Stem cell therapy is a promising approach for treating chronic diabetic wounds. However, its effectiveness is significantly limited by the high oxidative stress environment and persistent inflammation induced by diabetes. Strategies to overcome these challenges are essential to enhance the therapeutic potential of stem cell therapy.
Objective The repair of great toe donor site defect after wrap‐around flap transfer is still controversial. The bilobed superficial circumflex iliac artery perforator (SCIP) flap can improve the aesthetics of the great toe while maintaining its function. Thus, this study aimed to report our experience in the reconstruction of big toe donor site defects with the bilobed SCIP flap and describe the clinical outcomes. Methods This study was a retrospective trial. From May 2017 to May 2020, 13 patients with the great toe donor site defect after wrap‐around flap transfer were included in this study. The average age of the patients was 44 years (range, 23–60 years). All patients received free bilobed SCIP flaps to reconstruct the donor site defect of the great toe. Relevant clinical features were recorded preoperatively. The thickness and design of the SCIP flap and the harvesting layer of the flap were measured during the operation. The survival rate of flaps and skin grafts and the incidence of infection were recorded after operation. At follow‐up, donor site complications and postoperative outcomes were evaluated. Results In all cases, the SCIP flap covering the donor site of the great toe survived. All patients were followed up for 24–40 months (mean, 30.5 months). The average thickness of the SCIP flap was 0.38cm. All SCIP flaps were harvested from the superficial fascial layer except for three obese patients. The thin SCIP flap had a bilobed design with no further defatting procedures. Postoperatively, the great toe‐nail flap donor site regained its original appearance without bloating or flap necrosis. There was a hidden linear scar in the groin donor site, which did not affect hip joint movement. All patients were satisfied with the aesthetics of the surgical site. Conclusion The SCIP flap with bilobed design for repairing the donor defect of the great toe after wrap‐around flap transfer is a kind of surgical method with excellent contour, meeting the requirements of function and aesthetics.
Sonodynamic therapy (SDT) is a novel non-invasive treatment for cancer combining low-intensity ultrasound and sonosensitizers. SDT activates sonosensitizers through ultrasound, releasing energy and generating reactive oxygen species to kill tumor cells. Compared with traditional photodynamic therapy (PDT), SDT is a promising anti-cancer therapy with the advantages of better targeting, deeper tissue penetration, and higher focusing ability. With the development and broad application of nanomaterials, novel sonosensitizers with tumor-targeting specificity can deliver to deep tumors and enhance the tumor microenvironment. In this review, we first review the mechanisms of sonodynamic therapy. In addition, we also focus on the current types of sonosensitizers and the latest design strategies of nanomaterials in sonosensitizers. Finally, we summarize the combined strategy of sonodynamic therapy.
Long non-coding RNA (lncRNA) HOXA cluster antisense RNA 3 (HOXA-AS3) regulates the progression of several types of human malignancy. However, the role and potential mechanism of HOXA-AS3 in osteosarcoma (OS) remain unknown. In this study, upregulation of HOXA-AS3 was observed in OS tissues and cell lines and associated with poor clinical outcomes. Silencing of HOXA-AS3 significantly inhibited the proliferation, migration and invasion of OS cells in vitro and suppressed the tumorigenesis of OS cells in vivo. Furthermore, knockdown of HOXA-AS3 inhibited the proliferation and migration of human umbilical vein endothelial cells (HUVECs) and epithelial-to-mesenchymal transition (EMT) in OS. Further investigation of this mechanism revealed that HOXA-AS3 could directly upregulate the expression of TEAD1 via its competing endogenous RNA (ceRNA) activity on miR-1286. This study clarified the oncogenic roles of the HOXA-AS3/miR-1286/TEAD1 axis in OS progression, suggesting a novel therapeutic target for OS.
This research was to innovate a nanozyme-based therapeutic strategy that combines aggregation-induced emission (AIE) photosensitizers with copper nanozymes. This approach is designed to address the hypoxic conditions often found in bacterial infections and aims to boost the effectiveness of photodynamic therapy (PDT) by ensuring sufficient oxygen supply for reactive oxygen species (ROS) generation.
Objective To investigate the effect of repairing soft tissue defects in the middle and distal phalanx with the reverse dorsal metacarpal and digital fasciocutaneous flap based on the dorsal cutaneous branches of the proper digital artery. Methods Twenty-five fingers with soft tissue defects in the middle and distal phalanx were repaired by the reverse dorsal metacarpal and digital fasciocutaneous flaps based on the dorsal cutaneous branches of the proper digital artery from June 2007 to June 2009. Their pivot points were located at the midpoint or distal segment of proximal phalanx. Results Among 25 flaps, 24 survived completely, but cuticular layer in the distal part of one flap was partially necrotic. Twenty flaps were followed up from 12 to 18 months after operation. All flaps were characterized by rich blood supply, cold-resistance, suitable thickness, soft texture and good colour, except that 6 flaps required a secondary operation because of their fat and clumsy pedicel. There was no adhesion of extensor tendon and contraction of interdigital web in the donor sites. Two-point discriminations of anastomosing cutaneous nerve ranged from 6 mm to 10 mm in 5 of the 20 flaps, and 8 mm to 14 mm in the other 15 flaps. Conclusion The dorsal metacarpal and digital fasciocutaneous flap based on the dorsal cutaneous branches of the proper digital artery is an ideal option for repairing soft tissue defects of middle and distal phalanx because of its advantages of easy and secure dissection, reliable blood supply, longer arch of rotation, being closer to the raw surface of finger, less injury to the donor site, good appearance, avoidance of sacrificing major arteries ,and high probability of reconstructing flap sensation by anastomosing cutaneous nerve.
Key words:
Finger; Dorsal metacarpal and digital fasciocutaneous flaps; Proper digital artery; Reverse flap; Microsurgery
Objective To provide anatomic evidence for the application of the lateral thigh perforator flap.Methods Dissected five fresh Chinese adult lower limbs specimens which were injected with red latex via arterial cannula.On the lateral area of middle and distal thigh,obseved the number,distribution,course,category,length of pedicle and external diameter of the flaps' perforators on specimens.Results On the lateral area of middle and distal thigh 19 perforator arteris were observed in these specimens,averagely there were (3.8 ± 1.3) cutaneous perforators in each flap.Perforators mainly origined from the third perforator artery of profunda femoris,secondly from the second,fourth perforator artery and superior lateral genicular artery.Cutaneous perforators of the third perforator artery of profunda femoris pierced the flap on (13.8 ± 1.5) cm proximal of the fibulae capitulum,while the cutaneous perforators of superior lateral genicular artery on (8.6 ± 1.3) cm proximal of the fibulae capitulum.Averagely internal diameter of cutaneous perforators was (0.7 ± 0.2) mm at the point where the perforators pierced deep fascia.The diameter of the profunda femoris was (1.9 ± 0.2) mm,and the pedicle length was (12.2 ± 0.6)cm.The diameter of superior lateral genicular artery was (1.5 ± 0.2)mm,and the pedicle length was (6.8 ± 1.1) cm.There were inosculated branch in these perforators which came from profunda femoris and superior lateral genicular artery.Conclusion The anatomic characteristic allowed this flap would likely be clinically useful in repairing soft tissue defects in extremity limbs as a free or pedicled flap,which the cutaneous perforators invariably appeared on the skin of lateral areat of middle and distal thigh ; the flap could obtain enough length of the pedicle from its origination ; the vessel has large caliber supporting a substantial cutaneous territory.
Key words:
Profunda femoris; Superior lateral genicular artery; Perforator flap; Applied anatomy
Objective To present the clinical outcomes of transferring free lobulated posterior interosseous artery flap for coverage of multi-finger soft tissue defects.Methods According to the distance between the defects of the 2 to 4 digits,the posterior interosseous artery lobulated flap was designed by combining cutaneous branches of different regions.Bilobular flaps were applied for soft tissue reconstruction of 2-finger skin defects in 20 fingers of 10 patients.Trilobular flaps were applied in 6 fingers of 2 patients with 3-finger soft tissue defects.Two bilobular fiaps were applied for reconstruction of 4-finger soft tissue defects in 4 fingers of 1 patient.The size of the flaps ranged from 10 cm × 3.5 cm to 3 cm × 2.5 cm.The vessels for anastomosis at the recipient area were proper digital artery and dorsal digital vein at the proximal level of the finger.Results The flaps in 29 fingers survived completely.Necrosis at the tip of the flap occurred in 1 finger which healed by dressing changing.Postoperative follow-up period ranged from 6 to 22 months,the average being 12.2 months.The color and texture of the flaps were good.The flaps in 10 cases were thin while flaps in 3 cases were a bit thick.Twopoint discrimination recovered to 10 to 15 mm (mean,12.9 mm) in 10 fingers where the cutaneous nerve was included in the flap and sutured.There was no impairment of motor function of the forearm donor site.Conclusion Transfer of free lobulated posterior interosseous artery flap is a valuable option for reconstruction of multi-finger soft tissue defects.It can achieve cosmetically and functionally acceptable results with low morbidity on the donor site.
Key words:
Surgical flaps; Finger injuries; Microsurgery; Posterior interosseous artery
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