Phosphatidylinositol-specific phospholipase C can decrease Müller cell viability and suppress its phagocytic activity by modulating PI3K/AKT signaling pathway.

Bacillus cereus endophthalmitis is a devastating eye infection that causes rapid blindness through the release of extracellular tissue-destructive exotoxins. The phagocytic and antibacterial functions of ocular cells are the keys to limiting ocular bacterial infections. In a previous study, we identified a new virulence gene, plcA-2 (different from the original plcA-1 gene), that was strongly associated with the plcA gene of Listeria monocytogenes. This plcA gene had been confirmed to play an important role in phagocytosis. However, how the Bc-phosphatidylinositol-specific phospholipase C (PI-PLC) proteins encoded by the plcA-1/2 genes affect phagocytes remains unclear in B. cereus endophthalmitis. Here, we found that the enzymatic activity of Bc-PI-PLC-A2 was approximately twofold higher than that of Bc-PI-PLC-A1, and both proteins inhibited the viability of Müller cells. In addition, PI-PLC proteins reduced phagocytosis of Müller cells by decreasing the phosphorylation levels of key proteins in the PI3K/AKT signaling pathway. In conclusion, we showed that PI-PLC proteins contribute to inhibit the viability of and suppress the phagocytosis of Müller cells, providing new insights into the pathogenic mechanism of B. cereus endophthalmitis.

A Review of the Motion Planning and Control Methods for Automated Vehicles.

The motion planning and control method of automated vehicles, as the key technology of automated vehicles, directly affects the safety, comfort, and other technical indicators of vehicles. The planning module is responsible for generating a vehicle driving path. The control module is responsible for driving the vehicle. In this study, we review the main methods and achievements in motion planning and motion control for automated vehicles. The advantages and disadvantages of various planning and control methods are comparatively analyzed. Finally, some predictions and summaries based on the existing research results and trends are proposed. Through this analysis, it is believed that various types of algorithms will be further integrated in the future to complement each other's strengths and weaknesses. The next area of research will be to establish more accurate vehicle models to describe vehicle motion, improve the generalization-solving ability of algorithms, and enhance the planning and control of integrated 'human-vehicle-road' traffic systems.

Effectiveness of exercise intervention on fall-related fractures in older adults: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Exercise intervention can significantly improve physical function and bone strength; however, the effect of exercise on fall-related fractures in older adults remains controversial. This study aimed to assess the effectiveness of exercise intervention on fall-related fractures in older adults by conducting a meta-analysis of randomized controlled trials (RCTs). METHODS: PubMed, EMBASE, and Cochrane databases were systematically searched for RCTs through November 24, 2019 to investigate the effectiveness of exercise intervention on fall-related fractures in older adults. Pooled relative risk (RR) with 95% confidence interval (CI) was calculated using the random-effects model. Sensitivity, subgroup, and publication bias analyses were also conducted. RESULTS: A total of 7704 older adults and 428 fall-related fracture events from 20 RCTs were selected for the final meta-analysis. The follow-up duration across included trials ranged from 6.0 months to 7.0 years. The pooled RR suggested that exercise intervention was associated with a reduced fall-related fracture risk in older adults (RR: 0.74; 95% CI: 0.59-0.92; P = 0.007; I2 = 12.6%). The pooled conclusion was robust and not affected by any individual trial. Subgroup analysis revealed that the significant effect of exercise intervention on fall-related fractures was mainly detected when the study reported results from both male and female subjects, when it did not report the baseline body mass index, when individuals received both home- and center-based interventions, when the follow-up duration was > 1.0 year, and when it was a high-quality study. CONCLUSIONS: Regular exercise intervention could prevent fall-related fractures in older adults. Further large-scale RCTs should be conducted to assess the effectiveness of different exercise programs on fall-related fractures at various sites.

Single Neural Adaptive PID Control for Small UAV Micro-Turbojet Engine.

The micro-turbojet engine (MTE) is especially suitable for unmanned aerial vehicles (UAVs). Because the rotor speed is proportional to the thrust force, the accurate speed tracking control is indispensable for MTE. Thanks to its simplicity, the proportional-integral-derivative (PID) controller is commonly used for rotor speed regulation. However, the PID controller cannot guarantee superior performance over the entire operation range due to the time-variance and strong nonlinearity of MTE. The gain scheduling approach using a family of linear controllers is recognized as an efficient alternative, but such a solution heavily relies on the model sets and pre-knowledge. To tackle such challenges, a single neural adaptive PID (SNA-PID) controller is proposed herein for rotor speed control. The new controller featuring with a single-neuron network is able to adaptively tune the gains (weights) online. The simple structure of the controller reduces the computational load and facilitates the algorithm implementation on low-cost hardware. Finally, the proposed controller is validated by numerical simulations and experiments on the MTE in laboratory conditions, and the results show that the proposed controller achieves remarkable effectiveness for speed tracking control. In comparison with the PID controller, the proposed controller yields 54% and 66% reductions on static tracking error under two typical cases.

Dietary betaine supplementation improves meat quality of transported broilers through altering muscle anaerobic glycolysis and antioxidant capacity.

BACKGROUND: To investigate the effect of dietary betaine supplementation on growth performance, meat quality, muscle anaerobic glycolysis and antioxidant capacity of transported broilers, 1-day-old partridge-shank-broiler-chickens (n = 192) were randomly divided into three groups for a 50-day feeding trial. The broilers in the control group were fed a basal diet, and experienced 0.75-h transport before slaughter. The broilers in the other three groups were fed a basal diet supplemented with 0, 500 or 1000 mg kg-1 betaine, respectively, and experienced 3-h transport before slaughter (T, T + BET500 or T + BET1000 groups). RESULTS: Dietary betaine supplementation increased (P < 0.05) average daily gain of broilers, and feed conversion ratio was also improved (P < 0.05) by 500 mg kg-1 betaine supplementation. Compared with the control group, 3-h transport increased (P < 0.05) live weight loss, serum corticosterone and cortisol concentrations, as well as muscle lactate and malondialdehyde (MDA) contents, and decreased (P < 0.05) muscle pH24h , glycogen content and total superoxide dismutase activity. Compared with the T group, betaine supplementation decreased (P < 0.05) serum corticosterone and cortisol concentrations and muscle MDA content, and increased (P < 0.05) muscle a*24 h . In addition, 1000 mg kg-1 betaine supplementation further decreased (P < 0.05) muscle drip loss, lactate content and lactate dehydrogenase activity, and increased (P < 0.05) muscle glutathione content and glutathione peroxidase activity. CONCLUSION: Betaine supplementation not only improved growth performance of broilers, but also alleviated meat quality deterioration of transported broilers through altering muscle anaerobic glycolysis and antioxidant capacity. © 2020 Society of Chemical Industry.

A linker selective retention strategy to construct hierarchical porous metal-organic frameworks with high catalytic activity for oxidative desulfurization.

In order to improve the oxidative desulfurization (ODS) performance of MOF materials, an effective way is to convert a microporous MOF into a hierarchical porous MOF (HP-MOF) by utilizing the linker selective retention strategy. Herein, UiO-66 with the introduction of an unstable linker ligand (dihydro-1,2,4,5-tetrazine-3,6-dicarboxylate, dhtz) can selectively remove dhtz ligands to form HP-MOF (HP-UiO-66-dhtz) through heat treatment at high temperature. While maintaining the original structure of UiO-66, HP-UiO-66-dhtz features mesopores and abundant Lewis acid sites, showing excellent ODS performance for diphenylthiophene (DBT).

An AC voltammetry approach for the detection of droplets in microfluidic devices.

A simple electrochemical method using ac voltammetry to detect aqueous droplets up to 480 droplets per second in a flow-focusing microfluidic device is presented. The method offers a promising and versatile platform with simple and inexpensive instrumentation for droplets real time detection and preliminary characterization.

Attributes of direct current aperiodic and alternating current harmonic components derived from large amplitude Fourier transformed voltammetry under microfluidic control in a channel electrode.

The flow rate dependencies of the aperiodic direct current (dc) and fundamental to eighth alternating current (ac) harmonic components derived from large-amplitude Fourier transformed ac (FT-ac) voltammetry have been evaluated in a microfluidic flow cell containing a 25 µm gold microband electrode. For the oxidation of ferrocenemethanol ([FcMeOH]/[FcMeOH](+) process) in aqueous 0.1 M KNO(3) electrolyte, standard "Levich-like" dc behavior is observed for the aperiodic dc component, which enables the diffusion coefficient for FcMeOH to be obtained. In experimental studies, the first and second ac harmonic components contain contributions from the double layer capacitance current, thereby allowing details of the non-Faradaic current to be established. In contrast, the higher order harmonics and dc aperiodic component are essentially devoid of double layer capacitance contributions allowing the faradaic current dependence on flow rate to be studied. Significantly, flow rate independent data conforming to linear diffusion controlled theory are found in the sixth and higher ac harmonics at a frequency of 15 Hz and for all ac harmonics at a frequency of ≥ 90 Hz. Analysis of FT-ac voltammograms by theory based on stationary microband or planar electrode configurations confirms that stationary microband and planar electrode configurations and experimental data all converge for the higher order harmonics and establishes that the electrode kinetics are very fast (≥1 cms(-1)). The ability to locate, from a single experiment, a dc Faradaic component displaying Levich behavior, fundamental and second harmonics that contain details of the double layer capacitance, and Faradaic ac higher order harmonic currents that are devoid of capacitance, independent of the volume flow rate and also conform closely to mass transport by planar diffusion, provides enhanced flexibility in mass transport and electrode kinetic analysis and in understanding the performance of hydrodynamic electrochemical cells and reactors.

Effects of Dietary Rutin Supplementation on the Intestinal Morphology, Antioxidant Capacity, Immunity, and Microbiota of Aged Laying Hens.

This research investigated the effects of dietary rutin supplementation on the intestinal morphology, antioxidant capacity, immunity, and microbiota of aged laying hens. The results showed that 500 mg/kg rutin supplementation increased the villus height of jejunum (P < 0.05). Rutin affected the immune system of the ileum and the jejunum. In the jejunum, a diet with 500 mg/kg rutin supplementation enhanced secretory immunoglobulin A (sIgA) and reduced tumor necrosis factor-α (TNF-α) levels (P < 0.05). A diet with 1000 mg/kg rutin supplementation increased jejunal sIgA, immunologlobulin M (IgM), and interleukin-4 (IL-4) levels while decreasing interleukin-1ß (IL-1ß), TNF-α, and interferon-γ (IFN-γ) levels (P < 0.05). Meanwhile, a diet with 500 mg/kg rutin increased sIgA, immunologlobulin G (IgG), IgM, and interleukin-10 (IL-10) levels and reduced TNF-α and IFN-γ levels in the ileum (P < 0.05). In the ileum, a diet with 1000 mg/kg rutin supplementation raised sIgA, IgG, IgM, IL-4, and IL-10 levels while decreasing IL-1ß, TNF-α, and IFN-γ levels (P < 0.05). At the family level, a diet with 500 mg/kg rutin supplementation raised the relative abundance of Monoglobaceae and decreased the relative abundance of Eubacteriaceae (P < 0.05) compared to the control group. In the 1000 mg/kg rutin group, the relative abundance of Lactobacillaceae and Unclassified Coriobacteriale was considerably lower and the relative abundance of Monoglobaceae was higher than the control group (P < 0.05). This study showed that a diet with rutin supplementation can improve the intestinal health of aged laying hens, and the mechanism is related to improving the intestinal morphology and intestinal immune status, and regulating the intestinal microbes.

Comparative Genomic and Pan-Genomic Characterization of Staphylococcus epidermidis From Different Sources Unveils the Molecular Basis and Potential Biomarkers of Pathogenic Strains.

Coagulase-negative Staphylococcus (CoNS) is the most common pathogen causing traumatic endophthalmitis. Among which, Staphylococcus epidermidis is the most common species that colonizes human skin, eye surfaces, and nasal cavity. It is also the main cause of nosocomial infection, specially foreign body-related bloodstream infections (FBR-BSIs). Although some studies have reported the genome characteristics of S. epidermidis, the genome of ocular trauma-sourced S. epidermidis strain and a comprehensive understanding of its pathogenicity are still lacking. Our study sequenced, analyzed, and reported the whole genomes of 11 ocular trauma-sourced samples of S. epidermidis that caused traumatic endophthalmitis. By integrating publicly available genomes, we obtained a total of 187 S. epidermidis samples from healthy and diseased eyes, skin, respiratory tract, and blood. Combined with pan-genome, phylogenetic, and comparative genomic analyses, our study showed that S. epidermidis, regardless of niche source, exhibits two founder lineages with different pathogenicity. Moreover, we identified several potential biomarkers associated with the virulence of S. epidermidis, including essD, uhpt, sdrF, sdrG, fbe, and icaABCDR. EssD and uhpt have high homology with esaD and hpt in Staphylococcus aureus, showing that the genomes of S. epidermidis and S. aureus may have communicated during evolution. SdrF, sdrG, fbe, and icaABCDR are related to biofilm formation. Compared to S. epidermidis from blood sources, ocular-sourced strains causing intraocular infection had no direct relationship with biofilm formation. In conclusion, this study provided additional data resources for studies on S. epidermidis and improved our understanding of the evolution and pathogenicity among strains of different sources.

Effects of graded levels of dietary squalene supplementation on the growth performance, plasma biochemical parameters, antioxidant capacity, and meat quality in broiler chickens.

This study was conducted to evaluate the effects of dietary squalene supplementation on the growth performance, plasma biochemical indices, antioxidant status, and meat quality in broilers. Two hundred and forty 0-day-old male chicks were allocated into 5 groups of 6 replicates and were fed a basal diet supplemented with 0 (Control group), 250, 500, 1,000, or 2,000 mg/kg squalene for 42 d. Dietary squalene supplementation linearly increased weight gain and feed efficiency of broilers during the grower and overall periods (P < 0.05). Squalene linearly decreased 21-d malondialdehyde (MDA) level and 42-d glutathione peroxidase (GSH-Px) activity, and both linearly and quadratically decreased 42-d MDA level in plasma (P < 0.05). In contrast, squalene linearly increased plasma reduced form of glutathione (GSH) level on 21 and 42 d and superoxide dismutase activity on 42 d (P < 0.05). Squalene supplementation linearly decreased 21-d MDA accumulation but linearly increased GSH level on 21 d and 42 d and both linearly and quadratically increased 21-d GSH-Px activity in liver (P < 0.05). Supplementing squalene linearly increased pH value at 48 h and linearly decreased lightness at 48 h and 24-h drip loss of breast muscle (P < 0.05). The lightness at 24 h and cooking loss of breast muscle were both linearly and quadratically reduced by squalene (P < 0.05). Dietary squalene administration linearly decreased MDA accumulation but linearly increased GSH level and GSH-Px activity of breast muscle (P < 0.05). Compared with the control group, aforementioned growth performance, antioxidant-related parameters (except 42-d GSH-Px in plasma and breast and hepatic GSH), and meat quality were improved by squalene when its level was 1,000 and 2,000 mg/kg (P < 0.05), with their results being similar between these 2 groups (P > 0.05). It was concluded that squalene administration especially at a level of 1,000 mg/kg can improve growth performance, antioxidant status, and meat quality in broilers, providing insights into its application as a potential feed additive in broiler production.

Myelodysplastic Syndrome with Complex Chromosomal Abnormalities: A Case Report and Literature Review.

OBJECTIVE: Karyotype is the most important diagnostic and prognostic parameter in myelodys-plastic syndrome (MDS). Here, we describe a novel case of MDS with complex chromosomal abnormalities. CASE PRESENTATION: A 55-year-old Chinese female was admitted to the hospital for facial edema and a loss of appetite. Bone marrow aspiration showed the blast cell count 3.6%. Erythrocyte hyperplasia was active, megaloblastoid change was observed, and a wide variability of nuclear numbers, as well as variability of size and shape was present. Bone marrow chromosomal analyses showed 45~48, X, -X, -4, t (5;8) (q13;q22), add (7) (q11), add (13) (p11), -14, del (16) (p13), add (19) (q13), -20, i(21)(q10),+4~6mar [cp15]/46,XX[5]. The patient was diagnosed with MDS with WPSS of the high risk group. IPSS was medium risk-2. IPSS-R was categorized as the extremely high risk group. CONCLUSION: The prognosis and treatment of MDS with complex chromosomal abnormalities are still uncertain, and further studies are needed.

Comparative Toxic Effects of Manufactured Nanoparticles and Atmospheric Particulate Matter in Human Lung Epithelial Cells.

Although nanoparticles (NPs) have been used as simplified atmospheric particulate matter (PM) models, little experimental evidence is available to support such simulations. In this study, we comparatively assessed the toxic effects of PM and typical NPs (four carbonaceous NPs with different morphologies, metal NPs of Fe, Al, and Ti, as well as SiO2 NPs) on human lung epithelial A549 cells. The EC50 value of PM evaluated by cell viability assay was 148.7 µg/mL, closest to that of SiO2 NPs, between the values of carbonaceous NPs and metal NPs. All particles caused varying degrees of reactive oxygen species (ROS) generation and adenosine triphosphate (ATP) suppression. TiO2 NPs showed similar performance with PM in inducing ROS production (p < 0.05). Small variations between two carbonaceous NPs (graphene oxides and graphenes) and PM were also observed at 50 µg/mL. Similarly, there was no significant difference in ATP inhibition between carbonaceous NPs and PM, while markedly different effects were caused by SiO2 NP and TiO2 NP exposure. Our results indicated that carbonaceous NPs could be served as potential surrogates for urban PM. The identification of PM model may help us further explore the specific roles and mechanisms of various components in PM.

PAMAM dendrimer-enhanced DNA biosensors based on electrochemical impedance spectroscopy.

A novel, simple and sensitive DNA biosensor based on DNA-poly(amidoamine) (PAMAM) dendrimer nanoconjugates was developed by using the electrochemical impedance spectroscopy (EIS) technique. In this context, the assay relies on the hybridization of the single-stranded DNA (ssDNA) probe covalently conjugated on a mercaptoacetic acid self-assembled monolayer on gold electrodes, with the generation 4.5 (G-4.5) PAMAM-target DNA complex in solution. Once the double-stranded DNA (dsDNA) formed on the gold electrodes, G-4.5 PAMAM bearing carboxyls on the periphery was anchored on the hybrids; the changes of interfacial electron-transfer resistance (R(et)) of the electrodes were measured using an Fe(CN)(6)(3-/4-) redox probe by electrochemical impedance spectroscopy. The results showed that only a complementary sequence could form a dsDNA-PAMAM with the DNA-PAMAM probe and give an obviously enlarged R(et) value. The non-complementary and three-base mismatched sequence exhibited negligible impedance change compared with the blank measurement (the blank measurement means: ssDNA probe-modified gold electrode was directly measured by EIS). The unique spherical structure combining with more negative charges on the G-4.5 PAMAM periphery anchored on the hybrids could significantly amplify the hybridization signal (R(et) value), and the detection limit for measuring the full complementary sequence is down to pM level.

Effects of Ginger Extract on Laying Performance, Egg Quality, and Antioxidant Status of Laying Hens.

The objective of this study was to investigate the effects of ginger extract (GE) as a dietary supplement for laying hens. A total of 40-week-old 288 Hyline Brown laying hens were randomly divided into two groups with six replicates, and fed a basal diet with or without 100 g/t GE for eight weeks. Dietary GE supplementation increased egg weight, albumin height, and Haugh unit of eggs, and decreased yolk cholesterol content and activities of alanine transaminase and aspartate transaminase in serum at eight weeks. Moreover, GE resulted in higher total superoxide dismutase (T-SOD) activity and lower malondialdehyde (MDA) content in yolk at four and eight weeks and in serum. It was concluded that GE was effective in increasing egg weight and improving the egg quality and antioxidant status of laying hens.

PD-1 Polymorphisms Are Associated with Susceptibility of Acute Anterior Uveitis in Chinese Population.

Acute anterior uveitis (AAU) is an ordinary type of uveitis, which is an autoimmune disease produced by T cells. Programmed apoptosis protein 1 (PD-1) is a vital negative regulatory protein of immune tolerance. We detect the single nucleotide polymorphisms (SNPs) rs41386349, rs10204525, and rs2227982 of PD-1 to investigate the correlation between PD-1 polymorphisms and AAU. A total of 166 AAU patients and 263 controls were recruited in this case-control study. Compared with controls, the frequencies of the GG genotypes were higher in rs10204525 in AAU patients (p = 0.012). There were obvious increases in frequencies of the TT genotypes in rs2227982 and the GG genotypes in rs10204525 in human leukocyte antigen (HLA)-B27-negative AAU patients compared with controls (p = 0.03; p = 0.015, respectively). There were also increases in frequencies of TT genotypes in rs2227982 and the GG genotypes in rs10204525 in the patients without ankylosing spondylitis (AS) when compared with controls (p = 0.021; p = 0.003, respectively). Furthermore, the frequencies of TT genotypes in rs2227982 were higher in female patients diagnosed with AAU than with control group (p = 0.033). Our results showed that SNPs rs2227982 and rs10204525 were interrelated to AAU; the influence on AAU could be related with gender, HLA-B27, and AS status.

The electrochemical detection of droplets in microfluidic devices.

This paper presents a new electrochemical method for the detection and characterisation of aqueous droplets in an organic carrier fluid (1,2-dichloroethane) formed in flow-focusing microfluidic devices. The devices consist of a conventional flow-focusing channel 250 microm wide and 250 microm deep cast out of poly(dimethylsiloxane) (PDMS) which is sealed onto a glass substrate containing a set of microelectrodes 100 microm long. Chronoamperometric analysis of a suitable electrolyte contained in the organic phase is presented for characterising the droplet frequency and size. This chronoamperometric method is then extended to a dual working electrode approach in order to determine the velocity of the droplet. Good agreement between experimental measurements and theory was observed.

Imbalance of Th17/Treg cells in pathogenesis of patients with human leukocyte antigen B27 associated acute anterior uveitis.

Th17 and regulatory T cells, involved in the pathogenesis of several autoimmune diseases, are new lineages of CD4+ T helper cells. However, the role of their imbalance in human leukocyte antigen B27-associated acute anterior uveitis has not been elucidated. In our study, the percentages of Th17 and Treg cells, their molecular markers and related factors in peripheral blood of patients and healthy controls were measured by flow cytometry, real-time RT-PCR and ELISA. We observed a remarkable increase of CD4+ and CD4+IL-17+ T cells in peripheral blood of patients compared to controls. The molecular markers and related factors of Th17 cell were also showed a distinct elevation. Interestingly, we observed an obvious decrease of CD4+CD25+Foxp3+ T cells and Foxp3 mRNA level in patients. The ratio of Th17/Treg in patients was dramatically higher than controls. Moreover, the ratio of Th17/Treg cells had a more significantly positive correlation with the disease activity score than Th17 cells whereas Treg cells had a negative correlation. Our findings demonstrated a distinct increase of Th17 cells and a significant decrease of Treg cells in patients compared to controls. The imbalance of Th17 and Treg cells may play a vital role in the pathogenesis of the disease.

Association of Genotyping of Bacillus cereus with Clinical Features of Post-Traumatic Endophthalmitis.

Bacillus cereus is the second most frequent cause of post-traumatic bacterial endophthalmitis. Although genotyping of B. cereus associated with gastrointestinal infections has been reported, little is known about the B. cereus clinical isolates associated with post-traumatic endophthalmitis. This is largely due to the limited number of clinical strains available isolated from infected tissues of patients with post-traumatic endophthalmitis. In this study, we report successful isolation of twenty-four B. cereus strains from individual patients with different disease severity of post-traumatic endophthalmitis. Phylogenetic analysis showed that all strains could be categorized into three genotypes (GTI, GTII and GTIII) and the clinical score showed significant differences among these groups. We then further performed genotyping using the vrrA gene, and evaluated possible correlation of genotype with the clinical features of B. cereus-caused post-traumatic endophthalmitis, and with the prognosis of infection by conducting follow-up with patients for up to 2 months. We found that the disease of onset and final vision acuity were significantly different among the three groups. These results suggested that the vrrA gene may play a significant role in the pathogenesis of endophthalmitis, and genotyping of B. cereus has the potential for predicting clinical manifestation and prognosis of endophthalmitis. To the best of our knowledge, this is the first report of isolation of large numbers of clinical isolates of B. cereus from patients with endophthalmitis. This work sets the foundation for future investigation of the pathogenesis endophthalmitis caused by B. cereus infection.

[Anterolateral thigh and groin conjoined flap for emergent repair of ultra-long complex tissue defects in forearm and hand].

OBJECTIVE: To evaluate the effectiveness of anterolateral thigh and groin conjoined flap in emergent repair of ultra-long complex tissue defects in forearm and hand. METHODS: Between February 2009 and October 2011, 6 patients with complex tissue defect of dorsal forearm and hand were in adminsion. There were 5 male and 1 female with an average age of 38.5 years (range, 32-47 years). Injury reasons included machine injury in 5 cases and traffic accident injury in 1 case. Injury to admission time was from 3 to 16 hours (mean, 6 hours). All case were single limb injury, including right forearm and hand injury in 4 cases and left forearm and hand injury in 2 cases. The wound area was from 36 cm x 9 cm to 48 cm x 12 cm. The type of associated injury included elbow dislocation associated with open injury in 2 cases; fractures of the radial, ulnar, and metacarpal bone in 4 cases; defects of wrist dorsal skin and extensor tendons of fingers and wrist in 5 cases; and defects of ulnar artery and ulnar nerve in 1 case. The anterolateral thigh and groin conjoined free flaps were used to repair defects in the forearm and hand in emergency. The area of flap was from 36 cm x 9 cm to 48 cm x 12 cm. Meanwhile the partial functional reconstruction was performed. The donor site was repaired by skin grafts. RESULTS: The anastomotic embolization of vascular pedicle and arteria interossea dorsalis occurred in 1 case, purulent secretion under the flap in 1 case, which were cured after symptomatic treatment; the skin flaps completely survived, and primary healing of the wounds were obtained in the other cases. The donor skin grafts survived in 2 cases, and partial necrosis of the skin graft of lower abdominal occurred in 4 cases, and healed after changing dressing. All of the 6 patients were followed up 3 to 18 months (mean, 10 months). The appearance and texture of the flaps were good. The protective sensation was recovered in 2 cases followed up for more than 14 months; no sensory recovery was observed in the other cases. At last follow-up, according to the upper extremity functional evaluation standard by Hand Surgery Branch of Chinese Medical Association, the results were excellent in 1 case, good in 4 cases, and poor in 1 case, and the excellent and good rate was 83.3%. CONCLUSION: It could get a good short-term effectiveness to use the anterolateral thigh and groin conjoined flap for emergent repair of the ultra-long and complex tissue defects in forearm and hand.