[Inhibitory Effects of Sphingosine-1-phosphate Receptor-2 on Vascular Permeability in Mice].

OBJECTIVES: To determine the effect of sphingosine-1-phosphate receptor 2 (S1PR2) on vascular permeability in mice. METHODS: Acute lung injury models of mice were constructed with intra-tracheal administration of lipopolysaccharide (LPS) and compared with the controls with intra-tracheal administration of saline. The effect of S1PR2 on vascular permeability was observed by detecting leakage of Evans blue into lung tissues, pulmonary vascular leakage of fluorescein isothiocyanate (FITC)-dextran, and the wet/dry mass ratio of lungs. The effect of vascular endothelial growth factor (VEGF) on vascular endothelial permeability was detected by Miles analysis. RESULTS: LPS injections induced significant Evans blue leakage, FITC-dextran pulmonary vascular leakage and pulmonary edema, which appeared to be more serious in S1PR2-deleted mice compared with those in wild-type mice. LPS enhanced Evans blue leakage associated with VEGF in a dose-dependent way in both S1PR2-deleted mice and wild type mice. But the vascular permeability response in subcutaneous tissues induced by VEGF was higher in S1PR2-deleted mice than that in wild-type mice. CONCLUSIONS: S1PR2 is involved in endothelial cell barrier protections, which inhibits vascular permeability.

Thalidomide Reduces Activation of Murine Pancreatic Stellate Cells by Inhibiting the TGF-ß/Smad Pathway.

OBJECTIVE: The aim of this study was to investigate the effects and mechanism of thalidomide on pancreatic stellate cell (PSC) activation in mice and to find the optimal timing of thalidomide administration. METHODS: PSCs, isolated from mouse pancreas tissue, were divided into five groups with specific treatments: (A) control PSCs (PSC), (B) PSCs induced by TGF-ß1 (PSC+TGF-ß1), (C) PSCs induced by TGF-ß1 followed by thalidomide (PSC+TGF-ß1+Thalidomide), (D) PSCs receiving TGF-ß1 and thalidomide simultaneously (PSC+(TGF-ß1+Thalidomide)), and (E) PSCs treated with thalidomide only (PSC+Thalidomide). We measured the effects of thalidomide on PSC activation by detecting the expression of α-SMA, collagen type I, and the TGF-ß/Smad pathway through quantitative real-time PCR and Western blot analysis. RESULTS: Compared with TGF-ß1 alone, thalidomide significantly inhibited PSC activation by reducing α-SMA expression (P<0.05) and decreasing collagen type I deposition (P<0.05). PSCs treated with thalidomide alone showed lower expression of α-SMA and collagen type I than those treated with thalidomide and TGF-ß1 at random order (P<0.01). Thalidomide downregulated TGF-ß1 and Smad3 and upregulated Smad7 (P<0.05). CONCLUSION: Thalidomide could repress PSC activation and alleviate fibrosis by regulating the TGF-ß/Smad pathway. Preventive use of thalidomide had maximum effect, and there was no evidence for the reversal of the activation of quiescent PSCs.

[Severe complications in the treatment of chronic rhinosinusitis and nasal polyps with endoscopic sinus surgery].

OBJECTIVE: To investigate the classification, incidence and influential factors of severe complications occurred in endoscopic sinus surgery (ESS) and how to deal with them. METHODS: One thousand and one hundred two patients with chronic sinusitis and nasal polyps treated by ESS were analyzed. RESULTS: Twenty-one patients had severe complications. The types of complication included intraorbital hematoma (n=3), medial rectus injury (n=2), blindness (n=1), intracranial, hematoma (n=1), cerebrospinal rhinorrhea (n=3), nasolacrimal duct injury (n=3), nasal septum perforation (n=2), hemorrhage (n=2), thrombosis in legs (n=2) and asthma (n=2). The total incidence of severe complications was 1.91% (21/1102), most of which were complications in orbit (0.54%) and cranium (0.36%). The extent of the lesion, the surgical history of the patients, the technique and experience of the surgeons were the most important influential factors to severe complications. CONCLUSIONS: Although there are many influential factors to severe complications in ESS, subjective factors are the more important, especial, the technique and the experience of the surgeon.

[Resection of tumors involving the cranio-naso-orbital area via fronto-orbito-ethmoidal approach].

OBJECTIVE: To introduce a better surgical approach for the resection of tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area. METHODS: A "T" form incision was made in the fronto-orbito-ethmoidal region and along the nasal pyramid down. Parts of ethmoid sinus, lamina papyracea, fronto-orbito bone and behind wall of frontal sinus were resected in order to expose the tumors in the anterior skull base and the fronto-orbito-ethmoidal region. Then, the tumor was resected partly under the operation microscope, protecting the neighbouring important structures, for instance: optic nerve, internal carotid artery, sella, meninx, etc. The nasal pyramid was repaired and fixed to the frontal bone with titanium board and titanium nail in order to resume the appearance of a good face. RESULTS: Thirteen patients received tumour resection through this approach. The patients were followed-up for 24 months, 11 patients showed no tumour recurrence, no severe complication, such as cerebrospinal rhinorrhea, meningoencephlocele, etc, in this series. The facial appearance was good. CONCLUSIONS: The approach via the fronto-orbito-ethmoidal region is a good surgical procedure to resect the tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area.