Objective To develop a new strategy for preparing large-area full-thickness skin grafts with donor incisions small enough to allow direct suture under low pressure.Methods A geometrical analysis was carried out to design the best strategy to obtain skin grafts with minimal donor defect.In this strategy,two semicircular donor skin grafts are subjected to a malpositioned joining to form a circle which is equal in size to the large-area skin defect.Seven patients with cutaneous malignancy were managed by this operation regimen,including three cases of basal cell carcinoma,three cases of squamous cell carcinoma,and one case of malignant melanoma.Tumors were located in the face or head in five patients,and in feet in two patients.Results The width of donor incisions was significantly reduced by this strategy,and donor defects were sutured directly with the minimal loss of donor graft.Of the five patients with malignancies of the head or face,three achieved complete survival of skin grafts,two experienced mild erosion at the margin of skin grafts.A 10％-20％ necrosis of skin graft was observed in the sole of feet in 2 patients,which healed 1-2 months after dressing changes.Conclusion Joined grafts of equal size may be an effective approach to the repair of large skin defect.

OBJECTIVETo study the anticonvulsive action of scorpion alcoholic extraction (SAE) on phenytoin-resistant convulsive rats made by direct cortical electrical stimulation in order to investigate the mechanism of antagonizing drug-resistance of SAE.

METHODUsing the method of implanting microelectrodes in the cortical motor area of the brains of rats where the brain tissue was stimulated frequently by electricity through microelectrodes until igniting and then PHT (0.154 g x kg(-1) x d(-1)) ig for 7 days, We established phenytoin-resistant convulsive rat model. Total 6 groups were set up in the experiment: Normal control group, convulsion model control group (CMCG), phenytoin-resistant convulsion control group (PRCG), verapamil positive control group (VPCG, 0.0385 g x kg(-1)), scorpion alcohol extraction (SAE1, 6.5 g x kg(-1)) and scorpion alcohol extraction (SAE2, 13.0 g x kg(-1)). After ig both doses of SAE (6.5, 13.0 g x kg(-1)), the effects of SAE on the changes of convulsion threshold of phenytoin-resistant convulsive rats were observed. The method of RT-polymerase chain reaction (RT-PCR) was used to detect the changes of mdrl gene expression and the method of immunohistochemistry (SABC) was adopted to determine the changes of P-gp expression.

RESULTBoth doses of SAE and verapamil (Ver) ig all raised the convulsant threshold of phenytoin-resistant rats (480.38 +/- 18.48) microA, there were statistical differences (P < 0.05) compared to themselves before drugs-treated. PHT was administrated, and mdrl mRNA and P-gp expression in PRCG was much higher than that in CMCG, with significantly statistical difference (P < 0.01); ig both doses of SAE and Ver all decreased mdrl mRNA and P-gp expression compared to PRCG respectively (P < 0.01).

CONCLUSIONSAE and Ver ig all produce antagonizing action on phenytoin-resistant convulsive rat model. The machanism is related with inhabiting the mdrl mRNA expression and further decreasing the product P-gp.

ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Animals ; Brain ; drug effects ; metabolism ; Disease Models, Animal ; Ethanol ; chemistry ; Female ; Gene Expression ; drug effects ; Humans ; Phenytoin ; pharmacology ; Rats ; Rats, Wistar ; Scorpions ; chemistry ; Seizures ; drug therapy ; genetics ; metabolism

Objective To investigate the CT manifestations and pathology features of solitary fibrous tumors of the pleural (SFTP),to improve diagnostic accuracy of this disease.Methods CT manifestations of 12 cases with SFTP confirmed by surgery were analyzed retrospectively by comparison with the pathological findings.Results The CT images of the 12 cases showed intrathoracic soft-tissue shadow with well-defined margin which was widely connected with pleural.There were 4 cases with mound like and mushroom shape,3 cases with round or oval shape,2 cases with irregular shape growing into the pleural space,3 cases with large mass filling unilateral thoracic cavity,9 cases with pleural tail sign and 1 case with pleural pedicle sign.The plain CT showed homogeneous density in 7 cases,high-low mixed density in 4 cases and with internal calcification in 1 case.After contrast enhancement,5 cases were map like heterogeneous and progressive enhancement,and 4 cases have strip distorted vessel inside or on the edge of the lesion.Conclusion CT manifestations of SFTP have certain characteristics,such as broad base,shaping growth and pleural tail sign,which could be helpful to improve the diagnostic accuracy of SFTP by analyzing carefully.

OBJECTIVETo observe the pathological changes in the myocardial and pulmonary tissues in miniature pigs with chronic pulmonary hypertension induced by monocrotaline (MCT).

METHODSTwelve male miniature pigs (weigh 15.0-18.0 kg, aged 4.0-4.5 months) were examined for baseline mean pulmonary artery pressure (mPAP), followed by intraperitoneal injection of 10.0 mg/kg MCT in 10 randomly selected pigs. The mean pulmonary artery pressure at 4 and 8 weeks were determined, and the pathological changes in the myocardial and pulmonary tissues were observed.

RESULTSThe baseline mPAP of normal miniature pigs was 15.19∓0.70 mmHg. At 4 and 8 weeks after MCT injection, the sPAP and dPAP were 19.69∓2.47 mmHg and 25.62∓4.88 mmHg, respectively, and the mPAP increased significantly compared with that of the normal control group (P<0.01). Obvious pathological changes such as pulmonary hypertension and right ventricular hypertrophy were found in the pigs 4 weeks after MCT injection, and at 8 weeks, significant pathological changes occurred including right ventricular fibrosis and thickening of the tunica media of the pulmonary artery.

CONCLUSIONMCT can cause pulmonary hypertension in miniature pigs 8 weeks after drug administration, shown as increased pulmonary artery pressure and pulmonary vascular remodeling.

Animals ; Hypertension, Pulmonary ; chemically induced ; pathology ; Lung ; pathology ; Male ; Monocrotaline ; adverse effects ; Myocardium ; pathology ; Swine ; Swine, Miniature

Objective: To explore the expression of epidermal growth factor receptor(EGFR) protein during benzo(a)pyrene (BaP) induced carcinogenesis. Methods: This study, we firstly utilized immunofluorescence assay and Western-blot to examine EGFR expression of the BaP which was constructed previously by project team induced malignant transformation human bronchial epithelial cell (BTC) and the control (16HBE cell). Then, we selected 36 healthy SD rats, divided into two groups according to simple random method, 18 rats each group. The constructed rat lung neoplasm model induced by pulmonary injection of BaP (10 mg/ml of BaP solution in 0.2 ml corn oil), contrast group use 0.2 ml corn oil, lung tissue was collected and the EGFR expression of lung tissue was detected by immunofluorescence assay and Western blot. T analysis was used to test the different of EGFR between two groups. Results: Immunofluorescence analysis showed that the EGFR expression in BTC was significantly higher than 16HBE cell. Meanwhile, Western blot also was used to confirmed this result, the relative expression of EGFR protein in the rats of the model group the control group were 1.04±0.13 and 2.32±0.12, respectively, and the difference was statistically significance (t=12.39, P<0.001). In vivo, well-defined tumor was found in the rat with pulmonary injection of BaP, and the lung showed diffuse alveolar septal thickening, alveolar wall destruction and pulmonary alveoli fusion, which suggested that the rat lung neoplasm model was constructive successfully. Furthermore, we found the EGFR expression of lung was increased dramatically in the rat lung neoplasm model by immunofluorescence detection and Western blot. The relative expression of EGFR protein in the rats of the model group the control group were 0.21±0.03 and 1.30±0.07, respectively, and the difference was statistically significance (t=12.84, P<0.001). Conclusion Expression of EGFR protein was increased during BaP carcinogenesis, and EGFR may play an important role in the carcinogenesis of BaP.

Objective To investigate the relationship between osteoprotegerin ( OPG ) gene polymorphisms and susceptibility to large-artery atherosclerotic stroke ( LAA ). Methods A total of 1 010 patients with LAA registered in Nanjing Stroke Registry Program between August 2013 and May 2017 were retrieved, and 1 121 healthy residents were selected as controls. Two single nucleotide polymorphisms of rs2073617 and rs3134069 of OPG gene were genotyped by SNPscan technique. Multivariate logistic regression analysis was used to analyze the relationship between rs2073617/rs3134069 and susceptibility to LAA. Results Multivariate logistic regression analysis indicated that the rs3134069 C allele (odds ratio [OR] 1.39, 95%confidence interval [CI] 1.13-1.71; P=0.002) and its corresponding CC/CA genotype (OR 1.43, 95% CI 1.14-1.80; P=0.002) were the independent risk factors for LAA. Stratification analysis showed that this association was more pronounced in the subgroups of olderly (≥60 years), those with hypertension, smoking or without diabetes and hyperlipidemia. In addition, haplotype analysis showed that G-C haplotype of rs2073617/rs3134069 was also an independent risk factor for LAA onset (OR 1.36, 95% CI 1.10-1.68; P=0.005). Conclusion OPG gene polymorphisms are associated with the susceptibility to LAA.

Objective:To investigate the clinical effect of bridging fixation with locking plate for the Seinsheimer type V subtrochanteric femoral fracture. Methods:From March 2009 to September 2014,18 cases of Seinsheimer type V sub-trochanteric femoral fracture were treated by open reduction and bridging fixation with locking plate through proximal and distal approach including 16 males and 2 females with an average age of 41 years old ranging from 22 to 67 years old. Among them , 12 cases caused by traffic accident,5 cases by falling,1 case by heavy aboving. All cases were fresh and closed fractures. Time between injury and operation was from 4 to 9 days with an average of 6.2 days. Of them ,11 cases were fixed with reverse LISS and the other 7 cases were fixed with anatomical locking plates of proximal femur. Results:The mean time of operation was 110 min (ranged from 90 to 155 min). The mean blood loss during operation was 425 ml (ranged from 350 to 650 ml) and 16 cases got blood transfusion which was meanly 300 ml. The mean hospital time was 14 days (ranged from 12 to 18 days). The mean duration of followed up was 11.8 months (ranged from 8 to 22 months). The mean time of bone union was 6.6 months (ranged from 5 to 8 months). There was not any complication such as infection,implant failure,hip varus,external rotation deformity of low limb or fat embolism. The Sanders hip scores were 53.22±6.48,the result was excellent in 12 cases and good in 6 cases at the last follow up. Conclusion:Under the principle of biological osteosynthesis ,treatment of Seinsheimer type V sub-trochanteric femoral fracture with bridging locking plate fixation has such advantages as high mechanism ,less interference of blood supply,stable fixation and little complication. It is a safe and idea way for the treatment of the Seinsheimer type V sub-trochanteric femoral fracture.

Objective:The study aimed to investigate the association between lesion location and post-stroke depression (PSD) in acute ischemic stroke patients.Methods:In this case-control study, acute ischemic stroke patients were recruited from the Department of Neurology, First Affiliated Hospital of the University of Science and Technology of China (USTC), between September 2020 and June 2021. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, the patients were divided into the PSD and non-PSD groups. The 24-item Hamilton Rating Scale (HAMD) was used to evaluate the severity of depression. The Student′s t-test, Mann-Whitney test, and Chi-square test were used to compare the clinical baseline characteristics of PSD and non-PSD groups. Voxel-based lesion-symptom mapping (VLSM) was applied to investigate the association between lesion location and depression occurrence and severity. Results:A total of 70 and 173 patients were admitted to the PSD and non-PSD groups, respectively. The mean age of patients was 59 years (23-86). There were 153 males and 90 females. Univariate analysis showed a significant difference only in Hamilton Anxiety ( P=0.025) and Depression ( P<0.001) scores between the PSD and non-PSD groups. VLSM analysis identified clusters within the anterior cingulate gyrus ( Z=-3.05, P<0.001), left hippocampus ( Z=-3.15, P<0.001), and left lingual lobe ( Z=-3.08, P<0.001) where lesions were significantly associated with PSD. Additionally, the severity of PSD was associated with damage in the anterior cingulate gyrus ( Z=-3.64, P<0.001), left hippocampus ( Z=-3.51, P<0.001), left lingual lobe ( Z=-4.18, P<0.001), and pericalcarine cortex ( Z=-3.65, P<0.001). Conclusion:VLSM demonstrated that lesion location could be used to predict the occurrence of PSD in patients with acute ischemic stroke.

Objective:To investigate the relationship between caspase activation and recruitment domain 8 ( CARD8) gene rs2043211 polymorphism and the age of onset for large artery atherosclerosis (LAA) stroke in Chinese Han population. Methods:Based on Nanjing Stroke Registry Program, patients with LAA stroke from January 2010 to December 2014 were included retrospectively and genotyped. Grouping according to different genetic models, the age distribution among different genotypes were compared, and Kaplan-Meier curve was used to compare the age-related cumulative non-onset frequency of the patients with different genotypes.Results:A total of 738 patients were admitted and 717 (97.15%) were successfully genotyped and included in the study. There were no significant differences in age, sex, body mass index, hypertension, diabetes, hyperlipidemia, smoking and drinking history among the genotype groups. Patients with T allele had earlier onset under codominant model (AA genotype: 61.68 years, 95% confidence interval [ CI] 59.92-63.45 years; AT genotype: 60.51 years, 95% CI 59.41-61.60 years; TT genotype: 60.44 years, 95% CI 58.96-61.92 years). Kaplan-Meier curve analysis showed that there was a significant difference in the age-related cumulative non-onset frequency between patients with different genotypes (log-rank test, P=0.041). Similar results in the female was observed in the stratified analysis (log-rank test, P=0.001). Conclusions:T allele of CARD8 rs2043211 is associated with the early age of onset of large artery atherosclerosis stroke in Chinese Han population, especially in female patients.