BACKGROUND: How to determine the proximal section of electricity-injury nerve which is available for nerve grafting, is key point to the functional recovery. The method used before is to observe if there is normal axonal structure under operating microscope. But the clinical result proves unsatisfactory.OBJECTIVE: To evaluate the appliance value of somatosensory evoked potential (SEP) technique in the detection of nerve injury after electrical injury.DESIGN: Retrospective analysis based on the cases.SETTING: Department of Plastic Surgery, Ninth People's Hospital Affiliated to Shanghai Jiaotong University PARTICIPANTS: Totally 12 patients with severe electrical injury who received treatment in the Department of Plastic Surgery, Shanghai Ninth People's Hospital were included in this study. Among them, there were 9male and 3 female, aged from 6 to 54 years.METHODS: SEP of injured nerve was measured progressively and pathological section observation was given correspondingly. The function recovery of patients receiving nerve transplantation by using SEP was evaluated and compared with that before treatment through a follow-up.MAIN OUTCOME MEASURES: Amplitude, latency and corresponding pathological section of SEP of injured nerve as well as the functional recovery of the SEP plane of the cases with patients receiving nerve transplantation by using SEP to choose transplanted plane.plitude and latency of SEP was positively correlative with the quality of were repaired with SEP technique to select the anastomosis site for nerve transplantation and 8 cases were followed up after operation. The average follow-up time was 22.7 months ranging from 17 to 26 months. And 2-point resolution sense reaches grade Ⅱ or Ⅲ in 5 cases. (America hand surgery association criterion: 2-point resolution distance ＜ 6 mm was grade Ⅰ ,6-10 mm was grade Ⅱ ,11-15 mm was grade Ⅲ ,＞ 15 mm was grade Ⅳ).CONCLUSION: Electricity-injured nerve owns complicated pathology.SEP technique is a valuable method for function evaluating or selecting of the anastomsis site for nerve grafting in those cases.

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

Objective To study the effect of electrical stimulation of vagus nerve on inflammatory response in septic shock rats. Methods SD rats were randomly divided into 5 groups: Group Ⅰ was the sham group, group Ⅱ with the cecal ligation and puncture (CLP) and the vagus nerve were isolated but not transected, group Ⅲ with bilateral cervical vagotomy following CLP, group Ⅳ with bilateral cervical vagotomy after CLP and the left vagus nerve trunks were stimulated with bipolar electrodes, group Ⅴ with bilateral cervical vagotomy after CLP and the right vagus nerve trunks were stimulated. The common carotid artery pressure was monitored, and the plasma tumor necrosis factor α (TNF-α), nitric oxide synthases (NOS) and nitric oxide (NO) were measured 2 h after stimulation. Results The mean arterial blood pressure (MAP) gradually decreased and the concentration of plasma TNF-α, NOS and NO significantly increased after CLP. Electrical stimulation of the left and right vagus nerve significantly increased the MAP and decreased the plasma TNF-α, NOS and NO levels. Conclusion Direct electrical stimulation of the left and right vagus nerve can significantly improve the blood pressure and reduced plasma TNF-α, NOS and NO levels during septic shock, which may play a role in anti-shock in rats.

Objective To construct the permanent colostomy patients with rectal cancer in archives information module content. Methods Using expert meeting,semi- structured interview, literature review, Delphi expert consultation method, establish the system of permanent rectal cancer patients file information specific module. Results In two- round consultation authority coefficient was 0.847. Kendall coordination coefficient (Kendall′s W) was 0.195-0.331, the difference had statistical significance (P<0.01); through the expert consultation method to construct the file information module for permanent colostomy patients with rectal cancer, which contained 4 first-level indicators (colostomy patient information module, stoma nursing modules, stoma patients transitional care modules, colostomy patients with network platform module), 11 secondary indicators, 36 third grade indicators. Conclusions This study established file information module content for permanent stoma patients with rectal cancer. It has good scientificity and reliability, and can provide a theoretical basis for the clinical development of a file information system network for transitional care of permanent stoma patients with rectal cancer.

Objective:To monitor the dynamic changes in coagulation function and assess their clinical significance in patients with gas-tric cancer by using thromboelas to gram (TEG). Methods:A total of 178 patients with gastric cancer from March 2014 to May 2015 in Xinxiang Central Hospital were selected as the experimental group. The patients were grouped based on different tumor stages, inva-sion depths, and lymph node metastasis. The TEG results of all patients were dynamically monitored before and after operation, and 60 healthy persons were selected as normal control group. Blood coagulation change was analyzed by comparing the TEG test results. Results:Compared with those of the control group, the TEG parameters of the experimental group showed significantly decreased R and K values, as well as significantly increased Angle, CI, and MA values, and the differences were statistically significant (P<0.05). In the experimental group, the K values were significantly decreased after operation, whereas Angle, MA, and CI were significantly in-creased (P<0.05). No significant changes were observed in R, LY30, and others. TEG values were significantly different in the compari-son of values for tumor patients with different stages, different tumor infiltration degrees, and with or without lymphatic metastasis. Conclusion:Blood hypercoagulability in the perioperative period was observed in patients with gastric cancer and was positively corre-lated with tumor stages, tumor infiltration degrees, and lymphatic metastasis. Dynamic monitoring of gastric cancer perioperative TEG can provide valuable information for clinical treatment, improve the safety of gastric cancer surgery, and reduce postoperative compli-cations associated with active clinical significance.

OBJECTIVEThis paper aims to investigate the impact of anthracene addition on microbial community in agricultural soil irrigated with tap water or reclaimed wastewater.

METHODSThe changes of microbial community were characterized by terminal restriction fragment length polymorphism in combination with 16S rRNA gene clone library analysis.

RESULTSA significant change in microbial community composition was observed during the biodegradation of anthracene, with dominantly enriched members from the genus Methylophilus.

CONCLUSIONThis work might be useful for developing techniques for the isolation of novel putative PAH degrader.

Anthracenes ; analysis ; Bacteria ; classification ; genetics ; isolation & purification ; Biodegradation, Environmental ; DNA, Bacterial ; genetics ; isolation & purification ; Hazardous Waste ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 16S ; genetics ; Soil Microbiology ; Soil Pollutants ; analysis ; Waste Disposal, Fluid ; methods

Objective To investigate the effects of urinary ostomy bag connected with disposable drainage bag on drainage of abdominal cavity after surgery on gastrointestinal tumor.Methods A total of 82 patients carried out drainage of the abdominal cavity after surgery on gastrointestinal tumor in Cancer Hospital of Jiangxi Province from January to December 2015 were selected and divided into control group (n=40) and observation group (n=42).During the period of abdominal cavity drainage,the control group was given routine dressing change.In addition to the conventional treatment of the drainage incision,the observation group utilized urinary ostomy bag connected with disposable drainage bag for drainage.The incidence rates of leakage and irritable dermatitis around abdominal drainage mouth,dressing times of drainage incision,healing time of drainage incision and patient comfort in drainage were compared between the two groups.Results At the end of abdominal cavity drainage,the incidence rates of leakage and irritable dermatitis around abdominal drainage mouth of the observation group were significantly lower than those of the control group (x2 =5.550,6.717;P=0.043,0.010);the dressing times of drainage incision in the observation group was significantly less than that in the control group (t=13.840,P=0.000);the healing time of drainage incision in the observation group was significantly shorter than that in the control group (t=6.854,P=0.000);the comfort in the observation group was significantly higher than that in the control group 0=7.429,P=0.000).Conclusion Urinary bag connected with disposable drainage bag for drainage after surgery on gastrointestinal tumor can effectively reduce the occurrence of leakage and irritable dermatitis around abdominal drainage mouth,improve patient comfort,it is worthy of clinical promotion.

Although methyltransferase has been recognized as a major element that governs the epigenetic regulation of the genome during temozolomide (TMZ) chemotherapy in glioblastoma multiforme (GBM) patients, its regulatory effect on glioblastoma chemoresistance has not been well defined. This study investigated whether DNA methyltransferase (DNMT) expression was associated with TMZ sensitivity in glioma cells and elucidated the underlying mechanism. DNMT expression was analyzed by western blotting. miR-20a promoter methylation was evaluated by methylation-specific PCR. Cell viability and apoptosis were assessed using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) and TdT-mediated dUTP-biotin nick end labeling assays, respectively. The results showed that compared with parental U251 cells, DNMT1 expression was downregulated, miR-20a promoter methylation was attenuated and miR-20a levels were elevated in TMZ-resistant U251 cells. Methyltransferase inhibition by 5-aza-2\'-deoxycytidine treatment reduced TMZ sensitivity in U251 cells. In U251/TM cells, DNMT1 expression was negatively correlated with miR-20a expression and positively correlated with TMZ sensitivity and leucine-rich repeats and immunoglobulin-like domains 1 expression; these effects were reversed by changes in miR-20a expression. DNMT1 overexpression induced an increase in U251/TM cell apoptosis that was inhibited by the miR-20a mimic, whereas DNMT1 silencing attenuated U251/TM cell apoptosis in a manner that was abrogated by miR-20a inhibitor treatment. Tumor growth of the U251/TM xenograft was inhibited by pcDNA-DNMT1 pretreatment and boosted by DNMT1-small hairpin RNA pretreatment. In summary, DNMT1 mediated chemosensitivity by reducing methylation of the microRNA-20a promoter in glioma cells.
Animals ; Antineoplastic Agents, Alkylating/*pharmacology/therapeutic use ; Apoptosis/drug effects ; Brain/drug effects/metabolism/pathology ; Brain Neoplasms/drug therapy/*genetics/pathology ; DNA (Cytosine-5-)-Methyltransferase/antagonists & inhibitors/*genetics/metabolism ; DNA Methylation ; Dacarbazine/*analogs & derivatives/pharmacology/therapeutic use ; Drug Resistance, Neoplasm ; Female ; Gene Expression Regulation, Neoplastic ; Glioma/drug therapy/*genetics/pathology ; Humans ; Mice, Inbred C57BL ; MicroRNAs/*genetics ; Promoter Regions, Genetic

Objective: To summarize clinical experience on reconstruction of severe facial disfigurement with flap prefabrication and soft tissue expansion. Methods: From September 2005 to June 2016, 49 patients with type Ⅲ and type Ⅳ facial deformities underwent facial reconstruction with an integrated method on the basis of prefabricated flaps. In the first stage, the descending branch of the lateral femoral circumflex vessels and the surrounding muscle fascia were dissected and transferred to subcutaneous pocket in the cervicothoracic area. The pedicles of the fascial flap were anastomosed to either the facial or superior thyroid artery and their venae comitantes in flap prefabrication. A tissue expander was placed beneath the fascial flap. In the second stage, over-expansion was achieved with intra-flap stem cell transplantation once patient′s skin showed signs of intolerance to expansion. In the third stage, prefabricated flap was transferred to cover the facial defects. the second or third internal mammary artery perforators or lateral thoracic artery perforators were reserved and flap supercharging would be performed depending on the perfusion of the flap revealed by indocyanine green angiography intra-operatively. Later, flap revisions further restored facial outline and delicate organ configuration. Aesthetic and functional status were independently graded to assess the facial appearance and function before and after the reconstruction. Results: 49 patients with severe facial deformities were included. 5 patients received stem cell transplantation. The final inflated volume ranged from 2 530 ml to 3500 ml and each patient had facial reconstruction with a prefabricated flap (range 23 cm×18 cm-34 cm×32 cm). Flap supercharging technique were used in 25 cases to augment blood perfusion, however, flap necrosis (5 cm× 2 cm) occurred in 1 patient, and tip necrosis occurred in 4 patients, otherwise, all flaps survived entirely. The aesthetic (1.15 to 2.29) and functional (0.86 to 2.42) status scores were statistically improved (P<0.01). Facial expressions such as smiling, blinking and frowning were noted. Conclusions Autologous full face reconstruction with an integrated method based on flap prefabrication can bring satisfying aesthetic and functional recovery, rendering a safe and effective option for most patients with massive facial defects.

Background::Scleroderma is characterized by inflammation and fibrosis, predominantly occurring in the skin and extending to various parts of the body. The pathophysiology of scleroderma is multifaceted, with the current understanding including endothelial damage, inflammatory cell infiltration, and fibroblast activation in its progression. Nonetheless, the mechanism of cellular interactions and the precise spatial distribution of these cellular events within the fibrotic tissues remain elusive, highlighting a critical gap in our comprehensive understanding of scleroderma’s pathogenesis.Methods::In this study, we administered bleomycin intradermally to the dorsal skin of four individual murine models. Subsequently, skin tissues were harvested at predetermined intervals for comprehensive spatial transcriptomic analysis to determine the spatial dynamics influencing scleroderma pathogenesis. To validate the possible results from bioinformatic analysis, further in vitro and in vivo experiments were conducted. Results::Analysis of the spatial transcriptome revealed significant alterations in cell clusters during the progression of scleroderma. Gene Ontology analysis identified disruptions in lipid metabolism as the disease advanced. Pseudotime analysis provided evidence for a phenotypic transition from adipocytes to fibroblasts. In vitro studies demonstrated increased expression of Col1a1 and α-SMA as the disease progressed. These fibroblasts have been identified as key contributors to the increasing inflammation. Co-culturing TGF-β induced adipocytes with RAW264.7 cells resulted in overexpression of pro-inflammatory cytokines in the RAW264.7 cells. Both in vitro and in vivo experiments confirmed adipocyte loss and fibroblast formation, with transformed fibroblasts showing pronounced pro-inflammatory characteristics, highlighting their crucial role in the disease mechanism. Conclusions::Our study showed the spatial distribution and dynamic alterations of various cell types during scleroderma progression. Crucially, we identified the transformation of adipocytes into fibroblasts as a key factor promoting disease advancement. These emergent fibroblasts intensify inflammation, indicating that research on these cell clusters could reveal key scleroderma mechanisms and guide future therapies.