Myocardial fibrosis is a pathological process characterized by fibroblast proliferation and collagen deposition,which occurs in the normal structure of the myocardium.MicroRNAs (miRNAs) are a class of endogenous,non-coding RNA of approximately 22 nucleotides in length,regulating gene expression at posttranscriptional level by complementary pairing with the target gene mRNA.Recent studies have showed that miRNAs play an important role in the formation of myocardial fibrosis,therefore,much attention has been paid to miRNAs as they may serve as targets for prevention and treatment of myocardial fibrosis.

This study was aimed to compare the function of dendritic cells (DCs) in patients of Y in-Huang syn-drome and Y ang-Huang syndrome from the peripheral blood of HBV related hepatic failure. Jaundice patients of HBV related hepatic failure were divided into two groups, which were the Y ang-Huang syndrome group and Y in-Huang syndrome group. And a healthy control group was also established. The DCs were separated and cultured in vitro from PBMCs in the peripheral blood. Surface molecules such as HLA-DR, CD80, CD86, CD83 and CD1αwere detected by the flow cytometry. And the level of IFN- α and IL-4 in the supernatant of DCs were also de-tected. The expression difference of inflammatory cytokines and immune cells between Y in-Huang and Y ang-Huang syndrome in patients of HBV related hepatic failure were compared. The results showed that compared with healthy people, the expression rate of DCs phenotype such as HLA-DR, CD1α, CD83, CD80, CD86 in patients of HBV related hepatic failure was significantly decreased (P < 0.01); the excreted factor IFN-α had a significant rising (P < 0.01). Compared to Y ang-Huang syndrome group, the expression rate of CD83 and CD86 in the Y in-Huang syndrome group of HBV related hepatic failure patients was significantly reduced (P < 0.01). And the ex-creted factor of IL-4 had a significant rising in Y in-Huang syndrome group (P < 0.01). Compared to the Y in-Huang syndrome group, the excreted factor IFN-α in the Yang-Huang syndrome group had a significant rising (P< 0.01). It was concluded that DCs function of patients with HBV related hepatic failure in both Y in-Huang syn-drome and Y ang-Huang syndrome group showed low immune function. And the immune function of the Y in-Huang syndrome group was lower. There was excessive releasing of inflammatory factors in the Y ang-Huang syn-drome group. And there was enhanced anti-inflammatory cytokine expression in the Y in-Huang group.

OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

Adult ; Female ; Humans ; Lacrimal Apparatus ; immunology ; Lymphocytes ; immunology ; Male ; Mucous Membrane ; immunology

Objective To investigate the ideal reconstruction methods after pelvic tumor resection and to assess the feasibility of three-dimensional (3D) printing technology for pelvic reconstruction,we performed a retrospective study of patients with pelvic tumors who received tumor resection and reconstruction using 3D-printed pelvic endoprostheses.Methods Thirty-five patients received tumor resection and functional reconstruction with 3D-printed pelvic endoprostheses in our center from Sep.2013 to Dec.2015.According to Enneking' s classification,there were 3 cases of Type Ⅰ,12 cases of Type Ⅱ+Ⅲ,5 cases of Type Ⅰ+Ⅱ,2 case of Type Ⅰ+Ⅱ+Ⅲ,10 cases of type Ⅰ+Ⅱ+Ⅳ and 3 cases of type Ⅰ+Ⅱ+Ⅲ+Ⅳ resection.Methods of reconstruction included 3 patients with 3D-printed iliac endoprosthesis,12 patients with 3D-printed standard hemipelvic endoprosthesis and 20 patients with 3D-printed screw-rod connected hemipelvic endoprosthesis.Results All 35 patients underwent en bloc resection.Margins were wide in 15 cases,marginal in 14 cases and intralesional in 6 cases.After a mean followed-up of 20.5 months (6 to 30),25 patients survived without evidence of disease,5 patients were alive with diseases and 5 patients died of distant metastasis.Complications included 7 cases of delayed wound healing,2 cases of hip dislocation and no cases of deep infection.The average MSTS 93 score was 19.1 (9-26) for all of the 30 alive patients,22.7 (20 to 25) for 3 patients with iliac endoprosthesis reconstruction,19.8 (15 to 26) for 12 patients with standard hemipelvic endoprosthesis reconstruction,and 17.7 (9 to 25) for 15 patients with screw-rod connected hemipelvic endoprosthesis at the last follow up.Conclusion The application of 3D-printing technology could facilitate precise matching and osseointegration between the implants and host bone.Our clinical results proved that application of 3D-printed pelvic endoprostheses for reconstruction of bony defect was safe without additional complications,and that good functional results could be expected during short-term follow-up.

Objective To explore the value of apparent diffusion coefficient (ADC)in differentiating brain tuberculomas from me-tastases.Methods Conventional and enhanced MRI as well as diffusion weighted imaging (DWI)were performed in 24 cases of brain tuberculomas(immature in 18 cases and mature in 6 case)and 36 cases of metastases.The mean ADC values and relative ADC (rADC)values were calculated from the enhanced and non-enhanced regions of mass and the peripheral edema regions of brain le-sions.Results The mean ADC values and rADC values in the enhanced,non-enhanced and the peripheral edema regions were 796.90×10 -6 mm2/s and 1.1 6,864.85×10 -6 mm2/s and 1.27,1 531.60×10 -6 mm2/s and 2.24 for the immature brain tuberculo-mas;791.95×10 -6 mm2/s and 1.1 6,61 1.80×10 -6 mm2/s and 0.87,and 1 488.45×10 -6 mm2/s and 2.10 for the mature tubercu-lomas;421.95×10 -6 mm2/s and 0.61,961.00×10 -6 mm2/s and 1.36,1 545.00×10 -6 mm2/s and 2.18 for the brain metastases, respectively.There were significant differences in the mean ADC values (H =42.293,P ≤0.05)and rADC values (H =42.575, P ≤0.05)for the enhance regions in the three groups .There were also significant differences in the mean ADC values (H =33.100, P ≤0.05)and rADC values (H =1 7.867,P ≤0.05)for the non-enhance regions.No significant difference in the mean ADC values (H =1.550,P ≥0.05)and rADC values (H =5.511,P ≥0.05)were found for the peripheral edema regions.Conclusion The ADC values of DWI can help to differentiate brain tuberculomas from metastases,when combining with the conventional and enhanced MRI.

Adolescent ; Humans ; Laryngeal Neoplasms ; Male ; Sarcoma, Synovial

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) have a remarkable differentiation potential and superiority as a type of seed cells,but their application is limited in the presence of certain diseases,such as aplastic anemia and myelogenous neoplasm.The present studies have found that seed cells called muscle-derived stem cells (MDSCs) have brought more and more attention,because of their capability of stir-renewal and multi-diffcrentiation like B MSCs.OBJECTIVE: To explore the biological characterization of the muscle-derived stem cells (MDSCs) from rabbits,and analyze the phenotype.DESIGN,TIME AND SETTING: Cell in vitro observation experiment was performed at the Medical Research Center of Second Affiliated Hospital of Sun Yat-sen University from August 2005 to March 2006.MATERIALS: A New Zealand rabbit (1.5 months old,clean grade) was enrolled for the preparation of Muscle-derived stem cells.Growth medium was DMED-LG added with 10% fetal bovine serum and 10% horse serum and fusion medium was DMEM-LG added with 2% fetal bovine serum.METHODS: The muscle mass was removed from the anesthetized rabbit to isolate MDSCs.These cells were dissociated using three enzymes (collagenase XI,dispase and trypsin) respectively.Sediment was resuspended.Then preplate technique was used.The muscle cell extract was plated on a collagen-coated culture flask with growth medium.The flask was called PP1.PPI was kept overnight in a 37 ℃ incubator containing 5% CO2,After that,the suspension was transferred to another collagen-coated culture flask,which was called PP2.PP3,PP4,PP5 and PP6 were constructed later following the same procedures.The cells adhered in PP6 were collected,plated in 6-well plates,and divided into 2 groups.Growth medium was used in one group,in which the cells were kept growing at a degree of confluence beyond 50%,and fusion medium was used in the other one,in which the cells were passaged with a degree up to 30%.MAIN OUTCOME MEASURES: The cells from PP1 to PP6 were collected,and the characterization was identified preliminary by Flow cytomctry,Immunocytochemistry and Western Blotting.The fusion of cells in PP6 was detected at different confluence degrees and concentration of medium.RESULTS: The cells in PP6 showed ＞ 80% desmin+,＞ 70% Bcl-2+,＞ 95% CD45,which indicated that MDSCs were in a high concentration.The expressions of α-SMA in the cells were decreasing with the Preplate technique used and the cells in PP6 almost had no α -SMA expression.When passaged at a high confluence (＞ 50%) or cultured with low concentrations of serum (2% serum),the cells in PP6 had a strong tendency of fusing into myotubes or cell chains and were skeletal myosin+.CONCLUSION: MDSCs,which are capable of multi-differentiation under a high fusion or low serum conditions,express dcsmin and Bcl-2 highly,but extreruelv little CD45 and no α -SMA.

Objective To study the relationship of surgical procedures with clinical effect in herniat-ed lumbar disc in order to improve operative methods and obtain a better outcome.Methods Retrospec-tive analysis was carried out in7235patients with herniated lumbar disc,who had been operated by removal of nucleus pulposus using small incision and fenestration in our hospital since1983,313cases of whom re-ceived second operation because of postoperative complications.There were187males and126females aging from27to62years(mean,45.8years),the incidence of morbidity was4.32%.During the same period,552patients,who had less approved operative result primarily treated in other hospitals,were admitted to our hospital.There were317males and235females aging from31to64years(mean,46.0years).Results The postoperative complications could be divided into short term(within1month after operation)and mid-dle to long term(more than1month after operation)groups.The total446cases with short term compli-cation were133cases primarily treated in our hospital and313cases in other hospital,including of re-herni a-tion or incomplete nuclear extirpation in77treated with second operation,discitis in106treated with con-servative therapy for 67and second operative management for 39,canal hematoma compression in76treated surgi cally,multi-level herniation and leakage in21and mislocalization in59re-operated,injury of nerve root or cauda equina in85treated with nerve exploration,release and anastomosis,residual materials in canal in17with removal of foreign body,venous thrombus in2,and arachnoiditis in3.The total424cases with middle to long term complications were185cases primarily treated in our hospital and239cases in other hospitals,including of nerve root adhesion in159,recurred disc herniation in122,segmental instability in81,and ia-trogenic spinal stenosis in62.Conclusion Many factors may influence the outcome of herniated lum bar disc which can be abolished by sufficient preparation,careful operation and proper managememt.

Objective To investigate the feasibility and effectiveness of internal jugular vein (IJV) intervention therapy in patients with cerebral venous sinus thrombosis (CVST)with color Doppler ultrasound (CDU). Methods Twelve patients with CVST diagnosed by CDU and the 13 IJV lesions (localized luminal stenosis in 9 cases,venous long-segment slender in 2 cases,and right IJV localized luminal stenosis,and long-segment slender on the left in 1 case)confirmed by magnetic resonance venography (MRV)and/ or digital subtraction angiography (DSA)were enrolled retrospectively. CDU examinations were used at 1 week before and after IJV intervention therapy,6 months,1 year,and 2 years. The changes of the maximum diameter and the maximum velocity (V max )of the IJV were compared. The success rate and the long-term efficacy of the intervention therapy were analyzed. Results One week after treatment,the CDU examinations showed that the diameter of IJV stenosis in 13 IJV were increased significantly compared with those before procedure (4. 7 ± 2. 1 mm vs. 2. 3 ± 1. 3 mm;t = 5. 325,P < 0. 01). The velocity of blood flow of IJV was improved compared with before procedure (localized stenosis in 10 IJV[50 ± 15 cm/ s vs. 87 ± 24 cm/ s];t = 6. 285,P < 0. 01). Six of the 12 patients were followed up for a mean of 18 ± 7 months, two patients had restenosis after balloon dilatation. Conclusions For CVST patients with IJV lesions,the preliminary observation has indicated that IJV intervention therapy may improve the lesion lumen and hemodynamics. However,the intervention therapy,especially after balloon dilatation,the incidence of restenosis is higher. CDU can be used as an objective evaluation means for the long-term efficacy of IJV stenosis.