Preparative technique of anterolateral thigh flap / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the surgical techniques and methods of anterolateral thigh (myocutaneous) flap.</p><p><b>METHODS</b>Two hundred and forty-five consecutive free anterolateral thigh (myocutaneous) flaps for reconstruction of the defects of oral and maxillofacial region following the malignant tumors resection from January 2007 to August 2009 were reviewed. The incision was designed in the upper, middle or lower part 3 cm medial of the iliac-patella line according to the thickness of flaps needed. The perforators with suitable vessel diameter and strong pulse were chosen to make flaps with muscular tissue to fill dead space. More than one perforators were taken when large flaps were harvested. The size of the flaps ranged from 4 cm × 4 cm to 10 cm × 25 cm. Eighteen fat flaps were made thinned.</p><p><b>RESULTS</b>Of the 245 flaps harvested, 3 complete necrosis occurred, and the survival rate was 98.8%. Blisters occurred in 8 thinned flaps, but they all survived. All the wounds were closed directly except 5 cases, which needed skin graft because of too large defects of skin. All the skin graft came from the upper part of the wound of donor site. The shape and function were satisfactory after the reconstruction.</p><p><b>CONCLUSIONS</b>When anterolateral thigh (myocutaneous) flaps are harvested, the incision should be designed 3 cm medial of the iliac-patella line according to the thickness of flaps needed. It is helpful to find the perforators. All of the lower, middle and upper parts of anterolateral thigh region have cutaneous perforators. The skin defects within 8 cm can be closed directly, while the skin defects more than 8 cm often need skin grafting. The skin grafts can be taken from the upper part of donor site wounds.</p>

[Association analysis between polymorphisms of PON gene cluster with coronary heart disease in Chinese].

An extensive association analysis of PON gene cluster (PONs) with coronary heart disease (CHD) was performed in Chinese Han population. Eleven polymorphisms of PON1, PON2 and PON3 gene were investigated for association with CHD in 474 male patients and 475 controls. Univariate analyses showed the cases had significantly higher frequencies of PON1 192Q allele, 160R allele, -162A allele and PON2 311C allele than were seen in the controls. Logistic regression analyses revealed only the PON1 R160G and -162G/A polymorphisms remained significantly associated with CHD (P = 0.0054 and P = 0.0002). Haplotype analyses for various polymorphism combinations further confirmed the results of individual polymorphism analyses. Only the frequencies of haplotypes containing -162A allele were significantly higher,whereas only the frequencies of haplotypes containing 160G allele significantly lower in cases than those in controls in various polymorphism combinations. This extensive association study has identified the PON1 -162G/A and R160G polymorphisms to be independently associated with CHD in Chinese Han population,and warrants further study to elucidate the biological mechanism.

[Polymorphisms screening of PON gene cluster].

To identify all putative functional polymorphisms of PON gene cluster in Chinese Han population. Common polymorphisms of PON1, PON2 and PON3 gene were identified by directly sequencing of genomic DNAs derived from 48 randomly selected patients with coronary heart disease. We designed PCR arrays to amplify regions up to about 1kb upstream from transcription-initiation sites, i.e., putative promoter regions, all exons and adjacent non-coding regions. In a total length of 13.9 kb explored, we identified thirty-one SNPs, of which, 17 were first reported. A new coding polymorphism was detected in PON1 gene, which gives rise to amino acid substitutions of arginine (R) for glycine (G) at codon 160, whereas L54M polymorphism, which is common in white population, was not detected in our Han population. Among the five polymorphisms identified in PON3 gene, one in the promoter regions at position -133 (C/A) was located in a potential binding site for transcription factor LF-A1. Allele frequencies of some polymorphisms are significantly different from those reported in Caucasian populations. Complete or nearly complete association between polymorphisms was frequently observed. The identified multiple putative functional polymorphisms in PON gene cluster and their linkage disequilibrium patterns in combination with the population specific frequencies are of values for futher association studies of PON gene cluster with cardiovascular disease.

Paraoxonase gene cluster variations associated with coronary heart disease in Chinese Han women.

BACKGROUND: The oxidative modification of low-density lipoprotein in the artery wall is currently believed to be central to the pathogenesis of atherosclerosis. Paraoxonase (PON1), an enzyme located on high-density lipoprotein (HDL), can prevent low-density lipoprotein (LDL) from oxidation at a certain extent. Recent studies show two other members of paraoxonase gene family, PON2 and PON3, possess antioxidant properties similar to PON1. The aim of the present study was to explore the role of PON gene cluster on coronary heart disease (CHD) in Chinese Han women. METHODS: Seven polymorphisms including PON1 -107C > T, -162G > A, -831G > A, R160G, Q192R, PON2 S311C, and PON3 -133C > A were genotyped in 184 female patients with CHD and 239 female controls. The plasma PON1 activity toward phenylacetate was determined in 50 cases and 50 controls randomly selected. RESULTS: The plasma PON1 activities were significantly lower in cases than in controls. Individual SNP analysis showed that cases had significantly higher frequencies of PON1 -107T, -831G and PON2 311S alleles than controls. The genotype distributions of -107C > T were also significantly different between two groups. The odds ratios for the development of CHD were 1.66 for -107TC carriers and 2.0 for -107TT carriers, compared with -107CC carriers. Haplotype analyses showed that the distributions of haplotypes comprised of PON1 -107C > T and PON2 S311C were significantly different between cases and controls, with cases having higher frequency of T-S haplotype (44.8% vs. 36.3%, P = 0.013). The T-S haplotype remained significantly associated with CHD after adjusting environmental risk factors (P = 0.0069). CONCLUSIONS: This association study suggested that lower plasma PON1 activity increased the risk of CHD in Chinese women, which may be mediated by the higher frequency of -107T allele in cases. Haplotype analyses indicated that there might be some synergistic effects between the PON1 -107C > T and PON2 S311C polymorphisms.

[Progress in the studies on the relationship between the polymorphism of P22phox gene and coronary heart disease].

Reactive oxygen species (ROS) are thought to contribute to the progression of cardiovascular disease (CVD). At present, it has been known that the NADH/NADPH oxidase system is the major source of superoxide in the vascular system. Cytochrome b-245 (P22phox), which is a critical component of NADH/NADPH oxidase, plays an important role in electron transport and producing the superoxide anion. It is considerable to take attention to whether the polymorphism of P22phox gene is associated with a risk of coronary heart disease (CHD). To distinguish the relationship between them will be beneficial to elucidate the genetic mechanisms of CHD, and develop a new genetic marker to provide theoretical base for the prevention and cure of CHD.

[The insertion/deletion polymorphism of angiotensin I converting enzyme gene and coronary heart disease--discordant sib pair analysis and transmission/disequilibrium test].

To investigate whether the insertion/deletion polymorphism of the human angiotensin I converting enzyme gene increased the risk of coronary heart disease (CHD) in CHD pedigrees,discordant sib pair analysis (DSP) and transmission/disequilibrium test (TDT) were used. Forty-five CHD pedigrees with at least one CHD patient in the first degree relatives of probands were recruited during Oct. 1998 to Feb. 1999, of which parental genotype known, one or both parental genotype missing was 21.2 and 22 respectively. ACE genotype was measured by PCR technique. Conditional Logistic regression was used to analyze the DSP, and TDT-STDT program 1.1 was used for TDT and STDT. Univariable conditional Logistic regression did not find significant difference of the distribution of three different ACE genotypes in the 106 discordant sib pairs obtained from the 45 pedigrees. After adjusting effects of traditional risk factors of CHD, no significant difference of the distribution was found by multiple Logistic regression model. Neither the TDT for 13 nuclear families or STDT (sib transmission/disequilibrium test) for 24 sibships showed significant difference between the transmitted and untransmitted ACE gene D allele distributions. Our results show that the insertion/deletion polymorphism of ACE gene is not associated or linked with CHD in Chinese population.