Angiotensin I ; Hepatic Stellate Cells ; Insulin-Like Growth Factor Binding Protein 2 ; Peptide Fragments ; Peptidyl-Dipeptidase A

Humans ; Liver ; cytology ; metabolism ; Liver Diseases ; metabolism ; pathology ; therapy ; Receptors, Angiotensin ; metabolism ; Receptors, Cell Surface ; metabolism ; Receptors, Endothelin ; metabolism ; Receptors, Vasopressin ; metabolism

Objective To explore the protective role of lipoxin A4 (LXA4) during early process of atherosclerosis formation in rats with juvenile metabolic syndrome (MS).Methods Rat models of juvenile MS were established with 3-week Sprague-Dawley (SD) rats fed on high-carbonhydrates and high-fat diet for 6 weeks.The other qualified ones were randomly grouped into model group,LXA4 low-dose group,LXA4 middle-dose group,and LXA4high dose group,and a control group fed with normal forage.The low,middle,high-dose groups were injected different doses of LXA4 daily,while the model group and control group were injected with the same dose of isotonic NaCl solution for 2 consecutive weeks.After 2-week medication,the visceral adipose tissue were isolated by laparotomy and heart blood collected by thoracotomy under anesthesia,followed the fixation of thoracic and abdominal aortas in the immobilized rats.The mRNA expression level of inflammation cytokines interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),C-reactive protein (CRP) in the adipose tissue were determined by semi-quantitative reverse transcription PCR (RT-PCR),respectively.Secretions of IL-6,and TNF-α in serum were determined by enzyme linked immunosorbent assay (ELISA).Immunocytochemistry was used to label endomembrane and middle-membrane of thoracic aorta,and endothelial cell layer in each group and the ratios of thickness of endomembrane and middle-membrane were compared.Results Compared with the control group,weight,body length and abdominal circumference of juvenile MS rats increased significantly (all P ＜ 0.05),and levels of fasting plasma glucose (FPG),triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and insulin in models increased significantly (P ＜ 0.05).RT-PCR showed that the mRNA expressions of inflammatory cytokines IL-6,TNF-α and CRP in adipose tissue in model rats were upexpressed (all P ＜ 0.05).Compared with model rats,mRNA of IL-6,TNF-oα,and CRP in mid,high-dose rats were downexpressed (all P ＜ 0.05),mRNA of TNF-α in low-dose rat downexpressed (all P ＜ 0.05),and there were no significant differences between mRNA expressions of IL-6,CRP in low-dose and model rats according to statistics (all P ＞0.05).Compared with control group,inflammatory cytokines IL-6,TNF-α secreted in serum of model rats were increased significantly (all P ＜ 0.05),and inflammatory cytokines secreted in serum of intervention rats were decreased significantly compared with model rats (P ＜ 0.05).Pathological changes were as follows:HE staining:compared to model group,aortic tunica intima of model rats were remarkably thickened and endothelial cell layer was fragmented and incomplete,which was attenuated in each intervention group.The ratios of endomembrane and middle-membrane in rats:at the end of consecutive medication for 2 weeks,the ratios of endomembrane and middle-membrane in model rats were significantly greater than those of control group (P ＜ O.05),and the ratios of endomembrane and middle-membrane in high-dose intervention rats were significantly smaller than those of the model group (P ＜ 0.05),but still greater than control group,while there were no statistical differences between the ratios in low,middle-dose intervention rats and model rats (P ＞ 0.05).Conclusions The increasing inflammatory cytokines are involved in early process of atherosclerosis formation in rats with juvenile MS.LXA4 by reducing the expression of inflammatory factor level in adipose tissue,thereby reducing the inflammatory cytokines in serum,alleviate the damage of arterial wall.

Objective To investigate the expression of unfolded protein response (UPR) gene glucose regulated protein 78(GRP78) and X-box binding protein 1(XBP1) in esophageal squamous cell carcinoma, its effect on activation of the endoplasmic reticulum stress (ERS) and its mechanism in the growth of esophageal squamous cell carcinoma. Methods The expressions of GRP78 and XBP1 were detected by immunohistochemistry in 30 samples of esophageal squamous cell carcinoma and 30 samples of normal esophageal squamous epithelium. The correlation between expressions of both proteins and prognosis was analyzed. Results GRP78 positive rate was 83.3 %(25/30) in esophageal carcinoma, while the proportion was 20.0 %(6/30) in normal esophageal (χ2=25.833, P<0.05). XBP1 positive rate was 70.0 % (21/30) in esophageal carcinoma, while the proportion was 26.7%(8/30) in normal esophageal(χ2=20.872, P<0.05). The positive rates of GRP78 and XBP1 in invasive muscular layer of esophageal squamous cell carcinoma were significantly higher than those in invasive mucous layer. Conclusion GRP78 and XBP1 are highly expressed in esophageal squamous cell carcinoma, which may involve the occurrence and development of the esophageal carcinoma.

Objective To investigate the clinical feature and prevalence of chronic actinic dermatitis in a four-generation family with both monovular twins affected by chronic actinic dermatitis.Methods The clinical and laboratory findings from monovular twins simultaneously affected by chronic actinic dermatitis and their four-family members were analyzed.Results There were 76 members in the four-generation family,with 22 members (including 14 males and 8 females) diagnosed with chronic actinic dermatitis.No positive results were found from laboratory examinations or environmental survey.Conclusion Chronic actinic dermatitis was inherited in an autosomal mode in this family.

Objective: To study the effect of benazepril on the expression of nuclear factor E2 related factor 2 (Nrf2), nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) and reactive oxygen species (ROS) concentration in rats with hepatic fibrosis and to explore the possible antifibrotic mechanism of benazepril. Methods: Twenty-two healthy male Sprague-Dawley rats were randomly divided into 3 groups: control group (6 rats), model group (8 rats) and benazepril treatment group (8 rats). Two rats died during modeling and treatment in the model group and the benazepril treatment group, and a model of hepatic fibrosis induced by carbon tetrachloride (CCL₄) was established. The rats in benazepril group were given benazepril for 8 weeks by gastric gavage. The assessment of liver tissue damage in each group was measured using conventional hematoxylin-eosin and Masson staining. The mRNA level of Nrf2, NOX4 in liver tissue was detected by RT-PCR, and serum ROS concentration was determined by colorimetry. All data were expressed in mean ± standard deviations, and were analyzed using SPSS21.0 statistical software. The data were compared using one-way analysis of variance, and the LSD-t method was used for pairwise comparison between the two groups. The correlation analysis was performed by Spearman’s correlation analysis. Results: In the liver of the model group, with the aggravation of liver fibrosis the expression of Nrf2mRNA, NOX4 mRNA and ROS concentration were higher than control group [(4.01 ± 3.40), (31.78 ± 3.96), (1.82 ± 0.46) μg/ ml vs. (0.12 ± 0.11), (2.03 ± 0.31), (1.56±0.84) μg/ml, P < 0.05]. After benazepril treatment, NOX4 mRNA expression and ROS concentration were decreased than the model group [(15.93 ± 5.01), (0.78 ± 0.44) μg/ml vs. (31.78 ± 3.96), (1.82 ± 0.46) μg /ml, P < 0.05], while Nrf2 mRNA expression was higher than the model group [(6.69 ± 4.86) vs. (4.01 ± 3.40), P < 0.05]. There was a positive correlation between Nrf2 and NOX4, Nrf2 and ROS, and NOX4 and ROS (r = 0.616, 0.411, 0.802, P < 0.05). Conclusion Benazepril may exert an anti-hepatic fibrosis effect by activating Nrf2 expression, or may inhibit the ROS-mediated oxidative stress in response to NOX4.

Nuclear factor-erythroid 2-related factor-2 (Nrf2) is an important transcription factor for cells to resist oxidative stress. It interacts with antioxidant response elements to induce the expression of downstream protective phase II detoxification enzymes and antioxidant enzymes and thus exerts a protective effect on cells. Oxidative stress is the common pathogenesis of many liver diseases, and the Nrf2-ARE antioxidant pathway is an important anti-oxidative stress pathway in vivo. It can induce the expression of downstream target genes and thus plays an important role in the development, progression, and prevention of liver diseases. This article briefly describes the mechanism of action of the Nrf2 antioxidant pathway in the development and progression of liver diseases and points out that Nrf2 may be a potential target for the prevention or treatment of liver diseases.

Objective: To systematically evaluate the efficacy and safety of endoscopic resection and laparoscopic surgery for gastrointestinal stromal tumors(GIST) (diameter<3.5 cm). Methods: According to the Cocharane system search strategy, Chinese and English literature comparing endoscopic with laparoscopic treatment of GIST published from January 2000 to March 2018 were collected. Ten articles meeting the inclusion criteria were included and analyzed with Revman 5.3. Results: Of the 10 articles, 1 was a prospective randomized controlled trial and 9 were retrospective non-randomized controlled trials. The total number of patients was 1 062. There were 732 cases in the endoscopic treatment group, and 330 cases in the laparoscopic surgery group. The meta-analysis results showed that the endoscopic treatment group had shorter operation time (MD=-30.58 min, 95%CI: -39.31--21.84, P<0.05), less blood loss (MD=-12.99 mL, 95%CI: -16.40--9.57, P<0.05), shorter hospital stay (MD=-3.17 d, 95%CI: -4.76--1.59, P<0.05), and less total cost (MD=-1.63 ten thousand RMB, 95%CI: -2.42--0.84, P<0.05) than those of the laparoscopic group. But there were no significant differences in the positive rate of margin(RR=2.35, 95%CI: 0.52-10.69, P=0.27) or perioperative complications(RR=1.08, 95%CI: 0.48-2.42, P=0.85). Conclusion Existing studies have shown that endoscopic treatment for GIST is effective, minimally invasive, economical with better prognosis, ensuring complete resection.

Objective: To explore the excellent methods for aesthetic repair of the donor sites of flaps. Methods: From January 2013 to March 2018, 120 patients (94 males and 26 females, aged from 3 to 60 years) were admitted to the Department of Burns of Beijing Jishuitan Hospital. Wounds areas after debridement or removing scar were ranged from 8.0 cm×3.5 cm to 24.0 cm×18.0 cm. Twenty patients with facial and neck scar were repaired with expanded flaps, including 4 scalp flaps, 8 supraclavicular flaps, 4 deltoid flaps, and 4 trapezius myocutaneous flaps. The flaps in ideal donor sites were selected to repair the wounds in 40 patients, including 20 cases of hand wounds or scars repaired with inguinal flaps, 10 children of foot skin defects or scars repaired with cross inguinal skin flap, 10 cases of knee joint wounds repaired with medial or lateral thigh flaps. The optimal flap design was used to repair wounds in 50 patients. Among the patients, wounds of 36 patients were repaired with relaying flaps, including donor sites of free anterolateral thigh flaps of 8 patients repaired with anteromedial thigh perforator flaps and donor sites of free anterolateral thigh flaps of 8 patients repaired with ilioinguinal flaps or superficial abdominal artery flaps, and donor sites of flaps of 20 patients repaired with peroneal perforator relaying flaps. Besides, wounds of 9 patients were repaired with free lobulated anterolateral thigh flaps, and wounds of 5 patients were repaired with modified V-Y propelling latissimus dorsi myocutaneous flaps. The donor sites of flaps were repaired with allogenic acellular dermal matrix combined with autologous split-thickness skin grafts in 10 cases. The areas of the flaps or myocutaneous flaps were ranged from 6.0 cm×4.0 cm to 30.0 cm×20.0 cm. The survival of flap, myocutaneous flap, or skin graft and the repair of donor site after operation and during follow-up were observed. Results: Blood flow obstacle at 0.5 cm to the distal margin of the flap occurred in 1 patient repaired with expanded flap, which were healed after dressing change. Blood supply disorder occurred at the tip of the anteromedial thigh perforator flap of 1 patient repaired by optimal flap design, which were healed completely after second debridement and restitching. The other flaps or myocutaneous flaps survived well. The allogenic acellular dermal matrix and the autologous split-thickness skin graft survived with good color and texture. During follow-up of 3 months to 4 years, the donor sites of flaps had good appearance, only with linear scar and the function recovered well. The donor sites of skin grafts had no scar hyperplasia, only with scattered pigmentation. Conclusions According to the characteristics of donor sites of flaps, individualized and reasonable design before the operation such as pre-expanding of the flaps, selecting the ideal donor sites, optimization of the flap design or allogenic acellular dermal matrix combined with autologous split-thickness skin graft to repair donor sites of flaps can minimize the damage for function and appearance of donor sites of flaps and achieve aesthetic effects of donor sites of flaps.

Objective: To study the outcome of perforator flap combined with mesh in repairing cicatricial abdominal hernia after deep burn. Methods: From June 2000 to June 2016, 11 cases of cicatricial abdominal wall hernia after deep burn were treated. 8 cases were caused by electrical burn, 2 cases by stove burn and 1 case by molten iron burn. All of them were Ⅳ degree burn of abdominal wall. The overall treatment time was 1-11 years, with the average of 4.1 years. The hernias were 6 cm × 6 cm to 12 cm × 11 cm in size. The abdominal wall hernia was repaired following the process of scar excision, mesh and perforator flap transfer and defect repairment. 3 kinds of mesh materials were used, polypropylene mesh (n=7), composite mesh (n=2), and acellular allogenic dermis (n=2). The size of meshes ranged from 8 cm ×8 cm to 16 cm ×13 cm. Meanwhile, paraumbilical perforator flaps were used in 5 patients, and anterolateral thigh perforator flaps were 6. The flaps were 18 cm ×10 cm to 22 cm ×13 cm in size. Results: All 11 cases of abdominal wall hernia were repaired. Follow-up period was 6 months to 2 years. There was no recurrence was found. The shape of the flap was satisfying. Conclusions The perforator flap combined with mesh is a good method to repair cicatricial abdominal wall hernia after deep burn.