Objective To discuss the clinical application of reverse dorsal metatarsal artery perforator flap for reconstruction of forefoot soft tissue defects.Methods Since January,2008 to March,2016,43 patients with forefoot soft tissue defect due to various causes were reconstructed with the flap based on dorsal metatarsal artery perforator.Dorsal pedis was used as a donor site with dorsal metatarsal artery perforator as the donor artery.The flap size varied from 2.0 cm × 4.0 cm to 6.0 cm × 8.0 cm.Among them,27,8,4 and 4 cases were reconstructed with flap based on first,second,third and fourth dorsal metatarsal artery perforator flap respectively.Results All the patients were followed-up which ranged from 3 months to 24 months.Six flaps suffered from post operative venous congestion.Out of 6,4 survived with early emergency management while the remaining 2 suffered epidermal necrosis which survived with regular dressing change.Eventually,all the flaps survived.They had good texture and they were elastic,good-looking and very wear-resisting.Walking function was normal.Conclusion Reverse dorsal metatarsal artery perforator flap is an ideal choice in reconstruction of small to medium sized soft tissue defects of forefoot.

Objective Mannitol-poly(D,L-lactide-co-glycolide) (M-PLGA),a star-shaped biodegradable polymer,was synthesized with the intent in this research,to provide novel nanoformulation for cervical cancer chemotherapy.Methods The novel star-shaped copolymer was prepared by ring-opening polymerization,and characterized by NMR.The docetaxel-loaded M-PLGA nanoparticles,prepared by modified nano-precipitation method,were observed to be near-spherical shape with narrow size distribution.Results The CLSM results showed the uptake level of M-PLGA NPs was higher than PLGA NPs in Hela cells.A significantly higher level of cytotoxicity was achieved by docetaxel-loaded M-PLGA NPs than that of commercial Taxotere and docetaxel-loaded PLGA NPs,indicating that the star-shaped biodegradable polymer M-PLGA could be superior to the linear polymer PLGA as a drug carrier.The study on drug loading and encapsulation efficiency also proved that star-shaped M-PLGA could carry higher level of drug than linear polymer,therefore could be more efficient for cancer treatment.Conclusions In conclusion,the star-shaped M-PLGA copolymer may be used as a potential and promising drug-loaded biomaterial applied in developing novel nanoformulations for cervical cancer therapy.

Objective To assess the efficacy of urethroplasty by using the mucosa of diverticulum as the distal urethral for the recurrence of urethral stricture.Methods We reviewed our experience about 6 cases from Jan.2007 to Oct.2012,including 5 hypospadias and 1 epispadias.The mean age of the patients was 28 ± 16 (12-45)month,range 12 to 45 months.The patients presenting urethral diverticulum should last for 6 months after urethroplasty,which should last for 6 months.The preoperative mean urinary flow rate was 5.1 ± 1.4 (range 3.1 to 7.3) ml/s.All the patients took the retrograde urethrography and cystoscopy to confirm the position and length of urethrostenosis.The positions of urethrostenosis were at the penis coronary in 5 cases and glans penis in 1 case.The mean length of stricture was 13.3 ±4.2(range 8.8 to 20.5) mm.The mean length of diverticulum was 37.5 ± 15.3 (range 21.8 to 55.2) mm.All patients received the urethral reconstruction by using the pedicel diverticulum mucosa.After resecting the stenosis urethra and exposed the whole diverticulum,we opened the diverticulum laterally and halved it.One was used for tabularized urethroplasty in situ,the other was flipped to the distal urethral as pedicel flap to remedy the defect of the urethral.Results Totally 6 cases received the procedure.The mean operating time was 133 ± 48 (range 84 to 192) min.Postoperatively,urethral catheter was remained 2 weeks.All the patients can urinate smoothly after removing the catheter.The postoperative mean urinary flow rate was 10o 9 ± 3.3 (range 6.3 to 15.9) ml/s.The mean follow-up time was 2.2 yrs(range 1 to 4 years).At the end point of follow-up,all patients had not experienced a recurrent diverticulum or stricture at the anastomotic site.Urethrocutaneous fistula in the coronary glan was reported in 2 patients,which were finally cured after 2nd repair.No complication was found in other 4 patients.Conclusions Urethroplasty by flipping the mucosa of diverticulum takes full advantage of urinary mucosa that already existing,which can be very useful in those patients who are lack of foreskin.This approach can also reduce the patient's pain by completing the urethroplasty in situ and avoiding staging operation.But up till now,it can only be applied to the urethral diverticulum secondary to urethrostenosis.It also demands flip flap skilled.And the long-term effects and complications still remain to be seen.

Sri Lanka and China enjoy profound traditional friendship and active bilateral friendly cooperation. With the deepening of bilateral FTA negotiations, service trade of traditional Chinese enters into Sri Lanka is also promising. Though the current policy and law exists insufficiency, leveraging the FTA negotiations, TCM-Center binding Confucius Institute, providing TCM features and developing tour routes of medical tourism can help to push service trade of traditional Chinese medicine into Sri Lanka. The development of overseas Chinese medicine health services is not only benefit to the local, but also contribute to the new pattern of Chinese economic reformation.

ATP binding cassette transporter A3（ABCA3）is a critical protein involved in phospholipid metabolism in typeⅡ alveolar cells，participating in the synthesis of pulmonary surfactant.Early studies have found that mutations in ABCA3 gene can lead to childhood interstitial lung disease（chILD），but the underlying mechanisms remain unclear.Recent elucidation of the ABCA3 structure，coupled with functional inquiries into the protein，has engendered fresh insights into the intricate mechanisms governing phospholipid metabolism orchestrated by ABCA3，inspiring the development of small molecule drugs targeting ABCA3 gene mutations.This article provides a comprehensive review of the involvement of ABCA3 in phospholipid metabolism，the pathogenic mechanisms of related lung diseases，the genotype-phenotype correlations，and the forefront advances in treatment.Additionally，it underscores lingering unresolved queries，aiming to provide a platform for the future refinement of precision treatments for ABCA3 mutations.

Objective To advance China's foreign medical work to a new level by comparing medical teams from Japan,the United States,and India,focusing on transforming and upgrading to international development cooperation.Methods Liter-ature and data on the foreign medical teams of the three countries were retrieved and compared in five aspects:institutional mech-anisms,forms of assistance,foreign medical training,traditional medicine assistance,and evaluation of assistance effectiveness.Results Among the three countries,Japan and the United States showed minor differences in their approaches to foreign medical assistance,while India exhibited a distinct pattern.Conclusion China can enhance the international profile of its medical teams,consider both domestic and international interests,and continuously refine the overall strategy for foreign medical aid.Specifically,the country needs to optimize China's contribution to global health by way of strengthening international health ex-changes and cooperation and establishing a 5G smart medical technology platform for remote assistance.

Objective To evaluate the feasibility and outcomes of robotic-assisted laparoscopic pyeloplasty in children .Methods A retrospective study was performed in patients who underwent robotic-assisted laparoscopic pyeloplasty ( Anderson-Hynes ) at our institution between January 2014 to August 2014.Totally 6 boys were diagnosed as left ureteropelvic junction obstruction depending on the symptoms and radiographic studies .The mean age was 9 years ( range 4 -12 years ) .Results The procedure was performed successfully without conversion to open surgery in all of the cases .Mean operative time was 216 min (range 175-269 min), with a mean robotic anastomosis time of 45 min (range 30-60 min).Mean estimated blood loss was less than 15 ml.The mean hospitalization was 4.5 days.Mean follow-up period was 10 months ( range 7 -14 months ) .There were no perioperative complications , and recovery was uncomplicated (without recurrence, pyelonephritis, nephrarctia) in all of the patients.Conclusion Robotic-assisted laparoscopic pyeloplasty can be safely performed in children older than 4-year-old with ureteropelvic junction obstruction .

OBJECTIVETo prepare a pH fluorescence probe based on styrylcyanine dyes for live cell imaging.

METHODSThe Probe 1 was prepared by reaction of 4-pyridinecarboxaldehyde with 1,1,2-trimethylbenz[e]indole. The influence of pH on the fluorescent properties was examined, and the cell viability was examined using cell counting kit-8. The Probe 1 was used as a pH fluorescence probe in living cell.

RESULTSProbe 1 emitted green fluorescence under neutral and basic conditions but orange fluorescence under acid condition. Probe 1 selectively stained the cytoplasmic regions of living cells without significantly affecting the cell viability.

CONCLUSIONThe pH-sensitive fluorescent probe prepared based on styrylcyanine possesses good ability of cell membrane permeation for live cell fluorescent imaging.

There is a long exchanges history between China and Spain. The acceptance of traditional Chinese medicine (TCM) and acupuncture therapy in Spain is increasing in recent years. However, the legal status of TCM has not yet been recognized by the Spanish government, who has a wait-and-see attitude towards acupuncture. The prospects of TCM and acupuncture are still unclear. We could try to gradually permeate TCM and Acupunction into Spain Health System by taking Chinese medicine insurance as a breakthrough, building Chinese medicine knowledge platform and optimizing overseas mergers and acquisitions so as to promote traditional Chinese medicine into the mainstream of Spain.

Objective:To evaluate the efficacy and safety of lumen-apposing metal stent (LAMS) for the treatment of pancreatic walled-off necrosis (WON).Methods:A retrospective cohort study was performed on data of 43 consecutive patients with pancreatic WON who underwent endoscopic ultrasound-guided drainage by LAMS or plastic stents (PS) in Hangzhou First People's Hospital from December 2010 to June 2020. According to the type of stent used, the patients were divided into the LAMS group ( n=16) and the PS group ( n=27). The technical success rate, the clinical success rate, the operation time, the session of endoscopic necrosectomy, the stent insertion time and adverse events were compared between the two groups. Results:All 43 patients were successfully stented, indicating a technical success rate of 100% in both groups. For the LAMS group, the clinical success rate, the operation time, the session of endoscopic necrosectomy, the stent insertion time and overall incidence of adverse events were 75.0% (12/16), 26.0 (19.1, 39.8) min, 0.5 (0, 2.0) times, (41.3±28.4) days, and 43.7% (7/16), respectively, whereas these indices of the PS group were 37.0% (10/27) ( χ2=5.795, P=0.016), 31.0 (26.0, 48.0) min ( Z=1.221, P=0.222), 0 (0, 0) times ( Z=2.245, P=0.025), (176.1±99.1) days ( t=5.187, P<0.001) and 14.8% (4/27) ( χ2=8.893, P=0.064), respectively. Conclusion:LAMS placement is safe and effective for the treatment of pancreatic WON with a higher clinical success rate compared with PS. However, it requires more endoscopic intervention.