1.Effects of Xiaoyao-Kang'ai-Jieyu formula-containing serum on BV2-HT22 cell co-culture system from mice with breast cancer-related depression
Song YANG ; Yuanshan HAN ; Manshu ZOU ; Xiaoshi YU ; Yonghong YU ; Yuhong WANG
Chinese Journal of Pathophysiology 2025;41(9):1748-1756
AIM:To investigate the effects of Xiaoyao-Kang'ai-Jieyu formula(XYKAJY)-containing serum on the co-culture of BV2 and HT22 cells from mice with breast cancer-related depression(BCRD).METHODS:The op-timal concentration of XYKAJY-containing serum was determined using mouse HT22 cells.In vitro co-culture model of mouse HT22 and BV2 cells was established through incubation with 4T1 cell supernatant and 200 μmol/L corticosterone.The cells were then divided into control group,model group,blank serum group,positive drug serum group,5%XY-KAJY-containing serum group,10%XYKAJY-containing serum group,15%XYKAJY-containing serum group and 20%XYKAJY-containing serum group.Alterations in HT22 cell viability was detected by CCK8 assay.The concentration level of interleukin-1β(IL-1β),IL-6 and IL-18 in the cell supernatant was quantified using enzyme-linked immunosorbent as-say(ELISA).Flow cytometry was conducted to assess the apoptosis rate of HT22 cells and quantify the expression levels of adhesion molecule CD11b on the surface of BV2 cells.Immunofluorescence was performed to determine the expression of neuron-specific enolase(NSE),synapsin 1(Syn1)and postsynaptic density protein 95(PSD95)in HT22 cells,and that of inducible nitric oxide synthase(iNOS)in BV2 cells.RESULTS:Treatment with XYKAJY-containing serum down-regulated CD11b expression level in BV2 cells(P<0.01),and reduced the release of IL-1β,IL-6 and IL-18(P<0.01).Moreover,it significantly improved the viability of HT22 cells(P<0.01),enhanced cell morphology integrity,and reduced the apoptosis rate(P<0.01).CONCLUSION:These findings indicated that XYKAJY-containing serum im-proved the function of mouse HT22 neurons by regulating the polarization phenotype of mouse BV2 cells and alleviating neuroinflammatory-induced toxicity.
2.Machine vision and learning for evaluating different rancidity grades of Prunus mandshurica (Maxim.) Koehne
Yashun Wang ; Huirong Chen ; Jianting Gong ; Yang Cui ; Huiqin Zou ; Yonghong Yan
Journal of Traditional Chinese Medical Sciences 2025;2025(2):287-296
ObjectiveTo explore a rapid and accurate method for evaluating the quality of Prunus mandshurica (Maxim.) Koehne (P. mandshurica, Ku Xing Ren) during rancidity using machine vision and learning.MethodsSensory evaluation and chemometrics were used to classify P. mandshurica quality grades after rancidity. Chemical indicators of the P. mandshurica quality change were determined to verify the obtained grades and support the subsequent modeling. The International Commission on Illumination color space was used to extract the color features of the P. mandshurica. Discrimination and prediction models based on color features combined with multiple machine learning algorithms were established using 10-fold cross-validation and external test set validation.ResultsThe P. mandshurica rancidity samples were allocated to three quality grades. The Bayes net model based on powder color successfully identified the P. mandshurica at different grades with an accuracy of 88.89% and 100% using two validations, and the naive Bayes model based on section color achieved the same accuracy with an receiver operating characteristic area of 0.979. The instance-based k-nearest neighbors model based on powder color performed best in predicting the amygdalin content [R2 = 0.9801, mean absolute error (MAE) = 0.2071, root mean squared error (RMSE) = 0.4170], followed by the random committee model in predicting the acid value (R2 = 0.9580, MAE = 1.5121, RMSE = 1.9099) and the random forest model in predicting the peroxide value (R2 = 0.8857, MAE = 0.0027, RMSE = 0.0035).ConclusionThis study demonstrates that color digitization analysis is a potential method for rapidly evaluating the quality of P. mandshurica across the rancidity process, providing a new reference for the quality assessment of traditional Chinese medicines.
3.Application strategies and clinical effects of superior gluteal artery perforator tissue flaps in repairing stage Ⅳ pressure ulcers in the sacrococcygeal region
Rufei DENG ; Baowen FAN ; Songhua SONG ; Luyao LONG ; Yanwei CHEN ; Jiaxin CHEN ; Ruchen JI ; Yonghong ZHANG ; Xiangtian HU ; Guoneng HUANG ; Zhenyu JIANG ; Lan JIANG ; Lijin ZOU ; Guohua XIN ; Yuanlin ZENG ; Youlai ZHANG
Chinese Journal of Burns 2025;41(3):232-241
Objective:To explore the application strategies and clinical effects of superior gluteal artery perforator tissue flaps in repairing stage Ⅳ pressure ulcers in the sacrococcygeal region.Methods:This study was a retrospective observational study. From July 2019 to April 2024, 89 patients with stage Ⅳ pressure ulcers in the sacrococcygeal region who met the inclusion criteria were admitted to the First Affiliated Hospital of Nanchang University, including 59 males and 30 females, aged 21 to 84 years. There were 89 sacrococcygeal pressure ulcers, with an area of 5.0 cm×4.0 cm-21.0 cm×21.0 cm after debridement. According to the shape, size, and depth of the wounds after debridement, combined with the elasticity and texture of the skin around the wounds, and the principle of minimizing damage to the donor area, the appropriate forms of superior gluteal artery perforator tissue flaps were cut for wound repair in the following three conditions. (1) For wounds with a round shape, an area of 5.0 cm×5.0 cm-21.0 cm×21.0 cm, and a depth of 1.0-3.5 cm, the superior gluteal artery perforator propeller flap or myocutaneous flap, bilobed superior gluteal artery perforator relay flap, and bilateral superior gluteal artery perforator rotational flap were used. (2) For wounds with an oval shape, an area of 5.0 cm×4.0 cm-18.5 cm×10.5 cm, and a depth of 1.0-3.0 cm, the superior gluteal artery perforator propeller flap or myocutaneous flap, unilateral superior gluteal artery perforator propeller flap combined with contralateral superior gluteal artery perforator V-Y advanced flap or keystone flap were used. (3) For wounds with a fusiformis shape, an area of 7.0 cm×4.0 cm-17.5 cm×6.0 cm, and a depth of 1.5-5.0 cm, the unilateral or bilateral superior gluteal artery perforator V-Y advanced flap, superior gluteal artery perforator keystone flap, or superior gluteal artery perforator keystone flap combined with gluteus maximus muscle flap were used. In this group of patients, a total of 40 superior gluteal artery perforator propeller flaps (with an resection area of 11.0 cm×6.0 cm-17.0 cm×11.0 cm), 22 superior gluteal artery perforator propeller myocutaneous flaps (with an resection area of 10.0 cm×5.0 cm-14.0 cm×8.0 cm), 7 bilobed superior gluteal artery perforator relay flaps (with a main flap resection area of 5.5 cm×5.5 cm-18.0 cm×11.5 cm and a side flap resection area of 4.5 cm×3.0 cm-11.0 cm×6.5 cm), 5 bilateral superior gluteal artery perforator rotational flaps (with a total resection area of 20.0 cm×16.0 cm-26.0 cm×21.0 cm on both sides), 14 superior gluteal artery perforator V-Y advanced flaps (with an resection area of 12.0 cm×10.0 cm-18.0 cm×18.0 cm), 13 superior gluteal artery perforator keystone flaps (with an resection area of 13.0 cm×6.5 cm-19.0 cm×18.0 cm), and 3 gluteus maximus muscle flaps (with an resection area of 8.0 cm×3.0 cm-15.0 cm×4.5 cm). The donor area wounds were all directly sutured. The survival of tissue flaps was observed and the incidence rate of delayed wound healing in the reception area was calculated, and wound healing in the donor area was observed. The appearance and texture of tissue flaps and recurrence of pressure ulcers were followed up.Results:After surgery, all bilateral superior gluteal artery perforator rotational flaps, superior gluteal artery perforator V-Y advanced flaps, superior gluteal artery perforator keystone flaps, and gluteus maximus muscle flaps survived well. There were 6 cases of delayed wound healing in the reception area after surgery, with an incidence rate of 6.7% (6/89). Two patients had incision dehiscence in the donor area wounds due to postoperative bleeding, the wounds healed after debridement, vacuum sealing drainage, and dressing change. The wounds in the donor area of the remaining patients healed well. Six patients were lost to follow-up. Eighty-three patients were followed up for 3-48 months, of whom 4 patients died. Among the remaining 79 patients, 3 cases had pressure ulcers recur due to improper nursing, while the rest of the patients had tissue flaps with good appearance and soft texture and no recurrence of pressure ulcers.Conclusions:Based on the characteristics of wound shape, size, and depth after debridement of stage Ⅳ pressure ulcers in the sacrococcygeal region, individualized selection of flap, myocutaneous flap, or a combination of flap and gluteus maximus muscle flap based on the perforating branch of the superior gluteal artery perforator can achieve good clinical repair results. The postoperative tissue flap survived well, with a good appearance, soft texture, and less recurrence of pressure ulcers.
4.Effects of Xiaoyao-Kang'ai-Jieyu formula-containing serum on BV2-HT22 cell co-culture system from mice with breast cancer-related depression
Song YANG ; Yuanshan HAN ; Manshu ZOU ; Xiaoshi YU ; Yonghong YU ; Yuhong WANG
Chinese Journal of Pathophysiology 2025;41(9):1748-1756
AIM:To investigate the effects of Xiaoyao-Kang'ai-Jieyu formula(XYKAJY)-containing serum on the co-culture of BV2 and HT22 cells from mice with breast cancer-related depression(BCRD).METHODS:The op-timal concentration of XYKAJY-containing serum was determined using mouse HT22 cells.In vitro co-culture model of mouse HT22 and BV2 cells was established through incubation with 4T1 cell supernatant and 200 μmol/L corticosterone.The cells were then divided into control group,model group,blank serum group,positive drug serum group,5%XY-KAJY-containing serum group,10%XYKAJY-containing serum group,15%XYKAJY-containing serum group and 20%XYKAJY-containing serum group.Alterations in HT22 cell viability was detected by CCK8 assay.The concentration level of interleukin-1β(IL-1β),IL-6 and IL-18 in the cell supernatant was quantified using enzyme-linked immunosorbent as-say(ELISA).Flow cytometry was conducted to assess the apoptosis rate of HT22 cells and quantify the expression levels of adhesion molecule CD11b on the surface of BV2 cells.Immunofluorescence was performed to determine the expression of neuron-specific enolase(NSE),synapsin 1(Syn1)and postsynaptic density protein 95(PSD95)in HT22 cells,and that of inducible nitric oxide synthase(iNOS)in BV2 cells.RESULTS:Treatment with XYKAJY-containing serum down-regulated CD11b expression level in BV2 cells(P<0.01),and reduced the release of IL-1β,IL-6 and IL-18(P<0.01).Moreover,it significantly improved the viability of HT22 cells(P<0.01),enhanced cell morphology integrity,and reduced the apoptosis rate(P<0.01).CONCLUSION:These findings indicated that XYKAJY-containing serum im-proved the function of mouse HT22 neurons by regulating the polarization phenotype of mouse BV2 cells and alleviating neuroinflammatory-induced toxicity.
5.Application strategies and clinical effects of superior gluteal artery perforator tissue flaps in repairing stage Ⅳ pressure ulcers in the sacrococcygeal region
Rufei DENG ; Baowen FAN ; Songhua SONG ; Luyao LONG ; Yanwei CHEN ; Jiaxin CHEN ; Ruchen JI ; Yonghong ZHANG ; Xiangtian HU ; Guoneng HUANG ; Zhenyu JIANG ; Lan JIANG ; Lijin ZOU ; Guohua XIN ; Yuanlin ZENG ; Youlai ZHANG
Chinese Journal of Burns 2025;41(3):232-241
Objective:To explore the application strategies and clinical effects of superior gluteal artery perforator tissue flaps in repairing stage Ⅳ pressure ulcers in the sacrococcygeal region.Methods:This study was a retrospective observational study. From July 2019 to April 2024, 89 patients with stage Ⅳ pressure ulcers in the sacrococcygeal region who met the inclusion criteria were admitted to the First Affiliated Hospital of Nanchang University, including 59 males and 30 females, aged 21 to 84 years. There were 89 sacrococcygeal pressure ulcers, with an area of 5.0 cm×4.0 cm-21.0 cm×21.0 cm after debridement. According to the shape, size, and depth of the wounds after debridement, combined with the elasticity and texture of the skin around the wounds, and the principle of minimizing damage to the donor area, the appropriate forms of superior gluteal artery perforator tissue flaps were cut for wound repair in the following three conditions. (1) For wounds with a round shape, an area of 5.0 cm×5.0 cm-21.0 cm×21.0 cm, and a depth of 1.0-3.5 cm, the superior gluteal artery perforator propeller flap or myocutaneous flap, bilobed superior gluteal artery perforator relay flap, and bilateral superior gluteal artery perforator rotational flap were used. (2) For wounds with an oval shape, an area of 5.0 cm×4.0 cm-18.5 cm×10.5 cm, and a depth of 1.0-3.0 cm, the superior gluteal artery perforator propeller flap or myocutaneous flap, unilateral superior gluteal artery perforator propeller flap combined with contralateral superior gluteal artery perforator V-Y advanced flap or keystone flap were used. (3) For wounds with a fusiformis shape, an area of 7.0 cm×4.0 cm-17.5 cm×6.0 cm, and a depth of 1.5-5.0 cm, the unilateral or bilateral superior gluteal artery perforator V-Y advanced flap, superior gluteal artery perforator keystone flap, or superior gluteal artery perforator keystone flap combined with gluteus maximus muscle flap were used. In this group of patients, a total of 40 superior gluteal artery perforator propeller flaps (with an resection area of 11.0 cm×6.0 cm-17.0 cm×11.0 cm), 22 superior gluteal artery perforator propeller myocutaneous flaps (with an resection area of 10.0 cm×5.0 cm-14.0 cm×8.0 cm), 7 bilobed superior gluteal artery perforator relay flaps (with a main flap resection area of 5.5 cm×5.5 cm-18.0 cm×11.5 cm and a side flap resection area of 4.5 cm×3.0 cm-11.0 cm×6.5 cm), 5 bilateral superior gluteal artery perforator rotational flaps (with a total resection area of 20.0 cm×16.0 cm-26.0 cm×21.0 cm on both sides), 14 superior gluteal artery perforator V-Y advanced flaps (with an resection area of 12.0 cm×10.0 cm-18.0 cm×18.0 cm), 13 superior gluteal artery perforator keystone flaps (with an resection area of 13.0 cm×6.5 cm-19.0 cm×18.0 cm), and 3 gluteus maximus muscle flaps (with an resection area of 8.0 cm×3.0 cm-15.0 cm×4.5 cm). The donor area wounds were all directly sutured. The survival of tissue flaps was observed and the incidence rate of delayed wound healing in the reception area was calculated, and wound healing in the donor area was observed. The appearance and texture of tissue flaps and recurrence of pressure ulcers were followed up.Results:After surgery, all bilateral superior gluteal artery perforator rotational flaps, superior gluteal artery perforator V-Y advanced flaps, superior gluteal artery perforator keystone flaps, and gluteus maximus muscle flaps survived well. There were 6 cases of delayed wound healing in the reception area after surgery, with an incidence rate of 6.7% (6/89). Two patients had incision dehiscence in the donor area wounds due to postoperative bleeding, the wounds healed after debridement, vacuum sealing drainage, and dressing change. The wounds in the donor area of the remaining patients healed well. Six patients were lost to follow-up. Eighty-three patients were followed up for 3-48 months, of whom 4 patients died. Among the remaining 79 patients, 3 cases had pressure ulcers recur due to improper nursing, while the rest of the patients had tissue flaps with good appearance and soft texture and no recurrence of pressure ulcers.Conclusions:Based on the characteristics of wound shape, size, and depth after debridement of stage Ⅳ pressure ulcers in the sacrococcygeal region, individualized selection of flap, myocutaneous flap, or a combination of flap and gluteus maximus muscle flap based on the perforating branch of the superior gluteal artery perforator can achieve good clinical repair results. The postoperative tissue flap survived well, with a good appearance, soft texture, and less recurrence of pressure ulcers.
6.Analysis of adverse events related to linezolid in tuberculosis treatment based on the US FAERS database
Yonghong ZOU ; Honglan ZHONG ; Duohua SU ; Aiguang XU ; Yi FANG
Modern Hospital 2024;24(10):1554-1556,1559
Objective To analyze the adverse events(AEs)associated with linezolid in tuberculosis treatment reported in the FDA Adverse Event Reporting System(FAERS)database,assess its safety profile,and provide scientific evidence for ra-tional clinical use.Methods Reports of adverse events related to linezolid in tuberculosis treatment from Q1 2016 to Q1 2024 were extracted.The data were cleaned and pre-processed,and signal detection was performed using the Reporting Odds Ratio(ROR)and Information Component(IC)methods.Results A total of 1,135 linezolid-related AEs were identified,with the most common types being hospitalization(18.46%)and death(10.99%).The Results indicated that linezolid AEs primarily involved disorders of the blood and lymphatic system,as well as liver and biliary system diseases.Common adverse reactions in-cluded anemia,peripheral neuropathy,and optic neuropathy.Additionally,some adverse reaction signals not mentioned in the prescribing information were identified,such as polyneuropathy(ROR=75.25,IC025=5.8),toxic optic neuropathy(ROR=776.95,IC025=8.86),and hearing loss(ROR=14.66,IC025=3.26).Conclusion This study suggests that linezolid may be associated with some serious adverse reactions in tuberculosis treatment.It is recommended that patients on long-term linezolid therapy undergo regular neurological,ophthalmological,and auditory assessments to provide a more adequate basis for rational clinical use.
7.Effect of active music therapy on cognitive function for older adults with cognitive impairment: a systematic review based on ICD-11 and ICF
Hangyu WANG ; Keke GE ; Yonghong FAN ; Lilu DU ; Min ZOU ; Lei FENG
Chinese Journal of Rehabilitation Theory and Practice 2024;30(1):36-43
ObjectiveTo conduct a systematic review of the effect of active music therapy on cognitive function for older adults with cognitive impairment based on International Classification of Diseases, the 11th Revision (ICD-11), and International Classification of Functioning, Disability and Health (ICF). MethodsA PICO framework was constructed. Thematic keyword searches were conducted in databases including PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang data, for literature on the effect of active music therapy on cognitive function for older adults with cognitive impairment, published up to November 5th, 2023. Information on authors, countries, publication date, sample characteristics, study designs, intervention methods, measurement tools and outcomes were extracted. The methodological quality of the researches was evaluated using the Physiotherapy Evidence Database (PEDro) scale. ResultsEight researches from six countries were included, which were all randomized controlled trials involving 356 older adults with mild cognitive impairment and dementia. The articles were published from 2014 to 2020, with an average of 7.4 of the PEDro scale. Active music therapy was used by singing and playing instruments. Interventions took place in hospitals, nursing homes, and health centers. The intervention duration ranged from mostly 30 to 60 minutes a time, with a few 120 minutes a time. Interventions were implemented mostly one to three times a week, lasting from eight to twelve weeks. Health outcomes focused on cognitive function, including overall cognitive function, executive function, attention function and memory function. ConclusionA theoretical framework for the benefits of active music therapy on the cognitive function for older adults with cognitive impairment has been constructed based on ICD-11 and ICF. Active music therapy can improve overall cognitive function, executive function, attention function and memory function for older adults with cognitive impairment.
8.Health benefit of mindfulness intervention for older adults with insomnia disorders: a systematic review
Keke GE ; Yonghong FAN ; Hangyu WANG ; Lilu DU ; Changjiang LI ; Min ZOU
Chinese Journal of Rehabilitation Theory and Practice 2024;30(1):54-60
ObjectiveTo conduct a systematic review of the health benefits of mindfulness interventions for older adults with insomnia disorders. MethodsThematic keyword search was conducted in databases including Web of Science, PubMed, Embase, EBSCO, CNKI, VIP and Wanfang data, for literature on the impact of mindfulness intervention on sleep quality in older adults with insomnia disorders, published up to August, 2023. The methodological quality of the researches was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Insomnia disorders, sleep function and mindfulness interventions were coded using International Classification of Diseases 11th Revision, International Classification of Functioning, Disability and Health, and International Classification of Health Interventions Beta-3; and a systematic review was conducted following the PRISMA. ResultsNine researches from four countries were included, involving 800 participants, and all the researches were randomized controlled trials. The average score of PEDro scale was 7.1. The health-related conditions were insomnia disorders and insomnia disorders complicated with mild cognitive impairment. Mindfulness interventions used included mindfulness-based therapy for insomnia, mindfulness-based stress reduction, mindfulness-based cognitive therapy and mindfulness meditation. Interventions were implemented in institutions or health centers, care facilities, and community health service centers, varying from six to eight weeks. Health benefits of mindfulness intervention included improvements in sleep quality and psychological and behavioral health. ConclusionMindfulness interventions effectively improve sleep quality in older adults with insomnia disorders, alleviate negative emotional states such as depression, anxiety and perceived stress, and improve the quality of life.
9.Reconstruction of chronic wounds with sinus tract in inguinal region using a pedicled gracilis musculocutaneous flap: a report of 10 cases
Rufei DENG ; Yonghong ZHANG ; Jiaxin CHEN ; Ruchen JI ; Zhenyu JIANG ; Lijin ZOU ; Xuhui DENG ; Youlai ZHANG
Chinese Journal of Microsurgery 2024;47(5):528-532
Objective:To explore the clinical effect of a pedicled gracilis musculocutaneous flap on reconstruction of chronic sinus wounds in inguinal region.Methods:From September 2015 to June 2023, 10 patients with chronic inguinal sinus wounds were treated in Medical Centre of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University. The patients were 6 males and 4 females, aged 15-72 years old with an average age of 45 years old. Causes of injury: 4 patients were of non-healed wound after inguinal lymph node dissection for external genital or penile cancer, 2 of chronic radiation ulcers formed in the inguinal area after radiotherapy, 2 of femoral artery angiography site non-healing after lower limb artery balloon angioplasty, 1 of wound non-healing after resection of inguinal protuberant skin fibrosarcoma, and 1 of non-healing ulceration after repeated scratching due to inguinal pruritus. The wounds were all chronic in the groin region, all with a course over 30 days and sinus formation. Soft tissue defects on the surface of wounds ranged from 2.0 cm × 3.0 cm to 5.0 cm × 7.0 cm, and the depth of the sinus was from 2.0 cm to 5.0 cm. After debridement, ipsilateral gracilis musculocutaneous flaps were taken for defect reconstruction. Size of the flaps was 3.5 cm × 4.0 cm - 8.0 cm × 9.0 cm, the length of the gracilis musculocutaneous composite flaps was 16.0 - 24.0 cm, and the volume of the flap was 96.0 - 180.0 cm 3. The gracilis tissue of the flap was filled into the sinus tract and the wound was covered by the cutaneous tissue of the flap. Donor sites of the flap were pulled together and directly sutured. After surgery, hip movements were avoided and appropriately raised the affected limb, observed the survival of gracilis musculocutaneous flap as well as the healing of donor site. Scheduled postoperative follow-ups were conducted through the visits of outpatient clinic and interviews via WeChat or Internet hospital. Results:All the flaps survived. One flap had bleeding at the edge of flap within 24 hours after surgery and resulted in suture dehiscence. After bedside haemostasis, debridement and re-suture, it was healed. All donor sites achieved primary healing. All of the 10 patients were included in the postoperative follow-up for 6-21 months, with an average of 13 months. The flaps were in good colour and appearance, and the patients were satisfactory with the appearance. Scars were seen in the donor sites, but there was no obvious functional impairment. During the follow-up, no flap rupture occurred.Conclusion:The pedicled gracilis musculocutaneous flap is used to reconstruction of chronic inguinal sinus wounds, which can fully fill the sinus tract and simultaneously reconstruct the soft tissue defect of wound. This surgery is simple, practical and with good clinical efficacy.
10.Reconstruction of chest wound with the pedicled 5th intercostal perforator flap of the internal thoracic artery: a report of 10 cases
Rufei DENG ; Yonghong ZHANG ; Yanwei CHEN ; Jiaxin CHEN ; Ruchen JI ; Zhenyu JIANG ; Lijin ZOU ; Xuhui DENG ; Youlai ZHANG
Chinese Journal of Microsurgery 2024;47(6):614-619
Objective:To explore the feasibility and clinical efficacy of reconstruction of the soft tissue defect after keloidectomy and/or cicatricial ulcers excision caused by sternotomy with the 5th intercostal perforator flap of the internal thoracic artery.Methods:From September 2016 to August 2023, 10 patients with sternal keloids and/or sternal scar ulcers caused by sternotomy were treated in the Medical Centre of Burn Plastic Surgery and Wound Repair, the First Affiliated Hospital of Nanchang University. The soft tissue defect after resection reconstructed by the pedicled 5th intercostal perforator flap of the internal thoracic artery. The patients were 7 males and 3 females, aged 17-65 years, with an average age of 43 years. The history of sternal scar was 2-15 years, with an average of 5.5 years. And the sizes of sternal scars were 2.0 cm×6.5 cm-5.5 cm×10.0 cm. After admission, the patients firstly received surgery to remove sternal keloids and/or scar ulcers. The defects of soft tissue were found from 2.5 cm×7.0 cm to 6.0 cm×10.5 cm in size after surgery. Then one-stage reconstructive surgery were performed on all of the patients with a transposition of the pedicled 5th intercostal perforator flap of the internal thoracic artery. Flaps were harvested in surgery at 3.5 cm×7.5 cm-6.0 cm×11.0 cm in size. The donor sites of flaps were pulled and directly sutured. After the surgery, wound healing and flap survival were observed, through regular follow-ups at outpatient clinics, and via internet hospitals or WeChat reviews to monitor the colour and appearance of the flaps, recurrence of keloids and/or ulcers, the appearance of donor sites and the secondary dysfunction of surgery.Results:All incisions healed well after surgery, and all the pedicled 5th intercostal perforator flaps of the internal thoracic artery survived. All 10 patients were included in the postoperative follow-up for a period of 6-31 months, with an average of 15 months. During follow-up, the colour and appearance of the flaps were found good, and the patients were satisfied. There was no recurrence of keloid and/or scar ulcer in the reception sites. Two patients had linear scar hyperplasia at the incision sites over the period of follow-up, due to the failure of adherence to regular scar prevention and treatment after wound healing. Appearances of the donor sites were good without functional impairment.Conclusion:The pedicled 5th intercostal perforator flap of the internal thoracic artery has a better clinical effect in reconstruction of the soft tissue defect after keloidectomy and/or cicatriciad ulcers excision caused by sternotomy and without a postoperative recurrence of a keloid and/or scar ulcer, with a good colour and appearance in the affected area and in a good appearance without a secondary functional impairment at the donor site.


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