Arrhythmias, Cardiac ; etiology ; physiopathology ; Humans ; Myocardial Infarction ; physiopathology ; Sympathetic Nervous System ; physiopathology

BACKGROUND:Recent studies have demonstrated that growth factor, as a molecular signal, regulates cellular proliferation, differentiation, immigration and metabolism. Its expression and regulation play an important role in the chronic wound healing.OBJECTrVE: To observe the effect of vascular endothelial growth factor (VEGF) on the expression of VEGF receptor (VEGFR), basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) mRNA in wound tissue, and elucidate the mechanism of VEGF in promoting wound healing.DESrGN: Controlled animal experiment.SETTING: Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA. MATERIALS: Six New Zealand rabbits, aged 48-60 months, were involved in the experiment. Nanosphere-coated recombinant plasmid DNA eukaryotic expression vector pcDNA3.1/myc-hisA-VEGF166 was donated by Master Jia Ning, who was from Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA. METHODS: This experiment was carried out in the laboratory of Department of Plastic Surgery, Xijing Hospital from October 2004 to June 2005. ①VEGF (VEGF165) was taken as target gene to construct eukaryotic expression vector pcDNA3.1/myc-hisA- VEGF165. Nanosphere- VEGF165 complex was used. Three round excisional wounds, 6 mm in diameter, were created over the ventral surface of ears of anesthetized rabbits, and cartilage was exposed. Gelatin sponge thin slice dipping 100 μL nanosphere-VEGF165 complex was spread on unilateral wounds of each rabbit, and aseptic sealing membrane was spread on outer layer, serving as VEGF group; Gelatin sponge thin slice dipping 100 μL nanosphere without plasmid load was spread on contralateral wound, serving as control group; Skin of rabbit ear subterminal to circumcise region served as normal group. ② At postoperative 14 days, reverse transcription-polymerase chain reaction (RT-PCR) was used to observe the changes in the expression of VEGFR, bFGF and PDGF mRNA in wound tissue. ③ At postoperative 14 days, wound was took as center, and square tissue mass with size of 1 cm×1 cm (full-thickness rabbit ear included) was excised and prepared into sample, then which was stained by haematoxylin & eosin (HE). Under the optical microscope, the growth of newly regenerated granulation tissue was observed. MAIN OUTCOME MEASURES: Expression of VEGFR, bFGF and PDGF mRNA in wound tissue. RESULTS: ①HE staining results showed the growth speeds of granulation tissue and epithelium tissue in VEGF group were obviously faster than those in the control group. ②RT-PCR detected a significantly higher expression of VEGFR, bFGF and PDGF mRNA in the wound tissues in VEGF group than that in the control group (P ＜ 0.05) and normal group (P＜ 0.01).CONCLUSION: Exogenous VEGF up-regulates the expression of VEGFR, bFGF and PDGF mRNA in wound tissue. VEGF may act on its receptor and play an important role in promoting wound healing through its interaction with other cytokines.

Objective To investigate the possibility of performing epicanthoplasty with same stage small incision blepharoplasty. Methods At the same stage of designing small incision blepharo-plasty, modified "Z" plasty without flap transposition was designed. The upper lid incisive line of epi-canthoplasty was bided in the double eyelid fold, while the lower eyelid incision located at the edge of eyelid. Results A series of 56 patients were treated with this method. Satisfactory esthctical result of double eyelid fold and inner canthus shape was achieved. Conclusion This modified method including epicanthoplasty combined with same stage small incision blepharoplasty has the advantages of minimal scar formation, easy to design perform and in accordance with physiology.

It designs a way that can easily screen high-pyruvate-producing strain.It is a intelligently selected method which can highly improve the efficiency of strain screening.The principle can be described as the following:On the CaCO-3 medium,a transparent ring can be exhibited based on the reaction of PYR produced by the strain and CaCO-3 in the medium for pyruvate-calcium is a kind of soluble substance,it is obviously that the high-pyruvate-producing strain has a bigger dimension of the transparent ring.On the other hand,color reaction between TTC and ADH indicate the enzyme activities which have a proportional relation with color,our object strain is a weak-ADH-enzyme-activities type with a weak metabolic flux from PYR to alcohol.So the white color strain may be the right choice.

Objective To investigate the cosmetic outcome of treatments for mentalis scars with expanded skin flaps.Methods From the experiences of past 26 cases in our department,we summarised the technique for treating the mentalis scars with expanded skin flaps.For simple mentalis scars or localized inferior facial scars,the mentalis,bottom jaw or facial skin were expanded and the expander kept superior to the neck-jaw angle.Otherwise the expander would only fill the angle and the expanding efficiency was reduced.For severe mentalis,neck or facial scars without extra normal treating skin,expanded deltopectoral flaps were chosen to cover the wound after cicatrectomy with pedicles which were cut 3 weeks later.Results All the local ordistant expanded flaps survived successfully in the 26 cases with optimistic outcomes.Conclusions Application of local or distant expanded flaps is a useful technique for mentalis scars treatment.

Objective To develop new repairing techniques for acquired inferior palpebral region defects. Methods Expanded forehead flaps were used to reconstruct the inferior palpebral defects or post-excision wound surface and the flaps were pedicled with supra-trochlea vessels or ramus frontalis arteriae temporalis superficialis. As for supra-trochlea vessels, contralateral ones were prior to the homolateral ones. The incision site located in the scalp and the major axis of the expander parallel to the forehead. Firstly, the leisions were cut and the subcutaneous tissues loosed to regain the anatomy position of inferior palpebra. Secondly, the expanded flaps were transfered onto the defects by the wound sizes with the supra-trochlea vessels as their pedicles. At last, the pedicles were cut 3 weeks later.For ramus frontalis arteriae temporalis superficialis, the flap was transfered with a subdermal pedicle and the donor site was closed directly. Results There were 10 cases in the present group, 6 for supratrochlea vessels and the 4 others for ramus frontalis arteriae temporalis superficialis. All the flaps survived successfully. 3 cases returned with optimistic outcomes 6 months later. Conclusion The expanded forehead flaps are fit for repairing the inferior palpebral defects, which can successfully avoid ectropion. This technique is very useful for reconstructing the texture of the site of defects.

Objective To study whether ferulic acid can promote healing on chronic ischemic wounds and its possible mechanisms.Methods 40 male New Zealand white rabbits were randomly divided into 4 groups:vaseline group,ischemic control group,5％ ferulic acid group and recombinant bovine basic fibroblast growth factor for external use (rb-bFGF) group.Gross wounds were carefully observed and HE staining was used to observe the wound healing and immumohistochemical staining to observe the expression of the VEGF and CD31.The RNA was extracted to detect the expression of VEGF and HIF-1a by real-time PCR.Results The general observation and the HE staining of each specimen 11 days after operation all indicated that the duration of wound healing of the 5 ％ ferulic acid group was similar to that of the rb-bFGF group and markedly shorter than the ischemic control group and the vaseline smear group.The result of the immunohistochemical staining indicated that the content of the VEGF and CD31 expression of the 5 ％ ferulic acid groups and the rb-bFGF group made lit tle difference,but there was markedly less VEGF and CD31 in ischemic control group and the vaseline smear group.The result of the PCR showed that expression level of VEGF and HIF-1α in the 5 ％ fer ulic acid group was similar to that in the rb bFGF group and the vaseline smear group,but was obviously more than that of the ischemic control group and the vaseline smear group (P ＜ 0.05).Conclusions Ferulic acid can promote angiogenesis by increasing VEGF and HIF-1α which are closely related to angiogenesis and then promote the healing of chronic wounds.

Objective: To investigate the clinical effect of conjoint fascial sheath (CFS) suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis. Methods: From February 2017 to April 2018, 19 severe blepharoptosis patients (21 eyelids) were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening, and repaired through the technology of CFS suspension. Results: There were 19 cases, 17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes, and the other 2 cases obtained satisfactory results though reoperation. There were no complications of exposure keratitis, ectropion and infection occurred. Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months. Conclusions The application of conjoint fascial sheath (CFS) suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.

OBJECTIVETo investigate the possibility to fabricate a blood vessel scaffold with a combined polymer for tissue engineering.

METHODSA blood vessel scaffold was designed with a combined polymer composed of rabbit vascular smooth muscle cells(VSMCs), collagen and a non-spinning fabric mesh of polyglycolic acid (PGA). VSMCs were implanted into collagen gel and their growth was observed. The mixed solution of VSMCs and collagen was dropped into the tubular scaffold, followed by 7-day culturing.

RESULTSVSMCs formed many prominences after culturing in gelatinous collagen for 3-4 hours. With cells extending, some cells became shuttle- or spindle-shaped. After VSMCs-collagen complex was implanted into the PGA mesh, most of VSMCs remained in the pore of PGA mesh with the formation of gelation. VSMCs could adhere to and grow on the PGA fiber.

CONCLUSIONThe non-spinning PGA porous biodegradable material coated with collagen is a good carrier for VSMCs to adhere and grow.

Animals ; Blood Vessels ; growth & development ; Collagen ; Muscle, Smooth, Vascular ; growth & development ; Polyglycolic Acid ; Polymers ; Rabbits ; Time Factors ; Tissue Engineering ; instrumentation ; methods ; Tissue Scaffolds

OBJECTIVETo investigate suitable treatment method for contracture of inframammary scars.

METHODSNine female patients with contracture of inframammary sear hospitalized in our hospital from July 2000 to July 2007 were subjected to skin expansion around the breast. The sites of incisions were mainly located on the inframammary scars. The expanders were placed around the breast and middle chest near the sternum. On the lateral side of chest, the expander should be inserted at the site parallel to upper level of the breast. The expanders should be placed under deep fascia and superficial to the gland. At II stage of operation, the scars were excised and the subcutaneous tissues should be thoroughly loosened to assure that the soft tissue and mammary gland would be restored to its anatomical position. Expanded skin was then designed as advancement or transposition flaps to repair the defects, or effects were closed with suturing.

RESULTSBlood circulation disturbance occurred at the tip of a flap in one patient, with the size of 4.0 cm x 3.0 cm, and the resulting wound healed after skin grafting. Flaps in the other 8 patients survived, and the wounds healed satisfactorily. Nipples and mammary areola were successfully restored to the anatomical positions. Three patients were followed up for 6 months to 2 years, and the result was satisfactory.

CONCLUSIONSExpanded flap is feasible for repairing contracture of inframammary scar and with good result.

Adolescent ; Breast ; Child ; Cicatrix ; surgery ; Female ; Humans ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Young Adult