Divisional Reconstruction Strategy: The Repair of Perineal Skin Defect After Tumor Resection.

BACKGROUND AND AIMS: The unique anatomical and physiological function of the perineum region makes it difficult to be repaired after tumor resection. We aim to evaluate the efficacy of PSC divisional reconstruction strategy in the reconstruction of perineal skin defect. MATERIALS AND METHODS: This study includes patients undergoing perineal skin defect reconstruction with PSC strategy-P (penis), S (scrotum), C (circum-penoscrotal skin) divisional reconstruction strategy. RESULTS: From August 2013 to August 2018, 47 patients were enrolled in the surgical procedure. The defect area after resection measured 2 cm × 2.5 cm, minimum, and 12 cm × 18 cm, maximum. Among them, the cases involved one, two, and three zones are 12, 10, and 25, respectively. The skin defects were divisionally repaired. All flaps were well survived without complications or scar contracture. No tumor recurrence happened. CONCLUSION: The application of PSC divisional reconstruction strategy is a promising way to repair wounds in circum-penoscrotal skin area. Moreover, this strategy is easy to process and shows no significant complications during follow-up period.

Relationship between electrocardiographic changes and EPO level in stable CAD patients with autonomic nerve functional damage.

OBJECTIVE: To investigate the relationship between electrocardiographic changes and erythropoietin (EPO) level in stable coronary artery disease (CAD) patients with autonomic nerve functional damage. PATIENTS AND METHODS: Clinical data of 96 stable CAD patients who were treated in our hospital from January 2017 to December 2019 were retrospectively analyzed. All patients were grouped according to whether autonomic nerve function damage was combined; the baseline characteristic data and the morphological characteristics of ECG scattergram were compared between 2 groups, and the relationship between ECG scattergram and EPO level & autonomic nerve function was analyzed. RESULTS: The levels of EPO and red cell volume distributing width (RDW) in stable CAD patients with autonomic nerve dysfunction were significantly higher than that of CAD patients without autonomic nerve dysfunction (p<0.05). The length of scattergram in stable CAD patients with autonomic nerve dysfunction was significantly shorter than that of those without autonomic nerve dysfunction (p<0.05). The cometary sign proportion of ECG scattergram in stable CAD patients with autonomic nerve dysfunction was significantly lower than that of stable CAD patients without autonomic nerve dysfunction (p<0.05). There was negative correlation between EPO levels and scattergram length in stable CAD patients with and without autonomic nerve dysfunction (r=0.44, p=0.02). There was no correlation between EPO levels and scatter width in stable CAD patients with and without autonomic nerve dysfunction (r=0.10, p=0.58). The results of binary logistic regression analysis showed that EPO level was the independent risk factor for the occurrence of autonomic dysfunction in patients with stable CAD (p<0.05). The length of scattergram was the independent protective factor of autonomic nerve function impairment in patients with stable CAD (p<0.05). The AUC of EPO level and scattergram was 0.74 and 0.72 respectively, both of which have similar prediction value. CONCLUSIONS: The level of EPO in stable CAD patients with autonomic nerve dysfunction was related to the change of ECG; and the EPO level and scattergram length can be used to predict the occurrence risk of autonomic nerve dysfunction.

MiR-29 regulates retinopathy in diabetic mice via the AMPK signaling pathway.

OBJECTIVE: This work aims to study the influence of micro-ribonucleic acid (miR)-29 on the retinopathy in diabetic mice via the adenosine 5'-monophosphate-activated protein kinase (AMPK) signaling pathway. MATERIALS AND METHODS: A total of 24 C57BL/6 mice were randomly divided into normal group (n=12) and model group (n=12). Mice in the normal group were given to normal diet, and those in the model group were prepared for establishing diabetes mouse model. After animal procedures, electroretinogram was performed to detect the latent period and amplitude of b-wave. The expressions of B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated X protein (Bax) were detected via immunohistochemistry. The protein levels of the phosphorylated AMPK (p-AMPK) and phosphorylated mammalian target of rapamycin (p-mTOR) were determined using Western blotting. Moreover, miR-29 expression and cell apoptosis were detected via quantitative Polymerase Chain Reaction (qPCR) and terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL), respectively. RESULTS: Compared with those in the normal group, the latent period prolonged and amplitude of b-wave decreased in the model group (p<0.05). Immunohistochemistry showed that compared with normal group, mice in the model group exhibited increased Bax expression and decreased Bcl-2 expression (p<0.05). The Western blotting analysis showed that the protein levels of p-AMPK decreased and p-mTOR increased in the model group compared with those in the normal group (p<0.05). The qPCR revealed that compared with the normal group, the model group had notably decreased miR-29 expression (p<0.05). TUNEL detection displayed that the apoptotic rate was remarkably elevated in the model group compared with that in the normal group (p<0.05). CONCLUSIONS: Inhibition of miR-17-5p up-regulates the expression of VEGF-A and GDNF in MSCs, and promotes the repair of spinal cord injury by MSCs.

Targeted hepatocellular carcinoma proapoptotic BikDD gene therapy.

Hepatocellular carcinoma (HCC), the third leading cause of cancer death in the world, is the most general type of primary liver cancer. Although current treatment modalities, such as liver transplantation, resection, percutaneous ablation, transarterial embolization, chemotherapy and radiotherapy are potentially curative, these methods are not universally applicable to all of HCC patients, especially for those with poor prognosis in which no effective remedy is available. Therefore, development of novel therapeutic approach for the treatment of HCC is urgently needed. In the current study, we developed a promising HCC-targeted gene therapy vector driven by liver cancer-specific α-fetoprotein promoter/enhancer coupled to an established platform technology. The activity of this expression vector is comparable with or even higher than that of strong cytomegalovirus (CMV) promoter and exhibits strong promoter activity in liver cancer cells/tumors, but has nearly no or very low activity in normal cells/organs in vitro and in orthotopic animal models in vivo. Its cancer specificity exceeds that of the CMV promoter, which expresses non-specifically in both normal and tumor cells. In addition, targeted expression of a therapeutic BikDD, a mutant of proapoptotic gene Bik effectively and preferentially killed liver cancer cells, but not normal cells and significantly repressed growth of HCC tumors, and prolonged survival in multiple xenograft and syngeneic orthotopic mouse models of HCC through intravenous systemic gene delivery. Importantly, systemic administration of BikDD by our expression vector exerted no systemically acute toxicity compared with CMV-BikDD in mice. Taken together, this study elucidates a relatively safe and highly effective and specific systemic gene therapy strategy for liver cancer, and is worthy of further development for future clinical trials.

Evidence for changing of cosmic ray composition between 10(17) and 10(18) eV from multicomponent measurements

The average mass composition of cosmic rays with primary energies between 10(17) and 10(18) eV has been studied using a hybrid detector consisting of the High Resolution Fly's Eye (HiRes) prototype and the MIA muon array. Measurements have been made of the change in the depth of shower maximum and the muon density as a function of energy. The results show that the composition is changing from a heavy to lighter mix as the energy increases.