OBJECTIVETo introduce the clinical application of venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot.

METHODSBased on the anastomoses between the medial plantar artery of the hallux and the nutritional vein, the flap was designed with the perforator of medial plantar artery adjacent to the first metatarsal bone as the rotation point. The flap axis was along the vein at the medial aspect of the foot between rotation point and medial malleolus.

RESULTS5 cases were treated with primary healing and complete survival flaps. The patients were followed up for 1-12 months with good match of texture and color.

CONCLUSIONSThe venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot can be transpositioned to repair the defect at forefoot.

Arteries ; Forefoot, Human ; Hallux ; blood supply ; Humans ; Metatarsal Bones ; Surgical Flaps ; blood supply ; Veins ; Wound Healing

Objective To provide the oxygen supply apparatus when the civil aviator and airforce pilot are inspected the hypoxia tolerance and altitude tolerance in the hypobaric environment.Methods Demand oxygen and contstant flow oxygen were supplied.Results The portable hypobaric oxygen supply apparatus can supply mixed oxygen below the altitude 8 000 m,and the oxygenous concentration of mixed oxygen was adjusted according to the altitude.The pure oxygen was supplied when the altitude was at 8 000～12 000 m.Conclusion The normal and emergency oxygen supply performance can fulfill the system physiological requirements.The portable hypobaric oxygen supply apparatus may be used by the persons engaging in special task on plateau also.

Objective To summarize the experience of intraoperative neuromonitoring (IONM) system for monitoring and protection of recurrent laryngeal nerve (RLN) during thyroid surgery.Methods A total of 220 cases were enrolled in this study (53 males and 167 females),with the median age of 38.2 years old.There were 85 cases of thyroid cancer,19 cases of thyroid benign tumor,90 cases of thyroid goiter,3 cases of Hashimoto's diseases,and 23 cases of hyperthyroidism.113 cases had tumors larger than 5 cm in diameter.During the procedure,2 recording needle electrodes were put in cricothyroid muscle and 1 stimulator electrode was explored in tracheoasophageal groove.If any RLN was fight there or nearby,doctors can see the electromyogram and hear the toothonk.With careful dissection,RLN can be found out till exploring into the larynx site.Results Electromyogram showed in 207 cases (278 nerves),and it didn't show in 13 cases,among whom 9 cases were false-negative because of system or annesthesia problems,4 cases didn't manage to have needle electrodes put in properly due to cricothyroid muscle being invaded.No permanent RLN paralysis occoured.Transient nerve paralysis occurred in 2 cases,who recovered in 1 month after operation.Conclusion IONM system is an effective way to avoid damage to RLN in thyroidectomy.

AIM: To observe the effect of Tripterygium glycosides on NOXs-ROS-NLRP3 inflammatory signa-ling pathways in the colon tissue in dextran sulphate sodium (DSS)-induced ulcerative colitis (UC) mice, and to investi-gate the underlying mechanisms.METHODS: BALB/c mice were used and the mouse model of UC was established by DSS induction.The mice were randomly divided into 5 groups (model group, low-, medium-and high-dose Tripterygium glycosides groups, and normal group).The colon tissues were collected 21 d after Tripterygium glycosides gavage.The mRNA expression of NLRP3, ASC and caspase-1 in the colon tissues was detected by real-time PCR.The caspase-1 ex-pression in the colorectal mucosa was observed by immunohistochemical method.ELISA was used to detect the protein le-
vels of IL-1α, TNF-αand IL-13.The production of reactive oxygen species (ROS) was measured by chemiluminescence technique, and the consumption rate of NADPH, which was inhibited by DPI, was analyzed to determine the activity of NADPH oxidases (NOXs).The neutrophils were isolated, and the ROS production, NOXs activity, and the mRNA ex-pression of NLRP3, ASC and caspase-1 were also detected.RESULTS: The colon tissues were abnormal with different de-grees in Tripterygium glycosides groups, and histopathological scores were lower than that in model group.In Tripterygium glycosides groups, in addition to the mRNA expression levels of caspase-1 in the colon tissues between normal group and high-dose group, ROS production, NOXs activity and the mRNA expression levels of NLRP3, ASC and caspase-1 in the colon tissues and colon-isolated neutrophils were lower than those in model group (P <0.05), and higher than those in normal group (P <0.05).The results of pairwise comparison for the efficacy of Tripterygium glycosides administration showed that the above indexes were statistically significant except the mRNA expression levels of caspase-1 between middle-dose group and high-dose group.Tripterygium glycosides administration significantly decreased the expression levels of proinflammatory cytokines IL-1αand TNF-αin the homogenates of colon tissues in the model mice (P <0.05).No differ-ence of IL-13 expression among the groups was observed.CONCLUSION: Tripterygium glycosides inhibits NOXs-ROS-NLRP3 inflammatory signaling pathways to reduce the expression of IL-1α, TNF-αand other proinflammatory cytokines, and attenuates DSS-induced ulcerative colitis in mice, by which the neutrophils might be involved in the process.

Objective:To summarize and compare the characteristics of oral microbiota in women during the preconception period and the third trimester.Methods:This retrospective cohort study involved 55 women who were recruited in the Preconceptional Offspring Trajectory Study (PLOTS) conducted by Fudan University and followed up to the third trimester in the Maternal and Child Health Care Hospital of Jiading District of Shanghai from September 2016 to December 2019. A total of 110 unstimulated saliva samples were collected in the preconception period ( n=55) and the third trimester ( n=55). Features of oral microbiota in the samples were analyzed by 16S rRNA gene-based sequencing. Moreover, the related factors were also analyzed. Paired t test or Wilcoxon matched-pairs signed-ranks test were used to analyze the differences in α-diversity during preconception and the third trimester; t test, analysis of variance (ANOVA), Kruskal-Wallis test and Mann-Whitney U test for comparison between groups with different characteristics and permutational multivariate analysis of variance (PerMANOVA) for β-diversity were used; Linear discriminant analysis (LDA) effect size (LEfSe 1.0) was used to identify the iconic oral flora. Results:(1) The Ace index of oral microbiota was significantly lower in the third trimester than that in the preconception period [661.14(578.15-752.85) vs 730.64 (632.40-911.00), T=1 077.00, P=0.010]. There was also a significance difference in β-diversity ( F=12.539, R2=0.104, P=0.001). Some species such as Saccharibacteria_TM7_G3, Prevotella_7, Absconditabacteria_SR1_G1, Porphyromonas, Ruminococcaceae_UCG_014, Prevotella, Peptostreptococcus, Prevotella_2, Alloprevotella, Parvimonas, Solobacterium and Eubacterium_nodatum_group in saliva were statistically more abundant in the third trimester than those in the preconception period (all P<0.05). (2) The third-trimester Shannon index was lower among those with lower income [5.44 (5.08-5.77) vs 5.75 (5.44-6.12), U=219.00, P=0.029] and those with gargle habit after meal or dessert [5.36 (4.91-5.48) vs 5.72 (5.44-6.05), U=374.00, P=0.046]. Conclusions:The features of oral microbiota vary in women during the preconception period and the third trimester. There is a significant increase in the abundance of oral pathogenic and opportunistic bacteria in the third trimester.

Objective To investigate the changes of the axial length,corneal curvature and refractive power in infants with monocular congenital cataract.Methods A retrospective cohort study was carried out.The clinical data of 105 eyes of 105 cases with monocular congenital cataract who were received cataract extraction during January 2015 to December 2017 were collected in the First Affiliated Hospital of Zhengzhou University.According to the initial operation age,the infants were assigned to 3-6 month old group,7-12 month old group and 13-18 month old group.The patients were followed-up for 12 months.Axial length,corneal curvature and refractive power were recorded in 3,6 and 12 months after surgery.This study followed the Declaration of Helsinki,and written informed consent was obtained from each guardian prior to any medical examination.Results The increasing value of axial length in 3-6 month old group was larger than that in 7-12 month old group,and increasing value in 7-12 month old group was larger than that in 13-18 month old group (all at P＜0.001).The increasing value of axial length of operated eyes was larger than that of fellow eyes in both 3-6 month old group and 7-12 month old group during following-up,and so was in the 13-18 month old group at 6 months and 12 months after surgery (all at P＜0.001).The ocular axial length of operated eyes was significantly shorter than that of the fellow eyes in three groups before operation (t =-10.420,P＜0.001;t=-32.288,P＜0.001;t =-2.370,P =0.024),and at 12 months after operation,the axial length of operated eyes was longer than that of the fellow eyes in the 13-18 month old group (t =18.513,P＜0.001).No significant difference was found in the axial length between operated eyes and fellow eyes in both 3-6 month old group and 7-12month old group (P =0.051,0.062).The pre-operative corneal curvature was significantly larger than that of fellow eyes in both 3-6 month old group and 7-12 month old group (both at P＜0.01),and was not significantly different in 13-18 month old group (P =0.433).There were not significant differences in corneal curvature in the three groups at 12 months after surgery (all at P＞0.05).The change value of refractive power was gradually increased as aging at 12 months after surgery (all at P＜0.001).The surgical eye amplitude of change in refractive diopter was higher than healthy eye,with significant difference between them (P＜0.001).Conclusions The developing process of axial length and corneal curvature are interacted and coordinated in bilateral eyes in infants who received extraction surgery of monocular congenital cataract.It is better to remove the cataract as early as possible in infants.Refraction of bilateral eyes still has a trend to myopia,and the shifting amplitude of myopic power decreases with aging.

This study was aimed to investigate the effect of sinomenine on the expression of tumor suppressor gene P 16 and P53 in rats with lung cancer.A total of 40 male SD rats were treated by left-lung vein injection of WALKER-256 cell suspension to establish transplanted lung cancer model.After 3 weeks,30 rats screened of tumor were randomly divided into the model group,cyclophosphamide (CP) group and the sinomenine treatment group.Another 10 healthy SD rats were set as the normal control group.Sinomenine treatment group was treated with the subcutaneous injection of 10％ sinomenine hydrochloride for 10 weeks.CP was injected in the CP group as positive control.The same amount of normal saline was injected in the normal control group and the model control group.After 10 weeks of treatments,lung tumors of each group were removed to measure the tumor volume and weight.And the tumor inhibition rate was calculated.Then,flow cytometry was used to detect the proportion of WALKER-256 cells in tumor tissues in G1,G2,M and S around four cycles.Immunohistochemistry was adopted to detect positive expression rates of P16 and P53 protein.Reverse transcription polymerase chain reaction (RT-PCR) were used to detect expression of P16mRNA and P53mRNA.The results showed that compared with the model control group,the inhibition rate of sinomenine group was 30.15％;the positive expression rate of P16mRNA and P53mRNA protein were significantly decreased;expressions of P 16mRNA and P53mRNA were lower;tumor volume and tumor weight in S period got down significantly.The rates of cells in G1 and G2 periods got higher (P＜0.05).It was concluded that sinomenine may inhibit the differentiation and proliferation of WALKER-256 transplanted lung cancer cells in rats by regulating the expression of tumor suppressor gene P 16 and P53,regulating the ratio of cells in G1,G2 and S periods.

Objective:To compare the application effectiveness of conventional rehabilitation combined with thoracic spine mobility exercises and conventional rehabilitation in postoperative rehabilitation of patients with rotator cuff injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 204 patients with rotator cuff injury admitted to First Affiliated Hospital of Jinan University from February 2019 to February 2022, including 88 males and 116 females; aged 18-87 years [(54.1±11.8)years]. Initial unilateral arthroscopic rotator cuff repair was performed on all the patients. A total of 98 patients received a conventional rehabilitation plan (conventional rehabilitation group), and 106 patients received additional thoracic spine mobility exercises as well as conventional rehabilitation (additional exercise rehabilitation group). The visual analog scale (VAS), Constant shoulder joint score, University of California at Los Angeles (UCLA) shoulder joint score, and shoulder range of motion (forward flexion, abduction, and external rotation) before surgery and at 1, 3, and 6 months after surgery were compared between the two groups. The occurrence of complications after rehabilitation was observed.Results:All the patients were followed up for 6-18 months [(8.4±3.5)months]. The VAS score, Constant shoulder joint score, UCLA shoulder joint score, and shoulder joint range of motion of both groups were improved significantly at 1, 3, and 6 months after surgery compared with those before surgery (all P<0.01). There was no statistically significant difference in VAS score between the two groups before surgery and at 1, 3, and 6 months after surgery respectively (all P>0.05). At 3 and 6 months after surgery, the values of the Constant shoulder joint score of the additional exercise rehabilitation group were (77.7±5.8)points and (88.4±7.7)points respectively, which were higher than those of the conventional rehabilitation group [(73.7±6.6)points and (85.5±4.9)points] (all P<0.01). There was no statistically significant difference in the Constant shoulder joint score between the two groups before and at 1 month after surgery (all P>0.05). At 3 months after surgery, the value of the UCLA shoulder joint score of the additional exercise rehabilitation group was (25.5±3.7)points, significantly higher than that of the conventional rehabilitation group [(21.8±5.6)points] ( P<0.01). There was no statistically significant difference in the UCLA shoulder joint score between the two groups before surgery and at 1 and 6 months after surgery (all P>0.05). At 3 and 6 months after surgery, the forward flexion angles of the additional exercise rehabilitation group were (135.5±12.8)° and (165.1±11.3)° respectively, which were higher than those of the conventional rehabilitation group [(129.3±12.3)° and (151.1±11.2)°]; the abduction angles of the additional exercise rehabilitation group were (102.3±12.9)° and (130.4±15.1)° respectively, which were higher than those of the conventional rehabilitation group [(93.2±11.0)° and (123.5±13.7)°]; the external rotation angles of the additional exercise rehabilitation group were (57.2±13.1)° and (72.3±12.3)°respectively, which were higher than those of the conventional rehabilitation group [(46.4±8.8)° and (67.4±14.1)°] (all P<0.01). There was no statistically significant difference in the forward flexion, abduction and external rotation angles between the two groups before surgery and at 1 month after surgery (all P>0.05). At 6 months after surgery, recurrent rotator cuff tear occurred in 1 patient (1.0%) in the conventional rehabilitation group and in 2 (1.9%) in the additional exercise rehabilitation group; shoulder joint adhesion deveplpoed in 5 patients (5.1%) in the conventional rehabilitation group and in 3 (2.8%) in the additional exercise rehabilitation group. No statistically significant difference was found in the incidence rate of postoperative complications between the two groups (all P>0.05). Conclusion:Compared with the conventional rehabilitation plan, addition of thoracic spine mobility exercise to the rehabilitation after arthroscopic repair surgery in patients with rotator cuff injury can achieve better joint function and range of motion, with no increase in the incidence of complications.

Objective Search and collect the previous relevant literature on the influence of diabetes on the progress of tendinosis,summarize the relevant conclusions and discuss the pathogenesis of diabetes accelerating the progress of tendinosis,mainly including summarizing the biomechanical and histological changes of diseased tendons in diabetes patients,as well as its pathogenesis at the cellular level.Methods This paper reviewed and analyzed the domestic and foreign literature related to dia-betes tendinosis by searching some Chinese and English databases like PubMed,Springer Link,CNKI,Google Academic.Re-sults Most previous studies more support the theory of degeneration as the pathogenesis of tendinosis,but now more and more researchers find that diabetes,as a systemic metabolic disease,can induce the occurrence of tendinosis through a variety of mech-anisms,or aggravate the progress of tendinosis,such as the accumulation of advanced glycation end products(AGEs)at the le-sion site,chronic inflammatory reaction at the lesion site,increased oxidative stress level of tendon cells And changes in the ac-tivities of matrix metalloproteinases and glutamine transaminase.By summarizing and analyzing the various understandings of dia-betes on the pathogenesis of tendinosis proposed by previous researchers,the relationship between diabetes and tendinosis is grad-ually clear.Conclusion As a systemic metabolic disease,diabetes can induce the occurrence of tendinosis or aggravate the pro-gress of tendinosis through a variety of ways and mechanisms.Research and clarification of these ways can provide us with a pow-erful weapon to study and treat tendinosis.However,at present,there are many possible pathogenesis of diabetes tendinosis,which still needs to be studied step by step to further clarify its main pathogenesis.

Objective To study the relationship between circulating tumor cells(CTCs) in peripheral blood of the pa‐tients with hepatocellular carcinoma (HCC) and its metastasis and prognosis .Methods 35 patients with hepatocellular carci‐noma were collected as the research objects .CTCs density were enriched through gradient centrifugation and negative‐immu‐nomagnetic methods ,then the cells were detected by chromosome fluorescence in situ hybridization combined with immunofluo‐rescence tests to identify CTCs .The clinical characters were recorded and the data were statistically analyzed .Results All the patients were detected CTC positive .The number of CTC was (4 .1 ± 2 .5) .The patients were divided into 2 groups .Group Ⅰincluded patients whose CTCs were <5 ,and others were included in group Ⅱ .The difference between number of group I and group Ⅱ had significant significance(P=0 .001);Metastasis had nothing to do with patients′sex and age(P=0 .581 ,0 .531);The number of CTCs was related to metastasis and prognosis(P=0.024 ,0.01) ,and there was significant statistic significance between group I and groupⅡ .Conclusion The number of CTCs was related to tumor metastasis .The tumor may be more prone to occur metas‐tasis and may had worse prognosis ,and the patients may had shorter life time when the number of CTCs was≥5 .