Hepatic ischemia/reperfusion injury (HIRI) is a serious complication that occurs following shock and/or liver surgery. Gut microbiota and their metabolites are key upstream modulators of development of liver injury. Herein, we investigated the potential contribution of gut microbes to HIRI. Ischemia/reperfusion surgery was performed to establish a murine model of HIRI. 16S rRNA gene sequencing and metabolomics were used for microbial analysis. Transcriptomics and proteomics analysis were employed to study the host cell responses. Our results establish HIRI was significantly increased when surgery occurred in the evening (ZT12, 20:00) when compared with the morning (ZT0, 08:00); however, antibiotic pretreatment reduced this diurnal variation. The abundance of a microbial metabolite 3,4-dihydroxyphenylpropionic acid was significantly higher in ZT0 when compared with ZT12 in the gut and this compound significantly protected mice against HIRI. Furthermore, 3,4-dihydroxyphenylpropionic acid suppressed the macrophage pro-inflammatory response in vivo and in vitro. This metabolite inhibits histone deacetylase activity by reducing its phosphorylation. Histone deacetylase inhibition suppressed macrophage pro-inflammatory activation and diminished the diurnal variation of HIRI. Our findings revealed a novel protective microbial metabolite against HIRI in mice. The potential underlying mechanism was at least in part, via 3,4-dihydroxyphenylpropionic acid-dependent immune regulation and histone deacetylase (HDAC) inhibition in macrophages.

Schizophyllum commune has emerged as the most promising model mushroom to study developmental stages (mycelium, primordium), which are two primary processes of fruit body development. Long non-coding RNA (lncRNA) has been proved to participate in fruit development and sex differentiation in fungi. However, potential lncRNAs have not been identified in S. commune from mycelium to primordium developmental stages. In this study, lncRNA-seq was performed in S. commune and 61.56 Gb clean data were generated from mycelium and primordium developmental stages. Furthermore, 191 lncRNAs had been obtained and a total of 49 lncRNAs were classified as differently expressed lncRNAs.Additionally, 26 up-regulated differently expressed lncRNAs and 23 down-regulated between mycelium and primordia libraries were detected. Further, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that differentially expressed lncRNAs target genes from the MAPK pathway, phosphatidylinositol signal, ubiquitin-mediated proteolysis, autophagy, and cell cycle. This study provides a new resource for further research on the relationship between lncRNA and two developmental stages (mycelium, primordium) in S. commune

In September 2020, an elderly patient with cognitive impairment(CI) was admitted in Deparment of Microsurgery, Hangzhou Qiushi Hospital. The patient was in bed and could not answer correctly before surgery. The preoperative Minimum Mental State Examination(MMSE) score was 3(3/30) and the Montreal Cognitive Assessment (MoCA) score was 2(2/30). After completion of preoperative examinations, a 3D microscope combined with fluorescence tracing technique was used to perform deep cervical lymphatic-venous anastomosis at the bilateral cervical Va lymph nodes part: two anastomosis methods were performed, one was end to side anastomosis and the other was end to end anastomosis. The diameters of all anastomotic dilated lymphatic vessels were less than 0.2 mm, the diameters of end-to-side, end to end anastomotic veins were 0.6 mm and 0.2 mm. Short-term postoperative anti-inflammatory treatment was given and a long-term functional rehabilitation training was performed. There were no postoperative complications and the incision healed well. The MMSE scores were 8, 12, 14, 18 point, and the MoCA scores were 8, 9, 11, 13 point. At 3, 30, 90, 180 days after surgery, respectively. Basic cognitive function was restored at 9 months after surgery.

Objective To investigate the method and curative effect of the posterior cervical esophageal de-fect after the reconstruction of lower pharyngeal carcinoma by dissociation of the lower pharyngeal carcinoma. Meth-ods From August,2015 to June,2017, we used the jejunum segment. to reconstruct five patients' esophageal defect in the neck segment enlarged after the enlargement of the hypopharyngeal carcinoma. The length of the jejunum was 8.0 -15.0 cm, We used microvascular stapling to anastomosis vein in surgery. The morphological and functional changes of the graft tube were observed by endoscopic follow-up. Results All 5 patients were discharged from the hospital with an average of 12 days in hospital.The mean time of heat ischemia was 8 minutes,and the average oper-ation time was 5.2 hours. After endoscopic follow-up for 12 months, no stricture or anastomotic leakage occurred in the transplanted bowel, and the intestine moves downward autonomously, the morphological and functional remodeling of transplanted intestinal tract was observed. Conclusion Free jejunal reconstruction of hypopharyngeal carcinoma resection for cervical esophageal is a safe method with a good outcome in morphological and functional remodeling.It' s one of the ideal methods to reconstruct cervical esophageal defect.

Objective To discuss the clinical effect of Da Vinci robot-assisted free fibula flap for the management of mandibular and mouth segmental defect.Methods There was a patient with malignant neoplasm of lower gum,which underwent robot-assisted free fibula flap for the management of mandibular and mouth segmental defect,was analyzed.The surgery was divided into two groups:a group resected the primary tumors,another group cut fibula free flap.Use of Da Vinci robotic surgical system for vascular anastomosis and suture of the oral mucosa.Results Four weeks after surgery,the free fibula flap survived completely.There was no infection in the mouth.The patient can walk freely and eating semifluid.Conclusion The Da Vinci robotic surgical system is a stable,minimally invasive,clear and safe method for microsurgery.

Objective To investigate the clinical efficacy of using the tissue engineering bone loaded with adipose derived stem cells (ADSCs)and perforator flap in the treatment of composite tissue defects.Methods From April,2013 to June,2015,there were 9 cases of traumatic bone and skin composite tissue defects,including 7 males and 2 females,with an averaged age of 43 years old.The ADSCs were isolated,induced and co-cultured with demineralized bone scaffold.The tissue engineering bone and deep inferior epigastric artery perforator (DIEP) flap were adopted for reconstruction of composite tissue defects.Results All 9 patients were followed up for 12-36 months,averaged of 18 months.The bone growth was obviously for 5 cases with bone defects at the middle and lower part of the tibia.They tolerated full weight bearing walking.One case of middle humeral bone defect demonstrated normal bone tissue growth,and the 2/3 of cross section had been restored.One case of humeral bone defect and 1 case of radial bone defect reached bone union.The remaining 1 with skull defect showed new bone growth,but it had not yet achieved complete bone healing.Conclusion The combination of tissue engineering bone and perforator flap is a minimally invasive,easy accessible and effective method for reconstruction of composite tissue defects.

Objective To investigate the effectiveness of ultrasound in evaluating the degree of xerostomia in the patients with nasopharyngeal carcinoma ( NPC) receiving intensity?modulated radiotherapy (IMRT). Methods A total of 30 NPC patients who were admitted to our hospital from May 2013 to December 2014 were enrolled in this study. The degree of xerostomia in these NPC patients was scored according to the Radiation Therapy Oncology Group scoring criteria. Color Doppler ultrasound was used to measure the peak systolic blood flow velocity of the parotid gland and submandibular gland and the changes in vascular diameter of the parotid gland in the NPC patients before, during, and after IMRT. The correlation between each parameter and the degree of xerostomia was determined by analysis of variance. Results In the 28 NPC patients included in the statistical analysis, the degree of xerostomia during IMRT was significantly higher than that before IMRT ( P=0024 ) , and the degree of xerostomia at 3 months after IMRT was significantly lower than that during IMRT ( P=0035) . The peak systolic blood flow velocity of the parotid gland and submandibular gland and the proportion of patients with decreases in vascular diameter of the parotid gland during IMRT were significantly higher than those before IMRT ( P=0001 and 0003;P=0001);the above parameters at 3 months after IMRT were significantly lower than those during IMRT ( P=0008 and 0012;P=0001) . During IMRT and after IMRT, the degree of xerostomia was significantly correlated with the peak systolic blood flow velocity of the parotid gland ( r=0563, P=0026;r=0409, P=0031) . Conclusions Ultrasound can be used as a noninvasive detection for the hemodynamic changes in the parotid gland, and it has a certain clinical reference value for evaluating the degree of xerostomia in NPC patients during and after IMRT.

Objective To investigate the reliability and effect of using the chimeric flap retrieved by laparoscopic surgery to cover the large defect of the extremities.Methods The debridement and vacuum sealing drainage (VSD) were performed on 18 patients, who were admitted due to the defects of the extremities.The free chimeric peritoneal-deep inferior epigastric artery perforator (DIEP) flap assisted by laparoscopic surgery was transplanted to cover the defect with exposed tendons and/or skeleton.Results The remaining defects of the extremities were 12 cm × 8 cm-30 cm × 17 cm.The peritoneal component of the chimeric flaps measuring 8 cm × 6 cm -14 cm × 10 cm retrieved by laparoscopic surgery was used to cover the tendons, bones and joints.The deep inferior epigastric artery perforator (DIEP) flaps measuring 13 cm × 10 cm-32 cm × 18 cm allowed the cutaneous coverage of wounds.The chimeric flaps survived completely excepting two patients.The two patients experienced partial necrosis of the chimeric flaps and received skin grafting to achieve the wound closure.The function of the injured extremities recovered partially after 6-18 months of follow-up.No abdominal pain, distension, herniation,bulging and intestinal obstruction were recorded.Conclusion The chimeric flap assisted by laparoscopy is a helpful, safe and effective method for reconstruction of large wounds in extremities with exposed tendons and bones.

Objective To investigate the efficacy of using the extensor carpi ulnaris as the motor tendon in correcting claw hand deformity and improving hand function.Methods A total of 12 patients with ulnar nerve palsy and claw finger deformity were included into this study from October, 2009 to September, 2011.Results All ceses had an average followed-up of 15.5 months, ranging from 12 months to 24 months.According to the Total Active Movement (TAM) score, there were 4 cases receiving excellent results, 6 cases receiving good results and 2 cases receiving fair results.The claw finger deformity was corrected and intrinsic hand function improved significantly.The average increase in grip strength was 41％ at the 12 months post operation, compared with the preoperative data (P ＜ 0.05).The mean DASH score decreased from 53.6 ± 11.4 preoperatively to 20.4 ± 6.8 postoperatively (P ＜ 0.05).Conclusion The technique of using the extensor carpi ulnaris as the motor tendon is effective in correcting claw fingers, increasing the grip strength and improving overall hand function.This surgical procedure is also beneficial for patients accompanied by the median nerve injury.

BACKGROUNDA variety of inflammatory mediators and effector cells participate together in acute lung injury, and lead to secondary injury that is due to an inflammatory cascade and secondary diffuse lung parenchyma injury. Inflammation is associated with an oxidative stress reaction, which is produced in the development of airway inflammation, and which has positive feedback on inflammation itself. Resolvin D1 can reduce the infiltration of neutrophils, regulate cytokine levels and reduce the inflammation reaction, and thereby promote the resolution of inflammation. The purpose of this study is to investigate the effects of resolvin D1 on an inflammatory response and oxidative stress during lipopolysaccharide (LPS)-induced acute lung injury.

METHODSLPS (3 mg/kg) was used to induce the acute lung injury model. Pretreatment resolvin D1 (100 ng/mouse) was given to mice 30 minutes before inducing acute lung injury. Mice were observed at 6 hours, 12 hours, 1 day, 2 days, 3 days, 4 days and 7 days after LPS was administrated, then they were humanely sacrificed. We collected bronchoalveolar lavage fluid (BALF) and the lung tissues for further analysis. Paraffin section and HE staining of the lung tissues were made for histopathology observations. Parts of the lung tissues were evaluated for wet-to-dry (W/D) weight ratio. tumor necrosis factor (TNF)-α, inter leukin (IL)-1β, IL-10 and myeloperoxidase (MPO) were detected by enzyme-linked immunosorbent assay (ELISA). A lipid peroxidation malondialdehyde (MDA) assay kit was used to detect MDA. A total superoxide dismutase assay kit with WST-1 was used to analyze superoxide dismutase (SOD). We determined the apoptosis of neutrophils by Flow Cytometry. A real-time quantitative PCR Detecting System detected the expression of mRNA for heme oxygenase (HO)-1.

RESULTSPretreatment with resolvin D1 reduced the pathological damage in the lung, decreased the recruitment of neutrophils and stimulated their apoptosis. It markedly decreased the expressions of TNF-α, IL-1β and increased the expressions of IL-10, and decreased the production of MDA and increased the expressions of SOD. The mRNA expression of HO-1 was also significantly increased.

CONCLUSIONSResolvin D1 displays potent anti-inflammatory actions by regulating cytokines, inhibiting aberrant neutrophil recruitment and stimulating apoptosis of neutrophils. Resolvin D1 can also relieve the injury due to oxidative stress. The mechanisms might be related to increase HO-1 expression.

Acute Lung Injury ; chemically induced ; drug therapy ; immunology ; Animals ; Bronchoalveolar Lavage Fluid ; immunology ; Docosahexaenoic Acids ; therapeutic use ; Interleukin-10 ; metabolism ; Interleukin-1beta ; metabolism ; Lipopolysaccharides ; toxicity ; Male ; Mice ; Mice, Inbred BALB C ; Oxidative Stress ; drug effects ; Peroxidase ; metabolism ; Superoxide Dismutase ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism