Manipulation of optical orbit-induced localized spin angular momentum using the periodic edge dislocation.

Orbit-induced localized spin angular momentum (OILS) has recently garnered significant attention. This paper introduces periodic edge dislocation (PED) into the tight focusing system. The study delves into the tight focusing characteristics of the radially polarized vortex plane beam with PED, demonstrating that PED serves as a straightforward and effective means of manipulating OILS, especially when both the orbital angular momentum and the polarization of the incident beam are fixed. Our findings indicate that the longitudinal OILS reaches its maximum when the difference between the period of PED and the vortex topological charge is equal to 1. Conversely, when the difference is 0, the transverse OILS reaches its maximum, while the longitudinal OILS reaches its minimum. Similar patterns are also observed in linearly polarized vortex beams. This research proposes a simple and practical way to control OILS, contributing to our understanding of optical orbit-spin coupling.

Multi-focused electric and magnetic field sourcing from an azimuthally polarized vortex circular hyperbolic umbilic beam.

In this paper, one kind of multi-focusing electric and magnetic field which is sourced from an azimuthally polarized vortex circular hyperbolic umbilic beam (APVCHUB) is presented. After passing through a high NA objective, both the electric and magnetic fields of the APVCHUBs will focus multiple times, and a high-purity longitudinal magnetic field (p q =80%) will be generated. Besides, the mutual induction of the vortex phase and azimuthal polarization changes the electric and magnetic fields' vibration state and intensity distribution, making the longitudinal magnetic field carry an m-order concentric vortex. Our findings suggest that the APVCHUB could have potential applications in magnetic particle manipulation, extremely weak magnetic detection, data storage, semiconductor quantum dot excitation, etc.

Multi-focus autofocusing circular hyperbolic umbilic beams.

We propose and demonstrate a type of multi-focus autofocusing beams, circular hyperbolic umbilic beams (CHUBs), based on the double-active variable caustics in catastrophe theory. The mathematical form is more general compared to circular Airy, Pearcey and swallowtail beams. The CHUBs can generate multi-focus at its optical axis, while the on-axis intensity fluctuates up to two orders of magnitude that of the maximum intensity in the initial plane. Using the concept of topographic prominence, we quantify the autofocusing ability. We construct the criteria for selecting the effective foci, and then explore the influence of related parameters. Our findings suggest that the CHUBs could be a suitable tool for multi-particle manipulation, optical tweezers, optical lattices and related applications.

Efficacy analysis of three kinds of surgery for trigger thumb.

PURPOSE: To study the efficacy of three kinds of surgery for trigger thumb. METHODS: A total of 60 cases of trigger thumb (Quinnell Grade IV) were randomly divided into three groups. The A1 pulley was disconnected at the middle in Group A, at the extreme radial side in Group B, excised in Group C. The following indicators were recorded pre-operatively (D0), and at one (D1), three (D3), seven (D7), 14 (D14), and 28 (D28) days post-operatively: 1. the pain visual analogue score (VAS) when flexing the affected thumb; 2. range of motion (ROM) of the interphalangeal joint with pain tolerance; 3. the time of pain disappearance when flexing the affected thumb. RESULTS: The differences of VAS and ROM between D1 and D0, D3 and D1, D7 and D3, D14 and D7, D28 and D14 were statistically significant (P < 0.05). There was no significant difference in changes of VAS (or ROM) at D1 or D28 in contrast to D0 among the three groups. The differences of VAS (or ROM) changes at D3, D7, and D14 in contrast to D0 among the three groups were statistically significant (P < 0.05). The difference of the time when the pain disappearing in the normal range of motion among the three groups were statistically significant (P < 0.05). CONCLUSION: Disconnecting the A1-pulley at the extreme radial side is better than another two methods for treating the trigger thumb (Quinnell Grade IV). It has been shown to effectively accelerate postoperative pain relief and functional recovery. TRIAL REGISTRATION: Clinical trial registry number: ChiCTR2100051193.

Effects of Cartilage Progenitor Cells, Bone Marrow Mesenchymal Stem Cells and Chondrocytes on Cartilage Repair as Seed Cells: An in vitro Study.

Purpose: To determine the effects of cartilage progenitor cells, bone marrow mesenchymal stem cells and chondrocytes on cartilage repair as seed cells. Methods: Porcine cartilage progenitor cells (CPCs), bone marrow mesenchymal stem cells (BMSCs) and chondrocytes (CCs) were obtained from the femoropatellar joints of young pigs, and seeded in agarose gel as a graft. During the 28-day culture, proliferation ability was measured by MTT assay, and gene expression of Collagen I, Collagen II, Aggrecan and SOX 9 were measured by qPCR. Qualitative and quantitative analysis of collagen, glycosaminoglycan and DNA were appraised by immunohistochemical staining and biochemical assay, and integration strength was analyzed by push-out tests. Results: After 28-day culture, proliferation ability of CPCs and BMSCs was higher than CCs. Collagen, glycosaminoglycan, DNA content and chondrocyte-related genes expression in the cartilage progenitor cells seeded gel were significantly higher than the other two gels. Integration strength in the cartilage progenitor cells seeded gel was also higher compared with the other two gels. Conclusion: Compared with CCs and BMSCs, CPCs in vitro have dominance in the ability of cell proliferation and differentiation as seed cells in tissue engineering.

Treatment of the fresh central slip avulsion of the extensor tendon by bone tunnel-tendon suture: a prospective cohort study.

BACKGROUND: The current evidence base for the management of central slip avulsions is limited from obtaining a best approach. The purpose of this study was to evaluate the clinical effect and feasibility of repairing the fresh central slip avulsion by bone tunnel-tendon suture. METHODS: Twenty-four cases of open and closed central slip avulsions were prospectively studied. They were treated by suturing the tendon to the pre-holed bone through two parallel bone tunnels. Follow-up was conducted at 1 month, 3 months, 6 months, 12 months and 18 months after the operation. Symptoms, degree of satisfaction with the appearance, complications, Crawford's evaluation, DASH scores and the total active movement (TAM) were collected. RESULTS: The follow-up period was 6~18 months (mean 13 months). Finger function was assessed using the Crawford's evaluation criteria: excellent in 12, good in 10, average in 2, with an excellent and good rate of 91.7%. DASH scores ranged from 37 to 47(mean 39). According to the Chinese Medical Association's trial criteria for assessing the function of upper limbs, excellent, good and average cases were 9, 14 and 1 respectively. The range of motion gradually improved over time. Conclusions Good prognosis can be achieved through bone tunnel-tendon suture for the treatment of fresh central slip avulsion.

Reconstruction of Heel Soft Tissue Defects Using Medial Plantar Artery Island Pedicle Flap: Clinical Experience and Outcomes Analysis.

We report our clinical experience with 11 cases of heel soft tissue defects treated with a medial plantar artery island pedicle flap. We also evaluated the functional outcomes of reconstruction. We enrolled 11 patients (10 [90.9%] males and 1 [9.1%] female), who received a medial plantar artery island pedicle flap for heel soft tissue defects from August 2010 to July 2014. The cause of the defects included trauma (post-traumatic heel skin necrosis) in 2 (18.2%) patients, infection (calcaneal osteomyelitis with overlying soft tissue infection) in 2 (18.2%) patients, and tumor (stage IA melanoma) in 7 (63.6%) patients. The mean average size of the defect was 3.7 cm × 4.4 cm (range 3.1 cm × 4.0 cm to 4.5  cm × 5.5  cm). The mean follow-up period was 19.6 (range 8 to 35) months, and all flaps survived within that period. The mean static 2-point discrimination was 34.4 (range 29 to 40) mm at the heel and 17.2 mm at the distal sole. The mean visual analog scale score for the aesthetic appearance of the reconstructed heel was 9 (range 8 to 9.5). The average revised Foot Function Index score was 25.8 (range 21 to 37). The medial plantar artery island pedicle flap is a versatile and effective method for reconstructing heel soft tissue defects.

[Modified anterolateral thigh perforator flap pedicled by cross-bridge microvascular anastomosis for repairing soft tissue defects in middle and lower segments of leg].

Objective: To explore the effectiveness of modified anterolateral thigh perforator flap pedicled by cross-bridge microvascular anastomosis in treatment of soft tissue defects in the middle and lower segments of the leg. Methods: Between March 2011 and June 2015, 15 cases with skin and soft tissue defects in the middle and lower segments of the legs were treated. There were 9 males and 6 females, aged 22-48 years (mean, 32.6 years). Of whom, 8 patients caused by traffic accidents, 5 by machine twist, and 2 by crash injury of heavy object. The mean interval from injury to admission was 82.6 hours (range, 2 hours to 1 week). The area of defect ranged from 13 cm×9 cm to 23 cm×16 cm. After primary debridement and vaccum sealing drainage treatment, the defects were repaired with modified anterolateral thigh perforator flap pedicled by cross-bridge microvascular anastomosis. The size of flap ranged from 15 cm×10 cm to 25 cm×15 cm. The donor sites were sutured directly or repaired with the skin grafts. The pedicle division was done at 4 weeks after operation. Results: After operation, venous crisis occurred in 1 case and distal skin necrosis in 2 cases which was healed by dressing change. The other tissue flaps survived successfully and wounds healed by first intention. All skin grafts at donor site survived after operation, and primary healing of wound was obtained. All patients were followed up 6-24 months (mean, 13 months). All flaps were characterized by soft texture, satisfactory appearance, and restoring the protective sensation. Moreover, the two-point discrimination ranged from 15 to 28 mm (mean, 19.5 mm) at 6 months after operation. The function of both lower extremities were normal without obvious contracture of scar at donor site. Conclusion: Modified free anterolateral thigh perforator flap, with little damage in donor site, a reliable blood supply by making a cross-bridge microvascular anastomosis with pretibial or posterior tibial blood vessel on normal leg, is a reliable alternative method for repairing soft tissue defects with the main vessels of serious injury in the middle and lower segments of the leg.

[Free grafting of big toe nail bed repairing defects of fingernail bed].

Objective: To investigate the feasibility and indication of free grafting of split big toe nail bed for defects of fingernail bed. Methods: From September 2008 to September 2011,13 cases (4 females and 9 males) with fingernail bed defects(aged 17-38,average,32) were treated with split big toe nail bed. The split big toe nail was harvested according to the defects size without bone exposure at donor site. Results: Three grafted nail beds were necrotic completely and reconstructed with flaps. The 2 grafted nail bed was partial loss and healed after dressing. All the other grafted nail bed survived completely with primarily healing both in donor sites and recipient sites. The patients were followed up for 6-30 months(average,14 months).The therapeutic effect was graded as excellent in 8 cases, good in 2 cases and poor in 14 cases(good rate,76.9％).The nail matrix was excellent in 8 cases,good in 1 case and poor in 1 case(good rate,90％).The toe nails in donor sites grew well. Conclusions: The single fingernail defect with intact nail matrix can be reconstructed by split toe nail bed graft with good cosmetic and functional effect. There is no malfunction at donor site. The indication should be selected.

A Systematic Review of Outcomes and Complications of Primary Fingertip Reconstruction Using Reverse-Flow Homodigital Island Flaps.

BACKGROUND: Fingertip reconstruction using reverse-flow homodigital island flaps has been very popular over the years. However, the outcomes of reconstruction have not been clearly understood. In these circumstances, a systematic review of available literature is warranted. OBJECTIVE: To assess the outcomes and complications of fingertip reconstruction using reverse-flow homodigital island flaps. To justify the usage of reverse-flow homodigital island flaps for fingertip reconstruction. SEARCH METHODS: A PubMed [MEDLINE] electronic database was searched (1985 to 15 April 2015). SELECTION/ELIGIBILITY CRITERIA: Retrospective case series that met the following criteria were included: (1) Study reported primary data; (2) Study included at least five cases of fingertip defects treated using reverse-flow homodigital island flaps; (3) Study reported outcomes and complications of fingertip reconstruction, either primary or delayed, using reverse-flow homodigital island flaps; (4) The study presented at least one of the following functional outcomes: Static two-point discrimination, return-to-work time, range of motion of distal interphalangeal joints; (5) The study presented at least one complication. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed search results, and two other review authors analyzed the data and resolved disagreements. The following endpoints were analyzed: survival rate of the flap, sensibility, and functional outcomes and complications. MAIN RESULT: Eight studies were included in this review. The included studies were published between 1995 and 2014, and a total of 207 patients with 230 fingertip defects were reported. The overall survival rate of the flap was 98 % (including partial survival). The mean static two-point discrimination (2PD) was 7.2 mm. The average range of motion of the DIP joint was 63°. The average return-to-work time was 7 weeks after injury. On average, 2 % of the patient had complete flap necrosis, 5 % had partial flap necrosis, 4 % developed venous congestion, 4 % developed flexion contracture, and 12 % experienced mild-to-moderate cold intolerance. AUTHORS' CONCLUSIONS: Survival of reconstructed fingertips (98 %) is better with reverse-flow homodigital island flaps than fingertip replantation (86 %). The sensibility outcome using sensate flaps (mean s2PD = 7.2 mm) is similar to the sensibility outcome following replantation (mean s2PD = 7 mm). The common complications include cold intolerance, venous congestion, and flexion contracture. Therefore, reverse-flow homodigital island flaps may not be the ideal choice but are a very reliable alternative for fingertip reconstruction. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Second toe microsurgical free-flap for aesthetic and sensory reconstruction of palmar soft tissue defects of fingers.

OBJECTIVES: To illustrate the surgical methods and clinical efficacy of microsurgical free-flaps obtained from second toe for the reconstruction of palmar soft-tissue defect of fingers. METHODS: We enrolled 22 patients (13 men and 9 women), who received second toe free-flap for 22 finger defects between August 2007 and July 2013. The average age was 35 years (range, 18-62 years). The average size of flap was 2.7 cm × 2.0 cm (range, 1.5 cm × 1.5 cm-3.5 cm × 2.5 cm). RESULTS: All flaps survived well without any complications. Follow-up period ranged from 8 to 30 months (mean 15 months). The Visual Analog Scale for flap appearance (VAS flap) was ranged from 8 to 10 (average, 9.5). Based on the CISS questionnaires, 6 cases had mild cold intolerance. The average value of Michigan Hand Outcome Questionnaire (MHOQ) scoring for overall hand function was 8 (range, 5-13). The sensibility outcomes in 10 patients who underwent nerve repair were satisfactory. Average value of static two point discrimination (2PD) was 6.4 mm (range, 4-10 mm) and SWM test was 3.45 (range 2.83-4.12). CONCLUSIONS: Second toe free micro-flap is a very useful and reliable alternative for the reconstruction of palmer soft-tissue defect of fingers. LEVEL OF EVIDENCE: IV.

[The experience of lateral arm free-flaps for hand thermal-crush injury: 15 cases].

Objective: To investigate the effect of lateral arm free-flaps for hand thermal-crush injury. Methods: 15 patients with hand thermal-crush injury were treated with emergency debridement and one-staged coverage with lateral arm free-flaps pedicled with deep brachial artery between January 2010 and December 2013. . Results: Good results were achieved. All 15 flaps survived Conclusions: Emergency debridement and reconstruction with lateral arm free-flap is a very effective method for hand thermal-crush injuries. Meanwhile, it also can reduce complications, shorten the duration of hospitalization and reduce health care costs.

Effect of transgenic human insulin-like growth factor-1 on spinal motor neurons following peripheral nerve injury.

The aim of the present study was to observe the protective effect of exogenous human insulin-like growth factor-1 (hIGF-1) on spinal motor neurons, following its local transfection into an area of peripheral nerve injury. A total of 90 male Wistar rats that had been established as sciatic nerve crush injury models were randomly divided into three groups: hIGF-1 treatment, sham-transfected control and blank control groups. The different phases of hIGF-1 expression were observed in the spinal cord via postoperative immunostaining and the apoptosis of motor neurons was observed using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method. Pathological changes of the motor neurons and Nissl bodies within cell bodies were observed via Marsland and Luxol fast blue double staining, while changes in the neuropil of the spinal cord anterior horn were investigated via ultrastructural observation. It was found that hIGF-1, locally transfected into an area of peripheral nerve injury, was expressed in the spinal anterior horn following axoplasmic transport; the peak hIGF-1 expression occurred approximately a week following transfection. The number of apoptotic spinal cord motor neurons observed in the hIGF-1 treatment group was fewer than that in the sham-transfected and blank control groups at days 7, 14 and 21 following transfection (P<0.01). Furthermore, the quantity of motor neuron cells in the anterior horn of the spinal cord in the hIGF-1 treatment group was higher compared with those in the sham-transfected and blank control groups at days 2, 7, 14 and 28 following transfection (P<0.01). The degenerative changes of Nissl bodies within the cytoplasm of the hIGF-1 treatment group were less severe compared with those of the sham-transfected and blank control groups. At day 56 following transfection, the spinal anterior horn neuropil ultrastructure in the hIGF-1 treatment group was generally normal, while the sham-transfected and blank control groups exhibited an increased number of protruding gaps and local cavities. These results indicate that the application of exogenous hIGF-1 is capable of protecting spinal cord motor neurons following peripheral nerve injury.

Aesthetic and sensory reconstruction of finger pulp defects using free toe flaps.

BACKGROUND: This study illustrates aesthetic and sensory reconstruction of finger pulp defects with free toe flaps from the lateral aspect of the great toe or the medial aspect of the second toe. METHODS: Between August 2007 and July 2010, free toe flaps were harvested and used for 21 fingers of 21 patients. The average patient age was 34.5 years (range 19-62 years). The soft tissue defects were found in the thumb of 6 patients, the index finger of 7 patients, the middle finger of 5 patients, and the ring finger of 3 patients. The donor site was the great toe for 9 patients and the second toe for 12 patients. The average flap size was 2.8 × 2.0 cm (range 1.7 × 1.7 to 3.5 × 3.0 cm). Restoration of the sensitivity, aesthetic appearance, and mobility of the injured fingers compared with the opposite side was assessed using appropriate tools during the follow-up time. RESULTS: All the flaps in this series survived completely, with a high survival rate of 100 %. No urgent operative revision necessitated by postoperative thrombosis of the vessels was performed during the follow-up period. During a mean follow-up period of 18.4 months (range 12-24 months), the average static two-point discrimination score for the injured finger pulp was 4.8 mm (range 3-7 mm), and the Michigan Hand Outcome Questionnaire score was 4.9 mm. The mean range of motion of the distal interphalangeal joint in the injured finger was 69.7°. CONCLUSION: Transplantation of free microvascular flaps from the great toe or the second toe is a useful and reliable technique for finger pulp defect reconstruction. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Treatment of distal fingertip degloving injuries using a cross-finger flap based on the dorsal branch of the proper digital artery at the middle phalanx.

This study reports our experience with reconstruction of distal fingertip degloving injuries using a single cross-finger flap based on the dorsal branch of the proper digital artery at the middle phalanx. From January 2009 to October 2011, 18 patients (18 fingers) presented with distal fingertip degloving injuries and were treated with this technique. The mean size of the soft tissue defects was 4.5 cm in length and 2.0 cm in width. The mean size of the cross-finger flaps was 4.7 × 2.1 cm. In the series, all flaps survived completely. No complication was reported, and no further flap debunking procedure was required. At the mean follow-up period of 20.5 months (range, 12-48 mo), the mean static two-point discrimination was 6.3 mm (range, 5-9 mm) of the reconstructed finger pulp. The total range of active motion of the proximal and the distal interphalangeal joints of the donor fingers were 105 and 77.4 degrees, respectively. The cross-finger flap based on the dorsal branch of the proper digital artery at the middle phalanx is a reliable and simple method in reconstruction of distal degloving injuries of the finger.