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Objective: To introduce a classification of alar retraction, and to discuss the therapeutic strategy of alar retraction with cartilage graft and the satisfaction evaluation of patients after operation. Methods: A retrospective analysis was performed on 88 patients with alar retraction admitted to the Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University from January 2015 to December 2020, including 20 males and 68 females, aged 20 to 48 years, with an average age of 28.98 years. All patients underwent external rhinoplasty according to a series of treatment plans determined by the classification of alar retraction based on nostril exposure. Visual Analogue Scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE) were used to conduct satisfaction survey before and 12 months after operation. Wilcoxon signed-rank test was used to analyze patient satisfaction. Results: A total of 88 patients were included in this study. According to the classification of alar retraction based on nostril exposure, 45 cases were mild, 23 cases were moderate, and 20 cases were severe. There were 16 cases of unilateral and 72 cases of bilateral alar retraction. The patients were followed up for 12 to 18 months, with an average of 13.37 months. The VAS score and ROE score after each type of surgery were higher than those before surgery, with statistically significant (all P<0.05). Among them, the difference in VAS score (6.75±1.29) and in ROE satisfaction (67.70±7.38) of patients with severe alar retraction were the most significant improvement. Conclusion: The classification of alar retraction based on nostril exposure in the frontal view can comprehensively evaluate the severity of alar retraction, and makes the treatment algorithms systematic and comprehensive. The satisfaction of patients is relatively high.
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Masculino , Femenino , Humanos , Adulto , Rinoplastia , Estudios Retrospectivos , Satisfacción del Paciente , Resultado del Tratamiento , Estética , Nariz/cirugíaRESUMEN
Remodeling the tumor microenvironment through reprogramming tumor-associated macrophages (TAMs) and increasing the immunogenicity of tumors via immunogenic cell death (ICD) have been emerging as promising anticancer immunotherapy strategies. However, the heterogeneous distribution of TAMs in tumor tissues and the heterogeneity of the tumor cells make the immune activation challenging. To overcome these dilemmas, a hybrid bacterium with tumor targeting and penetration, TAM polarization, and photothermal conversion capabilities is developed for improving antitumor immunotherapy in vivo. The hybrid bacteria (B.b@QDs) are prepared by loading Ag2S quantum dots (QDs) on the Bifidobacterium bifidum (B.b) through electrostatic interactions. The hybrid bacteria with hypoxia targeting ability can effectively accumulate and penetrate the tumor tissues, enabling the B.b to fully contact with the TAMs and mediate their polarization toward M1 phenotype to reverse the immunosuppressive tumor microenvironment. It also enables to overcome the intratumoral heterogeneity and obtain abundant tumor-associated antigens by coupling tumor penetration of the B.b with photothermal effect of the QDs, resulting in an enhanced immune effect. This strategy that combines B.b-triggered TAM polarization and QD-induced ICD achieved a remarkable inhibition of tumor growth in orthotopic breast cancer.
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Objective@#To investigate the clinical effect of diced cartilage in correcting nasal alar base depression after cleft lip surgery.@*Methods@#A retrospective study was conducted in 15 patients of nasal deformity after lip surgery from January 2018 to January 2019. All the patients were taken from autologous costal cartilage to reconstruct the outline of nasal malformation, and the remaining autologous costal cartilage was cut into 0.5-1.0 mm pieces and filled into the basilar lacunar space of the nasal alar by the 1 ml syringe whose anterior needle nipples was removed. The effects of visual images before and after operation were compared and analyzed by Adobe Photoshop CS6 software. The patients were followed up for 6-15 months (mean 10months). The satisfaction and complications of the patients were investigated.@*Results@#The nasal alar base was significantly elevated and the outline of the nasal deformity was improved in 15 patients after operation. The overall effect was satisfactory and no obvious complications were found. No obvious absorption was found in the follow-up.@*Conclusions@#The application of diced cartilage to correct the nasal alar base depression after cleft lip surgery was a feasible method with important clinical value. It advanced in taking good use of the remaining cartilage and reducing the damage to both the donor and recipient area.
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Objective@#To study the tissue size, calcification characteristics and the correlation between calcification and age and lateral side of 6, 7 and 8 costal cartilage in women, so as to provide reference for clinical application.@*Methods@#From the radiology storage center of Second Xiangya Hospital, 70 cases of female costal cartilage were treated with dual-source CT three-dimensional reconstruction. The reconstructed images were treated with maximum intensity projection (MIP) and volume reconstruction (VR). The length, width and thickness of bilateral 6, 7 and 8 costal cartilage were measured by VR images, and the correlation between calcification rate, calcification degree, calcification type, calcification location, calcification with age and side was observed and analyzed on VR and MIP images. The data were analyzed by SPSS 20.0 and compared by corresponding statistical method, including independent sample t test, chi-square test, logistic regression analysis and variance analysis.@*Results@#(1) The length of costal cartilage on the left was (98.7 ±12.7) mm, (132.8 ±13.8) mm, (81.5 ±11.6) mm, width (12.6 ±1.5) mm, (11.0 ±1.4) mm, (7.4 ±1.1) mm, thickness (8.1 ±0.5) mm, (7.7 ±0.6) mm, (6.6 ±0.6) mm. On the right side, the length of costal cartilage was (95.8 ±11.3) mm, (133.1 ±12.0) mm, (81.7 ±12.3) mm, width (12.2 ±1.4) mm, (11.11 ±1.5) mm, (7.4 ±1.1) mm, thickness (8.2 ±0.6) mm, (7.7 ±0.5) mm, (6.5 ±0.6) mm. There was no significant difference in the length, width and thickness of the left and right sides of the costal cartilage in the same sequence (P>0.05). There were significant differences in length, width and thickness between unilateral costal cartilage with different ordinal numbers (P<0.01). (2) The total calcification rates of left and right costal cartilage were 61.9% (130/210) and 60.0% (126/210), respectively, and there was no significant difference between the two groups (The chi-square was equal to 0.160. The P value was equal to 0.689), but there was no significant difference in left and right total calcification types, total calcification location and total calcification count (P>0.05). There was no significant difference in the total calcification type between left and right, the total calcification location and the total calcification degree count (P>0.05). There was also no significant difference between the two groups (P>0.05). There was no significant difference in the calcification rate between the left and right sides of the 6th, 7th and 8th costal cartilage, but there was significant difference in the total calcification types of the 6th, 7th and 8th costal cartilage (The chi-square was equal to 61.541, P value was less than 0.001). (3)The relationship between calcification rate and age was analyzed by univariate analysis and logistic regression equation. The higher the age, the higher the calcification rate. The relationship between the calcification degree and age of the 6th, 7th and 8th costal cartilage was tested by variance test, and the regression equation showed that the calcification degree of the 6th, 7th and 8th costal cartilage was higher with the age.@*Conclusions@#Preoperative three-dimensional reconstruction and image post-processing of costal cartilage with dual-source CT can accurately measure the amount of cartilage tissue and define the characteristics of calcification, so as to guide the clinical selection of costal cartilage that meets the requirements of operative method. In female patients of different ages undergoing rhinoplasty and external ear reconstruction, the calcification rate of costal cartilage increased with age, but there was no positive correlation. With the increase of calcification with age, artificial materials can be used for cases with severe calcification to avoid the blindness of surgery.
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Objective@#To investigate the treatment and clinical effect of thin anterolateral thigh perforator flap with sensory nerve in the repair of soft tissue defect of dorsal foot.@*Methods@#During January 2012 to February 2017, 14 cases of soft tissue defect of dorsalis pedis were treated. The flap was designed according to the three-dimensional structure of the defect in the recipient area, and the lateral femoral cutaneous nerve was carried. Free transplantation was performed for repair of soft tissue defect of dorsal foot after fine thinning under microscope. The selected size of the flap ranged from 6 cm×4 cm to 15 cm×9 cm, 10 cases of donor site width is less than or equal to 8 cm with direct suture, 4 cases of donor site wound greater than 8 cm, Free skin graft on the wound surface.@*Results@#After operation, all flaps survived. Meanwhile, superficial necrosis occurred in the distal part of the flap in 1 case due to local infection, and healed after dressing change. All patients were followed up for 6-24 months, the appearance of the flap was pleasant, the texture, color and elasticity of the flap were satisfactory. In addition, Partial skin flap two-point discrimination was 6-10 mm with S2, S3 sensory recovery. During the follow-up, patients were able to walk with normal shoes, no ulcer occurred in the flap, and healed well in donor site.@*Conclusions@#The application of thin anterolateral thigh perforator flap with sensory nerve is safe and reliable in the repair of soft tissue defect of dorsal foot. After the repair, the skin flap has a good appearance and can restore part of the sensation.
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Objective To introduce the experience of using costal cartilage in oriental secondary rhinoplasty.Methods From January 2012 to December 2016,we used costal cartilage grafts to obtain a functional and aesthetic reconstruction,in which silicone was used in 34 previous cases and e-PTFE was used in 5 cases.Results The mean duration of follow-up was 1.5 years,43 (86％) patients showed high satisfaction with the shape of nose.1 case of infection and 2 cases of costal cartilage warping occurred.1 case was somewhat dissatisfactied with outcome.There was no case of chest wall deformity and pneumothorax,but scar on the chest wall at the donor site was observed in 2 cases.Conclusions We have obtained good aesthetic results using costal cartilage grafts which could display sufficient and stable support for the scaffold of nose.We can conclude that costal cartilage is a good material in secondary rhinoplasty,and can be used to reconstruct an aesthetic nose.
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Objective To discuss the prevention and treatment of the complications of rib rhinoplasty in Chinese.Methods A total of 209 patients received rib rhinoplasty in which postoperative complications happened in 14 cases from Jan.2010 to Aug.2017,and the clinical data were analyzed retrospectively.Results 195 patients showed satisfactory results and no complications.Postoperative complications occurred in 14 cases.There were 12 cases of rib cartilage warping (incidence rate was 5.7％).4 cases were thought that warping was within acceptable range,and 8 cases had satisfactory results after the secondary repair surgery.There were 3 cases of resorption of rib cartilage (incidence rate was 1.4％),of which 2 cases were complicated with cartilage warping and 1 case complicated with infection.None of them underwent repair surgery.The infection complicated with cartilage resorption was 1 case (0.5％).The infection was improved by conservative treatment and the cartilage was not removed.There was 1 case of hypertropic scar on chest wall (incidence rate was 0.5％).Conclusions The warping of cartilage can be significantly reduced by selecting straight section of costal cartilage,preserving the central costal cartilage grafts,symmetrically carving and crosscutting.Meanwhile,sterility and accurate operation can decrease the incidence of infection,aerothorax and scars.
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In order to optimize the prescription and preparation process of norcantharidin/tetrandrine dual loaded liposomes, the dual drug loaded liposomes were prepared by film dispersion-ultrasonic method using norcantharidin-mesoporous silica nanoparticles（MSN-NCTD）and tetrandrine（Tet）. With particle size and encapsulation efficiency as comprehensive indexes, the influences of phospholipid cholesterol amount, ultrasonic time and ultrasonic power on prescription process were investigated by orthogonal test; the release characteristics of liposomes were investigated by dialysis method. The results indicated that the best prescription process of prepared norcantharidin/tetrandrine dual loaded liposomes was as follows: phospholipid-cholesterol ratio 2.5:1, ultrasonic time 4 min, ultrasonic power 40%; the encapsulation efficiency was 86.62% and 79.19%respectively for NCTD and Tet;liposomes were well-shaped under the transmission microscope, with average particle size of （207.5±3.6） nm, Zeta potential of （1.345±0.173） mV; and the 48 h cumulative release rates of NCTD and Tet were 85.14% and 85.00% respectively. The experiment results proved that the dual drug loaded liposomes prepared by film dispersion-ultrasonic method had uniform particle size, high encapsulation efficiency and sustained release characteristics.
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Objective@#To explore flap thinning based on the study of the arterial structure and blood perfusion of the deep inferior epigastric artery perforator (DIEP) flap using computed tomography (CT) angiography.@*Methods@#Clinical imaging study: Preoperative CT angiography was performed in 15 patients with DIEP flap reconstruction to investigate the vascular structure of arterial perforator. Cadaveric imaging study: 10 abdominal specimens harvested from fresh cadavers were cannulated with trocar and injected with contrast medium in the deep inferior epigastric artery perforator. During the perfusion of the contrast medium in the flap, the flap was scanned by three-dimensional CT. The CT data was then sent to CT workstation and the images were processed and reformatted to study the vascular structure of arterial perforators and the blood perfusion.@*Results@#75 artery perforators in clinical study and 40 artery perforators in cadaveric study were chosen and analyzed. The major deep inferior epigastric artery perforators run directly across the deep layer of adipose tissue without bifurcating beneath the Scarpa′s fascia. Above the Scarpa′s fascia, the artery perforators bifurcate and ultimately terminate in the subdermal vascular plexus. Blood perfusion mode: The subdermal vascular plexus served as the only pathway for blood perfusion between perforasomes. There are two different pathways for blood perfusion in the perforasome: the subdermal plexus and the existing vascular structure of perforator.@*Conclusions@#Based on the vascular structure of arterial perforator and blood perfusion of the DIEP flap, thinning of the DIEP flap under the Scarpa′s fascia is safe while thinning above the Scarpa′s fascia should performed according to the blood supply zone of the DIEP flap.
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Evidence suggested that glycogen synthase kinase-3β (GSK-3β) is involved in Nogo-66 inhibiting axonal regeneration in vitro, but its effect in vivo was poorly understood. We showed that stereotactic injection of shRNA GSK-3β-adeno associated virus (GSK-3β-AAV) diminished syringomyelia and promoted axonal regeneration after spinal cord injury (SCI), using stereotactic injection of shRNA GSK-3β-AAV (tested with Western blotting and RT-PCR) into the sensorimotor cortex of rats with SCI and by the detection of biotin dextran amine (BDA)-labeled axonal regeneration. We also determined the right position to inject into the sensorimotor cortex. Our findings consolidate the hypothesis that downregulation of GSK-3β promotes axonal regeneration after SCI.
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Animales , Humanos , Ratas , Axones , Metabolismo , Dependovirus , Genética , Glucógeno Sintasa Quinasa 3 beta , Genética , Metabolismo , Regeneración Nerviosa , Genética , ARN Interferente Pequeño , Genética , Corteza Sensoriomotora , Patología , Traumatismos de la Médula Espinal , Genética , Patología , Terapéutica , Siringomielia , Genética , Patología , TerapéuticaRESUMEN
OBJECTIVE@#To investigate the association between angiopoietin-like 4 (ANGPTL4) and aldolase A (ALDOA) in human melanoma cell. @*METHODS@#Overexpression or knockdown of ANGPTL4 was performed in WM-115 or WM-266-4 cells, respectively. The expression of ANGPTL4 and ALDOA was measured by RT-PCR and Western blot, respectively. The promoter activity of ALDOA gene was determined by luciferase assay. @*RESULTS@#The promoter activity of ALDOA gene and the expression of ALDOA (mRNA and protein) were increased or decreased in the melanoma cells with overexpression or knockdown of ANGPTL4, which was blocked by selective protein kinase C (PKC) inhibitor or restored by PKC agonist, respectively. @*CONCLUSION@#ANGPTL4 promotes ALDOA expression in human melanoma cell in a PKC dependent manner.
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Humanos , Proteína 4 Similar a la Angiopoyetina , Angiopoyetinas , Genética , Metabolismo , Western Blotting , Línea Celular Tumoral , Fructosa-Bifosfato Aldolasa , Metabolismo , Técnicas de Silenciamiento del Gen , Melanoma , Genética , Metabolismo , ARN Mensajero , Genética , MetabolismoRESUMEN
<p><b>OBJECTIVE</b>Nogo-A is an axon regeneration inhibitor, and its function in central nervous system (CNS) is still unknown. The present study is to explore the relationship between the expression of Nogo-A and the malignancy of oligodendroglial tumors in patients.</p><p><b>METHODS</b>Tumor tissue samples with different malignancy grade were obtained from the hospitals. The samples used for detection had been diagnosed as oligodendroglial tumors (oligodendroglioma or anaplastic oligodendroglioma). The expression of Nogo-A was detected by immunohistochemistry and western-blot analysis. The correlation test between the Nogo-A expression and the morphological changes (the percentages of atypical cells and mitotic cells in the tumors) related to the malignancy of tumor tissues was performed.</p><p><b>RESULTS</b>There was significant negative correlation between the Nogo-A expression and the morphological change of tumor tissues according to immunohistochemistry. Western-blot analysis also indicated that the gray value of Nogo-A protein band in the oligodendroglioma group was significantly higher than that in the anaplastic oligodendroglioma group.</p><p><b>CONCLUSION</b>Nogo-A expression was negatively correlated with the malignancy grade of oligodendroglial tumors.</p>
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Biomarcadores de Tumor , Metabolismo , Neoplasias Encefálicas , Diagnóstico , Metabolismo , Regulación hacia Abajo , Fisiología , Inmunohistoquímica , Índice Mitótico , Proteínas de la Mielina , Metabolismo , Invasividad Neoplásica , Diagnóstico , Proteínas Nogo , Oligodendroglioma , Diagnóstico , Metabolismo , Valor Predictivo de las PruebasRESUMEN
Objective To explore the effects of chronic electrical stimulation (ES) on Nogo-A expression in the hippoeampus of rats.Methods Thirty male Wistar rats were randomly divided into a control group and 4 exper- imental groups.The rats in the control group were given sham ES,while those in the experimental groups received 1, 3,6,or 9 days of ES before being sacrificed for the detection of Nogo-A expresson in the hippoeampus by immunohis- tochemistry and Western plotting.Results There was a positive correlation between the level of Nogo-A expression and the duration of ES,as shown by the immunohistochemistry technique.Western blotting showed the same result. Conclusion In general,seizure occurred 8 days after electrical stimulation began.Elevated Nogo-A expression in the hippocampus began earlier than seizures in the epilepsy model groups.