Type Ⅱ transmembrane serine proteases 4 (TMPRSS4) is a novel type Ⅱ transmembrane serine protease.Present study showed that its expression was related with tumor invasion and metastasis,although its oncogenic significance and molecular mechanisms are still unknown.In this review,the author try to introduce its structure,biological function and mechanism in tumor invasion and metastasis.

Objective To analyze the epidemiological and clinical characteristics of 5 patients with importing yellow fever ,and to explore the preventive and control strategies of infection in hospital .Methods The epidemiological and clinical characteristics of 5 cases of importing yellow fever in Infectious Disease Hospital of Fujian Medical University from March 18th to April 6th in 2016 were retrospectively reviewed and analyzed .Results Five patients were all from Angola Luanda .One of them was vaccinated before going aboard ,and the others were vaccinated 1—10 days before disease onset in Angola .All of them were bitten by mosquitoes ,and their onset date ranged from March 11th to March 27th ,before returned to Fujian .The main clinical symptoms were fever ,chilly ,shivering ,fatigue ,arthrodynia ,headache ,and liver and kidney injury .At manifestations ,two patients had positive nuclear acid of yellow fever virus in serum samples and 3 patients were positive in urine samples .All of these patients were negative for dengue virus and Zika virus testing ,meanwhile no plasmodium was found in blood smears .All patients were cured and discharged . Conclusions There is risk of yellow fever transmission in Fujian Province . Prevention and control of the disease should be focus on improving the ability of finding and coping with the importing cases .Vaccination and hygiene knowledge propagation should be given for those who are going to epidemic country/area .Emergency monitoring and control of mosquitoes are necessary .

Objective To analyze the epidemiological and clinical characteristics of 403 local cases with dengue fever , and to provide guidance for dengue fever's prevention , diagnosis and treatment . Methods The epidemical data ,clinical characteristics ,laboratory results ,therapy and outcomes of 403 cases with dengue fever treated in Mengchao Hepatobiliary Hospital of Fujian Medical University ,Fuzhou from July to November 2016 were collected and analyzed retrospectively .Results Among the 403 cases , 56 cases (13 .89％ ) were younger than 20 years old ,160 cases (39 .71％ ) were 21 to 50 years old ,and 187 cases (46 .40％ ) were over 50 years old .The peak incidence period of dengue fever was from August to October ,accounting for 94 .29％ of the cases .The clinical classification was dominated by typical dengue fever (98 .01％ ) .Most of the cases had sudden onset .The main clinical symptoms included fever in 391 cases (97 .02％ ) , body aches in 355 cases (88 .09％ ) , and rash in 156 cases (38 .71％ ) . All patients were tested for serology and etiology of dengue virus at the early stage of disease .Among them , the positive rate of NS1 antigen was 95 .04％ ;the positive rate of IgM antibody was 13 .90％ ,and the positive rate of IgG antibody was 8 .19％ . Thrombocytopenia was founded in 332 cases (82 .38％ ) .Neutrophil count decreased in 293 cases (72 .70％ ) , w hite blood cell count decreased in 274 cases (67 .99％ ) .Aspartate aminotransferase increased in 256 cases (63 .52％ ) and alanine aminotransferase increased in 146 cases (36 .23％ ) .Creatine kinase elevated in 130 cases (32 .26％ ) and prothrombin time was prolonged in 40 cases (9 .93％ ) .A total of 289 cases (82 .75％ ) had bilateral lesions in both lungs and 25 cases (6 .20％ ) had pleural effusions . Color doppler ultrasound found 46 cases (11 .41％ ) of hepatomegaly ,84 cases (20 .84％ ) of splenomegaly ,8 cases (1 .99％ ) of a small amount of ascites . Conclusions Most of the 403 cases of dengue fever show typical clinical manifestations .Dengue fever mainly affects the blood system ,liver ,heart ,lung ,kidney ,skeletal muscle system ,and immune system . Clinicians should carefully observe the condition ,master the warning signs of severe dengue fever ,and achieve early identification and timely treatment of severe cases ,thereby reducing the mortality rate .

Objective:To evaluate the clinical effectiveness of the reconstruction of multiple digit-tip defects with transfer of polyfoliate perforator flaps of the fibular hallux.Methods:From January 2019 to June 2022, 15 patients had undergone reconstruction surgery for multiple digit-tip defects using polyfoliate perforator flaps of ipsilateral fibular hallux, with the first dorsal metatarsal artery as the pedicle, in the Department of Upper Limb Repair and Reconstruction Surgery, Guizhou Hospital of Beijing Jishuitan Hospital. The patients were 10 males and 5 females and aged 20 to 45 years old. Eight patients had the defects of thumbs and index fingers, 4 of thumbs and middle fingers, 2 of thumb, index and middle fingers and 1 of thumb, index and ring fingers. All the 15 digit injuries had nail bed defects to which reconstructive surgery were required. For the flaps of dorsal artery, flaps were 1.8 cm×2.0 cm-2.0 cm×3.1 cm in size and for those of plantar artery, the flaps sized 1.5 cm×2.0 cm-2.5 cm×3.0 cm. Donor site defects in the hallux were reconstructed with free superficial circumflex iliac perforator flaps. Postoperative follow-up lasted until 30th June 2023 and included visits to the outpatient clinic, WeChat and telephone reviews to assess the appearance, function and sensation recovery of the digits.Results:All the 15 flaps survived. During the 6 to 24 months (16 months in average) of postoperative follow-up, the appearance and texture of all flaps were found close to the healthy digits, with good nail growth and without deformity. TPD were found between 8.0 mm and 12.0 mm. The donor sites on the great toes that reconstructed with superficial circumflex iliac artery flaps were all survived well, and the incisions were satisfactorily healed without the functions of walking, running or jumping being significantly affected.Conclusion:The use of polyfoliate perforator flaps of fibular hallux for reconstruction of multiple digit-tip defects is an ideal surgical method due to the consistency of vascular anatomy, ease with flap harvest, similarity in the normal digital skin texture, and the capability to include a nail bed with the flap. A single donor from the hallux can simultaneously reconstruct two defects of digit-tip, making it an excellent treatment in the reconstruction of small-to medium-sized composite tissue defects in multiple digits.

Objective:To explore the clinical characteristics and experiences in diagnosis and treatment of severe hand injuries caused by chaff cutters.Methods:A retrospective analysis was conducted on 60 patients (193 digits) who had mangled hand injuries caused by chaff cutters and admitted to the Department of Upper Limb Repair and Reconstruction, Beijing Jishuitan Hospital Guizhou Hospital between January 2015 and June 2022. The patients were 39 males and 21 females, with 10 to 72 (mean 42.6) years old of age. The injuries involved 41 right hands and 19 left hands. The extent of hand injuries of soft tissue and bones varied from digit-tips to wrist. Among them, 5 digits were completely destroyed in 8 cases, 3 digits including thumb were destroyed in 12 cases, 4 digits including thumb were destroyed in 10 cases, 3 or more fingers without thumb were destroyed in 8 cases, simple hand destroyed in 8 cases, digits and palm destroyed in 8 cases, and total hand destroyed in 6 cases. The sizes of wound ranged from 1.8 cm×2.0 cm to 6.8 cm×15.6 cm. Based on the wound contamination and conditions of tissue damage, surgical treatment included debridement, stump trimming, in-situ replantation, transpositional replantation, venous bridging flap transfer and emergency or phased free second toe and free flap transfers. The flap sizes were 3.0 cm×5.0 cm-7.0 cm×16.0 cm. Both the reconstructed and flap donor sites were primarily closed in one stage. Postoperative follow-ups were conducted through regular visits of outpatient clinic or via WeChat interviews. The survival and functional recovery of flap and finger were observed.Results:Of the 60 patients, emergency orthotopic replantation of 112 digits were performed with survival of 96 digits; 16 digits transposition replantation were carried out with 12 survived; 5 digits received venous bridging flap transfer with 4 survived; all 5 Flow-through anteriolateral thigh perforator flaps (ALTPFs) were survived; all of 12 phase II digit reconstructions with free second toe transfer survived; and all 18 phase II free flap transfers survived [10 ALTPFs and 8 superficial circumflex iliac artery perforator flaps(SCIAPFs)]. Postoperative complications such as wound exudation and fever happened in 8 patients, and all were rectified after debridement and symptomatic anti-infection treatment. The follow-up ranged 6 to 18 months, with 12 months in average. Hand functions were assessed using the Michigan Hand Outcomes Questionnaire (MHQ), and the scores achieved at 20.3 to 72.8 points, with 42.6 points ± 16.6 points in average.Conclusion:Severe hand injuries caused by chaff cutters are severe and complicated. A thorough assessment of wound contamination and residual digits and tissues are required. Successful surgical outcomes can be achieved through emergency and elective surgery with multiple microsurgical techniques and multi-phased surgical reconstructions, although overall functional recovery of the injured hand is often not quite realistic.