OBJECTIVE: To explore the feasibility of reconstruction of phonatory function by using a tubular free flap from upper-lateral upper arm to repair the laryngotracheal circumferential defect after near-total laryngectomy for laryngeal cancer. METHODS: A retrospective study was conducted on 7 patients who underwent near-total laryngectomy between June 2021 and October 2023, aged from 48 to 70 years (median, 59 years), 6 males and 1 female. The disease duration ranged from 1 to 11 months, with a median of 6 months. Pathological diagnosis of preoperative biopsy was squamous cell carcinoma. Tumor classification: glottic type in 5 cases, supraglottic type in 1 case, transglottic type in 1 case; TNM staging: T ₄N ₀M ₀ in 6 cases, T ₄N ₂M ₀ in 1 case; American Joint Committee on Cancer (AJCC) staging in 2017 was stage Ⅳ. Preoperative MRI angiography of upper arm was performed to investigate the blood supply in the upper and lateral regions of the upper arm. After near-total laryngectomy and bilateral neck lymph node dissection, the area of the laryngotracheal defect was measured. A free flap measuring 7.0 cm×5.0 cm to 8.0 cm×7.0 cm was harvested from the upper-lateral upper arm, rolled into a tube shape, and connected between the stump of the cervical trachea in the neck root and that of the epiglottis at the tongue base. Four patients received adjuvant radiochemotherapy, 1 patient received radiochemotherapy and targeted therapy, 2 patients adopted no further adjuvant treatment. RESULTS: All 7 patients were followed-up 1-2 years (mean, 1 year and 3 months). Four patients had primary wound healing, 2 patients had minor pharyngeal fistulas that healed after dressing change, 1 patient experienced pharyngeal fistula because of flap necrosis and the wound still healed without secondary surgery. All patients took food orally within 1 month after operation, and the tracheal cannula was retained. Six patients with survived flap gradually adapted to their new pronunciation mode and obtained satisfactory phonatory function from 15 days to 2 months after operation. Four patients had slight aspiration after operation. Till the end of the follow-up, all patients survived and no local recurrence or distant metastasis had been observed. The motor function of the upper arm was not affected, only partial sensory loss occurred in the area near the incision. The scar of the incision could be covered by the short sleeve so as to obtain a better aesthetic effect. CONCLUSION Using a tubular free flap from upper-lateral upper arm to repair the laryngotracheal circumferential defect after near-total laryngectomy for laryngeal cancer can achieve satisfactory phonatory restoration while preserve the motor function and aesthetics of the donor site.
Humans ; Laryngectomy/methods* ; Male ; Middle Aged ; Female ; Laryngeal Neoplasms/surgery* ; Aged ; Free Tissue Flaps ; Retrospective Studies ; Plastic Surgery Procedures/methods* ; Carcinoma, Squamous Cell/surgery* ; Phonation ; Arm/surgery* ; Neck Dissection

Recent studies have confirmed that the meningeal lymphatic system (MLS), a functional lymphatic network, exists in the dura mater of the central nervous system (CNS). It can connect to the peripheral lymphatic system and remove metabolic wastes from the CNS. MLS discovery has overturned the traditional view that the brain is an "immune-exempt" organ and provides a new perspective for Alzheimer's disease (AD) research. This article reviews the discovery, anatomical structure, and physiological functions of MLS, and deeply explores the mutual regulation mechanism between MLS and immune system and its key role in AD occurrence and development, aiming to provide new ideas for AD treatments targeting MLS.

Pinelliae Rhizoma (PR), known as Banxia in Chinese, Hange in Japanese, and Banha in Korean, is a renowned herbal medicine in East Asia derived from the dry tuber of Pinellia ternata (Thunb.) Breit. (PT). It is extensively utilized in dispensing granules, classical prescriptions, and herbal formulas to treat various conditions, including cough, infection, phlegm, nausea, asthma, and inflammation. Despite numerous studies on PR and its classical prescriptions over recent decades, a comprehensive synthesis of available evidence regarding its multifunctional roles and therapeutic potential is lacking. This review aims to address this gap by examining emerging evidence from metabonomics, preclinical studies, and clinical trials, while exploring potential trends and prospects for future research. A systematic literature search was conducted across six electronic databases, including PubMed, Web of Science, Scopus, ScienceDirect, Wanfang, and China National Knowledge Infrastructure, to identify relevant articles on PR published until March 2023. PR contains 107 compounds with diverse pharmacological activities, including anti-inflammatory, immune regulatory, anti-viral, anti-cancer, anti-asthma, antitussive and expectorant, antioxidant, anti-obesity, anti-atherosclerosis, anti-microbial, emetic and anti-emetic, anti-convulsant and anti-epileptic, sedative and hypnotic, learning and memory enhancement, and anti-depressant effects. Metabonomic studies suggest that raw PR may exhibit cardiotoxicity and pregnancy toxicity while showing no apparent hepatorenal toxicity. However, limited pharmacokinetic investigations on PR constrain its clinical translation. Furthermore, clinical safety data on PR is scarce, with only four clinical trials assessing its positive effects in pediatric epilepsy, nausea and vomiting, soft tissue injury, and chronic sinus tract. This review aims to enhance understanding of PR and provide valuable information and recommendations for further research and development of herbal medicine.
Humans ; Pinellia/chemistry* ; Animals ; Ethnopharmacology ; Drugs, Chinese Herbal/chemistry* ; Phytochemicals/chemistry* ; Rhizome/chemistry*

[This corrects the article DOI: 10.1016/j.jpha.2023.08.006.].

This study constructed a porcine reproductive and respiratory syndrome virus(PRRSV)NADC30-like strain GP3 recombinant adenovirus vector vaccine through in vitro homologous re-combination to explore its immunological efficacy evaluation at the mouse level.Using type 5 ade-novirus as a vector,a recombinant adenovirus expressing PRRSV GP3 protein was prepared and i-dentified in vitro by fluorescence observation,PCR,and Western blot analysis.Immunize mice with recombinant adenovirus and detect humoral and cellular immune responses induced by recombi-nant adenovirus using indirect ELISA and ELISpot methods.The recombinant adenovirus rAdGP3 was identified by enzyme digestion,PCR,fluorescence and Western blot,indicating that the recom-binant adenovirus rAdGP3 was successfully constructed and packaged.After immunizing mice,spe-cific antibodies and neutralizing antibodies were produced,indicating that the recombinant adenovi-rus could elicit strong humoral immunity.ELISpot and lymphocyte proliferation assays showed that the recombinant adenovirus vaccine could stimulate the secretion of IFN-γ-specific T lymphocytes and induce the proliferation of lymphocytes,indicating that the recombinant adenovi-rus could enhance the level of cellular immune response.In this study,rAdGP3 recombinant adeno-virus was successfully constructed and had good immunogenicity at the mouse level,which provid-ed a reference for the development of novel PRRSV vaccines.

This study identified the types and pathogen carrying status of fleas on the surface of sheep in some areas of southern Xinjiang,and analyzed the genetic evolution differences with respect to related pathogens.The aim was to provide a reference for the local prevention and control of fleas and insect borne infectious diseases.A total of 1 586 fleas were collected from agricultural and pas-toral areas of Tumushuke City and Hotan Prefecture.Flea species were identified on the basis of morphology and the Pulex irritans mi-tochondrial COII gene.Flea DNA was extracted,and PCR was conducted to amplify the Bartonella gltA gene;Arsenophonus,Ana-plasma,Ehrlichia,and Wolbachia 16S rRNA genes;RickettsiaOmpA,17kDa,16S rRNA genes,and Yersinia pestis 16S rDNA gene.The amplified products were sequenced,and the homology of the genes of the three detected pathogens(gltA gene of Bartonella,16S rRNA gene of Wolbachia,and Anaplasma phagocytophilum)with respect to known corresponding genes of the same pathogen in Gen-Bank was analyzed.Phylogenetic trees were constructed with the adjacency method in MEGA 11.0.According to morphological and mo-lecular biology identification results,all fleas collected in this study were Pulex irritans.PCR indicated that the target gene fragments had been added to the mitochondrial COII,BartonellagltA,Wolbachia,and autophagosomal 16S rRNA genes of human fleas,all of which were consistent with the expected fragment sizes.Target bands were not amplified from Ehrlichia,Arsenophonus,spotted fever group Rickettsia,and Yersinia pestis.According to homology and genetic evolution analysis of human flea mitochondrial COII and the corresponding genes of the above-described pathogens,the COX2 gene(ON455234.1)of human fleas in Tumushuke city and Iran ob-tained in this study showed the highest homology(99.84%).The COII gene(NC_063709.1)of human fleas in Hetan City and Hunan region showed the highest homology(100%).Our findings further confirmed that the flea species was Pulex irritans.The PCR amplifi-cation results indicated that the collected Pulex irritans carried multiple pathogens,among which Bartonella and Wolbachia had the highest infection rates,and the infection rate with Anaplasma phagocytophilum was relatively low.This study is the first to discover flea species on the surface of sheep in some areas of southern Xinjiang.Our findings preliminarily confirmed that Bartonella,Wolba-chia,and Anaplasma phagocytophilum are the main Pulex irritans pathogens.

This study identified the types and pathogen carrying status of fleas on the surface of sheep in some areas of southern Xinjiang,and analyzed the genetic evolution differences with respect to related pathogens.The aim was to provide a reference for the local prevention and control of fleas and insect borne infectious diseases.A total of 1 586 fleas were collected from agricultural and pas-toral areas of Tumushuke City and Hotan Prefecture.Flea species were identified on the basis of morphology and the Pulex irritans mi-tochondrial COII gene.Flea DNA was extracted,and PCR was conducted to amplify the Bartonella gltA gene;Arsenophonus,Ana-plasma,Ehrlichia,and Wolbachia 16S rRNA genes;RickettsiaOmpA,17kDa,16S rRNA genes,and Yersinia pestis 16S rDNA gene.The amplified products were sequenced,and the homology of the genes of the three detected pathogens(gltA gene of Bartonella,16S rRNA gene of Wolbachia,and Anaplasma phagocytophilum)with respect to known corresponding genes of the same pathogen in Gen-Bank was analyzed.Phylogenetic trees were constructed with the adjacency method in MEGA 11.0.According to morphological and mo-lecular biology identification results,all fleas collected in this study were Pulex irritans.PCR indicated that the target gene fragments had been added to the mitochondrial COII,BartonellagltA,Wolbachia,and autophagosomal 16S rRNA genes of human fleas,all of which were consistent with the expected fragment sizes.Target bands were not amplified from Ehrlichia,Arsenophonus,spotted fever group Rickettsia,and Yersinia pestis.According to homology and genetic evolution analysis of human flea mitochondrial COII and the corresponding genes of the above-described pathogens,the COX2 gene(ON455234.1)of human fleas in Tumushuke city and Iran ob-tained in this study showed the highest homology(99.84%).The COII gene(NC_063709.1)of human fleas in Hetan City and Hunan region showed the highest homology(100%).Our findings further confirmed that the flea species was Pulex irritans.The PCR amplifi-cation results indicated that the collected Pulex irritans carried multiple pathogens,among which Bartonella and Wolbachia had the highest infection rates,and the infection rate with Anaplasma phagocytophilum was relatively low.This study is the first to discover flea species on the surface of sheep in some areas of southern Xinjiang.Our findings preliminarily confirmed that Bartonella,Wolba-chia,and Anaplasma phagocytophilum are the main Pulex irritans pathogens.

This study constructed a porcine reproductive and respiratory syndrome virus(PRRSV)NADC30-like strain GP3 recombinant adenovirus vector vaccine through in vitro homologous re-combination to explore its immunological efficacy evaluation at the mouse level.Using type 5 ade-novirus as a vector,a recombinant adenovirus expressing PRRSV GP3 protein was prepared and i-dentified in vitro by fluorescence observation,PCR,and Western blot analysis.Immunize mice with recombinant adenovirus and detect humoral and cellular immune responses induced by recombi-nant adenovirus using indirect ELISA and ELISpot methods.The recombinant adenovirus rAdGP3 was identified by enzyme digestion,PCR,fluorescence and Western blot,indicating that the recom-binant adenovirus rAdGP3 was successfully constructed and packaged.After immunizing mice,spe-cific antibodies and neutralizing antibodies were produced,indicating that the recombinant adenovi-rus could elicit strong humoral immunity.ELISpot and lymphocyte proliferation assays showed that the recombinant adenovirus vaccine could stimulate the secretion of IFN-γ-specific T lymphocytes and induce the proliferation of lymphocytes,indicating that the recombinant adenovi-rus could enhance the level of cellular immune response.In this study,rAdGP3 recombinant adeno-virus was successfully constructed and had good immunogenicity at the mouse level,which provid-ed a reference for the development of novel PRRSV vaccines.

Recent studies have confirmed that the meningeal lymphatic system (MLS), a functional lymphatic network, exists in the dura mater of the central nervous system (CNS). It can connect to the peripheral lymphatic system and remove metabolic wastes from the CNS. MLS discovery has overturned the traditional view that the brain is an "immune-exempt" organ and provides a new perspective for Alzheimer's disease (AD) research. This article reviews the discovery, anatomical structure, and physiological functions of MLS, and deeply explores the mutual regulation mechanism between MLS and immune system and its key role in AD occurrence and development, aiming to provide new ideas for AD treatments targeting MLS.

Objective:To compare the clinical efficacy of the H-Loop knotless double-row technique and the suture bridge technique in repairing L-shaped rotator cuff tears under arthroscopy.Methods:A retrospective analysis was performed on 58 patients with L-shaped rotator cuff injuries who underwent arthroscopic repair at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, between January 2019 and December 2021. The H-Loop knotless double-row technique was used in 16 cases (8 males and 8 females, mean age 63.69±8.78 years), while the suture bridge technique was used in 42 cases (24 males and 18 females, mean age 61.02±7.02 years). The American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles Shoulder Score (UCLA), Simple Shoulder Test (SST), shoulder range of motion, and muscle strength were evaluated and compared between the two groups one year after surgery.Results:The follow-up period was 12.81±0.98 months for the H-Loop group and 13.29±0.94 months for the suture bridge group. No significant differences were found between the groups in terms of age, sex, dominant hand, preoperative symptom duration, tear shape, tear size, or long head tendon amputation (P>0.05). The operative time was significantly shorter in the H-Loop group 67.50±16.02 minutes compared to the suture bridge group 76.67±13.19 minutes ( t=2.234, P=0.031). Additionally, the number of anchors used was significantly lower in the H-Loop group 2.00±0 compared to the suture bridge group 4.14±0.35 ( t=16.573, P<0.001). The ASES scores increased significantly in both groups: from 57.44±15.91 to 92.00±4.41 in the H-Loop group and from 58.21±16.58 to 87.71±6.19 in the suture bridge group ( F=53.439, P<0.001; F=72.511, P<0.001). Similarly, the UCLA scores improved from 20.63±3.79 to 31.56±3.65 in the H-Loop group and from 20.83±5.78 to 30.36±4.71 in the suture bridge group ( F=57.788, P<0.001; F=50.043, P<0.001). The Constant-Murley scores also showed significant improvement: from 68.50±15.31 to 87.5±8.70 in the H-Loop group and from 66.21±16.51 to 86.33±9.14 in the suture bridge group ( F=6.733, P<0.001; F=30.173, P<0.001). SST scores increased from 6.38±3.76 to 9.06±2.59 in the H-Loop group and from 6.55±3.31 to 9.17±2.45 in the suture bridge group ( F=2.847, P<0.001; F=11.096, P<0.001). The shoulder flexion range of motion increased from 158.75°±21.25° to 178.75°±47.07° in the H-Loop group and from 139.29°±45.12° to 179.76°±3.42° in the suture bridge group ( t=3.814, P=0.002; t=5.877, P<0.001). Shoulder abduction motion increased from 145°±45.46° to 178.75°±3.42° in the H-Loop group and from 135.24°±47.07° to 179.76°±1.54° in the suture bridge group ( t=2.952, P=0.001; t=6.185, P<0.001). Muscle strength improved from 53.36±25.21 N to 73.69±24.09 N in the H-Loop group and from 43.31±24.49 N to 61.8±30.07 N in the suture bridge group ( t=4.916, P<0.001; t=5.623, P<0.001). The ASES score at one year post-surgery was significantly higher in the H-Loop group 92.00±4.41 compared to the suture bridge group 87.71±6.19 ( t=2.529, P=0.014). There were no significant differences in UCLA scores, Constant-Murley scores, SST scores, shoulder motion, or muscle strength between the groups ( P>0.05). Conclusion:The H-Loop technique provides a good early curative effect. Compared to the traditional suture bridge technique, the H-Loop technique offers a higher early postoperative ASES score, shorter operative time, and fewer anchors required.