[Effects of modified proper digital artery island flap in repairing complex fingertip defects]

Objective: To investigate the surgical method and clinical effects of the modified proper digital artery island flap in repairing complex fingertip defects. Methods: A retrospective observational study was conducted. From January 2017 to December 2021, 15 patients (15 fingers) with complex fingertip defects, involving the pulp, nail bed, and lateral wall of the nail, who met the inclusion criteria were admitted into General Hospital of Northern Theater Command, including 11 males and 4 females, aged from 18 to 55 years. The area of the post debridement wound was from 2.5 cm×2.0 cm to 3.5 cm×3.5 cm, and all the wounds were repaired by using modified proper digital artery island flap (including 3 parts: main flap, tongue-shaped flap, and triangular flap), of which the main flap was used to cover the finger pulp defect, the tongue-shaped flap was used to cover the nail bed and the nail lateral wall defect, and the triangular flap was inserted into the edge of the finger pulp wound to cover the vessel pedicle. The range of the flap ranged from 3.0 cm×2.0 cm to 4.5 cm×3.0 cm. The wound at the donor site was repaired with full-thickness skin graft of the groin, and the donor site of the skin graft was sutured directly. After operation, the survival of the flap and skin graft as well as and the appearance of the affected finger were observed. During the follow-up, the fingertip morphology of the affected finger was observed, two-point discrimination distance of the affected finger pulp was measured, and the patients' satisfaction with the efficacy (including very satisfied, satisfied, and dissatisfied) was asked, and the affected finger function was evaluated by the total active movement (TAM) system evaluation standard recommended by American Academy for Surgery of Hand. Results: After operation, the main flaps and skin grafts in 15 patients all survived; but the incision at the edge of tongue-shaped flap in one patient healed poorly, and one patient developed venous stasis at the distal end of the tongue-shaped flap; the triangular flap at the pedicle was slightly bloated in the early postoperative period and became smooth after 2 to 3 months. Overall, two patients developed subcutaneous hematoma in their flaps. All the complications were healed by appropriate dressing change, suture removal, or compression bandaging. After operation, the appearance of the flap was full and formed a prominent fingertip shape. During the follow-up of 6 months to 5 years, the fingertips of the affected fingers were prominent and full; the two-point discrimination distance of the affected finger pulp was (8.6±1.4) mm; 8 patients were very satisfied with the efficacy, 6 patients were satisfied, and one patient was dissatisfied; the functional assessment of the affected fingers were all excellent. Conclusions: The modified proper digital artery island flap can repair complex fingertip defects involving the pulp, nail bed, and lateral wall of the nail. The operation is simple, and the shape and function of the fingertip are good after surgery.

Reforming the Uniformity of Solid Electrolyte Interphase by Nanoscale Structure Regulation for Stable Lithium Metal Batteries

The stability of high-energy-density lithium metal batteries depends on the uniformity of solid electrolyte interphase (SEI) on lithium metal anodes. Rationally improving SEI uniformity is hindered by poorly understanding the effect of structure and components of SEI on its uniformity. Herein, a bilayer structure of SEI formed by isosorbide dinitrate (ISDN) additives in localized high-concentration electrolytes was demonstrated to improve SEI uniformity. In the bilayer SEI, LiNx Oy generated by ISDN occupies top layer and LiF dominates bottom layer next to anode. The uniformity of lithium deposition is remarkably improved with the bilayer SEI, mitigating the consumption rate of active lithium and electrolytes. The cycle life of lithium metal batteries with bilayer SEI is three times as that with common anion-derived SEI under practical conditions. A prototype lithium metal pouch cell of 430 Wh kg-1 undergoes 173 cycles. This work demonstrates the effect of a reasonable structure of SEI on reforming SEI uniformity.

Rhizobacteria communities reshaped by red mud based passivators is vital for reducing soil Cd accumulation in edible amaranth

Red mud (RM) was constantly reported to immobilize soil cadmium (Cd) and reduce Cd uptake by crops, but few studies investigated whether and how RM influenced rhizobacteria communities, which was a vital factor determining Cd bioavailability and plant growth. To address this concern, high-throughput sequencing and bioinformatics were used to analyze microbiological mechanisms underlying RM application reducing Cd accumulation in edible amaranth. Based on multiple statistical models (Detrended correspondence analysis, Bray-Curtis, weighted UniFrac, and Phylogenetic tree), this study found that RM reduced Cd content in plants not only through increasing rhizosphere soil pH, but by reshaping rhizobacteria communities. Special taxa (Alphaproteobacteria, Gammaproteobacteria, Actinobacteriota, and Gemmatimonadota) associated with growth promotion, anti-disease ability, and Cd resistance of plants preferentially colonized in the rhizosphere. Moreover, RM distinctly facilitated soil microbes' proliferation and microbial biofilm formation by up-regulating intracellular organic metabolism pathways and down-regulating cell motility metabolic pathways, and these microbial metabolites/microbial biofilm (e.g., organic acid, carbohydrates, proteins, S^2-, and PO₄^3-) and microbial cells immobilized rhizosphere soil Cd via the biosorption and chemical chelation. This study revealed an important role of reshaped rhizobacteria communities acting in reducing Cd content in plants after RM application.

[Analysis the influence factors of treatment free remission outcome with chronic myeloid leukemia patients who discontinued tyrosine kinase inhibitors]

Objective: To explore the related factors affecting the outcome of treatment free remission (TFR) in patients with chronic myeloid leukemia (CML). Methods: Clinical data of CML patients with automatic discontinuation of tyrosine kinase inhibitor (TKI) from the CML cooperative organization of Henan province between June 2, 2013 to March 27, 2021 and the follow-up time was ≥ 6 months were retrospectively analyzed. Log-rank test was used for univariate analysis and Cox proportional risk regression model was used for multivariate analysis. Results: A total of 135 patients were enrolled, and 69 patients (51.1%) were femal and 66 patients (48.9%)were male. Median age was[M(Q₁,Q₃)] 49 years (38, 58)at discontinuation.Before discontinuation, 72 patients (53.3%) were on treatment with second-generation TKI, 63 patients (46.7%) were on treatment with IM, 17patients (12.6%) had a history of TKI reduction/withdrawal;median duration of treatment was months 84 (68, 108) for all patients;median time of TKI treatment to DMR was months 12(8, 26);median duration of DMR was months 65 (54, 84), and 9 patients (6.7%) had unsustained DMR.The median follow-up time was months 16(6-96), 35 patients (25.9%) lost MMR at a median months 3(1-22), overall estimated TFR was 74.1%.The univariate analysis results showed that:second-generation TKI was used, the time of TKI treatment to DMR was ≤12 months, DMR duration time ≥48 months, had sustained DMR, without TKI reduction/withdrawal history were favorable factors affecting of TFR in patients with TKI discontinuation (all P<0.05).The TFR rate of the second-generation TKI therapy group was significantly higher than the IM therapy group (81.9% vs 65.1%, P=0.019).The multivariate analysis results showed that second-generation TKI treatment[RR=0.451, 95%CI (0.227-0.896), P=0.023] and had sustained DMR [RR=0.120, 95%CI (0.053-0.271), P<0.001] were the protective factors of TFR in patients with TKI discontinuation. Conclusions: Treated with second-generation TKI and had sustained DMR are the protective factors of TFR in patients with TKI discontinuation.The CML patients who had sustained DMR more≥48 months before TKI discontinuation showed a better TFR.

[The relationship between brain networks and symptoms of schizophrenia]

The pathogenesis of schizophrenia (SCZ) is not yet clear, and the pathological changes of the brain activity remains debatable. There are still numerous unresolved issues and debates regarding the relationship between functional connection of the brain network and the symptoms of SCZ. In this paper, we provide a comprehensive review of recent research progresses on resting-state and task-based brain networks, which covers the symptoms of SCZ. Furthermore, we discuss the relationship between large-scale brain networks and SCZ symptoms, and propose possible future research directions in the field of SCZ diagnosis and treatment.

[The influence of two calculation methods on the outcomes of Toric intraocular lenses]

Objective: To evaluate the influence of Barrett calculator and AcrySof calculator on astigmatism correction effect. Methods: This is a randomized prospective study. A total of 64 cases (81 eyes) who planed to undergo phacoemulsification at Tianjin Medical University Eye Hospital during January 2017 and March 2018 were enrolled and divided into two groups randomly, including of the Barrett calculator group of 34 cases (41 eyes) and the AcrySof calculator group of 30 cases (40 eyes). Preoperative ocular biological parameters were measured using Lenstar LS900. The Toric intraocular lenses (IOL) plans were determined based on Barrett calculator and the AcrySof calculator for the two groups respectively. Subjective optometry was performed by phoropter and Toric IOL alignment was detected by slitlamp examination at 1 and 3 months postoperatively. Statistical analysis was taken with the data of 29 cases (35 eyes) in the Barrett calculator group and 26 cases (35 eyes) in the AcrySof calculator group, there were 20 males (25 eyes) and 35 females (45 eyes) with an average age of (72±10) years. The difference between the predicted residual astigmatism by the two calculators and the residual astigmatism obtained by postoperative optometry is the error of refractive astigmatism (ERA). The magnitude error is the algebraic difference of ERA. Vector error(VE) is a vector difference of ERA. Statistical analysis of magnitude error and VE between the two groups were taken by student's t test or rank sum test. Results: At 1 months and 3 months, the magnitude error absolute value of Barrett calculator group were (0.19±0.16)D, (0.28±0.24)D, and those of AcrySof calculator group were (0.36±0.28)D, (0.46±0.41)D, and the differences were statistically significant (t=-3.050, -2.036, both P<0.05). At 1 month postoperatively, the overall, with-the-rule astigmatism, and against-the-rule astigmatism VE of the Barrett calculator group were (0.30±0.21)D, (0.26±0.22)D, (0.37±0.26)D respectively, and those of the AcrySof calculator group were (0.47±0.33)D, (0.51±0.34)D and (0.52±0.38)D respectively, the differences between the two groups were statistically significant (t=-2.533, -2.436, -2.150, all P<0.05). At 3 months postoperatively, the overall, with-the-rule astigmatism, and against-the-rule astigmatism VE of the Barrett calculator group were (0.37±0.28)D, (0.29±0.17)D, (0.35±0.27)D respectively, and those of the AcrySof calculator group were (0.59±0.46)D, (0.54±0.37)D, (0.64±0.52)D respectively, the differences between the two groups were statistically significant (t=-2.142, -2.038, -2.481, all P<0.05).The difference of X(EV) between the Barrett calculator group and the AcrySof calculator group was statistically significant[-0.13(-0.36-0.80)D vs. 0.19(-1.01-0.71)D, Z=-2.965,P<0.01], and the difference of Y(EV) was statistically significant [-0.02(-0.51-0.64)D vs. -0.15(-0.88-1.10)D, Z=-2.076, P<0.05] at 1 months. There was no significant difference in X(EV) and Y(EV) (both P>0.05) at 3 months. Conelusion: As compared to AcrySof Toric calculator, the application of Barrett calculator in selecting Toric IOL may reduce ERA and improve Toric IOL correction outcomes. (Chin J Ophthalmol, 2019, 55:208-213).

[Clinical comparison analysis in surgically induced astigmatism of the total, anterior and posterior cornea after 2.2-mm versus 3.0-mm clear corneal incision cataract surgery]

Objective: To compare the surgical induced astigmatism(SIA) of the total, anterior and posterior cornea between eyes with 2.2-mm and 3.0-mm clear corneal incisions in phacoemulsification. Methods: A prospective double-blind randomized controlled study was conducted on 131 patients (131 eyes) with age-related cataract from October 2017 to June 2018. They were randomized according to the random number table. Sixty-nine patients received phacoemulsification through a 2.2-mm clear corneal incision at 140 degrees; 62 patients were recruited in the control group with a 3.0-mm clear corneal incision at the same position. Lens density was graded and compared between the groups preoperatively. Total corneal refractive power (TCRP), simulated keratometry (SimK) and posterior corneal astigmatism (PCA) (Apex, 4-mm zone) were recorded through the Pentacam preoperatively and at 1 week, 1 month and 3 months postoperatively. Corneal astigmatism was decomposed to vertical/horizontal (X) and oblique changes (Y) using the power vector analysis. Independent sample t test and matched t test were used for statistical analysis. Results: A total of 123 patients (123 eyes) completed 3 months of follow-up including 65 in the 2.2-mm group and 58 in the control group. The age of the two groups was (69±9) and (71±10) years old, and the lens density was (2.08±0.47) and (2.12±0.46) grades, respectively. Both the age and the lens density of the two groups were not statistically significant (both P>0.05). Preoperative TCRP, SimK and PCA were not statistically significant (all P>0.05). SIA was calculated using the vector analysis. Centroid SIA conducted from TCRP, SimK and PCA in the 2.2-mm group was -0.11 D@146°, -0.11 D@151° and -0.03 D@67°, respectively, at 3 months postoperatively. In the 3.0-mm group, it was -0.25 D@158°, -0.24 D@147° and -0.04 D@47°, respectively. Statistical significance was found between the two groups in the Y polar value of SIA of the anterior surface [(-0.10±0.30) vs.(-0.22±0.37) D, t=-2.133, P=0.035] and the SIA of the posterior surface [(0.24±0.16) vs. (0.19±0.12) D, t=2.009, P=0.047] at 3 months postoperatively. In the comparison of the SIA of TCRP and anterior surface, statistical significance was found in the absolute value of SIA at all the intervals in the 2.2-mm group [(0.87±0.80) vs. (0.58±0.48) D, (0.58±0.48) vs. (0.50±0.28)D, (0.57±0.37) vs. (0.47±0.28) D, t=5.102, 4.155, 3.877, all P<0.01] and at 1 week and 1 month in the 3.0-mm group [(0.82±0.57) vs. (0.58±0.41) D, (0.59±0.36) vs. (0.50±0.28) D, t=5.034, 3.919, both P<0.01]. X components of SIA(TCRP) and SIA(simk) were significantly different at 3 month postoperatively in 3.0-mm group (P<0.05). Y components of SIA(TCRP) and SIA(SimK) were significantly different at 1 week postoperatively in the 2.2-mm group[(-0.48±0.85) vs.(-0.24±0.42) D, P<0.01] and 3.0-mm group [(-0.58±0.66) vs. (-0.37±0.42) D, P<0.01]. Conclusions: Compared with the 3.0-mm incision, the 2.2-mm coaxial micro-incision cataract surgery has a lower and more stable SIA. The effect of a clear corneal incision in cataract surgery on the total cornea is more obvious than that on the anterior surface of the cornea. The difference is significant in the early stage and gradually decrease with time. (Chin J Ophthalmol, 2019, 55: 495-501).

[Screening of the SETX gene in sporadic amyotrophic lateral sclerosis patients of Chinese origin]

Objective: To investigate all coding regions of amyotrophic lateral sclerosis (ALS)-related gene Senataxin (SETX) in sporadic amyotrophic lateral sclerosis patients of Chinese origin. Methods: From January 2010 to December 2014, the peripheral venous blood samples and clinical data were collected from 311 patients with sporadic amyotrophic lateral sclerosis (SALS) and 311 healthy controls who were of Chinese ancestry from the Department of Neurology, Chinese PLA General Hospital.Genomic DNA was extracted from peripheral venous blood of all participants using standard methods. The coding regions of SETX were amplified by polymerase chain reaction (PCR) and screened for mutations using next-generation sequencing technology. The online software SIFT and PolyPhen-2 were used to analyze the conservation of an altered amino acid and predict the potential pathogenicity of identified mutations. The SPSS 22.0 software was used to analyze the clinical feature of all participants. Results: Tenkinds of rare and one novel nonsynonymous mutations were identified and were absent in 311 controls. Twelve (3.86%) patients carried one SETX gene mutation. Five (1.61%) out of above-mentioned 12 patients carried highly pathogenic mutations including p. Pro1868Leu (c.5603G>A), p. Pro1331Leu (c.3992G>A), p. Glu756Val (c.2267T>A), p. Leu564Val (c.1690A>C), and p. Asn144Ser (c.431T>C). Patients carried SETX mutations were not different from other patients in onset age. Conclusion: Mutations in SETX are likely to be a pathogenesis for Chinese sporadic amyotrophic lateral sclerosis.

EDA mutation as a cause of hypohidrotic ectodermal dysplasia: a case report and review of the literature

Ectodermal dysplasia (ED) represents a collection of rare disorders that result from a failure of development of the tissues derived from the embryonic ectoderm. ED is often associated with hair, teeth, and skin abnormalities, which are serious conditions affecting the quality of life of the patient. To date, a large number of genes have been found to be associated with this syndrome. Here, we report a patient with hypohidrotic ED (HED) without family history. We identified that this patient's disorder arises from an X-linked HED with a mutation in the EDA gene (G299D) found by whole-exome sequencing. In addition, in this paper we summarize the disease-causing mutations based on current literature. Overall, recent clinical and genetic research involving patients with HED have uncovered a large number of pathogenic mutations in EDA, which might contribute to a full understanding of the function of EDA and the underlying mechanisms of HED caused by EDA mutations.

Interaction between dioxoruthenium(VI) porphyrins and hydroxylamines: coordination of N-substituted hydroxylamine to ruthenium and X-ray crystal structures of ruthenium complexes with a unidentate nitrosoarene ligand

The interactions between dioxoruthenium(VI) porphyrins 1 with N-phenylhydroxylamine or unsubstituted hydroxylamine are described. Reaction of complexes 1 with excess PhNHOH leads to isolation of bis(nitrosobenzene)ruthenium(II) porphyrins 3 and mono(nitrosobenzene)ruthenium(II) porphyrins 4. Both the types of ruthenium complexes are characterized by 1H NMR, IR, and UV/Vis spectroscopy, and mass spectrometry. The X-ray structure determinations on [Ru(II)(TPP)(PhNO)2] (3a), [Ru(II)(2,6-Cl-TPP)(PhNO)2] (3e), and [Ru(II)(4-MeO-TPP)(PhNO)(PhNH2)] (4d) (TPP tetraarylporphyrin) disclose a unidentate nitrosoarene coordination in all these complexes, with Ru-N(PhNO) bond lengths of 2.003(3) (3a, average), 1.991(3) (3e, average), and 2.042(2) A (4d). In the case of 4d, the Ru-N(PhNH2) bond length is found to be 2.075(3) A. Mechanistic investigations reveal the formation of intermediates [Ru(II)(Por)(PhNO)(PhNHOH)] (5; Por=porphyrin), a ruthenium complex with N-substituted hydroxylamine ligand, in the "1 + PhNHOH" system. The Ru-NH(OH)Ph moiety in 5 undergoes no rapid exchange with free PhNHOH in solution at room temperature, as revealed by 1H NMR spectroscopy. Unlike the interaction between complexes 1 and PhNHOH, reaction of such complexes with NH2OH affords nitrosylruthenium(II) porphyrins [Ru(II)(Por)(NO)(OH)] (6).

[Preliminary study on the antimutagenesis of vegetables and fruits]

Possible antimutation of 108 preparations of 91 kinds of vegetables and fruits on Salmonella typhimurium TA98 and TA100 mutants was tested. 4-nitroquinoline-N-oxide (4 NQO), N-methyl-N-nitro-N-nitrosoguanidine (MNNG), aflatoxin B1 (AFB1) and benzo (a) pyrene (BaP) were used as mutagens. The results showed that 67 (62%) preparations had antimutagenic action in vitro to different degrees. 9.6% of all preparations showed inhibition action on 4 NQO in TA100 mutant and 12.3%, in TA98, 5% on MNNG in TA100, 38% on AFB1 in TA100 and 45.1% in TA98, 28.9% on BaP in TA100. This experiment provides a scientific basis to the study of food resources as prevention of carcinogenesis.