Objective:To compare the clinical outcomes of reconstruction of oral and maxillofacial soft tissue defects using superficial circumflex iliac artery perforator flap （SCIA PF） and radial forearm free flap （RFF）. Methods:A retrospective analysis was conducted on 90 patients with head, neck, and maxillofacial tumors who were treated in our department from June 2019 to January 2024. Patients were divided into two groups based on the surgical method used: the SCIA group（n=45）, who underwent reconstruction with SCIA PF, and the RFF group（n=45）, who received RFF reconstruction. Six months postoperatively, clinical efficacy was evaluated by comparing flap swelling, flap survival rate, and patient satisfaction. Oral function was assessed using standardized scoring systems before surgery, at 1 week, 3 months, and 6 months post-surgery. Hemorheological parameters, including high-shear viscosity（shear rate 200/s）, low-shear viscosity（shear rate 30/s）, plasma viscosity, erythrocyte aggregation index, and erythrocyte sedimentation rate（ESR）, were also measured at each time point. Results:Compared with the RFF group, the SCIA group showed significantly larger flap size, longer flap harvesting and reconstruction times, earlier nasogastric tube removal and oral intake initiation, higher scores in all aspects of oral function, reduced flap edema and faster resolution, higher flap survival rates, and greater overall satisfaction （all P<0.05）. During the follow-up period （preoperative, 1 week, 3 months, and 6 months post-surgery）, hemorheological indices including high-and low-shear viscosity, plasma viscosity, erythrocyte aggregation index, and ESR progressively decreased in the SCIA group （P<0.05）. In the RFF group, these parameters improved significantly by 6 months postoperatively compared with preoperatively and 1-week postoperatively, with a notable decrease in erythrocyte aggregation index at 6 months （P<0.05）. Conclusion:Compared with RFF, SCIA PF provides larger flaps, better functional recovery, higher patient satisfaction, improved flap survival, fewer complications, and more favorable hemorheological profiles following reconstructive surgery for oral and maxillofacial defects.
Humans ; Perforator Flap/blood supply* ; Plastic Surgery Procedures/methods* ; Retrospective Studies ; Free Tissue Flaps ; Iliac Artery/transplantation* ; Forearm/surgery* ; Male ; Female ; Soft Tissue Injuries/surgery* ; Head and Neck Neoplasms/surgery* ; Middle Aged ; Treatment Outcome ; Adult

Image 1.

Depressive disorder is a common psychiatric condition clinically characterized by impaired cognitive function， which profoundly affects patients' daily living and social functioning. Despite extensive research on the mechanism underlying the interaction between ghrelin and depressive disorder， comprehensive reviews， summary， and systematic organization of these findings remain lacking. To address this gap， this study aims to conduct a systematic evaluation of the effects and mechanisms of ghrelin on cognitive function in patients with depressive disorder， thereby providing references for targeted clinical interventions. On October 20， 2024， literature exploring the role and mechanisms of ghrelin in improving cognitive function in depressive disorder was sourced from the CNKI， PubMed and Web of Science databases， covering the period from the inception of the database till October 20， 2024. Two researchers independently conducted literature screening and data extraction. Ultimately， 9 articles were included in this review. The findings suggest that ghrelin improves cognitive function in patients with depressive disorder through multiple mechanisms， including mitigating inflammatory responses， modulating oxidative stress， and activating the cyclic adenosine monophosphate response element binding protein-brain-derived neurotrophic factor （CREB-BDNF） signaling pathway.

Objective Aiming at the problem of significant anisotropy in the three-dimensional ( 3D) printed polyether-ether-ketone ( PEEK) bone substitutes manufactured by material extrusion technology, taking the femur, the main load-bearing long bone of the lower limb, as an example, the biomechanical properties of the femoral model under different direction in the build chamber were evaluated by the combination of finite element analysis and in-vitro mechanical experiment. Methods A left femoral model was obtained by reconstruction from CT data. The stress and displacement of the 3D printed PEEK femur with different directions in the build chamber under five physiological postures in the human gait cycle were simulated by varying the orthogonal anisotropy mechanical properties. An in-vitro mechanical experiment was conducted to investigate the safety and stability of the femur through a 3D printed PEEK femur. Results When the long axis of the femur model was perpendicular to the building platform of the 3D printer, a better mechanical property was obtained, and the maximum von Mises stress was 46. 56 MPa, which was lower than the yield stress of PEEK, while the maximum displacement was larger than that of the natural femur under same loading condition. Therefore, the 3D printed PEEK femur met the strength requirement, but the stability needs to be improved. Conclusions The long axis is recommended to be perpendicular to the building platform when the material extrusion technology was used for the substitute of the load-bearing long bone, and the effect of its anisotropy on service performance of the substitute should be carefully considered when the 3D printing technology is used for load-bearing bone substitute.

OBJECTIVE：To estab lish a method that can comprehensively and rapidly analyze the chemical compositions of Miao medicine Caesalpinia decapetala，and to providing reference for quality control and pharmacodynamic material basis study of C. decapetala . METHODS ：UPLC-Q-TOF-MS/MS was adopted . The determination was performed on Agilent SB-C 18 column with mobile phase consisted of 0.1％ formic acid solution- 0.1％ formic acid acetonitrile （gradient elution ）at the flow rate of 0.25 mL/min. The column temperature was 30 ℃，and sample size was 2 µL. ESI source was applied in negative and positive scanning ion mode and data collection range of m/z 50-1 500. The capillary voltage was 4.5 kV，the atomizing gas （nitrogen）pressure was 1.2 Bar， the solvent removal gas was nitrogen ，the flow rate of solvent removal gas was 8 L/min and the solvent removal gas temperature was 200 ℃. Data Analysis 4.2 software was adopted to analyze fragment ion information of each peak ，and identify chemica l compositions on the basis of relevant literature and mass spectograms of reference substance. RESULTS ：Under positive ion mode ， 9 chemical compounds were identified ；peak 1，2，3，4，5，6，7，8，9 were catechin ，protohematoxylin B ，epicatechin，ethyl gallate，quercetin，luteolin，3-deoxy-hematoxylin chalcone ， isoliquiritigenin and linoleic acid. Under negative ion mode ， U1812403）， totally 21 peaks were confirmed and 13 compounds were identified；peak 3，4，5，6，7，8，9，10，11，12，13，15， 21 were catechins ， brevifolin carboxylic acid ， proto- hematoxylin B ，epicatechin，ethyl gallate ，epicatechin gallate ， quercetin，resveratrol，hematoxylin，luteolin，3-deoxy-hema- toxylin， isoliquiritigenin， linoleic acid. CONCLUSIONS UPLC-Q-TOF-MS/MS method is established successfully for analysis of chemical compositions in C. decapetala .

OBJECTIVE： To study the protective effects of Polygonum orientale extract on myocardial ischemia-reperfusion injury （MIRI） model rats， and to provide reference for it’s deeply development of medicinal source. METHODS： Totally 24 rats were randomly divided into sham operation group （normal saline）， model group （normal saline）， Compound danshen tablet group （positive group， 0.17 g/kg） and P. orientale extract group （86 g/kg， calculated by crude drug）， with 6 rats in each group. All groups were given drugs 2 mL/100 g intragastrically once a day. After 4 d of consecutive administration， MIRI model was induced by the left anterior descending branch of arteria coronaria in all groups except for sham operation group. 24 h after reperfusion， they were given related medicine again. After medication， the changes of electrocardiogram ST segment were monitored in each group. The plasma levels of LDH， CK-MB， CK， cTn-I， SOD and NO were detected in each group. The myocardial infarction rate in each group was calculated and the pathomorphological changes in the myocardium were observed. RESULTS： Compared with sham operation group， ST segment of myocardial electrocardiogram was increased in model group （P＜0.01）. The plasma levels of LDH， CK， CK-MB and cTn-I were increased significantly （P＜0.01）， while the plasma levels of SOD and NO were decreased significantly （P＜0.01）. The rate of myocardial infarction was increased significantly （P＜0.01）， and pathomorphological changes were observed in myocardial tissue such as infiltration of inflammatory cells and loose cytoplasm of cardiac myocytes. Compared with model group， ST segment of myocardial electrocardiogram was decreased significantly in Compound danshen tablet group and P. orientale extract group （P＜0.05）； the plasma levels of LDH， CK， CK-MB and cTn-I were decreased significantly （P＜0.05）， while the plasma levels of SOD and NO were increased significantly （P＜0.05）； the rate of myocardial infarction was decreased significantly （P＜0.05）， and inflammatory cell infiltration and tissue edema in myocardium were relieved to varying degrees. CONCLUSIONS： The protective effect of P. orientale extract protect on MIRI may be exerted by anti-oxidative damage.

OBJECTIVE： To study in vitro metabolism pathway of effective component of Bletilla striata as Militarine in liver microsomes and kinetics characteristics of enzyme-catalyzed reactions. METHODS： The in vitro incubation system of rat and human liver microsomes was established， and incubation reaction of Militarine was performed. UPLC-QTOF-MS was used to identify the structure of its metabolites in combination with UNIFI database and references. Using puerarin as internal standard， UPLC-Triple Quad-MS was used to quantitatively analyze metabolic transformation of Militarine in rat liver microsomes. The kinetic parameters （vmax， km， CLint） of Militarine enzyme-catalyzed reactions with/without reducing coenzyme Ⅱ （NADPH） were calculated by fitting the curves with GraphPad Prism 5.0 software. RESULTS： After incubation in rat and human liver microsomes， Militarine produced a chemical formula C21H29O11， which was presumed to be a metabolite of Militarine ester bond hydrolysis. The kinetic study of enzyme-catalyzed reactions showed that vmax of Militarine enzyme-catalyzed reactions with/without NADPH were 1.955， 2.129 nmol/（h·mg）； km were 8.601， 9.854 nmol/mL； CLint were 0.227 3， 0.216 1 mL/（h·mg）； there was no significant difference between with NADPH and without NADPH. CONCLUSIONS： The main metabolic pathway of Militarine in liver microsomes is the hydrolysis of C1 and C4 ester bonds. Its metabolism does not depend on the pathway of cytochrome P450 enzymes initiated by NADPH.

Objective To investigate the extents of corpus callosotomy (CC) resulting in optimal seizure control and compare the efficacies and complications of two CC approaches. Methods Clinical data of 25 patients underwent CC in our hospital from January 2013 to December 2018 were retrospectively analyzed. All 25 patients were diagnosed as having medically refractory epilepsy, and 27 CC procedures were performed. The patients underwent either anterior two thirds CC (n=13) or single-stage complete CC (n=12). Two patients had a second-stage posterior CC in 61 and 36 months after anterior CC, respectively. The efficacies were studied by using two evaluation indexes, the effective rate (worthwhile improvements) and the markedly effective rate (favorable outcomes).Results The average postoperative follow-up time was 2.6 years. In comparison, the markedly effective rate (>75％ reduction in seizure frequency or severity) was 71.4％ after complete CC and 15.4％ after anterior two thirds CC with a statistical significant difference between the two groups (P<0.05). The effective rate (>50％ reduction in seizure frequency or severity) of complete CC (78.6％) was higher than that of anterior two thirds CC (53.8％), but without significant difference (P>0.05). Overall, 66.7％ of patients benefited from anterior or complete CC. There were no such complications as intracranial hemorrhage, hydrocephalus, cerebrospinal fluid leakage or postoperative infection.Conclusion Complete CC is more effective for seizure control than anterior two thirds CC; no permanent neurological deficits are observed postoperatively.

The field of gene therapy has been increasingly studied in the last four decades, and its clinical application has become a reality in the last 15 years. Traditional Chinese medicine (TCM), an important component of complementary and alternative medicine, has evolved over thousands of years with its own unique system of theories, diagnostics and therapies. TCM is well-known for its various roles in preventing and treating infectious and chronic diseases, and its usage in other modern clinical practice. However, whether TCM can be applied alongside gene therapy is a topic that has not been systematically examined. Here we provide an overview of TCM theories in relation to gene therapy. We believe that TCM theories are congruent with some principles of gene therapy. TCM-derived drugs may also act as gene therapy vehicles, therapeutic genes, synergistic therapeutic treatments, and as co-administrated drugs to reduce side effects. We also discuss in this review some possible approaches to combine TCM and gene therapy.

Objective To investigate the clinical efficacy of purging fu-organs traditional Chinese medicine (TCM)therapy for treatment of patients with severe pneumonia and sthenia-heat. Methods According to random number table method,71 patients with sthenia-heat of severe pneumonia were divided into a treatment group (35 cases)and a control group(36 cases). Conventional basic treatment was given to both groups,and additionally, small chengqi decoction was applied nasogastrically for the therapy in treatment group for 2 weeks. The clinical pulmonary infection score(CPIS),Marshall score,integration score of TCM syndromes and the mortalities in 28 days and 60 days were used to compare the clinical efficacy of the two groups. Results With the prolongation of treatment,the CPIS,Marshall score and integration score of syndromes in the two groups were gradually decreased. In treatment group,CPIS and Marshall scores were lower than those of control group on the 4th day ,and there were statistically significant differences(CPIS score:5.8±1.7 vs. 6.8±1.9,Marshall score:5.3±2.3 vs. 6.6±2.7,both P<0.05);the above 2 scores in treatment group were also lower than those of control group on the 7th and 14th day after treatment(7th day CPIS score:5.3±1.5 vs. 5.6±1.4,Marshall score:5.1±1.9 vs. 5.7±1.8;14th day CPIS score:3.9±1.7 vs. 4.4±2.3,Marshall score:4.2±1.9 vs. 4.9±2.5),but there were no statistically significant differences(all P>0.05). In addition,the integration scores of syndromes were significantly decreased on the 4th, 7th and 14th day in the treatment group significantly lower than those in the control group(4th day:7.6±2.3 vs. 10.6±2.7,7th day:7.4±2.5 vs. 9.2±2.1,14th day:6.1±1.9 vs. 8.3±2.4,all P<0.05). However,there were no statistically significant differences in mortality rates in 28 days and 60 days respectively between control group and treatment group(28 days:16.7% vs. 11.4%,60 days:25.0% vs. 20.3%,both P>0.05). Conclusion Purging fu-organs therapy not only can decrease the CPIS and Marshall scores of patients with sthenia-heat of severe pneumonia,but also can improve their syndromes.