Objective   To introduce the Xie's 1+X surgical approach, a lymphatic microsurgical technique that combines multiple local lymphaticovenous anastomosis (LVA) at key points for the treatment of secondary lymphedema.   Methods   From January 2023 to June 2024, a total of 11 patients who developed secondary lymphedema after tumor resection combined with lymphadenectomy were treated using the Xie's 1+X surgical approach. The onset of lymphedema after tumor surgery ranged from 7 to 190 months, with an average of 24.5 months. The duration of lymphedema before surgical intervention ranged from 10 to 185 months, with an average of 42.6 months. All patients underwent treatment using the Xie's 1+X surgical technique. The postoperative follow-up period ranged from 2 to 12 months, with an average of 6.5 months. Results   The severity of limb lymphedema, the stage of the affected limb, and the presence and timing of secondary cellulitis were recorded before and after surgery. Follow-up evaluations were conducted at preoperative baseline and at 1, 3, 6, and 12 months postoperatively. There were significant differences in comparative analysis of preoperative and postoperative indicators (P<0.05).    Conclusions    The Xie's 1+X microsurgical technique is an effective approach for addressing both the underlying causes and manifestations of secondary lymphedema. It offers significant advantages, including high treatment efficacy, minimal surgical incisions, and shorter operative time, making it a promising surgical option for secondary lymphedema management.

Objective  To explore the surgical method and clinical efficacy of venous lymph node transplantation (VLNT) combined with lymphatic vein anastomosis (LVA) for the treatment of secondary upper limb lymphedema.   Methods   From August 2021 to June 2024, our hospital treated 16 patients with secondary upper limb lymphedema using venous lymph node transplantation (VLNT) combined with LVA. All patients underwent preoperative measurements of the circumference of both upper limb arms, with measurements taken every 5cm from the wrist to the axilla, and data was recorded. All patients underwent high-frequency color Doppler ultrasound lymphatic examination and indocyanine green (ICG) near-infrared lymphatic imaging examination before surgery to locate and mark functional lymphatic vessels in the limbs and lymphatic obstruction areas in the axilla. The inguinal lymph node tissue flap (3-4 lymph nodes) containing superficial venous vessels were cut and transplanted to the axilla of the affected limb for flow-through anastomosis of the superficial vein and recipient vein. Based on preoperative lymphatic vessel localization, a small longitudinal incision (2-3 cm) was made to cut through the skin to the fat layer, and functional lymphatic vessels were selected for anastomosis with subcutaneous veins under a microscope. The circumference of the upper limb arm of the affected limb after surgery was measured and recorded using the same method.    Results    All 16 patients had unilateral upper limb lymphedema, aged 52-78 years old. All patient incisions healed well. The follow-up period was 6-24 months (average 12 months), and the edema of the affected limb was significantly reduced before surgery. The measured circumference of the affected limb in different planes was significantly reduced compared to before surgery (P<0.05). The upper limb activity function has improved compared to before surgery, and the patient was satisfied with the recovery.  Conclusions   The combination of venous lymph node transplantation and LVA treatment for secondary upper limb lymphedema can significantly reduce limb edema, improve patient's limb function, and achieve satisfactory therapeutic effects.

Objective  To investigate the clinical efficacy of deep cervical lymphatic-venous anastomosis (dcLVA) in the treatment of Parkinson's disease, evaluating postoperative improvements in both motor and cognitive impairments in patients with Parkinson's disease. Methods From April 2024 to December 2024, 8 patients with Parkinson's disease underwent dcLVA at Chashan Hospital in Dongguan. Under indocyanine green (ICG) fluorescence navigation, the deep cervical lymphatic system was visualized. Lymphatic vessels in ICG-stained cervical lymph node zones II and III were selected for end-to-end anastomosis with adjacent veins, or lymph nodes in zone IV were selected for end-to-side anastomosis with the external jugular vein trunk. The Unified Parkinson's Disease Rating Scale was used to measure and assess patients at predetermined time points before and after surgery. Results None of the 8 surgical patients experienced severe complications. Postoperative follow-up results showed significant improvements in motor dysfunction, including enhanced gait stability, reduced tremors, and improved motor coordination. Additionally, cognitive impairments such as sleep quality, emotional stability, and olfactory and gustatory functions also demonstrated some degree of improvement. Conclusions dcLVA improves intracranial lymphatic circulation, reduces intracranial lymphatic pressure, and promotes the clearance of brain metabolic proteins, thereby alleviating clinical symptoms in patients with Parkinson's disease. This provides a novel approach to the treatment of Parkinson's disease.

Objective    To explore the anatomical basis based on ultrasound angiography (CEUS) for limb lymphatic vessel venous anastomosis (LVA).   Methods    Twenty-five patients with secondary lymphatic vessel edema were prospectively included, 84 surgical sites before and after LVA operation, and the influence of different lymphatic vessel classification on surgical efficacy was compared.   Results   There was some differences in anastomotic patency after LVA.  Conclusion  The lymphocyte classification and auxiliary positioning technique based on CEUS can significantly improve the accuracy and therapeutic effect of LVA surgery.

Objective    To establish a rat model of deep neck lymphatic vein anastomosis with complex anatomy and repeatable operation in response to the training needs of experimental animal microsurgery techniques, in order to enhance the operational ability of microsurgery physicians in lymphatic vein anastomosis in the deep neck anatomical area.    Methods   Twenty 4-5 week old SPF grade male SD rats (weighing approximately 100 g) were selected and anesthetized with pentobarbital sodium (45 mg/kg) via intraperitoneal injection, and then fixed in a supine position. Diluted indocyanine green (ICG) 0.05-0.1 mL (concentration: 0.1 mg/mL) was injected under the nasal mucosa to visualize lymphatic vessels, make a 1.5 cm incision along the midline of the neck, and intraoperative fluorescence imaging technology was used to expose deep cervical lymphatic vessels and external jugular veins. Lymphatic vein end-to-end anastomosis or end-to-end anastomosis at a magnification of 25 times was performed.   Results   The average diameter of the candidate lymphatic vessels in the deep neck was 0.18 mm (0.1-0.4 mm), and the diameter of the venous vessels was (0.6-1.2) mm. 20 cases of anastomosis were completed, with an immediate lymphatic vein recanalization rate of 95% (19/20) and 1 failure.   Conclusions   This model can simulate the clinical scenario of deep neck lymphatic vein anastomosis, and has both anatomical preparation and operational repeatability, providing an operable animal model for training deep neck lymphatic vein anastomosis.

Central nervous lymphatic system is an important breakthrough in neuroscience research in recent years. The anatomical structure of central nervous lymphatic system mainly includes glial lymphatic system formed around blood vessel wall of astrocyte foot process, and meningeal lymphatic vessels associated with meningeal venous sinus, which have metabolic waste clearance, immune function, signal transduction, material transport and drug delivery, and are regulated by AQP4, hemodynamics, sleep, and circadian rhythm and other factors. At the same time, the system is closely related to neurodegenerative diseases, central nervous system demyelinating diseases, cerebrovascular diseases, and other neurological diseases. This review focuses on anatomical structure, function, and role of nervous system diseases, and summarizes the research progress in recent years.

Objectives    To clarify the branches, distribution, arrangement and quantitative relationship of micro arteries, veins, sympathetic nerves and lymphatic vessels around the hepatopancreatic ampulla.   Methods   375 continuous paraffin tissue sections were divided into three groups: those in the first group were stained with hematoxylin and eosin (HE), those in the second group with anti-tyrosine hydroxylase antibody, and those in the third group with anti-lymphatic vessel endothelial receptor-1 (LYVE1) antibody staining. The scanning data of the slides were registered by Photoshop and  the scanned data slices were superimposed，divided and 3D reconstructed by using Mimics 21.0. The distribution and anastomosis of arteries, veins, sympathetic nerves, lymphatic vessels, as well as their branches around the hepatopancreatic ampulla were analyzed in the three-dimensional models. The relationships among these four structures were also analyzed.   Results   The micro arteries and veins in the region of hepatopancreatic ampulla accompanied each other, bending walked around the ampulla and closely adhering to it. Sympathetic nerve  tracts were clearly distributed around the hepatopancreatic ampulla and were accompanied by the vascular bundles. Lymphatic vessels and blood vessels were concomitant, surrounding the surface of the hepatopancreatic ampulla and lymph nodes. The structure of the two muscle layers of the hepatopancreatic ampulla was clearly distinguished.   Conclusions   This study provides accurate anatomical basis for the diagnosis and surgery of extrahepatic biliary tract and gallbladder diseases. 

Objective   To investigate the features of compensatory hypertrophy of inferior turbinate mucosa in different course of deviated nasal septum.   Methods  The preoperative sinuses computed tomography (CT) images of 65 patients with deviated nasal septum in our hospital were retrospectively analyzed. Patients were divided into three groups according to the course of disease: group A for 1~5 years, group B for 6~10 years, and group C for more than 10 years. Thickness and density of the lateral mucosa of the inferior turbinate were measured and compared among all groups.   Results   The thickness of lateral mucosa of the inferior turbinate was (4.2±0.8) mm, (5.2±0.7) mm and (4.7±1.3) mm, respectively in the three groups. Thickness of lateral mucosa of inferior turbinate in group B was thicker than that of group A and group C, and there was statistical difference (P<0.05). The mucosal density of the medial side of the inferior turbinate in patients with course of disease from 1~5 years, 6~10 years and more than 10 years gradually increased, and was (38.6±7.1) HU, (49.7±4.5) HU, 56.7 (41.6, 59.3) HU, and with statistical difference respectively(P<0.05).   Conclusions   There are morphological differences in the compensatory hypertrophy of inferior turbinate mucosa in patients with different course of disease, which may reflect the pathological characteristics of inferior turbinate mucosa hypertrophy.

Objective    To investigate the activation, subcellular localization, and 3D reconstruction of the NLRP3 inflammasome within muscle fibers under in vitro inflammatory conditions.  Methods C2C12 cells were cultured in vitro and differentiated with horse serum. Lipopolysaccharide (LPS) and Nigericin (Nig) were used to stimulate NLRP3 inflammasome activation in C2C12 myotubes. qPCR and Western blot were employed to analyze the gene and protein levels of NLRP3, ASC, and Caspase-1.  Immunofluorescence analysis was performed to assess NLRP3 and ASC aggregation and co-localization. Confocal microscopy and Imaris software were used to visualize and reconstruct the associations of aggregated NLRP3 and ASC with specific organelles, such as the Golgi apparatus, mitochondria, and endoplasmic reticulum.   Results In vitro, LPS/Nig co-stimulation increased the gene and protein expression of NLRP3, ASC, and Caspase-1 in muscle fibers, with cytoplasmic aggregation of NLRP3 and ASC observed. The mitochondrial functional molecule TOM20 and Golgi marker TGN38 were significantly upregulated, and co-localization was detected between aggregated NLRP3, ASC, and both mitochondria and the Golgi apparatus.   Conclusions LPS/Nig stimulation induces activation of the NLRP3 inflammasome in skeletal muscle fibers. The activated components of the NLRP3 inflammasome are closely associated with mitochondria and the Golgi apparatus.

Objective   Using enhanced CRISPR/Cas9 technology (Clustered Regularly Interspaced Short Palindromic Repeats, CRISPR), to construct an efficient method for producing a human pre-B lymphocyte line with the recombination activating gene 1 (RAG1) c.946 T>G point mutation by delivering a novel Cas9-gRNA ribonucleoprotein (RNP) complex and investigate the mutant's function.   Methods   Human pre-B lymphocyte cell line (Nalm6 cell) was employed as the research subject in this study. RNP complexes were generated in vitro by combining high-fidelity HIFI Cas9 protein with chemically modified gRNA (gRNA). Using nuclear transfection technique, RNP and ultramer single-stranded oligodeoxynucleotides (Ultramer-ssODNs) homologous templates containing RAG1 c.946T>G target mutation and synonymous mutation (C>A) were introduced into cells to induce RAG1 gene cleavage and recombination. The gene editing efficiency was detected by T7E I digestion assay, and monoclonal screening was performed by counting dilution method. Genotypes were identified by Sanger sequencing.  Results Ultimately, the RAG1 (c.946T>G) homozygous point mutation cell line was successfully constructed, and the cleavage efficiency reached 78.21%. Additionally, a high percentage of 33.33% (4/12) of the desired monoclonal was acquired using monoclonal selection. Preliminary functional investigations revealed that the c.946T>G point mutation decreased expression of RAG1 and RAG2 proteins in pre-B cells and increased apoptosis rate, which could explain the decrease in the generation of mature B lymphocytes.   Conclusions  This study's optimized Cas9 RNP technology effectively produce the RAG1 c.946T>G homozygous point mutation in the pre-B lymphocyte line, providing experimental basis for the creation of a single base mutation disease model as well as a novel technique for enhancing edit accuracy and improving transfection efficiency.

Objective    To investigate the effects of recombinant human brain natriuretic peptide (rhBNP) on cardiac remodeling, angiogenesis, and the NF2/Mst1 signaling pathway in rats with acute myocardial infarction.    Methods    According to random number method, 50 male rats were divided into sham operation group, model group, the low, medium and high dose rhBNP groups (10 rats  separately). Acute myocardial infarction models were established in the remaining rats except the sham group. After successful modeling, the rats in the low, medium and high dose rhBNP groups were injected with 5, 10 or 15μg/kg rhBNP solution in the jugular vein, and the other rats were injected with equal volume of normal saline. LVIDd, LVIDs, LVEDV, LVESV were detected by cardiac ultrasound. LVEDP and ±dp/dt max were detected by BL-420 biological function test. BW, THW/BW, LVW/BW were tested. TUNEL was used to detect the apoptosis rate of myocardial cells. Myocardial angiogenesis was detected by immunohistochemistry. The protein expressions of NF2, Mst1, Bax and Bcl-2 were detected by Western blot.    Results    Compared with the sham group, rats in the model group showed increased LVIDd, LVIDs, LVEDV, LVESV, LVEDP, THW/BW, LVW/BW, myocardial cell apoptosis rate, and increased expression of NF2, Mst1, Bax (P<0.05), while ±dp/dt max and Bcl-2 expression decreased (P<0.05). Compared with the model group, rats in the low, medium, and high-dose rhBNP groups showed decreased LVIDd, LVIDs, LVEDV, LVESV, LVEDP, THW/BW, LVW/BW, cell apoptosis rate, and decreased expression of NF2, Mst1, Bax (P<0.05), while ±dp/dt max and Bcl-2 expression increased (P<0.05).    Conclusions    rhBNP can significantly improve cardiac remodeling in rats with acute myocardial infarction, reduce myocardial cell apoptosis, and promote angiogenesis in myocardial tissue, which may be related to the activity inhibition of NF2/Mst1 signaling pathway.

Objective    To study the effect of osteoporosis on the proliferation and differentiation of mouse  bone marrow mesenchymal stem cells (mBMSCs), and to provide theoretical and experimental support for the treatment of osteoporosis.    Methods    Thirty C57BL/6 mice were randomly divided into sham operation group and operation group. Sham operation group only removed the fat around the ovary, and operation group removed the ovary. mBMSCs were taken from the femur and tibia of mice and cultured 8 weeks after operation to observe the changes of proliferation and differentiation.    Results   The proliferation and migration ability of mBMSCs in osteoporosis mice were decreased. The results of alkaline phosphatase staining showed that mBMSCs had decreased osteogenic differentiation ability in osteoporosis mice. Conclusions    The proliferation, migration, and differentiation ability of mBMSCs in osteoporotic mice were decreased.

Objective    To evaluate the protective effect of bone marrow mesenchymal stem cells (BMSC) on ovarian transplantation after radiotherapy.   Methods   40 female Wistar inbred rats were randomly divided into control group and observation group, with 20 rats in each group. BMSC were isolated from 10 rats and cultured and identified. The rats in control group received ovarian transplantation +200 cGy radiation + phosphate buffer solution, and the rats in observation group received ovarian transplantation +200 cGy radiation +BMSC transplantation. The general condition and adverse reactions of rats were observed 1 month after transplantation, and all rats were killed. The serum levels of estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured by radioimmunoassay. The apoptosis of rat ovarian granulosa cells was detected by in situ end transferase labeling technique. Results The immunophenotype of P3 BMSC showed that the high expression rates of surface markers CD44 (+) and CD90 (+) were 78.04% and 75.17% of cultured cells, respectively. In addition, the expression rates of CD45 (+) and CD34 (+) were relatively low, only 8.05% and 10.40%. After BMSC transplantation, the diet, fur, behavior and mental state of rats in the observation group recovered faster than that in the control group, the body weight increased significantly (P<0.05), and the adverse reaction rate was lower (P=0.028). In addition, compared with the control group, the serum E2 level of rats in the observation group was significantly increased, and the LH and FSH levels were significantly decreased (P<0.001). At the same time, the apoptosis rate of ovarian granulosa cells in the observation group was significantly lower than that in the control group, with statistical significance (P<0.001).  Conclusions  BMSC can play a protective role after radiotherapy for ovarian transplantation, increase the level of serum E2, decrease the level of LH and FSH, and inhibit the apoptosis of ovarian granulosa cells.

Objective    To investigate the potential mechanism of LINC00626-targeted regulation of the JAK1/STAT3/KHSRP axis in the malignant biological behavior of gastric cancer.   Methods   qRT-PCR was used to detect the expression levels of LINC00626 and KHSRP mRNA in gastric cancer cell lines (AGS, MGC-803, NCI-87, BGC-823, MNK-45, SGC-7901) and human normal gastric epithelial cell line (GES-1) and 120 cases of gastric cancer tissue specimens and normal tissue specimens. The biological characteristics of cell proliferation, migration and invasion were detected by cell counting kit-8 (CCK-8), scratch and Transwell migration/invasion assays, respectively. The expression levels of JAK/STAT and KHSRP proteins in stably transfected cells were detected by Western blot. The role of LINC00626 in vivo was analyzed in nude mice. Results   qRT-PCR results showed that the expression of LINC00626 and KHSRP in gastric cancer cell lines (AGS, MGC-803, NCI-87, BGC-823, MNK-45, SGC-7901) and tumor tissues was significantly higher than that in human normal gastric cancer cells (GES-1) and tissues. Cell function experiments showed that LINC00626 overexpression promoted the proliferation, migration and invasion of gastric cancer cell lines MNK-45 and SGC-7901, and KHSRP was able to restore the ability of proliferation, migration and invasion in gastric cancer cells with knockdown of LINC00626. The results of in vivo animal experiments showed that, compared with the sh-NC group, the tumor volume and weight, cell proliferation rate and the number of lung metastases of gastric cancer in the sh-LINC00626 group were significantly reduced, while the overexpression results were opposite. Signaling pathway experiments showed that compared with the sh-NC group, the expression levels of JAK1 and STAT3 mRNA in the sh-LINC00626 group showed a significant downward trend, while the results in the overexpression group were opposite. Compared with the sh-NC group, the expression of JAK1 and STAT3 in the sh-KHSRP group was significantly down-regulated, and the results in the overexpression group were opposite.   Conclusions   LINC00626 accelerates the malignant metastasis of gastric cancer by JAK1/STAT3/KHSRP signaling pathway.

Objective    To investigate the clinical effect of different surgical methods in the treatment of  Dubberley Type B humeral capitellum-trochlea fracture.    Methods    A retrospective case-series study was conducted in 136 patients with humeral cephalic and trochlear fractures treated with Herbert screws or anatomical locking plates(LCP) from January 2017 to December 2023, including 42 males and 94 females aged 30-78 years (mean 54.2 years). According to Dubberley classification, 65 cases were type IB, 52 cases were type IIB and 19 cases were type IIIB. Open reduction and internal fixation were used in all the surgeries, with Herbert screw fixation alone or screw fixation followed by anatomic locking plate fixation. The operative time of the two internal fixation methods were compared. At the last follow-up, the elbow function of the patients was scored using the Mayo Elbow-Performance Score, and the patients' elbow flexion range of motion, forearm internal and external rotation range and complications were recorded.   Results   Patients were followed up for 10 to 46 months (mean 28.6 months).. The operation time of LCP group was longer than that of Herbert group, and the difference was statistically significant. The Herbert group was superior to the LCP group in terms of postoperative limb extension Angle, elbow flexion Angle and forearm rotation, but the differences were not statistically significant. The postoperative MEPS of the LCP group was lower than that of the Herbert group, but the difference was not statistically significant.   Conclusions    For type IB, a lateral or posterior approach may be considered, with screw and plate options. For type IIB and Type IIIB, the posterior approach is superior and plate binding screws provide firm fixation.

Objective   To investigate the expression levels of centrosomal protein 55 (CEP55) and excitatory amino acid transporter 1 (GLAST) in hepatocellular carcinoma (HCC), and to analyze the relationship between them and recurrence and metastasis in patients with HCC after radical resection.   Methods    A total of 128 patients with HCC admitted to the hospital from March 2020 to October 2023 were selected. Normal tissues adjacent to the tumor with a distance of at least 5 cm from the tumor edge were collected as control. Immunohistochemistry was used to detect the expression levels of CEP55 and GLAST. The expression of CEP55 and GLAST proteins in cancer tissues and adjacent normal tissues was compared. Spearman correlation analysis was used to analyze the relationship between CEP55 and GLAST protein expression and clinicopathological characteristics. As of October 2024, patients with recurrence or distant metastasis were included in the recurrence and metastasis group. Those without recurrence or metastasis were included in the non-recurrence and metastasis group. The expression of CEP55 and GLAST protein and clinicopathological characteristics of the two groups were compared. Risk factors for recurrent metastasis after HCC were analyzed by using COX multifactorial regression. Kaplan-Meier survival analysis was used to analyze progression-free survival of patients with different expression levels of CEP55 and GLAST.    Results Finally, 120 cases were included in the study. The positive rate of CEP55 protein in cancer tissues was higher than that in adjacent tissues, and the positive rate of GLAST protein was lower than that in adjacent tissues (P<0.05). Spearman correlation analysis showed that CEP55 expression was positively correlated with age, tumor diameter, number of tumors, Child-Pugh grading, Barcelona Clinic Liver Cancer (BCLC) staging and preoperative alpha fetoprotein (AFP) level (P<0.05), and negatively correlated with differentiation degree (P<0.05). GLAST expression was negatively correlated with age, tumor diameter, number of tumors, Child-Pugh grade, BCLC stage and preoperative AFP level (P<0.05), and positively correlated with differentiation degree (P<0.05). Among the 120 patients, 32 patients experienced postoperative recurrence and metastasis, with an incidence rate of 26.67%. The CEP55 protein positivity rate in the recurrent metastasis group was higher than that in the non-recurrent metastasis group (P<0.05), and the GLAST protein positivity rate was lower than in the non-recurrent metastasis group (P<0.05). Multifactorial COX regression analysis showed that CEP55 positivity was a risk factor for recurrent metastasis after HCC surgery (P<0.05) and GLAST positivity was a protective factor for recurrent metastasis after HCC surgery (P<0.05). There were statistically significant differences in survival time among patients with different expression levels of CEP55 and GLAST (P=0.000, 0.017).   Conclusions   The expression levels of CEP55 and GLAST in HCC tissues are closely related to recurrence and metastasis of HCC after radical resection. High expression of CEP55 and low expression of GLAST may indicate an increased risk of recurrence and metastasis in patients with HCC, and significantly shorten progression-free survival.

Objective    To provide new imaging diagnostic basis for the early quantitative diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE).    Methods   Twenty normal neonates with check of different ages and 40 neonates with HIE of different degrees were selected by arterial spin labeling (ASL) perfusion weighted imaging examination. At the image post-processing workstation, the regions of interest (ROI) of brain structure were divided, and the cerebral blood flow (CBF) value of ROI were measured. The CBF values of brain structure ROI among the different ages and its corresponding ROI in HIE were compared. Results    There were statistical significance in the head of caudate nucleus, lenticular nucleus, dorsal thalamus, frontal white matter and the CBF values of ROI in different age groups (P<0.05). The CBF value increased gradually with the increasing of birth age, and the CBF value of the brain nucleus was significantly higher than that of frontal white matter. The CBF values of the head of caudate nucleus, lenticular nucleus, dorsal thalamus and frontal white matter in the observation group were (30.75±1.05) mL/100g·min, (32.02±0.97) mL/100g·min, (39.13±1.36) mL/100g·min, (15.89±0.89) mL/100g·min respectively. There were statistical significances in the CBF value of ROI among the observation group and the mild, moderate, severe lesions groups (P<0.05). The CBF value of the head of caudate nucleus, lenticular nucleus and dorsal thalamus increased gradually with the severity of the disease, while the CBF value of the frontal white matter decreased gradually with the severity of the disease.   Conclusions    The basal ganglia and dorsal thalamus are the most sensitive parts in the neonatal brain structure to ischemia and hypoxia, the CBF value of ASL perfusion weighted imaging can reflect the level of reperfusion and the degree of injury in the brain structure of HIE in early stage.

Ossification of the Nuchal Ligament (ONL) refers to the dense calcification or ossification of the soft tissue area of the nuchal ligament often caused by the damage and degeneration of the nuchal ligament tissue, which disrupts the biomechanical balance of the cervical spine and causes neck discomfort. ONL is often found accidentally by X-ray examination of cervical spondylosis, because the initial symptoms of most patients with ossification of the nuchal ligament are mild. Although studies have suggested that the occurrence and development of ONL are related to a variety of molecular and environmental factors, the pathophysiological development of ONL at different stages of development is still unclear. ONL is one type of the heterotopic ossification. Many studies have confirmed the correlation between ONL and preoperative cervical instability and cervical spondylosis. However, ONL is often removed in laminoplasty, and studies on the long-term stability of cervical spondylosis patients with ONL after surgery are rare. Different genes and extrinsic causative factors have been proved to play an important role in the progression of ectopic ossification. Meanwhile, osteogenic precursor cells, local tissue microenvironment and nervous system regulation also play an important role in ectopic ossification. This paper analyzes the epidemiology and etiology, anatomy and biomechanics, clinical history, classification and clinical significance. Pathophysiological mechanism and external pathogenic factors of ONL, and further summarizes them for a better understanding of ONL. In addition, suggestions were provided for the study of cervical spine stability and molecular mechanism of ONL in patients with degenerative cervical myelopathy after single door opening surgery.

Objective    To analyze the research trends and hotspots of anterolateral thigh flap based on Web of Science database.    Methods    A thematic search was performed in the Web of Science Core Collection across all time periods. Bibliometric analysis was conducted using Web of Science tools, and research hotspots and trends were analyzed via keyword co-occurrence and cluster analysis using CiteSpace 6.3.R3.    Results   A total of 3,009 relevant articles were retrieved, with 2,869 included in general statistical analysis and 2,652 in knowledge graph analysis. Publications on the anterolateral thigh flap have increased yearly, with China and the United States leading in publication volume. Keywords co-occurrence analysis indicates that “neck," "complications," "free flap," and "donor site morbidity" were strongly associated and frequently mentioned. Cluster analysis identified eight main research focuses: "perforator flap, free flap, one-stage reconstruction, mandibular reconstruction, pharyngoesophageal reconstruction, neck, lower extremity, hemifacial atrophy."  Burst term analysis highlighted "neck defects, soft tissue flap, and anatomy" as the most active research areas, with "lower extremity, radiotherapy, soft tissue defects, and vascular anatomy" emerging as recent focuses. Conclusion     Chinese researchers have made significant contributions to the study of the anterolateral thigh flap. The research focus has primarily been on neck tissue injury repair, while the research content has centered on the application of anterolateral perforator flaps. Recent research hotspots have included lower extremity reconstruction, radiotherapy, soft tissue defect repair, and vascular anatomy.