Objective To investigate the primary repair methods and efficacy of island pedicled pectoralis major muscle flap in soft tissue defect after the operation of head and neck malignant tumors .Methods From April 2011 to September 2012 ,27 patients from this hospital who underwent primary repair using island pedicled pectoralis major muscle flap after a head and neck extensive soft tissue defect were investigated ,including 11 cases of tongue cancer defect ,2 cases of parotid gland defect ,3 cases of gum cancer defect ,2 cases of oropharyngeal cancer defect ,9 cases of floor of the mouth cancer defect .Results 27 patients were safety in periop-erative ,27 cases of island pectoralis major muscle flap survived ,patients were satisfied with both the appearance and function .There was postoperative neck hematoma in 1 patient ,it was eliminated through timely remove the hematoma and hemostasis completely ;There was 1 case of removing the epidermal necrolysis skin as flap necrosis ,while it was acceptable efficacy as the muscle flap sur-vival and surface granulation repaired .Conclusion Island pectoralis major muscle flap obtains unique advantages in repairing a large area of soft tissue defect in head and neck cancer patients after operation ,such as abundant of tissue ,a constant arterial anatomy of thoracoacromial ,easy to operate ,rich blood supply ,strong resistance to infection ,high survival rate and so on .A fine surgery opera-tion is the key of island pectoralis major muscle flap survival .

Objective To discuss the prevention and management method for chylous fistula after neck lymph node dissec‐tion .Methods Totally 1 793 cases of neck lymph node dissection in this department from January 2005 to September 2014 were retrospectively analyzed .The clinical data in the cases of chylous fistula occurred after operation were summarized .Results Twenty one cases of chylous fistula occurred ,accounting for 1 .17% ,in which 13 cases were cured by the local compressed bandaging and continuous negative pressure drainage;5 cases adopted the conventional method for 2-3 d ,but under the ineffective condition ,then they were treated by combining with somatostatin pumping (somatostatin 6 mg+0 .9% normal saline 48 mL ,2 mL/h ,lasting for 24 h ,for successive 2-3 d) and finally cured;3 cases were cured after reoperation .Conclusion Prevention is the best treatment for chylous fistulas ,local compression bandage plus continuous negative pressure drainage is the main method for treatment of chylous fistulas after neck dissection .The combined therapy with somatostatin can increase the close rate of chylous fistulas;for the patients with long persistent time ,large drainage volume and invalid conservative therapy should adopt the remedial measure of operation .

OBJECTIVETo establish a HepG2 cell line stably expressing the human cytochrome P450 1A2 and to study its metabolic activity.

METHODSThe human wild-type CYP1A2 cDNA was subcloned into a mammalian expression vector pREP9. A transgenic cell line was established by transfecting the recombinant plasmid of pREP9-CYP1A2 to HepG2 cells. The expression of CYP1A2 mRNA was validated by RT PCR. The metabolic activation of HepG2 CYP1A2 cells on aflatoxin B1 (AFB1) was assayed by cytotoxicity test.

RESULTThe HepG2-CYP1A2 cells expressed CYP1A2 mRNA and could increase the cytotoxicity to AFB1 in comparison with that of wild type HepG2 cells.

CONCLUSIONThe established HepG2-CYP1A2 can express the mRNA and has the metabolic activity to AFB1. The cell line may be useful for testing the toxicity and metabolism of xenobiotics, which might possibly be activated or metabolized by CYP1A2.

Aflatoxin B1 ; metabolism ; Biotransformation ; Cell Line ; Cytochrome P-450 CYP1A2 ; genetics ; metabolism ; DNA, Complementary ; chemistry ; Humans ; RNA, Messenger ; analysis

OBJECTIVETo evaluate the preventive effects of ulinastatin (Uti) on postoperative complications in elderly patients undergoing hip joint replacement.

METHODSFrom Angust 2009 to June 2010, 160 elderly patients undergoing selective hip joint replacement with ASA I to II were assessed according to American Society of Anesthesiologists classification, including 81 males and 79 females ranging in age from 65 to 83 years (mean 73.9 years). All the patients were divided into 2 groups according to random number table (80 patients in each group): control group (group C) and ulinastatin group (group U). The patients in Group U received intravenous injection of ulinastatin with a dose of 10,000 U/kg before skin incision,and then with dose of 5000 U/kg respectively at 1, 2 and 3 days after operatio. The patients in Group C received the same volume of normal saline instead of ulinastatin. Blood samples were taken preoperatively,at the end of surgery and 1, 2, 3 days after operation for determination of ALT, AST, Scr, BUN and Plasma D-dimer. Deep vein thrombosis and postoperative cognitive dysfunction (POCD) were also examined through color Doppler ultrasonography and neuroeognirive assessment on the postoperative 3 days respectively.

RESULTSCompared with the preoperative values, the contents of ALT, AST, Scr, BUN and plasma D-dimer in each group all increased. Compared with group C,the values of ALT, AST, Scr, BUN and plasma D-dimer decreased markedly (P < 0.05). The incidence rate of DVT and POCD was 0 and 3.75% in group U, which were lower than those of patients in the group C (40%, 27.5%) respectively.

CONCLUSIONIntravenous infusion of ulinastatin during operation can protect important organ function, correct blood hypercoagulability, lower the occurrence of DVT and POCD, and prevent the postoperative complications in some degree.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Blood Urea Nitrogen ; Case-Control Studies ; Cognition Disorders ; prevention & control ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Glycoproteins ; therapeutic use ; Humans ; Male ; Postoperative Complications ; prevention & control ; Trypsin Inhibitors ; therapeutic use ; Venous Thrombosis ; prevention & control

BACKGROUNDGlaucoma is one of the leading causes of blindness in the world. Primary open-angle glaucoma (POAG) and primary congenital glaucoma (PCG) are subtypes of glaucoma. Myocillin is the first gene identified to be involved in POAG. Recently, myocillin mutation has been found in PCG. In this context, we reported a special glaucoma pedigree, which was composed of both PCG and POAG patients, and analyzed the mutation of myocillin in this pedigree.

METHODSThe family was composed of the parents, a son and a daughter. All members of the family underwent the complete ophthalmologic examinations. All coding exons 1 - 3 and flanking introns of myocilin gene were screened for sequence alterations by polymerase chain reaction and direct DNA sequencing.

RESULTSThe son was the proband, who was diagnosed as PCG in both eyes. The father was diagnosed as POAG in the right eye, the left eye was still normal. Both the sister and the mother of the proband had normal intraocular pressure without glaucomatous optic disc changes. The mutations in intron 2 of myocilin gene were detected in the family. While the proband and the father were homozygous, the mother and the sister were heterozygous for the mutation.

CONCLUSIONSHomozygous mutation in intron 2 of myocilin gene is involved in both POAG and PCG. It is suggested that the pathogenesis might be overlapping in POAG and PCG.

Cytoskeletal Proteins ; genetics ; Eye Proteins ; genetics ; Female ; Glaucoma ; congenital ; genetics ; Glaucoma, Open-Angle ; genetics ; Glycoproteins ; genetics ; Humans ; Introns ; Male ; Mutation ; Pedigree

Glaucoma is rarely complicated by retinitis pigmentosa (RP). To provide clinical evidences for this rare situation, we report the concurrence of these two diseases in two children of a Chinese family. In the present two-child Chinese family without positive history, the older sister presented with bilateral sector RP and coexisting chronic angle-closure glaucoma, and the brother with bilateral whole RP but without coexisting glaucoma. Clinical evidences in concurrence of variants of RP and glaucoma because of possible different gene mutations from the same genetic background represent a rare situation, which may provide clues for future researches in molecular pathogenesis of these rare diseases.
Female ; Glaucoma ; diagnosis ; Humans ; Retinitis Pigmentosa ; diagnosis ; Young Adult

OBJECTIVETo investigate the effects of ulinastatin (Uti) and low-molecular-weight heparin (Lmwh) on coagulation function and deep vein thrombosis (DVT) in patients undergoing hip joint replacement.

METHODSFrom March to December 2010 150 ASAI-II patients with average age of 72.5 (65 - 85) years undergoing hip joint replacement were randomly divided into 3 groups (n = 50 each): normal saline (NS) control group (Group C), Uti group (Group U) and Lmwh group (Group L). Group U received intravenous infusion of ulinastatin (10 000 U/kg) at preoperative, perioperative and after operation 1, 2 and 3 d, respectively. Group C received the same volume of NS instead of Uti. Group L were injected Lmwh subcutaneously (3200 U/d) at preoperative, after operation 1, 2 and 3 d. Blood samples were taken before operation (T(0)), at the end of surgery (T(1)), 1 d (T(2)), 2 d (T(3)) and 3 d (T(4)) after operation for determination the values of R, K, α angle, MA and CI, using thromboelastography, and the DVT were also examined through color Doppler ultrasonography at 3 d after operation.

RESULTSCompared with T(0), R, K were shorter, α angle, MA and CI were larger in group C, the values at T(2) were up to the peak then declined at T(4). Compared with group C, the value of R, K were larger, the value of α angle, MA and CI were shorter in group U and group L. The DVT checked by ultrasonography were found in 20 cases in group C, 1 case in group U, and zero case in group L. The differences were no statistically significant between group U and group L.

CONCLUSIONIntravenous infusion of Uti during the period of operation can correct the hypercoagulability of blood and decrease the incidence of DVT after operation.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Blood Coagulation ; Double-Blind Method ; Female ; Glycoproteins ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Male ; Postoperative Complications ; prevention & control ; Venous Thrombosis ; etiology ; prevention & control

OBJECTIVETo gain insight into the potential mechanism of mitochondria dysfunction in pathogenesis, progression and therapeutic management of glaucoma.

DATA SOURCESThe data used in this review were mainly published in English from 2000 to present obtained from PubMed. The search terms were "mitochondria", "glaucoma" and "trabecular meshwork" or "retinal ganglion cells".

STUDY SELECTIONArticles studying the mitochondria-related pathologic mechanism and treatment of glaucoma were selected and reviewed.

RESULTSMitochondrial dysfunction or injury was demonstrated in different eye tissue of glaucoma. A variety of potential injuries (light, toxic materials, oxidative injury, mechanical stress, aging, etc.) and the inherent DNA defects are deemed to cause mitochondrial structural and functional destruction in trabecular meshwork cells, retinal ganglion cells, etc. of glaucoma. In addition, various new experimental and therapeutic interventions were used to preserve mitochondrial function, which may be useful for protecting against optic nerve degeneration or reducing the death of retinal ganglion cells in glaucoma.

CONCLUSIONSMitochondria play an important role in the pathogenesis of glaucoma, various strategies targeting mitochondrial protection might provide a promising way to delay the onset of glaucoma or protect RGCs against glaucomatous damage.

Glaucoma ; metabolism ; pathology ; Humans ; Mitochondria ; metabolism ; Retinal Ganglion Cells ; metabolism ; Trabecular Meshwork ; metabolism

OBJECTIVETo study how the combined effects of various differentiation inducers and heat stress on the expression of JWA protein in K562 cell, the relationship between JWA and Hsp70 expression, and the signal regulation mechanism possibly involved.

METHODSThe experimental model was established in K562 cells. Various directional differentiation inducers (TPA, Ara-C, hemin, adriamycin, ATRA and As(2)O(3)) were used alone or combined with heat shock treatment (42 degrees C, 2 h). Western blot was used for detecting expressions of JWA, Hsp70, heat stress factor 1 (HSF1) and HSF2.

RESULTS(1) The expressions of both JWA protein and Hsp70 were significantly up-regulated after K562 cells treated by TPA (100, 200 ng/ml) or adriamycin (4 x 10(-8) mol/L) 48 h, and followed by heat shock (42 degrees C, 2 h). However, the opposite effects were observed when the cells treated by hemin (3 x 10(-5) mol/L, 48 h), Ara-C (80 ng/ml, 48 h) and As(2)O(3) (1 x 10(-6) mol/L, 48 h) followed by 2 h heat shock. No obvious changes were found when the cells treated by ATRA (1 x 10(-6) mol/L, 48 h) alone or followed by heat shock. (2) Both the heat shock transcriptional factors HSF1 and HSF2 did not show any significant changes when K562 cells were treated with various differentiation inducers and followed by heat stress.

CONCLUSIONJWA not only takes part in the regulation of K562 cellular differentiation, but also of heat stress, it might be the co-target gene of several differentiation inducers and heat stress. The expression of Hsp70 seems not mediated by both HSF1 and HSF2 in K562 cells undergoing directional differentiation or heat stress treatment. JWA is likely to be a new signal molecule similar to Hsp70 signal pathways. The results show that JWA takes part in the mechanism of K562 cell response to heat stress.

Blotting, Western ; DNA-Binding Proteins ; analysis ; Flow Cytometry ; HSP70 Heat-Shock Proteins ; analysis ; Heat Shock Transcription Factors ; Heat-Shock Proteins ; analysis ; Hot Temperature ; Humans ; Intracellular Signaling Peptides and Proteins ; K562 Cells ; Transcription Factors ; analysis

OBJECTIVETo study the expression of JWA protein and heat shock protein (Hsp70), and to explore these relationship and the possible mechanism of JWA gene involved in induced differentiation and heat stress (42 degrees C) of K562 cells.

METHODSThe models of differentiation and heat stress of K562 cells were established. Western blot was used for detecting expressed proteins of JWA gene, Hsp70, heat shock factor (HSF1 and HSF2).

RESULTS(1) Under the condition of differentiations induced by TPA (100 ng/ml), hemin (3 x 10(-5) mol/L), Ara-C (80 ng/ml), adriamycin (4 x 10(-8) mol/L), ATRA (1 x 10(-6) mol/L) and As(2)O(3) (1 x 10(-6) mol/L) for 48 h respectively, the expression of JWA protein and Hsp70 were more significantly increased than control; the level of HSF2 protein was increased by inductions of hemin, Ara-C and adriamycin, respectively. (2) After heat exposure to 42 degrees C for 10, 20, 30, 45, 60, 90 min, and heat exposure to 39 degrees C, 42 degrees C, 45 degrees C, the trend of changing in expression of Hsp70 was similar to that of JWA protein, and HSF1 was expressed in earlier stage.

CONCLUSIONThe expression of JWA protein and Hsp70 were upregulated in induced differentiation and in heat stress, and the change of expression of JWA protein were similar to that of Hsp70, but the intracellular transduction signal pathways involved may be various. JWA might not be specifically related with both HSF1 and HSF2.

Antibiotics, Antineoplastic ; pharmacology ; Antimetabolites, Antineoplastic ; pharmacology ; Blotting, Western ; Cell Differentiation ; drug effects ; Cytarabine ; pharmacology ; DNA-Binding Proteins ; analysis ; Doxorubicin ; pharmacology ; HSP70 Heat-Shock Proteins ; analysis ; Heat Shock Transcription Factors ; Heat-Shock Proteins ; analysis ; Hemin ; pharmacology ; Hot Temperature ; Humans ; Intracellular Signaling Peptides and Proteins ; K562 Cells ; Transcription Factors ; analysis