Although current epidemiological studies have not demonstrated that there is an association between serum cholesterol concentration and stroke, the effect of statins has been confirmed in the high-risk (mainly coronary heart disease, diabetes or hypertension) and advanced-age populations in the primary prevention studies. Statins have a good safety profile, and they do not increase the risk of intracerebral hemorrhage. The effect of statins in the secondary prevention of ischemic stroke remains to be confirmed by the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Study.

Objective This is the first study to explore clinical application value of serum Dickkopf-1 (DKK-1) detection in diagnosis of heptocellular carcinoma (HCC) by magnetic solid phase chemiluminescent immunoassay.Methods The level of serum DKK-1 and AFP in 205 cases of HCC,40 cases of liver cirrhosis,and 200 cases of healthy control were quantitatively detected by Magnetic solid phase chemiluminescent immunoassay.The area under ROC curve,sensitivity and specificity of DKK-1 and AFP for diagnosing HCC were calculated.Results The serum level of DKK-1 in HCC group was significantly higher than those of the liver cirrhosis group and healthy control group (P<0.01).DKK-1 maintained diagnostic sensitivity for patients with HCC who were alpha-fetoprotein (AFP) negative (66.3%).ROC curves showed optimum diagnostic cut-off value was 2.4 ng/mL,area under curve (AUC) was 0.822 (95% CI:0.783-0.856),sensitivity 65.9%,and specificity 87.5%).Moreover,measurement of DKK1 and AFP together improved diagnostic accuracy for HCC versus all controls compared with either test alone [AUC 0.915,95%CI:0.886-0.940),sensitivity 81.5 %(P<0.05)].Conclusion Serum DKK-1 detection has an important clinical value for diagnosis of HCC,especially for HCC with AFP negative.The combined detection of serum DKK-1 and AFP can greatly increase sensitivity and accuracy for diagnosing HCC.

Objective To investigate the feasibility of repairing soft-tissue defects of the fifth phalange and the back of hand with ulnar palmar artery perforator flaps from the little finger.Methods Based on anatomic dissection,the fifth phalange ulnar palmar artery perforator flaps were created and transferred to repair soft-tissue defects at the little finger and the back of hand in 15 cases.Types of injury were stamping injury in 5 cases,planer injury in 4 cases,mechanical crash injury in 3 cases,blast injury in 2 cases,and cicatrical contracture following electric burn in 1 case.Injury involved in the palmar aspect near the middle segment of fifth phalange in 4 cases,dorsal aspect near the middle segment of fifth phalange in 6 cases,ulnar mesiodistal of the back of hand in 3 cases,and distal ulnar palmar aspect of hands in 2 cases.There were 6 patients wounded in left hands and 9 patients wounded in right hands.Results All flaps survived and all wounds healed by first intention.At the follow-up of 2-18 months,the flaps resurfaced the soft-tissue defects with good color and texture match and the maintenance of contour and function of donor and recipient sites were satisfactory.Conclusion The fifth phalange ulnar palmar artery perforator flap,as it has advantages of constant perforator vessels,rich blood supply and good texture and can be operated safely and easily,is considered an ideal treatment choice in repairing softtissue defects of the fifth phalange and the back of hand.

Objective To detect the positive rates of antibodies against avian influenza virus (AIV) subtypes H5, H6, H7 and H9 among people in poultry occupations in Guangdong province and to analyze the transmission of various subtypes of AIV from poultry to human contacts for the prevention and control of novel AIV infection in human beings.Methods Serum specimens were collected from 1066 peo-ple in poultry occupations ( occupational group) and 205 people not in poultry occupations ( non-occupational group) in 10 cities of Guangdong province.The inactivated AIV strains, isolated from poultry or environment of Guangdong province, were used as antigens to detect antibodies against AIV subtypes H5, H6, H7 and H9 by using the hemagglutination inhibition ( HI) assay.Results The positive rates of antibodies against AIV subtypes H5, H6, H7 and H9 carried by people from the occupational group were respectively 0.44%, 0%, 0.30%and 0.30%in 2013 and 1.08%, 0.0%, 0.0%and 0.27%in 2014.Only the anti-H9 anti-bodies were detected in serum samples collected form people in the non-occupational group in 2013 with a positive rate of 0.95%.No significant differences with the positive rates of anti-AIV antibodies were found between the occupational group and the non-occupational group.However, the geometric mean titer ( GMT) of anti-AVI antibodies in people from the occupational group was higher than that of the non-occupational group.Conclusion Although a grand spread of AIV from avian to human is not likely to happen yet, con-tacting with poultry is the risk factor for AIV infection in Guangdong population.A long-term surveillance of anti-AIV antibodies in serum should be strengthened among people in poultry occupations for the timely pre-vention and control of novel AIV outbreak.

Objective To investigate the effects of sodium butyrate on the activity of RAW264.7 cells and the osteoclast differentiation.Methods The RAW264.7 cells were treated by sodium butyrate at concentrations of 0,0.25,0.50,1.00,2.00,3.00,4.00 and 5.00 mmol/L,with 3 double pores for each concentration.The cytotoxicity of sodium butyrate on RAW264.7 cells was detected by a CCK-8 kit.The effects of sodium butyrate (0,0.25,0.50 and 1.00 mmol/L) on apoptosis of RAW264.7 cells were detected by Hoechst33342 staining.RAW264.7 cells were induced into osteoclasts by osteoclast differentiation factors.The experiment was carried out in 2 groups (n =3).After induced maturation,the experimental group was treated with 1.00 mmol/L sodium butyrate and the control medium was added only with the same volume of solvent.The number of osteoclasts and the area of bone resorption were observed and compared.The differentiation of RAW264.7 cells was detected by tartrate-resistant acid phosphatase (TRAP) staining.Western blotting was used to detect the effects of sodium butyrate (0,0.25,0.50 and 1.00 mmol/L) on NF-κB-related signaling pathway in RAW264.7 cells.Results Compared with the group of 0 mmol/L sodium butyrate,the activity of cells treated with 1.00,2.00,3.00,4.00 and 5.00 mmol/L sodium butyrate for 24 h was significantly decreased (P ＜ 0.05).Treatment with 1.00 mmol/L sodium butyrate for 24 h induced apoptosis.The number of osteoclasts in the control group and the experimental group were 9.33 ± 2.08 and 4.67 ± 1.16,respectively,showing a significant difference between the 2 groups (t =3.395,P =0.027).The percentages of bone resorption area in the control group and the experimental group were 52.43％ ± 5.38％ and 14.28％ ± 2.72％,respectively,also showing a significant difference between the 2 groups (t =10.970,P ＜ 0.001).Western blot results showed that,compared with other concentrations of sodium butyrate,treatment with 1 mmol/L sodium butyrate on RAW264.7 cells for 24 h led to an increase in the expression levels of cytoplasmic p65,B lymphoma-2 associated X protein and cleaved-caspase 3 and the acetylation of Histone H3 but a decrease in the phosphorylation level of α/β subunit of NF-κB kinase.Conclusions With the increased concentration of sodium butyratecan,the activity of NF-κB may be suppressed and the number of apoptotic cells may increase.1.00 mmol/L sodium butyrate can reduce osteoclast formation and bone resorption area.

Objective:To explore the anatomical levels and injection approaches of the major temporal fat compartments through cadaveric head dissection and to analyze the efficacy of high-volume fat transplantation of the temporal region in a clinical retrospective research.Methods:To clarify the safe and stable levels of high-volume filling of the temporal fat compartment by dissecting the temporal fat compartment of 5 fresh cadaveric heads (10 sides, 25-50 years old, 2 males, 3 females). We retrospectively analyzed the data of patients with temporal fat transplantation admitted to the Second Xiangya Hospital of Central South University and Changsha Mylike Medical Cosmetic Hospital from January 2020 to January 2021. According to the levels and volume of fat filling injection, the patients were divided into large-volume group and conventional group. In the large-volume group the patients were filled with at least three fat compartments with a filling volume of more than 15 ml, while in the conventional group only with 1 to 2 layers, which were the subcutaneous fat and the middle temporal fascia, and the filling volume was generally less than 15 ml. Fat injections were performed with a needle entry within the frontal hairline, targeting the main fat compartments. We compared and studied the mean injection volume per side, postoperative surgeon’s Likert scale score, patient satisfaction and other indicators in the two groups of cases. Stromal vascular fraction-gel(SVF-gel), which was made from surplus fat during the initial operation, was used to locally fine-tune the effect at the 3-month follow-up evaluation.Results:The anatomical study revealed the existence of three main fat compartments in the temporal region: subcutaneous fat layer, superficial and deep temporal fat pad. In the elderly cadavers, the subcutaneous fat was thin, the superficial temporal fat pad and deep temporal fat pad atrophied obviously, and the supporting effect on temporal superficial soft tissue was significantly weakened. The deep temporal fat pad showed obvious atrophy with a certain degree of downward movement. A total of 50 women who underwent bilateral temporal fat transplantation were enrolled in the clinical study, with 25 in the conventional group and 25 in the large-volume group. The age of the patients in the conventional group was (32.7±7.1) years, and the body mass index (BMI) was (20.2±1.9) kg/m 2. In the large-volume group, the age was (32.5±8.3) years, and the BMI was (19.8±2.0) kg/m 2. There were no significant differences in age and BMI between the two groups (all P>0.05). The filling volume was (19.66±4.61) ml/side in the large-volume group, with a Likert scale score of (4.32±0.63) and the patient satisfaction was 92.0%(23/25); the filling volume was (11.06±2.62) ml/side in the conventional group, with a Likert scale score of (3.32±0.80) and the patient satisfaction was 68.0%(17/25). There were statistical differences between the two groups (all P<0.05), suggesting that the large-volume group had better efficacy and patients were more satisfied. No severe complications such as infection, liquefaction, embolism, and nerve injury occurred in all patients during the follow-up period. Conclusion:Anatomical studies have proved that the main three-layer fat compartments filling in the temporal region have a clear approach, especially the feasibility of the puncture approach of the deep temporal fat pad, which provides the basis and feasibility for temporal fat filling with large volume. Compared with the conventional fat filling, multi-level and large-volume filling can significantly improve the surgical effect and patient satisfaction.

Objective:To explore the anatomical levels and injection approaches of the major temporal fat compartments through cadaveric head dissection and to analyze the efficacy of high-volume fat transplantation of the temporal region in a clinical retrospective research.Methods:To clarify the safe and stable levels of high-volume filling of the temporal fat compartment by dissecting the temporal fat compartment of 5 fresh cadaveric heads (10 sides, 25-50 years old, 2 males, 3 females). We retrospectively analyzed the data of patients with temporal fat transplantation admitted to the Second Xiangya Hospital of Central South University and Changsha Mylike Medical Cosmetic Hospital from January 2020 to January 2021. According to the levels and volume of fat filling injection, the patients were divided into large-volume group and conventional group. In the large-volume group the patients were filled with at least three fat compartments with a filling volume of more than 15 ml, while in the conventional group only with 1 to 2 layers, which were the subcutaneous fat and the middle temporal fascia, and the filling volume was generally less than 15 ml. Fat injections were performed with a needle entry within the frontal hairline, targeting the main fat compartments. We compared and studied the mean injection volume per side, postoperative surgeon’s Likert scale score, patient satisfaction and other indicators in the two groups of cases. Stromal vascular fraction-gel(SVF-gel), which was made from surplus fat during the initial operation, was used to locally fine-tune the effect at the 3-month follow-up evaluation.Results:The anatomical study revealed the existence of three main fat compartments in the temporal region: subcutaneous fat layer, superficial and deep temporal fat pad. In the elderly cadavers, the subcutaneous fat was thin, the superficial temporal fat pad and deep temporal fat pad atrophied obviously, and the supporting effect on temporal superficial soft tissue was significantly weakened. The deep temporal fat pad showed obvious atrophy with a certain degree of downward movement. A total of 50 women who underwent bilateral temporal fat transplantation were enrolled in the clinical study, with 25 in the conventional group and 25 in the large-volume group. The age of the patients in the conventional group was (32.7±7.1) years, and the body mass index (BMI) was (20.2±1.9) kg/m 2. In the large-volume group, the age was (32.5±8.3) years, and the BMI was (19.8±2.0) kg/m 2. There were no significant differences in age and BMI between the two groups (all P>0.05). The filling volume was (19.66±4.61) ml/side in the large-volume group, with a Likert scale score of (4.32±0.63) and the patient satisfaction was 92.0%(23/25); the filling volume was (11.06±2.62) ml/side in the conventional group, with a Likert scale score of (3.32±0.80) and the patient satisfaction was 68.0%(17/25). There were statistical differences between the two groups (all P<0.05), suggesting that the large-volume group had better efficacy and patients were more satisfied. No severe complications such as infection, liquefaction, embolism, and nerve injury occurred in all patients during the follow-up period. Conclusion:Anatomical studies have proved that the main three-layer fat compartments filling in the temporal region have a clear approach, especially the feasibility of the puncture approach of the deep temporal fat pad, which provides the basis and feasibility for temporal fat filling with large volume. Compared with the conventional fat filling, multi-level and large-volume filling can significantly improve the surgical effect and patient satisfaction.

IL-34 can promote osteoclast differentiation and activation, which may contribute to steroidinduced osteonecrosis of the femoral head (ONFH). Animal model was constructed in both BALB/c and IL-34 deficient mice to detect the relative expression of inflammation cytokines. Micro-CT was utilized to reveal the internal structure. In vitro differentiated osteoclast was induced by culturing bone marrow-derived macrophages with IL-34 conditioned medium or M-CSF. The relative expression of pro-inflammation cytokines, osteoclast marker genes, and relevant pathways molecules was detected with quantitative real-time RT-PCR, ELISA, and Western blot. Up-regulated IL-34 expression could be detected in the serum of ONFH patients and femoral heads of ONFH mice. IL-34 deficient mice showed the resistance to ONFH induction with the up-regulated trabecular number, trabecular thickness, bone value fraction, and down-regulated trabecular separation. On the other hand, inflammatory cytokines, such as TNF-α, IFN-γ, IL-6, IL-12, IL-2, and IL-17A, showed diminished expression in IL-34 deficient ONFH induced mice. IL-34 alone or works in coordination with M-CSF to promote osteoclastogenesis and activate ERK, STAT3, and non-canonical NF-κB pathways. These data demonstrate that IL-34 can promote the differentiation of osteoclast through ERK, STAT3, and non-canonical NF-κB pathways to aggravate steroid-induced ONFH, and IL-34 can be considered as a treatment target.

Objective To explore the effects of ApoC3 gene on the severity of hypertriglyceridemiainduced acute pancreatitis (AP).Methods ApoC3 transgenetic mice and C57BL/6J mice AP model was induced by cerulein intraperitoneal injection,and ApoC3 transgenetic mice and C57BL/6J mice injected by normal saline solution in equal volume served as control group.Serum triglyceride and cholesterol were detected,and the pathological changes of the pancreas were observed.RT PCR method was used to examine the changes of the inflammatory factor including IL-1β,IL-6,α-SMA and TNF-α mRNA levels,which reflected the severity of the inflammation.Results Serum triglyceride and cholesterol were higher in ApoC3 transgenetic mice than in C57BL/6J mice [(3.434 ± 0.931) mmol/L vs (0.766 ± 0.120) mmol/L,(2.553 ±0.178) mmol/L vs (1.996 ± 0.080) mmol/L],and the differences were statistically different (P ＜ 0.05).The pathological changes of the pancreas were more severe in ApoC3 transgenetic AP mice than in C57BL/6J AP mice,and the IL-1β,IL-6 and α-SMA mRNA levels in the pancreatic tissue were obviously higher in ApoC3 transgenetic AP mice than in C57BL/6J mice (1.72 ± 0.07vs 0.78 ± 0.09,1.58 ± 0.09vs 0.87 ±0.04,0.83 ± 0.05vs 0.44 ± 0.04),and the differences were statistically significant (P ＜ 0.05),while there was no statistical difference on TNF-αmRNA level (0.70 ± 0.09vs 0.65 ± 0.08,P ＞ 0.05).Conclusions ApoC3 gene could aggravate the severity of the inflammation in hypertriglyceridemia-induced AP.

Objective To provide scientific evidence to identify and confirm severe acute respiratory syndrome (SARS) by laboratory detection.Methods Multiple clinical specimens were collected serially and systematically from the 4 suspected SARS patients, which occurred between Dec.2003 to Jan.2004 in Guangdong Province. The samples were tested by serologic and molecular methods.Results IgM or IgG antibodies against SARS-CoV were detectable after 6—8 days of the onset in four patients. The four-fold or greater rising in antibodies was clearly detected in three of the four patients, while the fourth patient’s seroconversion was from negative to positive. The results analysed by enzyme-linked immunosorbent assay( ELISA), immunoflourescence assay (IFA), and neutralization test were highly correlated. SARS-CoV RNA was just detected in 3 throat swab specimens from case 1 by real-time PCR. M, N and S genes were amplified by reverse transcriptase polymerase chain reaction (RT-PCR) from the positive samples. Sequencing results showed that they were SARS-CoV gene segments, and most closely matched SARS-CoV gene sequences were isolated from civet cats in Guangdong Province. Nevertheless, SARS-CoV was not isolated from any samples of the 4 patients.Conclusion Based on these results, the 4 reported cases were laboratorily confirmed as SARS cases.