Anatomical and Ultrasonographic Analyses of the Levator Labii Superioris Alaeque Nasi Muscle at the Level of the Nasal Ala / Análisis Anatómico y Ecográfico del Músculo Elevador Nasolabial a Nivel del Ala Nasal

SUMMARY: We aimed to determine the width of the levator labii superioris alaeque nasi muscle (LLSAN) at the level of the nasal ala through cadaveric dissections and ultrasonography (US), to provide essential anatomical information for use during both invasive and noninvasive procedures in the nasal ala region. The LLSAN was investigated in the 40 hemifaces of 20 Korean cadavers, comprising 10 males and 10 females with a mean age of 73.6 years. The LLSAN width of the 40 specimens at the level of the midpoint of the nasal ala was 5.02±2.35 mm (mean±standard deviation), and ranged from 1.45 mm to 10.11 mm. The LLSAN widths were 5.96±2.36 mm and 3.93±1.89 mm in males and females, respectively, with ranges of 2.40-10.11 mm and 1.45-6.96 mm, respectively. The LLSAN widths on the left and right sides were 4.77±2.72 mm and 5.26±1.99 mm, respectively. The proportions of the LLSAN fibers inserting into the nasal ala and upper lip were similar in 13 specimens (32.5 %), while more fibers inserted into the nasal ala in 11 specimens (27.5 %) and more fibers inserted fibers of the LLSAN into the upper lip in 16 specimens (40 %). When clinicians need to target or avoid the LLSAN, the present width and range data can be helpful for ensuring the efficacy and safely of both invasive and noninvasive procedures. In addition, the possibility of asymmetry in the width of the LLSAN in the nasal ala region should be confirmed by US before performing such procedures.

Nuestro objetivo fue determinar el ancho del músculo elevador nasolabial (MENL) a nivel del ala nasal mediante disecciones cadavéricas y ecografía, para proporcionar información anatómica esencial, para su uso durante procedimientos invasivos y no invasivos, en la región del ala nasal. El MENL se estudió en 40 hemicaras de 20 cadáveres coreanos (10 hombres y 10 mujeres) con una edad media de 73,6 años. El ancho de MENL de las 40 muestras a nivel del punto medio del ala nasal fue de 5,02 ± 2,35 mm (media ± desviación estándar) y osciló entre 1,45 mm y 10,11 mm. Los anchos de MENL fueron 5,96 ± 2,36 mm y 3,93 ± 1,89 mm en hombres y mujeres, respectivamente, con rangos de 2,40 a 10,11 mm y 1,45 a 6,96 mm, respec- tivamente. Los anchos de MENL en los lados izquierdo y derecho fueron 4,77 ± 2,72 mm y 5,26 ± 1,99 mm, respectivamente. Las proporciones de fibras de MENL que se insertaban en el ala nasal y en el labio superior fueron similares en 13 muestras (32,5 %), mientras que se insertaron más fibras en el ala nasal en 11 muestras (27,5 %) y además, se insertaron fibras de MENL en el labio superior en 16 ejemplares (40 %). Cuando los médicos necesitan apuntar o evitar el MENL, los datos actuales de ancho y rango pueden ser útiles para garantizar la eficacia y seguridad de los procedimientos, tanto invasivos como no invasivos. Además, la ecografía puede ser utilizada para confirmar una posible asimetría en el ancho del MENL en la región del ala nasal antes de realizar los procedimientos.

Evaluation of the Association between Pelvic Diameters and Pelvic Types on Computed Tomography Images in Healthy Turkish Females / Evaluación de la Asociación entre Diámetros Pélvicos y Tipos de Pelvis en Imágenes de Tomografías Computarizadas en Mujeres Turcas Sanas

SUMMARY: Pelvis contributes to both human locomotion and obstetrics, and normal vaginal delivery is associated with a spacious inlet, a large interspinosus diameter. This paper aimed to measure crucial diameters of pelvic ring, and to determine both the prevalence of pelvic types, and labor types including normal vaginal delivery or caesarean section in Turkish healthy females. Additionally, it was aimed to evaluate presence of relationship between pelvic types and pelvic diameters. Labor shape of subjects was obtained from hospital records. This retrospective study was carried out on 165 healthy subjects aged between 18 and 45 years. Anteroposterior diameter of the pelvic inlet (APDI), anteroposterior diameter of the pelvic outlet, sacrum length (SL), sacrum depth, conjugata vera, obstetrical conjugate, the diagonal conjugate, diameter transversa, diameter bispinous, intertuberous diameter were measured. From these measurements, brim index was calculated and decided to gynecoid, anthropoid and platypelloid type. Also, the andoid type was calculated to the ratio of posterior sagittal diameter of the inlet to conjugata obstetrica. 50.91 % of participants has gynecoid type pelvis, followed by 24.85 % anthropoid type, 14.55 % platypelloid, and 9.70 % android type pelvis. There was a significant difference in APDI, SL, SD, Conjugata vera, Conjugata obstetrica, Conjugata diagonalis, Conjugata transversa, diameter bispinous, diameter intertubercularis and Brim index measurements according to pelvic types. the first degree of narrowing (conjugata vera from 11 to 9) was found in 18 pelvises and 12 pelvises with the pathological degree of narrowing bellonged to the platypelloid type followed by android type pelvis with 6 pelvices. The android type pelvis is not appropriate for natural labor and a good assessment of birth canal can reduce the labor risks. Also, only 7 females who delivered with cesarean have gynecoid type pelvic type. The APDI and SL were significantly lower in subjects having pathological narrowing according to conjugata obstetrica values.

La pelvis contribuye tanto a la locomoción humana como a la obstetricia. El parto vaginal normal se asocia con una entrada espaciosa y un diámetro interespinoso grande. Este artículo tuvo como objetivo medir diámetros cruciales del anillo pélvico y determinar tanto la prevalencia de los tipos pélvicos como los tipos de parto, incluido el parto vaginal normal o la cesárea en mujeres turcas sanas. Además, se buscó evaluar la presencia de relación entre los tipos de pelvis y los diámetros de la pelvis. La forma laboral de los sujetos se obtuvo de los registros hospitalarios. Este estudio retrospectivo se llevó a cabo en 165 mujeres sanas con edades comprendidas entre 18 y 45 años. Se midieron el diámetro anteroposterior de la entrada pélvica (APDPI), el diámetro anteroposterior de la salida pélvica, la longitud del sacro (SL), la profundidad del sacro, la conjugada vera, el conjugado obstétrico, el conjugado diagonal, el diámetro transverso, el diámetro biespinoso y el diámetro intertuberoso. A partir de estas mediciones se calculó el índice del ala y se decidió tipo ginecoide, antropoide y platipoide. Además, el tipo androide se calculó en función de la relación entre el diámetro sagital posterior de la entrada y la conjugada obstétrica. El 50,91 % de los participantes tenía pelvis de tipo ginecoide, seguida del 24,85 % de pelvis de tipo antropoide, el 14,55 % de tipo platipeloide y el 9,70 % de tipo androide. Hubo una diferencia significativa en las mediciones de APDPI, SL, SD, Conjugada vera, Conjugada obstétrica, Conjugada diagonal, Conjugata transversa, diámetro biespinoso, diámetro intertubercular e índice de ala según los tipos de pelvis. El primer grado de estrechamiento (conjugada vera del 11 al 9) se encontró en 18 pelvis y 12 pelvis, siendo el grado patológico de estrechamiento del tipo platipeloide seguido de pelvis tipo androide con 6 pelvis. La pelvis tipo androide no es apropiada para el parto natural y una buena evaluación del canal del parto puede reducir los riesgos. Además, solo 7 mujeres que dieron a luz por cesárea tenían un tipo pélvico de tipo ginecoides. El APDPI y SL fueron significativamente más bajos en mujeres que tenían estrechamiento patológico según los valores obstétricos conjugados.

A televigilância à saúde da pessoa idosa em tempos de pandemia da covid-19: uma avaliação da satisfação quanto aos cuidados de saúde / Telesurveillance for the health ofelderlypatientsduring the COVID-19 pandemic: ahealth care assessment satisfaction / La televigilancia a la salud del anciano entiempo de pandemiadel COVID-19: evaluación de la satisfacción conla atención ensalud

No cenário pandêmico do novo coronavírus, o uso de ferramentas tecnológicas por profissionais de saúde foi imprescindível e muito contribuiu na assistência ao público vulnerável. Com o intuito de evitar a exposição da pessoa idosa ao coronavírus e monitorá-la quanto ao seu estado de saúde, um projeto de telemonotiramento foi desenvolvido. Objetivo:Esse estudo visou avaliar a satisfação dos idosos monitorados pelo serviço de televigilância durante a pandemia da COVID-19 no município de Natal/RN.Metodologia:Trata-se de um estudo descritivo, com amostragem de 719 idosos avaliados, considerando uma média de 35 idosos por unidade básica de saúde, dentre as 21 unidades básicas vinculadas ao projeto, de 25 de novembro de 2020 a 10 de dezembro de 2020.Resultados:Entre os 376 idosos participantes,238eramdo sexo feminino (63,3%), com idade média de 69 anos. Dentre os partícipes, consideraram satisfeitos quanto ao acesso à informação acerca da COVID-19 (89,6%), orientação aos cuidados (90,7%), acolhimento (90,2%). Quanto à satisfação, (67,6%) consideraram o telemonitoramento responsável pela aproximação entre idosos e unidades básicas. Conclusões:Foi alta a satisfação dos idosos acompanhados pelo serviço de televigilância, na medida que se sentiram acolhidos, bem informados e cuidados pelas equipes de saúde das unidades básicas. Dessa forma, a longitudinalidade da atenção, uma atribuição essencial da Estratégia de Saúde da Família, foi mantida pelo trabalho da televigilância (AU).

In the pandemic scenario of the new coronavirus, the use of technological tools by health professionals was essential and contributed greatlyto the assistance of the vulnerable public. In order to avoid the exposure of the elderly person to the coronavirus and monitor them regarding their health status, a telemonitoringproject was developed.Objective:This research aimed at evaluatingthe satisfaction of the elderly monitored by the telesurveillance service during the COVID-19 pandemic in the city of Natal/RN. Methodology:This is a descriptive study, with a sample of 719 elderly people evaluated, considering an average of 35 elderly people per basic health unit, among the 21 basic units linked to the project, from November 25, 2020 to December 10, 2020.Results:Among the 376 elderly participants, 238 were female (63,3%), with an average age of 69 years. The participants considered the access to information about COVID-19(89,6%), care guidance (90,7%), reception (90,2%)satisfactory. As for satisfaction, (67,6%) the participants also considered telemonitoring responsible for bringing the elderly closer to health units.Conclusions:Thesatisfaction from the elderly was enormous. They were accompanied by surveillance service and as they felt welcomed, well-informed and taken care by the basic health service caretakers. This way, the longitudinality of attention, an essential attribution of Family Health Strategy, was maintained by the surveillance service (AU).

En el escenario de pandemia delnuevo coronavirus, el uso de herramientas tecnológicas por parte de los profesionales de la salud fue fundamental y contribuyó en gran medida a la asistencia al público vulnerable. Con el objetivo de evitar la exposición dela persona mayor al coronavirusy monitorear su estado de salud, se desarrolló un proyecto de telemonitoreo.Objetivo: Este estudio tuvo como objetivo evaluar la satisfacción de los ancianos monitoreados por el servicio de televigilancia durante la pandemia de COVID-19 en la ciudad de Natal/RN.Metodología: Este es unestudio descriptivo, con una muestra de 719 ancianos evaluados, considerando un promedio de 35 ancianos por unidad básica de salud, entre las 21 unidades básicas vinculadas al proyecto, del 25 de noviembre de 2020 al 10 de diciembre de 2020.Resultados: Entre los 376 ancianos participantes,238 eran mujeres (63,3%), con una edad media de 69 años. Entre los participantes,consideraron satisfecho el acceso a la información sobre la COVID-19 (89,9%), la orientación asistencial (90,7%), la recepción (90,2%). En cuanto a la satisfacción, (67,6%) consideró al teleseguimiento responsable de acercar a los ancianos a las unidades básicas. Conclusiones: La satisfacción de los ancianos por el servicio de telemonitoreo fue elevada, una vez que se sintieron acogidos, bien informados y asistidos por los equipos de salud de las unidades básicas. De esa manera, la atención longitudinal, una atribución esencial de la Estrategia de Salud de la Familia, se mantuvo por el trabajo del telemonitoreo (AU).

Evaluación del polimorfismo Pro12Ala del gen PPARƴ en mujeres con diabetes mellitus gestacional / Evaluation of the Pro12Ala polymorphism of the PPARƴ gene in women with gestational diabetes mellitus

Resumen OBJETIVO: Determinar la frecuencia del alelo Ala en una muestra de mujeres mexicanas con diabetes mellitus gestacional y asociar su repercusión en la glucemia. MATERIALES Y MÉTODOS: Estudio ambispectivo, observacional, transversal y correlacional efectuado en una cohorte de pacientes con diabetes gestacional atendidas entre los meses de enero a junio del 2014 en el Hospital Militar de Especialidades de la Mujer y Neonatología de la Secretaría de la Defensa Nacional en la Ciudad de México. Se evaluó el polimorfismo mediante amplificación de un fragmento de ADN mediante la reacción en cadena de la polimerasa (PCR) y su secuenciación. RESULTADOS: Se estudiaron 81 pacientes; 3 de ellas con el alelo Ala, con concentraciones de glucosa menores y antecedente de más abortos en comparación con las mujeres sin el alelo Ala. CONCLUSIONES: La coexistencia del alelo Ala en mujeres embarazadas con diagnóstico de diabetes mellitus gestacional pudiera tener un efecto protector en contra de la hiperglucemia en el embarazo y el riesgo de aborto.

Abstract OBJECTIVE: To determine the frequency of peroxisomal proliferator-activated receptor gamma (PPARg) polymorphism of proline substituted with an alanine in amino acid 12 (Pro12Ala), in women with gestational diabetes mellitus and associate its impact with glycemia. MATERIALS AND METHODS: An ambispective, observational, cross-sectional and correlational study was carried out in a cohort of women with gestational diabetes that included 81 pregnant women treated at the Military Hospital for Women's Specialties and Neonatology of the Ministry of National Defense in the city from Mexico. Polymorphism was evaluated by amplification of a DNA fragment by PCR Polymerase Chain Reaction and its sequencing. RESULTS: The results indicated that 13.5% of the women carriers of the Ala allele also had lower blood glucose values and a history with a higher number of abortions compared to women without the Ala allele. CONCLUSIONS: The presence of the Ala allele in pregnant women with gestational diabetes mellitus could have a protective effect against hyperglycemia in pregnancy and a risk of abortion.

Use of sail excision in Alar Morphology modification of asian noses

@#Globular hanging nasal alae, described as convex round shaped alar lobule which may be an aesthetic nuisance in the final result of rhinoplasty, are commonly seen among Southeast Asian noses. Such alar lobule morphology is an important part of nasal aesthetics and should not be disregarded. Surgical techniques used to address a hanging ala include direct external approaches. External rim excision was proposed to address hidden columella, sigmoid alae, small nostrils, dropped rim and foreshortened nose.1,2 Rim tissue was excised in full thickness fashion and sutured in one layer. Others proposed alar groove excision followed by alar repositioning and full-thickness skin grafting to reposition the alar base and correct hanging alae.3 Although these approaches have been proven to correct hanging alae, they leave a visible scar and/or permanent alar rim deformity if not done cautiously, especially on thick skinned patients.1-3 The alar rim may not be natural looking since it is lined by a scar, thus losing the lobular texture of the rim. A vestibular incision has been proposed to correct a hanging ala with unsightly scar.4 A maximum of 3mm elliptical vestibular skin was recommended to be removed to lift the alar rim with significant results. However, this recommendation was based on estimates and surgeon’s experience in western noses and may be insufficient for Asian noses. In addition, performing this technique without specific landmarks is difficult in achieving accurate results, especially when performed by a novice surgeon. Hence, further modification is important to address these concerns. Attempting to address the hanging alae in Asian noses, the senior author (ECY) modified the vestibular incision and came up with the sail excision technique based on the patient’s nasal anatomy.5 By presenting definite landmarks, the technique resulted in an alar lift procedure with reproducible outcomes. Furthermore, after performing sail excision in several patients, the authors noted the effect of this technique on alar morphology. This procedure is done by excising a precisely marked piece of inner nasal vestibular skin that is shaped like the sail of a boat to achieve a symmetrical and redictable result. This creates a lifting effect and improves the alar columellar disproportion specially when combined with septal advancement techniques.6,7 Furthermore, limiting the excision along the inner vestibular area and rolling the alar rim skin inwards results in correction of hanging ala (with a hidden scar) without an obvious, external scar. After performing the technique on several patients, we observed that in addition to its effect on lifting a hanging ala, the sail excision technique also changes the alar morphology from a globular-shaped lobule to a more aesthetically pleasing ridge-shaped lobule. To the best of our knowledge, such an effect of sail excision on alar morphology has not been described in the literature. This article aims to demonstrate the effect of the sail excision technique on alar rim morphology of Asian noses by describing the step-by-step procedure, surgical landmarks, and pearls in performing this technique.

Mortalidade carcerária em tempos de COVID-19 e a ineficiência do Estado na efetivação do direito à saúde / Prison mortality in times of COVID-19 and the inefficiency of the state in the enforcement of right to health / Mortalidad carcelaria en la época del COVID-19 y la ineficiencia del estado en la eficacia del derechoa la salud

Objetivo: investigar os índices de mortalidade carcerária em razão da COVID-19, partindo de dados estatísticos oficiais e analisar a ineficiência do estado na efetivação do direito à saúde. Metodologia: foi utilizado o método dedutivo, fundamentado na técnica da investigação bibliográfica, com coleta de dados estatísticos e revisão narrativa de obras teóricas, de artigos científicos, da legislação brasileira, e de estudos na área da criminologia crítica, que revelam a crueldade do cárcere. Resultados: as condições de confinamento a que ficam expostas as pessoas encarceradas no Brasil são de superlotação, falta de ventilação e falta de higiene, o que pode ser uma grande fonte de contaminação por doenças contagiosas, potencializando o risco à saúde e à vida. Conclusão: o estudo expõe a vulnerabilidade de indivíduos encarcerados e a necessidade de que a normatização e as decisões judiciais visem à efetivação do direito à saúde e que o Estado seja responsabilizado pelas mortes, por ser omisso nas suas responsabilidades legais.

Objective: to investigate prison mortality rates due to COVID-19, based on official statistical data and analyze the state ́s inefficiency in realizing the right to health. on how the penal system is facing one of the worst pandemics ever faced by humanity. Methods: the method used was deductive, based on the technique of bibliographic research, with collection of statistical data, records of works, scientific articles, Brazilian legislation, as well as studies in critical criminology, which reveal the cruelty of prison. Results: the conditions of confinement to which people incarcerated in Brazil are exposed are overcrowding, lack of ventilation and poor hygiene, which can be a major source of contamination by contagious diseases, increasing the risk to health and life. Conclusion: the contributions of the study indicate the vulnerability of incarcerated individuals and the need for the regulation and judicial decisions to be designed with a view the realization of the right to health and that the state be held responsible for their death when it fails to fulfill itslegal responsibilities.

Objetivo: investigar las tasas de mortalidad carcelaria por COVID-19, con base en datos estadísticos oficiales y analizar la ineficiencia del estado en la realización del derecho a la salud. res pandemias jamás enfrentadas por la humanidad. Metodología:el método utilizado fue deductivo, basado en la técnica de investigación bibliográfica, con recolección de datos estadísticos, registros de trabajos, artículos científicos, legislación brasileña, así como estudios en el área de criminología crítica, que revelan la crueldad de prisión. Resultados: las condiciones de confinamiento a las que están expuestas las personas encarceladas en Brasil son el hacinamiento, la falta de ventilación y la falta de higiene, que pueden ser una fuente importante de contaminación por enfermedades contagiosas, aumentando el riesgo para la saludy la vida. Conclusión: los aportes del estudio indican la vulnerabilidad de las personas encarceladas y la necesidad de que la regulación y las decisiones judiciales sean delineadas con miras a la realización del derecho a la salud y que el estado sea responsable por su muerte cuando no cumple con sus responsabilidades legales.

Association of FAAH p.Pro129Thr and COMT p.Ala72Ser with schizophrenia and comorbid substance use through next-generation sequencing: an exploratory analysis

Objective: Individuals with schizophrenia and substance use disorders have a poor prognosis and increased psychiatric symptoms. The present study aimed to explore the association of 106 genes in individuals with schizophrenia and comorbid substance use through a next-generation sequencing (NGS) analysis and different in silico algorithms. Methods: We included 105 individuals diagnosed with schizophrenia and a family history of schizophrenia, of whom 49 (46.67%) presented comorbid substance use. Using NGS, we sequenced 106 genes previously associated with schizophrenia. Logistic regression models were used to assess differences in allele frequencies, and a generalized gene-set analysis was performed at the gene level. Functional annotations were performed using different algorithms and databases. Results: We identified a total of 3,109 variants, of which 25 were associated with schizophrenia and comorbid substance use and were located in regulatory and coding regions. We found low-frequency variants in COMT p.Ala72Ser, independently of p.Val158Met, that were associated with substance use. The endocannabinoid functional variant FAAH p.Pro129Thr was also associated with substance use. Conclusions: Genetic variants of genes related to dopaminergic and cannabinoid neurotransmitter systems were associated with comorbid substance use in schizophrenia. Nevertheless, more studies with larger sample sizes are needed to confirm our findings.

Application of tunneled subcutaneous pedicle flaps in repair of nasal alar defects / 中华皮肤科杂志

Objective:To investigate clinical efficacy of tunneled subcutaneous pedicle flaps in the repair of ipsilateral nasal alar defects.Methods:A total of 20 patients with nasal alar defects after excision of basal cell carcinoma, which were repaired with ipsilateral tunneled subcutaneous pedicle flaps, were retrospectively collected from January 2018 to January 2020. There were 11 male patients and 9 female patients, with an average age of 60.6 years (range, 48 - 76 years) . According to clinical manifestations, the basal cell carcinoma lesions could be classified into 3 types: nodular-ulcerative type (13 cases) , superficial type (4 cases) and pigmented type (3 cases) , and the skin lesions varied from 0.4 cm × 0.5 cm to 0.9 cm × 1.1 cm in size. All the patients received extended surgical resection of basal cell carcinoma, and nasal alar defects were repaired with tunneled subcutaneous pedicle flaps, with the size of flaps ranging from 0.7 cm × 0.8 cm to 1.2 cm × 1.4 cm.Results:All flaps survived successfully, the nasal alar defects were completely repaired, and all wounds healed primarily. During the postoperative follow-up of 6 - 24 months, neither recurrence of tumors nor obvious scar hyperplasia occurred on the nasal ala, and nasal morphology and appearance were favorable.Conclusion:The tunneled subcutaneous pedicle flap can be used for the repair of ipsilateral nasal alar defects following excision of tumors or other lesions, resulting in favorable therapeutic outcomes and aesthetic appearance.

Bioresponsive immune-booster-based prodrug nanogel for cancer immunotherapy

The combination of chemotherapy and immunotherapy motivates a potent immune system by triggering immunogenic cell death (ICD), showing great potential in inhibiting tumor growth and improving the immunosuppressive tumor microenvironment (ITM). However, the therapeutic effectiveness has been restricted by inferior drug bioavailability. Herein, we reported a universal bioresponsive doxorubicin (DOX)-based nanogel to achieve tumor-specific co-delivery of drugs. DOX-based mannose nanogels (DM NGs) was designed and choosed as an example to elucidate the mechanism of combined chemo-immunotherapy. As expected, the DM NGs exhibited prominent micellar stability, selective drug release and prolonged survival time, benefited from the enhanced tumor permeability and prolonged blood circulation. We discovered that the DOX delivered by DM NGs could induce powerful anti-tumor immune response facilitated by promoting ICD. Meanwhile, the released mannose from DM NGs was proved as a powerful and synergetic treatment for breast cancer in vitro and in vivo, via damaging the glucose metabolism in glycolysis and the tricarboxylic acid cycle. Overall, the regulation of tumor microenvironment with DOX-based nanogel is expected to be an effectual candidate strategy to overcome the current limitations of ICD-based immunotherapy, offering a paradigm for the exploitation of immunomodulatory nanomedicines.

The application of nasolabial fold flap in the nasal ala subtotal defect after nasal ala tumor operation / 中国医师进修杂志

Objective:To explore the effect of nasolabial fold flap in the treatment of nasal ala subtotal defect nasal afte ala tumor operation.Methods:The clinical data of 7 nasal ala subtotal defect patients underwent nasal ala basal cell carcinoma operation in the First People′s Hospital of Lianyungang City from February 2018 to September 2020 were retrospectively analyzed.Results:Seven patients with nasal ala subtotal defect were successfully repaired with nasolabial fold flap. The patients were followed up for 19 to 52 months, the flaps survived, the color was good, the contour was not bloated, the nasal ventilation was not affected, and good results were achieved.Conclusions:The nasolabial fold flap repair of the nasal ala subtotal defect after nasal ala tumor operation has the advantages of simple method, rich materials, no need for vascular anastomosis, no need for secondary surgery, accurate effect and so on, which is suitable for clinical promotion in clinical.

O caos sanitário da crise por COVID-19 no Brasil e o direito à saúde na jurisprudência do Supremo Tribunal Federal / The sanitary chaos of the COVID-19 crisis in Brazil and the right to health in the Supreme Federal Court's jurisprudence / El caos sanitario de la crisis del COVID-19 en Brasil y el derecho a la salud en la jurisprudencia del Supremo Tribunal Federal

Investiga-se os pressupostos do caos sanitário no Brasil por COVID-19 e como o sistema judicial decide em relação ao enfrentamento da epidemia. Observa-se que a crise, em sua complexidade, causa uma desorganização, que é resultante de dois fenômenos: o federalismo descoordenado e a constitucionalização simbólica. A metodologia adotada resulta de pesquisa qualitativa com a técnica de análise de conteúdo. Para testar a hipótese da análise foram coletados dois acórdãos da jurisprudência temática sobre COVID-19 do site do Supremo Tribunal Federal, em que se mediu a frequência das categorias teóricas estudadas. Tem-se por resultado que o caos sanitário é acentuado com a alteração da lógica federativa em relação à centralização de poder referente à União sobre os demais entes federativos, somado ao processo de constitucionalização simbólica que afeta os países periféricos como o Brasil.

The presuppositions of the sanitarychaos in Brazil are investigated by COVID-19 and how the judicial system decides in relation to the fight against the epidemic. It is observed that the crisis, in its complexity, causesdisorganization which is the result oftwo assumptions:the uncoordinated federalism and the symbolic constitutionalization. The adopted methodology results from qualitative research with the technique of content analysis. To evaluatethe hypothesis of this analysis, two judgments from the thematic jurisprudence on COVID-19were collected from the website of the Supreme Court, in which the frequency of the studied theoretical categories was measured. As a result, the sanitary chaos is accentuated with the alteration of the federative logic in relation to the centralization of power related to the Union over the other federative entities, added to the symbolic constitutionalization process that affects peripheral countries like Brazil.

Los presupuestos del caos sanitario en Brasil son investigados por COVID-19 y cómo el sistema judicial decide sobrela lucha contra la epidemia. Se observa que la crisis, en sucomplejidad, causa una desorganización que é resultado dedos supuestos: el federalismo descoordinado y la constitucionalización simbólica. La metodología adoptada es el resultado de una investigación cualitativa con la técnica de análisis de contenido. Para contrastar la hipótesis de este análisis, se recogieron dos sentencias de lajurisprudencia temática sobre COVID-19 del sitio web de la Corte Suprema, en las que se midió la frecuencia de las categorías teóricas estudiadas. Como resultado, el caos sanitario se acentúa con la alteración de la lógica federativa en relación conla centralización del poder relacionado con la Unión sobre las demás entidades federativas, sumado al proceso simbólico de constitucionalización que afecta a países periféricos como Brasil.

Familial amyloid polyneuropathy caused by transthyretin Ala117Ser mutation: a case report and literature review / 中华神经科杂志

Objective:To investigate the clinical manifestations of familial amyloid multiple neuropathy (FAP) caused by Ala117Ser mutation, and to improve the clinical recognition of FAP.Methods:The clinical manifestations, electrophysiological examination, pathology and gene mutation characteristics of a case of FAP, who admitted to Fujian Medical University Union Hospital on November 25, 2014, were analyzed, and the literatures on the FAP cases caused by Ala117Ser mutation were reviewed and summarized.Results:The patient was a 59-year-old male from Fujian province. The first symptom was numbness in the extremities, followed by obvious autonomic nerve symptoms and motor disorder, and fatal cardiac dysfunction occurred in the later stage of the disease. The skin biopsy showed amyloidosis, and transthyretin gene analysis indicated the mutation of c.349G>T p.Ala117Ser. The clinical manifestations of FAP caused by Ala117Ser mutation reported in literatures are consistent with this case. And the reported FAP cases in China are concentrated in southern regions such as Fujian Province and Guangdong Province.Conclusions:Ala117Ser mutation in FAP patients is usually late onset and clinically manifested as multiple sensorimotor peripheral neuropathy, accompanied by prominent autonomic symptoms. The distribution of the patients has significant regional characteristics. Histopathological and genetic tests for the clinical diagnosis are of great significance.

Clinical efficacy of composite subcutaneous pedicled flaps in repairing full-thickness nasal alar defects of 11 patients: a clinical observation / 中华皮肤科杂志

Objective:To investigate clinical efficacy of composite subcutaneous pedicled flaps in repairing full-thickness nasal alar defects.Methods:Clinical data were collected from 11 patients with basal cell carcinoma of nasal ala in Department of Dermatologic Surgery, the Third People′s Hospital of Hangzhou from August 2019 to September 2020, and analyzed retrospectively. There were 6 females and 5 males, aged 70 years in average (range, 56-87 years) . After tumor resection, full-thickness nasal alar defects were formed, a flap was designed along the inner side of the cheek and turned by 180 degrees to repair the nasal mucosal lining; then, a subcutaneous pedicled flap was designed along the ipsilateral nasolabial fold to repair the outer secondary defects and postoperative defects.Results:The mean diameter of postoperative defects was 1.8 cm (range, 1.5-2.5 cm) , and the mean diameter of the nasal lining was 0.9 cm (range, 0.6-1.5 cm) . Seven days after the operation, stitches were removed, wounds healed without complications, and all flaps survived with a satisfactory appearance. The follow-up period ranged from 1 to 13 months (average, 6 months). After scar maturation, all patients were satisfied with the aesthetic outcome. No tumor recurrence was observed during the follow-up period.Conclusion:The composite subcutaneous pedicled flap is safe and effective for the repair of full-thickness nasal alar defects, and has advantages of a well-hidden donor site, good color match, and stage-I operation for reconstruction.

Boosting 5-ALA-based photodynamic therapy by a liposomal nanomedicine through intracellular iron ion regulation

5-Aminolevulinic acid (5-ALA) has been approved for clinical photodynamic therapy (PDT) due to its negligible photosensitive toxicity. However, the curative effect of 5-ALA is restricted by intracellular biotransformation inactivation of 5-ALA and potential DNA repair of tumor cells. Inspired by the crucial function of iron ions in 5-ALA transformation and DNA repair, a liposomal nanomedicine (MFLs@5-ALA/DFO) with intracellular iron ion regulation property was developed for boosting the PDT of 5-ALA, which was prepared by co-encapsulating 5-ALA and DFO (deferoxamine, a special iron chelator) into the membrane fusion liposomes (MFLs). MFLs@5-ALA/DFO showed an improved pharmaceutical behavior and rapidly fused with tumor cell membrane for 5-ALA and DFO co-delivery. MFLs@5-ALA/DFO could efficiently reduce iron ion, thus blocking the biotransformation of photosensitive protoporphyrin IX (PpIX) to heme, realizing significant accumulation of photosensitivity. Meanwhile, the activity of DNA repair enzyme was also inhibited with the reduction of iron ion, resulting in the aggravated DNA damage in tumor cells. Our findings showed MFLs@5-ALA/DFO had potential to be applied for enhanced PDT of 5-ALA.

Corticosterone induced D-serine release deficit play an important role in long-term potentiation impairment by corticosterone in perforant path-dentate gyrus pathway / 中国药理学与毒理学杂志

OBJECTIVE Previous studies showed that over activation of NMDA receptors may be a crucial cause of long-term potentiation (LTP) and cognitive impairment induced by stress or corticosterone. However, other studies showed that the function of NMDA receptors is insufficient since the NMDA receptors co-agonist D-serine could improve stress-induced cognitive impairment. The purpose of this study is to clarify whether over activation of NMDA receptors or hypofunction of NMDA receptors is involved in hippocampal impairment of LTP by corticosterone and the underlying mechanisms. METHODS Cort was injected subcutaneously 1 h before the high-frequency stimulation (HFS) to induce LTP impairment. NMDA receptor antagonists and agonists were administrated by icv. RESULTS Hippocampal LTP and object location recognition memory were impaired in corticosterone-treated mice. Corticosterone increased the gluta?mate level in hippocampal tissues, neither NMDA receptors antagonist nor its subtype antagonists alleviated impairment of LTP, while enhancing the function of NMDA receptors by D-serine did alleviate impairment of LTP by corticosterone, suggesting that hypofunction of NMDA receptors might be one of the main reasons for impairment of LTP by corticoste?rone. Further results showed that the level of D-serine and its precursor L-serine did not change. D-serine release-related protein Na+-independent alanine-serine-cysteine transporter-1 (ASC-1) in the cell membrane was decreased and increas?ing D-serine release by the selective activator of ASC-1 antiporter activity alleviated impairment of LTP by corticoste?rone. CONCLUSION Taken together, this study demonstrates that hypofunction of NMDA receptors may be involved in impairment of LTP by corticosterone and reduced D-serine release may be an important reason for its hypofunction, which is an important complement to existing mechanisms of corticosterone-induced LTP and cognitive impairment.

Quality control of Jinzhen Oral Liquid based on amino acids fingerprint and simultaneous determination of 29 amino acids / 中草药

Objective: To establish the amino acids fingerprint of Jinzhen Oral Liquid (JOL) and simultaneous determination of 29 amino acids (P-Ser, Tau, Asp, Thr, Ser, Asn, Glu, Gln, Sar, Gly, Ala, Cit, α-ABA, Val, Cys, Ile, Leu, Tyr, Phe, β-Ala, β-AiBA, γ-ABA, Orn, Lys, His, 3-Mehis, Arg, Hypro, Pro) by automatic amino acid analyzer. Methods: The separation was developed on HITACHI HPLC PACKED column (60 mm × 4.6 mm, 3 μm) by gradient elution with citric acid buffer solution at 570 and 440 nm, reaction column temperature was maintained at 115 ℃ and the carrier gas flow rate was 0.35 mL/min and flow rate of derivative pump was 0.30 mL/min. An amino acid fingerprint of JOL was set up, and 16 batches of JOL were evaluated by similarity assay. Furthermore, the contents of the main 29 amino acids were determined. Results: The amino acid fingerprint of JOL was established with good separation, and 29 amino acids were determined simultaneously. The similarity of 16 batches of JOL was about 0.989 to 1.000. Moreover, good linear relationships were found (R2 = 1.000), and the average recovery rates were 95.71%-101.87%, the content range of quantitative components in 16 batches of JOL was as following: P-Ser 15.457 2-29.362 4 μg/mL, Tau 64.423 4-114.238 6 μg/mL, Asp 19.056 4-32.549 0 μg/mL, Thr 6.704 8-7.841 8 μg/mL, Ser 22.609 4-39.382 8 μg/mL, Asn 61.134 0-115.456 0 μg/mL, Glu 32.254 6-63.127 2 μg/mL, Gln 5.223 8-8.953 2 μg/mL, Sar 4.081 0-44.007 6 μg/mL, Gly 12.403 0-23.516 4 μg/mL, Ala 33.876 8-44.257 4 μg/mL, Cit 3.514 2-9.881 0 μg/mL, α-ABA 1.126 4-2.287 8 μg/mL, Val 11.584 6-15.469 0 μg/mL, Cys 1.660 2-4.041 8 μg/mL, Ile 4.087 8-5.469 2 μg/mL, Leu 8.295 2-11.724 0 μg/mL, Tyr 7.492 6-10.761 2 μg/mL, Phe 4.856 4-9.248 0 μg/mL, β-Ala 2.309 4-6.782 6 μg/mL, β-AiBA 0.175 0-14.790 6 μg/mL, γ-ABA 17.654 4-26.621 8 μg/mL, Orn 42.338 4-58.172 6 μg/mL, Lys 12.994 9-28.498 0 μg/mL, His 1.802 6-4.067 4 μg/mL, 3-Mehis 2.608 4-4.384 0 μg/mL, Arg 107.141 6-301.649 8 μg/mL, Hypro 15.811 6-37.807 6 μg/mL, Pro 143.714 6-243.956 6 μg/mL. Conclusion: The method for the determination and analysis of amino acids in JOL by automatic amino acid analyzer has the advantages of good reproducibility, reliable results, and the qualitative and quantitative study of amino acids in JOL has clarified the contribution of Caprae hircus cornu's horn to the composition of preparation to a certain extent, which provides a useful supplement for the construction of the quality evaluation system of JOL.

Morphological differences in a population of Rufous-collared Sparrow (Zonotrichia capensis, Statius Müller, 1776) (Passerine, Emberizidae) at different elevations in the Tropical Andes / Diferencias morfologicas en una poblacion de Copetón (Zonotrichia capensis, Emberizidae) a diferente altitud en los Andes tropicales

Abstract Populations that breed along steep elevation gradients show diverse physiological and morphological changes in response to the different environmental conditions. The latter has been discussed by Bergmann's and Allen's ecogeographic rules about body and appendage sizes and environmental temperature. We compared morphometric measures (mass, bill width, tarsus, wing, and tail length) of a Zonotrichia capensis population in two localities at different elevations with similar latitudes and photoperiods on the western slope of the Colombian Central Andes. We compared a Low Elevation locality (LE) at 1800 m a.s.l. and a High Elevation locality (HE) at 3853 m a.s.l. that have approximate wind speeds of 1.3 m/s and 8.4 m/s, respectively. During 12 months of sampling, we captured 46 adults using mist-nets; 26 in the LE and 20 in the HE. Each individual was sexed using molecular techniques at the Laboratory of Genetics of the Department of Biological Sciences of Universidad de Caldas. Individuals (males + females) from the HE had longer wings and tails than those from the LE (F1,44 = 5.93; P = 0.019). Also, wings of males in the HE were longer than those of females in both localities and tails of males in the HE were longer than those of LE males. Our results did not agree with what was expected according to Allen's and Bergmann's ecogeographic rules. Longer wings and tails increase sustainment, maneuverability, and balance in low atmospheric pressures and strong air currents and these conditions are found at high elevation habitats. Most likely, the longer wings found for HE males allow greater movement during territorial behavior. Further, these differences in morphological traits along elevational gradients could result from micro-evolutionary changes between localities or phenotypic plasticity of individuals exposed to different environmental conditions.

Resumen Las poblaciones que se reproducen en gradientes altitudinales, adoptan diversos cambios morfológicos para afrontar las condiciones ambientales. En el presente estudio se compararon las medidas morfológicas (peso corporal, longitud del tarso, ala, cola y culmen) de una población de Zonotrichia capensis, a diferente altitud en los Andes colombianos. Las localidades de tierra baja (TB) y alta (TA) se encuentran a 1800 m.s.n.m. y 3853 m.s.n.m., con velocidad aproximada del viento de 1.3 m/s y 8.4 m/s, respectivamente. Durante 12 meses se realizó la captura de 46 individuos (TB n=26, TA n=20) para la medición de los rasgos morfológicos. La longitud del ala de los individuos de TA fue mayor que en TB. Así mismo, en machos de TA la longitud del ala fue mayor que en hembras en general. Es posible que a las más grandes incrementen la eficiencia del vuelo en zonas ventosas y con baja presión atmosférica, como ocurre en TA. Probablemente la diferencia del tamaño del ala entre los machos de TA y las hembras, se deba a un mayor desplazamiento dentro de la conducta territorial. Estas diferencias podrían ser el resultado de cambios microevolutivos entre localidades o la plasticidad fenotípica de individuos expuestos a diferentes condiciones ambientales.

Enhanced anti-tumor efficacy of 5-aminolevulinic acid-gold nanoparticles-mediated photodynamic therapy in cutaneous squamous cell carcinoma cells

The objective of this study was to investigate whether the conjugation of gold nanoparticles (GNPs) to 5-aminolevulinic acid (5-ALA) could enhance the anti-tumor efficiency of photodynamic therapy (PDT) in epidermoid carcinoma cells. The mRNA and protein expression levels were determined by quantitative real-time PCR and western blot, respectively. Cell viability, apoptosis, invasion, and migration were determined by MTT assay, flow cytometry, transwell invasion assay, and migration assay, respectively. Singlet oxygen generation was detected by the singlet oxygen sensor green reagent assay. Our results showed that PDT with 5-ALA and GNPs-conjugated 5-ALA (5-ALA-GNPs) significantly suppressed cell viability, increased cell apoptosis and singlet oxygen generation in both HaCat and A431 cells, and PDT with 5-ALA and 5-ALA-GNPs had more profound effects in A431 cells than that in HaCat cells. More importantly, 5-ALA-GNPs treatment potentiated the effects of PDT on cell viability, cell apoptosis, and singlet oxygen generation in A431 cells compared to 5-ALA treatment. Further in vitro assays showed that PDT with 5-ALA-GNPs significantly decreased expression of STAT3 and Bcl-2 and increased expression of Bax in A431 cells compared with PDT with 5-ALA. In addition, 5-ALA-GNPs treatment enhanced the inhibitory effects of PDT on cell invasion and migration and Wnt/β-catenin signaling activities in A431 cells compared to 5-ALA treatment. In conclusion, our results suggested that GNPs conjugated to 5-ALA significantly enhanced the anti-tumor efficacy of PDT in A431 cells, which may represent a better strategy to improve the outcomes of patients with cutaneous squamous cell carcinoma.

Asociación entre la morfología alar y el uso del hábitat en seis especies de palomas (Columbidae) neotropicales

Los factores biomecánicos, el comportamiento e historia natural de las especies pueden influenciar la forma y dimensión del ala en las aves. Por lo tanto, la morfología de las alas de cada especie podría estar adaptada al ambiente en el que habitan. En palomas (familia Columbidae) existe un gradiente de especies que tienden a volar mucho y otras que vuelan muy poco. El objetivo de esta investigación es determinar si la forma de las alas de seis especies de palomas se asocia con su capacidad de vuelo. Predecimos que las especies Patagioenas flavirostris y P. nigrirostris que tienden a volar largas distancias presentan alas relativamente largas y puntiagudas; mientras que Geotrygon montana que se desplaza principalmente caminando presenta alas relativamente anchas y redondeadas. Especies con capacidad de vuelo intermedio (Leptotila verreauxi, L. cassini y Zenaida asiatica) van a presentar alas con características intermedias. Estimamos la carga alar, proporción de la forma, conicidad alar, largo relativo y el área alar promedio para cada especie. Realizamos un análisis discriminante para determinar cuál combinación de variables explica mejor la diferencia morfológica de las alas entre las seis especies y probamos que tan robusto es este modelo mediante una prueba binomial. El modelo clasificó correctamente el 57 % de los individuos en su propia especie. Por lo tanto, encontramos que el tipo de desplazamiento predominante en cada una de las seis especies de Columbidae analizadas, se asocia con la morfología alar: alas adaptadas para vuelos en zonas abiertas en P. flavirostris y P. nigrirostris, alas adaptadas para vuelos muy maniobrables en hábitats densos en G. montana, y alas con características intermedias en L. verreauxi, L. cassini y Z. asiatica.

Biomechanics, behavior, and natural history influence wing dimension and shape. Wing design often correlates with features of the habitat in which each species is found. Doves and pigeons (Columbidae family) range from long-distance fliers (e.g., canopy and open area species) to very short-distance fliers (e.g., species adapted to dense understory forests) and such variation makes this group fit to test the association between flying habits and wing morphology. Our objective in this study is to determine whether the wing morphology (shape and dimensions) of six dove species is associated to their flying capability. We predict that the long-distance fliers Patagioenas flavirostris and P. nigrirostris will have long and sharp wings; while the very short-distance flier Geotrygon montana will have broad and rounded wings. Other species (e.g., Leptotila verreauxi, L. cassini and Zenaida asiatica) whose flying capability fits in between these two will have wings with intermediate morphological features. We measured the wing disc loading, shape ratio, the ratio of mean to maximum wing chord, relative wing length, and wing area for each species. We conducted a discriminant function analysis to compare which variables explain better the differences in wing morphology across the six species, and used a binomial test to evaluate the power of the model. The model correctly classified 57 % of individuals within their own species. The flying capability is associated with the wing morphology of the six Columbidae species; with a wing design for long-distance fliers in P. flavirostris and P. nigrirostris, wing design for maneuvering in dense habitats in G. montana, and wings with an intermediate design in L. verreauxi, L. cassini and Z. asiatica.

Synergistic antitumor activity of artesunate and HDAC inhibitors through elevating heme synthesis synergistic upregulation of ALAS1 expression

Artemisinin and its derivatives (ARTs) were reported to display heme-dependent antitumor activity. On the other hand, histone deacetylase inhibitors (HDACi) were known to be able to promote heme synthesis in erythroid cells. Nevertheless, the effect of HDACi on heme homeostasis in non-erythrocytes remains unknown. We envisioned that the combination of HDACi and artesunate (ARS) might have synergistic antitumor activity through modulating heme synthesis. studies revealed that combination of ARS and HDACi exerted synergistic tumor inhibition by inducing cell death. Moreover, this combination exhibited more effective antitumor activity than either ARS or HDACi monotherapy in xenograft models without apparent toxicity. Importantly, mechanistic studies revealed that HDACi coordinated with ARS to increase 5-aminolevulinate synthase (ALAS1) expression, and subsequent heme production, leading to enhanced cytotoxicity of ARS. Notably, knocking down significantly blunted the synergistic effect of ARS and HDACi on tumor inhibition, indicating a critical role of ALAS1 upregulation in mediating ARS cytotoxicity. Collectively, our study revealed the mechanism of synergistic antitumor action of ARS and HDACi. This finding indicates that modulation of heme synthesis pathway by the combination based on ARTs and other heme synthesis modulators represents a promising therapeutic approach to solid tumors.