Objective:To investigate the clinical effect of free anterolateral thigh myocutaneous flap combined with oral repair membrane in the reconstruction of nasal mucosa defect after maxillary malignant tumor surgery. Methods:A total of 12 patients with maxillary gingival squamous cell carcinoma and maxillary sinus cancer who had been treated in Department of Oral and Maxillofacial Surgery, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, were selected from November 2020 to November 2023. Free anterolateral thigh musculocutaneous flap transplantation combined with oral repair membrane were used in all patients. Meanwhile, maxillary soft and hard tissue defects and nasal mucosa defects left after tumor operation were repaired and reconstructed. The clinical effect was evaluated after 6-12 months follow-up. Results:Subtotal maxillary resection was performed in 1 case, total maxillary resection in 9 cases and extended maxillary resection in 2 cases. The musculocutaneous flaps of all patients survived, the facial appearance was basically symmetrical, no obvious depression deformity, the swallowing and speech function recovered well, the mouth and nasal cavity were closed completely, the food could be eaten through the mouth, and the lower nasal passage was not blocked. Conclusion:The free anterolateral thigh musculoflap combined with oral repair membrane can be used to repair and reconstruct maxillary malignant tumor complicated with extensive maxillary tissue and nasal mucosa defect after operation, and the appearance and function can be recovered well after operation, which is a choice for maxillary malignant tumor complicated with nasal mucosa defect.
Humans ; Myocutaneous Flap ; Plastic Surgery Procedures/methods* ; Maxillary Neoplasms/surgery* ; Carcinoma, Squamous Cell/surgery* ; Male ; Middle Aged ; Female ; Nasal Mucosa/surgery* ; Maxilla/surgery* ; Thigh/surgery* ; Maxillary Sinus Neoplasms/surgery*

Objective To investigate the clinical efficacy of the traditional Chinese medicine(TCM)throat opening and brightening method in treating unilateral vocal cord paralysis(UVCP).Methods Sixty patients with UVCP were prospectively collected and randomly assigned to two groups:the Chinese herbal medicine group(trea-ted with Buyang Huanwu Decoction,n=30)and the throat opening and brightening method group(treated with TCM throat opening and brightening method,n=30).The clinical studies that had utilized injection laryngoplasty for the treatment of UVCP(historical control group).Evaluation indicators included the voice handicap index-10(VHI-10),GRBAS-G,objective acoustic measurements of voice(vocal intensity,F0,shimmer,jitter,HNR),and aerodynamic measurements(maximum phonation time,MPT).Results Before treatment,no significant differences were observed between the two groups in all the evaluation indicators(P＞0.05).Post-treatment,the throat open-ing and brightening method group demonstrated significant improvements in VHI-10,GRBAS-G,shimmer,jitter,HNR,and MPT compared to pre-treatment values(P＜0.01),and these improvements were superior to those in the Chinese herbal medicine group.Pre-treatment VHI-10,GRBAS-G,and shimmer scores in the throat opening and brightening method group were significantly higher than those in the historical literature group(P＜0.01).Af-ter treatment,no significant differences were noted in any assessed parameters between the two groups(P＞0.05).Conclusion The TCM throat opening and brightening method significantly enhances phonatory function and quality of life in patients with UVCP,showing comparable efficacy to injection laryngoplasty.

Objective:To investigate the value of serum microRNA (miRNA) levels in the early diagnosis of acute aortic dissection (AAD).Methods:(1) Human umbilical vein endothelial cells (HUVEC) were transfected with hsa-miR-744-5p mimic and its negative control mimic, and cell proliferation and migration were assessed using the CCK-8 assay and wound healing assay. (2) A total of 40 patients diagnosed with AAD by whole-aorta CT angiography in the Emergency Department of the First Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2022 were enrolled as the AAD group. The time interval between chest pain onset and blood sample collection was less than 24 hours. Meanwhile, 40 age- and sex-matched healthy individuals undergoing routine physical examinations were selected as the control group. The initial blood samples were collected from AAD patients upon admission, while fasting blood samples were collected from the control group. Based on our previous research findings, the top 10 miRNAs with the highest fold-change (>1) and the most significant upregulation were identified. Through a literature review, three miRNAs (miR-206, miR-143-3p, and miR-744-5p) were selected as target miRNAs. Laboratory test results, including D-dimer levels, were collected from both groups. The relative expression levels of target miRNAs in both groups were measured using quantitative real-time polymerase chain reaction (qRT-PCR). Spearman correlation analysis was performed to assess the correlation of target miRNA expression levels. Receiver operating characteristic (ROC) curves were plotted to calculate the area under the curve ( AUC), sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. Results:(1) The CCK-8 assay showed that compared with HUVEC transfected with negative control mimic, HUVEC transfected with hsa-miR-744-5p exhibited lower absorbance values at all time points (all P<0.05). The wound healing assay indicated that the relative migration rate of HUVEC transfected with hsa-miR-744-5p mimic was significantly lower ( P<0.05). (2) The D-dimer level significantly differed between the AAD group and the control group (1 737.0 (660.5, 3 297.5) μg/L vs. 66.0 (34.0, 89.0) μg/L, P<0.001). The expression levels of all three miRNA in the serum of AAD patients were significantly upregulated compared with the control group by qRT-PCR (all P<0.05). Spearman correlation analysis revealed positive correlations between miR-206 and miR-744-5p ( r=0.508, P<0.001), miR-143-3p and miR-744-5p ( r=0.695, P<0.001), and miR-206 and miR-143-3p ( r=0.651, P<0.001). All three miRNAs had diagnostic value for AAD in ROC analysis, with miR-206 demonstrating the highest diagnostic accuracy (67.50%) and a specificity of 92.5%. The combined detection of miRNA improved diagnostic accuracy, with miR-206+miR-143-3p achieving an accuracy of 71.25%, specificity of 100%, and positive predictive value of 100%. The combination of miRNA with D-dimer further enhanced diagnostic accuracy, with miR-206+miR-744-5p+D-dimer achieving the highest accuracy (97.50%), along with sensitivity, specificity, positive predictive value, and negative predictive value all at 97.5%. The diagnostic performance of miR-206+miR-143-3p+miR-744-5p+D-dimer was identical to that of miR-206+miR-744-5p+D-dimer. Conclusion:miR-206, miR-143-3p, and miR-744-5p show great potential for the early diagnosis of acute aortic dissection, and their combination with D-dimer can significantly improve diagnostic sensitivity, specificity and accuracy.

Objective: To confirm the therapeutic efficacy of the ginkgo biloba extract EGb761 on ischemic stroke and elucidate its underlying mechanism. Methods: Male Sprague-Dawley rats were divided into three groups: sham, model, and EGb761 (ginkgo biloba extract). Ischemic stroke was then simulated in rats via embolic middle cerebral artery occlusion surgery, with the extract administered half an hour before surgery. Neurological deficit scores, infarct volume, cerebral edema rate, and inflammatory factors served as the primary metrics for drug efficacy. Serum metabolites were analyzed using 1H-nuclear magnetic resonance to elucidate the operative mechanism. Results: Treatment with the ginkgo biloba extract EGb761 significantly ameliorated the neurological deficit scores (P = .0343), diminished the cerebral infarct volume (P = .0001) and cerebral edema rate (P = .0030), and alleviated neuroinflammation (all P < .05) in middle cerebral artery occlusion rats. In addition, it significantly altered the contents of various metabolites, such as 2-hydroxybutyrate, isoleucine, isopropanol, isobutyric acid, N6-acetyllysine, glutamate, glutamine, methionine, and N,N-dimethylglycine (all P < .05). Enrichment analysis of the differential metabolites indicated that EGb761 may be involved in the regulation of amino acid metabolism, betaine metabolism, glucose-alanine cycle, Warburg effect, and urea cycle. Conclusion The ginkgo biloba extract EGb761 demonstrates anti-ischemic stroke effect on ischemic stroke model rats by regulating amino acids and amino acid derivatives, such as isoleucine, N6-acetyllysine, glutamate, methionine, and N,N-dimethylglycine.

Objective:To explore the distribution characteristics of glioma-associated oncogene homolog 1 (Gli1) positive cells during orthodontic tooth movement process and conduct a proteomic analysis of these cells.Methods:Forty Gli1-LacZ transgenic mice were used to establish an in vivo orthodontic tooth movement (OTM) model for labeling Gli1 positive cells in Gli1-LacZ transgenic mice (OTM group) and an unforced control group, with tooth movement distance measured using micro-CT. The spatial relationship and distribution characteristics of Gli1 positive cells and H-type vessels of CD31 and endomucin (EMCN) in periodontal tissues were detected by immunofluorescence staining. Twenty Gli1-membrane-targeted tandem dimer Tomato (mT)/membrane-targeted green fluorescent protein (mG) double-genotype mice were bred and Gli1 positive cells were sorted for proteomic sequencing after tamoxifen induction. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases were used for enrichment analysis. Results:The micro-CT three-dimensional reconstruction results showed that the mesial movement of the maxillary first molar in mice after 7 days of force application was (69±15) μm, indicating the successful establishment of the Gli1-LacZ transgenic mouse OTM model. Immunofluorescence staining showed that the blood vessels in periodontal tissue were mostly H-type vessels of CD31 and EMCN. The blood vessels in the periodontal tissues are predominantly H-type vessels positive for both CD31 and EMCN. The percentage of Gli1 positive cells in the OTM group, expressed as (54.5±13.2)%, and the relative fluorescence intensity, expressed as 2.6±0.9, were both significantly greater than those in the control group, which had a Gli1 positive cell percentage of (36.3±9.1)% ( t=3.60 , P=0.002) and a relative fluorescence intensity of 1.0±0.3 ( t=5.20, P<0.001). In contrast to the control group where only a small number of Gli1 positive cells were consistent with the distribution of H-type vessels, in the OTM group the number of Gli1 positive cells increased on the tension side were closely associated with the spatial distribution of H-type vessels. GO enrichment analysis of biological processes found that a large number of proteins in Gli1 positive cells were enriched in pathways such as angiogenesis and tissue remodeling. KEGG enrichment analysis found that related proteins were mainly enriched in pathways related to angiogenesis and Gli1, such as hypoxia-inducing factor 1 signaling pathway, vascular endothelial growth factor signaling pathway and hedgehog signaling pathway. Conclusions:The number of Gli1 positive cells increased on tension side and were closely related to H-type blood vessels in response to mechanical force during orthodontic tooth movement. This may be related to profile of inducing blood vessel formation and tissue remodeling.

Objective:To explore the distribution characteristics of glioma-associated oncogene homolog 1 (Gli1) positive cells during orthodontic tooth movement process and conduct a proteomic analysis of these cells.Methods:Forty Gli1-LacZ transgenic mice were used to establish an in vivo orthodontic tooth movement (OTM) model for labeling Gli1 positive cells in Gli1-LacZ transgenic mice (OTM group) and an unforced control group, with tooth movement distance measured using micro-CT. The spatial relationship and distribution characteristics of Gli1 positive cells and H-type vessels of CD31 and endomucin (EMCN) in periodontal tissues were detected by immunofluorescence staining. Twenty Gli1-membrane-targeted tandem dimer Tomato (mT)/membrane-targeted green fluorescent protein (mG) double-genotype mice were bred and Gli1 positive cells were sorted for proteomic sequencing after tamoxifen induction. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases were used for enrichment analysis. Results:The micro-CT three-dimensional reconstruction results showed that the mesial movement of the maxillary first molar in mice after 7 days of force application was (69±15) μm, indicating the successful establishment of the Gli1-LacZ transgenic mouse OTM model. Immunofluorescence staining showed that the blood vessels in periodontal tissue were mostly H-type vessels of CD31 and EMCN. The blood vessels in the periodontal tissues are predominantly H-type vessels positive for both CD31 and EMCN. The percentage of Gli1 positive cells in the OTM group, expressed as (54.5±13.2)%, and the relative fluorescence intensity, expressed as 2.6±0.9, were both significantly greater than those in the control group, which had a Gli1 positive cell percentage of (36.3±9.1)% ( t=3.60 , P=0.002) and a relative fluorescence intensity of 1.0±0.3 ( t=5.20, P<0.001). In contrast to the control group where only a small number of Gli1 positive cells were consistent with the distribution of H-type vessels, in the OTM group the number of Gli1 positive cells increased on the tension side were closely associated with the spatial distribution of H-type vessels. GO enrichment analysis of biological processes found that a large number of proteins in Gli1 positive cells were enriched in pathways such as angiogenesis and tissue remodeling. KEGG enrichment analysis found that related proteins were mainly enriched in pathways related to angiogenesis and Gli1, such as hypoxia-inducing factor 1 signaling pathway, vascular endothelial growth factor signaling pathway and hedgehog signaling pathway. Conclusions:The number of Gli1 positive cells increased on tension side and were closely related to H-type blood vessels in response to mechanical force during orthodontic tooth movement. This may be related to profile of inducing blood vessel formation and tissue remodeling.

Objective To investigate the clinical efficacy of the traditional Chinese medicine(TCM)throat opening and brightening method in treating unilateral vocal cord paralysis(UVCP).Methods Sixty patients with UVCP were prospectively collected and randomly assigned to two groups:the Chinese herbal medicine group(trea-ted with Buyang Huanwu Decoction,n=30)and the throat opening and brightening method group(treated with TCM throat opening and brightening method,n=30).The clinical studies that had utilized injection laryngoplasty for the treatment of UVCP(historical control group).Evaluation indicators included the voice handicap index-10(VHI-10),GRBAS-G,objective acoustic measurements of voice(vocal intensity,F0,shimmer,jitter,HNR),and aerodynamic measurements(maximum phonation time,MPT).Results Before treatment,no significant differences were observed between the two groups in all the evaluation indicators(P＞0.05).Post-treatment,the throat open-ing and brightening method group demonstrated significant improvements in VHI-10,GRBAS-G,shimmer,jitter,HNR,and MPT compared to pre-treatment values(P＜0.01),and these improvements were superior to those in the Chinese herbal medicine group.Pre-treatment VHI-10,GRBAS-G,and shimmer scores in the throat opening and brightening method group were significantly higher than those in the historical literature group(P＜0.01).Af-ter treatment,no significant differences were noted in any assessed parameters between the two groups(P＞0.05).Conclusion The TCM throat opening and brightening method significantly enhances phonatory function and quality of life in patients with UVCP,showing comparable efficacy to injection laryngoplasty.

Objective:To investigate the value of serum microRNA (miRNA) levels in the early diagnosis of acute aortic dissection (AAD).Methods:(1) Human umbilical vein endothelial cells (HUVEC) were transfected with hsa-miR-744-5p mimic and its negative control mimic, and cell proliferation and migration were assessed using the CCK-8 assay and wound healing assay. (2) A total of 40 patients diagnosed with AAD by whole-aorta CT angiography in the Emergency Department of the First Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2022 were enrolled as the AAD group. The time interval between chest pain onset and blood sample collection was less than 24 hours. Meanwhile, 40 age- and sex-matched healthy individuals undergoing routine physical examinations were selected as the control group. The initial blood samples were collected from AAD patients upon admission, while fasting blood samples were collected from the control group. Based on our previous research findings, the top 10 miRNAs with the highest fold-change (>1) and the most significant upregulation were identified. Through a literature review, three miRNAs (miR-206, miR-143-3p, and miR-744-5p) were selected as target miRNAs. Laboratory test results, including D-dimer levels, were collected from both groups. The relative expression levels of target miRNAs in both groups were measured using quantitative real-time polymerase chain reaction (qRT-PCR). Spearman correlation analysis was performed to assess the correlation of target miRNA expression levels. Receiver operating characteristic (ROC) curves were plotted to calculate the area under the curve ( AUC), sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. Results:(1) The CCK-8 assay showed that compared with HUVEC transfected with negative control mimic, HUVEC transfected with hsa-miR-744-5p exhibited lower absorbance values at all time points (all P<0.05). The wound healing assay indicated that the relative migration rate of HUVEC transfected with hsa-miR-744-5p mimic was significantly lower ( P<0.05). (2) The D-dimer level significantly differed between the AAD group and the control group (1 737.0 (660.5, 3 297.5) μg/L vs. 66.0 (34.0, 89.0) μg/L, P<0.001). The expression levels of all three miRNA in the serum of AAD patients were significantly upregulated compared with the control group by qRT-PCR (all P<0.05). Spearman correlation analysis revealed positive correlations between miR-206 and miR-744-5p ( r=0.508, P<0.001), miR-143-3p and miR-744-5p ( r=0.695, P<0.001), and miR-206 and miR-143-3p ( r=0.651, P<0.001). All three miRNAs had diagnostic value for AAD in ROC analysis, with miR-206 demonstrating the highest diagnostic accuracy (67.50%) and a specificity of 92.5%. The combined detection of miRNA improved diagnostic accuracy, with miR-206+miR-143-3p achieving an accuracy of 71.25%, specificity of 100%, and positive predictive value of 100%. The combination of miRNA with D-dimer further enhanced diagnostic accuracy, with miR-206+miR-744-5p+D-dimer achieving the highest accuracy (97.50%), along with sensitivity, specificity, positive predictive value, and negative predictive value all at 97.5%. The diagnostic performance of miR-206+miR-143-3p+miR-744-5p+D-dimer was identical to that of miR-206+miR-744-5p+D-dimer. Conclusion:miR-206, miR-143-3p, and miR-744-5p show great potential for the early diagnosis of acute aortic dissection, and their combination with D-dimer can significantly improve diagnostic sensitivity, specificity and accuracy.

Objective    To evaluate the changes in the expression and significance of serum exosomal miRNAs in patients with DeBakey typeⅠacute aortic dissection (AAD). Methods    Twelve male patients with AAD and six healthy male medical examiners from our hospital were retrospectively included in this study. According to the time of chest pain, the AAD patients were divided into an AAD group within 24 h of chest pain onset, aged 47.00±8.79 years and an AAD group within 48 h of chest pain onset, aged 50.17±9.99 years. The healthy males were allocated to a control group, aged 49.17±4.26 years. Serum exosomal miRNAs were isolated, identified and quantified, and then differentially expressed exosomal miRNAs were screened. The bioinformatic analyses such as GO and KEGG were performed on the differentially expressed exosomal miRNAs. Results    High-throughput screening results revealed differential expression of AAD serum exosomal miRNAs. The upregulated miRNAs of AAD groups was hsa-miR-574-5p (P<0.05), and downregulated miRNAs were hsa-miR-223-3p, hsa-miR-146b-5p, hsa-miR-15b-5p, and hsa-miR-155-5p (P<0.05). Further bioinformatic analysis of the above miRNAs revealed that they were mainly enriched in signaling pathways such as transforming growth factor-β, cell cycle and endoplasmic reticulum protein synthesis. Conclusion    Differential expressions of serum exosomal miRNAs in AAD patients may be related to the pathogenesis of AAD, providing new ideas and clues for further exploration of AAD diagnostic markers and pathogenesis.

Hyperaldosteronism is a common disease that is closely related to endocrine hypertension and other cardiovascular diseases. Cytochrome P450 11B2 (CYP11B2), an important enzyme in aldosterone (ALD) synthesis, is a promising target for the treatment of hyperaldosteronism. However, selective inhibitors targeting CYP11B2 are still lacking due to the high similarity with CYP11B1. In this study, atractylenolide-I (AT-I) was found to significantly reduce the production of ALD but had no effect on cortisol synthesis, which is catalyzed by CYP11B1. Chemical biology studies revealed that due to the presence of Ala320, AT-I is selectively bound to the catalytic pocket of CYP11B2, and the C8/C9 double bond of AT-I can be epoxidized, which then undergoes nucleophilic addition with the sulfhydryl group of Cys450 in CYP11B2. The covalent binding of AT-I disrupts the interaction between heme and CYP11B2 and inactivates CYP11B2, leading to the suppression of ALD synthesis; AT-I shows a significant therapeutic effect for improving hyperaldosteronism.