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AIM: To investigate how macrophage inducible C-type lectin (Mincle) influences inflammation in mice fungal keratitis induced by Aspergillus fumigatus (A. fumigatus). METHODS: C57BL/6 mice were infected with A. fumigatus after pretreated with Mincle agonist TDB or Mincle neutralizing antibody (MincleAb), taking DMSO or IgG as control group respectively. The cornea lesions were monitored with slit-lamp microscope and evaluated by clinical score. Mincle expression was assessed using reverse transcription-ploymerase chain reaction (RT-PCR) and immunostaining. The expression of cytokines (IL-1ß, TNF-α and IL-6) chemokines (CXCL-1 and MIP-2) was determined by RT-PCR and ELISA. Neutrophil infiltration was observed by immunostaining. The levels of nitric oxide (NO) generated by corneas were tested by Griess reaction. RESULTS: Mincle mRNA and protein levels were higher in infected corneas than normal corneas of C57BL/6 mice, saving clinical scores revealed differences. When pretreated with Mincle agonist TDB, the mRNA and protein levels of IL-1ß, TNF-α and IL-6 in infected corneas were significantly increased compared with the control group (P<0.01). Results of the counterpart in corneas pretreated with Mincle neutralizing antibody was decreased consistently (P<0.01). Expression of CXCL1 and MIP-2 mRNA levels were up-regulated in TDB group and down-regulated in MincleAb group (P<0.01), coincide with neutrophil aggregation degree in corneas showed by immunostaining. As for the concentration of NO, it was promoted in TDB group compared with DMSO control group, and decreased in MincleAb group compared with IgG control group. CONCLUSION: Mincle plays a dual role in mice fungal keratitis. It participates in the innate immune system by enhancing inflammation. What's more, Mincle can mediate cytotoxic effects by regulating the formation of NO.
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OBJECTIVE: To investigate the anatomical study and clinical applications of sural neuron-myocutaneous flap transposition for repairing the special patients with soft tissue defect in foot and ankle. METHODS: The branches, distributions and anastomoses of the vessels and nerves lie in superficial layer of the posterior crural region were observed on 30 sides of adult cadaver lower limb specimens perfused with red latex. Since February 2004, distally based sural neuron-myocutaneous flap was applied for repairing 7 cases of soft tissue defect in foot and ankle. RESULTS: The nutrient vessels of sural nerve, small saphenous vein and posterior femoral cutaneous nerve anastomosed permanently with the musculocutaneous perforators of medial and lateral head of gastrocnemius. There were 2 - 3 anastomoses found respectively. The musculocutaneous perforators pierced the two heads of gastrocnemius muscle (1.8 +/- 0.5) cm medially and (3.7 +/- 0.9) cm laterally away from the groove of the muscle. The medial anastomoses more closed to the middle groove and their diameters were found larger than the lateral ones. In operation, we routinely observed the compound flap for 15 to 20 minutes and found actively errhysis on the muscle, so the fine blood circulation in the flap was demonstrated. All flap survived after operation and the cases were followed up 2 to 6 months with cured osteomyelitis and satisfied flap outline. CONCLUSIONS: Distally based sural neuro-myocutaneous flap can live. The operative method is simple. The flap offers an excellent donor site for repairing the soft tissue defect in foot and ankle in special cases.