Objective To investigate the expressions of CXCR4 and β-catenin in pancreatic cancer, explore the relationship between them, and explore the possible biomarkers about invasion and metastasis of pancreatic cancer. Methods Forty-eight samples of pancreatic cancer and 20 samples of normal pancreas tissues were selected. The expressions of CXCR4 and β-catenin were examined by the immunohistological technique. Spearman, Chi-square， and rank test were used to analyze the relation between the protein expressions and clinical characteristics. Survival analysis was evaluated by Kaplan-Meier product limit method and Log-rank test. Variables were evaluated by Cox proportional hazards analysis. The size of test was 0.05. Results The positive expression rates of CXCR4 and β-catenin in pancreatic cancer tissues were 85.4% (41/48) and 75.0% (36/48), respectively. Co-expression rate of CXCR4 and β-catenin was 70.8% (34/48). There were significant differences between various CXCR4 staining and lymph node metastasis and TNM stage (P=0.012, 0.005, respectively). β-catenin positive expression was associated with lymph node metastasis (P=0.047). However, abnormal β-catenin positive expression could not determine the clinical survival. Kaplan-Meier estimated curves suggested that clinical prognosis was poor for patients with CXCR4 expression. Multivariate analysis showed that CXCR4, late TNM stage, and lymph node metastasis were independent prognostic factors for pancreatic cancer. Conclusions Both CXCR4 and β-catenin abnormally express in pancreatic cancer. CXCR4 may be an important marker for pancreatic cancer progression.
OBJECTIVE: To explore the mechanism of microvascular spasm after limb ischemia-reperfusion. METHODS: The rabbit hindlimb normothermic tourniquet ischemia model was employed. The tendon on the dorsum of the foot was exposed for observation of microvessels. The responses of arterioles on tendon surface to topical application of 10(-6) mol/L noradrenaline (NE) (a vasoconstrictor), 10(-6) mol/l acetylcholine(Ach) (an endothelium-dependent vasodilator) and 10(-4) mol/L nitroglycerin(NTG) (an endothelium-independent vasodilator) were observed at the period of ischemia and following 30 minutes of reperfusion after 2 hours and 5 hours of ischemia by use of intravital microscopy. RESULTS: No significant changes in the responses of arterioles to NE, Ach and NTG were noted following 30 minutes of reperfusion after 2 hours of ischemia compared with pre-ischemia. The constrictor responses of arterioles to NE were still not significantly altered following 30 minutes of reperfusion after 5 hours of ischemia, however, the dilation responses to Ach and NTG were significantly decreased (to Ach P lt; 0.01; to NTG, P lt; 0.05). CONCLUSION: Reperfusion after 5 hours of ischemia significantly impairs both the endothelium-dependent and endothelium-independent vasodilation, meanwhile preserves constrictor responses to NE, these may contribute to the genesis of the vasospasm in ischemia reperfusion.
To introduce the experience and comprehend of appl ication of many kinds of skin flaps in repair of heel skin and soft tissue defect. Methods From August 1993 to April 2007, 242 cases of skin and soft tissue defect on heel were treated. There were 157 males and 85 females aged 27-76 years. There were 35 cases of unstable scar, 46 cases ofchronic ulcer, 57 cases of squamous cell carcinoma, 72 cases of mal ignant melanoma and 32 cases of injury. The defect area ranged from 2 cm × 2 cm to 8 cm × 14 cm, wound was with low-grade infection in 51 cases. The course of disease was 1 hour to 5 years. The lateral calcaneal flaps (34 cases), the dorsum pedis flaps (15 cases), the medial plantar artery island flaps (108 cases), the sural neurovascular flaps (36 cases), the saphenous neurocutaneous vascular flaps (26 cases) and free (myocutaneous) skin flaps (23 cases) were used to repair heel wounded surface according to specific location of heel wounded surface, range of skin and soft tissue defect. The size of the (myocutaneous) skin flap was 3.0 cm × 2.5 cm to 15.0 cm × 9.0 cm. The donor area was directly sutured or covered with skin grafts. Results In 242 cases, 235 cases achieved heal ing by first intention, 5 cases had partial necrosis of flaps, 2 cases had mild infection. The donor area healed by first intention. A total of 217 patients were followed up for 1 month to 60 months. The color of flaps were normal and the texture of flaps were softer than that of normal heel tissue; the flaps were wearable, the shape of flaps were satisfactory. The patients can walk after 6 months of operation, andthe gait was normal. In 118 cancer patients, no local tumor recurrence occurred, and distant metastatic lesions were observe in 22 mal ignant melanoma patients. In 32 cases of mal ignant melanoma followed up 60 months, no distant metastatic lesions were found. Conclusion In base of following the primary disease treatment, heel function reconstruction and contour structural feature remodel ing, we adopted some kind of island or free (myocutaneous) skin flap can be used to repair heel wound. The ideal effect in heel function reconstruction and contour structural feature remodel ing were obtained.
Objective To investigate the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) in reducing the occurrence of these complications through a clinical randomized controlled trial. Methods We included 72 coronary heart disease patients in our hospital from December 2013 through March 2014. There were 48 males and 24 females aged 38.4±18.6 years undergoing coronary artery bypass graft(CABG) surgery, and great saphenous veins were chosen as grafts. Patients were equally randomized into a trial group and a control group. The patients in the trial group underwent 5 d of b-NPWT for thigh incision and interrupted suture for shank incision after the harvesting of great saphenous veins. Patients in the control group received an interrupted suture for both thigh incision and shank incision after the harvesting of great saphenous veins. We evaluated the function of b-NPWT by reducing the complications arising from the harvesting of great saphenous veins in CABG patients. Results The incidences of early complications, such as lymphedema, incision infection, non-union, and skin flap necrosis of the vascular zone in the trial group were significantly lower than those of the control group. There was no death or new problem in heart or deep venous thrombosis in both groups. No complication occurred in long term. The incidence of lower limb edema was lower in the trial group than that in the control group at the end of 3 months follow-up. Conclusion B-NPWT can effectively prevent lymphorrhagia in CABG patients who underwent the harvesting of great saphenous veins. It can also reduce the incidence of complications and discomfort of the patients.
Objective To observe and explore the effects of adipose-derived stem cells (ADSCs)-hyaluronic acid (HA) composite on heal ing of wound combined with radiation injury. Methods The ADSCs were harvested from the fat tissue in groin of 10 inbred Sprague Dawley (SD) rats and were isolated and cultured by enzyme digestion. The ADSCs-HA composite wasprepared with ADSCs (5 × 106 cells/mL) at passage 6 and HA (10 mg/mL). Thirty inbred SD rats, 15 males and 15 females, were randomly divided into groups A (n=10), B (n=10), and C (n=10). A 2 cm × 2 cm full-thickness skin defect was made on the rat back before 20 Gy 60Co radiation exposure. One week after debridement, wounds were treated by petrolatum gauze in group A as the control group, by HA (0.4 mL) and petrolatum gauze in group B, and by ADSCs-HA composite (0.4 mL) and petrolatum gauze in group C. The microvessel density (MVD) and the distribution of CD90 positive cells were observed at 1st, 2nd, 3rd, and 4th weeks. Results The wound heal ing was slower, and wound did not heal at 4th week and still filled with granulation tissue in group A; the wound heal ing of group B was faster than that of group A, and the wound did not heal completely with depression in the center at 4th week; the wound healed completely with epidermil izated surface and no obvious depression at 4th week in group C. The histological observation showed that MVD was significantly higher in group C than in groups A and B at the 1st, 2nd, and 3rd weeks (P lt; 0.05), and in group B than in group A at the 3rd week (P lt; 0.05); MVD was significantly higher in groups B and C than in group A (P lt; 0.05), but no significant difference was found between groups B and C (P gt; 0.05) at 4th week. No CD90 positive cell was found in groups A and B; CD 90 positive cells were observed in group C and gradually decreased with time. Conclusion ADSCs-HA composite can accelerate heal ing of wound combined with radiation injury by promoting and controll ing wound angiogenesis.
Objective To investigate the surgical techniques and effectiveness for reconstruction of severe full-thickness chest wall defects. Methods Between January 2006 and December 2010, 14 patients with full-thickness chest wall defects were treated, including 12 cases caused by giant chest wall mal ignant tumor excision, 1 case by thermocompression injury, and 1 case by radiation necrosis. There were 8 males and 6 females with an average age of 42 years (range，23-65 years). The size of chest wall defects ranged from 8 cm × 5 cm to 26 cm × 14 cm. All patients compl icated by rib defect (1-5 ribs), and 3 cases by sternum defect. Thoracic skeleton reconstruction was performed with Vicryl mesh or polytetrafluroethylene mesh in 10 patients. Other 4 patients did not undergo thoracic skeleton reconstruction. The bilobed skin flaps, pectoral is major myocutaneous flap, latissimus dorsi myocutaneous flap, and rectus abdominis myocutaneous flap were util ized for repairing soft tissue defects. The size of the dissected flaps ranged from 10 cm × 7 cm to 25 cm × 13 cm. The donor sites were sutured directly or were repaired by free skin graft. Results Poor heal ing of incision occurred in 2 cases, which was cured after debridement, myocutaneous flap transfer, and skin graft. The other wounds healed by first intention. All patients were followed up 6-36 months (mean, 8 months). No tumor recurrence during follow-up, except 1 patient with osteosarcoma who died of l iver matastasis at 6 months after operation. Transient sl ight paradoxical respiration occurred in 1 patient who did not undergo thoracic skeleton reconstruction at 5 days after operation. Integrity of chest wall in other patients was restored without paradoxical respiration and dyspnea. Conclusion Depending on the cause, the size, and the location of defect, single or combination flaps could be used to repair soft tissue defect, and thoracic skeleton reconstruction should be performed when defect is severe by means of syntheticmaterials.