1.A prospective study of the effect of laparoscopic splenectomy and azygoportal disconnection on liver synthetic function and liver cirrhosis
Kunqing XIAO ; Tianming GAO ; Jinhong CAI ; Zhaobao SHI ; Shengjie JIN ; Chi ZHANG ; Baohuan ZHOU ; Dousheng BAI ; Guoqing JIANG
Chinese Journal of Surgery 2025;63(1):51-57
Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.
2.A prospective study of the effect of laparoscopic splenectomy and azygoportal disconnection on liver synthetic function and liver cirrhosis
Kunqing XIAO ; Tianming GAO ; Jinhong CAI ; Zhaobao SHI ; Shengjie JIN ; Chi ZHANG ; Baohuan ZHOU ; Dousheng BAI ; Guoqing JIANG
Chinese Journal of Surgery 2025;63(1):51-57
Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.
3.Curcumin-loaded nanoparticles reversed radiotherapy-triggered enhancement of MDR1 expression of CNE-2 cells in nasopharyngeal carcinoma.
Guoqing ZENG ; Nan LIAO ; Ning LI ; Gaixia ZHANG ; Yi SU ; Jiangshun SONG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(4):351-356
Objective:This study explored the effect of nanoparticle-encapsulated curcumin on the highly expressed multidrug resistance gene 1 (MDR1) in a human low-differentiated nasopharyngeal carcinoma cell line (CNE2). Methods:Curcumin/chitosan deoxycholic acid nanoparticles were prepared, and the cells were subjected to different treatments: radiotherapy, empty carriers, curcumin, and curcumin-loaded nanoparticles. Cell survival was analyzed using the clonogenic assay, and assessments of apoptosis, MDR1 levels, and miR593 levels were conducted. Results:The cell survival fractions in the curcumin group and the curcumin-loaded nanoparticles group were significantly reduced. Notably, higher apoptosis rates were observed in cells treated with curcumin or curcumin-loaded nanoparticles compared to those that received only radiotherapy. Moreover, a decreased MDR1 level was noted in both the curcumin group and the curcumin-loaded nanoparticles group, with further reduction in MDR1 expression observed in the nanoparticle group (P<0.05). Enhanced expression of miR593 was found in the curcumin group and the curcumin-loaded nanoparticles group, with a relatively higher level in the nanoparticle group (P<0.05). Curcumin encapsulated in nanoparticles exhibited a stronger radiosensitizing effect. The combination of curcumin and radiotherapy effectively inhibited nasopharyngeal carcinoma (NPC) tumor growth, suppressed MDR1 expression, and enhanced miR593 levels. After inhibiting miR593, MDR1 expression increased. The radiosensitizing effect of curcumin-loaded nanoparticles was regulated by miR593 rather than being triggered by MDR1. Conclusion:Curcumin-loaded nanoparticles mediated enhanced expression of miR593, which in turn inhibited the transcription and translation of the MDR1 gene, thereby reducing the radioresistance of NPC and effectively restraining its growth.
Humans
;
Curcumin/pharmacology*
;
Nasopharyngeal Neoplasms/pathology*
;
Nasopharyngeal Carcinoma
;
Nanoparticles
;
Cell Line, Tumor
;
Apoptosis/drug effects*
;
MicroRNAs
;
ATP Binding Cassette Transporter, Subfamily B
;
ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism*
;
Cell Survival
4.Cuscutae Semen-Lycii Fructus Improves Spermatogenesis in Rat Model of Oligoasthenozoospermia by Inhibiting Oxidative Stress-induced Blood-testis Barrier Damage via Regulating SIRT1/Nrf2 Signaling Pathway
Wen DUAN ; Xiaojing ZHANG ; Wenjie DING ; Jianning JIN ; Guoqing CHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):29-38
ObjectiveTo investigate the effect of the herb pair Cuscutae Semen-Lycii Fructus on oxidative stress-induced blood-testis barrier dysfunction and spermatogenesis in the rat model of oligoasthenozoospermia (OAS) and decipher the mechanism based on the silent information regulator 1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. MethodsThirty-five male SD rats were randomized into a blank group (n=7) and a modeling group (n=28). The OAS model was established by gavage of hydrocortisone aqueous solution combined with single factor electrical stimulation. The modeled rats were randomly assigned into the following groups: model, Cuscutae Semen-Lycii Fructus granules (3.2 g·kg-1), Cuscutae Semen-Lycii Fructus total flavonoids (0.34 g·kg-1), and L-carnitine (0.38 g·kg-1), and treated for 4 weeks. The sperm quality of rats was assessed by an automatic sperm analyzer. The levels of superoxide dismutase (SOD), malondialdehyde (MAD), and glutathione peroxidase (GSH-Px) in the testicular tissue were determined by enzyme-linked immunosorbent assay. Hematoxylin-eosin staining was employed to reveal the pathological changes in the testicular tissue and score the spermatogenic function. Transmission electron microscopy was employed to observe the ultrastructural changes of Sertoli cells. Western blot and Real-time PCR were employed to determine the protein and mRNA levels, respectively, of SIRT1, Nrf2, Occludin, zonula occludens-1 (ZO-1), connexin 43 (CX43), and β-catenin. ResultsCompared with the blank group, the model group showed decreased total sperm count and motility (P<0.05, P<0.01), obvious damage in the testicular tissue and blood-testis barrier structure, reduced score of spermatogenic function (P<0.01), declined levels of GSH-Px and SOD in the testicular tissue (P<0.05), elevated level of MDA, and down-regulated protein levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin (P<0.05, P<0.01) and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, and β-catenin in the testicular tissue (P<0.05, P<0.01). After treatment, the testicular tissue, blood-testis barrier structure, and score of spermatogenic function (P<0.01) were improved in the Cuscutae Semen-Lycii Fructus granules group, Cuscutae Semen-Lycii Fructus total flavonoids group, and L-carnitine group. Compared with the model group, the treatment groups presented lowered levels of GSH-Px and SOD (P<0.05, P<0.01), and the Cuscutae Semen-Lycii Fructus granule group showed a decline in MDA level. The protein and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin were up-regulated in the Cuscutae Semen-Lycii Fructus granules group and total flavonoids group (P<0.05, P<0.01). ConclusionThe herb pair Cuscutae Semen-Lycii Fructus can regulate the SIRT1/Nrf2 pathway to inhibit oxidative stress and alleviate the blood-testis barrier damage, thereby improving the spermatogenic function in the rat model of OAS. Total flavonoids may be the material basis for the therapeutic effect of Cuscutae Semen-Lycii Fructus.
5.Cuscutae Semen-Lycii Fructus Improves Spermatogenesis in Rat Model of Oligoasthenozoospermia by Inhibiting Oxidative Stress-induced Blood-testis Barrier Damage via Regulating SIRT1/Nrf2 Signaling Pathway
Wen DUAN ; Xiaojing ZHANG ; Wenjie DING ; Jianning JIN ; Guoqing CHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):29-38
ObjectiveTo investigate the effect of the herb pair Cuscutae Semen-Lycii Fructus on oxidative stress-induced blood-testis barrier dysfunction and spermatogenesis in the rat model of oligoasthenozoospermia (OAS) and decipher the mechanism based on the silent information regulator 1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. MethodsThirty-five male SD rats were randomized into a blank group (n=7) and a modeling group (n=28). The OAS model was established by gavage of hydrocortisone aqueous solution combined with single factor electrical stimulation. The modeled rats were randomly assigned into the following groups: model, Cuscutae Semen-Lycii Fructus granules (3.2 g·kg-1), Cuscutae Semen-Lycii Fructus total flavonoids (0.34 g·kg-1), and L-carnitine (0.38 g·kg-1), and treated for 4 weeks. The sperm quality of rats was assessed by an automatic sperm analyzer. The levels of superoxide dismutase (SOD), malondialdehyde (MAD), and glutathione peroxidase (GSH-Px) in the testicular tissue were determined by enzyme-linked immunosorbent assay. Hematoxylin-eosin staining was employed to reveal the pathological changes in the testicular tissue and score the spermatogenic function. Transmission electron microscopy was employed to observe the ultrastructural changes of Sertoli cells. Western blot and Real-time PCR were employed to determine the protein and mRNA levels, respectively, of SIRT1, Nrf2, Occludin, zonula occludens-1 (ZO-1), connexin 43 (CX43), and β-catenin. ResultsCompared with the blank group, the model group showed decreased total sperm count and motility (P<0.05, P<0.01), obvious damage in the testicular tissue and blood-testis barrier structure, reduced score of spermatogenic function (P<0.01), declined levels of GSH-Px and SOD in the testicular tissue (P<0.05), elevated level of MDA, and down-regulated protein levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin (P<0.05, P<0.01) and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, and β-catenin in the testicular tissue (P<0.05, P<0.01). After treatment, the testicular tissue, blood-testis barrier structure, and score of spermatogenic function (P<0.01) were improved in the Cuscutae Semen-Lycii Fructus granules group, Cuscutae Semen-Lycii Fructus total flavonoids group, and L-carnitine group. Compared with the model group, the treatment groups presented lowered levels of GSH-Px and SOD (P<0.05, P<0.01), and the Cuscutae Semen-Lycii Fructus granule group showed a decline in MDA level. The protein and mRNA levels of SIRT1, Nrf2, ZO-1, CX43, β-catenin, and occludin were up-regulated in the Cuscutae Semen-Lycii Fructus granules group and total flavonoids group (P<0.05, P<0.01). ConclusionThe herb pair Cuscutae Semen-Lycii Fructus can regulate the SIRT1/Nrf2 pathway to inhibit oxidative stress and alleviate the blood-testis barrier damage, thereby improving the spermatogenic function in the rat model of OAS. Total flavonoids may be the material basis for the therapeutic effect of Cuscutae Semen-Lycii Fructus.
6.The clinical application value of coagulation function indicators in pediatric patients with Burkitt lymphoma
Ping GU ; Qi ZHANG ; Chengyun WANG ; Guoqing ZHU ; Qiuhui PAN ; Jing WANG
Chinese Journal of Blood Transfusion 2025;38(9):1195-1204
Objective: To investigate the abnormal fluctuation of coagulation function indicators in pediatric Burkitt lymphoma patients, and to analyze its correlation with disease progression and prognosis. Methods: The data of 172 children with Burkitt lymphoma in Children's Medical Center, Shanghai Jiao Tong University School of Medicine from January 2020 to December 2023 were retrospectively analyzed, and 120 healthy children were used as control group. Plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib), International standardized ratio (INR), D-dimer (D-D), fibrinogen degradation products (FDP), and antithrombin (AT) were measured. Appropriate statistical methods were used to compare the data between two groups, and the Cox regression model was employed to analyze the influencing factors. A P-value <0.05 was considered statistically significant. Results: Levels of D-D, FDP, INR, and PT were significantly higher in children with Burkitt lymphoma than in the healthy controls [median (P25, P75) for the case group: 0.35 (0.13, 1.22), 3.10 (1.30, 10.20), 1.16 (1.06, 1.24), 12.60 (11.43, 13.50); median (P25, P75) for the healthy control group: 0.10 (0.07, 0.15), 0.60 (0.20, 1.08), 1.06 (1.02, 1.13), 11.50 (11.00, 12.30)](P<0.05). Levels of D-D, FDP, INR, PT, and TT were significantly elevated in children with recurrence compared to those without recurrence [median (P25, P75) for the recurrent group: 0.44 (0.16, 1.42), 3.85 (1.50, 12.25), 1.17 (1.08, 1.24), 12.70 (11.73, 13.50), 16.20 (14.80, 17.80); median (P25, P75) for the non-recurrent group: 0.21 (0.11, 0.69), 2.00 (1.00, 6.85), 1.11 (1.03, 1.24), 11.90 (11.10, 13.43), 15.20 (14.50, 16.40)](P<0.05). Levels of D-D, FDP in children with metastasis were significantly higher than those without metastasis [median (P25, P75) for the metastatic group: 0.51 (0.17, 1.84), 4.38 (1.70, 13.45); median (P25, P75) for the non-metastatic group: 0.20 (0.11, 0.39), 1.50 (1.00, 3.10)] (P<0.05). Levels of D-D and FDP were significantly higher in children with advanced stage than in those with early stage [median (P25, P75) for the high-stage group: 0.33 (0.14, 1.20), 3.10 (1.40, 10.23); median (P25, P75) for the low-stage group: 0.12 (0.08, 0.24), 0.90 (0.50, 2.50)] (P<0.05). Levels of D-D and FDP in high-risk children were significantly higher than those of low-risk [median (P25, P75) for the high-risk group: 0.28 (0.13, 1.01), 2.90 (1.15, 9.65); median (P25, P75) for the low-risk group: 0.12 (0.08, 0.17), 0.80 (0.43, 1.98)] (P<0.05). Levels of D-D, FDP, INR, and PT were significantly higher in children with poor prognosis than in those with favorable prognosis [median (P25, P75) for the poor prognosis group: 1.76 (0.80, 2.72), 13.45 (7.20, 25.30), 1.19 (1.12, 1.32), 12.85 (12.10, 14.35); median (P25, P75) for the favorable prognosis group: 0.23 (0.12, 0.52), 2.00 (1.00, 4.80), 1.14 (1.05, 1.23), 12.30 (11.40, 13.40)] (P<0.05). INR levels significantly increased with accumulating chemotherapy cycles [median (P25, P75) for one session: 1.09 (1.02, 1.20); two sessions: 1.31 (1.23, 1.38); three sessions: 1.79 (1.52, 2.41)] (P<0.05). Age, APTT, D-D, FDP, INR, PT, recurrence and metastasis had a significant effect on the survival of children with Burkitt lymphoma (P<0.05). Conclusion: Patients with Burkitt lymphoma exhibit coagulation disorders, which are influenced by recurrence, metastasis, clinical stage, risk stratification, and prognosis. In clinical practice, it is crucial to prioritize the monitoring of coagulation indicators to facilitate timely detection of coagulation dysfunction.
7.Effect of buccal and lingual tooth thickness on the restoration of molars after root canal therapy
Guoqing ZHANG ; Limin WANG ; Ali ZHAO ; Liang CAO ; Weiguo WANG
China Modern Doctor 2025;63(2):12-15
Objective To compare the stress magnitude and distribution of the restorations,remaining tooth tissues,and bonding interfaces of endodontically mandibular first molar with different buccolingual residual tooth tissue thicknesses in two different restorations.Methods The finite element method was used to model the restorations of mandibular first molars with different buccolingual residual tissue thicknesses after root canal treatment.The vertical and oblique loads were applied to record the stress magnitude and distribution of restorations,residual tissues,and bonding interfaces of the different restorations.Results Three different models of mandibular first molar were designed based on the amount of buccal and glossal side dental tissue.Based on this simulation of the dental preparation of FO and EC and the preparation of the prosthesis,generating 6 different groups:FO repair in A1 group,thickness of the buccal tooth tissue is 2mm;A2 group was repaired by FO,thickness of the buccal tooth tissue is 3mm;A3 Group was performed with FO repair,thickness of the buccal and lingual remaining tooth tissue is 4mm;In B1 group,with EC repair,thickness of buccal tooth tissue is 2mm;In B2 group with EC repair,thickness of buccal tooth tissue is 3mm;In B3 group,using EC repair,thickness of remaining dental tissue on buccal and lingual side was 4mm.Results Two loading modes,the restoration such as effect force distribution are concentrated around the loading point,dentin effect force are concentrated in the tooth neck,the full coverage of high embedded group restoration-dental resin interface maximum main stress(MPS)is concentrated in the hole wall and shaft wall Angle,the pulp cavity setting crown group restoration-dental resin interface MPS focus in the bottom wall angle of the pulp cavity setting hole type.In the model of tooth tissue thickness in the same buccal-lingual side,except that the peak effect force of the restoration was greater than the peak of the full coverage crown,the peak of the observed index of the full coverage crown was greater than that of the whole cavity.Conclusion Endocrown can better protect the tooth tissue after root canal treatment,and it is recommended to choose endocrown for restoration after root canal treatment.
8.Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury (version 2025)
Aijun XU ; Shuixia LI ; Bo CHEN ; Mengyuan YE ; Lejiao LANG ; Ning NING ; Lin ZHANG ; Changqing LIU ; Zhonglan CHEN ; Weihu MA ; Weishi LI ; Xiaoning WANG ; Dongmei BIAN ; Jiancheng ZENG ; Xin WANG ; Yuan GAO ; Yaping CHEN ; Jiali CHEN ; Yun HAN ; Xiuting LI ; Yang ZHOU ; Xiaojing SU ; Qiong ZHANG ; Tianwen HUANG ; Ping ZHANG ; Hua LIN ; Xingling XIAO ; Ruifeng XU ; Fanghui DONG ; Bing HAN ; Luo FAN ; Yanling PEI ; Suyun LI ; Xiaoju TAN ; Rongchen GUO ; Yefang ZOU ; Xiaoyun HAN ; Junqin DING ; Yi WANG ; Shuhua DENG ; Jinli GUO ; Yinhua LIANG ; Yuan CEN ; Xiaoqin LIU ; Junru CHEN ; Haiyang YU ; Lunlan LI ; Ying REN ; Yunxia LI ; Jianli LU ; Ying YING ; Lan WEI ; Yin WANG ; Qinhong XU ; Yanqin ZHANG ; Yang LYU ; Shijun ZHANG ; Sui WENJIE ; Sanlian HU ; Shuhong YANG ; Guoqing LI ; Jingjing AN ; Baorong HE ; Leling FENG
Chinese Journal of Trauma 2025;41(6):530-541
Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.
9.Infrared thermography-assisted design and harvesting of ultrathin anterolateral thigh perforator flaps.
Chenxi ZHANG ; Jiadong PAN ; Shanqing YIN ; Guoqing SHAO ; Xianting ZHOU ; Gaoxiang YU ; Luzhe WU ; Xin WANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1143-1148
OBJECTIVE:
To explore the application value of infrared thermography in the design and harvesting of ultrathin anterolateral thigh perforator flaps.
METHODS:
Between June 2024 and December 2024, 9 cases of ultrathin anterolateral thigh perforator flaps were designed and harvested with the assistance of infrared thermography. There were 7 males and 2 females, aged 21-61 years (mean, 39.8 years). The body mass index ranged from 19.49 to 26.45 kg/m² (mean, 23.85 kg/m²). Causes of injury included 5 cases of traffic accident injuries and 4 cases of machine crush injuries. There were 3 cases of leg wounds, 2 cases of foot wounds, and 4 cases of hand wounds. After debridement, the size of wound ranged from 7 cm×4 cm to 13 cm×11 cm. The time from admission to flap repair surgery was 5-12 days (mean, 7 days). Preoperatively, perforator localization was performed using a traditional Doppler flow detector and infrared thermography, respectively. The results were compared with the actual intraoperative locations; a discrepancy ≤10 mm was considered as consistent localization (positive), and the positive predictive value was calculated. All 9 cases were repaired with ultrathin anterolateral thigh perforator flaps designed and harvested based on thermographic images. The size of flap ranged from 8 cm×5 cm to 14 cm×8 cm, with a thickness of 3-6 mm (mean, 5.2 mm). One donor site was repaired with a full-thickness skin graft, and the others were sutured directly. Postoperatively, anti-inflammatory, anticoagulant, and anti-vascular spasm treatments were administered, and follow-up was conducted.
RESULTS:
The Doppler flow detector identified 22 perforating vessels within the set range, among which 16 were confirmed as superficial fascia layer perforators intraoperatively, with a positive predictive value of 72.7%. The infrared thermograph detected 23 superficial fascia layer perforating vessels, and 21 were verified intraoperatively, with a positive predictive value of 91.3%. There was no significant difference between the two methods [OR (95%CI)=3.93 (0.70, 22.15), P=0.100]. The perforator localization time of the infrared thermograph was (5.1±1.3) minutes, which was significantly shorter than that of the Doppler flow detector [(10.1±2.6) minutes; MD (95%CI)=-5.00 (-7.08, -2.91), P<0.001]. Postoperatively, 1 case of distal flap necrosis healed after dressing change; all other flaps survived successfully. The skin grafts at donor site survived, and all incisions healed by first intention. All patients were followed up 3-6 months (mean, 4.7 months). No pain or other discomfort occurred at the donor or recipient sites. All patients with foot wounds could walk with shoes, and no secondary flap revision was required. Flaps in 3 hand wound cases, 2 foot wound cases, and 3 leg wound cases recovered light touch and pressure sensation, but not pain or temperature sensation; the remaining 2 cases had no sensory recovery.
CONCLUSION
Preoperative localization using infrared thermography for repairing ultrathin anterolateral thigh perforator flaps can help evaluate the blood supply status of perforators, reduce complications, and improve surgical safety and flap survival rate.
Humans
;
Perforator Flap/blood supply*
;
Adult
;
Male
;
Thermography/methods*
;
Female
;
Thigh/blood supply*
;
Middle Aged
;
Plastic Surgery Procedures/methods*
;
Tissue and Organ Harvesting/methods*
;
Infrared Rays
;
Skin Transplantation/methods*
;
Soft Tissue Injuries/surgery*
;
Young Adult
10.Thalassemia screening and genotype analysis in 488 sperm donors in Chongqing Human Sperm Bank
Weiqiong SHENG ; Jing HUANG ; Tianfeng ZHANG ; Yi ZHANG ; Hua HUANG ; Hong WANG ; Guoqing JIA ; Chengjiang KANG
Journal of Chongqing Medical University 2025;50(4):511-515
Objective:To investigate the carriage of the thalassemia gene in sperm donors in Chongqing,China by analyzing the thalas-semia screening and gene mutation types of sperm donors in Chongqing Human Sperm Bank(CHSB),and to provide a reference for thalassemia screening in sperm donors in Chongqing.Methods:Blood samples were collected from 488 sperm donors in CHSB(donors with all tests qualified during the quarantine)from December 2021 to August 2024.A complete blood count analysis was performed to measure the mean corpuscular volume(MCV)and mean corpuscular hemoglobin(MCH).Polymerase chain reaction(PCR)/agarose gel electrophoresis was used to detect deletional α-thalassemia mutations.PCR and DNA reverse dot blot hybridization were used to detect 3 common non-deletional α-thalassemia mutations and 17 common β-thalassemia mutations.The test results were then analyzed.Results:Among the 488 sperm donors aged 25.64±4.95 years,15(3.07%,all Han nationality)tested positive for thalassemia.This carriage rate was lower than that of the thalassemia population in Chongqing(9.24%).Among the 15 thalassemia carriers,13 had deletional α-gene mutations(-α3.7 genotype in 11 cases[73.33%],-α4.2 genotype in 1 case[6.67%],and-SEA genotype in 1 case[6.67%]),and 2 had non-deletional α-gene mutations(both with the WSM heterozygous mutation).There was only 1 case of abnor-mal MCV and MCH2 indicators among thalassemia carriers(screening positive rate was 6.67%).Conclusion:Thalassemia screening in sperm donors in CHSB reveals a low thalassemia carriage rate,reflecting geographic(predominantly Sichuan and Chongqing ori-gins)and demographic(healthy men of childbearing potential)characteristics.Given the significant impact of thalassemia on the off-spring conceived through sperm donation,it is recommended to conduct thalassemia gene screening among sperm donors in human sperm banks.

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