Objective To describe our experience and method of reconstruction after resection of tumors around inner canthus and nasion in the elderly. Methods The line between outer and inner canthus was considered during reconstruction.If the surface of wound after resection was above this line,glabellar flap was used to reconstruct the upper part and the residual defect was repaired with advancement of lower eyelid and rotation of flap.If the surface of wound was below this line,lower eyelid flap was used and the residual defect was reconstructed with glabellar flap. Results All flaps survived without any significant complications.9 cases among 15 patients were followed up from 1 to 24 months.Repaired tissues all matched well with surrounding tissue in color,texture,and outline.Eyelid and medial canthal were not disturbed and there was no tumor recurrence.Scars were smoothy,soft and hidden with satisfactory appearance and vision. Conclusions Single local flap or combined local skin flaps around the nasion and inner canthus is one of reconstruction methods to get satisfactory cosmetic effect or facial morphology.

Objective To investigate the effects of ginsenoside Rg3 (GS-Rg3) on the hypertrophic scars of rabbit ears and provide experimental foundation for study on its inhibition on the hypertrophic scars. Methods Hypertrophic scars were proved on 24 white rabbits,of which the whole level of the skin was excised for 2 cm?2 cm,4-6 points for each ear,controlled by itself. GS-Rg3 0.1 mL(concentration 3 g?L-1) was injected into experimental group and the same volume of saline solution into control group,once every three days regionally. The scar tissues were collected 2,4 and 6 weeks after the injection respectively,the thickness of the scar,structure under the microscope,and the expressions of PCNA,Bcl-2 and Bax were observed. Results In control group,three weeks after the epithelization of the wound,the thickness of the hypertrophic tissue was 3-4 times of ventro ear skin. Under microscope,the dermis was hyperplasia and got thicker,consisted with amount of fibroblast cells,collagen and vessels,the collagen was untidy,nodule or vortex,and the cartilage could be observed in some region.In experimental group, six weeks after the injection,the skin got thinner,the collagen became neath and the quantity of the vessels decreased. In the hypertrophic scars,there was high expression of PCNA,the percent of positive cells was higher (39.55%?6.07%) compared normal tissue (11.18%?1.71%).In GS-Rg3 group,the expression of Bcl-2 was gradually decreased two weeks after injection and obviously decreased six weeks later,there was significant difference compared with before injection (P

AIM:To study the oral bioavailability of Silymarin-loaded Nanoparticles(SM-NP). METHODS: Beagle dogs were employed as experiment animals,Yiganling Tablet and Silymarin Extraction were used as the reference preparations.Three constituents were isolated on Ultimate~(TM) AQ-C_(18) column with mobile phase methanol:water(50∶50) at 0.8 mL/min flow rate using gradient elution and ESI ionic source and negative ion detection.Silybin plasma concentration in rat was determined by LC-M. RESULTS: The pharmacokinetics of the tested preparation and Yiganling Tablet met with one-compartment model.The relative bioavailability of three components of SMNP were higher than that of Yiganling Tablet. CONCLUSION: The results indicate that SM-NP has better bioavailability than the reference preparation,which confirms that nanoparticles is a good carrier for improving oral bioavailability of poorly-soluble drugs.

Aim To investigate the effect of Salvianol-ic acid A (Sal A)on mice with isoproterenol (ISO)-induced myocardial infraction and its possible mecha-nisms.Methods The mice were subcutaneously in-jected with ISO (8 mg·kg-1 )to induce myocardial in-farction.The myocardial protective effect of Salvianolic acid A was evaluated from mortality rate,electrocardio-gram (ECG),heart function,myocardial infarction in-dex,serum myocardial enzymes and its action mecha-nisms were explored from inflammation,anti-oxidation and cells apoptosis.Results Salvianolic acid A dose-dependently enhanced the heart function of myocardial infarction mice,reduced the heart index,inhibited the myocardial enzyme leakage,showed obvious myocardi-al protection effects.ELISA results showed that Salvi-
anolic acid A could reduce the expression of myocardial inflammatory cytokines such as IL-6(interleukin-6,IL-6),TNF-α(tumornecrosis factor-α,TNF-α).West-ern-blotting confirmed that Salvianolic acid A could in-crease the expression of anti-apoptotic proteins Bcl-2, reduce the expression of apoptosis protein Bax,and raise the phosphorylation level of PI3K and Akt.Con-clusion Salvianolic acid A displays a significant pro-tective effect against isoproterenol-induced myocardial infarction and its mechanism may be related to the in-crease of PI3K/Akt signal pathway and the inhibition of cell apoptosis and inflammatory reaction.

AIM:To investigate the neuroprotective effect of hydrogen sulfide ( H2 S) after cardiopulmonary re-suscitation in rats with cardiac arrest ( CA) , and to explore the effects of H2 S on neuron autophagy.METHODS:The CA model was established through asphyxia.Male Wistar rats were randomly divided into sham group, model group and NaHS group.The levels of beclin-1 and LC3 II/I were measured by Western blot at 2 h, 4 h, 12 h and 24 h after the restoration of spontaneous circulation (ROSC).At 12 h after ROSC, the formation of autophagic vacuole with LC3 dots was deter-mined by immunohistochemical ( IHC) method.The phenomenon of neuron autophagy was observed under transmission electron microscope.The numbers of apoptotic neurons were counted by TUNEL staining at 72 h after ROSC.The neurolo-gic deficit score ( NDS) was used to evaluate the neurologic function after ROSC.RESULTS: The level of beclin-1 was gradually increased in model group, but it was increased and then gradually recovered in NaHS group ( P<0.05 ) .The conversion of LC3 II in the cerebral cortex was the same as beclin-1.The results of IHC showed that LC3-positive nuclei in model group were more than those in NaHS group ( P<0.05) .The number of autophagic vacuole in model group was more than that in NaHS group (P<0.05).The number of the TUNEL-positive cells in model group was more than that in NaHS group (P<0.05).The NDS of the animals in NaHS group after ROSC was lower than that in model group(P<0.05). CONCLUSION:H2 S inhibits neuronal autophagy, decreases apoptosis and improves neurologic function in CA rats after ROSC.

Blood and lymphatic vessels are absent from the normal cornea.Pathological stimulation such as corneal in-fection,chemical burns and transplantation rejection can disrupt the balance between pro-and anti-lymphangiogenesis fac-tors,causing lymphatic vessels to extend from the corneal limbus to the central cornea.Corneal lymphangiogenesis is closely related to various regulatory factors and cellular signaling pathways.Further study and elucidation of the mechanism of corneal lymphangiogenesis will open up new directions for treating corneal transplantation rejection,inflammatory disea-ses,dry eyes and tumor metastasis.This review concludes the endogenous regulatory factors of corneal lymphangiogenesis and therapeutic strategies for its related ocular surface diseases.

Objective To evaluate the efficacy and safety of combined therapy with 89Sr for treating skeletal-related events of prostate cancer. Methods Databases including PubMed,MEDLINE,EMBASE,the Cochrane library,CNKI,CBM and Wanfang were systematically searched since 89Sr was first reported in 1976 to September 2015 to include the randomized controlled trials (RCTs) of the combined therapy with 89Sr for skeletal-related events of prostate cancer.The statistical analysis was performed using Review Manager Version 5.2. Results A total of 18 RCTs involving 1 280 patients were analyzed.The results of meta-analysis indicated:there were statistically significant differences in the pain relief rate [OR=4.71,95%CI(3.34, 6.62),P<0.000 1],decrement rate of bone metastasis[OR=3.63,95%CI(2.60,5.09),P<0.000 1] and improvement rate of life quality [OR=2.16,95%CI(1.16,4.02),P<0.05].Progression-free survival of patients in experimental group was significantly longer than that in control group [HR=0.84,95%CI(0.73,0.97),P=0.02].No significant difference was found in overall survival [HR=0.82,95%CI(0.65,1.02),P=0.07].There were no significant differences in the incidence of adverse events [OR=1.46,95%CI(0.98,2.17),P>0.05]. Conclusion Combined therapy with 89Sr has better efficacy and comparable safety profile compared with standard therapy.However,the quality and sample size of the included studies are limited,so more high-quality and large-sample RCTs are needed to verify the validity.

This article introduced Professor Wang Xingkuan's academic thoughts and clinical experience in diagnosing and treating burning mouth syndrome(BMS)in perimenopausal women based on the theory of"yin injury and internal dryness".Professor Wang advocates the principle of"treating the root cause of the disease and harmonizing multiple organs".Starting from the unique physiological characteristics of perimenopausal women,he believes that the BMS in perimenopausal women should be attributed to the kidneys,liver,heart,and small intestine.The fundamental cause of the disease is the deficiency of kidney essence and the gradual decline of liver blood,and the key to the onset is the dryness of the kidney,liver,heart,and small intestine.In treatment,the overall strategy is to take"yin injury and internal dryness"as the main guideline,focusing on the liver and kidney,with nourishing and replenishing the liver and kidney as the main approach and clearing heat and moistening as auxiliary methods.The basic formula for treating BMS is a combination of Erdong Decoction and Baihe Dihuang Decoction,which has shown significant clinical efficacy.

Objective To construct and identify a patient-derived organoid model,and to investigate the sensitivity of chemotherapy drugs using this model.Methods Pancreatic cancer cells were obtained from the surgical specimens of two female patients with a confirmed diagnosis of pancreatic cancer after tumor tissue digestion,and then the cells were inoculated into a culture dish using matrigel for three-dimensional culture.Paraffin sections were prepared for HE staining and immunohistochemical staining and were compared with the parent tumor tissue to determine whether the histopathological features of the tumor in vivo were preserved.The pancreatic cancer organoids were treated with seven chemotherapy drugs at different concentrations;Cell Titer-Glo?3D reagent was used to measure cell viability,and the results of drug sensitivity were analyzed.Results Two patient-derived pancreatic cancer organoids were successfully constructed,and HE staining and immunohistochemical staining showed that the pancreatic cancer organoids had consistent histopathological features with the tumors of the corresponding patient.Both pancreatic cancer organoids were more sensitive to gemcitabine monotherapy and the combination of oxaliplatin+SN38+fluorouracil,and patient 1 was more sensitive than patient 2.There were individual differences in the response to drugs between the organoids from different patients.Conclusion The pancreatic cancer organoid model successfully constructed in this study can reflect the histological classification of parent pancreatic tumors and can be used for in vitro chemotherapy drug sensitivity test,which is expected to provide a reference for clinical medication.

Objective To compare the safety and effectiveness of intravenous thrombolysis treatment in large artery atherosclerosis (LAA) and cardioembolic (CE) strokes in patients with acute anterior circulation ischemic stroke.Methods Two hundred and thirty-eight patients with acute anterior circulation ischemic stroke, admitted to and treated with intravenous thrombolysis in our hospital from January 2017 to June 2018 were chosen in our study. These patients were divided into either a LAA group (n=158) or a CE group (n=80) according to etiological subtypes. The differences in baseline data and outcomes 90 d after the onset between the two groups were compared. Baseline data of patients in the good outcome group and the poor outcome group were compared and independent risk factors for poor outcome were determined by multivariate Logistic regression analysis.Results As compared with the patients from the LAA group, patients from the CE group had older age and higher proportion of patients combined with atrial fibrillation, with significant differences (P<0.05); there were no statistically significant differences in the good outcome rate, mortality rate and incidence of symptomatic intracranial hemorrhage between the two groups (P>0.05). Among the 238 patients, 112 were into the good outcome group and 126 were into the poor outcome group; as compared with patients from the poor outcome group, patients from the good outcome group had younger age, and lower National Institute of Health Stroke Scale (NIHSS) scores and lower levels of fasting blood glucose before and after thrombolysis, with statistically significant differences (P<0.05); multivariate Logistic regression analysis showed that older age (odds ratio [OR]=1.040, 95％ confidence interval [CI]: 1.010-1.071,P=0.008) and higher NIHSS scores 24 h after thrombolysis (OR=1.259, 95％CI: 1.175-1.350,P=0.000) were independently associated with poor outcome.Conclusion The outcomes of intravenous thrombolysis in patients with acute anterior ischemic stroke are only associated with age and severity of stroke, and not associated with TOAST etiological subtypes; intravenous thrombolysis for cardiogenic stroke is safe and effective.