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Long-term follow-up study on the sensory and motor function recovery of foot after repair of forefoot plantar wounds with retrograde medial plantar flap  YANG Yijie, ZHONG Haiyan, CUI Lei, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 331-.   Abstract （971）      PDF（pc） （7518KB）（99）       Knowledge map    Save  Objective To evaluate the recovery of sensory and motor function after repair of forefoot plantar wounds with retrograde medial plantar flap. Methods The clinical data of 15 patients with forefoot plantar wounds that were repaired by retrograde medial plantar flap from February 2016 to August 2023 were retrospectively reviewed. The causes of the wounds included electric injury （3 cases）， avulsion injury （1 case）， diabetes mellitus （2 cases）， and tumor resection （9 cases，including 8 melanomas and 1 desmoid）. The size of harvested flaps ranged from 5 cm×5 cm to 6 cm×8 cm. Patients were followed up for 13-103 months to evaluate the flap sensation， sensory and motor function of the foot and toe， and appearance of donor and recipient site. Results The blood supply of all flaps was good after operation. Postoperative venous congestion occurred in 2 cases， which was relieved by needle puncture for bloodletting and heparin saline flushing. One-month and three-month postoperative follow-up showed that all 15 flaps presented soft texture and good appearance without bloating. However， the sensation of pain， temperature and two-point discrimination were lost. In the long-term follow-up initiated in September 2024， four cases were lost to follow-up， three of them were unavailable and one died. The remaining 11 patients could walk on the ground in normal gait without difficulty. Sensation of pain， temperature and touch were partially restored. Futhermore， active flexion and extention of the toes on the affected side were present， and toe muscle strength （Manual Muscle Testing， MMT） was graded≥4. Conclusion The retrograde medial plantar flap is effective in repairing small to  medium-size forefoot plantar wounds by achieving good appearance， restoring the sensory， motor and weight-bearing function partially to a reasonable extent. Related Articles | Metrics | Comments（0）

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Research progress on the age-related changes in facial skin in Chinese women LU Nan, HUANG Tao, SONG Jiao, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (2): 205-.   Abstract （393）      PDF（pc） （1033KB）（677）       Knowledge map    Save Skin is the largest organ in the human body and serves as the boundary between the internal and external environments. The aging process of facial skin is influenced by various factors， such as exposure to sunlight， environmental pollution， and lifestyle habits. Over time， facial skin exhibits typical signs of aging， including wrinkles， sagging， roughness， pigmentation， uneven skin tone， dryness， and decreased elasticity. With the rapid development of the economy and people's pursuit of a high-quality life， the quest for face rejuvenation has gained increasing attention. In this paper， research progress of age-related changes in facial skin among Chinese women was reviewed to offer theoretical support for the development of skincare products and the treatment practices of dermatologists. Related Articles | Metrics | Comments（0）

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The mechanisms of midfacial anatomical aging and the research progress on midfacial lifting surgery CHEN Heng, ZHOU Xu Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (3): 319-.   Abstract （321）      PDF（pc） （2809KB）（101）       Knowledge map    Save The anatomical layers of the midface are primarily divided into five layers： skin， subcutaneous tissue， SMAS layer， muscles， and bone. With aging， the midfacial skeleton gradually undergoes resorption； Muscle strength weakens and remains in a persistent hypertonic state； Deep fat atrophies， and superficial fat descends； Facial ligaments degenerate and undergo fibrosis； The skin loses moisture， elasticity decreases， wrinkles form， pigmentation increases， and dryness ensues. These complex anatomical layers interact， collectively leading to the outward appearance of midfacial aging. In response to midfacial aging and soft tissue descent， various facelift techniques have been continuously developed. Skin and subcutaneous tissue lifts are suitable for mild skin laxity； SMAS-layer lifting plays a central role in facial lifting surgery， forming a variety of classic SMAS lift techniques and minimally invasive methods； Deep plane lifting， which involves releasing the deep tissues beneath the SMAS layer， provides lasting rejuvenation effects， but with increased surgical complexity and risk. Related Articles | Metrics | Comments（0）

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Advances in the application of tissue engineering materials modified with epigallocatechin gallate TIAN Jiaqi, LONG Tao, WANG Ran, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 391-.   Abstract （305）      PDF（pc） （940KB）（27）       Knowledge map    Save Epigallocatechin gallate （EGCG） is the main component of polyphenols in tea. In recent years， many studies have proved that drinking green tea can reduce the risk of chronic diseases， such as cardiovascular disease， diabetes and various cancers. At the same time， some scholars say that green tea also has a potential preventive effect on COVID-19. In recent years， materials science has developed rapidly， and many studies have synthesized materials that bind to EGCG. In this paper， the preventive and therapeutic effects of EGCG in diseases were reviewed， and the application of each effect in the modification of tissue engineering materials was discussed. Related Articles | Metrics | Comments（0）

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Research advances in the biological mechanism of bone repair with biphasic calcium phosphate bioceramic materials GUAN Wenge, TANG Renbo, HUA Wenda, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 383-.   Abstract （300）      PDF（pc） （985KB）（269）       Knowledge map    Save Biphasic calcium phosphates （BCPs） are bioactive ceramics composed of a mixture of hydroxyapatite and β-tricalcium phosphate in varying proportions， with a chemical composition very similar to the inorganic composition of bone tissue. It has become the most promising bone replacement material due to its excellent biocompatibility， osteoinductivity，osteoconductivity and adjustable degradation rate. This is attributed to the physicochemical properties， pore structure，crystallinity and morphological characteristics of BCP bioceramics. Numerous studies have shown that the bone-forming capacity of BCP bioceramics can be enhanced by optimising their phase composition， ionic environment and surface roughness. However， their potential bone-forming molecular mechanism of action remains a mystery. In this paper， the role of BCP bioceramics in relation to the surrounding biological environment of bone tissues was reviewed， the differentiation of  mesenchymal stem cells and immune response-induced bone and vasculogenesis in BCP bioceramics during the process of bone defect repair were introduced， as well as describing modified BCP bioceramics and discussing the future prospects in this field. Related Articles | Metrics | Comments（0）

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Application of anterolateral thigh flap in repairing severe diabetic foot ulcers LIU Yuanhang, CHANG Baoguo, MOU Yong, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 337-.   Abstract （299）      PDF（pc） （1326KB）（69）       Knowledge map    Save  Objective To explore the clinical effect of using free anterolateral thigh flaps （ALTF） to repair severe diabetic foot ulcer wounds. Methods From January 2019 to September 2023，15 patients with severe diabetic foot ulcers were treated with free ALTF transplantation. The wound area ranged from 4.0 cm×6.0 cm to 8.0 cm×18.5 cm. Postoperatively， the patients received routine anti-infection， anticoagulation， anti-vascular spasm， and blood sugar control treatments. Follow-up was conducted for 6-24 months. The follow-up contents included flap appearance， sensation， wound healing， ulcer recurrence， foot function， and the condition of the donor area. Results Among the 15 cases，13 cases had complete flap survival，1 case had partial flap survival， and 1 case experienced necrosis within 72 hours after surgery. The case with partial flap survival healed after active wound dressing changes and symptomatic treatment. In the 14 cases with flap survival， the foot flaps had an aesthetically pleasing appearance， two-point discrimination ranged from 8 to 15 mm， and there was no recurrence of ulcers. The donor site in all patients healed linearly without affecting the range of motion of the hip and knee joints. According to the Maryland Foot Function Score， the foot function scores were as follows：5 cases rated excellent，7 cases rated good， and 2 cases rated fair. Conclusion The use of free anterolateral thigh flaps can effectively repair severe diabetic foot ulcers. However， strict control of surgical indications and active management and control of complications are necessary， otherwise， there is a certain risk of poor healing or even necrosis of the flap Related Articles | Metrics | Comments（0）

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Research progress of 3D printing technology in bone tissue engineering LIU Mingrui, LIN Tao, LIN Zhiwei, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (3): 297-.   Abstract （292）      PDF（pc） （1342KB）（331）       Knowledge map    Save  In recent years， 3D printing technology has been widely applied in the field of medicine， especially in the area of bone tissue engineering. 3D printing technology is capable of integrating different types of living cells into threedimensional structures composed of traditional micro- or nano-scale biomaterials， thereby creating artificial bone implants capable of regenerating damaged tissues. This technology enables the customization of the shape and size of bone implants according to the specific needs of patients， as well as the adjustment of material mechanical properties and pore structures to promote cell attachment， proliferation， and bone tissue regeneration. Such personalized treatment methods can provide patients with improved therapeutic effects and functional recovery. This review introduced several commonly used 3D printing methods and materials for bone substitutes， with a particular focus on their technical applications in bone repair and regeneration， aiming to familiarize readers with the latest developments and prospects of this technology in the field of bone tissue engineering. Related Articles | Metrics | Comments（0）

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Advances in mesenchymal stem cells secretome for the treatment of chronic wounds WANG Jiaxin, DUAN Yuren, WANG Xiaobing Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (2): 148-.   Abstract （285）      PDF（pc） （1108KB）（248）       Knowledge map    Save Mesenchymal stem cells （MSCs） are widely used in the field of repair and regeneration because of their numerous biological effects. However， MSC cell therapy for chronic wounds has a number of drawbacks， including a limited ability to homing living cells， a lower survival rate， and the possibility of malignant differentiation. Recent advances have been made in the study of MSCs secretome， and cell-free therapy based on MSC secretome is considered to be a novel strategy for enhancing MSC bioavailability to treat chronic wounds. In this paper， the benefits of MSC secretome therapy， the mechanism by which the secretome acts on the wound， preconditioning methods to improve the secretome therapeutic potential were all discussed， and the research status of MSCs conditioned medium and MSCs extracellular vesicles was summarized， laying the groundwork for future clinical trials. Related Articles | Metrics | Comments（0）

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Experience in the treatment of 6 cases of acute necrotizing fasciitis LI Qinglin Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (2): 142-.   Abstract （262）      PDF（pc） （7719KB）（120）       Knowledge map    Save Objective　 To summarize the treatment experience of acute necrotizing fasciitis and provide reference for clinical practice. Methods　A retrospective analysis was conducted on the clinical data of six patients with acute necrotizing fasciitis from June 2021 to October 2024. The changes in wound characteristics， abnormal laboratory indicators， surgical methods and frequency， treatment of complications， length of hospital stay， and follow-up of wounds after discharge were analyzed. Results　After admission， all the 6 patients had fever， elevated hemogram， and excessive inflammatory indexes of C-reactive protein and procalcitonin. One patient had extensive redness， swelling， and pain in the right thigh skin， with high skin temperature， tenderness， and obvious fluctuant sensation. In addition， five patients had skin ulceration and necrosis accompanied by exudate， and the surrounding skin was red， swollen， hot， and painful. Five patients had a history of type 2 diabetes， two patients had stage IV pressure sores in the ischial tuberosity （one was bilateral）， and one patient had grayblack erosion and necrosis of the second and third toes of the right foot. After admission， all patients received empirical anti infective treatment by intravenous drip of antibiotics， and actively regulated blood glucose. After 2-6 days， all patients received wound debridement and vacuum sealing drainage， and then adjusted the anti infective treatment of antibiotics according to the results of wound bacterial culture. All patients had anemia， electrolyte disorder， hypoproteinemia and  abnormal coagulation function， and were given corresponding symptomatic treatment. Two cases were complicated with pleural effusion， and one case received closed thoracic drainage. All patients were treated with debridement and vacuum sealing drainage， and the method of“ conservative debridement of superficial fascia and thorough debridement of deep fascia” was adopted. Among them， 1 case underwent 6 times of debridement and vacuum sealing drainage， 3 cases underwent 1 time， 1 case underwent 2 times， and 1 case reached the repair standard of granulation tissue bright red and no inflammatory reaction after 3 times. Five patients’ wounds were closed by direct suture， one patient received skin graft closure and toe amputation， and the patient with sciatic nodule pressure ulcer received gluteus maximus myocutaneous flap repair at the same time. After debridement and vacuum sealing drainage， the inflammatory indexes of all patients decreased significantly， the body temperature gradually returned to normal， and the abnormal laboratory indexes gradually tended to be normal. The hospital stay was 24-91 days. No recurrence of necrotizing fasciitis was found during the follow-up of 3-40 months after discharge. Conclusion　 The treatment of acute necrotizing fasciitis needs to consider many factors. Active anti infection treatment， blood glucose control and correction of abnormal laboratory indicators to maintain the balance of the body’s internal environment are the basis of treatment. Early conservative debridement of superficial fascia and thorough debridement of deep fascia combined with vacuum sealing drainage are very important to control the progress of the disease， which can retain the skin tissue on the surface of necrotic fascia to the greatest extent. After the granulation tissue of the wound is fresh and has no inflammatory reaction， the wound can be effectively cured by direct suture or skin grafting. Related Articles | Metrics | Comments（0）

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The survey research of epidemiology and risk factors of large to giant congenital melanocytic nevi in China LAI Bohan, WEI Boxuan, JIN Jiamin, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (3): 250-.   Abstract （254）      PDF（pc） （1053KB）（53）       Knowledge map    Save Objective  To explore the relationship between clinical phenotype and clinical manifestations of large-togiant congenital melanocytic nevi （LGCMN）， analyze the differences in risk factors during the embryonic period between normal children and patients with congenital melanocytic nevi （CMN）， and provide a new strategy for the prevention of this disease. Methods In total， 125 patients diagnosed with congenital melanocytic nevi （CMN） were recruited and completed the questionnaire， which contained questions about phenotype， clinical manifestations， family history， and risk factors during pregnancy. In the control group， 66 parents of children without CMN were asked questions about their family history and pregnancy risk factors. Results Pruritis or ulceration was correlated with projected adult size（ P=0.007）， satellite nevi （OR=4.712， P=0.035）， and complications（ OR=13.377， P=0.006）. Lesion rugosity was significantly associated with lesion bulge （OR=22.873， P<0.001）. Malignant melanoma developed in 1.6% of the CMN patients； both had LGCMN and >20 satellites. CMN incidence was significantly associated with a family history of hyperpigmentation disorders（ 26.4% vs. 6.06%， P<0.001）， complications during pregnancy （48.0% vs. 28.8%， P=0.019） and a history of chemical substance exposure （15.2% vs. 1.5%， P=0.007）. Conclusion This study provides novel clues about the association between phenotypes and manifestations and provides potential knowledge on the LGCMN aetiology. In addition， analysis of family history and risk factors during pregnancy also provides strategies for prevention of the disease. Related Articles | Metrics | Comments（0）

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The role of thymic epithelial cells in immune regulation HE Minyan, LIU Fei, YANG Jun, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 396-.   Abstract （243）      PDF（pc） （949KB）（27）       Knowledge map    Save The thymus is an important central immune organ that provides the microenvironment necessary for the development of T lymphocytes from hematopoietic stem cells. Thymic epithelial cells （TECs）， as one of the most critical components of the thymic microenvironment， play an important role in immune regulation. Thymic epithelial cells are mainly categorized into cortical epithelial cells and medullary epithelial cells， which mediate the positive and negative selection of thymocytes， respectively. From the perspective of the pathway of action， thymic epithelial cells mainly regulate thymocyte development through the secretion of cytokines， thymic hormones， or direct interaction with thymocytes. In this paper， the role of thymic epithelial cells in immunomodulation was reviewed. Related Articles | Metrics | Comments（0）

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Research progress of estrogen and wound healing WU Weimin, XIA Ming, WEN Lixia Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (2): 157-.   Abstract （229）      PDF（pc） （1037KB）（122）       Knowledge map    Save Studies have shown that estrogen plays a role in the four healing stages of hemostasis， inflammation， proliferation， and remodeling. It can regulate immune cells， fibroblasts， keratinocytes and other cells involved in healing through a variety of signaling pathways， reduce inflammatory response， promote cell proliferation and migration， regulate collagen synthesis and degradation， and accelerate wound healing. Topical application of estrogen or similar compounds has shown the potential to promote wound healing in animal experiments， but more research is needed to verify its efficacy and safety in clinical practice. The regulatory mechanism of estrogen on wound healing is complex， which needs further research. Related Articles | Metrics | Comments（0）

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Predictive modeling of risk factors associated with complications after microtia external ear reconstruction and analysis of structural versus narrative therapy QIN Wenying, HAN Wenjuan, GUI Yuanyuan Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (3): 258-.   Abstract （228）      PDF（pc） （1287KB）（23）       Knowledge map    Save Objective To explore the related risk factors of complications after microtia external ear reconstruction and establish a predictive model， as well as the effect analysis of structural versus narrative therapy. Methods  Thirty-two patients who developed complications after microtia external ear reconstruction from January 2020 to December 2023 were selected as the complication group， and 153 patients who did not develop complications after microtia external ear reconstruction performed in the same period were selected as the non-complication group. The clinical data of the two groups were collected， the risk factors were evaluated using logistic regression model， the predictive value was assessed using the receiver operating characteristic （ROC） curve， and the decision tree model was constructed based on the risk factors. Meanwhile， 56 patients who underwent external ear reconstruction for microtia from March 2023 to December 2023 were selected as the control group， and conventional therapy was implemented， while 49 patients who underwent external ear reconstruction for microtia from January 2024 to September 2024 were selected as the observation group， and structural and narrative therapy was implemented. The two groups were compared in terms of psychological resilience， fear state and complication occurrence. Results  Logistic regression analysis showed that age ≥10 years （OR=6.709）， auricular malformation Max grade Ⅲ （OR=3.049）， atresia grade Ⅲ （OR=5.440）， having chronic diseases （OR=3.958）， intraoperative bleeding ≥50 mL （OR=5.029）， and admission time from April to September （OR=6.676） were independent risk factors for complications after microtia external ear reconstruction （P<0.05）. The ROC curves showed that age， Max grading of auricular deformity， atresia grading of the external auditory canal， chronic disease， intraoperative bleeding， admission time， and joint prediction were statistically significant in predicting the occurrence of complications after microtia external ear reconstruction （P<0.05）. Among them， the area under the curve（ AUC） of the joint prediction was 0.916， the 95% CI was 0.874-0.957， the sensitivity was 0.906， the specificity was 0.850， and the predictive value was relatively high. The decision tree model showed that grade Ⅲ of external auditory canal atresia grading was the most important predictor， and the classification accuracy of the model was 81.00%. After the intervention， the psychological resilience scale （CD-RISC） score of the observation group was higher than that of the control group （P<0.05）， and the children′s medical fear scale （CMFS） score was lower than that of the control group（ P<0.05）. The complication rate of 2.04% in the observation group was significantly lower than 12.50% in the control group （P<0.05）. Conclusion Age ≥10 years old， auricular deformity Max grading grade Ⅲ， external auditory canal atresia grading grade Ⅲ， chronic diseases， intraoperative bleeding ≥50 mL， and admission time from April to September were independent risk factors for complications after external ear reconstruction for microtia. In addition， structural and narrative therapy interventions are more effective， can improve the psychological state of patients and reduce the complication rate， which is worthy of clinical promotion and application. Related Articles | Metrics | Comments（0）

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Unveiling hypoxia-related biomarkers for diabetic foot ulcers through integrated bioinformatics analysis and machine learning GUO Genyu, ZHANG Chuqiao, XU Yinmei, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (3): 238-.   Abstract （227）      PDF（pc） （6473KB）（266）       Knowledge map    Save   Objective  Diabetic foot ulcer （DFU） is a severe complication in diabetic patients， where the hypoxic microenvironment plays a critical role in its pathogenesis and delayed healing， though the underlying molecular mechanisms remain unclear. To systematically analyze the regulatory network of hypoxia-related genes in DFU using bioinformatics approaches， identify key biomarkers， and provide insights for targeted therapies. Methods Integrated datasets from GEO and MSigDB hypoxia-related gene sets were utilized. Differential expression analysis（ limma， DESeq2）， weighted gene coexpression network analysis （WGCNA）， and GO/KEGG functional enrichment were performed. Hub genes were screened using three machine learning algorithms（ Lasso， SVM-RFE， and random forest）， and their diagnostic efficacy was validated. Results  A total of 152 differentially expressed genes （DEGs） were identified， including 14 hypoxia-related DEGs （HRDEGs）. Enrichment analysis revealed HRDEGs involvement in glucose metabolism， lipid metabolism， and immune cell regulation. Machine learning further pinpointed the hub gene BGN. BGN exhibited significantly lower expression in DFU groups， with area under the ROC curve （AUC） values of 0.833 （training set） and 0.931 （validation set）， indicating high diagnostic accuracy. Single-gene GSEA demonstrated that BGN participates in DFU pathology by regulating tissue repair， inflammatory responses， and extracellular matrix interactions. Conclusion BGN is a key biomarker in the hypoxic microenvironment of DFU and may serve as a potential molecular target for early diagnosis and targeted therapy. This study provides new directions for understanding DFU mechanisms and clinical interventions. Related Articles | Metrics | Comments（0）

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Observation on the efficacy of cross-lip flap repair for upper lip philtrum defects HE Jianlin, ZHANG Binbin, WANG Xiaoxiao, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 342-.   Abstract （224）      PDF（pc） （2785KB）（44）       Knowledge map    Save  Objective To explore the clinical effectiveness of the lower lip cross-lip flap in repairing upper lip philtral defects. Methods Apply two types of cross-lip flaps to repair full-thickness or partial-thickness defects of the upper lip， with the defect ranging from 1/3 to 1/2 of the entire lip， located in the philtrum area. The surgery involves one-stage transfer of the flap to repair the defect， followed by a second-stage pedicle division and trimming after the blood supply has stabilized. Results All the flaps survived without significant complications. The overall satisfaction rate for upper lip defect repair was 91.7% （including very satisfied and satisfied）. The integrity and function of the lip were good. Conclusion When the defect in the philtrum area of the upper lip reaches 1/3 to 1/2 of the entire lip， the cross-lip flap repair can be performed. The postoperative results are satisfactory， with good recovery of aesthetic appearance and lip function. Related Articles | Metrics | Comments（0）

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Biological characteristics and applications of mesenchymal stem cell membranes WANG Yuhuan, QIAN Shutong, HU Zheyuan, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (2): 198-.   Abstract （218）      PDF（pc） （2156KB）（436）       Knowledge map    Save Mesenchymal stem cells （MSCs） have been widely applied in cell therapy due to their multipotent differentiation capabilities， homing properties， and immunoregulatory functions. MSC membranes and their derivatives retain the membrane composition and biological characteristics of the source cells， and have gradually become a new focus of drug delivery research. MSC membranes can not only target diseased tissues but also modulate host immune responses through immunoregulatory molecules， thereby assisting in therapy. They demonstrate excellent targeting ability and biocompatibility in the treatment of diseases such as inflammation and tumors. However， the specific composition and corresponding functions of MSC membranes still require further investigation， and challenges remain in large-scale production and preservation for clinical applications. In this paper， the biological characteristics of MSC membranes and their applications in drug delivery and disease treatment were summarized， and the potential of engineering modifications to enhance targeting efficiency and therapeutic potential was discussed， providing a reference for the development of novel cell membrane therapies and carrier systems. Related Articles | Metrics | Comments（0）

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The effect of Zhangpi ointment on the microecology of chronic venous leg ulcers by 16S ribosomal RNA high-throughput sequencing LI Yan, HU Yueyu, YAO Danhua, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 586-.   Abstract （218）      PDF（pc） （2036KB）（10）       Knowledge map    Save Objective To investigate the clinical efficacy of Zhangpi ointment in the treatment of chronic venous leg ulcers （CVLU） and its impact on the microecology of the wound surface by using 16S ribosomal RNA （16S rRNA） high-throughput sequencing. Methods A total of 35 patients with CVLU were divided into a Zhangpi ointment group （treatment group，18 cases） and a control group （17 cases） based on the treatment method. The treatment group was treated with Zhangpi ointment， while the control group received conventional treatment. The treatment course was 4 weeks. The clinical efficacy， wound granulation tissue growth， and changes in the microbial flora were observed. Additionally， the differences in dominant bacterial genera and the correlation with clinical symptoms were analyzed. Results At 28 days post-treatment， the total effective rate of the treatment group was 88.9% （16/18）， and that of the control group was 70.6% （12/17）. The coverage of granulation tissue in the treatment group was significantly higher than that in the control group （P<0.05）. High-throughput sequencing of the 16S rRNA of the wound microbiota showed that compared with before treatment and the control group， the Alpha diversity index in the treatment group decreased significantly after treatment （P<0.05）， and the abundance of the Proteobacteria phylum and Pseudomonas genus decreased significantly （P<0.05）. LEfSe analysis indicated that the  differences in bacterial genera before and after treatment mainly included Pseudomonas and diminuta（P<0.05）. Correlation analysis revealed that the abundance of Pseudomonas was positively correlated with the clinical PUSH score （r=0.467，P< 0.01）， but negatively correlated with the coverage of granulation tissue （r=-0.545，P<0.01）. Conclusion Zhangpi ointment can ameliorate the clinical symptoms of patients with CVLU and promote the growth of granulation tissue on the wound surface. It may exert its effect by regulating the wound surface microbiota and has a significant inhibitory effect on Pseudomonas of the Proteobacteria phylum. Related Articles | Metrics | Comments（0）

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Clinical observation of early rehabilitation training after free flap repair of foot and ankle soft tissue defects LI Xiaobing, LIU Hongjun, YANG Chao, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (2): 125-.   Abstract （208）      PDF（pc） （6186KB）（44）       Knowledge map    Save Objective　To explore the clinical effect of early rehabilitation training of foot and ankle joint after repairing soft tissue defect with free flap. Methods　A total of 32 patients with foot and ankle soft tissue defects who were treated in our department from January 2018 to January 2022 were selected. The control group included 15 patients who did not receive rehabilitation treatment after free flap transplantation. The observation group consisted of 17 patients who received early rehabilitation training after free flap transplantation. The tissue defect wound of all patients involved ankle joint skin， accompanied by tendon and bone exposure. The area of the patient’s wound after debridement was 7.0 cm×3.0 cm~25.0 cm× 23.0 cm， and the femoral anterolateral free flap was transplanted to repair the wound. The area of skin flap was 9.0 cm×4.0 cm~ 27.0 cm×15.0 cm. The survival of the flap， the healing time of the wound after flap transplantation and the occurrence of complications were recorded. The patients in the observation group began the rehabilitation training of the affected foot 4 days  after operation until they were discharged from hospital. AOFAS scoring system of American Orthopedic Foot and Ankle Association was used to evaluate the function of foot and ankle before operation， 3 weeks after operation and 6 months after operation. Barthel index was used to evaluate the activity of daily living （ADL） of patients before operation， 3 weeks after operation and 6 months after operation. At the same time， patient satisfaction was recorded 6 months after operation. Results　All the 32 flaps survived， while 2 cases in the observation group and 2 cases in the control group had partial tissue necrosis at the edge of the flap， and recovered after dressing change. The wound healing time of the observation group was （16.35±2.83） days， which was less than that of the control group （18.67±3.22） days（ P<0.05）. All patients had good skin flap texture and appearance， and no secondary scar and joint release surgery was performed. No skin ulcers， amputations or deaths occurred during follow-up. There was no significant difference in AOFAS score and ADL score between the observation group and the control group before operation（ P>0.05）. At 3 weeks and 6 months after surgery， AOFAS score and ADL score of foot and ankle function in observation group were significantly higher than those in control group（ P<0.05）. The satisfaction of patients in observation group was slightly higher than that in control group， and the difference was not statistically significant （Z=-0.937， P>0.05）. Conclusion　 The intervention of early rehabilitation training after free skin flap transplantation for soft tissue injury of foot and ankle can significantly improve the joint function of foot and ankle， improve the patients' self-care ability in daily life， and have long-term effects Related Articles | Metrics | Comments（0）

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Study of the mechanism of trimanganese tetroxide nanoenzyme for diabetic wound healing MAO Zhiyuan, WANG Chen Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 353-.   Abstract （206）      PDF（pc） （7790KB）（56）       Knowledge map    Save Objective To develop a wound dressing that promotes diabetic wound healing by removing ROS and explore its mechanism. Methods Manganese tetraoxide nanozyme was prepared， and its structure and properties were characterized by materials science testing. The biocompatibility and anti-oxidative stress ability of nanozyme were tested by in vitro cell  experiments. The skin defect model of diabetic mice was used to verify the performance of the material in promoting wound healing by gross observation and histology. Results Manganese tetraoxide nanozyme is about 5 nanometers in size， with both Mn2+and Mn3+on the surface. It has good crystallinity， dispersibility and enzyme activity， and has no cytotoxicity at concentrations below 8 μg/mL. In in vitro experiments， the M1 marker increased significantly by 5.1-9.7 times after the addition of ROS. After the addition of manganese tetraoxide nanozyme， the M1 marker was significantly downregulated， with no difference from the control group （P＞0.05）. On the 14th day of the in vivo experiment， only 0.3% of the wound surface remained in the material group，8.5% in the control group， and 3.7% in the blank control group， with significant statistical differences （P<0.000 1）. Conclusion Manganese tetraoxide nanozymes were successfully prepared in this study， which have good safety and efficacy. The combined in vivo and in vitro experimental results show that the material can effectively remove ROS， alleviate the effects of various adverse factors in the wound， and ultimately promote wound healing， providing a new choice for wound dressings in clinical practice. Related Articles | Metrics | Comments（0）

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Research status and progress of PIK3CA-related overgrowth spectrum XIONG Fei, YUAN Siming Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (4): 401-.   Abstract （206）      PDF（pc） （1161KB）（61）       Knowledge map    Save PIK3CA-related overgrowth spectrum （PROS） is characterized by multi-site overgrowth manifestations caused by activating mutations in the PIK3CA gene， resulting in high phenotypic variability. With the expansion and deepening of research， the disease spectrum is still expanding. PROS's phenotype is highly overlapping and commonly includes segmental overgrowth， vascular malformations， and nonvascular lesions. It is closely linked to the timing and location of mutations in the PIK3CA gene during embryonic development. Diagnosis of PROS remains challenging and requires confirmation through clinical manifestations， genetic and molecular testing， and differentiation from similar clinical diseases. Traditional treatment strategies primarily aim to correct local deformities and manage symptoms associated with the disease. Ongoing research focuses on developing targeted therapeutic interventions to enhance treatment effectiveness and improve the prognosis of PROS patients. Related Articles | Metrics | Comments（0）