Objective To explore the mechanism and inhibition of botulinum toxin type A (BTXA) on hypertrohic scar fibroblasts.Methods The cells were treated by 0 (control),0.2,0.4,0.8 U/ml BTXA for 48 h.Cell viability was detected by MTT assay.Cell apoptosis was detected by Hoechst staining.Cell cycle was detected by flow cytometry.The level of cell cycle related protein D1 (Cyclin D1),proliferation nuclear antigen (PCNA) and activation of phosphatidylinositol 3 kinase (PI3K) / protein kinase B (AKT) signaling pathway were assayed by western blot.Results Compared with control group(0.75±0.07),0.2,0.4,0.8 U/mL BTXA(0.59 ± 0.06,0.43 ± 0.04,0.34± 0.03) inhibited hypertrohic scar fibroblasts cell viability,increased cell apoptotic rate[control group(2.38±0.24)％;BTXA(15.79±1.54)％,(27.32±2.69)％,(38.46±3.90)％],down-regulated the expression of Cyclin D1(control group 1.57±0.18;BTXA 0.93±0.07,0.42±0.04,0.35±0.03) and PCNA(control group 1.46±0.16;BTXA 0.50±0.05,0.59±0.05,0.37±0.03),inhibited the expression of PI3K(control group 0.98±0.06;BTXA 0.49±0.04,0.50±0.04,0.39±0.03) and the phosphorylation of AKT(control group 1.38±0.08;BTXA 0.97±0.06,0.60±0.04,0.29± 0.02),made cell cycle arrested in G1 phase,The difference was statistically significant (P＜0.05).Conclusion These results suggested BTXA inhibit proliferation via blocking the activation of PI3K/AKT signal pathway and down-stream related cell cycle related protein.

Objective To explore the difference of gene expression profiling between normal basilar arteries and basilar arteries of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits. Methods cDNA chip of normal basilar arteries and basilar arteries of CVS after SAH in rabbits were downloaded from GEO database. The chip was analyzed and screened by Bioconductor software, and function enrichment and pathway analysis of the differentially expressed genes were analyzed by Cytoscape software. Then 6 adult male Japanese rabbits were used, and randomly divided into normal control group (n=3) and SAH model group (n=3). Rabbit SAH models were established by cisterna secondary-blood-injection method. RNA data of normal basilar artery specimens on the 0 day and basilar artery specimens after SAH on the 5-day were used to validate the parts of differentially expressed genes by qRT-PCR. Results A total of 4356 differentially expressed genes were found in normal basilar arteries and basilar arteries of CVS after SAH in rabbits. Among them, 920 genes were considered to be significant with P-value<0.05, such as GRIK1, MYH13, ZNF45, SAA3, RLN1, MSR1 and others. Function enrichment analysis indicated that the differentially expressed genes were involved in regulation of Ca2+transmembrane transporter activity, negative regulation of ion transmembrane transport, regulation of potassium ion transport, positive regulation of JAK-STAT signaling cascades and other biological processes. Pathway analysis showed that calcium signaling pathway, cGMP-PKG signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway and other signaling pathways maybe related with the differentially expressed genes. qRT-PCR verification showed that the expression of MSR1 in SAH model group was consistent with that of the chip result. Conclusion The gene expressions of basilar arteries of CVS after SAH in rabbits are significantly different, and MSR1 gene can be used as a potential target for studying the pathological mechanism of CVS.

Objective:To review the clinical effect of oral mucosa prefabricated urethra in the treatment of complicated hypospadias in adult patients.Methods:A retrospective analysis was performed on adult patients with complicated hypospadias who underwent two-stage surgical repair in the Second Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2011 to December 2020. In the first stage, the urethra was prefabricated with oral mucosa, which was 5.0-6.0 cm in length and 1.0-1.2 cm in width. The second stage was urethral anastomosis, in which scrotal flap was applied to cover the wound. Postoperative follow-up was conducted by telephone or WeChat, including penile appearance and the situation of urination.Results:A total of 114 patients were enrolled, age raging from 18 to 63 years old, with an average age of 28 years. There were 22 cases who had underwent one previous repair operation, 69 cases had two repair operations, and 23 cases had three repair operations. The time from the last operation was 6 months to 60 months, with an average of 25 months. Postoperative complications included urinary fistula in 36 cases, urethral orifice stenosis in 52 cases and penile scar in 58 cases. The scrotal septal skin flap was used in 46 cases and scrotal fascia flap was used in 68 cases. The flaps size ranged from 1.2 cm×3.0 cm to 3.0 cm×5.5 cm. Among the 114 patients, 6 patients were complicated with urinary extravasation, which healed spontaneously in 2-4 weeks; 2 patients developed urinary fistula due to blood supply disorder at the distal end of the scrotal flap, which was repaired half a year later. Other patients healed well. 94 patients were followed up for 6-84 months, with an average of 37 months. All patients had no chordee, smooth urination, no urethral stricture and fistula. All patients were satisfied with the appearance of the penis. Urethral ultrasound and magnetic resonance hydrography were performed in 18 patients. The results showed that the reconstructed urethra was smooth, the mucosa graft had good extension, and there was no residual urine in the urethra.Conclusions:Oral mucosa prefabricated urethra could be used for repair hypospadias in adult patients who failed in repair surgeries, and could obtain good clinical effect.

Objective:To review the clinical effect of oral mucosa prefabricated urethra in the treatment of complicated hypospadias in adult patients.Methods:A retrospective analysis was performed on adult patients with complicated hypospadias who underwent two-stage surgical repair in the Second Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2011 to December 2020. In the first stage, the urethra was prefabricated with oral mucosa, which was 5.0-6.0 cm in length and 1.0-1.2 cm in width. The second stage was urethral anastomosis, in which scrotal flap was applied to cover the wound. Postoperative follow-up was conducted by telephone or WeChat, including penile appearance and the situation of urination.Results:A total of 114 patients were enrolled, age raging from 18 to 63 years old, with an average age of 28 years. There were 22 cases who had underwent one previous repair operation, 69 cases had two repair operations, and 23 cases had three repair operations. The time from the last operation was 6 months to 60 months, with an average of 25 months. Postoperative complications included urinary fistula in 36 cases, urethral orifice stenosis in 52 cases and penile scar in 58 cases. The scrotal septal skin flap was used in 46 cases and scrotal fascia flap was used in 68 cases. The flaps size ranged from 1.2 cm×3.0 cm to 3.0 cm×5.5 cm. Among the 114 patients, 6 patients were complicated with urinary extravasation, which healed spontaneously in 2-4 weeks; 2 patients developed urinary fistula due to blood supply disorder at the distal end of the scrotal flap, which was repaired half a year later. Other patients healed well. 94 patients were followed up for 6-84 months, with an average of 37 months. All patients had no chordee, smooth urination, no urethral stricture and fistula. All patients were satisfied with the appearance of the penis. Urethral ultrasound and magnetic resonance hydrography were performed in 18 patients. The results showed that the reconstructed urethra was smooth, the mucosa graft had good extension, and there was no residual urine in the urethra.Conclusions:Oral mucosa prefabricated urethra could be used for repair hypospadias in adult patients who failed in repair surgeries, and could obtain good clinical effect.

Objective:To investigate the clinical efficacy of different surgical approaches for repairing eyelid coloboma.Methods:Patients with the divided nevus of eyelid treated at Hypospadias Plastic Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from January 2005 to January 2022 were included. The surgeries were categorized into 4 types. (1) Direct excision and suture. (2) Local skin grafts: covering the defect with split- or full-thickness skin grafts according to the size of the defect on the upper and lower eyelids. (3) Combined skin grafts with orbicularis oculi myocutaneous flap: grafting skin flaps for defects on the upper eyelid and near the lower eyelid, and temporal area skin flaps based on the same side orbicularis oculi muscle pedicle for lower eyelid defects. (4) Temporal area expanded flap based on the orbicularis oculi muscle combined with skin grafts: the surgery was divided into two stages, the first stage involves the placement of an expander in the temporal area of the affected side, and the second stage involves the removal of the expander, excision of eyelid lesion tissue and formation of an island-shaped skin flap with the orbital part of the orbicularis oculi muscle pedicle as the pedicle, which was rotated 180° to cover the lower eyelid defect. Defects near the upper and lower eyelid margins were still covered with skin grafts. Follow-up was conducted through outpatient visits, telephone calls, and WeChat messaging to assess facial appearance postoperatively. SPSS 22.0 statistical software was used for analysis, and the measurement data were expressed as Mean±SD, the count data were expressed as percentage, and the comparison of preoperative and postoperative was calculated by aesthetic and functional status of facial soft-tissue deformities (A&F scores) within the group was performed by paired t-test, the difference was considered statistically significant at P<0.05. Results:A total of 34 patients were included; average age was 17.7±15.3 years. The size of the lesions varied from the smallest nevus measuring 0.3 cm × 0.2 cm and the largest measuring 14.0 cm × 14.0 cm. Direct excision with suturing was performed in 6 cases, among which 2 cases received simultaneous double eyelid surgery, the postoperative A&F score (4.54 ± 1.32) was higher than the preoperative (3.28 ± 0.98) score, the difference was not statistically significant ( P>0.05). The skin graft was performed in 10 cases, the postoperative A&F score (5.13 ± 1.59) was higher than the preoperative (2.25 ± 1.59), the difference was not statistically significant ( P>0.05). The skin graft combined with using orbicularis oculi muscle skin flap was performed in 7 cases, the postoperative A&F score of our patients (5.54 ±1.46) was significantly higher than the preoperative (2.18 ±1.61 ), the difference was statistically significant ( P<0.05). The skin graft combined with the expanded temporal area flap based on the orbicularis oculi muscle was performed in 11 cases, the A&F score of our patients after repair (4.95 ±0.60) was improved compared with the preoperative (2.18±1.48) score, and the difference was not statistically significant ( P>0.05). Twenty-eight patients were followed up for 8 to 81 months while 6 cases lost due to change of contact information, among whom three developed secondary ectropion of the lower eyelid, three experienced recurrence of nevi in the incision and grafting area, two exhibited significant pigmentation in the grafting area, and one developed secondary ptosis of the upper eyelid, while the rest of the patients were satisfied with the repair results. Conclusion:Surgical excision is the only effective treatment for eyelid cleft nevi with different clinical presentations. Covering defects on the upper and lower eyelids with different tissue transplantation method can disperse the entire nevus, resulting in more stable long-term repair effects and a more natural appearance. The combination of an orbicularis muscle flap and a free skin graft provides more stable result in the plastic surgery of medium to large eyelid split nevi. Free skin grafting of the upper and lower lids near the margins, and flap grafting of the lower lids are more consistent with the physiological state of the upper and lower lids, and the combination of different tissue grafting method can make the appearance of the face more reasonable.

Objective The aim of this study was to explore the role and mechanism of ferroptosis in SiO2-induced cardiac injury using a mouse model. Methods Male C57BL/6 mice were intratracheally instilled with SiO2 to create a silicosis model.Ferrostatin-1(Fer-1)and deferoxamine(DFO)were used to suppress ferroptosis.Serum biomarkers,oxidative stress markers,histopathology,iron content,and the expression of ferroptosis-related proteins were assessed. Results SiO2 altered serum cardiac injury biomarkers,oxidative stress,iron accumulation,and ferroptosis markers in myocardial tissue.Fer-1 and DFO reduced lipid peroxidation and iron overload,and alleviated SiO2-induced mitochondrial damage and myocardial injury.SiO2 inhibited Nuclear factor erythroid 2-related factor 2(Nrf2)and its downstream antioxidant genes,while Fer-1 more potently reactivated Nrf2 compared to DFO. Conclusion Iron overload-induced ferroptosis contributes to SiO2-induced cardiac injury.Targeting ferroptosis by reducing iron accumulation or inhibiting lipid peroxidation protects against SiO2 cardiotoxicity,potentially via modulation of the Nrf2 pathway.

Objective:To investigate the clinical efficacy of different surgical approaches for repairing eyelid coloboma.Methods:Patients with the divided nevus of eyelid treated at Hypospadias Plastic Surgery Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from January 2005 to January 2022 were included. The surgeries were categorized into 4 types. (1) Direct excision and suture. (2) Local skin grafts: covering the defect with split- or full-thickness skin grafts according to the size of the defect on the upper and lower eyelids. (3) Combined skin grafts with orbicularis oculi myocutaneous flap: grafting skin flaps for defects on the upper eyelid and near the lower eyelid, and temporal area skin flaps based on the same side orbicularis oculi muscle pedicle for lower eyelid defects. (4) Temporal area expanded flap based on the orbicularis oculi muscle combined with skin grafts: the surgery was divided into two stages, the first stage involves the placement of an expander in the temporal area of the affected side, and the second stage involves the removal of the expander, excision of eyelid lesion tissue and formation of an island-shaped skin flap with the orbital part of the orbicularis oculi muscle pedicle as the pedicle, which was rotated 180° to cover the lower eyelid defect. Defects near the upper and lower eyelid margins were still covered with skin grafts. Follow-up was conducted through outpatient visits, telephone calls, and WeChat messaging to assess facial appearance postoperatively. SPSS 22.0 statistical software was used for analysis, and the measurement data were expressed as Mean±SD, the count data were expressed as percentage, and the comparison of preoperative and postoperative was calculated by aesthetic and functional status of facial soft-tissue deformities (A&F scores) within the group was performed by paired t-test, the difference was considered statistically significant at P<0.05. Results:A total of 34 patients were included; average age was 17.7±15.3 years. The size of the lesions varied from the smallest nevus measuring 0.3 cm × 0.2 cm and the largest measuring 14.0 cm × 14.0 cm. Direct excision with suturing was performed in 6 cases, among which 2 cases received simultaneous double eyelid surgery, the postoperative A&F score (4.54 ± 1.32) was higher than the preoperative (3.28 ± 0.98) score, the difference was not statistically significant ( P>0.05). The skin graft was performed in 10 cases, the postoperative A&F score (5.13 ± 1.59) was higher than the preoperative (2.25 ± 1.59), the difference was not statistically significant ( P>0.05). The skin graft combined with using orbicularis oculi muscle skin flap was performed in 7 cases, the postoperative A&F score of our patients (5.54 ±1.46) was significantly higher than the preoperative (2.18 ±1.61 ), the difference was statistically significant ( P<0.05). The skin graft combined with the expanded temporal area flap based on the orbicularis oculi muscle was performed in 11 cases, the A&F score of our patients after repair (4.95 ±0.60) was improved compared with the preoperative (2.18±1.48) score, and the difference was not statistically significant ( P>0.05). Twenty-eight patients were followed up for 8 to 81 months while 6 cases lost due to change of contact information, among whom three developed secondary ectropion of the lower eyelid, three experienced recurrence of nevi in the incision and grafting area, two exhibited significant pigmentation in the grafting area, and one developed secondary ptosis of the upper eyelid, while the rest of the patients were satisfied with the repair results. Conclusion:Surgical excision is the only effective treatment for eyelid cleft nevi with different clinical presentations. Covering defects on the upper and lower eyelids with different tissue transplantation method can disperse the entire nevus, resulting in more stable long-term repair effects and a more natural appearance. The combination of an orbicularis muscle flap and a free skin graft provides more stable result in the plastic surgery of medium to large eyelid split nevi. Free skin grafting of the upper and lower lids near the margins, and flap grafting of the lower lids are more consistent with the physiological state of the upper and lower lids, and the combination of different tissue grafting method can make the appearance of the face more reasonable.

Objective:To review the clinical effect of oral mucosa prefabricated urethra in the treatment of complicated hypospadias in adult patients.Methods:A retrospective analysis was performed on adult patients with complicated hypospadias who underwent two-stage surgical repair in the Second Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2011 to December 2020. In the first stage, the urethra was prefabricated with oral mucosa, which was 5.0-6.0 cm in length and 1.0-1.2 cm in width. The second stage was urethral anastomosis, in which scrotal flap was applied to cover the wound. Postoperative follow-up was conducted by telephone or WeChat, including penile appearance and the situation of urination.Results:A total of 114 patients were enrolled, age raging from 18 to 63 years old, with an average age of 28 years. There were 22 cases who had underwent one previous repair operation, 69 cases had two repair operations, and 23 cases had three repair operations. The time from the last operation was 6 months to 60 months, with an average of 25 months. Postoperative complications included urinary fistula in 36 cases, urethral orifice stenosis in 52 cases and penile scar in 58 cases. The scrotal septal skin flap was used in 46 cases and scrotal fascia flap was used in 68 cases. The flaps size ranged from 1.2 cm×3.0 cm to 3.0 cm×5.5 cm. Among the 114 patients, 6 patients were complicated with urinary extravasation, which healed spontaneously in 2-4 weeks; 2 patients developed urinary fistula due to blood supply disorder at the distal end of the scrotal flap, which was repaired half a year later. Other patients healed well. 94 patients were followed up for 6-84 months, with an average of 37 months. All patients had no chordee, smooth urination, no urethral stricture and fistula. All patients were satisfied with the appearance of the penis. Urethral ultrasound and magnetic resonance hydrography were performed in 18 patients. The results showed that the reconstructed urethra was smooth, the mucosa graft had good extension, and there was no residual urine in the urethra.Conclusions:Oral mucosa prefabricated urethra could be used for repair hypospadias in adult patients who failed in repair surgeries, and could obtain good clinical effect.

Objective:To review the clinical effect of oral mucosa prefabricated urethra in the treatment of complicated hypospadias in adult patients.Methods:A retrospective analysis was performed on adult patients with complicated hypospadias who underwent two-stage surgical repair in the Second Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2011 to December 2020. In the first stage, the urethra was prefabricated with oral mucosa, which was 5.0-6.0 cm in length and 1.0-1.2 cm in width. The second stage was urethral anastomosis, in which scrotal flap was applied to cover the wound. Postoperative follow-up was conducted by telephone or WeChat, including penile appearance and the situation of urination.Results:A total of 114 patients were enrolled, age raging from 18 to 63 years old, with an average age of 28 years. There were 22 cases who had underwent one previous repair operation, 69 cases had two repair operations, and 23 cases had three repair operations. The time from the last operation was 6 months to 60 months, with an average of 25 months. Postoperative complications included urinary fistula in 36 cases, urethral orifice stenosis in 52 cases and penile scar in 58 cases. The scrotal septal skin flap was used in 46 cases and scrotal fascia flap was used in 68 cases. The flaps size ranged from 1.2 cm×3.0 cm to 3.0 cm×5.5 cm. Among the 114 patients, 6 patients were complicated with urinary extravasation, which healed spontaneously in 2-4 weeks; 2 patients developed urinary fistula due to blood supply disorder at the distal end of the scrotal flap, which was repaired half a year later. Other patients healed well. 94 patients were followed up for 6-84 months, with an average of 37 months. All patients had no chordee, smooth urination, no urethral stricture and fistula. All patients were satisfied with the appearance of the penis. Urethral ultrasound and magnetic resonance hydrography were performed in 18 patients. The results showed that the reconstructed urethra was smooth, the mucosa graft had good extension, and there was no residual urine in the urethra.Conclusions:Oral mucosa prefabricated urethra could be used for repair hypospadias in adult patients who failed in repair surgeries, and could obtain good clinical effect.

The increasing incidence of chronic kidney disease (CKD) has become a major global public health problem. Hypertension and CKD can cause and effect each other and often coexist. Controlling blood pressure is one of the core tasks in the treatment of CKD. Over the past 10 years, many large clinical studies have provided evidence-based medical evidence for the updating and revision of hypertension management guidelines, but there remains controversies in targets of blood pressure in hypertensive patients with CKD. Personalized and evidence-based management is the key to achieve effective control of blood pressure and slow the progression of CKD. This review will summary the epidemiological status of hypertensive patients with CKD and the progress related to the targets of controlling blood pressure in CKD.