A nomogram for predicting the possibility of effusion deterioration in patients with traumatic subdural effusion.

BACKGROUND: Traumatic subdural effusion (TSDE) may increase progressively or evolve into chronic subdural hematoma. These events, defined as deterioration of the effusion, often require close observation or even surgical treatment. The aim of our study was to develop and validate a nomogram for predicting the possibility of an effusion deteriorating in patients with TSDE based on the available clinical characteristics. METHODS: Clinical data from 78 patients with TSDE were retrospectively analyzed. All patients were admitted from January 2019 to May 2022. Logistic regression was applied to the data to screen for independent predictors of effusion deterioration within six months; then, a predictive nomogram model was established in R language. The consistency, predictive accuracy and clinical utility of the model were evaluated with the C-index, calibration plots, ROC curves and decision curve analysis (DCA). Furthermore, we performed internal validation using a bootstrap approach to assess the effectiveness of the model. RESULTS: Time of effusion after trauma, maximum thickness of the effusion, CT value of the effusion as well as the use of atorvastatin were identified as predictors in the nomogram. The predictive model was well calibrated and demonstrated good discrimination (C-index: 0.893). The AUC of the model was 0.893 (95% CI: 0.824-0.962), and the modified C-index (0.865) indicated excellent performance in the internal validation. In addition, DCA revealed that the nomogram had clinical value. CONCLUSIONS: This predictive model can effectively assess the risk of effusion deterioration in TSDE patients within six months and identify high-risk patients early.

Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage.

Objective: Spontaneous hypertensive brainstem hemorrhage (HBSH) is characterized by sudden onset, rapid progression and poor prognosis. There has been a growing tendency of surgical treatment for HBSH. This study aimed to investigate outcomes and potential factors associated with the prognosis of robot-assisted drainage surgery for HBSH treatment. Methods: Patients with HBSH from July 2016 to March 2023 at a single neurosurgery center were included and divided into conservative group and surgical groups. Baseline and clinical data, radiographic characteristics, complications, and outcome evaluations were recorded and analyzed. Results: A total of 125 patients, with 74 in the conservative group and 51 in the surgical group, were enrolled in the study. Mortality at 6 months was 59/74 (79.7%) in the conservative group and 9/51 (17.6%) in the surgical group. Twenty-four patients (47.1%) achieved favorable outcomes in the surgical group, whereas this rate in the conservative group was only 5.4% (4/74). There was a significant difference in NIHSS, GCS, and mRS at 6 months between surviving patients in the conservative and surgical groups. In prognostic analysis in the surgical subgroup, initial GCS score [5 (IQR 4-7) vs. 3 (IQR 3-4), p < 0.001], NIHSS [36 (IQR 32-38) vs. 40 (IQR 38-40), p < 0.001], smoking history [45.8% (11/24) vs. 74.1% (20/27), p = 0.039], hematoma volume [6.9 (IQR 6.2-7.6) vs. 9.6 (IQR 7.3-11.4), p = 0.001], and hemorrhage location (p = 0.001) were potential risk factors for poor 6-month prognosis after robot-assisted surgery for HBSH. Conclusion: Based on the results of this study, robot-assisted minimally invasive drainage of brain stem hematoma may significantly reduce mortality and improve prognosis. Surgery should be conducted for selected patients.

Exosome-transmitted ANGPTL1 suppresses angiogenesis in glioblastoma by inhibiting the VEGFA/VEGFR2/Akt/eNOS pathway.

OBJECTIVE: Glioblastoma (GBM) is a highly vascularized malignancy that relies on new vessel generation, and thus targeting angiogenesis has been a promising anti-GBM approach. ANGPTL1 is well-known for its anti-angiogenic property; nevertheless, its role in GBM is yet to be explored. Recently, the crucial role of exosomes (Exos) as intercellular communication mediators has gained prominence in GBM therapy. This work aimed to explore the role of exosomal ANGPTL1 in GBM angiogenesis and its mechanisms. METHODS: Bioinformatic analysis was performed to evaluate ANGPTL expression in GBM. Human GBM cell lines (U87 and U251) and a xenograft mouse model were employed. Exos were isolated from oe-NC- and oe-ANGPTL-transfected bone mesenchymal stem cells and identified. Cell proliferation, migration, and apoptosis were detected. Immunofluorescence, qRT-PCR, western blotting, co-immunoprecipitation, and immunohistochemistry were used to determine the molecular mechanisms underlying exosomal ANGPTL1 against GBM angiogenesis. Besides, tube generation and transmission electron microscope assays were conducted to assess GBM angiogenesis. RESULTS: Low ANGPTL1 expression was observed in GBM tumor tissues and cells. Functionally, e-ANGPTL-Exos inhibited GBM malignant progression and angiogenesis in vitro and in vivo. Mechanically, e-ANGPTL-Exos reduced VEGFA expression and blocked the VEGFR2/Akt/eNOS pathway in GBM cells and tumor tissues. Co-immunoprecipitation revealed a link between ANGPTL1 and VEGFA in GBM cells. Notably, oe-VEGFA abolished the suppressive functions of e-ANGPTL-Exos in GBM progression and angiogenesis and the VEGFR2/Akt/eNOS axis. The VEGFR2 inhibitor, vandetanib, eliminated the promotive effects of oe-VEGFA on GBM angiogenesis with suppressed VEGFR2/Akt/eNOS pathway. CONCLUSIONS: Exosomal ANGPTL1 suppressed GBM angiogenesis by inhibiting the VEGFA/VEGFR2/Akt/eNOS axis.

Transcranial Magnetic Stimulation in Disorders of Consciousness: An Update and Perspectives.

Disorders of consciousness (DOC) is a state in which consciousness is affected by brain injuries, leading to dysfunction in vigilance, awareness, and behavior. DOC encompasses coma, vegetative state, and minimally conscious state based on neurobehavioral function. Currently, DOC is one of the most common neurological disorders with a rapidly increasing incidence worldwide. Therefore, DOC not only impacts the lives of individuals and their families but is also becoming a serious public health threat. Repetitive transcranial magnetic stimulation (rTMS) can stimulate electrical activity using a pulsed magnetic field in the brain, with great value in the treatment of chronic pain, neurological diseases, and mental illnesses. However, the clinical application of rTMS in patients with DOC is debatable. Herein, we report the recent main findings of the clinical therapeutics of rTMS for DOC, including its efficacy and possible mechanisms. In addition, we discuss the potential key parameters (timing, location, frequency, strength, and secession of rTMS applications) that affect the therapeutic efficiency of rTMS in patients with DOC. This review may help develop clinical guidelines for the therapeutic application of rTMS in DOC.

Clinical effect of short-term spinal cord stimulation in the treatment of patients with primary brainstem hemorrhage-induced disorders of consciousness.

Objective: Recently, short-term spinal cord stimulation (st-SCS) has been used in neurorehabilitation and consciousness recovery. However, little is known about its effects on primary brainstem hemorrhage (PBSH)-induced disorders of consciousness (DOC). In this study, we examined the therapeutic effects of st-SCS in patients with PBSH-induced DOC. Methods: Fourteen patients received a 2-week st-SCS therapy. Each patient's state of consciousness was evaluated using the Coma Recovery Scale-Revised (CRS-R). CRS-R evaluation scores were recorded at the baseline (before SCS implantation) and 14 days later. Results: Over 70% (10/14) of the patients (CRS-R score increased to ≥2 points) responded to the SCS stimulation after 14 days of st-SCS treatment. All items included in the CRS-R exhibited a significant increase post-treatment compared with pretreatment. After 2 weeks of st-SCS treatment, seven patients showed diagnostic improvement, resulting in a 50% (7/14) overall effective rate. Approximately 75% (3/4) of patients with minimally conscious state plus (MCS+) improved to emergence from MCS (eMCS), and 50% (1/2) of patients with vegetative state or unresponsive wakefulness syndrome (VS/UWS) improved to MCS+. Conclusion: In PBSH-induced DOC, st-SCS is a safe and effective treatment. The clinical behavior of the patients improved significantly following the st-SCS intervention, and their CRS-R scores markedly increased. This was most effective for MCS+.

Prevalence and identification of antibiotic-resistant scarlet fever group A Streptococcus strains in some paediatric cases at Shenzhen, China.

OBJECTIVES: This study aimed to investigate the annual incidence, molecular epidemiological characteristics, and antimicrobial resistance of group A Streptococcus (GAS) clinical isolates from paediatric patients at Shenzhen Children's Hospital during 2016-2020. METHODS: Clinical samples were collected from paediatric patients with a suspected diagnosis of GAS infections. We studied the annual incidence and characteristics of GAS infections using the GAS antigen detection method. Additionally, 250 GAS isolates were randomly selected for genotyping of the emm gene, and antimicrobial susceptibility assay was performed using the Kirby-Bauer paper dispersion strategy. RESULTS: Among 43 593 collected samples, 9313 were positive for the GAS antigen. The main emm type was emm12, followed by emm1, emm6, and emm 4, which were used for distinguishing 90% of the scarlet fever isolated strains. The percentage of emm1 increased from 36% in 2016 to 44% in 2019, whereas the percentage of emm12 decreased from 62% to 50%. Several unusual emm types isolated from scarlet fever patients showed an increase in proportions from 2016 to 2020. These GAS isolates were sensitive to penicillin, ceftriaxone, and vancomycin and were highly resistant to erythromycin and clindamycin. CONCLUSION: There was a high incidence of GAS infections during 2016-2020 in Shenzhen, China. The GAS isolates had a high resistance rate to erythromycin and clindamycin; penicillin was the antibiotic of choice for GAS infections. The common emm types were emm12 and emm1. Future studies should investigate the clonal structure and superantigen profiles of the population of GAS isolates associated with scarlet fever.

Effects of Dietary Tributyrin on Growth Performance, Biochemical Indices, and Intestinal Microbiota of Yellow-Feathered Broilers.

This study aimed to evaluate the effects of tributyrin on growth performance, biochemical indices and intestinal microbiota of yellow-feathered broilers. 360 one-day-old chicks were randomly allocated to three treatments with six replicates of 20 chicks each, including a normal control group (NC), an antibiotic group (PC), and a tributyrin (250 mg/kg) group (TB) for 63 days. The results showed that compared with the control, the feed conversion ratio (FCR) in the TB group decreased during the d22 to d42 (p < 0.05) and overall, the final weight and FCR of broilers tended to increase and decrease, respectively. Moreover, the TB group showed the highest creatine concentrations at the entire period (p < 0.05). TB treatment increased the Bacteroidetes relative abundance and decreased Firmicutes. Principal coordinates analysis yielded clear clustering of the three groups. Linear discriminant analysis effect size analysis found seven differentially abundant taxa in the TB group, including several members of Bacteroidedetes. The relative abundance of Eisenbergiella, Phascolarctobacterium, Megasphaera and Intestinimonas increased in tributyrin-treated broilers. Spearman correlation analysis identified a correlation between Eisenbergiella abundance and overall feed efficiency. These results demonstrated that tributyrin could improve the growth performance by modulating blood biochemical indices and the cecal microflora composition of broilers.

The effectiveness of alprostadil in treating coronary microcirculation dysfunction following ST-segment elevation myocardial infarction in a pig model.

Though alprostadil has been reported to improve the impaired microcirculation of patients with pulmonary arterial hypertension, its effectiveness as a treatment for coronary microvasculature dysfunction (CMD) following ST-segment elevation myocardial infarction (STEMI) is unknown. A total of 18 miniature pigs with CMD following STEMI were randomized into three groups that received an intracoronary injection of 5 ml of normal saline, 2 mg of nicorandil or 10 µg of alprostadil immediately after measurement of the index of microcirculatory resistance (IMR) and then an intravenous drip containing 5 ml of normal saline, 2 mg of nicorandil or 10 µg of alprostadil once a day for 6 days. The IMR, cardiac function using ultrasound, infarct areas and heparanase levels in infarct areas were measured and compared between the three groups. The IMR decreased markedly 10 min after alprostadil or nicorandil intracoronary injection (both P<0.05) but not following saline injection (P>0.05). After 7 days, the IMR was substantially lower in the alprostadil and nicorandil groups compared with the saline group (both P<0.05) and the ejection fraction was considerably higher in the alprostadil and nicorandil groups compared with the saline group (both P<0.05). Differences in infarct areas and the relative heparanase expression levels among the 3 groups were similar to the differences in the ejection fraction. No significant differences in the above assessment indexes were identified in the alprostadil and nicorandil groups. Alprostadil infusion improved coronary microcirculation function, reduced the infarct area and limited left ventricular dilatation in a pig coronary microvasculature dysfunction model following STEMI.

Scalable Preparation of Cellulose Nanofibers from Office Waste Paper by an Environment-Friendly Method.

Waste paper is often underutilized as a low-value recyclable resource and can be a potential source of cellulose nanofibers (CNFs) due to its rich cellulose content. Three different processes, low acid treatment, alkali treatment and bleaching treatment, were used to pretreat the waste paper in order to investigate the effect of different pretreatments on the prepared CNFs, and CNFs obtained from bleached pulp boards were used as control. All sample fibers were successfully prepared into CNFs by 2,2,6,6-tetramethyl-piperidine-1-oxyl (TEMPO) oxidation. It was quite obvious that the bleached CNFs samples showed dense fibrous structures on a scanning electron microscopy (SEM), while needle-like fibers with width less than 20 nm were observed on a transmission electron microscopy (TEM). Meanwhile, the bleaching treatment resulted in a 13.5% increase in crystallinity and a higher TEMPO yield (e.g., BCNF, 60.88%), but a decrease in thermal stability. All pretreated CNFs samples showed narrow particle size distribution, good dispersion stability (zeta potential less than -29.58 mV), good light transmission (higher than 86.5%) and low haze parameters (lower than 3.92%). This provides a good process option and pathway for scalable production of CNFs from waste papers.

Research Note: Effects of glycerol monolaurate supplementation on egg production, biochemical indices, and gut microbiota of broiler breeders at the late stage of production.

The objective of the present study was to determine the effect of glycerol monolaurate (GML) supplementation on egg production, biochemical indices, and gut microbiota of broiler breeders at the late stage of production. Total of 180 healthy Qingyuan Partridge broiler breeders were randomly assigned to 2 groups: 1) corn-soybean meal based diet, and 2) basal diet supplemented with 300 mg glycerol monolaurate/kg. Each treatment group had 6 replicates with 15 birds within each replicate. The experiment started at wk 33 and lasted for 8 weeks. Feed conversion rate, egg weight, egg shape index, shell breaking strength, and shell thickness were not different between control and treatment groups. Supplementation of GML significantly decreased the egg breaking rate. All blood chemical indices and antioxidant parameters were not affected by GML except total antioxidant capacity which increased significantly with GML supplementation. Alpha diversity indices (Shannon, Simpson, Chao1, Ace, goods_coverage, and PD_whole tree) were not different between the 2 groups. Composition of cecal microbiota was not affected by GML supplementation except Euryarchaeota and Proteobacteria at phylum level. Overall, supplementation of glycerol monolaurate at 300 mg/kg level improved eggshell quality but its effect on cecal microbiota composition was limited on broiler breeders at the late stage of production.

Phasic Off responses of auditory cortex underlie perception of sound duration.

It has been proposed that sound information is separately streamed into onset and offset pathways for parallel processing. However, how offset responses contribute to auditory perception remains unclear. Here, loose-patch and whole-cell recordings in awake mouse primary auditory cortex (A1) reveal that a subset of pyramidal neurons exhibit a transient "Off" response, with its onset tightly time-locked to the sound termination and its frequency tuning similar to that of the transient "On" response. Both responses are characterized by excitation briefly followed by inhibition, with the latter mediated by parvalbumin (PV) inhibitory neurons. Optogenetically manipulating sound-evoked A1 responses at different temporal phases or artificially creating phantom sounds in A1 further reveals that the A1 phasic On and Off responses are critical for perceptual discrimination of sound duration. Our results suggest that perception of sound duration is dependent on precisely encoding its onset and offset timings by phasic On and Off responses.

Effects of monobutyrin supplementation on egg production, biochemical indexes, and gut microbiota of broiler breeders.

The objective of the present study was to determine the effect of monobutyrin supplementation on egg production, biochemical indexes, and gut microbiota of broiler breeders at the late stage of production. A total of 180 healthy Qingyuan partridge broilers were randomly assigned to 2 groups: 1) corn-soybean meal-based diet and 2) basal diet supplemented with 250 mg monobutyrin/kg. Each treatment group had 6 replicates/cages with 15 birds within each replicate. The experiment started at week 33 and lasted for 8 wk. Egg production rate, feed conversion rate, shell breaking strength, and shell thickness were not different between control and treatment groups. Supplementation of monobutyrin increased egg weight and tended to decrease egg breaking rate of Qingyuan partridge chickens. Supplementation of monobutyrin did not affect any of the biochemical indexes except total protein concentration. The 4 antioxidant parameters measured were not affected either. Alpha diversity indexes (Shannon, Simpson, Chao1, Ace, and Good's Coverage) and composition of cecal microbiota were not affected by monobutyrin supplementation. Overall, supplementation of monobutyrin at 250 mg/kg level improved egg quality, but its effect on cecal microbiota composition was limited.

Stabilization of maneb group by ethylenediamine and direct-determination by liquid chromatography tandem mass spectrometry.

A rapid, low-cost, and selective method for simultaneous and direct determination of maneb group residues (containing ethylenebis and propylenebis dithiocarbamates) in fruit by liquid chromatography coupled to tandem mass spectrometry was developed and validated in the current study. The results showed the maneb group could be melt and stabilized by 5 v% ethylenediamine for 60 days keeping in conventional refrigerators, in which a stable and ionizable pentadentate ligand complex was considered to be formed by the bidentate diamine and sulfhydryl followed by Density Functional Theory calculation. The validated method showed a sensitive quantification limits (0.03 mg/kg), a steady recovery (82.1%-91.0%) and an excellent precision (2.7%-4.3% RSD). This method is applied to analyze fruit samples and achieved satisfactory results. Therefore, this method can be proposed as a robust analytical method of maneb group in fruit, and can be adapted to detect other compounds with sulfhydryl group.

Simultaneous Correction of Complex Secondary Deformities of Cleft Lip Using Autogenous Costal Cartilage Combined With Rib Grafts.

OBJECTIVE: Complex secondary deformities of cleft lip include nasal and labial deformities, alveolar cleft, oronasal fistula, and so on. In this report, the authors present a method to simultaneously repair the above complex deformities with autogenous costal cartilage and rib grafts. METHODS: The surgical procedure of simultaneous correction includes RESULTS:: Satisfactory outcomes were achieved in all 22 patients. Fifteen patients were followed up for 6 to 24 months and exhibited good nasal shape, repaired alveolar cleft, improved labial shape, and closed oronasal fistula. Three patients presented with red nasal tips. One patient had local infection, which was cured by antibiotics. CONCLUSION: This methodAs this method has led to positive outcomes, it has the potential to be widely used in clinical practice.

Overactivated neddylation pathway in human hepatocellular carcinoma.

Dysregulation of the neddylation pathway is related to various cancers. However, the specific role of the neddylation pathway in human hepatocellular carcinoma (HCC) remains largely unclear. In this study, the neddylation pathway in HCC and adjacent noncancerous liver (ANL) tissues was evaluated by immunohistochemistry (IHC), Western blotting, and qRT-PCR (quantitative real-time polymerase chain reaction). The results showed that the entire neddylation pathway, including NEDD8 (the IHC staining of NEDD8 represents the global-protein neddylation), E1 NEDD8-activating enzymes (NAE1 and UBA3), E2 NEDD8-conjugating enzymes (UBE2F and UBE2M), E3 NEDD8-ligases (MDM2, RBX1 and RNF7), and deneddylation enzymes (COPS5, UCHL1 and USP21), was overactivated in HCC. Furthermore, the upregulation of NEDD8 in HCC was correlated with aggressive characteristics and was an independent risk factor for overall survival (OS) and recurrence-free survival (RFS) in patients with HCC after hepatectomy. The upregulation of NAE1, UBE2M, and UCHL1 in HCC was associated with aggressive characteristics and poor OS and RFS in patients with HCC after hepatectomy. In conclusion, our research reveals that the entire neddylation pathway is overactivated in HCC and associated with clinical characteristics and prognosis of patients with HCC.

Fabrication of Magnetic Nanofibers by Needleless Electrospinning from a Self-Assembling Polymer Ferrofluid Cone Array.

Magnetic nanofiber has been widely applied in biomedical fields due to its distinctive size, morphology, and properties. We proposed a novel needleless electrospinning method to prepare magnetic nanofibers from the self-assembling "Taylor cones" of poly(vinyl pyrrolidone) (PVP)/Fe3O4 ferrofluid (PFF) under the coincident magnetic and electric fields. The results demonstrated that a static PFF Rosensweig instability with a conical protrusion could be obtained under the magnetic field. The tip of the protrusion emitted an electrospinning jet under the coincident magnetic and electric fields. The needleless electrospinning showed a similar process phenomenon in comparison with conventional electrospinning. The prepared nanofibers were composed of Fe3O4 particles and PVP polymer. The Fe3O4 particles aggregated inside and on the surface of the nanofibers. The nanofibers prepared by needleless electrospinning exhibited similar morphology compared with the conventionally electrospun nanofibers. The nanofibers also exhibited good ferromagnetic and magnetic field responsive properties.

Interleukin-4 Ameliorates the Functional Recovery of Intracerebral Hemorrhage Through the Alternative Activation of Microglia/Macrophage.

Neuro-inflammation plays an important role in the recovery of brain injury after stroke. Microglia/macrophage is the major executor in the neuro-inflammation, which can be polarized into two distinct phenotypes: injurious/toxic classical activation (M1 phenotype) and protective alternative activation (M2 phenotype). Here, we investigated whether intracerebral administration of interleukin-4 (IL-4) at an early stage could affect the activation of microglia/macrophage and the corresponding outcome after intracerebral hemorrhage (ICH). The neuro-behavior was recorded between different groups in the rat ICH model. The M1 and M2 markers were then determined by qRT-PCR, western blotting, ELISA, and immunofluorescence, respectively. We observed aberrant activation of microglia/macrophage after ICH. After intracerebral injection of IL-4, M1 activation was greatly inhibited while M2 activation was enhanced, along with improving neurobehavioral recovery from deficits after ICH. Our study showed that early intracerebral injection of IL-4 potentially promotes neuro-functional recovery, probably through enhancing the alternative activation of microglia/macrophage.

Aldolase B inhibits metastasis through Ten-Eleven Translocation 1 and serves as a prognostic biomarker in hepatocellular carcinoma.

BACKGROUND: Downregulation of Aldolase B (ALDOB) has been reported in hepatocellular carcinoma. However, its clinical significance and its role in pathogenesis of HCC remain largely unknown. METHODS: We analyzed the expression of ALDOB and its clinical features in a large cohort of 313 HCC patients using tissue microarray and immunohistochemistry. Moreover, the function of stably overexpressed ALDOB in HCC cells was explored in vitro and in vivo. Gene expression microarray analysis was performed on ALDOB-overexpressing SMMC7721 cells to elucidate its mechanism of action. RESULTS: ALDOB downregulation in HCC was significantly correlated with aggressive characteristics including absence of encapsulation, increased tumor size (>5 cm) and early recurrence. ALDOB downregulation was indicative of a shorter recurrence-free survival (RFS) and overall survival (OS) for all HCC patients and early-stage HCC patients (BCLC 0-A and TNM I stage patients). Multiple analyses revealed that ALDOB downregulation was an independent risk factor of RFS and OS. Stable expression of ALDOB in HCC cell lines reduced cell migration in vitro and inhibited lung metastasis, intrahepatic metastasis, and reduced circulating tumor cells in vivo. Mechanistically, we found that cells stably expressing ALDOB show elevated Ten-Eleven Translocation 1 (TET1) expression. Moreover, ALDOB expressing cells have higher levels of methylglyoxal than do control cells, which can upregulate TET1 expression. CONCLUSION: The downregulation of ALDOB could indicate a poor prognosis for HCC patients, and therefore, ALDOB might be considered a prognostic biomarker for HCC, especially at the early stage. In addition, ALDOB inhibits the invasive features of cell lines partly through TET1 expression.

Reconstruction of skin defects in the medial cheek using lateral cheek rotation flap combined with Z-plasties.

BACKGROUND: Cervicofacial flaps are commonly used in the reconstruction of skin defects in regions such as the medial cheek and lower eyelid. However, their drawbacks include long flap incision, extensive undermining, and a high possibility of postoperative complications including distal flap necrosis and lower eyelid ectropion. METHODS: Nine cases of reconstruction of skin defects in the medial cheek and adjacent areas were performed using a lateral cheek rotation flap in combination with Z-plasties between October 2009 and August 2014. In the surgery, the defect was trimmed into a downward-pointing triangle, with the flap incision line starting from the bottom edge of the defect and extending outward in the lateral orbital direction in an arc until before the sideburn. After the flap was undermined, double or quadruple Z-plasties were performed along the lateral orbital incision line to elongate the flap. RESULTS: All flaps survived without the occurrence of complications such as hematoma, wound infection, distal flap necrosis, and lower eyelid ectropion. During the follow-up period, the flaps exhibited good color and texture. A natural looking cheek was restored without obvious scars. CONCLUSIONS: A lateral cheek rotation flap in combination with Z-plasty is an optimal method for reconstruction of skin defects in the medial cheek and lower eyelid region. Compared to conventional cervicofacial flaps, the lateral cheek rotation flap was shown to have a variety of advantages, including a simpler operation, shorter flap incision, minimal undermining, and effective prevention of complications such as lower eyelid ectropion and distal flap necrosis.

Cross-talk between human neural stem/progenitor cells and peripheral blood mononuclear cells in an allogeneic co-culture model.

Transplantation of human neural stem/progenitor cells (hNSCs) as a regenerative cell replacement therapy holds great promise. However, the underlying mechanisms remain unclear. We, here, focused on the interaction between hNSCs and allogeneic peripheral blood mononuclear cells (PBMCs) in a co-culture model. We found that hNSCs significantly decrease the CD3+ and CD8+ T cells, reduce the gamma delta T cells and increase the regulatory T cells, along with reduced pro-inflammatory cytokines and increased anti-inflammatory cytokines after co-culture. We also found that PBMCs, in turn, significantly promote the proliferation and differentiation of hNSCs. Our data suggest that hNSCs cross-talk with immune cells.