Objective To investigate the clinical efficacy and safety of emergency microsurgery repair for retrograde avulsion injury of hand skin.Methods 36 patients with retrograde avulsion injury of hand skin were randomly divided into research group and control group,18 cases in each group.The control group was treated with flap free re-implantation,and the research group was treated with emergency microsurgical repair.The clinical efficacy of the two groups was compared.Results The effective rate of the research group was 94.44%,which was higher than 66.67% of the control group(x2=4.433,P<0.05).The duration of operation,bleeding and hospitalization time in the study group were better than those in the control group(t=-5.523,-4.889,-3.690,all P<0.05).The survival rate of the research group was (95.54±4.21)%,which was higher than (73.22±6.44)% of the control group(t=12.308,P<0.05).The proportion of beautiful skin recovery of the research group was 88.99%,which was higher than 66.67% of the control group(x2=4.985,P<0.05).Conclusion Emergency microsurgery repair for patients with retrograde avulsion injury of hand skin can improve the efficacy of treatment and the survival rate of skin,which is beneficial to the recovery of skin,and can improve the function and appearance of the patients.The effect is remarkable,and it is worthy of popularization and application.

BACKGROUND: Colorectal carcinogenesis and progression are related to the gut microbiota and the tumor immune microenvironment. Our previous clinical trial demonstrated that berberine (BBR) hydrochloride might reduce the recurrence and canceration of colorectal adenoma (CRA). The present study aimed to further explore the mechanism of BBR in preventing colorectal cancer (CRC). METHODS: We performed metagenomics sequencing on fecal specimens obtained from the BBR intervention trial, and the differential bacteria before and after medication were validated using quantitative polymerase chain reaction. We further performed ApcMin/+ animal intervention tests, RNA sequencing, flow cytometry, immunohistochemistry, and enzyme-linked immunosorbent assays. RESULTS: The abundance of fecal Veillonella parvula ( V . parvula ) decreased significantly after BBR administration ( P = 0.0016) and increased through the development from CRA to CRC. Patients with CRC with a higher V. parvula abundance had worse tumor staging and a higher lymph node metastasis rate. The intestinal immune pathway of Immunoglobulin A production was activated, and the expression of TNFSF13B (Tumor necrosis factor superfamily 13b, encoding B lymphocyte stimulator [BLyS]), the representative gene of this pathway, and the genes encoding its receptors (interleukin-10 and transforming growth factor beta) were significantly upregulated. Animal experiments revealed that V. parvula promoted colorectal carcinogenesis and increased BLyS levels, while BBR reversed this effect. CONCLUSION: BBR might inhibit V. parvula and further weaken the immunomodulatory effect of B cells induced by V. parvula , thereby blocking the development of colorectal tumors. TRIAL REGISTRAION ClinicalTrials.gov, No. NCT02226185.
Animals ; Humans ; Berberine/therapeutic use* ; Carcinogenesis ; Veillonella ; Colorectal Neoplasms/genetics* ; Tumor Microenvironment