and AX.</p><p><b>RESULTS</b>HE staining demonstrated the formation of more than 4 lays of keratinocytes and basement membrane, with slight keratinization of the cells. Pancytokeratin(+) in immunohistochemical results confirmed that the cultured cells on AX were keratinocytes, not other kinds of cells. Laminin(+) indicated that new procreant basement membrane appeared in CK.</p><p><b>CONCLUSION</b>Keratinocytes cultured on the acellular pig dermis grow well and form basement membrane. This study implies successful construction of composite skin.</p>

The significance and the expression of homeobox genes during human burn wound healing / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the expression of several homeobox genes during the wound healing in fetal and adult skin and their roles in fetal scarless wound healing.</p><p><b>METHODS</b>The expressions of PRX-2, HOXB13, HOX2.2 and HOX2.3 during wound healing in fetal and adult skin were determined with in situ hybridization.</p><p><b>RESULTS</b>(1) PRX-2 positive expression could be identified in normal fetal and adult skin, especially in the fetus. But there was difference in location sites of the genes. The positive expression in normal fetal skin was mainly found in the peripheral cells at the hair shafts within dermal papilla layers and was also found in the epithelium. Nevertheless, weak positive expression of PRX-2 was found in the epithelial basal layer cells in normal adult skin but not in dermal tissue. There was strong positive expression of the PRX-2 in the tissue around the wound in fetus but not of that in adults except the epithelial basal layers. (2) Positive expression of HOXB13 could be identified in both normal fetal and adult skins. And the expression was concentrated mainly in hair follicle cells in the dermis and in the basal layer cells in the epithelium. Furthermore, the expression became weak after trauma, especially in fetal skin. (3) The positive expression of HOX2.2 and HOX2.3 in normal fetal skin was observed mainly in the whole layer of the epithelium and especially in the epithelial basal layers. Weak positive expression could be found in the dermis and strong expression found in the tissue near the wound. But there was no positive expression of the HOX genes in normal adult skin and wounds.</p><p><b>CONCLUSION</b>The difference in the HOX expression in fetal and adult skin wound healing might be the key factor leading to different wound healing. Homeobox genes might be closely related with the developmental biology.</p>