Anatomy of Hidden Dzyaloshinskii-Moriya Interactions and Topological Spin Textures in Centrosymmetric Crystals.

The Dzyaloshinskii-Moriya interaction (DMI) is understood to be forbidden by the symmetry of centrosymmetric systems, thus restricting the candidate types for investigating many correlated physical phenomena. Here, we report the hidden DMI existing in centrosymmetric magnets driven by the local inversion symmetry breaking of specific spin sublattices. The opposite DMI spatially localized on the inverse spin sublattice favors the separated spin spiral with opposite chirality. Furthermore, we elucidate that hidden DMI widely exists in many potential candidates, from the first-principles calculations on the mature crystal database. Interestingly, novel topological spin configurations, such as the anti-chirality-locked merons and antiferromagnetic-ferromagnetic meron chains, are stabilized as a consequence of hidden DMI. Our understanding enables the effective control of DMI by symmetry operations at the atomic level and enlarges the range of currently useful magnets for topological magnetism.

AoRab7A interacts with AoVps35 and AoVps41 to regulate vacuole assembly, trap formation, conidiation, and functions of proteasomes and ribosomes in Arthrobotrys oligospora.

Rab GTPases regulate vesicle trafficking in organisms and play crucial roles in growth and development. Arthrobotrys oligospora is a ubiquitous nematode-trapping (NT) fungus, it can form elaborate traps to capture nematodes. Our previous study found that deletion of Aorab7A abolished the trap formation and sporulation. Here, we investigated the regulatory mechanism of AoRab7A using transcriptomic, biochemical, and phenotypic comparisons. Transcriptome analysis, yeast library screening, and yeast two-hybrid assay identified two vacuolar protein sorting (Vps) proteins, AoVps41 and AoVps35, as putative targets of AoRab7A. The deletion of Aovps41 and Aovps35 caused considerable defects in multiple phenotypic traits, such as conidiation and trap formation. We further found a close connection between AoRab7A and Vps proteins in vesicle-vacuole fusion, which triggered vacuolar fragmentation. Further transcriptome analysis showed that AoRab7A and AoVps35 play essential roles in many cellular processes and components including proteasomes, autophagy, fatty acid degradation, and ribosomes in A. oligospora. Furthermore, we verified that AoRab7A, AoVps41, and AoVps35 are involved in ribosome and proteasome functions. The absence of these proteins inhibited the biosynthesis of nascent proteins and enhanced ubiquitination. Our findings suggest that AoRab7A interacts with AoVps41 and AoVps35 to mediate vacuolar fusion and influence lipid droplet accumulation, autophagy, and stress response. These proteins are especially required for the conidiation and trap development of A. oligospora.

Proximity-Induced Interfacial Room-Temperature Ferromagnetism in Semiconducting Fe3GeTe2.

The discoveries of two-dimensional ferromagnetism and magnetic semiconductors highly enrich the magnetic material family for constructing spin-based electronic devices, but with an acknowledged challenge that the Curie temperature (Tc) is usually far below room temperature. Many efforts such as voltage control and magnetic ion doping are currently underway to enhance the functional temperature, in which the involvement of additional electrodes or extra magnetic ions limits their application in practical devices. Here we demonstrate that the magnetic proximity, a robust effect but with elusive mechanisms, can induce room-temperature ferromagnetism at the interface between sputtered Pt and semiconducting Fe3GeTe2, both of which do not show ferromagnetism at 300 K. The independent electrical and magnetization measurements, structure analysis, and control samples with Ta highlighting the role of Pt confirm that the ferromagnetism with the Tc of above 400 K arises from the Fe3GeTe2/Pt interfaces, rather than Fe aggregation or other artificial effects. Moreover, contrary to conventional ferromagnet/Pt structures, the spin current generated by the Pt layer is enhanced more than two times at the Fe3GeTe2/Pt interfaces, indicating the potential applications of the unique proximity effect in building highly efficient spintronic devices. These results may pave a new avenue to create room-temperature functional spin devices based on low-Tc materials and provide clear evidence of magnetic proximity effects by using nonferromagnetic materials.

Large and tunable magnetoresistance in van der Waals ferromagnet/semiconductor junctions.

Magnetic tunnel junctions (MTJs) with conventional bulk ferromagnets separated by a nonmagnetic insulating layer are key building blocks in spintronics for magnetic sensors and memory. A radically different approach of using atomically-thin van der Waals (vdW) materials in MTJs is expected to boost their figure of merit, the tunneling magnetoresistance (TMR), while relaxing the lattice-matching requirements from the epitaxial growth and supporting high-quality integration of dissimilar materials with atomically-sharp interfaces. We report TMR up to 192% at 10 K in all-vdW Fe3GeTe2/GaSe/Fe3GeTe2 MTJs. Remarkably, instead of the usual insulating spacer, this large TMR is realized with a vdW semiconductor GaSe. Integration of semiconductors into the MTJs offers energy-band-tunability, bias dependence, magnetic proximity effects, and spin-dependent optical-selection rules. We demonstrate that not only the magnitude of the TMR is tuned by the semiconductor thickness but also the TMR sign can be reversed by varying the bias voltages, enabling modulation of highly spin-polarized carriers in vdW semiconductors.

AoMedA has a complex regulatory relationship with AoBrlA, AoAbaA, and AoWetA in conidiation, trap formation, and secondary metabolism in the nematode-trapping fungus Arthrobotrys oligospora.

The asexual sporulation of filamentous fungi is an important mechanism for their reproduction, survival, and pathogenicity. In Aspergillus and several filamentous fungi, BrlA, AbaA, and WetA are the key elements of a central regulatory pathway controlling conidiation, and MedA is a developmental modifier that regulates temporal expression of central regulatory genes; however, their roles are largely unknown in nematode-trapping (NT) fungi. Arthrobotrys oligospora is a representative NT fungus, which can capture nematodes by producing adhesive networks (traps). Here, we characterized the function of AoMedA and three central developmental regulators (AoBrlA, AoAbaA, and AoWetA) in A. oligospora by gene disruption, phenotypic comparison, and multi-omics analyses, as these regulators are required for conidiation and play divergent roles in mycelial development, trap formation, lipid droplet accumulation, vacuole assembly, and secondary metabolism. A combined analysis of phenotypic traits and transcriptome showed that AoMedA and AoWetA are involved in the regulation of peroxisome, endocytosis, and autophagy. Moreover, yeast one-hybrid analysis showed that AoBrlA can regulate AoMedA, AoAbaA, and AoWetA, whereas AoMedA and AoAbaA can regulate AoWetA. Our results highlight the important roles of AoMedA, AoBrlA, AoAbaA, and AoWetA in conidiation, mycelia development, trap formation, and pathogenicity of A. oligospora and provide a basis for elucidating the relationship between conidiation and trap formation of NT fungi. IMPORTANCE Conidiation is the most common reproductive mode for many filamentous fungi and plays an essential role in the pathogenicity of fungal pathogens. Nematode-trapping (NT) fungi are a special group of filamentous fungi owing to their innate abilities to capture and digest nematodes by producing traps (trapping devices). Sporulation plays an important role in the growth and reproduction of NT fungi, and conidia are the basic components of biocontrol reagents for controlling diseases caused by plant-parasitic nematodes. Arthrobotrys oligospora is a well-known NT fungus and is a routinely used model fungus for probing the interaction between fungi and nematodes. In this study, the functions of four key regulators (AoMedA, AoBrlA, AoAbaA, and AoWetA) involved in conidiation were characterized in A. oligospora. A complex interaction between AoMedA and three central regulators was noted; these regulators are required for conidiation and trap formation and play a pleiotropic role in multiple intracellular activities. Our study first revealed the role of AoMedA and three central regulators in conidiation, trap formation, and pathogenicity of A. oligospora, which contributed to elucidating the regulatory mechanism of conidiation in NT fungi and helped in developing effective reagents for biocontrol of nematodes.

Neural basis of the attention bias during addiction stroop task in methamphetamine-dependent patients with and without a history of psychosis: an ERP study.

Background: Attentional bias plays an important role in sustaining various types of drug addiction. No prior studies examined methamphetamine (MA)-associated psychosis (MAP) relationships between ERP time course and performance on an addiction Stroop task in MA abusers. The aim of the present study was to determine whether MA abusers with (MAP+) or without (MAP-) psychosis exhibit alterations of the ERP during the addiction Stroop task. Methods: Thirty-one healthy controls (CTRL), 14 MAP-, and 24 MAP+ participants were recruited and completed the addiction Stroop task during EEG recording using 32 electrodes. Group variations were compared on measures of behavioral task performance and event-related potentials (ERP) of performance monitoring (N200, P300, N450). The Barratt impulsiveness scores were analyzed to investigate correlations with ERP changes. Results: MA-related word stimulus elicited a more negative N200 amplitude over left-anterior electrodes in MAP- abusers; furthermore, a positive association between the N200 amplitude and Barratt attentional scores and non-planning scores was observed, while no such differences were found in MAP+ abusers. There were no significant differences in reaction time (RT) and error rate between each group. Conclusion: This is the first study to examine psychosis relationships between ERP time course and performance on an addiction Stroop task in MA abusers with or without psychosis. These findings support the association between attentional bias measured by the MA addiction Stroop task and N200 component as well as indicate the possibility of using this cognitive task in combination with ERP technology to detect psychosis factors among abstinent MA abusers.

Characteristics of amplitude of low-frequency fluctuations in the resting-state functional magnetic resonance imaging of alcohol-dependent patients with depression.

The high comorbidity of alcohol use disorder and depressive disorder is associated with poor patient prognosis. The mechanisms underlying this comorbidity, however, are largely unknown. By applying the amplitude of low-frequency fluctuations parameter in resting-state functional magnetic resonance imaging, this study investigated changes in the brain functioning of alcohol-dependent patients with and without depression. Alcohol-dependent patients (n = 48) and healthy controls (n = 31) were recruited. The alcohol-dependent patients were divided into those with and without depression, according to Patients Health Questionnaire-9 scores. Amplitude of low-frequency fluctuations in resting-state brain images were compared among the alcohol-dependent patients with depression, alcohol-dependent patients without depression, and healthy controls groups. We further examined associations between amplitude of low-frequency fluctuations alterations, alcohol-dependence severity, and depressive levels (assessed with scales). Compared with the healthy controls group, both alcohol groups showed amplitude of low-frequency fluctuations enhancement in the right cerebellum and amplitude of low-frequency fluctuations abatement in the posterior central gyrus. The alcohol-dependent patients with depression group had higher amplitude of low-frequency fluctuations in the right cerebellum than the alcohol-dependent patients without depression group. Additionally, we observed a positive correlation between amplitude of low-frequency fluctuations value and Patients Health Questionnaire-9 score in the right superior temporal gyrus in the alcohol-dependent patients with depression group. Alcohol-dependent subjects showed abnormally increased spontaneous neural activity in the right cerebellum, which was more significant in alcohol-dependent patients with depression. These findings may support a targeted intervention in this brain location for alcohol and depressive disorder comorbidity.

Peroxin Pex14/17 Is Required for Trap Formation, and Plays Pleiotropic Roles in Mycelial Development, Stress Response, and Secondary Metabolism in Arthrobotrys oligospora.

The peroxins encoded by PEX genes involved in peroxisome biogenesis play a crucial role in cellular metabolism and pathogenicity in fungi. Herein, we characterized a filamentous fungus-specific peroxin Pex14/17 in the Arthrobotrys oligospora, a representative species of nematode-trapping fungi. The deletion of AoPEX14/17 resulted in a remarkable reduction in mycelial growth, conidia yield, trap formation, and pathogenicity. Compared with the wild-type strain, the ΔAopex14/17 mutant exhibited more lipid droplet and reactive oxygen species accumulation accompanied with a significant decrease in fatty acid utilization and tolerance to oxidative stress. Transcriptomic analysis indicated that AoPEX14/17 was involved in the regulation of metabolism, genetic information processing, environmental information processing, and cellular processes. In subcellular morphology, the deletion of AoPEX14/17 resulted in a decrease in the number of cell nuclei, autophagosomes, and Woronin bodies. Metabolic profile analysis showed that AoPex14/17 affects the biosynthesis of secondary metabolites. Yeast two-hybrid assay revealed that AoPex14/17 interacted with AoPex14 but not with AoPex13. Taken together, our results suggest that Pex14/17 is the main factor for modulating growth, development, and pathogenicity in A. oligospora. IMPORTANCE Peroxisome biogenesis genes (PEX) play an important role in growth, development, and pathogenicity in pathogenic fungi. However, the roles of PEX genes remain largely unknown in nematode-trapping (NT) fungi. Here, we provide direct evidence that AoPex14/17 regulates mycelial growth, conidiation, trap formation, autophagy, endocytosis, catalase activity, stress response to oxidants, lipid metabolism, and reactive oxygen species production. Transcriptome analysis and metabolic profile suggested that AoPex14/17 is involved in multiple cellular processes and the regulation of secondary metabolism. Therefore, our study extends the functions of PEX genes, which helps to elucidate the mechanism of organelle development and trap formation in NT fungi and lays the foundation for the development of efficient nematode biocontrol agents.

SNARE Protein AoSec22 Orchestrates Mycelial Growth, Vacuole Assembly, Trap Formation, Stress Response, and Secondary Metabolism in Arthrobotrys oligospora.

Soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNAREs) facilitate intracellular vesicle trafficking and membrane fusion in eukaryotes and play a vital role in fungal growth, development, and pathogenicity. However, the functions of SNAREs are still largely unknown in nematode-trapping fungi. Arthrobotrys oligospora is a representative species of nematode-trapping fungi that can produce adhesive networks (traps) for nematode predation. In this study, we characterized AoSec22 in A. oligospora, a homolog of the yeast SNARE protein Sec22. Deletion of Aosec22 resulted in remarkable reductions in mycelial growth, the number of nuclei, conidia yield, and trap formation, especially for traps that failed to develop mature three-dimensional networks. Further, absence of Aosec22 impaired fatty acid utilization, autophagy, and stress tolerance; in addition, the vacuoles became small and fragmented in the hyphal cells of the ∆Aosec22 mutant, and large vacuoles failed to form. The reduced sporulation capacity correlated with the transcriptional repression of several sporulation-related genes, and the impaired accumulation of lipid droplets is in line with the transcriptional repression of several genes involved in fatty acid oxidation. Moreover, absence of Aosec22 remarkably impaired secondary metabolism, resulting in 4717 and 1230 compounds upregulated and downregulated in the ∆Aosec22 mutant, respectively. Collectively, our data highlighted that the SNARE protein AoSec22 plays a pleiotropic role in mycelial growth and development, vacuole assembly, lipid metabolism, stress response, and secondary metabolism; in particular, it is required for the proper development of traps in A. oligospora.

Anisotropic Dzyaloshinskii-Moriya Interaction and Topological Magnetism in Two-Dimensional Magnets Protected by P4Ì m2 Crystal Symmetry.

As a fundamental magnetic parameter, Dzyaloshinskii-Moriya interaction (DMI), has gained a great deal of attention in the last two decades due to its critical role in formation of magnetic skyrmions. Recent discoveries of two-dimensional (2D) van der Waals (vdW) magnets has also gained a great deal of attention due to appealing physical properties, such as gate tunability, flexibility, and miniaturization. Intensive studies have shown that isotropic DMI stabilizes ferromagnetic (FM) topological spin textures in 2D magnets or their corresponding heterostructures. However, the investigation of anisotropic DMI and antiferromagnetic (AFM) topological spin configurations remains elusive. Here, we propose and demonstrate a family of 2D magnets with P4m2 symmetry-protected anisotropic DMI. More interestingly, various topological spin configurations, including FM/AFM antiskyrmion and AFM vortex-antivortex pair, emerge in this family. These results give a general method to design anisotropic DMI and pave the way toward topological magnetism in 2D materials using crystal symmetry.

AoATG5 plays pleiotropic roles in vegetative growth, cell nucleus development, conidiation, and virulence in the nematode-trapping fungus Arthrobotrys oligospora.

Autophagy is an evolutionarily conserved process in eukaryotes, which is regulated by autophagy-related genes (ATGs). Arthrobotrys oligospora is a representative species of nematode-trapping (NT) fungi that can produce special traps for nematode predation. To elucidate the biological roles of autophagy in NT fungi, we characterized an orthologous Atg protein, AoAtg5, in A. oligospora. We found that AoATG5 deletion causes a significant reduction in vegetative growth and conidiation, and that the transcript levels of several sporulation-related genes were significantly downregulated during sporulation stage. In addition, the cell nuclei were significantly reduced in the ΔAoATG5 mutant, and the transcripts of several genes involved in DNA biosynthesis, repair, and ligation were significantly upregulated. In ΔAoATG5 mutants, the autophagic process was significantly impaired, and trap formation and nematocidal activity were significantly decreased. Comparative transcriptome analysis results showed that AoAtg5 is involved in the regulation of multiple cellular processes, such as autophagy, nitrogen metabolism, DNA biosynthesis and repair, and vesicular transport. In summary, our results suggest that AoAtg5 is essential for autophagy and significantly contributes to vegetative growth, cell nucleus development, sporulation, trap formation, and pathogenicity in A. oligospora, thus providing a basis for future studies focusing on related mechanisms of autophagy in NT fungi.

Molecular Epidemiological Analysis of ST11-K64 Extensively Drug-Resistant Klebsiella pneumoniae Infections Outbreak in Intensive Care and Neurosurgery Units Based on Whole-Genome Sequencing.

Klebsiella pneumoniae (Kp) is the primary causative bacteria for nosocomial infections and hospital outbreaks. In particular, extensively drug-resistant K. pneumoniae (XDRKp) causes severe clinical infections in hospitalized patients. Here, we used pulsed-field gel electrophoresis (PFGE), drug susceptibility tests, and the whole-genome sequencing (WGS) technology to examine genetic relatedness and phenotypic traits of the strains isolated during an outbreak period. Based on PFGE, a distinct clones cluster comprised of eight XDRKp was observed. These strains were confirmed as ST11-K64 via multiple-locus sequence typing database of Kp. The strains also had genes related to the regulation of biofilm biosynthesis (type 1 & 3 fimbriae, type IV pili biosynthesis, RcsAB, and type VI secretion system) and multiple drug resistance (ß-lactamase and aminoglycoside antibiotic resistance). WGS data based on core-single nucleotide polymorphisms and epidemiological investigation showed that the neurosurgery unit was likely the source of the outbreak, the strain was likely to have been transmitted to the ICU through patients. In addition, the two highly probable transmission routes were in the ICU (exposure through shared hospital beds) and the neurosurgery units (all cases were treated by the same rehabilitation physician and were most likely infected during the physical therapy). Notably, the bed mattress had played a crucial transmission role of this outbreak, served as a pathogen reservoir.

AoBck1 and AoMkk1 Are Necessary to Maintain Cell Wall Integrity, Vegetative Growth, Conidiation, Stress Resistance, and Pathogenicity in the Nematode-Trapping Fungus Arthrobotrys oligospora.

The cell wall integrity (CWI) pathway is composed of three mitogen-activated protein kinases (MAPKs), Bck1, Mkk1/2, and Slt2, and is one of the main signaling pathways for fungal pathogenesis, cell wall synthesis, and integrity maintenance. In this study, we characterized orthologs of Saccharomyces cerevisiae Bck1 and Mkk1 in the nematode-trapping (NT) fungus Arthrobotrys oligospora by multiple phenotypic comparison, and the regulation of conidiation and cell wall synthesis was analyzed using real-time PCR (RT-PCR). Both ΔAoBck1 and ΔAoMkk1 mutants showed severe defects in vegetative growth, cell nucleus number, and stress resistance. Both the mutants were unable to produce spores, and the transcription of several genes associated with sporulation and cell wall biosynthesis was markedly downregulated during the conidiation stage. Further, cell walls of the ΔAoBck1 and ΔAoMkk1 mutants were severely damaged, and the Woronin body failed to respond to cellular damage. In particular, the mutants lost the ability to produce mycelial traps for nematode predation. Taken together, AoBck1 and AoMkk1 play a conserved role in mycelial growth and development, CWI, conidiation, multi-stress tolerance, trap formation, and pathogenicity. We highlighted the role of AoBck1 and AoMkk1 in regulating the Woronin body response to cellular damage and cell nucleus development in A. oligospora.

Reducing Dzyaloshinskii-Moriya interaction and field-free spin-orbit torque switching in synthetic antiferromagnets.

Perpendicularly magnetized synthetic antiferromagnets (SAF), possessing low net magnetization and high thermal stability as well as easy reading and writing characteristics, have been intensively explored to replace the ferromagnetic free layers of magnetic tunnel junctions as the kernel of spintronic devices. So far, utilizing spin-orbit torque (SOT) to realize deterministic switching of perpendicular SAF have been reported while a large external magnetic field is typically needed to break the symmetry, making it impractical for applications. Here, combining theoretic analysis and experimental results, we report that the effective modulation of Dzyaloshinskii-Moriya interaction by the interfacial crystallinity between ferromagnets and adjacent heavy metals plays an important role in domain wall configurations. By adjusting the domain wall configuration between Bloch type and Néel type, we successfully demonstrate the field-free SOT-induced magnetization switching in [Co/Pd]/Ru/[Co/Pd] SAF devices constructed with a simple wedged structure. Our work provides a practical route for utilization of perpendicularly SAF in SOT devices and paves the way for magnetic memory devices with high density, low stray field, and low power consumption.

Aolatg1 and Aolatg13 Regulate Autophagy and Play Different Roles in Conidiation, Trap Formation, and Pathogenicity in the Nematode-Trapping Fungus Arthrobotrys oligospora.

Autophagy is a conserved cellular recycling and trafficking pathway in eukaryotes that plays an important role in cell growth, development, and pathogenicity. Atg1 and Atg13 form the Atg1-Atg13 complex, which is essential for autophagy in yeast. Here, we characterized the roles of the Aolatg1 and Aolatg13 genes encoding these autophagy-related proteins in the nematode-trapping fungus Arthrobotrys oligospora. Investigation of the autophagy process by using the AoAtg8-GFP fusion protein showed that autophagosomes accumulated inside vacuoles in the wild-type (WT) A. oligospora strain, whereas in the two mutant strains with deletions of Aolatg1 or Aolatg13, GFP signals were observed outside vacuoles. Similar results were observed by using transmission electron microscopy. Furthermore, deletion of Aolatg1 caused severe defects in mycelial growth, conidiation, conidial germination, trap formation, and nematode predation. In addition, transcripts of several sporulation-related genes were significantly downregulated in the ΔAolatg1 mutant. In contrast, except for the altered resistance to several chemical stressors, no obvious differences were observed in phenotypic traits between the WT and ΔAolatg13 mutant strains. The gene ontology analysis of the transcription profiles of the WT and ΔAolatg1 mutant strains showed that the set of differentially expressed genes was highly enriched in genes relevant to membrane and cellular components. The Kyoto Encyclopedia of Genes and Genomes analysis indicated that differentially expressed genes were highly enriched in those related to metabolic pathways, autophagy and autophagy-related processes, including ubiquitin-mediated proteolysis and SNARE interaction in vesicular transport, which were enriched during trap formation. These results indicate that Aolatg1 and Aolatg13 play crucial roles in the autophagy process in A. oligospora. Aolatg1 is also involved in the regulation of asexual growth, trap formation, and pathogenicity. Our results highlight the importance of Aolatg1 in the growth and development of A. oligospora, and provide a basis for elucidating the role of autophagy in the trap formation and pathogenicity of nematode-trapping fungi.

[Endoscopic low-temperature plasma radiofrequency ablation with acellular dermal matrix patch for chronic abdominal wall sinus].

OBJECTIVE: To investigate the effectiveness of endoscopic low-temperature plasma radiofrequency ablation with acellular dermal matrix patch for chronic abdominal wall sinus by comparing with the traditional surgical method. METHODS: Retrospective analysis was made on the clinical data of 53 cases of chronic abdominal wall sinus between January 2006 and May 2012. Of 53 patients, 18 underwent endoscopic low-temperature plasma radiofrequency ablation with acellular dermal matrix patch (trial group), and 35 underwent traditional surgical treatment (control group). No significant difference was found in gender, age, etiology, disease duration, and location between 2 groups (P > 0.05). RESULTS: The blood loss during sinus clearance, postoperative hospitalization days, and sinus union time of the trial group were significantly better than those of the control group (P < 0.05), but no significant difference was found in the operative time for sinus clearance (t = 0.28, P = 0.78). No postoperative sinus bleeding or infection occurred in the trial group, but bleeding and infection in 5 and 3 cases of the control group respectively, showing significant differences between 2 groups (P < 0.05). The follow-up time was 4-18 months (mean, 12.4 months) in the trial group, and was 6-48 months (mean, 38.5 months) in the control group. No sinus recurrence was observed during follow-up. CONCLUSION: Endoscopic low-temperature plasma radiofrequency ablation with acellular dermal matrix patch has the following advantages in treating chronic abdominal wall sinus: clear view, thorough cleaning of granulation necrosis tissues, less bleeding, faster sinus union, and shorter hospitalization days; however, further observations on the long-term effectiveness and the safety are required.

[Effectiveness analysis of laparoscopic repair of parastomal hernia using CK Parastomal patch].

OBJECTIVE: To summarize the surgical technique and the effectiveness of CK Parastomal patch in laparoscopic repair of parastomal hernia. METHODS: The clinical data were retrospectively analysed from 24 patients who received laparoscopic repair of parastomal hernia using CK Parastomal patch between June 2006 and March 2010. There were 15 males and 9 females with a median age of 55 years (range, 47-80 years). Among them, 19 patients were with colon parastomal hernia in the left lower quadrant and 5 patients with ileum parastomal hernia in the right lower quadrant. The parastomal hernia duration was 1 to 4 years (mean, 2.4 years). The maximal diameter of the hernia ring was 3 to 7 cm (mean, 5.2 cm). All patients did not receive hernia repair. RESULTS: Laparoscopic repair of parastomal hernia was successfully performed in 18 cases, and open repair was used in 6 cases because of extensive adhesion. The average operating time was 121 minutes (range, 78 to 178 minutes). All wounds healed by first intention. Wound seroma occurred in 8 cases at 3 to 7 days after operation and disappeared by aspiration. Eleven patients complained of pain in the operative area within 1 month after operation and it disappeared without intervention. All patients were followed up 6 to 39 months (mean, 27 months). One recurrence occurred at 3 months after operation, and no recurrence occurred in the other patients. CONCLUSION: Laparoscopic repair of parastomal hernia using CK Parastomal patch is a safe and feasible procedure with a satisfactory short-term effectiveness, but the long-term effectiveness should be further observed.

[Preventive effect of polypropylene mesh bonded norvancomycin slow-release microsphere on Staphylococcus aureus infection of incisional hernia repair model].

OBJECTIVE: Mesh infection may occur after incisional hernia repair using prosthetic mesh. Preparation of antibiotics-bonded meshes to prevent infection is one of the solutions. To evaluate the anti-infection effect of polypropylene mesh bonded norvancomycin slow-release microsphere by preparing the rat model of incisional hernia repair contaminated with Staphylococcus aureus. METHODS: The norvancomycin slow-release microspheres were prepared by emulsion and solvent evaporation method and they were bonded to polypropylene mesh (50 mg/mesh). The appearance of the microspheres was observed using scanning electronic microscope (SEM). The content of norvancomycin in microspheres and the release rate of the norvancomycin in norvancomycin-bonded polypropylene mesh were detected using high performance liquid chromatography method. The rat models of incisional hernia were developed in 40 healthy Sprague Dawley rats, aged 10-11 weeks and weighing 200-250 g. The rats were divided randomly into the experimental group (norvancomycin-bonded polypropylene mesh repair, n=20) and the control group (polypropylene mesh repair, n=20). And then the mesh was contaminated with Staphylococcus aureus. The wound healing was observed after operation. At 3 weeks after operation, the mesh and the tissue around the mesh were harvested to perform histological observation and to classify the inflammatory reaction degree. RESULTS: The norvancomycin microsphere had integrated appearance and smooth surface with uniform particle diameter, 64% of particle diameter at 60 to 100 microm, and the loading-capacity of norvancomycin was 19.79%. The norvancomycin-bonded polypropylene patch had well-distributed surface and the loading-capacity of norvancomycin was (7.90 +/- 0.85) mg/cm2. The release time of norvancomycin in vitro could last above 28 days and the accumulative release rate was 72.6%. The rats of 2 groups all survived to experiment completion. Wound infection occurred in 2 rats of the experimental group (10%) and 20 rats of the control group (100%), showing significant difference (chi2 = 32.727 3, P = 0.0000). The inflammatory reaction in experimental group was not obvious, grade I in 16 rats and grade II in 4 rats, and numerous inflammatory cell infiltration occurred in the control group, grade II in 3 rats and grade III in 17 rats, showing significant difference (chi2 = 32.314, P = 0.000). CONCLUSION: The polypropylene mesh bonded norvancomycin slow-release microsphere has definite anti-infection effect in rat model of incisional hernia repair contaminated by Staphylococcus aureus.

[Use of allogenic acellular dermal matrix in abdominal wall hernia and defect repair in 31 cases].

OBJECTIVE: To summarize the clinical effect of allogenic acellular dermal matrix in repair of abdominal wall hernia and defect. METHODS: The clinical data were analyzed retrospectively from 31 patients with abdominal wall hernia and defect repaired by allogenic acellular dermal matrix between March 2007 and November 2009. There were 19 males and 12 females with an age range of 10-70 years (median, 42 years), including 6 abdominal wall defects caused by abdominal wall tumor resection, 4 patches infection after abdominal wall hernia repair using prosthetic mesh, 2 incisional hernia, 1 parastomal hernia, 1 recurrent parastomal hernia receiving mesh repair, 1 mesh infection caused by parastomal hernia repair using prosthetic patch, 3 mesh infection caused by tension free inguinal after hernia repair, and 13 inguinal hernia. There were 12 patients with contaminated or infectious wound. The disease duration was from 1 to 34 months (6 months on average). The defect size of abdominal wall ranged from 6 cm x 4 cm to 19 cm x 10 cm. Abdominal wall hernia or defect underwent repair using allogenic acellular dewall matrix. RESULTS: Of the 31 patients, 29 patients recovered with primary wound healing. Chronic sinus tract occurred in 1 patient and the wound was cured by change dressing. Wound dehiscence and patch exposure occurred in 1 patient, and second healing was achieved after change dressing. All the 31 patients were followed up 6-36 months, no abdominal wall hernia or hernia recurrence occurred in other patients except 1 patient who had abdominal bulge. And no foreign body sensation or chronic pain in wound area occurred. CONCLUSION: It is feasible and safe to use allergenic acellular dermal matrix patch for repair of abdominal wall hernia or soft tissue defect, especially in contaminated or infectious wound.

[In situ repair of parastomal hernia with Sublay methods in 34 cases].

OBJECTIVE: To summarize the therapeutic method and effectiveness of parastomal hernia repair in situ with sublay methods. METHODS: Between February 2003 and May 2009, 34 patients with parastomal hernia were treated with Sublay methods using primary midline incision approach and polypropylene patch. There were 23 males and 11 females with an average age of 58.4 years (range, 43-78 years). The disease duration was 1 to 17 years (mean, 4.7 years). Of 34 patients, 6 had recurrent parastomal hernia. The diameter of hernia ring was 5-12 cm (mean, 7.2 cm). RESULTS: Sublay technique repair was successfully performed in all patients. The operative time was 96-160 minutes (mean, 116 minutes). The gastric tube was pulled out 12 hours to 5 days (mean, 3 days) after operation. The drainage tube was taken out at 2-7 days (mean, 4 days) after operation. The postoperative hospitalization time was 7 to 15 days (mean, 9 days). And the incisions of 32 patients healed by first intention. Incisional fat liquefaction occurred in 1 case and infection in 1 case, and their incisions healed after dressing change. Seroma at the upper of the patch occurred in 7 patients and was cured by 2 to 3 times of percutaneous puncture and local pressure. Thirty-two patients were followed up 6-75 months (mean, 32 months). No chronic pain, lumping sensation, or local expansion in wound area occurred. Two recurrences occurred 3 months and 7 months after operation, respectively, and patients restored after expectant treatment or re-operation. CONCLUSION: The in situ Sublay methods using primary midline incision approach and nonabsorbable patch is a feasible and safe method for parastomal hernia repair.