A comparison between anterolateral thigh perforator flap and abdominal pedicle flap in repair of hand injuries and tissue defects.

The purpose of this study was to compare the outcome of anterolateral thigh perforator flap and abdominal pedicled flap repair for treating traumatic tissue defects of the hand. A total of 140 patients with hand trauma tissue defects were randomly divided (random number table) into Group A and Group B, with 70 cases in each group. Group A was given anterolateral thigh perforator flap repair, while Group B was given abdominal pedicled flap repair. The healing time of wounds in Group A was noted to be shorter than that in Group B (p<0.001). At one week after surgery, VAS score, serum IL-6 and TNF-α levels in Group A were 4 times lower than those in Group B (p<0.001 for all). Anterolateral thigh perforator flap repair works more effectively on traumatic tissue defects of the hands than abdominal pedicled flap repair. It reduces pain, shortens wound healing time, and lowers serum IL-6 and TNF-α levels.

Effect of transverse wrist crease perforator flap on repairing soft tissue defect of fingers and its influence on hand function.

OBJECTIVE: To investigate the effect of transverse wrist crease perforator flap repair on sensory nerve function, survival of flap, hand function, hand appearance and satisfaction rate in patients with soft tissue defect of fingers. METHODS: This retrospective study was performed in 30 patients admitted to the Hand and Foot Microsurgery Department of our hospital between January 2018 and December 2020. These patients were divided into to the control group and the experimental group (15 patients for each group) according to the operative methods. Patients in the control group underwent abdominal flap repair, while patients in the experimental group received transverse wrist crease perforator flap repair. Intraoperative parameters, sensory nerve function, function of finger reconstruction, survival rate of skin flap, degree of scar contracture and flap bloatedness, DASH score, two-point discrimination and satisfaction rate were compared between the two groups. RESULTS: Compared with the control group, the operative time in the experiment group was obviously decreased (P<0.05). There was no difference in amount of bleeding between the two groups. The proportion of sensory nerve function grade S3+ and S4 in the experimental group was significantly increased in contrast to the control group (P<0.05). The total excellent and good rate in function of finger reconstruction in the experiment group was significantly higher than that in the control group, while no difference was found in the survival rate of skin flap and scar contracture between the two groups. Compared with the control group, DASH score, two-point discrimination distance, and degree of flap bloatedness in the experiment group were significantly reduced and the patients' satisfaction rate in the experiment group was remarkably increased (all P<0.05). CONCLUSION: Transverse wrist crease perforator flap repair plays a critical role in reducing operative time, improving sensory nerve function and recovery of hand function, and alleviating flap bloatedness. It is an optimal treatment for soft tissues defect of fingers.

Computed Tomography Angiography and B-Mode Ultrasonography under Artificial Intelligence Plaque Segmentation Algorithm in the Perforator Localization for Preparation of Free Anterolateral Femoral Flap.

This research was aimed to investigate the accuracy of U-shaped network (UNet)-based computed tomography angiography (CTA) and B-mode ultrasonography (US) in the perforator localization of free anterolateral thigh flap (ALTF). Based on UNet, a fusion of deep supervision mechanism, squeeze-and-excitation module, and attention mechanism was introduced to optimize the algorithm. Then, a CTA segmentation model, DA-UNet, was established. The segmentation performance of DA-UNet and other algorithms was compared under the same conditions. 30 patients who were planned to receive ALTF surgery were selected as the research objects. According to different preoperative localization methods, they were divided into group A (CTA) and group B (B-mode US), 15 cases in each group. Combined with the actual situation during surgery, the diagnostic accordance rate, sensitivity (Sen), specificity, and the distance between the perforator location and the actual location were compared between the two groups. The Dice coefficient, Jaccard index, Sen, the area under curve (AUC), and average Hausdorff distance (AVD) of the DA-UNet segmentation algorithm were 80.70%, 69.97%, 77.56%, 0.887, and 2.48, respectively. These results were significantly better than those of other algorithms (P < 0.05). In group A, the diagnostic accordance rate, Sen, and specificity of patients were 96.55%, 90.52%, and 73.58%, respectively, which were higher than 91.53%, 81.36%, and 15.60% of patients in group B significantly (P < 0.05). There was no statistical difference in the distance between the perforator location and the actual location (P > 0.05). It showed that the accuracy of CTA under the UNet-based DA-UNet segmentation model in the perforator localization of ALTF was better than that of B-mode US. Thus, a reference could be provided for the preparation of free ALTF and its clinical application.

[AMPK regulates mitochondrial oxidative stress in C2C12 myotubes induced by electrical stimulations of different intensities].

OBJECTIVE: To study effect of electrical stimulations of different intensities on mitochondrial oxidative stress in C2C12 myotubes and explore the molecular mechanisms. METHODS: After 7 days of differentiation, C2C12 myotubes were subjected to electrical stimulations (15 V, 3Hz, 30 ms) for 60, 120, or 180 min, and the morphological changes of muscular tubes were observed under inverted microscope. The levels of MDA and SOD activity of the cells were detected, and flow cytometry was used to detect mitochondrial reactive oxygen species (ROS) and membrane potential. Western blotting was used to detect the expression of PGC1, AMPK-Ser485, AMPK-Thr172, and AMPK in the cells. RESULTS: No significant changes occurred in the morphology of C2C12 myotubes in response to electrical stimulations. Electrical stimulation for 60 min resulted in significantly increased levels of MDA, AMPK-Ser485 and AMPK-Thr172 in the cells (P<0.05); simulations of the cells for 120 and 180 min caused significantly increased MDA, ROS, mitochondrial ROS, AMPK-Ser485 and PGC1 along with marked reduction of mitochondrial membrane potential (P<0.05). CONCLUSION: Electrical stimulation significantly activates oxidative stress, and a longer stimulation time causes stronger mitochondrial oxidation. AMPK-Thr172 regulates oxidative stress induced by stimulations for a moderate time length, while AMPK-Ser485 and PGC1 function to modulate oxidative stress following prolonged stimulations.

Cdk5 Inhibitory Peptide Prevents Loss of Dopaminergic Neurons and Alleviates Behavioral Changes in an MPTP Induced Parkinson's Disease Mouse Model.

Parkinson's disease (PD) is one of the most affected neurodegenerative diseases in the world. Deregulation of cyclin-dependent kinase 5 (Cdk5) is believed to play an important role in neurodegenerative diseases including PD. p25 is a cleavage peptide of p35, a physiologic activator of Cdk5. p25 combines to Cdk5 and leads to the hyperactivity of Cdk5, which in turn hyperphosphorylates downstream substrates and leads to neuroinflammation and apoptosis of neurons. Previously, we have demonstrated that adeno-associated virus serotype-9 (AAV9) mediated Cdk5 inhibitory peptide (CIP) inhibits the activity of Cdk5/p25 complex and alleviates pathologic and behavioral changes in Alzheimer's disease mouse model. In this study, we evaluated whether AAV9-CIP protected dopaminergic (DA) neurons in 1-methyl-4-phe-nyl-1,2,3,6-tetrahydropyridine-probenecid (MPTP/p) induced PD mouse model. The data showed that administration of AAV9-CIP by intracerebroventricular injection 1 week before MPTP/p exposure protected loss of DA neurons in substantia nigra compact of the model mice. Importantly, AAV9-CIP also alleviated the motor and anxiety-like symptoms of the disease animals. In summary, AAV9 mediated CIP might be a potential intervention for PD.