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Cold chain storage and transportation provides strong guarantees for the safety and quality of fresh foods. Currently, the cold chain system in China is still under rapid development, and quality deterioration in fresh foods caused by uncontrolled cold chain conditions is nothing new. Therefore, rapid and sensitive detection of quality deterioration in fresh foods during cold chain storage and transportation is of great significance for timely and effective early warning and control of quality and safety risks of fresh foods. This article provides an overview of the rapid techniques reported in recent three years for the detection of quality deterioration in fresh food products in the cold chain, such as indicator methods, spectroscopy, and sensors, with a particular focus on those based on new materials (nanomaterials and composite materials), new devices (smartphones and smart packaging) and new approaches (artificial intelligence and neural networks), as well as the application of in-situ real-time mass spectrometry. The advantages and limitations of each method are discussed, and future development prospects are discussed to provide a reference for the development of new methods for the detection of quality deterioration in fresh food products in the cold chain.

Objective To explore whether hepatocyte Perilipin-2 (Plin2) is involved in the development of fatty liver related to comparative gene identification-58 (CGI-58) deficiency mice and compare the effects of Plin2 and Plin3 on lipid droplet formation and lipid accumulation. Methods Based on CGI-58Flox/Flox mice as animal model, the adeno-associated viruses targeting mouse liver, CGI-58 knockout and Plin2 knockdown were achieved by co-expression Cre protein and micro-RNA targeting Plin2 (Mi-KD). Then CGI-58 deficiency mice were used as control (NC) to detect the differences in metabolic phenotype and liver pathology. AML-12 mouse hepatocytes were used as cellular model and interfered with siRNA to achieve Plin2/Plin3 knockdown in AML-12 cells. Lipid droplet formation and lipid accumulation were compared with Bodipy staining and enzyme colorimetry in basal condition or lipid-overloaded condition (OA inducement) after Plin2/Plin3 knockdown. Results Plin2 knockdown (Mi-KD) reduced PLIN2 protein level by >99% in mouse livers. Mi-KD decreased hepatomegaly (P=0.019 5) and liver injury (P=0.000 4), while reduced the histological NAS score (P=0.000 2) and hepatic triglyceride content (P=0.016 6) in the CGI-58 deficiency female mice. Mi-KD prevented microvesicular hepatic steatosis in the CGI-58 deficient female mice. Plin3 knockdown significantly reduced the triglyceride content in basal condition of hepatocytes (P=0.001 4), and Plin2 knockdown just showed a decreased trend. Plin2 or Plin3 knockdown significantly reduced the triglyceride content separately in lipid-overloaded hepatocytes (P < 0.05). Conclusion Hepatocyte Plin2 is essential in the development of microvesicular hepatic steatosis caused by CGI-58 deficiency. Both Plin2 and Plin3 are involved in lipid droplet formation and lipid accumulation in hepatocytes, and Plin3 shows a stronger effect.

ObjectiveTo determine the effects of Dendrobium nobile Lindl. on the regulation of lipid metabolism based on metabolomics.MethodsTwenty-four rats were randomly divided into the normal control and D. nobile treatment （0.25 g/kg） groups. Rats were intragastrically administered their assigned treatment once every 6 h for 5 d. After the last treatment， the plasma and liver of the animals were collected. Metabolomics were evaluated using UPLC-MS. Principal component analysis （PCA）， cluster analysis， and KEGG pathway analysis were performed to assess the metabolomics data. Compared with the normal control group， different metabolites were identified in the D. nobile treatment group. The expression levels of lipid metabolism-related genes were validated using quantitative real-time PCR.ResultsObvious differences were found between the normal control group and D. nobile treatment group， with significant differences obtained for 1 448 metabolites （P

The micromorphology and functional properties of aerogels from rice, pea, potato or corn starch were characterized by a scanning electron microscope (SEM), an automatic surface area and pore size analyzer, an X-ray diffractometer, and a texture analyzer. The findings revealed that all the four starch aerogels had low density and high porosity. Under SEM observation, rice starch aerogel showed a lamellar structure, pea and potato starch aerogels showed a porous structure with uneven pore size distribution and thick pore walls in some zones, and corn starch aerogel presented a good three-dimensional network structure. The average pore sizes of the four starch aerogels were not much different, mainly distributed in the range of 5–13 nm, whereas there were differences in specific surface area, being smallest in pea starch aerogel (0.330 m2/g) and largest in corn starch aerogel (0.562 m2/g). The X-ray diffraction results showed that the crystallinity of these four starches declined after gelatinization and retrogradation, with corn starch experiencing the greatest decrease, from 30.71% to 8.13%. Compared with pea and potato starch aerogels, corn starch aerogel had higher solubility, water absorption rate, and Young’s modulus (6.233 MPa), and showed stronger deformation resistance, indicating excellent aerogel performance.

In this study, fermented hot pepper products were prepared using Kluyveromyces lactis Km and Lactobacillus plantarum QB3 singly and in combination. The physicochemical analysis showed that fermented hot peppers inoculated with QB3 consumed the most reducing sugar, resulting in the fastest drop of pH of the fermentation broth, and an increase in the contents of short-chain fatty acids and vitamin A by 62.5% and 13.8%, respectively. QB3 grew dominantly in fermented hot peppers, reducing the α-diversity of microorganisms. A total of 73 volatile compounds were detected in fermented hot peppers, 46 of which may contribute to the flavor. Correlation analysis showed that 148 species of microorganisms may be involved in the synthesis of 71 compounds, and L. plantarum and K. lactis may be involved in the synthesis of 26 volatile compounds. K. lactis was key to the formation of flavor compounds, and the synthesis of most volatile compounds was negatively correlated with L. plantarum. This study may provide a theoretical basis and technical support for the preparation of fermented hot pepper products with various flavors by inoculating lactic acid bacteria and yeast, and provide a reference for the flavor diversification of fermented food.

Diabetic retinopathy (DR) is an immune-inflammatory disease and immunoglobulin G(IgG) N-glycosylation modifications are closely associated with DR. Among them, the modification of galactosylation, fucosylation, sialylation and bisecting N-acetylglucosamine of IgG changed has been proved to be predisposing factor to stimulate inflammation and related retinopathy.

Objective To investigate the dynamic expression profile of mdanoma associated antigen D1 (Mage-D1) at different tooth development stages in mice after birth, and explore the effect of Mage-D1 knockout on tooth development in vivo. Methods C57-BL/6 wild-type suckling mice were grouped according to their age (1, 4, 7, 11 and 15 d after birth, n=3 in each group). Tissue samples were prepared and the developmental dynamics of the first mandibular molars in mice were observed by HE staining. Immunohistochemical staining was used to observe the expression of Mage-D1 as well as the homologous box genes Dlx1 and Msx1 at different stages of postnatal tooth development in mice. The Mage-D1 homozygous knockout mice (KO) and wild-type mice (WT) aged 1 and 3 months (n=6 in each group) were selected for phenotypic observation, and micro-CT scanning for mandible was performed to analyze the data of teeth and mandible. Results Morphological observation showed that on postnatal day 1, the first mandibular molar was in the late bell-shaped stage without obvious hard tissue formation; on day 4, dentin and enamel alternatively formed and crown began to develop; on day 7, epithelial root sheaths shaped and root development initiated; on day 11, the enamel and crown dentin were almost completed, with the root about half developed; on day 15, the root of the tooth further developed, reaching more than 2/3, and the cementum was formed. Mage-D1 and the homeobox genes Dlx1 and Msx1 were positively expressed in both ameloblasts and odontoblasts of mice throughout the period from 1 d to 15 d after birth. As compared with WT mice, the body weight of KO mice was increased (P < 0.05); though the number of teeth was the same in the 2 groups, the teeth appearance in KO group was slightly different, with incisors less stained and molars more easily worn. Scanning results indicated no significant difference in the density of teeth and alveolar bone. Conclusion Mage-D1, Dlx1 and Msx1 may contribute together to the formation of tooth enamel and dentin in mice, and the mice with Mage-D1 gene knockout present obesity signs and altered tooth phenotype.

Objective To investigate the regulative effect of neurally differentiated EC-cell-derived protein, Necdin, on the odontogenic differentiation and mineralization of rat dental germ ectomesenchymal stem cells (EMSCs). Methods Immunofluorescence staining was used to detect the expression and distribution of Necdin in E13.5d and E19.5d rat dental germ. EMSCs derived from E19.5d rat dental germ were isolated and cultured, and identified with flow cytometry for cell surface antigens. The EMSCs were stably transfected with lentiviral vector of Necdin silencing. Then, the apoptosis of EMSCs was detected by flow cytometry in the negative control group (sh-NC) and silenced group (sh-Necdin). The proliferation capacity of EMSCs was detected by CCK-8 assay, and the migration ability of EMSCs was detected by cell scratching assay. After mineralization induction, the regulative effect of Necdin on the odontogenic differentiation and mineralization of EMSCs was observed by alkaline phosphatase staining, alizarin red staining, RT-PCR and Western blotting. Results The immunofluorescence results showed that Necdin was strongly expressed and concentrated in the inner enamel epithelium, outer enamel epithelium and in the contact area between epithelium and mesenchyme. After Necdin silencing, the EMSCs showed higher apoptotic rate, enhanced proliferation ability but weaker migration ability when compared with the cells from the sh-NC group (all P < 0.01). What's more, Necdin silencing also resulted in lighter alkaline phosphatase stain and less mineralized nodule formation, and up-regulations of the molecules related to tooth differentiation and mineralization at mRNA and protein levels (P < 0.05) in the cells from the sh-Necdin group than those from the sh-NC group. Conclusion Necdin is specifically expressed in the future odontogenic differentiation and mineralization regions in rat dental germ. Its silencing promotes the apoptosis and proliferation, but inhibits the migration and the abilities of odontogenesis differentiation and mineralization in EMSCs. Necdin might play an important role in tooth development and mineralization.

Objective To evaluate the correlation between vestibular symptoms and headache in patients with migraine, and to explore the diagnostic value of vestibular symptoms in migraine. Methods Consecutive patients who visited our outpatient department of neurology due to a principal complaint of headache during January to December 2019 were recruited in this study. According to the International Classification of Headache Disorders, 3rd edition (ICHD-3), these patients with primary headache were divided into the episodic migraine group, chronic migraine group and tension-type headache group, and those with episodic migraine were assigned into low-, medium-and high-frequency groups. A semi-structured questionnaire was used to collect their information on the clinical symptoms. The vestibular symptoms were identified according to the standard of vestibular symptoms in vestibular migraine. Results There were 424 patients recruited, including 222 in the episodic migraine group, 174 in the chronic migraine group and 28 in the tension-type headache group. Vestibular symptoms accounted for 25.3% and 3.6% in the migraine group and tension-type headache group, respectively. The frequency of vestibular symptoms was higher in the chronic migraine group (31.0%) than the episodic migraine group (20.7%) (P=0.019). The medium-frequency group (with a headache frequency of 2~8 d per month) had the largest number of patients (125/222), with most typical migraine features and accompanying symptoms. In the time correlation between vestibular symptoms and headache, 68.8% of the patients in the low-frequency group had separate attacks of headache and vestibular symptoms. The simultaneous attack of headache and vestibular symptoms was higher in the high-frequency group and the chronic migraine group than the low-frequency group (P < 0.05). Conclusion Vestibular symptoms occur frequently in patients with chronic migraine, suggesting that vestibular symptoms may be associated with the chronicity of migraine.

In order to analyze the differences in functional genes of Bifidobacterium pseudocatenulatum. Comparative genomics analysis was performed on 104 strains of Bifidobacterium pseudocatenulatum isolated from China, Japan and America. The results showed that the number of coding sequences of Japanese isolates were significantly higher than Chinese and American isolates in genome level (P<0.01).Phylogenetic tree based on core gene and average nucleotide identity clustering heat map showed that strains isolated from the same country were more similar. The results of functional gene annotation further showed that the isolation could affect the functional genes distribution of strains. The annotation of carbohydrate active enzymes revealed that 15 carbohydrate active enzymes had regional differences. The number of antibiotic resistance genes and adhesion virulence factors carried by Chinese isolates were more abundant than Japanese isolates by the annotation of antibiotic resistance genes database and virulence factors database. The number of Replication\recombination\repair and phage associated mobile genetic elements carried by the Chinese and Japanese isolates were different from American isolates. In this study, it was found that the location of strains will affect the functional genes of Bifidobacterium pseudocatenulatum, and Bifidobacterium pseudocatenulatum in different locations have different functional genes. This study provides theoretical basis for the analysis of the functional differences of Bifidobacterium pseudocatenulatum. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of 1,25(OH)2D3 on the regulation of bone metabolism in a high-glucose environment and to provide evidence for the possible regulatory mechanism of 1,25(OH)2D3 on osteoblasts in a high-glucose environment.Methods The osteoblast cell line MC3T3-E1 was cultured in 3 groups: ① control group, cultured in low-glucose (5.5 mmol/L) DMEM; ② high-glucose group: cultured in high-glucose (22 mmol/L) DMEM; ③ high-glucose +1,25(OH)2D3 group: high-glucose DMEM + 1,25(OH)2D3 medium culture. The CCK-8 method was used to detect cell proliferation in each group; Annexin V and FITC apoptosis kits were used to detect apoptosis; Alizarin red was used to semiquantitatively analyze cell differentiation; qRT-PCR was used to detect forkhead transcription factor-1 (forkhead transcription factor 1, FoxO1) mRNA expression. Immunofluorescence was used to observe the changes in FoxO1 protein expression and its relative position in the nucleus.Results Our analysis showed that compared with those in the control group, the osteoblast apoptosis and proliferation in the high-glucose group were improved, while differentiation was inhibited (P < 0.05); at the same time, the mRNA expression of FoxO1(P = 0.006) was reduced. The immunofluorescence results showed that more FoxO1 was inside the nucleus (P < 0.001). Compared with those in the high-glucose group, excessive proliferation was inhibited, apoptosis was reduced, and osteogenic differentiation was improved in the high-glucose +1,25(OH)2D3 group (P < 0.05); furthermore, FoxO1 mRNA was decreased (P = 0.006), and the transfer of FoxO1 protein was blocked (P < 0.001).Conclusion We found that 1,25(OH)2D3 may prevent the transfer of FoxO1 to the cell nucleus, inhibit the abnormal proliferation and apoptosis of osteoblasts in a high-glucose environment, and reverse the inhibitory effect of high glucose on the differentiation of osteoblasts.

Research status of alginate fiber in biomedical field was discussed. Structure and properties and production preparation process of alginate fiber, and application status in biomedical field were introduced. Development of alginate fiber was prospected. It is considered that optimizing preparation process of alginate fiber, improving functional design of alginate fiber, developing new high-end intelligent and imitation biomedical textiles can effectively expand scope of alginate fiber in the biomedical field. [ABSTRACT FROM AUTHOR]

Objective To investigate the current situation of clinicians mastering the digital rectal examination in this area. Methods A questionnaire survey was conducted among 177 non-tumor professional clinicians participating in clinical practice for 1-3 years in frontline clinical departments. Results Top 3 recognizable rectum indications of digital rectal examination among 177 clinicians investigated were:"stool deformation/ attenuation"(153 cases, 86.4% ), "anal/abdominal mass"(149 cases, 84.2%) and "ematochezia/black stool"(143 cases, 80.8%). 132 respondents (74.6%) realized the importance of digital rectal examination and 69 respondents (39.0%) mastered the operation steps and key points completely. 139 respondents (78.5%) the diagnosis and treatment measures of digital rectal examination. 146 respondents (82.5%) claimed that they had operated the digital rectal examination. Conclusion The digital rectal examination is easy to operate and has high clinical value. It should gradually bring non-tumor professional clinicians' attention. [ABSTRACT FROM AUTHOR]

Objective: To explore the effectiveness of lobulated pedicled rectus abdominis myocutaneous flap to repair huge chest wall defect., Methods: Between June 2021 and June 2022, 14 patients with huge chest wall defects were treated with radical resection of the lesion and lobulated pedicled rectus abdominis myocutaneous flap transplantation for reconstruction of chest wall defects. The patients included 5 males and 9 females with an average age of 44.2 years (range, 32-57 years). The size of skin and soft tissue defect ranged from 20 cm×16 cm to 22 cm×22 cm. The bilateral pedicled rectus abdominis myocutaneous flaps in size of 26 cm×8 cm to 35 cm×14 cm were prepaired and cut into two skin paddles with basically equal area according to the actual defect size of the chest wall. After the lobulated pedicled rectus abdominis myocutaneous flap was transferred to the defect, there were two reshaping methods. The first method was that the skin paddle at the lower position and opposite side was unchanged, and the skin paddle at the effected side was rotated by 90° (7 cases). The second method was that the two skin paddles were rotated 90° respectively (7 cases). The donor site was sutured directly., Results: All 14 flaps survived successfully and the wound healed by first intention. The incisions at donor site healed by first intention. All patients were followed up 6-12 months (mean, 8.7 months). The appearance and texture of the flaps were satisfactory. Only linear scar was left at the donor site, and the appearance and activity of the abdominal wall were not affected. No local recurrence was found in all tumor patients, and distant metastasis occurred in 2 breast cancer patients (1 liver metastasis and 1 lung metastasis)., Conclusion: The lobulated pedicled rectus abdominis myocutaneous flap in repair of huge chest wall defect can ensure the safety of blood supply of the flap to the greatest extent, ensure the effective and full use of the flap tissue, and reduce postoperative complications.

Objective: To introduce the technique and clinical application of free lobed anteromedial thigh perforator flap., Methods: Between October 2017 and December 2021, 65 patients with buccal and oral cancer penetrating defects were planned to treat with free lobed anterolateral thigh flap transplantation, of which 15 cases were found that the sole anterolateral thigh perforator was actually a branch of the anteromedial thigh perforator, and then the free lobed anteromedial thigh perforator flap was harvested for repair. There were 12 males and 3 females with an average age of 34.6 years (range, 29-55 years). According to Union for International Cancer Control (UICC) TNM staging, there were 7 cases of T 4 N 0 M 0 , 4 cases of T 4 N 1 M 0 , 2 cases of T 3 N 1 M 0 , and 2 cases of T 3 N 2 M 0 . The disease duration was 1-10 months (mean, 6.3 months), and the area of secondary soft tissue defect left after radical resection of buccal and oral cancer was from 5 cm×4 cm to 10 cm×6 cm. The anterolateral thigh skin flap ranged from 5 cm×4 cm to 13 cm×6 cm, and the anteromedial thigh skin flap ranged from 5 cm×3 cm to 10 cm×6 cm. The free trilobed anteromedial thigh flap was prepared according to the actual branches of the main trunk of the anteromedial thigh perforator in 4 cases, and the vastus medialis muscle flap was used to fill the cavity defect of the floor of mouth in 7 cases. Among the 15 patients, the vessel pedicles of the anteromedial thigh perforators were derived from the main femoral artery and vein in 8 cases, from the main descending branch of the lateral femoral circumflex artery in 4 cases, and from the main lateral femoral circumflex artery in 3 cases., Results: Hematoma occurred in 2 cases after operation, which was successfully saved after emergency exploration. No vascular crisis occurred, and partial necrosis of anterolateral femoral skin island occurred in 1 case, which was healed with debridement. The remaining flaps survived successfully, and the wounds and donor site incisions healed by first intention. All the patients were followed up 12-36 months (mean, 14.6 months). The appearance of the flap was satisfactory, and no obvious swelling was found; the mouth opening and language function were satisfactory; only linear scar was left in the donor area, and the thigh function was not significantly affected. Local recurrence occurred in 3 cases, and the defect after tumor resection was repaired with pedicled pectoralis major myocutaneous flap. Four patients with neck lymph node metastasis, including ipsilateral side in 3 patients and contralateral side in the other 1 patient, all underwent neck lymph node dissection again. The 3-year survival rate was 86.7% (13/15)., Conclusion: The anteromedial thigh perforator vessels distributed in the anterolateral region of the thigh can be used to prepare the anterolateral thigh split lobed flap to repair the buccal and oral cancer penetrating defects.

Objective: To summarize the combination methods and optimization strategies of the harvest procedure of anterolateral thigh chimeric perforator myocutaneous flap., Methods: A clinical data of 359 cases of oral cancer admitted between June 2015 and December 2021 was retrospectively analyzed. There were 338 males and 21 females with an average age of 35.7 years (range, 28-59 years). There were 161 cases of tongue cancer, 132 cases of gingival cancer, and 66 cases of buccal and oral cancer. According to the Union International Center of Cancer (UICC) TNM staging, there were 137 cases of T 4 N 0 M 0 , 166 cases of T 4 N 1 M 0 , 43 cases of T 3 N 1 M 0 , 13 cases of T 3 N 2 M 0 . The disease duration was 1-12 months (mean, 6.3 months). The soft tissue defects in size of 5.0 cm×4.0 cm to 10.0 cm×7.5 cm remained after radical resection were repaired with the free anterolateral thigh chimeric perforator myocutaneous flaps. The process of harvesting the myocutaneous flap was mainly divided into 4 steps. Step 1: exposing and separating the perforator vessels, which mainly came from the oblique branch and the lateral branch of the descending branch. Step 2: isolating the main trunk of the perforator vessel pedicle and determining the origin of the vascular pedicle of muscle flap, which was came from oblique branch, lateral branch of the descending branch, or medial branch of the descending branch. Step 3: determining the source of muscle flap, including lateral thigh muscle and rectus femoris muscle. Step 4: determining the harvest form of muscle flap, which included muscle branch type, main trunk distal type, and main trunk lateral type., Results: The 359 free anterolateral thigh chimeric perforator myocutaneous flaps were harvested. In all cases, the anterolateral femoral perforator vessels existed. The perforator vascular pedicle of the flap came from the oblique branch in 127 cases and the lateral branch of the descending branch in 232 cases. The vascular pedicle of muscle flap originated from the oblique branch in 94 cases, the lateral branch of the descending branch in 187 cases, and the medial branch of the descending branch in 78 cases. The muscle flaps harvested from the lateral thigh muscle in 308 cases and the rectus femoris muscle in 51 cases. The harvest forms of muscle flaps included 154 cases of muscle branch type, 78 cases of main trunk distal type, and 127 cases of main trunk lateral type. The size of skin flaps ranged from 6.0 cm×4.0 cm to 16.0 cm×8.0 cm, and the size of muscle flaps range from 5.0 cm×4.0 cm to 9.0 cm×6.0 cm. In 316 cases, the perforating artery anastomosed with the superior thyroid artery, and the accompanying vein anastomosed with the superior thyroid vein. In 43 cases, the perforating artery anastomosed with the facial artery, and the accompanying vein anastomosed with the facial vein. After operation, the hematoma occurred in 6 cases and vascular crisis in 4 cases. Among them, 7 cases were successfully saved after emergency exploration, 1 case had partial necrosis of skin flap, which was healed after conservative dressing change, and 2 cases had complete necrosis of skin flap, which was repaired by pectoralis major myocutaneous flap. All patients were followed up 10-56 months (mean, 22.5 months). The appearance of the flap was satisfactory, and the swallowing and language functions were restored satisfactorily. Only linear scar left in the donor site with no significant effect on thigh function. During follow-up, 23 patients had local tumor recurrence and 16 patients had cervical lymph node metastasis. The 3-year survival rate was 38.2% (137/359)., Conclusion: The flexible and clear classification of the key points in the harvest process of anterolateral thigh chimeric perforator myocutaneous flap can optimize the protocol to the greatest extent, increase the safety of the operation, and reduce the difficulty of the operation.

Objective: To summarize the anatomical types of the concomitant veins of deep inferior epigastric artery and the corresponding choice of anastomosis methods, and to evaluate the indications and safety of various methods., Methods: Between October 2015 and June 2021, 296 female patients received breast reconstruction with autologous free lower abdominal flap, including 154 cases of immediate breast reconstruction and 142 cases of delayed breast reconstruction. The average age of the patients was 36.5 years, ranged from 26 to 62 years. Unilateral free deep inferior epigastric artery perforator flap transplantation was performed in 172 cases, and unilateral free muscle-sparing rectus abdominis myocutaneous flap transplantation was performed in 124 cases. The internal thoracic vessels were selected as the recipient vessels in all cases. The length of vascular pedicle ranged from 9.5 to 13.0 cm, with an average of 11.2 cm. The concomitant veins of deep inferior epigastric artery included three anatomical types: one-branch type in 26 cases (8.8%), two-branch type in 180 cases (60.8%), and Y-shaped structure in 90 cases (30.4%). Anastomosis of inferior epigastric artery was performed with the proximal end of internal thoracic artery, while that of vein should be adjusted according to the diameter, length, wall thickness, and branches of the vein. The specific classification of venous anastomosis included: ① The sole concomitant vein of deep inferior epigastric artery was anastomosed with the internal mammary vein (26 cases); ② The two concomitant veins of deep inferior epigastric artery were anastomosed with the internal mammary vein respectively (151 cases); ③ The larger one of two concomitant veins of deep inferior epigastric artery was anastomosed with the internal mammary vein, and the other one was ligated and discarded (29 cases); ④ The two concomitant veins of deep inferior epigastric artery were Y-shaped, and the common trunk segment was directly anastomosed with the internal mammary vein (31 cases); ⑤ The smaller branch of the concomitant veins of Y-shaped structure was ligated, and the thicker branch was anastomosed with the internal mammary vein (17 cases); ⑥ The concomitant veins of Y-shaped structure were anastomosed with the internal mammary veins respectively (42 cases)., Results: Among the patients who underwent venous anastomosis according to scheme ④, 3 cases had venous crisis of flap after operation, of which 1 case was successfully rescued by emergency exploration; the other 2 cases had flap necrosis, of which 1 case survived after being repaired by pedicled latissimus dorsi flap, and 1 case closed the wound directly. Flaps with other venous anastomosis protocols survived completely. All 296 patients were followed up 12-70 months, with an average of 37.5 months. The reconstructed breast has good shape, good elasticity, and no skin flap contracture. The donor site of the flap only left linear scar, and the abdominal wall function was not affected., Conclusion: The method of direct anastomosis of concomitant veins of deep inferior epigastric artery with Y-shaped structure is relatively risky, and the vessels are prone to be twisted and compressed, leading to the occurrence of venous crisis. It can improve the safety of surgery if only one large vein is anastomosed or two veins are separated to anastomose respectively.

Objective: To investigate the method and effect of free anterolateral thigh myocutaneous flap combined with pedicled latissimus dorsi myocutaneous flap transfer for functional reconstruction after resection of huge shoulder tumor. Methods: The clinical data of 6 patients who were treated with pedicled latissimus dorsi myocutaneous flap combined with free anterolateral thigh myocutaneous flap to repair large-area complex defects after shoulder tumor resection at Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital from December 2015 to December 2020 were retrospectively analyzed. There were 2 males and 4 females, with an average age of 41.7 years (range:29 to 56 years). There were 2 cases of synovial sarcoma,2 cases of phylloid cell sarcoma,1 case of liposarcoma and 1 case of fibrosarcoma. Before this operation, tumor resection had been performed for 1 to 5 times on each case,and the course of disease was 6 to 24 months. Pedicled latissimus dorsi myocutaneous flap combined with free anterolateral thigh myocutaneous flap were used to repair soft tissue defects and reconstruct deltoid function. Postoperative flap status, complications, appearance and function of upper limbs and tumor recurrence were recorded. Results: Six patients were followed up for an average of 21.6 months (range: 12 to 36 months). There were no serious complications after operation,and all flaps survived. No tumor recurrence was found. The appearance of shoulder contour reconstructed by flaps was satisfactory. The reinnervation effect of lateral femoral muscle was confirmed recovered smoothly by neuroelectromyography 3 months after operation. Shoulder function was mildly limited in 3 patients,moderately limited in 2 patients and severely limited in 1 patient. All patients reported significant improvement in shoulder discomfort.The overall functional results of all patients were satisfactory. Conclusion: Combined myocutaneous flaps transplantation can perfectly repair the wound left after the resection of huge shoulder tumor,minimize the recurrence of tumor,reconstruct the function of shoulder joint and greatly improve the quality of life of patients.

Objective: To investigate the application of anterior serratus branch of thoracodorsal vessel in repairing chest wall defect., Methods: Between October 2018 and March 2021, bilateral free lower abdominal flaps were used to repair large-area complex defects after chest wall tumor surgery in 23 patients. The patients were all female; the age ranged from 23 to 71 years, with an average age of 48.5 years. There were 11 cases of locally advanced breast cancer, 4 cases of phyllodes cell sarcoma, 3 cases of soft tissue sarcoma, 3 cases of recurrence of breast cancer, and 2 case of osteoradionecrosis. The size of secondary chest wall defect after tumor resection and wound debridement ranged from 20 cm×10 cm to 38 cm×14 cm, the size of flap ranged from 25 cm×12 cm to 38 cm×15 cm, the length of vascular pedicle was 9-12 cm (mean, 11.4 cm). Fourteen cases of simple soft tissue defects were repaired by flap transplantation; 5 cases of rib defects (<3 ribs) and soft tissue defects were repaired by simple mesh combined with flap transplantation; and 4 cases of full-thickness chest wall defect with large-scale rib defect (>3 ribs) were repaired by "mesh plus bone cement" rigid internal fixation combined with flap transplantation. The anterior serratus branch of thoracodorsal vessel was selected as the recipient vessel in all cases, the revascularization methods include 3 types: the proximal end of the anterior serratus branch plus other recipient vessels (13 cases), proximal and distal ends of anterior serratus branch (6 cases), and proximal ends of two anterior serratus branches (4 cases)., Results: The main trunk of thoracodorsal vessels was preserved completely in 23 patients. All patients were followed up 10-18 months, with an average of 13.9 months. After operation, the flap survived completely, the shape of reconstructed chest wall was good, the texture was satisfactory, and there was no flap contracture deformation. There was only a linear scar left in the flap donor site, and the abdominal wall function was not significantly affected. There was no tumor recurrence during follow-up., Conclusion: The anterior serratus branch of thoracodorsal vessel has a constant anatomy and causes little damage to the recipient site, so it can provide reliable blood supply for free flap transplantation.

Objective: To investigate the application of expanded anterolateral thigh myocutaneous flap in the repair of huge chest wall defect., Methods: Between August 2018 and December 2020, 12 patients, including 4 males and 8 females, were treated with expanded anterolateral thigh myocutaneous flap to repair huge complex defects after thoracic wall tumor surgery. The age ranged from 28 to 72 years, with an average of 54.9 years. There were 4 cases of phyllodes cell sarcoma, 2 cases of soft tissue sarcoma, 1 case of metastatic chest wall tumor of lung cancer, and 5 cases of breast cancer recurrence. All cases underwent 2-7 tumor resection operations, of which 3 cases had previously received lower abdominal flap transplantation and total flap failure occurred, the other 9 cases were thin and were not suitable to use the abdomen as the flap donor site. After thorough debridement, the area of secondary chest wall defect was 300-600 cm 2 ; the length of the flap was (24.7±0.7) cm, the width of the skin island was (10.6±0.7) cm, the length of the lateral femoral muscular flap was (26.8±0.5) cm, the width was (15.3±0.6) cm, and the length of the vascular pedicle was (7.9±0.6) cm., Results: The myocutaneous flaps and the skin grafts on the muscular flaps were all survived in 11 patients, and the wounds in the donor and recipient sites healed by first intention. One male patient had a dehiscence of the chest wall incision, which was further repaired by omentum combined with skin graft. The appearance of the reconstructed chest wall in 12 patients was good, the texture was satisfactory, and there was no skin flap contracture and deformation. Only linear scar was left in the donor site of the flap, and slight hyperplastic scar was left in the skin harvesting site, which had no significant effect on the function of the thigh. All patients were followed up 9-15 months, with an average of 12.6 months. No tumor recurrence was found., Conclusion: The expanded anterolateral thigh myocutaneous flap surgery is easy to operate, the effective repair area is significantly increased, and multiple flap transplantation is avoided. It can be used as a rescue means for the repair of huge chest wall defects.

Objective: To investigate if intercostal neurovascular perforator can nourish lower abdominal flap., Methods: Between June 2017 and December 2020, in 39 female patients with predominant perforator originated from intercostal nerve nutrient vessels, main trunk of the deep inferior epigastric vessels was chosen to be the pedicle to harvest free lower abdominal flap for breast reconstruction. The age of the patients ranged from 28 to 52 years, with an average of 38.6 years. There were 16 cases on the left and 23 cases on the right. The duration of breast cancer was 3-32 months, with an average of 21.8 months. Pathological stage was stageⅡin 31 cases and stage Ⅲ in 8 cases. Among them, 25 cases were primary tumor resection and one stage breast reconstruction and 14 cases were delayed breast reconstruction., Results: The lower abdominal flap pedicled with one side pedicle was harvested in 32 cases, all of which were supplied by the main trunk of the deep inferior epigastric vessel combined with the intercostal neurovascular perforator; 7 cases were harvested with bilateral pedicled lower abdominal flaps, of which 4 cases were supplied by the main trunk of the deep inferior epigastric vessel combined with intercostal neurovascular perforator on one side and deep inferior epigastric artery perforator on the other side, and the other 3 cases were supplied by bilateral main trunk of the deep inferior epigastric vessel and the intercostal neurovascular perforator. In the flaps nourished with the main trunk of the deep inferior epigastric vessel combined with the intercostal neurovascular perforator, the intercostal neurovascular perforators were one branch type in 15 cases, one branch+reticular type in 19 sides, and reticular type in 8 sides. The size of flap ranged from 26 cm×10 cm to 31 cm×13 cm; the thickness was 2.5-5.5 cm (mean, 2.9 cm); the vascular pedicle length was 7.0-11.5 cm (mean, 9.2 cm); the weight of the flap was 350-420 g (mean, 390 g). All the flaps survived completely and the incisions at donor sites healed by first intention. All patients were followed up 14-35 months (mean, 25.4 months). The shape, texture, and elasticity of reconstructed breasts were good and no flap contracture happened. Only linear scar left at the donor site, the function of abdomen was not affected. No local recurrence happened., Conclusion: When the direct perforator of the deep inferior epigastric artery may not provide reliable blood supply for the lower abdominal flap, the intercostal neurovascular perforator with deep inferior epigastric vessels can ensure the blood supply of the free lower abdominal flap.

Objective: To summarize the difficulties and key points of free deep inferior epigastric artery perforator flap (DIEP) transplantation in breast shaping of two-staged breast reconstruction with vertical scar., Methods: The clinical data of 32 postoperative breast cancer patients after mastectomy who underwent free DIEP transplantation for breast reconstruction between October 2015 and October 2019, whose original surgical incisions were all vertical and longitudinal, were retrospectively analysed. All the patients were female, aged from 31 to 42 years, with an average of 34.6 years. The disease duration of breast cancer ranged from 9 to 48 months (mean, 22.8 months). Free DIEP pedicled with contralateral vessels were used in all cases, and the recipient vessels were intrathoracic vessels. Among them, 17 flaps were placed longitudinally, 15 flaps were placed obliquely; Z-shaped flaps were used in 18 cases to adjust the chest wall skin contracture, and contralateral breast reduction and mastopexy were accomplished at the same time in 23 cases., Results: All DIEP survived completely, and all donor and recipient sites healed by first intention. Internal thoracic lymph node metastasis was found in 1 case and treated with radiotherapy. All 32 cases were followed up 9-48 months, with an average of 19.4 months. The appearance and texture of all flaps were satisfactory, and only linear scar was left in donor site. Eleven patients underwent further autologous fat transplantation and nipple reconstruction. All patients had no effect on abdominal wall activity, and no local recurrence and metastasis was found., Conclusion: It is difficult to use free DIEP for two-staged breast reconstruction in patients received mastectomy with vertical longitudinal scar left. Combined with different breast shaping techniques, the outcomes can significantly improve.

Objective: To explore the surgical technique, effectiveness, and safety of muscle-sparing rectus abdominis myocutaneous flap vascularized with intercostal artery perforator and inferior epigastric artery perforator for breast reconstruction., Methods: Between December 2016 and February 2019, 6 cases of early breast cancer received modified radical surgery, lower abdominal flap was applied for one- or two-staged breast reconstruction. The average age of the patients was 34.6 years (range, 29-56 years). The disease duration ranged from 2 to 16 months, with an average of 9.5 months. The tumor was located in the upper outer quadrant in 4 cases and the lower outer quadrant in 2 cases. Pathological examination showed that they were all invasive ductal carcinoma. Four cases of breast cancer were in stage Ⅰ and 2 cases was in stage Ⅱ. During operation, the inferior epigastric artery perforators were found to be close to the upper edge of the flap and/or near the umbilical cord in 4 cases, the inferior epigastric artery perforator vessels were relatively small (<0.3 mm) in 2 cases; and the breast was reconstructed with muscle-sparing rectus abdominis myocutaneous flap vascularized with intercostal artery perforator and inferior epigastric artery perforator. The length, width, and thickness of the flap were (28.9±0.2), (12.1±0.4), and (4.4±0.3) cm, respectively. The length of the vascular pedicle was (11.5±0.2) cm and the weight of the flap was (420.5±32.7) g., Results: All 6 muscle-sparing rectus abdominis myocutaneous flaps were successful, and the breast incisions healed by first intention. There was no vascular crisis, donor site effusion, hematoma, or infection. All 6 patients were followed up 12-36 months (mean, 26.8 months). The reconstructed breast had a good shape, good elasticity, and no flap contracture or deformation; only linear scars left at the donor site of the flap, and the abdominal wall function was not affected. During follow-up, there was no breast cancer recurrence and metastasis., Conclusion: When the inferior epigastric artery perforators are too close to the upper edge of the flap and/or near the umbilical cord, the vascularity of lower abdominal flap can be ruined, harvested in form of muscle-sparing rectus abdominis myocutaneous flap vascularized with intercostal artery perforator and inferior epigastric artery perforator can efficiently ensure blood supply safety.

Objective: To investigate the reconstructive methods and effectiveness of modified pedicled anterolateral thigh (ALT) myocutaneous flap for large full-thickness abdominal defect reconstruction., Methods: Between January 2016 and June 2018, 5 patients of large full-thickness abdominal defects were reconstructed with modified pedicled ALT myocutaneous flaps. There were 3 males and 2 females with an average age of 43.7 years (range, 32-65 years). Histologic diagnosis included desmoid tumor in 3 cases and sarcoma in 2 cases. The size of abdominal wall defect ranged from 20 cm×12 cm to 23 cm×16 cm. Peritoneum continuity was reconstructed with mesh; lateral vastus muscular flap was used to fill the dead space and rebuild the abdominal wall strength; skin grafting was applied on the muscular flap, the rest abdominal wall soft tissue defects were repaired with pedicled ALT flap. The size of lateral vastus muscular flap ranged from 20 cm×12 cm to 23 cm×16 cm, the size of ALT flap ranged from 20 cm×8 cm to 23 cm×10 cm. The donor site was closed directly., Results: All flaps and skin grafts survived totally, and incisions healed by first intention. All patients were followed up 6-36 months (mean, 14.7 months). No tumor recurrence occurred, and abdominal function and appearance were satisfying. No abdominal hernia was noted. Only linear scar left in the donor sites, and the function and appearance were satisfying., Conclusion: Modified pedicled ALT myocutaneous flap is efficient for large full-thickness abdominal defect reconstruction, decrease the donor site morbidity, and improve the donor site and recipient site appearance.

Objective: To explore the effectiveness of pedicled anterolateral thigh myocutaneous flap for full-thickness abdominal wall reconstruction after tumor resection., Methods: Between September 2010 and December 2017, 18 patients with abdominal wall tumors were collected. There were 11 males and 7 females, with an average age of 45.2 years (range, 29-68 years). Histologic diagnosis included desmoid tumor in 8 cases, sarcomas in 6 cases, malignant teratoma in 2 cases, and colon adenocarcinoma in 2 cases. All abdominal wall defects were full-thickness defects. Peritoneum continuity was reconstructed with mesh; the lateral vastus muscular flaps were used to fill the dead space and rebuild the abdominal wall strength; the abdominal wall soft tissue defects were repaired with pedicled anterolateral thigh flaps. The size of abdominal wall defects ranged from 15 cm×6 cm to 25 cm×22 cm; the size of lateral vastus muscular flap ranged from 10 cm×8 cm to 22 cm×10 cm; the size of anterolateral thigh flap ranged from 14.0 cm×8.0 cm to 21.0 cm×8.5 cm. The bilateral pedicled anterolateral thigh myocutaneous flaps were harvested to repair the extensive abdominal wall defects in 2 cases. All donor sites were sutured directly., Results: All wounds healed smoothly and all flaps survived totally. All donor sites healed smoothly. The mean follow-up time was 22.5 months (range, 11-56 months). No tumor recurrence occurred, the abdominal function and appearance were satisfactory, no abdominal hernia was noted. Only linear scar left at the donor sites., Conclusion: Pedicled anterolateral thigh myocutaneous flap combined with mesh is fit for large full-thickness abdominal defect reconstruction.

Objective: To explore the effectiveness of pedicled chimeric thoracoacromial artery perforator (TAAP) flap as a reconstructive option for circular hypopharyngeal defects., Methods: Between January 2013 and December 2014, the pedicled chimeric TAAP flap was used to repair oncologic circular hypopharyngeal defects in 8 patients, included 6 males and 2 females, with an average age of 57 years (range, 45-80 years). All patients were treated in other hospitals before and recurrence was noted. The duration between latest treatment and recurrence ranged from 3 to 28 months (mean, 16.5 months). According to Union for International Cancer Control (UICC) TNM staged, 3 cases were T 2 N 1 M 0 , 2 cases were T 3 N 1 M 0 , 1 case was T 3 N 2 M 0 , 2 cases were T 4 N 1 M 0 . After laryngectomy, the size of circular hypopharyngeal defect ranged from 9.0 cm×8.5 cm to 12.0 cm×10.5 cm. The size of TAAP flap ranged from 7.0 cm×4.0 cm to 9.5 cm×6.0 cm．The size of pectoralis major flap ranged from 9.0 cm×5.0 cm to 14.5 cm×6.0 cm．The donor sites were closed directly in all cases., Results: Postoperatively all flaps survived smoothly, and all defects healed by first intention. No early complication was noted. The mean hospital stay period ranged from 12 to 22 days (mean, 14.5 days). All patients were followed up 12-45 months (mean, 18.7 months). Patients possessed good appearance of surgical sites. No recurrence, fistulas, stenosis/strictures, dehiscence, or swelling occurred. Only linear scars were left on the donor sites, and the pectoralis major muscle function was completely preserved in all patients., Conclusion: Patients with high comorbidities may not be suitable candidates for free flap reconstruction, especially when the recipient vessels are affected from disease or radiotherapy. Pedicled chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defects in such conditions．.

Objective: To investigate the iodine status of lactating women and the influence on infants during the first 24 weeks postpartum in Tianjin City., Methods: The iodine concentration of human milk and urine were measured from 438 lactating women and their exclusive breastfeeding infants., Results: Significant difference was found between the levels of BMIC according to the time of collecting samples( P < 0. 001). The BMIC was lower at the 24th week postpartum with a M( P25-P75) of 123. 5 μg/L( 83. 1-177. 6 μg/L) and the level of lactating women's UIC was lower at the 4th week postpartum with the M( P25-P75) of 87 μg/L( 52-159 μg/L). Besides that, the level of infants ' UIC was lower at the 12th week postpartum with the M( P25-P75) of 191 μg/L( 130-302 μg/L). Lactating women's BMIC and UIC( r = 0. 238, P <0. 001), lactating women's BMIC and infants' UIC( r = 0. 257, P < 0. 001), lactating women's UIC and infants' UIC( r = 0. 148, P < 0. 001) were significantly positive correlated. According to different time of collecting samples, the levels of infants' UIC were significant different categorized by BMIC at 4th, 12th, 24th week postpartum( P <0. 05)., Conclusion: The BMIC gradually decreased during the first 24 weeks postpartum in Tianjin, but still been in the sufficient iodine status. The iodine status of lactating women can affect their infants' iodine status.

Objective: To explore the clinical application of combined transverse upper gracilis flap and adductor magnus perforator flap in breast reconstruction of breast cancer patients after mastectomy., Methods: Between August 2016 and February 2017, the combined transverse upper gracilis flap and adductor magnus perforator flap was used in 12 cases of breast cancer patients who received modified radical surgery for breast reconstruction. All patients were females with the age of 32 to 59 years (mean, 41.5 years). There were 7 cases in left side and 5 cases in right side. Eight cases were received breast reconstruction by one-stage operation and 4 cases by two-stage operation. In one-stage operation cases, pathological diagnosis includes invasive ductal carcinoma in 4 cases and invasive lobular carcinoma in 4 cases. The disease duration ranged from 2 to 9 months (mean, 4.5 months). In two-stage operation cases, the time interval between mastectomy and breast reconstruction ranged from 12 to 70 months (mean, 37.4 months). The length of flap was 20-28 cm, the width of flap was 5.5-7.5 cm, the thickness of flap was 2.5-4.5 cm. The length of gracilis flap pedicle was 6.5-9.2 cm, the length of adductor magnus perforator flap pedicle was 7.5-10.4 cm. The weight of flap was 295-615 g., Results: The ischemia time of flap ranged from 95 to 230 minutes (mean, 135 minutes). All flaps were successfully survived. All incisions of recipient donor sites healed by first intention. All patients were followed up 7-14 months (mean, 9.5 months). The reconstructed breasts' shape, texture, and elasticity were good and no flap contracture deformation happened. Only linear scar left in the donor sites, but the function of thighs was not affected. No local recurrence happened during follow-up., Conclusion: With appropriate patient selection and surgical technique, the combined transverse upper gracilis flap and adductor magnus perforator flap can be a valuable option as an alternative method for autologous breast reconstruction.

Objective: To investigate the effectiveness of bipaddled anterolateral thigh perforator flap in repair of through-and-through maxillofacial defect following oral cancer ablation., Methods: Between January 2008 and December 2016，42 patients with oral cancer were treated. There were 31 males and 11 females with an average age of 44.5 years (range, 31-68 years). There were 28 cases of buccal mucosa carcinoma, 10 cases of basal cell carcinoma of buccal skin, 3 cases of gingiva carcinoma, and 1 case of recurrent parotidduct carcinoma. The disease duration ranged from 1 to 24 months (mean, 13.5 months). The size of through-and-through maxillofacial defect ranged from 6.0 cm×4.5 cm to 9.0 cm×7.0 cm. All defects were repaired with the bipaddled anterolateral thigh perforator flap. The paddles were adjusted to repair the buccal area. And the size of flap ranged from 7 cm×5 cm to 10 cm×8 cm. The donor sites were closed directly., Results: The operation time was 4.5-7.5 hours (mean, 5.5 hours). All flaps healed and the wounds of recipient and donor sites healed by first intention. All patients were followed up 9-60 months (mean, 22 months). All patients were satisfied with their facial appearance and the speech function. The range of mouth opening was 3-5 cm. Three patients died of recurrence during the follow-up period and the other patients were alive., Conclusion: The bipaddled anterolateral thigh perforator flap is flexible and reliable for the through-and-through maxillofacial defect reconstruction following oral cancer ablation.

Objective: To investigate the application of free anteromedial thigh (AMT) perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma., Methods: From September 2010 to January 2015,57 cases with tongue carcinoma underwent radical resection, leaving tongue and mouth floor defects which were reconstructed by AMT perforator flaps at the same stage. These 57 eases included tongue carcinoma at lingual margin (n =36),at ventral tongue (n =15) and at mouth floor (n=6). ., Results: The size of AMT perforator flap ranged from 5.5 cm ×4.0 cm to 7.5 cm × 5.5 cm, the thickness of flap ranged from 1.0-1.7 cm. The length of pedicle from descending branch of lateral circumferential femoral artery is (8.2 ± 0.6) cm, found in 28 cases. The length of pedicle from profunda femoral artery is (8.5 ±0.4) cm, found in 17 cases. The length of pedicle from femoral artery is (8.1 ± 0.7) cm, found in 12 cases. All 57 perforator flaps survived uneventfully, the defects at donor site were closed directly in all cases. All patients were followed up for 12-24 months with satisfactory esthetic and functional results in reconstructed tongue. No local recurrence happened. Only linear scar left in the donor sites, the function of thighs were not affected, Conclusions: The free AMT perforator flap is an ideal choice for reconstruction of the tongue and mouth floor defect after radical resection of tongue carcinoma.

Objective: To investigate the clinical outcome of free thoracoacromial artery perforator (TAAP) flap in the reconstruction of tongue and mouth floor defects after radical resection of tongue carcinoma., Methods: Between May 2010 and February 2015, 11 cases of tongue carcinoma underwent radical resection and reconstruction of tongue and mouth floor defects with free TAAP flaps. The locations of tongue carcinoma were the lingual margin in 7 cases, the ventral tongue in 2 cases, and the mouth floor in 2 cases. According to Union for International Cancer Control (UICC) TNM stage, 3 cases were classified as T 4 N 0 M 0 , 3 cases as T 4 N l M 0 , 2 cases as T 3 N 1 M 0 , 2 cases as T 3 N 2 M 0 , and 1 case as T 3 N 0 M 0 . The disease duration ranged from 3 to 28 months, 10.6 months on average. The tumor size ranged from 6.0 cm×3 cm to 10 cm×5 cm. The TAAP flap ranged from 7.0 cm×4.0 cm to 11.0 cm×5.5 cm in size, and 0.6-1.2 cm (0.8 cm on average) in thickness, with a pedicle length of 6.8-9.9 cm (7.2 cm on average)., Results: All 11 flaps survived, the donor site was closed directly and healed primarily in all cases. The patients were followed up 12-24 months (17.2 months on average). The reconstructed tongue had satisfactory appearance and good functions of swallowing and language. No local recurrence was observed during follow-up. Only linear scar was left at the donor site, and the function of pectoralis major muscle was normal., Conclusion: The TAAP flap is an ideal choice in the reconstruction of tongue defect after resection of tongue carcinoma, which has good texture, appearance, and function results.

Objective: To explore the effectiveness of pedicled thoracoacromial artery perforator (TAAP) flap for pharyngocutaneous fistula repair after total laryngectomy and radiotherapy., Methods: Between February 2012 and January 2015, TAAP flap was used to repair pharyngocutaneous fistula after total laryngectomy and radiotherapy in 8 patients. The eight patients were male, aged from 46 to 72 years (mean, 51.8 years). The disease duration was 8-62 months (mean, 27.5 months). Fistula size ranged from 4.0 cm×2.5 cm to 6.0 cm×4.0 cm and the skin defect size ranged from 4.0 cm×3.0 cm to 6.0 cm×4.0 cm. The flap size ranged from 7.0 cm×4.0 cm×0.3 cm to 9.5 cm×6.0 cm×0.5 cm. The length of pedicle was (8.3±0.5)mm. The distance from pivot point of flap to central point of recipient site was (94.5±1.9) mm., Results: All 8 flaps survived and all incisions healed smoothly. The hospitalization time was 7-14 days (mean, 9.6 days). The barium meal examination showed no fistula or stenosis. The patients were followed up 8-42 months (mean, 28.5 months). During follow-up, the neck appearance was good, and no fistulas or stenosis occurred. Only linear scars were observed at the donor sites, pectoralis major muscle function was normal in all patients., Conclusions: Pharyngocutaneous fistula should be repaired as early as possible after total laryngectomy. TAAP flap is suitable for the reconstruction of pharyngocutaneous fistula after total laryngectomy.

Objective: To explore the clinical effect of thoracoacromial artery perforator (TAAP) flap as a reconstructive option for hypopharyngeal defects., Methods: Between June 2011 and November 2015,TAAP flap was used to restore oncologic hypopharyngeal defects in 13 patients with recurrence of hypopharyngeal carcinoma. The size of hypopharyngeal defects ranged from 7.0 cm× 4.5 cm to 8.5 cm × 5.5 cm. Doppler was used to detect the location of thoracoacromial artery perforator. The flap was designed on the line joining the acromion to the xiphoid process with the size 0.5-1.0 cm larger than the defect,the flap was passed under the clavicular head of the pectoralis major and under the clavicle bone and sternocleidomastoid to the recipient site for insetting. The donor site was closed directly., Results: The size of TAAP flap is from 7.0 cm×5.0 cm to 9.5 cmu×6.0 cm. The length of pedicle is 7.5-9.0 cm. The distance from pivot point of flap to central point of recipient site was 9.0-10.5 cm. All 13 flaps survived completely, the defect at donor site was closed directly in all cases. Good appearance was achieved at 8 months to 42 months' follow up, with no recurrence, fistulas, stenosis/strictures, dehiscence, or swelling, only linear scars were left on the donor sites, pectoralis major muscle function was completely preserved in all patients., Conclusions: TAAP flap is a good choice for reconstruction of hypopharyngeal defects.

Objective: To explore the surgical strategy for postburn cervical scar contracture., Methods: Sixty-five patients with scar contracture as a result of burn injury in the neck were hospitalized from July 2013 to July 2014. Release of cervical scar contracture was conducted according to different demands of the 3 anatomic subunits of neck, i.e. lower lip vermilion border-supramaxillary region, submaxillary region, and anterior region of neck. After release of contracture, platysma was released. For some cases with chin retrusion, genioplasty with horizontal osteotomy was performed. The coverage of wound followed the principle of similarity, i.e. the skin tissue covering the wound in the neck should be similar to the characters of skin around the wound in terms of color, texture, and thickness. Based on this principle, except for the preschool children in whom skin grafting was performed, the wounds of the other patients were covered by local skin flaps, adjacent skin flaps, or free skin flaps., Results: All patients underwent release of scar and platysma, while 9 patients underwent genioplasty with horizontal osteotomy. Wounds were covered with local skin flaps in 32 patients, with adjacent skin flaps in 7 patients, with free skin flaps in 11 patients, and with skin grafts in 15 patients. All skin grafts and flaps survived. Good range of motion was achieved in the neck of all patients, with the cervicomental angle after reconstruction ranging from 90 to 120°. All patients were followed up for 6 to 24 months. Six patients who had undergone skin grafting were found to have some degrees of skin contracture, while none of the patients who had undergone flap coverage showed any signs of contracture recurrence., Conclusions: Restoration of the cervicomental angle is critical in the treatment of postburn cervical scar contracture, and the release of scar contracture should conform to the subunit principle. The coverage of wound should be based on the principle of similarity, with repair by skin flaps as the first choice, and skin grafting as the second choice. Satisfactory effect of repair would be achieved by following the above surgical principles.

Objective: To investigate the therapeutic effect of heating and bandage treatment for chronic lymphedema of extremities accompanied with erysipelas., Methods: From March 2004 to March 2013, 80 patients with chronic lymphedema of extremities accompanied with erysipelas were analyzed retrospectively. The patients underwent heating treatment (42 degree centigrade) with infrared light machine made by Shanghai Ninth People's Hospital, 2 hours a day, 20 hours for a session. Bandage treatment was adopted after heating treatment. 1 or 2 sessions were performed for each patient every year. The erysipelas occurring frequency, patients subjective feeling, treatment sessions and elastic material usage was recorded during the follow-up period. The erysipelas occurring frequency was tested by the method of rank and inspection. SPSS 17. 0 was used for statistical analysis., Results: After heating and bandage treatment, the occurrence frequency of erysipelas was obviously controlled (Z = 7.598, P = 0.000). Erysipelas was not occurred any more in 60 (75%)patients. Remarkable reduction of occurrence frequency of erysipelas caused by various reasons was showed after treatment. Primary and secondary lymphedema after treatment were compared with those before treatment respectively, showing statistical difference (Z = 3.417 and 5.009, P = 0.001 and 0.000). Most of patients felt better subjectively. The relapse rate of erysipelas and lymphedema was lower if keeping using elastic material to give more pressure on extremities after therapy., Conlusions: Heating and bandage treatment can obviously reduce the occurrence frequency of erysipelas. It can improve the quality of patients' lives. Simultaneously, the subsequent elastic material pressure therapy is essential.

Objective: To evaluate the efficacy and safety of acupuncture for optic atrophy., Methods: All the randomized controlled trials (RCTs) on optic atrophy treatment with acupuncture were included after retrieving the PubMed, Embase, Cochrane Library, CBM, CNKI, VIP, Wanfang database from their establishment to November 2012. The bibliographies of the included studies were retrieved as well. The quality of RCTs meeting the inclusion criteria was evaluated and the data were extracted. Meta-analyses were performed with Stata 11.2 software., Results: Thirteen RCTs involving 1180 eyes were included. Meta-analyses showed that the effect of acupuncture or combined with medicine was superior to medicine alone in terms of total effectiveness [OR=3.281, 95% CI ( 2.517, 4.278)], visual acuity [3.287, 95% CI (2.193, 4.925)], and visual field [3.215, 95% CI (1.580, 6.543)]. The visual sensitivity and P-VEP test showed the similar results., Conclusion: Acupuncture is superior to medicine in terms of improved visual acuity, visual field and P-VEP. However, large samples, and high-quality studies are needed for stronger evidence.

Global warming caused by the increasing CO2 concentration in atmosphere is a serious problem in the international political, economic, scientific and environmental fields in recent years. Intensive carbon dioxide capture and storage (CCS) technologies have been developed for a feasible system to remove CO2 from industrial exhaust gases especially for combustion flue gas. In these technologies, the biofixation of CO2 by microalgae has the potential to diminish CO2 and produce the biomass. In this review, the current status focusing on biofixation of CO2 from combustion flue gases by microalgae including the selection of microalgal species and effect of flue gas conditions, the development of high efficient photobioreactor and the application of microalgae and its biomass product were reviewed and summarized. Finally, the perspectives of the technology were also discussed.

To compare of performance of beta-1,3-1,4-glucanase gene (bgl) in different expression systems, the beta-1,3-1,4-glucanase gene (GenBank Accession No. EU623974) was amplified from Bacillus amyloliquefaciens BS5582 by PCR and was cloned into three vectors pEGX-4T-1, pET20b(+) and pET28a(+) to construct pEGX-4T-1-bgl, pET20b(+)-bgl and pET28a(+)-bgl recombinant plasmids. The pEGX-4T-1-bgl was transformed into three different Escherichia coli host strains. The pET20b (+)-bgl and pET28a (+)-bgl were transformed into E. coli BL21 (DE3) respectively. Recombinant beta-glucanase was expressed by IPTG inducement in these recombinants. E. coli BL21 (DE3)-pET28a (+)-bgl had the highest enzyme activity. In Luria-Bertani medium, the total enzyme activity was (322.0 +/- 8.8) U/mL, which was 40.1% of original strain in optimal shaking flask condition. This recombinant's performance was studied in Terrific Broth medium under inducement of IPTG and lactose at the same time., and the highest total enzyme activity could reach (1883.3 +/- 45.8) U/mL (818.8% of the original), which indicate that the recombinant strain has a good value in industry application.

The ECM25 deletion mutant of industrial brewing yeast, G03/a, was constructed by replacing the ECM25 gene with the kanMX gene. The transformant was verified to be genetically stable. The PCR analysis showed that ECM25 gene in the G-03/a was deleted. Under aerobic conditions of ll degrees C and 28 degrees C, compared with the host strain G-03, the excretive glutathione concentration of G-03/a increased by 21.4% and 14.7%, respectively. Strains G-03 and G-03/a were inoculated in flasks and cultivated continuously for 4 generations. Compared with the host strain G-03, the glutathione concentration in the main fermentation broth and final beer of strain G-03/a increased by 32.1% and 13.8%, the stability index (SI) increased by 7.7% and 5.3%, respectively, and the flavor resistance staling value (RSV value) in final beer increased by 45.0%. During EBC fermentation, the glutathione concentration in the main fermentation broth of strain G-03/a increased by 34.0%, compared with the host strain G-03. Furthermore, no significant difference in routine fermentation parameters was found. The strain G-03/a is proved to be an excellent anti-staling brewing yeast to improve beer flavor stability.

Objective: To explore the technique for reconstructing nasal subunits with the reversed vascularized preauricular and ear composite flap., Methods: From June 2003 to August 2005 the preauricular and ear composite flap, which was pedicled by the reversed superficial temporal vessel, was harvested and transplanted to repair the defects of the nasal tip, soft triangle, and ala by the microsurgical technique. The flap ranged in area from 3.5 cm x 2. 5 cm to 2. 0 cm x 1. 5 cm, with the pedicles 4 to 6 cm in length. The reversed superficial temporal vessel pedicles were directly anastomosed to the angular artery and vein adjacent to the nasal ala., Results: Among the 12 patients who had been treated, 11 had their vessel pedicles successfully anastomosed to the angular vessels, while the remaining 1 patient had the stump of the superficial temporal vessel anastomosed after the flap harvest via the vessel graft because the angular vessels were not found in the recipient area. All the flaps survived with a satisfactory esthetic result after operation., Conclusion: The technique for reconstructing nasal subunits with the reversed vascularized preauricular and ear composite flap, which is directly anastomosed to the angular vessel, can avoid the vessel grafting and therefore it can avoid an additional damage to the patient.

Objective: To discuss the reconstruction of severe neck contracture by transplanting combined scapular/parascapular bilobar flaps, and the probability to reestablish three-dimensional movement of the neck., Methods: From January 2003 to November 2004, 9 cases of sustained severe neck contractures were treated (aged 9-32 years). The combined scapular/parascapular bilobar flaps, pedicled on the circumflex scapular vascular bundle, were microsurgically used to cover the soft tissue defect after excision of hypertrophic scar and release of contracture. The maximum size of the combined bilobar flap was 20 cm x 8 cm to 20 cm x 11 cm, while the minimum one was 15 cm x 4 cm to 15 cm x 6 cm., Results: The combined scapular/parascapular flaps were successfully used to treat 9 cases of severe neck contracture. All patients were satisfied with the final functional and aesthetic results. There was no recurrence during 3-9 months follow-up for 8 patients. The cervicomental angle was 90-105 degrees., Conclusion: The combined bilobar scapular/parascapular flap, providing a large area of tissue for coverage in three dimensions with a reliable blood supply by only one pedicle anastomosis during operation, is a good option for reconstruction of the severe neck contracture.

Objective: To introduce the free multiple flaps of lower extremity based on the anterior tibital vascular pedicle for primary repair of the complex burned hand deformities., Methods: From September 2000 to February 2003, the lateral leg flap, dosalis pedis flap and trimmed first toe based on the anterior tibial vascular pedicle were utilized to reconstruct the thumb and repair the first web, thenar, wrist or palmar scar contracture simultaneously in 6 patients. The flap size of lateral leg and dosalis pedis ranged from 4 cm x 10 cm to 7 cm x 10 cm and from 5 cm x 10 cm to 9 cm x 12 cm, respectively., Results: Six cases were treated and followed up for 6 weeks to 1 year. The transplanted flaps survived with satisfactory recovery in function and appearance of the burned hand. The function of donor lower extremity was not damaged., Conclusion: The procedure of the free multiple flaps of lower extremity based on the anterior tibial vascular pedicle is reliable and effective for primary repair of burned hand.