Objective:To compare the clinical effects between the homodigital radial flap of the dorsal cutaneous branch of radial palmar proper digital artery (PPDA) and the homodigital reverse island flap of the ulnar dorsal digital artery (DDA) on reconstruction of defects in thumb-tip or thumb-pulp.Methods:The retrospective case-control study method was used. From January 2016 to August 2022, a total of 65 thumb-tip or thumb-pulp defects were treated in the Department of Hand Surgery of the Second Hospital of Tangshan. Thirty-five defects of thumbs were reconstructed with the homodigital radial flap pedicled with dorsal cutaneous branch of radial PPDA (PPDA group) and the other 30 thumbs were treated by the homodigital ulnar reverse island flap pedicled with ulnar DDA (DDA group). Sizes of the wounds and flaps in PPDA group were 1.9 cm×1.5 cm to 2.9 cm×2.4 cm and 2.1 cm× 1.7 cm to 3.1 cm×2.6 cm, respectively, and the dimensions of the wounds and flaps in DDA group were 2.0 cm× 1.7 cm to 2.9 cm×2.5 cm and 2.2 cm×1.9 cm to 3.2 cm×2.8 cm, respectively. The wounds of donor site in both groups were all directly closed. Survival of the flaps and wound healing of donor sites were observed in both groups. The time of surgery and duration of follow-up of the 2 groups were recorded. Postoperative follow-up included outpatient clinic visits, telephone reviews and WeChat video-clips. At the final follow-up, record of total active motion (TAM) of the injured thumbs, angle of first web of the affected hands, static TPD of the flaps, patient satisfaction of the appearance of flaps and donor sites were taken. According to the Michigan Hand Function Questionnaire (MHQ) evaluation criteria, the patient satisfaction of the appearance of flaps and donor sites were evaluated. The measurement and count data acquired from both groups were compared by independent sample t-test and χ2 tests or Fisher's exact test, respectively. P<0.05 was considered statistically significant. Results:All 35 flaps in PPDA group and 26 flaps in DDA group survived primarily, except 4 flaps in the DDA group that showed blisters and healed with dressing changes. The primary survival rate of flap in PPDA group (100%) was higher than that of DDA group (87%), and the difference was statistically significant ( P<0.05). Donor sites of both groups healed primary. The time of surgery and duration of follow-up in PPDA and DDA groups were 59.11 minutes±5.42 minutes and 15.37 months±3.32 months, and 61.27 minutes±5.96 minutes and 16.17 months±3.60 months, respectively. There was no statistically significant difference between the 2 groups ( P>0.05). At the final follow-up, the thumb TAM and angle of thumb web in PPDA and DDA groups were 135.14°±10.04° and 90.29°±4.36° and 132.17°±11.04° and 89.00°±4.81°, respectively. There was no statistically significant differences between the 2 groups ( P>0.05). The static TPD, patient satisfaction of the appearance of flaps and donor sites in PPDA group were 7.11 mm±1.21 mm, 4.69 point±0.47 point and 4.43 point±0.50 point, which were better than DDA group [8.20 mm±1.47 mm, 4.40 point±0.50 point and 4.13 point±0.57 point, respectively] with a statistically significant difference ( P<0.05). Conclusion:The homodigital radial flap of the dorsal cutaneous branch of radial PPDA and the homodigital ulnar reverse island flap of the ulnar DDA are both suitable for reconstruction of defects in thumb-tip or thumb-pulp. Compared with the homodigital reverse island flap with the DDA, a homodigital radial flap with the dorsal cutaneous branch of PPDA has advantages in higher primary survival rate, better flap sensation and appearance at both of recipient and donor sites.

The coronavirus disease 2019 (COVID-19) pandemic, triggered by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has ravaged the globe, resulting in a staggering loss of life and wreaking havoc on the worldwide economy.[1,2] Sepsis is a cascade of abnormal responses provoked by infection, leading to a critical deterioration in organ function that poses a life-threatening risk.[3] However, it is unclear from published reports whether COVID-19 and sepsis are commonly affected by molecular factors. Therefore, we performed a bioinformatics analysis to uncover shared diagnostic genes and potential mechanisms between COVID-19 and sepsis.

OBJECTIVE To evaluate the clinical efficacy and safety of XELOX chemotherapy （oxaliplatin+capecitabine） combined with antiangiogenic agent （apatinib） and immunotherapy （camrelizumab） in patients with inoperable metastatic colorectal cancer （CRC）of microsatellite stable （MSS） type. METHODS Clinical medical records of 40 patients with inoperable metastatic CRC of MSS type treated in Lishui People’s Hospital from January 2020 to January 2021 were retrospectively collected. According to the treatment plan， the patients were divided into control group （20 cases） and observation group （20 cases）. Control group was given XELOX+apatinib regimen， while observation group was given XELOX+apatinib+camrelizumab regimen. Every 3 weeks was a treatment cycle， and the treatment lasted for 2 consecutive cycles. The objective response rate （ORR）， disease control rate （DCR）， progression-free survival （PFS）， overall survival （OS） and adverse events （AEs） were recorded for all patients. RESULTS The ORR and DCR of observation group were 65.0% and 85.0%， respectively； and the ORR and DCR of control group were 35.0% and 75.0%， respectively， with no statistical significance between 2 groups （P＞0.05）. The median PFS of observation group and control groups were 16.0 months and 8.0 months， respectively； and the median OS were 19.0 months and 12.5 months， respectively， with statistical significance between 2 groups （P＜0.05）. Each patient in both groups had at least one AEs， and the incidences of reactive skin capillary hyperplasia and hyperthyroidism in observation group （40.0%， 20.0%） were significantly higher than those in control group （both were 0） （P＜0.05）. The incidence of nausea and vomiting in control group （90%） was significantly higher than observation group （10%） （P＜0.05）. There were 14 cases （70.0%） of patients with grade 3 or above AEs in observation group， and only 5 cases （25.0%） in control group， with statistical significance between 2 groups （P＜0.05）. However， no severe AEs that could not be tolerated or fatal occurred in the two groups， which could be alleviated after drug withdrawal or treatment. CONCLUSIONS The efficacy of XELOX chemotherapy combined with apatinib and camrelizumab in inoperable metastatic CRC patients of MSS type is comparable to that of XELOX chemotherapy combined with apatinib， but it has certain advantages in ORR， PFS and OS， and controllable safety.

The importance of structural variants(SVs)for human phenotypes and diseases is now recognized.Although a variety of SV detection platforms and strategies that vary in sensitivity and specificity have been developed,few benchmarking procedures are available to confidently assess their performances in biological and clinical research.To facilitate the validation and application of these SV detection approaches,we established an Asian reference material by characterizing the genome of an Epstein-Barr virus(EBV)-immortalized B lymphocyte line along with identified benchmark regions and high-confidence SV calls.We established a high-confidence SV callset with 8938 SVs by integrating four alignment-based SV callers,including 109x Pacific Biosciences(PacBio)continuous long reads(CLRs),22 x PacBio circular consensus sequencing(CCS)reads,104x Oxford Nanopore Technologies(ONT)long reads,and 114×Bionano optical mapping plat-form,and one de novo assembly-based SV caller using CCS reads.A total of 544 randomly selected SVs were validated by PCR amplification and Sanger sequencing,demonstrating the robustness of our SV calls.Combining trio-binning-based haplotype assemblies,we established an SV benchmark for identifying false negatives and false positives by constructing the continuous high-confidence regions(CHCRs),which covered 1.46 gigabase pairs(Gb)and 6882 SVs supported by at least one diploid haplotype assembly.Establishing high-confidence SV calls for a benchmark sample that has been characterized by multiple technologies provides a valuable resource for investigating SVs in human biology,disease,and clinical research.

Objective To evaluate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in treatment of patients with liver cancer.Methods Totally 20 patients with liver cancer undergoing DEB-TACE treatment were enrolled.Clinical efficacy included complete response (CR),partial response (PR),stable disease (SD) and progressive disease (PD).The overall response rate (ORR) was defined as proportion of patients achieved CR and PR.Results After treatment of DEB-TACE,the ORR,CR,PR,SD,and PD of patients were 80.00％ (16/20),40.00％ (8/20),40.00％ (8/20),15.00％ (3/20),and 5.00％ (1/20),respectively;while for single tumor nodule,the ORR,CR,PR,SD,and PD were 81.58％ (31/32),50.00 (19/38)％,31.58％ (12/38),15.79％ (6/38),and 2.63％ (1/38),respectively.After the treatment of DEB-TACE,the relapse free survival rate in half year was 85.00％,and the overall survival rate was 95.00％.The adverse events of patients were mild pain,fever,nausea and vomiting.Conclusion CalliSpheres(R) DEB-TACE is an effective and well tolerated treatment in liver cancer patients.

Objective To investigate the changes of the levels of sonic hedgehog (SHH) and vascular endothelial growth factor (VEGF) in serum and its relationship with collateral circulation in patients with symptomatic middle cerebral artery stenosis. Methods From January 2015 to January 2018, a total of 268 patients with acute ischemic stroke confirmed as unilateral middle cerebral artery M1 segment (MCA-M1) severe stenosis or occlusion by digital subtract angiography (DSA) were enrolled. The baseline clinical data were collected. According to the establishment of collateral circulation shown by DSA, they were divided into good collateral circulation group (152 patients) and poor collateral circulation group (116 patients). The levels of SHH and VEGF in serum were detected by enzyme linked immunosorbent assay (ELISA), the expression characteristics of SHH and VEGF in serum and the relative factors influencing the establishment of collateral circulation were analyzed. Results The levels of serum SHH and VEGF in good collateral circulation group were significantly higher than those in poor collateral circulation group (P < 0.01). Pearson correlation analysis showed that there was a positive correlation between SHH and VEGF (r=0.758, P < 0.01). Multivariate Logistic regression analysis showed that the levels of serum SHH ( OR=0.310, 95% CI 0.117-0.819, P=0.018) and VEGF ( OR=0.361, 95% CI 0.147-0.887, P=0.026) were independent protective factors for the establishment of collateral circulation. Diabetes ( OR=3.094, 95% CI 1.321-7.245, P=0.009) was independent risk factor for the establishment of collateral circulation. Conclusions The levels of serum SHH and VEGF are closely related to the formation of collateral circulation and they are independent protective factors. SHH may be involved in the establishment of cerebral collateral circulation by regulating the expression of VEGF and diabetes is not conducive to the formation of collateral circulation.

Objective To investigate the effect of early rehabilitation intervention model on improving intelligence, motor function and prognosis in premature infants with brain injury. Methods 150 cases of premature infants with brain injury who were diagnosed in the department of pediatrics in our hospital from June 2012 to October 2015 were selected. A total of 114 cases whose parents actively participated in the intervention guidance were selected as the observation group. 36 cases whose parents were not willing to participate in the early intervention guide were selected as the control group. The control group was given routine intervention, and the observation group was given early rehabilitation intervention model on the basis of the control group. The two groups of children were given intervention for 24 months. The intelligence and motor development index 12 and 24 months after intervention were observed and compared between the two groups, and the rate of nerve disability was compared. Results After intervention for 12 and 24 months, MDI and PDI in the observation group were significantly better than those in the control group (P＜0. 05). After intervention for 24 months, the incidence rate of neurological disability in the observation group was significantly lower than that in the control group(P＜0. 05). Conclusion Early rehabilitation intervention model has a positive effect on the recovery of premature infants with brain injury, which can improve the level of intelligence and motor development, develop the potential of children, reduce the rate of nerve disability, and improve the prognosis of children.

Objective To explore facial characteristics of patients with different organ diseases; To provide some references for objective study on TCM inspection information. Methods Smart TCM-I type Life Information Analysis Systems was used to detect facial characteristics of 510 patients with five zang-organs diseases. 36 specific quantitative parameters including red ?, green (G), blue (B) and hue (H), saturation (S), value (V) of the face, forehead, eyes, cheeks, nose and chin were collected, and the Kruskal M-Wallis H and Nemenyi test were used for statistical analysis. Results Among the 510 patients with five zang-organs diseases, 96 patients belonged to lung system diseases, 105 heart system diseases, 101 liver system diseases, 107 spleen and stomach system diseases and 101 kidney system diseases. There was statistical significance in R, G, B, H, S, and V in forehead, eyes, cheeks and nose. Conclusion Facial characteristics can provide objective references for the facial division of five zang-organs diseases.

Objective To understand the plasma protein differential expression before and after cardiopulmonary bypass (CPB)through conducting the comparative proteomics study on rats in order to find the plasma markers with potential value in the early diagnosis of CPB resulted complications.Methods 10 adult male SD rats were divided into the experiment group and the con-trol group randomly (n=5),and took food and water freely before operation.The rat models of CPB were constructed in the experi-ment group.But no any CPB operation was administered in the control group in addition to anesthesia induction,arterial and venous puncture procedure.1 mL of blood sample was extracted for separating plasma before CPB and at the end of CPB in the two groups. The total plasma protein was purified.Then the 2-dimensional electrophoresis and the scanning imaging by ImageScanner were per-formed.The protein spots verified to be differential expression were performed the cutting,enzymolysis and peptide fragment ex-traction.Finally the mass spectrometer was adopted to conduct the analysis and identification.Results The number of visualized spots was increased significantly after CPB.17 protein spots with up-regulated expression were identified as differential expression caused by CPB.5 proteins were verified by mass spectrometer analysis and database research.They were gelsolin,haptoglobin,apo-lipoprotein A-1,immunoglobulin gamma-2b and Ba1-647 respectively.Conclusion CPB can cause the differential expression of plas-ma proteins in rat model.According to the function analysis,gelsolin,haptoglobin and apolipoprotein A-1 have the potentiality of be-ing the plasma markers for studying CPB complications.

Standardization, objectification, and normalization of TCM syndromes are emphasis, difficulty, and hot issue of inheritance and development of TCM.With the technological development of computer and extensive application of multi-disciplinary integration, research methods for the identification of TCM syndrome classification emerge in endlessly. This article analyzed the application status of multivariate statistical analysis in the identification of TCM symdrome classification, summarized application status and existing problems of cluster analysis, PCA and factor analysis, discriminant analysis and Logistic regression analysis, and structure equation model in the identification of TCM symdrome classification, which provided references for further studies on identification methods of TCM symdrome classification.