Objective To study the expression of transient receptor potential channel (TRPC) isoforms (TRPC1,3,4,5,6,7) inrats with cardiac hypertrophy.Methods Thirty adult male SD rats,weighing 200-240 g were divided into surgical group (model group,20 rats) and sham group (control group,10 rats) by random number table according to body weight.Aortic coarctation surgery was performed to establish a rat model of myocardial hypertrophy and the control group did not ligate thoracic aorta,but the same surgical procedure with the model group was performed.After 10 weeks,echocardiography was used to check changes of cardiac function; cardiac tissues of rats were weighed and cardiac hypertrophy index was calculated.Cardiac HE staining was used for observation of myocardial tissue morphological changes.Quantitative RT-PCR method was used for measuring the mRNA expression of TPRC isoforms (TRPC1,3,4,5,6,7).Western blotting assay was applied to detect the protein expression of TRPC4 and TPRC5 in hypertrophic cardiac tissue of rats.The relationship between cardiac hypertrophy exponential and TRPC4,TRPC5 protein expression was studied.Results Echocardiography showed that the septal thickness and posterior wall thickness in model group increased significantly compared with those of the control group [mm:(2.64 ± 0.31) vs.(1.89 ± 0.15),(2.30 ± 0.14) vs.(1.60 ± 0.09),t =9.19,8.57,all P ＜ 0.05].Compared with the control group,cardiac hypertrophy index was significantly increased in model group [(3.21 ± 0.15)vs.(1.82 ± 0.10)mg/g,t =17.02,P ＜ 0.01].HE staining of myocardium showed that cardiomyocyte hypertrophy,abnormal nuclear morphology and significantly enlarged nuclear,and hyperplasia of myocardial interstitial fibrous connective tissue could be seen in model group.The mRNA expression of TRPC4 and TRPC5 was significantly increased in the model group as compared to those of the control group (1.51 ± 0.48 vs.1.22 ± 0.25,1.65 ± 0.35 vs.1.27-± 0.87,t =3.55,4.65,all P ＜ 0.05).The protein expression of TRPC4 and TRPC5 was significantly increased in the model group as compared to those of the control group (1.00 ± 0.54 vs.1.45 ± 0.68,1.00 ± 0.65 vs.1.58 ±0.93,t =5.51,7.10,all P ＜ 0.05).The protein expression of TRPC4 and TPRC5 were associated with cardiac hypertrophy index (r =0.728,0.681,all P ＜ 0.05).Conclusion Expression of TRPC4 and TRPC5 is increased in rats with cardiac hypertrophy.

BACKGROUND:Orthotopic liver transplantation is the most effective therapy for the treatment of end-stage liver diseases, but the lack of donor source, immune rejection, and repeated infections limit its application. Stem celltransplantation technology provides a new idea for the treatment of end-stage liver diseases. A variety of methods have been confirmed to successful y induce umbilical cord blood mesenchymal stem cells converted into liver cells in vitro.
OBJECTIVE:To explore the clinical efficacy and feasibility of human umbilical cord blood mononuclear cells transplantation in the treatment of decompensated cirrhosis.
METHODS:Twenty-three patients with decompensated cirrhosis received al ogeneic human umbilical cord blood mononuclear celltransplantation. Serum alanine aminotransferase, albumin, cholinesterase, total bilirubin and prothrombin time were detected at post-transplantation weeks 2, 4, 8 and 24. Improvement in clinical signs and symptoms as wel as adverse reactions was observed.
RESULTS AND CONCLUSION:Liver function had no changes at 2 weeks after human umbilical cord blood mononuclear celltransplantation (P>0.05). At 4 weeks after celltransplantation, serum alanine aminotransferase was improved significantly (P<0.05), but the other indexes stil had no changes. Until 12 weeks after celltransplantation, there were significant improvements in al the liver function indicators (P<0.05) and the liver stiffness (P<0.05). By the end of 24 weeks, al the test results were improved significantly (P<0.01). Clinical symptoms were al eviated, including fatigue improvement in 20 cases (87%), improved appetite in 21 cases (91%), and relieved ascites in 19 cases (83%). No severe adverse reactions were found during the transplantation and 24-week fol ow-up. These findings suggest that human umbilical cord blood mononuclear cells transplantation is effective and safe for the treatment of decompensated cirrhosis, which can be considered as a clinical therapy for patients with advanced cirrhosis.

Objective To evaluate the efficacy and reliability of intraoperative microvascular Doppler uhrasonography (IMDU)in urgent clipping surgery of ruptured aneurysms,and assess the impact of this method on the surgical procedure itself.Methods For 62 patients who underwent urgent clipping surgery for the treatment of ruptured aneurysms,both blood flow velocities in the aneurismal sac and in the adjacent vessels and alterations of the Doppler spectrum were determined by IMDU before and after aneurysm clipping.The findings of IMDU were analysed and compared with those of visual inspection of the surgical site and postoperative angiography. Results A relevant stenosis of an adjacent vessel induced by efip position that had escaped detection by visual inspection was identified by IMDU in 12 out of 62 patients.In addition, IMDU demonstrated a primarily incomplete clipping aneurysm in 4 out of 62 patients.The clipping aneurysm was repositioned on the basis of the IMDU findings in 16 out of 62 patients.The findings from IMDU equated with those from angiography in 38 eases.Conclusion IMDU is a safe,instantaneous,effective and reliable technique for the urgent dipping surgery of raptured aneurysms.

Objective To investigate the clinical results of free super-thin peroneal artery perforator flap containing neurovascular axis in reconstruction of hand or foot soft tissue defects.Methods A retrospective case series study was made on 23 cases of hand or foot soft tissue defects admitted from January 2006 to March 2013.There were 16 males and 7 females,with a mean age of 33 years (range,17-51 years).Wounds were located in dorsal hand (n =12),dorsal pedis or amputated forefoot (n =8),greater thenar (n =2) and index finger (n =1) respectively.Defects ranged in size from 5.0 cm × 3.5 cm to 11.5 cm × 7.5 cm.Flap elevating was performed underneath the deep fascia and the perforator supplying the flap was dissected thoroughly,ligated and cut at the location arose from the peroneal artery.Most of the deep fascia except stripe shaped areas along the main blood supply chains was moved sharply and the fat underlying thinned primarily to the subdermal vascular network.After transferred to the recipient site,the flaps were revascularized by anastomosis of the perforating artery and its venae comitantes to appropriate recipient vessels.A total of 15 cases received innervated flap reconstruction.Flap vascularity and cosmetic results were recorded.Hand function was evaluated with the standard set up by the hand surgery branch of Chinese Medical Association.For foot reconstruction,shoe wearing status,gait,pressure-sore,flap sensibility,donor site appearance and complications were evaluated.Results All flaps were transplanted successfully with satisfactory cosmetic results,except that one flap used to cover dorsal ring finger defect left slightly bulky appearance.Mean duration of follow-up was 19 months (range,11-26 months).For hand reconstruction,the functional results were excellent in 6 cases and good in 9 cases.Repairing of foot defects with the flaps caused no problem of shoe wearing and no sore occurred.Normal gait was acquired except two cases of partially amputated foot.If innervated,flap sensibility was restored at least to the degree of S3.Protective sensation and touchpressure sensation were restored in eight non-innervated cases,and two of them were recovered to the degree of S3.There was only suture or small grafting scars on the donor leg and partially sensibility loss of lateral foot without functional defects in 13 cases.Conclusion Free super-thin peroneal artery perforator flap containing neurovascular axis is an easy and reliable technique that can attain satisfactory results for accurate coverage of hand or foot soft tissue defects.

Objective:To explore the mechanism of phase-transition fluorocarbon nanomaterials and evaluate its synergistic efficacy on microwave ablation (MWA).Methods:A novel phase transition nanodroplet (PTN) was designed with poly (lactic-co-glycolic acid) (PLGA) as the shell and perfluorocarbon (PFC) mixture as the core. Based on that, a phase-transition mechanism of microwave droplet vaporization (MWDV) was explored, which was based on the thermal phased transition. The basic physicochemical properties and biological characteristics of PTN were monitored by scanning electron microscope (SEM), dynamic laser light scattering (DLS), in vitro hemolysis and CCK-8 experiment.Based on the gel-hole model experiment in vitro, the phase transition of PTN were monitored; based on the live/dead cell double staining kit, flow cytometry and cytotoxicity test, the synergistic efficacy of phase-transition PTN on microwave ablation, which was mediated by MWDV was evaluated. Results:The phase-transition temperature of PTN was exactly the boundary temperature of microwave ablation (60 ℃) when the ratio between perfluoropentane (PFP) and perfluorohexane (PFH) in the core of PTN was 3∶2. Furthermore, the smart proportional PTN didn′t only have good stability and biocompatibility, but also could enhance the two-dimensional ultrasonic imaging and increase the efficacy of MWA under the mediation of MWDV.Conclusions:MWDV can be treated as a phase-transition mechanism of fluorocarbon nanomaterials, which provides a potential synergistic strategy for the thermal ablation of tumors.

Objective To investigate the inhibitory effect of Withaferin A ( WFA) on the growth of orthotopic xenograft tumor of hepatocellular carcinoma in nude mice and the mechanism of its antitumoral effect. Methods For in vivo model, anti-tumor efficacy of Withaferin A was evaluated in nude mice mod-els of human liver cancer orthotopic xenograft. The nude mice were randomly divided into model group, Sunitinib group,and Withaferin A groups [6, 3 mg/(kg·d)]. All mice were given intraperitoneal injec-tion for 14 days. Tumor volume and tumor weight were observed. Antiangiogenic effects were assessed in vi-vo by the tumor inhibition rate and microvessel density. Quantitative polymerase chain reaction ( QPCR) as-say was used to detect the mRNA expression of vascular endothelial growth factor ( VEGF) , basic fibroblast growth factor (bFGF), angiopoietin-2 (Ang-2), vascular endothelial growth factor receptor 2 (VEGFR2) from tumor tissues. For in vitro experiments, the cell count kit 8 ( CCK8 ) assay was used to detect the effect of Withaferin A on HepG2 cells proliferation. QPCR assay and enzyme-linked immunosorbent assay ( ELISA) were used to detect the mRNA expression of VEGF. Results Compared to the model group, the high-dose Withaferin A group and the Sunitinib group had a significantly lower tumor weight (P<0. 05). The tumor inhibition rate was 42. 69％ in the high-dose Withaferin A group, 20. 22％ in the low-dose With-aferin A group, and 49. 43％ in the Sunitinib group. The growth of HepG2 cells was significantly inhibited by different concentrations of Withaferin A,and the 50％ concentration of inhibition ( IC50 ) of Withaferin A were (2. 64 ± 0. 18)μmol/L at 24 h. Withaferin A (6,3 μmol/L) could inhibit the protein and mRNA ex-pression of VEGF ( P<0. 05 ) . Conclusions Withaferin A significantly reduces the growth of orthotopic xenograft tumor of hepatocellular carcinoma in nude mice via antiangiogenic effect. Downregulation of the protein and mRNA expression of VEGF by WFA may be one mechanism of its anti-liver cancer effect.

Objective: To report operative techniques and clinical results of free sural cutaneoadipofascial flap containing the neurovascular axis based on a dominant peroneal perforating artery (DPPA, with a caliber≥0.8 mm) and its concomitant veins for reconstruction of dorsal forefoot soft tissue defects. Methods: The flap was applied in 32 cases with middle to large soft tissue defects in the dorsal forefoot from Aug. 2009 to Dec. 2014. DPPAs arising from the posterolateral intermuscular septum was located and assessed preoperatively with color Doppler flow image and computed tomography angiography. According to the location, size, and shape of the defects, one of these DPPAs was chosen for flap planning. The flap was harvested from the posterolateral aspect of the leg. The neighboring neurovascular axis (one or more of that of the sural nerve, the medial cutaneous nerve, the lateral cutaneous nerve of calf and the sural communicating nerve) was included to ensure vascular supply. According to skin laxity of the donor site, the width of the full harvesting part which should be able to cover the region of the recipient site where pressure and friction force were prominent while wearing shores was decided; the rest was harvested as an adipofascial flap (without skin) to get enough size. After transfer to recipient site, the flap was revascularized by anastomosing the perforating artery and its venae comitantes with appropriate recipient vessels, and reinnervated (antegrade or retrograded methods). Skin grafting was performed on the adipofascial surface of the flap primarily or secondarily. The defects in donor site of the leg was closed directly. Results: All flaps (ranged from 7.5 cm×5.0 cm to 23.0 cm×13.0 cm) were transplanted successfully, and no vascular or donor site problems occurred. All primary skin grafts (19 cases) was partially lost, but only 2 of them need a second grafting. Adipose necrosis occurred in 4 of 13 cases receiving secondary grafting but only needed wound care before surgery. Following up for 11-26 months showed both satisfactory functional and cosmetic results without problems of shoe wearing. Flap sensibility restored at least to the degree of S3. Conclusions The cutaneoadipofascial flap combines the advantages of perforator, neurocutaneous axis, free and adipofascial flaps leaving only suture scar in the donor leg, and is a satisfactory method for free-style and acute coverage of dorsal forefoot defects.

Objective To report our efficacy of one-stage definite treatment of Gustilo type Ⅲ open fractures of long bone by plate osteosynthesis.Methods A retrospective case series study was conducted of the 69 cases who had undergone plate osteosynthesis for one-stage definite treatment of Gustilo type Ⅲ open fractures of long bone from January 2006 to June 2016 at Microsurgery and War Trauma Center of Chengdu Military Command,59 Hospital of Chinese PLA.They were 47 males and 22 females with an average age of 34.2 years (from 2 to 62 years).There were 27 shaft fractures of tibia or fibula (13 cases of type ⅢA,12 cases of type Ⅲ B and 2 cases of type Ⅲ C),4 fractures of distal tibia (2 cases of type Ⅲ A and 2 cases of type ⅢB),14 shaft fractures of ulna or radius (9 cases of type ⅢA,3 cases of type ⅢB and 2 cases of type Ⅲ C),12 factures of humeral shaft (7 cases of type Ⅲ A,3 cases of type Ⅲ B and 3 cases of type Ⅲ C),3 fractures of distal humerus (all type ⅢC),6 fractures of femoral shaft (5 cases of type ⅢA and one type Ⅲ C),and 3 fractures of distal femur (2 cases of type ⅢA and one type ⅢC).The intervals between injury and operation ranged from 4 to 17 hours,averaging 9.6 hours.After thorough debridement,osteosynthesis was performed with locking compression plate,limited contact dynamic compression plate or/and reconstruction locking plate,or 1/3 tubular plate.Direct closure with decreased tension or without tension was used for type Ⅲ A injury;deep open defects were repaired with perforator flaps,neurovascular axis flaps,traditional axis flaps and muscular flaps,or local flaps;limb reconstructions included neurovascular repair in 12 cases,tendon and ligament repair in 5 cases,and muscle reconstruction in 3 cases.Superficial defects were covered by skin grafts simultaneously or secondarily.Results The duration of hospitalization averaged 19 days (from 5 to 37 days).Partial necrosis occurred in one case of sural neurovascular axis flap.Superficial infection with multiple antibiotic-resistant bacteria occurred in 2 cases.Follow-up for the 69 patients ranged from 12 to 27 months (average,19.2 months).No deep bone infection occurred.Implant breaking occurred in 4 cases and implant loosening in one.The implant failures were corrected by change into intramedullary nails or plate refixation (respectively in 2 cases) in addition to bone graft.Bone union was achieved after 5 to 15 months (average,7.7 month)with satisfactory aesthetic and functional outcomes.Conclusion For patients with Gustilo type Ⅲ open fracture of long bone,especially those with metaphyseal,intraarticular or upper limb fracture and pediatric ones,plate osteosynthesis can be a satisfactory one-stage definite treatment besides intramedullar nailing and external fixation,providing that through debridement and satisfactory soft-tissue coverage can be achieved.