Complications After Prepectoral Versus Subpectoral Breast Reconstruction in Patients Receiving Postmastectomy Radiation Therapy: A Systematic Review and Meta-Analysis.

BACKGROUND: Outcomes of immediate breast reconstructions can be influenced by postoperative radiotherapy. However, there is no clarity on the use of prepectoral or subpectoral breast reconstruction in the setting of postmastectomy radiation therapy (PMRT). We reviewed evidence on the complication rates of prepectoral and subpectoral breast reconstruction in women undergoing PMRT. METHODS: PubMed, Web of Science, and Embase databases were scanned for studies comparing complication rates of prepectoral and subpectoral breast reconstruction with PMRT. All complications were pooled in a random-effect meta-analysis to obtain odds ratio (OR). RESULTS: Eight observational studies were included. Meta-analysis showed no difference in the risk of infections (OR: 1.22 95% CI 0.79, 1.88 I2=0%), implant loss (OR: 0.86 95% CI 0.50, 1.50 I2=14%), seroma (OR: 1.01 95% CI 0.43, 2.34 I2=50%), hematoma (OR: 0.44 95% CI 0.12, 1.71 I2=0%), wound dehiscence (OR: 0.95 95% CI 0.42, 2.17 I2=0%), and skin necrosis (OR: 0.61 95% CI 0.21, 1.75 I2=36%), contracture (OR: 0.46 95% CI 0.15, 1.48 I2=54%) and the need for revision surgeries (OR: 0.85 95% CI 0.45, 1.60 I2=15%) between the prepectoral and subpectoral groups. CONCLUSIONS: Data from observational studies indicates that in appropriately selected patients there may not be any difference in the risk of early complications with prepectoral or subpectoral breast reconstruction with PMRT. Current evidence is limited by the small number of studies, short follow-up and selection bias. There is a need for randomized controlled trials comparing the two approaches to obtain robust evidence on long-term outcomes. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Botulinum toxin type A prevents the phenotypic transformation of fibroblasts induced by TGF­ß1 via the PTEN/PI3K/Akt signaling pathway.

Hypertrophic scar (HS) is a common type of dermatosis. Botulinum toxin type A (BTXA) can exert an anti­HS effect; however, the regulatory mechanisms underlying this effect remain unclear. Thus, the aim of this study was to examine the effects of BTXA on phosphatase and tensin homolog deleted on chromosome ten (PTEN) expression and the fibroblast phenotypic transformation induced by transforming growth factor (TGF)­ß1, which is an important regulatory factor involved in the process of HS. For this purpose, fibroblasts were treated with various concentrations of BTXA and then treated with 10 ng/ml of TGF­ß1 with gradient concentrations of BTXA. The proliferation and apoptosis of fibroblasts were measured by cell counting kit­8 assay (CCK­8) and flow cytometry, respectively. PTEN methylation was analyzed by methylation­specific PCR (MSP) and DNA methyltransferase (DNMT) activity was determined using a corresponding kit. RT­qPCR and western blot analysis were performed to detect the transcription and translation levels. The results revealed that BTXA suppressed the proliferation and increased the apoptosis of fibroblasts treated with TGF­ß1 in a dose­dependent manner. BTXA in combination with TGF­ß1 suppressed the expression of molecules related to the extracellular matrix (ECM), epithelial­mesenchymal transition (EMT) and apoptosis. BTXA reduced the PTEN methylation level and downregulated the expression levels of methylation­associated genes. BTXA also inhibited the phosphorylation of phosphoinositide 3­kinase (PI3K) and Akt. On the whole, the findings of this study indicate that BTXA may inhibit fibroblast phenotypic transformation by regulating PTEN methylation and the phosphorylation of related pathways. The findings of this study can provide a theoretical basis for HS treatment.

Anticancer action of lactucopicrin in SKMEL-5 human skin cancer cells is mediated via apoptosis induction, G2/M cell cycle arrest and downregulation of m=TOR/PI3K/AKT signalling pathway.

PURPOSE: Skin cancer is one of the cancers responsible for significant morbidity and mortality across the globe. The treatment options for skin cancer are limited and associated with significant toxicity. Therefore, researches have been directed towards exploring molecules that could prove beneficial in the treatment of this disease. Lactucopicrin is an important sesquiterpene lactone with important pharmacological potential. METHODS: In the present study the anticancer effects of lactucopicrin against human skin SKMEL-5 cancer cell line were investigated. Antiproliferative effects were examined by CCK-8 assay. Apoptosis was detected by DAPI and annexin V/propidium iodide (PI) staining. Cell cycle analysis was carried out by flow cytometry. Protein expression was determined by western blotting. RESULTS: The results indicated that lactucopicrin exerts significant anticancer effects on the SKMEL-5 cells with an IC50 of 7.5 µM. Its anticancer effects were due to induction of apoptosis. Lactucopicrin could upregulate the expression of Bax which was associated with concomitant downregulation of Bcl-2 expression. Additionally, lactucopicrin induced G2/M cell cycle arrest in SKMEL-5 cells in a dose-dependent manner and also inhibited the m-TOR/PI3K/AKT signalling pathway. CONCLUSION: These results indicate that lactucopicrin shows potent anticancer action in the tested skin cancer cells and may prove a prospective lead molecule for the treatment of skin cancer.

[Species Identification of Puparium Samples of Common Sarcosaphagous Flies Based on Molecular Marker Analysis].

OBJECTIVE: To investigate the application value of empty puparia in species identification of common sarcosaphagous flies. METHODS: Fifty-five samples of adult flies and their empty puparia were collected. All the samples were identified as 2 families, 6 genera and 8 species by morphological characteristics. The samples were divided into 3 groups according to their time period between eclosion and our analyses: less than 2 years (n = 23), 2-5 years (n = 20), and more than 5 years (n = 12). The mtDNA of each sample was extracted by CTAB method. The purity and concentration of DNA were tested. PCR products were amplified using two sets of primers. Two sequences of CO I gene (sequence I: 498 bp, sequence II : 841 bp) from each sample were compared to the sequences in GenBank using BLAST for species identification. RESULTS: The mtDNA was extracted successfully from all the samples. DNA concentration of adult chest muscle preserved less than or equal to 5 years and empty puparia preserved less than 2 years ranged from 1.0 to 3.0 µg/µl, and the value of A260/A280 ranged from 1.6 to 1.8. The purity and concentration was lower than 1.6 and 1.0 µg/µl, when the adult chest muscle and empty puparia preserved more than 5 years and 2 years, respectively. DNA concentration of the samples significantly decreased with the prolonged preservation time (P < 0.01). Two sequences of CO I gene was amplified in adult chest muscle and empty puparia which preserved less than 2 years. The success rates of amplification decreased with the prolonged preservation time, especially for the sequence II (P < 0.01). The morphological identification of 8 species did not match exactly with the results based on the COI gene, correct species identification occurred in 6 and 7 species out of 8 based on the two sequences, respectively, and their Max ident value exceeded 97% CONCLUSION: Empty puparium samples can be used to extract mtDNA and identify species.

Magnetic bead-based separation of sperm from buccal epithelial cells using a monoclonal antibody against MOSPD3.

Forensic DNA analysis of sexual assault evidence requires unambiguous differentiation of DNA profiles in mixed samples. To investigate the feasibility of magnetic bead-based separation of sperm from cell mixtures using a monoclonal antibody against MOSPD3 (motile sperm domain-containing protein 3), 30 cell samples were prepared by mixing 10(4) female buccal epithelial cells with sperm cells of varying densities (10(3), 10(4), or 10(5) cells/mL). Western blot and immunofluorescence assays showed that MOSPD3 was detectable on the membrane of sperm cells, but not in buccal epithelial cells. After biotinylated MOSPD3 antibody was incubated successively with the prepared cell mixtures and avidin-coated magnetic beads, microscopic observation revealed that each sperm cell was bound by two or more magnetic beads, in the head, neck, mid-piece, or flagellum. A full single-source short tandem repeat profile could be obtained in 80% of mixed samples containing 10(3) sperm cells/mL and in all samples containing ≥10(4) sperm cells/mL. For dried vaginal swab specimens, the rate of successful detection was 100% in both flocked and cotton swabs preserved for 1 day, 87.5% in flocked swabs and 40% in cotton swabs preserved for 3 days, and 40% in flocked swabs and 16.67% in cotton swabs preserved for 10 days. Our findings suggest that immunomagnetic bead-based separation is potentially a promising alternative to conventional methods for isolating sperm cells from mixed forensic samples.