1.The relationship between serum lncRNA NEAT1,miR-106 a-5p expression and the severity and prognosis of sepsis patients
Chunli ZHANG ; Manlin XU ; Yaping CUI ; Zhiying DING ; Yi ZHOU
International Journal of Laboratory Medicine 2025;46(13):1647-1652
Objective To investigate the relationship between the expression of serum long non coding RNA nuclear-enriched abundant transcript 1(lncRNA NEAT1)and microRNA-106a-5p(miR-106a-5p)and the severity and prognosis of sepsis patients.Methods A total of 185 patients with sepsis who were diagnosed and treated in this hospital from August 2021 to July 2024 were selected as the study group,and another 215 healthy volunteers who underwent physical examinations in this hospital during the same period were selected as the control group.The research group was divided into the mild group(n=92),the severe group(n=58)and the shock group(n=35)according to the severity of the disease.The research group was divided into the good prognosis group(n=121)and the poor prognosis group(n=64)according to the prognosis.The expres-sions of lncRNA NEAT1 and miR-106a-5p were detected by real-time fluorescence quantitative polymerase chain reaction,and the correlation of the expressions of lncRNA NEAT1 and miR-106a-5p in the study group was analyzed by Pearson correlation analysis.The binding sites of lncRNA NEAT1 and miR-106a-5p were an-alyzed by StarBase,and the influencing factors of poor prognosis in patients were analyzed by multivariate Lo-gistic regression.The receiver operating characteristic curve was used to analyze the diagnostic value of the combination of lncRNA NEAT1 and miR-106a-5p for poor prognosis in patients.Results The expression of lncRNA NEAT1 in the study group was higher than that in the control group,and the expression of miR-106a-5p was lower than that in the control group,the difference was statistically significant(P<0.05).The expressions of lncRNA NEAT1 and miR-106a-5p in the study group were negatively correlated(r=-0.413,P<0.001),and there were binding sites between the two.With the increase of the severity of sepsis,the ex-pression of lncRNA NEAT1 increased and the expression of miR-106a-5p decreased,and the difference was statistically significant(P<0.05).The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,tumor necrosis factor-α,C-reactive protein,and ln-cRNA NEAT1 in the poor prognosis group were higher than those in the good prognosis group,while the ex-pression of miR-106a-5p was lower than that in the good prognosis group,the difference was statistically sig-nificant(P<0.05).Elevated APACHE Ⅱ score,SOFA score and lncRNA NEAT1 were independent risk fac-tors for poor prognosis in patients,and miR-106a-5p was an independent protective factor(P<0.05).The ar-ea under the curve of the combined diagnosis of the two was 0.918(95%CI:0.868-0.953),which was supe-rior to the separate diagnosis of each(Zcombined with lncRNA NEAT1=4.112,Zcombined with miR-106a-5p=4.023,P<0.05).Con-clusion With the increase of disease severity in patients with sepsis,the expression of lncRNA NEAT1 in-creases and the expression of miR-106a-5p decreases.The combined diagnosis of the two for poor prognosis in patients has a high clinical value.
2.Expert consensus on the diagnosis and treatment of cemental tear.
Ye LIANG ; Hongrui LIU ; Chengjia XIE ; Yang YU ; Jinlong SHAO ; Chunxu LV ; Wenyan KANG ; Fuhua YAN ; Yaping PAN ; Faming CHEN ; Yan XU ; Zuomin WANG ; Yao SUN ; Ang LI ; Lili CHEN ; Qingxian LUAN ; Chuanjiang ZHAO ; Zhengguo CAO ; Yi LIU ; Jiang SUN ; Zhongchen SONG ; Lei ZHAO ; Li LIN ; Peihui DING ; Weilian SUN ; Jun WANG ; Jiang LIN ; Guangxun ZHU ; Qi ZHANG ; Lijun LUO ; Jiayin DENG ; Yihuai PAN ; Jin ZHAO ; Aimei SONG ; Hongmei GUO ; Jin ZHANG ; Pingping CUI ; Song GE ; Rui ZHANG ; Xiuyun REN ; Shengbin HUANG ; Xi WEI ; Lihong QIU ; Jing DENG ; Keqing PAN ; Dandan MA ; Hongyu ZHAO ; Dong CHEN ; Liangjun ZHONG ; Gang DING ; Wu CHEN ; Quanchen XU ; Xiaoyu SUN ; Lingqian DU ; Ling LI ; Yijia WANG ; Xiaoyuan LI ; Qiang CHEN ; Hui WANG ; Zheng ZHANG ; Mengmeng LIU ; Chengfei ZHANG ; Xuedong ZHOU ; Shaohua GE
International Journal of Oral Science 2025;17(1):61-61
Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans
;
Dental Cementum/injuries*
;
Consensus
;
Diagnosis, Differential
;
Cone-Beam Computed Tomography
;
Tooth Fractures/therapy*
3.Current status and influencing factors of alexithymia in patients with kinesiophobia after total knee arthroplasty
Hongxiu LIU ; Libai CAI ; Miaoran CUI ; Yaping LIU
Chinese Journal of Modern Nursing 2025;31(29):3968-3975
Objective:To explore the alexithymia of patients with kinesiophobia after total knee arthroplasty (TKA) and analyze its influencing factors.Methods:Convenience sampling was used to select 221 patients with kinesiophobia after TKA admitted to the First Affiliated Hospital of Zhengzhou University in Henan Province between June and October 2024. A survey was conducted using the self-designed General Information Questionnaire, Tampa Scale of Kinesiophobia-11, Chinese version of Toronto Alexithymia Scale-20 (TAS-20), Social Support Rating Scale, and General Self-efficacy Scale. Multiple linear regression was used to analyze the factors influencing patients' alexithymia.Results:A total of 221 questionnaires were distributed, and 210 questionnaires were effectively collected, with an effective response rate of 95.02%. Chinese version of TAS-20 score of 210 patients with kinesiophobia after TKA were (60.70±8.16), and the incidence of alexithymia was 52.86% (111/210), mainly manifested as describing emotional feeling disorders and externally oriented thinking disorders. Multiple linear regression analysis showed that educational level, per capita monthly household income, personality types, score of kinesiophobia, self-efficacy, and social support were statistically significant factors influencing the alexithymia of patients with kinesiophobia after TKA ( P<0.05), explaining 83.50% of the total variance. Conclusions:Patients with kinesiophobia after TKA have a high level of alexithymia. Patients with low educational level, low per capita monthly household income, introverted personalities, high levels of kinesiophobia, low self-efficacy, and low levels of social support are prone to developing alexithymia. Healthcare professionals should pay attention to the alexithymia of patients with kinesiophobia after TKA. Effective measures should be formulated from the aspects of emotional education, disease cognition, social skill training, and social support to reduce the level of alexithymia in patients with kinesiophobia.
4.Meta-Synthesis of qualitative researches on women' experiences of emergency cesarean sections
Panpan ZHANG ; Yingying TIAN ; Yaping YUAN ; Jianhai YU ; Haoxin LIU ; Xiaohua CUI
Chinese Journal of Modern Nursing 2025;31(33):4481-4488
Objective:To systematically synthesize the real experiences of women who have undergone emergency cesarean sections, providing evidence-based insights to inform the development of personalized care strategies.Methods:A comprehensive literature search was conducted across PubMed, Web of Science, Embase, CINAHL, Cochrane Library, PsycINFO, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative and mixed-methods studies related to the psychological experiences of women who underwent emergency cesarean sections. The search covered all publications up to January 31, 2025. The methodological quality of included studies was appraised using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were integrated using an aggregative synthesis approach.Results:A total of 16 studies were included, from which 78 findings were extracted and grouped into nine new categories. These were further synthesized into three overarching themes: shift in birth plan and emergence of dynamic emotional responses; desire for diversified external support and encouragement; emotional investment and character growth.Conclusions:Women undergoing emergency cesarean sections commonly experience intense negative emotions. It is essential for healthcare providers and family members to pay close attention to the physical and psychological well-being of postpartum women, offer timely emotional support, and help them recover from psychological trauma, thereby promoting maternal mental and physical health.
5.SRF promotes the progression of lung adenocarcinoma by regulating lncRNA FGD5-AS1
Yishuang CUI ; Yue ZHAO ; Yaping TIAN ; Xuan ZHENG ; Hongjiao WU ; Xuemei ZHANG ; Guogui SUN
Chinese Journal of Oncology 2025;47(9):872-884
Objective:To explore the role and mechanism of serum response factor (SRF) and lncRNA FGD5-AS1 in lung adenocarcinoma (LUAD).Methods:The plasma and tissue wax of LUAD patients treated in Tangshan People's Hospital from 2020 to 2022 and the plasma of healthy people were collected. The expression of SRF in LUAD tissues and cells, and the expression of lncRNA FGD5-AS1 in LUAD tissues, plasma and cells were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The expression levels of SRF and lncRNA FGD5-AS1 in LUAD tissue microarray were detected by immunohistochemistry and in situ hybridization. LUAD cells A549, H1299 and H1975 were cultured in vitro and divided into si-NC and si-SRF groups, si-NC and si-lncRNA FGD5-AS1 groups, pcDNA3.1 and lncRNA FGD5-AS1 groups, si-NC+pcDNA3.1/si-SRF+pcDNA3.1/si-SRF+lncRNA FGD5-AS1 groups. The effects of the above groups on the proliferation, invasion and migration of LUAD cells were detected by CCK-8, cloning formation, EdU, Transwell and scratch test. The JASPAR database was used to predict the downstream lncRNA FGD5-AS1 that can be regulated by SRF; double luciferase experiment, chromatin Immunoprecipitation (CHIP) and electrophoretic mobility shift assay (EMSA) experiment were used to verify the regulatory effect between SRF and lncRNA FGD5-AS1, and the subcutaneous tumorigenesis experiment in nude mice was used to detect the effects of cells that stably knock down SRF and stably overexpress lncRNA FGD5-AS1 on the growth of transplanted tumors. Results:The results of immunohistochemistry showed that the mean optical density of SRF in LUAD tissues (1.49±0.33) was higher than that in adjacent tissues (1.00±0.00, P<0.001). The expression level of SRF in paraffin tissues of LUAD patients was higher than that in normal tissues adjacent to cancer ( P=0.037). CCK-8, cloning, scratch and Transwell experiments showed that knockdown SRF could inhibit the proliferation, migration and invasion of A549 and H1299 cells, respectively. [For A549 cells: The clone formation count, migration count, invasion count, and 48-h migration distance ratio were (233.70±18.50), (808.70±6.11), (489.70±53.00), and 1.00±0.03, respectively, in the si-NC group; and (131.30±22.50), (403.00±9.54), (372.70±26.27), and 2.14±0.09, respectively, in the si-SRF group. For H1299 cells: The clone formation count, migration count, invasion count, and 48-h migration distance ratio were (194.30±20.98), (988.70±64.52), (907.70±67.02), and 1.00±0.05, respectively, in the si-NC group; and (137.70±7.77), (665.70±157.10), (565.70±67.01), and 1.52±0.03, respectively, in the si-SRF group. All comparisons showed statistically significant differences ( P<0.05)] JASPAR database prediction shows that SRF and lncRNA FGD5-AS1 have binding site. The double luciferase experiment, CHIP and EMSA experiments showed that SRF could regulate lncRNA FGD5-AS1. In situ hybridization showed that the mean optical density of lncRNA FGD5-AS1 in tissue microarray of LUAD patients (1.28±0.31) was higher than that in adjacent tissues (1.00±0.00, P<0.001). The results of qRT-PCR experiment showed that the expression level of lncRNA FGD5-AS1 in wax tissues of LUAD patients was higher than that in normal tissues adjacent to cancer ( P=0.017). The expression level of lncRNA FGD5-AS1 in plasma of LUAD patients (3.48±2.62) was higher than that of healthy people (1.02±0.03, P<0.001). CCK-8, cloning, EDU, scratch and Transwell experiments showed that overexpression of lncRNA FGD5-AS1 could promote cell proliferation [For A549 cells: The clone formation count, EdU-positive cell count, invasion count, and 48-h migration distance ratio were (22.67±5.86), (1.00±0.09), (135.70±13.20), and 0.35±0.02, respectively, in the pcDNA3.1 group; and (46.33±9.07), (1.65±0.10), (205.00±13.23), and 0.20±0.01, respectively, in the FGD5-AS1-overexpressing group. All comparisons showed statistically significant differences ( P<0.05)], migration and invasion and vice versa [For H1975 cells: The clone formation count, EdU-positive cell count, invasion count, and 48-h migration distance ratio were (75.33±4.16), (1.00±0.02), (258.70±45.79), and 0.18±0.01, respectively, in the NC group; and (37.00±4.00), (0.52±0.07), (130.70±9.07), and 0.53±0.04, respectively, in the lncRNA FGD5-AS1 knockdown group (si-lncRNA FGD5-AS1 group). All comparisons showed statistically significant differences ( P<0.05)]. Overexpression of lncRNA FGD5-AS1 could rescue the effect of knockdown SRF on the proliferation, migration and invasion of A549 and H1299 cells. The results of subcutaneous tumorigenesis experiment in nude mice indicated that the tumorigenicity of LUAD cells stably knockdown SRF was weakened and vice versa. Conclusion:SRF can promote the progress of LUAD by regulating lncRNA FGD5-AS1.
6.Reconstruction of soft tissue defects in lower extremity in elderly patients with free anterolateral thigh perforator flaps: a report of 24 cases
Hua ZHENG ; Linjun TANG ; Lin HE ; Taian CUI ; Xuying ZHAO ; Ye YUAN ; Chen ZHANG ; Yaping LIU
Chinese Journal of Microsurgery 2025;48(4):394-398
Objective:To evaluate the clinical efficacy of free anterolateral thigh perforator flap (ALTPF) for reconstruction of soft tissue defects in lower extremity in elderly patient.Methods:From February 2018 to August 2024, 24 elderly patients (14 males, 10 females. Age range: 70-89 years, mean age: 73.47 years) with soft tissue defects in lower extremity were treated with free ALTPFs in the Department of Hand Microsurgery, Sichuan Modern Hospital. All patients had comorbidities including chronic pulmonary diseases (10 cases), anaemia in various severity (15 cases), atherosclerosis (9 cases), diabetes mellitus (6 cases), hypertension (5 cases) and great saphenous varicose veins (4 cases). Fourteen patients were admitted to hospital though emergency department due to trauma. Of these patients, 2 underwent emergency flap transfer surgery, 12 had temporary wound coverage with negative pressure wound therapy (NPWT) or bone cement, followed by flap surgery at 3-7 days later. Ten patients with chronic wounds were admitted through outpatient clinic and underwent flap surgery at approximately 7 days after multidisciplinary team consultation and completion of preoperative preparation. A total of 15 patients received blood transfusion: 3 before the surgery, 10 in the surgery and 2 after the surgery. Defect locations were: right calf and ankle (6 cases), right foot (5 cases), left calf and ankle (10 cases) and left foot (3 cases). Defect sizes ranged from 5.0 cm×7.0 cm to 9.0 cm×30.0 cm, with exposure of tendon, bone or internal fixation. The size of ALTPFs ranged from 6.0 cm×8.0 cm to 10.0 cm×40.0 cm. All artery of flaps was end-to-end anastomosed with the recipient artery, and the vein of flaps was anastomosed with the accompanying vein by recipient artery. Donor sites were either closed directly or reconstructed with skin grafts. All patients were included in postoperative follow-up via visit of outpatient clinic or WeChat for evaluation of flap and donor sites.Results:All 24 flaps survived. Two cases presented with venous occlusion after surgery and surgical exploration discovered: 1 patient had a long-segment venous thrombosis in the recipient vein and was treated with great saphenous vein transposition for re-anastomosis; the other had a deep haematoma compressing of the flap, which was removed surgically with haemostasis. Follow-up lasted for 3 to 24 months. All donor sites healed well without local tenderness, leaving only linear or skin graft scars. The flap survived well, without infection, ulceration or necrosis. All ankle function was preserved.Conclusion:Transfer of free ALTPF is a valuable technique for treatment of soft tissue defects in lower extremity in elderly patients. Despite higher risks, satisfactory outcome can be achieved with thorough preoperative evaluation and surgical intervention, especially when the condition of a patient is stable, an early ambulation for functional recovery should be started.
7.Key questions of translational research on international standards of acupuncture-moxibustion techniques: an example from the WFAS Technical Benchmark of Acupuncture and Moxibustion: General Rules for Drafting.
Shuo CUI ; Jingjing WANG ; Zhongjie CHEN ; Jin HUO ; Jing HU ; Ziwei SONG ; Yaping LIU ; Wenqian MA ; Qi GAO ; Zhongchao WU
Chinese Acupuncture & Moxibustion 2025;45(8):1159-1165
OBJECTIVE:
To provide the experience and demonstration for the transformation of acupuncture-moxibustion techniques standards from Chinese national standards to international standards.
METHODS:
Questionnaire research, literature research, semi-structured interviews and expert consultation were used.
RESULTS:
The safety of acupuncture-moxibustion techniques was evaluated through literature research, and based on the results of the questionnaire survey, expert interviews, and expert consultation, 11 main bodies and structure of the former Chinese national standard, Technical Benchmark of Acupuncture and Moxibustion: General Rules for Drafting, were adjusted and optimized in accordance with the requirements of international standard (including the language, normative references, purpose, scope, applicable environment, target population, work team, terms and definitions, general principles and basic requirements, structural elements and text structure, and compilation process); and the first international standard, World Federation of Acupuncture-Moxibustion Societis (WFAS) Technical Benchmark of Acupuncture and Moxibustion: General Rules for Drafting was formulated to specify the general rules for drafting.
CONCLUSION
The 3 key questions, "international compatibility", "technical operability" and "safety" should be solved technically on the basis of explicit international requirements. It is the core technical issue during transforming the national standards of technical benchmark of acupuncture and moxibustion into international standards.
Moxibustion/methods*
;
Acupuncture Therapy/methods*
;
Humans
;
Translational Research, Biomedical/standards*
;
Surveys and Questionnaires
;
China
;
Benchmarking/standards*
8.SRF promotes the progression of lung adenocarcinoma by regulating lncRNA FGD5-AS1
Yishuang CUI ; Yue ZHAO ; Yaping TIAN ; Xuan ZHENG ; Hongjiao WU ; Xuemei ZHANG ; Guogui SUN
Chinese Journal of Oncology 2025;47(9):872-884
Objective:To explore the role and mechanism of serum response factor (SRF) and lncRNA FGD5-AS1 in lung adenocarcinoma (LUAD).Methods:The plasma and tissue wax of LUAD patients treated in Tangshan People's Hospital from 2020 to 2022 and the plasma of healthy people were collected. The expression of SRF in LUAD tissues and cells, and the expression of lncRNA FGD5-AS1 in LUAD tissues, plasma and cells were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The expression levels of SRF and lncRNA FGD5-AS1 in LUAD tissue microarray were detected by immunohistochemistry and in situ hybridization. LUAD cells A549, H1299 and H1975 were cultured in vitro and divided into si-NC and si-SRF groups, si-NC and si-lncRNA FGD5-AS1 groups, pcDNA3.1 and lncRNA FGD5-AS1 groups, si-NC+pcDNA3.1/si-SRF+pcDNA3.1/si-SRF+lncRNA FGD5-AS1 groups. The effects of the above groups on the proliferation, invasion and migration of LUAD cells were detected by CCK-8, cloning formation, EdU, Transwell and scratch test. The JASPAR database was used to predict the downstream lncRNA FGD5-AS1 that can be regulated by SRF; double luciferase experiment, chromatin Immunoprecipitation (CHIP) and electrophoretic mobility shift assay (EMSA) experiment were used to verify the regulatory effect between SRF and lncRNA FGD5-AS1, and the subcutaneous tumorigenesis experiment in nude mice was used to detect the effects of cells that stably knock down SRF and stably overexpress lncRNA FGD5-AS1 on the growth of transplanted tumors. Results:The results of immunohistochemistry showed that the mean optical density of SRF in LUAD tissues (1.49±0.33) was higher than that in adjacent tissues (1.00±0.00, P<0.001). The expression level of SRF in paraffin tissues of LUAD patients was higher than that in normal tissues adjacent to cancer ( P=0.037). CCK-8, cloning, scratch and Transwell experiments showed that knockdown SRF could inhibit the proliferation, migration and invasion of A549 and H1299 cells, respectively. [For A549 cells: The clone formation count, migration count, invasion count, and 48-h migration distance ratio were (233.70±18.50), (808.70±6.11), (489.70±53.00), and 1.00±0.03, respectively, in the si-NC group; and (131.30±22.50), (403.00±9.54), (372.70±26.27), and 2.14±0.09, respectively, in the si-SRF group. For H1299 cells: The clone formation count, migration count, invasion count, and 48-h migration distance ratio were (194.30±20.98), (988.70±64.52), (907.70±67.02), and 1.00±0.05, respectively, in the si-NC group; and (137.70±7.77), (665.70±157.10), (565.70±67.01), and 1.52±0.03, respectively, in the si-SRF group. All comparisons showed statistically significant differences ( P<0.05)] JASPAR database prediction shows that SRF and lncRNA FGD5-AS1 have binding site. The double luciferase experiment, CHIP and EMSA experiments showed that SRF could regulate lncRNA FGD5-AS1. In situ hybridization showed that the mean optical density of lncRNA FGD5-AS1 in tissue microarray of LUAD patients (1.28±0.31) was higher than that in adjacent tissues (1.00±0.00, P<0.001). The results of qRT-PCR experiment showed that the expression level of lncRNA FGD5-AS1 in wax tissues of LUAD patients was higher than that in normal tissues adjacent to cancer ( P=0.017). The expression level of lncRNA FGD5-AS1 in plasma of LUAD patients (3.48±2.62) was higher than that of healthy people (1.02±0.03, P<0.001). CCK-8, cloning, EDU, scratch and Transwell experiments showed that overexpression of lncRNA FGD5-AS1 could promote cell proliferation [For A549 cells: The clone formation count, EdU-positive cell count, invasion count, and 48-h migration distance ratio were (22.67±5.86), (1.00±0.09), (135.70±13.20), and 0.35±0.02, respectively, in the pcDNA3.1 group; and (46.33±9.07), (1.65±0.10), (205.00±13.23), and 0.20±0.01, respectively, in the FGD5-AS1-overexpressing group. All comparisons showed statistically significant differences ( P<0.05)], migration and invasion and vice versa [For H1975 cells: The clone formation count, EdU-positive cell count, invasion count, and 48-h migration distance ratio were (75.33±4.16), (1.00±0.02), (258.70±45.79), and 0.18±0.01, respectively, in the NC group; and (37.00±4.00), (0.52±0.07), (130.70±9.07), and 0.53±0.04, respectively, in the lncRNA FGD5-AS1 knockdown group (si-lncRNA FGD5-AS1 group). All comparisons showed statistically significant differences ( P<0.05)]. Overexpression of lncRNA FGD5-AS1 could rescue the effect of knockdown SRF on the proliferation, migration and invasion of A549 and H1299 cells. The results of subcutaneous tumorigenesis experiment in nude mice indicated that the tumorigenicity of LUAD cells stably knockdown SRF was weakened and vice versa. Conclusion:SRF can promote the progress of LUAD by regulating lncRNA FGD5-AS1.
9.Reconstruction of soft tissue defects in lower extremity in elderly patients with free anterolateral thigh perforator flaps: a report of 24 cases
Hua ZHENG ; Linjun TANG ; Lin HE ; Taian CUI ; Xuying ZHAO ; Ye YUAN ; Chen ZHANG ; Yaping LIU
Chinese Journal of Microsurgery 2025;48(4):394-398
Objective:To evaluate the clinical efficacy of free anterolateral thigh perforator flap (ALTPF) for reconstruction of soft tissue defects in lower extremity in elderly patient.Methods:From February 2018 to August 2024, 24 elderly patients (14 males, 10 females. Age range: 70-89 years, mean age: 73.47 years) with soft tissue defects in lower extremity were treated with free ALTPFs in the Department of Hand Microsurgery, Sichuan Modern Hospital. All patients had comorbidities including chronic pulmonary diseases (10 cases), anaemia in various severity (15 cases), atherosclerosis (9 cases), diabetes mellitus (6 cases), hypertension (5 cases) and great saphenous varicose veins (4 cases). Fourteen patients were admitted to hospital though emergency department due to trauma. Of these patients, 2 underwent emergency flap transfer surgery, 12 had temporary wound coverage with negative pressure wound therapy (NPWT) or bone cement, followed by flap surgery at 3-7 days later. Ten patients with chronic wounds were admitted through outpatient clinic and underwent flap surgery at approximately 7 days after multidisciplinary team consultation and completion of preoperative preparation. A total of 15 patients received blood transfusion: 3 before the surgery, 10 in the surgery and 2 after the surgery. Defect locations were: right calf and ankle (6 cases), right foot (5 cases), left calf and ankle (10 cases) and left foot (3 cases). Defect sizes ranged from 5.0 cm×7.0 cm to 9.0 cm×30.0 cm, with exposure of tendon, bone or internal fixation. The size of ALTPFs ranged from 6.0 cm×8.0 cm to 10.0 cm×40.0 cm. All artery of flaps was end-to-end anastomosed with the recipient artery, and the vein of flaps was anastomosed with the accompanying vein by recipient artery. Donor sites were either closed directly or reconstructed with skin grafts. All patients were included in postoperative follow-up via visit of outpatient clinic or WeChat for evaluation of flap and donor sites.Results:All 24 flaps survived. Two cases presented with venous occlusion after surgery and surgical exploration discovered: 1 patient had a long-segment venous thrombosis in the recipient vein and was treated with great saphenous vein transposition for re-anastomosis; the other had a deep haematoma compressing of the flap, which was removed surgically with haemostasis. Follow-up lasted for 3 to 24 months. All donor sites healed well without local tenderness, leaving only linear or skin graft scars. The flap survived well, without infection, ulceration or necrosis. All ankle function was preserved.Conclusion:Transfer of free ALTPF is a valuable technique for treatment of soft tissue defects in lower extremity in elderly patients. Despite higher risks, satisfactory outcome can be achieved with thorough preoperative evaluation and surgical intervention, especially when the condition of a patient is stable, an early ambulation for functional recovery should be started.
10.Current status and influencing factors of alexithymia in patients with kinesiophobia after total knee arthroplasty
Hongxiu LIU ; Libai CAI ; Miaoran CUI ; Yaping LIU
Chinese Journal of Modern Nursing 2025;31(29):3968-3975
Objective:To explore the alexithymia of patients with kinesiophobia after total knee arthroplasty (TKA) and analyze its influencing factors.Methods:Convenience sampling was used to select 221 patients with kinesiophobia after TKA admitted to the First Affiliated Hospital of Zhengzhou University in Henan Province between June and October 2024. A survey was conducted using the self-designed General Information Questionnaire, Tampa Scale of Kinesiophobia-11, Chinese version of Toronto Alexithymia Scale-20 (TAS-20), Social Support Rating Scale, and General Self-efficacy Scale. Multiple linear regression was used to analyze the factors influencing patients' alexithymia.Results:A total of 221 questionnaires were distributed, and 210 questionnaires were effectively collected, with an effective response rate of 95.02%. Chinese version of TAS-20 score of 210 patients with kinesiophobia after TKA were (60.70±8.16), and the incidence of alexithymia was 52.86% (111/210), mainly manifested as describing emotional feeling disorders and externally oriented thinking disorders. Multiple linear regression analysis showed that educational level, per capita monthly household income, personality types, score of kinesiophobia, self-efficacy, and social support were statistically significant factors influencing the alexithymia of patients with kinesiophobia after TKA ( P<0.05), explaining 83.50% of the total variance. Conclusions:Patients with kinesiophobia after TKA have a high level of alexithymia. Patients with low educational level, low per capita monthly household income, introverted personalities, high levels of kinesiophobia, low self-efficacy, and low levels of social support are prone to developing alexithymia. Healthcare professionals should pay attention to the alexithymia of patients with kinesiophobia after TKA. Effective measures should be formulated from the aspects of emotional education, disease cognition, social skill training, and social support to reduce the level of alexithymia in patients with kinesiophobia.

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