ABSTRACT
Objective@#To discuss the clinical results of three-stage functional ear reconstruction for microtia with congenital aural stenosis (CAS).@*Methods@#From September 2007 to June 2017, 53 cases of microtia with CAS underwent all three-stage functional ear reconstruction, and 445 cases of microtia underwent two stage ear reconstruction without meatoplasty at the same periods. First-stage of three-stage functional ear reconstruction: it was similar to Nagata technique. The crus of helix could not be too long, since we needed the space for the next meatoplasty. Second-stage: it was a modified meatoplasty with endoaural-conchal incision, in which two local rotation flaps and a transposition split-thickness scalp flap were used to widen the stenotic external auditory canal (EAC) and reconstructed the tympanic membrane. Third-stage: it was a modified technique for firm elevation of the reconstructed auricle by using the retro-auricular fascial flap wrapping a porous polyethylene (Medpor) wedge or stored cartilage as the strut. If the patient showed EAC cholesteatoma or infection, we could do the meatoplasty at the first stage. If the patient had completed ear reconstruction, meatoplasty could be done at the third stage.@*Results@#53 cases underwent all three-stage functional ear reconstruction. There were 41 cases (77.4%) obtaining serviceable hearing. The complication rate of meatoplasty was 1.89% and the complication rate of ear reconstruction was 5.66%. Among the 445 cases of microtia treated with two stage ear reconstruction without meatoplasty, the complication rate of ear reconstruction was 9.43%. There was no significant difference between the two groups (P>0.05).@*Conclusions@#Our novel three-stage functional ear reconstruction is a feasible strategy for microtia with CAS. The patients can obtain satisfactory auricle and serviceable hearing. The results are stable and can improve the life quality in both aesthetics and hearing function.
ABSTRACT
The epoxy chloropropane Kelch sample related protein-1(Keap1)-nuclear factor erythroid-2 related factor(Nrf2)/antioxidant response element(ARE)signal pathway is of critical importance in cellular antioxidant response. The induction of down?stream phaseⅡmetabolic enzymes and antioxidant protein/enzyme offers cellular protection under oxidative stress. Research of Nrf 2 protein has gained much attention in recent years. This article reviewes Keap1-Nrf2/ARE signal pathway in three perspectives:the ba?sic structure including the structure of Nrf2,Keap1 and ARE,their involvement in anti-oxidative actions including the basic function of Keap1-Nrf2/ARE signal pathway and the downstream activation of phaseⅡmetabolic enzymes and antioxidant protein/enzyme,as well as their regulation mechanisms,such as decoupling,degradation,the latch and the hinge.
ABSTRACT
Acute promyelocytic leukemia (APL) is a distinctive subtype of acute myeloid leukemia with a distinct biology and clinical presentation. Its molecular biology characteristic is a aberrant chromosomal translocation of the promyelocytic leukemia (PML) gene on chromosome 15 and the retinoic acid receptor α(RARα) gene on chromosome 17. This translocation generates PML-RARα fusion protein, which plays an important role in the genesis, development, diagnosis and therapy of APL. The PML protein has a close relationship with PML-RARαfusion gene. This article mainly summarizes the character, the function of PML protein and the degradation pathway of PML-RARα.
