Skin flaps are frequently employed in plastic and reconstructive surgery to address tissue defects.However,their low survival rates remain a challenge,attributed to vascular crisis and necrosis.Despite numerous studies investigating drugs to alleviate flap necrosis,a comprehensive analysis of the research trend in this critical area is lacking.To gain a deeper understanding of the current status,research focal points,and future trends in drugs aimed at enhancing flap survival,a thorough retrospective analysis is imperative.This study aims to employ bibliometric methods to scrutinize the evolution,mechanisms,and forthcoming trends of drugs targeting flap survival improvement.Using VOSviewer software,we quantitatively and visually depict 1)annual temporal trends in the number of documents and citations;2)national/regional publications and their collaborations;3)institutional and authors'contribution;4)journal contribution and relevance;and 5)analysis of research hotspots and directions derived from keywords.Ultimately,we discussed the prospects and challenges of future advances and clinical trans-lation of drugs designed to enhance skin flap survival.In conclusion,the field of pharmacology dedicated to improving skin flap survival is expanding,and this study aims to offer a fresh perspective to promote the advancement and clinical application of such drugs.

Objective To explore the clinical effect of floating acupuncture on military training injuries,so as to provide reference for the prevention and treatment of military training injuries.Methods A total of 300 patients with ankle,knee,hip,lower back,neck and shoulder diseases caused by military training were divided into two groups.One group was treated with floating acupuncture,and the other group(control group)was treated with traditional physical therapy,medicine and acupuncture.Visual analogue scale(VAS)and Functional Movement Screening(FMS)were used to assess pain and functional movement before and after treatment,respectively.Results After treatment,VAS scores in the floating acupuncture subgroups were significantly lower than those in the control group,and FMS scores in the floating acupuncture subgroups were significantly higher than those in the control group(all P<0.05).Conclusion Floating acupuncture has significant effect on ankle,knee,hip,lower back,neck and shoulder diseases caused by military training,and it is worthy of popularization.

OBJECTIVE: Identifying novel strategies to prevent particulate matter (PM)-induced lung injury is crucial for the reduction of the morbidity of chronic respiratory diseases. The combined intervention represented by herbal formulae for simultaneously targeting multiple pathological processes can provide a more beneficial effect than the single intervention. The aim of this paper is therefore to design a safe and effective medicinal and edible Chinese herbs (MECHs) formula against PM-induced lung injury. METHODS: PM-induced oxidative stress, inflammatory response and apoptosis A549 cell model were used to screen anti-oxidant, anti-inflammatory and anti-apoptotic MECHs, respectively. A network pharmacology method was utilized to rationally design a novel herbal formula. Ultra performance liquid chromatography-mass spectrometer was utilized to assess the quality control of MECHs formula. The excretion of magnetic iron oxide nanospheres of the MECHs formula was estimated in zebrafish. The MECH formula against PM-induced lung injury was investigated with mice experiments. RESULTS: Five selected herbs were rationally designed to form a new MECH formula, including Citri Exocarpium Rubrum (Juhong), Lablab Semen Album (Baibiandou), Atractylodis Macrocephalae Rhizoma (Baizhu), Mori Folium (Sangye) and Polygonati Odorati Rhizoma (Yuzhu). The formula effectively promoted the magnetic iron oxide nanospheres excretion in zebrafish. The mid/high dose formula significantly prevented PM-induced lung damage in mice by enhancing the activity of SOD and GSH-Px, reducing the MDA and ROS level and attenuating the upregulation of pro-inflammatory cytokine (IL-6, IL-8, IL-1β and TNF-α), down regulating the protein expression of NF-κB, STAT3 and Caspase-3. CONCLUSION Our findings suggest that the effective MECHs formula will become a novel strategy for preventing PM-induced lung injury and provide a paradigm for the development of functional foods using MECHs.

Objective:To introduce the clinical experiences in multilevel suspension rhytidectomy with limited dissection of the immobile zone in superficial musculoaponeurotic system(SMAS).Methods:From January 2014 to December 2019, at total of 110(1 male and 109 females, 46-72 years old)cases of facial rhytidectomy were performed in our institution. During the operation, the area of skin flap elevation is similar to the classic rhytidectomy. SMAS layer dissection is contained within the immobile area.Dynamic evaluation was conducted every 1 cm of SMAS flap elevation, by gently pulling the SMAS flap.The change of depth of the nasolabial fold, the change of lips elevation were the parameters for which the degree of dissection is determined.The subjective satisfaction and overall improvement were investigated and the complications were recorded.Results:All 110 patients were followed up for 6-30 months, with an average of 12 months. The subjective satisfaction rate was 94.5%(104/110). Among them , 61 cases rated "very satisfied" , 43 cases were "satisfied" , 2 cases were "acceptable" and 4 cases were "unsatisfactory" . All patients had significant improvement on brow sagging, nasolabial fold, mouth sagging, and skin texture. The early postoperative complications were local hematoma in 4 cases (3.6%). The long-term complications included 3 cases (2.7%) of periauricular scar hyperplasia , 2 cases (1.8%) of earlobe displacement and 1 case (0.9%) of hair loss at temporal incision (0.9%).Conclusions:Limited dissection of the immobile zone in SMAS flap has no significantly negative impact on the overal outcomes. By such contained surgical dissection, facial rejuvenation can be achieved, and the risks of complications were reduced.

Objective:To introduce the clinical experiences in multilevel suspension rhytidectomy with limited dissection of the immobile zone in superficial musculoaponeurotic system(SMAS).Methods:From January 2014 to December 2019, at total of 110(1 male and 109 females, 46-72 years old)cases of facial rhytidectomy were performed in our institution. During the operation, the area of skin flap elevation is similar to the classic rhytidectomy. SMAS layer dissection is contained within the immobile area.Dynamic evaluation was conducted every 1 cm of SMAS flap elevation, by gently pulling the SMAS flap.The change of depth of the nasolabial fold, the change of lips elevation were the parameters for which the degree of dissection is determined.The subjective satisfaction and overall improvement were investigated and the complications were recorded.Results:All 110 patients were followed up for 6-30 months, with an average of 12 months. The subjective satisfaction rate was 94.5%(104/110). Among them , 61 cases rated "very satisfied" , 43 cases were "satisfied" , 2 cases were "acceptable" and 4 cases were "unsatisfactory" . All patients had significant improvement on brow sagging, nasolabial fold, mouth sagging, and skin texture. The early postoperative complications were local hematoma in 4 cases (3.6%). The long-term complications included 3 cases (2.7%) of periauricular scar hyperplasia , 2 cases (1.8%) of earlobe displacement and 1 case (0.9%) of hair loss at temporal incision (0.9%).Conclusions:Limited dissection of the immobile zone in SMAS flap has no significantly negative impact on the overal outcomes. By such contained surgical dissection, facial rejuvenation can be achieved, and the risks of complications were reduced.

OBJECTIVE: To discuss the advantages and technical limitations of various molecular genetic techniques in the diagnosis of two infants featuring all-round developmental retardation. METHODS: The two patients were initially screened by using chromosomal microarray analysis (CMA). For patient 1, his parents were also subjected to CMA analysis, and the data was analyzed by using ChAS and UPD-tool software. For patient 2, methylation-specific PCR (MS-PCR) was carried out. RESULTS: Patient 1 was diagnosed with maternal uniparental disomy (UPD) type Prader-Willi syndrome (PWS) by CMA and UPD-tool family analysis. His chromosomes 15 were of maternal UPD with homology/heterology. Patient 2 was diagnosed with deletion type PWS by combined CMA and MS-PCR. CONCLUSION Correct selection of laboratory methods based on the advantages and limitations of various molecular techniques can help with diagnosis of genomic imprinting disorders and enable better treatment and prognosis through early intervention.

Objective To investigate the effects of pirfenidone on orbital fibroblasts (OFs) from patients with thyroid-associated ophthalmopathy (TAO) and its underlying mechanisms.Methods OFs from patients with TAO were isolated and cultured in DMEM.Cells were divided into four groups and treated with 0,250,500 and 1 000 μg/ml pirfenidone for 24,48 or 72 hours,respectively.Cell proliferation was detected by tetramethyl azo salt (MTT) assay,and cell viability was determined by trypan blue.Transforming growth factor (TGF) β1 mRNA level was determined by real-time fluorescence quantitative PCR (RT-qPCR).Type Ⅰ and type 11Ⅲ collagen secreted from cultured cells were measured by enzyme-linked immuno sorbent assay (ELISA).Results (1) The primary cultured OFs had typical fibroblast spindle-like morphology.(2) MTT assay showed that pirfenidone treatment significantly inhibited the proliferation of OFs in a dose-dependent manner (P＜0.05) with the proliferation rates of pirfenidone treated groups of-15.31％,-24.92％,-48.53％ from 250,500,1 000 μg/ml after 72 h,respectively,in which the inhibition effect of 1 000 μg/ml pirfenidone was significantly different from the other two treated groups (P＜0.05).There were no significant differences in the inhibitory effect of the same concentration group among different time points at 24 h,48 h and 72 h (P＞0.05).Trypan blue showed that the survival rate of OFs in different concentrations of pirfenidone from 0,250,500,1 000 μ-g/ml at 72 h were 78.37％,79.21％,78.24％ and 76.28％,respectively.There were no significant differences between each drug treated and the control group (P＞0.05).(3) RT-qPCR results showed that the mRNA expression levels of TGFβ1 at 250,500,1 000 μg/ml pirfenidone treated groups at 72 h were 0.760±0.010,0.440±0.006,and 0.290±0.002,respectively.Compared with the control group (0.950±0.014),the differences were statistically significant (all P＜0.05).Moreover,TGFβ1 mRNA expression level in 1 000 μg/ml pirfenidone treated group was significantly lower than those in the other two treated groups (all P＜0.05).The secretion of type Ⅰ collagen (0.633 ± 0.006,0.527 ± 0.003 and 0.402±0.008) and type 11Ⅲ collagen (0.511±0.003,0.439±0.007 and 0.223±0.006) in 250,500 and 1 000 μg/ml pirfenidone treated groups at 72 h were significantly lower than those in the control group (0.794±0.005,0.527±0.007,all P＜0.05).Type Ⅰ and type Ⅲ collagen secretion in 1 000 μg/ml pirfenidone treated group were significantly lower than those in the other two groups (P＜0.05).Conclusions Pirfenidone inhibits the cell proliferation,TGFβ1 expression and collagen secretion of OFs,which may contribute to the anti-fibrotic effect of pirfenidone.

Objective To explore the mechanism of bone marrow-derived endothelial progenitor cells (EPCs)in the treatment of peripheral neuropathy of diabetic rats. Methods Rats with diabetic peripheral neuropathy (DPN)were induced by streptozotocin(60 mg/kg). Male SD rats were divided into normal control group(NC group),DPN group, DPN+saline group(DPN+S group), and DPN+ EPCs group. Sciatic nerve motor nerve conduction velocity(MNCV)was measured. The expressions of NF-κB and myelin basic protein(MBP)in sciatic nerve were detected by immunohistochemistry. Results Compared with DPN group,the expression of NF-κB was reduced in the sciatic nerve of DPN+EPCs group,while the expression of NF-κB was increased in the sciatic nerve of DPN+ S group. There was no statistical difference in the expression of MBP between DPN and DPN+ EPCs groups. Compared with DPN+S group, the expression of MBP was higher in DPN+EPCs group. Conclusion Transplantation of EPCs inhibits the expression of NF-κB and increases the expression of MBP, which might be conducive to the repairs of nerve injury.

Objective To explore whether endothelial progenitor cells (EPCs) exerts therapeutic effects on rats with diabetic peripheral neuropathy (DPN).Methods Diabetes was induced by streptozotocin.Male SD rats were divided into normal control group(NC group), diabetic peripheral neuropathy group(DPN group), DPN+saline group(DPN+S group), and DPN+EPCs group.Sciatic nerve motor nerve conduction velocity(MNCV) was measured by a electromyography and trigger potentiometer instrument.Pathological changes were observed under optical microscope and electron microscope.Results Compared with normal control group [(52.91 ± 4.53) m/s], both DPN group and DPN+S group had slower sciatic nerve MNCV [(36.51 ± 6.30 and 25.37 ± 5.48) m/s, P＜0.01].Compared with DPN group, the MNCV of sciatic nerve in DPN + EPCs group had improved significantly [(36.51 ± 6.30 vs 46.20 ± 11.70) m/s, P ＜ 0.01].Sciatic nerve pathological changes, characterized by demyelination and axonal degeneration under light microscope and electron microscope were observed in DPN group, DPN+EPCs group, and DPN+S group.Compared with DPN+S group, the sciatic nerve pathological changes of DPN+EPCs group were alleviated.Conclusion After fed for 12 weeks, diabetic rats could progress to DPN rats.Transplantation of EPCs could improve MNCV, demyelination and axonal degeneration changes of sciatic nerver of the DPN rats.

Objective To investigate the expression of secretagogin(SCGN) and chromogranin A(CgA) in pancreatic neuroen‐docrine tumors (PNETs) .Methods Totally 54 cases of PNETs hospitalized in our hospital from October 2007 to October 2013 were enrolled in our study .Immunohistochemical detection was used to determine secretagogin and CgA .Results Secretagogin and CgA were highly expressed in all PNETs specimens .Compared with CgA ,secretagogin were highly expressed in the non‐functional PNETs ,tumor volume>30 cm3 ,the enveloped ,vascular invasion and lymph node metastasis (P<0 .05) .There were no statistically significant difference between SCGN and CgA in functional PNETs tumor volume ≤30 cm3 ,no enveloped ,no vascular invasion and lymph node metastasis(P>0 .05) .Conclusion The expression of secretagogin and CgA in tumor combined with PNETs pathologi‐cal characteristics can predict the severity of PNETs .