ABSTRACT
PURPOSE: This review aimed to systematically and comprehensively compare the effectiveness and applicability of reverse homodigital artery island flaps (RHAIF) and reverse dorsal homodigital island flaps (RDHIF) to treat fingertip defects. METHODS: A comprehensive search was conducted in multiple databases for studies that compared RHAIF versus RDHIF for treating fingertip defects with no language restrictions from inception until July 31, 2022. A meta-analysis was performed using RevMan 5.4 software. RESULTS: A total of 14 articles were retrieved, comprising 484 patients (509 fingers) in the RHAIF group and 453 patients (484 fingers) in the RDHIF group. The pooled estimates suggested that patients treated with RHAIF experienced more donor-side complications and less postoperative venous crisis than patients in the RDHIF group. On the other hand, no significant differences were found in operative time, flap necrosis, static 2-point discrimination, moving two-point discrimination, total active motion, satisfaction rates and sensory recovery grade (S3+ to S4) between the RHAIF and RDHIF groups. CONCLUSIONS: No difference in effectiveness was found between the two surgical procedures for treating fingertip defects. Accordingly, the selection of the optimal approach should be based on the functional requirements of the patient and the surgeon's expertize.
Subject(s)
Finger Injuries , Humans , Arteries/surgery , Finger Injuries/surgery , Fingers/blood supply , Retrospective Studies , Sensation , Surgical Flaps/blood supplyABSTRACT
Objective: Postmenopausal osteoporosis (PMOP) is a common age-associated disease in the life course. Clinically, Xiaozeng Qianggu Tablets (XQT) have a potent therapeutic effect on the PMOP. However, the bioactive components and the mechanism of XQT underlying the PMOP treatment were unclear and it should be explored to discover the scientific connotation in traditional medical practice. Methods: The components in XQT were identified by UPLC-Q-TOF/MS. The animal model of PMOP was established by surgical ovariectomy in the female Sprague-Dawley rats. After treatment of XQT, the therapeutic effect was assessed by the determination of bone metabolism biomarkers in serum and histopathological examination. The effect of XQT on the autophagy and bone micro-situation were tested using western blot, RT-qPCR, and transmission electron microscope. Results: There were 27 compounds identified in XQT, including catalpol, monotropein, verbascoside, cryptochlorogenic acid, 5,7-dihydroxychromone 7-rutinoside, biorobin, and so on. The bone metabolism markers (alkaline phosphatase, bone alkaline phosphatase, procollagen type I intact N-terminal propeptide, cross-linked carboxy-terminal telopeptide of type I collagen, and tartrate-resistant acid phosphatase) were significantly increased in the PMOP rats and reversed by XQT administration. Moreover, the width of bone trabeculae and the ratio of the area of calcium deposition to bone trabeculae were also improved after treating the middle dose of XQT. Meanwhile, the bone micro-structure was improved by XQT. The mRNA and protein expression of unc-51 like kinase 1, beclin-1, and microtubule-associated protein 1B-light chain 3 in PMOP rats were down-regulated and up-regulated by XQT administration. Conclusions: The compounds in XQT, including catalpol, monotropein, verbascoside cryptochlorogenic acid, and so on, were valuable for further pharmacy evaluation. The pathological changes and bone micro-structure were improved by XQT, and the down-regulated autophagy level was also restored, which suggested a potent effect of XQT on treating PMOP, corresponding to its clinic use.
