Flap transplantation is a critical surgical strategy for the reconstruction of tissue defects caused by trauma, tumor resection, and congenital malformations, and its survival rate directly determines surgical efficacy and patient prognosis. Following transplantation, flaps inevitably undergo ischemia-reperfusion (I/R) injury, during which oxidative stress, inflammatory responses, and metabolic disturbances are intricately intertwined, ultimately leading to cellular injury and tissue necrosis. Recent studies have demonstrated that multiple forms of programmed cell death—including apoptosis, pyroptosis, ferroptosis, necroptosis, and PANoptosis—play central roles in flap I/R injury. The extensive crosstalk and molecular interactions among these pathways form a highly complex cell death network. Specifically, apoptosis is mediated by the imbalance of Bcl-2 family proteins and the activation of cysteine-dependent aspartate-specific protease (caspase) cascades; pyroptosis is driven by the NLRP3-caspase-1-GSDMD axis, resulting in membrane pore formation and the release of pro-inflammatory cytokines; ferroptosis is characterized by iron-dependent lipid peroxidation and dysfunction of glutathione peroxidase 4 (GPX4); necroptosis is triggered by the receptor-interacting serine/threonine-protein kinase 1 (RIPK1)-RIPK3-MLKL signaling complex, leading to membrane rupture; and PANoptosis represents an integrated form of inflammatory cell death that coordinates multiple death pathways. Importantly, these forms of programmed cell death are not independent but are interconnected through extensive signaling crosstalk. Key regulatory molecules, including caspase-8, reactive oxygen species (ROS), nuclear factor-κB (NF-κB), and nuclear factor erythroid 2-related factor 2 (Nrf2), collectively modulate the dynamic balance among these pathways. Therefore, the multidimensional interplay and spatiotemporal dynamics of programmed cell death constitute a fundamental pathological basis of flap I/R injury. This review systematically summarizes the latest advances in the mechanisms and interactions of various programmed cell death pathways in flap I/R injury, aiming to elucidate the underlying regulatory network. These insights may provide novel theoretical foundations for optimizing flap protection strategies, improving flap survival, and promoting tissue repair.

Objective:To investigate the application value of 72-hour three-lead electrocardiogram(ECG)monitoring with adhesive patch(AP)in patients with palpitation.Methods:A retrospective analysis was performed for the medical history and ECG data of the patients who underwent 72-hour three-lead ECG monitoring with AP due to palpitation in The First Affiliated Hospital of Chongqing Medical University.The incidence rates of arrhythmia and transient ST-T changes were compared at 24 and 72 hours,as well as the rate difference between the detection rate of arrhythmia and transient ST-T changes at 72 hours and the detection rate at 24 hours in the context of various risk factors such as age,hypertension,hyperlipidemia,and coronary heart disease.Results:Among the 216 pa-tients with palpitation,the detection rates of various types of arrhythmia and transient ST-T changes at 72 hours were significantly higher than those at 24 hours(P<0.05).The rate difference of atrial premature beats in patients aged<60 years was significantly higher than that in patients aged≥60 years(P<0.01).The rate difference of atrial premature beats in hypertensive patients was lower than that in non-hypertensive patients(P<0.05).The rate difference of T-wave changes in patients without hypertension or coronary heart dis-ease was greater than that in patients with hypertension or coronary heart disease(P<0.01).Compared with 24-hour three-lead ECG monitoring,72-hour three-lead ECG monitoring with AP can significantly improve the detection rate of arrhythmia and transient ST-T changes.In patients with palpitation aged<60 years or without hypertension,72-hour three-lead ECG monitoring with AP is more sen-sitive to atrial premature beats which are consistent with self-perceived symptoms,and in patients with palpitation without hyperten-sion or coronary heart disease,72-hour three-lead ECG monitoring with AP is more sensitive to transient T-wave changes associated with symptoms.Conclusion:The technique of 72-hour three-lead ECG monitoring with AP greatly promotes the accuracy and timeli-ness of diagnosis,reduces the economic burden of patients with pal-pitations,and optimizes the allocation of medical resources.

Objective To analyze the burden of atherosclerotic cardiovascular disease(ASCVD)attributable to lifestyle and metabolic factors in China from 1990 to 2021 and predict its future trends,providing evidence for public health prevention and control.Methods Based on the Global Burden of Disease(GBD)2021 database,we extracted disability-adjusted life years(DALYs)of ASCVD attributable to 7 key risk factors:dietary,low physical activity,smoking,high body mass index(BMI),high fasting blood glucose,high low-density lipid cholesterol(LDL-C),and hypertension.Age-standardized DALY rates(ASDR)were also calculated to account for variations in age structure,and an ARIMA model was applied to predict future trends.Results ① Overall trend analysis showed the leading risk factor for ischemic heart disease(IHD)shifted from dietary risks in 1990 to hypertension in 2021,while hypertension and smoking remained the primary risk factors for ischemic stroke(IS)and peripheral artery disease(PAD),respectively.② In BRICS nations,hypertension was the dominant risk factor for both IHD and IS,whereas in China,smoking and high fasting blood glucose continued to be the major drivers of PAD burden.③ Sex-specific analysis revealed that hypertension was the leading risk factor for IHD and IS in both males and females.For PAD,smoking was the main risk factor in males,while high fasting blood glucose was for females.Age-stratified analysis revealed that in the 15-49 age group,dietary,high LDL-C and smoking were the primary factor for IHD,IS and PAD,respectively;in the 50-69 group,dietary predominated IHD risk,hypertension IS,and smoking PAD;and among those aged≥70 years,hypertension was the leading risk factor for both IHD and IS,and high fasting blood glucose was for PAD.④ ARIMA model forecasted that by 2035,DALYs for IHD,IS,and PAD will increase to 82.816 million,46.808 million,and 0.192 million person-years,respectively.Conclusion The ASCVD burden attributable to lifestyle and metabolic factors continues to rise in China from 1990 to 2021,and is projected to further increase by 2035.Countermeasures We suggest that current prevention and control priorities are enhanced management of metabolic factors,tailored interventions by sex and age,promotion of healthy lifestyles and tobacco control,and establishment of an integrated system of prevention-treatment-rehabilitation-research.

The gut microbiota is closely related to the occurrence and development of colitis.Enterotoxigenic Bacteroides fragilis secretes enterotoxins,which can stimulate the body to induce colitis,while the type Ⅵ secretion system and antimicrobial proteins of non-enterotoxigenic Bacteroides fragilis are engaged in competition among the Bacteroides.The bacterial products of non-enterotoxigenic Bacteroides fragilis,such as polysaccharide A,short-chain fatty acids,and α-galactosylceramide,can mediate beneficial interactions with the host.This article reviewed the biological characteristics of non-enterotoxigenic Bacteroides fragilis and its mechanism of action in colitis,with the aim of providing theoretical basis for its future clinical application as a probiotics.

Objective To develop multimodal joint cognitive representations for the research of visual cognitive activities of the brain,enhance the classification performance of visual information cognitive representations,predict brain electro-encephalogram(EEG)responses from visual image features,and decode visual images from EEG signals.Methods A architecture combining a multimodal variational autoencoder network with the Mixture of Product Experts(MoPoE)approach and with a style generation adversarial network based on adaptive discriminator augmentation(Style-GAN2-ADA)was used for facilitating the learning of cognitive representations and the encoding and decoding of EEG signals.This framework not only catered to classification tasks but also enabled cross-modal generation of images and EEG data.Results The present study integrated features from different modalities,enhancing the classification accuracy of cognitive representations of visual information.By aligning the feature spaces of diverse modalities into a cohesive latent space,cross-modal generation tasks were made possible.The cross-modal generation results of EEG and images,derived from this unified latent space,outperformed the one-way mapping methods that involved transition from one modality to another employed in previous research.Conclusion This study effectively integrates and aligns information from various modalities,enabling the classification performance of joint cognitive representations beyond any single modality.Moreover,the study demonstrates superior outcomes in cross-modal generation tasks compared to modality-specific unidirectional mappings,which is expected to offer a new line of thought for the effective unified encoding and decoding modeling of visual cognitive information in the brain.

The incidence of ulcerative colitis(UC)is on the rise globally,but its pathogenesis has not yet been clarified.Existing studies suggest that UC is closely related to genetic susceptibility,impaired intestinal epithelial barrier,abnormal immune response,intestinal flora dysbiosis and environmental factors.Intestinal flora has the functions of substance metabolism,nutrient absorption,energy conversion,immune regulation and maintenance of intestinal mucosal barrier,and has been proved to play an important role in UC.This article reviewed the progress of research on intestinal flora and its metabolites in UC,thus providing theoretical basis and new ideas for the diagnosis and treatment of UC.

Objective:To investigate the mechanism by which non-enterotoxin-producing Bacteroides fragilis (NTBF) inhibits TNF-α-induced inflammatory responses in human normal colonic epithelial cells hcoEPIC, and explore new probiotic therapies for the prevention and treatment of colitis. Methods:The co-culture system of NTBF and hcoEPIC cells was established, and the adhesion and invasion ability of NTBF were detected, respectively. TNF-α was added to induce cellular inflammation after 4 h of co-culture of NTBF and hcoEPIC cells, and cell survival and apoptosis were detected by the CCK-8 assay and the AnnexinⅤ-FITC/PI assay respectively after 24 h. Key proteins of the NF-κB signalling pathway in hcoEPIC cells in different treatment groups were detected by Western blot and RT-qPCR, and the expression of downstream cytokines of this pathway incluing IL-1β, TNF-α and IL-10 were detected by ELISA. The effect of NTBF intervention on dextran sodium sulfate(DSS)-induced colitis mice was assessed by in vivo animal experiments. Results:NTBF adhered to hcoEPIC cells, and was non-toxic to the cells. Compared with control group, NTBF treatment alone did not affect cell survival and apoptosis of hcoEPIC cells ( P>0.05), but significantly reduced cell damage and apoptosis induced by TNF-α ( P<0.05); Compared with the TNF-α treatment alone group, the expression levels of p-NF-κB p65 and p-IκBα protein as well as NF-κB and IκBα mRNA were significantly reduced ( P<0.05); the production of IL-1β and TNF-α in the cell supernatant was reduced and the release of IL-10 was increased ( P<0.05). Animal experiments demonstrated that NTBF was indeed effective in alleviating DSS-induced colitis in ulcerative colitis model mice, which was mainly manifested by inhibiting weight loss, lowering DAI scores, improving colonic shortening, and attenuating colonic pathological damage in colitis-induced mice. Conclusions:NTBF may inhibit TNF-α-induced inflammatory responses in colonic epithelial cells by down-regulating the NF-κB pathway.

Aim To investigate the relationship between carotid artery perivascular fat density and carotid artery stenosis,prognosis.Methods A total of 209 consecutive patients with extracranial internal carotid artery stenosis in Taizhou Central Hospital(Taizhou University Affiliated Hospital)were retrospectively included from January 2017 to Janu-ary 2021.The carotid artery perivascular fat density in the narrowest axial layer and in the same contralateral axial layer was evaluated by computed tomography angiography.Clinical data of patients were collected.The stenosis was graded according to the guidelines.Symptomatic carotid stenosis was determined according to the medical history.The patients were followed up for one year.Results Carotid artery perivascular fat density was 4.2％higher on the stenosis side than those on the opposite side(P＜0.001).The fat density increased with the stenosis severity.On the stenosis side,carotid artery perivascular fat density was 6.25％higher in symptomatic patients than that in asymptomatic patients(P=0.015).In asymptomatic patients,perivascular fat density in patients with stenosis related cerebrovascular events oc-curred within 1 year was 12.4％higher than that in patients without related cerebrovascular events(P=O.017),and the difference remained after adjusting the clinical parameters by Logistic regression analysis(OR=1.060,95％CI:1.006～1.117,P=0.028).Conclusions Carotid artery perivascular fat density is positively correlated with the degree of ca-rotid stenosis.Patients with symptomatic carotid artery stenosis or recurrent related ischemic cerebrovascular outcome e-vents have higher carotid artery perivascular fat density.

Objective:To analyze the expression levels and clinical significance of interferon (IFN)-α/β in the renal cortex and serum of children with lupus nephritis (LN).Methods:A total of 32 children with LN diagnosed in the pediatric nephrology department of the Second Xiangya Hospital of Central South University from December 2017 to September 2020 were selected as the study subjects (LN group). The normal kidney control group consisted of 3 normal kidney transplant volunteers who underwent biopsy of kidney tissue (normal kidney control group), while 14 healthy children who underwent physical examination were collected as the normal control group. According to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), LN patients were divided into mild activity group ( n=8), moderate activity group ( n=9), and severe activity group ( n=15). According to the International Society of Nephrology/Society of Nephrology (ISN/RPS) 2003 LN classification criteria, pathological classification was performed (3 cases in the mild pathological damage group, 8 cases in the moderate pathological damage group, and 11 cases in the severe pathological damage group); Immunohistochemistry was used to detect the expression and distribution of IFN-α/β in glomeruli and renal interstitium; Enzyme linked immunosorbent assay (ELISA) was used to detect the concentration of IFN-α/β in serum samples and analyze its correlation with the pathological classification and disease activity of LN patients. Results:The serum and renal cortex IFN-α/β levels in the LN group were higher than those in the normal control group and normal kidney control group, respectively (all P<0.05). The average level of serum IFN-α/β in the heavy activity group was higher than that in the light and moderate activity groups (all P<0.05). The serum and renal cortex IFN-α/β levels in the severe pathological damage group were significantly higher than those in the mild and moderate pathological damage groups (all P<0.05). Conclusions:IFN-α/β in the renal cortex is closely related to renal injury in LN; Serum IFN-α/β can assist in evaluating the disease activity level of LN to a certain extent.