The aim of this article is to study the effect of tumor necrosis factor alpha (TNF-α) on the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in keratoconus fibroblasts in vitro. Normal cornea and keratoconus fibroblasts were extracted using enzyme digestion method and were cultured in the medium containing TNF-α (0, 10 and 100 ng/mL). The expression of MMPs proteins in the supernatant of corneal fibroblasts and the expression of TIMPs in the normal cornea and keratoconus fibroblasts were detected by Western blot and real-time quantitative polymerase chain reaction respectively. The active form of MMP1 could be detected in the supernatant of keratoconus fibroblasts and upregulated by TNF-α. TNF-α could increase the protein expression of MMP2, MMP3, MMP9 in the supernatant of keratoconus fibroblasts and decrease the gene expression of TIMP1, TIMP2 in keratoconus fibroblasts. The increased MMPs and the decreased TIMPs can increase the degradation of the extracellular matrix. TNF-α may play an important role in the occurrence and development of keratoconus by regulating the expression of MMPs/TIMPs.
ObjectiveTo explore the feasibil ity and rel iabil ity of rib-sparing technique for internal mammary vessels exposure and anastomosis in breast reconstruction and thoracic wall repair with deep inferior epigastric perforator (DIEP) flaps. MethodsBetween November 2009 and September 2011, 11 female patients with post-mastectomy deformities were treated. The mean age was 42 years (range, 33-65 years). Of them, 10 patients underwent breast reconstruction with the DIEP flaps, and 1 patient received defect repair for chronic thoracic wall irradiated ulcer with the DIEP flap. The size of the flap ranged from 18 cm×9 cm to 28 cm×12 cm. Rib-sparing technique was applied in all these cases. The internal mammary vessels were exposed by dissection intercostal space and anastomosed with the deep inferior epigastric vessels. The donor sites were closed directly in all cases. ResultsIn all cases, the rib-sparing technique for internal mammary vessels exposure and anastomosis was successfully performed. The mean time for internal mammary vessels exposure was 52 minutes (range, 38-65 minutes). The mean exposure length of the internal mammary vessels was 1.7 cm (range, 1.3-2.2 cm). All flaps survived completely postoperatively, and wounds and incisions at donor sites healed primarily. All patients were followed up 8-26 months (mean, 12 months). All patients were satisfied with the reconstructive outcomes. No collapse deformity or discomfort of the thoracic wall occurred. ConclusionThe rib-sparing technique for internal mammary vessels exposure and anastomosis is a rel iable and reproducible approach to reconstruct the breast and repair the thoracic wall with DIEP flap, and it can reduce collapse deformity of the thoracic wall.
With silk fibroin and vancomycin (VCM) as carrier and drug model, respectively, we prepared silk fibroin microspheres (SFM) with different concentration using the water-in-oil emulsion solvent diffusion method. We further developed VCM loaded calcium sulfate hemihydrates (CSH)/SFM artificial bone composites. In this study, surface morphology of the materials was observed using scanning electron microscope (SEM). Structure of the materials was studied with Fourier transform infrared spectroscopy (FTIR). Antibacterial activity of the materials was validated with the inhibition zone test. Drug release property of materials was evaluated using ultraviolet/visible spectrophotometry. Mechanical property of the materials was tested using computer-controlled electronic universal testing machine. The results showed that silk fibroin concentration had no significant effect on molecular conformation and antibacterial property of the SFM. The average diameter of SFM increased and the release rate decreased gradually as the silk fibroin concentration increased. The release rate decreased and the compressive fracture work increased as the silk fibroin concentration increased when adding SFM to CSH. This composite had partly corrected the disadvantages of CSH including the high brittleness and initial burst release. The research would have a good application foreground in the clinical treatment of infectious bone defect.