[Application of acellular bovine pericardium patch in implant based immediate breast reconstruction].

Objective: To examine the clinical effect of acellular bovine pericardium patch in implant based immediate breast reconstruction. Methods: The clinicopathological information of 141 breast cancer patients, who admitted to Department of Breast Reconstruction and Oncoplastic Surgery, Tianjin Medical University Cancer Hospital, underwent immediate mammoplasty with implants combined with acellular bovine pericardium patches were analyzed from June 2016 to October 2019. All patients were female, with the age of (38.8±8.5) years (range: 13 to 60 years). The body mass index was (21.9±2.5) kg/m2 (range: 16.0 to 32.3 kg/m2). There were 39 cases of duct carcinoma in situ, 46 cases of stage Ⅰ, 40 cases of stage Ⅱ and 16 cases of stage Ⅲ. All patients received nipple-areola-sparing mastectomy or skin-sparing mastectomy with sentinel lymph node biopsy or axillary lymph node dissection, and prosthesis implantation with sub-pectoralis combined with breast patch. The correlation of clinicopathological characters and complications was assessed by t test, χ2 test, Fisher's exact probability method and Logistic regression. Pre-and post-operative aesthetic, quality of life scores were recorded. Results: The operation time (M(IQR)) was 3.6(1.5) hours (range: 3.0 to 6.5 hours). The early postoperative complication rate was 22.0% (31/141), prosthesis removal was the main postoperative complication, accounting for 64.5% (20/31) of the total complications, of which 15 cases occurred in the first 30 patients. The follow-up time was 28(8) months (range: 20 to 53 months), The most frequent long-term complications were capsular contracture and implant displacement, with the incidence of 11.2% (14/125) and 10.4% (13/125), respectively. Multivariate analysis showed that prosthesis volume ≥300 ml (OR=8.173, 95%CI: 1.302 to 51.315, P=0.021) and peri-areolar incision (OR=7.809, 95%CI: 2.162 to 28.211, P<0.01) were independent relative factors for the occurrence of short-term postoperative local complications. After 2 years of operation, the score of breast appearance satisfaction was 71.7±15.5, postoperative effect satisfaction was 90.4±9.5, psychological satisfaction was 90.7±17.1, sexual satisfaction was 70.1±25.1. The immediate postoperative satisfaction rate at discharge was 95.4% (134/141), and 17.6% (22/125) of patients had the intention to received revision surgery. Conclusions: Prosthesis volume ≥300 ml and peri-areolar incision were independent realtive factors for short-term local complications after bovine pericardium patch combined with prosthesis implantation in the immediate breast reconstruction. After completing the learning curve, the postoperative complications of the procedure could be decreased.

[Progress in HIV-2 detection methodology].

Laboratory test is the routine method of diagnosis, monitoring and blood screening of HIV infection, and main basis for early diagnosis of AIDS. HIV is divided into HIV-1 and HIV-2 subtypes, HIV-1 infection is the major cause of AIDS pandemic, while HIV-2 infection occurs in limited areas in the world, mainly in West Africa. HIV-2 infection has been reported in China since 1998. They are sporadic cases, and mainly HIV-1/HIV-2 mixed infections. There are less concerns about HIV-2 detection in China at present, and domestic HIV-2 detection reagents have not come into the market. At present, the detection method of HIV-2 is mainly antibody test and nucleic acid test. The initial screening is through rapid test and other methods and the confirmation is depended on Western Blot and Line Immune Assay. According to the HIV antibody test results, HIV-2 infection is confirmed. With the rapid development of molecular biology, the diagnostic method of nucleic acid detection laboratory has made great progress.

Reference values for the arterial pulse wave in Chinese.

BACKGROUND: Pulse wave analysis using the SphygmoCor system allows the estimation of central pulse pressure (PP) and peripheral and central augmentation indexes (AIxs). We studied the limits of normality of these measurements in Chinese. METHODS: We computed limits of normality as the 95% confidence boundaries from regression models relating the arterial indexes to age. RESULTS: The reference population included 924 subjects (50.7% men, mean age 40.7 years) without overt cardiovascular disease. Men, compared to women, had higher peripheral (43.3 vs. 41.7 mm Hg; P = 0.01) and central (32.9 vs. 30.9 mm Hg; P < 0.0001) PPs, but lower peripheral (69.0 vs. 74.2%; P < 0.0001) and central (16.6 vs. 21.0%; P < 0.0001) AIxs. All arterial measurements showed a curvilinear relation with age. Both before and after adjustment for confounding factors, peripheral and central PPs increased less (P < or = 0.01) with age in men than in women, whereas the relation of peripheral and central AIxs with age was similar (P > or = 0.13) in both sexes. In 40-year-old Chinese, approximate thresholds for peripheral and central PPs, peripheral and central AIxs were 58 mm Hg, 48 mm Hg, 105% and 45%, respectively. Considering the age range from 20 to 60 years, thresholds varied within approximately 5 mm Hg, approximately 10 mm Hg, approximately 20%, and approximately 15% of the aforementioned thresholds for peripheral and central PPs, peripheral and central AIxs, respectively. CONCLUSIONS: Pending further validation in prospective studies, our present study provides preliminary diagnostic thresholds for PP and AIxs in Chinese.

Central and peripheral blood pressures in relation to plasma advanced glycation end products in a Chinese population.

We investigated the association of plasma AGE (advanced glycation end product) concentration with central and peripheral blood pressures and central-to-brachial blood pressure amplification in a Chinese population. The study subjects were from a newly established residential area in the suburb of Shanghai. Using the SphygmoCor system, we recorded radial arterial waveforms and derived aortic waveforms by a generalized transfer function and central systolic and pulse pressure by calibration for brachial blood pressure measured with an oscillometric device. The central-to-brachial pressure amplification was expressed as the central-to-brachial systolic blood pressure difference and pulse pressure difference and ratio. Plasma AGE concentration was measured by the enzyme-linked immunosorbent assay method and logarithmically transformed for statistical analysis. The 1051 participants (age, 55.1±13.1 years) included 663 women. After adjustment for sex, age and other confounding factors, plasma AGE concentration was associated with central but not peripheral blood pressures and with some of the pressure amplification indexes. Indeed, each 10-fold increase in plasma AGE concentration was associated with 2.94 mm Hg (P=0.04) higher central systolic blood pressure and 2.39% lower central-to-brachial pulse pressure ratio (P=0.03). In further subgroup analyses, the association was more prominent in the presence of hypercholesterolemia (+8.11 mm Hg, P=0.008) for central systolic blood pressure and in the presence of overweight and obesity (-4.89%, P=0.009), diabetes and prediabetes (-6.26%, P=0.10) or current smoking (-6.68%, P=0.045) for central-to-brachial pulse pressure ratio. In conclusion, plasma AGE concentration is independently associated with central systolic blood pressure and pulse pressure amplification, especially in the presence of several modifiable cardiovascular risk factors.

Magnesium ions prevent phencyclidine-induced cerebrovasospasms and rupture of cerebral microvessels: direct in-vivo microcirculatory studies on the rat brain.

Phencyclidine (PCP) abuse is reaching alarming proportions. PCP has recently been shown to induce hypertensive encephalopathies, microvascular cerebrovasospasm and acute intracerebral hemorrhage. Since we have shown in vitro that cerebral vasospasms induced by PCP could be completely reversed, or prevented, by use of organic calcium antagonists, we utilized a television microscope recording system to determine whether magnesium ions (Mg2+) could inhibit the ability of PCP to induce contraction of pial arterioles and its sequelae of microvascular damage. Administration of either MgCl2 or Mg aspartate HCl, i.a. or i.v. (1, 10, and 20 mumol/min), before or after administration of PCP produced dose-dependent inhibition (30-80%) of PCP-induced arteriolar spasms and the subsequent vascular damage. A variety of pharmacologic receptor antagonists and cyclooxygenase inhibitors failed to influence PCP-induced cerebrovasospasms. These data suggest that a naturally-occurring Ca2+ antagonist, viz. Mg2+, may be useful in the treatment of PCP intoxication and its cerebral vascular consequences.

Cocaine-induced cerebral vascular damage can be ameliorated by Mg2+ in rat brain.

Cocaine HCl (10 micrograms/ml) delivered perivascularly to the surface of the rat brain resulted in rapid contraction of pial arterioles, which reduced the diameters by 26% compared to controls. This was followed by venular vasospasm and rupture of postcapillary venules and micro-hemorrhages at postcapillary sites. Administration of Mg aspartate HCl, by intraarterial or intravenous infusion (1, 10 and 20 mumol/min), before or after the cocaine, produced dose-dependent inhibition (20-85%) of the cocaine-induced arteriolar spasms and prevention and attenuation of the venular vasculotoxicity and hemorrhaging. These data suggest that magnesium salts might be useful agents in the treatment of cocaine-induced intoxication and prevention of brain damage.

[Effects of "qing kai ling" injection on experimental cerebral hematoma in rabbits].

OBJECTIVE: To observe the effect of "Qingkailing" (QKL) on cerebral hematoma. METHODS: The experimental cerebral hematoma models were produced by injecting autogenous clot in the rabbit. The influences of QKL on blood gas, brain index, contents of water, sodium, potassium, calcium, magnesium in brain tissues and changes of cerebrovascular permeability, histomorphology at the third day, seventh day, fourteenth day after cerebral hematoma were observed. RESULTS: In the pathological group brain index and contents of water, sodium, calcium of brain tissue, ventilation of lung were increased progressively, cerebrovascular permeability were raised obviously, especially in the side of hematoma (right brain). After the forming of cerebral hematoma cerebral edema was reduced, brain index, contents of water, sodium, calcium in brain tissue and cerebrovascular permeability, hyperventilation were all less than pathological group and close to the control group. CONCLUSION: QKL was advantageous in the treatment of encephal edema induced by experimental cerebral hematoma.

Insights on a new path of pre-mitochondrial apoptosis regulation by a glycosaminoglycan mimetic.

Lysosomal cathepsins have recently been reported to play crucial roles in the regulation of the mitochondrial death cascade by an unclear mechanism leading to mitochondrial membrane permeabilization. Glycosaminoglycans (GAG) are a family of ionic polysaccharides present at the lysosomal compartment and shown to inhibit lysosomal cathepsin activities. The implication of this family of polysaccharides in the regulation of the pre-mitochondrial death cascade has still not been considered. Here, we demonstrate in a model of skin fibroblasts submitted to oxidative stress that a GAG-mimetic protects the lysosome from membrane disruption, reduces intracellular ROS levels, and inhibits mitochondrial membrane potential collapse, cytochrome c release and caspases-9 and -3 activations without affecting the extrinsic pathway of apoptosis. Heparan sulfate and chondroitin sulfate, but not heparin, showed also protecting effects when assessing key points of the intrinsic pathway of apoptosis. We suggest the existence of molecular links between endogenous GAGs and the regulation of apoptosis.

Mg2+ protects against PCP-induced cerebrovasospasms and vascular damage in rat brain.

Recently, it was found in studies in vitro and in vivo that phencyclidine hydrochloride (PCP, 'angel dust') can induce cerebral arterial and arteriolar spasms, in psychotomimetic concentrations, by acting on specific PCP receptors, which is followed by rupture of cerebral and postcapillary venules. We wondered whether a chemical substance which has the ability to block Ca2+ channels, neurotransmitter release, intracellular Ca2+ release and the NMDA-glutamate receptor channel, viz., Mg2+, might block the PCP receptor which subserves cerebral contractile events and thereby prevent rupture of microvessels. In vivo experiments carried out on cerebral microvessels in a rat pial brain preparation revealed that different dose regimens of Mg aspartate HCl administered intravenously attenuated cerebrovasospasms induced by PCP and shifted PCP concentration-effect curves (ED50) rightward to higher concentrations. These data suggest that Mg2+ may alter the binding of PCP for its vascular receptors. Since Mg2+ prevented rupture of the cerebral microvessels, it may prove useful, clinically, in prevention and treatment of PCP-intoxicated victims.

Role of excitatory amino acids in regulation of rat pial microvasculature.

Recently, attention has been drawn to the possibility that excitatory amino acids (EAAs) may play an important role in the pathogenesis of hypoxic-ischemic neuronal injury. Exaggerated release of EAAs and excessive stimulation of N-methyl-D-aspartate (NMDA) receptors and other EAA receptors have been suggested to contribute to neuronal death in ischemia and anoxia. A number of in vitro and in vivo experimental studies have shown that EAA-receptor antagonists exert a protective effect on the brain after cerebral ischemia. Because neurons are in close apposition to small intracerebral vessels, synaptically released EAAs might also regulate small blood vessel function. With the use of quantitative television microscopic observations, in vivo studies were undertaken on pial arterioles of rats. Perivascular administration of cumulative doses (10(-7)-10(-2) M) of L-glycine, L-glutamate, L-aspartate, and NMDA on the pial microvessels resulted in concentration-dependent constriction of pial arterioles (5-30% decreases in diameter) and cerebrovasospasm; the relative order of potency was aspartate > NMDA > glycine > glutamate. High concentrations of EAAs often resulted in rupture of postcapillary venules. No amine or opiate antagonist or cyclooxygenase inhibitor prevented or attenuated the effects of these putative EAAs. EAA-induced constriction and spasm of pial arterioles as well as rupture of venules could, however, be blocked by the noncompetitive NMDA-receptor antagonist MK-801 and by Mg2+. MK-801 also produced a concentration-dependent relaxation on normal pial arterioles. These results are compatible with the idea that a specific NMDA-receptor complex (RC) exists in rat cortical microvessels, which subserves vasoconstriction.(ABSTRACT TRUNCATED AT 250 WORDS)

[Age changes in location of mandibular foramen].

In order to understand the changes in location of the mandibular foramen with age in children, lateral cephalometric radiographs from 112 child and adult patients, including both males and females, were randomly selected according to age. The subjects were divided into 6 age-groups; 3, 5, 7, 9, 11 and adult. Certain lines and points were traced on the radiographs used. The location of the mandibular foramen was identified by two persons. The perpendicular distance from the center of the mandibular foramen to the occlusal plane and the location of the mandibular foramen relative to the ramus height (Ar-Kk), as well as to the ramus width (a-p), were measured. The mandibular foramen was located 4.12 mm below the occlusal plane at the age of 3. It subsequently moved upward with age. By the age of 9, it had reached approximately the same level as the occlusal plane. The foramen continued to move upward to 4.16 mm above the occlusal plane in the adult group. The height percentage averages ranged from the lower 1/3 of the ramus height in the 3 year-old group to the middle of the ramus height in adults. The depth percentage averages ranged from 67.8% in 3 year-old children to 61.7% in adults. For greater accuracy in anesthetic procedures, dentists should relate the locational changes in the mandibular foramen with age when performing block anesthesia for the inferior alveolar nerve.