Super-thin anterolateral thigh flap for reconstruction of the medial plantar artery perforator flap donor site.

BACKGROUND: The medial plantar artery perforator (MPAP) flap is widely used to reconstruct the weight-bearing area of the foot. Traditionally, its donor site is closed using a skin graft, which is associated with several complications, including walking disability. This study aimed to examine our experience with using a super-thin anterolateral thigh (ALT) flap to reconstruct the MPAP flap donor site. METHODS: We examined 10 patients who underwent reconstruction of the MPAP flap donor site using a super-thin ALT flap between August 2019 and March 2021. The vascular pedicle was anastomosed to the proximal end of the medial plantar vessels or the end of the posterior tibial vessels. RESULTS: All reconstruction flaps survived and all patients were satisfied with the aesthetic appearance. No blisters, ulcerations, hyperpigmentation, or contractures occurred. All patients gained protective sensation in the super-thin ALT flap. The average visual analog scale score for the aesthetic appearance of the reconstructed foot was 8.5 ± 0.7 (range, 8-10). All patients were able to ambulate without aids and could wear regular shoes. The average revised Foot Function Index score was 26.4 ± 4.1 (range, 22-34). CONCLUSION: Reconstruction of the MPAP flap donor site using a super-thin ALT flap is reliable and provides satisfactory functional recovery, aesthetic appearance, and protective sensation while minimizing postoperative morbidity.

Propofol-based total intravenous anesthesia decreases the incidence of postoperative nausea and vomiting without affecting flap survival in free flap breast reconstruction.

BACKGROUND: Postoperative nausea and vomiting (PONV) may cause undesirable effects after microsurgical breast reconstruction. Although total intravenous anesthesia (TIVA) with propofol has been demonstrated to be effective in reducing PONV, it has not been assessed in autologous free flap breast reconstruction. The purpose of this study was to investigate the antiemetic prophylaxis effect and safety of TIVA in microvascular breast reconstruction. METHODS: Eighty-three patients undergoing microsurgical breast reconstruction with propofol (31 patients) or sevoflurane (52 patients) were retrospectively reviewed. The incidence of PONV was assessed at 2, 6, and 24 hours after surgery. Mean arterial blood pressure (MAP) was compared at T1 (after flap elevation but before transfer), T2 (15 minutes after revascularization), and T3 (at the end of surgery). RESULTS: The incidence of nausea was significantly reduced in the TIVA group over 0 to 2 hours period (P=0.017), and over 2 to 6 hours period (P=0.033). The incidence of vomiting was significantly reduced in the TIVA group over 0 to 2 hours period (P=0.006), and over 2 to 6 hours period (P=0.005). MAP was higher in the TIVA group at T1 (P=0.018), T2 (P=0.005), and T3 (P=0.007). The incidence of flap failure was similar between the two groups (P=0.373). CONCLUSIONS: Compared with sevoflurane maintaining anesthesia, propofol-based TIVA improves PONV with less fluctuation of MAP, and did not affect flap survival.

Fasting inhibits aerobic glycolysis and proliferation in colorectal cancer via the Fdft1-mediated AKT/mTOR/HIF1α pathway suppression.

Evidence suggests that fasting exerts extensive antitumor effects in various cancers, including colorectal cancer (CRC). However, the mechanism behind this response is unclear. We investigate the effect of fasting on glucose metabolism and malignancy in CRC. We find that fasting upregulates the expression of a cholesterogenic gene, Farnesyl-Diphosphate Farnesyltransferase 1 (FDFT1), during the inhibition of CRC cell aerobic glycolysis and proliferation. In addition, the downregulation of FDFT1 is correlated with malignant progression and poor prognosis in CRC. Moreover, FDFT1 acts as a critical tumor suppressor in CRC. Mechanistically, FDFT1 performs its tumor-inhibitory function by negatively regulating AKT/mTOR/HIF1α signaling. Furthermore, mTOR inhibitor can synergize with fasting in inhibiting the proliferation of CRC. These results indicate that FDFT1 is a key downstream target of the fasting response and may be involved in CRC cell glucose metabolism. Our results suggest therapeutic implications in CRC and potential crosstalk between a cholesterogenic gene and glycolysis.

[Screening and inhibition of antagonistic endophytic bacteria isolated from soybean (Glycine max)nodules against Alternaria longipes.] / çƒŸè‰èµ¤æ˜Ÿç— èŒæ‹®æŠ—æ€§å¤§è±†æ ¹ç˜¤å† ç”ŸèŒçš„ç­›é€‰åŠæŠ‘åˆ¶ä½œç”¨.

Using Alternaria longipes as tested phytopathogen, endophytic bacteria isolated from soybean nodules were selected to study antagonistic effects by confrontation and metabolic liquid culture methods. The inhibited hyphae were determined by microscopic observation, and the screened strains were characterized by cell culture, physiological and biochemical tests, 16S rDNA sequencing, phylogenetic analysis and inoculation trials in greenhouse. The results indicated that the seven of the endophytes exerted more than 42% inhibitory effects after the first and the second screening. These strains belonged to genus Bacillus, Pseudomonas, Sinorhizobium and Stenotrophomonas, respectively. Microscopic observation showed that the affected hyphae ends of A. longipes appear deformity of coralline branch, spherical expansions and so on. Antagonistic experiments with metabolites showed that the inhibition of endophytic bacteria against pathogenic fungus played an effective role mainly by bacteria producing extracellular substances. Confrontation tests suggested that endophytic Bacillus rapidly produced biofilm to effectively hinder the growth and extension of pathogen hyphae. Inoculation experiments showed that the disease index of treatment group was significantly lowered compared with the control, suggesting it could be utilized as a biological control resource inhibiting tobacco brown spot.

[Risk factors of the failure in digit replantation].

OBJECTIVE: To explore the relative factors on the failure in digit replantation in order to take preventions to control the risk factors. METHODS: From January 2013 to December 2013, 236 consecutive patients (311 fingers) underwent digit replantation were collected to analyze retrospectively, involving 183 males and 53 females with an average age of 34.5 years old ranging from 2 to 62 years old (6 cases under 6 years old and 230 cases elder than 6 years old). There were 51 thumbs, 87 index fingers, 78 middle fingers, 63 ring fings and 32 little thumbs. Forty cases(forty fings) who were failured as the observation group, the others as the control group. The factors of age, gender, finger, cause of injury, smoking history, ischemia duration, plane of division, condition of venous drainage and condition of arterial repair we assessed. RESULTS: All 236 cases with 311 fingers were replanted, 40 fingers were failured after operation. The relative factors on the failure in digit replantation included smoking history, cause of injury, plane of division, condition of venous drainage and condition of arterial repair (P< 0.05). There were no significant correlation between the failure and age, gender, finger and ischemia duration (P>0.05). CONCLUSION: Smoking history, causes of injury, plane of division, condition of venous drainage and condition of arterial repair are risks of failure in digit replantation. Before choosing the type of operation, it should be think about the patient's general conditions, injury status, grasp firmly the operative indications and actively carry out surgical treatment.

[Volume fraction of gas vesicle and floating characteristics of cyanobacteria in Taihu Lake under different pressures].

In order to ascertain the volumetric change of gas vesicles in cyanobacteria and the floating characteristics, capillary pressure method and image analysis method were used to study burst situation and remanent volume fraction of gas vesicles in cyanobacteria under different pressures. The reform situation after pressuring was also analyzed in this research. The results showed that the volume fraction of gas vesicles in Taihu Lake were 29.52%, 5.73%, 4.43%, 2.71%, 2.46%, 2.19% under 0 MPa, 0.3 MPa, 0.4 MPa, 0.5 MPa, 0.6 MPa, 0.7 MPa determined by the image analysis, and were 10.93%, 1.14%, 0.90%, 0.27%, 0.14%, 0.04% determined by the capillary pressure method; cyanobacteria sank due to the gas vesicles' bursting when the pressure was greater than 0.4 MPa. Gas vesicles and structure after pressure were reformed with the lapse of time, under 1 000 lx, 25 degrees C, after 8 h, 24 h, 48 h, the reformed gas vesicles accounted for 31.02%, 45.68%, 81.05% of total gas vesicles before pressuring. Image analysis method is more accurate in the determination for cyanobacteria gas vesicles' volume, while the volume is smaller measured by traditional capillary pressure method.

[Efficacy of iron saturated recombinant human lactoferrin on alleviating iron deficiency anemia in rats].

OBJECTIVE: To investigate the effect of iron saturated recombinant human lactoferrin (Fe-rhLf) on treating iron deficiency anemia (IDA). METHODS: SD rats received iron deficient diet and deionized water during the whole experiment. After 4 weeks, the rats with hemoglobin less than 100 g/L were selected and divided into 5 groups randomly. IDA group received 100 mg/(kg×d) casein dissolved in deionized water intragastrically; FeSO4 group received 5.43 mg/(kg×d) [2.0 mg/(kg×d) iron]+100 mg/(kg×d) casein intragastrically; low dose Fe-rhLf group received 75.53 mg/(kg×d) Fe-rhLf [0.5 mg/(kg×d) iron] +75 mg/(kg×d) casein intragastrically; middle dose group received 151.06 mg/(kg×d) Fe-rhLf [1.0 mg/(kg×d) iron]+50 mg/(kg×d) casein intragastrically; high dose group received 302.11 mg/(kg×d) Fe-rhLf [2.0 mg/(kg×d) iron] intragastrically. After 30 days of intervention, the rats' blood was collected and used to do the routine blood test, serum iron and serum anti-oxidants test. The liver hepcidin and ferroportin mRNA expression was tested by real time PCR. RESULTS: Compared with the animals in the IDA group, Fe-rhLf could increase weight significantly (P<0.05), hematological parameters, like hemoglobin (P<0.01) and red blood cell count (P<0.01) recovered significantly. Compared with animals in FeSO4 group, high dose Fe-rhLf could improve hemoglobin significantly (P<0.05). The liver hepcidin expression was up regulated and ferroportin down regulated. CONCLUSION: Fe-rhLf has a significant effect on treating iron deficiency anemia.

[Application of thenar perforator flaps for the narrow cicatricial contracture at thumb and the first web].

OBJECTIVE: To discuss the therapeutic effect of thenar perforator flaps for the narrow cicatricial contracture at thumb and the first web. METHODS: From Aug. 2010 to Jan. 2012, 9 cases with narrow cicatricial contracture at thumb and the first web, were treated. The defect size after releasing the contracture ranged from 8 mm x 20 mm to 15 cm x 30 mm. The bilateral thenar perforator flaps beside the wound were designed which size was 10 mm x 25 mm to 15 mm x 35 mm. The wounds at donor sites were closed directly. RESULTS: All the 9 flaps survived completely with primary healing. The patients were followed up for 6-18 months. The flaps had soft texture and good appearance. The shape of flaps and function of the fingers were satisfied after 6-18 months of follow-up. There was no scar contracture at incisions in thenar. The thumb motion was really normal. The abduction of first web was 70 degrees - 90 degrees degrees. CONCLUSIONS: The thenar perforator flaps is one of the ideal methods for the treatment of narrow cicatricial contracture at thumb and the first web. The main artery is not sacrified.

Colonization and plant growth promoting characterization of endophytic Pseudomonas chlororaphis strain Zong1 isolated from Sophora alopecuroides root nodules

The endophytic strain Zong1 isolated from root nodules of the legume Sophora alopecuroides was characterized by conducting physiological and biochemical tests employing gfp-marking, observing their plant growth promoting characteristics (PGPC) and detecting plant growth parameters of inoculation assays under greenhouse conditions. Results showed that strain Zong1 had an effective growth at 28 ºC after placed at 4-60 ºC for 15 min, had a wide range pH tolerance of 6.0-11.0 and salt tolerance up to 5% of NaCl. Zong1 was resistant to the following antibiotics (µg/mL): Phosphonomycin (100), Penicillin (100) and Ampicillin (100). It could grow in the medium supplemented with 1.2 mmol/L Cu, 0.1% (w/v) methylene blue and 0.1-0.2% (w/v) methyl red, respectively. Zong1 is closely related to Pseudomonas chlororaphis based on analysis the sequence of 16S rRNA gene. Its expression of the gfp gene indicated that strain Zong1 may colonize in root or root nodules and verified by microscopic observation. Furthermore, co-inoculation with Zong1 and SQ1 (Mesorhizobium sp.) showed significant effects compared to single inoculation for the following PGPC parameters: siderophore production, phosphate solubilization, organic acid production, IAA production and antifungal activity in vitro. These results suggest strains P. chlororaphi Zong1 and Mesorhizobium sp. SQ1 have better synergistic or addictive effect. It was noteworthy that each growth index of co-inoculated Zong1+SQ1 in growth assays under greenhouse conditions is higher than those of single inoculation, and showed a significant difference (p < 0.05) when compared to a negative control. Therefore, as an endophyte P. chlororaphis Zong1 may play important roles as a potential plantgrowth promoting agent.

[Application of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot].

OBJECTIVE: To investigate the therapeutic effect of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot. METHODS: From Aug. 2008 to Aug. 2010, 9 cases with skin defects at the dorsal side of feet were treated by V-Y flaps pedicled with superior malleolus cutaneous branch. The flap size ranged from 6.0 cm x 5.5 cm to 12.0 cm x 6.5 cm. The defects at the donor sites were closed directly. RESULTS: All flaps survived completely. 9 cases were followed up for 6-12 months after operation. The flaps had good texture and color match. The 2-point discrimination distance at the flap was 10-14 mm. The function of ankle was normal. CONCLUSIONS: The V-Y flap pedicled with superior malleolus cutaneous branch is ideal for the treatment of small skin defect at the dorsal side of foot.

[Repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint].

OBJECTIVE: To investigate the repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint (DIP). METHODS: From Jun. 2009 to Mar. 2010, 15 cases with soft tissue defects at 15 fingers tip were treated with this island flaps. The flap size ranged from 1.2 cm x 0.8 cm to 2. 0 cm x 3.0 cm. The defects at donor sites were covered with skin grafts from forearm. RESULTS: All the flaps and skin grafts survived. 10 fingers in 10 cases were followed up for 6-12 months. The color, texture and contour of the flaps were good. The two-point discrimination distance was 5-6 mm on the directed island flaps, and 7-10 mm on the reverse island flaps. No obvious functional problem was found in DIP motion. The hand function was assessed as excellent in 8 fingers, good in 1 finger and medium in 1 finger. CONCLUSIONS: The main artery and nerve will not be sacrificed when the island flap is used. The operative procedures are easily performed for the treatment of fingertip skin defect.

[Repair of thumb tip defect with thumb island flaps at ulnar side by V-Y advancement].

OBJECTIVE: To investigate the method for treatment of thumb tip defect. METHODS: The thumb tip defect was treated with thumb island flaps at ulnar side by V-Y advancement. The flap size ranged from 1.4 cm x 2.0 cm approximately 1.4 cmx 2.5 cm. The wounds at donor sites were covered by skin grafts. RESULTS: From March 2007 to October 2009, 10 cases of thumb tip defects were treated. All the flaps and skin grafts were survived with primary healing. The patients were followed up for 6-18 months with both satisfactory functional and cosmetic results. The two-point discrimination was 5-6 mm at the thumb tip. CONCLUSIONS: The thumb tip defect can be successfully repaired with thumb island flaps at ulnar side by V-Y advancement.

[Effects of marine collagen peptide on delaying the skin aging].

OBJECTIVE: To investigate the protective effect of marine collagen peptides (MCPs) on the skin of aged mice induced by D-galactose. METHODS: Subchronic toxicity study was conducted while D-galactose induced subacute aging model was established. D-galactose dose of 0.125 g/kg body weight was intraperitoneally injected daily for 90 days. Marine collagen peptide 0.225, 0.450, 1.350 g/kg body weight were administered by oral gavage. Superoxide dismutase (SOD), catalase (CAT) activity and malondialdehyde (MDA) content in blood serum were measured, along with cutaneous histopathology examination. RESULTS: Epidermal thickness was significantly higher in MCPs treated group. Number and activity of fibroblast in MCPs treated dermis was increased prominently. The activity of SOD in 0.225, 0.450, 1.350 g/kgbw MCPs treated groups were 455.52 +/- 11.39, 460.15 +/- 18.09, 468.59 +/- 27.25 U/ml respectively, each of which was significantly higher than that in model control group; the activity of serum CAT in 0.225, 1.350 g/kgbw MCPs treated groups (21.33 +/- 4.82, 21.69 +/- 1.68 U/ml) were obviously increased compared with that in model control group (17.14 +/- 2.81 U/ml); MDA level in 0.450, 1.350 g/kgbw MCPs treated groups were 5.67 +/- 0.93, 5.76 +/- 1.02 nmol/ml respectively, each of which was significantly lower than that in model control group (7.63 +/- 1.37 nmol/ml). CONCLUSIONS: The results showed that MCPs might play a protective role on skin aging by improving the activity of antioxidant.

[The clinical experience in transplantation of the anterolateral femoral skin flap].

OBJECTIVE: To introduce the clinical experience in transplantation of the anterolateral femoral skin flap. METHODS: A total of 625 anterolateral femoral skin flaps in 600 patients were transplanted from 1988 to 2003. The retrospective analysis was carried out in all the cases as to the flap pedicle, the vascular variations, the surgical procedures and modifications, and the adaptation for a cutaneous-branch-absent flap. RESULTS: The 625 flaps were transferred except 7 cancelled in the operation. Postoperatively, 17 cases encountered vascular complications, 10 of which survived completely with successful vessel exploration, 3 cases had partial necrosis, and 4 cases had complete necrosis. The survival rate was 97.8%. 545 flaps were pedicled with the descending branch or lateral branches; 45 flaps with the transverse branch or the high-site anterolateral cutaneous artery, 10 cases with the descending-transverse branch, 18 cases with other vessels. 7 cases were found cutaneous-branch-absent. The vessel variation rate of the flap was 4.06%. CONCLUSIONS: The anterolateral femoral skin flap has less variation of its pedicle and high success rate of operation. It is an ideal choice for repair of soft tissue defects in the extremities.

[Serum levels of macrophage colony stimulating factor in the patients with Alzheimer's disease].

OBJECTIVE: To investigate the availability of serum level of macrophage clony stimulating factor (M-CSF) as a marker for early diagnosis of Alzheimer's disease (AD). METHODS: The serum levels of M-CSF in 70 patients with AD, 52 healthy controls, 22 patients with VAD (vascular dementia) were measured and the serum levels of IL-1 beta, IL-6, TNF-alpha in 32 patients with AD and 20 controls were measured as well. RESULTS: Serum levels of M-CSF were significantly elevated in patients with AD when compared with healthy controls (P < 0.01) and VAD controls (P < 0.05) respectively. At the early stage of mild dementia and middle dementia, serum levels of M-CSF were significantly elevated, but at the later stage of severe dementia, they returned to normal level. Serum levels of IL-1 beta were significantly elevated in AD patients compared with controls (P < 0.05), and serum levels of TNF-alpha and IL-6 were within the normal range in patients with AD. CONCLUSIONS: The results suggest that serum M-CSF level may provide a convenient and sensitive means for the early diagnosis of Alzheimer's disease.