The Application of Preoperative Computed Tomography Angiography and Color Ultrasound Assisted Lower Limb Perforator Flap Design in the Repair of Lower Limb Soft Tissue Defects.

Objective: The goal of this study was to explore the application effect of preoperative computed tomography (CT) angiography and color ultrasound-assisted design of lower limb perforator flaps in the repair of lower limb soft tissue defects. Repair of soft tissue defects in the lower limbs is a challenging surgical task, and accurate preoperative location of vascular structures and detailed design of the surgical plan are crucial to the success of the surgery. This study aims to improve the accuracy and effectiveness of lower limb perforator flap repair surgery by introducing CT angiography and color ultrasound technology. Methods: Sixty-four patients who underwent lower limb soft tissue defect repair with perforator flaps were enrolled at our hospital from February 2020 to February 2023. According to their admission time, they were divided into two groups: 32 patients admitted before June 31, 2022, were included in the control group, and preoperative color Doppler ultrasound was used to assist in designing the lower limb perforator flap; 32 patients admitted after June 31, 2022, were included in the study group, and preoperative CT angiography and color Doppler ultrasound were used to assist in designing the lower limb perforator flap. Specifically, we conducted detailed records and analyzes of patients' age distribution, gender ratio, and relevant medical history. This demographic information will help reveal whether there are differences in the effectiveness of preoperative CT angiography and color ultrasound-assisted lower extremity perforator flap design among different patient groups. By considering these key factors, we can more accurately assess the actual utility of new technologies in different patient groups and provide more specific guidance for clinical practice.The therapeutic effects of the two groups of patients were recorded. The differences between the preoperative CT angiography measurements and intraoperative actual measurements of the study group were compared. Clinical indicators, sensory function in the graft area, flap survival rate, flap complication rate, and donor area complication rate were compared between the two groups. The satisfaction of patients in the two groups with the recovery of the surgical area was also compared. Results: The treatment success rate of the study group was higher than that of the control group (P < .05). There was no significant difference in the preoperative CT angiography measurements (shallow branch localization, shallow branch starting diameter, shallow branch length, deep branch starting diameter) and intraoperative actual measurements of the study group (P > .05). The operation time and intraoperative blood loss of the study group were shorter than those of the control group (P < .05), and there was no significant difference in flap harvesting area and length of hospital stay between the two groups (P > .05). There was a difference in sensory function in the graft area between the two groups, with a higher proportion of S4 grade in the study group and better recovery compared to the control group (P < .05). There was no significant difference in satisfaction evaluation between the two groups (P > .05). Conclusion: Preoperative CT angiography and color ultrasound-assisted design of lower limb perforator flaps have shown significant clinical advantages in repairing lower limb soft tissue defects, improving treatment effects and surgical efficiency. In clinical practice, this technology is expected to reduce surgical complexity, shorten surgical time, reduce the risk of intraoperative bleeding, and achieve effective defect repair while maintaining or improving the patient's sensory function.However, there are some limitations to the study, such as the relatively small sample size and single-center nature. Future research can optimize the operation process of this technology, expand the scope of research, and explore its application in the repair of soft tissue defects caused by specific causes. This technology may provide more precise and effective options for personalized treatment, especially for patients who need to preserve more sensory function.

ical Efficacy of Early Plastic Surgery Treatment for Patients with Deep Hand Burns.

Objective: This study aims to assess the effectiveness of early plastic surgery for deep hand burns by examining variables like VAS scores, wound healing time, and excellent hand function recovery rates. Methods: A total of 130 patients with deep hand burns admitted to our hospital between January 2020 and October 2021 were enrolled in this study. They were randomly assigned to either a control group (n = 65, deferred reconstructive surgery) or an observation group (n = 65, early reconstructive surgery) using a random number table. We compared the VAS scores, wound healing time, rates of excellent hand function recovery, complications, and overall treatment efficacy between the two groups. Results: The preoperative VAS scores were comparable between the observation and control groups (P > .05). Postoperative VAS scores in the observation group were significantly lower than those in the control group at 1, 3, and 7 days following surgery (P < .05). Additionally, the observation group exhibited shorter wound healing times and higher rates of excellent hand function recovery (P < .05). The incidence of complications such as numbness, infection, and necrosis of implants was lower in the observation group compared to the control group (P < .05). The overall treatment efficacy was also significantly better in the observation group than in the control group (P < .05). Conclusions: These findings underscore the high clinical value of early surgical intervention, supporting its broader application in the treatment of deep hand burns and potentially improving patient outcomes.

Effects of Meteorological Factors on Waterbird Functional Diversity and Community Composition in Liaohe Estuary, China.

Functional trait diversity represents ecological differences among species, and the structure of waterbird communities is an important aspect of biodiversity. To understand the effect of meteorological changes on the waterbird functional diversity and provide suggestions for management and conservation, we selected a study area (726 km2) in Liaohe Estuary, located in northeast China. We explored the trends of the waterbird functional diversity changes in response to meteorological factors using fourth corner analysis. Our study demonstrated that temperature was a key factor that impacted waterbird functional diversity in spring, while precipitation had a greater impact in autumn. The population size of goose and duck was positively associated with temperature and negatively with precipitation, while that of the waders (Charadriiformes) showed opposite association trends. Herbivores and species nesting on the bare ground exhibited responses to meteorological factors similar to those of geese and ducks, while benthivores and waterbirds nesting under grass/shrubs exhibited trends similar to those of waterbirds. Waterbirds with smaller bodies, shorter feathers, and lower reproductive rates preferred higher temperatures and less precipitation than other waterbirds. In addition, we observed seasonal variations in waterbird functional diversity. In spring, we should pay attention to waders, herbivores, and waterbirds nesting on the bare ground when the temperature is low. In autumn, waders, benthivores, and omnivores need more attention under extreme precipitation. As the global climate warms in this study area, waterbird functional diversity is expected to decline, and community composition would become simpler, with overlapping niches. Biodiversity management should involve protecting intertidal habitats, supporting benthic macrofaunal communities, preparing bare breeding fields for waterbirds favoring high temperatures to meet their requirements for population increase, and preventing the population decline of geese and ducks, herbivores, and species nesting under grass/shrubs. The findings of our study can aid in developing accurate guidelines for waterbird biodiversity management and conservation.

Assessing hydrodynamic effects of ecological restoration scenarios for a tidal-dominated wetland in Liaodong Bay (China).

Estuarine wetlands have experienced a variety of ecological and environmental problems caused by natural and anthropogenic factors. China has proposed a series of measures and made great efforts to control coastal degradation; however, decision makers still urgently need to know which measures to implement and how they will influence the estuarine environment and functions. This study used field observations, a hydrodynamic model, and statistical methods to investigate the effects of potential restoration scenarios on hydrodynamic conditions in the tidal-influenced estuarine wetland system, Liaodong Bay (China). Results reveal that the average total phosphorus, organic carbon, available phosphorus, pH, total nitrogen content, and moisture content in the soil and sediment environment were 0.04 ± 0.003%, 0.84 ± 0.25%, 16.3 ± 4.7 mg/kg, 8.3 ± 0.1, 0.07 ± 0.02%, and 44 ± 2%, respectively, exhibiting an overall trend of degradation. A series of restoration scenarios in regards to hydrodynamic regulation and tidal inputs were used to preserve the ecological value of the estuarine wetland. Model simulations indicate that the significant improvement of hydrodynamic fields (inundation depth and flow velocity) is more likely to occur when the tidal amplitudes reach around 2 m, while relatively weak responses can be observed when the tidal levels are lower than 1 m. Additionally, the construction of floodgates may play a key role in determining the tidal inputs and flowpaths across the wetland. The modifications in micro-topography of the wetland may play a complementary role in enhancing the connectivity condition via increased creek depth of 0.5 m and width up to around 20 m. This work represents a first attempt in exploring hydrodynamic effects of restoration scenarios for a tidal-dominated wetland. An improved understanding of the estuarine system also highlights that the design and implementation of wetland restoration projects should use more comprehensive measures to achieve long-term landscape management, connectivity planning, and ecological sustainability.

Newborn Screening of Genetic Mutations in Common Deafness Genes With Bloodspot-Based Gene Chip Array.

PURPOSE: This study screens for deafness gene mutations in newborns in the Northwest China population. METHOD: The 9 sites of 4 common deafness genes (GJB2, GJB3, SLC26A4, and mt 12S rRNA) were detected by bloodspot-based gene chip array in 2,500 newborns. RESULTS: We detected mutations of the 4 genes in 101 (4.04%) newborns; particularly, 0.20% detected the double mutations. In the Hui population, 4.58% of the newborns tested positive for mutations, whereas 4.01% of Han newborns tested positive for mutations. The detective rates are as follows: 1.44% for GJB2 235delC, 1.08% for SLC26A4 IVS7-2A>G, 0.48% for GJB2 299_300delAT, 0.28% for SLC26A4 2168A>G, 0.2% for mt 12S rRNA 1555A>G, and 0.16% for GJB3 538C>T. The 31.25% (5/16) of infants with GJB2 235delC, 50% (3/6) with GJB2 299_300delAT, and 25% (3/12) with SLC26A4 IVS7-2A>G showed abnormal hearing when tested; only 1 double mutation case received the hearing test, and this infant showed abnormality in both ears on the hearing test. CONCLUSIONS: High mutation rates in the common deafness genes were detected in newborns in Northwest China. Our study is helpful in understanding the deafness genomic epidemiology and also provides evidence for prenatal and postnatal care as well as policy making on population health in the region.

Tim3/Gal9 interactions between T cells and monocytes result in an immunosuppressive feedback loop that inhibits Th1 responses in osteosarcoma patients.

The Tim3/Gal9 pathway is associated with immunosuppression and worse clinical outcome in multiple cancers. To illustrate the specific mechanism of Tim3/Gal9 interaction in osteosarcoma, we examined expression, function, and regulation of Tim3/Gal9 in various cells from osteosarcoma patients. Data showed that CD4+ T cells, CD8+ T cells, and monocytes from both peripheral blood and tumor of osteosarcoma patients contained high frequencies of Tim3+ cells, while the Gal9 expression was primarily found in regulatory T cells (Tregs) from osteosarcoma patients and was elevated compared to that in non-cancer controls. The Tim3+ CD4+ and CD8+ T cells presented lower proliferation capacity compared to their Tim3- counterparts, which could be reverted by blocking Tim3 or Gal9. Interestingly, purified Tim3+ CD4+ T cells secreted more interferon gamma (IFNγ) than purified Tim3- CD4+ T cells, but IFNγ production by Tim3+ CD4+ T cells was vulnerable to Gal9-mediated suppression. In monocytes, Tim3 expression was associated with high interleukin (IL)-10 and low IL-12 cytokine secretion profile. Exogenous recombinant Gal9, as well as CD4+CD25+ Treg supernatant, further decreased IL-12 expression in monocytes. In CD4+ T cell-monocyte coculture experiments, Tim3+ monocytes inhibited IFNγ expression from total CD4+ T cells and the development of IFNγ response in naive CD4+ T cells. Blocking the Tim3/Gal9 pathway reverted these effects. Together, these results suggested that in osteosarcoma patients, Tim3 expression did not directly mediate immune suppression, but the interaction between Tim3+ T cells and monocytes, naive CD4+ T cells, and Gal9-expressing CD4+CD25+ Tregs could resulting in progressive suppression of Th1 responses.

Screening of Bioactive Ingredients in Ligusticum Chuanxiong Hort for Protection against Myocardial Ischemia.

BACKGROUND/AIMS: To study the spectrum-effect relationship and effective components of Ligusticum Chuanxiong Hort. (LCH) on the protection of canine myocardial ischemia. METHODS: Fingerprint spectrum of LCH extracts was developed using high performance liquid chromatography (HPLC), and a canine model of acute myocardial ischemia was established by ligating the coronary artery. Bivariate correlation analysis and multivariate regression analysis were used to correlate the pharmacodynamics of LCH extract and its common peaks in HPLC. RESULTS: The bioactive components of LCH were ligustrazine, ferulic acid, cnidilide and ligustilide. Ligustrazine and ferulic acid could significantly reduce serum lactic acid in canine model of acute myocardial ischemia, while ligustilide could significantly reduce the elevation of serum free fatty acid. CONCLUSIONS: The spectrum-effect relationship study shows that the effective components of LCH are ligustrazine, ferulic acid, cnidilide and ligustilide, which have protective effect on myocardial ischemia.

Therapeutic implications of mesenchymal stem cells in acute lung injury/acute respiratory distress syndrome.

Acute lung injury (ALI), and its more severe form, acute respiratory distress syndrome (ARDS), are syndromes of acute hypoxemic respiratory failure resulting from a variety of direct and indirect injuries to the gas exchange parenchyma of the lungs. Current treatment of ALI/ARDS is primarily supportive, with lung protective ventilation and fluid conserving strategies. Despite improvement in these strategies, recent data indicate that the mortality of ALI/ARDS is still as high as 30 to 50%. Thus, there is a need for innovative therapies to further improve clinical outcomes of ALI/ARDS. Recent studies involving the administration of mesenchymal stem cells (MSCs) for the treatment of experimental ALI/ARDS have shown promising results. This review focuses on existing studies that have tested the use of MSCs in models of ALI/ARDS, and the potential mechanisms underlying their therapeutic effects.

Treatment of thoracolumbar fracture with pedicle screws at injury level: a biomechanical study based on three-dimensional finite element analysis.

The aim of this study was to investigate the biomechanical mechanisms of treatment of thoracolumbar compression fracture with pedicle screws at injury level based on a three-dimensional finite element method. We constructed one three-dimensional finite element model of T11-L1 in a patient with a compression fracture of the T12 vertebral body(anterior edges of vertebral body were compressed to 1/2, and kyphosis Cobb angle was 18.6°) fixed by four pedicle screws and another model fixed by six pedicle screws at the injured vertebrae, and then assigned different forces to the two models to account for axial compression, flexion, extension, left lateral bending, and rightward axial rotation by Ansys software. After different loading forces were applied to the models, we recorded stress measurements on the vertebral pedicle screws, as well as the maximum displacement of T11. The stress distribution suggested that stress concentration was appreciable at the root of the pedicle screws under different loading modalities. Under axial compression, flexion, extension, left lateral bending, and rightward axial rotation load, the stress for the superior screw was significantly greater than the stress for the inferior screw (P < 0.05). The stress in the six pedicle screw fixation model was significantly decreased compared to the four screw interbody fusion model (P < 0.05), but the maximum displacement of T11 between two models under different loadings was not statistically different. The use of pedicle screws at injured vertebral bodies may optimize internal fixation load and reduce the incidence of broken screws.