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In October 2016, a male patient attacked by a black bear was treated in the Department of Plastic Surgery, the Second Affiliated Hospital of Kunming Medical University.The patient had facial skin and soft tissue defects, and zygomatic arch and buccal damage. The patient received three operations, including debridement, scapular free skin flap transplantation, and reconstruction of zygomatic arch. The facial appearance recovered well after 6-months follow-up.
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Objective@#To explore the effects of anteriolateral thigh perforator flap and fascia lata transplantation in combination with computed tomography angiography (CTA) on repair of electrical burn wounds of head with skull exposure and necrosis.@*Methods@#Seven patients with head electrical burns accompanied by skull exposure and necrosis were admitted to our burn center from March 2016 to December 2017. Head CTA was performed before the operation. The diameters of the facial artery and vein or the superficial temporal artery and vein were measured, and their locations were marked on the body surface. Preoperative CTA for flap donor sites in lower extremities were also performed to track the descending branch of the lateral circumflex femoral artery with the similar diameter as the recipient vessels on the head, and their locations were marked on the body surface. Routine wound debridement and skull drilling were performed successively. The size of the wounds after debridement ranged from 12 cm×8 cm to 20 cm×12 cm, and the areas of skull exposure ranged from 8 cm×6 cm to 15 cm×10 cm. Anteriolateral thigh perforator flaps with areas from 13 cm×9 cm to 21 cm×13 cm containing 5-10 cm long vascular pedicles were designed and dissected accordingly. The fascia lata under the flap with area from 5 cm×2 cm to 10 cm×3 cm was dissected according to the length of vascular pedicle. The fascia lata was transplanted to cover the exposed skull, and the anteriolateral thigh perforator flap was transplanted afterwards. The descending branch of the lateral circumflex femoral artery and its accompanying vein of the flap were anastomosed with superficial temporal artery and vein or facial artery and vein before the suture of flap. The flap donor sites were covered by intermediate split-thickness skin graft collected from contralateral thigh or abdomen.@*Results@#The descending branch of the lateral circumflex femoral artery and its accompanying vein were anastomosed with superficial temporal artery and vein in six patients, while those with facial artery and vein in one patient. All the flaps survived after the operation, and no vascular crisis was observed. Wound healing was satisfactory. One patient was lost to follow up. Six patients were followed up for 6 to 10 months. The patients were bald in the head operation area with acceptable appearance. No psychiatric symptom such as headache or epileptic seizure was reported. The flap donor sites were normal in appearance. The muscle strength of the lower extremities all reached grade V. The sensation and movement of the lower extremities were normal.@*Conclusions@#Anterolateral thigh perforator flap with fascia lata transplantation can effectively repair electrical burn wounds of head with skull exposure and necrosis. The fascia lata can be used to protect the vascular pedicle of flaps, which is beneficial to the survival of the flap. Preoperative head and lower extremities CTA can provide reference for intraoperative vascular exploration in donor site and recipient area, so as to shorten operation time.
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Objective To detect serum level of long noncoding RNA ( lncRNA) BC200 in gastric cancer(GC) patients, and investigate its relationship with clinical features , and evaluate its diagnostic value for GC.Methods A case-control study was performed.From November 2014 to July 2015, serum levels of lncRNA BC200 were detected by real-time quantitative polymerase chain reaction in 124 patients with GC , 41 patients with atrophic gastritis and 59 normal controls who were hospitalized in Qilu Hospital of Shandong University.Meanwhile , serum carcinoembryonic antigen ( CEA ) and carbohydrate antigen 72-4 ( CA72-4 ) were detected by electrochemical luminescence immunoassay .Serum levels of lncRNA BC200, before and 3, 7, 10, 30, 100 days after radical operation in another 31 patients with GC were determined.The sensitivity and specificity of serum lncRNA BC200, CEA and CA72-4 were analyzed by using of the receiver operating characteristic ( ROC) curve.The comparison between two groups was performed with Mann-Whitney U test and the comparison among many groups was conducted with Kruskal-Wallis H test.Results Serum levels of lncRNA BC200 in GC patients with stage Ⅰ and Ⅱ[1.041(0.794,1.462)] and stage Ⅲ and Ⅳ[1.290 (0.978,1.794)]were significantly higher than those in patients with precancerous lesion [0.969(0.699, 1.219)]and normal controls[0.801(0.556,1.599)](H =54.68,P<0.000 1).Compared with pre-operation[1.120 (0.859,1.663)], the serum BC200 levels decreased significantly in 10 days [0.903 (0.724,1.182)](U=55.0,P<0.000 1), 30 days[0.759(0.671,1.037)](U=299.0,P=0.026 1), and 100 days[0.478(0.378,0.635)](U=41.0,P<0.000 1) after surgery.The area under the receiver operating characteristics curve ( AUC) of serum lncRNA BC200 was 0.865 for GC diagnosis, which was significantly higher than that of serum CA 72-4 ( AUC =0.699 ) or CEA ( AUC =0.807 ) .The AUC of combined detection of three tests was 0.934.Conclusion Serum lncRNA BC200 levels are significantly increased in GC patients , which may be used as a potential biomarker in GC diagnosis and monitoring .
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Objective To explore the value of non-invasive prenatal test (NIPT) in pregnant women with intermediate risk after traditional Down syndrome screening. Methods From March 1 2015 to March 31 2016, a total of 2 949 pregnant women with intermediate risk after traditional Down syndrome screening who received NIPT as the second-line screening method at Shenzhen Maternity and Child Healthcare Hospital after informed consent were recruited for this study. Retrospective data analysis including the results of traditional Down syndrome screening, ultrasound, NIPT and invasive amniocentesis to fetal karyotype analysis were conducted, and pregnant outcomes were followed up. Results NIPT results were all obtained in 2 949 pregnant women with intermediate risk after traditional Down syndrome screening. Of 25 NIPT-positive cases, 24 cases received invasive amniocentesis to fetal karyotype analysis. Thirteen cases were confirmed with fetal chromosomal abnormalities including 5 cases of trisomy 21, 2 cases of trisomy 13, 4 cases of sex chromosomal abnormalities and 2 cases of other chromosomal abnormalities. In addition, 1 NIPT-positive case refused prenatal diagnosis was confirmed normal result after birth. The postnatal follow-up in NIPT-negative women did not find any newborn with chromosomal abnormality. The incidence of fetal chromosomal abnormalities in women with intermediate risk was 0.44% (13/2 949). Conclusion NIPT can be used as second-line screening method in pregnant women with intermediate risk after Down syndrome screening, which could lead to the prenatal detection of a higher proportion of fetal chromosomal abnormalities and a lower invasive-testing rate.
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This study was aimed to investigate the effects of Si-Wu mixture on the secretion of E2 and the expression of CYP19al gene in granulosa cells after cell injury.Ovarian granulosa cells of SD rats were treated with cisplatin (CDDP).And the expression levels of E2 and CYP19a1 were determined by different testing methods.The results showed that the level of E2 induced by radioimmunoassay of the Si-Wu group was significantly higher than that of the CDDP group.Meanwhile,the group which added TGF-β3 protein pathway blocker was lower than others.The results of immunohistochemistry and western blotting showed that the expression level of CYP 19a1 of the Si-Wu group was higher than that of the CDDP group.In the western blotting,the group which added blocker was significantly lower than the non-blocking group.It was concluded that the pharmacological serum of Si-Wu mixture can enhance the level of E2 in CDDP cells through TGF-β3 protein pathway.And the effect is accomplished by the intervention of CYP 19a1.
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Objective To investigate the effects of DRP1 gene silencing on the chemosensitivity of human gastric cancer MKN-45 cells to oxaliplatin.Methods A lentiviral vector containing short hairpin RNA (shRNA) targeting DRP1 was constructed and cotransfected to MKN-45 cells.Levels of DRP1mRNA was detected by quantitative RT-PCR,With a final concentration of 0.5,1.0,2.0,4.0,8.0,16.0 and 32.0 μg/ml of oxaliplatin processing Lv-shRNA-DRPI group (experimental group),negative control group (NC group),and blank control group (CON group) respectively.Cellular proliferation was determined by MTT assay and calculate half maximal inhibitory concentration (IC5o).Celluar apoptosis was analyzed by flowcytometry.Using Western blot to detect LC3-Ⅱ and p62 expression.Results DRP1mRNA levels in experimental group (0.087 ± 0.025) was significantly inhibited as compared with NC group (1.040 ± 0.020) and CON group (1.027 ± 0.021) (P < 0.001).Cellular survival rate decreased in a oxaliplatin dose-dependent manner (all P < 0.001).IC50 value in experimental group (14.1 ± 0.4) μg/ml dropped compared with NC group (20.0 ± 1.1) μg/ml and CON group (20.0 ± 1.8) pg/ml (both P < 0.01).Celluar apoptosis rates in experimental group (9.4% ± 1.1%) elevated in contrast with NC group (6.4% ± 0.8%) and CON group (6.5% ± 1.0%) (both P < 0.05),expression of LC3 in experimental group(0.36 ± 0.03) dropped compared with NC group (0.62 ± 0.04) and CON group (0.59 ± 0.07) (both P < 0.05),expression of P62 in experimental group (0.58 ±-0.04) increased in contrast with NC group (0.39±0.04) and CON group (0.36 ±0.04) (both P<0.05).Conclusions DRP1-mediated overactive mitophagy plays a vital role in increasing the sensitivity of gastric cancer cell MKN-45 to oxaliplatin.
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Objective To investigate the effects of DRP1 gene silencing on the chemosensitivity of human gastric cancer MKN-45 cells to oxaliplatin.Methods A lentiviral vector containing short hairpin RNA (shRNA) targeting DRP1 was constructed and cotransfected to MKN-45 cells.Levels of DRP1mRNA was detected by quantitative RT-PCR,With a final concentration of 0.5,1.0,2.0,4.0,8.0,16.0 and 32.0 μg/ml of oxaliplatin processing Lv-shRNA-DRPI group (experimental group),negative control group (NC group),and blank control group (CON group) respectively.Cellular proliferation was determined by MTT assay and calculate half maximal inhibitory concentration (IC5o).Celluar apoptosis was analyzed by flowcytometry.Using Western blot to detect LC3-Ⅱ and p62 expression.Results DRP1mRNA levels in experimental group (0.087 ± 0.025) was significantly inhibited as compared with NC group (1.040 ± 0.020) and CON group (1.027 ± 0.021) (P < 0.001).Cellular survival rate decreased in a oxaliplatin dose-dependent manner (all P < 0.001).IC50 value in experimental group (14.1 ± 0.4) μg/ml dropped compared with NC group (20.0 ± 1.1) μg/ml and CON group (20.0 ± 1.8) pg/ml (both P < 0.01).Celluar apoptosis rates in experimental group (9.4% ± 1.1%) elevated in contrast with NC group (6.4% ± 0.8%) and CON group (6.5% ± 1.0%) (both P < 0.05),expression of LC3 in experimental group(0.36 ± 0.03) dropped compared with NC group (0.62 ± 0.04) and CON group (0.59 ± 0.07) (both P < 0.05),expression of P62 in experimental group (0.58 ±-0.04) increased in contrast with NC group (0.39±0.04) and CON group (0.36 ±0.04) (both P<0.05).Conclusions DRP1-mediated overactive mitophagy plays a vital role in increasing the sensitivity of gastric cancer cell MKN-45 to oxaliplatin.
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Objective To investigate neurological function, volume of cerebral infarction, changes of lipid peroxidation, and the intervention effect of compound angelica injection (CAI) on rats with focal cerebral ischemia injury. Methods Models of rat with cerebral ischemia were reproduced by middle cerebral artery occlusion (MCAO). All animals were randomly divided into sham-operation group, model group, CAI group, and edaravone group. 1 hour after the models were established, rats in the sham-operation group and model group received intraperitoneal injection with normal saline, while rats in CAI group and edaravone group received intraperitoneal injection with relevant medicine for continuing 7 days. Volume of cerebral infarction was detected by Tetrazole staining method, neurologic function were detected by neuroethology, and concentration of MDA in brain tissue was also detected. Results After 7-day cerebral ischemia, compared with the model group, volume of cerebral infarction in CAI group was significantly reduced (P<0.05), and the concentration of MDA was a little lower. Conclusion CAI has significant protective effects which can significantly improve neurological function, reduce volume of cerebral infarction, and alleviate the effects of lipid peroxidation of rats with focal cerebral ischemia injury.
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Objective Primary myocardial cell culture , as an important technique for in vitro experiment , provides an essen-tial basis for the establishment of models of cardiovascular diseases .This study aimed to investigate the influence of digestion time on primary myocardial cell culture and to find some simple primary culture methods for obtaining myocardial cells with high survival rate , purity, and activity. Methods We used only one collagenase for repeated digestion of myocardial tissue for 8 and 10 minutes, re-spectively , and obtained high-purity cardiomyocytes by differential adhesion and Brdu inhibition .We observed the morphological chan-ges of the cardiomyocytes under the optical microscope , measured their vitality according to the beating frequency in different regions , and counted the living cells after typan blue staining. Finally, we established a model of myocyte hypertrophy for verification of cell activity and compared the cell surface area between the experimental ( angiotensinⅡ) and control ( 10%FBS DMEM [H +] medium ) groups. Results After cultured for 48 hours, the primary cardimyocytes in the 10 min group mostly extended pseudopodia , in-terwoven into a network and gradually forming cell clusters , with obviously powerful beating and contraction .After isolation and purifi-cation, the average survival rate of the cells was >90%, significantly higher in the 10 min group than in the 8 min ([95.4 ±0.8]%vs [93.0 ±0.8]%, P95%in both of the groups.After cultured with angiotensinⅡfor 48 hours, the 10 min group showed a significantly increased level of atrial natriuretic peptide (ANP) (20.8 ±0.67 vs 15.8 ±0.48, P<0.05) and cell surface area ([34.77 ±8.43] μm2 vs [14.11 ±4.29] μm2, P<0.05) as compared with the 8 min group. Conclusion Primary culture of cardimyocytes with 8 min digestion is simple and time-saving, and what is most important , can obtain high-quality cardiomyocytes .
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Objective The distribution and drug resistance of Klebsiella pneumonia isolated from clinical department were ana‐lyzed in this article .It will provide evidence for the clinical rational medication and the control of nosocomial infections .Methods In this hospital ,892 strains of Klebsiella pneumonia isolated from January 2011 to December 2013 were performed a statistical analy‐sis .Results Among all the samples ,the extended spectrumβ‐lactamases(ESBLs) positive Klebsiella pneumoniae accounted for 40 . 92% .The highest detection rate in the all the clinical department is the ICU with a value of 46 .46% .The highest detection rate in the sample is the sputum with a value of 43 .51% .In addition ,the ESBLs positive strains had a trend of multiple drug resistance . The Klebsiella pneumonia was the most sensitive bacteria to imipenem ,meropenem ,piperacillin/tazobactam and cefoperazone/sul‐bactam ,no matter whether they produced ESBLs or not .Conclusion The resistant rate of ESBLs positive strains is higher than that of ESBLs negative strains .It was recommended to the rational use of antibiotics based on the duration of disease and the products with or without ESBLs .Furthermore ,it will be of great importance to reduce the incidence of multiple drug resistance ,and to con‐trol the hospital infection effectively .
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Objective To investigate the clinical significance of early diagnosis and treatment of impal-pable breast tumor.Methods From Jan.2007 to Dec.2014, 570 patients with impalpable breast tumor were treated.Among them, 107 patients were found with breast nodules by ultrasound scan , 340 patients were found with nodules , calcification or distort gland structure and 123 patients were found with nipple discharge by mam-mography .They were biopsied with various methods such as wire localization guided by ultrasound , X-ray mam-mography and fiberoptic ductoscopy .All patients were treated routinely and followed up .Results The his-topathological examination results were as follows:134 cases of breast cancer (23.51%) and 436 cases of benign lesions.44 breast cancer patients were localized by ultrasound , 78 cases were localized by X-ray mammography, and 12 cases were localized by fiberoptic ductoscopy .All lesions were accurately localized and excised .During the two-year follow up, no recurrence or metastasis occurred .Conclusion Early diagnosis and treatment of im-palpable breast tumor can improve early diagnosis level of breast cancer .
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This study was aimed to compare the antioxidant activity of puerarin and 3 other flavonoid compounds, and to investigate their structure-activity relationship. The intragastric administration of 4 kinds of typical flavonoids compounds (soybean element, puerarin, quercetin and rutin) were given to mice, respectively. The model mice of acute hepatic injury were established with intraperitoneal injection of 0.1% carbon tetrachloride (CCl4) after 7 days. After 18 h fasting, liver tissues were removed. The histomorphology was observed after paraffin sectioning and hematoxylin-eosin staining. The activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP) in serum were detected with automatic biochemical analyzer. The content of malondialdehyde (MDA), the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in liver tissues were detected with homogenization. The pathological results of liver tissues showed that hepatic damages were decreased in all 4 medicine treatment groups compared with the model group, but there were no significant differences among these treatment groups. The results of blood serum bio-chemical analysis showed that compared with the model group, puerarin and quercetin could decrease the activities of ALT, AST and GGT in serum significantly (P < 0.05, orP < 0.01). There were no content changes of ALP. In the soybean element group, only the activities of ALT and AST decreased obviously (P < 0.05, orP < 0.01). There was no obvious change in the serum of mice in the rutin treatment group. The homogenate detection results of liver tissues showed that compared with the model group, quercetin and rutin significantly lowered MDA (P < 0.05), increased SOD and GSH-Px (P < 0.05, orP < 0.01); while soybean element and puerarin only improved GSH-Px levels (P < 0.05, orP < 0.01). It was concluded that the antioxidant capacity of quercetin was better than that of soybean element, puerarin and rutin, which may be related to its structure. Compared with 3 other chemical compounds, quercetin had more polyhydroxies and its polyhydroxies were not glycosylated, which suggested that the structure of quercetin may be closely related to its antioxidation activity.
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Objective To investigate the clinical correlated problems of immediate breast reconstruction with silicagel prosthesis after modified radical mastectomy.Methods From Jun.2007 to Dec.2011,30 patients were treated with skin sparing modified mastectomy and immediate reconstruction by placing silicone implants into submuscle.15 cases were reserved the nipple-areola complexes.All patients were treated routinely after operation.Results Objective evaluation after operation showed that the excellent rate reached to 90.0%,and subjective evaluation showed that the excellent rate reached to 93.3%.Two cases suffered under-flap hydrops,one case suffered capsular contraction,one case suffered flap ischemia and superficial necrosis of nipple-areola complex,one case suffered gel metastasis,and one cases suffered obvious asymmetry.All the cases were followed up for 12 to 54 months,among whom one case had hepatic and bone metastasis,and the others had no recurrence or metastasis.Conclusions Immediate breast reconstruction with silicagel prosthesis after modified radical mastectomy was proven to be an effective and safe method,with no increase of local recurrence.The modification of operation may avoid the risk of complications.
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A total of 17 cases with pelvic limb hyperhidrosis were selected for lumbar sympathetic nerve modulation.The puncture of lumbar sympathetic nerve was guided by computed tomography (CT) through the gap of L2-3 until the needle tip reached the lateral of the second or third lumbar vertebra body and outside of psoas major.A mixture of 1% lidocaine 3 ml and 30% Iohexol injection 0.3 ml was injected.If the diffusion of lidocaine was observed between lumbar vertebra body and psoas major.After 15 min,5 ml of absolute alcohol was injected to modulate the lumbar sympathetic nerve.After 5 min,oximetry-derived perfusion index of toe and sole temperature increased (5.9 ± 1.4) folds and (4.16± 0.89) ℃ on average respectively.Pelvic limb hyperhidrosis was all cured within 6 months and one case recurred after a year.There were no occurrences of complications.Lumbar sympathetic nerve modulation guided by CT may be used for treating female pelvic limbs hyperhidrosis.
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Objective To elucidate the protein expression and gene expression status and the relationship between epidermal growth factor receptor (EGFR) protein expression and EGFR gene status.Methods Tissue microarray containing 72 cervical squamous cell carcinoma tissues was constructed,and EGFR protein expression and gene status were evaluated by immunohistochemical and fluorescence in situ hybridization (FISH) techniques.Results Protein expression of EGFR:69 of 72 cervical squamous cell carcinomas were observed.The results demonstrated it was significant association with invasion depth,lymphnode metastasis and lymph-vessel invasion (x2 =4.998,P < 0.05 ; x2 =4.299,P < 0.05 ; x2 =4.686,P < 0.05) in cervical squamous cell carcinomas.For FISH assessing EGFR gene,64 of 72 carcinomas were observed; 7 of 64 cases showed EGFR gene amplification,and 25 disomy,23 trisomy and 9 polysomy were detected.There were high levels of protein expression in all the EGFR gene amplification cases,and there were significant association between EGFR protein expression and the gene copy number (x2 =13.564,P < 0.05).Conclusions EGFR may participate in the occurrence,progression and metastasis of cervical squamous cell carcinoma.Overexpression of EGFR protein may result from gene amplification and gene copy number increases,which showed that EGFR gene expression status may be a more effective biological indicator of cervical squamous cell carcinoma targeted therapy.
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Migraine is the most common type of primary headache.The ideal animal models of migraine should be able to well replicate the key pathophysiological mechanism of migraine.According to the different pathogeneses,this article reviews the advances in research on the animal models of migraine from the aspect of making methods,determination criterion,advantages and disadvantages,and the scope of application,
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Objective To investigate the expressions of Sema4D and HER-2 in breast cancers and their relationship with microlymphtic vessel density (MLVD).Methods MLVD and expressions of Sema4D and HER-2 were detected in 110 cases of breast cancer tissues by immunohistochemistry.The relationship of Sema4D and HER-2 expressions with clinicopathologic parameters was analyzed.Results The positive expression rate of Sema4D and HER-2 was 71.82% (79/110) and 33.64% (37/110),respectively,with a statistically significant differences compared to those in the control group ( P <0.01 ).The positive expression rates of Sema4D and MLVD in cases with lymphatic metastasis were higher than that without lymphatic metastasis ( P < 0.01 ).The expressions of Sema4D and HER-2 were closely correlated with the histological grade,TNM stage,lymph node metastasis,and expression of ER of breast cancers ( P <0.05),but were not related to tumor size and expression of PR (P > 0.05 ).On univariate analysis,the disease-free survival rate of patients with Sema4D positive expression was better than those with its negative expression ( P < 0.05).Sema4D expression was positively correlated with the HER-2 expression ( r =0.535,P < 0.01 ).Conclusions Sema4D may play important roles in the carcinogenesis and development of a breast cancer.
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The aim of the present study was to explore the prevalence characteristics of brucellosis in Hainan by investigating the biological characteristics and clinical type of pathogenic bacteria isolated from the blood of a patient infected by infective endocarditis.Bacteriological experiments were conducted according to the standard identification methods of Brucella including morphology,cultural characters,biochemistry characters,serological test and phage test,etc.At the same time,systematic analysis on the information about epidemiology,clinical manifestation and laboratory data of the patient was carried on.The Brucella melitensis was identified as Brucella melitensis biotype 2 and was significantly different from the Brucella melitensis biotypes 1 and 3 isolated in China reported in recent years.The urease test result of Brucella melitensis was variable and there is no strong positive result reported except the isolates in Hainan.As Brucellosis cause by Brucella melitensis biotype 2 was firstly reported in Hainan Province,great importance should be attached to its point-like prevalence.
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Objective To contrast the curative effect of mosapride with that of domperidone on gastroparesis diabeticorum (DGP).Methods 52 DGP definite patients were divided into two groups randomly, mosapride group and domperidone group. The clinical effect and the change and untoward effect of gastric emptying time of this two medicines were observed after treatment for four weeks’.Results The curative effect of mosapride in treating DGP was obviously better than that of domperidone The total clinical effective rate between this two groups showed significant difference (P
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Objective To explore the relationship between the maxi ll ofacial complexion and age-sex in Han nationality. Methods The maxillofacial skin chroma L*, a* and b* were measured a nd compared in 1462 people aged from 18 to 85 years old in Han nationality, incl uding 682 men and 780 women, by means of Minolta Chroma Meter CR-100. Results Male had the lower L* and b* value and the hig her a* value than those in female. The maxillofacial chroma L* and a* were related to age negatively, and b* was related to age positiv ely. Conclusion The effect of sex and age on color of the maxillofacial skin should be considered while matching colors in construction o f maxillofacial defect.