The concept of holism is the core idea of traditional Chinese medicine （TCM）. Various organs and tissues coordinate with each other to maintain the body's life activities， with a close and mutual influence between the spleen， stomach， and the central nervous system （brain）. The gut-brain axis plays an important bridging role between the digestive system and the central nervous system， achieving bidirectional information exchange between the brain and the gastrointestinal tract through complex neuroendocrine and immune mechanisms. The theory of cross-organ interaction involves the mutual influence， coordination， and integration between different organs and systems； multimodality， on the other hand， utilizes multiple sensory modalities， such as vision， hearing， and touch， to convey information. By combining TCM theory with the gut-brain axis theory， a cross-organ multimodal characterization system is established to explore its mechanism and application value in refractory diseases such as functional gastrointestinal disorders， precancerous gastrointestinal diseases， Alzheimer's disease， Parkinson's syndrome， type 2 diabetes， and depression.

Objective This paper aims to construct a system integrating mixed reality technology with artificial algo-rithm and to evaluate its effectiveness in vascular localization during anterolateral thigh perforator flap surgery to provide new insights for clinical practice.Methods Twenty patients undergoing anterolateral thigh perforator flap repair were selected.After attaching positioning devices on the lower limb,CT angiography(CTA)scans were performed.The 2D data obtained were converted into a 3D model of the positioning device and vessels.Mixed reality technology was uti-lized to achieve 3D visualization of perforator vessels.An artificial algorithm was developed in HoloLens 2 to match the positioning device automatically with its 3D model intraoperatively to overlap the perforator vessels with their 3D mod-els.The number of perforator vessels identified within the flap harvesting area and the actual number detected during sur-gery were recorded to calculate the accuracy rate of vessel identification based on CTA data reconstruction.The distance between the perforator vessel exit points located by the system and the actual exit points was measured,and the error val-ues were calculated.The surgical time required for the system to harvest the anterolateral thigh perforator flap was docu-mented and compared with the surgical time required by conventional methods.The clinical applicability of the system was discussed.Results The CTA data reconstruction identified 30 perforator vessels,while the actual number found during surgery was 32,resulting in an identification accuracy rate of 93.75％.The average distance between the perfora-tor vessel exit points located by the system and the actual exit points was(1.65±0.52)mm.The average surgical time for flap harvesting with the assistance of the system was(43.45±4.6)min compared with(57.6±7.9)min required by conven-tional methods.All perforator flaps survived the procedure.One case of flap infection occurred seven days postoperative-ly,and one case of partial flap necrosis was treated with symptomatic therapy,resulting in delayed healing.Conclusion The system constructed in this paper can achieve 3D visualization of perforator vessels through mixed reality technology and improve the accuracy of perforator vessel localization using artificial algorithms,hence demonstrating potential ap-plication in anterolateral thigh perforator flap harvesting surgeries.

ObjectiveTo discuss the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. MethodsA total of 47 patients with depression in remission in Beijing Huilongguan Hospital were enrolled. Insomnia Severity Index （ISI） and the sleep efficiency calculated by the first four items of Pittsburgh Sleep Quality Index （PSQI） were defined as insomnia. Among the selected patients， 22 subjects were classified into insomnia group， and 25 subjects in non-insomnia group. The objective sleep status of all subjects was evaluated by polysomnography （PSG）， and the cognitive function was evaluated with the Repeatable Battery for Assessment of Neuropsychological Status （RBANS）. A regression model was established to explore the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. ResultsThere was statistically significant difference in immediate memory factor scores of RBANS between depression patients in remission with and without insomnia （t=-2.102， P<0.05）. The sleep efficiency （Z=-2.113， P<0.05）， the proportion of N3 sleep stage （Z=-3.175， P<0.01） and the duration of N3 sleep stage （Z=-3.196， P<0.01） in insomnia group were all lower than those in non-insomnia group， and the nocturnal awakening （Z=-2.058， P<0.01）， the proportion of N1 sleep stage （Z=-2.399， P<0.05） and the duration of N1 sleep stage （Z=-2.463， P<0.05） were higher than those of the insomnia group. Within insomnia group， the increased proportion of REM sleep was correlated with the improvement of attention function （β=0.953， 95% CI： 0.123~2.038， P<0.05）， and the increase of nocturnal awakening was correlated with the decline of delayed memory （β=-0.173， 95% CI： -0.325~-0.024， P<0.05）. ConclusionObjective sleep is associated with cognitive impairment in remission depression patients with insomnia， the proportion of REM sleep has a positive impact on attention function， and frequent nocturnal awakening at night has a negative impact on delayed memory.

Objective:To explore the situation of insomnia, fatigue, depression, anxiety and cognitive impairment in adolescents with different characteristics, and the chain mediating effect of fatigue, depression and anxiety on insomnia and cognitive impairment.Methods:The general demographic data of 6 014 adolescents were collected.Insomnia severity index (ISI), the multidimensional fatigue inventory (MFI-20), patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and perceived deficits questionnaire-depression(PDQ-D) were used to compare the insomnia, fatigue, depression, anxiety and cognitive impairment of adolescents with different characteristics.Spearman correlation analysis was conducted by SPSS 20.0 software.The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The detection rates of insomnia, fatigue, depression, anxiety and cognitive impairment were different in adolescents with different genders, grades and academic achievements.Cognitive impairment was significantly positively correlated with insomnia ( r=0.654, P<0.01), fatigue ( r=0.476, P<0.01), depression ( r=0.677, P<0.01), anxiety ( r=0.655, P<0.01), which was suitable for mediating effect test.Fatigue, depression and anxiety in adolescents had a chain mediating effect between insomnia and cognitive impairment.Insomnia indirectly affects cognition by affecting fatigue and depressive symptoms.The intermediary effect value was 1.253, the effect amount was 55.60%, and the total effect was 2.254.Insomnia indirectly affects cognition by affecting fatigue and anxiety symptoms.The intermediary effect value was 1.161, the effect amount was 51.50%, and the total effect was 2.254. Conclusion:Insomnia can not only directly affect their cognitive impairment, but also indirectly affect their cognitive impairment through the chain mediation of fatigue, depression and anxiety of adolescents.

Objective:To compare the effect of three-dimensional CT angiography (CTA) and color Doppler ultrasound (CDU) in reconstruction of soft tissue defects after oral cancer surgery with anterolateral thigh flap (ALTF).Methods:Patients who underwent reconstruction of postoperative defects with ALTF in Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Southwest Medical University from January 2013 to January 2020 were retrospectively reviewed. According to the imaging method used for examining perforating artery, all patients were divided into two groups. In group A, CTA and three-dimensional vascular reconstruction were used to locate the lateral femoral circumflex artery and its perforating vessels, and the individualized ALTF was designed. In group B, the lateral circumflex femoral artery and its perforating vessels were located by CDU. The clinical features, operation time, flap survival rate, postoperative complication rate, image quality of angiography, difference of superficial skin points of perforating vessels before and during operation, and diameter of perforators were compared between the two groups. The measurement data were expressed by Mean±SD, and the differences between the two groups were compared by independent sample t-test; paired sample t-test was used to compare the intra-group differences; patients’ clinical features and other enumeration data were expressed in the number of cases (%), and analyzed by chi-square test; reliability analysis was adopted for the image quality score of two doctors at different times, taking Cronbach’s α value; correlations between body mass index (BMI) and flap survival rate were tested by Pearson correlation, whereas the correlation between flap survival rate and underlying diseases, drug combination, bad smoking and drinking habits, and surgical complications were tested by Spearman correlation, which were all performed using SPSS version 20.0 at significance level P<0.05. Results:A total of 50 patients with oral cancer were collected, 25 patients in each group. There were no significant differences between the two groups in clinical features such as sex distribution, age, TNM stage, BMI, underlying diseases, drug combination, bad smoking and drinking habits, tumor location and so on ( P>0.05). The mean operation time of group A was significantly shorter than that of group B[(67.64±5.94) min vs. (70.88±4.88) min, P<0.05]. All flaps in group A survived; one case in group B had complete flap necrosis. There was no significant difference in flap survival rate between the two groups(100% vs. 96%, P>0.05). One case in group A and two cases in group B had complications such as effusion of donor site wound, and there was no significant difference ( P>0.05). Compared with the image quality of the two groups, the angiographic quality score of group A was significantly higher than that of group B, the difference was statistically significant [(3.08±0.64) scores vs. (2.56±0.65) scores, P<0.05]. In group A, the distance difference between the position of the skin superficial point of perforator vessel positioned before operation and during operation was significantly shorter than that in group B, and the difference was statistically significant [(1.32±0.50) mm vs. (1.75±0.84) mm, P<0.05]. In group A, the diameter of perforating artery measured by imaging before operation was (1.68±0.17) mm, which had no significant difference with the actual value[(1.70±0.18) mm] ( P>0.05); whereas, in group B, the diameter of perforating artery measured by imaging before operation was (1.77±0.14) mm. The actual measured value during operation was (1.66±0.15) mm, the difference was statistically significant ( P<0.05). A significant correlation emerged between surgical complications and flap survival rate ( r=0.57, P<0.001), however, there were no significant correlations between BMI, combined with basic diseases, combined medication, bad smoking and drinking habits and flap survival ( P>0.05). Conclusions:Compared with CDU, CTA combined with three-dimensional vascular reconstruction is a feasible and reliable method for preoperative evaluation, flap design. The flap preparation time is shorter. Therefore, it is a good method of preoperative vascular localization.

Objective:To compare the effect of three-dimensional CT angiography (CTA) and color Doppler ultrasound (CDU) in reconstruction of soft tissue defects after oral cancer surgery with anterolateral thigh flap (ALTF).Methods:Patients who underwent reconstruction of postoperative defects with ALTF in Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Southwest Medical University from January 2013 to January 2020 were retrospectively reviewed. According to the imaging method used for examining perforating artery, all patients were divided into two groups. In group A, CTA and three-dimensional vascular reconstruction were used to locate the lateral femoral circumflex artery and its perforating vessels, and the individualized ALTF was designed. In group B, the lateral circumflex femoral artery and its perforating vessels were located by CDU. The clinical features, operation time, flap survival rate, postoperative complication rate, image quality of angiography, difference of superficial skin points of perforating vessels before and during operation, and diameter of perforators were compared between the two groups. The measurement data were expressed by Mean±SD, and the differences between the two groups were compared by independent sample t-test; paired sample t-test was used to compare the intra-group differences; patients’ clinical features and other enumeration data were expressed in the number of cases (%), and analyzed by chi-square test; reliability analysis was adopted for the image quality score of two doctors at different times, taking Cronbach’s α value; correlations between body mass index (BMI) and flap survival rate were tested by Pearson correlation, whereas the correlation between flap survival rate and underlying diseases, drug combination, bad smoking and drinking habits, and surgical complications were tested by Spearman correlation, which were all performed using SPSS version 20.0 at significance level P<0.05. Results:A total of 50 patients with oral cancer were collected, 25 patients in each group. There were no significant differences between the two groups in clinical features such as sex distribution, age, TNM stage, BMI, underlying diseases, drug combination, bad smoking and drinking habits, tumor location and so on ( P>0.05). The mean operation time of group A was significantly shorter than that of group B[(67.64±5.94) min vs. (70.88±4.88) min, P<0.05]. All flaps in group A survived; one case in group B had complete flap necrosis. There was no significant difference in flap survival rate between the two groups(100% vs. 96%, P>0.05). One case in group A and two cases in group B had complications such as effusion of donor site wound, and there was no significant difference ( P>0.05). Compared with the image quality of the two groups, the angiographic quality score of group A was significantly higher than that of group B, the difference was statistically significant [(3.08±0.64) scores vs. (2.56±0.65) scores, P<0.05]. In group A, the distance difference between the position of the skin superficial point of perforator vessel positioned before operation and during operation was significantly shorter than that in group B, and the difference was statistically significant [(1.32±0.50) mm vs. (1.75±0.84) mm, P<0.05]. In group A, the diameter of perforating artery measured by imaging before operation was (1.68±0.17) mm, which had no significant difference with the actual value[(1.70±0.18) mm] ( P>0.05); whereas, in group B, the diameter of perforating artery measured by imaging before operation was (1.77±0.14) mm. The actual measured value during operation was (1.66±0.15) mm, the difference was statistically significant ( P<0.05). A significant correlation emerged between surgical complications and flap survival rate ( r=0.57, P<0.001), however, there were no significant correlations between BMI, combined with basic diseases, combined medication, bad smoking and drinking habits and flap survival ( P>0.05). Conclusions:Compared with CDU, CTA combined with three-dimensional vascular reconstruction is a feasible and reliable method for preoperative evaluation, flap design. The flap preparation time is shorter. Therefore, it is a good method of preoperative vascular localization.

A plethora of organic pollutants such as pesticides, polycyclic and halogenated aromatic hydrocarbons, and emerging pollutants, such as flame retardants, is continuously being released into the environment. This poses a huge threat to the society in terms of environmental pollution, agricultural product quality, and general safety. Therefore, effective removal of organic pollutants from the environment has become an important challenge to be addressed. As a consequence of the recent and rapid developments in additive manufacturing, 3D bioprinting technology is playing an important role in the pharmaceutical industry. At the same time, an increasing number of microorganisms suitable for the production of biomaterials with complex structures and functions using 3D bioprinting technology, have been identified. This article briefly discusses the principles, advantages, and disadvantages of different 3D bioprinting technologies for pollutant removal. Furthermore, the feasibility and challenges of developing bioremediation technologies based on 3D bioprinting have also been discussed.
Biocompatible Materials ; Biodegradation, Environmental ; Bioprinting ; Environmental Pollutants ; Technology ; Tissue Engineering

OBJECTIVE:To investigate the prognosis of coronary heart disease complicated with heart failure patients abandon-ing percutaneous coronary intervention (PCI) and receiving drug comprehensive therapy. METHODS:From Dec. 2010 to Jul. 2012,217 patients with coronary heart disease complicated with heart failure in our hospital were divided into operation group (105 cases) and non-operation group (112 cases). Based on routine treatment,operation group was given aspirin combined with clopidogrel before and after PCI,and non-operation group was given aspirin combined with clopidogrel all the time. The patients were followed up regularly during discharging from hospital to May 2015 by outpatient,telephone and coronary angiography re-checking,lasting for 24-38 months. Death cases,readmission and revascularization again caused by main adverse cardio-cerebrovas-cular events were recorded during follow-up period. RESULTS:7 cases and 8 cases in operation group and non-operation group did not accept follow-up;median follow-up time was 33 months and 32 months,respectively. Case number of myocardial infarction, heart failure and death in non-operation group was more than operation group,with statistical significance (P<0.05). 94 patients survived in operation group in 3 years,with survival rate of 95.9%;66 in non-operation group,with survival rate of 63.5%;with statistical significance(P<0.05). The survival time of non-operation group was shorter than that of operation group,with statistical significance(P<0.05). CONCLUSIONS:Although we still cannot get the conclusion that PCI is a better treatment or drug therapy is better. But the survival rate of patients are not optimistic 3 years after abandoning PCI coronary heart disease patients with severe myocardial ischemia should choose PCI firstly.

The development of bioremediation for contaminated soil in China during past 30 years was briefly reviewed, mainly including the developing stages, bioremediation techniques/strategies and their applications, and isolation, screening and characterizations of microbial strains for bioremediation as well as their efficiencies in bioremediation of contaminated soils. Finally, future development of bioremediation techniques/strategies and their applications were also discussed.
Biodegradation, Environmental ; China ; Environmental Pollution ; Soil Microbiology ; Soil Pollutants

Polythioesters newly emerged as a type of novel polymer and they have showed great potential for application in industries. In this study, genes of butyrate kinase (buk) and phosphotransbutyrylase (ptb) from Clostridium acetobutylicum, and poly (3-hydroxybutyrate) (PHB) synthase gene from Thiocapsa pfennigii were used for construction of a metabolic pathway to synthesize the polythioesters. When 3-mercaptopropionate and 3-hydroxybutyrate were fed, poly (3-mercaptopropoinate) [poly (3MP)] and poly(3-mercaptopropionate-co-3-hydroxybutyrate) [poly(3MP-co-3HB)] were synthesized by recombinant Escherichia coli JM109 (pBPP1) harboring the constructed metabolic pathway. Results indicated clearly that all these genes are necessary for the synthesis of poly(3MP) and poly(3MP-co-3HB).
3-Hydroxybutyric Acid ; chemistry ; 3-Mercaptopropionic Acid ; chemistry ; Acyltransferases ; genetics ; metabolism ; Escherichia coli ; genetics ; metabolism ; Gas Chromatography-Mass Spectrometry ; Models, Biological ; Molecular Weight ; Phosphate Acetyltransferase ; genetics ; metabolism ; Phosphotransferases (Carboxyl Group Acceptor) ; genetics ; metabolism ; Plasmids ; Polymers ; chemistry ; metabolism ; Spectrophotometry, Infrared