Color Doppler Sonographic and Cadaveric Study of the Arterial Vascularity of the Lateral Upper Arm Flap.

OBJECTIVES: To determine the importance of adequate preoperative assessment with color Doppler sonography to assist in the successful transfer of lateral upper arm flaps by studying the lateral upper arm flap with color Doppler sonography and analyzing the anatomic features of the radial collateral artery. METHODS: A clinical case-control study was performed. The radial collateral artery was studied with color Doppler sonography in 15 healthy volunteers. The origins, courses, variations, and locations of the perforators of the radial collateral artery were recorded. The results and data from the color Doppler sonographic investigation were compared with an anatomic study that was performed on 22 adult cadaveric upper limb specimens. RESULTS: The volunteer group (14 of 15 volunteers) and the cadaveric group (19 of 22 upper arm specimens) clearly showed that the branch pattern of the arterial supply was as follows: brachial artery → deep brachial artery → radial collateral artery → posterior radial collateral artery → myocutaneous perforator. Variations in the origin of the radial collateral artery were identified in 1 volunteer bilaterally and in 3 upper arm specimens. The diameters of the artery and vein measured at the distal insertion of the deltoid and the origin of the deep brachial artery were not significantly different between the volunteer and cadaver groups (P > .05). Due to the difference in measuring methods, the length of the vascular pedicles was significantly different between the groups (P < .05). CONCLUSIONS: Color Doppler sonography can facilitate the preoperative assessment of the origin, course, variations, and locations of the radial collateral artery and therefore may increase the success rate of lateral upper arm flap transfer.

Effect of Iodine Intake on p14ARF and p16INK4a Expression in Thyroid Papillary Carcinoma in Rats.

BACKGROUND: Iodine intake is related to thyroid disease. This study investigated the effect of the amount of iodine intake on p14ARF and p16INK4a expression of thyroid papillary carcinoma in rats. MATERIAL AND METHODS: A cohort of 240 SD rats were randomly divided into control group, low iodine, normal iodine, and high iodine groups (n=60 per group). We inoculated 2 × 10(5) papillary thyroid carcinoma (PTC) cells on the left side of the thyroid gland. After 6 and 12 weeks, serum thyroid hormone level and urine iodine level were measured in addition to morphological observations of tumor tissues. Expression of p14ARF, p16INK4a was detected by immunohistochemical staining. RESULTS: The expression of p14ARF, p16INK4a, FT3, and FT4 levels in all iodine-treated animals were significantly lower than in the control group, while TSH level was significantly higher (P<0.05). Compared to the normal iodine group, the low and high groups had lower p14ARF and p16INK4a expression, lower FT3 and FT4 levels, higher TSH levels, and heavier tumors (P<0.05). In a further between-group comparison, p14ARF and p16INK4a expression and FT3 and FT4 levels at 12 weeks were lower than at 6 weeks. Expression of p14ARF and p16INK4a were positively correlated with FT3 and FT4, and negatively correlated with TSH and tumor weight. CONCLUSIONS: Low and high iodine diet intake could reduce p14ARF and p16INK4a expressions and promote tumor development.

Cloudy or sunny? Effects of different environmental types of urban green spaces on public physiological and psychological health under two weather conditions.

Numerous studies have demonstrated that urban green spaces (UGSs) benefit human health, but few have focused on the influence of weather on environmental restorativeness. This study assessed how different weather conditions and environments affect human health. We exposed 50 participants to different UGS environments under cloudy and sunny conditions and collected physiological, psychological and aesthetic preference data. The result showed that the physical and mental benefits of UGSs were stronger on sunny days (pulse: [t = 2.169, p < 0.05]; positive affect: [Z = -10.299, p < 0.001]; perceived restortiveness: [Z = -3.224, p < 0.01]). The spaces with exposed sky had greater physiological restorativeness on sunny days; the spaces with calm water had greater emotional restorativeness on cloudy days, and natural spaces with less sky exposure had greater perceived restoration in both weather conditions. The spaces with water and less sky exposure promoted psychophysiological restoration in both weather conditions. This study demonstrates that weather significantly influences the restorative potential of UGSs, and there are also restorative variations in different green space environments under two weather conditions. In future UGS planning practices, it would be advisable to select appropriate environmental types and features based on the climatic characteristics of different regions. For instance, in areas with frequent overcast conditions, incorporating serene water bodies could be advantageous, while regions with predominantly sunny weather should encompass spaces with expansive sky views. By conducting comprehensive research on restoration environments that take weather conditions into account, new insights and nature-based solutions can be provided for creating healthy human habitats in the context of global climate change.

Study of treatment using percutaneous acetabuloplasty and interstitial implantation of (125)I seeds for patients with metastatic periacetabular tumors.

BACKGROUND: The periacetabular area is one of the primary sites of metastatic tumors, which often present as osteolytic bone destruction. Bone destruction in the acetabulum caused by metastatic tumors will cause hip pain and joint dysfunction. It results in decreased quality of life for patients. The aim of our study was to explore the clinical effect of metastatic periacetabular tumors treated with percutaneous cementoplasty and interstitial implantation of (125)I seeds. METHODS: A retrospective analysis was performed on 24 patients with metastatic periacetabular tumors who underwent combined therapy of percutaneous acetabuloplasty and interstitial implantation of (125)I seeds between February 2003 and June 2011. There were 13 males and 11 females aged 19-80 years with a mean age of 57.3. The primary tumor site was the lung in eight cases, the breast in six, the prostate cancer in eight, and the liver in two. The amount of implanted (125)I seeds was 12-20 seeds/person, with a mean of 16.5 seeds/person, and the matching peripheral dosage (MPD) was 80~100Gy. Routine postoperative chemotherapy and other combined treatments were applied to patients after the surgical operation. Changes in the Karnofsky Score(KPS), Harris Hip Score(Harris), and Visual Analog Scale(VAS) were observed during the follow-up period. RESULTS: The 24 patients' operations were all successful. No major complications occurred. Complete pain relief was achieved in 58% (14 of 24) of patients, and pain reduction was achieved in the 42% remaining (10) patients. The mean duration of pain relief was 8.3 months. Pain recurred in one patient 3 months after surgery. Six patients had died and 18 patients were alive at the time of the 1-year follow-up. Comparing the KPS, Harris and VAS scores pre- and postoperativelyat 1, 6, and 12 months, the combined therapy method was significantly effective in metastatic periacetabular tumor patients (P<0.05). CONCLUSIONS: Percutaneous cementoplasty with interstitial implantation of (125)I seeds is an effective treatment method for metastatic periacetabular tumor patients, providing tumor resistance, pain relief, increased bone stability, and improved quality of life for patients.

Differences in epithelial-mesenchymal-transition in paraquat-induced pulmonary fibrosis in BALB/C and BALB/C (nu/nu) nude mice.

Exposure to the toxic herbicide paraquat (PQ) can lead to the active absorption and enrichment of alveolar epithelial cells, resulting in pulmonary fibrosis and respiratory failure. At present, no effective clinical treatment is available. Notably, however, patients infected with human acquired immunodeficiency virus (HIV) (with T lymphocyte deficiency) do not show pulmonary fibrosis after PQ poisoning, suggesting that T lymphocytes may be involved in the occurrence and pathological development of lung fibers following PQ exposure, although relevant studies remain limited. Here, we found that the degree of pulmonary fibrosis induced by intragastric administration of PQ in congenital immunodeficiency BALB/C (nu/nu) nude (T lymphocyte loss) mice was lower than that in normal mice. However, pulmonary fibrosis was aggravated after transplantation of BALB/C (nu/nu) T lymphocytes into congenital immunodeficiency mice. This study is the first to report on the involvement of T lymphocytes in the occurrence and pathological development of lung fibers induced by PQ exposure. Thus, T cells may be an important cellular target for the clinical treatment of pulmonary fibrosis caused by PQ.

Three-dimensional-arterial spin labeling perfusion correlation with diabetes-associated cognitive dysfunction and vascular endothelial growth factor in type 2 diabetes mellitus rat.

BACKGROUND: Type 2 diabetes mellitus (T2DM) has been strongly associated with an increased risk of developing cognitive dysfunction and dementia. The mechanisms of diabetes-associated cognitive dysfunction (DACD) have not been fully elucidated to date. Some studies proved lower cerebral blood flow (CBF) in the hippocampus was associated with poor executive function and memory in T2DM. Increasing evidence showed that diabetes leads to abnormal vascular endothelial growth factor (VEGF) expression and CBF changes in humans and animal models. In this study, we hypothesized that DACD was correlated with CBF alteration as measured by three-dimensional (3D) arterial spin labeling (3D-ASL) and VEGF expression in the hippocampus. AIM: To assess the correlation between CBF (measured by 3D-ASL and VEGF expression) and DACD in a rat model of T2DM. METHODS: Forty Sprague-Dawley male rats were divided into control and T2DM groups. The T2DM group was established by feeding rats a high-fat diet and glucose to induce impaired glucose tolerance and then injecting them with streptozotocin to induce T2DM. Cognitive function was assessed using the Morris water maze experiment. The CBF changes were measured by 3D-ASL magnetic resonance imaging. VEGF expression was determined using immunofluorescence. RESULTS: The escape latency time significantly reduced 15 wk after streptozotocin injection in the T2DM group. The total distance traveled was longer in the T2DM group; also, the platform was crossed fewer times. The percentage of distance in the target zone significantly decreased. CBF decreased in the bilateral hippocampus in the T2DM group. No difference was found between the right CBF value and the left CBF value in the T2DM group. The VEGF expression level in the hippocampus was lower in the T2DM group and correlated with the CBF value. The escape latency negatively correlated with the CBF value. The number of rats crossing the platform positively correlated with the CBF value. CONCLUSION: Low CBF in the hippocampus and decreased VEGF expression might be crucial in DACD. CBF measured by 3D-ASL might serve as a noninvasive imaging biomarker for cognitive impairment associated with T2DM.

[Endogenous BDNF promote regeneration of injured nervous system].

OBJECTIVE: To test the effect of endogenous BDNF on injured nervous system. METHODS: The left sciatic nerves of the rats were cut off, and then divided into two groups, each with 8 rats. The rats in the experimental group were intraperitoneally injected with anti-BDNF, while the control group was given normal sheep serum (NSS). The dorsal coclums of the rats were cut on the 8th day. The L5 DRG were cut into length wise sections to dye with fluorescent antibody. Positive cells of GAP-43 in the L5 DRG were counted. The second experiment had both sides of sciatic nerves of the rats cut off, followed by the same procedure as the first experiment. The HRP tracing and ABC immunohistochemical staining were performed to analyse the effect of endogenous BDNF on the recovery of injured spinal cords. RESULTS: For the rats with left sciatic nerves cut off, the experimental group had less GAP-43 positive cells in the left L5 DRG than the controls (P<0.01). For the rats with both sciatic nerves cut off, the experimental group had less nerves with positive fibers-labeled HRP than the controls at the site of tSCI (P<0.01). CONCLUSION: Endogenous BDNF promote the recovery of injured nervous system.

[Anatomical study of improved lateral arm free flap].

OBJECTIVE: To study the anatomy and preparation methods of an improved lateral arm free flap (LAFF) for the future clinical application. METHODS: Twenty-two adult upper extremities from cadavers after injected with red latex through common carotid arteries were used. The course, branches, distribution and variations of the blood vessels and nerves of the improved LAFF were observed. The outer diameters of the vessels were measured. RESULTS: The mean length of vascular pedicle of the improved LAFF was (14.85 ± 1.28) cm, significantly more than that (5.46 ± 2.60) of traditional LAFF (t = -8.483, P < 0.001). The mean outer diameters of pedicle arteries and veins in the improved LAFF were (2.24 ± 0.66) mm and (2.22 ± 0.52) mm, significantly more than those (1.15 ± 0.21 and 1.26 ± 0.23) in traditional LAFF (t = -8.690, P < 0.001; t = -15.057, P < 0.001), respectively. CONCLUSION: The improved LAFF has a longer vascular pedicle and larger artery and vein in diameter than conventional LAFF, and is more suitable for the repair of the small and medium-sized defects of the head and neck.

[Expression and clinical significance of P-gp in colonic gland of chronic schistosomiasis patients].

OBJECTIVE: To study the expression of P-glycoprotein (P-gp) in patients with chronic schistosomiasis and its relationship with gender and age, and to explore its clinical significance. METHODS: The colonic mucosa specimens of 50 chronic schistosomiasis patients and 4 persons who had a family history of colon cancer but their physical examinations were normal (as a control group) were selected and the expressions of P-gp in the colonic gland of these samples were detected with the immunohistochemical staining method. RESULTS: Compared with the control group, the mean gray value of the positive particles of P-gp of colonic epithelial cells of the chronic schistosomiasis group was significantly reduced (P < 0.05), but positive unit values were significantly increased (P < 0.05), which meant the P-gp expression in colonic gland of the patients with chronic schistosomiasis was significantly increased, but this increase had no relationship with sex and age. CONCLUSION: Chronic schistosomiasis may induce the increase of P-gp expression which may be a compensatory protection mechanism due to the stimulation of schistosome eggs to the colon tissues.

Test for increasing convex order in multivariate response.

Trend test based on cross-classified data in dose-response has been a central problem in medicine. Most of existing test methods are known to only fit to binary response variables. However, the approaches for binary response tables may suffer from the lack of a clear choice for dichotomization. For multivariate response with ordered categories, some studies have been done for simple stochastic order, likelihood ratio order and so on. However, methods of statistical inference on increasing convex order for more than two multinomial populations have not been fully developed. For testing the increasing convex order alternative, this article provides a model-free test method which can be used in the case of two-way tables and stratified data. Two real examples will be used to illustrate how to apply our test method.