[Effects of the anterolateral thigh chimeric perforator flaps in repairing complex wounds of foot and ankle].

Objective: To investigate the effects of anterolateral thigh chimeric perforator flap in repairing complex wounds of foot and ankle. Methods: A retrospective observational study was conducted. From May 2018 to June 2022, 23 patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University to repair complex wounds of foot and ankle with anterolateral thigh chimeric perforator flaps, including 15 males and 8 females, aged from 20 to 66 years. The wounds were all accompanied by bone exposure and defects, and were complicated with varying degrees of infection. All patients underwent debridement and continuous vacuum sealing drainage treatment for 1 week in stage Ⅰ, with the skin and soft tissue defect area after debridement being 10 cm×5 cm to 22 cm×7 cm. In stage Ⅱ, the anterolateral thigh chimeric perforator flap was used to cover the defective wound, of which the muscle flap was used to fill the deep invalid cavity of the ankle joint or cover bone and internal fixation exposures, and the skin flap was used to cover the superficial wound, with the area of the skin flap ranging from 11 cm×6 cm to 23 cm×8 cm, and the area of the muscle flap ranging from 4.0 cm×2.5 cm to 8.0 cm×5.0 cm. The survival of the flap was observed after operation. During follow-up, the color, texture, appearance, and complications of the flap were observed, the function of ankle joint and its range of dorsiflexion motion and plantar flexion motion were measured, and the scar hyperplasia and muscular hernia in donor area were observed. Results: Ecchymosis and epidermal necrosis occurred at the tip of the flap in 1 patient on 5 days after operation and healed after dressing change for 1 week; the other flaps of patients survived successfully. After 6 to 40 months of follow-up, the color, texture, and shape of flaps were good, but 1 patient was not satisfied with the shape of the flap because of flap swelling; the ankle joint movement was basically normal, the dorsiflexion motion was 15-30°, and the plantar flexion motion was 20-45°; the scar hyperplasia in the donor area of the flap was not obvious, and no muscular hernia occurred. Conclusions: The anterolateral thigh chimeric perforator flap can effectively fill the deep invalid cavity of ankle joint and cover the superficial wound at the same time, with minimal damage to the donor site. So it is an ideal flap for repairing the complex wounds of foot and ankle.

In Vitro and In Vivo Efficacy of DNA Damage Repair Inhibitor Veliparib in Combination with Artesunate against Echinococcus granulosus.

Cystic echinococcosis (CE), caused by the cestode Echinococcus granulosus, is a worldwide chronic zoonosis. Albendazole (ABZ) and mebendazole are effective against CE, but a high dosage in a long-term period is usually required. In this study, we evaluate the effects of DNA damage repair inhibitor (i.e., Veliparib) in combination with artesunate (AS) on hydatid cysts. For the in vitro assay, protoscoleces of E. granulosus (E.g PSCs) were incubated with low AS (AS-L, 65 µM), moderate AS (AS-M, 130 µM), and high AS (AS-H, 325 µM), AS-L/M/H+Veliparib (10 µM), and ABZ (25 µM), respectively. The AS-H+Veliparib group showed the maximal protoscolicidal effects. Ultrastructural change revealed that germinal layer (GL) cells were reduced, and lipid droplets appeared. AS could induce DNA injuries in PSCs. The 8-OHdG was expressed in the PSCs and GL of the cysts in mice, especially in the presence of Veliparib. The most severe DNA damages were observed in the AS-H+Veliparib group. Meanwhile, the expression of ribosomal protein S9 (RPS9) gene in the AS-H+Veliparib group was significantly lower than that in the AS-H group. The in vivo chemotherapeutic effects of AS-L (50 mg/kg), AS-H (200 mg/kg), and AS-H+Veliparib (25 mg/kg) were assessed in experimentally infected mice. Upon 6 weeks of oral administration, ultrasonography was used to monitor the volume change of vesicles. Maximum potentiation was seen on day 15 with values (versus AS) of 34 (P < 0.05) for AS-H + Veliparib. It led to the reduction of cyst weight (55.40%) compared with the model group (P < 0.01), which was better than AS alone (52.84%) and ABZ-treated mice (55.35%). Analysis of cysts collected from AS-H+Veliparib-treated mice by transmission electron microscopy revealed a drug-induced structural destruction. The structural integrity of the germinal layer was lost, and the majority of the microtriches disappeared. In conclusion, our study demonstrates that AS or AS in combination with Veliparib is effective for treating CE, especially the combination group. On this basis, AS represented promising drug candidates in anti-CE chemotherapy.

[A follow-up study of six years' outcome of children with asthma in urban area of Beijing].

Objective: To understand the outcome of asthma in children from urban area of Beijing and the factors associated with the outcome. Methods: A total of 497 children with asthma diagnosed in the epidemiological survey of childhood asthma in urban area of Beijing in 2010 were selected in this study. Telephone follow-up was conducted in 2016 to obtain information about asthma attack, emergency visit, hospitalization, medication and disease control, and data of comorbidities of allergic diseases from 1 year earlier. Enumeration data were compared using chi-square test, measurement data were compared by rank sum test. The multi-factor logistic regression analysis was employed for the relationship between the related factors and asthma, Kaplan-Meier survival analysis and COX regression was employed to understand the relationship between the related factors and the course of the disease. Results: Questionnaires were conducted in 366 children, of whom 66.7% (244/366) were male, and 33.3% (122/366) were female.Compared with 2010, the rate of asthma attack and emergency room visits in children in last 12 months were significantly lower (19.1%(70/366) vs. 57.1%(284/497), and 3.0% (11/366) vs.19.7% (98/497), χ(2)=125.910 and 53.352, both P<0.01). There was no significant change in the proportion of allergic rhinitis and atopic dermatitis in last 12 months compared with that 6 years ago (both P>0.05). The number of children with clinical remission (2 years and above) was 75.4% (276/366). The number of children without remission within 2 years was 24.6% (90/366). The majority of children without remission were less than 12 years old boys (52.4% (33/63) vs. 30.9% (56/181) , χ(2)=9.273, P<0.01) . The proportion of children without remission associated with allergic rhinitis (67.8%(61/90)), atopic dermatitis (30.0%(27/90)), first-degree relatives with asthma (68.9%(62/90)) was higher than that of children with remission (51.8%(143/276), 17.0%(47/276), and 54.7%(151/276), respectively, χ(2)=7.013, 7.079, 5.608, respectively, all P<0.05). The proportion of children without remission who used control drugs was (33.3%(30/90)), which was higher than that in children with remission (7.2%(20/276), χ(2)=39.158, P<0.01). Multiple logistic regression showed that boy (OR=2.402 (1.611-3.580), P<0.05), later onset (OR=4.339 (>3-6 years old vs. 0-3 years old), OR=2.630(>6 years old vs. 0-3 years old), χ(2)=18.512, 31.371, 6.510, all P<0.05) were independent risk factors for asthma remission. COX regression analysis showed that the use of control drugs (HR=0.705 (0.515-0.964), χ(2)=4.795, P<0.05) was the relevant factor in the course of the disease. Conclusions: With the increase of age, the incidence of asthma in children in Beijing city in recent 12 months reduced. Male and late onsets were independent risk factors for asthma remission. The use of control drugs was the relevant factor in the course of the disease.

[Establishment and assessment of a nomogram for predicting the differentiation syndrome of acute promyelocytic leukemia].

Objective: By analyzing the risk factors for occurrence of differentiation syndrome (DS) during induction therapy in newly-diagnosed acute promyelocytic leukemia (APL) patients, a prediction nomogram for DS was established and the accuracy of this nomogram was validated. Methods: The modeling group was made up of 130 classical APL patients during the period of 1st January 2011 to 31st December 2013. After single factor screening of clinical variables, the logistic regression model was used to identify the final model variables. A nomogram subsequently established by R software was validated by Bootstrap resampling as internal validation. Concordance index (C-index) was used for the accuracy evaluation of the nomogram, and calibration curves were painted to test the actual observation and the nomogram-prediction of occurrence rate of DS. Results: Occurrence rate of DS in 130 APL patients was 30.0%; In multivariate analysis, body mass index (BMI) ≥24 kg/m2 and without using steroids for prevention of DS were identified as independent risk factors. The C-index of the nomogram for predicting DS was 0.818 (95% CI 0.741-0.895). The calibration curves showed good concordance of occurrence rate of DS between nomogram-prediction and actual observation. Conclusion: The nomogram was successfully established as a more accurate and visible tool for predicting the occurrence rate of DS in APL patients.

[Clinical data analysis of valvular involvement in Takayasu arteritis].

OBJECTIVE: To investigate the clinical features of valvular lesions in Takayasu's arteritis. METHODS: We analyzed 22 medical records of patients with Takayasu's arteritis and valvular lesions in Anzhen Hospital, Capital Medical University from January 2012 to January 2015. RESULTS: The spectrums of valvular involvements were aortic valve regurgitation (11, 50%), aortic valve stenosis (1, 4.5%), mitral valve regurgitation (1, 4.5%), mitral valve stenosis (1, 4.5%) and multiple valvular diseases (7, 36.5%).64.7% of patients with aortic valve regurgitation had aortic root dilation.Heart failure was the most common manifestation (63.6%). Glucocorticoid and/or immunosuppressant were administrated on 11 (50%) patients.One (4.5%) patient received Tocilizumab injection.Surgeries were performed on 12 (54.5%) patients with cardiac architecture.Reversible changes in cardiac structure were found by echocardiography within one week after surgery (P<0.05). Three patients died during 10-46 month follow-up, with none of whom taking any anti-inflammatory treatments. CONCLUSIONS: Aortic regurgitation is the prominent valvular lesion in Takayasu's arteritis, mostly secondary to aortic root dilation.Operation could block myocardium reconstruction promptly.The early surgical complication is rare, while perivalvular leakage may occur during longstanding follow-up.Poor inflammatory control might lead to poor long-term outcome.

Molecular data and ecological niche modelling reveal the phylogeographic pattern of Cotinus coggygria (Anacardiaceae) in China's warm-temperate zone.

The phylogeography of common and widespread species helps to elucidate the history of local flora and vegetation. In this study, we selected Cotinus coggygria, a species widely distributed in China's warm-temperate zone. One chloroplast DNA (cpDNA) region and ecological niche modelling were used to examine the phylogeographic pattern of C. coggygria. The cpDNA data revealed two phylogeographic groups (Southern and Northern) corresponding to the geographic regions. Divergence time analyses revealed that divergence of the two groups occurred at approximately 147,000 years before the present (BP), which coincided with the formation of the downstream area of the Yellow River, indicating that the Yellow River was a weak phylogeographic divide for C. coggygria. The molecular data and ecological niche modelling also indicated that C. coggyria did not experience population expansion after glaciations. This study thus supports the fact that Pleistocene glacial cycles only slightly affected C. coggygria, which survived in situ and occupied multiple localised glacial refugia during glaciations. This finding is contrary to the hypothesis of large-scale range habitat contraction and retreat into a few main refugia.

Stress distribution and induced birefringence analysis for pressure vector sensing based on single mode fibers.

We propose a theoretical approach to analyze the pressure stress distribution in single mode fibers (SMFs) and achieve the analytical expression of stress function, from which we obtain the stress components with their patterns in the core and compute their induced birefringence. Then we perform a pressure vector sensing based on approximately 2 km SMF. Using Mueller matrix method we measure the birefringence vectors which are employed to compute the pressure magnitudes and their orientation. When rotating the pressure around the fiber, the corresponding birefringence vector rotates around a circle with double speed. Statistics show the average deviation of calculated pressure-magnitude to practical value is approximately 0.17 N and it is approximately 0.85 degrees for orientation.

Improved tolerance of maize plants to salt stress by arbuscular mycorrhiza is related to higher accumulation of soluble sugars in roots.

The effect of colonization with the arbuscular mycorrhizal (AM) fungus Glomus mosseae (Nicol. & Gerd.) Gerdemann & Trappe on the growth and physiology of NaCl-stressed maize plants ( Zea mays L. cv. Yedan 13) was examined in the greenhouse. Maize plants were grown in sand with 0 or 100 mM NaCl and at two phosphorus (P) (0.05 and 0.1 mM) levels for 34 days, following 34 days of non-saline pre-treatment. Mycorrhizal plants maintained higher root and shoot dry weights. Concentrations of chlorophyll, P and soluble sugars were higher than in non-mycorrhizal plants under given NaCl and P levels. Sodium concentration in roots or shoots was similar in mycorrhizal and non-mycorrhizal plants. Mycorrhizal plants had higher electrolyte concentrations in roots and lower electrolyte leakage from roots than non-mycorrhizal plants under given NaCl and P levels. Although plants in the low P plus AM fungus treatment and those with high P minus AM fungus had similar P concentrations, the mycorrhizal plants still had higher dry weights, soluble sugars and electrolyte concentrations in roots. Similar relationships were observed regardless of the presence or absence of salt stress. Higher soluble sugars and electrolyte concentrations in mycorrhizal plants suggested a higher osmoregulating capacity of these plants. Alleviation of salt stress of a host plant by AM colonization appears not to be a specific effect. Furthermore, higher requirement for carbohydrates by AM fungi induces higher soluble sugar accumulation in host root tissues, which is independent of improvement in plant P status and enhances resistance to salt-induced osmotic stress in the mycorrhizal plant.

Blood lead dynamics of lead-exposed pregnant women and its effects on fetus development.

The dynamics of blood lead (Pb-B) and blood zinc protoporphyrin (ZPP-B) of women in early pregnancy and parturient women with lead exposure and the effects on fetus development were investigated. Pb-B of lead-exposed women was high: 0.984 mumol/L (20.38 micrograms/dl) and ZPP was 84.52 micrograms/dl. Cord blood Pb-B was 0.896 mumol/L (18.56 micrograms/dl) and cord blood ZPP was 69.24 micrograms/dl. In the control group, Pb-B was 0.261 mumol/L (5.41 micrograms/dl), ZPP-B, 37.59 micrograms/dl, cord blood, Pb-B 0.34 mumol/L (7.03 micrograms/dl), and cord ZPP-B 49.0 micrograms/dl. There was a significant correlation between blood lead and blood ZPP, maternal Pb-B and cord Pb-B, maternal Pb-B and cord ZPP-B. The significance of the consistency of high level Pb-B and the effects on fetus development is discussed.