Hyperbaric oxygen treatment on keloid tumor immune gene expression / 中华医学杂志(英文版)

BACKGROUND@#Hyperbaric oxygen treatment (HBOT) has been demonstrated to influence the keloid recurrence rate after surgery and to relieve keloid symptoms and other pathological processes in keloids. To explore the mechanism of the effect of HBOT on keloids, tumor immune gene expression and immune cell infiltration were studied in this work.@*METHODS@#From February 2021 to April 2021, HBOT was carried out on keloid patients four times before surgery. Keloid tissue samples were collected and divided into an HBOT group (keloid with HBOT before surgery [HK] group, n = 6) and a non-HBOT group (K group, n = 6). Tumor gene expression was analyzed with an Oncomine Immune Response Research Assay kit. Data were mined with R package. The differentially expressed genes between the groups were compared. Hub genes between the groups were determined and verified with Quantitative Real-time PCR. Immune cell infiltration was analyzed based on CIBERSORT deconvolution algorithm analysis of gene expression and verified with immunohistochemistry (IHC).@*RESULTS@#Inflammatory cell infiltration was reduced in the HK group. There were 178 upregulated genes and 217 downregulated genes. Ten hub genes were identified, including Integrin Subunit Alpha M (ITGAM), interleukin (IL)-4, IL-6, IL-2, Protein Tyrosine Phosphatase Receptor Type C (PTPRC), CD86, transforming growth factor (TGF), CD80, CTLA4, and IL-10. CD80, ITGAM, IL-4, and PTPRC with significantly downregulated expression were identified. IL-10 and IL-2 were upregulated in the HK group but without a significant difference. Infiltration differences of CD8 lymphocyte T cells, CD4 lymphocyte T-activated memory cells, and dendritic resting cells were identified with gene CIBERSORT deconvolution algorithm analysis. Infiltration levels of CD4 lymphocyte T cell in the HK group were significantly higher than those of the K group in IHC verification.@*CONCLUSION@#HBOT affected tumor gene expression and immune cell infiltration in keloids. CD4 lymphocyte T cell, especially activated memory CD4+T, might be the key regulatory immune cell, and its related gene expression needs further study.

Necroptosis was found in a rat ischemia/reperfusion injury flap model / 中华医学杂志(英文版)

BACKGROUND@#Necroptosis is a new form of cell death that has been identified as a third pathway causing cell death. In this study, necrostatin-1 (Nec-1) was used to determine whether necroptosis exists in a rat ischaemia/reperfusion injury flap model.@*METHODS@#In this study, twenty male Sprague-Dawley rats were divided randomly into two groups: a control group (CTL group) and a Nec-1 group. Each abdominal skin flap underwent 3 h of ischaemia and then reperfusion. Fifteen minutes before and after reperfusion, phosphate buffer saline (PBS) was administered intraperitoneally to the CTL group, while Nec-1 was administered intraperitoneally to the Nec-1 group. Twenty-four hours after reperfusion, the whole flap was divided equally into 54 sections. Flap blood perfusion was measured. One sample was taken randomly from each row. Morphological changes, apoptosis, receptor-interacting protein-1 (RIP-1) expression and caspase-3 activity were observed and detected. The measurements between the two groups were compared with the independent t-test, and a P value of <0.05 was considered statistically significant.@*RESULTS@#Compared to flaps in the CTL group, flaps in the Nec-1 group showed longer survival rates, better blood perfusion and less inflammatory infiltration. The total flap area considered to have survived was 70.88 ± 10.28% in the CTL group, whereas 80.56 ± 5.40% of the area was found to be living in the Nec-1 group (Nec-1 vs. CTL, t = -2.624, P < 0.05). For some rows, there were significant differences in cell apoptosis between the two groups, the apoptosis index (AI) in rows "9 cm", "7 cm", "6 cm" and "5 cm" was significantly lower in the Nec-1 group than that in the CTL group (Nec-1 vs. CTL, P < 0.05). RIP-1 expression was much lower in the Nec-1 group than that in the CTL group in rows "5 cm" to "9 cm" (Nec-1 vs. CTL, P < 0.05). No significant differences in caspase-3 activity were found.@*CONCLUSION@#According to the results, necroptosis was present in a rat abdominal ischaemia/reperfusion injury flap model.

Hyperbaric oxygen therapy improves the effect of keloid surgery and radiotherapy by reducing the recurrence rate / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue following an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy (HBOT) to reduce the keloid recurrence rate after surgical excision and radiotherapy.@*METHODS@#(1) A total of 240 patients were randomly divided into two groups. Patients in the HBOT group (O group) received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy (K group). (2) Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin (H&E) staining was used to observe keloid morphology. Certain inflammatory factors (interleukin-6 (IL-6), hypoxia-inducible factor-1α (HIF-1α), tumor necrosis factor-α (TNF-α), nuclear factor κB (NF-κB), and vascular endothelial growth factor (VEGF)) were measured using immunohistochemical staining.@*RESULTS@#(1) The recurrence rate of the O group (5.97%) was significantly lower than that of the K group (14.15%), P<0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group (P<0.05). (2) Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group.@*CONCLUSIONS@#Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.

Effects of hyperbaric oxygen preconditioning on ischemia-reperfusion inflammation and skin flap survival / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hyperbaric oxygen preconditioning (HBO) is a new method of ischemia preconditioning. In this study, we examined its effects on skin flap survival and the mechanisms involved.</p><p><b>METHODS</b>Thirty-six rats were divided into three groups: HBO preconditioning, control, and sham groups. An extended epigastric adipocutaneous flap based on the right superficial epigastric artery and vein was raised. A 3-hour period of flap ischemia was induced by clamping the pedicle vessels with a microvascular clamp. At the end of ischemia induction, the clamp was removed and the flap was resutured. Rats in the HBO preconditioning group were treated with HBO four times before surgery. Microcirculation in the skin flap was measured on postoperative days 1, 3 and 5. The size of the flap was measured on postoperative day 5, before the animals were sacrificed. Samples of the skin flap were prepared and stained with hematoxylin and eosin. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the flap samples were measured.</p><p><b>RESULTS</b>Surviving flap size was significantly higher in the HBO preconditioning group compared with controls, with a reduced inflammatory response and increased perfusion. IL-1, TNF-α, and IL-6 levels in the HBO preconditioning group were lower than in controls.</p><p><b>CONCLUSIONS</b>HBO preconditioning improved flap survival in this ischemia-reperfusion rat model. The mechanisms responsible for this effect may relate to attenuation of the inflammatory response and increased flap perfusion following HBO preconditioning.</p>

An individualized approach combining local flaps with radiotherapy for the treatment of auricle keloid / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate an individualized approach to the treatment of auricle keloid to maintain the normal appearance of external ear and meanwhile reduce the recurrence.</p><p><b>METHODS</b>Different local flaps were performed according to the location of the keloid in our approach. The auricle was divided into different anatomical regions and all the patients received local postoperative radiotherapy.</p><p><b>RESULTS</b>Of 68 patients with auricle keloid received the individualized approach, 3 cases suffered delayed healing due to partial flap necrosis. The remaining patients were followed up for 8-21 months(mean:11.5 months) . Recurrence occurred in one patient(1.47%) .</p><p><b>CONCLUSION</b>The individualized approach combining local flaps with radiotherapy in treating auricle keloid can effectively maintain the normal ear appearance with low recurrence rate.</p>

The investigation of behavior problem with secondary deformity of cleft lip / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the behaviors of the children suffered from the secondary deformity after the repair of the cleft lip.</p><p><b>METHODS</b>With the application of the PCPI, eighty patients with the secondary deformity after the repair of the cleft lip were selected in this study and 134 normal children was used for the control.</p><p><b>RESULTS</b>In the age between 6 and 11 years, there were no significant difference of the behaviors between the children suffered from secondary deformity of cleft lip and the normal children,but in the age from 12 to 16, the children with the deformity showed more behavior problems with the social withdraw and the poor social relationships, compared with the normal children.</p><p><b>CONCLUSION</b>The children with the secondary deformity after cleft lip repair in adolescence could have the tendency to suffer from the behavior problems, especially showing the social withdraw and the poor social relationships.</p>

Leptin as a survival enhanced-factor in grainy fat transplantation / 中华整形外科杂志

<p><b>OBJECTIVE</b>This experiment is to test the survival enhance effect of leptin in grainy fat transplantation.</p><p><b>METHODS</b>The 0.6 g grainy fat was obtained from the Wistar mouse subcutaneous tissue in the abdomen. It was then mixed with 0.9% NS and 20 ng/ml leptin and transplanted in the head subcutaneously. The transplanted tissue was taken out after 10, 20 and 40 days. After being weighed, the tissue was dyed with HE staining and VEGF staining. The data was analyzed with SPSS software.</p><p><b>RESULTS</b>The fibrous membrane around the tissue in leptin group was thin and there was less fat cell necrosis, compared with the control group. The remained-weight rate was 108.3%, 83.3% and 66.3% in 10, 20 and 40 days after the surgery. The differences were statistic significant between the leptin groups and the control (P < 0.05). The examinations of the HE and VEGF stain showed that there was the rich vascularization in leptin treated tissue.</p><p><b>CONCLUSION</b>Leptin could enhance the survival of the transplanted grainy fat due to its angiogenesis effect.</p>

Clinically analyzing the possible side-effects after injecting hydrophilic polyacrylamide gel as a soft-tissue filler / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the possible side-effects after injecting hydrophilic polyacrylamide gel for augmentation of the soft-tissue.</p><p><b>METHODS</b>Fifteen patients with some side-effects after injecting the hydrophilic polyacrylamide gel had been undergoing for the treatment in our unit from 2000 to 2001. Their symptoms were analyzed and the specimen of the tissue was also removed for pathologic examination.</p><p><b>RESULTS</b>The major complaints of the patients after injecting hydrophilic polyacrylamide gel were feeling pain(60.00%), uncomfortable (13.33%), no cosmetic improvement results (33.33%), secondary deformity (20.00%), long-lasting swelling (6.67%), and nodules (80.00%). The pathologic examination was showing the capsule formation (53.33%), macrophagocyte infiltration (60.00%) and granuloma producing (20.00%).</p><p><b>CONCLUSION</b>Clinical application of the hydrophilic polyacrylamide gel may result in some serious side-effects. It should be cautious to the physicians who may apply the product for clinic use.</p>