Objective:To investigate the effects of medial plantar artery perforator flap in the reconstruction of palmar scar contracture.Methods:This study was a retrospective observational study. From January 2016 to January 2023, 15 patients with palmar scar contracture who met the inclusion criteria were admitted to Guangzhou Peace Orthopedic Hospital, including 12 males and 3 females, aged 15 to 50 years. Before surgery, the Michigan Hand Outcomes Questionnaire (MHQ) scores for the affected hands ranged from 58 to 77, and the total active motion for the affected hands ranged from 190° to 220°. The skin and soft tissue defect area after scar excision on the palmar side of the affected hands was 5.2 cm×3.2 cm to 7.2 cm×6.0 cm. According to the location and area of the wounds, the defects were repaired using either medial plantar artery superficial perforator flaps or combined flaps of the cutaneous perforator of superficial branch of medial plantar artery and medial branch of medial plantar artery deep branch. The area of the harvested flaps was 5.5 cm×3.5 cm to 7.5 cm×6.8 cm. The donor site wounds on the feet were repaired using superficial circumflex iliac artery perforator flaps. Postoperatively, the survivals of the medial plantar artery perforator flaps and superficial circumflex iliac artery perforator flaps were observed. After survival of the flaps, patients were guided for rehabilitation exercises for the affected hands. Regular outpatient follow-up was conducted after surgery to observe the appearance, color, and texture of the medial plantar artery perforator flaps, and the recovery of foot function. At the final follow-up, the two-point discrimination distance of the medial plantar artery perforator flap was measured, the function of the affected hands was evaluated using the trial criteria for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association and the MHQ.Results:Postoperatively, two patients experienced vascular crisis of the medial plantar artery perforator flaps, while the flaps survived after emergency exploration; the medial plantar artery perforator flaps and superficial circumflex iliac artery perforator flaps survived in other patients. Follow-up for 6 to 18 months postoperatively showed that the medial plantar artery perforator flaps had no bulky appearance, similar color and texture to the surrounding skin, and the foot functions such as running and jumping were not affected. At the final follow-up, the two-point discrimination distance of the medial plantar artery perforator flap ranged from 7 to 10 mm, with an average of 8 mm; the affected hand function was rated as excellent in 12 cases and good in 3 cases; the MHQ scores of the affected hand function ranged from 81 to 95, and the patients were satisfied with the postoperative appearance, pain relief, and functional recovery of the affected hand.Conclusions:The medial plantar artery perforator flap is used for the reconstruction of palmar scar contracture. The flap is easy to harvest, and has a high survival rate, resulting in good postoperative recovery of the flap sensation and function of the affected hand, and minimal donor site injury in the foot. It is therefore worthy of clinical promotion.

Objective:To investigate the effects of medial plantar artery perforator flap in the reconstruction of palmar scar contracture.Methods:This study was a retrospective observational study. From January 2016 to January 2023, 15 patients with palmar scar contracture who met the inclusion criteria were admitted to Guangzhou Peace Orthopedic Hospital, including 12 males and 3 females, aged 15 to 50 years. Before surgery, the Michigan Hand Outcomes Questionnaire (MHQ) scores for the affected hands ranged from 58 to 77, and the total active motion for the affected hands ranged from 190° to 220°. The skin and soft tissue defect area after scar excision on the palmar side of the affected hands was 5.2 cm×3.2 cm to 7.2 cm×6.0 cm. According to the location and area of the wounds, the defects were repaired using either medial plantar artery superficial perforator flaps or combined flaps of the cutaneous perforator of superficial branch of medial plantar artery and medial branch of medial plantar artery deep branch. The area of the harvested flaps was 5.5 cm×3.5 cm to 7.5 cm×6.8 cm. The donor site wounds on the feet were repaired using superficial circumflex iliac artery perforator flaps. Postoperatively, the survivals of the medial plantar artery perforator flaps and superficial circumflex iliac artery perforator flaps were observed. After survival of the flaps, patients were guided for rehabilitation exercises for the affected hands. Regular outpatient follow-up was conducted after surgery to observe the appearance, color, and texture of the medial plantar artery perforator flaps, and the recovery of foot function. At the final follow-up, the two-point discrimination distance of the medial plantar artery perforator flap was measured, the function of the affected hands was evaluated using the trial criteria for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association and the MHQ.Results:Postoperatively, two patients experienced vascular crisis of the medial plantar artery perforator flaps, while the flaps survived after emergency exploration; the medial plantar artery perforator flaps and superficial circumflex iliac artery perforator flaps survived in other patients. Follow-up for 6 to 18 months postoperatively showed that the medial plantar artery perforator flaps had no bulky appearance, similar color and texture to the surrounding skin, and the foot functions such as running and jumping were not affected. At the final follow-up, the two-point discrimination distance of the medial plantar artery perforator flap ranged from 7 to 10 mm, with an average of 8 mm; the affected hand function was rated as excellent in 12 cases and good in 3 cases; the MHQ scores of the affected hand function ranged from 81 to 95, and the patients were satisfied with the postoperative appearance, pain relief, and functional recovery of the affected hand.Conclusions:The medial plantar artery perforator flap is used for the reconstruction of palmar scar contracture. The flap is easy to harvest, and has a high survival rate, resulting in good postoperative recovery of the flap sensation and function of the affected hand, and minimal donor site injury in the foot. It is therefore worthy of clinical promotion.

Objective To investigate the effect of serum calcium level on the prognosis of patients with sepsis. Methods Clinical data of 119 patients with sepsis admitted to intensive care medicine (ICU) of the First Affiliated Hospital of the University of Science and Technology of China from January 2017 to October 2018 were retrospectively analyzed. Gender, age, and C-reactive protein (CRP), procalcitonin (PCT), serum calcium levels, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure score (SOFA) within 24 hours of diagnosis, and 28-day mortality were collected. The patients were divided into the normal serum calcium group (serum calcium 2.00-2.67 mmol/L) and the hypocalcemia group (serum calcium < 2.00 mmol/L) according to their serum calcium level. The patients were divided into survival group and death group according to 28-day prognosis. Pearson correlation test was used to analyze the correlation between serum calcium level and clinical indicators. Receiver operator characteristic (ROC) curve was used to analyze the predictive value of serum calcium level on prognosis. Results A total of 119 patients with sepsis were included, including 50 patients with normal serum calcium, with serum calcium level of (2.14±0.10) mmol/L; and 69 patients of hypocalcemia, and the incidence of hypocalcemia was 57.98%, with serum calcium level of (1.81±0.14) mmol/L. In the hypocalcemia group, except that the APACHEⅡ score was significantly higher than that of the normal serum calcium group (25.59±5.52 vs. 22.28±4.89, P < 0.01), there was no significant difference in gender, age, CRP, PCT and SOFA score between the two groups. The 28-day mortality rate of the hypocalcemia group was significantly higher than that of the normal serum calcium group [78.26% (54/69) vs. 48.00% (24/50), χ2 = 10.45, P < 0.01]. The level of serum calcium in the death group was significantly lower than that in the survival group (mmol/L: 1.90±0.20 vs. 2.04±0.19), while the APACHEⅡ score was significantly higher than the survival group (25.78±5.25 vs. 21.20±4.68), with statistically significant differences (both P < 0.01). There was a negative correlation between serum calcium level and PCT, APACHEⅡ scores in patients with sepsis (r1 = -2.10, P1 = 0.04;r2 = -3.91, P2 < 0.01), but no correlation with CRP and SOFA score (r1 = 0.75, P1 = 0.46; r2 = -1.21, P2 = 0.23). The ROC curve analysis showed that the area under the ROC curve (AUC) for predicting the prognosis of sepsis patients with serum calcium level was 0.70 [95% confidence interval (95%CI) = 0.602-0.798], and the best cut-off value was 1.92 mmol/L, with the sensitivity was 52.56%, and the specificity was 82.93%. Conclusions The prognosis of sepsis patients with hypocalcemia is poor. Serum calcium level can be used as a predictor of prognosis in patients with sepsis.

Objective To investigate the protective effect of ligustrazine on the transporting function of hepatocellular mitochondria membrane in the rats with sepsis-induced acute liver injury (SALI). Methods The Sprague-Dawley (SD) rats were randomly divided into sham operation group, SALI group [established by cecal ligation and puncture (CLP)], ligustrazine treatment group (injection of ligustrazine 60 mg/kg through tail vein after CLP) and ligustrazine preventive group (7 days before CLP, ligustrazine was injected daily through tail vein for 60 mg/kg), and there were 12 rats in each group. Abdominal aorta blood and liver were harvested at 10 hours after operation. The content of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and mitochondrial aspartate aminotransferase (m-AST) were determined by enzyme coupling rate method. The content of ATP was detected by colorimetric and chemical fluorescein method. The activity of mitochondrial ATPase was detected by phosphorus quantification. The expressions of mitochondrial membrane aquaporin 8 (AQP8) and carnitine palmitoyl transferase (CPT) were detected by Western Blot. Results Compared with sham operation group, the levels of serum ALT, AST and m-AST were significantly increased in SALI group, ligustrazine treatment group and ligustrazine preventive group, and the content of ATP was reduced, the activity of mitochondrial membrane ATPase, the expressions of AQP8 and CPT-1A were significantly decreased. Compared with SALI group, the levels of serum ALT, AST and m-AST were significantly decreased in ligustrazine treatment and ligustrazine preventive groups [ALT (U/L): 123.8±32.8, 105.0±44.5 vs. 233.0±110.1; AST (U/L):427.0±117.9, 303.9±110.3 vs. 742.6±441.4; m-AST (U/L): 239.6±64.9, 168.2±60.0 vs. 412.8±252.6; all P <0.01], the content of ATP were significantly increased (nmol/mg: 29.5±10.3, 34.6±11.2 vs. 19.3±8.8, both P < 0.01), the activity of ATPase in hepatocellular mitochondrial membrane were significantly increased [Na+-K+-ATPase (U/mg):3.91±0.30, 3.97±0.35 vs. 2.87±0.82; Mg2+-ATPase (U/mg): 3.75±0.38, 3.88±0.35 vs. 2.64±1.06; Ca2+-ATPase (U/mg): 3.15±0.58, 2.98±0.31 vs. 1.75±1.25; Ca2+-Mg2+-ATPase (U/mg): 3.82±0.31, 3.91±0.42 vs. 2.57±1.01, all P < 0.01], the expressions of AQP8 and CPT-1A were significantly increased [percentage increase from sham operation group (100%), AQP8/COX-Ⅳ: (79.12±7.79)%, (88.40±9.22)% vs. (62.08±11.91)%; CPT-1A/COX-Ⅳ:(87.92±10.06)%, (84.91±17.48)% vs. (72.11±7.82)%, all P < 0.01]. The levels of serum AST and m-AST in ligustrazine preventive group were significant lower than those in ligustrazine treatment group [AST (U/L): 303.9± 110.3 vs. 427.0±117.9; m-AST (U/L): 168.2±60.0 vs. 239.6±64.9, both P < 0.05]. There was no significant difference in the expression of CPT-2 in mitochondrial membrane between the four groups. Conclusions Ligustrazine could play a protective role on the mitochondrial membrane function of transporting water, ion and fat in the rats with SALI. The preventive function of ligustrazine is better than the treatment effect of the rats with sepsis.

Objective To investigate expression characteristics in regenerating hair follicles induced by Wnt10b, and to explore mechanisms underlying Wnt10b-induced regeneration of hair follicles. Methods Both adenovirus containing the Wnt10b gene(AdWnt10b)and that containing the green fluorescent protein-encoding gene(AdGFP)were amplified in HEK-293 cells and purified by caesium chloride density gradient centrifugation. A total of 36 C57BL/6J mice were randomly and equally divided into the AdWnt10b group and AdGFP group to be intracutaneously injected with AdWnt10b and AdGFP on the back respectively. Three mice were sacrificed on day 2.5, 5, 7, 9, 14 and 28 after the injection separately, and skin samples were resected from the injected sites subsequently. Hematoxylin and eosin(HE) staining and immunohistochemical staining were performed to observe hair follicle structure, analyze expression characteristics of the Wnt signaling pathway, and to estimate proliferative activity of regenerating hair follicles induced by Wnt10b. Results As HE staining showed, new hair follicles appeared as early as day 5 after the injection, then grew normally, and entered into catagen phase on day 28 in the AdWnt10b group. Immunohistochemical staining showed that AE15 expression was observed in new hair follicles as early as day 5 after the injection in the AdWnt10b group, then increased along with the growth of hair follicles, but decreased on day 28. On day 5 after AdWnt10b injection, both β-catenin and Lef1 expressions were seen in the cell nucleus. Lef1 was expressed specifically in hair germs and hair matrix, and its expression began to decrease on day 28. In addition, Ki67 expression was observed in the epidermis and outer root sheath of hair follicles as early as day 2.5 after the injection, in the bulge region of hair follicles on day 2.5, 7, 9 and 14, and in hair matrix cells as early as day 7. Conclusion Wnt10b could induce regeneration of hair follicles with normal structure, likely by activating the canonical Wnt signaling pathway in hair follicle stem cells and their daughter cells.

Objective To correct the nasal deformities of cleft lip by expanded-polytetrafluoroe thylene (e-PTFE) combined with autologous nasal septal cartilage.Methods e-PTFE was placed nearby verge of anterior nasal aperture to raise the fundament of nose.Autologous nasal septal cartilage was harvested and combined with e-PTFE to form a sandwich structure.Nasal tip and collapsed nasaI alar were repaired by this method.Results Fifty cases were treated by this method and 42 cases were followed up for about one year.The results were satisfying.The contour of the nose was similar to normal.Only 3 cases were relapsed after one year.Conclusions e-PTFE combined with autologous nasal septal cartilage is an ideal method to correct nasal deformities of cleft lip.

The paper has established an assessment system and a quantitative calculation method of the "implicit" environmental impact including environmental impact indicator, resources consumption indicator and energy consumption indicator. The quantitative calculation of the environmental impact indicator is based on the life cycle assessment system and the evaluation software BEES. The paper identifies normalization reference values and weights for 12 categories of the environmental impact. It also analyzes the environmental impact indicator in life cycle stages, raw materials, transportation, manufacturing, utilization, and end of life. A university refectory project is studied. The result has shown that human health, global warming and acidification are the first three environmental impacts in 12 categories. The environmental impact indicator per m2 of this project is 18.448×10-2 standard human equivalent weight. Moreover, 97.3 % of the total environmental impact occurs at the raw material stage, in which the most severe environmental impact is cancerous health effect; the global warming is the main impact at the transportation and manufacturing stages; the indoor air quality impact is at the usage stage.