The Modified Rectangle Flap Epicanthoplasty: A Novel and Individualized Design.

BACKGROUND: The epicanthal fold is ordinary in the eyelids of Asians, and the aesthetic appearance of eyelid surgery could be reduced and undermined; thus, medial epicanthoplasty is commonly performed to eliminate the effect of the epicanthal fold with less scarring. At present, there are a lot of techniques that have been described for the treatment of epicanthal fold. The potential problems, however, such as visible scar or under correction in the medial canthus area are challenges to surgeons. The purpose of our study was to explore a novel and individualized design using a modified rectangle flap with acceptable functional and aesthetic outcomes. METHODS: From January 2017 to January 2018, epicanthoplasty was performed for 40 patients by using a modified rectangle flap. All patients underwent double-eyelid surgery at the same time when they needed it. The evaluation criteria included the intercanthal distance (ICD), interpupillary distance (IPD), the ratio of ICD to IPD (ICD ratio), scar visibility, and cosmetic results. RESULTS: From January 2017 to January 2018, the modified rectangle flap method was carried out on 40 patients, who were evaluated at follow-up from 7 to 15 months. The average intercanthal length was 36.9 ± 2.2 mm preoperatively and decreased significantly to 31.5 ± 1.8 mm postoperatively, 7 months after the surgery (P < 0.01). The excellent cosmetic results, in terms of an open medial canthus, were observed during follow-up periods, with no definite recurrence, hypertrophic scar, or injury of the lacrimal apparatus. The inner canthus and lacrimal caruncle are fully exposed with an invisible scar. Both the patients and the surgeon judged that the aesthetic outcomes were excellent or good. CONCLUSIONS: This modified rectangular flap is an effective and personalized method of correcting the medial folds that leave no additional scar in the medial canthal area, and the procedure meets the patient's aesthetic expectations. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Transfection of adenovirus-mediated mircoRNA-126 gene into infant hemangioma endothelial cells in vitro.

Objective: To investigate the effects of microRNA-126 (miR-126) overexpression on hemangioma endothelial cells (HemECs). Methods: An adenoviral vector containing the miR-126 gene was constructed. HemECs were passaged and expanded and adenovirus-mediated green fluorescent protein (GFP) gene was transfected in vitro. The infection efficiency of adenovirus vector to HemECs was tested by Ad-GFP infection procedure. GFP expression efficiency was observed using a fluorescence microscope and flow cytometry was used to determine the best virus multiplicity of infection (MOI). The experiment was divided into the blank group, AD-GFP group, and AD-miR-126 group. The miR-126 group was transfected into HemECs in vitro with adenovirus-mediated miR-126 gene under optimal MOI conditions. RT-PCR was applied to detect expression of miR-126 gene in cells. The influence of recombinant adenovirus on cell activity was evaluated by CCK-8 assay. Flow cytometry was utilized to detect cell cycle and apoptosis. Results: HemECs could be effectively infected by adenovirus containing GFP gene in vitro, the transfection efficiency had the dose-effect relationship with multiplicities of infection (MOI). When MOI was 400, the infection efficiency was more than 90%. miR-126 expression in HemECs was significantly enhanced in miR-126 group (P<0.05). Compared to the control group, cell proliferation was significantly enhanced (P<0.05) and induced S-phase arrest significantly (P<0.05) when miR-126 was upregulated. In addition, compared with the control group, the early apoptotic rate was significantly decreased by upregulating miR-126 (P<0.05). Conclusion: miR-126 overexpression can successfully promote proliferation and inhibit apoptosis of HemECs. This work will provide the theoretical and experimental basis for further transplantation study in vivo.

Interaction between HIV-1 Tat and DNA-PKcs modulates HIV transcription and class switch recombination.

HIV-1 tat targets a variety of host cell proteins to facilitate viral transcription and disrupts host cellular immunity by inducing lymphocyte apoptosis, but whether it influences humoral immunity remains unclear. Previously, our group demonstrated that tat depresses expression of DNA-PKcs, a critical component of the non-homologous end joining pathway (NHEJ) of DNA double-strand breaks repair, immunoglobulin class switch recombination (CSR) and V(D)J recombination, and sensitizes cells to ionizing radiation. In this study, we demonstrated that HIV-1 Tat down-regulates DNA-PKcs expression by directly binding to the core promoter sequence. In addition, Tat interacts with and activates the kinase activity of DNA-PKcs in a dose-dependent and DNA independent manner. Furthermore, Tat inhibits class switch recombination (CSR) at low concentrations (≤ 4 µg/ml) and stimulates CSR at high concentrations (≥ 8 µg/ml). On the other hand, low protein level and high kinase activity of DNA-PKcs promotes HIV-1 transcription, while high protein level and low kinase activity inhibit HIV-1 transcription. Co-immunoprecipitation results revealed that DNA-PKcs forms a large complex comprised of Cyclin T1, CDK9 and Tat via direct interacting with CDK9 and Tat but not Cyclin T1. Taken together, our results provide new clues that Tat regulates host humoral immunity via both transcriptional depression and kinase activation of DNA-PKcs. We also raise the possibility that inhibitors and interventions directed towards DNA-PKcs may inhibit HIV-1 transcription in AIDS patients.

FOXL2 suppresses proliferation, invasion and promotes apoptosis of cervical cancer cells.

FOXL2 is a transcription factor that is essential for ovarian function and maintenance, the germline mutations of which give rise to the blepharophimosis ptosis epicanthus inversus syndrome (BPES), often associated with premature ovarian failure. Recently, its mutations have been found in ovarian granulosa cell tumors (OGCTs). In this study, we measured the expression of FOXL2 in cervical cancer by immunohistochemistry and its mRNA level in cervical cancer cell lines Hela and Siha by RT-PCR. Then we overexpressed FOXL2 in Hela cells and silenced it in Siha cells by plasmid transfection and verified using western blotting. When FOXL2 was overexpressed or silenced, cells proliferation and apoptosis were determined by Brdu assay and Annexin V/PI detection kit, respectively. In addition, we investigated the effects of FOXL2 on the adhesion and invasion of Hela and Siha cells. Finally, we analyzed the influences of FOXL2 on Ki67, PCNA and FasL by flow cytometry. The results showed that FOXL2 was highly expressed in cervical squamous cancer. Overexpressing FOXL2 suppressed Hela proliferation and facilitated its apoptosis. Silencing FOXL2 enhanced Siha proliferation and inhibited its apoptosis. Meanwhile, silencing FOXL2 promoted Siha invasion, but it had no effect on cells adhesion. In addition, overexpressing FOXL2 decreased the expression of Ki67 in Hela and Siha cells. Therefore, our results suggested that FOXL2 restrained cells proliferation and enhanced cells apoptosis mainly through decreasing Ki67 expression.

Intracranial transplantation of human adipose-derived stem cells promotes the expression of neurotrophic factors and nerve repair in rats of cerebral ischemia-reperfusion injury.

Adipose tissue-derived mesenchymal stem cells (ADSCs) are of great interest as a cellular therapeutic agent for regenerative and immunomodulatory purposes. The aim of this study was to investigate whether ADSCs transplantation could promote nerve repair in rats of cerebral ischemia-reperfusion (I/R) injury. We isolated and cultured human ADSCs, and then measured cell surface antigens by flow cytometry and immunofluorescence. Healthy SD rats were randomly divided into sham group, MCAO group, MCAO+vehicle group and MCAO+ADSCs group. Cerebral ischemia-reperfusion injury was induced by middle cerebral artery occlusion (MCAO). Then the human ADSCs were transplanted into the brain of rats 24 h after MCAO. The mRNA level of BDNF (brain derived neurotrophic factor, BDNF), NGF (nerve growth factor, NGF) and bFGF (basic fibroblasts growth factor, bFGF) were detected by real-time PCR at different time points (d7, d14, d21 and d28 after MCAO). Meanwhile, the neurological deficit scores were estimated. The neurological deficit of rats in MCAO+ADSCs group attenuated at d7 in contrast to the MCAO+vehicle group (P<0.05). Subsequently, they were dramatically ameliorated with the time especially at d28. At d7, d14, d21 and d28 after ADSCs transplantation, BDNF, NGF and bFGF mRNA in MCAO+ADSCs group were strikingly higher than those in MCAO+vehicle group, and these two groups both reached the peak at d14. The western blotting results showed that BDNF and Bcl-2 expressed higher in MCAO+ADSCs group than MCAO+vehicle group. Therefore, our current results suggest that ADSCs promote nerve repair after injury through elevating the expression of neurotrophic factors and inhibiting the apoptosis of neural cells.

[Experimental study of chondrogenesis in vitro by co-culture of bone marrow stromal cells and chondrocytes].

OBJECTIVE: To investigate the feasibility of chondrogenesis in vitro with bone marrow stromal cells (BMSCs) induced by the co-cultured chondrocytes. METHODS: The BMSCs and chondrocytes were separated from pig and cultured. The supernatant of chondrocytes was used as the inducing solution for BMSCs from the 2nd generation. 7 days later, samples were taken and underwent immunohistochemistry and RT-PCR for detection of the expression of specific type II cartilage collagen, type II collagen and aggrecan mRNA. The cultured BMSCs and chondrocytes were mixed at a ratio of 8:2 (BMSC: cartilage cell) and were inoculated into a polyglycolic acid/polylactic acid (PGA/PLA) scaffold at the final concentration of 5.0 x 10(7)/ml. The cartilage cells and BMSCs were also inoculated separately at the same concentration as the positive and negative control. Pure cartilage cells at 20% of the above mentioned concentration (1.0 x 10(7)/ml) were used as the low concentration cartilage cell control group. Samples were collected 8 weeks later. General observations, wet weight, glycosaminoglycans (GAGs) determination and histological and immunohistochemistry examinations were performed. RESULTS: The expression of type II collagen, type II collagen and aggrecan mRNA were positive in induced BMSCs. In the co-cultured group and the positive control group, pure mature cartilage was formed after 8 weeks of culture in vitro, and the size and shape of the scaffold were maintained. The newly formed cartilage in the two groups were almost the same in appearance and histological properties. The immunohistochemistry results indicated that the cartilage cells of the two groups all expressed ample cartilage-specific type II collagen. The average wet weight and GAG content in the co-cultured group reached more than 70% of those in positive control group. Only an extremely small amount of immature cartilage tissues was formed in local regions in pure BMSC group, and the scaffold was obviously shrunk and deformed. Although the wet weight of newly generated cartilage tissue in the low concentration cartilage cell group reached 30% of that in positive control group, the scaffold was obviously shrunken and deformed. Only regional and discontinuous cartilage tissues were formed, and the amount of newly formed cartilage was obviously less than that in the co-culture group and the positive control group. CONCLUSIONS: Chondrocytes can provide a micro-environment for the formation of cartilage, and also effectively induce BMSC to differentiate into chondrocytes and form tissue-engineered cartilage in vitro.

[Mutation analysis of FOXL2 gene and its structure protein in patients of blepharophimosis-ptosis-epicanthus inversus syndrome].

OBJECTIVE: The aim of this study was to investigate the effect of mutations of the forkhead transcription factor 2 (FOXL2) gene on the primary and secondary structure of the coded protein and seek for the molecular mechanism of blepharophimosis-ptosis-epicanthus inversus syndrome (BPES). METHODS: The genomic DNA was extracted from peripheral blood of 7 clinically diagnosed BPES patients, PCR amplification of FOXL2 coding region and 5' untranslated region were performed. Sequence analysis was performed using the PCR or cloning products. The structure of the protein was predicted with PDH and ExPASy software, and the difference between the normal and the mutational protein was analyzed. RESULTS: A 901- 930 dup 30 mutation of FOXL2 was found in two patients from a BPES family of type II and a sporadic case, and no any mutations were detected in normal control. Analysis of the primary structure displayed that the molecular weight of the protein coded by the mutated gene was greater than the normal, but both have the same isoelectric point. Analysis of the secondary structure showed that FOXL2 was a transmembrane protein with a polyalanine tract which contained a alpha-helix. When the polyalanine tract expanded, the helix region extended, as a result, the proportion of alpha-helix increased by 4.1%, but the proportions of beta-pleated sheet and random coil decreased correspondingly. CONCLUSION: Our results suggest that the 901 - 930 dup 30 mutation of FOXL2 is a novel finding. Moreover, this mutation causes great changes in the primary and secondary structure of the coded protein, which may be the molecular pathogenesis of BPES.

[Study of chondrocytic differentiation of bone marrow stem cells with the supernatant of chondrocytes in vitro].

AIM: To induce bone marrow stem cells(BMSC) of rats to differentiate directionally towards chondrocytes in vitro and identify the differentiated cells. METHODS: BMSC and chondrocytes were isolated from SD rats and cultured in vitro. The supernatant of chondrocytes was collected and used to induce transformation of BMSC from the second passage. After 7 days of induction, specific markers of differentiation of chondrocytes were detected by the appearance of toluidine blue staining, Masson staining, immunohistochemistry detection of collagen type II, and RT-PCR detection of collagen type II and aggrecan mRNA. RESULTS: After 7 days, the induced BMSC changed into triangle or polygonal shape from spindle shape. Specific markers of chondrocytes were positive in the appearance of toluidine blue staining, Masson staining, immunohistochemistry detection of collagen type II, and RT-PCR detection of collagen type II and aggrecan mRNA. CONCLUSION: The supernatant of chondrocytes can induce BMSC to differentiate into chondrocytes in vitro.

[An observation of the effects of the truncated septin2 on mouse epidermal cell and fibroblast].

OBJECTIVE: To construct eukaryotic expression vector of the truncated septin2 and investigate the influence on the cultured mouse epidermal cell and fibroblast in vitro exerted by the transgenic expression product. METHODS: The short splicing fragment was obtained by amplifying the reverse transcription product of the fetal mouse skin mRNA with PCR. Then its recombinant expression vector pcDNA3.1 (-)/septin2s was constructed and used to transfect the mouse epidermal cell and fibroblast cultured in vitro. The expression of the foreign gene was detected with RT-PCR and the changes of cell proliferation were observed and analysed. RESULTS: RT-PCR results indicated that pcDNA3.1/septin2 was expressed in the cultured mouse epidermal cells and fibroblasts in vitro. We found that the epidermal cells accelerated their reproduction, but the fibroblasts had no obvious changes. CONCLUSION: We successfully constructed eukaryotic expressive vectors of pcDNA3.1/ septin2s and transfected it into mouse epidermal cells and fibroblasts in vitro. The results settle a basis for showing effect of septin2s on fetal mouse skin.

[The mutation study of the FOXL2 gene in a big Chinese family with blepharophimosis-ptosis-epicanthus inversus syndrome].

OBJECTIVE: We have studied 4 generations 12 patients in a family which has blepharophimosis-ptosis-epicanthus-inversus syndrome (BPES) for the gene, FOXL2, the group also have 12 normal members in this family and other 80 normal individuals for contrast. METHODS: The FOXL2 gene was amplified by polymerase chain reaction and then analyzed by direct genomic sequencing. RESULTS: A 892C > T at nucleotides in FOXL2 was found in the twelve affected patients. No mutations was found in any of the health members in the family. CONCLUSIONS: FOXL2 may be a important pathogenesis for the disease in this Chinese family.

[Template design of tissue flaps for covering auricular cage in one-stage total auricular reconstruction].

OBJECTIVE: To study the template design of tissue flaps for covering auricular cage in order to acquire accurate and reliable design method. METHODS: By the theory of engineering drawing and three-dimensional measuring on CT image, three dimensional configuration of 40 auricular surfaces were expanded approximately, and the character of them was analysed for the template design. RESULTS: It is similar of the expanded graphs of auricular surface three dimensional configuration in healthy persons, and simplified template of tissue flaps is drawn based on the key points of the above graph. CONCLUSIONS: CT three-dimensional measurement of auricular surface configuration can be used to design the template of tissue flaps for covering auricular cage, and can provide accurate and reliable template of tissue flaps for clinics.

A novel mutation in the FOXL2 gene in a Chinese family with blepharophimosis, ptosis, and epicanthus inversus syndrome.

OBJECTIVE: To screen mutations in the forkhead transcriptional factor 2 gene (FOXL2) in six Chinese families with blepharophimosis, ptosis, and epicanthus inversus syndrome(BPES). METHODS: PCR amplification and direct sequencing of the FOXL2 coding region in genomic DNA were performed in affected patients and 80 healthy controls. BLAST analysis of the sequence was made on Internet. RESULTS: A novel 951-953(delC) was found in the two affected patients of a Chinese family with BPES. No mutations were found in the healthy controls. The 951-953(delC) may cause a frameshift mutation after codon 238 that exists downstream of the forkhead domain, resulting in the production of truncated proteins. CONCLUSION: These findings indicated that the 951-953(delC) deletion mutation in the two patients resulted in truncated proteins and hence led to their BPES. To the authors' knowledge, the 951-953(delC) in FOXL2 has not been previously reported.

[The effect of pcDNA 3.1/RPs15 on skin fibroblasts in vitro].

OBJECTIVE: To construct eukaryotic expression vector of ribosomal protein sl5(RPs15) gene and study its effect on mouse skin fibroblasts in vitro. METHODS: The RPs15 cDNA encoding region of fetal mouse skin was amplified by reverse transcription-polymerase chain reaction (RT-PCR) method and cloned into eukaryotic expression vector pcDNA3.1(-). The recombinant plasmid was transfected into adult mouse skin fibroblasts by FuGENE6 transfection reagents. Then the expression of RPs15 gene, was detected and its biological effect on fibroblasts was measured. RESULTS: The DNA sequencing result of pcDNA3.1/RPs15 was identical with the reported. The RPs15 gene was expressed in transfected fibroblasts. The growth density of fibroblasts decreased with the conformation changing accordingly. CONCLUSIONS: The eukaryotic expression vector pcDNA3.1/RPs15 is successively constructed and can be expressed in mouse skin fibroblasts. The results set up a basis for further study of the effect of RPs15 gene on skin fibroblasts.