OBJECTIVETo explore the anatomic basis and clinical application of the horn shaped perforator flap pedicled with the angular artery for the reconstruction of midface defect.

METHODS(1) 10 fresh cadavers were perfused with a modified guiding oxide gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized software (Materiaise' s interactive medical image control system, MIMICS). The origin and distribution of the angular artery perforator were observed. (2) Between July 2012 and July 2014, twenty-one patients underwent operations for the reconstruction of midface defect. Ten patients had squamous cell carcinoma, nine patients had basal cell carcinoma and two patients had nevus. The flaps' size ranged from 1.5 cm x 3.5 cm to 2.5 cm x 5.0 cm.

RESULTSThe facial artery branches the lateral nasal artery 1 cm from the outside corner of the mouth, subsequently strenches to inner canthus continuing as the angular artery. The angular artery anastomoses extensively with the dorsal nasal artery and the infraorbital artery. All the flaps survived. The patients were satisfied with the final aesthetic and functional results.

CONCLUSIONSThe flap can be designed flexibly and simply with reliable blood supply. The donor sites could be closed directly without skin graft, it is a simple and fast method for the reconstruction of midface defect.

Anastomosis, Surgical ; methods ; Arteries ; anatomy & histology ; Cadaver ; Carcinoma, Basal Cell ; surgery ; Carcinoma, Squamous Cell ; surgery ; Face ; blood supply ; Facial Neoplasms ; surgery ; Humans ; Nevus ; surgery ; Nose ; blood supply ; Perforator Flap ; blood supply ; transplantation ; Skin Neoplasms ; surgery ; Skin Transplantation ; Software ; Tomography, Spiral Computed

Tumor-associated macrophages (TAMs) mostly exhibit M2-like (alternatively activated) properties and play positive roles in angiogenesis and tumorigenesis. Vascular endothelial growth factor (VEGF) is a key angiogenic factor. During tumor development, TAMs secrete VEGF and other factors to promote angiogenesis; thus, anti-treatment against TAMs and VEGF can repress cancer development, which has been demonstrated in clinical trials and on an experimental level. In the present work, we show that miR-150 is an oncomir because of its promotional effect on VEGF. MiR-150 targets TAMs to up-regulate their secretion of VEGF in vitro. With the utilization of cell-derived vesicles, named microvesicles (MVs), we transferred antisense RNA targeted to miR-150 into mice and found that the neutralization of miR-150 down-regulates miR-150 and VEGF levels in vivo and attenuates angiogenesis. Therefore, we proposed the therapeutic potential of neutralizing miR-150 to treat cancer and demonstrated a novel, natural, microvesicle-based method for the transfer of nucleic acids.
Animals ; Carcinogenesis ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Exosomes ; HEK293 Cells ; Heterografts ; Humans ; Macrophages ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; MicroRNAs ; genetics ; metabolism ; Neoplasm Transplantation ; RNA, Antisense ; administration & dosage ; genetics ; Up-Regulation ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Objective To discuss the clinical effect of horn perforator flaps for the treatment of finger soft tissue defect.Methods ① Lead oxide-gelatin mixture injection and CT scanning were performed in 4 fresh adult cadavers and the data was put into mimics 17.0 to achieve the three-dimensional reconstruction.The regulation and origins of the perforator vessel in proper palmar digital artery was observed.②From July 2012 to July 2015,9 cases with finger soft tissue defects were treated with horn perforator flaps.The defect areas ranged from 0.6 cm × 0.8 cm to 1.2 cm × 1.5 cm and the flap size ranged from0.8 cm×2.5 cm to 1.6 cm×4.2 cm.We put the head end of flaps at defect side.The horn perforator flap was designed with 1-2 perforator vessel and rotated to cover the defect.The defect at donor site was closed directly.Results We got 4 symmetric arteries in palmar and back surfaces of fingers,2 for proper palmar digital arteries and 2 for dorsal digital arteries.The proper palmar digital arteries have a larger diameter which is the main source of blood supply for fingers.All 9 flaps survived after the operation.Both the recipient area and donor areas received sound healing.With 2 months to 1.5 years of follow-up visit,the shape,color and luster,texture and function all had good healing.Conclusions The horn perforator flaps for repair finger soft tissue defect have advantages of flexible design,reliable perforator vessels.The defect at donor site can be closed directly with no skin graft.This method considers both shape and function and is a good way for finger soft tissue defect.

Objective To discuss the clinical effect of horn perforator flaps for the treatment of finger soft tissue defect.Methods ① Lead oxide-gelatin mixture injection and CT scanning were performed in 4 fresh adult cadavers and the data was put into mimics 17.0 to achieve the three-dimensional reconstruction.The regulation and origins of the perforator vessel in proper palmar digital artery was observed.②From July 2012 to July 2015,9 cases with finger soft tissue defects were treated with horn perforator flaps.The defect areas ranged from 0.6 cm × 0.8 cm to 1.2 cm × 1.5 cm and the flap size ranged from0.8 cm×2.5 cm to 1.6 cm×4.2 cm.We put the head end of flaps at defect side.The horn perforator flap was designed with 1-2 perforator vessel and rotated to cover the defect.The defect at donor site was closed directly.Results We got 4 symmetric arteries in palmar and back surfaces of fingers,2 for proper palmar digital arteries and 2 for dorsal digital arteries.The proper palmar digital arteries have a larger diameter which is the main source of blood supply for fingers.All 9 flaps survived after the operation.Both the recipient area and donor areas received sound healing.With 2 months to 1.5 years of follow-up visit,the shape,color and luster,texture and function all had good healing.Conclusions The horn perforator flaps for repair finger soft tissue defect have advantages of flexible design,reliable perforator vessels.The defect at donor site can be closed directly with no skin graft.This method considers both shape and function and is a good way for finger soft tissue defect.

Checking the accuracy of references cited in Compendium ofMateria Medica is of significance for the research of Compendium ofMateria Medica.Furthermore,it can also serve as an example for ex-ploring the general rule on citations of historical documents by ancient authors.It has been found that there is a regularity in the format of the title of cited references,including book title,abridged title,alias title,author (surname,given name,secondary name,alternative name),name of reviser (surname, given name,secondary name,alternative name)etc.These references yield important significance for the discipline of literature.For example,by verifying the true and false of various editions of WU Rui’s Materia Medica in Daily Use of the Yuan Dynasty,the author of Dietetic Materia Medica of the Ming Dy-nasty and the true and false of its various editions can be thus confirmed.It is found that within the 276 references cited in the Compendium ofMateria Medica,64 cited references weren’t recorded in the for-mer bibliographies.Moreover,there were also other problems appearing in these cited historical docu-ments,such as two different books confused as one book,overlapping of books repeatedly,wrong cited book title,mistaken author,and with reference title but not really quoted etc.All these should be paid attention by the readers.

Amniotic Fluid ; drug effects ; metabolism ; Female ; Fetus ; drug effects ; metabolism ; Gene Expression Regulation, Developmental ; drug effects ; genetics ; Humans ; MicroRNAs ; genetics ; pharmacology ; Placenta ; metabolism ; Pregnancy ; RNA, Plant ; genetics ; pharmacology ; Umbilical Cord ; drug effects ; metabolism