Tessier 3型面裂鼻眼畸形矫正3例报道

目的介绍为3例Tessier 3型面裂鼻眼畸形患者行整复术的经验。方法1例患者经Z成形术和鼻内眦固定术矫正，1例患者经鼻唇沟皮瓣和Z成形术矫正，1例患者经联合应用鼻唇沟皮瓣、额鼻皮瓣和睑颊颧部旋转皮瓣矫正。结果3例患者均获得较满意的矫正效果，无并发症发生。结论只要病例选择适当，应用局部皮瓣矫正不完全型Tessier 3型面裂鼻眼畸形可获得较满意的效果。     

双旗形皮瓣矫正双侧唇裂术后前唇部过短过宽畸形

目的 探索双侧唇裂术后前唇部过短、过宽畸形矫正的手术方法.方法 设计上唇双旗形皮瓣,切除四边形原手术瘢痕皮肤(皮瓣的旗杆部分),切开掀起经鼻孔底部向鼻翼沟伸沿的旗形皮瓣(旗面部分).牵引唇珠,钝性分离人中上端,形成宽4～6 mm创面,将两侧旗形皮瓣,向中央旋转、推进,间断缝合,形成新的鼻底、前唇部.唇珠、唇红部畸形,采用V-Y或Z成形术矫正.结果 2008年1月至2012年12月于临床应用10例,患者术后前唇部增高4 ～6 mm,从根本上矫正了双侧唇裂术后前唇部过短、过宽引发的上唇畸形;同时矫正了唇珠区凹陷或缺损、人中过宽、人中嵴瘢痕和红唇连续性差等畸形,随访3个月至3年,效果满意.结论 上唇鼻底部双旗形皮瓣,操作简单、效果良好,是一种矫正双侧唇裂术后前唇部过短、过宽畸形的方法.     

耳郭复合组织移植修复Tessier Ⅲ型面裂鼻畸形

我科自1990年以来，对6例TessierⅢ型面裂采用耳郭复合组织移植修复双侧鼻翼畸形，效果均较满意。     

整形

整形外科围手术期应用抗生素的探讨；33例颅面裂Tessier分类诊断与治疗体会；吻合血管的逆行游离耳前皮瓣移植修复鼻部分缺损；延长成骨术修复颅骨缺损的实验研究；TessierNo．0面裂分叉鼻畸形矫正术     

Z成形术加游离植皮法矫治隐耳畸形

目的：探讨Z成形术加游离植皮法矫正隐耳畸形的疗效。方法：对我科2008年至2010年16例（24耳）隐耳畸形患者应用耳廓Z成形术加植皮法进行治疗。结果：本组患者16例（24耳）,其中双侧8例,术后随访3个月～1年,被矫治的隐耳均获得了满意而稳定的外形。结论：本手术方法简单、术后耳廓形态自然,是矫正隐耳畸形较理想手术方法。     

双侧唇裂术后上唇短小畸形的矫正

双侧唇裂尤其是前唇短小型双侧唇裂术后,常伴有鼻、唇部多种继发性畸形。由于前唇组织量异常紧缺,从而使畸形的整复困难重重。为了解决这一难题,探索一种较为理想的手术方法。采用双侧鼻唇沟岛状皮瓣旋转下移以及上唇多个皮瓣转移,对双侧唇裂术后畸形进行一次性手术整复。１９９３年以来,临床应用５例,经随访,均获得满意效果。该术式应用鼻唇沟岛状皮瓣转移,并充分利用一切可以利用的组织,有效地解决前唇组织量紧缺问题,从而使其诸多畸形一次性得到确切的整复成为可能     

双侧唇裂术后继发唇鼻畸形的治疗

目的:评价和探讨双侧唇裂术后继发唇鼻畸形的整复矫治方法。方法:将23例患者按唇畸形、鼻畸形的不同,分别采用三种不同的术式治疗。对上唇及鼻畸形较轻者,采用上唇瘢痕切除,口轮匝肌重建,V-Y成形、Z成形术或双侧肌蒂红唇肌粘膜瓣向中间推进矫正红唇口哨畸形;对唇鼻畸形较严重但上唇组织较多者,采用鼻底叉形瓣延长鼻小柱进行矫治;对唇鼻畸形严重并有上唇过紧者,采用前唇组织瓣延长鼻小柱,下唇带蒂组织瓣(Abbé瓣)旋转修复上唇正中缺损。结果:23例患者中,17例效果满意,5例患者有明显改进,1例不满意。结论:本文介绍的三种术式适用于不同类型双侧唇裂术后唇鼻畸形的患者。     

鼻唇沟皮瓣的分类及其在鼻部创面修复中的应用

目的 探讨鼻唇沟皮瓣的分类及其在鼻部皮肤缺损创面修复的方法.方法 根据鼻亚单位组成的美学原则,按鼻部皮肤软组织肿瘤切除后创面及创伤后皮肤缺损的部位、大小、深度及鼻唇沟区域组织可利用情况等,分别选择相应形式的鼻唇沟任意皮瓣转移修复鼻部缺损创面0.8 cm×0.8 cm～2.0 cm×3.0 cm,切取鼻唇沟皮瓣1.0 cm×1.0 cm～2.5 cm×3.5 cm.采用皮下蒂岛状鼻唇沟皮瓣者58例、改良菱形皮瓣者46例、"风筝"皮瓣者43例、易位皮瓣者9例、旋转皮瓣者11例,设计蒂在上方的鼻唇沟皮瓣109例,设计蒂在下方的鼻唇沟皮瓣58例,所有切取的皮瓣与创面大小匹配良好.结果 本组167例患者,其中165例创面Ⅰ期愈合;2例患者皮瓣远端部分表皮坏死.经局部换药后创面愈合.术后113例患者获随访1～60个月,鼻外形轮廓及视觉效果良好,修复组织与周围皮肤组织在色泽、质地、轮廓、光化性损害程度等方面相匹配,鼻唇沟区切口瘢痕不明显,获得满意的面部形态和美学效果.肿瘤无复发.结论 遵循鼻业单位美学原则,应用鼻唇沟任意皮瓣修复鼻部肿瘤切除及创伤后中等大小创面,不仅操作方便,面部彤态无明显改变,而且修复后创面的皮肤色泽、质地、轮廓等均能与周嗣皮肤达到较好的匹配和协调.町获得满意的功能和稳定的美学效果. 例患者,其中165例创面Ⅰ期愈合;2例患者皮瓣远端部分表皮坏死.经局部换药后创面愈合.术后113例患者获随访1～60个月,鼻外形轮廓及视觉效果良好,修复组织与周围皮肤组织在色泽、质地、轮廓、光化性损害程度等方面相匹配,鼻唇沟区切口瘢痕不明显,获得满意的面部形态和美学效果.肿瘤无复发.结论 遵循鼻业单位美学原则,应用鼻唇沟任意皮瓣修复鼻部肿瘤切除及创伤后中等大小创面,不仅操作方便,面部彤态无明显改变,而且修复后创面的皮肤色泽、质 、轮廓等均能与周围皮肤达到较好的匹配和协调.可获得满意的功能和稳定的美学效果. 例患者,其中165例创面Ⅰ期愈合;2例患者皮瓣远端部分表皮坏死.经局部换药后创面愈合.术后113例患者获随访1～60个月,鼻外形轮廓及视觉效果良好,修复组织与周围皮肤组织在色泽、质地、轮廓、光化性损害程度等方面相匹配,鼻唇沟区切口瘢痕不明显,获得满意的面部形态和美学效果.肿瘤无复发.结论 遵循鼻业单位美学原则,应用鼻唇沟任意皮瓣修复鼻部肿瘤切除及创伤后中等大小创面,不仅操作方     

鼻背部皮瓣旋转推进法在面斜裂鼻畸形修复中的应用

目的：探讨鼻背部皮瓣在面斜裂鼻畸形修复中的应用。方法：应用鼻背部皮瓣旋转向下推进纠正单侧面斜裂鼻畸形。结果：应用鼻背皮瓣旋转推进修复单侧面斜裂鼻畸形,术后鼻畸形基本矫正,无并发症发生。结论：鼻背旋转推进皮瓣安全,易操作,是修复面斜裂鼻畸形的有效方法。     

“V-Y”联合不对等“Z”形皮瓣外眦成形术效果观察

目的探讨"V-Y"联合不对等"Z"形皮瓣在外眦成形术中的应用效果。方法对76例睑裂短小或要求开大睑裂以满足美容需求的患者,均采用"V-Y"推进皮瓣及不对等"Z"形交叉皮瓣行外眦成形术。结果本组76例患者获随访6个月至3年,术后效果较好,无粘连及复发,患者均较满意。结论应用"V-Y"联合不对等"Z"形皮瓣行外眦成形术,术后效果良好,并发症较少,患者满意度较高,值得临床推广应用。     

pcDNA3-hBMP2转染对成纤维细胞 生物学性状的影响

目的 探讨人BMP2基因转染对成纤维细胞NIH3T3生物学性状的影响。方法 构建重组真核表达载体pcDNA3-hBMP2,并在脂质体介导下,将其导入NIH3T3成纤维细胞,通过G418筛选获得阳性克隆,用细胞原位杂交和免疫组织化学方法检测hBMP2基因在NIH3T3成纤维细胞内的表达情况;MTT法和FCM检测pcDNA3-hBMP2转染pcDNA3-hBMP2后成纤维细胞超微结构的改变,碱性磷酸酶的检测观察转染pcDNA3-hBMP2后成纤维细胞向成骨细胞分化情况。结果 转染pcvDNA3-hBMP2后的NIH3T3细胞内有大量hBMP2mRNA的转录及其蛋白的表达;转染pcDNA3-hBMP2对成纤维细胞增殖和细胞周期无影响;转染pcDNA3-hBMP2后的成纤维细胞超微结构可见粗面内质网丰富,囊腔扩张明显其内充满中等电子密度的蛋白分泌物;碱性磷酸酶活性显著上升。结论 pcDNA3-hBMP2转染对成纤维细胞NIH3T3增殖和细胞周期无影响。转染后的成纤维细胞不仅可形成BMP2,而且具有向成骨细胞系分化的特性。     

Choledochal cysts: Part 3 of 3: Management

Much about the etiology, pathophysiology, natural course and optimal treatment of cystic disease of the biliary tree remains under debate. Gastroenterologists, surgeons and radiologists alike still strive to optimize their roles in the management of choledochal cysts. To that end, much has been written about this disease entity, and the purpose of this 3-part review is to organize the available literature and present the various theories currently argued by the experts. In part 3, we discuss the management of choledochal cysts, thus completing our comprehensive review.     

H3K4m3和H3K9m3修饰对胰岛组织特异性基因表达的影响

目的 通过比较不同细胞类型之间胰腺十二指肠同源盒1(Pdx-1)、配对盒基因4(Pax4)、MafA(mast cell function associated antigen)和Nkx6.1等胰岛组织特异性基因其转录起始区的H3K4m3和H3K9m3修饰的差异,探讨H3K4m3和H3K9m3修饰对胰岛组织特异性基因表达的作用.方法 采用染色质免疫共沉淀一实时定量聚合酶链反应(PCR)法检测小鼠胚胎干细胞(mES,1×10~7)、小鼠成纤维细胞株NIH3T3细胞(1×10~7)和小鼠β细胞株NIT-1细胞(1×10~7)三者中的胰岛组织特异性基因、Oct4基因和MLH1基因转录起始区H3K4m3和H3K9m3修饰的状况.同时采用实时定量逆转录(RT)-PCR检测上述3种细胞各基因mRNA表达水平.分析H3K4m3和H3K9m3修饰改变与基因表达之间的关系.结果 NIT-1细胞中Pdx-1、Pax4、MafA、Nkx6.1等胰岛组织特异性基因转录起始区的H3K4m的修饰水平分别为:(4.84±0.05)%、(9.91±1.33)%、(10.64±0.87)%、(0.23±0.03)%,与mES细胞比较明显增高(P<0.05),基因表达;NIH3T3细胞中Pdx-1、Pax4、MafA、Nkx6.1等胰岛组织特异性基因转录起始区的H3K9m3的修饰水平分别为:(0.64±0.21)%、(7.04±1.29)%、(0.39±0.10)%、(2.35±0.81)%,与mES细胞比较明显增高(P<0.05),基因不表达.结论 H3K4m3与H3K9m3修饰能相互协调,共同调控胰岛组织特异性基因的表达.     

Identification of the insulin-regulated interaction of phosphodiesterase 3B with 14-3-3 beta protein

Phosphodiesterase (PDE)-3B, a major PDE isoform in adipocytes, plays a pivotal role in the antilipolytic action of insulin. Insulin-induced phosphorylation and activation of PDE3B is phosphatidylinositol 3-kinase (PI3-K) and Akt dependent, but the precise mechanism of PDE3B activation is not fully understood. We have identified 14-3-3 beta, a critical scaffolding molecule in signal transduction, as a protein that interacts with PDE3B using the yeast two-hybrid system. The interaction between PDE3B and 14-3-3 beta was then confirmed in vitro. The glutathione S-transferase (GST)-tagged 14-3-3 beta interacts with endogenous PDE3B of rat adipocytes, and this interaction is enhanced when adipocytes are treated with insulin. Coimmunoprecipitation experiments reveal that endogenous PDE3B also associates with endogenous 14-3-3 beta in rat adipocytes, and this interaction is enhanced by insulin. Two different PI3-K inhibitors, wortmannin and Ly294002, block this induction, suggesting that PI3-K is required. Synthetic 15 amino acid peptides of rat PDE3B containing phosphorylated Ser-279 or -302 inhibit this interaction, indicating that the insulin-regulated phosphorylation of these serine residues is involved. Because insulin receptor substrate-1 also associates with 14-3-3, the dimeric 14-3-3 beta could function as a scaffolding protein in the activation of PDE3B by insulin.     

Overexpression of EIF3S3 promotes cancer cell growth

BACKGROUND: Amplification and overexpression of EIF3S3 gene has been demonstrated in breast and prostate cancer. Here, our goal was to study the effect of EIF3S3 on cell growth. METHODS: The effect of EIF3S3 on growth of NIH 3T3 murine fibroblasts as well as breast (SK-Br-3 and ZR-75-1) and prostate (PC-3 and LNCaP) cancer cell lines was examined by using transfection with inducible pTet-Off system and siRNAs. RESULTS: NIH 3T3 cells with overexpression of EIF3S3 grew significantly faster than cells transfected with empty vector and survived longer when grown in soft agar. The EIF3S3 overexpression was associated with increased fraction of cells in S-phase and with phosphorylation of retinoblastoma (Rb) protein. siRNA treatment inhibited significantly (P = 0.0022) the growth of all breast and prostate cancer cell lines studied. CONCLUSIONS: The results suggest that EIF3S3 regulates cell growth and viability, and that overexpression of the gene may provide growth advantage to the cancer cells.     

Effects of carboxy-terminal modifications of proteinase 3 (PR3) on the recognition by PR3-ANCA

BACKGROUND: Autoantibodies directed against neutrophil proteinase 3 (PR3-ANCA) from patients with Wegener's granulomatosis and microscopic polyangiitis recognize conformational epitopes of PR3. During maturation of neutrophils, PR3 undergoes amino-terminal and carboxy-terminal processing. In contrast to amino-terminal processing, the effects of carboxy-terminal processing on recognition of PR3 by PR3-ANCA remain unknown. Carboxy-terminally modified or tagged recombinant PR3 (rPR3) molecules may be useful for the refinement of diagnostic assays and for the study of biological processes. METHODS: This study was designed to determine whether 293 cells can be used to express specifically designed carboxy-terminal variants of rPR3, and to evaluate the effects of different carboxy-terminal modifications on the recognition by PR3-ANCA in the capture ELISA. RESULTS: The rPR3-variants secreted into the media supernatants of transfected 293 cells escaped proteolytic processing. Furthermore, in contrast to the effects of amino-terminal pro-peptide deletion on PR3-ANCA binding, carboxy-terminal modifications (deletion and additions) did not significantly affect recognition by PR3-ANCA. CONCLUSIONS: This expression system is ideally suited for the expression of custom-designed carboxy-terminal rPR3 variants, and major conformational effects of carboxy-terminal modifications seem unlikely.     

Expression of p63 and 14-3-3σ in normal and hyperdifferentiated mucosa of the upper aerodigestive tract

Objective: Our goal was to analyze p63 and 14-3-3σ expression in normal and hyperdifferentiated head and neck mucosa. Study Design: Compare the in vivo expression of p63 and 14-3-3σ by immunohistochemistry in normal mucosa and oral lichen planus, a benign mucosal lesion marked by hyperdifferentiation and apoptosis. Results and Conclusion: p63 is underexpressed and 14-3-3σ is overexpressed in lichen planus on immunohistochemical analysis. Significance: The findings support the hypothesis that p63 plays an antidifferentiation role, whereas 14-3-3σ plays a prodifferentiation role in the upper aerodigestive tract epithelium. Lichen planus is a valuable model for the study of p63, 14-3-3σ, and mucosal differentiation. p63 and 14-3-3σ may be molecular markers for oral lichen planus. (Otolaryngol Head Neck Surg 2002;126:598-601.)     

3H-thymidine, 3H-uridine and 3H-leucine uptake in erythroblasts of patients with chronic renal failure

The in vitro incorporation of 3H-thymidine, 3H-uridine and 3H-leucine, reflecting the synthetic capacity for DNA, RNA and protein, respectively, was detected by radioautography in the erythroid precursors of 10 patients with chronic renal failure. The results were compared with the uptake of the isotopes in the erythroid precursors of healthy subjects. The pattern of incorporation for all three isotopes in the patients' cells was similar to that of control cells, but significantly lower. The possible causes of this difference are discussed.