OBJECTIVE: To review the clinical applications of functional perforator flaps in restoring human body functions. METHODS: An extensive literature review was conducted on both domestic and international publications to summarize the clinical use of functional perforator flaps for functional restoration. RESULTS: Perforator flaps are among the most commonly used flaps in reconstructive surgery. Beyond providing soft tissue repair, they are increasingly employed to reconstruct diverse bodily functions, leading us to propose the concept of the "functional perforator flap". Although various forms of functional perforator flaps are currently utilized, reports are predominantly scattered case studies, lacking systematic organization. Commonly used functional perforator flaps can be categorized into five types: chimeric perforator flaps, perforator flaps for nerve function restoration, perforator flaps for lymphatic drainage enhancement, flow-through perforator flaps, and perforator flaps for restoring bone and joint motion. These flaps significantly broaden the application scope of perforator flaps, elevating the goal of reconstruction from mere wound repair to achieving repair concurrent with functional reconstruction. CONCLUSION The application of various functional perforator flap designs significantly improves wound reconstruction outcomes and represents an effective approach for managing complex defects. Future developments will undoubtedly see more forms of functional perforator flaps reported to meet increasingly sophisticated reconstructive demands.
Humans ; Perforator Flap/blood supply* ; Plastic Surgery Procedures/methods* ; Soft Tissue Injuries/surgery* ; Skin Transplantation/methods* ; Wound Healing

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

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

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

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

Objective To investigate the impact of SARS-CoV-2 infection on male semen quality through meta-analysis and retrospec-tive study.Methods Literature retrieval was conducted in PubMed,CNKI,Wanfang Database and CBM database.Meta-analysis was performed using Stata 15.0.The male patients meeting the inclusion criteria from our hospital were enrolled as study subjects.General demographic data and semen parameters were collected.Single factor analysis of variance and graphing of semen parameters were con-ducted using GraphPad Prism 9.5.1.The test level was set at 0.05.Results A total of 9 studies involving 267 patients were included in the meta-analysis.There were no significant differences in sperm concentration and survival rate before and after SARS-CoV-2 infec-tion(P＞0.05).Semen volume and percentage of normal morphology significantly increased during 1-3 months after infection(P=0.005,P=0.010),with semen volume recovering to pre-infection level＞3 months later(P＞0.05).Sperm motility and progressive mo-tility increased＞3 months after infection(P=0.046,P=0.045),recovering to pre-infection levels(P=0.099,P=0.098).Sperm DNA fragmentation index may be temporarily elevated within 3 months after infection but gradually decreased＞3 months later.In the retrospective study of 8 cases,there were no statistical differences in semen parameters at different stages compared with pre-infection(P＞0.05),but semen parameters showed a negative trend during＜1 month after infection and recovered to pre-infection levels＞3 months later.Conclusion The results of this laboratory study are basically consistent with the meta-analysis.SARS-CoV-2 infection in males only caused short-term negative effects on sperm morphology,vitality and DNA integrity,but generally recovered to pre-infection levels＞3 months after infection.Due to the limitations of study subjects and sample size,the impact of SARS-CoV-2 infection on male semen quality needs to be further confirmed by long-term large-scale prospective studies.

Objective:To analyze the risk factors of pulmonary thromboembolism (PTE) in patients with pulmonary tuberculosis (PTB), to improve the awareness of clinicians.Methods:A total of 120 PTB patients complicated with PTE (PTE group) and 120 PTB patients without PTB (control group) admitted to the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022 were included. Clinical data from both groups were collected and compared. Statistical analyses were performed using the chi-square tests and Mann-Whitney U test, and binary logistic regression analysis was performed to identify the risk factors for PTE in PTB patients. Results:The age of the PTE group was 69.00(63.00, 76.75) years. The rates of comorbid chronic pulmonary diseases, respiratory failure, and diabetes in PTE group were 40.00%(48/120), 24.17%(29/120), and 12.50%(15/120), respectively.The incidence rates of dyspnea, chest distress, chest pain, and palpitations in PTE group were 80.83%(97/120), 21.67%(26/120), 23.33%(28/120), and 10.00%(12/120), respectively. The D-dimer level in PTE group was 3.34 (2.05, 6.60) mg/L. These results were all higher than those in the control group (10.00%(12/120), 7.50%(9/120), 3.33%(4/120), 36.67%(44/120), 6.67%(8/120), 13.33%(16/120), 3.33%(4/120), and 0.97(0.41, 2.11) mg/L, respectively). The differences were all statistically significant ( χ2=28.80, 12.51, 6.92, 48.30, 11.10, 4.01 and 4.29, respectively, Z=-8.76; all P<0.05). Binary logistic regression analysis revealed that older age (odds ratio( OR)=1.057), comorbid chronic pulmonary diseases ( OR=2.998), diabetes ( OR=8.703), presence of dyspnea ( OR=5.132), and elevated D-dimer levels ( OR=1.672) were independent risk factors for PTE in PTB patients (all P<0.05). Conclusions:Older age, comorbid chronic pulmonary diseases, diabetes, dyspnea and elevated D-dimer levels are risk factors for PTE in PTB patients. Clinicians should remain vigilant to these factors to reduce the risk of missing PTE in this population.

Objective:To explore the impact of negative perfectionism on academic procrastination, as well as the mediating role of anxiety and the moderating role of negative cognitive emotion regulation strategies.Methods:In December 2022, a cross-sectional survey was conducted on 4 178 students from a medical college in Heilongjiang Province. The Zi negative perfectionism questionnaire, procrastination assessment scale-student, generalized anxiety disorder-7, and cognitive emotion regulation questionnaire were used to conduct the questionnaire survey, and 4 004 valid questionnaires were recovered. SPSS 26.0 statistical software was used for common method deviation test, descriptive statistics and correlation analysis, PROCESS macro program was used for mediation and moderation effect analysis.Results:(1) The scores of nursing students' negative perfectionism, anxiety, negative cognitive emotion regulation strategy, and academic procrastination were (120.48±23.40), (12.75±5.36), (44.82±11.20), and (42.95±14.30), respectively. (2) Negative perfectionism was positively correlated with anxiety ( r=0.311, P<0.01) and academic procrastination ( r=0.113, P<0.01). Academic procrastination was positively correlated with anxiety ( r=0.190, P<0.01) and negative cognitive emotion regulation strategies ( r=0.260, P<0.01). (3) Anxiety played a partially mediating role between negative perfectionism and academic procrastination, with direct effect and mediating effect accounting for 49.11% (0.055/0.112) and 50.89% (0.057/0.112) of the total effect, respectively. (4) The effect of negative perfectionism on anxiety was moderated by negative cognitive emotions, and the predictive effect of negative perfectionism on anxiety was stronger in nursing college students with high negative cognitive emotion ( β=0.231, P<0.001). Conclusion:Among nursing college students, negative perfectionism can predict academic procrastination through anxiety, and cognitive emotion regulation strategies moderate the predictive effect of negative perfectionism on anxiety.

Objective:To explore the impact of negative perfectionism on academic procrastination, as well as the mediating role of anxiety and the moderating role of negative cognitive emotion regulation strategies.Methods:In December 2022, a cross-sectional survey was conducted on 4 178 students from a medical college in Heilongjiang Province. The Zi negative perfectionism questionnaire, procrastination assessment scale-student, generalized anxiety disorder-7, and cognitive emotion regulation questionnaire were used to conduct the questionnaire survey, and 4 004 valid questionnaires were recovered. SPSS 26.0 statistical software was used for common method deviation test, descriptive statistics and correlation analysis, PROCESS macro program was used for mediation and moderation effect analysis.Results:(1) The scores of nursing students' negative perfectionism, anxiety, negative cognitive emotion regulation strategy, and academic procrastination were (120.48±23.40), (12.75±5.36), (44.82±11.20), and (42.95±14.30), respectively. (2) Negative perfectionism was positively correlated with anxiety ( r=0.311, P<0.01) and academic procrastination ( r=0.113, P<0.01). Academic procrastination was positively correlated with anxiety ( r=0.190, P<0.01) and negative cognitive emotion regulation strategies ( r=0.260, P<0.01). (3) Anxiety played a partially mediating role between negative perfectionism and academic procrastination, with direct effect and mediating effect accounting for 49.11% (0.055/0.112) and 50.89% (0.057/0.112) of the total effect, respectively. (4) The effect of negative perfectionism on anxiety was moderated by negative cognitive emotions, and the predictive effect of negative perfectionism on anxiety was stronger in nursing college students with high negative cognitive emotion ( β=0.231, P<0.001). Conclusion:Among nursing college students, negative perfectionism can predict academic procrastination through anxiety, and cognitive emotion regulation strategies moderate the predictive effect of negative perfectionism on anxiety.

Objective:To analyze the risk factors of pulmonary thromboembolism (PTE) in patients with pulmonary tuberculosis (PTB), to improve the awareness of clinicians.Methods:A total of 120 PTB patients complicated with PTE (PTE group) and 120 PTB patients without PTB (control group) admitted to the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2022 were included. Clinical data from both groups were collected and compared. Statistical analyses were performed using the chi-square tests and Mann-Whitney U test, and binary logistic regression analysis was performed to identify the risk factors for PTE in PTB patients. Results:The age of the PTE group was 69.00(63.00, 76.75) years. The rates of comorbid chronic pulmonary diseases, respiratory failure, and diabetes in PTE group were 40.00%(48/120), 24.17%(29/120), and 12.50%(15/120), respectively.The incidence rates of dyspnea, chest distress, chest pain, and palpitations in PTE group were 80.83%(97/120), 21.67%(26/120), 23.33%(28/120), and 10.00%(12/120), respectively. The D-dimer level in PTE group was 3.34 (2.05, 6.60) mg/L. These results were all higher than those in the control group (10.00%(12/120), 7.50%(9/120), 3.33%(4/120), 36.67%(44/120), 6.67%(8/120), 13.33%(16/120), 3.33%(4/120), and 0.97(0.41, 2.11) mg/L, respectively). The differences were all statistically significant ( χ2=28.80, 12.51, 6.92, 48.30, 11.10, 4.01 and 4.29, respectively, Z=-8.76; all P<0.05). Binary logistic regression analysis revealed that older age (odds ratio( OR)=1.057), comorbid chronic pulmonary diseases ( OR=2.998), diabetes ( OR=8.703), presence of dyspnea ( OR=5.132), and elevated D-dimer levels ( OR=1.672) were independent risk factors for PTE in PTB patients (all P<0.05). Conclusions:Older age, comorbid chronic pulmonary diseases, diabetes, dyspnea and elevated D-dimer levels are risk factors for PTE in PTB patients. Clinicians should remain vigilant to these factors to reduce the risk of missing PTE in this population.