Antitumor effects of dioscin in A431 cells via adjusting ATM/p53-mediated cell apoptosis,DNA damage and migration

Skin cancer is the deadliest type of malignant disease and causes primary mortality worldwide. Dioscin, which exists in medicinal plants, has potent anticancer effects. However, its effects on skin cancer remain unknown. In the present study, the activity and mechanism of dioscin on the human skin cancer A431 cell line were investigated, MTT, colony formation, Transwell, wound-healing, TUNEL, Comet, immunofluorescence and western blot assays were used to assess the effects of dioscin on A431 cells. The results of MTT, colony formation, Transwell and wound-healing assays revealed that dioscin suppressed proliferation, colony formation and invasion of the cancer cells. TUNEL and comet assays demonstrated that dioscin exhibited significant effects on cell apoptosis and DNA damage. Investigations into the mechanism revealed that the expression levels of phosphorylated Ataxia telangiectasia-mutated (ATM) were considerably activated by dioscin, which significantly upregulated the expression levels of p53 to activate mitochondrial apoptosis signaling. Furthermore, the expression levels of BAX, cleaved caspase-3/9 and cleaved poly (ADP-ribose) polymerase were upregulated, and the expression levels of BCL-2 were downregulated by dioscin. Additionally, dioscin markedly downregulated the expression levels of matrix metalloproteinase 2 (MMP2), MMP9, RHO and cdc42, which are all associated with tumor invasion. In addition, p53-small interfering RNA transfection experiments indicated that dioscin exhibited excellent activity against skin cancer in vitro by decreasing p53 expression. Overall, the present results suggested that dioscin inhibited skin cancer cell proliferation via adjusting ATM/p53-mediated cell apoptosis, migration and DNA damage, which should be considered as a potential option for future treatments of skin cancer.     

逆行髓内钉辅助在儿童股骨延长中的应用

目的采用髓内钉辅助延长技术进行儿童股骨大段延长,评估其可行性,并对比同期矫正和分期手术的技术要点,明确此技术在儿童患儿中的应用价值。方法自2014年7月7日至2018年1月16日共规划完成逆行髓内钉辅助延长手术10例,其中男9例,女1例;年龄(13.10±2.18)岁。所有患儿延长截骨点均位于股骨远端干骺端,初诊至末次随访记录内容包括:性别、出生日期、不等长病因及治疗史、术时年龄、延长长度、带架时间、延长段愈合时间、屈膝角度、并发症等。比较同期延长和分期矫正的愈合时间,采用SPSS 22.0软件进行统计分析,提出合理的治疗策略。结果10例患儿患肢平均延长(7.07±1.01)cm,中位带架时间为8.5(4,16)个月,中位随访时间为39(34,54)个月。所有病例均获得了良好的临床和影像学愈合,并全部恢复正常行走功能,无延长后骨折发生。同期矫正与分期手术间在愈合速度为[(1.70±1.10)月/cm vs.(1.16±0.54)月/cm],膝关节功能(136.67°±20.82°vs.125.71°±26.37°)和并发症率方面的差异均无统计学意义。结论外固定架辅助逆行髓内钉技术进行股骨延长治疗儿童股骨短缩畸形是可行的,是股骨延长的有效手术方式之一;较轻的角度畸形和延长手术可同期进行;干骺端截骨延长成骨质量更佳,可有效减少带架时间;内生软骨瘤患儿的病变区延长是安全的。     

嗜酸性细胞肺类癌18F-FDG PET/CT异常高摄取一例

患者女,40岁,因"咳嗽10个月余,咳绿色浓痰伴发热5 d"就诊本院。体格检查:神志清,一般情况可。2018年10月26日外院胸部CT平扫及增强(图1)示右肺上叶肺门旁直径约2.2 cm类圆形结节影,边缘光整,无毛刺及卫星灶,密度尚均匀;增强后明显强化,动脉期CT值约107 HU,静脉期CT值约89 HU,考虑为硬化性肺细胞瘤。于外院行抗炎、止咳、化痰等治疗,症状无缓解。     

Identification of key genes and pathways in discoid lupus skin via bioinformatics analysis

Discoid lupus erythematosus (DLE) is the most common skin manifestation of lupus; however, the molecular mechanisms underlying DLE remain unknown. Therefore, we aimed to identify key differentially expressed genes (DEGs) in discoid lupus skin and investigate their potential pathways.To identify candidate genes involved in the occurrence and development of the disease, we downloaded the microarray datasets {"type":"entrez-geo","attrs":{"text":"GSE52471","term_id":"52471"}}GSE52471 and {"type":"entrez-geo","attrs":{"text":"GSE72535","term_id":"72535"}}GSE72535 from the Gene Expression Database (GEO). DEGs between discoid lupus skin and normal controls were selected using the GEO2R tool and Venn diagram software (http://bioinformatics.psb.ugent.be/webtools/Venn/). The Database for Annotation, Visualization, and Integrated Discovery (DAVID), Enrichr, and Cytoscape ClueGo were used to analyze the Kyoto Encyclopedia of Gene and Genome pathways and gene ontology. Protein-protein interactions (PPIs) of these DEGs were further assessed using the Search Tool for the Retrieval Interacting Genes version 10.0.Seventy three DEGs were co-expressed in both datasets. DEGs were predominantly upregulated in receptor signaling pathways of the immune response. In the PPI network, 69 upregulated genes were selected. Furthermore, 4 genes (CXCL10, ISG15, IFIH1, and IRF7) were found to be significantly upregulated in the RIG-I-like receptor signaling pathway, from analysis of Enrichr and Cytoscape ClueGo.The results of this study may provide new insights into the potential molecular mechanisms of DLE. However, further experimentation is required to confirm these findings.     

Using arterial spin labeling blood flow and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma from lymphoid hyperplasia

To investigate the feasibility of arterial spin labeling (ASL) blood flow (BF) and its histogram analysis to distinguish early-stage nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoid hyperplasia (NPLH).Sixty-three stage T1 NPC patients and benign NPLH patients underwent ASL on a 3.0-T magnetic resonance imaging system. BF histogram parameters were derived automatically, including the mean, median, maximum, minimum, kurtosis, skewness, and variance. Absolute values were obtained for skewness and kurtosis (absolute value of skewness [AVS] and absolute value of kurtosis [AVK], respectively). The Mann–Whitney U test, receiver operating characteristic curve, and multiple logistic regression models were used for statistical analysis.The mean, maximum, and variance of ASL BF values were significantly higher in early-stage NPC than in NPLH (all P < 0.0001), while the median and AVK values of early-stage NPC were also significantly higher than those of NPLH (all P < 0.001). No significant difference was found between the minimum and AVS values in early-stage NPC compared with NPLH (P = 0.125 and P = 0.084, respectively). The area under the curve (AUC) of the maximum was significantly higher than those of the mean and median (P < 0.05). The AUC of variance was significantly higher than those of the other parameters (all P < 0.05). Multivariate analysis showed that variance was the only independent predictor of outcome (P < 0.05).ASL BF and its histogram analysis could distinguish early-stage NPC from NPLH, and the variance value was a unique independent predictor.     

Metastasis of oral squamous cell carcinoma to the parotid lymph nodes

Parotid lymph node (PLN) metastasis greatly worsens the prognosis of patients with oral squamous cell carcinoma (OSCC) and poses a great challenge for further treatment of OSCC. The clinicopathological characteristics and treatment strategies for PLN metastasis from OSCC need to be comprehensively elucidated. A retrospective review of OSCC patients who experienced postoperative PLN metastasis in our department between 2000 and 2018 was performed in this study. A total of 47 OSCC patients with postoperative PLN metastasis were identified. PLN with metastasis were divided into three groups based on the location: parotid tail (PLN-t), superficial lobe (PLN-sl), and deep lobe (PLN-dl). Most of the patients experienced PLN metastasis within less than 12 months after the primary surgery for OSCC. Comparatively, patients with PLN-sl metastasis were more prone to have infiltration of the facial nerve. The tongue and buccal mucosa were the most frequent primary sites associated with PLN metastasis from OSCC. PLNs in the parotid tail were most commonly affected by the metastasized OSCC. Consequently, we recommend a series of strategies for the prevention and treatment of PLN metastasis for OSCC patients. In conclusion, PLNs should not be overlooked during preoperative evaluation and postoperative follow-up examinations for OSCC patients.     

Thinned-out skin paddle versus collagen matrix as an optimized peri-implant soft tissue following fibula osteoseptocutaneous free flap: 3-year retrospective study

The objective of this study was to compare the implant longevity following two methods of peri-implant soft tissue optimization following free fibula flap (FFF): thinning of skin paddle (SP) and collagen matrix (CM). All patients who underwent rehabilitation with dental implants after mandibular reconstruction with FFF between June 2009 to May 2014 were retrospectively reviewed. Two methods of peri-implant soft tissue optimization were applied: (1) SP group, (2) CM group. Outcome measurements were: modified plaque index (mPI), modified sulcus bleeding index (mSBI), probing depth (PD), marginal bone loss (MBL), implant success rate and complication rates. A total of 24 patients with 69 implants were included in the study, with 8.7% (n = 6) of implants lost in 3 years. No statistically significant difference was found regarding the outcome measurements in both groups. Failed implants presented with statistically significant higher mPI, mSBI, PD and MBL scores during prosthesis delivery and subsequent follow-ups (P<0.03). In the SP group, one patient experienced SP necrosis which later underwent soft tissue optimization using CM. CM is an alternative peri-implant soft tissue, while thinning of SP is feasible if thickness is well controlled.     

A novel extraoral registration method for a dynamic navigation system guiding zygomatic implant placement in patients with maxillectomy defects

Zygomatic implants (ZIs) are used for the oral rehabilitation of patients with maxillectomy defects as an alternative to extensive bone grafting surgeries. New technologies such as computer-assisted navigation systems can improve the accuracy and safety of ZI placement. The intraoral anchorage of fiducial markers necessary for navigation registration is not possible in the case of a severe maxillary defect and lack of residual bone. This technical note presents a novel extraoral registration method for a dynamic navigation system guiding ZI placement in patients with maxillectomy defects. Titanium microscrews were inserted in the mastoid process, supraorbital ridge, and posterior zygomatic arch as registration markers. The mean fiducial registration error (FRE) was 0.53 ± 0.20 and the deviations between the planned and placed ZIs were 1.56 ± 0.54 mm (entry point), 1.87 ± 0.63 mm (exit point), and 2.52 ± 0.84° (angulation). The study results indicate that the placement of fiducial markers at extraoral sites can be used as a registration technique to overcome anatomical limitations in patients after maxillectomy, with a clinically acceptable registration accuracy.