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Objective To evaluate the efficacy and safety of laser-assisted balloon angioplasty(LABA)in treating patients with infrapopliteal arterial occlusion complicated by critical limb ischemia(CLI).Methods The clinical data of patients with infrapopliteal artery occlusion complicated by CLI,who were admitted to the Fuwai Central China Cardiovascular Hospital to receive LABA(LABA group)or balloon angioplasty alone(BA group)between January 2019 and December 2021,were retrospectively analyzed.The incidence of perioperative complications and postoperative clinical efficacy were compared between the two groups.Results A total of 32 patients received LABA therapy and 40 patients received BA alone.The technical success rate,the postoperative ankle-brachial index(ABI),the numerical value of postoperative ABI value deducting preoperative ABI value,the postoperative 24-month continuous improvement rate of clinical symptoms and the primary patency rate of target vessels in the LABA group were remarkably higher than those in the BA group(all P＜0.05).No procedure-related target vessel perforation,amputation,or death occurred in both groups.No statistically significant differences in the target vessel dissection,distal embolism,remedial stenting,and postoperative 24-month amputation-free survival existed between the groups(all P＞0.05).Conclusion For the infrapopliteal arterial occlusion complicated by CLI,LABA therapy is clinically safe and effective,and its mid-term efficacy is superior to BA alone.
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Abstract@#Executive function development is crucial for the overall development of physical and mental health, improvement of mental health literacy, and enhancement of adolescent health and well being in the adolescent population. It is scientific and feasible to promote the development of executive function by improving the cardiorespiratory fitness of adolescents. Therefore, it is important to grasp the "cardiorespiratory fitness improvement" and actively explore ways and methods to improve cardiorespiratory fitness and thus promote the executive function of adolescents, in order to comprehensively strengthen the construction of the adolescent mental health protection mechanism and work system, and to improve the work of students mental health in the new era.
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Objective:To investigate the efficacy of excimer laser atherectomy (ELA) combined with drug-coated balloon (DCB) in the treatment of femoropopliteal arteriosclerosis obliterans (ASO) and its influencing factors.Methods:The clinical data of patients with femoropopliteal ASO treated by ELA combined with DCB from July 2019 to March 2022 were retrospectively analyzed, including technical success rate, ankle-brachial index(ABI), primary patency rate and freedom from target lesion revascularization (TLR) rate. Cox regression was applied to analyze the risk factors affecting the decline in the rate of primary patency and freedom from TLR.Results:All 82 patients were treated with ELA+DCB. The technical success was 91.5%. The post-operative ABI (0.73±0.13) was significantly higher than preoperative ABI (0.39±0.11) ( t=35.26, P<0.001). The 24-month cumulative primary patency and TLR-free rates were 64.1% and 76.8%, respectively. Lesion length>15 cm ( HR=2.57, P=0.047) and severe calcification ( HR=3.26, P=0.021) were associated with loss of primary patency. Having diabetes ( HR=5.24, P=0.010) and a single postoperative outflow tract ( HR=4.18, P=0.008) were associated with a decrease in TLR-free rates. Conclusions:ELA combined with DCB for femoropopliteal ASO is safe and has good intermediate efficacy. Lesion length>15 cm and severe calcification were independent risk factors for primary patency rate, and diabetes and a single postoperative outflow tract were independent risk factors for TLR-free rate.
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Objective:To investigate the risk factors for retrograde type A dissection (RTAD) associated with thoracic endovascular aortic repair (TEVAR) which provided the basis for clinical risk stratification and treatment decision.Methods:The clinical data of 1 688 patients with thoracic aortic disease who underwent TEVAR in our center from January 2004 to December 2019 were retrospectively analyzed. The pathological classification included aortic dissection (1 592 cases) and other thoracic aortic diseases (96 cases). Univariate analysis and categorical multiple logistic regression analysis were used to explore the risk factors for the development of RTAD during or after TEVAR.Results:A total of 18 cases of RTAD were found, with an overall incidence of 1.1% (18/1 688), all of which occurred in aortic dissection group. After adjusting for confounding factors, multivariate logistic regression analysis showed that the incidence of RTAD was significantly decreased(OR=0.27,95%CI 0.07-0.96, P=0.043) when the oversize of stentgraft was 11%-20%, the oversize of stentgraft was ≤10% as the control group, and the difference was statistically significant( P<0.05). The ascending aorta diameter was <40 mm as the control group, and there was no significant difference in the incidence of RTAD between the ≥40 mm group and the control group(OR=2.71,95%CI 0.94-7.84, P=0.065). Conclusions:Aortic dissection is more likely to develop RTAD than other thoracic aortic diseases. A proper stentgraft oversizing ratio could reduce the probability of RTAD. That is to say that a too low stentgraft oversizing ratio is not recommended.
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Objective To evaluate the efficacy and safety of chocolate balloon assisted drug-coated balloon(DCB)angioplasty for the treatment of TASC Ⅱ type C/D femoropopliteal artery lesions.Methods The clinical data of 58 patients with TASC Ⅱ type C/D femoropopliteal artery lesions treated with chocolate balloon +DCB or plain balloon+DCB at Fuwai Central China Cardiovascular Hospital from January 2021 to October 2022 were retro-spectively analyzed.A total of 27 cases were assigned to the observation group(chocolate balloon + DCB)and 31 cases tothe control group(plain balloon + DCB).The rate of dissection and the clinical outcomes between the two groups were compared.Results The technical success rates of the observation and control groups were 88.9%and 80.6%,respectively.The rates of dissection,flow-limiting dissection,and bailout stenting were significantly lower in the observation group than of the control group(all P<0.05).Postoperative clinical symptoms of patients in both groups improved significantly compared with the preoperative period.The 12-month cumulative primary patency rate of the observation group was significantly higher than that of the control group(P<0.05).There was no significant difference in the 12-month cumulative freedom from clinically driven-target lesion revascularization rate between the two groups(P>0.05).Conclusion Chocolate balloonassisted DCB angioplasty was safe and effective for TASC Ⅱ type C/D femoropopliteal artery lesions.It reduced the rates of dissection and bailout stenting,and had better near-term outcomes than plain balloon + DCB.
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Implanted brain-computer interface (iBCI) is a system that establishes a direct communication channel between human brain and computer or an external devices by implanted neural electrode. Because of the good functional extensibility, iBCI devices as a platform technology have the potential to bring benefit to people with nervous system disease and progress rapidly from fundamental neuroscience discoveries to translational applications and market access. In this report, the industrialization process of implanted neural regulation medical devices is reviewed, and the translational pathway of iBCI in clinical application is proposed. However, the Food and Drug Administration (FDA) regulations and guidances for iBCI were expounded as a breakthrough medical device. Furthermore, several iBCI products in the process of applying for medical device registration certificate were briefly introduced and compared recently. Due to the complexity of iBCI in clinical application, the translational applications and industrialization of iBCI as a medical device need the closely cooperation between regulatory departments, companies, universities, institutes and hospitals in the future.
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Humans , Brain-Computer Interfaces , Brain/physiology , Electrodes, ImplantedABSTRACT
Objective@#To explore age, gender, and regional differences in physical activity among children and adolescents in China, and to provide a scientific reference for enhancing physical activity promotion.@*Methods@#A total of 4 269 children and adolescents aged 7 to 18 years were selected from six administrative regions of China (East China, Northwest China, North China, Central China, Southwest China and South China) using a stratified random cluster sampling method from September to December 2018. A questionnaire was administered to evaluate the physical activity level of Chinese children and adolescents aged 7 to 18.@*Results@#The overall detection rate of MVPA insufficiency in children and adolescents in China was 53.8%, of which the detection rate of MVPA insufficiency was 50.8% among boys and 57.1% among girls. Gender differences were statistically significant ( χ 2= 17.10 , P <0.05). Among the different age groups, the lowest detection rate of MVPA among 10-12 year olds was 43.6%, whereas the highest rate among 16-18 year olds was 63.0%, with significant differences between gender ( χ 2=4.33, 30.79, P <0.05). The P 50 values of total physical activity(TPA), light intensity physical activity(LPA), moderate intensity physical activity(MPA), vigorous intensity physical activity(VPA), moderate to vigorous physical activity(MVPA) were 92.9,24.3,41.4,7.1 and 55.7 min/d , respectively. The P 50 values of physical exercise, housework activities, entertainment activities and transportation activities were 34.3 , 2.1, 2.3 and 30.0 min/d, respectively, and the difference in age groups was statistically significant( H =95.03, 74.99, 300.26 , 64.16, P <0.05). There was a statistically significant difference in the detection rate of insufficient MVPA among children and adolescents in different regions ( χ 2=83.91, P <0.05). The lowest rate was 44.0% in North China, and the highest was 65.9% in East China.@*Conclusion@#The detection rate of MVPA insufficiency among Chinese children and adolescents firstly decreased and then increased with age. Boys participated in higher levels of physical activity than girls.
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OBJECTIVE@#To explore the genetic basis for a Chinese pedigree with a novel ABO subtype.@*METHODS@#The proband and his family members were subjected to serological analysis, and their genotypes were determined by fluorescence PCR and direct sequencing of the coding regions of the ABO gene. Exons 6 to 7 of the ABO gene were also subjected to clone sequencing for haplotype analysis.@*RESULTS@#The proband was determined as an AxB subtype. By fluorescence PCR, he was typed as A/B. Clone sequencing has revealed a insertional mutation c.797_798 insT in exon 7 of the ABO gene, which yielded a novel allele. Pedigree analysis confirmed that the novel ABO*A1.02 allele carried by the proband and his sister was inherited from their father. The c.797_798insT mutation has been submitted to GenBank with an accession number of MK125137.@*CONCLUSION@#The c.797_798insT mutation of exon 7 of the ABO gene probably has led to weakened expression of A antigen.
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Humans , Male , ABO Blood-Group System/genetics , Alleles , China , Genotype , Mutation , N-Acetylgalactosaminyltransferases/genetics , PedigreeABSTRACT
OBJECTIVE@#To delineate the serological and molecular profiles of a patient with A(w)37B subtype.@*METHODS@#The ABO bloodtypes of the proband, his wife and daughter were determined with a standard serological method. Their ABO genotypes were determined by sequence-specific primer polymerase chain reaction (PCR-SSP). All exons of the ABO gene were directly sequenced. Exons 6 and 7 of the ABO gene were further analyzed by cloning and sequencing.@*RESULTS@#The red blood cells of the proband showed a weak B phenotype. His serum sample contained weak reactive anti-A antibody, which was defined as A(w)B blood group based on the serological characteristics. The A and B alleles were detected by blood group genotyping. Gene cloning and sequencing have identified a characteristic c.940A>G variant (ABO*AW.37) in exon 7 of the ABO gene, which resulted in substitution of Lysine by Glutamate at position 314. The proband's daughter has inherited the ABO*AW.37 allele.@*CONCLUSION@#The c.940A>G variant in exon 7 of the ABO gene probably underlay the decreased activity of GTA transferase and resulted in the Aw37 phenotype.
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Humans , ABO Blood-Group System/genetics , Alleles , Genotype , Pedigree , PhenotypeABSTRACT
【Objective】 The purpose of this study was to perform bioinformatics analysis of infliximab （IFX） treatment of rheumatoid arthritis （RA） non-responders and responders gene data chip based on autophagy， and to screen out the characteristic autophagy-related genes， carry out a preliminary experiment on the role of characteristic genes， and explore the possible mechanism of IFX treatment of RA non-response. 【Methods】 R language was used to analyze the differential expressions of autophagy-related genes on the selected gene expression omnibus database （GEO） data set. Univariate logistic regression， least absolute shrinkage and selection operator （Lasso） regression， and multiple logistic regression analyses were made to screen out the characteristic autophagy-related genes； receiver operating characteristic curve （ROC） was used to assess the diagnostic value of the characteristic autophagy-related genes. Real-time PCR was used to detect the expressions of characteristic autophagy-related genes in RA clinical samples， and Western blot was used to detect the role of characteristic autophagy-related genes in autophagy in RA synovial cell line MH7A cells. 【Results】 Part of autophagy-related genes were differentially expressed between non-responders and responders to IFX treatment of RA （P<0.05）， and autophagy-related gene sets were mainly expressed in non-responders. Hepatocyte growth factor-regulated tyrosine kinase substrate （HGS） and autophagy related 4 homolog B （ATG4B） were screened out as characteristic genes of non-response to IFX treatment of RA. The ROC showed that the predictive model constructed using the selected markers had good discrimination ability in the internal validation data set GSE78068 （AUC=0.708， P<0.05） and the external validation data set GSE58795 （AUC=0.719， P<0.05）. The Real-time PCR results showed that the expression of HGS was increased in peripheral blood leukocytes in the non-responders. After overexpression of HGS in MH7A cells， the ratio of LC3BⅡ/LC3BⅠ was increased while the expression of P62 was decreased， indicating that autophagy increased. 【Conclusion】 The autophagy-related gene expression profiles were different between IFX-treated RA non-responders and responders， suggesting that the non-response of IFX treatment of RA may be related to autophagy. The prediction model constructed with HGS and ATG4B had a certain ability to predict IFX-treated RA non-response， and HGS promoted autophagy in MH7A cells， which provides a new idea for future research on the molecular mechanism of IFX in treating RA non-response.
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Objective:To investigate the treatment strategies for the thoracic endovascular aortic repair (TEVAR) of Stanford type B aortic dissection (TBAD) accompanied with intra-or post-operational retrograde type A aortic dissection (RAAD).Methods:TBAD patients who underwent TEVAR in Henan Provincial People′s Hospital from February 2004 to January 2020 were retrospectively analyzed. Among 1 176 cases, 14 cases (1.2%) were accompanied with RAAD. Another 9 patients who received TEVAR at other hospitals with TBAD accompanied with RAAD were also collected. In total 23 patients [18 males and 5 females, age as (54±12) years old , ranging from 38 to 79] were included in this study. There were 15 cases of typical dissection, 7 cases of intramural haematoma, and 1 case of penetrating aortic ulcer. Sixteen patients received surgical operation, 1 received hybrid surgery, and the remaining 6 patients underwent conventional therapies. The clinical data and followed up data were collected and analyzed.Results:Among 23 cases, 2 RAAD cases were discovered during the TEVAR, 8 cases were discovered during the perioperative period, 5 cases were discovered within 3 months after discharge, and 8 cases were discovered at more than 1 year after TEVAR, with the longest time point of 120 months after TEVAR. The RAAD rupture was located on the greater curvature side of the aorta in 21 cases, and on the minor curvature side in 2 cases. In 13 cases, the rupture was close to the stent head, and in 10 cases, the rupture was located on the ascending aorta and more than 2 cm from the stent head. Followed up data were collected in 21 cases, with the mean follow-up time as (59±40) months, ranging from 1 to 134 months. Six patients died, with 3 cases of all-reason death and 3 cases of cardiac-reason death. Among the 16 patients receiving surgical operation, one patient died during the perioperative period, and 1 patient suffered from the cerebral infarction and mediastinal infection. Well recovery was found in 1 patient received the hybrid operation. Five of 6 patients who received the conventional treatment died.Conclusions:RAAD is a serious complication related to TEVAR, with low incidence and high mortality rate. RAAD can occur in the early or late stages of TEVAR. TEVAR-associated RAAD has poor therapeutic outcomes, and the surgical operation should be recommended as the preferred treatment for RAAD in clinical practice.
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Objective@#To analyze the causes of complication of early acute kidney injury (AKI) in four severely burned patients, and to explore the related treatment methods.@*Methods@#The clinical data of 4 patients with severe burn complicated with early AKI admitted to Guangzhou Red Cross Hospital Affiliated to Medical College of Jinan University (hereinafter referred to as our hospital) from June 2014 to December 2017 were retrospectively analyzed. All the patients were male, aged 23-33 (30±5) years old, with depth of burns ranged from deep partial-thickness to full-thickness, complicated with myofascial compartment syndrome of extremities and varying degrees of striated muscle injury, and treated in other hospitals before transfer to our hospital. The patients were numbered from small to large according to the total burn area. The total burn area of patients No. 1, 2, 3, and 4 was 10%, 80%, 90%, and 95% total body surface area respectively, their occurrence time of early AKI was 48, 11, 29, and 48 hours after injury respectively, and their time of arriving our hospital was 60, 11, 29, and 144 hours after injury respectively. Hypovolemic shock occurred in patients No. 2 and 3 at admission to our hospital. All the patients received continuous renal replacement therapy (CRRT) after admission to our hospital. Under the support of hemodynamic monitoring and organ function monitoring, the limbs complicated with myofascial compartment syndrome were incised, thorough decompression exploration was performed, and necrotic muscle tissue was removed or amputation was performed. After escharectomy and decompression of limbs, fresh granulation wounds were formed by temporarily covering wounds with Jieya dressing skin or pig skin, multiple debridements, and vacuum sealing drainage. Fresh granulation wounds and other wounds underwent staged eschar excision and shaving were covered with autologous Meek skin graft, particulate skin graft, reticular skin graft and small skin graft respectively. The treatment outcome, CRRT time, operation times, time of recovery of serum creatinine and myoglobin, length of hospital stay, and follow-up were recorded.@*Results@#All the 4 patients were cured after transfer to our hospital. Among them, totally 5 limbs of patients No. 1 and No. 4 underwent amputation because of complication of myofascial compartment syndrome and a large amount of necrotic muscle which could not be preserved. Patients No. 1, 2, 3, and 4 were treated with CRRT for 19, 35, 14, and 25 days respectively and performed with operation for 5, 6, 10, 8 times respectively. Serum creatinine of patients No. 1, 2, 3, and 4 returned to normal on 22, 35, 37, and 48 days after transfer respectively, and their serum myoglobin returned to normal on 18, 28, 25, and 30 days after transfer respectively. Patients No. 1, 2, 3, and 4 were hospitalized for 52, 105, 148, and 156 days and discharged after basic wound healing. Follow-up for 1 to 36 months showed no abnormal renal function in 4 patients.@*Conclusions@#The early AKI in patients No. 1 and 4 was caused by rhabdomyolysis after severe burn complicated with myofascial compartment syndrome, while that of the other 2 cases were also related to hypovolemic shock and poor renal perfusion. The success rate of early AKI treatment in severely burned patients can be effectively improved by removing the causes of diseases at the same time of CRRT and actively treating burn wounds under the support of organ function and hemodynamic monitoring.
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Objective@#To determine the relationship between body mass index (BMI) and physical fitness index (PFI) in Chinese and Japanese children and adolescents and to provide theoretical support for physical fitness improvement in Chinese children and adolescents.@*Methods@#A total of 9 594 children and adolescents aged 7-18 years were tested in China and Japan, 4 800 of which with various BMI were randomly selected for analyzing and comparing PFI between the two countries. The relationship between different BMI-Z scores and PFI was analyzed.@*Results@#In general, the PFI of wasting, normal weight, overweight and obesity in Chinese boys was -1.17, -0.03, 0.04 and 0.26, the figures were -2.59, -0.34, -1.46 and -2.44 for Japanese boys, significant differences were found in overweight and obese group (P<0.01). the PFI of wasting, normal weight, overweight and obesity in Chinese girls was -1.18, -0.08, 0.01 and 1.03, the figures were -1.21, 0.51, 0.11 and -1.30 for Japanese girls, significant differences were found in normal weight and obese group(P<0.05). Significant differences in PFI were found within Chinese boys, Chinese children, Japanese boys, Japanese girls and Japanese children with different BMI-Z levels(F=2.89, 3.05, 4.81, 2.33,5.34,P<0.01).@*Conclusion@#There is an inverted "U" curve relationship between BMI and PFI in Chinese and Japanese children and adolescents. With the increase of BMI-Z score, decreasing rate of PFI in Chinese boys is higher than Japanese boys. Practical and effective intervention measures should be taken to improve physical fitness of children and adolescents in China.
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Objective@#To analyze and compare the correlation between body mass index (BMI) and cardiopulmonary fitness of children and adolescents aged 7 to 18 years in China and Japan, and to provide important reference for healthy development promotion of children and adolescents in China.@*Methods@#A total of 9 594 children and adolescents aged 7-18 years in China and Japan were selected and examined for height, weight and 20 meters shuttle run test (20mSRT), 4 800 of whom were randomly selected and included for analysis. Independent sample t test was used to compare the differences of BMI and 20mSRT between Chinese and Japanese children and adolescents of different sex and age. Logistic regression was used to compare the odds ratio of high cardiopulmonary fitness among children and adolescents of different nutritional status. Pearson correlation and linear regression were used to analyze the correlation between BMI and 20mSRT.@*Results@#Odds ratios of high cardiopulmonary fitness were 0.57, 0.52 and 0.33 in wasting, overweight and obese children and adolescents in China, and 0.49, 0.36 and 0.16 in Japan, respectively, with significant differences(P<0.05). The BMI-Z scores of Chinese and Japanese children and adolescents ranged from - 2.72 to 8.76. There were significant differences in 20mSRT-z between different BMI-Z groups(P<0.05). The 20mSRT-z score of Chinese and Japanese children and adolescents initially increased with BMI-Z score and then decreased with the increase of BMI-z score. With the decrease of BMI-Z score, 20mSRT performance in Chinese boys decreased significantly.@*Conclusion@#Compared with the normal weight peers in China and Japan, the proportion of wasting, overweight and obese children and adolescents with high cardiopulmonary fitness is lower. The BMI-Z score and 20mSRT-z score shows a general inverted "U-shaped" trend. The effect of wasting on cardiopulmonary fitness is greater in Chinese boys.
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Objective@#This paper analyses the secular trend in physical growth among Japanese children and adolescents from 1900 to 2016, and to provide scientific reference for growth and development in Chinese adolescents.@*Methods@#Data of height and weight of Japanese children and adolescents aged 6-17 years from 1900 to 2016 included in the Survey of School Health Care were used to illustrate growth rate and range of height, weight and BMI during different periods by using one-way ANOVA. Longitudinal correlation between height, weight and BMI was analyzed by using longitudinal analysis method.@*Results@#During 1900 to 2016, height growth ranged between 9.5-19.9 cm in boys and 10.8-18.9 cm in girls aged 6-17 years and the weight growth ranged between 4.0-15.9 kg in boys and 3.9-14.2 kg in girls, with males significantly higher than females; Peak height and weight growth rate of Japanese children and adolescents occurred between 1950 and 1960 (boys: 4.8 cm and 2.7 kg; girls: 3.9 cm and 2.4 kg). On the contrary, from 1939 to 1950, height and weight of Japanese children and adolescents showed a significant decreasing trend (boys: -1.8 cm and -1.2 kg per 10 years; girls: -0.8 cm and -0.4 kg per 10 years); During 2000-2016, the growth rates of height of boys and girls in all age groups in Japan were -0.2 to 0 cm in boys and -0.2 to -0.1 cm in girls per 10 years, respectively.@*Conclusion@#The long-term growth trend of Japanese children and adolescents shows an increasing trend before and after World War II; During World War II and the early post-war period, Japanese children and adolescents showed long-term decreasing trend. In the 21st century, the slow decreasing trend in growth among Japanese children and adolescents is observed, which might associate with absence of favorable environment.
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The 2018 Academic Annual Meeting of the Society of Burn Surgery of Chinese Medical Doctor Association, sponsored by the Chinese Medical Doctor Association, was successfully held in Guangzhou, Guangdong province from November 16th to 18th, 2018. More than 300 representatives of burn surgery attended the meeting. The content of the meeting included academician lectures, special reports, seminar, difficult and complex case discussions, which were closely related to clinical needs. In response to the development status and challenges of burn specialty and the status and problems of the training of burn specialist in China, special experts were invited to make special reports and discussions. During the meeting, a general election meeting of the Society of Burn Surgery of Chinese Medical Doctor Association was held, the fourth committee was elected, and professor Peng Yizhi was elected as the president.
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The treatment of critically burned patients has benefited from the development of knowledge and technologies that we got in critical care medicine of our country in the past ten years. The close-ended management model of general intensive care unit (ICU) and the idea of general ICU doctors who treat the monitoring of organ function and alternative therapy of organs as their primary tasks would affect the treatments for special critical patients hospitalized in general ICU, especially for those patients who were severely burned. If the burn wounds of patients are not treated timely, properly or in effective manner, the final treatment outcome would be affected. Therefore, the establishment of burn ICU is necessary. The development and close-ended management of burn specialty ICU has significantly improved the success rates, reduced complications, shortened hospitalization time, and increased the quality of wound healing of severe burn patients in the past more than 10 years in our unit. With the reducing of burn, especially severe burn accidents, the construction of regional burn center and burn specialty ICU locating in burn center is necessary. It can not only reduce the waste of medical resource, but also ensure timely and professional treatments for the patients in sudden fire accidents. At present, there is no consensus on the establishment and management model of burn specialty ICU, and further discussion is needed in practice.
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Objective@#To investigate the effect and regulatory mechanism of Smurf2 on the negative regulator Smad7 of TGF-β1/Smad signaling pathway in hypertrophic scar fibroblasts.@*Methods@#From January to October 2014, 8 patients with hypertrophic scar after burn were admitted. The age of patients ranged from 1 year 8 months to 7 years, and the time of scar hyperplasia ranged from 2 to 12 months. The residual normal skin of the same patient was used as the control. The fibroblasts were isolated from hypertrophic scar and normal skin respectively and cultured. The third to fifth passage cells were used for the experiments. ① The protein expression of Smad7 in the two groups was detected by Western Blot. ② Hypertrophic scar fibroblasts and normal skin fibroblasts were treated with exogenous TGF-β1 at concentration of 10 ng/ml for 0 min, 5 min, 15 min, 30 min, 1 h, 2 h and 12 h. The expression of Smad7 protein and mRNA were detected by Western Blot and RT-PCR, respectively. ③ The cell lysates of the two groups were collected and incubated with the ubiquitin mixture for 1 h, 2 h and 6 h at 37℃, respectively. The degradation level of Smad7 protein was detected by Western Blot. ④ The cell lysate of hypertrophic scar fibroblasts was collected and incubated with ubiquitin mixture with or without proteasome inhibitor (MG132: MG115=1: 1) to study its inhibitory effect on the degradation of Smad7 in vitro. ⑤ Immunoprecipitation (IP) technique was used to detect the interaction between Smad 7 and E3 ubiquitin ligase Smurf2 in hypertrophic scar fibroblasts. ⑥ The expression of Smad7 protein in hypertrophic scar fibroblasts stimulated by TGF-β1 after Smurf2 silencing by small interference RNA (siRNA) technique were detected by Western blot.@*Results@#① There was no significant difference in the expression level of Smad7 protein between hypertrophic scar and normal skin fibroblasts(t=0.76, P=0.46). ② Expressions of Smad7 mRNA and protein in normal skin fibroblasts stimulated by exogenous TGF-β1 gradually increased in a time-dependent manner(P<0.05). The expression of Smad7 mRNA in the hypertrophic scar fibroblasts increased at all-time points except at 5min , (P<0.05), while there was no significant difference in the expression level of Smad7 protein at all-time points with or without TGF-β1 stimulation(P>0.05). ③ Degradation of Smad7 protein was enhanced in hypertrophic scar fibroblasts (the expression level of Smad 7 protein at each time point was compared with that of the control group and the last time point, P<0.05), while there was no significant difference in Smad7 protein degradation in normal skin fibroblasts(P=0.162). ④ Enhanced degradation of Smad7 in hypertrophic scar fibroblasts was blocked by the addition of the proteasome inhibitors MG132/MG115. ⑤ In hypertrophic scar fibroblasts, the Smurf2-Smad7 complex was detected, which indicated the interaction between Smurf2 and Smad7 in hypertrophic scar fibroblasts. ⑥ The expression of Smad7 protein was not increased in the hypertrophic scar fibroblasts stimulated by TGF-β1, whereas the stimulation of TGF-β1 increased the expression of Smad7 protein after silencing of Smurf2 gene expression.@*Conclusions@#In the hypertrophic scar fibroblasts, Smurf 2 attenuates the inhibitory effect of Smad 7 on TGF-β1 signaling pathway through the degradation of Smad7 by ubiquitination, which may be involved in the formation of hypertrophic scar.
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Objective: To investigate the effectiveness of the arthroscopic lateral retinacular release combined with medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation.
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Objective@#To explore the effects of silencing Smad ubiquitination regulatory factor 2 (Smurf2) on the secretion of transforming growth factor beta 1 (TGF-β1), alpha-smooth muscle actin (α-SMA), and collagen type Ⅰ by human hypertrophic scar-derived fibroblasts.@*Methods@#The human normal skin-derived fibroblasts and hypertrophic scar-derived fibroblasts were cultured with explant culture technique from the normal skin and hypertrophic scar tissue, which was obtained from 9 patients with hypertrophic scars after burn. Two kinds of fibroblasts of the third passage were both divided into 6 groups according to the random number table, with 9 wells in each group. Fibroblasts in blank control group were cultured for 72 h without transfection of any small interfering RNA (siRNA), fibroblasts in negative control group were for cultured for 72 h after transfected with non-target siRNA, fibroblasts in Smurf2 siRNA group were cultured for 72 h after transfected with 100 nmol/L Smurf2 siRNA, fibroblasts in blank control+ TGF-β1 group were cultured for 72 h without transfection of any siRNA and then treated with 10 ng/mL TGF-β1 for 6 h, fibroblasts in negative control+ TGF-β1 group were cultured for 72 h after transfected with non-target siRNA and then treated with 10 ng/mL TGF-β1 for 6 h, fibroblasts in Smurf2 siRNA+ TGF-β1 group were cultured for 72 h after transfected with Smurf2 siRNA and then treated with 10 ng/mL TGF-β1 for 6 h. (1) The protein and mRNA expression levels of Smurf2 of the two kinds of cells in blank control group, negative control group, and Smurf2 siRNA group were assessed by Western blotting and reverse transcription-polymerase chain reaction (RT-PCR), respectively. (2) The content of TGF-β1 in the cell culture supernatant of the two kinds of cells in blank control group and Smurf2 siRNA group was determined by enzyme-linked immunosorbent assay (ELISA). (3) The protein expression levels of α-SMA of the two kinds of cells in the 6 groups were assessed by Western blotting. The content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in the 6 groups was determined by ELISA. (4) The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in the 6 groups were assessed by RT-PCR. The sample numbers of each group in the above experiments were all 9. Data were processed with analysis of variance of factorial design and Bonferroni test.@*Results@#(1) The protein and mRNA expression levels of Smurf2 of the two kinds of cells in Smurf2 siRNA group were significantly lower than those in blank control group and negative control group (with P values below 0.05). The protein and mRNA expression levels of Smurf2 of the two kinds of cells in blank control group and negative control group were close (with P values above 0.05). (2) The content of TGF-β1 in the cell culture supernatant of hypertrophic scar-derived fibroblasts in blank control group and Smurf2 siRNA group was respectively (4.34±0.56) and (2.14±0.28) pg/mL, which was significantly higher than (1.52±0.20) and (1.41±0.18) pg/mL of normal skin-derived fibroblasts respectively (with P values below 0.05). In hypertrophic scar-derived fibroblasts, the content of TGF-β1 in the cell culture supernatant in Smurf2 siRNA group was significantly lower than that in blank control group (P<0.05). In normal skin-derived fibroblasts, the content of TGF-β1 in the cell culture supernatant in Smurf2 siRNA group was close to that in blank control group (P>0.05). (3) The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in blank control+ TGF-β1 group were significantly higher than those in blank control group (with P values below 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in negative control+ TGF-β1 group were significantly higher than those in negative control group (with P values below 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in Smurf2 siRNA group were close to those in blank control group and negative control group (with P values above 0.05). The protein expression levels of α-SMA and content of collagen type Ⅰ in the cell culture supernatant of the two kinds of cells in Smurf2 siRNA+ TGF-β1 group were significantly lower than those in blank control+ TGF-β1 group and negative control+ TGF-β1 group (with P values below 0.05). (4) The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in blank control+ TGF-β1 group were significantly higher than those in blank control group (with P values below 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in negative control+ TGF-β1 group were significantly higher than those in negative control group (with P values below 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in Smurf2 siRNA group were close to those in blank control group and negative control group (with P values above 0.05). The mRNA expression levels of α-SMA and collagen type Ⅰ of the two kinds of cells in Smurf2 siRNA+ TGF-β1 group were significantly lower than those in blank control+ TGF-β1 group and negative control+ TGF-β1 group (with P values below 0.05).@*Conclusions@#Silencing Smurf2 in human hypertrophic scar-derived fibroblasts can reduce the autocrine of TGF-β1 and inhibit the TGF-β1-induced α-SMA expression and collagen type Ⅰ synthesis.