In recent years, the spread of clubroot disease caused by Plasmodiophora brassicae infection has seriously affected the yield and quality of Brassica juncea (L.) Czern.. The cascade of mitogen-activated protein kinases (MAPKs), a highly conserved signaling pathway, plays an important role in plant responses to both biotic and abiotic stress conditions. To mine the MAPK genes related to clubroot disease resistance in B. juncea, we conducted a genome-wide analysis on this vegetable, and we analyzed the phylogenetic evolution and gene structure of the MAPK gene family in mustard. The 66 BjuMAPK genes identified by screening the whole genome sequence of B. juncea were unevenly distributed on 17 chromosomes. At the genomic scale, tandem repeats led to an increase in the number of MAPK genes in B. juncea. It was found that members of the same subfamily had similar gene structures, and there were great differences among different subfamilies. These predicted cis-acting elements were related to plant hormones, stress resistance, and plant growth and development. The expression of BjuMAPK02, BjuMAPK15, BjuMAPK17, and BjuMAPK19 were down-regulated or up-regulated in response to P. brassicae infection. The above results lay a theoretical foundation for further studying the functions of BjuMAPK genes in B. juncea in response to the biotic stress caused by clubroot disease.
Mustard Plant/parasitology* ; Plasmodiophorida/pathogenicity* ; Plant Diseases/genetics* ; Mitogen-Activated Protein Kinases/metabolism* ; Phylogeny ; Disease Resistance/genetics* ; Gene Expression Regulation, Plant ; Genome, Plant ; Plant Proteins/genetics*

Objective:To investigate the clinical efficacy of laparoscopic eversion fixation of cyst wall in the treatment of simple hepatic cyst.Methods:The clinical data of 27 patients with simple hepatic cyst who underwent laparoscopic cyst eversion fixation in Department of Hepatobiliary Surgery, the First Affiliated Hospital of Henan University of Science and Technology from January 2017 to December 2020 were retrospectively analyzed. There were 8 males and 19 females, aged (60.6±9.0) years. Methods of operation, operation time, pathological results, incisional pain, peritonitis, bleeding or infection in the sac were analyzed. Recurrence was followed up by outpatient or telephone review.Results:Laparoscopic eversion fixation of cyst wall was successfully performed in all patients. Twelve cases (44.4%) were fixed in the falciform ligament, and 15 cases (55.6%) were fixed on the liver surface. The operative time was (119.3±44.3) min. The histopathologic results of the capsular wall were all fibrous connective tissue coated with endothelial cells, and no tumor cells were found. After the operation, 25 cases (92.6%) of light clear cyst fluid were not cultured for bacteriology, and 2 cases (7.4%) of turbid cyst fluid bacteriology culture was negative. There were 11 cases (40.7%) with right upper abdominal incision pain on the first day after surgery, and the pain disappeared after proper treatment without bile leakage, peritonitis, bleeding or infection. All patients were followed up for 18 to 36 months, with a median follow-up time of 24 months, and no cyst recurrence was reported.Conclusion:Laparoscopic eversion fixation of cyst wall is a good method for the treatment of simple hepatic cyst.

Objective:To explore the feasibility and clinical effect of the infrared vascular imager in the transplantation of free arterialized venous flaps.Methods:A retrospective analysis was conducted with patient data of hand microsurgery using free arterialized venous flaps to repair hand wounds in the Second Affiliated Hospital of Wenzhou Medical University from March 2019 to November 2020. An arterialized venous flap was designed according to the Goldschlager’s Type Ⅲ flap design with the aid of a magnifying glass following the venous course. The flap was transfer to cover the wound of the recipient area. The reconstructive effect was observed postoperatively, including the blood supply, color, texture, survival of the flap, the flexion and extension of the affected finger, and the appearance of the forearm donor site. The hand function was evaluated by the Chinese Medical Association Hand Surgery Society’s upper limb function evaluation trial standard.Results:A total of 17 patients were included, including 11 males and 6 females, ranging in age from 19 to 68 years old, with an average age of 34.6 years. A total of 18 skin flaps were designed and elevated, and the flap size ranged from 2.0 cm × 3.0 cm to 8.0 cm × 9.0 cm. The patients were followed up 3 to 12 months after the operation, with an average follow-up of 6 months. Blisters appeared on the second day after the operation in 8 flaps, and the affected limbs were raised to maintain the integrity of the blisters. The blisters of the flaps subsided one week after the operation. Congestion occurred on the second day after operation in 7 flaps, which subsided after two weeks after routine treatment, such as raising the affected limb and removing some sutures. One flap developed progressive hypoperfusion one week after the operation, and eventually necrosis. Seventeen flaps survived, and one flap failure was observe. All the surviving skin flaps were free of bloat and had a good appearance. In two cases, the skin graft area was pigmented, and the flexion and extension activities of the affected fingers were suitable. Using the Chinese Medical Association Society of Hand Surgery’s upper limb function evaluation trial standard, 16 patients (excluding one flap failure) were evaluated for hand function, showing 11 cases were excellent and 5 cases were good.Conclusions:Infrared vascular imaging technology enables free arterialized venous flap transplantation to realize non-contact, non-invasive, simple operation, intuitive and accurate, and truly realizes rapid flap design under direct vision. Infrared vascular imaging technology is an effective auxiliary tool for free arterialized venous flap transplantation.

Objective:To explore the feasibility and clinical effect of the infrared vascular imager in the transplantation of free arterialized venous flaps.Methods:A retrospective analysis was conducted with patient data of hand microsurgery using free arterialized venous flaps to repair hand wounds in the Second Affiliated Hospital of Wenzhou Medical University from March 2019 to November 2020. An arterialized venous flap was designed according to the Goldschlager’s Type Ⅲ flap design with the aid of a magnifying glass following the venous course. The flap was transfer to cover the wound of the recipient area. The reconstructive effect was observed postoperatively, including the blood supply, color, texture, survival of the flap, the flexion and extension of the affected finger, and the appearance of the forearm donor site. The hand function was evaluated by the Chinese Medical Association Hand Surgery Society’s upper limb function evaluation trial standard.Results:A total of 17 patients were included, including 11 males and 6 females, ranging in age from 19 to 68 years old, with an average age of 34.6 years. A total of 18 skin flaps were designed and elevated, and the flap size ranged from 2.0 cm × 3.0 cm to 8.0 cm × 9.0 cm. The patients were followed up 3 to 12 months after the operation, with an average follow-up of 6 months. Blisters appeared on the second day after the operation in 8 flaps, and the affected limbs were raised to maintain the integrity of the blisters. The blisters of the flaps subsided one week after the operation. Congestion occurred on the second day after operation in 7 flaps, which subsided after two weeks after routine treatment, such as raising the affected limb and removing some sutures. One flap developed progressive hypoperfusion one week after the operation, and eventually necrosis. Seventeen flaps survived, and one flap failure was observe. All the surviving skin flaps were free of bloat and had a good appearance. In two cases, the skin graft area was pigmented, and the flexion and extension activities of the affected fingers were suitable. Using the Chinese Medical Association Society of Hand Surgery’s upper limb function evaluation trial standard, 16 patients (excluding one flap failure) were evaluated for hand function, showing 11 cases were excellent and 5 cases were good.Conclusions:Infrared vascular imaging technology enables free arterialized venous flap transplantation to realize non-contact, non-invasive, simple operation, intuitive and accurate, and truly realizes rapid flap design under direct vision. Infrared vascular imaging technology is an effective auxiliary tool for free arterialized venous flap transplantation.

Objective:To explore the feasibility and clinical effect of the infrared vascular imager in the transplantation of free arterialized venous flaps.Methods:A retrospective analysis was conducted with patient data of hand microsurgery using free arterialized venous flaps to repair hand wounds in the Second Affiliated Hospital of Wenzhou Medical University from March 2019 to November 2020. An arterialized venous flap was designed according to the Goldschlager’s Type Ⅲ flap design with the aid of a magnifying glass following the venous course. The flap was transfer to cover the wound of the recipient area. The reconstructive effect was observed postoperatively, including the blood supply, color, texture, survival of the flap, the flexion and extension of the affected finger, and the appearance of the forearm donor site. The hand function was evaluated by the Chinese Medical Association Hand Surgery Society’s upper limb function evaluation trial standard.Results:A total of 17 patients were included, including 11 males and 6 females, ranging in age from 19 to 68 years old, with an average age of 34.6 years. A total of 18 skin flaps were designed and elevated, and the flap size ranged from 2.0 cm × 3.0 cm to 8.0 cm × 9.0 cm. The patients were followed up 3 to 12 months after the operation, with an average follow-up of 6 months. Blisters appeared on the second day after the operation in 8 flaps, and the affected limbs were raised to maintain the integrity of the blisters. The blisters of the flaps subsided one week after the operation. Congestion occurred on the second day after operation in 7 flaps, which subsided after two weeks after routine treatment, such as raising the affected limb and removing some sutures. One flap developed progressive hypoperfusion one week after the operation, and eventually necrosis. Seventeen flaps survived, and one flap failure was observe. All the surviving skin flaps were free of bloat and had a good appearance. In two cases, the skin graft area was pigmented, and the flexion and extension activities of the affected fingers were suitable. Using the Chinese Medical Association Society of Hand Surgery’s upper limb function evaluation trial standard, 16 patients (excluding one flap failure) were evaluated for hand function, showing 11 cases were excellent and 5 cases were good.Conclusions:Infrared vascular imaging technology enables free arterialized venous flap transplantation to realize non-contact, non-invasive, simple operation, intuitive and accurate, and truly realizes rapid flap design under direct vision. Infrared vascular imaging technology is an effective auxiliary tool for free arterialized venous flap transplantation.

Objective:To explore the feasibility and clinical effect of the infrared vascular imager in the transplantation of free arterialized venous flaps.Methods:A retrospective analysis was conducted with patient data of hand microsurgery using free arterialized venous flaps to repair hand wounds in the Second Affiliated Hospital of Wenzhou Medical University from March 2019 to November 2020. An arterialized venous flap was designed according to the Goldschlager’s Type Ⅲ flap design with the aid of a magnifying glass following the venous course. The flap was transfer to cover the wound of the recipient area. The reconstructive effect was observed postoperatively, including the blood supply, color, texture, survival of the flap, the flexion and extension of the affected finger, and the appearance of the forearm donor site. The hand function was evaluated by the Chinese Medical Association Hand Surgery Society’s upper limb function evaluation trial standard.Results:A total of 17 patients were included, including 11 males and 6 females, ranging in age from 19 to 68 years old, with an average age of 34.6 years. A total of 18 skin flaps were designed and elevated, and the flap size ranged from 2.0 cm × 3.0 cm to 8.0 cm × 9.0 cm. The patients were followed up 3 to 12 months after the operation, with an average follow-up of 6 months. Blisters appeared on the second day after the operation in 8 flaps, and the affected limbs were raised to maintain the integrity of the blisters. The blisters of the flaps subsided one week after the operation. Congestion occurred on the second day after operation in 7 flaps, which subsided after two weeks after routine treatment, such as raising the affected limb and removing some sutures. One flap developed progressive hypoperfusion one week after the operation, and eventually necrosis. Seventeen flaps survived, and one flap failure was observe. All the surviving skin flaps were free of bloat and had a good appearance. In two cases, the skin graft area was pigmented, and the flexion and extension activities of the affected fingers were suitable. Using the Chinese Medical Association Society of Hand Surgery’s upper limb function evaluation trial standard, 16 patients (excluding one flap failure) were evaluated for hand function, showing 11 cases were excellent and 5 cases were good.Conclusions:Infrared vascular imaging technology enables free arterialized venous flap transplantation to realize non-contact, non-invasive, simple operation, intuitive and accurate, and truly realizes rapid flap design under direct vision. Infrared vascular imaging technology is an effective auxiliary tool for free arterialized venous flap transplantation.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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Objective:To investigate the therapeutic effect of modified sural neuro-fasciocutaneous perforator flap in reconstruction of foot and ankle soft tissue defects.Methods:Sixteen patients undergoing the modified flap for foot and ankle reconstruction were included in this study between June, 2016 and June, 2018. The 16 patients were 11 males and 5 females with an average age of 32.5 (range 21 to 51) years. Ten defects were in heel and 6 in ankle and dorsal side of foot. A "Z" -shape skin incision was performed to explore the perforator vessels. A peroneal-based perforator, a superficial vein, and the vascular axis of the sural nerve were included in the pedicle. A relaying island perforator flap was used to close the donor site without skin graft. Follow-up was carried out through outpatient service, telephone follow-up and Wechat photo transmission.Results:The patients were followed-up for 12 to 18 months. All flaps survived completely without complications. The colour, texture and apperance of the flaps were good. The area of the flaps ranged from 12 cm×5 cm to 30 cm×15 cm. The diameter of the pedicle ranged from 1 to 2 cm. No complication occurred in the donor sites. A relaying perforator island flaps were used in 10 cases for donor site closure and without a skin graft. All cases were satisfied with appearance and function at the final followed-up.Conclusion:It is possible to use the modified sural neuro-fasciocutaneous perforator flap to repair foot and ankle soft tissue defects. A relaying island perforator flap can be used as a relaying flap to cover the donor site without skin graft.

Objective:To analyze the expression of LC3-Ⅱ and ATF3 in hepatocellular carcinoma (HCC) , to explore the relationship between their expression and the prognosis of patients with HCC, and to analyze the expression correlation betweenLC3-Ⅱ and ATF3 in HCC tissues.Methods:Immunohistochemical method was used to detect the expression of LC3-Ⅱ and ATF3 protein in HCC tissue and corresponding paracancerous tissue specimens, to analyze the relationship between these two proteins and the patient's clinicopathological characteristics as well as survival time. Western blot was used to detect the expression of LC3-Ⅱ and ATF3 proteins in fresh HCC tissues and corresponding paracancerous tissue.Results:The expression of LC3-Ⅱ and ATF3 inparacancerous tissues was significantly higher than that in HCC tissues. The expression levels of were related to HCC histopathological grade and venous tumor thrombus (all P<0.05), but were not related to age, gender, and serum alpha-fetoprotein, tumor diameter, HBsAg, etc (all P>0.05) . The low expression of LC3-Ⅱ and ATF3 was significantly related to the poor prognosis of patients with HCC (both P<0.05). Conclusions:Both LC3-Ⅱ and ATF3 protein expression are related to the occurrence and development of HCC. The combined detection of LC3-Ⅱ and ATF3 is helpful for the assessment of the malignant degree of HCC and it is expected to become an important indicator for judging the prognosis of patients.

Objective To investigate the therapeutic effect of modified dorsal metacarpal artery island flap of index finger without skin graft in repairing different types of soft tissue defect of thumb tip.Methods From August,2015 to October,2017,25 patients with soft tissue defect of the thumb tip were included in the study.Sixteen cases were males and 9 cases were females.Seventeen defects were in thumb dorsal and 8 cases were in thumb pulp.A modified dorsal island flap of index finger was used and the dorsal metacarpal superficial vein fascial flap could be harvest and combined to repair the thumb pulp defect if necessary.A relaying perforator flap pedicled on the second dorsal metacarpal artery was raised through the same incision to cover the donor site without skin graft.Followed-up was made by clinic,telephone and WeChat.Results The patients were followed-up for 6 to 18 months.All flaps survived completely without complications.The color,texture and contour of the flaps was good.Only 1 linear scar was left in the dorsum of the hand and no skin grafts.The second dorsal metacarpal artery flap was used to cover the donor site.Twenty-one cases (84％) were satisfied with the postoperative appearance of the thumb.The function was assessed as excellent in 16 fingers,good in 6 fingers and fair in 3 fingers.No complication occurred in the donor site.Conclusion It is possible to use the modified dorsal island flap of index finger to repair different types of thumb tip defects.A second dorsal metacarpal artery flap can be used as a relaying flap to cover the donor site without skin grafts.