Objective:To investigate the effect of inferior epigastric artery perforator flap transplantation in repairing traumatic soft tissue defects of lower limbs.Methods:A retrospective case series study was conducted to analyze the clinical data of 34 patients with traumatic soft tissue defects of lower limbs admitted to Chongqing Great Wall Hospital from January 2019 to May 2021, including 31 males and 3 females; aged 12-65 years [(38.5±5.6)years]. There were 8 patients with defects on the calf and 26 on the ankle. All wounds were found with exposed tendons, muscles and/or bones. The area of soft tissue defects ranged from 10 cm×6 cm to 40 cm×11 cm. All patients were repaired with inferior epigastric artery perforator flap. The wound healing, flap survival and recovery were observed. The visual analogue scale (VAS) and American Orthopedic Foot and ankle Society (AOFAS) ankle-hindfoot score were used to evaluate pain and ankle function before operation and at 3 days, 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation. The complications were observed.Results:All patients were followed up for 12-36 months [(19.5±5.3)months]. All wounds were healed by stage I, showing the healing time of 14-24 days [(17.6±2.8)days]. All flaps survived with good color, soft texture and satisfactory appearance, with no obvious swelling. All flaps produced protective sensation. The VAS was (4.3±0.8)points, (3.3±0.7)points, (1.4±0.5)points, (1.2±0.3)points, (0.8±0.2)points and (0.4±0.1)points at 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation, decreased gradually from preoperative (7.4±1.3)points (all P<0.05). The AOFAS ankle-hindfoot score was (35.6±3.1)points, (42.6±3.6)points, (50.3±4.3)points, (56.2±5.6)points, (60.3±6.8)points and (65.3±9.0)points at 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation, increased from preoperative (22.4±2.5)points (all P<0.05). The ankle function was excellent in 25 patients, good in 5 and fair in 4 at 12 months after operation, with an excellent and good rate of 88.2%. Venous crisis occurred in 3 patients after operation, and the flaps survived completely after venous reanastomosis or venous bridging. Conclusion:For traumatic soft tissue defects of lower limbs, inferior epigastric artery perforator flap transplantation has advantages of enhanced survival of flaps, satisfactory appearance, attenuated pain, good functional recovery and few complications.

OBJECTIVE To investigate the improvement effects of sinomenine （Sin） on non-alcoholic steatohepatitis （NASH） and its potential mechanism. METHODS Male C57BL/6J mice were randomly divided into standard chow diet （SCD） group， high- fat diet （HFD） group， Sin low-dose group （Sin-L group， 50 mg/kg）， and Sin high-dose group （Sin-H group， 100 mg/kg）， with 6 mice in each group. The mice of SCD groups were fed with SCD， and other groups were given HFD for consecutive 24 weeks to establish NASH model. Since 17th week， the mice in each drug group were given corresponding drug solutions intragastrically， once a day， for 8 consecutive weeks. After the last medication， the body weight and liver weight of mice were determined， and liver indexes were calculated. The contents of total cholesterol （TC） and triglyceride （TG） in liver tissue， the serum contents of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， interleukin-1β （IL-1β） and IL-18 were all determined. Hepatic steatosis and fibrosis were observed， and hepatic lipid droplets were located. The expressions of IL-18 and IL-1β mRNA， inflammation-related proteins （IL-1β， cleaved-IL-1β）， fibrosis-related proteins [collagen Ⅰ （Col-Ⅰ）， α-smooth muscle actin （α-SMA）， connective tissue growth factor （CTGF）]， and pathway-related protein [adenosine monophosphate-activated protein kinase （AMPK）， phosphorylated AMPK （p-AMPK）， Yes-associated protein （YAP）， phosphorylated YAP （p-YAP）] were all determined. HepG2 human liver cancer cells were selected as subjects and divided into control group， oleic acid （OA） group， Sin 50 μmol/L group， Sin 100 μmol/L group， OA+Sin 50 μmol/L group and OA+Sin 100 μmol/L group. After 24 hours of treatment， the accumulation of lipid droplets was observed， and the expressions of pathway-related proteins were detected.RESULTS Compared to HFD group， hepatic steatosis， zengcheng@gdpu.edu.cn fibrotic lesions and lipid droplet accumulation were all alleviated in Sin groups； body weight， liver weight， liver indexes， the contents of AST， ALT， IL-1β， IL-18 in serum and TG， TC in liver tissue， the mRNA expressions of IL-1β and IL-18， and the expressions of cleaved-IL-1β and fibrosis-related proteins all decreased significantly （P＜0.01）； the protein expression of IL-1β， and the phosphorylation levels of AMPK and YAP proteins significantly increased （P＜0.01）. Compared with OA group， the lipid droplet accumulation of cells in OA+Sin groups significantly decreased， while the phosphorylation levels of AMPK and YAP proteins significantly increased （P＜0.05）. CONCLUSIONS Sin can ameliorate the inflammation， lipid deposition and fibrosis of liver tissue in mice， the mechanism of which may be associated with activating the AMPK signaling pathway and promoting YAP phosphorylation.