Inhibition of microRNA-214 promotes epithelial–mesenchymal transition process and induces interstitial cystitis in postmenopausal women by upregulating Mfn2

Our study aims to investigate the roles that microRNA-214 (miR-214) plays in the epithelial mesenchymal transition (EMT) process and the development of interstitial cystitis (IC) in postmenopausal women by targeting Mitofusin 2 (Mfn2). IC bladder tissues and adjacent normal bladder tissues were collected from postmenopausal women. Immunohistochemistry (IHC) staining was conducted. The target relationship between miR-214 and Mfn2 was determined by a dual luciferase reporter gene assay. Adipose-derived mesenchymal stem cells (ADMSCs) were extracted from postmenopausal rats and assigned to the blank, mimics, miR-214 inhibitors, mimics negative control (NC), inhibitors NC, Mfn2 siRNA, miR-214 inhibitors and Mfn2 siRNA groups. Exosomes secreted by transfected ADMSCs were instilled into the bladders of postmenopausal rats. The expression of miR-214 and Mfn2 mRNA and EMT markers was assessed by qRT-PCR and western blotting. It was confirmed that Mfn2 was the target gene of miR-214 in IC. Compared with the normal bladder tissues, miR-214 decreased, but Mfn2 increased in IC bladder tissues. Compared with the blank group, the expression of miR-214 and the expression levels of N-cadherin, Fibronectin, Twist1, Snail and Vimentin mRNA and protein increased, whereas the expression levels of Mfn2, E-cadherin and ZO-1 mRNA and protein decreased in the miR-214 mimics and Mfn2 groups. The expression of MiR-214 and the expression levels of N-cadherin, Fibronectin, Twist1, Snail and Vimentin mRNA and protein decreased, whereas the expression levels of Mfn2, E-cadherin and ZO-1 mRNA and protein increased in the miR-214 inhibitors group. Our findings indicate that the inhibition of miR-214 promotes the EMT process and contributes to bladder wall fibrosis by up-regulating Mfn2, thus leading to the occurrence of IC in postmenopausal women.

Color Doppler ultrasound in evaluating the cerebrospinal fluid dynamics before and after duraplasty in patients with Chiari Ⅰ malformation treated with foramen magnum decompression / 中华神经医学杂志

Objective To evaluate the recovery of circulation of cerebral spinal fluid (CSF)around foramen magnum before and after duraplasty in patients with Chiari Ⅰ malformation (CMI) treated by foramen magnum decompression by using colored Doppler ultrasound (CDU). Methods Twenty patients suffered from CMI, including 17 combined with syringomyelia, admitted to our hospital from December 2008 to June 2009, were performed foramen magnum decompression via posterior midline approach; Neuropatch was used to repair the dura mater. Tarlov's grading scale and MRI was employed to evaluate the efficacy and the improvement of syringomyelia. All patients underwent CDU before and 10-20 d after the duraplasty to evaluate the circulation of CSF in arachnoid space below tonsil of cerebellar (TC). Results Fifteen patients (75%) got improvement and 5 without change after the surgery. Postoperative MRI indicated that 82.4% patients (14/17) combined with syringomyelia enjoyed good results. Cisterna magna reappeared after the surgery. CDU showed that bidirectional flow of CSF was recovered around foramen magnum in all patients with the Caudal-directed flow rate of CSF in dorsal arachnoid space below TC 8.92 ±5.19 cm/s and cephalad-directed flow rate of 6.85 ±2.44 cm./s; as compared with that after the surgery, the bidirectional flow could be found in only 11 patients before duraplasty (55%). Conclusion Foramen magnum decompression with duraplasty can restore the circulation of CSF around foramen magnum effectively in patients with CMI, and CDU, providing accurate data of circulation of CSF during or after the surgery, is a useful tool to evaluate the flow of CSF in patients with CMI.

Application of free anterolateral thigh flap in head and neck surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the results of reconstruction by free anterolateral thigh flaps (ALT) after operation of head and neck tumors.</p><p><b>METHODS</b>Forty-three cases underwent the reconstruction of postoperative defects with free anterolateral thigh flaps after head and neck cancer surgeries between November 2007 and June 2010 were reviewed. Ages of the patients ranged from 40 to 81 years, with a median of 56 years; 32 males and 11 females; 23 cases of oral carcinoma, 7 cases of tonsil carcinoma, 11 cases of hypopharyngeal carcinoma, and 2 cases of head skin cancer. TNM classified as follows: no case of distant metastasis; T1 9 cases; T2 17 cases; T3 11 cases; T4 6 cases. All patients were applied with ALT to restore swallowing and respiratory functions. The mean length of blood vessel pedicles of the ALT free flaps was 12.5 (8 - 18) cm. The flaps were 4 - 15 cm in width, 5 - 25 cm in length.</p><p><b>RESULTS</b>In the 43 cases applied with ALT free flaps, 40 cases were successful and 3 cases unsuccessful. Two of the failed cases were reconstructed with pectoralis major flap. In 11 cases of hypopharyngeal carcinoma, except 3 cases with total laryngectomy, 8 cases (72.7%) had their laryngeal function been preserved.</p><p><b>CONCLUSIONS</b>The successful rate of ALT free flaps is perfect. There were no serious complication in offered areas. The flap could be shaped into various forms. ALT free flap is an ideal flap to reconstruct the defect after surgery in some head and neck tumors.</p>

Preservation of parathyroid glands and their functions during total thyroidectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the protection methods of parathyroid glands (PTGs) and their functions during total thyroidectomy.</p><p><b>METHODS</b>The locations and the blood supplies of parathyroid glands in 292 cases underwent total thyroidectomy between February 1990 and December 2009 were studied. The protective measures for PTGs and their blood supplies during total thyroidectomy were analyzed.</p><p><b>RESULTS</b>Total of 542 superior PTGs and 467 inferior PTGs were found in 296 cases of total thyroidectomy. Of the superior PTGs, 444 (81.9%) consistently located in the back sides of the thyroid glands and at the level of inferior edge of thyroid cartilage. The locations of the inferior PTGs were variable, 231 (49.5%) of them located in the inferior 1/3 part of the back sides of the thyroids and 116 (24.8%) at the inferior thyroid, in where inferior thyroid artery (ITA) branches enter thyroid. The fine dissections showed that the blood supplies to superior PTGs were mainly from the upper branch of ITA, accounting for 71 (68.3%) of 104 superior PTGs and the blood supplies to inferior PTGs were from the inferior branches of ITA system, accounting for 114 (80.3%) of 142 inferior PTGs. There was 13 cases with short-term hypocalcemia postoperatively, but no case with permanent hypoparathyroidism.</p><p><b>CONCLUSIONS</b>The blood supplies of PTGs are associated with their locations. During total or subtotal thyroidectomy, parathyroid glands and their artery blood-supply should be exposed and preserved to prevent hypoparathyroidism after surgery.</p>

Laparoscopic splenectomy: color Doppler flow imaging for preoperative evaluation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Laparoscopic splenectomy (LS) is currently the standard approach for resection of a normal-sized spleen. However, this method becomes technical challenge in cases of splenomegaly due to intraoperative hemorrhage. A complete understanding of the splenic vessel anatomy is important to facilitate the difficult laparoscopic procedure. In this retrospective study, we examined the role of color Doppler flow imaging (CDFI) in splenic vessel anatomy and evaluated its value for LS.</p><p><b>METHODS</b>Forty-eight patients who underwent splenectomy for various hematologic and autoimmune disorders from May 2004 to December 2007 were enrolled in this study. Twenty-three patients underwent preoperative CDFI examination that included examination of the anatomic type of splenic pedicle, the adjacent relationship between the splenic vessel and pancreas, and spleen size (CDFI group). In the remaining 25 patients, ultrasonic inspections of the splenic vessel were not performed (non-CDFI group). Laparoscopic splenectomies in the CDFI group were performed in accordance with the information provided by the preoperative CDFI in each patient. In the non-CDFI group, LS was performed according to the conventional method. In the CDFI group, the constituent ratios of the above-mentioned parameters by CDFI were compared with those recorded during LS using the chi square test. The effectiveness of the technique on surgery in both groups was compared with an independent sample Student's t test.</p><p><b>RESULTS</b>All laparoscopic splenectomies in both groups were performed successfully. However, 2 cases in the non-CDFI group were converted to LS with the assistance of micro-incision because the branches of the splenic vein were inadvertently torn. Two anatomic types of splenic pedicle and four different adjacent relationships between the splenic vessel and pancreas were detected by CDFI. About 80% of spleens fit the criteria of megalosplenia. There were no statistically significant differences between the constituent ratios of the parameters by CDFI and those by intraoperative telerecording in the CDFI group (chi(2) = 0.383, 1.072, 0.119, P = 0.536, 0.784, 0.730). However, statistically significant differences were observed in the operative time ((158.70 +/- 42.51) minutes vs (200.65 +/- 47.89) minutes, P = 0.003), intraoperative blood loss ((55.87 +/- 17.36) ml vs (101.83 +/- 62.21) ml, P = 0.001), and recovery time of gastrointestinal function ((24.39 +/- 8.88) hours vs (30.60 +/- 9.45) hours, P = 0.024) between the groups.</p><p><b>CONCLUSIONS</b>The individual operative route and schedule can be successfully determined on the basis of various kinds of reproducible anatomic frameworks of the spleen provided by preoperative CDFI. This technique facilitates the surgical procedure, shortens the operative time, reduces intraoperative blood loss and decreases the risk of LS in splenomegaly cases.</p>

Expression of survivin gene in a rat model of acute pancreatitis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expression of survivin in acute pancreatitis in rats.</p><p><b>METHODS</b>Acute pancreatitis was induced in rats by retrograde injection of sodium taurocholate into the pancreaticobiliary duct. The expressions of survivin in the pancreatic tissues was detected by immunohistochemisty, Western blotting and RT-PCR, and the apoptotic ratio of the acinar cells was determined by TUNEL assay.</p><p><b>RESULTS</b>Survivin was not detected in the control group, and in rat models of acute pancreatitis, the expressions of survivin protein and mRNA increased but the apoptotic index of the acinar cells decreased gradually with the severity of inflammation.</p><p><b>CONCLUSION</b>Survivin is involved in the regulation of acinar cell apoptosis and also the necrosis of the apoptotic acinar cells through its anti-apoptosis activity to aggravate acute pancreatitis, suggesting its value as a promising marker in predicting the severity of acute pancreatitis.</p>

Effect of resveratrol-induced FasL up-regulation on the apoptosis of pancreatic acinar cells in rats with severe acute pancreatitis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of resveratrol on the apoptosis of pancreatic acinar cells in rats with severe acute pancreatitis (SAP) and explore the mechanism of such effect.</p><p><b>METHOD</b>SD rats with 3.5% sodium taurocholate-induced SAP were treated with resveratrol, and the serum amylase was detected with automatic biochemistry analyzer. The apoptosis of the pancreatic acinar cells in the rats was detected by TUNEL assay, and the expression of Fas and FasL genes was determined by RT-PCR and Western blotting. The pathological changes of the pancreas were observed under optical microscope.</p><p><b>RESULTS</b>Compared with SAP group, the resveratrol-treated rats showed obviously decreased serum amylase and scores for pancreatic histopathological lesions. Resveratrol treatment significantly increased the apoptotic indices of pancreatic acinar cells and the levels of FasL mRNA and protein in rats with SAP.</p><p><b>CONCLUSION</b>Resveratrol produces important therapeutic effect on SAP in rats by inducing pancreatic acinar cell apoptosis possibly as a result of up-regulated FasL gene expression.</p>

Evaluation on clinical outcomes of one-stage surgical treatment for atlanto -occipital malformation accompanied by cervical spondylotic myelopathy / 中华神经医学杂志

Objective To present a clinical and radiological evaluation of 22 consecutive patients with two kinds of cranio-cervical junction malformation who were managed in a one-stage operation with different approaches and methods. Methods Admitted into the Third Affiliated Hospital of Peking University from January 2002 to July 2007, 22 consecutive patients with two kinds of cranio-cervical junction disorders (congenital atlanto-occipital malformation accompanied by acquired cervical spondylotic myelopathy) underwent clinical, radiological and MRI evaluations. Clinical assessment consisted of a detailed history and neurological assessment and JOA grading. According to their clinical symptoms and imaging findings, the patients were treated with different operative approaches and methods (posterior occipitocervical decompression and/or cistema magna reconstruction for atlanto-occipital malformation, and anterior cervical microdiscectomy with titanium intervertebralcage fusion or expansive open-door laminoplasty for cervical spondylotic myelopathy, and cavitary drainage for syringomyelia). All of the patients were observed by follow-up to evaluate their post-operative conditions. Results Of the 22 cases, the operative outcome was graded as excellent(difference between pre- and post-operative JOA scores was more than 2) in 6 cases, as good (the difference was 1) in 13, as unchanged (the difference was 0) in 3. In the follow-up of 2-48 months, 20 cases get further better, and 2 cases became stable. Conclusion The patients with atlanto-occipitalmalformation and cervical spondylotic myelopathy can be treated by one-stage operation with different approaches and methods according to their clinical manifestations and signs and imaging features. The treatment can reach excellent clinical and radiological outcomes and low morbidity.

Level VI and II-V cervical lymph node metastasis in differentiated thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the characters of the cervical lymph node metastasis in differentiated thyroid carcinoma, and to provide evidence for proper surgery of differentiated thyroid carcinoma.</p><p><b>METHODS</b>From 1984 to 2000, 99 cases with differentiated thyroid carcinoma were performed thyroidectomy and neck dissection. The patients were followed up. A retrospective analysis was performed. Results In 99 cases with differentiated thyroid carcinoma, there were 61 papillary carcinoma, 13 papillary and follicular mixed carcinoma, 25 follicular carcinoma. According to 2002 UICC TNM classification, 60 cases were staged I, 1 case staged II, 5 cases staged III, 33 cases staged IV. Lobectomy and isthmectomy was performed in 80 cases, lobectomy was resected and opposite subtotal lobectomy in 15 cases, total thyroidectomy in 4 cases. One hundred and four neck dissection were performed in 99 cases (5 cases were bilateral neck dissection ). Among them, 66 (68 sides) were radical neck dissection, 33 (36 sides) were modified neck dissection. Pathological results showed that lymph nodes were positive in 86 sides of 83 cases. The rate of cervical lymph node metastasis was 83.8% (83/99). The positive rates of lymph node were 37.5% (39/104) in level VI and 76.9% (80/104) in II-V, which was statistically different (chi2 = 33.01, P < 0.01). The cervical lymph node metastasis in lateral area (level II-V) and that in VI had not relationship (chi2 = 2.08, P > 0.05). Ten and 15 year survival rates of all 99 cases were 88.3% and 84.5% respectively.</p><p><b>CONCLUSIONS</b>The occurrence of lymph node metastasis in level VI and level II was different and no relationship .One can not judge whether lateral neck metastasis by the lymph node statue in level VI only . Although they all had good prognosis, patients with positive nodes in level VI were not worse than that in lateral neck (II-V).</p>

Operation for well-differentiated invading thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the surgical data of well-differentiated invading thyroid carcinoma (WITC) , for acquiring the clinical experience.</p><p><b>METHODS</b>A retrospective analysis was made in 201 cases with well-differentiated invading thyroid carcinoma in Liaoning Tumour Hospital from 1984 to 2000. The data were statistically treated for survival curves according to the Kaplan-Meier method. The Log-Rank tests were employed to assess the statistical significance of various groups.</p><p><b>RESULTS</b>There were 3 cases with total laryngectomy and partial cervical trachea resection, 6 cases with partial cervical trachea resection, 67 cases with shaving off tumor from its surface, 9 cases with recurrent laryngeal nerve resection, 26 cases with shaving off tumor from the surface of recurrent laryngeal nerve. Other local structures invaded in 90 cases was resected with the thyroid tumour en bloc. One hundred and eighty nine cases with one thyroid lobe and isthmus ectomy, 5 cases one lobe and opsite subtotal ectomy. One hundred and twenty nine cases simultaneous neck dissection (5 cases bilateral neck dissection), in them, 75 neck radical neck dissection, 59 neck modified dissection. The 5-, 10- and 15-year living rates of well-differentiated thyroid carcinoma patients were 85.6% , 77.3% and 69.4% respectively. Multivariate analysis showed that patients' age, tumour invading structure were independent prognostic factors.</p><p><b>CONCLUSIONS</b>With proper operation, a better cure will be made in WITC.</p>

Pingyangmycin emulsion inducing apoptosis in infantile proliferating capillary hemangiomas / 中华整形外科杂志

<p><b>OBJECTIVE</b>To insight whether PYM emulsion induces apoptosis more rapidly in proliferating capillary hemangiomas so as to find the optimal method for hemangiomas' treatment.</p><p><b>METHODS</b>Thirty volunteers of infantile proliferating hemangiomas were divided into control group (15 cases) and mediational group (15 cases). PYM was made into emulsion and smeared on the surfaces of the lesion in mediational group with 3 times every day as well as only matrix in control group. The specimens were resected on day 7, then made into pathological slices and electron microscope slices in order to observe the cells microcosmic structure changes and ultrastructure changes. Furthermore , the apoptotic index of two groups were detected by the molecular biology method (TUNEL test ).</p><p><b>RESULTS</b>The number of apoptotic cells were lower in control group (AI 9.693 +/- 4.948) but higher apparently in mediational group (AI 39.373 +/- 15.927). The difference between two groups was significant (t = 6.893, P < 0.01) .</p><p><b>CONCLUSIONS</b>PYM emulsion can effectively accelerate apoptosis in infantile proliferating capillary hemangiomas . The mechanism is supposed to related to the blockage of cell cycle and activation of apoptotic signal transduction pathway.</p>

Colocalized expression of Fas and Fas-ligand in acute pancreatitis and its correlation with cell apoptosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the expressions of Fas and Fas-Ligand (FasL) genes in rats with acute pancreatitis (AP) and their relation to apoptosis of pancreatic acinar cells.</p><p><b>METHODS</b>Rat models of acute pancreatitis with varied severity were established by retrograde injection of sodium taurocholate at different concentrations via the apancreatobiliary duct. The expressions of Fas and FasL mRNAs and proteins were detected by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. The apoptosis of acinar cells was quantified by in situ nick ending-labeling technique.</p><p><b>RESULTS</b>of expressions fas, FasL mRNA and protein were colocalized in normal pancreatic acinar cells. In pancreatic tissue with less severe inflammation, the expressions of Fas and FasL mRNA increased significantly, and the apoptosis index of the acinar cells was also elevated; with the increase in the severity of the pancreatitis, the expression of Fas and FasL mRNAs were gradually lowered and apoptosis index of the acinar cells was increased.</p><p><b>CONCLUSION</b>Fas/FasL system might be involved in the renewal and homeostasis of normal pancreatic tissue, and constitute an important pathway mediating the apoptosis of pancreatic acinar cells in AP.</p>

Histopathological study on the regularity of pyriform sinus carcinoma invading adjacent tissue and structure / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the regularity invading adjacent tissue of pyriform sinus carcinoma.</p><p><b>METHODS</b>The whole organ serial section of 68 total or partial laryngectomy and hypopharyngectomy specimen of pyriform sinus carcinoma were histopathologically studied.</p><p><b>RESULTS</b>In 68 pyriform sinus carcinoma, invaded ventricular and paraglottic spaces was 63 and 38 cases respectively, the difference of invasive frequency of both spaces was significantly marked (chi2 = 21.37, P < 0.01). Thyroid cartilage had the most invaded frequency of 92.6% (63/68). The all touching and pressing invasion of laryngeal cartilage was 89 times, and infiltrating invasion was 51 times. The invasive frequency of lateral cricoarytenoid muscle, posterior cricoarytenoid one, thyroarytenoid and interarytenoid ones were 63.2% (43/68), 57.4% (39/68), 55.9% (38/68), 51.5% (35/68) respectively. The invasive frequency of cricoarytenoid and cricothyroid joints were 30.9% (21/68), 17.6% (12/68) respectively. The invasive frequency of superior laryngeal nerve was 67.7% (44/65) , and more than that of recurrent laryngeal nerve (18/65, 27.7%). The pyriform sinus medial wall carcinoma was 14 cases, lateral wall carcinoma 18 cases, medial and lateral wall carcinoma 36 cases. The invaded pyriform sinus apex was 34 cases, normal its apex was 26 ones, submucous invasion of its apex was 8 ones. Light lymphocytic invasion was 66.2% (45/68) and seen most in pyriform sinus carcinoma. Submucous and leaping invasion of pyriform sinus carcinoma were 24 and 8 cases.</p><p><b>CONCLUSIONS</b>Intralaryngeal invasion of pyriform sinus carcinoma arose through paraglottic space first. Laryngeal cartilage membrane and their cartilage were anatomical obstacle against cancerous invasion. Lateral cricoarytenoid muscle, posterior cricoarytenoid one, thyroarytenoid and interarytenoid ones were often invaded. Pyriform sinus medial wall carcinoma invaded intralaryngeal structure easily, its lateral wall carcinoma may invade upward, downward and outward along thyroid cartilage interior wall, medial and lateral wall carcinoma may invade intralaryngeal and extralaryngeal structure, and was the most serious lesion. The invasion of pyriform sinus apex is an important sign of pyriform sinus carcinoma spreading downward to inferior and peripheral tissues of hypopharynx.</p>

Re-operation for thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the results of re-operation of thyroidectomy for patients of thyroid carcinoma.</p><p><b>METHODS</b>268 patients of thyroid carcinoma received completion thyroidectomy were retrospectively reviewed from 1984 to 2000. There were 59 males and 209 female cases. 256 cases had received nodule enucleating or partial thyroidectomy in other hospitals and 12 cases had unilateral subtotal thyroidectomy in this hospital. The types of reoperation were: Total thyroidectomy for bilateral thyroid carcinoma (6 cases); expand isthmectomy for isthmus carcinoma (1 case). Lobectomy plus isthmectomy for unilateral disease (261) Simultaneous neck dissections were performed in 196 cases. Among them, 94 cases had classical neck dissection, 102 cases had modified neck dissection.</p><p><b>RESULTS</b>Pathological results confirmed that there were 78 cases with residual thyroid carcinoma. The rate of residual carcinoma was 29. 1% (78/268). There were 95 cases with lymphnode metastasis. The rate of lymphnode metastasis was 48.5% (95/196). The rate of recurrent laryngeal nerve injury was 1.1% (3/268). The 5-year and 10-year survival rates of patients were 94. 0% (251/267) and 85. 2% (127/149) respectively.</p><p><b>CONCLUSIONS</b>The residual carcinoma of completing thyroidectomy was high. Therefore re-operations of thyroid in selected cases were necessary.</p>