OBJECTIVE: To investigate the accuracy of color Doppler ultrasound (CDU) and CT angiography (CTA) in the preoperative evaluation of perforator vessels in free posterior interosseous artery perforator (PIAP) flaps. METHODS: Between January 2020 and December 2023, 19 patients with hand skin and soft tissue defects caused by trauma were admitted. There were 11 males and 8 females, with a median age of 45 years (range, 26-54 years). The interval between injury and admission was 5-11 days (mean, 7.2 days). The skin and soft tissue defects were located on the dorsum of the hand in 8 cases and on the fingers in 11 cases. The size of defect ranged from 4.0 cm×2.5 cm to 7.5 cm×3.5 cm. After locating the perforator vessels through CDU and CTA before operation, the free PIAP flaps were designed to repair hand defects, with the size of 4.5 cm×3.0 cm-7.5 cm×4.0 cm. The defects of donor sites were directly sutured. The number and diameter of perforator vessels in the posterior interosseous artery detected by CDU and CTA were compared. The differences in localization of perforator vessels using CDU and CTA and their clinical effects were also compared to calculate the accuracy and recognition rate. During follow-up, the survival of the skin flap was observed, and the Vancouver scar scale (VSS) score was used to evaluate the healing of the donor site, while the visual analogue scale (VAS) score was used to evaluate the patient's satisfaction with the appearance of the skin flap. RESULTS: The number and the diameter of PIAP vessels was 5.8±1.2 and (0.62±0.08) mm assessed by CDU and 5.2±1.0 and (0.60±0.07) mm by CTA, showing no significant difference between the two methods ( P>0.05). The number, course, and distribution of perforator vessels of the PIAP vessels observed during operation were basically consistent with those detected by preoperative CDU and CTA. Compared with intraoperative observation results, the recognition rates of dominant perforating vessels by CDU and CTA were 95.0% (18/19) and 89.5% (17/19), respectively, and the accuracy rates were 100% (19/19) and 84.2% (16/19), with no significant difference between the two methods ( P>0.05). All flaps survived after operation, and all wounds and incisions at donor sites healed by first intention. All patients were followed up 6-13 months (mean, 8.2 months). At last follow-up, the skin flaps had elasticity and soft texture，with the patient satisfaction VAS score of 9.2±0.8. The donor sites had no obvious scar hyperplasia with the VSS score of 11.7±0.9. CONCLUSION CDU and CTA accurately identify the dominant perforator vessels and provide reliable information for vessel localization, facilitating precise flap harvesting and minimizing donor site injury. However, CDU offers superior visualization of distal end of perforator vessels in the forearm compared to CTA.
Humans ; Female ; Male ; Adult ; Perforator Flap/blood supply* ; Middle Aged ; Ultrasonography, Doppler, Color/methods* ; Computed Tomography Angiography/methods* ; Soft Tissue Injuries/diagnostic imaging* ; Hand Injuries/diagnostic imaging* ; Plastic Surgery Procedures/methods* ; Hand/surgery* ; Preoperative Care ; Arteries/diagnostic imaging*

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Abstract Prenatal stress is a common, systemic, nonspecific stress response that occurs during pregnancy. The gut microbiota, which is known as the “second genome” of the human body, interacts with all major systems of the body. Changes in the gut microbiota can impact the development and health of infants and young children. Advances in research technology have allowed us to uncover the relationship between prenatal stress and imbalances in offspring intestinal microbiota, as well as the development of multiple systemic diseases. However, the exact mechanisms through which prenatal stress disrupts the gut microbiota of offspring remain incompletely understood. This review summarizes the existing research on diseases caused by prenatal stress disrupting the offspring intestinal flora, and seeks future research directions to expand the understanding of the pathogenesis of infant diseases.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

【Objective】 To explore the effect of autologous platelet-rich plasma(PRP) in the treatment of dry eye syndrome. 【Methods】 A total of 64 patients with dry eye treated in the Ophthalmology Department of Jingdong Sino-American Hospital of Hebei Province from March to November 2023 were randomly selected for the study. The patients were divided into observation group and control group according to the random number table method, with 32 cases and 64 eyes in each group. The control group was treated with artificial tears of polyvinyl alcohol without preservatives, and the observation group was treated with PRP eye drops. The clinical efficacy and adverse reactions of the two groups were compared. Overall efficacy, duration of symptom resolution, ocular surface disease index (OSDI), tear film break up time (TBUT), schirmer's test(St) and corneal fluorescein staining (CFS) results of the two groups were observed and compared in 4 weeks. 【Results】 After 4 weeks of treatment, the total effective rate of observation group was 96.88%(31/32), which was significantly higher than that of control group 84.38%(27/32), with statistical significance (P<0.05). After treatment, the St, TBUT, CFS, OSDI and lacrimal river height in observation group were significantly superior to control group, with statistical significance (P<0.05). The disappearance time of dryness, visual fatigue and foreign body sensation in the observation group was shorter than that in the control group, and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was 46.875%(15/32), and there was no significant difference between the observation group and the control group. 【Conclusion】 Autologous PRP is an effective and safe choice for the treatment of dry eye syndrome, which is worthy of further study and confirmation.

Objective To investigate the safety and efficacy of domestic Kangduo endoscopic robotic surgical system(SR1500)in laparoscopic partial nephrectomy via abdominal approach.Methods Perioperative data of 5 patients with renal tumors undergoing transabdominal partial nephrectomy with SR1500 at Miyun Hospital during Jul.and Aug.2023 were prospectively collected.The surgical procedure,operation time,pathological margins,intraoperative bleeding,hospital stay,and catheter removal time were recorded.Results The average tumor diameter was 1.92 cm,staged as T1a in TNM classification,with an average R.E.N.A.L score of 5.80.The mean docking time of equipment was 3.00 min,robotic arm operating time 97.20 min,and renal warm ischemia time 19.80 min.Postoperative pathology revealed negative surgical margins in all patients.No high-grade perioperative complications or device-related adverse events occurred.Conclusion Laparoscopic partial nephrectomy using the Kangduo endoscopic robotic surgical system(SR1500)via abdominal approach is safe and effective in the treatment of T1a renal tumors.

Objective To investigate the correlation between the level of oxidative stress indicators in placental tissues and placental perfusion level in twin-to-twin transfusion syndrome (TTTS). Methods A total of 105 cases of dichorionic monoamniotic monozygotic twin pregnant women were included in the study. They were divided into control group of 90 cases and observation group of 15 cases based on whether TTTS occurred during pregnancy. The levels of oxidative stress indicators[malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX)]in placental tissues below the attachment points of the two umbilical cords in the two groups were detected. The maximum diameters of arterio-arterial (AA) anastomosis, veno-venous (VV) anastomosis, and arterio-venous (AV) anastomosis, as well as the difference ratio of placental tissue areas (PTD), were compared between the two groups. The correlation between the levels of oxidative stress indicators in placental tissues and placental perfusion level was analyzed. Results Compared with placental A and placental B in the control group, the MDA level in the placental tissues of the blood supply end and the blood recipient end in the observation group was increased, while the SOD and GSH-PX levels were decreased, and the maximum diameter of AA anastomosis was reduced, there were statistically significant differences (P < 0.05). In the observation group, the MDA level in the placental tissues of the blood supply end was higher than that of the blood recipient end, the SOD and GSH-PX levels were lower than those of the blood recipient end, and the maximum diameter of AA anastomosis was smaller than that of the blood recipient end, with statistically significant differences (P < 0.05). The maximum diameters of AV anastomosis and PTD in the observation group were larger than those in the control group (P < 0.05). There was no significant difference in the maximum diameter of VV anastomosis between the two groups (P>0.05). Pearson correlation analysis showed that there were no significant correlations of MDA, SOD and GSH-PX levels with the maximum diameter of AA anastomosis and PTD in the placental tissues of the control group (P>0.05).In the placental tissues of the blood supply end and the blood recipient end in the observation group, MDA levels showed a strong negative correlation with the maximum diameter of AA anastomosis and a strong positive correlation with the maximum diameter of AV anastomosis and PTD (P < 0.05). SOD and GSH-PX levels showed strong positive correlations with the maximum diameter of AA anastomosis and strong negative correlations with the maximum diamete of AV anastomosis and PTD (P < 0.05). Conclusion There is a significant imbalance of oxidative stress in placental tissues of TTTS pregnant women, and the decrease in antioxidant activity of placental tissues may be an important cause of placental perfusion injury.

Robotics ; Robotic Surgical Procedures ; Kidney Transplantation

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.

Objective: To investigate the antimicrobial resistance in and multilocus sequence typing (MLST) of Campylobacter jejuni in meat and meat products in Liaoning Province, so as to provide insights into the management of C. jejuni infection. Methods: Nine C. jejuni isolates from meat and meat products in 2020 were subjected to whole genome sequencing, and the minimum inhibitory concentration was measured with the agar dilution method. MLST of C. jejuni isolates was performed with the microbial resistance mechanism traceability reference database and analysis system. Results: Six drug-resistant C. jejuni isolates were detected, and there were four multidrug-resistant isolates. There were six C. jejuni isolates resistant to tetracycline, five isolates resistant to nalidixic acid, four isolates resistant to ciprofloxacin, two isolates resistant to florfenicol, one isolate resistant to gentamicin and one isolate resistant to streptomycin. Nine C. jejuni isolates showed sensitive to azithromycin, chloramphenicol and clindamycin. MLST identified six ST types in nine C. jejuni isolates, with ST45 and ST2274 as the predominant type, and detected one isolate with unclassified ST type. Phylogenetic analysis showed that KW028 and KW029 of ST45 type were closely related and had high homology, and KW040 and KW042 of ST2274 type were closely related with high homology, while KW007 of ST6701 type was closely related to KW040 and KW042 of ST2274 type, with only one pgm housekeeper gene in difference. Conclusions High resistance to tetracycline, nalidixic acid and ciprofloxacin was detected in nine C. jejuni isolates from meat and meat products, and ST45 and ST2274 were predominant ST types of C. jejuni.