The regulatory role of the RUS family in plant growth and development / 生物工程学报

The chloroplast genome encodes many key proteins involved in photosynthesis and other metabolic processes, and metabolites synthesized in chloroplasts are essential for normal plant growth and development. Root-UVB (ultraviolet radiation B)-sensitive (RUS) family proteins composed of highly conserved DUF647 domain belong to chloroplast proteins. They play an important role in the regulation of various life activities such as plant morphogenesis, material transport and energy metabolism. This article summarizes the recent advances of the RUS family proteins in the growth and development of plants such as embryonic development, photomorphological construction, VB6 homeostasis, auxin transport and anther development, with the aim to facilitate further study of its molecular regulation mechanism in plant growth and development.

Preparation and in vitro evaluation of polylactic acid nanoparticles containing arginine and glucose oxidase / 药学学报

Hydrogen peroxide (H2O2) and nitric oxide (NO) has a short half-life, low bioavailability, poor tumor targeting and systemic adverse reactions in the physiological environment. In this study, phacoemulsification and nano-precipitation were used to synthesize didecyl dimethyl ammonium bromide (DDAB)/polylactic acid nanoparticles (PLA), then L-arginine (L-Arg) and glucose oxidase (GOx)-loaded nanoparticles (GADP) were prepared, and the in vitro antitumor activity was investigated．The particle size, potential, embedding rate and the ability to produce H2O2/NO of the nanoparticles were investigated. Meanwhile, in vitro cell cytotoxicity against human hepatoma cells (HepG2) was evaluated．The results showed that the prepared L-Arg-DDAB/PLA (ADP) nanoparticles were spherical particles. And the particle size and zeta potential were (225.7 ± 6.33) nm and (+23.5 ± 0.12) mV, respectively. The adsorption rate of GOx was 87.23% ± 0.02%. The drug loading of L-Arg was 15.6% ± 0.22%. The pH value of glucose solution and the amount of H2O2 showed that GADP had good catalytic activity. In vitro cytotoxicity experiments showed that blank nanoparticles were nontoxic, while the drug-loaded nanoparticles presented enhanced antitumor effect on HepG2 cells. And can inhibit tumor cell migration. The low dose nano-scale NO delivery system GADP can effectively inhibit the migration of tumor cells and kill tumor cells, thus producing therapeutic benefits.

Diagnosis and treatment of the portal vein complications for children undergoing spilt liver transplantation / 器官移植

Objective To investigate the diagnosis and treatment strategy of the portal vein complications in children undergoing split liver transplantation. Methods The clinical data of 88 pediatric recipients who underwent split liver transplantation were retrospectively analyzed. Intraoperative anastomosis at the bifurcating site of the portal vein or donor iliac vein bypass anastomosis was performed depending on the internal diameter and development of the recipient's portal vein. A normalized portal venous blood stream monitoring was performed during the perioperative stage. After operation, heparin sodium was used to bridge warfarin for anticoagulation therapy. After portal vein stenosis or thrombosis was identified with enhanced CT or portography, managements including embolectomy, systemic anticoagulation, interventional thrombus removal, balloon dilatation and/or stenting were performed. Results Among the 88 recipients, a total of 10 children were diagnosed with portal vein complications, of which 4 cases were diagnosed with portal vein stenosis at 1 d, 2 months, 8 months, and 11 months after surgery, and 6 cases were diagnosed with portal vein thrombosis at intraoperative, 2 d, 3 d (n=2), 6 d, and 11 months after surgery, respectively. One patient with portal vein stenosis and one patient with portal vein thrombosis died perioperatively. The fatality related to portal vein complications was 2% (2/88). Of the remaining 8 patients, 1 underwent systemic anticoagulation, 2 underwent portal venous embolectomy, 1 underwent interventional balloon dilatation, and 4 underwent interventional balloon dilatation plus stenting. No portal venous related symptoms were detected during postoperative long term follow up, and the retested portal venous blood stream parameters were normal. Conclusions The normalized intra- and post-operative portal venous blood stream monitoring is a useful tool for the early detection of portal vein complications, the early utilization of useful managements such as intraoperative portal venous embolectomy, interventional balloon dilatation and stenting may effectively treat the portal vein complications, thus minimizing the portal vein complication related graft loss and recipient death.

Finite element analysis of cervical intervertebral discs after removing different ranges of uncinate processes / 解剖学报

Objective To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three⁃dimensional finite element model of the C

Diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province / 中国胸心血管外科临床杂志

@#Esophageal cancer is a highly prevalent tumor species in Henan province, which brings heavy medical burden to families and society. Surgical treatment plays a dominant role in the treatment of non-advanced esophageal cancer. However, cancer cells in esophageal cancer lesions are highly invasive, postoperative recurrence and metastasis rates are pretty high. More effective systemic and comprehensive treatment is urgently needed to improve the prognosis. We invited 52 doctors in esophageal surgery, oncology, pathology, imaging, and radiation therapy of 32 hospitals at all levels in Henan province, to repeatedly negotiate and fully discuss in combination with evidence and clinical practice experience. Finally, “diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province” was formulated. In this treatment pathway, seven recommendations were proposed from seven perspectives including target population, patient evaluation, protocol selection, surgical timing, postoperative management, organ preservation, and general principles to offer reference for medical personnel related to esophageal cancer surgery.

Ethical Problems and Countermeasures in Rehabilitation Intervention for Patients with lymphedema after Breast Cancer Operation / 中国医学伦理学

In order to explore the medical and social problems related to postoperative lymphedema in breast cancer patients, improve the compliance of rehabilitation treatment and help patients return to society. The self-designed questionnaire was used to investigate 76 patients who met the criteria of lymphedema after breast cancer and refused or failed to adhere to rehabilitation threapy. According to the relevant measurement scale theory and method, the computer-aided software was used to analyze the data to find out the problem and analyze the cause. The prominent problems of poor compliance in patients with breast cancer after operation were successively: subjective factors, objective factors, family social and ethical factors, multidisciplinary factors, hospital management and policy issues. For the above ethical problems, we should adopt positive coping strategies to increase the compliance of patients and improve their quality of life.

Association of attention deficit hyperactivity disorder symptoms and bullying behavior in children / 中国学校卫生

Objective@#The association between school bullying and attention deficit hyperactivity disorder (ADHD) symptoms among students in primary schools and the moderating role of gender was explored to provide scientific evidence for the prevention and control of school bullying.@*Methods@#A total of 4 764 students from 2 primary schools in Wuhan were selected using the convenience sampling method in March 2023. The Olweus Bully/Victim Questionnaire and Strengths and Difficulties Questionnaire were used. A Pearson χ 2 test was used to compare differences in school bullying rates among children with and without ADHD symptoms. Pearson correlation analysis and Process 3.3 were used to analyse the association between ADHD symptoms, and school bullying behaviour and the moderating role of gender.@*Results@#The reported rate of bullying victims in primary schools was 24.2% and the rate of bullying perpetration was 3.8%. The rate of ADHD symptom detection among primary school students was 5.9%. ADHD symptoms were positively associated with bullying and bullying victim behaviour ( r =0.16, 0.27, P <0.01). Specifically, the association between ADHD symptoms and bullying behavior tended to be stronger among boys than girls ( β boy =0.17, t =11.13; β girl =0.07, t =4.11, P <0.01).@*Conclusions@#ADHD symptoms are an important factor influencing school bullying behaviors in students, and gender moderates the association. In the process of preventing and controlling school bullying, ADHD symptoms and gender differences should be emphasized and comprehensive interventions should be implemented.

GLUL stabilizes N-Cadherin by antagonizing β-Catenin to inhibit the progresses of gastric cancer

Glutamate-ammonia ligase (GLUL, also known as glutamine synthetase) is a crucial enzyme that catalyzes ammonium and glutamate into glutamine in the ATP-dependent condensation. Although GLUL plays a critical role in multiple cancers, the expression and function of GLUL in gastric cancer remain unclear. In the present study, we have found that the expression level of GLUL was significantly lower in gastric cancer tissues compared with adjacent normal tissues, and correlated with N stage and TNM stage, and low GLUL expression predicted poor survival for gastric cancer patients. Knockdown of GLUL promoted the growth, migration, invasion and metastasis of gastric cancer cells in vitro and in vivo, and vice versa, which was independent of its enzyme activity. Mechanistically, GLUL competed with β-Catenin to bind to N-Cadherin, increased the stability of N-Cadherin and decreased the stability of β-Catenin by alerting their ubiquitination. Furthermore, there were lower N-Cadherin and higher β-Catenin expression levels in gastric cancer tissues compared with adjacent normal tissues. GLUL protein expression was correlated with that of N-Cadherin, and could be the independent prognostic factor in gastric cancer. Our findings reveal that GLUL stabilizes N-Cadherin by antagonizing β-Catenin to inhibit the progress of gastric cancer.

Targeting ferroptosis and ferritinophagy: new targets for cardiovascular diseases / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Cardiovascular diseases (CVDs) are a leading factor driving mortality worldwide. Iron, an essential trace mineral, is important in numerous biological processes, and its role in CVDs has raised broad discussion for decades. Iron-mediated cell death, namely ferroptosis, has attracted much attention due to its critical role in cardiomyocyte damage and CVDs. Furthermore, ferritinophagy is the upstream mechanism that induces ferroptosis, and is closely related to CVDs. This review aims to delineate the processes and mechanisms of ferroptosis and ferritinophagy, and the regulatory pathways and molecular targets involved in ferritinophagy, and to determine their roles in CVDs. Furthermore, we discuss the possibility of targeting ferritinophagy-induced ferroptosis modulators for treating CVDs. Collectively, this review offers some new insights into the pathology of CVDs and identifies possible therapeutic targets.

Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine：Fibromyalgia Syndrome / 中国实验方剂学杂志

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Bone marrow-derived mesenchymal stem cell-conditioned medium ameliorates diabetic foot ulcers in rats

Abstract Objectives: This study aimed to explore the effects of bone marrow-derived Mesenchymal Stem Cell-Conditioned Medium (MSC-CM) treating diabetic foot ulcers in rats. Methods: Models of T2DM rats were induced by a high-fat diet and intraperitoneal injection of STZ in SD rats. Models of Diabetic Foot Ulcers (DFUs) were made by operation on hind limbs in diabetic rats. Rats were divided into four groups (n = 6 for each group), i.e., Normal Control group (NC), Diabetes Control group (DM-C), MSC-CM group and Mesenchymal Stem Cells group (MSCs). MSC-CM group was treated with an injection of conditioned medium derived from preconditioned rats' bone marrow MSCs around ulcers. MSCs group were treated with an injection of rats' bone marrow MSCs. The other two groups were treated with an injection of PBS. After the treatment, wound closure, re-epithelialization (thickness of the stratum granulosums of the skin, by H&E staining), cell proliferation (Ki67, by IHC), angiogenesis (CD31, by IFC), autophagy (LC3B, by IFC and WB; autoly-sosome, by EM) and pyroptosis (IL-1β, NLRP3, Caspase-1, GSDMD and GSDMD-N, by WB) in ulcers were evaluated. Results: After the treatment wound area rate, IL-1β by ELISA, and IL-1β, Caspase-1, GSDMD and GSDMD-N by WB of MSC-CM group were less than those of DM group. The thickness of the stratum granulosums of the skin, proliferation index of Ki67, mean optic density of CD31 and LC3B by IFC, and LC3B by WB of MSC-CM group were more than those of DM group. The present analysis demonstrated that the injection of MSC-CM into rats with DFUs enhanced the wound-healing process by accelerating wound closure, promoting cell proliferation and angiogenesis, enhancing cell autophagy, and reducing cell pyroptosis in ulcers. Conclusions: Studies conducted indicate that MSC-CM administration could be a novel cell-free therapeutic approach to treat DFUs accelerating the wound healing process and avoiding the risk of living cells therapy.

Simulated weightlessness led to the transformation of glycolipid metabolism in the livers of mice / La antigravedad simulada provocó la transformación del metabolismo de los glicolípidos en el hígado de ratones / Antigravidade simulada levou à transformação do metabolismo de glicolipídios no fígado de camundongos

ABSTRACT Objectives: The effects of weightlessness on the liver were studied using a tail suspension (TS) male mouse model. Methods: The effects of 0-, 2- and 4-week TS (CON, TS2 and TS4 groups) on glycogen and lipid content, as well as on the molecular processes of the synthesis and degradation pathways, were examined. Results: (1) The number of glycogenosomes under ultrastructure and the glycogen content were considerably larger in the TS4 group than in the other two groups. (2) In the TS4 group, glycogen synthase activity remained constant while glycogen phosphorylase activity dropped, indicating that glycogen breakdown was reduced. (3) The livers of the TS2 group had the highest lipid and triglyceride content, indicating lipid buildup in the liver at this time. (4) In the TS2 group, the activities of the fatty acid synthesis-related factors acetyl-CoA carboxylase and fatty acid synthase increased, while hepatic lipase decreased, indicating that lipid synthesis increased, while decomposition decreased. (5) In the TS2 group, the protein expression of glucose transporters 1 and 2 increased. Conclusions: From TS2 weeks to TS4 weeks, the main energy consumption mode in the livers of mice transitioned from glucose metabolism to lipid metabolism as glucose use decreased. Level of evidence II; Comparative prospective study.

RESUMEN Objetivos: Se estudiaron los efectos de la antigravedad en el hígado utilizando un modelo de ratón macho en prueba de suspensión de la cola (TS, tail suspension). Métodos: Se examinaron los efectos de la TS a las 0, 2 y 4 semanas (grupos CON, TS2 y TS4) sobre el contenido de glucógeno y lípidos, así como sobre los procesos moleculares de las vías de síntesis y degradación. Resultados: (1) El número de glucogenosomas ultraestructurales y el contenido de glucógeno fueron expresivamente más altos en el grupo TS4 que en los otros dos grupos. (2) En el grupo TS4, la actividad de la glucógeno sintasa se mantuvo constante, mientras que la actividad de la glucógeno fosforilasa disminuyó, lo que indica que la degradación del glucógeno se redujo. (3) Los hígados del grupo TS2 presentaron el mayor contenido de lípidos y triglicéridos, lo que indica la acumulación de lípidos en el hígado en ese momento. (4) En el grupo TS2, la actividad de los factores relacionados con la síntesis de ácidos grasos acetil-CoA carboxilasa y ácido graso sintasa aumentó, mientras que la lipasa hepática disminuyó, indicando que la síntesis de lípidos aumentó mientras que la descomposición disminuyó. (5) En el grupo TS2, la expresión proteica de los transportadores de glucosa 1 y 2 aumentó. Conclusiones: Desde la semana TS2 hasta la semana TS4, el principal modo de consumo de energía en el hígado de los ratones pasó del metabolismo de la glucosa al metabolismo de los lípidos a medida que disminuía el uso de la glucosa. Nivel de Evidencia II, Estudio retrospectivo comparativo.

RESUMO Objetivos: Os efeitos da antigravidade no fígado foram estudados usando um modelo de camundongo macho com a suspensão pela cauda (TS, tail suspension). Métodos: Foram examinados os efeitos da TS em 0, 2 e 4 semanas (grupos CON, TS2 e TS4) sobre o conteúdo de glicogênio e lipídios, bem como nos processos moleculares das vias de síntese e degradação. Resultados: (1) O número de glicogenossomos ultraestruturais e o teor de glicogênio foram expressivamente maiores no grupo TS4 do que nos outros dois grupos. (2) No grupo TS4, a atividade de glicogênio sintase permaneceu constante, enquanto a atividade de glicogênio fosforilase caiu, indicando que a degradação do glicogênio foi reduzida. (3) Os fígados do grupo TS2 tiveram o maior teor lipídico e de triglicérides, indicando acúmulo de lipídios no fígado no momento. (4) No grupo TS2, a atividade dos fatores relacionados com a síntese de ácidos graxos acetil-CoA carboxilase e ácido graxo sintase aumentaram, enquanto a lipase hepática diminuiu, indicando que a síntese de lipídios aumentou, enquanto a decomposição diminuiu. (5) No grupo TS2, a expressão proteica dos transportadores de glicose 1 e 2 aumentou. Conclusões: De TS2 semanas para TS4 semanas, o principal modo de consumo de energia no fígado de camundongos passou do metabolismo da glicose para o metabolismo lipídico, à medida que o uso de glicose diminuiu. Nível de evidência II, Estudo retrospectivo comparativo.

Effect of functional training on adolescent health / Efeito do treinamento funcional na saúde do adolescente / Efecto del entrenamiento funcional en la salud del adolescente

ABSTRACT Introduction The high rate of obesity caused by the modern sedentary lifestyle associated with bad eating habits and the high intellectual demand at school generates a physical and psychological deficit in contemporary youth. The damage caused in this growth phase is irrecoverable, and the habits acquired during this period are crucial to individual health. The urgency of this problem has generated research on methods to reverse this situation, among them functional training. Objective To study the effect of functional training on adolescent health. Methods 30 boys and 30 girls were recruited as study subjects. The experiment lasted one semester, including two weekly physical education classes focused on functional training. Data on body indexes, fitness, and physical test results were collected before and after the intervention. The results of the experiment were integrated and compared. Results The selection of functional training can optimize adolescents' biochemical indexes, making adolescents' orthostatic posture more balanced, and significantly improve muscle strength, body flexibility, explosive strength of upper and lower extremities, motor coordination, body flexibility, muscular endurance, cardiopulmonary function, etc. Conclusion Functional training can effectively improve the physical health of adolescents. Participants have increased their interest in sports, and this intervention can potentially promote the development of adolescents' physical and mental health if replicated nationwide. Studies are needed to popularize functional training in adolescents. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O elevado índice de obesidade ocasionada pelo sedentarismo moderno associado a maus hábitos alimentares e a alta demanda intelectual escolar geram um déficit físico e psicológico na juventude contemporânea. Os danos ocasionados nessa fase de crescimento são irrecuperáveis e os hábitos adquiridos nesse período são determinantes para a saúde individual. A urgência desse problema tem gerado pesquisas sobre métodos para reverter essa situação, dentre eles desponta o treinamento funcional. Objetivo Estudar o efeito do treinamento funcional na saúde do adolescente. Métodos 30 meninos e 30 meninas foram recrutados como sujeitos de estudo. O experimento durou um semestre, incluindo duas aulas semanais de educação física, com foco no treinamento funcional. Os dados dos índices corporais, aptidão física e resultados dos testes físicos foram coletados antes e depois da intervenção. Os resultados do experimento foram integrados e comparados. Resultados A seleção do treinamento funcional pode otimizar os índices bioquímicos dos adolescentes, tornar a postura ortostática dos adolescentes mais equilibrada, melhorar significativamente a força muscular, a flexibilidade corporal, a força explosiva das extremidades superior e inferior coordenação motora, flexibilidade corporal, resistência muscular, função cardiopulmonar, etc. Conclusão O treinamento funcional pode melhorar efetivamente a saúde física dos adolescentes. Os participantes aumentaram seu interesse pelo esporte e essa intervenção tem o potencial de promover o desenvolvimento da saúde física e mental dos adolescentes caso replicada a nível nacional. Estudos são necessários para a popularização do treinamento funcional em adolescentes. Nível de evidência II; Estudos terapêuticos - investigação dos desfechos do tratamento.

RESUMEN Introducción La alta tasa de obesidad causada por el sedentarismo moderno asociado a malos hábitos alimenticios y la alta exigencia intelectual escolar generan un déficit físico y psicológico en la juventud contemporánea. Los daños causados en esta fase de crecimiento son irrecuperables y los hábitos adquiridos durante este periodo son cruciales para la salud del individuo. La urgencia de este problema ha generado la investigación de métodos para revertir esta situación, entre ellos surge el entrenamiento funcional. Objetivo Estudiar el efecto del entrenamiento funcional en la salud de los adolescentes. Métodos Se reclutaron 30 chicos y 30 chicas como sujetos de estudio. El experimento duró un semestre, incluyendo dos clases semanales de educación física, centradas en el entrenamiento funcional. Se recogieron datos sobre los índices corporales, la forma física y los resultados de las pruebas físicas antes y después de la intervención. Los resultados del experimento se integraron y compararon. Resultados La selección del entrenamiento funcional puede optimizar los índices bioquímicos de los adolescentes, hacer que la postura ortostática de los adolescentes sea más equilibrada, mejorar significativamente la fuerza muscular, la flexibilidad corporal, la fuerza explosiva de las extremidades superiores e inferiores la coordinación motora, la flexibilidad corporal, la resistencia muscular, la función cardiopulmonar, etc. Conclusión El entrenamiento funcional puede mejorar eficazmente la salud física de los adolescentes. Los participantes han aumentado su interés por el deporte y esta intervención tiene el potencial de promover el desarrollo de la salud física y mental de los adolescentes si se reproduce a nivel nacional. Se necesitan estudios para la popularización del entrenamiento funcional en adolescentes. Nivel de evidencia II; Estudios terapêuticos - investigación de los resultados del tratamiento.

Repair of finger pulp defect with free thenar perforator flap / 中华显微外科杂志

Objective:To investigate the effect of free thenar perforator flap on repair of finger pulp defect.Methods:From September 2019 to November 2021, 79 cases of finger injuries complicated with defects in the pulp of fingers received free thenar perforator flap transfer surgery for reconstruction of finger pulps in the Department of Hand and Foot Surgery, Taizhou Hospital, Zhejiang Province. The patients were 51 males and 28 females, aged from 17 to 52(37.5±5.2) years old. There were 34 finger-pulp defects of index fingers, 15 of middle fingers, 26 of ring fingers and 4 of little fingers. All patients were treated with free thenar perforator flaps sized 2.0 cm×2.5 cm-3.0 cm×3.5 cm. All thenar perforator flaps were pedicled with the perforator artery and subcutaneous superficial vein in the thenar region, and the vessels were anastomosed with the proper palmar digital artery and dorsal digital vein, respectively. At the same time, subcutaneous nerve and proper palmar digital nerve were sutured to reconstruct the sensation of flaps. During the operation, the dominant perforating branch of thenar was found being originated from the superficial palmar branch of radial artery in 27 cases, from the superficial palmar arch in 21 cases, from the perforating branch of metacarpophalangeal proper artery of thumb in 11 cases, from the radial artery in 10 cases and from the main artery of thumb in 10 cases. The origins of nerves within the flaps were found from the superficial branch of radial nerve(24 cases), the terminal branch of lateral cutaneous nerve of forearm(22 cases) and the palmar branch of median nerve(33 cases). The operation time was (96.7±10.7) minutes. The donor site for the flap was closed directly without skin grafting. Most of the follow-up were conducted through the visit of outpatient clinic and the patients from other regions were reviewed via telephone or WeChat.Results:All perforator flaps survived completely and the flap donor sites healed smoothly. Follow-up lasted for (20.5±3.8) months. The reconstructed finger pulp was not bulky and the texture was satisfactory. TPD of the flaps was (5.6±0.9) mm. Only a linear scar left in the flap donor sites without significant affect on thenar function.Conclusion:The vascular anatomy of thenar perforator flap is constant, which helps to regain sensations of the flap. The texture and thickness of the flap are similar to those of the finger. It is ideal for reconstruction of defect of finger pulp.

Combining vibroacoustic therapy with audio-visual feedback can improve the swallowing and the emotional state of survivors of a brainstem stroke / 中华物理医学与康复杂志

Objective:To observe any effect of combining vibroacoustic therapy with audio-visual feedback on the swallowing and the emotional state of persons with a swallowing disorder after a brainstem stroke.Methods:Fifty brainstem stroke survivors with dysphagia were randomly divided into a control group and a combination group, each of 25. In addition to routine swallowing function training, the control group received additional direct feeding training, while the combination group was provided with vibroacoustic feeding training and swallowing stimulation from an animated audio-visual presentation. Before and after the treatment, the subjects′ swallowing function was quantified using the Standard Swallowing Assessment (SSA) scale and the Gugging swallowing screen (GUSS). The Positive and Negative Emotions Scale (PNAS) was used to quantify their emotional state.Results:After the treatment the average SSA scores of both groups had decreased significantly, while the average GUSS and PNAS scores had increased significantly. The average improvements in all three measures were significantly greater in the combination group than in the control group.Conclusion:In addition to routine swallowing function training, feeding training applying vibroacoustics and audio-visual stimulation can significantly improve the feeding function and emotional state of brainstem stroke survivors with dysphagia.

The effects on the language ability and life quality of aphasic stroke survivors of synchronous, long-distance speech rehabilitation training based on Oral Reading for Language with Aphasia / 中华物理医学与康复杂志

Objective:To observe any effect of long-distance application of Oral Reading for Language with Aphasia (ORLA) training on patients with post-stroke aphasia.Methods:A total of 42 stroke survivors with aphasia were randomly divided into an inpatient group, and two online groups, each of 14. All three groups had their routine rehabilitation treatment supplemented with ordinary multimodal language therapy and ORLA. The inpatient group completed the routine in the rehabilitation treatment room, while the online groups completed it at home using Tencent video conferencing software. The conventional multimodal language therapy was conducted once daily, 5 days a week for 4 weeks. For the inpatient group and online group 2 the daily session lasted 30 minutes, while for the online 1 groups the daily length was doubled. The ORLA therapy was also conducted once daily, 5 days a week for 4 weeks, for the inpatient group and online group 2 the daily session lasted 1h, while for the online 1 groups the daily length was 30min.The speech function, reading ability and life quality of the three groups were evaluated before and after the intervention using the Western Aphasia Battery, the Chinese Standard Aphasia Examination Scale and the Chinese version of the Stroke Aphasia Quality of Life Scale.Results:After treatment, the average aphasia quotient (AQ), reading, naming and quality of life scores in all three groups had improved significantly compared with those before treatment. And related language ability scores (such as retelling, fluency, information volume, listening comprehension, etc.) had also improved significantly in all three groups. However, the average AQ, reading, and oral fluency scores of the inpatient group and online group 2 were significantly higher than those of online group 1. Significant improvement was also observed in the reading aloud and life quality of all three groups, but the average improvement in reading aloud was significantly greater in the inpatient group and in online group 2 compared to online group 1. The average life quality of the online groups was significantly superior to that of the inpatient group.Conclusion:Medium- and high-intensity ORLA synchronous remote speech rehabilitation can significantly improve the speech ability, reading ability and life quality of aphasic stroke survivors.

Relationship between serum lactate and early prognosis after liver transplantation in children / 中华器官移植杂志

Objective:To explore the relationship between serum lactate level and early prognosis after liver transplantation (LT) in children.Methods:Between January 1, 2018 and December 31, 2020, 675 pediatric LT recipients were recruited. Clinical data were retrospectively reviewed, early postoperative serum lactate level and clearance rate recorded and receiver operating characteristic (ROC) curve plotted for determining optimal cut-off values. The inter-group differences in early postoperative complications and patient/graft survival rates were compared.Results:According to ROC, blood lactate levels >1.99 mmol/L at 12 h postoperatively were associated with early postoperative graft loss (AUC 0.73, 95% CI: 0.62-0.84, P=0.01). Age and weight of recipients in high-level group were 7.17(5.70-10.40) month and 7.00(6.00-8.60) kg and both were significantly lower than those in low-level group [7.80(6.21-13.58) month and 7.20(6.45-9.00) kg]. The inter-group differences were statistically significant ( P=0.017, P=0.034). Blood plasma transfusion volume, red blood cell transfusion volume, portal vein pressure pre-closure, postoperative intensive care unit (ICU) stay, ventilator use time, early allograft dysfunction rate, early postoperative pulmonary infection rate and recipient mortality rate in high-level group were 400 (200-400) ml, 2.00 (2.00-4.00) U, (15.71±4.44) mmHg, 2.50(2.00-3.00) day, 3.81(2.47-8.50) hour, 22.95%(42/185), 16.76%(31/185) and 6.49%(12/185) respectively. The above values were significantly higher than those in low-level group 200(100-400) ml, 2.00 (2.00-3.00) U, (14.69±4.68) mmHg, 2.00(2.00-3.00) day, 3.53(2.34-6.12) hour, 14.69%(72/490), 11.02%(54/490) and 1.43%(7/490) respectively. The inter-group differences were statistically significant ( P<0.001, P=0.014, P=0.015, P=0.037, P=0.043, P=0.011, P=0.045 & P<0.001). The incidence of early postoperative acute cellular rejection was significantly lower in high-level group than that in low-level group [11.89%(22/185) vs 22.86%(112/490)]. The inter-group difference was statistically significant ( P=0.01). The 1/3-month cumulative survival rates of patient/graft were 94.6%, 94.1% and 92.4%, 91.4% in high-level group versus 99.2%, 98.6% and 99.0%, 98.4% in low-level group. There were significant inter-group differences ( P=0, P<0.000 1). With a rising level of lactate at 12 h postoperatively, risk of early graft loss and early recipient mortality spiked markedly ( P<0.05). Conclusions:Serum lactate level post-operation is a valid predictor of early prognosis after LT in children.

Reconstructing S3 hepatic vein with middle hepatic vein confluence in pediatric living donor liver transplantation using left lateral segment / 中华器官移植杂志

Objective:To explore the reconstruction strategy and technical selection of S3 hepatic vein with middle hepatic vein confluence in pediatric liver transplantation(LT)using living donor left lateral segment to lower the risk of vascular complications caused by variant grafts.Methods:From January 2015 to June 2021, retrospective analysis is performed for 840 consecutive cases of pediatric living donor LT using left lateral segment(LLS).There are 32 cases of S3 hepatic vein with middle hepatic vein confluence with an overall incidence of 3.81%.Individualized reconstruction strategies are implemented according to the specific conditions of variation and different interposition vessels available: group I unification venoplasty technique with interposition vein graft is employed for reconstructing HV from grafts, prolonged S3 is formed into a single opening with S2 and then anastomosed with recipient(21 cases); group Ⅱ dual HV reconstructions were performed(11 cases); venoplasty of recipients'LHV, MHV and inferior vena cava(IVC)is performed for creating a large orifice for anastomosis with S2 HV from graft and S3 is anastomosed with stump of recipient right HV directly or interposed blood vessels.Clinical features and prognosis of two groups, the incidence, treatment and prognosis of HVOO and the incidence of HVOO between variant and non-variant groups were compared.Results:The median follow-up time of variant group(32 cases)is 23.8 month with an incidence of HVOO at 15.6%.During the same period, the non-variant group incidence of HVOO is 4.5%.There is inter-group statistical difference( P=0.014).The only statistical difference between groups Ⅰ and Ⅱ is ultrasonic blood flow velocity of S3 HV at 14 POD [(39.15±16.37)vs(20.05±8.52)cm/s, P=0.001].HVOO occurred in 7 cases and 6 cases respectively in groupⅠ and group Ⅱ.There is no statistical difference( P=0.310).There are no intractable vascular complications.Long-term vascular patency of allogeneic and autologous interposition vein is satisfactory and there is no graft failure or mortality related to HVOO. Conclusions:Selecting strategies and techniques for reconstructing S3 hepatic vein with middle hepatic vein confluence at our center are reasonable, safe and effective.And the overall treatment efficacy is satisfactory.Reasonable selection of multidimensional reconstruction methods and accurate application of various technologies are conducive to improving patient prognosis.

Early implementation of group rehabilitation exercise improves quality of life in patients with Parkinson's disease / 中华老年医学杂志

Objective:To investigate the impact of group-based rehabilitation exercise on motor and non-movement symptoms of Parkinson's disease(PD).Methods:A total of 88 patients from out-patient and in-patient services at our hospital were randomly assigned to an early exercise group(E-EG), a late exercise group(L-EG), and a control group(CG)using a randomized delayed-start design.Patients in the E-EG carried out a rigorous, formal group exercise program, one hour per session, twice per week, for 18 months(May 2018-November 2019). Patients in the L-EG took part in the exercise program in the final 6-12 months of the study.We assessed outcomes using the Unified Parkinson's Disease Rating Scale(UPDRS), Parkinson's disease questionnaire-39(PDQ-39 Q), trail-making test part A & B, nine-hole peg test(9-HPT), 30 second sit to stand test(30s SST), 10 m walk test(10 m W), mini-balance evaluation systems test(Mini-BEST), Fullerton Advanced Balance(FAB)Scale and time up and go(TUG)test.Results:Compared with pre-exercise levels, patients with PD in the E-EG had lower performance in UPDRS(17.5±8.3 vs.20.0±8.6, t=-2.2, P=0.02)and lower performance in PDQ-39(27.2±2.1 vs.29.0±9.8, t=-2.6, P=0.001)after exercise.Moreover, compared with pre-exercise levels, patients with PD in the E-EG showed decreased post-exercise performance in trail-making test part B(114.2±25.5 vs.129.8±28.4, t=-2.3, P=0.02)and in 9-HPT(33.7±7.3 vs.39.6±9.3, t=-2.6, P=0.001). Conclusions:The practice of group-based rehabilitation exercise can improve movement abilities and quality of life in PD patients, especially if implemented early.Targeted rehabilitation exercise should be taken as part of the treatment strategy for PD patients as early as possible to deliver the best benefits.

Clinical application differences between TW3-Carpal and TW3-RUS based artificial intelligence-assisted bone age assessment system: a real-world pilot study / 中华放射学杂志

Objective:To investigate the differences between Tanner-Whitehouse (TW)3-Carpal and TW3-RUS(radius, ulna and short bone)-based artificial intelligence (AI)-assisted bone age assessment system using real world data.Methods:The image data of 262 children who received X-ray examination of left wrist in the Affiliated Children′s Hospital, Capital Institute of Pediatrics from July to September 2021 were retrospectively collected. The AI bone age assistant methods based on TW3-RUS and TW3-Carpal criteria were used to obtain the bone age results, respectively. Two senior pediatric radiologists evaluated the bone age on the basis of TW3-RUS and TW3-Carpal criteria, and the averaged values of two reviewers was calculated and taken as the gold standard reference. The cases were stratified into six age groups at 3-year intervals according to the gold standard reference, including 1-3 ( n=10), 4-6 ( n=35), 7-9 ( n=70), 10-12 ( n=118), 13-15 ( n=27) and 16-18 ( n=2) years old groups. Intraclass correlation coefficient (ICC) was used to evaluate the consistency between AI results and the gold standard bone age results. Pearson correlation method was used to measure the reliability between AI results and the gold standard results. The difference of bone age results between using TW3-RUS and TW3-Carpal criteria in different age groups was compared using paired t-test. Results:As for the whole sample, the results based on TW3-RUS criteria were 8.9±3.1 years old for AI assessment and 8.7±2.9 years old for the golden standard reference, with the ICC of 0.983; and the results based on TW3-Carpal criteria were 8.7±3.0 years old for AI and 8.8±2.8 years old for the golden standard reference, with the ICC of 0.976. Positive correlation were found in both TW3-RUS ( r=0.985, P<0.001) and TW3-Carpal criteria groups ( r=0.978, P<0.001). There were significant differences between TW3-RUS and TW3-Carpal at age groups of 7-9( t=-3.36, P=0.001), 10-12( t=-1.77, P=0.046), and 13-15 years old ( t=1.84, P=0.040). The bone age assessment using TW3-RUS and TW3-Carpal criteria were both in good agreement with the gold standard reference in age group of 4-6 years old (ICC=0.929 and 0.940), as well as in age group of 7-9 years old (ICC=0.882 and 0.927, respectively), with the results using TW3-Carpal criteria were slightly higher. As for the age groups of 10-12 and 13-15 years old, the method using TW3-RUS criteria showed excellent agreement with the gold standard reference (ICC=0.962 and 0.963, respectively), which were better than the performance of method using TW3-Carpal criteria (ICC=0.744 and 0.605, respectively). Conclusions:AI-assisted bone age system based TW3-Carpal and TW3-RUS criteria both show good reliability and accuracy in the bone age measurements. The AI method based TW3-Carpal criteria shows better performance in age group of 4-9 years old, while the method based on TW3-RUS criteria may be better for children of age 10-15 years old.