[Clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery]

Objective: To explore the clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery. Methods: A retrospective observational study was conducted. From January 2019 to June 2021, 12 patients with wounds after lower leg limb-sparing surgery who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital, including 6 males and 6 females, aged 17 to 74 years, with original wound area ranging from 17 cm×9 cm to 40 cm×15 cm. Five patients had infection in wounds. The wounds were all repaired by free anterolateral thigh perforator flap from contralateral thigh, with area of 18 cm×10 cm to 37 cm×9 cm. The artery of flap was anastomosed with the descending genicular artery, and the wounds in donor areas were sutured directly. Seven patients were transplanted with split-thickness skin grafts from the contralateral thigh to cover the remaining wounds that can not be covered by flap and the wounds in donor areas were covered with gauze. During the operation, the types of perforating branch carried by flap and the types of arteries and veins in recipient areas were recorded. The survival and occurrence of vascular crisis of flap, the survival of skin graft, the wound healing in donor and recipient areas, and the length of hospital stay after flap transplant surgery were recorded. During follow-up, the color and texture of flap, reinfection in lower leg, and fracture healing were recorded. At the last follow-up, the limb salvage function of patients was evaluated according to the functional evaluation criteria of Chen Zhongwei's amputated limb replantation. Results: The types of perforating branches carried by flaps were as follows: 6 cases of only carrying the descending branch of the lateral circumflex femoral artery, 3 cases of only carrying the oblique branch of the lateral circumflex femoral artery, and 3 cases of carrying the descending branch of the lateral circumflex femoral artery and oblique branch of the lateral circumflex femoral artery after internal pressurization anastomosis. The types of arteries in the recipient area of flap were as follows: one case of main trunk of the descending genicular artery, 8 cases of the saphenous branch of the descending genicular artery, and 3 cases of the articular branch of the descending genicular artery. The types of veins in the recipient area of flap were as follows: 8 cases of one accompanying vein of the descending genicular artery and one branch of the great saphenous vein, and 4 cases of two branches of the great saphenous vein. All the flaps survived without vascular crisis, and all the skin grafts also survived. The wounds in the donor and recipient areas were all healed. The length of hospital stay of patient after flap transplant surgery ranged from 13 to 79 days. During the follow-up of 6 to 23 months, the color and texture of flap were both good, with no infection in lower leg wound. Internal or external fixation were removed after fracture healing in 5 patients, and bone graft internal fixation was performed in 7 patients whose fractures were not healed after surgery and all the incisions healed without infection. At the last follow-up, the limb salvage effect of patients was evaluated as followings: excellent in 7 patients, good in 4 patients, and fair in one patient. Conclusions: Free anterolateral thigh flap pedicled with descending genicular artery can effectively repair the wounds after lower leg limb-sparing surgery and control infection with short length of hospital stay, while not increasing the risk of secondary injury of distal limb vessels. Thus, it can obtain satisfactory limb salvage effect which is worthy of clinical promotion.

[Relationship between auditory hallucination and regional homogeneity of functional magnetic resonance imaging in first-episode childhood and adolescence-onset schizophrenia]

Objective: To investigate the characteristics of regional homogeneity (ReHo) of the resting-state magnetic resonance imaging (fMRI) in first-episode childhood and adolescence-onset schizophrenia (CAOS) and to analyze the relationship between the severity of auditory hallucinations and ReHo. Methods: Seventy-nine cases of first-episode CAOS patients (case group) aged 10 to 16 were collected from October 2017 to December 2019 in the Second Affiliated Hospital of Xinxiang Medical University. There were 28 males and 51 females with a mean age of (14.1±1.3) years. And meantime, 32 healthy children matched with the patients in baseline data were selected as healthy controls (HCs). The patients with CAOS were divided into three groups according to the auditory verbal hallucinations (AVH) assessment of positive symptoms scale (SAPS): non-AVH group (0-1 point), 20 cases; mild-to-moderate AVH group (2-3 points), 36 cases; severe AVH group (4-5 points), 23 cases. The severity of psychiatric symptoms was evaluated using the Positive and Negative Syndrome Scale (PANSS). ReHo analysis was performed on the resting state fMRI scan data of all subjects. Covariance analysis (ages was used as a covariate) was performed between the case group and the HCs, and the three case groups were analyzed to find the different brain areas. Finally, covariance analysis (ages as a covariate) was performed on ReHo values between the case group and the HCs, and among the three groups of patients. Correlation analysis was conducted between the ReHo values in different brain regions and PANSS scores, as well as AVH scores. Results: Compared with the HCs, the decreased ReHo of patients were mainly located in the left superior frontal gyrus, right superior temporal gyrus, left central anterior gyrus, and right central anterior gyrus (all P<0.05). Besides, the ReHo deficits were in the right superior temporal gyrus, left middle frontal gyrus, precuneus lobe, and left central anterior gyrus among the three groups (all P<0.05). Moreover, the severe-AVH group showed decreased ReHo values in precuneus lobe compared with the non-AVH group (P<0.05), and showed decreased ReHo values in left middle frontal gyrus and left central anterior gyrus compared with the mild-to-moderate AVH group (both P<0.05). Furthermore, the ReHo in the right superior temporal gyrus and the left anterior central gyrus were negatively correlated with the AVH score (rs=-0.34, -0.32, P<0.05); and the positive symptom score was negatively correlated with the ReHo in the right superior temporal lobe (r=-0.23, P<0.05). Conclusion: Firstly, decreased ReHo is found in multiple brain regions in CAOS. Secondly, the occurrence of auditory hallucinations may be related to the abnormal activity of local neurons in the resting state. Consequently, Abnormal brain function may be the underlying neural basis for the first-episode CAOS.

Hsa_circ_0011946 promotes the migration and invasion of hepatocellular carcinoma by inducing EMT process

OBJECTIVE

Recently, the vital role of circular RNAs is discovered in many diseases including tumor progression and metastasis. Hepatocellular carcinoma (HCC) is one of the most ordinary malignant tumors. The purpose of our study is to detect the potential function of hsa_circ_0011946 in HCC to offer new biomarkers and targets.

PATIENTS AND METHODS

The level of hsa_circ_0011946 in HCC tissues and cell lines was monitored by Real Time Quantitative Polymerase Chain Reaction (RT-qPCR). Pearson's Chi-square test was used to determine the association between hsa_circ_0011946 expression and several clinicopathological factors. Then, hsa_circ_0011946 was knocked down in HCC cells to uncover its function in metastasis of HCC. Cell migrated and invaded ability was measured through transwell assay, Matrigel assay and wound healing assay. Western blot assay was performed to analyze the effect of hsa_circ_0011946 on the epithelial-to-mesenchymal transition (EMT) process.

RESULTS

In this research, the expression level of hsa_circ_0011946 was significantly increased in HCC tissues compared to that in adjacent samples. The expression of hsa_circ_0011946 was also increased in HCC cell lines. The hsa_circ_0011946 expression was associated with lymphatic metastasis in HCC patients. Knockdown of hsa_circ_0011946 led to the inhibition of cell migration and invasion in HCC. In addition, results of further experiments revealed that the EMT-related proteins were regulated via the knockdown of hsa_circ_0011946 in HCC.

CONCLUSIONS

The hsa_circ_0011946 could enhance cell migration and invasion of HCC by inducing the EMT process.

Role of miR-541-3p/TMPRSS4 in the metastasis and EMT of hepatocellular carcinoma

OBJECTIVE

The aim of this study was to investigate the role of miR-541-3p in hepatocellular carcinoma (HCC), and to explore the possible underlying mechanism.

PATIENTS AND METHODS

80 pairs of cancerous and para-cancerous tissues were collected in this study. Human HCC SMMC-7721 cells and normal liver HL-7702 cells were enrolled as well. Quantitative Polymerase Chain Reaction (qPCR) was performed to detect the expression level of miR-541-3p in tissues and cells. Potential target genes of miR-541-3p were screened and confirmed by online prediction websites and Dual-Luciferase reporter gene assay, respectively. SMMC-7721 cells were used for functional experiments in vitro. Cell proliferation was detected by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay. The invasion and migration of the cells were evaluated by transwell and scratch wound-healing assay, respectively. Furthermore, the epithelial-mesenchymal transition (EMT) associated markers were measured by Western blot assay.

RESULTS

MiR-541-3p was lowly expressed in both HCC tissues and cells. Transmembrane protease serines 4 (TMPRSS4) was defined as a functional target of miR-541-3p. The miR-541-3p/TMPRSS4 axis showed containment in HCC cells, such as proliferation, invasion and migration. These effects might be manifested by altering the expressions of EMT-related molecular proteins, including TGF-β, E-cadherin and N-cadherin.

CONCLUSIONS

Our data indicated that miR-541-3p suppressed the invasion and migration of HCC cells by directly targeting and inhibiting TMPRSS4 protein expression. Furthermore, the newly identified miR-541-3p/TMPRSS4 axis provided new insight into the pathogenesis of HCC. It might also serve as a novel potential therapeutic target for HCC treatment.

[Brain gray matter volume alterations and cognitive function in first-episode childhood-and adolescence-onset schizophrenia]

Objective: To investigate the abnormal changes of gray matter volume and its relationship with cognitive function in first-episode childhood- and adolescence-onset schizophrenia. Methods: A total of 39 (aged 10-16 years) first-episode childhood- and adolescence-onset schizophrenia (patient group) were recruited from the inpatient departments of Second Affiliated Hospital of Xinxiang Medical University between 2014 and 2016, meanwhile, 30 age-, sex- and education years-matched healthy children and adolescents (control group) were also enrolled. All the subjects underwent 3.0 T magnetic resonance imaging (MRI) scan. The volume of gray matter in two groups was compared by voxel based morphometric method (VBM). MATRICS Consensus Cognitive Battery (MCCB) and the Stroop Color and Word Test (SCWT) were employed to evaluate the cognitive function of the two groups, and the relationship between the abnormal gray matter region and the cognitive function in the two group was analyzed. Results: Compared with the control group, brain gray matter volume in the right insula, left inferior frontal gyrus, the left limbic edge were significantly decreased (t=-5.303, -5.302, and -6.211; all P<0.05). Trail making test scores in the patient group were higher than those of the control group (t=3.22, P<0.01). However, scores of symbol coding, HVLT-R, BVMT-R, word fluency, digital span, maze test, word, color and color word were lower than those of the control group (t=-6.41, -5.42, -7.77, -5.59, -8.78, -6.99, -6.98, -6.47 and 4.84, all P<0.01). Pearson correlation analysis showed that the right insula was positively correlated with the BVMT-R and maze test scores, and the left inferior frontal gyrus was positively correlated with the maze scores in the patient group (r=0.32, 0.50 and 0.45, all P<0.05). The left inferior frontal gyrus was positively correlated with the digital span in control group (r=0.46, P<0.05). Conclusion: The first-episode childhood-and adolescence-onset schizophrenia exhibits abnormal changes of gray matter volume and cognitive function, and the pathophysiological mechanisms of a wide range of cognitive impairments may be related to abnormal volume changes of gray matter.

[Fractional amplitude of low-frequency fluctuations in childhood and adolescence-onset schizophrenia: a resting state fMRI study]

Objective: To explore the whole brain activity features of childhood and adolescence-onset schizophrenia using resting state fMRI. Methods: A total of 63 childhood and adolescence-onset schizophrenia patients (patients group), admitted to the second affiliated hospital of Xinxiang Medical University from October 2013 to October 2015 and fulfilled our inclusion criteria, and 39 healthy controls with age, sex and education matched (control group) were enrolled, then a resting-state fMRI scan was conducted for each participant. Fractional amplitude of low-frequency fluctuations (fALFF) approach was used to explore the differences of resting-state brain function between patients and controls. Results: Compared with the healthy control group, patients group showed significantly decreased fALFF in left superior temporal gyrus and parietal lobe (MNI coordinate: x=-42, -57; y=-3, -21; z=-12, 9; voxels: 22, 32; t=-4.792 3, -5.269 7; Alphasim corrected, corrected P<0.05); patients group showed significantly increased fALFF in left frontal lobe and medial frontal gyrus, right superior frontal gyrus, Postcentral Gyrus, caudate, (MNI coordinate: x=-42, -21, 12, 27, 15; y=54, 39, 48, -18, 15; z=0, 21, 33, 30, 9; voxels: 12, 21, 17, 28, 18; t=4.784 8, 4.90 7, 4.861 5, 5.444 1, 4.270 4; Alphasim corrected, corrected P<0.05). When included age as a covariant, the analysis found that the brain region with significant fALFF change was the left thalamus with decreased fALFF (MNI coordinate: x=-6, y=-12, z=24; voxels: 9; t=-4.268 4; Alphasim corrected, corrected P<0.05) in patients group, while for other brain regions, there was no obvious change in the fALFF, compared with healthy group. Conclusion: Compared with control group, the results indicate that there are intrinsic brain activity abnormalities of some brain regions in childhood and adolescence-onset schizophrenia.

Establishment and characterization of a chimeric infectious cDNA clone of classical swine fever virus

Classical swine fever virus (CSFV) causes a highly contagious disease among swine that has an important economic impact worldwide. There are two important CSFV strains in China, Shimen and hog cholera lapinized virus (HCLV). Shimen strain is highly virulent while HCLV, also referred to as C-strain, is a live attenuated vaccine strain considered to be one of the most effective and safest live vaccines. In this study, a chimeric infectious cDNA clone of CSFV named pT7SM-c was engineered by replacing the E(rns) genomic region of an infectious clone of CSFV Shimen strain, pT7SM, with the same region obtained from HCLV. RNA transcripts of pT7SM-c containing an engineered EcoRI site that served as a genetic marker were directly infectious in PK15 cells. The rescued virus vT7SM-c showed similar growth kinetics and cytopathic effect with the parental virus vT7SM in the cells. The chimeric infectious cDNA clone can be used as a practical tool for further studying of the virulence, protein function and pathogenesis of CSFV through genetic manipulation.

p21-activated kinase 4 regulation of endometrial cancer cell migration and invasion involves the ERK1/2 pathway mediated MMP-2 secretion

Endometrial cancer (EC) is one of the most common malignancy of the female genital tract. Patients with metastatic disease have a poor prognosis. So far, however, the underlying molecular mechanisms of EC metastasis are largely unknown. P21-activated kinase 4 (Pak4) is important in cell motility and oncogenesis. Here we investigated a role of Pak4 in EC cell migration and invasion. Pak4 overexpression was observed in multiple human EC cell lines. In clinical samples, expression of total and phosphorylated Pak4 (Pak4 and p-Pak4, respectively) increased significantly with progression of EC from normal tissue to lymph node metastasis; both were positively correlated with depth of myometrial and vascular space invasion, lymph nodes metastasis, and poor histological differentiation. In two human EC cell lines, Pak4 overexpression promoted cell migration and invasion in vitro. Short hairpin RNA (shRNA)-mediated stable knockdown of Pak4 inhibited the metastatic potential of EC in an ERK1/2-MMP-2-dependent manner. These results suggest that Pak4 is an important regulator of EC cell migration and invasion. Therefore, Pak4 may be a promising target for the treatment of metastatic EC.

Improving the corrosion resistance of Mg-4.0Zn-0.2Ca alloy by micro-arc oxidation

In this paper, corrosion resistance of the Mg-4.0Zn-0.2Ca alloy was modified by micro-arc oxidation (MAO) process. The microstructure and phase constituents of MAO layer were characterized by SEM, XRD and X-ray photoelectron spectroscopy (XPS). The corrosion resistance of MAO treated Mg-4.0Zn-0.2Ca alloy in the simulated body fluid were characterized by potentiodynamic polarization and electrochemical impedance spectroscopy (EIS) techniques. The microstructure results indicated that a kind of ceramic film was composed by MgO and MgF2 was formed on the surface of Mg-4.0Zn-0.2Ca alloy after MAO treatment. The electrochemical test reveals that the corrosion resistance of MAO treated samples increase 1 order of magnitude. The mechanical intensity test showed that the MAO treated samples has suitable mechanical properties.

Effects of calcitonin injected into various brain areas on pain threshold and Ca2+ in rats

AIM

To study the effects of calcitonin (Cal) injected into different brain areas on pain threshold.

METHODS

The analgesic effects of Cal were investigated in rats by the tail-flick test.

RESULTS

Cal injected into lateral cerebral ventricle (LCV) or periaqueductal gray (PAG) increased obviously the pain threshold to 49 +/- 22% or to 68 +/- 12% (P < 0.01), respectively. When PAG was blocked with lidocaine, the analgesic effect of Cal injected into LCV was lowered 41 +/- 9%. Cal injected into habenula (Hab) decreased the pain threshold to -30 +/- 5% (P < 0.01).

CONCLUSION

Cal in different rat brain areas induced different effects on pain responses: analgesia or hyperalgesia, and showed that PAG played an important role in the analgesic effect induced by Cal, and the changing of pain threshold was mediated by the Ca2+ in brain.