Clinical Effectiveness of Free Upper Arm Medial Flap in Repairing Skin and Soft Tissue Defects of the Dorsum of the Hand.

Objective: To study the effectiveness of medial upper arm free flap in repairing skin and soft tissue (SST) defects of the dorsum of the hand. Methods: 10 patients with SST defects on the dorsum of the hand who underwent free upper arm medial flap repair in our hospital from March 2017 to August 2018 were included in the study. Hand function, flap survival rate, wound healing, donor wound recovery, and the level of pain in the injured area were recorded before the operation, 1 month, and 6 months postoperatively. Results: The highest score in hand function was seen at the 6-month postoperative interval, followed by that at the 1-month postoperative interval. The lowest score in hand function was the preoperative score (P < 0.05). All flaps were still surviving 6 months postoperatively. Recovery of the function of the donor muscle, the elbow joint, as well as wound healing, all progressed well. 6 months postoperatively, 3 patients developed numbness and stiffness of the hand, but the symptoms were relieved following treatment. Compared to the preoperative scores, the visual analogue scale (VAS) scores at the injured site 1 month and 6 months postoperatively were significantly decreased, with the 6-month postoperative score being lower than the 1-month postoperative score (P < 0.05). Conclusion: The free upper arm medial flap is a good alternative for repairing skin and soft tissue defects of the dorsum of the hand with exposed phalanges, an approach that merits widespread promotion and clinical application.

The CBM48 domain-containing protein FLO6 regulates starch synthesis by interacting with SSIVb and GBSS in rice.

KEY MESSAGE: FLO6 is involved in starch synthesis by interacting with SSIVb and GBSS in rice. Starch synthesized and stored in plastids including chloroplasts and amyloplasts plays a vital role in plant growth and provides the major energy for human diet. However, the molecular mechanisms by which regulate starch synthesis remain largely unknown. In this study, we identified and characterized a rice floury endosperm mutant M39, which exhibited defective starch granule formation in pericarp and endosperm, accompanied by the decreased starch content and amylose content. The abnormal starch accumulation in M39 pollen grains caused a significant decrease in plant fertility. Chloroplasts in M39 leaves contained no or only one large starch granule. Positional cloning combined with complementary experiment demonstrated that the mutant phenotypes were restored by the FLOURY ENDOSPERM6 (FLO6). FLO6 was generally expressed in various tissues, including leaf, anther and developing endosperm. FLO6 is a chloroplast and amyloplast-localized protein that is able to bind to starch by its carbohydrate-binding module 48 (CBM48) domain. Interestingly, we found that FLO6 interacted with starch synthase IVb (SSIVb) and granule-bound starch synthase (GBSSI and GBSSII). Together, our results suggested that FLO6 plays a critical role in starch synthesis through cooperating with several starch synthesis enzymes throughout plant growth and development.