Anatomical basis of a pedicled cuboid bone graft based on the lateral tarsal artery for talar avascular necrosis

Missing medial tarsal artery replaced by the anterior medial malleolar artery

The present case report describes an unusual variant of a missing medial tarsal artery (MTA) being replaced by the anterior medial malleolar artery (AMMA). The dorsalis pedis artery (DPA) did not give off any branches to the medial foot. The DPA coursed downward in the foot along with the superficial fibular nerve on the foot dorsum at the lateral side of the first metatarsal bone before entering the sole. In the medial malleolus, the AMMA arose from the anterior tibial artery and then ramified several branches, one of which descended to the medial talus. Thus, the possibility of a missing MTA being replaced by the AMMA should be considered by surgeons and radiologists when various surgeries are performed in the medial tarsal area.

Notoginseng Triterpenes Inhibited Autophagy in Random Flaps via the Beclin-1/VPS34/LC3 Signaling Pathway to Improve Tissue Survival

Random flaps are widely used in tissue reconstruction, attributed to the lack of vascular axial limitation. Nevertheless, the distal end of the flap is prone to necrosis due to the lack of blood supply. Notoginseng triterpenes (NTs) are the active components extracted from Panax notoginseng, reducing oxygen consumption and improving the body’s tolerance to hypoxia. However, their role in random flap survival has not been elucidated. In this study, we used a mouse random skin flap model to verify that NT can promote cell proliferation and migration and that increasing blood perfusion can effectively improve the survival area of a skin flap. Our study also showed that the autophagy of random flaps after NT treatment was activated through the Beclin-1/VPS34/LC3 signaling pathway, and the therapeutic effect of NT significantly decreased after VPS34 IN inhibited autophagy. In conclusion, we have demonstrated that NT can significantly improve the survival rate of random flaps through the Beclin-1/VPS34/LC3 signaling pathway, suggesting that it might be a promising clinical treatment option.