Objective To discuss the diagnosis and treatment of the benign tumors of pancreas,especially the surgical options and the prevention and cure of the postoperative complications.Methods Clinical data of 23 patients with benign lesions of the pancreas were retrospectively analyzed in our hospital from Jan.2004 to Dec.2009.All of the patients underwent surgical operation.Five patients were treated with pancreatic enucleation,8 patients were treated with distal pancreatectomy with splenectomy,1 patient was treated with central pancreatectomy,5 patients were treated with pancreaticoduodenectomy,4 patients were treated with pancreatic cyst- jejunum R-Y anastomosis.Eighteen patients were treated with somatostatin analogue.Results The pathological diagnosis included pancreatic cyst in 8,islet cell tumor in 4,mucous cystadenomas in 6,serous cystadenomas in 3,solid-pseudopapillary tumor in 2.Seven of 10 cases having pancreatic leak occoured secondary abdominal infection.One patient died of multiple organ dysfunction syndrome after pancreaticoduodenectomy.Conclusion There is no specific symptoms and serologic laboratory examinations for pancreatic benign tumors.CT and ERCP is very helpful for diagnosis and treatment.Surgical option is according to the location of the lesion and the judgement of the tumor whether being benign or malignant.Pancreaticoduodenectomy,central pancreatectomy,distal pancreatectomy with or without splenectomy and pancreatic enucleation is the reasonable surgical option.Pancreatic leakage is the main post-operation complication.Ligation the pancreatic duct reliably,treating the pancreatic raw surface appropriately,external drainage of the pancreatic fluid can reduce the rate of pancreatic leakage.

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To generate an epitope-mutated foot-and-mouth disease virus (FMDV) as a marker vaccine, the infectious clone pAsia 1-FMDV containing the complete genomic cDNA of Asia 1 type FMDV was used as backbone, the residues at positions 27 and 31 in the 3D gene were mutated (H27Y and N31R). The resulting plasmid pAsia 1-FMDV-3DM encoding a mutated epitope was transfected into BHK-21 cells and the recombinant virus rAsia 1-3DM was rescued. The recombinant virus showed similar biological characteristics comparable with the parental virus. In serological neutralization test the antisera against recombine virus have a good reactivity with parental virus. The antisera against the mutant virus were shown to be reactive with the mutated epitope but not the wild-type one. The results indicated that the two virus strains could be distinguished by western blotting using synthetic peptides. This epitope-mutated FMDV strain will be evaluated as a potential marker vaccine against FMDV infections.
Animals ; Cell Line ; DNA, Complementary ; Epitopes ; genetics ; Foot-and-Mouth Disease Virus ; genetics ; Immune Sera ; Neutralization Tests ; Transfection

Objective To analyze the outcome of the flow-through anterolateral thigh flap for reconstruction in the Gustilo type Ⅲ C traumatized extremities.Methods From June 2008 to June 2011,sixteen flow-through anterolateral thigh flaps were used for limb salvage.All in this series suffered from Gustilo type Ⅲ C open fractures in upper (4 cases) or lower extremities (12 cases).All patients had the presence of wide segmental soft tissue defects and segmental artery defects with compromised circulation.Four patients received primary operations and 12 patients received debridement combined with vacuum sealing drainage and secondary operations.Results All patients were followed up from 12 months to 40 months (average of 22 months).The mean age was 37.5 years old (from 18 to 62 years).The mean timing of free flap transfer was 6.7 days after injury (from 5 hours to 16 days).The mean artery defect was 12 cm in length (from 6 to 16 cm).All the flaps survived completely with a soft tissue texture.After operation,infection occurred in one patient,venous thrombosis occurred 1 day post-operatively in one patient,local flap necrosis occurred in two patients.No donor site morbidity was noted.In the last follow-up,according to Johner-Wruhs and Berton scores,the overall excellent/good rate for lower and upper extremities were 83.3％ and 75.0％ respectively.Conclusion Flow-through anterolateral thigh flaps provide for reconstruction of both the vessels and soft tissue simultaneously.Because of avoiding sacrificing one of the major vessels,it particularly indicates for only one major artery survival in the extremity.The clinical results show that the above reconstruction technique is useful for upper and lower extremities salvage.

BACKGROUND:Hyperbaric oxygen (HBO) therapy can aleviate the skin flap congestion by improving the angiogenesis and increasing the oxygen content of blood in skin flaps. Although the HBO therapy ability to increase flap survival has been wel described, the research on the application of HBO pretreatment in skin flap transplantation does not arouse adequate concern.
OBJECTIVE: To investigate the effect of HBO pretreatment on early-stage flap congestion in the rat model of over-length dorsal random skin flaps.
METHODS: Thirty-six SD rats were randomly divided into control group (n=12), HBO pretreatment group (n=12) and HBO treatment group (n=12). Rats in the HBO pretreatment group received 4 days of HBO therapy prior to transplantation, once a day. Rats in the HBO treatment group received 4 days of HBO therapy after transplantation. Rats in the control group were raised in the normal conditions after flap transplantation. At postoperative days 3 and 5, rats were sacrificed and the samples were colected. The inflammation of flap tissues was detected using hematoxylin-eosin staining. The expression of vascular endothelial growth factor and transforming growth factor-β was analyzed by immunohistochemistry staining. The flap survival rate was calculated at postoperative day 5.
RESULTS AND CONCLUSION:The flap survival area of the HBO pretreatment group and HBO treatment group was larger than that of the control group (P < 0.05). At postoperative days 3 and 5, the expression levels of vascular endothelial growth factor and transforming growth factor-β in the flap tissue were higher in the HBO pretreatment group and HBO treatment group than the control group (P < 0.05). However, there was no significant difference in the flap survival area and the expression of vascular endothelial growth factor and transforming growth factor-β between HBO pretreatment and HBO treatment groups (P > 0.05). HBO pretreatment can increase the expression of vascular endothelial growth factor and transforming growth factor-β and promotes angiogenesis in random pattern flaps,thereby improving skin flap survival.

Objective: To study the expression of TNF-α and PCNA in human breast tissue with polyacrylamide hydrogel(PAHG) injection, and to provide the initial theory basis for its prognosis and clinical treatment. Methods: Immunohistochemistry was used to measure the expression of tumor necrosis factor α(TNF-α)and proliferating cell nuclear antigen (PCNA) in 20 normal breast tissues and 40 cases with PAHG injection, analysis was also done by HE staining. Results: ①HE staining showed that there were a large number of homogeneous amorphous gel-like injections under optical microscope. Around PAHG there were different degrees of fibrous tissue hyperplasia with or without fibrous degeneration and lots of inflammatory cells. Local foreign body giant cell reaction and ductal dilatation also can be seen around PAHG. ②The IA levels of TNF-α and PCNA in the experimental group were 3.9± 0.3 and 3.2 ± 0.2, the IA levels of TNF-α and PCNA in the control group were 1.0 ± 0.1 and 1.3 ± 0.3, the IA level in the experimental group was significantly higher than that in the control group (P=0.000). The difference was statistically significant. The positive rates of TNF-α and PCNA in the experimental group were 90% (36/40)and 85% (34/40)respectively; the positive rates of TNF-α and PCNA in the control group were 30% (6/20), 40% (8/20). The positive expression rate in the experimental group was significantly higher than that in the control group (P=0.000). The difference was statistically significant. TNF-α and PCNA has Pearson positive relevance in the changes(r=0.3, P=0.040), the difference was statistically significant. Conclusions TNF-α and PCNA are involved in the immunoreaction of mammalian breast tissue injected with polyacrylamide hydrogel, which may induce the aseptic inflammation, fibrous tissue hyperplasia and related issues through mutual influence.

Objective: To explore the reasons and clinical treatment process of postoperative internal hernia in cases of gastric cancer, and improve the diagnosis and treatment level postoperative acute abdomen pain of gastric cancer patients. Methods: A retrospective analysis was carried out to study the data of clinical diagnosis and treatment in 7 patients, who were performed an emergency operation within the First Affiliated Hospital of Soochow University from January, 2013 to August, 2016 caused by postoperative internal hernias of gastric cancer. Results: Among the 7 postoperative gastric cancer patients, 2 cases had taken surgery of radical full gastric resection, 3 cases had taken surgery of radical distal gastric resection, and 2 cases had taken surgery of radical proximal gastric resection. All the 7 cases were confirmed to be incarcerated intestinal obstruction caused by internal hernia during emergency operation. Only 1 case was diagnosed to be internal hernia before surgery, while 3 cases were diagnosed as volvulus, 2 cases were diagnosed as perforation and 1 case was diagnosed as gastrolplegia. The small intestinal obstruction of all cases was caused by incarcerated intestinal. All the patients recovered well, and no complications occurred. Conclusions Internal hernias of the postoperative gastric cancer patients, which is often characterized by small intestinal obstruction symptoms, is difficult to diagnose before operation. Emergency operation in time for the postoperative gastric cancer patients with continuous acute abdominal pain may help to reduce the severe complications and improve patient′s prognosis.

Integrin alphavbeta3 plays a major role in various signaling pathways, cell apoptosis, and tumor angiogenesis. To examine the functions and roles of alphavbeta3 integrin, a stable CHO-677 cell line expressing the murine alphavbeta3 heterodimer (designated as "CHO-677-malphavbeta3" cells) was established using a highly efficient lentiviral-mediated gene transfer technique. Integrin subunits alphav and beta3 were detected at the gene and protein levels by polymerase chain reaction (PCR) and indirect immunofluorescent assay (IFA), respectively, in the CHO-677-malphavbeta3 cell line at the 20th passage, implying that these genes were successfully introduced into the CHO-677 cells and expressed stably. A plaque-forming assay, 50% tissue culture infective dose (TCID50), real-time quantitative reverse transcription-PCR, and IFA were used to detect the replication levels of Foot-and-mouth disease virus (FMDV) in the CHO-677-malphavbeta3 cell line. After infection with FMDV/O/ZK/93, the cell line showed a significant increase in viral RNA and protein compared with CHO-677 cells. These findings suggest that we successfully established a stable alphavbeta3-receptor-expressing cell line with increased susceptibility to FMDV. This cell line will be very useful for further investigation of alphavbeta3 integrin, and as a cell model for FMDV research.
Animals ; Animals, Suckling ; CHO Cells ; Cloning, Molecular ; Cricetulus ; DNA, Complementary/genetics/metabolism ; Disease Susceptibility/virology ; Foot-and-Mouth Disease/*genetics/virology ; Foot-and-Mouth Disease Virus/*physiology ; Integrin alphaVbeta3/*genetics/metabolism ; Mice

Objective:To summarize the clinical characteristics and prognosis of acute hyperextension spinal cord injury (SCI) in children, and to provide some recommendations for the treatment and prevention of this disease.Methods:Reviewed the data of children of SCI after sustained or repeated hyperextension of the spine at Wuhan Union Hospital and Wuhan Children's Hospital from September 2010 to September 2020. According to the American Spinal Injury Association impairment scale (AIS grade), the patients were divided into complete SCI group and incomplete SCI group. The age, symptoms and evolution after injury, neurological level of injury, imaging data, laboratory examination data, prognosis and complications of the two groups were analyzed. Retrospectively summarize the characteristics of this type of injury.Results:Forty-four cases of acute hyperextension SCI in children were included. Their age ranged from 3 to 10 years old, 95% of them were under 8 years old and 95% of them were female. There was no significant difference in age at injury and time of dance training between children with complete SCI and incomplete SCI. Back and leg pain, lower limb weakness or paresthesia, and rapidly progress to complete or incomplete SCI in a short period were typical symptoms. All blood test results anddiagnostic analysis of cerebrospinal fluid were unremarkable or negative. There was no fracture or dislocation in the whole spine. Magnetic resonance imaging showed a longitudinally extended intramedullary high-intensity signal in the thoracolumbar spinal cord. Complete SCI accounted for 60% of all cases, and the prognosis was poor with spinal cord atrophy and various complications.Conclusion:Children younger than 10 years old after sustained or repeated hyperextension of the spine may suffer acute hyperextension SCI. Children with complete SCI have poor prognosis and serious complications. Therefore, prevention of this type of injury is the best strategy.

Objective Based on the multi-camera digital image correlation (DIC) method, the dynamic deformation characteristics of human hand during grasping were studied. Methods A continuous four-camera DIC system was established to measure surface strain of the skin on the back of the hand during grasping process, and then through the connection between skin, joints, bones and muscles, the regular pattern of muscle deformation could be known indirectly. Results Four grasping postures (medium cylinder, lateral pinch, index finger extension, power sphere) were measured. It was found that the increases of strain magnitude were different at different positions on back surface of the hand under different grasping postures, and the maximum principal strains were between 0.1 and 0.3. The movement characteristics for each muscle group of the hand under different grasping postures were obtained through analysis. Conclusions This method has the characteristics of non-contact, full field, intuitive results, which provides a new way for in vivo measurement of dynamic deformation during grasping.