Meta-analysis of the safety and factors contributing to complications of MS-TRAM, DIEP, and SIEA flaps for breast reconstruction.

BACKGROUND: Muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM), deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) flaps have been increasingly adopted for breast reconstruction. However, their safety, patient satisfaction with them, and factors contributing to complications are not well understood. METHODS: PubMed, MEDLINE, EMBASE, and The Cochrane Library were searched to identify eligible studies for inclusion in our analysis. The complication rates of and patient satisfaction rates with the flaps were measured as the outcome, and factors contributing to complications and patient satisfaction were also studied. The data were extracted, and pooled relative risks (RRs) and 95 % confidence intervals (CIs) were calculated. RESULTS: Thirteen studies involving 1,843 patients met the inclusion criteria. The results of the meta-analysis showed that patients with MS-TRAM had a higher rate of abdominal hernias (RR 2.354, 95 % CI 1.154-4.802, P = 0.019) and a lower rate of fat necrosis (RR 0.502, 95 % CI 0.347-0.727, P = 0.000) than patients with DIEP. In addition, there was no significant difference between MS-TRAM and DIEP with respect to other complications (P > 0.05), between MS-TRAM and DIEP with respect to patient satisfaction (P = 0.923), and between DIEP and SIEA with respect to complication rates (P = 0.377). The complication rates of MS-TRAM, DIEP, and SIEA were 25.6, 27.9, and 26.7 %, respectively. Diabetes mellitus (P = 0.078) influenced the complication rate of MS-TRAM, and obesity (P = 0.086) and diabetes mellitus (P = 0.110) were the potential factors correlated with complications with DIEP flaps. CONCLUSION: There were no obvious differences in the overall incidence of complications between MS-TRAM and DIEP and between DIEP and SIEA. In addition, the patient satisfaction rates of MS-TRAM and DIEP were similar. However, MS-TRAM showed a higher rate of abdominal hernias and a lower rate of fat necrosis than DIEP. Obesity and diabetes mellitus were potential factors associated with the incidence of complications. Additional multicenter, large-sample-size, randomized controlled trials with long-term follow-up visits are necessary. LEVEL OF EVIDENCE III: 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 .

Reconstruction of singular eyelid defects in aging individuals based on facial aesthetic subunits.

BACKGROUND: In consideration of the distinctive structural characteristics of the eyelid, the optimally matching donor site to the original recipient site skin should be selected when a full-thickness skin graft is anticipated in a small-sized or medium-sized eyelid defect in middle-aged or elderly patients. METHODS: Eight patients ranging in age from 47 to 71 years suffered singular eyelid defects of different causes. Based on the location, shape, and degree of the defects, we removed the redundant skin as a skin graft from the same side in the contralateral eyelid in a routine blepharoplasty procedure and transferred the graft to repair the defect. RESULTS: The skin grafts survived in all cases, and the incisions healed primarily. The eyelid laxity improved, and no complications occurred. All cases were followed up for 3 months to 2 years, the quality of skin grafts was similar to that of the surrounding skin, and the activity was ideal. CONCLUSIONS: When an eyelid defect is not amenable to direct closure and skin grafting is selected, the proper donor site is vital to the final outcome. The same facial aesthetic subunits, such as sufficient laxity in the contralateral eyelid skin in middle-aged and elderly patients, can provide the best match with the recipient skin and represent the best donor site for defect reconstruction.

[Study on CuO-CeO2 catalysts doped with alkali and alkaline earth metal oxides by in-situ DRIFTS].

CuO-CeO2 series catalysts are the effective catalysts for the selective CO oxidation in hydrogen-rich gas. The adsorption species on the CuO-CeO2 catalysts doped with alkali and alkaline earth metal oxides were investigated with in situ diffuse reflectance FTIR spectroscopy (in-situ DRIFTS) technique. The results showed that a bane at 2 106 cm(-1), due to the carbonyl species, appeared on the CuO-CeO2 catalysts. In the reaction atmosphere, the intensity of this band increased first and then decreased with increasing the temperatures. It was noted that the main active adsorption sites of the CuO-CeO2 catalysts were Cu+ species. At lower temperatures, the carbonyl species were desorbed from the surface of CuO-CeO2 catalysts in the reversible form, while they were desorbed mainly in the irreversible form at the higher temperatures. A sharp peak at 3 660 cm(-1), attributed to the geminal Ce(OH)2 group, was also apparent on the surface of reduced CuO-CeO2 catalyst. The peaks at 1 568, 2 838 and 2 948 cm(-1) were attributed to formate species and the peaks centered at 1 257 and 1 633 cm(-1) were assigned to carbonate species. CO could react with the active hydroxyl species and generate formate species. At higher temperatures, the C-H bond of formate species could break and form carbonate species. These two species would decrease the performance of CuO-CeO2 catalysts at higher temperatures. The stronger IR peaks attributed to CO2 and formate species were observed, moreover there was still a weak IR peak assigned to carbonyl species for Cu1 Li1 Ce9Odelta catalyst when the temperature was above 180 degrees C. It was shown that as the electron donor, the doping of Li2 O on CuO-CeO2 catalyst could contribute to the irreversible desorption of CO at lower temperatures and inhibit the adsorption of H2 on the catalytic surface, and benefit the formation of formate species as well. Although the amounts of CO adsorption on Cu1 Mg1 Ce9 Odelta and Cu1 Ba1 Ce9 Odelta catalysts were much more than other catalysts at lower temperatures, they were mainly desorbed in the reversible form, which had no contribution to the selective CO oxidation.

[DRIFTS study of Cu1Zr1Ce9Odelta catalysts for selective CO oxidation].

The Cu1Zr1Ce9Odelta catalysts synthesized with coprecipitation method were used into the selective CO oxidation in hydrogen-rich gas. The adsorbed species and the intermediates on Cu1Zr1Ce9Odelta catalysts were examined by in-situ diffuse reflectance FTIR spectroscopy (in-situ DRIFTS) technique. It was found that hydrogen, oxygen and CO in the feed stream were adsorbed competitively at the same adsorption sites on the surface of Cu1Zr1Ce9Odelta catalysts. The pretreatment with hydrogen caused the deep reduction of Cu+ species to Cu0 species and decreased the capacity of CO adsorption on the catalyst surface. The Cu1Zr1Ce9Odelta catalyst pretreated with oxygen offered more active oxygen species and inhibited the deep reduction of Cu+ species. The helium pretreatment only purified the surface of Cu1Zr1Ce9Odelta catalyst. Two IR bands at 2938.7 and 2843.8 cm(-1) due to bridged formate and bidentate formate species appeared at 180 degrees C. The active oxygen anion of Cu1Zr1Ce9Odelta catalyst could react with CO and produce carbonate species at room temperatures. The carbonate and formate species occupied the adsorption sites and deteriorated the catalytic performance of Cu1Zr1Ce9Odelta. Flushing the Cu1ZnrCe9Odelta catalyst with helium at 300 degrees C, the bidentate formate species on the catalyst surface decomposed to monodentate carbonate species and then further decomposed to CO2, which could release the adsorption sites and restore well the catalytic activity.

Overexpression of microRNA-612 Restrains the Growth, Invasion, and Tumorigenesis of Melanoma Cells by Targeting Espin.

microRNA (miR)-612 shows anticancer activity in several types of cancers, yet its function in melanoma is still unclear. This study was undertaken to investigate the expression of miR-612 and its biological relevance in melanoma cell growth, invasion, and tumorigenesis. The expression and prognostic significance of miR-612 in melanoma were examined. The effects of miR-612 overexpression on cell proliferation, colony formation, tumorigenesis, and invasion were determined. Rescue experiments were conducted to identify the functional target gene(s) of miR-612. miR-612 was significantly downregulated in melanoma tissues compared to adjacent normal tissues. Low miR-612 expression was significantly associated with melanoma thickness, lymph node metastasis, and shorter overall, and disease-free survival of patients. Overexpression of miR-612 significantly decreased cell proliferation, colony formation, and invasion of SK-MEL-28 and A375 melanoma cells. In vivo tumorigenic studies confirmed that miR-612 overexpression retarded the growth of A375 xenograft tumors, which was coupled with a decline in the percentage of Ki-67-positive proliferating cells. Mechanistically, miR-612 targeted Espin in melanoma cells. Overexpression of Espin counteracted the suppressive effects of miR-612 on melanoma cell proliferation, invasion, and tumorigenesis. A significant inverse correlation (r = -0.376, P = 0.018) was observed between miR-612 and Espin protein expression in melanoma tissues. In addition, overexpression of miR-612 and knockdown of Espin significantly increased the sensitivity of melanoma cells to doxorubicin. Collectively, miR-612 suppresses the aggressive phenotype of melanoma cells through downregulation of Espin. Delivery of miR-612 may represent a novel therapeutic strategy against melanoma.

[Regulation of proliferation and apoptosis of human vascular endothelial cell by Acheron].

OBJECTIVE: To investigate regulatory effect of Acheron (Achn) on proliferation and apoptosis of human vascular endothelial cell. METHODS: (1) Eahy926 cells were cultured in serum-free DMEM medium (96-well plates) and were divided into Achn inhibition group (transfected with plasmid psi-Achn), psi4.1 group (transfected with psi4.1 empty vector), Achn induction group (transfected with pcDNA-Achn), pcDNA3.1 group (transfected with pcDNA3.1 empty vector), cotransfection group [cotransfected with pcDNA-Achn + psi-calcium/calmodulin-dependent serine protein kinase (CASK)], blank control group (treated with PBS) according to the random number table (the same method below). The cell proliferation was determined by MTT assay at post transfection hour (PTH) 1, 24, 48, 72, with expression of absorbance value. (2) Total protein of Eahy926 cells were extracted and quantitated by BCA assay, and then they were divided into Achn antibody precipitation group (100 µg protein), CASK antibody precipitation group (100 µg protein), IgG antibody group (100 µg protein), Western blot group (20 µg protein). Achn and CASK protein levels were determined by immunoprecipitation and Western blot. (3) Synchronously cultured Eahy926 cells were divided into LPS induction group (treated with 5 mol/L LPS), Achn transfection group (transfected with pcDNA-Achn), cotransfection group (cotransfected with psi-CASK and pcDNA-Achn), KCl group (treated with 5 mol/L KCl), and blank control group (treated with 5 mol/L PBS). Cells in transfection groups were stimulated by LPS for 12 hours after PTH 24. Caspase-3 protein level was detected by immunohistochemistry. (4) Synchronously cultured Eahy926 cells were divided into Achn inhibition group (transfected with psi-Achn vector), Achn induction group (transfected with pcDNA-Achn vector), and blank control group (treated with PBS). Apoptosis rate was determined by FITC/PI with flow cytometry. Data were processed with one-way analysis of variance and t test. RESULTS: (1) The cell proliferation in Achn inhibition group was lower than that in psi4.1 group from PTH 24, and the differences were statistically significant at PTH 48, 72 (with t value respectively 10.777, 6.112, P values all below 0.05). The cell proliferation in Achn induction group during PTH 24-72 were higher that in pcDNA3.1 group (with t value respectively 5.367, 6.053, 9.831, P values all below 0.05). The cell proliferation in cotransfection group at PTH 48, 72 were significantly lower than that in Achn induction group (with t value respectively 5.481, 9.517, P values all below 0.05). (2) Achn protein was detected in CASK antibody precipitation group while CASK protein was also detected in Achn antibody precipitation group. (3) Caspase-3 level in Achn transfection group was lower [(15.6 ± 0.5)%] as compared with that in LPS induction group [(32.8 ± 2.6)%, t = 10.083, P < 0.05], and that in cotransfection group showed further inhibition [(7.0 ± 2.0)%, t = 9.827, P < 0.01]. (4) Apoptosis rate in Achn inhibition group [(45.6 ± 10.9)%] was higher than that in blank control group [(13.2 ± 4.3) %, t = 7.043, P < 0.05]; while that in Achn induction group [(5.3 ± 2.9)%] was lower than that in blank control group (t = 6.499, P < 0.05). CONCLUSIONS: Achn can promote human vascular endothelial cell proliferation, and inhibit its apoptosis induced by LPS or burn serum, and the effect is related to CASK.