RESUMEN
OBJECTIVE@#To provide useful information for selecting the most appropriate peripheral nerve injury model for different research purposes in nerve injury and repair studies, and to compare nerve regeneration capacity and characteristics between them.@*METHODS@#Sixty adult SD rats were randomly divided into two groups and underwent crush injury alone (group A, n = 30) or transection injury followed by surgical repair (group B, n = 30) of the right hind paw. Each group was subjected to the CatWalk test, gastrocnemius muscle evaluation, pain threshold measurement, electrophysiological examination, retrograde neuronal labeling, and quantification of nerve regeneration before and 7, 14, 21, and 28 days after injury.@*RESULTS@#Gait analysis showed that the recovery speed in group A was significantly faster than that in group B at 14 days. At 21 days, the compound muscle action potential of the gastrocnemius muscle in group A was significantly higher than that in group B, and the number of labeled motor neurons in group B was lower than that in group A. The number of new myelin sheaths and the g-ratio were higher in group A than in group B. There was a 7-day time difference in the regeneration rate between the two injury groups.@*CONCLUSION@#The regeneration of nerve fibers was rapid after crush nerve injury, whereas the transection injury was relatively slow, which provides some ideas for the selection of clinical research models.
Asunto(s)
Animales , Ratas , Fibras Nerviosas , Regeneración Nerviosa , Ratas Sprague-Dawley , Nervio Ciático/lesionesRESUMEN
As one of the most commonly diagnosed cancers in the world, female breast cancer is induced by the high level of estrogen. Saussureae Involucratae Herba(SIH), a gynecological medicinal, regulates estrogen-induced diseases. However, the therapeutic effect of SIH on breast cancer has not been reported. Therefore, this study aims to explore the potential efficacy of SIH on breast cancer based on in vitro experiment and network pharmacology. The inhibitory effect of SIH water extract on proliferation and migration of breast cancer MDA-MB-231 cells was examined. The result demonstrated SIH water extract significantly suppressed the proliferation of breast cancer cells(IC_(50)=6.47 mg·mL~(-1)) and also restricted the migration. A total of 39 components of SIH were retrieved from traditional Chinese medicine database(TCMD) and 160 targets of SIH were screened by target fishing with the PharmaDB database. The Online Mendelian Inheritance in Man(OMIM) was used to establish a 1 001-targets data set of breast cancer. Based on the overlaps(45) of targets between SIH and breast cancer, a protein-protein interaction(PPI) network was built to analyze the interactions among these targets with STRING platform and Cytoscape. Finally, through topology and GO and KEGG analysis, 8 targets, 101 pathways and 85 biological processes were found to involve the treatment of breast cancer by SIH. SIH may exert the anti-breast cancer effect by regulating cell cycle, inhibiting proliferation, migration and adhesion of cancer cells, and modulating estrogen receptor. This study clarified the mechanism of SIH in treating breast cancer, which lays a foundation for the further development of SIH.
Asunto(s)
Femenino , Humanos , Neoplasias de la Mama/genética , Bases de Datos Genéticas , Medicamentos Herbarios Chinos , Medicina Tradicional ChinaRESUMEN
Objective@#Hypoglossal nerve-facial nerve 'side'-to-side neurorrhaphy is a new method for the treatment of potential incomplete facial paralysis after acoustic neuroma. However, there are differences in postoperative outcomes among patients. This study analysed preoperative factors that may influence the treatment outcomes of neurorrhaphy.@*Methods@#We performed a retrospective study of 53 patients who were treated by neurorrhaphy for facial paralysis after acoustic neuroma resection. After a one-year follow-up period, the patients were divided into two groups according to facial functional outcome: better recovery or ordinary recovery. We analysed the following factors: gender, age, tumour size, and characteristics, tumour adhesion to the facial nerve, the duration of facial paralysis (DFP) and F wave appearance prior to neurorrhaphy (F wave).@*Results@#Univariate analysis showed significant differences between the two groups in DFP ( = 0.0002), tumour adhesion to the facial nerve ( = 0.0079) and F waves ( = 0.0048). Logistic regression analysis of these factors also showed statistical significance with values of 0.042 for the DFP, 0.043 for F waves, and 0.031 for tumour adhesion to the facial nerve.@*Conclusions@#Tumour adhesion to the facial nerve, F waves appearance and DFP prior to neurorrhaphy are the predominant factors that influence treatment outcomes.
RESUMEN
<p><b>OBJECTIVE</b>To investigate the optimal timing for the repair of persistent incomplete facial paralysis by hypoglossal-facial 'side'-to-side neurorrhaphy in rats.</p><p><b>METHODS</b>A total of 30 adult rats with crushed and bulldog-clamped facial nerve injury were randomly divided into 5 groups (n = 6 each) that were subjected to injury without nerve repair or with immediate repair, 2-week-delayed repair, 4-week-delayed repair, or 8-week-delayed repair. Three months later, the effects of repair in each rat were evaluated by facial symmetry assessment, electrophysiological examination, retrograde labeling, and axon regeneration measurement.</p><p><b>RESULTS</b>At 3 months after injury, the alpha angle significantly increased in the group of rats with 4-week-delayed repair compared with the other four groups. Upon stimulation of the facial nerve or Pre degenerated nerve, the muscle action potentials MAPs were recorded in the whisker pad muscle, and the MAP amplitude and area under the curve in the 4-week-delayed repair group were significantly augmented at 3 months post-injury. Similarly, the number of retrograde-labeled motor neurons in the facial and hypoglossal nuclei was quantified to be significantly greater in the 4-week-delayed repair group than in the other groups, and a large number of regenerated axons was also observed.</p><p><b>CONCLUSION</b>The results of this study demonstrated that hemiHN-FN neurorrhaphy performed 4 weeks after facial nerve injury was most effective in terms of the functional recovery of axonal regeneration and activation of facial muscles.</p>
Asunto(s)
Animales , Modelos Animales de Enfermedad , Nervio Facial , Cirugía General , Traumatismos del Nervio Facial , Cirugía General , Parálisis Facial , Cirugía General , Nervio Hipogloso , Cirugía General , Regeneración Nerviosa , Procedimientos Neuroquirúrgicos , Métodos , Ratas Sprague-Dawley , Resultado del TratamientoRESUMEN
<p><b>BACKGROUND</b>Sinonasal inverted papilloma (IP) is a rare benign tumor of the nasal cavities and paranasal sinuses. It is destructive or bone-remodeling, tends to recur after surgical resection, and has a significant malignant potential. The present study aimed to perform a retrospective analysis of patients with squamous cell carcinoma (SCC) arising from IP, including characteristics, survival outcome, and predictors of associated malignancy.</p><p><b>METHODS</b>The medical records of 213 patients diagnosed with IP from January 1970 to January 2014 were retrospectively reviewed. Eighty-seven patients were diagnosed with SCC/IP; their clinical characteristics, treatments, and survival outcomes were analyzed.</p><p><b>RESULTS</b>Of the 87 patients with SCC/IP, the 5- and 10-year overall survival outcomes were 39.6% and 31.8%, respectively. Twenty-nine of these patients received surgery and 58 received combined surgery and radiation. Of the patients with stages III-IV, the 5-year survival rate was 30.7% for those treated with surgery only and 39.9% for those given the combination treatment (P = 0.849). Factors associated with significantly poor prognosis were advanced-stage, metachronous tumors, or with cranial base and orbit invasion. Age, synchronous or metachronous tumors, and pathological stage were independent risk factors for mortality, shown by multivariate analysis.</p><p><b>CONCLUSION</b>Patients with SCC/IP had low overall survival outcomes. Advanced age, stage, and metachronous tumors are the main factors affecting prognosis. Treatment planning should consider high-risk factors to improve survival outcome.</p>
Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Carcinoma de Células Escamosas , Mortalidad , Análisis Multivariante , Papiloma Invertido , Mortalidad , Estudios RetrospectivosRESUMEN
<p><b>OBJECTIVE</b>To explore the proposal using nearby perforator flaps as alternative reconstructive choices for anterolateral thigh (ALT) flap when lacking useful perforator.</p><p><b>METHODS</b>From August 2010 to August 2012, 8 cases with head and neck cancer were found lacking reliable perforator during ALT flap elevation, a tensor fascia latae (TFL) flap or an anteromedial thigh (AMT) flap was used to complete the reconstruction.</p><p><b>RESULTS</b>All 8 alternative flaps were successfully harvested, other donor sites were not needed. Flap harvest time was 50-85 min. Of 5 TFL flaps, pedicle lengths were 6-10 cm, and the diameters of the arteries and veins were 2.5-3.0 mm and 2.5-3.5 mm respectively. Of 3 AMT flaps, pedicle lengths were 10-15 cm, the rectus femoris branch was used as pedicle in 1 flap, with artery and vein more than 1.0 mm in diameter, and the descending branch of the lateral circumflex femoral artery was used as pedicle in other 2 flaps, the diameters of the arteries were 3.5 and 3.0 mm respectively, the diameters of the veins were 3.5 mm. The donor sites were directly closed in 7 cases and skin graft was performed in another case. All the flaps were alive and no complication was found in the donor sites.</p><p><b>CONCLUSION</b>TFL or AMT flap is an good alternative to ALT flap lacking useful perforator.</p>
Asunto(s)
Humanos , Arterias , Neoplasias de Cabeza y Cuello , Cirugía General , Colgajo Perforante , Procedimientos de Cirugía Plástica , Métodos , Trasplante de Piel , Colgajos Quirúrgicos , Muslo , Cirugía GeneralRESUMEN
<p><b>BACKGROUND</b>Various tissue engineering strategies have been developed to facilitate axonal regeneration after spinal cord injury. This study aimed to investigate whether neural stem cells (NSCs) could survive in poly(L-lactic-co-glycolic acid) (PLGA) scaffolds and, when cografted with Schwann cells (SCs), could be induced to differentiate towards neurons which form synaptic connection and eventually facilitate axonal regeneration and myelination and motor function.</p><p><b>METHODS</b>NSCs and SCs which were seeded within the directional PLGA scaffolds were implanted in hemisected adult rat spinal cord. Control rats were similarly injured and implanted of scaffolds with or without NSCs. Survival, migration, differentiation, synaptic formation of NSCs, axonal regeneration and myelination and motor function were analyzed. Student's t test was used to determine differences in surviving percentage of NSCs. One-way analysis of variance (ANOVA) was used to determine the differences in the number of axons myelinated in the scaffolds, the mean latency and amplitude of cortical motor evoked potentials (CMEPs) and Basso, Beattie & Bresnahan locomotor rating scale (BBB) score. The χ(2) test was used to determine the differences in recovery percentage of CMEPs.</p><p><b>RESULTS</b>NSCs survived, but the majority migrated into adjacent host cord and died mostly. Survival rate of NSCs with SCs was higher than that of NSCs without SCs ((1.7831 ± 0.0402)% vs. (1.4911 ± 0.0313)%, P < 0.001). Cografted with SCs, NSCs were induced to differentiate towards neurons and might form synaptic connection. The mean number of myelinated axons in PLGA + NSCs + SCs group was more than that in PLGA + NSCs group and in PLGA group ((110.25 ± 30.46) vs. (18.25 ± 3.30) and (11.25 ± 5.54), P < 0.01). The percentage of CMEPs recovery in PLGA + NSCs + SCs group was higher than in the other groups (84.8% vs. 50.0% and 37.5%, P < 0.05). The amplitude of CMEPs in PLGA + NSCs + SCs group was higher than in the other groups ((1452.63 ± 331.70) µV vs. (428.84 ± 193.01) µV and (117.33 ± 14.40) µV, P < 0.05). Ipsilateral retransection resulted in disappearance again and functional loss of CMEPs for a few days. But contralateral retransection completely damaged the bilateral motor function.</p><p><b>CONCLUSIONS</b>NSCs can survive in PLGA scaffolds, and SCs promote NSCs to survive and differentiate towards neurons in vivo which even might form synaptic connection. The scaffolds seeded with cells facilitate axonal regeneration and myelination and motor function recovery. But regenerating axons have limited contribution to motor function recovery.</p>
Asunto(s)
Animales , Femenino , Embarazo , Ratas , Axones , Fisiología , Células Cultivadas , Electrofisiología , Técnica del Anticuerpo Fluorescente , Ácido Láctico , Química , Regeneración Nerviosa , Fisiología , Células-Madre Neurales , Biología Celular , Ácido Poliglicólico , Química , Ratas Wistar , Células de Schwann , Biología Celular , Traumatismos de la Médula Espinal , Terapéutica , Ingeniería de Tejidos , Métodos , Andamios del Tejido , QuímicaRESUMEN
<p><b>BACKGROUND</b>Staphylococcus aureus (S. aureus) remains as an important microbial pathogen resulting in community and nosocomial acquired infections with significant morbidity and mortality. Few reports for S. aureus in lower respiratory tract infections (LRTIs) have been documented. The aim of this study was to explore the molecular epidemiology of S. aureus in LRTIs in China.</p><p><b>METHODS</b>A multicenter study of the molecular epidemiology of S. aureus in LRTIs was conducted in 21 hospitals in Beijing, Shanghai and twelve other provinces from November 2007 to February 2009. All the collected S. aureus strains were classified as minimum inhibitory concentration (MIC), mecA gene, virulence genes Panton-Valentine Leukocidin (PVL) and γ-hemolysin (hlg), staphylococcal cassette chromosome mec (SCCmec) type, agr type, and Multilocus Sequence Typing (MLST).</p><p><b>RESULTS</b>Totally, nine methicillin-sensitive S. aureus (MSSA) and 29 methicillin-resistant S. aureus (MRSA) strains were isolated after culture from a total of 2829 sputums or bronchoalveolar lavages. The majority of MRSA strains (22/29) had a MIC value of ≥ 512 µg/ml for cefoxitin. The mecA gene acting as the conservative gene was carried by all MRSA strains. PVL genes were detected in only one S. aureus strain (2.63%, 1/38). The hlg gene was detected in almost the all S. aureus (100% in MSSA and 96.56% in MRSA strains). About 75.86% of MRSA strains carried SCCmec III. Agr type 1 was predominant (78.95%) among the identified three agr types (agr types 1, 2, and 3). Totally, ten sequence type (ST) of S. aureus strains were detected. A new sequence type (ST1445) was found besides confirming ST239 as the major sequence type (60.53%). A dendrogram generated from our own MLST database showed all the bootstrap values ≤ 50%.</p><p><b>CONCLUSION</b>Our preliminary epidemiology data show SCCmec III, ST239 and agr type 1 of S. aureus as the predominant strains in LRTIs in Mainland of China.</p>
Asunto(s)
Humanos , Alelos , Antibacterianos , Usos Terapéuticos , China , Epidemiología , Farmacorresistencia Bacteriana , Genética , Pruebas de Sensibilidad Microbiana , Estudios Prospectivos , Infecciones del Sistema Respiratorio , Epidemiología , Infecciones Estafilocócicas , Epidemiología , Staphylococcus aureus , VirulenciaRESUMEN
<p><b>OBJECTIVE</b>To evaluate the functional outcomes of patients who underwent total or near total glossectomy with pectoralis major myocutaneous flap (PMMF) or free flap (FF) reconstruction.</p><p><b>METHODS</b>Retrospective study of 38 consecutive patients undergoing total or near total glossectomy with PMMF or FF reconstruction. The outcomes of decannulation, feeding and speech function recovery were compared.</p><p><b>RESULTS</b>Near total glossectomy was performed in 33 patients and total glossectomy was performed in 5 patients. Twenty five patients underwent reconstruction with PMMF including 2 salvage reconstructions after free flaps failure. All PMMFs survived except one complete necrosis. The success rate of PMMF was 96.0% (24/25). Fifteen patients underwent reconstruction with FF. Two flaps developed complete necrosis and the success rate of FF was 86.7% (13/15). The difference in the rates between the two groups was not significant (P=0.545). In the PMMF and FF groups, the renewal of oral feeding were 65.2% (15/23) and 100% (13/13), P<0.05, and the tracheostomy decannulation were 52.2% (12/23) and 100% (12/12), P<0.05, respectively. Postoperative feeding function recovery was better in FF group than that in PMMF group (P=0.011). Single factor analysis showed that using FF and maintaining the continuity of the mandible were related to successful rate of renewal of oral feeding. Multivariate Logistic regression analysis showed that the continuity of the mandible was the only independent predictor for renewal of oral feeding. There was no significant difference in the postoperative speech functions between the two groups.</p><p><b>CONCLUSIONS</b>The continuity of the mandible is the major factor to restore the functional outcomes in feeding after total or near total glossectomy. Compared with PMMF, using FF is more beneficial to retain or rebuild the continuity of the mandible.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Colgajos Tisulares Libres , Mandíbula , Cirugía General , Procedimientos Quirúrgicos Otorrinolaringológicos , Métodos , Procedimientos de Cirugía Plástica , Métodos , Estudios Retrospectivos , Lengua , Cirugía General , Neoplasias de la Lengua , Cirugía GeneralRESUMEN
<p><b>OBJECTIVE</b>To investigate the results of reconstruction of hypopharyngeal circumferential and cervical esophageal defects with free jejunal transfer.</p><p><b>METHODS</b>Retrospective review of 112 patients who underwent pharyngoesophageal reconstruction with free jejunal interposition. Analysis was confined to the patients with advanced hypopharyngeal, esophageal or recurrent laryngeal squamous cell cancer. Kaplan-Meier method was used to identify the accumulative survival rate.</p><p><b>RESULTS</b>The free jejunal success rate was 94.6% (106/112). The pharyngocutaneous fistula rate and anastomoses narrow rate were 8.9% (10/112) and 12.5% (12/96) respectively. The perioperative mortality rate was 1.8% (2/112). Except 1 case of dead, 6 cases with flap failure and 2 cases with laryngeal preservation, other 103 cases had resumed oral feeding.</p><p><b>CONCLUSIONS</b>The success rate of free jejunal transplantation is high and free jejunal interposition is an ideal reconstruction method for patients who have hypopharyngeal circumferential and cervical esophageal defects after tumor resection.</p>
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Esofágicas , Cirugía General , Colgajos Tisulares Libres , Neoplasias Hipofaríngeas , Cirugía General , Yeyuno , Trasplante , Cuello , Procedimientos de Cirugía Plástica , Métodos , Estudios RetrospectivosRESUMEN
<p><b>OBJECTIVE</b>To evaluate the efficacy of the distinct free flaps in reconstruction of different types of maxillectomy defects.</p><p><b>METHODS</b>A retrospective reviews was performed of in 66 consecutive cases of reconstructions with free flaps for maxillary tumor ablation defects from October 1997 to June 2010. There were 43 patients who had recurrences after previous operations and 46 patients had accepted radiation therapy before. According to the classification of Brown's maxilla defect:10 cases were in class I, 13 in class II, 23 in class III and 20 in class IV. The reconstructive free flaps included 26 fibula flaps, 10 radial forearm flaps, 7 latissimus dorsi flaps, 7 rectus abdominis flaps, 7 anterolateral thigh perforator flaps, 5 deep inferior epigastric artery perforators, 2 latissimus dorsi/rib flaps and 2 iliac crest flaps. Postoperative features and functions were assessed in 29 patients.</p><p><b>RESULTS</b>The overall free flap success rate was 93.9% (62/66). Three rectus abdominis flaps and one fibula flap failed. There were 29 patients who received postoperative function assessment. Sixty-two percent of the patients restored to taking regular diets, 24 (82.8%) patients had normal language communication ability, and 25 (86.2%) patients were satisfied with their feature.</p><p><b>CONCLUSIONS</b>Radial forearm flap was recommended to reconstruct the class 1 defect, fibula flap to class 2 or class 3 and preformatted flap to class 4.</p>
Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Huesos Faciales , Cirugía General , Colgajos Tisulares Libres , Maxilar , Patología , Cirugía General , Neoplasias Maxilares , Clasificación , Patología , Cirugía General , Procedimientos de Cirugía Plástica , Métodos , Estudios RetrospectivosRESUMEN
Objective To prepare the 99Tcm-survivin mRNA antisense peptide nucleic acid (PNA)and investigate its value as a gene imaging agent in tumor bearing mice and early diagnosis in tumor.Methods Survivin mRNA antisense PNA and mismatch PNA were synthesized.Four amino acids (Gly- (D)Ala-Gly-Gly) and Aba (4-aminobutyric acid) were linked to the 5' end of PNA.Gly- (D)Ala-Gly-Gly served as a chelating moiety for strong chelation of 99Tcm and Aba acted as a spacer to minimize the steric hindrance.PNAs were labeled with 99Tcm by the ligand-exchange method.The labeling efficiency and radiochemical purity were measured by HPLC and ITLC methods.There were five BALB/c nude mice bearing human lung carcinoma ( A549 ) in each of antisense PNA and mismatch PNA groups.Gene imaging of 99Tcm-survivin mRNA antisense and mismatch PNAs were performed at 1,2 and 4 h post the injection,respectively,and the T/NT ratio was measured by the method of ROI.The statistical comparisons of average values were performed with the two-group t-test for independent sample by SPSS 13.0.Results The product kept stable in vitro.The labeling efficiency of 99Tcm-survivin mRNA antisense PNA was (95.48 ±1.92)% and more than 85% after the incubation for24 h in serum.The radiochemical purity was > 95%.The labeling efficiency of mismatch PNA was similar to the antisense PNA.99Tcm-survivin mRNA antisense PNA was especially uptaken by tumor lesion,and its accumulation reached the top at 4 h post the injection.T/NT ratios at 1,2,and 4 h were 2.70 ± 0.28,3.44 ± 0.35,4.21 ± 0.63,respectively.In the comparison,the T/NT ratio of 99Tcm-survivin mRNA mismatch PNA at 4 h (3.12 ±0.50) was significantly lower (t =2.918,P =0.019).Conclusions 99Tcm-survivin mRNA antisense PNA has high labeling efficiency,good stability and no need of purification.Its characteristic of especial uptake by tumor lesion provides the potential value in early diagnosis of tumor.
RESUMEN
ObjectiveTo investigate the value of 99Tcm labeled survivin mRNA antisense peptide nucleic acid (PNA) as an imaging agent in the specific diagnosis for carcinoma.MethodsSurvivin mRNA antisense PNA was labeled directly with 99Tcm by the ligand-exchange method.Twenty nude mice with lung carcinoma A549 xenografts were randomly divided into 4 groups.Three groups were used for biodistribution study and one group was used for imaging study.Other twenty mice infected by staphylococcus aureus underwent the same procedure.The biodistribution and imaging of 99Tcm-survivin mRNA antisense PNA was studied at 1,2 and 4 h respectively after the intravenous injection in nude mice bearing lung carcinoma A549 xenografts or inflammation models.SPSS 13.0 was used in the study and all data were analyzed by t test.ResultsBiodistribution results showed that the highest radioactivity was found in the liver,and then in the kidney.Four hours after the administration of the imaging agent,the radioactivity ratios of target-tonon target (T/NT,tumor or inflamumatory lesions to the contralateral regions) in tumor model group were significantly higher than those in inflammation model group ( 3.69 ± 1.13 vs 2.03 ± 0.47,t =3.01,P =0.02 ).Tumors were clearly visible in the tumor model groups at 0.5 h and still clearly seen at 4 h after the injection of antisense PNA.On the contrary,inflammatory lesions could not be seen clearly.Conclusion 99Tcm labeled survivin mRNA antisense PNA can be used to distinguish tumor from inflammation and it may provide a new feasible method for specific tumor diagnosis.
RESUMEN
<p><b>BACKGROUND</b>Acinetobacter baumanii (A. baumanii ) remains an important microbial pathogen resulting in nosocomial acquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A. baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple β-lactamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections (LRTIs).</p><p><b>METHODS</b>Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system. Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods.</p><p><b>RESULTS</b>Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanii strains to ampicillin and first- and second-generation cephalosporins (94.87%, 100% and 97.44%, respectively), but also to the third-generation cephalosporins (ceftriaxone at 92.31%, ceftazidine at 51.28%) and imipenem (43.59%) as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains. Aminoglycoside-modifying enzyme gene aac-3-Ia was found in 23 strains, and the aac-6'-Ib gene in 19 strains. aac-3-Ia and aac-6'-Ib genes hibernated in three A. baumanii strains that showed no drug-resistant phenotype.</p><p><b>CONCLUSIONS</b>A. baumanii can carry multiple drug-resistant genes at the same time and result in multi-drug resistance. Aminoglycoside-modifying enzyme genes could be hibernating in aminoglycoside sensitive strains without expressing their phenotype.</p>
Asunto(s)
Humanos , Acinetobacter , Genética , Metabolismo , Virulencia , Infecciones por Acinetobacter , Microbiología , Proteínas Bacterianas , Genética , Líquido del Lavado Bronquioalveolar , Microbiología , Farmacorresistencia Bacteriana Múltiple , Genética , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa , Infecciones del Sistema Respiratorio , Microbiología , Esputo , MicrobiologíaRESUMEN
<p><b>OBJECTIVE</b>To investigate the recovery of rat transected spinal cord injury after implantation of Schwann cells combined with poly (lactide-co-glycolide) (PLGA).</p><p><b>METHODS</b>Schwann cells were expanded, co-cultured with PLGA for 9 days in vitro, and then analyzed with scanning electron microscope (SEM). Rat spinal cord at the level of T(9) was transected. Schwann cells labeled with BrdU and PLGA scaffold were implanted to injury site. After 1, 3, 6 months, BrdU/MBP immunohistochemistry double staining, semi-thin sections stained thionin and ultra-thin section were performed to investigate myelin renew. BBB open field locomotion, motor evoked potential (MEP), compound muscle action potential (CMAP) and somatosensory evoked potential (SEP) were recorded.</p><p><b>RESULTS</b>Schwann cells grew well on PLGA under SEM. BrdU/MBP double positive cells would been seen, remyelination was thin and formed by Schwann cells at 6 months later under electron microscope (EM). BBB behavioral tests revealed no significant difference in recovery comparing with experiment group and control group. The results of MEP, CMAP and SEP showed no significant improvement in the conduction of spinal cord.</p><p><b>CONCLUSIONS</b>There are the compatibility between Schwann cells and PLGA. Although remyelination was found in morphology, function conduction of spinal cord failed to be established.</p>
Asunto(s)
Animales , Femenino , Ratas , Células Cultivadas , Modelos Animales de Enfermedad , Potenciales Evocados Motores , Inmunohistoquímica , Ácido Láctico , Química , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Regeneración Nerviosa , Ácido Poliglicólico , Química , Prótesis e Implantes , Ratas Wistar , Células de Schwann , Química , Trasplante , Traumatismos de la Médula Espinal , Cirugía General , Ingeniería de Tejidos , MétodosRESUMEN
<p><b>OBJECTIVE</b>The advantage of perforator flaps versus musculocutaneous flaps is the reduced morbidity of the donor site with preservation of the nerves, muscles and deep fascia. We evaluate the reconstruction result of perforator flaps in head and neck region.</p><p><b>METHODS</b>A retrospective review was performed of perforator flap reconstructions for head and neck tumor ablation defects since December of 2003 to May of 2005. There were 14 flaps including 8 anterolateral thigh (ALT) flaps and 6 deep inferior epigastric artery perforator (DIEAP) flaps. Recipient sites were subdivide into oral tongue (n=3), buccal mucosa (n=3), pharyngeal wall (n=3), base of tongue (n=2), skull base (n=1), scalp (n=1) and midface (n=1).</p><p><b>RESULTS</b>The overall free flap success rate was 93% (13/14). One DIEAP flap lost because the draining jugular vein was thrombosed. No complications were observed in the donor site, including wound dehiscence, weakness and hernia.</p><p><b>CONCLUSION</b>Perforator flaps are the new and reliable technique for head and neck surgical defects. Because of the minimum donor site morbidity, the perforator flap may be one of the primary choice in the near future.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello , Cirugía General , Periodo Posoperatorio , Procedimientos de Cirugía Plástica , Métodos , Estudios Retrospectivos , Trasplante de Piel , Colgajos QuirúrgicosRESUMEN
<p><b>OBJECTIVE</b>To explore the anterolateral thigh (ALT) free flap in which the donor site is less noticeable and the morbidity is minimal for the reconstruction of head and neck defect.</p><p><b>METHODS</b>A retrospective review was performed of 8 ALT flaps reconstructions for head and neck tumor ablation defects between Dec. 2003 and May 2005. Recipient sites were subdivided into pharyngeal wall (n = 3), oral tongue (n = 2), buccal mucosa (n = 1), base of tongue (n = 1) and skull base (n = 1). The operative technique of ALT flap was described.</p><p><b>RESULTS</b>All 8 free flaps survived. No complication was observed in the donor site, like wound dehiscence, weakness of the legs. The anatomy of the perforators were recognized as musculocutaneous pattern in all 8 cases. The size of the flap ranged from (4 to approximately 8) cm x (5 to approximately 10) cm. The average time of operation was 7 hours with a range of 5 to 10 hours. The average time cost for ATL flap harvest was 80 minutes with a range of 65 to 115 minutes.</p><p><b>CONCLUSIONS</b>Free ALT flap is a reliable reconstruction technique for head and neck surgical defects. Because of the minimum donor site morbidity and the concealed site, this flap is the ideal choice for reconstruction of head and neck surgical defects.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Escamosas , Cirugía General , Colgajos Tisulares Libres , Neoplasias de Cabeza y Cuello , Cirugía General , Microcirugia , Procedimientos de Cirugía Plástica , Métodos , Estudios Retrospectivos , Muslo , Cirugía GeneralRESUMEN
<p><b>OBJECTIVE</b>To study the protective effect of volatile anesthetics, isoflurane and sevoflurane, on ischemic neurons after cerebral ischemia-reperfusion in rats and its possible molecular mechanism.</p><p><b>METHODS</b>Rat cerebral ischemia-reperfusion model was developed by occlusion of the middle cerebral artery (MCA) and bilateral common carotid arteries (CCAs) 1 h after reperfusion. Using flow cytometry (FCM) and Northern blot hybridization, we calculated the number of apoptotic bodies and detected the expression of bcl-2 mRNA and interleukin-1beta converting enzyme (ICE) mRNA.</p><p><b>RESULTS</b>The apoptotic bodies in hippocampus analyzed by FCM peaked at appeared 24 h after reperfusion, and decreased about 54% and 40%, respectively, after treatment with isoflurane and sevoflurane, as compared with ischemic group. There was no significant difference in the expression of bcl-2 mRNA and ICE mRNA between the inhaled anesthetic groups and ischemic group in hippocampus 24 h after MCA/CCAs occlusion.</p><p><b>CONCLUSION</b>Isoflurane and sevoflurane partially inhibit apoptosis but have no significant effect on the expression of bcl-2 and ICE genes.</p>
Asunto(s)
Animales , Masculino , Ratas , Anestésicos por Inhalación , Farmacología , Apoptosis , Isquemia Encefálica , Quimioterapia , Caspasa 1 , Genética , Metabolismo , Citometría de Flujo , Hipocampo , Patología , Isoflurano , Farmacología , Éteres Metílicos , Farmacología , Neuronas , Metabolismo , Patología , Proteínas Proto-Oncogénicas c-bcl-2 , Genética , Metabolismo , Ratas Wistar , ReperfusiónRESUMEN
<p><b>OBJECTIVE</b>To investigate the prevention of Frey syndrome after parotidectomy.</p><p><b>METHODS</b>A prospective cohort study of 100 patients with parotid cancer who received parotid surgery was underwent in our hospital from 2001 to 2004. These patients were assigned to two groups, study group (50 cases) and control group (50 cases). The patients in the study group received parotidectomy and intraoperative placement of collagen pieces within the parotid bed, between the skin flap and the facial nerve. The patients in the control group received a conventional parotidectomy and no collagen pieces was implanted. All of the patients were followed-up and were evaluated for Frey syndrome with identical questionnaires.</p><p><b>RESULTS</b>Compared with control group, the incidence rate of Frey syndrome was significantly decreased in the study group (20% vs 60%, chi(2) = 15.04, P < 0.001). Postoperative incidence of facial contour apparent deformity was 80% (40/50) in control group and 44% (22/50) in study group (chi(2) = 12.26, P < 0.001).</p><p><b>CONCLUSIONS</b>Use of collagen pieces as an interposition fill barrier improves parotidectomy outcome by reducing the incidence of Frey syndrome, and it improves cosmetic results concurrently.</p>
Asunto(s)
Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Materiales Biocompatibles , Colágeno , Estudios de Seguimiento , Procedimientos Quirúrgicos Orales , Métodos , Neoplasias de la Parótida , Cirugía General , Estudios Prospectivos , Prótesis e Implantes , Sudoración GustativaRESUMEN
<p><b>OBJECTIVE</b>To discuss the use of free jejunal flap in reconstruction for circumferential defect after tumor resection of hypopharyngeal and cervical esophageal cancer.</p><p><b>METHODS</b>Retrospective review of 51 patients who underwent circumferential pharyngoesophageal reconstruction with free jejunal flap after tumor ablation.</p><p><b>RESULTS</b>In 51 patients, 5 had flap failure and the flap success rate was 90% (46/51). Forty-five patients had oral intake after operation excluding one who had anastomosis stenosis and 5 who had flap failure. The 1-year and 3-year survival rate was 62% and 48% respectively. Positive surgical marginal status and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area were indicators for bad prognosis. Except 5 patients who had flap failure, one of which died from mediastinal infection, no other severe complications occurred.</p><p><b>CONCLUSIONS</b>Patients reconstructed with free jejunal flap after resection of hypopharyngeal and cervical esophageal cancer had low mortality and few complications. Those without positive surgical margin and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area had higher survival rate. Most of them had good quality of life. The choice of free jejunal flap for reconstruction of hypopharyngoesophageal defect was appropriate in selected patients who had guarantee of negative surgical margin and no external invasion.</p>