OBJECTIVETo explore the possibility of creating a rat new scar model by inserting gelatin sponge into rat excisional wounds.

METHODSTwo full-thickness wounds were created in each of total 49 SD rats. In the Experimental group (n = 19), a regular incisional wound (1 cm) was created on the left side, and an excisional wound of 1.0 cm x 0.2 cm was created on the right side with a gelatin sponge inserted. In control 1 group (n = 15), an excisional wound with sponge insertion was created on both sides of rats. In control 2 group (n = 15), two excisional wounds were created on both sides, and only one side wounds were inserted with a sponge. Animals were sacrificed at various time points for different examinations.

RESULTSThe wound/scar width increased 4 - 11 times in inserted wounds than in regular incisional wounds (P < 0.01), with an obvious delay of epithelialization. No difference in wound/scar width was found in both sides of wounds of control 1 group at various locations. In contrast to the linear scar of sponge-inserted wounds, contracted and irregular scar was found in non-inserted wounds of control 2 group.

CONCLUSIONSGelatin sponge insertion can create a thick linear scar in rat wounds, and thus provides a new model for scar research.

Animals ; Cicatrix ; pathology ; Dermatologic Surgical Procedures ; Disease Models, Animal ; Gelatin Sponge, Absorbable ; Male ; Rats ; Rats, Sprague-Dawley ; Skin ; pathology ; Suture Techniques ; Wound Healing

OBJECTIVETo evaluate the methods of diagnosis and surgical treatment for nonfunctional islet cell tumor (NICT).

METHODSForty-four patients with non-functional islet cell tumor treated at the First Affiliated Hospital of Nanjing Medical University during January 1968 to June 2008 were analyzed retrospectively. There were 9 males and 35 females, aged from 7- to 70-years-old. Clinical manifestation: 15 cases (34.1%) of abdominal masses, 17 patients (38.6%) with epigastric or back pain, 5 cases of jaundice, 5 cases (11.4%) for upper abdominal fullness or vomiting, 10 cases (22.7%) of pancreatic tumor noticed by routine health checkups or imaging examinations. Imaging examination: CT scan, sonography, ERCP, MRI, upper GI series were performed in 33 (75.0%), 16 (36.4%), 6 (13.6%), 2 (4.5%), and 10 cases (22.7%) respectively. Operation methods: 39 patients (88.6%) underwent surgical resection and the other 5 patients did not.

RESULTS

COMPLICATIONSpancreatic fistula in 7 patients (15.9%), intra-abdominal bleeding in 4 (9.1%), gastrojejunal anastomosis outlet obstruction in 1 (2.3%), biliary fistula in 2 (4.5%) and incisional infection in 3 (6.8%). Surgery related mortality happened in 2 patients (4.5%), both treated before 1999. Twenty-five patients underwent operation between January 1999 and June 2008 were followed up for 6 to 108 months. All survive except one died 75 months after the surgery for unknown reason.

CONCLUSIONSNo specific clinical manifestation is recognized for non-functional islet cell tumor. Spiral CT is an optimal diagnostic method, while surgery is the first choice for treatment. Middle segmental pancreatectomy has become an alternative surgical protocol for NICT.

Adenoma, Islet Cell ; diagnosis ; surgery ; Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; diagnosis ; surgery ; Prognosis ; Retrospective Studies ; Young Adult

Objective To construct a three-dimensional finite element model of human skull with anatomic structure and to study biomechanical responses of the head under various loading conditions. Methods The finite element model of high-precision human head with anatomic structure was reconstructed with the constitutive skull made from elastic-plastic material to simulate the fracture. This model was used to simulate frontal impact intracranial pressure testing, dynamic skull fracture testing and head drop testing reported by the literature, and the simulation reproduced the experimental process of head subjected to impact loads, skull fractures, and biomechanical responses of head fall at different speed. Results Under frontal impact loading, the model showed hedge-side positive-negative intracranial pressure distributions, and the occipital deformation was more serious than that in prefrontal, parietal under similar loading. The faster falling speed would cause more serious injuries. Conclusions To establish the accurate anatomic finite element model of human head can preferably simulate biomechanical responses of the head under the loading of impact and fall. Through quantifying parameters such as contact force and intracranial pressure, injury risks can be assessed to provide scientific references for design of protective devices.

Objective To screen the key Mutation Genes in endometrial adenocarcinoma and study the relationship between their expression and immune response and prognosis. Methods The data of 543 cases of endometrial adenocarcinoma and 177 cases of normal tissues were downloaded from the Cancer Genome Atlas (TCGA) and genotype tissue expression (GTEX) for bioinformatics analysis. 22 cases of endometrial adenocarcinoma were collected, RT-qPCR was used to verify the gene expression. Results More than 96.38% of the patients had mutations, including missense mutation, single nucleotide mutation and C>T mutation. The top 10 mutations were PTEN, PIK3CA, TTN, ARID1A, TP53, MUC16, PIK3R1, KMT2D, CTCF and CSMD3. In TCGA, the expression of TP53 mutant was significantly higher than that of wild type (P<0.0001). The expression of TP53 in cancer tissue was higher than that in normal tissue, and the expression of TP53 mutant was higher than that of wild type (P<0.05). The overall survival (OS), progression free survival (PFS), disease free survival (DFS) and disease free survival (DSS) of TP53 mutant were lower than those of TP53 wild type (P<0.0001, P<0.0001, P=0.001, P<0.0001). A total of 344 differentially expressed genes (195 up-regulated and 149 down regulated) were identified in wild-type and mutant TP53. Compared with the wild type, the mutant was negatively enriched in the ^“immune effector process^”, ^“immune response^”, ^“immune system progress^”, ^“innate immune response^” and ^“immune response regulation^” pathways (P=0.001). The scores of T cell CD8 +, neutrophil, macrophages and meyloid dendritic cells of TP53 mutant were lower than those of wild type. Conclusion TP53 is highly expressed in endometrioid adenocarcinoma, and the expression of mutant is higher than that of wild type. TP53 mutation is positively correlated with poor prognosis and can inhibit immune response.

Objective In this paper, we will discuss if the CETP polymorphism contributes to the centenarians in Hainan island. Methods We tested the TaqIB and I405V polymorphisms of CETP gene among 276 centenarians and 301 matched healthy individuals by AS-PCR and analyzed the data with SPSS software package (Version 19.0). Results Our data indicated that allele B1 and V have the significant differences between centenarians and healthy control groups with P < 0.001. Further analysis implied that genotypes B1B1 (P < 0.001, OR = 0.148, 95% CI = 0.095-0.230) and VV (P < 0.001 and OR = 0.353, 95% CI = 0.237-0.525) were significantly different between centenarians and matched controls. The combination of B and V, such as B1B1-II (P < 0.001, OR = 0.128, 95% CI = 0.049-0.329), B1B1-IV (P < 0.001, OR = 0.115, 95% CI = 0.056-0.237), B1B2-VV (P < 0.05, OR = 0.534, 95% CI = 0.310-0.920), and B2B2-VV (P < 0.001, OR = 0.198, 95% CI = 0.086-0.453) have significant differences between centenarians and matched healthy individuals from Hainan. Conclusion Our results implied that allele B1B1 and VV, as well as the combination B1B1-II, B1B1-IV, B1B2-VV and B2B2-VV may contribute to the longevity in centenarians of Hainan, south of China.

OBJECTIVE: To explore the effect of UVRAG on mitophagy in leukemia cells K562. METHODS: K562 cells were induced with different concentrations of mitophagy inducer carbonylcyanide-m-chlorophenylhydrazone (CCCP) for 6, 12 and 24 hours, and the cell viability was detected by the CCK-8 assay. K562 cells were divided into NC, UVRAG-siRNA, UVRAG-siRNA+CCCP, and CCCP group, while Western blot was used to detect the expression of UVRAG protein. Flow cytometry was used to detect the changes in reactive oxygen species (ROS) and mitochondrial structural integrity. The expressions of autophagy related proteins P62 and LC3-Ⅱ/LC3-Ⅰ were detected by Western blot. RESULTS: Compared with NC group, the expression of UVRAG protein in UVRAG -siRNA group significantly decreased (P<0.01). Compared with CCCP group, in UVRAG -siRNA+CCCP group ROS, mitochondrial structure damage, and the expression of LC3-Ⅱ/LC3-Ⅰ decreased significantly (P<0.05, P<0.05, P<0.01), while the expression of P62 protein increased (P<0.05). Compared with NC group, the differences in the expressions of P62 and LC3-Ⅱ/LC3-Ⅰ protein, ROS, and mitochondrial structural integrity in UVRAG -siRNA group were not obvious (P>0.05). CONCLUSION Under the treatment of CCCP, silencing UVRAG can inhibit mitophagy in K562 cells.
Humans ; Leukemia ; Tumor Suppressor Proteins

Objective: To explore the efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Seventy-three patients(including 60 males and 13 females) with OSAHS admitted to the department of otorhinolaryngology of our hospital in recent two years were retrospectively analyzed. All the patients had velopharyngeal obstructionevaluated by electronic endoscopic Müller test and were divided into control group (34 cases) and observation group (39 cases). The patients in the control group were performed modified uvulopalatopharyngoplasty, while those in the observation group were performed relocation and expansion pharyngoplasty by suspension sutures.The scores of ESS, AHI and LSaO₂ before and after treatment were collected and compared. Results: The total effective rate of the observation group was 94.87%, which was significantly higher than 79.41% of the control group. The AHI was lower and LSaO₂ value was higher (χ²=-1. 896,-1. 968,P<0.05)in the observation group. The sleeping symptoms and quality of life of the two groups were significantly improved. The ESS score of the observation group was decreased more significantly than that of the control group after treatment, and the difference was statistically significant (χ²=-1.451,P<0.05). The incidence of foreign body sensation in pharynx of the observation group (89.74%) was higher than that of the control group (55.88%), and the postoperative bleeding and postoperative recurrence rate (0.00%, 2.56%) was lower than that of the control group (8.82%, 14.70%)with statistical significance (χ²=4.738,4.249,4.119,P<0.05).The incidence of transient nasopharyngeal reflux in both groups was low and statistically insignificant (χ²=0.629,P>0.05). Conclusions: Preoperative strict screening of indications plays an important role in the selection of palatopharyngeal surgery methods and curative effect. Relocation and expansion pharyngoplasty by suspension sutures can improve the clinical efficacy of OSAHS with better safety and less recurrence.
Female ; Humans ; Male ; Palate, Soft/surgery* ; Pharynx/surgery* ; Quality of Life ; Retrospective Studies ; Sleep Apnea, Obstructive/surgery* ; Sutures

Objective: To evaluate the effect of ultrasound diagnosis of thyroid micro-malignant nodules and accumulate practical experience for the management of active surveillance for them, so as to avoid overtreatment. Methods: A total of 949 patients who were diagnosed with thyroid malignant nodules using ultrasonography, with the nodules being less than 1 cm in size and without regional lymph node metastasis or distant metastasis, were included. They were treated by the same surgeon of the Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from February 2014 to December 2020. 112 patients chose immediate surgery. The rest patients were asked to accept ultrasound examination every 6 months to 1 year. Follow-up endpoints: tumor size growth of 3 mm, tumor volume increase greater than 50%, lymph node metastasis or distant metastasis. Results: The median follow-up time was 19 months. 713 patients underwent surveillance for more than 6 months. Of the 713 patients, 570 (79.9%) were women, with mean age at 43.5 years old. Tumor progression was observed in 47 (6.6%) patients with a cumulative incidence of 2.7% (1 year), 7.2% (2 years) and 9.5% (3 years). In multivariate analysis, patient age [HR=0.508, 95%CI: 0.275-0.939, P=0.031], lesion number [HR=2.945, 95%CI: 1.593-5.444, P=0.001] and tumor size [HR=2.245, 95%CI: 1.202-4.192, P=0.011] at the beginning of observation were independent risk factors for tumor progression in patients with minimal thyroid malignant nodules during follow-up. During a median (range) active surveillance of 19 (6-80) months, 74 patients chose surgery during the surveillance. Among the 186 patients who underwent surgery, only 3 patients were diagnosed with fibrotic nodules in pathology, while the rest were papillary thyroid carcinoma. The ultrasound accuracy reached 98.4%(183/186). Conclusions: Ultrasonography is an effective method of diagnosing malignant thyroid nodules. Thyroid micro-malignant nodules progress slowly. As a result, it is safe to observe them instead of taking immediate surgery. Patient age, lesion number and tumor size at the beginning of observation are independent risk factors for the tumor progression of malignant nodules.
Humans ; Female ; Adult ; Male ; Thyroid Nodule/surgery* ; Carcinoma, Papillary/surgery* ; Lymphatic Metastasis ; Thyroid Neoplasms/surgery* ; Thyroidectomy/methods* ; Watchful Waiting ; Ultrasonography ; Retrospective Studies

OBJECTIVETo investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS).

METHODSSixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2).

RESULTSCompared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference (P>0.05); ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS (P<0.05).

CONCLUSIONSInflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.