Objective:To investigate a surgical method and clinical outcomes of a fascia pedicled island flap with dorsal branch of proper palmar digital nerve in reconstruction of defects of digital pulp.Methods:Seventy-five patients who had digital pulp defects and treated at Department of Orthopaedics, Xinjiang Production and Construction Corps Alar Hospital, Shaw Hospital Affiliated Zhejiang University School of Medicine, from December 2019 to December 2022, were retrospectively analysed. The patients were 40 males and 35 females aged 25-61 years with an average age of 42 years. The defects of digital pulp involved in 23 thumbs, 15 per group of index fingers, middle fingers and ring fingers, and 7 little fingers. The digital pulp defects were 0.8 cm×0.9 cm to 1.5 cm×2.1 cm in size, and the sizes of flap were 1.0 cm×1.2 cm to 1.8 cm×2.4 cm. Donor sites were covered by medium-thickness skin grafts and pressurised bandage was applied. Clinical outcomes of the surgery were monitored through the postoperative follow-ups at outpatient clinic, WeChat and telephone reviews.Results:Postoperative follow-up ranged 9 to 15 months, with an average of 12 months. The donor sites and skin grafts all achieved stage-I healing. Seventy-three flaps completely survived after surgery. However, 2 flaps had partial necrosis, which healed after dressing changes, 4 flaps encountered flap bruising and swelling, which were rectified by removal of high-tension sutures, and 7 flaps had tension blisters, which had disappeared in 2 weeks. At the final follow-up, the appearance and texture of the flaps were graded as excellent for 54 flaps and good for 21 flaps, all without pale, cyanotic or dark in colour. Forty-nine flaps showed normal elasticity or with slight atrophy, 24 with mild atrophy, 2 with moderate atrophy and none with obvious or severe atrophy. Mobility of the affected digits was rated as excellent for 57 digits (average 42.3°), good for 12 (average 26.7°) and fair in 6 digits (average 16.3°). TPD of flap surfaces ranged 6 to 11 mm, with an average of 8.1 mm. Digital function were evaluated according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, with 48 digits in excellent (average 11.2 points), 22 in good (average 8.1 points) and 5 in fair (average 5.4 points) and with a combined excellence and good rates of 93.33%. All flap donor sites were in normal function. For patient satisfaction: 53 patients were well satisfied, 21 were fairly satisfied and 1 was dissatisfied.Conclusion:Application of the island flap with dorsal branch of proper palmar digital nerve with fascio-pedicled in reconstruction of the defect of digital pulp has a high survival rate, simple surgical operation, good satisfactory outcome, with the digital artery being remained intact.

Objective Hypobaric chamber and simulated weightless bed are essential methods for aerospace medical research,and conducting state assessment of volunteers before and after hypobaric chamber and simulated weightless bed tests is an essential guideline for aerospace implementation medicine.To further improve the efficiency of human condition assessment,in addition to the conventional biochemical and physiological indicators,the human oral exhaled gas can be used for condition assessment,and the olfactometry acquisition equipment and analysis software can collect and detect most volatile gases to complete the human oral exhaled gas data acquisition.Conducting comparative analysis of olfactory mapping data from different populations may be a means to assess the status of the body.Methods The olfactometry acquisition equipment was used to collect the oral exhaled breath olfactometry profiles of the general population,hypobaric cabin volunteers,and ambulatory volunteers.The olfactometry analysis software was used to calculate the 12 eigenvalues of the olfactometry profiles and the t-SNE downscaling,and the radar plots were used to analyze the olfactometry profiles of the general population,low-pressure cabin volunteers,and ambulatory volunteers respectively.A comparative analysis of different populations was conducted.Results(1)The t-SNE mapping data of the general population and the ambulatory volunteers were almost indistinguishable;(2)the t-SNE mapping data of the hypobaric cabin volunteers and the general population had a slight overlap,but the distinguishability of the vast majority of the t-SNE mapping data was obvious;(3)the t-SNE mapping data of the hypobaric cabin volunteers and the ambulatory volunteers were distinguishable with no overlap,and the ambulatory t SNE data are highly aggregated,and the distribution of t-SNE data in low-pressure cabin is more discrete;(4)there are 2-3 sensors with large eigenvalues and a large range of variation for both low-pressure cabin volunteers and recumbent volunteers after training activities,and the common sensor with a large range of variation is S6.Conclusion Olfactory diagnostic analysis mapping may be a means to assess the health status of the body and may be useful for spaceflight health status assessment in the future.The analysis and application of flight health state assessment can be a reference in the future.

The elimination of biofilms is a crucial step in controlling hospital-acquired infections.Once biofilms colonize luminal instruments,it is difficult to remove them using traditional disinfection methods.Conventional disinfection approaches now face a series of challenges,including microbial resistance,corrosiveness,cytotoxicity,residual disinfection byproducts,and environmental pollution.Therefore,developing novel disinfection technologies specifically targeting biofilm removal is vitally important.New disinfection technologies,such as slightly acidic electrolyzed water,plasma technology,surface modification techniques,nanomaterial-based disinfection,bacteriophage disinfection,and enzymatic disinfection,are constantly emerging.These technologies exhibit excellent performance against biofilms by leveraging the synergistic effects of multiple mechanisms,including the reactive oxygen species(ROS)burst,photocatalytic oxidation,physical disruption,and biological targeting.This review summarizes the characteristics,underlying mechanisms,and potential application scenarios of these novel disinfection technologies,with a particular focus on their effects against biofilms formed by common pathogenic bacteria on surfaces in hospital settings.It aims to provide a reference basis for the practical application and translation of these disinfection technologies and the development of new disinfection strategies.

Astrocytes and microglia engage in extensive and complex communication and mutual effect, which referrs to microglia-astrocyte crosstalk. Recent studies have highlighted that this crosstalk plays a pivotal role in neurodegenerative diseases, exerting either protective or detrimental effects. This review briefly introduces the molecular mechanism of microglia-astrocyte crosstalk and its research progress in Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis, and Parkinson's disease, aiming to provide new research directions and therapeutic targets for clinical improvement of neurodegenerative diseases from perspective of microglia-astrocyte crosstalk.

Objective:To compare the efficacy of arthroscopic figure-of-eight transtibial tension-reducing technique combined with interference screw fixation versus interface screw fixation alone in the treatment of anterior cruciate ligament (ACL) rupture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 43 patients with ACL rupture admitted to Taihe Hospital between January 2022 and October 2023, including 24 males and 19 females, aged 17-61 years [(38.0±12.6)years]. Based on the tibial fixation method, 20 patients were treated with interference screw fixation alone (interference screw group) and 23 patients with figure-of-eight transtibial tension-reduction technique combined with interference screw fixation (figure-of-eight tension-reduction combined with interference screw group). An Endobutton suspension plate was used in femoral fixation in both groups. The following parameters were compared between the two groups: operative duration and graft diameter; coronal and sagittal tibial tunnel measurements by MRI within 72 hours postoperatively and at the last follow-up; knee range of motion, visual analogue scale (VAS) scores, International Knee Documentation Committee (IKDC) scores, and Lysholm scores preoperatively, at 1 month postoperatively, and at the last follow-up; perioperative complication rates.Results:All the patients were followed up for 11-28 months [(14.1±3.4)months]. There were no significant differences in operative duration or graft diameter between the two groups ( P>0.05). No significant differences were observed in coronal or sagittal tibial tunnel measurements between the two groups within 72 hours postoperatively ( P>0.05). Whereas at the last follow-up, the coronal and sagittal tibial tunnel measurements in the figure-of-eight tension-reduction combined with interference screw group were (11.6±0.7)mm and (11.7±1.1)mm, significantly lower than (13.5±0.6)mm and (13.4±1.9)mm in the interference screw group ( P<0.01). Preoperative knee range of motion, IKDC scores, Lysholm scores, and VAS scores showed no significant differences between the two groups ( P>0.05). At 1 month postoperatively and at the last follow-up, the figure-of-eight tension-reduction combined with interference screw group demonstrated significantly greater knee range of motion [100.0(95.0, 100.0)° and 130.0(120.0, 135.0)°], compared with 72.5(60.0, 95.0)° and 120.0(105.0, 133.3)° in the interference screw group ( P<0.05). VAS scores at 1 month postoperatively and at the last follow-up were 2.0(2.0, 2.0)]points and 1.0(1.0, 1.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly lower than 3.0(2.3, 4.0)points and 2.0(1.0, 2.0)points in the interference screw group ( P<0.05). IKDC scores at 1 month postoperatively and at the last follow-up were (58.8±5.7)points and (72.4±6.7)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (51.1±5.2)points and (67.4±7.9)points in the interference screw group ( P<0.05). Lysholm scores at 1 month postoperatively and at the last follow-up were (58.9±12.7)points and (89.1±6.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (41.2±15.0)points and (78.3±12.3)points in the interference screw group ( P<0.05). No perioperative complications were observed in either group. Conclusion:Compared with interface screw fixation alone, arthroscopic figure-of-eight transtibial tension-reduction technique combined with interference screw fixation for ACL rupture can enhance graft stability, restore knee joint range of motion, alleviate pain, and improve knee function recovery.

Objective:To compare the efficacy of arthroscopic figure-of-eight transtibial tension-reducing technique combined with interference screw fixation versus interface screw fixation alone in the treatment of anterior cruciate ligament (ACL) rupture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 43 patients with ACL rupture admitted to Taihe Hospital between January 2022 and October 2023, including 24 males and 19 females, aged 17-61 years [(38.0±12.6)years]. Based on the tibial fixation method, 20 patients were treated with interference screw fixation alone (interference screw group) and 23 patients with figure-of-eight transtibial tension-reduction technique combined with interference screw fixation (figure-of-eight tension-reduction combined with interference screw group). An Endobutton suspension plate was used in femoral fixation in both groups. The following parameters were compared between the two groups: operative duration and graft diameter; coronal and sagittal tibial tunnel measurements by MRI within 72 hours postoperatively and at the last follow-up; knee range of motion, visual analogue scale (VAS) scores, International Knee Documentation Committee (IKDC) scores, and Lysholm scores preoperatively, at 1 month postoperatively, and at the last follow-up; perioperative complication rates.Results:All the patients were followed up for 11-28 months [(14.1±3.4)months]. There were no significant differences in operative duration or graft diameter between the two groups ( P>0.05). No significant differences were observed in coronal or sagittal tibial tunnel measurements between the two groups within 72 hours postoperatively ( P>0.05). Whereas at the last follow-up, the coronal and sagittal tibial tunnel measurements in the figure-of-eight tension-reduction combined with interference screw group were (11.6±0.7)mm and (11.7±1.1)mm, significantly lower than (13.5±0.6)mm and (13.4±1.9)mm in the interference screw group ( P<0.01). Preoperative knee range of motion, IKDC scores, Lysholm scores, and VAS scores showed no significant differences between the two groups ( P>0.05). At 1 month postoperatively and at the last follow-up, the figure-of-eight tension-reduction combined with interference screw group demonstrated significantly greater knee range of motion [100.0(95.0, 100.0)° and 130.0(120.0, 135.0)°], compared with 72.5(60.0, 95.0)° and 120.0(105.0, 133.3)° in the interference screw group ( P<0.05). VAS scores at 1 month postoperatively and at the last follow-up were 2.0(2.0, 2.0)]points and 1.0(1.0, 1.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly lower than 3.0(2.3, 4.0)points and 2.0(1.0, 2.0)points in the interference screw group ( P<0.05). IKDC scores at 1 month postoperatively and at the last follow-up were (58.8±5.7)points and (72.4±6.7)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (51.1±5.2)points and (67.4±7.9)points in the interference screw group ( P<0.05). Lysholm scores at 1 month postoperatively and at the last follow-up were (58.9±12.7)points and (89.1±6.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (41.2±15.0)points and (78.3±12.3)points in the interference screw group ( P<0.05). No perioperative complications were observed in either group. Conclusion:Compared with interface screw fixation alone, arthroscopic figure-of-eight transtibial tension-reduction technique combined with interference screw fixation for ACL rupture can enhance graft stability, restore knee joint range of motion, alleviate pain, and improve knee function recovery.

Objective:To investigate a surgical method and clinical outcomes of a fascia pedicled island flap with dorsal branch of proper palmar digital nerve in reconstruction of defects of digital pulp.Methods:Seventy-five patients who had digital pulp defects and treated at Department of Orthopaedics, Xinjiang Production and Construction Corps Alar Hospital, Shaw Hospital Affiliated Zhejiang University School of Medicine, from December 2019 to December 2022, were retrospectively analysed. The patients were 40 males and 35 females aged 25-61 years with an average age of 42 years. The defects of digital pulp involved in 23 thumbs, 15 per group of index fingers, middle fingers and ring fingers, and 7 little fingers. The digital pulp defects were 0.8 cm×0.9 cm to 1.5 cm×2.1 cm in size, and the sizes of flap were 1.0 cm×1.2 cm to 1.8 cm×2.4 cm. Donor sites were covered by medium-thickness skin grafts and pressurised bandage was applied. Clinical outcomes of the surgery were monitored through the postoperative follow-ups at outpatient clinic, WeChat and telephone reviews.Results:Postoperative follow-up ranged 9 to 15 months, with an average of 12 months. The donor sites and skin grafts all achieved stage-I healing. Seventy-three flaps completely survived after surgery. However, 2 flaps had partial necrosis, which healed after dressing changes, 4 flaps encountered flap bruising and swelling, which were rectified by removal of high-tension sutures, and 7 flaps had tension blisters, which had disappeared in 2 weeks. At the final follow-up, the appearance and texture of the flaps were graded as excellent for 54 flaps and good for 21 flaps, all without pale, cyanotic or dark in colour. Forty-nine flaps showed normal elasticity or with slight atrophy, 24 with mild atrophy, 2 with moderate atrophy and none with obvious or severe atrophy. Mobility of the affected digits was rated as excellent for 57 digits (average 42.3°), good for 12 (average 26.7°) and fair in 6 digits (average 16.3°). TPD of flap surfaces ranged 6 to 11 mm, with an average of 8.1 mm. Digital function were evaluated according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, with 48 digits in excellent (average 11.2 points), 22 in good (average 8.1 points) and 5 in fair (average 5.4 points) and with a combined excellence and good rates of 93.33%. All flap donor sites were in normal function. For patient satisfaction: 53 patients were well satisfied, 21 were fairly satisfied and 1 was dissatisfied.Conclusion:Application of the island flap with dorsal branch of proper palmar digital nerve with fascio-pedicled in reconstruction of the defect of digital pulp has a high survival rate, simple surgical operation, good satisfactory outcome, with the digital artery being remained intact.

Astrocytes and microglia engage in extensive and complex communication and mutual effect, which referrs to microglia-astrocyte crosstalk. Recent studies have highlighted that this crosstalk plays a pivotal role in neurodegenerative diseases, exerting either protective or detrimental effects. This review briefly introduces the molecular mechanism of microglia-astrocyte crosstalk and its research progress in Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis, and Parkinson's disease, aiming to provide new research directions and therapeutic targets for clinical improvement of neurodegenerative diseases from perspective of microglia-astrocyte crosstalk.

Background: Insulin resistance (IR) is the key pathological basis of many metabolic disorders. Lack of asialoglycoprotein receptor 1 (ASGR1) decreased the serum lipid levels and reduced the risk of coronary artery disease. However, whether ASGR1 also participates in the regulatory network of insulin sensitivity and glucose metabolism remains unknown. Methods: The constructed ASGR1 knockout mice and ASGR1-/- HepG2 cell lines were used to establish the animal model of metabolic syndrome and the IR cell model by high-fat diet (HFD) or drug induction, respectively. Then we evaluated the glucose metabolism and insulin signaling in vivo and in vitro. Results: ASGR1 deficiency ameliorated systemic IR in mice fed with HFD, evidenced by improved insulin intolerance, serum insulin, and homeostasis model assessment of IR index, mainly contributed from increased insulin signaling in the liver, but not in muscle or adipose tissues. Meanwhile, the insulin signal transduction was significantly enhanced in ASGR1-/- HepG2 cells. By transcriptome analyses and comparison, those differentially expressed genes between ASGR1 null and wild type were enriched in the insulin signal pathway, particularly in phosphoinositide 3-kinase-AKT signaling. Notably, ASGR1 deficiency significantly reduced hepatic gluconeogenesis and glycogenolysis. Conclusion The ASGR1 deficiency was consequentially linked with improved hepatic insulin sensitivity under metabolic stress, hepatic IR was the core factor of systemic IR, and overcoming hepatic IR significantly relieved the systemic IR. It suggests that ASGR1 is a potential intervention target for improving systemic IR in metabolic disorders.

ObjectiveTo investigate the correlation between mild cognitive impairment (MCI) and traditional Chinese medicine (TCM) body constitution types in the elderly, and to provide an evidence for the control of cognitive impairment in the elderly. MethodsThe elderly aged 65 and above who participated in the community physical examinations in a community of Changning District, Shanghai were selected as the research subjects. The cognitive function was assessed by using the Clock Drawing Test combined with the Ascertain Dementia 8-item Questionnaire (AD8), the Montreal Cognitive Assessment (MoCA) and the Mini-mental State Examination (MMSE). The diagnostic criteria for MCI was identified based on the 2018 Chinese Guidelines for the Diagnosis and Treatment of Dementia and Cognitive Disorders, along with the assessment results and clinical history information. The current investigation method was used to collect the basic information and the prevalence of chronic disease of the subjects through questionnaire inquiries. The elderly subjects’ ability to take care of themselves was evaluated based on the Elderly Self⁃Care Ability Evaluation Scale, while the TCM body constitution types were determined based on the Chinese Medicine Health Care Management Service Specification. The association of the detection rate of MCI with gender, education level, history of chronic disease and TCM body constitution types were analyzed lastly. ResultsA total of 2 351 elderly people were investigated, including 1 037 males and 1 314 females, with an average age of (74.11±6.15) years. 174 subjects, accounting for 7.40%, were identified with MCI. The highest detection rate of MCI in the elderly are those with a Qi stagnation constitution (10.8%), followed by those with a dampness-heat constitution (9.1%) and a Qi deficiency constitution (8.4%). Multivariate logistic regression analysis showed that advanced age, lower educational level, a history of tuberculosis, and TCM constitutions such as dampness-heat, Qi stagnation, and Qi deficiency were the potential risk factors for MCI. ConclusionThere is a significant association between TCM constitution types such as dampness-heat, Qi stagnation, and Qi deficiency with MCI. TCM techniques can be integrated into the health management services for the elderly population, and targeted interventions can be provided to those with imbalanced constitution types so as to reduce the risk of MCI.