Objective:To investigate the clinical effect of indocyanine green angiography (ICGA)-assisted design and harvest of expanded flaps for scar reconstruction.Methods:This study was a retrospective observational study. From April 2019 to August 2023, 19 patients with scars (8 males, 11 females; aged 3-38 years) treated at the Plastic Surgery Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences met the inclusion criteria. The scars were distributed on the head, face, trunk, and extremities. In stage Ⅰ surgery, skin soft tissue expanders were implanted in suitable areas around the scars for skin soft tissue expansion. In stage Ⅱ surgery, the scar tissue was excised, resulting in wound areas ranging from 100 to 210 cm 2, and expanded flaps were designed. ICGA was used to identify target perforators and their accompanying veins, and the flap design was adjusted to ensure the inclusion of complete arterial and venous axes. The expanded flap with an area of 120 to 240 cm2 was harvested using unilateral back-cut technique and transferred to the recipient site, and the donor site wound was sutured directly. The durations of the arterial and venous phases of ICGA during flap design were recorded. The length-to-width ratios of the back-cut flaps were calculated for different regions. After stage Ⅱ surgery, the blood perfusion and survival of the flap, the wound healing at the donor site, and the occurrence of complications were observed. During follow-up, the appearance, color, and texture of the patient's flap were observed. Results:The arterial phase of ICGA lasted 10-27 (18±5) s, and the venous phase lasted 78-116 (100±10) s. The length-to-width ratios of the back-cut flaps were 1.22±0.32, 1.63±0.12, and 1.15±0.21 for the head and neck, trunk, and limb regions, respectively. After stage Ⅱ surgery, one patient had a large area of insufficient blood perfusion in the flap. By comparing ICGA images before and after flap transfer, the sutures at the oral commissure were loosened, the blood flow of the flap was restored. The blood perfusion of the flaps in other patients was good. All flaps survived completely, with well-healed donor site wounds and no complications. During 0.5-14.0 months of follow-up, all flaps of patients demonstrated excellent appearance, with color and texture matching the surrounding skin.Conclusions:As a means of superficial blood flow visualization, ICGA can not only clearly show the microvascular distribution of the expanded flap before operation, assist in optimizing the design of the flap, but also evaluate the blood perfusion of the flap after operation, reduce the occurrence of complications, and provide a full-process navigation for the harvesting of expanded flaps, thereby improving the safety of flap transfer for scar reconstruction.

Objective The aim of this study is to detect the expression of purinergic 2X7 receptor(P2X7R)and the NLRP3 inflammasome in benign prostatic hyperplasia(BPH)tissues and to analyze the clinical correlations.Methods Twelve patients undergoing surgery for BPH were enrolled.Based on the presence or absence of inflammatory cell infiltration in HE-stained tissue sections,the patients were divided into inflammation group and non-inflammation group.Preoperative routine ex-aminations excluded surgical contraindications,and International Prostate Symptom Score(IPSS)questionnaires,urinary flow rate measurements,expressed prostatic secretions(EPS)analysis,and prostate-specific antigen(PSA)tests were conducted.Prostate tissues obtained during surgery were subjected to HE staining,immunofluorescence/Western blot to detect the expression of NLRP3,P2X7R,Caspase-1,Cleaved-Caspase-1,IL-1 β,and TNF-α,and immunofluorescence to assess lymphocyte infiltra-tion.SPSS 26.0 software was used to analyze correlations between the expression levels of NLRP3 and P2X7R in prostate tissues and indicators including Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,lymphocyte count,IPSS score,urinary flow rate,EPS,and PSA.Results In BPH tissues,the expression levels of NLRP3 and P2X7R were positively correlated(P＜0.05).The ex-pression levels of NLRP3 and P2X7R were positively correlated with Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,and lym-phocyte count(P＜0.05).NLRP3 and P2X7R expression levels were positively correlated with white blood cell count in EPS,but showed no correlation with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA(P＜0.05).Conclusion P2X7R and NLRP3 in prostate tissues exacerbate local inflammatory responses,which may be an important mecha-nism in BPH development.However,they are not correlated with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA.

Objective The aim of this study is to detect the expression of purinergic 2X7 receptor(P2X7R)and the NLRP3 inflammasome in benign prostatic hyperplasia(BPH)tissues and to analyze the clinical correlations.Methods Twelve patients undergoing surgery for BPH were enrolled.Based on the presence or absence of inflammatory cell infiltration in HE-stained tissue sections,the patients were divided into inflammation group and non-inflammation group.Preoperative routine ex-aminations excluded surgical contraindications,and International Prostate Symptom Score(IPSS)questionnaires,urinary flow rate measurements,expressed prostatic secretions(EPS)analysis,and prostate-specific antigen(PSA)tests were conducted.Prostate tissues obtained during surgery were subjected to HE staining,immunofluorescence/Western blot to detect the expression of NLRP3,P2X7R,Caspase-1,Cleaved-Caspase-1,IL-1 β,and TNF-α,and immunofluorescence to assess lymphocyte infiltra-tion.SPSS 26.0 software was used to analyze correlations between the expression levels of NLRP3 and P2X7R in prostate tissues and indicators including Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,lymphocyte count,IPSS score,urinary flow rate,EPS,and PSA.Results In BPH tissues,the expression levels of NLRP3 and P2X7R were positively correlated(P＜0.05).The ex-pression levels of NLRP3 and P2X7R were positively correlated with Caspase-1,Cleaved-Caspase-1,IL-1 β,TNF-α,and lym-phocyte count(P＜0.05).NLRP3 and P2X7R expression levels were positively correlated with white blood cell count in EPS,but showed no correlation with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA(P＜0.05).Conclusion P2X7R and NLRP3 in prostate tissues exacerbate local inflammatory responses,which may be an important mecha-nism in BPH development.However,they are not correlated with IPSS score,lecithin body count in EPS,maximum urinary flow rate and PSA.

Objective:To investigate the clinical effect of indocyanine green angiography (ICGA)-assisted design and harvest of expanded flaps for scar reconstruction.Methods:This study was a retrospective observational study. From April 2019 to August 2023, 19 patients with scars (8 males, 11 females; aged 3-38 years) treated at the Plastic Surgery Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences met the inclusion criteria. The scars were distributed on the head, face, trunk, and extremities. In stage Ⅰ surgery, skin soft tissue expanders were implanted in suitable areas around the scars for skin soft tissue expansion. In stage Ⅱ surgery, the scar tissue was excised, resulting in wound areas ranging from 100 to 210 cm 2, and expanded flaps were designed. ICGA was used to identify target perforators and their accompanying veins, and the flap design was adjusted to ensure the inclusion of complete arterial and venous axes. The expanded flap with an area of 120 to 240 cm2 was harvested using unilateral back-cut technique and transferred to the recipient site, and the donor site wound was sutured directly. The durations of the arterial and venous phases of ICGA during flap design were recorded. The length-to-width ratios of the back-cut flaps were calculated for different regions. After stage Ⅱ surgery, the blood perfusion and survival of the flap, the wound healing at the donor site, and the occurrence of complications were observed. During follow-up, the appearance, color, and texture of the patient's flap were observed. Results:The arterial phase of ICGA lasted 10-27 (18±5) s, and the venous phase lasted 78-116 (100±10) s. The length-to-width ratios of the back-cut flaps were 1.22±0.32, 1.63±0.12, and 1.15±0.21 for the head and neck, trunk, and limb regions, respectively. After stage Ⅱ surgery, one patient had a large area of insufficient blood perfusion in the flap. By comparing ICGA images before and after flap transfer, the sutures at the oral commissure were loosened, the blood flow of the flap was restored. The blood perfusion of the flaps in other patients was good. All flaps survived completely, with well-healed donor site wounds and no complications. During 0.5-14.0 months of follow-up, all flaps of patients demonstrated excellent appearance, with color and texture matching the surrounding skin.Conclusions:As a means of superficial blood flow visualization, ICGA can not only clearly show the microvascular distribution of the expanded flap before operation, assist in optimizing the design of the flap, but also evaluate the blood perfusion of the flap after operation, reduce the occurrence of complications, and provide a full-process navigation for the harvesting of expanded flaps, thereby improving the safety of flap transfer for scar reconstruction.

Background Geriatric depression is a common psychiatric problem among older adults.Animal-assisted interventions(AAI)can aid in the treatment of psychiatric disorders,but their effectiveness in geriatric depression remains controversial.Objective To provide an overview of the current research on AAI in alleviating geriatric depression,in order to provide references for developing AAI programs for this population.Methods Based on Arksey's scoping review method,a comprehensive literature search was conducted on April 16,2023.The databases searched included China Knowledge Network,VIP,Wanfang Medical Network,China Biomedical Literature Database,Web of Science,PubMed,CINAHL,Cochrane Library and Embase.The search aimed to collect studies related to AAI and geriatric depression from the inception of each database until April 15,2023.Two trained researchers independently screened the literature and extracted data on basic information.Results A total of 13 studies were included in the final review.AAI settings included nursing homes,hospitals,communities,day care centers and residences.Interventions involved touching and naming the animals,verbally interacting with the animals,playing games with the animals,communicating with the therapists and learning to care for the animals.AAI was found to improve social interaction and communication abilities,bring positive emotional experiences and enhance life satisfaction in geriatric depression.However,its effect on cognitive function improvement was inconclusive.Conclusion AAI can potentially alleviate negative mood and depressive symptoms in geriatric depression.

Objective:To systematically evaluate the efficacy and safety of general anesthesia versus conscious sedation in patients with endovascular therapy for acute ischemic stroke.Methods:Databases, including English databases PubMed, Embase and Cochrane, as well as Chinese databases Wan Fang Data and CNKI, were screened for randomized controlled trials (RCT) of general anesthesia versus conscious sedation on the effect of endovascular treatment for acute anterior circulation ischemic stroke. The searching period was from the establishment of databases to July 14, 2022. Two researchers independently screened literatures, extracted data and evaluated the risk of bias. And meta-analysis was performed using RevMan5.3 software.Results:A total of 7 RCTs involving 923 patients were included, with 461 in the general anesthesia group and 462 in the other. As the meta-analysis showing, general anesthesia could significantly improve the good outcomes (modified Rankin Scale score≤2) at 3 months after endovascular treatment in comparison with conscious sedation ( OR=1.34, 95% CI 1.01-1.78, P=0.04), and significantly increased the rate of successful revascularization ( OR=1.87, 95% CI 1.32-2.65, P<0.001). In addition, there were no statistically significant differences between the two groups in mortality ( OR=0.93, 95% CI 0.66-1.29, P=0.65), symptomatic intracranial hemorrhage ( OR=0.88, 95% CI 0.57-1.35, P=0.55) and intervention-related complications ( OR=0.83, 95% CI 0.50-1.36, P=0.46). However, general anesthesia was associated with higher risk for both 20% reduction in mean arterial pressure ( OR=4.76, 95% CI 1.49-15.19, P=0.008) and pneumonia ( OR=2.58, 95% CI 1.51-4.39, P<0.001). Conclusions:Compared with conscious sedation, endovascular treatment under general anesthesia in patients with acute anterior circulation ischemic stroke may contribute to better outcomes and higher successful revascularization. However, this method will lead to the risk of blood pressure variability and the incidence of pneumonia.

ObjectiveTo analyze the management and treatment for patients with severe mental disorders in Chengdu from 2016 to 2020， in order to provide references for the relevant authorities to formulate policies and improving the mental health service system. MethodsData relating to 22 districts （cities） and counties in Chengdu from January 1， 2016 to December 31， 2020 were extracted from the National Information System for Severe Mental Disorders. Indicators such as reported prevalence rate， management rate， standardized management rate， medication rate， regular medication rate and stable condition rate of patients with severe mental disorders were analyzed on a yearly basis. ResultsBy the end of 2020， there were 71 899 registered cases of severe mental disorders in Chengdu， with a reported prevalence rate of 0.34%， a standardized management rate of 95.53%， and a regular medication rate of 72.50%. From 2016 to 2020， except the reported prevalence rate （χ²=269.566， P<0.01）， management rate （χ²=384.030， P<0.01）， standardized management rate （χ²=309.742， P<0.01）， medication rate （χ²=414.252， P<0.01）， regular medication rate （χ²=316.172， P<0.01） and stable condition rate （χ²=288.335， P<0.01） had linear trends of increasing with the annual increase. ConclusionFrom 2016 to 2020， the management rate， treatment rate and regular medication rate of patients with severe mental disorders have been increased year by year in Chengdu. Nevertheless， the increase in reported prevalence rate should be accompanied by strengthened management and follow-up to increase the regular medication rate to maintain the stability of patients' conditions.

Objective:To investigate the epidemiological characteristics and influencing factors of scoliosis among primary and middle school students in Dali Bai autonomous prefecture.Methods:A total of 176,729 students aged 6-18 years from 380 primary and secondary schools in eight counties of Dali Bai Autonomous Prefecture were screened for spinal health by visual method, Adams forward bend test and scoliometer measuring the angle of trunk rotation from September to November 2021. The angle of trunk rotation ≥5° or visual method retest positive was used as a positive standard to confirm suspected scoliosis population. Demographic data of the screening population including name, gender, age and ethnicity were collected. The average altitude of the community or village committee in the screening area was recorded. Binary logistic regression analysis was used to screen the influencing factors of scoliosis.Results:There were 176,729 people planned to complete the screening. A total of 140,026 people were actually completed screening with completion rate 79.23%. A total of 3,190 (2.28%) suspected scoliosis positive people were detected. The detection rate of female was 2.52%, which was higher than that of male 2.03% (χ 2=37.18, P<0.001). The detection rate of 10-18 years old group was 2.90%, which was higher than that of 6-9 years old group 0.70% (χ 2=620.79, P<0.001). There was a significant difference in the detection rate among different age groups from 6 to 18 years old (χ 2=1,451.00, P<0.001). The detection rate of Han population was 2.67%, which was higher than that of non-Han population 2.15% (χ 2=31.06, P<0.001). In non-Han population, the detection rate of Bai population was 2.07%, which was lower than that of non-Bai population 2.26% (χ 2=4.02, P=0.045). Trend chi-square test showed significant difference in the detection rate of scoliosis among the general population, 10-18 years old population and 6-9 years old population in the altitude <1,500 m, 1,500-1,599 m, 1,600-1,699 m, 1,700-1,799 m, 1,800-1,899 m, 1,900-1,999 m, 2,000-2,099 m, 2,100-2,199 m, 2,200-2,299 m and ≥2,300 m groups (χ 2=249.02, 195.64, 24.46, P<0.05). Binary logistic regression analysis showed that the risk of scoliosis was lower in males than that in females ( OR=0.82, P<0.001). The risk of scoliosis was increased in 10-18 years old compared with that in 6-9 years old ( OR=0.12, P<0.001). The risk of scoliosis was low in Bai population compared with that in Han populations ( OR=0.75, P<0.001). The altitude ≥2,000 m was a risk factor ( OR=1.52, P<0.001). Conclusion:The detection rate of suspected scoliosis in primary and middle school students in Dali Bai Autonomous Prefecture was 2.28%. Female, aged 10-18 years, Han populations, and residence in altitude ≥2,000 m might be the risk factors for scoliosis.

In the nucleus, chromatin is folded into hierarchical architecture that is tightly linked to various nuclear functions. However, the underlying molecular mechanisms that confer these archi-tectures remain incompletely understood. Here, we investigated the functional roles of H3 lysine 9 dimethylation (H3K9me2), one of the abundant histone modifications, in three-dimensional (3D) genome organization. Unlike in mouse embryonic stem cells, inhibition of methyltransferases G9a and GLP in differentiated cells eliminated H3K9me2 predominantly at A-type (active) genomic compartments, and the level of residual H3K9me2 modifications was strongly associated with B-type (inactive) genomic compartments. Furthermore, chemical inhibition of G9a/GLP in mouse hepatocytes led to decreased chromatin-nuclear lamina interactions mainly at G9a/GLP-sensitive regions, increased degree of genomic compartmentalization, and up-regulation of hundreds of genes that were associated with alterations of the 3D chromatin. Collectively, our data demonstrated essential roles of H3K9me2 in 3D genome organization.