A moisture-enabled fully printable power source inspired by electric eels.

Great efforts have been made to build integrated devices to enable future wearable electronics; however, safe, disposable, and cost-effective power sources still remain a challenge. In this paper, an all-solid-state power source was developed by using graphene materials and can be printed directly on an insulating substrate such as paper. The design of the power source was inspired by electric eels to produce programmable voltage and current by converting the chemical potential energy of the ion gradient to electric energy in the presence of moisture. An ultrahigh voltage of 192 V with 175 cells in series printed on a strip of paper was realized under ambient conditions. For the planar cell, the mathematical fractal design concept was adapted as printed patterns, improving the output power density to 2.5 mW cm-3, comparable to that of lithium thin-film batteries. A foldable three-dimensional (3D) cell was also achieved by employing an origami strategy, demonstrating a versatile design to provide green electric energy. Unlike typical batteries, this power source printed on flexible paper substrate does not require liquid electrolytes, hazardous components, or complicated fabrication processes and is highly customizable to meet the demands of wearable electronics and Internet of Things applications.

Experience in Microsurgical Treatment of Complete Scalp Avulsion.

BACKGROUND: Avulsion of the scalp is a rare destructive event worldwide. Before the emergence of microsurgery, skin transplantation, flap transplantation, greater omentum transplantation, and other methods were once widely used. However, replantation offers the optimum reconstruction. METHODS: Six cases of complete avulsion injury of a large scalp treated from May 2017 to May 2020 were retrospectively analyzed. Under the microsurgery technology, the wound was cleaned and explored, and the appropriate arteriovenous anastomosis was selected. Preoperative blood preparation and skin preparation were actively performed. Postoperative strict nursing and observation of the blood supply of replanted scalp were performed. Regular outpatient follow-up after discharge was performed. RESULTS: Replantation was successful in 5 cases and failed in 1 case, and in 1 case the occipital scalp (approximately 10% of the scalp area) died and crusted 2 months after the operation. After 6 to 24 months of follow-up, all patients were satisfied with the reconstructed appearance. CONCLUSIONS: Superb microsurgical technique and more detailed anatomical knowledge are the key conditions for successful complete scalp avulsion replantation. Compared with other methods, successful replantation can achieve the best aesthetic and functional results.

Use of the O-Z Flap to Repair Scalp Defects After Cancer Tumor Resection.

BACKGROUND: Large benign and malignant tumors in the scalp cannot be sutured directly after resection. Instead, skin grafting or skin flap repair is the most commonly used techniques. Local tissue depression and lack of hair growth are some of the drawbacks associated with these techniques. The use of a modified local flap (the O-Z flap) may effectively overcome these issues. OBJECTIVE: To explore the application of O-Z flap in wound repair after excision of benign and malignant tumors of the scalp. METHODS: Between April 2016 and November 2017, the authors treated 6 patients with scalp tumors. They underwent round or oval radical tumor resection with negative margins. Tumor specimens were diagnosed by cryosection during operation. According to the wound defect size and location, surrounding scalp looseness, and hair distribution, 2 rotating flaps in opposite directions were formed on the left and right sides or front and back of the wound. Subsequently, the skin flaps were rotated in opposite directions to repair the wound. RESULTS: The scalp tumors comprised 2 cases of basal cell carcinoma, 2 cases of squamous cell carcinoma, 1 case of hair sheath carcinoma, and 1 case of epidermoid cyst. After complete tumor resection, the wound defect area was between 3.0 cm × 3.5 cm and 5.0 cm × 6.0 cm. After operation, approximately 6% of the tip of the skin flap was necrotized. The wounds healed after 4 weeks of dressing treatment. All skin flaps survived in stage I and no complications occurred. All patients were followed up for 3 to 12 months; the scalps were in good condition and no tumor recurrence was found. CONCLUSIONS: The use of the O-Z flap to repair scalp wounds offers flexible design, good blood circulation, uniform tension, and good hair growth after operation; thus, this technique is suitable for wound repair following scalp tumor resection.

MiR-140-3p Ameliorates the Progression of Osteoarthritis via Targeting CXCR4.

Osteoarthritis is a common disease character with progressive destruction of cartilage. MicroRNA (miR)-140-3p was validated as a biomarker for osteoarthritis. However, the mechanism by which miRNA-140-3p regulates osteoarthritis remains unclear. Thus, this study aims to evaluate the potential function of miRNA-140-3p during the pathogenesis of osteoarthritis. MiRNA-140-3p expression in tissue and CHON-001 chondrocyte cells was determined with quantitative real time (qRT)-PCR. In vitro osteoarthritis model was established by treatment of the chondrocyte cells CHON-001 with interleukin (IL)-1ß. Cell proliferation and apoptosis were measured with cell counting kit-8 (CCK8) and Annexin V/propidium iodide (PI) apoptosis assay, respectively. Protein expressions were evaluated using Western blot. The target gene of miR-140-3p was predicted using Targetscan and miRDB. MiR-140-3p was downregulated in knee tissue from patients with osteoarthritis. IL-1ß inhibited the proliferation of CHON-001 cells via inducing apoptosis. In addition, IL-1ß significantly inhibited the expressions of collagen II and aggrecan and increased the level of matrix metalloproteinase (MMP)13. However, the effects of IL-1ß could be ameliorated by the addition of miR-140-3p mimics. Moreover, luciferase reporter assay demonstrated CXCR4 as a target gene of miR-140-3p. IL-1ß-induced upregulation of CXCR4 could be blocked by miR-140-3p mimics. Our study indicated that miR-140-3p could suppress the progression of osteoarthritis by directly targeting CXCR4. Therefore, miR-140-3p might serve as a potential therapeutic target for the treatment of osteoarthritis.

Graft bending angle affects allograft tendon maturity early after anterior cruciate ligament reconstruction.

PURPOSE: The aim of this study was to clarify the association of the anterior cruciate ligament (ACL) graft bending angle and graft maturity of autograft and allograft tendons using high-resolution MRI. METHODS: Patients with unilateral ACL reconstruction were invited to participate in this study, and they were examined using a 3.0-T MRI scan at 3, 6 and 12 months after the operation. Anatomic single-bundle ACL reconstruction was performed on 48 patients using the trans-portal technique, including 28 with autograft hamstring tendons and 20 with allograft tendons. To evaluate graft healing, the signal/noise quotient (SNQ) was measured in four regions of interest (ROIs) of the femoral tunnel, proximal, midsubstance and distal ACL grafts. The graft bending angle was defined as the angle between the femoral bone tunnel and the line connecting the femoral and tibial tunnel apertures. Graft SNQ and graft bending angle were assessed at 3, 6 and 12 months postoperatively, and the association between SNQ and the average graft bending angle was analyzed. RESULTS: Generally, the mean graft bending angle of this cohort increased gradually with time. The SNQ value of each graft region increased from 3 to 6 months and then decreased from 6 to 12 months. In the whole cohort, the graft bending angle had a significant positive association with graft SNQ in the femoral tunnel or proximal site. In the allograft subgroup, the graft bending angle had a significant positive association with the graft SNQ in the femoral tunnel or proximal site at 6 months after surgery, while there was no association between the graft bending angle and SNQ at 12 months. In the autograft subgroup, the graft bending angle had a significant positive association with graft SNQ in the femoral tunnel or proximal site at 12 months after surgery. CONCLUSION: Generally, the graft bending angle was correlated with a high signal intensity of the proximal graft in the early postoperative period for allograft tendons and in the late postoperative period for allograft tendons. This suggests that the biomechanical effect from the graft bending angle on graft healing may be different for allografts and autografts after ACL reconstruction. LEVEL OF EVIDENCE: III.

Identification of key candidate genes in local dorsal root ganglion inflammation by integrated bioinformatics analysis.

The purpose of the present study was to identify potential markers of local dorsal root ganglion (DRG) inflammation to aid diagnosis, treatment and prognosis evaluation of DRG pain. A localized inflammation of the DRG (LID) rat model was used to study the contribution of inflammation to pain. The dataset GSE38859 was obtained from the Gene Expression Omnibus database. Pre-treatment standardization of gene expression data for each experiment was performed using the R/Bioconductor Limma package. Differentially expressed genes (DEGs) were identified between a LID model and a sham surgery control group. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of DEGs and gene set enrichment analysis (GSEA) were carried out using the 'clusterProfiler' package in R. Using the Search Tool for Retrieval of Interacting Genes, a protein-protein interaction network was constructed and visualized. Candidate genes with the highest potential validity were validated using reverse transcription-quantitative PCR and western blotting. In total, 66 DEGs were enriched in GO terms related to inflammation and the immune response processes. KEGG analysis revealed 14 associated signaling pathway terms. Protein-protein interaction network analysis revealed 9 node genes, 3 of which were among the top 10 DEGs. Matrix metallopeptidase 9, chemokine CXCL9, and complement component 3 were identified as key regulators of DRG inflammatory pain progression.

[Application of free-style perforator pedicled propeller flap to repair the wound after extensive resection of skin malignant tumor on the thigh].

OBJECTIVE: To explore the effectiveness of free-style perforator pedicled propeller flap to repair the wound after extensive resection of skin malignant tumor on the thigh. METHODS: Between December 2016 and June 2019, 12 patients with skin malignant tumor on the thigh were treated. There were 9 males and 3 females, aged from 8 to 65 years (median, 38.5 years). The etiologies included basal cell carcinoma in 3 cases, squamous cell carcinoma in 7 cases, fibrosarcoma in 1 case, and malignant melanoma in 1 case. The disease duration ranged from 5 months to 10 years (median, 7.5 years). Color Doppler ultrasound was used to detect and mark at least one perforator vessel before operation. After extensive resection, the size of wound ranged from 5.0 cm×3.5 cm to 8.5 cm×6.5 cm. In the range of 1-3 cm from the edge of the lesion, the perforator vessels were explored again from the deep surface of the deep fascia to confirm and mark. The perforator vessel with diameter greater than 0.5 mm and closest to the edge of the lesion was taken as the rotation point of the flap. According to the wound size and shape, the free-style perforator pedicled propeller flap in size of 8.0 cm×3.5 cm to 12.5 cm×6.0 cm was designed. The wound was repaired with the big blade of the flap. The donor site was closed directly with the aid of the small blade. RESULTS: The distal part of the skin flap was necrosis after operation, and healed after symptomatic treatment such as dressing change; the other flaps survived successfully and the wounds healed by first intention. All incisions at the donor site healed by first intention. All patients were followed up 5-24 months (mean, 10.2 months). During the follow-up, there was no recurrence of tumor. The flap had good elasticity and texture with no obvious swelling or scar hyperplasia, and the appearance was satisfactory; the hip and knee joint activities were normal. CONCLUSION: Based on the extensive skin blood supply and abundant perforator vessels of the thigh, the free-style perforator pedicled propeller flap is an ideal flap for repairing small or medium wound after extensive resection of skin malignant tumor on the thigh.

[The clinical study of partial perineum area and wound repair in males].

OBJECTIVE: To explore the suitable division of male genitalia subunits and the effectiveness of large-area perineum defect repair under its guidance. METHODS: According to the anatomical and functional characteristics of male genitalia, the subunit division scheme was proposed: area Ⅰ, glans penis; area Ⅱ, body of penis; area Ⅲ, scrotum; area Ⅳ, scrotum. Between April 2017 and July 2019, 12 patients with large genitalia defects were treated, with an average age of 60.9 years (range, 57-66 years) and an average disease duration of 2.7 years (range, 2-5 years). The defect area involved area Ⅰ in 1 case, area Ⅱ in 7 cases, area Ⅲ in 5 cases, and area Ⅳ in 8 cases; the size of area ranged from 6 cm×4 cm to 23 cm×16 cm. The causes of defect included 3 cases of trauma, 6 cases of Paget disease, 2 cases of squamous cell carcinoma, 1 case of spindle cell tumor. According to the design of the corresponding repair scheme, the main repair methods were to rotate and advance the skin flap and pedicled skin flap in the same area. When the defect was large, the free skin flap transplantation, free skin grafting, and free mucosa transplantation were used to repair the defect. RESULTS: All the patients were followed up 6-13 months with an average of 8.6 months. Skin flap, skin graft, and mucosa survived in one stage in 10 patients; infection occurred in 1 case after the scrotal flap of area Ⅲ was transferred to repair the defect in area Ⅱ, 1 case had distal venous crisis at 2 days after repair area Ⅲ defect used free anterolateral thigh flap, and after active treatment, the condition improved. The appearance of the receiving area and the supplying area was good, and the local feeling was recovered satisfactorily. The range of motion of hip joint was good in 10 cases, and 2 cases were slightly stretched but did not affect normal life. All patients had normal urination and defecation function, and were satisfied with the treatment effectiveness. CONCLUSION: The subunits of male genitalia can be used to guide the repair of the defect, which can better restore the physiological appearance and function, and has positive clinical significance.