In vitro study of TGF-β1-induced epithelial-mesenchymal transition of keloid epithelial cells / 中华整形外科杂志

<p><b>OBJECTIVE</b>To construct and characterize the TGF-β1, induced epithelial-mesenchymal transition (EMT) model of keloid epithelial cells in vitro, and to investigate the expression of epithelial stem cells related surface markers in keloid epithelial cells during EMT induction.</p><p><b>METHODS</b>The epithelial cells from 3 keloid samples of ears were cultured in vitro and induced by transforming growth factor betal (TGF-β1, 1 ng/ml) for 5 days, which was the experimental group, the same cells untreated were considered as the negative control group. The expressions of EMT-associated markers and regulative genes were detected using immunofluorescence staining, real-time PCR and western blot analysis. Then the surface markers of epithelial stem cells were detected using real-time PCR. Statistical significance was determined using Independent-Samples t Test, a p value less than 0. 05 was considered statistically significant.</p><p><b>RESULTS</b>The mRNA expression of transcription factor snail2 and mesenchymal-specific marker vimentin increased significantly in TGF-β1, induced keloid epithelial cells (P < 0. 05), in which snail2 increasing from 0. 91 ± 0. 23 to 1. 69 ± 0. 10, and vimentin from 5. 86 ± 2. 07 to 24. 29 ± 5. 39. Whereas the mRNA expression of epithelial-specific marker E-cadherin decreased from 1. 06 ± 0. 19 to 0. 65 ± 0. 09. The mRNA expression of CD29 and Lgr6, two surface markers of epithelial stem cells, significantly increased after induction of the TGF-β1, (P < 0. 05), from 0. 55 ± 0. 14 and 1. 61 ± 0. 31 to 1. 19 ± 0. 12 and 3. 84 t 0. 62 respectively. In induced cells, the immunofluorescence results showed staining of E- cadherin became faint, but the number of positive staining cells of vimentin increased. Western blot confirmed the protein expression of E-cadherin weakened, and the vimentin and p-Smad3 enhanced (P < 0. 05).</p><p><b>CONCLUSIONS</b>TGF-β1, initiated EMT in keloid epithelial cells by inducing the up-regulation of snail2, and TGF-β1,/Smad3 signaling pathway was involved in EMT. EMT could change the phenotype of epithelial stem cells in keloid.</p>

Micro-plasma radio frequency treatment for facial post-burn hyperpigmentation / 中华整形外科杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of micro-plasma radio frequency treatment of facial post-burn hyperpigmentation.</p><p><b>METHODS</b>From June 2012 to August 2013, a total of 25 cases with facial post-burn hyperpigmentation were treated with micro-plasma treatment for 3-5 times. The roller tip was used with setting of 60-90 watts and 3-4 passes were performed in different directions. Treatments were repeated at an interval of 8 weeks.</p><p><b>RESULTS</b>All patients tolerated the pain. After treatment, the facial hyperpigmentation improved. Complete recovery was achieved in 4 cases; significant improvement in 11 cases; moderate in 7 cases and no effect in 3 cases. No hyperpigmentation, depigmentation and scar formation was observed.</p><p><b>CONCLUSION</b>Micro-plasma radio frequency treatment is an ideal treatment for post-burn hyperpigmentation with lower side effect.</p>

Repeated expansion of skin tissues:clinical,biomechanical and histological studies / 中华医学美学美容杂志

Objective To summarize the experiences of repeated expansion surgery,to evaluate the changes of skin histological and biomeehanical properties,and to afford rationale for its application and popularization.Methotis Skin soft tissues were repeatedly expanded to repair the massive skin defection.All the 31 cases were divided into children group and adult group according to their ages.In each group the treatment experiences were summarized.The biomechanical and pathological properties were investigated and compared after samples had been made.Resuits A total of 31 cases were treated by serial tissue expansion.Complication incidences of every expanded procedure were 10%and 17%respectively.After 6-12months postoperative follow-up,most of the curative effects were satisfactory.The repeated expanded skin had lower enlarged rate,depressed stress-relaxation and stress-strength character,so was the deceased proliferation of the epidermal cells.The changes were significant in the adult group.Conclusions Repeated expansion is a feasible method of repairing the massive skin defection.Its curative effect is more satisfactory in children than adult.Due to the increase of the risk and skin quality decline,enough attention must be paid in clinical application.

The autotransplanted tracheas wrapped in united muscle flap of the neck: an experiment / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the way of revascularization of donator's trachea wrapped in united muscle flap.</p><p><b>METHODS</b>Using fiberoptic bronchoscopy, histopathology and microangiography, we evaluated the tracheal mucosal blood flow, the survival rate, the percentage of patency, and the graft viability of autograft tracheas with varying lengths wrapped in one-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap and autograft tracheas with the length of 5 rings without wrapped in muscle flap in 32 dogs.</p><p><b>RESULTS</b>In the tracheal autograft wrapped in the united muscle flap group with a length less than 4 centimeters, the submucosal blood flow of graft could be detected by laser blood flowmetry one week after transplantation, and it reached 60% of the normal, which had no significant difference between the place near the site of anastomosis and the middle part of the graft. Dense vessels could be found to grow from the wrapped muscles into the autografted trachea by microangiography. Histopathological examination demonstrated that the structure of the autograft was the same as what it originally was. the inner surface of the autograft was covered with pseudostratified columnar ciliary epithelia, and no necrotic tracheal cartilages were found. Every autograft could survive over long time. However, at 1 week, most mucous membrane in the middle part of the graft with length over 4 cm was in gray or in pale; hyperemia, edema, and haemorrhage were found near the site of anastomosis. Mucosal blood flow measured by laser blood flowmetry in the middle part of the graft was significantly less than that near the site of anastomosis. Malacia, dissolution or granulation hyperplasia occurred in midportion of the major grafts shortly after transplanatation. As for those autografted trachea without wrapping in muscles flap, mucous membranes turned black one week after the transplantation and all dogs died of graft necrosis later.</p><p><b>CONCLUSION</b>One-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap can provide blood for the graft and the grafted trachea can survive for a long time.</p>

The influence of over-expansion on the blood supply of an axial-pattern flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of over-expansion on the viability and vascularity of an axial-pattern flap.</p><p><b>METHODS</b>Tissue expanders were implanted subcutaneously on the buttock of the mini-pig. After over expansion, an axial-pattern over-expanded skin flap was elevated in the pig of the experimental group. The differences in flap survival, LDF, MDA content and fluorescein stain were observed between the control and the experimental groups. The vascular architecture changes were also recorded using histological and clearing specimen examination.</p><p><b>RESULTS</b>The microcirculation in the distal segment of the axial flap was significantly weakened after over-expansion. There were injury manifestation, change in vessel distribution and reduction of vascular territory in the axial over-expanded flap.</p><p><b>CONCLUSIONS</b>Over-expansion could cause chronic injuries to the axial vessel network and damage the blood supply of the axial-pattern flap.</p>

Experience in Dealing with Infection Complications of Tissue Expanders / 中华医院感染学杂志

OBJECTIVE To review our experience with tissue expanders infection and how to treat it.METHODS Totally 168 patients were treated from Sep 2002 to Oct 2006.The relative infection complications were defined as operative plan was only partially satisfied,sometimes implying poor surgical judgment.RESULTS There were 43 cases with infection in the process of installing expanders.Though by proper treatment only 9 patients were with unsatisfied effect.The others had better result.CONCLUSIONS The reasons that cause tissue expander derived infection is complex,we must be carefully to do the operation.