Expert Consensus on Facial Reanimation with Masseteric-to-facial Nerve Transposition (2023) / 中华显微外科杂志

Facial paralysis causes both physical pain and psychological distress to patients. It is difficult for a patient with facial paralysis to engage with a normal social life and at work. Progresses have been made in recent years in the treatment of facial paralysis. More attentions have been caught by masseteric to facial nerve transposition, which has advantages of adjacency in location, abundancy in nerve supply and reliability in the outcome and now has deemed an important option of facial reanimation. It has not been long since the application of the technique of masseteric to facial nerve transposition in China, therefore it still lacks a universal guidance on practice. In order to achieve the aim of better quality control and popularisation of the technique, hereby a consensus with suggestions on facial reanimation with masseteric to facial nerve transposition is proposed as the reference for surgeons specialised in facial reanimation. This consensus is proposed, discussed and drafted by experts from plastic and reconstructive surgery, oral and maxillofacial surgery, head and neck surgery and neurosurgery.

Single-cell transcriptomic analysis uncovers the origin and intratumoral heterogeneity of parotid pleomorphic adenoma / 国际口腔科学杂志·英文版

Pleomorphic adenoma (PA) is the most common benign tumour in the salivary gland and has high morphological complexity. However, the origin and intratumoral heterogeneity of PA are largely unknown. Here, we constructed a comprehensive atlas of PA at single-cell resolution and showed that PA exhibited five tumour subpopulations, three recapitulating the epithelial states of the normal parotid gland, and two PA-specific epithelial cell (PASE) populations unique to tumours. Then, six subgroups of PASE cells were identified, which varied in epithelium, bone, immune, metabolism, stemness and cell cycle signatures. Moreover, we revealed that CD36+ myoepithelial cells were the tumour-initiating cells (TICs) in PA, and were dominated by the PI3K-AKT pathway. Targeting the PI3K-AKT pathway significantly inhibited CD36+ myoepithelial cell-derived tumour spheres and the growth of PA organoids. Our results provide new insights into the diversity and origin of PA, offering an important clinical implication for targeting the PI3K-AKT signalling pathway in PA treatment.

Effects of 10-Week Nordic Hamstring Training on Knee Eccentric Control Angle and Muscle Strength / 医用生物力学

Objective To compare the effects of different support method on eccentric control angle and muscle strength of knee joints in 10-week Nordic hamstring exercise.Methods Twenty-eight college male football players were randomly divided into hand support group (HS group, n=14) and non-hand support group (NHS group, n=14) for 10 weeks. The eccentric control angle and eccentric muscle strength of knee joints were tested before and after the intervention.Results After 10 weeks of Nordic hamstring training, the eccentric control flexion angle of knee joint in HS group and NHS group was significantly decreased by 8° and 10°, and the knee joint angle in NHS group was 12° lower than that in HS group (P<0.05); the peak torque of hamstring and quadriceps femoris in both HS group and NHS group was significantly increased, and the peak torque of hamstring centrifugal motion at 60°/s and 120°/s in NHS group was 16 and 13 N·m higher than that in HS group, respectively (P<0.05).Conclusions NHS group is better than HS group in improving knee flexion angle and centrifugal muscle force. It is suggested that Nordic hamstring training should be taken as one of the daily training tasks for football players to prevent hamstring injury.

Research progress in trauma registration system / 中华创伤杂志

Trauma registration is an important tool to record the process and timeline in the treatment of trauma patients. The operation of trauma database is of great significance for reducing the mortality of patients, promoting the construction of trauma treatment system, and providing reference for policy-making. Trauma registration system has been established in the United States, United Kingdom, Germany and other developed countries for many years. However, the domestic system is still at an initial stage, and there are problems like data deficiencies, data incoherence, no item of complications, no treatment data after discharge and limits of human and financial resources. Therefore, there is room for improvements in terms of personnel fixation, financial support and continuous data monitoring should be further improved. In this study, the authors summarize the traum registration system from aspects of basic situation both at home and abroad, data analysis, clinical value, operation mechanism and challenges so as to provide important data for clinical researches.

Correlation analysis of epidemiological characteristics and changes of influenza subtypes in Hefei City in 2015-2021 / 公共卫生与预防医学

Objective To analyze the correlation between detection of influenza pathogenic subtypes and epidemic situation in Hefei City during the surveillance years of 2015-2021, and to provide references for developing influenza prevention and control strategies. Methods The relevant data of influenza-like illness (ILI) surveillance, influenza etiology, and outbreak/cluster outbreaks reported from influenza surveillance sentinel hospitals in Hefei City from 2015 to 2021 in the China Influenza Surveillance Information System were analyzed. The statistical analysis was carried out. Results A total of 3 332 553 outpatient and emergency visits in 2 sentinel hospitals were reported in Hefei City from 2015 to 2021, of which 139,082 were ILI cases, accounting for 4.17%. The monthly proportion ranged from 1.60% to 7.15%. A total of 14 663 ILI specimens were submitted for detection, the submission rate was 10.54%, and the positive rate of influenza virus detection was 11.30%. There was no correlation between the proportion of monthly influenza like cases and the detection rate (rs=0.176, P=0.107). The composition ratio of each subtype of influenza virus varied greatly, showing diversified seasonality, and the epidemic strains changed constantly. The Victoria subtype (BV subtype) was dominant (40.21%). There was a moderate correlation between the positive rate of ILI in sentinel hospitals and the number of outbreaks per month (rs=0.696, P=0.000). There was a strong correlation between the monthly number of outbreaks and the detection rate (rss=0.696, P=0.000). There was a strong correlation between influenza A virus H3 subtype and BV subtype (rs -H3=0.686, P=0.030; rs -BV=0.632, P=0.000). There was a moderate correlation between the new A1 subtype and B Yamagata subtype (rs -new A H1=0.481, P=0.000 0; rs -BY=0.515, P=0.000). Conclusion There are two epidemic peaks in spring and winter in Hefei. Influenza subtypes are diverse. The results of ILI etiology can predict the outbreaks of different subtypes of influenza. Prediction and surveillance should be used for influenza control and outbreak management in a timely manner.

The diagnostic value of endoscopic ultrasonography and conventional imaging in pancreatic occupying lesions / 西安交通大学学报(医学版)

【Objective】 To compare the diagnostic value of endoscopic ultrasonography (EUS) with conventional imaging in pancreatic occupying lesions so as to provide guidance for the diagnosis of pancreatic occupying lesions. 【Methods】 We selected patients who underwent EUS in the Digestive Endoscopy Room of The First Affiliated Hospital of Xi’an Jiaotong University from September 2012 to December 2019 and were strictly screened by ultrasound endoscopists and diagnosed as pancreatic space-occupying lesions as the study subjects, and collected routine imaging examination results and related information and data of the patients (age, gender, tumor markers, blood amylase, urine amylase, and serum lipase) at the same time. We compared the sensitivity, specificity and accuracy of EUS and conventional imaging methods in the diagnosis of pancreatic space-occupying lesions, and evaluated their diagnostic value. 【Results】 A total of 188 cases were included, with more male ones than female ones. The age of patients in the tumor group was higher than that in the non-tumor group, and the levels of tumor markers serum CA-199 and CEA were significantly higher than those in the non-tumor group. The diagnostic sensitivity of pancreatic space-occupying lesions supported EUS (95.5%), which was significantly better than that of transabdominal ultrasound (54.4%), plain CT (57.1%), enhanced CT (75%), MRI (66.7%), PET-CT (72.7%) and other conventional imaging examination methods. The diagnostic accuracy of pancreatic space-occupying lesions supported EUS (91.5%), better than transabdominal ultrasound (58.3%), plain CT (57.1%), enhanced CT (74.6%), MRI (62.5%), and PET-CT (66.7%). The negative predictive value of the diagnosis of pancreatic space-occupying lesions supported EUS (76.7%), better than transabdominal ultrasound (27.9%), plain CT (22.9%), and enhanced CT (38.1%). 【Conclusion】 In the diagnosis of pancreatic space-occupying lesions, EUS is significantly better than conventional imaging methods such as transabdominal ultrasound, plain CT, enhanced CT, MRI, and PET-CT, and the negative predictive value of EUS is significantly better than that of transabdominal ultrasound, plain CT and enhanced CT.

Sensory assessment of meshed skin grafts over free gracilis muscle flaps without nerve coaptation for lower extremity reconstruction

Background@#Little is known about the sensate recovery of skin grafts over free non-neurotized muscle flaps. The aim of this study was to evaluate the sensitivity of free gracilis muscle flaps and meshed skin grafts without nerve coaptation. @*Methods@#Thirteen consecutive patients with a median age of 55 years (range, 21–70 years) who underwent lower extremity reconstruction between September 2014 and October 2016 were included. Complications, flap contour, skin perception, and sensate recovery were assessed. @*Results@#All flaps survived completely. In one patient, wound dehiscence and infection occurred 1 month after surgery. After a median follow-up of 14 months (range, 10–51 months), a satisfactory contour and skin perception were achieved. The Semmes-Weinstein (SW) monofilament test (154.8±22 g) and static two-point discrimination (2-PD) (12.6±0.7 mm) showed intermediate recovery compared to the surrounding site (41% and 76%, respectively). There was an intermediate correlation between flap size and sensate recovery (2-PD: r=0.27, P=0.36; SW test: r=0.45, P=0.12). Vibration sensation recovered to 60%, whereas thermal sensation remained poor (19% at 5°C and 25% at 25°C). @*Conclusions@#Finer sensation could be partially restored. However, thermal sensation remained poor.

Plantar Pressure Features under Different Walking Conditions in Patients after Trimalleolar Fracture Surgery / 医用生物力学

Objective To analyze plantar pressure features of patients in injured and healthy sides of the lower limbs under different walking conditions after the trimalleolar fracture surgery, and compare these characteristics with healthy subjects. Methods Twelve Trimalleolar fracture patients and twenty-three healthy subjects were recruited and their plantar pressure characteristics under different walking conditions were tested, including peak pressure, contact area and contact time percentage. Results Comparison between injured and healthy sides: during level walking, peak pressure of the 3rd-5th toe in the injured feet were smaller than those in the healthy sides; in inversion position, peak pressure and contact area of the 3rd-5th toe area in the injured feet were smaller than those in the healthy side; in eversion position, peak pressure, contact area and contact time of the 3rd-5th toe in the injured feet were smaller than those in the healthy sides, and peak pressures of the hindfoot area were larger than those in the healthy sides. Comparison between patients and healthy subjects: under three kinds of walking conditions, peak pressures of the 2nd and 3rd metatarsus bones, the 2nd toe, the 3rd-5th toe, contact area of the 1st-5th toe and contact time percentage of the 2nd toe, the 3rd-5th toe area were all smaller than those of healthy subjects, while contact time of the hindfoot and mid-foot area were all smaller than those of healthy subjects. Conclusions The plantar pressure characteristics of Trimalleolar fracture patients were asymmetrical. Compared with healthy subjects, the plantar pressure features of patients were abnormal during stance phase. Compared with healthy subjects, the motor control ability and stability of patients in eversion positions were decreased. The plantar pressure characteristics at ankle eversion can be used to evaluate ankle joint function.

Impact of nalmefene hydrochloride on inflammatory reaction in rats with traumatic brain injury / 中华创伤杂志

Objective To observe the changes of TNF-α and NF-κB after different doses of nalmefene hydrochloride (NAL) therapy for traumatic brain injury (TBI) in an effort to identify the effect of NAL on TBI-induced inflammatory response and the possible mechanism.Methods A model of TBI in the rat was produced using the improved Feeney' s free-fall impact method.The animals were randomly divided into sham group,TBI group,TBI + large dose of NAL (ip,0.2 mg/kg) group (TBI + NAL1group),TBI + medial dose of NAL (ip,0.14 mg/kg) group (TBI + NAL2 group),TBI + small dose of NAL (ip,0.07 mg/kg) group (TBI + NAL3 group).Form of brain tissues in each group was observed and mRNA levels of TNF-α and NF-κB were measured by real-time quantitative PCR assay.Results HE staining revealed severe injury and inflammatory infiltration of brain parenchyma in TBI group ;on the contrary,the situation ameliorated in TBI + NAL1 group,TBI + NAL2 group and TBI + NAL3group,with especially obvious improvement in TBI + NAL2 group.In PCR assay,significant expression of NF-κB and TNF-α was observed at post-TBI days 1,3,5 and 7 (P ＜ 0.05),followed by great reverse after NAL therapy (P ＜ 0.05),particularly in TBI + NAL2 group.Conclusions NAL can reduce the inflammation response to TBI and promote post-injury recovery.Moreover,there exists a NAL concentration window.

Electrical stimulation promotes BDNF expression in spinal cord neurons through Ca(2+)- and Erk-dependent signaling pathways.

Brief electrical stimulation has been shown to be effective in promoting neuronal regeneration following peripheral nerve injury. These effects are thought to be mediated largely by the upregulation of the expression of brain-derived neurotrophic factor (BDNF) in spinal cord neurons. However, the molecular mechanisms by which electrical stimulation can promote BDNF expression are not known. The mechanism involved in BDNF expression after electrical stimulation was explored in this study. Immunohistochemistry and Western blotting were used to test BDNF expression. Confocal microscopy was utilized to study intracellular Ca(2+) volume. Immunohistochemistry and Western blotting confirmed that brief electrical stimulation increased BDNF expression in spinal cord neurons both in vivo and in vitro. Treatment of cultured neurons with nifedipine, an inhibitor of voltage-gated calcium channels, significantly reduced the BDNF increase produced by electrical stimulation, and an inhibitor of Erk completely abolished the effect of electrical stimulation. Levels of BDNF expression in the presence of the Erk inhibitor were lower that in unstimulated and untreated controls, indicating that Erk activation is required to maintain baseline levels of BDNF. Confocal microscopy using a Ca(2+)-sensitive fluorochrome revealed that electrical stimulation is accompanied by an increase in intracellular Ca(2+) levels; the increase was partly blocked by nifedipine. These findings argue that electrical stimulation increases BDNF expression in spinal cord neurons by activating a Ca(2+)- and Erk-dependent signaling pathways.