Objective To explore the influences of proliferation and differentiation of preadipocytes on high fat diet-induced obesity and obesity prevention through exercises in rats.Methods Forty male Sprague-Dawley rats were divided into a normal diet control group (C,n=8),a normal diet with exercises group (E,n=8),a high fat diet control group (H,n=14) and a high fat diet with exercises group (HE,n=10).Group C and group H kept sedentary,while group E and group HE underwent treadmill exercises at about 75％VO2max level.After 12 weeks of intervention,the body weight,epididymal,perirenal and retroperitoneal fat mass were recorded,and the total fat mass was determinated.Stereology method was used to calculate the number and average diameter of fat cells.Western Blotting was conducted to measure the expression of PPARγ and C/EBPα protein in adipose tissues.Results (1) The body weight and total fat mass of group H were significantly higher than those of group C (P＜0.01).Perirenal,retroperitoneal fat and total fat mass of group E and HE were significantly lower than those of group C and H respectively (P＜0.01).(2) The total fat cell number of group H was significantly higher than that of group C.The average diameter of fat cells in perirenal and retroperitoneal fat pads of group E were significantly lower than that of group C (P＜0.05,P＜0.01),while that of group HE in epididymal,perirenal and retroperitoneal fat pads was significantly lower than that of group H (P＜0.01).(3) Compared with group C,the expression of PPARγ protein of group E and H increased significantly in epididymal,perirenal and retroperitoneal fat pads (P＜0.01).The expression of C/EBPα protein of group H was significantly higher than that of group C in epididymal and perirenal fat pads (P＜0.01),the expression of C/EBPα protein of group E was significantly higher than that of group C in perirenal and retroperitoneal fat pads (P＜0.01),while the expression of C/EBPα protein of group HE was significantly lower than that of group H in perirenal fat pads(P＜0.01).Conclusion The proliferation and differentiation of preadipocyte was enhanced in the development of high fat diet induced obesity and exercises to prevent obesity,but its role and mechanisms were different.The high fat diet increases the number of fat cells which is a compensatory mechanism for the body to adapt to fat accumulation,while exercises might promote cell renewal and decrease the average size of fat cells which is an adaptive mechanism to improve fat storage.

Objective To explore the diagnostic value of MRI signs combined with standard b-value diffusion weighted imaging(DWI)signals in meningioma.Methods A total of 134 patients with meningioma were selected.Using postoperative pathological examination results as the gold standard,the MRI signs,specific intensity of standard b-value DWI signals,apparent diffusion coefficient(ADC)value,and relative apparent diffusion coefficient(rADC)value between the two groups were compared;Receiver operating characteristic(ROC)curve was used to assess the ADC value and rADC value in differential diagnosis of low-grade and high-grade meningiomas.Results The proportions of no/mild peritumoral edema,clear tumor brain interface and tumor cystic changes in low-grade group were higher than high-grade group,and the proportion of lobulation sign was lower than high-grade group(P＜0.05).There was no statistically significant difference in DWI signal intensity between the two groups(P＞0.05).ADC and rADC values in low-grade group were higher than high-grade group(P＜0.05).The area under the curve(AUC)of ADC value,rADC value,and their combined differential diagnosis for low-grade and high-grade meningiomas were 0.765,0.844,and 0.903,respectively.Conclusion The standard b-value DWI signal intensity cannot be used for the diagnosis of meningioma,while MRI signs(peritumoral edema,tumor brain interface,tumor cystic changes,lobulation sign)and ADC value,rADC value have high clinical application value in the diagnosis of meningioma.

Objective:To explore the repair methods of complex facial defect wounds involving paranasal sinuses and their clinical effectiveness.Methods:A retrospective observational study was conducted. From January 2020 to May 2022, 5 patients admitted to the Department of Burns and Plastic Surgery of Xiangya Hospital of Central South University and 4 patients admitted to the Department of Burns and Plastic Surgery of Chenzhou First People's Hospital with complex facial defect wounds involving paranasal sinuses met the inclusion criteria, including 6 males and 3 females, aged 35-69 years, including 4 patients with titanium mesh exposure combined with paranasal sinuses injury and 5 patients with tumor involving paranasal sinuses. After an adequate assessment of the damage by a multiple discipline team, titanium mesh removal, paranasal sinus debridement, and paranasal sinus mucosa removal were performed in patients with exposed titanium mesh, and radical tumor resection was performed in patients with tumors, with postoperative skin and soft tissue defects areas of 5.0 cm×2.5 cm to 18.0 cm×7.0 cm, anterior paranasal sinus wall defects/absence areas of 3 cm×2 cm to 6 cm×4 cm, and sinus cavity depths of 1 to 4 cm. Depending on the perforator course of the descending branch of the lateral circumflex femoral artery, the anterolateral femoral chimeric flap or anterolateral femoral myocutaneous flap (with flap area of 9 cm×4 cm to 19 cm×8 cm, muscle size of 5 cm×3 cm×3 cm to 11 cm×6 cm×3 cm) was transplanted to repair the defect, and the donor site wound was sutured directly. The type of tissue flap transplanted, the blood vessel of the recipient area, and the vascular anastomosis way during the operation, the recovery of the donor and recipient areas and the occurrence of complications after operation were observed. The appearance and blood supply of the recipient area and the recurrence of ulcers and tumors were followed up.Results:The anterolateral femoral myocutaneous flap transplantation was performed in 6 patients, and the anterolateral femoral chimeric flap transplantation was performed in 3 patients. The blood vessels in recipient areas were facial arteries and veins in 3 cases and superficial temporal arteries and veins in 6 cases. The superficial temporal arteries and veins were bridged with blood vessels in tissue flaps by flow-through way in 2 patients, and end-to-end anastomosis of blood vessels in donor and recipient areas was performed in 7 patients. After operation, all the tissue flaps survived, and the facial defect wounds were well repaired without cerebrospinal fluid leakage or paranasal sinus secretion leakage, no intracranial infection occurred, and the wounds in donor areas were healed well. Follow-up of 6-35 months after operation showed that all the patients had good blood supply in the recipient area, and the shape was acceptable; 4 patients with exposed titanium mesh had no recurrence of ulceration, and 5 patients with tumor had no local tumor recurrence or metastasis.Conclusions:Based on an adequate assessment of the extent of paranasal sinuses involved in the facial wound and the nature of the defect, good clinical effects can be achieved by using the anterolateral femoral muscle flap or the anterolateral femoral chimeric flap transplantation to repair complex facial defect wounds with open paranasal sinuses.