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The beds base movement will be become a new Cartesian coordinate [https://www.selleckchem.com/products/scr7.html selleck chemical] program, and the balance of your superimposed perturbation is studied regarding Fourier (as well as Kelvin) methods. The actual ensuing Floquet system for your Fourier modes has three guidelines ɛ, N=N/Ω, along with μ, the actual viewpoint between your trend vector okay and also the utes=0 is the strongest.We study the performance of three-level quantum absorption refrigerators, paradigmatic autonomous quantum thermal machines, and reveal central impacts of strong couplings between the working system and the thermal baths. Using the reaction coordinate quantum master equation method, which treats system-bath interactions beyond weak coupling, we demonstrate that in a broad range of parameters the cooling window at strong coupling can be captured by a weak-coupling theory, albeit with parameters renormalized by the system-bath coupling energy. As a result, at strong system-bath couplings the window of cooling is significantly reshaped compared to predictions of weak-coupling treatments. We further show that strong coupling admits direct transport pathways between the thermal reservoirs. Such beyond-second-order transport mechanisms are typically detrimental to the performance of quantum thermal machines. Our study reveals that it is inadequate to claim for either a suppression or an enhancement of the cooling performance as one increases system-bath coupling-when analyzed against a single parameter and in a limited domain. Rather, a comprehensive approach should be adopted so as to uncover the reshaping of the operational window.In a biochemical assay that converts fan-in networks into feed-forward loops (FFLs), we show that the inter-regulator redundant information about the output gene product can be decomposed into finer components, mediated by the constituent pathways. Variance-based information within the linear noise regime facilitates quantifying these submodular redundancies. Contrary to the conventional wisdom on information decomposition, we report that information redundancy depends nontrivially on inter-regulator correlation. For the type-1 coherent (C1) and incoherent (I1) FFLs, the direct regulatory path-mediated redundancy is certainly correlation independent. However, components induced by the indirect regulatory path and interpathway interference are correlation dependent in (non)linear fashion. The trade-off between information redundancy and similarly decomposable extrinsic noise from input to output node has been demonstrated for the pathways and full motifs. Our analyses suggest that the interpathway cross redundancy positively and negatively influences the superposition of elementary redundancies in the C1- and I1-FFLs, respectively. Their corresponding total extrinsic noise is produced by the weighted sum and difference of the pathway-specific components. We find that the I1-FFL is able to manufacture more varied redundancy and extrinsic noise responses compared to the C1-FFL. Underlying the differing characteristics of the composite metrics across FFL variants, there exist uniformly behaving pathway-dependent elements. The decomposition framework has been meticulously explored in biologically rational parametric realizations through analytical estimates and stochastic simulations.Molecular expressions for thermodynamic properties of fluids and derivatives of the entropy up to third order in the isoenthalpic-isobaric ensemble are derived by using the methodology developed by Lustig for the microcanonical and canonical ensembles [J. Chem. Phys. 100, 3048 (1994)JCPSA60021-960610.1063/1.466446; Mol. Phys. 110, 3041 (2012)MOPHAM0026-897610.1080/00268976.2012.695032]. They are expressed in a systematic way by phase-space functions, which represent derivatives of the phase-space volume with respect to enthalpy and pressure. The expressions for thermodynamic properties contain only ensemble averages of combinations of the kinetic energy and volume of the system. Thus, the calculation of thermodynamic properties in the isoenthalpic-isobaric ensemble does not require volume derivatives of the potential energy. This is particularly advantageous in Monte Carlo simulations when the interactions between molecules are described by very accurate ab initio pair and nonadditive three-body potentials. The derived expressions are validated by Monte Carlo simulations for the simple Lennard-Jones model fluid as a test case.We developed an integer lattice gas method for the fluctuating diffusion equation. Such a method is unconditionally stable and able to recover the Poisson distribution for the microscopic densities. A key advance for integer lattice gases introduced in this paper is a sampling collision operator that replaces particle collisions with sampling from an equilibrium distribution. This can increase the efficiency of our integer lattice gas by several orders of magnitude.We study the dynamics and statistics of the Rule 150 reversible cellular automaton (RCA). This is a one-dimensional lattice system of binary variables with synchronous (Floquet) dynamics that corresponds to a bulk deterministic and reversible discretized version of the kinetically constrained "exclusive one-spin facilitated" (XOR) Fredrickson-Andersen (FA) model, where the local dynamics is restricted A site flips if and only if its adjacent sites are in different states from each other. Similar to other RCA that have been recently studied, such as Rule 54 and Rule 201, the Rule 150 RCA is integrable, however, in contrast is noninteracting The emergent quasiparticles, which are identified by the domain walls, behave as free fermions. This property allows us to solve the model by means of matrix product ansatz. In particular, we find the exact equilibrium and nonequilibrium stationary states for systems with closed (periodic) and open (stochastic) boundaries, respectively, resolve the full spectrum of the time evolution operator and, therefore, gain access to the relaxation dynamics, and obtain the exact large deviation statistics of dynamical observables in the long-time limit.Molecular motors convert chemical potential energy into mechanical work and perform a great number of critical biological functions. Examples include the polymerization and manipulation of nucleic acids, the generation of cellular motility and contractility, the formation and maintenance of cell shape, and the transport of materials within cells. The mechanisms underlying these molecular machines are varied, but are almost always considered in the context of a single kinetic pathway that describes motor stepping. However, the multidimensional nature of protein energy landscapes suggests the possibility of multiple reaction pathways connecting two states. Here we investigate the properties of a hypothetical molecular motor able to utilize parallel translocation mechanisms. We explore motor velocity and force dependence as a function of the energy landscape of each path and reveal the potential for such a mechanism to result in negative differential conductance. More specifically, regimes exist where increasing opposing force leads to increased velocity and an optimum load for motor function. We explore how the presence of this optimum depends on the rates of the individual paths and show that the distribution of stepping times characterized by the randomness parameter may be used to test for parallel path mechanisms. Last, we caution that experimental data consisting solely of measurements of velocity as a function of ATP concentration and force cannot be used to eliminate the possibility of such a parallel path mechanism.Recently, some general relations have been intensively investigated in nonequilibrium mesoscopic systems. In particular, the thermodynamic uncertainty relation (TUR) provides a general bound of the precision for the fluctuation of some currents in terms of the corresponding entropy production. On the other hand, the fluctuation of the work performed is also a significant quantity, which is supposed to satisfy TUR under some conditions, such as symmetric driving protocol. In this paper, we analytically show that the TUR holds for the work performed on an externally perturbed quantum harmonic oscillator interacting with multiple reservoirs in full quantum regime. In this manner, we evaluate how the noncommutativity affects the thermodynamic precision. We also explore its experimental accessibility.Centrality measures identify and rank the most influential entities of complex networks. In this paper, we generalize matrix function-based centrality measures, which have been studied extensively for single-layer and temporal networks in recent years to layer-coupled multiplex networks. The layers of these networks can reflect different relationships and interactions between entities or changing interactions over time. We use the supra-adjacency matrix as network representation, which has already been used to generalize eigenvector centrality to temporal and multiplex networks. With a suitable choice of edge weights, the definition of single-layer matrix function-based centrality measures in terms of walks on networks carries over naturally to the multilayer case. In contrast to other walk-based centralities, matrix function-based centralities are parameterized measures, which have been shown to interpolate between (local) degree and (global) eigenvector centrality in the single-layer case. As the explicit evaluation of the involved matrix function expressions becomes infeasible for medium to large-scale networks, we present highly efficient approximation techniques from numerical linear algebra, which rely on Krylov subspace methods, Gauss quadrature, and stochastic trace estimation. We present extensive numerical studies on synthetic and real-world multiplex transportation, communication, and collaboration networks. The comparison with established multilayer centrality measures shows that our framework produces meaningful rankings of nodes, layers, and node-layer pairs. Furthermore, our experiments corroborate the linear computational complexity of the employed numerical methods in terms of the network size that is theoretically indicated under the assumption of sparsity in the supra-adjacency matrix. This excellent scalability allows the efficient treatment of large-scale networks with the number of node-layer pairs of order 10^Seven or higher.Heat flux is a fundamental quantity in thermal science and engineering and is essential for understanding thermal transport phenomena. In this study, the heat flux in a solid-liquid interfacial region is obtained in a three-dimensional (3D) space at a subatomic spatial resolution based on classical molecular dynamics, yielding a 3D structure of the heat flux between the solid and liquid layers in contact. The results using the Lennard-Jones potential reveal the directional qualities of the heat flux, which are significantly dependent on the subatomic stresses in the structures of condensed phase systems. The heat flux and stress at the subatomic scale are related to the macroscopic transport quantities, which can be obtained using distribution functions; the stress and energy flux properties at the subatomic scale are comprehensively investigated using a single-interaction-based stress and energy flux to determine the origin of the thermal transport mechanism at the solid-liquid interface. The findings revealand outside the stress band in a high-stress field at the subatomic scale induces the net thermal transport across the interface in the nonequilibrium state.The severe neurological disorder epilepsy affects almost 1% of the world population. For patients who suffer from pharmacoresistant focal-onset epilepsy, electroencephalographic (EEG) recordings are essential for the localization of the brain area where seizures start. Apart from the visual inspection of the recordings, quantitative EEG signal analysis techniques proved to be useful for this purpose. Among other features, regularity versus irregularity and phase coherence versus phase independence allowed characterizing brain dynamics from the measured EEG signals. Can phase irregularities also characterize brain dynamics? To address this question, we use the univariate coefficient of phase velocity variation, defined as the ratio of phase velocity standard deviation and the mean phase velocity. Beyond that, as a bivariate measure we use the classical mean phase coherence to quantify the degree of phase locking. All phase-based measures are combined with surrogates to test null hypotheses about the dynamics underlying the signals. In the first part of our analysis, we use the Rössler model system to study our approach under controlled conditions. In the second part, we use the Bern-Barcelona EEG database which consists of focal and nonfocal signals extracted from seizure-free recordings. Focal signals are recorded from brain areas where the first seizure EEG signal changes can be detected, and nonfocal signals are recorded from areas that are not involved in the seizure at its onset. Our results show that focal signals have less phase variability and more phase coherence than nonfocal signals. Once combined with surrogates, the mean phase velocity proved to have the highest discriminative power between focal and nonfocal signals. In conclusion, conceptually simple and easy to compute phase-based measures can help to detect features induced by epilepsy from EEG signals. This holds not only for the classical mean phase coherence but even more so for univariate measures of phase irregularity.The existence of two structural forms in liquid water has been a point of discussion for a long time. A phase transition between these two forms of liquid water has been proposed based on evidence from molecular simulations, and experiments have also been very recently able to track the proposed transition of the low-density liquid form to the high-density liquid form. We propose to use the average angle an oxygen atom makes with its neighbors to describe the structural environment of a water molecule. The distribution of this order parameter is observed to have two peaks with one peak at ∼109.5^∘, corresponding to the internal angle of a regular tetrahedron, indicating tetrahedral arrangement. The other peak corresponds to an environment with a tighter arrangement of neighboring molecules. The distribution of O-O-O angles is decomposed into two skewed distributions to estimate the fractions of the two liquid forms in water. A good similarity is observed between the temperature and pressure trends of fractions of locally favored tetrahedral structure (LFTS) form estimated using the new order parameter and the reports in the literature, over a range of temperatures and pressures. We also compare the structural environments indicated by different order parameters and find that the order parameter proposed in this paper captures the structure of first solvation shell of the LFTS accurately.Systems of interacting bosons in triple-well potentials are of significant theoretical and experimental interest. They are explored in contexts that range from quantum phase transitions and quantum dynamics to semiclassical analysis. Here, we systematically investigate the onset of quantum chaos in a triple-well model that moves away from integrability as its potential gets tilted. Even in its deepest chaotic regime, the system presents features reminiscent of integrability. Our studies are based on level spacing distribution and spectral form factor, structure of the eigenstates, and diagonal and off-diagonal elements of observables in relationship to the eigenstate thermalization hypothesis. With only three sites, the system's eigenstates are at the brink of becoming fully chaotic, so they do not yet exhibit Gaussian distributions, which resonates with the results for the observables.The Metropolis Monte Carlo (MMC) method is used to extract reaction kinetics from a given equilibrium distribution of states of a complex system. The approach is illustrated by the folding/unfolding reaction for two proteins a model β-hairpin and α-helical protein α_SeveralD. For the β-hairpin, the free energy surfaces (FESs) and free energy profiles (FEPs) are employed as the equilibrium distributions of states, playing a role of the potentials of mean force to determine the acceptance probabilities of new states in the MMC simulations. Based on the FESs and PESs for a set of temperatures that were simulated with the molecular dynamics (MD) method, the MMC simulations are performed to extract folding/unfolding rates. It has been found that the rate constants and first-passage time (FPT) distributions obtained in the MMC simulations change with temperature in good agreement with those from the MD simulations. For α_3D protein, whose equilibrium folding/unfolding was studied with the single-molecule FRET method [Chung et al., J. Phys. Chem. A 115, 3642 (2011)1089-563910.1021/jp1009669], the FRET-efficiency histograms at different denaturant concentrations were used as the equilibrium distributions of protein states. It has been found that the rate constants for folding and unfolding obtained in the MMC simulations change with denaturant concentration in reasonable agreement with the constants that were extracted from the photon trajectories on the basis of theoretical models. The simulated FPT distributions are single-exponential, which is consistent with the assumption of two-state kinetics that was made in the theoretical models. The promising feature of the present approach is that it is based solely on the equilibrium distributions of states, without introducing any additional parameters to perform simulations, which suggests its applicability to other complex systems.Coherence resonance (CR) describes a counterintuitive phenomenon in which the optimal oscillatory responses in nonlinear systems are shaped by a suitable noise amplitude. This phenomenon has been observed in neural systems. In this research, the generation of double coherence resonances (DCRs) due to white noise is investigated in a three-dimensional reduced Hodgkin-Huxley neuron model with multiple-timescale feature. We show that additive white noise can induce DCRs from the resting state near a subcritical Hopf bifurcation. The appearance of DCRs is related to the changes of the firing pattern aroused by the increases of the noise amplitude. The underlying dynamical mechanisms for the appearance of the DCRs and the changes of the firing pattern are interpreted using the phase space analysis and the dynamics of the stable focus-node near the subcritical Hopf bifurcation. We find that the multiple-timescale dynamics is essential for generating the DCRs and different firing patterns. The results not only present a case in which noise can induce DCRs near a Hopf bifurcation but also provide its dynamical mechanism, which enriches the phenomena in nonlinear dynamics and provides further understanding on the roles of noise in neural systems with multiple-timescale feature.Classical density functional theory for finite temperatures is usually formulated in the grand-canonical ensemble where arbitrary variations of the local density are possible. However, in many cases the systems of interest are closed with respect to mass, e.g., canonical systems with fixed temperature and particle number. Although the tools of standard, grand-canonical density functional theory are often used in an ad hoc manner to study closed systems, their formulation directly in the canonical ensemble has so far not been known. In this work, the fundamental theorems underlying classical DFT are revisited and carefully compared in the two ensembles showing that there are only trivial formal differences. The practicality of DFT in the canonical ensemble is then illustrated by deriving the exact Helmholtz functional for several systems the ideal gas, certain restricted geometries in arbitrary numbers of dimensions, and, finally, a system of two hard spheres in one dimension (hard rods) in a small cavity. Some remarkable similarities between the ensembles are apparent even for small systems with the latter showing strong echoes of the famous exact of result of Percus in the grand-canonical ensemble.Important microfluidic phenomena, such as droplet deformation and cell motion, are impacted by the formation of Debye layers at charged interfaces. Previous studies examined interface problems with leaky dielectrics or the formation of diffuse charge layers. In most cases, the results are derived for weakly curved spherical geometries. Moreover, many studies of streaming-potential phenomena at fluid-solid interfaces lack a macroscale description of effects that are higher than first order. An asymptotic methodology capturing both complex surface geometries and an accurate description of higher-order phenomena is presented in this study. For this purpose, we consider a generic streaming-potential problem. As a result, the complex three-dimensional electrohydrodynamics in the Debye layer are entailed in two-dimensional discontinuity conditions. The latter contain a free parameter, the layer thickness, which mathematically represents the discontinuity position within the Debye layer. It can be used to derive an alternative definition of the Debye thickness capturing the influence of the ζ potential. We introduce a virtual particle whose outer boundary envelopes the solid particle plus a fraction of the Debye layer. It interacts with the macroscopic flow while incorporating the detailed electrohydrodynamics inside the layer.Long-term poor dietary habits can cause changes in the intestinal flora, resulting in the production of a large number of lipopolysaccharide, increase intestinal mucosal permeability, and activate the entrance of a large number of inflammatory factors into the portal vein. In addition, a high carbohydrate diet can increase liver metabolic burden, increase mitochondrial oxidative phosphorylation, leading to oxidative stress, generate new fat during adenosine triphosphate synthesis, and thus resulting in ectopic fat accumulation, which further activate nuclear factor-κB signaling pathway and release inflam- matory factors such as tumor necrosis factor-α, interleukin-1β (IL-1β), IL-6, and so on. This leads to obesity and insulin resis- tance, ultimately triggering systemic low-grade inflammation. This article reviews the mechanism of poor dietary habits leading to systemic low-grade inflammation, the clinical and experimental research progress of keloids and systemic low-grade inflammation, the association between dietary habits and keloid constitution, and puts forward the hypothesis that poor dietary habits may lead to the occurrence and development of keloids.The wound healing time, tension of wound edge, proliferation of fibroblast, and extracellular matrix deposition are the important factors of scar formation, and botulinum toxin type A can regulate the above. Prevention and treatment of scar with botulinum toxin type A is one of the hot topics of clinical research in recent years. This paper briefly reviews researches by scholars at home and abroad on the mechanism, clinical application, complications, and adverse effects of botulinum toxin type A in scar prevention and treatment.With the aging of population and the development of social economy, the incidence of chronic wounds is increasing day by day, while the incidence of burns and trauma remains at a high level, making wound repair an increasingly concerned area in clinical practice. Thymosin β4 is a naturally occurring small molecule protein in vivo, which is widely distributed in a variety of body fluids and cells, especially in platelets. Thymosin β4 has biological activities of promoting angiogenesis, anti-inflammation, anti-apoptosis, and anti-fibrosis, and has many important functions in wound repair. Thymosin β4 has been observed to promote the healing of various wounds, such as burns, diabetic ulcers, pressure ulcers. This paper will review the molecular structure, mechanism of wound healing promotion, pharmacokinetics, and clinical application of thymosin β4, aiming to introduce its potential in wound treatment and the shortcomings of current researches.Objective To explore the application effects of feedforward control theory in the rollover bed treatment of mass patients with burn-explosion combined injury. Methods A retrospective observational research was conducted. From June 13 to 14, 2020, 15 patients with severe burn-explosion combined injury caused by liquefied natural gas tank car explosion and conforming to the inclusion criteria were admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine. There were 13 males and 2 females, aged 33-92 (66±17) years. All the patients were treated with rollover bed from 48 h post admission, and the feedforward control theory was introduced, including establishing a special feedforward control management team for rollover bed, clarifying the duties of the medical staff in the rollover bed treatment of patients, implementing the cooperation strategy of multidisciplinary physician, training and examining for 80 nurses in the temporarily organized nurse team in the form of "rollover bed work20 turning over operations, the successful rate of one-time posture change reached 99.9% (1 319/1 320), and no adverse event occurred. Within 2 days of admission, the lowest levels of PaO2 and PaCO2 of the patients were (100±19) and (42±4) mmHg, respectively, and the number of patients with mild, moderate, and severe ARDS were 10, 2, and 3, respectively, and none of the patients had oxygenation index&gt;300 mmHg. On the 30th day of admission, the lowest levels of PaO2 and PaCO2 of the patients were (135±28) and (37±8) mmHg, respectively, 3 patients developed moderate ARDS, 1 patient developed severe ARDS, and 11 patients had oxygenation index&gt;300 mmHg. Conclusions The introduction of feedforward control theory in the treatment of rollover bed of mass patients with burn-explosion combined injury can ensure safe and successful completion of turning over with the rollover bed, promote the repair of burn wound, and improve respiratory function, and therefore improve the treatment quality of patients.On December 22, 2017, a 35-year-old male hemophilia A patient with a secondary chronic refractory wound after left knee joint surgery was transferred from the Department of Hematology of Maoming People's Hospital to the Department of Burns and Plastic Surgery in the same hospital. The physical examination revealed that the patient's left knee joint was swollen, with a full-thickness skin defect wound of 4 cm×4 cm on the lateral side of the joint and a large number of dark red blood clots at the bottom of the wound. The wound bleeding was controlled by intravenous infusion of plasma, cryoprecipitate, and human coagulation factor Ⅷ. After con- ventional debridement and dressing changes until the wound infection was controlled and necrotic tissue was removed, a subcutaneous cavity wound of 2 cm×2 cm in area and 3 cm in depth remained in the left knee joint and was difficult to heal. Nineteen days after transfer, the patient received autologous platelet-rich plasma (PRP) treatment, and 32 days after PRP treatment, the wound in left knee joint was healed with epithelialization. This case suggests that autologous PRP therapy would be a good option for hemophilia complicated chronic refractory wounds when they could not be repaired by surgery.Objective To investigate the clinical effects of en bloc resection and debridement combined with gluteus maximus muscle flap in the treatment of ischial tubercle pressure ulcer complicated with chronic osteomyelitis. Methods A retrospective observational study was conducted. From May 2018 to February 2020, 8 patients with pressure ulcers on the ischial tuberosity combined with chronic osteomyelitis who met the inclusion criteria were admitted to Fuyang Minsheng Hospital, including 5 males and 3 females, aged 38-69 years, with unilateral lesions in 6 patients and bilateral lesions in 2 patients. According to the anatomical classification of Cierny-Mader osteomyelitis, there were 6 patients (7 sides) with focal type, and 2 patients (3 sides) with diffuse type. The wound areas were 3 cm×2 cm to 12 cm×9 cm on admission. The pressure ulcer and chronic osteomyelitis lesions were completely removed by en bloc resection and debridement. The chronic infectious lesions were transformed into sterile incisions like fresh this group of patients, the incisions of 7 patients healed, while in one case, the incision suture was torn off during turning over and healed after secondary suture. The flaps survived well in 3 patients who underwent local flap transfer. During the follow-up period of 6-20 months, no recurrence of pressure ulcer or osteomyelitis occurred in 8 patients, the affected part had skin with good texture, mild pigmentation, and no sinus tract formation, and no secondary dysfunction or deformity occurred in the donor site. Conclusions The en bloc resection and debridement combined with gluteus maximus muscle flap has good clinical effects on ischial tubercle pressure ulcer complicated with chronic osteomyelitis. Neither pressure ulcer nor osteomyelitis recurs post operation. The skin texture and appearance of the affected area are good, and the donor site has no secondary dysfunction or deformity.Objective To investigate the regulatory effects of bio-intensity electric field on the transformation of human skin fibroblasts (HSFs). Methods The experimental research methods were used. HSFs were collected and divided into 200 mV/mm electric field group treated with 200 mV/mm electric field for 6 h and simulated electric field group placed in the electric field device without electricity for 6 h. Changes in morphology and arrangement of cells were observed in the living cell workstation; the number of cells at 0 and 6 h of treatment was recorded, and the rate of change in cell number was calculated; the direction of cell movement, movement velocity, and trajectory velocity within 3 h were observed and calculated (the number of samples was 34 in the simulated electric field group and 30 in 200 mV/mm electric field group in the aforementioned experiments); the protein expression of α-smooth muscle actin (α-SMA) in cells after 3 h of treatment was detected by immunofluorescence method (the number of sample wa01); compared with that in electric field treatment 1 h group, the protein expressions of PCNA of cells in electric field treatment 3 h group and electric field treatment 6 h group were significantly decreased (P less then 0.05 or P less then 0.01); compared with that in electric field treatment 3 h group, the protein expression of PCNA of cells in electric field treatment 6 h group was significantly decreased (P less then 0.01). Conclusions The bio-intensity electric field can induce the migration of HSFs and promote the transformation of fibroblasts to myofibroblasts, and the transformation displays certain dependence on the time and intensity of electric field.Objective To observe the clinical effects of free latissimus dorsi myocutaneous flap combined with artificial dermis and split-thickness skin graft in the treatment of degloving injury in lower limbs. Methods A retrospective observational study was conducted. From December 2017 to December 2020, 8 patients with large skin and soft tissue defect caused by degloving injury in lower extremity were admitted to Ningbo No.6 Hospital, including 5 males and 3 females, aged from 39 to 75 years, with wound area of 25 cm×12 cm-61 cm×34 cm. The free latissimus dorsi myocutaneous flap with latissimus dorsi muscle in the width of 12-15 cm and flap area of 20 cm×8 cm-32 cm×8 cm was used to repair the skin and soft tissue defect of bone/tendon exposure site or functional area. The other defect was repaired with bilayer artificial dermis, and the flap donor site was sutured directly. After the artificial dermis was completely vascularized, the split-thickness skin graft from thigh was excised and extended at a ratio of 1∶2 toion of the flap recovered to grade S2 or S3; 3 cases were excellent, 4 cases were good, and 1 case was fair in flap function; the Vancouver scar scale score of lower limb skin graft area was 4-7 (5.2±0.9), and the Vancouver scar scale score of thigh skin donor area was 1-5 (3.4±0.8). The patients were fairly satisfied with the curative effects. Conclusions In repairing the large skin and soft tissue defect from degloving injury in lower extremity, to cover the exposed bone/tendon or functional area with latissimus dorsi myocutaneous flap and the residual wound with artificial dermis and extended split-thickness skin graft is accompanied by harvest of small autologous flap and skin graft, good recovery effect of functional area after surgery, and good quality of healing in skin grafted area.Objective To explore the clinical effects of three-dimensional printed preformed titanium mesh combined with latissimus dorsi muscle flap free transplantation in the treatment of wounds with skull defect after radical surgery of squamous cell carcinoma in the vertex. Methods A retrospective observational study was conducted. From January 2010 to December 2019, 5 patients with squamous cell carcinoma in the vertex accompanied with skull invasion who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of the Second Affiliated Hospital of Air Force Medical University, including four males and one female, aged 50 to 65 years. The original lesion areas ranged from 5 cm×4 cm to 15 cm×8 cm. The titanium mesh was prefabricated via three-dimensional technic based on the result the scope of skull resection predicted with computerized tomography three-dimensional reconstruction before surgery. During the first stage, the soft tissue defect area of scalp (8 cm×7 cm to 18 cm×11 cm) afte was 12.1 h, and the intraoperative blood loss was not more than 1 200 mL. The muscle flaps in the first-stage surgery and the skin grafts in the second-stage surgery all survived well. During the follow-up of 6-18 months, no complications such as exposure of titanium mesh or infection occurred, with good shape in the recipient sites in the vertex, and no recurrence of tumor. Conclusions Three-dimensional printed preformed titanium mesh combined with latissimus dorsi muscle flap free transplantation and intermediate thickness skin graft cover is an effective and reliable method for repairing the wound with skull defect after extended resection of squamous cell carcinoma in the vertex. This method can cover the wound effectively as well as promote both recipient and donor sites to obtain good function and appearance.Objective To investigate the predictive value of D-dimer for deep venous thrombosis (DVT) of lower extremity in adult burn patients. Methods A retrospective case series study was conducted. The clinical data of 3 861 adult burn patients who met the inclusion criteria and were admitted to the Department of Burns of Zhengzhou First People's Hospital from January 1, 2015 to December 31, 2019 were collected. The patients were divided into DVT group (n=77) and non-DVT group (n=3 784) according to whether DVT of lower extremity occurred during hospitalization or not. Data of patients in the two groups were collected and compared, including the gender, age, total burn area, D-dimer level, with lower limb burn and inhalation injury or not on admission, with sepsis/septic shock, femoral vein indwelling central venous catheter (CVC), history of surgery, and infusion of concentrated red blood cells or not during hospitalization. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chrn and inhalation injury on admission, and femoral vein indwelling CVC and infusion of concentrated red blood cells during hospitalization between patients in the two groups (t=-8.17, with Z values of -5.04 and -10.83, respectively, χ2 values of 21.83, 5.37, 7.75, and 4.52, respectively, P0.05). Conclusions D-dimer level is an independent risk factor for DVT of lower extremity in adult burn patients, its AUC quality and sensitivity and specificity under the optimal threshold value are better than those of age and total burn area, and it has good predictive value for DVT of lower extremity in adult burn patients.Objective To explore the clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns. Methods A retrospective observational study was conducted. From May 2018 to April 2021, 11 patients with cervical cicatrix contracture deformity after burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 3 males and 8 females, aged 5 to 46 years, with a course of cervical cicatrix contracture deformity of 5 months to 8 years. The degree of cervical cicatrix contracture deformity was degree Ⅰ in one patient, degree Ⅱ in nine patients, and degree Ⅲ in one patient. In the first stage, according to the sizes of neck scars, one rectangular skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 200 to 600 mL was placed in the back. The expansion time was 4 to 12 months with the total normal saline injection volume being 3.0he flaps of ten patients were similar to the skin around the recipient site in texture and color, while the flap of one patient was slightly swollen. All of the 11 patients had good recovery of cervical function and no obvious scar hyperplasia nor contracture in the flaps or at the donor sites. Conclusions Application of expanded thoracodorsal artery perforator flaps can restore the appearance and function of the neck, and cause little damage to the donor site in reconstructing the cervical cicatrix contracture deformity after burns, which is worthy of clinical reference and application.Objective To investigate the clinical effects of free transplantation of expanded ilioinguinal flaps in the reconstruction of severe scar contracture after extensive burns. Methods A retrospective observational study was conducted. From August 2017 to October 2021, 7 patients with severe scar contracture deformity caused by extensive burns were hospitalized in Tongren Hospital of Wuhan University &amp; Wuhan Third Hospital, including 5 males and 2 females, aged 26-65 years, with scar area of 20 cm×4 cm-34 cm×14 cm. In the first stage, the rectangular skin and soft tissue expander (hereinafter referred to as the expander) with rated capacity of 500-600 mL were embedded above the inguinal ligament, and then normal saline was injected after stitch removal for expansion to meet the needs of repair surgery. In the second stage, the scar was removed by surgical excision to correct the deformity and release the adhesion and contracture; after the removal of the expanders, the expanded ilioinguinal free flaps were harvesf severe scar contracture deformity after extensive burns.Objective To summarize the clinical experience of expanded internal mammary artery perforator (IMAP) flap combined with vascular supercharge in reconstruction of faciocervical scar. Methods The retrospective observational study was conducted. From September 2012 to May 2021, 23 patients with postburn or posttraumatic faciocervical scars who met the inclusion criteria were admitted to Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, including 18 males and 5 females, aged from 11 to 58 years, all of whom were reconstructed with expanded IMAP flaps. At the first stage, one or two skin and soft tissue expander (s) with appropriate rated capacity were implanted in the anterior chest area according to the location and size of the scars. The IMAP, thoracic branch of supraclavicular artery, and lateral thoracic artery were preserved during the operation. The skin and soft tissue expanders were inflated with normal saline after the operation. The flaps were transferred during the sWhen combined with vascular supercharge, a double-pedicle flap can be designed flexibly to further enhance the blood supply and expand the flap incision area, which is a good choice for reconstruction of large faciocervical scar.Objective The surgical reconstruction strategy for scar contracture deformity in chin and neck was explored, aiming to obtain better aesthetic outcome. Methods A retrospective observational study was conducted. From December 2017 to April 2021, 34 patients with scar contracture deformity in chin and neck after burns were hospitalized in the Department of Plastic Surgery of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), aged 12-54 years, including 13 males and 21 females, 4 cases with chin affected only, 7 cases with neck affected only, and 23 cases with both chin and neck affected. The scar areas were 48-252 cm2. All the patients were treated by operation with expanded flaps, following the "MRIS" principle of matching of the color and thickness of the repair flaps (match), reconstructing of the aesthetic features of subunits (reconstruction), design of incision according to the plastic principle (incision), and prevention of the surgical incision scar (scar).n of chin and neck was observed, and the aesthetic shape of chin and neck was significantly improved, with mild scar hyperplasia of surgical incision. Conclusions Reconstruction of scar contracture deformity in chin and neck by using expanded flaps based on the "MRIS" principle is beneficial to improve the quality of surgery and achieve better aesthetic outcome.Skin and soft tissue expansion can provide skin tissue similar to the recipient area in color and texture, which is one of the ideal methods in the repair of superficial defects. However, due to the long treatment cycle and relatively high complications rate in pediatric patients, expansion still faces many challenges. Based on the clinical practice and the current progress in skin and soft tissue expansion, this paper briefly discusses the change of skin after expansion, and the application, prevention and treatment of complications in the application of expansion in pediatric patients, aiming to provide reference for expansion in pediatric patients.Objective To investigate the effects of fecal microbiota transplantation (FMT) on non-obese diabetic (NOD) mice of type 1 diabetes mellitus (T1DM) and its underlying mechanisms. Methods A total of 8-9 week-female NOD mice were randomly divided into control (n=36) and FMT groups (n=36) according to the random number table. Fecal microbiota from C57BL/6 mice were transplanted into FMT group, and control group were transplanted with microbiota from themselves, once every two days for 5 times. The insulitis score and incidence of T1DM were compared between two groups;16S rRNA gene sequencing was used to evaluate the structure of fecal bacteria in NOD mice. The expressions of intestinal barrier related genes were detected by real-time quantitative PCR. The proportions of regulatory T cells (Tregs), helper T cell (Th)-1 and Th17 in the enteric-pancreatic immune axis were detected by flow cytometry. Amino acid in serum was measured by amino acid metabolomics. Results Incidence of T1DM in NOD mice from FMT group was 004;(0.40±0.02)% vs (0.31±0.02)%, P=0.008;(0.51±0.06) vs (0.36±0.02), P=0.027] were decreased. The contents of leucine [(92.86±7.32) vs (91.87±12.62) μmol/L, P=0.027], valine [(162.74±15.97) vs (155.89±25.70) μmol/L, P=0.046] and isoleucine [(75.65±5.59) vs (73.61±9.67) μmol/L, P=0.048] in serum were decreased in FMT group. Conclusions FMT can alleviate insulitis and T1DM occurrence in NOD mice, of which mechanism may be related to remodeling gut microbiota and improving intestinal barrier function, affecting immune response of enteric-pancreatic immune axis, correcting amino acid metabolism disorder and reducing the accumulation of branch chain amino acids in NOD mice.Objective To identify rare variants in exon and exon-intron boundary of containing NLR family CARD domain protein 4 (NLRC4) in type 1 diabetes (T1DM) patients, and to explore their effects on gene function. Methods A total of 508 T1DM patients and 527 healthy controls in the Department of Metabolic Endocrinology, Second Xiangya Hospital of Central South University from August 2017 to September 2020 were selected. The case group included 264 males and 244 females, and the age [M (Q1, Q3)] was [27 (11, 43)] years. The control group included 290 males and 237 females, and their age［M（Q1，Q3）］was [47 (36, 60)] years old. Identification of rare variants in exons of NLRC4 gene in T1DM patients and healthy controls was performed and verified by next-generation sequencing and sanger sequencing. The NLRC4 gene wild-type and mutant plasmids were constructed and transfected into 293T cells. Western blot (WB) was used to detect the expression of NLRC4 protein and cleavage products of pro-cysteinyl aspartate specific prote12.98, 17.52) and 15.44 (13.81, 17.07) ng/L, respectively, which was lower than 18.70 (16.59, 20.81) ng/L of 293T cells transfected wild-type plasmid (P=0.020, 0.010). Conclusions NLRC4 gene rare variants c.208C&gt;T, c.1564T&gt;C and c.1219G&gt;C may not change the protein expression, degradation and localization, but c.208C&gt;T and c.1219G&gt;C may inhibit the secretion of IL-1β. This result suggests that NLRC4 rare variants may have an impact on gene function.Objective We aimed to investigate the autoimmune status of long-term type 1 diabetes mellitus (T1DM) patients with residual β-cell function. Methods The residual β-cell function of long-term (disease duration≥10 years) autoimmune T1DM patients from the T1DM Integrated Management Clinic of the Second Xiangya Hospital was assessed by serum C-peptide levels. Patients with fasting or 2-hour postprandial C-peptide levels over the lower sensitivity limit of detection (16.7 pmol/L) were grouped as C-peptide-positive, and others were grouped as C-peptide-negative. We screened and enrolled all the C-peptide-positive patients (n=19). C-peptide-negative patients with matched sex, age, duration, BMI (n=19) and healthy controls (n=19) were recruited at the same time. The frequencies of CD4+T cell (Th1/Th2/Th17/Treg) and B cell (MZB/FoB/B10) subsets, the expression of PD-1/PD-L1 on T and B lymphocytes, and the levels of T1DM related cytokines including IFN-γ, TNF-α, IL-1β, IL-1RA, IL-4, IL-6, IL-10, IL-12p40, IL-12p70, IL-23 and IP-10 were tested.