Objective:To investigate the clinical outcomes of scrotal local flap combined with thick split-thickness skin grafting in the treatment of penoscrotal Paget’s disease.Methods:The clinical data of patients with penoscrotal Paget’s disease admitted to the Department of Plastic Surgery, the First Affiliated Hospital of Anhui Medical University, were retrospectively analyzed. For the defect wounds remaining after extended resection of penile and scrotal lesions, scrotal local flap combined with thick split-thickness skin grafting was used for repair. The central part of the scrotal local flap was fenestrated (for penile passage) to cover the wounds of the penile root and perineum, and thick split-thickness skin grafts harvested from the thigh were used to resurface penile defects. The thigh donor sites were managed with direct pressure dressing. Postoperatively, the flap vascularity, incision healing, and skin graft survival were observed. The appearance of the penis, scrotum, and perineum, as well as penile erectile function, were followed up, and patients’ satisfaction with the surgical results was investigated.Results:A total of 15 male patients, aged 55-81 years, were included. The clinical manifestations included erythema and papules on the local skin of the penis and scrotum, with partial ulceration or exudation and obvious pruritus. The lesions involved the lower segment of the penis and the upper skin of the scrotum. After extended resection of the lesions, the perineal defect area ranged from 6.0 cm×7.5 cm to 15.0 cm×10.0 cm, and the penile wound area ranged from 4.0 cm×7.0 cm to 9.0 cm×9.0 cm. The area of the scrotal skin flap was approximately 6.0 cm×7.5 cm to 12.0 cm×8.0 cm, and the area of the transplanted skin graft was about 5.0 cm×7.0 cm to 8.0 cm×9.0 cm. Postoperatively, all flaps demonstrated good perfusion, and all skin grafts survived. Primary healing occurred in 12 cases, while 3 cases had mild distal flap dehiscence due to early ambulation, which healed by secondary intention after dressing changes. The thigh donor sites healed primarily. During the 12-36 months follow-up, the perineal appearance was good, no obvious contracture was observed in the penile skin grafts, urination was normal, and penile erectile function was not affected. No recurrence of the lesions was found during the follow-up period. There was mild pigmentation or uneven texture in the thigh donor sites, and no obvious scar hyperplasia. All patients were satisfied with the surgical outcomes.Conclusion:Scrotal local flap combined with thick split-thickness skin grafting can effectively repair the composite defect wounds of the penis and scrotum after lesion resection in penoscrotal Paget’s disease. The postoperative scar at the incision is inconspicuous, with no obvious displacement of the penis and scrotum and no impact on penile erectile function, leading to high patient satisfaction.

Objective To investigate the effect of miR-378-5p on glioma angiogenesis and its molecular mechanism. Methods The expression of miR-378-5p were detected by qRT-PCR in four glioma cells. The levels of VEGF were analyzed by ELISA. HUVECs were treated conditioned medium which collected by glioma cells supernatant. The effects of miR-378-5p on the proliferation,migration,invasion,and angiogenesis of HUVECs were detected by CCK-8,Transwell assay,and tubular formation assay. Results U251 was the highest expression of miR-378-5p,while U87 MG was the lowest expression. Glioma-conditioned media increased miR-378-5p levels significantly promoted the proliferation,migration,invasion,and angiogenesis of HUVECs. The results were con-trary with glioma-conditioned media decreased miR-378-5p levels. miR-378-5p promoted the release of VEGF-A from glioma cells. The proliferation,migration,invasion,and angiogenesis of HUVECs treated-VEGF neutralizing antibody were significantly downregulated. Conclusion miR-378-5p promoted HUVECs proliferation,migration,invasion,and angiogenesis by increasing the release of VEGF from glioma cells.

Objective To investigate the effect of miR-378-5p on glioma angiogenesis and its molecular mechanism. Methods The expression of miR-378-5p were detected by qRT-PCR in four glioma cells. The levels of VEGF were analyzed by ELISA. HUVECs were treated conditioned medium which collected by glioma cells supernatant. The effects of miR-378-5p on the proliferation,migration,invasion,and angiogenesis of HUVECs were detected by CCK-8,Transwell assay,and tubular formation assay. Results U251 was the highest expression of miR-378-5p,while U87 MG was the lowest expression. Glioma-conditioned media increased miR-378-5p levels significantly promoted the proliferation,migration,invasion,and angiogenesis of HUVECs. The results were con-trary with glioma-conditioned media decreased miR-378-5p levels. miR-378-5p promoted the release of VEGF-A from glioma cells. The proliferation,migration,invasion,and angiogenesis of HUVECs treated-VEGF neutralizing antibody were significantly downregulated. Conclusion miR-378-5p promoted HUVECs proliferation,migration,invasion,and angiogenesis by increasing the release of VEGF from glioma cells.

Objective:To investigate the clinical outcomes of scrotal local flap combined with thick split-thickness skin grafting in the treatment of penoscrotal Paget’s disease.Methods:The clinical data of patients with penoscrotal Paget’s disease admitted to the Department of Plastic Surgery, the First Affiliated Hospital of Anhui Medical University, were retrospectively analyzed. For the defect wounds remaining after extended resection of penile and scrotal lesions, scrotal local flap combined with thick split-thickness skin grafting was used for repair. The central part of the scrotal local flap was fenestrated (for penile passage) to cover the wounds of the penile root and perineum, and thick split-thickness skin grafts harvested from the thigh were used to resurface penile defects. The thigh donor sites were managed with direct pressure dressing. Postoperatively, the flap vascularity, incision healing, and skin graft survival were observed. The appearance of the penis, scrotum, and perineum, as well as penile erectile function, were followed up, and patients’ satisfaction with the surgical results was investigated.Results:A total of 15 male patients, aged 55-81 years, were included. The clinical manifestations included erythema and papules on the local skin of the penis and scrotum, with partial ulceration or exudation and obvious pruritus. The lesions involved the lower segment of the penis and the upper skin of the scrotum. After extended resection of the lesions, the perineal defect area ranged from 6.0 cm×7.5 cm to 15.0 cm×10.0 cm, and the penile wound area ranged from 4.0 cm×7.0 cm to 9.0 cm×9.0 cm. The area of the scrotal skin flap was approximately 6.0 cm×7.5 cm to 12.0 cm×8.0 cm, and the area of the transplanted skin graft was about 5.0 cm×7.0 cm to 8.0 cm×9.0 cm. Postoperatively, all flaps demonstrated good perfusion, and all skin grafts survived. Primary healing occurred in 12 cases, while 3 cases had mild distal flap dehiscence due to early ambulation, which healed by secondary intention after dressing changes. The thigh donor sites healed primarily. During the 12-36 months follow-up, the perineal appearance was good, no obvious contracture was observed in the penile skin grafts, urination was normal, and penile erectile function was not affected. No recurrence of the lesions was found during the follow-up period. There was mild pigmentation or uneven texture in the thigh donor sites, and no obvious scar hyperplasia. All patients were satisfied with the surgical outcomes.Conclusion:Scrotal local flap combined with thick split-thickness skin grafting can effectively repair the composite defect wounds of the penis and scrotum after lesion resection in penoscrotal Paget’s disease. The postoperative scar at the incision is inconspicuous, with no obvious displacement of the penis and scrotum and no impact on penile erectile function, leading to high patient satisfaction.

Platinum-based chemotherapy resistance is a key factor of poor prognosis and recurrence in hepatocellular carcinoma (HCC). Herein, RNAseq analysis revealed that elevated tubulin folding cofactor E (TBCE) expression is associated with platinum-based chemotherapy resistance. High expression of TBCE contributes to worse prognoses and earlier recurrence among liver cancer patients. Mechanistically, TBCE silencing significantly affects cytoskeleton rearrangement, which in turn increases cisplatin-induced cycle arrest and apoptosis. To develop these findings into potential therapeutic drugs, endosomal pH-responsive nanoparticles (NPs) were developed to simultaneously encapsulate TBCE siRNA and cisplatin (DDP) to reverse this phenomena. NPs (siTBCE + DDP) concurrently silenced TBCE expression, increased cell sensitivity to platinum treatment, and subsequently resulted in superior anti-tumor effects both in vitro and in vivo in orthotopic and patient-derived xenograft (PDX) models. Taken together, NP-mediated delivery and the co-treatment of siTBCE + DDP proved to be effective in reversing chemotherapy resistance of DDP in multiple tumor models.

Spinal cord lipomas is a kind of refractory neural tube defect with great harm. In the previous experiences, some neurosurgeons did not know enough about the pathoanatomical characteristics and surgical techniques of the disease, which led to a high rate of postoperative complications and symptom recurrence. This article reviews the embryopathology features, classifications, examination methods, surgical strategies, operative procedures, outcomes and follow-up results of spinal cord lipoma to provide references for clinical workers to diagnose and treat this disease.

Objective To investigate the expression levels of serum miR-210and miR-375in patients with non-small cell lung cancer (NSCLC).Methods A total of 25NSCLC patients (NSCLC group) and 14healthy volunteers (control group) were enrolled in this study.The relative expression levels of 9miRNAs (miR-182, miR-126, miR-31, miR-21, miR-221, miR-200b, miR-183, miR-210and miR-375) in 6 NSCLC patients and 6healthy volunteers were measured by RT-qPCR.The dysregulated miRNAs will be selected as candidate miR-NAs.The diagnostic value were evaluated by ROC curve.Results Compared with control group, 2 (miR-210and miR-375) out of 9miRNAs were up-regulated in NSCLC group, and the differences were statistically significant (P＜0.05), while the other 7miRNAs were not consistent with the reported literatures.Therefore, miR-210and miR-375were selected as candidate miRNAs.We found that the relative expression level of miR-210in the lung adenocarcinoma group was significantly different from control group (P＜0.05), while there was no significant difference between the squamous cell carcinoma group and the control group (P＞0.05).There was no significantly statistical difference in the relative expression level of miR-375between lung squamous cell carcinoma group, lung adenocarcinoma group and the control group (P＞0.05).The AUC of serum miR-210of lung adenocarcinoma group was 0.737 5 (95％CI:0.498 3-0.976 7, P=0.091 4) with a medium diagnostic value.Conclusion MiR-210is highly expressed in the serum of patients with lung adenocarcinoma, suggesting that miR-210may be a novel tumor marker for the diagnosis of lung adenocarcinoma.The value of miR-375in the diagnosis of lung cancer still needs to be further explored.

Objective To explore the surgical strategy of minimally invasive treatment for acoustic neuroma and to improve the tumor removal rate and facial nerve function preservation rate. Methods Four hundred and fifteen patients suffering from acoustic neuromas, admitted to and treated by minimally invasive surgery via trans-suboccipital retrosigmoid transmeatus approach in our hospital from January 2008 to December 2016, were chosen in our study. Their clinical data were analyzed retrospectively. Postoperative Karnofsky behavioral status scale (KPS) was used to evaluate the prognoses of the patients. Postoperative routine enhanced MR imaging was performed to determine the degrees of tumor resection. Three months after surgery, House-Brackmann facial function grading (H-B) was used to evaluate the facial function of all patients. Results KPS indicated that excellent prognosis was noted in 399 patients (96.10％), good prognosis in 14 (3.37％), and poor prognosis in 2 (0.48％); the larger the tumor diameter, the smaller the proportion of patients with good prognosis. Total resection of the tumors was achieved in 387 patients (93.25％), sub-total resection in 24 (5.78％), and partial resection in 4 (0.96％); the larger the tumor diameter, the smaller the proportion of patients with total resection. There were 398 patients with facial nerve preservation in anatomy, and the anatomic preservation rate of facial nerve was 95.9％; there were 17 without anatomic preservation, and 12 received end to end anastomosis of facial nerve. Three months after operation, H-B grading I-II was noted in 334 patients (80.5％), grading III-IV in 76 patients (18.3％), grading V-VI in 5 patients (1.2％); the larger the tumor diameter, the smaller the proportion of patients with H-B grading I-II. No surgically related deaths occurred. Conclusion Early diagnosis and early microsurgical treatment of acoustic neuroma is helpful in improving the safety and efficacy of tumor resection.

Objective: To evaluate the application of the expanded free deltopectoral flap, pedicled with perforation of internal thoracic artery, in the repairment of middle to large facial skin and soft tissue defect. Methods: From June 2015 to December 2017, 11cases diagnosed with facial lesions were included in this study. The tissue defect of 10 cases were caused by burn, and 1 case by superficial tumor. In the first stage, the tissue expander was implanted into the internal thoracic artery supplying area. After the expander was fully expanded, the second surgery, i. e. the resection of facial lesion, was performed. The defect areas of patients, with the range of 9 cm×7 cm to 17 cm×10 cm, were repaired by expanded free deltopectoral flaps. Results: All flaps were survived, with no vascular crisis occurred. The size of flaps ranged from 10.0 cm×9.0 cm to 18.0 cm×11.5 cm. All the patients were satisfied with the outcomes, after 6 to 24 months follow-up. The color and texture of flaps was close to normal. The scars were acceptable. Conclusions The expanded free deltopectoral flap, pedicled with the perforator of internal thoracic artery, is a promising way to repair middle to large facial skin and soft tissue defect.