Objective:To explore the clinical effect of reconstruction of soft tissue defect on the palmar side of 2 adjacent fingers with bilobed perforator flap of medial foot artery.Methods:From September 2020 to September 2023, 6 patients with soft tissue defects on the palmar side of 2 adjacent fingers were treated in the Department of Hand and Foot Microsurgery, the Affiliated Hospital of Qingdao University. After admission, Doppler ultrasound scan was performed to locate the perforating branches of the deep and superficial branches of medial foot artery, as well as the course of medial foot artery. A bilobed flap with two perforating branches of medial foot artery was used to reconstruct the soft tissue defects on the palmar side of 2 adjacent fingers. The perforators of medial foot artery were anastomosed with the proper palmar digital arteries, and the accompanying veins was anastomosed with the dorsal digital veins. The branches of saphenous nerve were anastomosed with the proper palmar digital nerves. The sizes of soft tissue defect were 4.5 cm×2.0 cm-3.0 cm×1.5 cm, and the flaps sized 5.0 cm×2.5 cm-3.5 cm×2.0 cm. All donor sites for the perforator flaps were covered by artificial dermis (4 patients) or autologous skin grafts (2 patients). Short and long-term follow-up for flap survival, flap shape, scar, and functions of interphalangeal joint and metacarpophalangeal joint function were evaluated in outpatient clinic and WeChat reviews.Results:All the bilobed perforator flaps of medial foot artery survived in 6 patients. There was no infection in the flap and donor area. Wounds in fingers and dornor sites in foot all healed well. Postoperative follow-up ranged 4-12 months, with an average of 9.3 months. The sensation of the palmar fingers recovered well with TPD at 7-10 mm and at 8.5 mm in average. The sensation recoveries were up to S 3-S 4. According to the Evaluation Trial Standards of Upper Limb Partial Function of Hand Surgery of the Chinese Medical Association, 5 patients (10 fingers) were rated as excellent and 1 patient (2 fingers) as good. The donor sites healed well and walking, running, jumping, mountaineering and other food motions were not affected, and without any obvious discomfort. According to the American Orthopedic Foot and Ankle Societ (AOFAS) ankle-hindfoot score, the ankle functions of 6 patients were evaluated as excellent. Conclusion:A bilobed perforator flap of medial foot artery is applied to reconstruct the soft tissue defects on the palmar side of 2 adjacent fingers. It can simultaneously reconstruct 2 defects in a single surgery, and offer a fast functional recovery and aesthetical appearance.

Objective:To explore the clinical effect of reconstruction of soft tissue defect on the palmar side of 2 adjacent fingers with bilobed perforator flap of medial foot artery.Methods:From September 2020 to September 2023, 6 patients with soft tissue defects on the palmar side of 2 adjacent fingers were treated in the Department of Hand and Foot Microsurgery, the Affiliated Hospital of Qingdao University. After admission, Doppler ultrasound scan was performed to locate the perforating branches of the deep and superficial branches of medial foot artery, as well as the course of medial foot artery. A bilobed flap with two perforating branches of medial foot artery was used to reconstruct the soft tissue defects on the palmar side of 2 adjacent fingers. The perforators of medial foot artery were anastomosed with the proper palmar digital arteries, and the accompanying veins was anastomosed with the dorsal digital veins. The branches of saphenous nerve were anastomosed with the proper palmar digital nerves. The sizes of soft tissue defect were 4.5 cm×2.0 cm-3.0 cm×1.5 cm, and the flaps sized 5.0 cm×2.5 cm-3.5 cm×2.0 cm. All donor sites for the perforator flaps were covered by artificial dermis (4 patients) or autologous skin grafts (2 patients). Short and long-term follow-up for flap survival, flap shape, scar, and functions of interphalangeal joint and metacarpophalangeal joint function were evaluated in outpatient clinic and WeChat reviews.Results:All the bilobed perforator flaps of medial foot artery survived in 6 patients. There was no infection in the flap and donor area. Wounds in fingers and dornor sites in foot all healed well. Postoperative follow-up ranged 4-12 months, with an average of 9.3 months. The sensation of the palmar fingers recovered well with TPD at 7-10 mm and at 8.5 mm in average. The sensation recoveries were up to S 3-S 4. According to the Evaluation Trial Standards of Upper Limb Partial Function of Hand Surgery of the Chinese Medical Association, 5 patients (10 fingers) were rated as excellent and 1 patient (2 fingers) as good. The donor sites healed well and walking, running, jumping, mountaineering and other food motions were not affected, and without any obvious discomfort. According to the American Orthopedic Foot and Ankle Societ (AOFAS) ankle-hindfoot score, the ankle functions of 6 patients were evaluated as excellent. Conclusion:A bilobed perforator flap of medial foot artery is applied to reconstruct the soft tissue defects on the palmar side of 2 adjacent fingers. It can simultaneously reconstruct 2 defects in a single surgery, and offer a fast functional recovery and aesthetical appearance.

Sweet potato is an important food crop that can also be used as an industrial raw material. Sucrose is the main form of long-distance carbohydrate transport in plants, and sucrose transporter (SUT) regulates the transmembrane transport and distribution of sucrose during plant growth and metabolism. Moreover, SUT plays a key role in phloem mediated source-to-sink sucrose transport and physiological activities, supplying sucrose for the sink tissues. In this study, the full-length cDNA sequences of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ were obtained by rapid amplification of cDNA ends (RACE) cloning according to the transcripts of the two SUT coding genes which were differentially expressed in sweet potato storage roots with different starch properties. Phylogenetic analysis was performed to clarify the classification of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆. The subcellular localization of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ was determined by transient expression in Nicotiana benthamiana. The function of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ in sucrose and hexose absorption and transport was identified using yeast functional complementarity system. The expression pattern of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ in sweet potato organs were analyzed by real-time fluorescence quantitative PCR (RT-qPCR). Arabidopsis plants heterologous expressing IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ genes were obtained using floral dip method. The differences in starch and sugar contents between transgenic and wild-type Arabidopsis were compared. The results showed IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ encoded SUT proteins with a length of 505 and 521 amino acids, respectively, and both proteins belonged to the SUT1 subfamily. IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ were located in the cell membrane and were able to transport sucrose, glucose and fructose in the yeast system. In addition, IbSUT₆₂₇₈₈ was also able to transport mannose. The expression of IbSUT₆₂₇₈₈ was higher in leaves, lateral branches and main stems, and the expression of IbSUT₈₁₆₁₆ was higher in lateral branches, stems and storage roots. After IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ were heterologously expressed in Arabidopsis, the plants grew normally, but the biomass increased. The heterologous expression of IbSUT₆₂₇₈₈ increased the soluble sugar content, leaf size and 1 000-seed weight of Arabidopsis plants. Heterologous expression of IbSUT₈₁₆₁₆ increased starch accumulation in leaves and root tips and 1 000-seed weight of seeds, but decreased soluble sugar content. The results obtained in this study showed that IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ might be important genes regulating sucrose and sugar content traits in sweet potato. They might carry out physiological functions on cell membrane, such as transmembrane transport of sucrose, sucrose into and out of sink tissue, as well as transport and unloading of sucrose into phloem. The changes in traits result from their heterologous expression in Arabidopsis indicates their potential in improving the yield of other plants or crops. The results obtained in this study provide important information for revealing the functions of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ in starch and glucose metabolism and formation mechanism of important quality traits in sweet potato.
Ipomoea batatas/metabolism* ; Arabidopsis/metabolism* ; Sucrose/metabolism* ; Saccharomyces cerevisiae/metabolism* ; DNA, Complementary ; Phylogeny ; Plants, Genetically Modified/genetics* ; Membrane Transport Proteins/metabolism* ; Starch/metabolism* ; Plant Proteins/metabolism* ; Gene Expression Regulation, Plant

Objective:To explore the surgical procedure and effect of reconstruction of soft tissue defects in the distal segment of dorsal finger with a perforator(joint branch) flap of proper palmar digital artery combined with a dorsal metacarpal artery flap.Methods:From January 2019 to June 2022, 9 patients with soft tissue defects in distal dorsal finger, mostly with avulsion at the extensor tendon insertion point, were treated in Department of Hand and Foot Microsurgery, the Affiliated Hospital of Qingdao University. The defect areas were 1.0 cm×1.0 cm-2.5 cm×2.0 cm. Steel wires were used to reconstruct the extensor tendon insertion point. The defects were reconstructed by a perforator(joint) flap of proximal phalanx artery and a dorsal metacarpal artery flap was used to repair the donor site for proximal flap. Postoperative follow-up and evaluation included flap survival, flap appearance, scars and function of interphalangeal and metacarpophalangeal joints, through outpatient clinical, WeChat and so on.Results:The flap of digital artery perforator (joint branch) and the fasciocutaneous flap of dorsal metacarpal artery all survived. One flap of the digital artery perforator(joint branch) appeared purple and tension blisters after surgery. The stitches of the pedicle of the flap were partially dismantled at 36-48 hours after surgery. The flap was then turned to ruddy in colour 7 days after surgery. The wounds of the distal finger joint and nail bed healed well without redness and infection. The postoperative follow-up lasted for 5 to 12 months, 9 months in average. The appearance, colour and texture of the skin at distal finger were similar to those at the dorsal proximal finger and dorsal palm. Sensation recovered well, all flaps exceeding S 3. The two-point resolution (TPD) was 8-10 mm, with an average of 9.5 mm. According to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 5 cases were in excellent and 4 in good. Conclusion:The perforator(joint branch) flap of proper palmar digital artery combined with a dorsal metacarpal artery flap is simple and safe treatment. It has a fast functional recovery with an aesthetic appearance in reconstruction of the soft tissue defect in distal segment of dorsal finger.

Objective:To investigate the clinical effect of bilateral anteriolateral thigh perforator flaps (ALTPF) pedicled with descending branch of lateral circumflex femoral artery in series on reconstruction of large soft tissue defects in lower limbs.Methods:A total of 9 patients with large soft tissue defects in lower limbs were selected in the study. The patients were 6 males and 3 females aged between 18 and 57 years old. They were treated in the Department of Hand and Foot Microsurgery, the Affiliated Hospital of Qingdao University from June 2018 to January 2023. Causes of injury: 4 of traffic accident, 2 of crushing, 2 of falling from height and 1 of explosion. Five patients had combined defects in dorsal feet and 4 with tibia fractures and anterior-and-posterior-tibial soft tissue defects. All affected limbs had tissue necroses and infections in various degrees. Deep tissue defects such as tendons, nerves, bones and joints or orthopaedic implants were exposed. The areas of soft tissue defects were 30 cm×14 cm-42 cm×14 cm. All the defects were reconstructed by the bilateral ALTPF pedicled with descending branch of lateral circumflex femoral artery in series. The size of proximal flaps was 25 cm×8 cm-33 cm×13 cm and 20 cm×7 cm-29 cm×13 cm for the distal flaps. Scheduled postoperative follow-ups were conducted to observe the survival of the transferred flaps and functional recovery of calfs and feet. Sensory recovery was assessed against British Medical Research Council (BMRC) criteria. Puno scoring was used to assess the functional recovery and the effectiveness of treatment.Results:All flaps survived and the donor sites healed well. One patient developed vascular compromise within 24 hours after surgery, but it was rectified after timely surgical exploration, however it left with a small area of necrosis at distal end of the flap. The necrosis and wound healed after skin grafting in stage-two surgery. Postoperative follow-up lasted for 8.3 months in average. Two patients underwent flap thinning in stage-two surgery due to bloating appearance, 2 patients had slightly bloated flaps at the calfs, and the rest of 5 patients had satisfactory flap appearance. Two patients received nerve reconstruction by anastomosis of the lateral femoral cutaneous nerves. At the final follow-up, the sensory recovery in 9 patients achieved S 2-S 3+ according to BMRC. The average Puno score achieved 88.36 point±5.36 point, of which 4 patients in excellent, 3 in good and 2 in fair. Conclusion:The use of bilateral ALTPF pedicled with descending branch of lateral circumflex femoral artery in series to reconstruct a large soft tissue defect in lower extremity has a good clinical value, and it has become one of the effective methods.