N klA Case Report on a IV-degree Thermal Crush Injury of Right Upper Arm: The Application of Functional Prosthesis Implantation Technology.

Severe IV-degree thermal crush injury of limbs involved the subcutaneous fascia, muscle and bone, which may lead to amputation and has a great impact on the patient's quality of life. We can repair wounds with pedicle flaps or even free flaps, However, there are still huge challenges in bone defect of extremities and functional reconstruction. In recent years, with the development of functional prostheses, we have reconstructed limb functions in many patients helping them to complete their daily lives. We report a case where the right upper arm was injured by thermal crush, leading severe burns to the skin, fascia, muscle and bone. We applied a pedicled latissimus dorsi flap and a free anterolateral thigh flap to repair the wound, and realized the function of limb salvage and movement of the right upper arm by implanting 3D printed scapula, upper arm, and elbow joint prostheses. This case illustrates that IV-degree burns involving bones have new technologies to repair and achieve mobility now.

Integrative Analysis Reveals the Landscape of Hypoxia-Inducible Factor (HIF) Family Genes in Pan-Cancer.

Inside the cancer microenvironment, reduced O2 concentration, termed as hypoxia, is a common phenotype and leads to cancer progression. However, little is known about how and when those HIF members are dysregulated in distinct cancers. Here, by integrating a full range of data of thousands of patients, we comprehensively analyzed the genetics, epigenetics, and transcriptomic level of HIF genes and further defined pathways triggered by disrupted hypoxia-inducible factors. We reveal the expression landscape of HIF family genes and further demonstrate that copy number variations underlie such dysregulation. Further analysis indicates that HIF genes associate with cancer hallmarks such as cell cycle and DNA damage response. Drug resistance analysis showed that HIF globally impacts drug effectiveness such as docetaxel. In summary, the overall analysis reveals the landscape of HIF genes in pan-cancer and may assist mechanism research about hypoxia.

[Yin-yang balance penetrating acupuncture combined with rehabilitation training on upper limb spasticity in stroke hemiplegia].

OBJECTIVE: To compare the therapeutic effect of yin-yang balance penetrating acupuncture combined with rehabilitation training and single rehabilitation training on upper limb spasticity in patients with stroke hemiplegia. METHODS: A total of 60 patients with upper limb spasticity of stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. On the basis of conventional western medication, rehabilitation training was adopted in the control group. On the basis of treatment in the control group, yin-yang balance penetrating acupuncture was applied from Jianyu (LI 15) to Binao (LI 14), Quchi (LI 11) to Shaohai (HT 3), Yanglingquan (GB 34) to Yinlingquan (SP 9), Xuanzhong (GB 39) to Sanyinjiao (SP 6), etc. of the affected side in the observation group. The treatment was given once a day, 5 days were as one course, with a 2-day interval between two courses, 4 courses were required in both groups. The classification of modified Ashworth spasticity scale (MAS), surface integrated electromyogram (iEMG) of affected upper limb and the scores of National Institute of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA) of upper limb and modified Barthel index (MBI) before and after treatment were observed, the therapeutic effect was evaluated in both groups. RESULTS: ①After treatment, the MAS classification reduced in both groups (P<0.05), the cases of grade 0 to Ⅰ+ in the observation group were more than those in the control group (P<0.05); iEMG values of the maximum isometric voluntary contraction of affected usculus biceps brachii, musculus triceps brachii, musculus flexor carpi, musculus extensor carpi, extensor digitorum, aductor pollicis brevis were increased in both groups (P<0.05), and the variations of iEMG of above muscles on the affected side in the observation group were larger than those in the control group (P<0.05). ②After treatment, the scores of NIHSS were decreased (P<0.05), the scores of FMA, MBI were increased in both groups (P<0.05), and the variations of NIHSS, FMA and MBI scores were larger than those in the control group (P<0.05). ③The total effective rate was 93.3% (28/30) in the observation group, which was superior to 70.0% (21/30) in the control group (P<0.05). CONCLUSION: Yin-yang balance penetrating acupuncture combined with rehabilitation training can improve upper limb spasticity, heighten the motor function of upper limb and daily self care in patients with stroke hemiplegia, its therapeutic effect is superior to single rehabilitation training.

Upregulation of HIF-1α protects neuroblastoma cells from hypoxia-induced apoptosis in a RhoA-dependent manner.

Hypoxic conditions regulate several metabolic enzymes and transcription factors that are involved in cancer, ischemia and pulmonary diseases. The Ras homolog (Rho) family, including Rho member A (RhoA), is involved in reorganization of the actin cytoskeleton, cell migration and in the regulation of apoptosis and gene transcription. The aim of the present study was to investigate the expression of hypoxia­inducible factor (HIF)­α and the activity of RhoA in PC12 neuroblastoma cells under hypoxic conditions. The upregulation of HIF­α and RhoA by hypoxia was determined using reverse transcription­quantitative polymerase chain reaction and western blot assays, cell apoptosis was analyzed using flow cytometry, and the activity of caspase 3 was examined using a western blot assay and caspase 3 activity assay kit. The PC12 cells were induced to apoptosis following exposure to hypoxia, and exhibited increased expression of HIF­α and increased mRNA and protein expression levels of RhoA. The overexpression of HIF­α attenuated the hypoxia­induced apoptosis of the PC12 cells. In addition, RhoA knockdown using small interfering RNA abrogated the antagonism of HIF­1α towards hypoxia­induced apoptosis. The results of the present study confirmed the protective role of HIF­1α and RhoA in hypoxia­induced PC12 cell apoptosis, and that the upregulation of HIF­1α by hypoxia is RhoA­dependent.

[Effects of electroacupuncture at Jiaji (EX-B 2) on extracellular matrix MMP-1, MMP-3 and TIMP-1 levels in the degenerated cervical intervertebral disc in rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of Jiaji (EX-B 2) on the contents of extracellular matrix metalloproteinase (MMP)-1, MMP-3 and tissue inhibitor of matrix metalloproteinase (TIMP)-1 in the cervical intervertebral disc (OIVD) tissue in rats with CIVD degeneration so as to explore its mechanism in relieving intervertebral disc degeneration. METHODS: SD rats were randomized into control (n = 15), model (n = 14), EA (n = 13) and medication (n = 14) groups. CIVO model was established according to Wang's and Shi's method. EA (10/20 Hz, 1 - 3 mA) was applied to Jiaji (EX-B 2) for 10 min, once daily for 30 days. The rats of medication group were fed with Fenbid (15 mg/kg/d) and Jingfukang (0.5 g/kg/d) for 30 days. Extracellular matrix MMP-1, MMP-3 and TIMP-1 levels of the intervertebral disc tissue (C4-6) were detected by ELISA. RESULTS: The contents of MMP-1 and MMP-3 in model group were increased significantly compared with control group (P < 0.05), while TIMP-1 in model group was markedly lower than that of control group (P < 0.05). Compared with model group, both MMP-1 and MMP-3 levels in EA group and MMP-1 in medication group were reduced considerably (P < 0.05), while TIMP-1 of EA group increased significantly (P < 0.05). No significant differences were found between medication and model groups in MMP-3 and TIMP-1 levels (P > 0.05). Under optical microscope, the injured degrees of the fibrous ring and nucleus pulposus, and the outline of the intervertebral disc of both EA and medication groups were evidently lighter than those of model group, but the degeneration severity of the intervertebral disc of EA group was lighter than that of medication group. CONCLUSION: EA of Jiaji (EX-B 2) can effectively relieve the degeneration degree of cervical intervertebral disc in the rat, which is probably related to its effect in regulating extracellular matrix system.