Objective To explore the use of rhomboid skin flap in expanded skin flap transfer. Methods A rhomboid skin flap was designed if the top soft part could not be fully utilized after expanded in a rotation skin flap. The flap pedicels were designed near the incision side. It should be ensured that ra-tio of the length to the width of the composite flap, which was composed of the rhomboid skin flap and the rotation skin flap, was 2.5∶1.0. Results Among these 11 patients with re-designed rhomboid skin flaps in the rotation skin flaps, the ratio of the length to the width reached to 3∶1 in some cases, but 2. 5∶1.0 in most cases. All the skin flaps survived, except one patient with disturbance of blood circulation in a small area and one with mild congestion. Conclusion The expanded soft tissue can be fully and rationally utilized to repair the skin defect in this design. Attention should be paid to the ratio of the length to the width of the composited flap, and it is better to select axial flap as the composite flap for safety. This method is safe, and worthy of recommendation.
Key words:
Rhomboid skin flap; Expanded shin flap; Skin and tissue expansion
Background The purpose of this systematic review and meta-analysis is to investigate the effects of vitamin D3 supplementation on skeletal muscle strength in athletes. Vitamin D3 supplements or vitamin D3 fortified foods always have claims for bringing people health benefits including bone and muscle health. An up-to-date rigorous systematic review and meta-analysis is important to better understand the effect of vitamin D3 supplementation on muscle strength.Methods English written randomized controlled trials (RCTs) that looked at effects of vitamin D3 supplementation on muscle strength in healthy athletes were searched using three databases (PubMed, Embase and Cochrane Library). Serum 25(OH)D above 30 ng/mL is considered to be sufficient in this systematic review and meta-analysis.Results Five RCTs with 163 athletes (vitamin D3 n = 86, placebo n = 77) met inclusion criteria. Fourteen athletes were lost to follow-up and 149 athletes (vitamin D3 n = 80, placebo n = 69) were documented with complete result. Among athletes with baseline serum 25(OH)D values suggesting insufficiency, vitamin D3 daily dosage at 5000 IU for over 4 weeks led to a serum 25(OH)D concentration of 31.7 ng/mL. Athletes with sufficient serum 25(OH)D level at baseline were recruited in only one study, and the participants of which were assigned to either vitamin D3 at a daily dosage of 3570 IU or placebo for 12 weeks, their serum 25(OH)D sufficiency (VD: 37.2 ± 7.6 vs. 45.6 ± 7.6; PL: 38 ± 6.8 vs. 32 ± 8.4) was well maintained above the cut-off boundary. One repetition maximum Bench Press (1-RM BP) was not improved significantly (SMD 0.07, 95% CI: − 0.32 to 0.47, P = 0.72) and there was no significant increase in maximal quadriceps contraction (SMD -2.14, 95% CI: − 4.87 to 0.59, P = 0.12). Furthermore, there was no significant overall effect of vitamin D3 intervention on muscle strength in this meta-analysis (SMD -0.75, 95% CI: − 1.82 to 0.32, P = 0.17).Conclusion Although, serum 25(OH)D concentrations after supplementation reached sufficiency was observed, muscle strength did not significantly improve at this point of current meta-analysis. Additional well-designed RCTs with large number of participants examined for the effect of vitamin D3 supplementation on serum 25(OH)D concentrations, muscle strength in a variety of sports, latitudes and diverse multicultural populations are needed.
Objective
To study the cell morphology and differentiation efficiency when rabbit bone marrow mesenchymal stem cells (BMSCs) were induced osteogenic differentiation as culturing by autologous platelet-rich plasma (PRP) instead of serum, and to explore a new method of inducing BMSCs osteogenic differentiation.
Methods
The PRP was prepared by arterial blood of rabbit. Punctured and The bone marrow was sampled from rabbit＇s iliac bone, and BMSCs were collected, which divided into PRP group, fetal calf serum (FBS) group and serum-free control group, and cultured in 10% autologous PRP, 10% FBS and serum-free respectively, combined with DMEM-F12 medium. The second generation cells were divided into experimental and control groups. The experimental groups＇ medium was added dexamethasone, β-sodium glycerophosphate and ascorbic acid, and the control groups went on. The cell morphological difference of each group was Observed between anterior and after inducing differentiation, and compared between each group.
Results
BMSCs of PRP and FBS groups grew quickly, presented like fusiform form before induction, and increasd in volume, became a triangle, polygonal and round form gradually after osteogenic induction. Cells of PRP and FBS groups aggregated spontaneously and multilayered, and formed calcium nodules and bone-like structure after induced 7 days averagely, which could be stained red by alizarin red S; cells of serum-free groups were induced 14 days averagely, only three samples showed osteogenesis performance. Cells of PRP and FBS groups differentiation efficiency was superior to serum-free groups when inducd 20 days, the difference was statistically significant (P 0.05).
Conclusions
Autologous PRP could be used to proliferate and induce osteogenic differentiation of BMSCs instead of serum.
Key words:
Rabbits; Bone marrow; Stromal cells; Stem cells; Platelet-rich plasma; Osteoblasts; Cell Differentiation
Objective
To compare the efficacy of ultrasound-guided lumbar epidural access using paramedian transverse scanning(PMTS) versus paramedian saggital scanning (PMSS) with the needle in-plane.
Methods
Fifty American Society of Anesthesiologists physical statusⅠ-Ⅲ patients, aged 50-75 yr, weighing 55-85 kg, undergoing lower extremity surgery under combined spinal-epidural anesthesia, were divided into PMSS group (n=25) and PMTS group (n=25) using a random number table.The real-time ultrasound-guided lumbar epidural access (L3, 4) was performed using PMTS and PMSS in PMTS and PMSS groups, respectively.The visibility of ligamentum flavum, posterior and anterior dura maters, posterior epidural space on the prepuncture ultrasound images, imaging quality score, time for puncture and depth of puncture were recorded.The development of air ultrasonic contrast sign and backflow of cerebrospinal fluid from the spinal needle were recorded.The development of adverse reactions such as paresthesia and hypokinesia was also recorded on 2 days after operation.
Results
Compared with group PMSS, the time for puncture was significantly shortened, the depth of puncture was shallower (P 0.05). No significant change was found in adverse reactions such as paresthesia or hypokinesia between the two groups (P>0.05).
Conclusion
PMTS provides clear imaging and simple and convenient operation in guiding lumbar epidural access with the needle in-plane when compared with PMSS, and it is worthy of clinical application.
Key words:
Ultrasonography; Epidural space; Subarachnoid space; Punctures
The potential of adult human adipose tissue stem cells (hASCs) to differentiate into hepatocytes has generated much excitement over the possible use of hASCs in therapeutic applications. An understanding of the molecular mechanisms that underlie the plasticity of hASCs toward hepatocytes will help to make this possibility a reality. Herein, we show that a homogenous population of hASCs characterized by a high level of CD73, CD90, and CD105 express the pluripotent transcription factors OCT4, SOX2, NANOG, and SALL4 under proliferation conditions. A high level of activin A allows for hASCs acquiring the fate of definitive endoderm (DE) cells and expressing the specific transcription factors HEX, FOXA2, SOX17, and GATA4 synchronously. Using a reproducible three-stage method by mimicking liver embryogenesis, hASCs were directed to differentiate into functional hepatocytes. In the first stage, hASCs were induced to become DE cells by 2 days cultured in serum-free medium and 3 days of activin A treatment. Next, the presence of fibroblast growth factor (FGF) 4 and bone morphogenetic protein (BMP) 2 in the medium for 5 days induced efficient hepatic differentiation from DE cells. After 10 days of further maturated by the sequential exposure to hepatocyte growth factor (HGF), oncostatin M (OSM), and dexamethasone (DEX), the hASC-derived hepatocytes expressed mature hepatocytes marker and exhibited functional characterization, including albumin secretion, glycogen storage, urea production, activity of drug transporters, and cytochrome P450 activity. These findings will be useful for the implementation of hASC-derived hepatocytes in therapeutic purposes, metabolic analyses, drug toxicity screening, and studies of hepatocyte function.
Vaccination is an effective method to control the spread of classical swine fever virus (CSFV), which is a major cause of economic losses to the swine industry. Although serological detection assays are commonly used to assess immune status, current methods for monitoring of antibodies (Abs) are time-consuming, expensive, and require cell culture and virus manipulation. To address these problems, the E2 protein of CSFV was expressed in transgenic rice seeds as a labeled antigen for the development of an immunochromatographic test strip (ICTS) for rapid, precise, and cost-effective detection of Abs. The ICTS has a reasonable sensitivity of 1:128,000 for detection of serum Abs against CSFV and no cross-reactivity with Abs of other porcine viruses. The similarity of the results between the proposed ICTS and a commercial enzyme-linked immunosorbent assay was 94.1% (128/136) for detection of serum Abs from immunized animals and 92.3% (72/78) for detection of maternally derived Abs. The proposed assay was successfully used to monitor Abs against E2 of both pigs and rabbits immunized with a live attenuated vaccine or an E2 subunit vaccine. The results confirmed that the ICTS can be applied to detect Ab levels in animals with different immunological backgrounds. The ICTS based on plant-derived E2 is a relatively inexpensive, rapid, and accurate assay for detection of Abs against CSFV and avoids the risk of contamination by animal products. IMPORTANCE The E2 protein of classical swine fever virus (CSFV) was expressed in transgenic rice endosperms as a diagnostic antigen for use with a rapid colloidal gold assay for the detection of antibodies (Abs) against CSFV. This improved test was used to monitor Abs against the E2 protein in both pigs and rabbits immunized with a live attenuated vaccine or E2 subunit vaccine. The assay successfully detected Ab levels in serum samples from piglets with different immunological backgrounds. In contrast to current E2 protein-based diagnostic methods using Escherichia coli or insect cells as expression systems, plant-derived E2 avoids the limitations of low immunogenicity of eukaryotic expression systems and potential contamination of fetal bovine serum with bovine viral diarrhea virus in cell culture.
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