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Objectives: To explore the spatial distribution characteristics, trend changes, and spatial clustering of esophageal cancer among residents in China at the county (city, district) scale, a spatial epidemiological approach was used, with the aim of providing localized evidence for the prevention and treatment of esophageal cancer in China. Methods: The data source was the incidence (crude rate) and mortality (crude rate) of esophageal cancer from 2005 to 2016 in the 2008-2019 edition of China Cancer Registration Annual Report published by the National Cancer Center. The Joinpoint model was used for time trend analysis. The tumor registration area in 2016 was selected as the study area for spatial feature analysis, with a total of 487 counties (cities and districts), covering 27.6% of the national population. Spatial autocorrelation analysis was performed to reveal spatial distribution characteristics by using Arcgis 10.6 software, and spatial scanning statistics was used to analyze spatial clustering characteristics by using SaTScan 9.5 software. The log-likelihood ratio (LLR) and relative risk (RR) were calculated in different windows, and the region with the largest LLR value represented the most likely cluster. Results: From 2005 to 2016, the incidence and mortality rate of esophageal cancer in China showed a trend of increasing at first and then decreasing. The incidence and mortality rate of esophageal cancer in 2016 were characterized by spatial positive correlation. High incidence and high mortality were mainly concentrated in the areas through which the Huaihe River flowed. The primary clusters (taking high incidence rate as an example LLR=6 374.41, RR=2.37, Pï¼0.001) were mainly distributed in Jiangsu, Anhui and Shandong in eastern China and eastern Henan and southern Hebei in central China, and secondary clusters (taking high incidence rate as an example LLR=1 971.19, RR=1.91, Pï¼0.001) in Gansu, Ningxia Hui Autonomous Region, Shaanxi, Sichuan and other central and western regions. Conclusions: The incidence and mortality of esophageal cancer in China have decreased since 2010. The disease burden of esophageal cancer has obvious spatial differences, and measures should be taken according to local conditions in high-risk cluster areas such as the Huaihe River basin.
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Neoplasias Esofágicas , Análisis Espacio-Temporal , Neoplasias Esofágicas/epidemiología , Neoplasias Esofágicas/patología , Humanos , China/epidemiología , Incidencia , Análisis por Conglomerados , Análisis Espacial , MasculinoRESUMEN
Objective: Explore the relationship between tip of the left bundle branch pacing lead and anatomic location of left bundle branch as well as the mechanism of left bundle branch current of injury. To clarify the clinical value of left bundle branch current of injury during operation. Methods: The pacing leads were implanted in the hearts of two living swines. Intraoperative electrophysiological study confirmed that the left bundle branch or only the deep left ventricular septum was captured at low output. Immediately after operation, the gross specimen of swine hearts was stained with iodine to observe the gross distribution of His-purkinje conduction system on the left ventricular endocardium and its relationship with the leads. Subsequently, the swine hearts were fixed with formalin solution, and the pacing leads were removed after the positions were marked. The swine hearts were then sectioned and stained with Masson and Goldner trichrome, and the relationship between the anatomic location of the conduction system and the tip of the lead was observed under a light microscope. Results: After iodine staining of the specimen, the His-purkinje conduction system was observed with the naked eye in a net-like distribution, and the lead tip was screwed deeply and fixed in the left bundle branch area of the left ventricular subendocardium in the ventricular septum. Masson and Goldner trichrome staining showed that left bundle branch pacing lead directly passed through the left bundle branch when there was left bundle branch potential with left bundle branch current of injury, while it was not directly contact the left bundle branch when there was left bundle branch potential without left bundle branch current of injury. Conclusion: The left bundle branch current of injury observed on intracardiac electrocardiogram during His-purkinje conduction system pacing suggests that the pacing lead directly contacted the conduction bundle or its branches, therefore, the captured threshold was relatively low. Left bundle branch current of injury can be used as an important anatomic and electrophysiological evidence of left bundle branch capture.
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Yodo , Tabique Interventricular , Animales , Porcinos , Fascículo Atrioventricular/fisiología , Estimulación Cardíaca Artificial , Sistema de Conducción Cardíaco , ElectrocardiografíaRESUMEN
Objective: To analyze the association between different treatment timings and adverse neonatal outcomes (premature birth, death, congenital syphilis) in syphilis-infected pregnant women. Methods: The National Management Information System for Prevention of HIV, Syphilis and HBV Mother-to-Child Transmission was used to collect information on the detection and treatment of syphilis-infected pregnant women and their newborns in Guangdong Province from October 2011 to December 2021. According to the gestational weeks of syphilis-infected pregnant women receiving penicillin treatment for the first time, they were divided into four groups: treatment in the first trimester, treatment in the second trimester, treatment in the third trimester, and no treatment during pregnancy. Multivariate logistic regression was used to analyze the association between different treatment timings and adverse neonatal outcomes in syphilis-infected pregnant women. Results: A total of 22 483 syphilis-infected pregnant women were included. The number of pregnant women who started treatment in the first trimester, second trimester, and third trimester and did not receive treatment during pregnancy were 4 549 (20.23%), 8 719 (38.78%), 2 235 (9.94%) and 6 980 (31.05%), respectively. Compared with pregnant women who started treatment in the first trimester, pregnant women who did not receive anti-syphilis treatment during pregnancy had increased risks of neonatal preterm birth (OR=1.42, 95%CI: 1.24-1.62), death (OR=4.27, 95%CI: 1.64-14.69) and congenital syphilis (OR=12.26, 95%CI: 6.35-27.45). At the same time, the risk of congenital syphilis in the newborns of pregnant women who started anti-syphilis treatment in the second trimester (OR=2.68, 95%CI: 1.34-6.16) and third trimester (OR=6.27, 95%CI: 2.99-14.80) also increased. Conclusion: Early initiation of anti-syphilis treatment during pregnancy in patients with syphilis can improve neonatal outcomes.
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Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro , Sífilis Congénita , Sífilis , Embarazo , Femenino , Recién Nacido , Humanos , Mujeres Embarazadas , Sífilis/tratamiento farmacológico , Sífilis/epidemiología , Sífilis/diagnóstico , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Sífilis Congénita/tratamiento farmacológico , Transmisión Vertical de Enfermedad Infecciosa/prevención & controlRESUMEN
The compressed ultrafast photography (CUP) can capture non-repetitive time-evolving events at 7 × 1013 fps, which is anticipated to find a diverse range of applications in physics, biomedical imaging, and materials science. The feasibility of diagnosing ultrafast phenomenon of Z-pinch by using the CUP has been analyzed in this article. Specifically, a dual-channel CUP design has been adopted for acquiring high quality reconstructed images and the strategies of identical masks, uncorrelated masks, and complementary masks have been compared. Furthermore, the image of the first channel was rotated by 90° to balance the spatial resolution between the sweep direction and the non-sweep direction. Both five synthetic videos and two simulated Z-pinch videos were chosen as the ground truth to validate this approach. The average peak signal to noise ratio of the reconstruction results is 50.55 dB for the self-emission visible light video and 32.53 dB for the laser shadowgraph video with unrelated masks (rotated channel 1). The simulation results show that the time-space-evolving process of plasma distribution can be well retold, and the phenomenon of plasma instability can be accurately diagnosed by the dual-channel CUP with unrelated masks (rotated channel 1). This study may promote the practical applications of the CUP in the field of accelerator physics.
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BACKGROUND AND PURPOSE: Intracranial aneurysms, a rare complication of radiation therapy, have been reported mainly in case reports or case series. We performed a multicenter, retrospective cohort study to investigate the characteristics of radiation-induced intracranial aneurysms. MATERIALS AND METHODS: Data on 2641 patients with intracranial aneurysms were retrospectively collected from 3 hospitals between January 2005 and June 2014. An additional 1519 patients were recruited from a single center between July 2014 and March 2020. Aneurysms in patients with a history of radiation therapy for at least 6 months were defined as radiation-related aneurysms. Patients' demographic profiles, clinical characteristics, and aneurysm parameters detected on CTA were compared between radiation-related and control groups. RESULTS: Of the 4160 patients, the average age was 57.9 (SD, 13.5) years, 2406 (57.8%) were women, 477 (11.5%) had multiple aneurysms, 3009 (72.3%) had SAH, and 34 (0.8%) had radiation-related aneurysms. The male-to-female ratio in the radiation-related group was significantly higher than that in the control group (2.4:1 versus 0.72:1, P = .001). The mean age of the radiation-related group was significantly younger than in the control group (51.4 [SD, 15.0] years versus 58.2 [SD, 13.5] years, P = .003). More patients in the radiation-related group presented with SAH than in the control group (without age and sex matching, 88.2% versus 72.2%, P = .037; with age and sex matching, 88.2% versus 58.8%, P = .006). Of the 4813 intracranial aneurysms, only 43 (0.9%) aneurysms were categorized as in the radiation-related group, whereas 4770 (99.1%) aneurysms constituted the control group. Compared with the control group, there was a significantly higher proportion of sidewall aneurysms (46.5% versus 32.3%, P = .048) and a predilection for aneurysms involving the ICA and posterior circulation arteries (72.1% versus 52.2%, P = .046) in the radiation-related group. CONCLUSIONS: Compared with the control group, radiation-related aneurysms are more prone to occur in men and young patients, with a higher percentage of sidewall aneurysms located in the ICA and posterior circulation arteries. Furthermore, SAH is highly prevalent in patients with radiation-induced aneurysms, indicating that dedicated screening for aneurysms after radiation therapy is necessary, but further studies are needed to determine when and how to screen.
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Aneurisma Intracraneal , Humanos , Masculino , Femenino , Persona de Mediana Edad , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/epidemiología , Aneurisma Intracraneal/complicaciones , Estudios Retrospectivos , Arterias , Factores SexualesRESUMEN
OBJECTIVE: We aimed to construct/validate a radiomics method based on MR FS-T2WI sequence for the evaluation of kidney function in patients with autosomal dominant polycystic kidney disease (ADPKD). PATIENTS AND METHODS: The clinical data and MRI images of 114 patients with ADPKD were retrospectively analyzed. With a glomerular filtration rate of 60 mL/min per 1.73 m2 as the cutoff value, patients were divided into two groups, where there were 59 patients with GFR ≥60 mL/min per 1.73 m2 (including CKD1 and CKD2 phase) and 55 patients with GFR <60 mL/min per 1.73 m2 (including CKD3 phase and higher). All patients underwent the 3.0T MR scan of the kidney. Then, the kidney were delineated layer by layer based on the FS-T2WI sequence to obtain the volume of interest (VOI) for radiomics features extraction. The optimal radiomics features were selected by least absolute shrinkage and selection operator (LASSO). Three kinds of data modality including the pure clinical data, the pure image data and the clinical-image fused data were utilized to establish three types of models (clinical, image and with their combination) separately by five machine learning classifiers: k-nearest-neighbors (KNN), support vector machine (SVM), logistic regression (LR), random forests (RF) and multi-layer perception (MLP). Receiver operating characteristic (ROC) curve, areas under the curve (AUC), sensitivity, specificity and precision were employed to evaluate the model's effectiveness to diagnosis the glomerular filtration rate of patients with ADPKD based on different models. Besides, Delong test was applied to compare ROCs between models. RESULTS: 960 radiomics features were extracted from each VOIs, and clinical information included the gender and age of each patient. After feature selection, 23 and 21 features based on pure image data and clinical-image fused data were independently used to construct models for the kidney function evaluation. The clinical-image fused model (AUC=0.89) has better performance than the pure image model (p=0.046) and pure clinical model (p<0.001). Clinical-image fused model based on LR classifier showed the best diagnostic efficiency, with AUC=0.89, sensitivity=0.8867 and specificity=0.7959. CONCLUSIONS: The MR FS-T2WI radiomics analysis based on clinical-image fused model is instrumental in evaluating and predicting the kidney function of patients with polycystic kidney disease.
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Imagen de Difusión por Resonancia Magnética/métodos , Riñón/diagnóstico por imagen , Riñón Poliquístico Autosómico Dominante/diagnóstico por imagen , Riñón Poliquístico Autosómico Dominante/genética , Adulto , Anciano , Área Bajo la Curva , Progresión de la Enfermedad , Femenino , Tasa de Filtración Glomerular , Humanos , Modelos Logísticos , Aprendizaje Automático , Masculino , Persona de Mediana Edad , Riñón Poliquístico Autosómico Dominante/fisiopatología , Curva ROC , Estudios Retrospectivos , Sensibilidad y Especificidad , Máquina de Vectores de Soporte , Adulto JovenRESUMEN
Objective: To summarize the preliminary experience in the treatment of esthesioneuroblastoma (ENB) and to explore the effect of age, chemotherapy, modified Kadish stage and pathological grade on the prognosis of ENB. Methods: The clinical data of 87 ENB patients from the First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University Cancer Center between June 2002 and November 2017 were retrospectively analyzed. The modified Kadish stage was used to evaluate the extent of the lesions, and the Hyams grading system was used for pathological grading. The patients were followed up regularly to evaluate the recurrence and metastasis of the tumor. Cox proportional hazard model was used for univariate and multivariate analyses. Prognostic factors with P<0.05 in univariate analysis were included in multivariate analysis. After controlling the confounding factors, the model coefficients were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: The median follow-up time of ENB patients was 29 months, and the 5-year overall survival rate was 39.3%. In univariate analysis, age, chemotherapy, modified Kadish stage and pathology grade were independent predictors of overall survival, while gender, radiotherapy and surgery were not prognostic factors. Multivariate analysis showed that modified Kadish stage and pathology grade were independent predictors of overall survival rate after excluding confounding factors. Conclusions: Age, chemotherapy, modified Kadish stage and pathological grade are taking important role in the overall survival rate of patients with ENB. Modified Kadish stage and pathological grade are independent predictors of overall survival rate.
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Estesioneuroblastoma Olfatorio , Neoplasias Nasales , Estesioneuroblastoma Olfatorio/patología , Estesioneuroblastoma Olfatorio/terapia , Humanos , Cavidad Nasal/patología , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Neoplasias Nasales/patología , Neoplasias Nasales/terapia , Pronóstico , Estudios RetrospectivosRESUMEN
Objective: To investigate the clinical effect of free fibula flap transplantation in repairing the defect of mandibular osteoradionecrosis (ORN). Methods: A total of 151 mandibular ORN patients undergoing free fibular flap transplantation were selected from August 2005 to September 2020 in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Among them, 109 patients were males and 42 patients were females, aged (54.1±10.1) (ranged 31-85) years old. The clinical data of the patients was collected and the survival rate of the flaps and postoperative function were calculated to evaluate the surgical efficacy. The χ2 test was used for difference analysis. Results: Among the 151 patients, mandibular ORN caused by radiotherapy for nasopharyngeal carcinoma accounted for 79.5% (120/151). The average time for mandibular ORN appeared was 5(6) years after radiotherapy. Facial artery [57.2%(87/152)] and superior thyroid artery [32.9%(50/152)] were the main anastomotic arteries in the recipient area. There was no significant difference in the necrosis rates of the two flaps [10.3%(9/87) and 12.5% (5/50), respectively, P=0.949]. The main anastomotic veins in the recipient area were the external jugular vein [48.4%(135/279)] and the common facial vein [26.5%(74/279)]. Twenty-five cases (16.6%) had one vein anastomosed, and 126 cases (83.44%) had two veins anastomosed. There was no significant difference in the flap necrosis rate between the two conditions [20.0%(5/25) and 7.1%(9/126), respectively, P=0.100]. Ninety-seven cases (64.2%) used the peroneal musculocutaneous-fascia composite flap to repair the maxillofacial soft and hard tissue defects. Thirteen cases (8.6%) underwent the restorations with digital virtual surgery design, of which 5 cases were repaired with dental implants at the same time. After the operations, lower respiratory tract infection occurred in 17 patients (11.3%), and upper respiratory tract obstruction occurred in 3 cases (2.0%). The survival rate of the flap after operation was 90.7% (136/151), and 21 patients (13.9%) had flap vascular crisis. Delayed healing of maxillofacial wounds occurred in 33 cases (21.9%). After 3 to 24 months of follow-ups, 110 patients (76.9%) had no fistula inside/outside the oral cavity, 118 patients (82.5%) had an improvement in opening mouth of increasing (≥0.5 cm) after surgery, 135 patients (94.4%) had pain relief, 97 cases (67.8%) could eat normal diet, semi-liquid or soft food, and 137 cases (95.8%) were satisfied or basically satisfied with the treatment effects. Conclusions: The free fibular flap transplantation is an effective method to repair mandibular ORN defects. Preoperative vascular assessment is helpful for the selection of recipient vessels. Facial artery, superior thyroid artery, external jugular vein and common facial vein can be used as the main recipient vessels. The repair of the peroneal musculocutaneous-fascia composite flap facilitates the closure of internal and external fistulas. Digital technology can help to restore the maxillofacial shape more accurately, improve the patient's occlusal and chewing function and enhance the quality of life of mandibular ORN patients.
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Colgajos Tisulares Libres , Osteorradionecrosis , Procedimientos de Cirugía Plástica , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca , Osteorradionecrosis/cirugía , Calidad de Vida , Trasplante de Piel , Resultado del TratamientoRESUMEN
The purpose of this study was to assess the outcomes of patients with advanced recurrent nasopharyngeal carcinoma (rNPC) and radiation-induced sarcoma of the head and neck (RISHN) who underwent en bloc resection and reconstruction. Fifty-two patients with advanced rNPC (n=36) and RISHN (n=16) underwent en bloc resection and reconstruction with an extended lower vertical trapezius island myocutaneous flap (TIMF). En bloc resection of the tumour (including craniomaxillofacial resections and neck resections) and major defect restoration was successful in all patients. TIMF survival was 92.3%. Postoperative mild hemiplegia occurred in one patient with rNPC. In total, 20 patients (55.5%) in the rNPC group and seven (43.8%) in the RISHN group recovered with no signs of disease at follow-up. No statistically significant difference in recovery status was observed between the rNPC and RISHN groups. En bloc resection of the tumour, including dissection of the carotid artery, ensured microscopic clearance of the disease; this is a viable treatment option for patients with advanced rNPC or RISHN without distant metastasis. The extended vertical lower TIMF is a large, straightforward, and reliable flap for repairing the resultant major defects in the craniomaxillofacial or neck region.
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Carcinoma de Células Escamosas , Neoplasias Nasofaríngeas , Procedimientos de Cirugía Plástica , Sarcoma , Carcinoma de Células Escamosas/cirugía , Humanos , Carcinoma Nasofaríngeo/radioterapia , Carcinoma Nasofaríngeo/cirugía , Neoplasias Nasofaríngeas/radioterapia , Neoplasias Nasofaríngeas/cirugía , Recurrencia Local de Neoplasia , Estudios Retrospectivos , Sarcoma/radioterapia , Sarcoma/cirugíaRESUMEN
A novel hydrophobic cellulose-based organic/inorganic nanomaterial (cellulose/TS-POSS) was prepared by oxygen plasma treatment followed by condensation reaction with TriSilanollsobutyl-Polyhedral oligomeric silsesquioxane. By careful design of cellulose film modified with TS-POSS by plasma etching, not only simply activated the hydroxyl groups on fiber surface, but also lowered the surface energy and increased the surface roughness. The surface morphology, chemical structure, thermal properties, and hydrophobic properties of cellulose/TS-POSS materials were systematically investigated by FTIR, SEM, AFM, CA, and TGA, respectively. The experimental results showed that the static water contact angle of cellulose/TS-POSS was 152.9°, demonstrating super-hydrophobicity. The results indicated that the TS-POSS were observed uniformly dispersed in the cellulose at the nanometer scale to form nanostructures, successful bonding to cellulose through condensation reaction. This process developed in this paper provided new solutions and approximations for the facile fabrication of sustainable cellulose-based hydrophobic materials.
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OBJECTIVE: To investigate the protective role of ulinastatin (UTI) on myocardial ischemia-reperfusion (I/R) injury in rats via endoplasmic reticulum stress (ERS)-induced apoptosis pathway. MATERIALS AND METHODS: A total of 60 rats were randomly divided into normal group (n=20), myocardial I/R model group (model group, n=20), and myocardial I/R model+UTI treatment group (treatment group, n=20). The myocardial function indicators [creatinine (Scr) and creatine kinase (CK)] were detected. Enzyme-linked immunosorbent assay (ELISA) was performed to measure serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and matrix metalloproteinase-9 (MMP-9). Meanwhile, the contents of reactive oxygen species (ROS), superoxide dismutase (SOD), and malondialdehyde (MDA) in rat left ventricular tissues were determined by ELISA as well. The cardiac function indexes were determined via magnetic resonance imaging (MRI) and echocardiography (ECG). Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) staining assay was carried out to detect the apoptosis of myocardial tissues. Additionally, the expression levels of endoplasmic reticulum stress and apoptosis genes were measured through quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) assay and Western blotting analysis, respectively. RESULTS: Serum levels of alanine aminotransferase (ALT), CK, and Scr in model group were significantly higher than those in normal group (p<0.05). Besides, rats in model group had significantly lowered SOD, ejection fraction (EF, %), and fractional shortening (FS, %) than those in normal group (p<0.05). In addition, remarkably increased contents of TNF-α, IL-6, MMP-9, MDA, and ROS, as well as higher left ventricular end-diastolic diameter (LVEDd) and left ventricular end-systolic diameter (LVESd) were observed in model group in comparison with normal group (p<0.05). TUNEL staining results revealed that there were more apoptotic cells in model group than that in the other two groups (p<0.05). Expression levels of cysteine aspartic acid-specific protease 12 (Caspase-12) and glucose-regulated protein 78 (GRP78) were evidently higher in model group than those in normal group (p<0.05), while the expression level of B-cell lymphoma 2 (Bcl-2) was clearly lower in model group than that in normal group (p<0.05). UTI treatment partially reversed the above expression changes (p<0.05). CONCLUSIONS: UTI has a protective effect against myocardial I/R injury in rats by repressing the occurrence of ERS-induced apoptosis.
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Apoptosis/efectos de los fármacos , Glicoproteínas/farmacología , Daño por Reperfusión Miocárdica/tratamiento farmacológico , Animales , Modelos Animales de Enfermedad , Estrés del Retículo Endoplásmico/efectos de los fármacos , Glicoproteínas/administración & dosificación , Inyecciones Intraperitoneales , Masculino , Daño por Reperfusión Miocárdica/metabolismo , Daño por Reperfusión Miocárdica/patología , Miocardio/metabolismo , Ratas , Ratas Sprague-DawleyRESUMEN
This study aimed to compare the outcomes of three surgical techniques for the treatment of patients with benign parotid tumours: superficial parotidectomy (SP; group 1), partial superficial parotidectomy (PSP; group 2), and ultrasonic scalpel-assisted minimal extracapsular dissection (US-MECD; group 3). Groups 1 and 2 received the conventional surgical technique, while group 3 underwent surgery with an ultrasonic scalpel. A total of 281 patients treated during 2012-2016 were included: 98 in group 1, 91 in group 2, and 92 in group 3. The mean surgical time and blood loss during surgery, as well as drainage time and amount, were significantly lower for US-MECD (P<0.01). The great auricular nerve and parotid fascia were both preserved with US-MECD (P<0.01), while the rate of capsule rupture with US-MECD was slightly higher than in the other groups (P>0.05). There was less transient facial nerve paralysis and Frey syndrome with US-MECD (P<0.01). No significant difference in wound infection, sialocele, or permanent facial nerve paralysis was observed among the three groups. Patients enrolled during 2012-2013 were selected to evaluate the recurrence rates, and no statistically significant differences were found among the groups. In conclusion, US-MECD showed similar effectiveness and fewer side effects than SP and PSP. The long-term effects of the new technique require further study.
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Procedimientos Quirúrgicos Orales/métodos , Neoplasias de la Parótida/patología , Neoplasias de la Parótida/cirugía , Terapia por Ultrasonido/métodos , Pérdida de Sangre Quirúrgica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Neoplasias de la Parótida/diagnóstico por imagen , Complicaciones Posoperatorias , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The purpose of this study was to evaluate the outcomes of surgery involving the use of folded trapezius flaps to repair large pharyngocutaneous fistulae (PCFs) developing after salvage total laryngectomy. Folded extended vertical lower trapezius island myocutaneous flaps (TIMFs) were created to repair large PCFs that developed after salvage total laryngectomy in eight patients. The maximum fistula dimension was 4.5×3.0cm and the minimum was 2.0×1.8cm. The skin paddle of the extended vertical TIMF ranged from 5cm to 9cm in width and 10cm to 23cm in length. The inner lining ranged from 3cm×3cm to 6cm×6cm in dimension and the outer lining from 6cm×5cm to 16cm×9cm. The folded flaps provided both inner mucosa and outer lining. All flaps survived. No fistula recurrence or stricture developed. After 6-24months of follow-up, six patients showed no evidence of disease, one was alive with disease, and one had died of local recurrence at 20months. The folded flap was very reliable and is well-suited for repairing large PCFs, even early large PCFs and those featuring carotid artery rupture.
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Carcinoma de Células Escamosas/cirugía , Fístula Cutánea/cirugía , Neoplasias Laríngeas/cirugía , Laringectomía , Colgajo Miocutáneo , Enfermedades Faríngeas/etiología , Enfermedades Faríngeas/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Terapia Recuperativa/métodos , Músculos Superficiales de la Espalda/trasplante , Anciano , Fístula Cutánea/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Short chain fatty acids (SCFAs) are the main products of indigestible carbohydrates that are fermented by microbiota in the hindgut. This study was designed to investigate the effects of oral SCFAs administration on the lipid metabolism of weaned pigs. A total of 21 barrows were randomly allocated into three groups, including control group (orally infused with 200 mL physiological saline per day), low dose SCFAs group (orally infused with 200 mL SCFAs containing acetic acid 20.04 mM, propionic acid 7.71 mM and butyric acid 4.89 mM per day), and high dose SCFAs group (orally infused with 200 mL SCFAs containing acetic acid 40.08 mM, propionic acid 15.42 mM and butyric acid 9.78 mM per day). The results showed that the average daily feed intake of SCFAs groups were lower than that of control group (P<0.05). Oral administration of SCFAs decreased the concentrations of triglyceride (TG), total cholesterol (TC), high density lipoprotein-cholesterol and insulin (P<0.05), and increased the leptin concentration in serum (P<0.05). The total fat, as well as TC and TG levels in liver, was decreased by oral SCFAs administration (P<0.05). In addition, SCFAs down-regulated the mRNA expressions of fatty acid synthase (FAS) and sterol regulatory element binding protein 1c (P<0.05), and enhanced the mRNA expression of carnitine palmitoyltransferase-1α (CPT-1α) in liver (P<0.05). SCFAs also decreased FAS, acetyl-CoA carboxylase (ACC) and peroxisome proliferator activated receptor σ mRNA expressions in longissimus dorsi (P<0.05). And in abdominal fat, SCFAs reduced FAS and ACC mRNA expressions (P<0.05), and increased CPT-1α mRNA expression (P<0.05). These results suggested that oral administration of SCFAs could attenuate fat deposition in weaned pigs via reducing lipogenesis and enhancing lipolysis of different tissues.
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Ácido Acético/administración & dosificación , Tejido Adiposo/efectos de los fármacos , Ácido Butírico/administración & dosificación , Regulación de la Expresión Génica/efectos de los fármacos , Lipogénesis/efectos de los fármacos , Lipólisis/efectos de los fármacos , Propionatos/administración & dosificación , Acetil-CoA Carboxilasa/genética , Acetil-CoA Carboxilasa/metabolismo , Tejido Adiposo/metabolismo , Alimentación Animal , Animales , Carnitina O-Palmitoiltransferasa/genética , Carnitina O-Palmitoiltransferasa/metabolismo , Castración , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Acido Graso Sintasa Tipo I/genética , Acido Graso Sintasa Tipo I/metabolismo , Insulina/sangre , Leptina/sangre , Lipogénesis/genética , Lipólisis/genética , Masculino , PPAR delta/genética , PPAR delta/metabolismo , Proteína 1 de Unión a los Elementos Reguladores de Esteroles/genética , Proteína 1 de Unión a los Elementos Reguladores de Esteroles/metabolismo , Porcinos , Triglicéridos/sangre , Destete , Receptor fas/genética , Receptor fas/metabolismoRESUMEN
This study was performed to evaluate the outcomes of combined bilobed trapezius myocutaneous and scapula osteomyocutaneous flaps for the restoration of through-and-through defects of the mandible. The subjects were six patients with recurrent malignant tumours who underwent salvage surgeries and reconstruction with combined flaps based on the transverse cervical vessels (TCVs). All patients had combined bone (four type H, one type LCL, and one type C) and extensive soft tissue defects (through-and-through defects) following salvage surgery. All tumours were removed and the complex defects restored successfully. Two patients experienced minor complications: one minor intraoral flap failure and one case of wound dehiscence at the donor site. The appearance of the face and neck was satisfactory or acceptable in all patients. No patient showed severely limited range of motion of the upper limb. The patients were followed up for 10 to 18months. One patient was living with no evidence of disease. The use of combined bilobed trapezius myocutaneous and scapula osteomyocutaneous flaps based on the TCVs may be an effective approach for the restoration of through-and-through defects of the mandible and may provide satisfactory or acceptable functional and aesthetic outcomes following salvage surgery for advanced head and neck tumours.
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Colgajos Tisulares Libres , Neoplasias de Cabeza y Cuello/cirugía , Neoplasias Mandibulares/cirugía , Reconstrucción Mandibular/métodos , Colgajo Miocutáneo , Terapia Recuperativa/métodos , Escápula/trasplante , Músculos Superficiales de la Espalda/trasplante , Quimioterapia Adyuvante , Femenino , Peroné/trasplante , Humanos , Masculino , Persona de Mediana Edad , Disección del Cuello , Recurrencia Local de Neoplasia , Complicaciones Posoperatorias , Radioterapia Adyuvante , Resultado del TratamientoRESUMEN
Weaning is characterized by intestinal inflammation, which is a big challenge in pig industry. Control of intestinal inflammation is important for improvement of growth performance and health. Therefore, the study was focused on the anti-inflammatory activity of low-molecular-weight chitosan oligosaccharide (LCOS) in a porcine small intestinal epithelial cell line (IPEC-J2). The results showed that TNF-α, as inflammation inducer, significantly upregulated the mRNA expression of IL-8 and MCP-1. Afterwards, LCOS significantly attenuated mRNA expression of IL-8 and MCP-1 induced by TNF-α in the cells. Mannose (MAN), as ligand of mannose receptor, had no effect on the anti-inflammatory activity of LCOS, which suggested that mannose receptor may not involve in the anti-inflammatory activity of LCOS in IPEC-J2 cells. Interestingly, N-[2-(p-bromocinnamylamino)ethyl]-5-isoquinolinesulfonamide 2HCl hydrate (H89), as PKA (protein kinase A)-specific inhibitor, reversed the mRNA expression of IL-8 when co-cultured with LCOS. Furthermore, LCOS concentration dependent downregulated the mRNA expression of claudin-1 compared with TNF-α treatment. However, the trans-epithelial electric resistance (TEER) was not affected by LCOS when co-cultured with TNF-α in 3 hr. In conclusion, LCOS have a potent anti-inflammatory activity, and as a feed additives, may be useful for the inhibition of inflammatory process in weaning period of pigs with intestinal inflammation occurring.
Asunto(s)
Quitosano/farmacología , Proteínas Quinasas Dependientes de AMP Cíclico/metabolismo , Células Epiteliales/efectos de los fármacos , Inflamación/tratamiento farmacológico , Mucosa Intestinal/citología , Animales , Antiinflamatorios/farmacología , Línea Celular , Supervivencia Celular , Citocinas/genética , Citocinas/metabolismo , Regulación de la Expresión Génica/efectos de los fármacos , Inflamación/inducido químicamente , Lipopolisacáridos/toxicidad , ARN Mensajero/genética , ARN Mensajero/metabolismo , Transducción de Señal/fisiología , PorcinosRESUMEN
MicroRNAs (miRNAs) are a class of small non-coding RNAs that negatively regulate gene expression of target messenger RNAs (mRNAs) and miRNAs have been proven to play vital roles in skeletal muscle development. The miRNA-499-5p has been reported to be negatively related with the expression of Sox6, a critical transcription factor for the maintenance of fast-twitch skeletal muscle. In this study, we amplified a length of 2012-bp mRNA that contains a 1512-bp porcine Sox6 (pSox6) 3'UTR from skeletal muscle of a Duroc×Landrace×Yorkshire pig. By luciferase reporter assay we verified that pSox6 is a target of miR-499-5p. In extensor digitorum longus and Soleus muscles of pigs, the expression levels of miR-499-5p and pSox6 mRNA were also inversely correlated. Besides, overexpression of miR-499-5p in porcine satellite cells promoted the expression of MyHC I and MyHC IIa mRNA, along with a reduction of pSox6 mRNA. Taken together, these results indicate that miR-499-5p may facilitate the oxidative myofibers formation by downregulating pSox6 expression.
Asunto(s)
Regulación de la Expresión Génica , MicroARNs/genética , Factores de Transcripción SOXD/genética , Porcinos/genética , Animales , Células Cultivadas , Regulación hacia Abajo , Femenino , Genes Reporteros , Células HEK293 , Humanos , Masculino , Desarrollo de Músculos/genética , Músculo Esquelético/crecimiento & desarrollo , ARN Mensajero/genética , Células Satélite del Músculo Esquelético , Porcinos/crecimiento & desarrolloRESUMEN
Mitochondria plays an important role in the regulation of energy homeostasis. Moreover, mitochondrial biogenesis accompanies skeletal myogenesis, and we previously reported that maternal high-energy diet repressed skeletal myogenesis in pig fetuses. Therefore, the aim of this study was to evaluate the effects of moderately increased maternal energy intake on skeletal muscle mitochondrial biogenesis and function of the pig fetuses. Primiparous purebred Large White sows were allocated to a normal energy intake group (NE) as recommended by the National Research Council (NRC) and a high energy intake group (HE, 110% of NRC recommendations). On day 90 of gestation, fetal umbilical vein blood and longissimus (LM) muscle were collected. Results showed that the weight gain of sows fed HE diet was higher than NE sows on day 90 of gestation (P<0.05). Maternal HE diet increased fetal umbilical vein serum triglyceride and insulin concentrations (P<0.05), and tended to increase the homeostasis model assessment index (P=0.08). Furthermore, HE fetuses exhibited increased malondialdehyde concentration (P<0.05), and decreased activities of antioxidative enzymes (P<0.05) and intracellular NAD+ level (P<0.05) in LM muscle. These alterations in metabolic traits of HE fetuses were accompanied by reduced mitochondrial DNA amount (P<0.05) and down-regulated messenger RNA expression levels of genes responsible for mitochondrial biogenesis and function (P<0.05). Our results suggest that moderately increased energy supply during gestation decreases mitochondrial biogenesis, function and antioxidative capacity in skeletal muscle of pig fetuses.
Asunto(s)
Alimentación Animal/análisis , Dieta/veterinaria , Ingestión de Energía , Desarrollo de Músculos/efectos de los fármacos , Porcinos/crecimiento & desarrollo , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Femenino , Insulina/metabolismo , Fenómenos Fisiologicos Nutricionales Maternos , Músculo Esquelético/metabolismo , Biogénesis de Organelos , ARN Mensajero/metabolismo , Porcinos/metabolismo , Aumento de PesoRESUMEN
This study was conducted to investigate the effects of benzoic acid (BA) on growth performance, intestinal development and intestinal barrier function in weaned pigs. Ninety weaned pigs were randomly assigned to one of three treatments: a basal diet (CON), the basal diet supplemented with 2000 mg/kg benzoic acid (BA1) and 5000 mg/kg benzoic acid (BA2). At the end of days 14 and 42, six pigs per treatment were randomly selected to collect plasma and intestinal samples. Results showed that BA supplementation not only improved final body weight, daily growth and feed conversion ratio from days 15 to 42 and days 1 to 42, but also decreased the activity of plasma diamine oxidase (day 42) and the pH values of jejunal contents (day 14) (p < 0.05). Ileal Bacillus populations (day 14) were increased by BA, while Escherichia coli counts in the ileum and caecum (day 42) were decreased (p < 0.05). Higher Lactobacillus counts occurred in the ileum (day 14, 42) of BA1-fed piglets as compared to CON and BA2-fed piglets (p < 0.05). In addition, BA supplementation increased the ratio of villus height to crypt depth (day 14, 42) and decreased the crypt depth (day 14) (p < 0.05). Growth-stimulating factors (insulin-like growth factor-1, day 42; insulin-like growth factor-1 receptor, day 14, 42) and tight junction protein (occludin, day 14, 42; zonula occludens-1, day 42)-related gene mRNA levels were upregulated in the jejunum of piglets fed BA diets (p < 0.05). In conclusion, this study provides the first evidence that BA has beneficial effects on intestinal development and intestinal barrier function of weaned pigs, which can partly explain why growth performance of pigs was improved by dietary BA supplementation.