An ingestible near-infrared fluorescence capsule endoscopy for specific gastrointestinal diagnoses.

Early diagnosis of gastrointestinal (GI) diseases is important to effectively prevent carcinogenesis. Capsule endoscopy (CE) can address the pain caused by wired endoscopy in GI diagnosis. However, existing CE approaches have difficulty effectively diagnosing lesions that do not exhibit obvious morphological changes. In addition, the current CE cannot achieve wireless energy supply and attitude control at the same time. Here, we successfully developed a novel near-infrared fluorescence capsule endoscopy (NIFCE) that can stimulate and capture near-infrared (NIR) fluorescence images to specifically identify subtle mucosal microlesions and submucosal lesions while capturing conventional white light (WL) images to detect lesions with significant morphological changes. Furthermore, we constructed the first synergetic system that simultaneously enables multi-attitude control in NIFCE and supplies long-term power, thus addressing the issue of excessive power consumption caused by the NIFCE emitting near-infrared light (NIRL). We performed in vivo experiments to verify that the NIFCE can specifically "light up" tumors while sparing normal tissues by synergizing with probes actively aggregated in tumors, thus realizing specific detection and penetration. The prototype NIFCE system represents a significant step forward in the field of CE and shows great potential in efficiently achieving early targeted diagnosis of various GI diseases.

Research on stem cell therapy for spinal cord injury: a bibliometric and visual analysis from 2018-2023.

Objectives: The aim of this study was to conduct a bibliometric analysis of the literature on stem cell treatment for spinal cord injury to gain an intuitive understanding of how the field is progressing, discover topics of interest, and determine what development trends are emerging in this field. Background: Spinal cord injury and its complications often cause an enormous economic burden, and postinjury repair and treatment have always been challenging in clinical and scientific research. Stem cell therapy for spinal cord injury can prevent immune rejection and induce the release of neuroprotective and anti-inflammatory factors to reduce the production of stress-related proteins, reactive oxygen species, and inflammatory reactions. Methods: We analyzed the number and quality of publications in the field of stem cell therapy in spinal cord injury between 2018.01.01 and 2023.06.30 in the core collection database of Web of Science. CiteSpace and VOSviewer were used to sort and summarize these studies by country, institution, authors' publications, and collaborative networks. In addition, the research topics of interest were identified and summarized. Results: This study ultimately included 2,150 valid papers, with the number of publications showing a gradual upward trend. The country, institution, author and journal with the greatest number of publications and citations are China, the Chinese Academy of Sciences, Dai JW, and the International Journal of Molecular Sciences, respectively. The top three high-frequency keyword clusters were hereditary paraplegia, reactive astrocytes and tissue engineering. Conclusion: With the help of visual analysis, we identified general trends and research topics of interest in the field of spinal cord injury over the last 5 years. Our findings suggest that stem cell transplantation for spinal cord injury and exosome therapy may be a focus of future research. This study provides a foundation for future research on stem cell therapy as well as clinical efforts in this field.

High-Performance Infrared Detectors Based on Black Phosphorus/Carbon Nanotube Heterojunctions.

Infrared detectors have broad application prospects in the fields of detection and communication. Using ideal materials and good device structure is crucial for achieving high-performance infrared detectors. Here, we utilized black phosphorus (BP) and single-walled carbon nanotube (SWCNT) films to construct a vertical van der Waals heterostructure, resulting in high-performance photovoltaic infrared detectors. In the device, a strong built-in electric field was formed in the heterojunction with a favored energy-band matching between the BP and the SWCNT, which caused a good photovoltaic effect. The fabricated devices exhibited a diode-like rectification behavior in the dark, which had a high rectification ratio up to a magnitude of 104 and a low ideal factor of 1.4. Under 1550 nm wavelength illumination, the 2D BP/SWCNT film photodetector demonstrated an open-circuit voltage of 0.34 V, a large external power conversion efficiency (η) of 7.5% and a high specific detectivity (D*) of 3.1 × 109 Jones. This external η was the highest among those for the photovoltaic devices fabricated with the SWCNTs or the heterostructures based on 2D materials and the obtained D* was also higher than those for most of the infrared detectors based on 2D materials or carbon materials. This work showcases the application potential of BP and SWCNTs in the detection field.

A case of Vagococcus fluvialis isolated from the bile of a patient with calculous cholecystitis.

BACKGROUND: Chronic cholecystitis, characterized by persistent inflammation of the gallbladder, predominantly stems from the prolonged presence of gallstones. Calculous cholecystitis has demonstrated a consistent escalation in its incidence over time.Gallbladder stones have been recognized as a predisposing factor for the development of biliary tract infections.Concomitantly, there have been substantial shifts in the distribution and resistance profiles of pathogenic microorganisms responsible for biliary tract infections. The timely acquisition of bile samples for pathogen analysis is of paramount importance, given its critical role in guiding judicious clinical pharmacotherapy and enhancing patient prognosis. CASE PRESENTATION: We present a case involving a 66-year-old female patient who had previously undergone subtotal gastrectomy due to diffuse large B-cell lymphoma. The patient was admitted to our institution with complaints of abdominal pain. Subsequent diagnostic evaluation revealed concurrent choledocholithiasis and cholecystolithiasis. The patient underwent surgical cholecystectomy as the therapeutic approach. Histopathological examination of the excised gallbladder disclosed characteristic features indicative of chronic cholecystitis. Subsequent laboratory analysis of the patient's bile specimen yielded Gram-positive cocci, subsequently identified through biochemical assays, mass spectrometry, and 16 S rRNA analysis as Vagococcus fluvialis. Further in vitro antimicrobial susceptibility testing using disk diffusion and microfluidic dilution showed that this strain exhibited inhibition zone diameters ranging from 12.0 to 32.0 mm in response to 26 antibiotics, including ampicillin, cefazolin, cefuroxime, cefotaxime, ceftriaxone, cefepime, ampicillin/sulbactam, piperacillin, ciprofloxacin, cefoperazone/sulbactam, imipenem, meropenem, piperacillin/tazobarb, penicillin, erythromycin, chloramphenicol, vancomycin, methotrexate/sulfamethoxazole, teicoplanin, linezolid, tigecycline, cefoxitin, ceftazidime, levofloxacin, minocycline and tobramycin. However, the inhibition zone diameters were 6.0 mm for amikacin, oxacillin, clindamycin, and tetracycline. The patient received ceftazidime anti-infective therapy both preoperatively and within 24 h postoperatively and was discharged successfully one week after surgery. CONCLUSION: In this study, we present the inaugural isolation and identification of Vagococcus fluvialis from bile specimens of patients afflicted with calculous cholecystitis. This novel finding lays a substantial experimental groundwork for guiding clinically rational antimicrobial therapy and advancing the exploration of relevant pathogenic mechanisms pertaining to Vagococcus fluvialis infections.

Black Phosphorus Field-Effect Transistors with Improved Contact via Localized Joule Heating.

Two-dimensional (2D) black phosphorus (BP) is considered an ideal building block for field-effect transistors (FETs) owing to its unique structure and intriguing properties. To achieve high-performance BP-FETs, it is essential to establish a reliable and low-resistance contact between the BP and the electrodes. In this study, we employed a localized Joule heating method to improve the contact between the 2D BP and gold electrodes, resulting in enhanced BP-FET performance. Upon applying a sufficiently large source-drain voltage, the zero-bias conductance of the device increased by approximately five orders of magnitude, and the linearity of the current-voltage curves was also enhanced. This contact improvement can be attributed to the formation of gold phosphide at the interface of the BP and the gold electrodes owing to current-generated localized Joule heat. The fabricated BP-FET demonstrated a high on/off ratio of 4850 and an on-state conductance per unit channel width of 1.25 µS µm-1, significantly surpassing those of the BP-FETs without electrical annealing. These findings offer a method to achieve a low-resistance BP/metal contact for developing high-performance BP-based electronic devices.

A kind of planar waveguides for cheating the high-speed digital signals into misidentifying the characteristic impedance.

Since a planar periodic transmission line can suppress drastically the electromagnetic coupling, it would be advantageous to use such a kind of transmission lines in solving the problem of miniaturization of circuit area. By adjusting the lattice constants and geometric parameters of periodic microstrip lines, a time domain characteristic impedance that is the same as that of conventional microstrip lines (CMLs) can be achieved. Such periodic microstrip lines can therefore be used to trick high-speed digital signals, causing a digital signal to misjudge the time domain characteristic impedance of the transmission lines. The theoretical analysis has been verified by our experimental measurement results. Besides, a specific expression for the characteristic impedance of lossless periodic artificial materials is deduced by a circuit model and a standard of misidentification for the characteristic impedance of periodic microstrip lines is given for the digital signals.

A Case of Weissella confusa Isolated from Blood of a Patient with Coronary Heart Disease Complicated with Gastrointestinal Bleeding.

Introduction: W. confusa has been known to cause various human infections. It is naturally resistant to vancomycin and is difficult to identify using traditional methods, which may lead to misidentification and delay treatment. Case Presentation: We present a case of a 42-year-old male patient with gastrointestinal bleeding and coronary heart disease who developed sepsis caused by Weissella confusa. The patient's blood cultures showed the presence of gram-positive coccobacilli, later identified as W. confusa through matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility testing revealed that W. confusa had low minimum inhibitory concentrations (MICs) for some drugs (eg, ampicillin) and higher MICs for others (eg, cefotaxime). Empirical treatment with vancomycin was initially started, but after obtaining the identification and susceptibility results, the treatment was switched to meropenem combined with daptomycin, resulting in a successful outcome. Conclusion: Weissella confusa bacteremia is relatively rare, and accurate pathogenic diagnosis is essential for effective clinical treatment.

High-Sensitive Wearable Strain Sensors Based on the Carbon Nanotubes@Porous Soft Silicone Elastomer with Excellent Stretchability, Durability, and Biocompatibility.

Wearable strain sensors can transfer human physical motions into digital features and connect the real world to the virtual world. However, there is still a huge challenge to prepare breathable strain sensors with good sensitivity, stretchability, softness, durability, and biocompatibility, simultaneously. Herein, we employ the soft silicone elastomer as a highly stretchable substrate and propose a new strain sensor based on the carbon nanotubes@porous soft silicone elastomer (CNTs@PSSE) by salt-template-assisted and dip-coating methods. The CNTs (conductive fillers) are firmly embedded in the PSSE. The obtained sensors exhibit excellent sensitivity up to 2845.1 and a large sensing strain range of 186%. Notably, the CNTs@PSSE sensors also possess strong robustness, which can resist ultrasonic deterioration and carry out more than 10,000 high-frequency stretch-relax cycles in the presence of an obvious notch caused by the scissor. Moreover, the excellent biocompatibility indicates that the sensors can be safely attached to human skin for precisely detecting full-range human motions and being configured on smart wireless gloves for synchronous control of the bionic hand robot.

Biomimetic Self-Assembling Metal-Organic Architectures with Non-Iridescent Structural Coloration for Synergetic Antibacterial and Osteogenic Activity of Implants.

Materials in nature feature versatile and programmable interactions to render macroscopic architectures with multiscale structural arrangements. By rationally combining metal-carboxylate and metal-organophosphate coordination interactions, Au25(MHA)18 (MHA, 6-mercaptohexanoic acid) nanocluster self-assembled structural color coating films and phytic acid (PA)-metal coordination complexes are sequentially constructed on the surface of titanium implants. The Lewis acid-base coordination principle applies for these metal-organic coordination networks. The isotropic arrangement of nanoclusters with a short-range order is investigated via grazing incidence wide-angle X-ray scattering. The integration of robust M-O (M = Ti, Zr, Hf) and labile Cu-O coordination bonds with high connectivity of Au25(MHA)18 nanoclusters enables these artificial photonic structures to achieve a combination of mechanical stability and bacteriostatic activity. Moreover, the colorless and transparent PA-metal complex layer allows the viewing of the structural color and surface wettability switching to hydrophilic and makes feasible the interfacial biomineralization of hydroxyapatite. Collectively, these modular metal-organic coordination-driven assemblies are predictive and rational material design strategies with tunable hierarchy and diversity. The complete metal-organic architectures will not only help improve the physicochemical properties of the bone-implant interface with synergistic antibacterial and osseointegration activities but also can boost surface engineering of medical metal implants.

ExoSD chips for high-purity immunomagnetic separation and high-sensitivity detection of gastric cancer cell-derived exosomes.

Gastric cancer cell-derived exosomes as biomarkers have a very high application potential to the non-invasive detection of early-stage gastric cancer. However, the small size of exosomes (30-150 nm) results in huge challenges in separating and detecting them from complex media (e.g., plasma, urine, saliva, and cell culture supernatant). Here we proposed a highly integrated exosome separation and detection (ExoSD) chip to immunomagnetic separate exosomes from cell culture supernatant in a manner of continuous flow, and to immunofluorescence detect gastric cancer cell-derived exosomes with high sensitivity. The ExoSD chip has achieved a high exosome recovery (>80%) and purity (>83%) at the injection rate of 4.8 mL/h. Furthermore, experimental results based on clinical serum samples of patients with gastric cancer (stages I and II) show that the detection rate of the ExoSD chip is as high as 70%. The proposed ExoSD chip has been successfully demonstrated as a cutting-edge platform for exosomes separation and detection. It can be served as a versatile platform to extend to the applications of separation and detection of the other cell-derived exosomes or cells.

A novel anticoagulant affinity membrane for enhanced hemocompatibility and bilirubin removal.

Affinity membrane is widely employed to promote specific adsorption of toxins and reduce the blood purification therapeutic time. However, it suffers from insufficient toxin binding and low hemocompatibility. Herein, a novel anticoagulant affinity membrane (AAM) was developed to clear bilirubin from human blood in a pore-flow-through way. Firstly, a nylon net membrane with a regularly arranged pore as the matrix was coated with poly(pyrrole-3-carboxylic acid) via chemical vapor deposition (CVD) method. Then, poly(L-arginine) (PLA) as a highly specific ligand of bilirubin, was immobilized onto the surface of the composited membrane after the modification of heparin. Owing to the 3-dimensional molecular architecture of PLA, up to 86.1 % of bilirubin was efficiently cleared. Besides, the AAM exhibited effective anticoagulant activity in the measurement of clotting time, with suppressed thrombus formation, low hemolysis ratio, minimized platelet and leukocyte adhesion, and excellent biosafety. Therefore, the AAM has enormous potential in blood purification therapy for enhancing hemocompatibility and bilirubin removal.

Ag-Modified 3D Reduced Graphene Oxide Aerogel-Based Sensor with an Embedded Microheater for a Fast Response and High-Sensitive Detection of NO2.

A chemiresistive gas sensor based on a three-dimensional Ag-modified reduced graphene oxide (3D Ag-rGO) aerogel is reported. We improve the graphene-based sensor performance by optimization of operating temperature, chemical modification, and new design of the material geometrical structure. The self-assembly and Ag nanoparticle (NP) decoration of the Ag-rGO aerogel are realized by a facile, one-step hydrothermal method. An integrated low-power microheater fabricated on a micromachined SiO2 membrane is employed to enhance the performance of the sensor with a fast response to NO2 and a shortened recovery time. The 3D Ag-rGO-based sensor at a temperature of 133 °C exhibits the highest response. At the same time, the response to other gases is suppressed while the response of the Ag-rGO sensor toward ammonia at 133 °C is reduced to half of the value at room temperature, demonstrating a greatly improved selectivity toward NO2. Additionally, the sensor exhibits a remarkably fast response to 50 ppb NO2 and a low limit of detection of 6.9 ppb.

Progress in Microfluidics-Based Exosome Separation and Detection Technologies for Diagnostic Applications.

Exosomes are secreted by most cell types and circulate in body fluids. Recent studies have revealed that exosomes play a significant role in intercellular communication and are closely associated with the pathogenesis of disease. Therefore, exosomes are considered promising biomarkers for disease diagnosis. However, exosomes are always mixed with other components of body fluids. Consequently, separation methods for exosomes that allow high-purity and high-throughput separation with a high recovery rate and detection techniques for exosomes that are rapid, highly sensitive, highly specific, and have a low detection limit are indispensable for diagnostic applications. For decades, many exosome separation and detection techniques have been developed to achieve the aforementioned goals. However, in most cases, these two techniques are performed separately, which increases operation complexity, time consumption, and cost. The emergence of microfluidics offers a promising way to integrate exosome separation and detection functions into a single chip. Herein, an overview of conventional and microfluidics-based techniques for exosome separation and detection is presented. Moreover, the advantages and drawbacks of these techniques are compared.

[Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion].

Objective: To investigate the effectiveness of transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion. Methods: Between January 2007 and May 2015, 23 patients with thumb nerve avulsion were treated by transferring the ulnaris proper digital nerve of index finger and its dorsal branch. There were 17 males and 6 females with an average age of 32 years (range, 16-63 years). The injuries were caused by machine twist in 10 cases, electric saw in 8 cases, and sharp article prick in 5 cases. And thumb rotational avulsion amputation happened in 8 cases, thumb incomplete amputation in 2 cases, laceration of thumb palmaris with the thumb nerve avulsion of both sides in 13 caese (7 cases with tendon rupture). The time from injury to operation was 1.0-3.5 hours (mean, 2.2 hours). Results: All incisions healed by first intention. Ten cases of thumb reimplantation were successful. All the patients were followed up for 5 months to 2 years and 8 months, with an average of 1 year and 4 months. Two-point discrimination was 3-9 mm (mean, 6.8 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the sensory of the thumb was rated as S 4 in 18 cases and S3+ in 5 cases; the sensory at donor sites recovered to S3. Conclusion Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp. Conclusion: Transferring the ulnaris proper digital nerve of index finger and its dorsal branch to repair the thumb nerve avulsion is a simple and effective method to restore sensory function of the thumb pulp.

p53 upregulated modulator of apoptosis sensitizes drug-resistant U251 glioblastoma stem cells to temozolomide through enhanced apoptosis.

Malignant glioma is a highly aggressive brain tumor with a poor prognosis. Chemotherapy has been observed to prolong overall survival rate and temozolomide (TMZ), a promising chemotherapeutic agent for treating glioblastoma (GBM), possesses the most effective clinical activity at present, although drug resistance limits its clinical outcome. Growing evidence supports the concept that initial and recurrent GBM may derive from glioblastoma stem cells, which may be responsible for drug resistance. However, the molecular mechanisms underlying this resistance remain to be elucidated. In the present study, a TMZ­resistant GBM cell line, U251R, was developed and subsequently divided into two subpopulations according to the CD133 immunophenotype. No significant difference was identified in the expression of O6­methylguanine­DNA­methyltransferase (MGMT) between CD133+ U251R cells and CD133­ U251R cells, whereas the CD133+ cell population was more resistant to TMZ­induced growth inhibition and cell death. TMZ achieves its cytotoxic effect by inducing DNA lesions and p53 upregulated modulator of apoptosis (PUMA) is an essential mediator of DNA damage­induced apoptosis independently of p53 status. Therefore, whether PUMA effectively enhances growth suppression and induces apoptosis when combined with TMZ was investigated. Consequently, it was found that adenoviruses expressing wild­type­PUMA not only lead to the apoptosis of CD133+ U251R cells alone, but also significantly increase their sensitivity toward TMZ by elevating the Bcl­2­associated X protein/B­cell lymphoma­2 ratio without alterations in MGMT expression. Therefore, PUMA may be a suitable target for intervention to improve the therapeutic efficacy of TMZ.

[Repair of degloving injury of fingertip with vascular pedicled cross finger flap].

OBJECTIVE: To investigate the effectiveness of cross finger flap pedicled with the dorsal branch of proper digital artery in repairing degloving injury of the fingertip. METHODS: Between January 2010 and June 2012, 13 cases of degloving injury of single fingertip were treated, including 9 males and 4 females with an average age of 33.6 years (range, 17-46 years). The defect locations were index finger in 5 cases, middle finger in 3 cases, ring finger in 3 cases, and little finger in 2 cases, including 4 cases of mechanical injury, 6 cases of twist injury, and 3 cases of crushing injury. The extent of skin avulsion was beyond the distal interphalangeal joint. The length of the avulsion was 1.0-2.1 cm (mean, 1.8 cm). Complicated injuries included phalangeal fracture in 2 cases. The time from injury to operation was 90-330 minutes (mean, 150 minutes). The wound was repaired with the cross finger flap pedicled with the dorsal branch of proper digital artery. The size of flaps ranged from 3.2 cm x 2.3 cm to 4.2 cm x 3.1 cm. After 3-4 weeks, the pedicle was cut. The donors were closed by skin graft. RESULTS: Tension blisters of the flap and partial necrosis of skin graft occurred in 3 cases and in 1 case respectively, which were cured after symptomatic treatment; the flap and skin graft survived, and primary healing was obtained in the other cases. Thirteen patients were followed up 6-10 months (mean, 7 months). The texture and appearance of all the flaps were satisfactory. At 6 months after operation, two-point discrimination ranged from 7 to 10 mm (mean, 8.1 mm). The total active movement of the fingers were excellent in 10 cases and good in 3 cases, and the excellent and good rate was 100%. CONCLUSION: The treatment of degloving injury of fingertip with the cross finger flap pedicled with the dorsal branch of proper digital artery is recommendable for the advantages of reliable blood supply, simple operation, high survival rate of the flap, good function recovery of the finger, and satisfactory appearance.

[Efficacy of albendazole orally administered at different dosages against Trichinella spiralis encapsulated larvae in mice].

OBJECTIVE: To evaluate the efficacy of albendazole (ABZ) orally administered at different dosages against Trichinella spiralis encapsulated larvae in striated muscle in mice. METHODS: A total of 72 BALB/c mice were divided equally into 9 groups. Each mouse was infected orally with 50 T. spiralis encapsulated larvae. At the 29th day after infection, albendazole was each orally administered to the mice of the 8 groups with doses of 50, 100, 150, 200, 250, 300, 350, and 400 mg/(kg x d), respectively, once a day at fixed time for 6 d. The control group was untreated. Mice were sacrificed at the 7th day post administration. The encapsulated larvae in diaphragmatic muscle, jugomaxillary muscle and gastrocnemius muscle were examined with pellet method. The encapsulated larva that the capsule was complete and the larva inside curled naturally with clear structure was considered survived. The therapeutic effect was estimated on the average quantity of total, survival and dead encapsulated larvae per gram muscle, total worm reduction and survival worm reduction. RESULTS: The total worm burden and survival worms showed a decreasing trend and the numbers of dead worms increased in diaphragmatic muscle, jugomaxillary muscle and gastrocnemius muscle when the dosage of albendazole were 50-250 mg/(kg x d), but the number of larvae in the muscles remained similar when the dosage of albendazole was greater than 250mg/kg x d. Compared with the control group, the total and survival worms in the muscles in 200 mg/(kg x d) and the greater dose groups decreased significantly (P<0.01). In 250 mg/(kg x d) group the total worm reduction in jugomaxillary muscle, diaphragmatic muscle and gastrocnemius muscle were 50.00%, 62.62% and 57.48%, and the survival worm reduction were 79.96%, 83.25% and 80.56%, respectively. CONCLUSION: Orally administered to mice for 6 d, albendazole at 250 mg/(kg x d) is a suitable dose against encapsulated larva stage of T. spiralis in muscle.

[Design of flap using eight-point-location method and clinical application].

OBJECTIVE: To introduce a new method of flap design and to investigate the feasibility of the clinical application. METHODS: Between April 2006 and November 2009, 89 patients with skin and soft tissue defects were treated. There were 47 males and 42 females with an average age of 36 years (range, 16-67 years). The injuries were caused by machine crush (38 cases), electric saw (16 cases), electricity (8 cases), traffic accident (18 cases), rolling machine (3 cases), and crash of heavy object (6 cases). The locations were forearm in 4 cases, palm in 23 cases, finger in 41 cases, lower leg in 7 cases, and dorsum of foot in 14 cases. All the cases complicated by exposure of tendons or bones. The time from injury to hospitalization was 30 minutes to 5 days (mean, 3 hours). The areas of skin and soft tissue defect ranged from 2.0 cm x 1.5 cm to 26.0 cm x 18.0 cm. The wounds were repaired with the pedicle flaps in 72 cases and the free flaps in 17 cases. All the flaps were designed with eight-point-location method. A trapezoid was made in the raw surface and the four vertexes of the trapezoid were on the edge of the raw surface. The exterior points of the heights of arciforms were made on the edge of the raw surface too. The eight points were the labelling points. The top width, the bottom width, the height of the trapezoid, and the heights of the arciforms could be measured. The above numerus were expanded 5%-10%. The expanded numerus were the corresponding numerus of the skin flap. The size of flaps ranged from 2.2 cm x 1.7 cm to 28.5 cmx 19.5 cm. The donor sites were closed directly in 17 cases, and repaired with skin grafts in 72 cases. RESULTS: All the flaps were successfully dissected according to flap design. When the flaps were transplanted to the wounds, tension of the flaps was appropriate. All the flaps and skin grafts survived. The wounds and incisions at donor sites healed by first intention. Eighty-nine patients were followed up 6 to 26 months (mean, 20 months). The texture, appearance, flexibility, and function of the flaps were satisfactory, and no complication occurred. The sensory restoration of the pedicle flaps were graded as S3-S4. CONCLUSION: It is an ideal and simple method to design flap using eight-point-location method. The flaps are precise in the figure and area.

[Application of the island flap at the dorsum of the middle phalange with the pedicel of the digital proper artery].

OBJECTIVE: To explore a method for the treatment of the skin defects at the distal phalanges of 2-5th fingers. METHODS: The island flap at the dorsum of the middle phalange was designed with the pedicle of dorsal branches from the digital proper artery. When the flap was used to repair defect at finger pulp, the dorsal branch of the digital proper nerve in the flap was kept to be anastomosed to the digital proper nerve at the recipient finger. From Feb. 2005 to May. 2010, 54 cases with skin defects at the distal phalanges of 61 fingers were treated with the flap, including 35 defects at finger pulp and 26 defects at finger tip. RESULTS: The maximum size of defects and flaps was 2.2 cm x 2.5 cm and 2.4 cm x 2.7 cm, respectively. 61 flaps survived completely. Blister was happened in 3 flaps 2 days after operation, which healed spontaneously without necrosis. 54 cases were followed up for 5 to 22 months (average, 11 months). The flaps had good texture and color match with normal sensation (grade S4). The 2-point discrimination distance was 6-9 mm. The interphalangeal joint had normal movement. CONCLUSIONS: The island flap at the dorsum of the middle phalange is an ideal method for the skin defect at the distal phalange of finger.