Conjunctival flap with auricular cartilage grafting: a modified Hughes procedure for large full thickness upper and lower eyelid defect reconstruction.

AIM: To investigate the suitability of a modified Hughes procedure, which consists of conjunctival flap with auricular cartilage grafting in reconstructing large full thickness upper and lower eyelid defect. METHODS: Patients with full thickness eyelid carcinoma involving more than 50% margin length who underwent surgical resection were retrospectively reviewed in the study. The defects were reconstructed using conjunctival flap with auricular cartilage grafting, covered with myocutaneous flap above. Followed-up time ranged from 12 to 24mo. Outcomes were classified as "good", "fair", and "poor" by evaluating the margin appearance, eyelid appearance, and complications. RESULTS: A total of 42 patients were enrolled in the study (26 males, 16 females, mean age, 68.6±7.7y, range: 53 to 82y). The mean defect widths measured 23.2±2.9 mm (range, 17 to 28 mm). The mean posterior lamellar defect height was 5.5±1.3 mm (4 to 8 mm). Thirty-seven patients had a "good" outcome (88.1%), 5 patients had a "fair" outcome (11.9%), and no one had a "poor" outcome. CONCLUSION: Conjunctival flap with auricular cartilage grafting and myocutaneous flap grafting is an effective procedure in reconstructing large full thickness upper and lower eyelid defect. It can not only achieve satisfied reconstruction, but also preserve intact tarsal plate of the opposite eyelid, avoiding retraction or entropion.

Auricular cartilage versus donor sclera as a wrapping of hydroxyapatite orbital implants.

AIM: To retrospectively compare postoperative outcomes after primary enucleation and placement of a hydroxyapatite (HA) implant without wrapping, wrapped with auricular cartilage or donor sclera. METHODS: Medical records of patients presented as intraocular tumor or severe ocular injury were identified from the electronic medical record system. Cases underwent enucleation and HA orbital implantation were enrolled in this study and were divided into 3 groups according to the wrapping material of HA implant. Cases with autogenous cartilage caps were enrolled in group A (n=11), with donor sclera caps in group B (n=12), and without any wrapping material in group C (n=9). Follow-ups were set at 1, 2wk, 1, 3, 6, and 12mo after surgery. RESULTS: Altogether 32 cases finished the follow-up and were enrolled in this study. Three cases (27.27%) in group A, 4 cases (33.33%) in group B, and 4 cases (44.44%) in group C developed one complication each after surgery. In group A, no HA exposure occurred, but conjunctival inclusion cyst occurred in one and severe conjunctive chemosis in two cases. In group B, one HA exposure occurred, conjunctive inclusion cysts occurred in one, severe conjunctive chemosis occurred in one, and conjunctival granuloma occurred in one case. In group C, one HA exposure occurred, severe conjunctive chemosis occurred in two cases, and conjunctival granuloma occurred in one case. The case of exposure of none-wrapped implant was noted in the first 6mo after placement of the orbital implant. The case of exposure of donor sclera-wrapped implant was noted at the 12mo after placement of the orbital implant. Both exposure cases were treated successfully with conservative treatment. CONCLUSION: With low incidence of implant exposure and mild complications, auricular cartilage can be a good choice of alternative wrapping material of orbit implant with satisfied outcome.

[Network Meta-analysis of 3 kinds of Chinese medicine injections in treatment of acute exacerbations of chronic obstructive pulmonary disease].

To evaluate the efficacy and safety of traditional Chinese medicine injections( CMI) in the treatment of acute exacerbation of chronic obstructive pulmonary disease( AECOPD). PubMed,Cochrane Library,CNKI,CBM,Wan Fang and VIP database( since the date of database establishment to July 2018) were retrieved through computer for controlled randomized trials( CRTs) of 3 kinds of traditional Chinese medicine injections( Chuankezhi Injection,Tanreqing Injection,Xuebijing Injection) for AECOPD. After the methodological quality of included researches were evaluated,and the valid data were extracted,statistical analysis was performed with Stata 14,RevMan 5.3 is used for risk bias map. There were including 4 RCTs and 20 quasi-RCTs,which involving 579 patients.The results of network Meta-analysis showed that: ①there were significant differences in the forced expiratory volume in the first second between the 3 CMI and control groups,and there was no significant difference between CMI; ②3 kinds of CMI adjuvant therapy AECOPD,According to the forced expiratory volume in the first second of the probability ranking results,Tanreqing Injection is more effective,followed by Xuebijing Injection and Chuankezhi Injection. Based on the present evidence,3 kinds of CMI can improve the forced expiratory volume in the first second on the basis of Western medicine routine treatment of AECOPD,having better safty. In addition,the conclusion of this study still needs a large number of RCTs with reasonable design and proper method to confirm it.

[Adsorption and Desorption Characteristics of Endosulfan in Purple Soil].

In order to reveal the residual process of endosulfan in purple soil and protect soil ecological environment, the adsorption and desorption characteristics of endosulfan in purple soil were investigated, and effects of temperature, adsorbent amount, and initial pH of adsorption solution on the adsorption capacity were also examined by static adsorption and desorption experiments. The results showed that the adsorption kinetic process could be well described by the second-order kinetic equation with the initial rate constants of α-, ß-endosulfan as 0. 157 and 0. 115 mg.(g.min)-1, respectively. The adsorption thermodynamic process could be well described by the Langmuir isotherm with the maximum adsorption capacities of α-, ß-endosulfan as 0. 257 mg . g -1 and 0. 155 mg . g -1, respectively. The adsorption process of endosulfan in purple soil may be an exothermic physicochemical process, and is dominated by physical adsorption. Under the experimental conditions examined in this study, the initial pH of adsorption solution had a relative great influence on the adsorption capacity, whereas the temperature and adsorbent amount had no significant influence. The desorption experiments found that the maximum desorption capacities of α-, ß-endosulfan adsorbed in purple soil were 0. 029 mg . g -1 and 0. 017 mg . g -1 at 6 and 4 h, and accounted for 10. 5% and 16. 1% in the maximum adsorption capacities, respectively.

MicroRNA-195 protects against dementia induced by chronic brain hypoperfusion via its anti-amyloidogenic effect in rats.

Previous studies have demonstrated that chronic brain hypoperfusion (CBH) causes Aß aggregation by upregulating expression of amyloid precursor protein (APP) and ß-site APP cleaving enzyme 1 (BACE1) protein, which is accompanied by cognitive impairment, but the mechanisms are not fully understood. In this study, we evaluated the effect of microRNA on memory impairment in rats induced by CBH. We show here that CBH generated by bilateral common carotid artery occlusion (2VO) significantly decreased the learning and memory ability in rats, as assessed by Morris water maze, and upregulated expression of APP and BACE1 proteins in the hippocampus and cortex of rats, as evaluated by Western blot and immunofluorescence. In reciprocal, qRT-PCR analysis showed that microRNA-195 (miR-195) was downregulated in both the hippocampus and cortex of rats following CBH, and in the plasma of dementia patients. APP and BACE1 proteins were downregulated by miR-195 overexpression, upregulated by miR-195 inhibition, and unchanged by binding-site mutation or miR-masks, indicating that APP and BACE1 are two potential targets for miR-195. Knockdown of endogenous miR-195 by lentiviral vector-mediated overexpression of its antisense molecule (lenti-pre-AMO-miR-195) elicited dementia in rats, whereas overexpression of miR-195 using lenti-pre-miR-195 reduced dementia vulnerability triggered by 2VO. Additionally, chromatin immunoprecipitation analysis showed that NFκB was bound to the promoter region of miR-195 and inhibited its expression. We conclude that miR-195 may play a key role in determining dementia susceptibility in 2VO rats by regulating APP and BACE1 expression at the post-transcriptional level, and exogenous complement of miR-195 may be a potentially valuable anti-dementia approach.

Increased mean platelet volume is associated with arterial stiffness.

The brachial-ankle pulse wave velocity (baPWV) is a useful index of arterial stiffness. Mean platelet volume (MPV), an indicator of platelet activation, is associated with hypertension, stroke, and coronary artery disease, all of which may be caused by arteriosclerosis. However, little research has been conducted to investigate the relationship between MPV and arterial stiffness. In this cross-sectional study, we investigated the relationship between platelet count, MPV, and baPWV in 2645 apparently healthy Chinese participants (1676 men, 969 women) in a general health examination. Different metabolic parameters were compared across MPV quintiles (Q1: ≤8.1 fl, Q2: 8.2-8.5 fl, Q3: 8.6-9.6 fl, Q4: 9.7-10.7 fl, and Q5: ≥10.8 fl). Age-adjusted mean values of baPWV gradually increased with MPV quintiles (Q1 = 1124, Q2 = 1134, Q3 = 1199, Q4 = 1207, and Q5 = 1270 cm/s). Univariate analysis showed that age, sex, smoking status, body mass index (BMI), systolic blood pressure (SBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), total platelet count, and MPV were significantly associated with baPWV. In addition, age, sex, BMI, MPV, SBP, and FPG were significant factors in the multivariate model with baPWV. Notably, MPV was found to be a significant determinant for baPWV (ß = 0.198; P < 0.001). The findings show that elevated MPV is positively correlated to arterial stiffness.

[Effect of peroxisome proliferation activated receptor-gamma on neuronal cell death induced by hypoxia and ischemia in rats in vitro and in vivo].

OBJECTIVE: To observe the effects of peroxisome proliferation activated receptor (PPAR)-gamma on neuronal cell death induced by hypoxia/reoxygenation and ischemia/reperfusion. METHODS: Cortical neural cells of fetal SD rats were cultured for 12 days and exposed to hypoxia/reoxygenation so as to establish a hypoxia/reoxygenation model. Another primary fetal rat cortical neuronal cells were pre-treated with different concentrations of GW9662, antagonist of PPAR-gamma, then underwent hypoxia for 3 hours, re-oxygenated for 21 hours. MTT was added one hour after to measure the cell viability. Eleven male SD rats underwent right middle cerebral artery occlusion (MCAO) using suture and reperfusion. Eleven rats underwent sham operation. after the rats were killed and their brains were taken out. Nucleoprotein was extracted from the cultured primary cortical cells and the cerebral cortexes of the rats and co-cultured with [gamma-(32)P]-labeled PPAR-gamma probe, EMSA to detect the PPAR-gamma binding activity. RESULTS: The PPAR-gamma activity of the cultured fetal rat cortical neurons that underwent hypoxia/reoxygenation significantly increased: It began to increase 1 hour after hypoxia and peaked in the 3rd hour of hypoxia, when the neurons underwent hypoxia for 3 hours and were reoxygenated for 2 hours, the binding activity still remained at a high level, and basically returned to the level of the untreated group 8 hours after reoxygenation. Data were quantified with control group as 100, 3 h of hypoxia was 160.3, and 2, 4, 8 h after reoxygenation were 157.5, 136.6, 103.3 separately. One hour after reperfusion the PPAR-gamma binding activity of the cortical cells at the ischemic side of the rats began to increase and peaked at the 4th hour, significantly higher than those of the cortical cells at the opposite side and of the sham operation group (both P < 0.01) then remained at a high level for the following 24 hours. The survival rate of the cultured neurons that underwent hypoxia for 3 hours and reoxygenation for 21 hours was significantly lower than that of the untreated neurons. Data were quantified with sham surgery group as 100, the side of MCAO and the contra side in surgery group were 144.8 and 102.6 separately. The survival rate of the neurons that were pretreated with GW9662 and then underwent hypoxia/reoxygenation was significantly higher than that of those without pretreatment (P < 0.01) with the peak protection effect of GW9662 at the concentration of 2.5 - 10 micromol/L. Data were quantified with control group as 100, hypoxia/reoxygenation group was 184, GW9662 group was 105. The PPAR-gamma binding activity of the primary cortical neurons pretreated with 5 micromol/L GW9662 for 30 minutes and than exposed to hypoxia for 3 hours and reoxygenation for 2 hours was significantly lower than that of the only hypoxia/reoxygenation group (P < 0.01). CONCLUSION: PPAR-gamma is involved in the pathogenesis of neuron death induced by hypoxia/ischemia and may become a new target of treatment of ischemic stroke.