Objective To evaluate the clinical significance of prenatal ultrasonography in diagnosis of retroaortic left innominate vein ( LINV ) . Methods Thirty fetus with retroaortic LINV were involved , including 17 cases of isolated retroaortic LINV and 13 cases of complicated retroaortic LINV . Three-vessel and trachea ( 3VT ) view was focused in the routine second trimester ultrasound screening to observe whether LINV existing or not . And then the transducer was rotated to the fetal sagittal view to assess the relationship between LINV and aortic arch and the convergence of left subclavian vein and left internal jugular vein into the LINV . Results The characteristic feature of retroaortic LINV was the LINV converge into right superior vena cava ( SVC) under the aortic arch ,not above the aortic arch . The most important plane to detect the retroaortic LINV was the 3VT view ,which revealed the abnormal vein lying to the left of pulmonary artery . The abnormal vein then could be traced and revealed its connection with the right SVC beneath the aortic arch on the transverse plane inferior to the 3VT view and on the fetal sagittal plane . Conclusions The whole course of retroaortic LINV can be revealed by ultrasound prenatally ,which can not only account for the abnormal vein to the left of pulmonary artery on 3VT view ,but also play an important role in surgery decision and future cardiac intervention treatment .

Objective To evaluate the feasibility of an intelligent three-dimensional ultrasound technique (Smart mid-sagittal planes,Smart MSP) in automatically detecting the fetal cranial mid-sagittal view.Methods Two hundred and forty pregnant women with singleton pregnancies were imaged to display the mid-sagittal view of fetal head using the Smart MSP by six doctors divided into three groups according the different experiences.Another two doctors were then invited to score the images acquired and to compare the successful rates of 6 doctors for acquiring fetal cranial mild-sagittal view according to the doctors' experience.Results The overall successful rate of acquiring the mid-sagittal view was 97.08％ (233/240) with the bipartial diameter plane (BPD plane) as the starting plane and 98.33(237/240) with the trans-cerebellum plane as the starting plane by using Smart MSP program.The successful rates in three groups were similar but the consumed times were different(P ＜0.05).The experienced doctors consumed less time than non-experienced doctors.The scores were also different in three groups.The scores of experienced doctors (group B and C) were significantly higher than that of non-experienced doctors (Group A) (P ＜0.05).There was no significant difference in the scores between experienced doctors (group B and C) (P＞0.05).Conclusions Smart MSP is a novel and feasible method for the automatic visualization of fetal cranial mid-sagittal plane,which may become an effective tool to screen the fetal midline anomalies in future.

Objective To evaluate the values of prenatal surveillances of ultrasonography in twin pregnancies with amniotic fluid discordance. Methods Two hundred and seventy cases of diamniotic twins were included. Both postnatal outcomes and prenatal amniotic fluid discordant variations were analyzed,and the incidences of amniotic fluid discordance were compared between the monochorionic-diamniotic(MCDA)and dichorionic-diamniotic (DCDA) gruop. Results Twenty four cases of twins with amniotic fluid discordance were found in the study. The incidence of amniotic fluid discordance in MCDA group was much higher than that in DCDA group (28.9% vs 5.6%, P ＜0. 001 ) ,and 24 cases of twin-to-twin transfusion syndrome (TTTS) were diagnosed in the former group and none were found in the latter group. Downward tendency of amniotic fluid discordance was shown in non-TTTS cases of MCDA group. Compared with TTTS cases, the postnatal outcomes of non-TTTS cases with amniotic fluid discordance were much better in MCDA group ( P ＜0.001 ). Conclusions TTTS and MCDA twins with amniotic fluid discordance may overlap each other in the early stage. Serial surveillances of ultrasonography are necessary for prenatal differentiating twin pregnancies complicated by amniotic fluid discordance,and providing strong support to clinical treament.

Defects involving specialised areas with characteristic anatomical features, such as the nipple, upper eyelid, and lip, benefit greatly from the use of sharing procedures. The vulva, a complex 3-dimensional structure, can also be reconstructed through a sharing procedure drawing upon the contralateral vulva. In this report, we present the interesting case of a patient with chronic, massive, localised lymphedema of her left labia majora that was resected in 2011. Five years later, she presented with squamous cell carcinoma over the left vulva region, which is rarely associated with chronic lymphedema. To the best of our knowledge, our management of the radical vulvectomy defect with a labia majora sharing procedure is novel and has not been previously described. The labia major flap presented in this report is a shared flap; that is, a transposition flap based on the dorsal clitoral artery, which has consistent vascular anatomy, making this flap durable and reliable. This procedure epitomises the principle of replacing like with like, does not interfere with leg movement or patient positioning, has minimal donor site morbidity, and preserves other locoregional flap options for future reconstruction. One limitation is the need for a lax contralateral vulva. This labia majora sharing procedure is a viable option in carefully selected patients.
Arteries ; Carcinoma, Squamous Cell ; Eyelids ; Humans ; Leg ; Lip ; Lymphedema ; Nipples ; Patient Positioning ; Perineum ; Tissue Donors ; Vulva

OBJECTIVETo construct a recombinant lentiviral vector that co-express green fluorescent protein (GFP) and FoxM1 shRNA and establish a prostate cancer cell line with stable FoxM1 down-regulation.

METHODSThree interfering sequences targeting FoxM1 were designed and inserted into the lentiviral vector pHBLV-U6-ZsGreen-Puro. After identification by DNA sequencing, the lentiviral vectors carrying Foxm1 shRNA were packaged in 293 cells. The lentiviral particles were collected to infect human prostate cancer DU-145 cells, and the transfection efficiency was observed under fluorescence microscope; the interference efficiency was assessed using real-time PCR. DU-145 cells with stable FoxM1 down-regulation were screened with puromycin, and the expression level of FoxM1 was detected by Western blotting and the cell growth was observed using MTT assay. The stably transfected cells were examined for cell apoptosis and cell clone formation capacity with flow cytometry and colony formation assay.

RESULTSDNA sequencing demonstrated successful construction of the 3 FoxM1 shRNA lentivirus vectors. Real-time PCR showed a high interference efficiency of FoxM1 shRNA1 vector, which resulted in obvious down-regulation of FoxM1 in DU-145 cells. Western blotting showed that the expression of FoxM1 protein was decreased in FoxM1 shRNA1 lentivirus-transfected cells, which displayed a suppressed cell proliferation, increased apoptosis rate, and attenuated clonogenic ability.

CONCLUSIONWe have successfully established a prostate cancer cell model with stable FoxM1 down-regulation, which shows lowered proliferative and clonogenic activities with increased cell apoptosis.

Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Down-Regulation ; Forkhead Box Protein M1 ; Forkhead Transcription Factors ; genetics ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Lentivirus ; Male ; Prostatic Neoplasms ; genetics ; RNA, Small Interfering ; genetics ; Real-Time Polymerase Chain Reaction ; Transfection

Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.

Objective:To systematically evaluate the therapeutic efficacy of enteral nutrition(EN)versus parenteral nutrition(PN)in patients after liver transplantation(LT).Methods:The databases of Cochrane Library, MEDLINE, EmBase, EBSCO, Sinomed, CBM, CNKI and Wanfang Data were systematically searched up to August 2021 for collecting randomized controlled trials(RCT)of comparing EN and PN in patients after LT.In strict accordance with the inclusion and exclusion criteria, two independent researchers carried out literature screening, data extracting and literature methodological quality evaluations.Then RevMan5.3 software was utilized for quantitative synthesis and statistical processing.Results:A total of 13 RCTs involving 571 grade B patients were included.Meta-analysis indicated that, as compared with PN, serum albumin of EN spiked[WMD=2.5(1.33, 3.68), WMD>0, P<0.000 1], prealbumin rose[WMD=59.78(32.22, 87.35), WMD>0, P<0.000 1], total bilirubin dropped[WMD=-27.81(-41.88, -13.74), WMD<0, P=0.000 1]and infection incidence was significantly lower[ OR=0.25(0.16, 0.39), OR<1, P<0.000 01]. Conclusions:After LT, as compared with PN, EN can boost the nutritional level, promote the recovery of liver function and lower the incidence of postoperative infections.It offers some clinical values.

BACKGROUND: The combination of polycaprolactone and hyaluronic acid creates an ideal environment for wound healing. Hyaluronic acid maintains a moist wound environment and accelerates the in-growth of granulation tissue. Polycaprolactone has excellent mechanical strength, limits inflammation and is biocompatible. This study evaluates the safety and efficacy of bio-conjugated polycaprolactone membranes (BPM) as a wound dressing. METHODS: 16 New Zealand white rabbits were sedated and local anaesthesia was administered. Two 3.0x3.0 cm full-thickness wounds were created on the dorsum of each rabbit, between the lowest rib and the pelvic bone. The wounds were dressed with either BPM (n=12) or Mepitel (n=12) (control), a polyamide-silicon wound dressing. These were evaluated macroscopically on the 7th, 14th, 21st, and 28th postoperative days for granulation, re-epithelialization, infection, and wound size, and histologically for epidermal and dermal regeneration. RESULTS: Both groups showed a comparable extent of granulation and re-epithelialization. No signs of infection were observed. There was no significant difference (P>0.05) in wound size between the two groups. BPM (n=6): 8.33 cm2, 4.90 cm2, 3.12 cm2, 1.84 cm2; Mepitel (n=6): 10.29 cm2, 5.53 cm2, 3.63 cm2, 2.02 cm2; at the 7th, 14th, 21st, and 28th postoperative days. The extents of epidermal and dermal regeneration were comparable between the two groups. CONCLUSIONS: BPM is comparable to Mepitel as a safe and efficacious wound dressing.
Bandages* ; Granulation Tissue ; Hyaluronic Acid ; Inflammation ; Membranes* ; Pelvic Bones ; Rabbits ; Re-Epithelialization ; Regeneration ; Ribs ; Skin ; Wound Healing ; Wounds and Injuries*

OBJECTIVE To establish a quantitative analysis model for the contents of tussilagone， moisture， ethanol-soluble extract and total ash in Farfarae Flos based on near-infrared spectroscopy （NIRS）， providing a new idea for the rapid quality evaluation of Farfarae Flos and its preparations. METHODS Referring to the 2020 edition of the Chinese Pharmacopoeia， the contents of the main quality control indexes tussilagone， moisture， ethanol-soluble extract and total ash in 130 batches of Farfarae Flos from 19 producing areas were determined by HPLC， drying method， hot dip method and ash assay， respectively. The NIRS data information of the medicinal herbs of Farfarae Flos was collected， and then NIRS combined with the partial least squares method was used to establish the individual quantitative analysis models of the above quality control indexes in the samples， and the predictive model of the NIRS content was obtained after sample validation with validation set. RESULTS The range for the contents of tussilagone， moisture， ethanol-soluble extract and total ash in 130 batches of Farfarae Flos were 0.051 4%-0.103 5%， 7.75%-10.93%， 20.17%-31.12%， and 7.68%-12.10%， respectively. The internal cross-validation coefficients of determination （R2） of the established models for the quantitative analysis of tussilagone， moisture， ethanol-soluble extract and total ash in Farfarae Flos were 0.985 8， 0.968 4， 0.973 4， 0.988 0， respectively； the root mean square errors of calibration （RMSEC） were 0.001 54， 0.187， 0.478， 0.127， respectively； the root mean square errors of prediction （RMSEP） were 0.001 81， 0.212， 0.543， 0.149， respectively； RMSEP/RMSEC were 1.175 3， 1.133 7， 1.136 0 and 1.173 2， respectively， which were all within a reasonable range （1＜RMSEP/RMSEC≤1.2）. The mean absolute errors between the true and model-predicted values of the above four quality control indexes in the validation set of samples were －0.000 36， 0.061 43， 0.144 00， and 0.010 43， respectively，and the mean predicted recoveries were 99.65%， 100.72%，100.66%， and 100.15%， respectively. CONCLUSIONS The established NIRS quantitative analysis model has high stability and reliable results， which can be used for the rapid batch prediction of the content of relevant quality control indexes in Farfarae Flos.