Sine oculis homeobox homolog family function in gastrointestinal cancer:Progression and comprehensive analysis

The sine oculis homeobox homolog(SIX)family,a group of transcription factors characterized by a conserved DNA-binding homology domain,plays a critical role in orchestrating embryonic development and organogenesis across various organisms,including humans.Comprising six distinct members,from SIX1 to SIX6,each member contributes uniquely to the development and differentiation of diverse tissues and organs,underscoring the versatility of the SIX family.Dysregulation or mutations in SIX genes have been implicated in a spectrum of developmental disorders,as well as in tumor initiation and progression,highlighting their pivotal role in maintaining normal developmental trajectories and cellular functions.Efforts to target the transcriptional complex of the SIX gene family have emerged as a promising strategy to inhibit tumor development.While the development of inhibitors targeting this gene family is still in its early stages,the significant potential of such interventions holds promise for future therapeutic advances.Therefore,this review aimed to comprehensively explore the advancements in understanding the SIX family within gastrointestinal cancers,focusing on its critical role in normal organ development and its implications in gastrointestinal cancers,including gastric,pancreatic,colorectal cancer,and hepatocellular carcinomas.In conclusion,this review deepened the understanding of the functional roles of the SIX family and explored the potential of utilizing this gene family for the diagnosis,prognosis,and treatment of gastrointestinal cancers.

Comprehensive analysis of the potential role and prognostic value of sine oculis homeobox homolog family in colorectal cancer

BACKGROUND Several genes,important for development,are reduced or silenced in adulthood,and their abnormal expression has been related to the occurrence and development of malignant tumors.Human sine oculis homeobox homolog(SIX)proteins belong to the homeobox family and play important roles in the development of different organs.Importantly,SIXs are predicted to have chromatin-binding and DNA-binding transcription factor activity with reported roles in cancers.However,a comprehensive analysis of SIXs in colorectal cancers(CRCs)has not been performed.AIM To explore the expression pattern of six SIX proteins in CRCs and their relationship with the clinicopathological parameters of CRC patients as well as investigate the potential utilization of SIXs as novel prognostic indicators in CRCs.METHODS The expression level of SIXs in normal tissues of different organs and related cancerous tissues was analyzed in the Human Protein Atlas.Kaplan-Meier Plotter and GEPIA2 were used to analyze the prognostic values of SIXs.To analyze the potential signaling pathways with SIX family involvement,LinkedOmics was used to perform Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses of SIX4-related genes.Subsequently,immunohistochemical experiments were performed on CRC tissues and adjacent normal tissues,and we examined the SIX4 expression level in 87 pairs of patients with tissue microarray.The relationship between SIX4 and clinicopathological parameters in CRC patients was tested using theχ2 test and Fisher’s exact probability to verify the results of the database analysis.RESULTS The RNA levels of SIX1-4 and SIX6 were relatively low in normal human tissues,while SIX5 was highly expressed at both the RNA and protein levels.However,the protein level of SIX4 was found to be elevated in various malignancies.In CRC tissues,SIX1,SIX2 and SIX4 were elevated in cancer tissues compared with adjacent normal tissue.Among all SIXs,a high level of SIX4 was found to be associated with poor overall and disease-free survival in patients with CRC.For different clinicopathological parameters,increased SIX4 expression was positively correlated with advanced CRC.The top 50 SIX4-related genes were involved with oxidative phosphorylation and the respiratory chain signaling pathways.CONCLUSION The current results provided a comprehensive analysis of the expression and prognostic values of SIX family members in CRC.Among different SIXs,SIX4 plays an oncogenic role in CRC to promote the development of malignancy.In CRC,SIX4 mRNA and protein expression is higher than that in normal tissues and associated with shorter CRC patient survival,suggesting that SIX4 may be a potential therapeutic target for treatment of CRC patients.

高度近视眼底形态分期、分型的初步研究

本文观察高度近视(HM)61例122眼,以眼底大体形态结合眼底血管荧光造影,将HM分为视网膜色素上皮正常、视网膜色素上皮萎缩、脉络膜萎缩三期。在第三期内又将弥漫性脉络膜毛细血管萎缩分为A型、斑块状脉络膜全层萎缩分为B型。临床常规检查,Ⅰ到Ⅲ期,患者的年龄、屈光度、眼轴长度、弧盘比值、后巩膜葡萄肿发生率等项均逐渐升高或加重。视觉电生理检查亦有相应改变,且早于眼底改变。

Quantitative features of myoelectric signals in the orbicularis oculi muscle during different motion states

Artificial facial nerve prostheses are thought to restore eye-closed function in peripheral facial paralysis patients.At present,however,there is no adequate quantitative or qualitative information regarding myoelectric signal（MES）features for healthy orbiculads oculi muscle（OOM）.The present study analyzed MES features of normal OOM in rabbits during the natural continuous eye-opening（N1）state,natural continuous eye-closing（N2）state,natural blink（N3）state,and evoked eye-closing（E）state according to time domain and frequency domain analysis.Results showed that OOM electrical activities in N1 and N2 states,as well as myoelectric amplitude,were low and stable.Nevertheless,during N3 and E states,OOM electrical activities were significantly increased and amplitude was much higher in the E state than in the N3 state.In the time domain,differences in MES peak absolute potential were not significant between N1 and N2 states,in the frequency domain,differences in power spectral density peak frequency of electromyogram signals were significant between two sets of four OOM movement states.These results suggest that OOM significantly contracts and induces eyelid-closing action.In addition,OOM is diastolic during the N1state.A N2 state does not require continuous intensive OOM contraction.Moreover,distinctions of quantitative information in time and frequency domain features of MES can be used as an OOM reference to identify muscle movement patterns.

Extensive full-thickness eyelid reconstruction with rotation flaps through "subcutaneous tunnel" and palatal mucosal grafts

· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.

Diagnostic value of orbicularis oculi muscle electromyography in functional epiphora

BACKGROUND Functional epiphora is a clinical condition which is not due to an anatomic defect.Most studies agree that it involves the action of the orbicularis oculi muscle,particularly its deeper segment(Horner’s muscle),but the exact mechanism is not clear.AIM To evaluate the orbicularis oculi muscle in functional epiphora patients using electromyography(EMG).METHODS A total of 8 Chinese patients(16 eyes)with functional epiphora were enrolled in this study,and ten volunteers(10 eyes)were included as normal controls.Five epiphora patients(five eyes)with facial palsy served as positive controls.Quantitative EMG was performed in the deeper segment of orbicularis oculi muscle.The average duration of each EMG waveform was measured.RESULTS The average duration of EMG waveforms in the normal control group,the functional epiphora group,and the facial palsy group were 6.39±0.73 ms,9.39±1.32 ms and 11.2±1.42 ms,respectively.The duration of EMG waveforms was significantly longer in the functional epiphora group than in the normal control group(P<0.05),and shorter than that in the facial palsy group(P<0.05).CONCLUSION These data indicate the presence of neurogenic orbicularis oculi muscle damage in epiphora patients,which may be the cause of functional epiphora.The etiology of neurogenic damage in the orbicularis oculi muscle requires further investigation.

TCM Treatment of Fundus Hemorrhage due to Obstruction of Retinal Vein

Twenty-four cases (25 eyes) of fundus hemorrhage due to obstruction of the retinal vein were treated with traditional Chinese herbal drugs and satisfactory therapeutic results were obtained. A brief report is as follows.……

A Guide to Cheek Augmentation: Single-Point Deep Injection of Hyaluronic Acid Filler at Midface in Close Proximity to Medial Suborbicularis Oculi Fat (SOOF) Area

Loss of volume in midface can result in an aged, wasted appearance. Osseous and fat atrophy with aging may further contribute to the loss of soft tissue support and midface ptosis. In the aging of periorbital area and midface, fat atrophy occurs mostly in the suborbicularis oculi fat (SOOF) area. The authors proposed that injection of hyaluronic acid (HA) filler to support the SOOF area could counteract the aging sign due to fat atrophy, restore volume loss and achieve a more youthful appearance. The authors described the treatment of 10 female patients who received CHAP®-particle hyaluronic acid (CHAP®-HA) injections for cheek augmentation, using single-point deep injection technique at midface in close proximity to SOOF area. Such approach provides satisfactory cheek augmentation results without significant complications. The authors discussed a rationale for their choice of dermal filler and provided an injection technique for restoring volume in the midface region with CHAP®-HA. Such technique is relatively quick to perform, have little down time, and result in a high rate of patient satisfaction.

A practical technique of reverse orbicularis oculi muscle resection with preserved subcutaneous capillary network for double eyelid blepharoplasty

Background: Traditional full-incision double eyelid blepharoplasty has several significant disadvantages, including slow recovery and bilateral asymmetry, which results in high rates of patient dissatisfaction. These problems can be minimized using improved surgical techniques aimed at reducing tissue damage and bleeding, decreasing operation time, and especially at protecting the subcutaneous capillary network during the operation. We therefore aimed to guard the capillary network and reduce intraoperative bleeding using the practical technique of reverse orbicularis oculi muscle resection.Methods: Fifty cases of double eyelid blepharoplasty with traditional full-incision(group A) and 61 cases of reverse double eyelid blepharoplasty with a preserved capillary network(group B) were divided into two groups from October 1 to December 31, 2021 and from March 1 to May 31, 2022, respectively. The orbicularis oculi muscle was removed reversely from the front of the tarsal plate using double eyelid blepharoplasty, and the muscular membrane and subcutaneous capillary network were preserved. The operation time recorded in previous medical records was checked and compared with that of our novel technique. The recovery of double eyelid blepharoplasty was determined at 1, 4, and 12 weeks after the operation and patient satisfaction was also compared with that in previous medical records of patients in group A.Results: The reverse double eyelid blepharoplasty procedure was less complicated and easier to control than the traditional full-incision double eyelid blepharoplasty methodology. The average operation time of the double eyelid blepharoplasty cases with traditional full-incision was significantly greater than that of the cases of reverse double eyelid blepharoplasty with the capillary network preserved(45.68 ± 5.27 min and 31.11 ± 5.58 min,respectively;t=14.018 9, P=0.000 0). Patient satisfaction was 42% and 78.69%, respectively, at 1 week postoperation(χ~2=15.724 8, P=0.000 1), 62% and 90.16% at 4 weeks post-operation(χ~2=12.490 2, P=0.000 4),and 90% and 95.08%, at 12 weeks post-operation(χ~2=1.061 1, P=0.303 0).Conclusion: Reverse double eyelid blepharoplasty with preserved subcutaneous capillary network effectively decreases the operation time and improves post-operative patient satisfaction. It is a double eyelid blepharoplasty method worthy of popularization.

A systematic review of the treatment of lower eyelid retraction and our attempt of a dermal-orbicularis oculi suspension flap

Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retraction into three categories:(1)change in the balance of forces associated with the lower eyelid margin;(2)excessive loss of lower eyelid volume;(3)changes in the relative position of the eyeball and lower lid margin.In this review,the corresponding treatment methods are elaborated on individually for the above three forming factors.We also reported,for the first time,a new treatment for lower eyelid retraction.We created a dermal-orbicularis oculi suspension flap on the lateral side of the canthus and suspended it upward and inward on the dense connective tissue over the lateral bony surface of the orbital rim.The longest follow-up time was one year,and the results were satisfactory.

Recurrence of Lower Eyelid Fat Pads (Herniated Fat) after Blepharoplasty: An Analysis of Different Operative Techniques

Background: Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts [1]. The aim of this study is to find the best approach in preventing fat herniation reccurnce in lower lid blepharoplasty. Methods: The patients in study were classified into three groups depending on the used surgical technique, to test the most effective technique associated with minimal rate of lower fat pad recurrence after surgery. Two of these techniques include a muscular flap suspension from the orbicularis oculae muscle. Results: The two surgical techniques that include orbicularis oculi muscle suspension are associated with no recurrence of lower herniated fat pads after blepharoplasty. Conclusions: The suspension of orbicularis oculi muscle has an important role in enhancing the lower orbital septum and prevents the recurrence of the lower herniated fat pads.