Objective: To investigate the clinical application of differential subsampling with Cartesian ordering (DISCO) contrastenhanced (CE) magnetic resonance angiography for anterolateral thigh (ALT) flap transplantation, using operative findings as a reference. Materials and Methods: Thirty patients (21 males and nine females; mean age ± standard deviation, 45.5 ± 15.6 years) who were scheduled to undergo reconstruction with ALT flaps between June 2020 and June 2021 were included in the prospective study. Before ALT flap transplantation, patients were scanned using CE-DISCO imaging. All acquired DISCO images of the 60 lower limbs (both sides from each patient) were analyzed using maximum intensity projection and volume rendering methods. Two experienced radiologists were employed to examine the patterns of the lateral circumflex femoral artery (LCFA), its branches, and perforators and their skin termini, which were compared with the operative findings. Results: Using CE-DISCO, the patterns of the LCFA and its branches were clearly identified in all patients. Four different origins of the LCFA were found among the 60 blood vessels: type I (44/60, 73.3%), type II (6/60, 10.0%), type III (8/60, 13.3%), and type IV (2/60, 3.3%). Owing to a lack of perforators entering the skin, two patients did not undergo ALT flap transplantation. For the remaining 28 patients, the ALT flaps in 26 patients were successfully operated without flap reselection during the operation, while the remaining two patients underwent other surgical procedures due to the thin diameter of the perforator or injury of the perforator during the operation. The success rate of flap transplantation was 92.8% (26/28). All transplanted flaps exhibited good blood supply and achieved primary healing without infection or delayed healing. Conclusion CE-DISCO imaging can be an effective method for preoperative perforator imaging before ALT flap transplantation.

Objective:To explore the effect of hydroxysafflor yellow A (HSYA) on the viability of the random skin flap in rats.Methods:A total of 30 SD rats were randomly divided into HSYA group and normal saline (NS) group. Using the modified McFarlane skin flap model, a rectangular random skin flap of approximately 3 cm×12 cm was dissected and sutured in situ over the central dorsum of the rats. The flap was divided into four zones from its caudal part to the cranial part: Zone Ⅰ, Zone Ⅱ, Zone Ⅲ, and Zone Ⅳ. The rats in the HSYA group received intraperitoneal injection of HSYA (20 mg/kg) dissolved in 0.9% sodium chloride solution immediately, while NS group rats were given intraperitoneal injection of an equal amount of NS. The injection was performed once a day for 14 days. On postoperative day 14, the flap was photographed to evaluate the survival rate. Tissue samples were collected from Zone Ⅲ of the flaps for histological analysis and real-time quantitative PCR (RT-qPCR). The number of the vessels with a diameter greater than 0.1 mm in the subdermal layer was evaluated using hemotoxylin & eosin (HE) staining. Microvascular density in the subdermis was assessed by the immunohistochemical (IHC) staining of CD31. The gene expression levels of endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor receptor 2 (VEGFR2) was quantified with RT-qPCR. Results:The mean survival rate of HSYA group (70.4%±7.0%) was significantly higher than that of NS group (55.4%±7.7%, P<0.01). The number of blood vessels > 0.1 mm in the HSYA group (31.5±5.0) was significantly higher than that in the NS group (15.3±3.4, all P<0.01). The mean microvascular density in HSYA group (82.8±14.0/mm 2) was significantly greater than that in NS group (43.0±4.6/mm 2,P<0.01). Compared with NS group, the mRNA expression of eNOS and VEGFR2 was upregulated in HSYA group (3.0±0.9 vs. 1.2±0.8; 14.2±7.7 vs. 1.1±0.6; P<0.05). Conclusions:HSYA might promote the vasodilation and angiogenesis through up-regulating eNOS and VEGFR2 expression, thus increasing the viability of the random skin flap.

Objective:To explore the effect of hydroxysafflor yellow A (HSYA) on the viability of the random skin flap in rats.Methods:A total of 30 SD rats were randomly divided into HSYA group and normal saline (NS) group. Using the modified McFarlane skin flap model, a rectangular random skin flap of approximately 3 cm×12 cm was dissected and sutured in situ over the central dorsum of the rats. The flap was divided into four zones from its caudal part to the cranial part: Zone Ⅰ, Zone Ⅱ, Zone Ⅲ, and Zone Ⅳ. The rats in the HSYA group received intraperitoneal injection of HSYA (20 mg/kg) dissolved in 0.9% sodium chloride solution immediately, while NS group rats were given intraperitoneal injection of an equal amount of NS. The injection was performed once a day for 14 days. On postoperative day 14, the flap was photographed to evaluate the survival rate. Tissue samples were collected from Zone Ⅲ of the flaps for histological analysis and real-time quantitative PCR (RT-qPCR). The number of the vessels with a diameter greater than 0.1 mm in the subdermal layer was evaluated using hemotoxylin & eosin (HE) staining. Microvascular density in the subdermis was assessed by the immunohistochemical (IHC) staining of CD31. The gene expression levels of endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor receptor 2 (VEGFR2) was quantified with RT-qPCR. Results:The mean survival rate of HSYA group (70.4%±7.0%) was significantly higher than that of NS group (55.4%±7.7%, P<0.01). The number of blood vessels > 0.1 mm in the HSYA group (31.5±5.0) was significantly higher than that in the NS group (15.3±3.4, all P<0.01). The mean microvascular density in HSYA group (82.8±14.0/mm 2) was significantly greater than that in NS group (43.0±4.6/mm 2,P<0.01). Compared with NS group, the mRNA expression of eNOS and VEGFR2 was upregulated in HSYA group (3.0±0.9 vs. 1.2±0.8; 14.2±7.7 vs. 1.1±0.6; P<0.05). Conclusions:HSYA might promote the vasodilation and angiogenesis through up-regulating eNOS and VEGFR2 expression, thus increasing the viability of the random skin flap.

ObjectiveA rapid method for identification of chemical constituents in Puerariae Lobatae Radix dispensing granules was established in order to clarify the material basis. MethodThe chemical constituents of Puerariae Lobatae Radix dispensing granules was qualitatively analyzed by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS/MS） under positive and negative ion modes， and the chromatographic conditions were on an ACQUITY UPLC HSS T3 column（2.1 mm×100 mm， 1.8 μm） with 0.1% formic acid aqueous solution（A）-0.1% formic acid acetonitrile solution（B） as mobile phase for gradient elution（0-4 min， 5%-10%B； 4-10 min， 10%-15%B； 10-20 min， 15%-16%B； 20-27 min， 16%-31%B； 27-33 min， 31%-59%B； 33-42 min， 59%-95%B； 42-42.1 min， 95%-5%B； 42.1-45 min， 5%B）， the flow rate was 0.35 mL·min^-1， the column temperature was 40 ℃， the injection volume was 5 μL， and electrospray ionization（ESI） was selected. Then these chemical constituents were comprehensively identified based on PeakView 1.2， PubChem， ChemicalBook， ChemSpider， comparative control profiles and literature information. ResultA total of 128 chemical constituents were identified from the dispensing granules， including 60 flavonoids， 26 organic acids， 7 glycosides， 6 coumarins， 3 nucleosides and 26 other compounds. By focusing on the cleavage patterns of flavonoids， organic acids， glycosides， coumarins， nucleosides and other compounds， 12 compounds that have not been reported in Puerariae Lobatae Radix species were identified from the dispensing granules. ConclusionThe established method can systematically and rapidly identify the chemical constituents in Puerariae Lobatae Radix dispensing granules， and cleared it composition is mainly flavonoids and organic acids. Laying a foundation for the study of the material basis， mechanism of action and clinical application of the dispensing granules.