Objective:To explore the effects of simultaneous transplantation of multiple foot flaps in repairing defects of varying degrees on the palmar side of multiple fingers.Methods:This study was a retrospective observational study. From February 2020 to March 2023, 11 patients aged 23-52 years with defects on the palmar side of multiple fingers (with 38 affected fingers) meeting the inclusion criteria were hospitalized at Longgang Orthopedics Hospital of Shenzhen, including 8 males (with 31 affected fingers) and 3 females (with 7 affected fingers). All affected fingers sustained skin and soft tissue defects, along with exposed deep tissue such as finger bones and tendons, and 2 thumbs exhibited nail bed and distal phalanx defects. The defect area of each finger ranged from 1.5 cm×1.0 cm to 5.5 cm×3.0 cm. Foot flaps were designed based on the area and depth of the finger defects, and multiple foot flaps were transplanted simultaneously to repair the wounds of fingers. The area of single flap resected ranged from 2.0 cm×1.0 cm to 5.5 cm×3.0 cm. Donor site wounds were closed directly or covered using artificial dermis or split-thickness skin grafts. The number of resected flaps, the number of affected fingers repaired, and the surgical duration were recorded. The flap survival and foot donor site wound healing were observed postoperatively. The flap and donor and recipient sites recovery were observed during follow-up. At the final follow-up, the functional recovery of affected fingers was evaluated based on the trial criteria of the Chinese Medical Association's Hand Surgery Society for function evaluation of thumb and finger reconstruction, the sensory function of the flaps was assessed by the sensory function evaluation standard of the British Medical Research Council, the cold tolerance of the affected hands was evaluated with the Cold Intolerance Severity Scale, the scars at the recipient and donor sites were assessed using the Vancouver scar scale (VSS), and the function recovery of flap donor foot was evaluated with the Maryland Foot Score criteria.Results:Donor sites were selected from 16 feet with 2-4 flaps harvested from each foot. Specifically, skin and soft tissue defects in 27 affected fingers were repaired using free lateral toe flaps, skin and soft tissue defects in 9 affected fingers were repaired using free medial foot flaps, and skin and soft tissue defects with finger bone defects in 2 affected fingers were repaired using free toenail osteocutaneous flaps. The surgical duration ranged from 5.60 to 9.25 hours. Postoperatively, all transplanted flaps in affected fingers survived, and all foot donor site wounds healed. Follow-up for 12-25 months showed that the appearance, color, and texture of the flaps were similar to the surrounding normal skin. The affected finger pulp was full with the fingertip having restored pain and touch sensation. There was no pain in the donor site of foot, and the walking ability of patients was not affected. At the final follow-up, the functional recovery was evaluated as excellent for 36 affected fingers and good for 2 affected fingers. The sensory function rating of the flaps was graded as S3-S4, and all affected fingers were mild intolerant to cold. VSS scores of the scars at the recipient sites ranged from 1-3, and VSS scores of the scars at the donor sites ranged from 1-5. The functional recovery of all flap donor feet was excellent.Conclusions:Simultaneous transplantation of multiple foot flaps is an effective treatment method for repairing defects of varying degrees on the palmar side of multiple fingers, resulting in excellent aesthetic and functional recovery of the affected fingers while causing minimal damage to the donor site.

Objective To explore the environmental factors affecting the growth of Lonicera japonica Thunb.;To predict the suitable areas of L.japonica in China under current and future climate conditions.Methods Totally 2 553 pieces of L.japonica distribution information and 19 environmental factors were collected.MaxEnt model was used to screen the main environmental factors affecting the growth of L.japonica.Combined with ArcGIS 10.8 software,this article simulated the suitable area of L.japonica in our country under current and future climate conditions.Results The main environmental factors affecting the distribution of L.japonica were the lowest temperature in the coldest month,the average daily temperature range,the precipitation in the wettest quarter and the annual temperature range.Under the current climate conditions,the suitable area of L.japonica in China was about 318.29×104 km2,which was mainly distributed in central and southern China.Under the future climate scenario,the total suitable area would decrease.Conclusion This study predicted distribution of L.japonica resources and ecological suitability areas can provide theoretical basis for its wild cultivation,rational cultivation,and resource protection.

Objective:To explore the efficacy and safety of the Da Vinci robotic single-port-plus-one technique in common urological surgeries in children.Methods:The data of 59 children who underwent robot-assisted single-port-plus-one laparoscopic surgery from May 2022 to November 2023 in Fuzhou University Affiliated Provincial Hospital were retrospectively analyzed. There were 44 males and 15 females, aged 36 (6, 108)months. Among them, 27 cases had ureteropelvic junction obstruction, with a preoperative anterior-posterior diameter of the renal pelvis of (31.83±6.59) mm. The American Society of Fetal Urology (SFU) grading system revealed grade Ⅲ in 8 sides and grade Ⅳ in 19 sides. Bilateral renal function showed a difference of 13.50% (7.18%, 31.06%). Additionally, 17 cases presented with vesicoureteral reflux. Preoperative voiding cystourethrogram (VCUG) indicated reflux grades Ⅲ, Ⅳ, and Ⅴ in 8, 14, and 4 sides, respectively, with a difference in bilateral renal function of 18.58% (6.04%, 28.30%). Ten cases had obstructive megaureter, with a preoperative renal pelvis diameter of (22.17±7.64)mm and a maximum ureteral diameter of (19.51±3.71)mm. The preoperative bilateral renal function difference was 18.02% (5.23%, 49.42%).Five cases involved duplicated kidney and ureter. Magnetic resonance urography (MRU) confirmed unilateral duplicated kidneys with associated dilatation of the upper renal pelvis and calyces, hydroureter, thin renal cortex in all 5 patients. Among them, 2 cases had ectopic ureteral opening and 1 case had terminal ureteral cyst. Patients with ureteropelvic junction stenosis underwent pyeloplasty, those with vesicoureteral reflux and obstructive megaureter underwent ureteral reimplantation, and patients with duplicated ureters underwent nephrectomy. The Da Vinci robotic surgical system was employed for all procedures. The port placement technique involved a 2-3 cm incision around the navel to insert a single-port four-channel device, followed by the placement of an additional 8 mm operating channel in the left or right abdomen under direct visualization based on the surgical site. Preoperative and postoperative parameters were compared.Results:All operations were successfully completed without conversion to open or laparoscopic surgery. The operation time of the ureteropelvic junction obstruction children was (141.52±22.93) min. The postoperative renal pelvis diameter and bilateral renal function difference were (12.54±4.05) mm and 5.60%(2.14%, 14.48%), respectively, both of which showed significant improvement compared to preoperative levels ( P<0.01). Postoperative hydronephrosis grades were as follows: 13 sides with grade Ⅰ, 13 sides with grade Ⅱ, and 1 side with grade Ⅲ. The operation time of vesicoureteral reflux children was (125.00±11.75) min in the unilateral group and (153.22±14.39) min in the bilateral group. Postoperatively, 2 sides demonstrated reflux grade Ⅰ, 1 side grade Ⅱ, and 1 side grade Ⅲ, indicating improvement compared to preoperative levels. Bilateral renal function difference post-surgery was 13.34% (1.85%, 20.54%), which was more balanced than preoperatively ( P=0.011). Postoperative renal pelvis anterior-posterior diameter and maximum ureteral diameter were reduced to (10.31±3.86) mm and (6.62±2.44) mm, respectively, which were significantly smaller than preoperative measurements ( P<0.01). The bilateral renal function difference post-surgery was 12.04% (4.85%, 47.53%), showing improvement, though not statistically significant ( P=0.508). The operation time of the repeated nephrectomy children was (140.00±12.75) min. No recurrence of preoperative symptoms was noted, and renal cortical function remained generally normal during follow-up. In this study, only 3 cases of obstructive megaureter developed febrile urinary tract infection within 1 month after surgery, and no complications were observed in the remaining cases. Conclusions:This study preliminarily confirmed that the Da Vinci robotic single-port-plus one-port technology can be used in the treatment of common diseases of the urinary system in children. The patients' symptoms were significantly relieved after surgery, and the indicators of hydronephrosis improved compared with those before surgery. The incidence of postoperative complications was low, and aesthetic outcomes of postoperative scars were enhanced. Further studies are needed to assess its long-term efficacy.

Objective:To explore the mechanism of Amomi Fructus in ameliorating ethanol-induced gastric ulcer (GU) in mice using metabolomics, network pharmacology and molecular docking techniques.Methods:The mice were divided into the blank group, model group, aqueous extract of Amomi Fructus group, volatile oil of Amomi Fructus group, combined aqueous extract and volatile oil of Amomi Fructus group and omeprazole group according to the random number table method, with 10 mice in each group. The blank and model groups were gavaged with sodium carboxymethyl cellulose, the Amomi Fructusaqueous extract group was gavaged with 0.152 5 g/kg of Amomi Fructus aqueous extract, the Amomi Fructus volatile oil group was gavaged with 26 μl/kg of Amomi Fructus volatile oil, the Amomi Fructus aqueous extract and volatile oil combined group was gavaged with 0.152 5 g/kg+26 μl/kg of Amomi Fructus aqueous extract and volatile oil synergistic solution, and the omeprazole group was gavaged with 5.2 mg/kg of omeprazole, 1 time/day, which was administered continuously for 7 d. The gastric ulcer model was established by using ethanol 2 h after the last administration, and the pathological changes of gastric histology were observed by using HE staining; the main differential metabolites were detected by UPLC-Q-TOF-MS/MS non-targeted metabolomics technique, and the metabolic pathway enrichment analysis was carried out; the potential targets and key pathways of the anti-GU action of Amomi Fructus were predicted by network pharmacology; the "metabolite-response-enzyme-gene" network was established by combining the serum metabolomics and network pharmacology; and the key targets were verified by molecular docking technology.Results:HE staining showed that the gastric mucosa of mice in the model group was severely damaged, with cellular tissue damage and inflammatory cell infiltration, whereas the drug administration group showed some protective effects; the results of non-targeted metabolomics showed that 2 metabolites were up-regulated and 17 metabolites were down-regulated in sera of mice in the co-administration group of aqueous extract and volatile oil of Amomi Fructus compared with the control group, and the 19 metabolites were strongly correlated and well clustered, involving nicotinic acid and nicotinamide metabolism, citric acid cycle, glyoxylate and dicarboxylic acid metabolism, phenylalanine metabolism, alanine, aspartate and glutamate metabolism and other metabolic pathways; the results of network pharmacology showed that Amomi Fructus improved GU by affecting target proteins, such as STAT3, AKT1, SRC, and TLR4, which were closely linked to the signaling pathways of cancer pathway, human cytomegalovirus infection, and lipids and atherosclerosis; the joint analysis of network pharmacology and the combined analysis of network pharmacology and metabolomics identified the glycerophospholipid metabolic pathway as the main metabolic pathway in which Amomi Fructus may exert gastroprotective effects; the molecular docking results showed that the main active component of quercetin had a better binding ability to the key targets.Conclusion:Amomi Fructus exerts a protective effect on ethanol induced GU model by regulating the glycerophospholipid metabolism pathway, providing theoretical basis for further research on Amomi Fructus.

Objective:To evaluate the efficacy of transumbilical single-port robotic-assisted laparoscopic surgery for congenital choledochal cysts in children.Methods:Clinical data of 13 children with congenital choledochal cysts undergoing surgery at the Provincial Hospital of Fuzhou University from January 2024 to June 2024 were retrospectively analyzed, including 4 males and 9 females, aged 48 (24, 60) months. All children underwent transumbilical single-port robotic-assisted laparoscopic radical resection of congenital choledochal cyst with common hepatic duct jejunum Roun-en-Y anastomosis by the same surgeon. The efficacy of this technique was evaluated by surgical safety indicators such as operation time and intra-operative blood loss, as well as indicators of the postoperative scar assessment scale (OSAS).Results:All surgeries were successfully performed without conversion to open surgery. The operation time was (200±22) min. The blood loss was (8.07±2.56) ml without intraoperative blood transfusion. The time to start water feeding was (2.76±0.83) d and the time to start liquid diet was (3.92±1.12) d. The postoperative hospital stay was (7.00±3.37) d and the postoperative follow-up time was (5.38±2.06) months. No postoperative complications such as bile reflux gastritis and cholangitis were seen in patients. No dilatation of the common hepatic duct or intrahepatic bile ducts were observed at three months postoperatively. There were good indicators of satisfaction with the appearance of wounds as assessed by OSAS.Conclusion:Transumbilical single-port robotic-assisted laparoscopic surgery could be safe and effective for congenital choledochal cysts in children.

Objective To explore the environmental factors affecting the growth of Lonicera japonica Thunb.;To predict the suitable areas of L.japonica in China under current and future climate conditions.Methods Totally 2 553 pieces of L.japonica distribution information and 19 environmental factors were collected.MaxEnt model was used to screen the main environmental factors affecting the growth of L.japonica.Combined with ArcGIS 10.8 software,this article simulated the suitable area of L.japonica in our country under current and future climate conditions.Results The main environmental factors affecting the distribution of L.japonica were the lowest temperature in the coldest month,the average daily temperature range,the precipitation in the wettest quarter and the annual temperature range.Under the current climate conditions,the suitable area of L.japonica in China was about 318.29×104 km2,which was mainly distributed in central and southern China.Under the future climate scenario,the total suitable area would decrease.Conclusion This study predicted distribution of L.japonica resources and ecological suitability areas can provide theoretical basis for its wild cultivation,rational cultivation,and resource protection.

Objective:To explore the efficacy and safety of the Da Vinci robotic single-port-plus-one technique in common urological surgeries in children.Methods:The data of 59 children who underwent robot-assisted single-port-plus-one laparoscopic surgery from May 2022 to November 2023 in Fuzhou University Affiliated Provincial Hospital were retrospectively analyzed. There were 44 males and 15 females, aged 36 (6, 108)months. Among them, 27 cases had ureteropelvic junction obstruction, with a preoperative anterior-posterior diameter of the renal pelvis of (31.83±6.59) mm. The American Society of Fetal Urology (SFU) grading system revealed grade Ⅲ in 8 sides and grade Ⅳ in 19 sides. Bilateral renal function showed a difference of 13.50% (7.18%, 31.06%). Additionally, 17 cases presented with vesicoureteral reflux. Preoperative voiding cystourethrogram (VCUG) indicated reflux grades Ⅲ, Ⅳ, and Ⅴ in 8, 14, and 4 sides, respectively, with a difference in bilateral renal function of 18.58% (6.04%, 28.30%). Ten cases had obstructive megaureter, with a preoperative renal pelvis diameter of (22.17±7.64)mm and a maximum ureteral diameter of (19.51±3.71)mm. The preoperative bilateral renal function difference was 18.02% (5.23%, 49.42%).Five cases involved duplicated kidney and ureter. Magnetic resonance urography (MRU) confirmed unilateral duplicated kidneys with associated dilatation of the upper renal pelvis and calyces, hydroureter, thin renal cortex in all 5 patients. Among them, 2 cases had ectopic ureteral opening and 1 case had terminal ureteral cyst. Patients with ureteropelvic junction stenosis underwent pyeloplasty, those with vesicoureteral reflux and obstructive megaureter underwent ureteral reimplantation, and patients with duplicated ureters underwent nephrectomy. The Da Vinci robotic surgical system was employed for all procedures. The port placement technique involved a 2-3 cm incision around the navel to insert a single-port four-channel device, followed by the placement of an additional 8 mm operating channel in the left or right abdomen under direct visualization based on the surgical site. Preoperative and postoperative parameters were compared.Results:All operations were successfully completed without conversion to open or laparoscopic surgery. The operation time of the ureteropelvic junction obstruction children was (141.52±22.93) min. The postoperative renal pelvis diameter and bilateral renal function difference were (12.54±4.05) mm and 5.60%(2.14%, 14.48%), respectively, both of which showed significant improvement compared to preoperative levels ( P<0.01). Postoperative hydronephrosis grades were as follows: 13 sides with grade Ⅰ, 13 sides with grade Ⅱ, and 1 side with grade Ⅲ. The operation time of vesicoureteral reflux children was (125.00±11.75) min in the unilateral group and (153.22±14.39) min in the bilateral group. Postoperatively, 2 sides demonstrated reflux grade Ⅰ, 1 side grade Ⅱ, and 1 side grade Ⅲ, indicating improvement compared to preoperative levels. Bilateral renal function difference post-surgery was 13.34% (1.85%, 20.54%), which was more balanced than preoperatively ( P=0.011). Postoperative renal pelvis anterior-posterior diameter and maximum ureteral diameter were reduced to (10.31±3.86) mm and (6.62±2.44) mm, respectively, which were significantly smaller than preoperative measurements ( P<0.01). The bilateral renal function difference post-surgery was 12.04% (4.85%, 47.53%), showing improvement, though not statistically significant ( P=0.508). The operation time of the repeated nephrectomy children was (140.00±12.75) min. No recurrence of preoperative symptoms was noted, and renal cortical function remained generally normal during follow-up. In this study, only 3 cases of obstructive megaureter developed febrile urinary tract infection within 1 month after surgery, and no complications were observed in the remaining cases. Conclusions:This study preliminarily confirmed that the Da Vinci robotic single-port-plus one-port technology can be used in the treatment of common diseases of the urinary system in children. The patients' symptoms were significantly relieved after surgery, and the indicators of hydronephrosis improved compared with those before surgery. The incidence of postoperative complications was low, and aesthetic outcomes of postoperative scars were enhanced. Further studies are needed to assess its long-term efficacy.

Objective:To explore the effects of simultaneous transplantation of multiple foot flaps in repairing defects of varying degrees on the palmar side of multiple fingers.Methods:This study was a retrospective observational study. From February 2020 to March 2023, 11 patients aged 23-52 years with defects on the palmar side of multiple fingers (with 38 affected fingers) meeting the inclusion criteria were hospitalized at Longgang Orthopedics Hospital of Shenzhen, including 8 males (with 31 affected fingers) and 3 females (with 7 affected fingers). All affected fingers sustained skin and soft tissue defects, along with exposed deep tissue such as finger bones and tendons, and 2 thumbs exhibited nail bed and distal phalanx defects. The defect area of each finger ranged from 1.5 cm×1.0 cm to 5.5 cm×3.0 cm. Foot flaps were designed based on the area and depth of the finger defects, and multiple foot flaps were transplanted simultaneously to repair the wounds of fingers. The area of single flap resected ranged from 2.0 cm×1.0 cm to 5.5 cm×3.0 cm. Donor site wounds were closed directly or covered using artificial dermis or split-thickness skin grafts. The number of resected flaps, the number of affected fingers repaired, and the surgical duration were recorded. The flap survival and foot donor site wound healing were observed postoperatively. The flap and donor and recipient sites recovery were observed during follow-up. At the final follow-up, the functional recovery of affected fingers was evaluated based on the trial criteria of the Chinese Medical Association's Hand Surgery Society for function evaluation of thumb and finger reconstruction, the sensory function of the flaps was assessed by the sensory function evaluation standard of the British Medical Research Council, the cold tolerance of the affected hands was evaluated with the Cold Intolerance Severity Scale, the scars at the recipient and donor sites were assessed using the Vancouver scar scale (VSS), and the function recovery of flap donor foot was evaluated with the Maryland Foot Score criteria.Results:Donor sites were selected from 16 feet with 2-4 flaps harvested from each foot. Specifically, skin and soft tissue defects in 27 affected fingers were repaired using free lateral toe flaps, skin and soft tissue defects in 9 affected fingers were repaired using free medial foot flaps, and skin and soft tissue defects with finger bone defects in 2 affected fingers were repaired using free toenail osteocutaneous flaps. The surgical duration ranged from 5.60 to 9.25 hours. Postoperatively, all transplanted flaps in affected fingers survived, and all foot donor site wounds healed. Follow-up for 12-25 months showed that the appearance, color, and texture of the flaps were similar to the surrounding normal skin. The affected finger pulp was full with the fingertip having restored pain and touch sensation. There was no pain in the donor site of foot, and the walking ability of patients was not affected. At the final follow-up, the functional recovery was evaluated as excellent for 36 affected fingers and good for 2 affected fingers. The sensory function rating of the flaps was graded as S3-S4, and all affected fingers were mild intolerant to cold. VSS scores of the scars at the recipient sites ranged from 1-3, and VSS scores of the scars at the donor sites ranged from 1-5. The functional recovery of all flap donor feet was excellent.Conclusions:Simultaneous transplantation of multiple foot flaps is an effective treatment method for repairing defects of varying degrees on the palmar side of multiple fingers, resulting in excellent aesthetic and functional recovery of the affected fingers while causing minimal damage to the donor site.

Objective:To evaluate the efficacy of transumbilical single-port robotic-assisted laparoscopic surgery for congenital choledochal cysts in children.Methods:Clinical data of 13 children with congenital choledochal cysts undergoing surgery at the Provincial Hospital of Fuzhou University from January 2024 to June 2024 were retrospectively analyzed, including 4 males and 9 females, aged 48 (24, 60) months. All children underwent transumbilical single-port robotic-assisted laparoscopic radical resection of congenital choledochal cyst with common hepatic duct jejunum Roun-en-Y anastomosis by the same surgeon. The efficacy of this technique was evaluated by surgical safety indicators such as operation time and intra-operative blood loss, as well as indicators of the postoperative scar assessment scale (OSAS).Results:All surgeries were successfully performed without conversion to open surgery. The operation time was (200±22) min. The blood loss was (8.07±2.56) ml without intraoperative blood transfusion. The time to start water feeding was (2.76±0.83) d and the time to start liquid diet was (3.92±1.12) d. The postoperative hospital stay was (7.00±3.37) d and the postoperative follow-up time was (5.38±2.06) months. No postoperative complications such as bile reflux gastritis and cholangitis were seen in patients. No dilatation of the common hepatic duct or intrahepatic bile ducts were observed at three months postoperatively. There were good indicators of satisfaction with the appearance of wounds as assessed by OSAS.Conclusion:Transumbilical single-port robotic-assisted laparoscopic surgery could be safe and effective for congenital choledochal cysts in children.

Objective : To analyze the clinical characteristics of patients with abdominal type allergic purpura(HSP), to improve their diagnostic level, and to explore the risk factors for gastrointestinal bleeding in HSP patients. Methods : A retrospective analysis was conducted on the clinical manifestations, laboratory data, imaging, endoscopic, and pathological characteristics of 98 patients with abdominal type HSP. Based on the occurrence of gastrointestinal bleeding, 98 patients were divided into a bleeding group and a non-bleeding group, and the risk factors for gastrointestinal bleeding in HSP patients were analyzed. Results : Abdominal HSP often presented with abdominal pain, vomiting, vomiting blood, black stools, and bloody stools. Imaging often showed edema and thickening of the duodenum and jejunum, as well as enlargement of surrounding lymph nodes. Under endoscopy, the descending part of the duodenum and jejunum mucosa were commonly congested and edematous with erosion, and ulcers were seen in the distal ileum. Pathology commonly involved acute and chronic inflammation of the mucosa with congestion, edema, and local erosion. Patients with gastrointestinal bleeding had significantly higher levels of white blood cell count(WBC), neutrophil count(NEUT), C-reactive protein(CRP), D-dimer(D-D), and fibrinolytic products(FDP) compared to non-bleeding patients(P<0.05), while levels of red blood cell count(RBC), hemoglobin(HGB), and albumin(ALB) were significantly lower than those of non bleeding patients(P<0.05). Logistic regression analysis showed that decreased ALB and increased FDP were independent risk factors for gastrointestinal bleeding in patients with abdominal HSP(P<0.05). The areas under the ROC curves of ALB and FDP were(AUC=0.877, 95%CI:0.794-0.960,P<0.01) and(AUC=0.806, 95%CI:0.722-0.890,P<0.01), respectively. The maximum value of the Jordan index for ALB was 0.734, with sensitivity and specificity of 89.6% and 83.9%, respectively, and had a critical value of 38.2 g/L. The maximum value of the Jordan index for FDP was 0.577, with sensitivity and specificity of 64.2% and 93.5%, respectively, and had a critical value of 18.14 μg/ml. There was no statistically significant difference in the ROC curves between ALB and FDP. Conclusion For HSP with abdominal pain as the initial symptom, imaging and endoscopic examination are helpful for early diagnosis. Decreased ALB and elevated FDP are independent risk factors for gastrointestinal bleeding in adult patients with abdominal HSP.