Objective:Through anatomical observations, anatomical data on the radial perforating vessels around the neck of first metacarpus were observed and classified, hence to provide an anatomical evidence for clinical application of the flap based on the perforating vessels.Methods:From July 2022 to June 2023, 15 fresh adult upper limb specimens were studied at the Department of Hand Surgery, Northwest University First Hospital. All perforators within the zone for flap design around the neck of radial first metacarpus were observed. The number, origin and outer calibre of the perforators were recorded. Perforators with an outer diameter greater than 0.13 mm were defined as dominant arteries. SPSS 20.0 statistical software was used to count the number and outer diameter of cutaneous branches originating from the radial artery of the first metacarpal bone, the radial palmar proper artery of thumb and other arteries. The results were expressed as mean ± standard deviation ( ± s), with P<0.05 indicating statistical significance. From July 2023 to May 2024, 14 patients (10 males, 4 females and aged 27-53 years) with digital soft tissue defects were treated. The defects were of 3 thumbs, 4 index fingers, 5 middle fingers, 1 ring finger and 1 little finger, and sized from 2.5 cm × 2.0 cm to 4.0 cm × 2.5 cm. The perforator flaps of the neck of radial first metacarpus (3.0 cm × 2.5 cm - 4.5 cm × 3.0 cm) were harvested and donor sites were closed directly in the emergency surgery. Follow-up through the visits of outpatient clinic and via telephone and WeChat interviews to assess the flap survival, digital function and aesthetics of the flap. Results:In the specimens, it was found that about 75% of dominant perforators were originated from the first metacarpal radial artery. There were statistical significance in the number and outer calibre of the perforators between the first metacarpal radial artery, radial proper palmar digital artery of thumb and other arteries ( P<0.05). Postoperative follow-up lasted for 5-12 (mean 10.1) months, all flaps survived after surgery. Sensation regained according to the British Medical Research Council (BMRC), and they were: S 2 in 6 flaps and S 3 in 8 flaps. According to Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 11 digits were excellent and 3 in good. Scar evaluation scored 3-4 (mean 3.43) points according to the Vancouver Scar Scale (VSS). Conclusion:The perforator flap around the neck of first radial metacarpus is primarily supplied by the radial artery of the first metacarpus. This flap achieves satisfactory functional and aesthetic outcomes with good sensory recovery, therefore it is an ideal flap for reconstruction of digital soft tissue defect.

Objective:Through anatomical observations, anatomical data on the radial perforating vessels around the neck of first metacarpus were observed and classified, hence to provide an anatomical evidence for clinical application of the flap based on the perforating vessels.Methods:From July 2022 to June 2023, 15 fresh adult upper limb specimens were studied at the Department of Hand Surgery, Northwest University First Hospital. All perforators within the zone for flap design around the neck of radial first metacarpus were observed. The number, origin and outer calibre of the perforators were recorded. Perforators with an outer diameter greater than 0.13 mm were defined as dominant arteries. SPSS 20.0 statistical software was used to count the number and outer diameter of cutaneous branches originating from the radial artery of the first metacarpal bone, the radial palmar proper artery of thumb and other arteries. The results were expressed as mean ± standard deviation ( ± s), with P<0.05 indicating statistical significance. From July 2023 to May 2024, 14 patients (10 males, 4 females and aged 27-53 years) with digital soft tissue defects were treated. The defects were of 3 thumbs, 4 index fingers, 5 middle fingers, 1 ring finger and 1 little finger, and sized from 2.5 cm × 2.0 cm to 4.0 cm × 2.5 cm. The perforator flaps of the neck of radial first metacarpus (3.0 cm × 2.5 cm - 4.5 cm × 3.0 cm) were harvested and donor sites were closed directly in the emergency surgery. Follow-up through the visits of outpatient clinic and via telephone and WeChat interviews to assess the flap survival, digital function and aesthetics of the flap. Results:In the specimens, it was found that about 75% of dominant perforators were originated from the first metacarpal radial artery. There were statistical significance in the number and outer calibre of the perforators between the first metacarpal radial artery, radial proper palmar digital artery of thumb and other arteries ( P<0.05). Postoperative follow-up lasted for 5-12 (mean 10.1) months, all flaps survived after surgery. Sensation regained according to the British Medical Research Council (BMRC), and they were: S 2 in 6 flaps and S 3 in 8 flaps. According to Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 11 digits were excellent and 3 in good. Scar evaluation scored 3-4 (mean 3.43) points according to the Vancouver Scar Scale (VSS). Conclusion:The perforator flap around the neck of first radial metacarpus is primarily supplied by the radial artery of the first metacarpus. This flap achieves satisfactory functional and aesthetic outcomes with good sensory recovery, therefore it is an ideal flap for reconstruction of digital soft tissue defect.

Objective To investigate the value of peripheral blood soluble interleukin-2 receptor(sIL-2R),CD4+lymphocyte percentage/CD8+lymphocyte percentage ratio(hereinafter referred to as CD4+/CD8+)and tumor necrosis factor-α(TNF-α)in evaluating the efficacy of chemotherapy in elderly patients with newly treated active pulmonary tuberculosis.Methods A total of 102 elderly patients with newly treated active tu-berculosis admitted to the hospital from December 2019 to December 2022 were enrolled in the study as the observation group,and 102 healthy people aged 60 and older who underwent physical examination in the hos-pital during the same period were enrolled as the control group.The levels of sIL-2R,TNF-α and CD4+/CD8+in peripheral blood were compared between the two groups,and the correlations between sIL-2R,TNF-α and CD4+/CD8+were analyzed.The observation group was treated with 2HRZE/4HR anti-tuberculosis treatment regimen.The levels of sIL-2R,TNF-α and CD4+/CD8+in peripheral blood of patients with different efficacy before treatment,1 month and 6 months after treatment in the observation group were compared.The correla-tion between sIL-2R,CD4+/CD8+,TNF-α levels and therapeutic effect was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of indicators in evaluating the efficacy of chemo-therapy in elderly patients.Results The levels of sIL-2R and TNF-α in the observation group were higher than those in the control group,while CD4+/CD8+was lower than that in the control group,and the differ-ences were statistically significant(P＜0.05).In the observation group,sIL-2R and TNF-α were negatively correlated with CD4+/CD8+(P＜0.05),sIL-2R was positively correlated with TNF-α(P＜0.05).After 1 month and 6 months of treatment,the levels of sIL-2R and TNF-α in patients with apparent efficacy were low-er than those in patients with efficacy,and the latter were lower than those in patients with no effect,while the CD4+/CD8+in patients with apparent efficacy was higher than that in patients with efficacy,and the latter was higher than that in patients with no efficacy,and the differences were statistically significant(P＜0.05).The levels of sIL-2R and TNF-α were negatively correlated with the efficacy(P＜0.05),and CD4+/CD8+was positively correlated with the efficacy(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of sIL-2R,CD4+/CD8+,and TNF-α used in combination to assess efficacy was significantly greater than the AUCs of the single indicators used in the assessment at each time point of treatment(P＜0.05),and the AUC of the combination of the indicators was greater after 6 months of treatment than after 1 month of treatment(P＜0.05).Conclusion The levels of sIL-2R,CD4+/CD8+and TNF-α are closely related to the ef-ficacy of chemotherapy in elderly patients with newly treated active pulmonary tuberculosis,and the combina-tion of the above indicators has certain reference value in evaluating the efficacy of chemotherapy in patients.

Background/Aims: To evaluate the causal correlation between complement components and non-viral liver diseases and their potential use as druggable targets. Methods: We conducted Mendelian randomization (MR) to assess the causal role of circulating complements in the risk of non-viral liver diseases. A complement-centric protein interaction network was constructed to explore biological functions and identify potential therapeutic options. Results: In the MR analysis, genetically predicted levels of complement C1q C chain (C1QC) were positively associated with the risk of autoimmune hepatitis (odds ratio 1.125, 95% confidence interval 1.018–1.244), while complement factor H-related protein 5 (CFHR5) was positively associated with the risk of primary sclerosing cholangitis (PSC;1.193, 1.048– 1.357). On the other hand, CFHR1 (0.621, 0.497–0.776) and CFHR2 (0.824, 0.703–0.965) were inversely associated with the risk of alcohol-related cirrhosis. There were also significant inverse associations between C8 gamma chain (C8G) and PSC (0.832, 0.707–0.979), as well as the risk of metabolic dysfunction-associated steatotic liver disease (1.167, 1.036–1.314). Additionally, C1S (0.111, 0.018–0.672), C7 (1.631, 1.190–2.236), and CFHR2 (1.279, 1.059–1.546) were significantly associated with the risk of hepatocellular carcinoma. Proteins from the complement regulatory networks and various liver diseaserelated proteins share common biological processes. Furthermore, potential therapeutic drugs for various liver diseases were identified through drug repurposing based on the complement regulatory network. Conclusions Our study suggests that certain complement components, including C1S, C1QC, CFHR1, CFHR2, CFHR5, C7, and C8G, might play a role in non-viral liver diseases and could be potential targets for drug development.

The rare endocrine and metabolic diseases, due to their varieties, face many challenges in the study of clinical diagnosis, pathogenesis, and treatment. In the past a couple of years, the research on rare endocrine and metabolic diseases has been gradually improved. The diagnosis has made great progress. The research into molecular mechanism of rare endocrine and metabolic diseases has significantly advanced. The effort in exploring the breakthroughs and progress in therapeutic methods based on the pathogenesis of the diseases has also made. This article provides a brief overview of the current status of research into diagnosis, mechanism, and treatment of rare endocrine and metabolic diseases. In addition, the article points out the problems and challenges and proposes future possibilities.

Shanghai East Hospital has built a general practice residency training information system based on "Internet +" technology since 2017. This training system effectively promoted the training quality, improved the clinical and research ability of general practitioners, and strengthened the supervision of the training. It has improved the training satisfaction, increased passing rate of national medical licensing examination and graduation comprehensive examination of trainees. This training system can largely break the time and space limitations, and has strong replicability. It may provide reference to optimize the general practice standardized residency training for other institutions.

Objective To investigate the current situation and correlation of cognitive dysfunction, activities of daily living (ADL) and quality of life in patients with traumatic brain injury (TBI). Methods A total of 148 patients hospitalized in the Rehabilitation Department of the Second Affiliated Hospital of Kunming Medical University from January to December 2016 were included in this study. The Montreal cognitive assessment scale (MoCA),modified Barthel Index scale (MBI) and WHO quality of life scale (WHO-QOL) were used to investigate the status of patients with traumatic brain injury. Results There were 78 of 148 patients with cognitive dysfunction and the incidence rate was 52.98%. Cognitive dysfunction after TBI was significantly positively related to the ADL ability (r=0.968,P<0.01);the visual space and executive function,attention,abstraction,delayed recall and orientation had the prediction effect on the ADL ability. Cognitive dysfunction after TBI was significantly positively related to the quality of life (r=0.973,P<0.01);cognitive items except the name could predict the quality of life. Conclusions There is a high incidence of cognitive dysfunction in patients with traumatic brain injury,which can affect their ADL ability and quality of life. It is necessary to take effective measures to improve the rehabilitation training of the cognitive function in early stage.

Objective To explore the dispassed reason of Anhui provincial health senior titles evaluation.Methods The senior professional titles of the year 2009-2011 assessment results which were announced by the office of personnel titles of Anhui Provincial Health Department and the recorded results of the jury assessment were analyzed.Results In Anhui Province from 2009 to 2011 for three years,a total of 4 523 people participated in the senior title review by staff 3 039 people,by the proportion of 67.2％.2009,2010,2011 pass rate was 69.14％,66.85％,65.89％,respectively.1 484 people did not pass,and the rate was 32.8％.The main reason was the lack of reporting by professional and technical proficiency,non-standard format of application materials,assessment reporting material falsification.Conclusion Increasing the professional title appraisal policy propaganda,assessment focus which should be focused,the RAE quantitative score standards of health senior professional title,the establishment of a senior title of the series of health reporting assessment information system can improve this conditions.

AIM: To investigate the effects of anisodamine on the sodium current (I_(Na)) in left ventricular myocytes of rabbit heart undergoing ischemia/reperfusion, so as to explore the cellular (ionic) basis of anisodamine treatment for antiarrhythmia. METHODS: Forty-five rabbits were randomly divided into three groups: ischemic/reperfusion group (I/R), anisodamine intervention group (Ani+I/R) and sham-operated control group (CON). Anesthetized rabbits were subjected to 30 min ischemia by ligation of the left anterior descending coronary artery and 60 min reperfusion. The animals in Ani group were injected with anisodamine at a dose of 5 mg/kg via femoral vein 1 min before operation. The incidence of ventricular arrhythmia was observed. Single ventricular myocytes were isolated enzymatically from the epicardial zone of the infracted region derived from the hearts in I/R, Ani+I/R group and the same anatomy region in CON. Whole cell patch clamp technique was used to record I_(Na). RESULTS: Anisodamine intervention decreased the incidence and duration of ventricular arrhythmia by reperfusion compared to I/R group, resulting in significant decrease in the scores of arrhythmia (2.6±0.7 vs 3.6±0.8, P<0.05). The peak I_(Na) current density (at-30 mV) was significantly decreased in I/R group (-22.46±5.32 pA/pF, n=12) compared to CON (-42.78±5.48 pA/pF, n=16, P<0.01), while it was significantly increased in Ani+I/R group (-38.89±5.24 pA/pF, n=13) compared to I/R group (P<0.01). CONCLUSION: Anisodamine has the ability to reduce the occurrence of ventricular arrhythmia. Ischemia-reperfusion induces significant down-regulation of I_(Na), while pretreatment with anisodamine attenuates this change, suggesting that anisodamine reverses this electrical remodeling, which may be partly responsible for its antiarrhythmia effects.

Objective To investigate the effects of simvastatin on membrane ionic currents in left ventricular myocytes after acutemyocardial infarction(AML.so as to explore the ionic mechanism of statin treatment for antiarrhythmia.Methods Fourty-five NewZeland rabbits were randomly divided into three groups:AMI group,simvastatin intervention group(statin group)and sham-operatedcontrol group (CON).Rabbits were infarcted by ligation of the left anterior descending coronary artery after administration of oralisolated enzymatically from the epicardial zone of the infractcd region.Whole cell patch clamp technique was used to record mmbranewas significantly decreased in AMI group(-23.26+5.1 8)compared with CON(-42.78±5.48,P＜0.05),while it was significantlyincreased in Stating roup(-39.23±5.45)compared with AMI group(P＜0.01);The peak Ica-L current density(at 0 mV) was significantlydecreased in AMI group(-3.23±0.91)compared with CON(-4.56±1.01,P＜0.05),while it was significantly increased in Statin group(-4.18±0.95)compared with AMI group(P＜0.05);The Ito current density(at+60 mV)was significantly decreased in AMI group(10.41±1.93)compared with CON(17.41±3.13,P＜0.01),while it was significantly increased in Statin group(16.21±2.42)compared withattenuate this change without lowering the serum cholesterol level,suggesting that simvastatin reverse this electrical remodeling thuscontributing to the ionic mechanism of statin treatment for antiarrhythmia.