Plant sphingolipids are not only structural components of the plasma membrane and other endomembrane systems but also act as signaling molecules during biotic and abiotic stresses. However, the roles of sphingolipids in plant signal transduction in response to environmental cues are yet to be investigated in detail. In this review, we discuss the signaling roles of sphingolipid metabolites with a focus on plant sphingolipids. We also mention some microbial sphingolipids that initiate signals during their interaction with plants, because of the limited literatures on their plant analogs. The equilibrium of nonphosphorylated and phosphorylated sphingolipid species determine the destiny of plant cells, whereas molecular connections among the enzymes responsible for this equilibrium in a coordinated signaling network are poorly understood. A mechanistic link between the phytohormone-sphingolipid interplay has also not yet been fully understood and many key participants involved in this complex interaction operating under stress conditions await to be identified. Future research is needed to fill these gaps and to better understand the signal pathways of plant sphingolipids and their interplay with other signals in response to environmental stresses.

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Purpose To evaluate the potential risk factors of posterior capsule opacification (PCO) after cataract surgery. Methods Data on PCO patients diagnosed from September 2015 to May 2017 were obtained from the Department of Ophthalmology at Qingdao Municipal Hospital, Qingdao, China. The factors associated with PCO were assessed using Pearson's χ2 test for univariate analyses and logistic regression for multivariate analyses. Results Eyes (652) from 550 patients were enrolled in this study. All patients were diagnosed with PCO/non-PCO and had <3 years of follow-up after surgery. The numbers of PCO and non-PCO were 108 eyes and 544 eyes, respectively. Statistically significant associations with PCO were found for age at the time of surgery (χ2 = 78.504; p < 0.001), diabetes (χ2 = 4.829; p=0.028), immune diseases (χ2 = 4.234; p=0.004), high myopia (χ2 = 5.753; p=0.016), lens nucleus hardness (χ2 = 11.046; p=0.026), surgery type (χ2 = 11.354; p=0.001), a history of vitrectomy (χ2 = 4.212; p=0.004), ocular inflammation (χ2 = 6.01; p=0.009), and the intraocular lens (IOL) type (χ2 = 8.696; p=0.003). Multivariable data analyses using logistic regression analyses of the variables showed that age at the time of surgery <60 years, diabetes, lens nucleus hardness of III–V, extracapsular cataract extraction (ECCE), postvitrectomy, and hydrophilic IOLs were significant independent risk factors associated with PCO. Conclusions Age <60 years, diabetes, lens nucleus hardness of III–V, ECCE, postvitrectomy, and a hydrophilic IOL were significantly associated with the formation of PCO. Estimation of the incidence of and risk factors for PCO should help in patients counseling and in the design of treatment protocols to reduce or prevent its development.

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Tracheocutaneous fistula (TCF) is the most common related post-operative complication after tracheotomy. Treatments such as surgery and flap grafting are usually applied to close TCFs. We report a case of a large TCF with an area of ∼3.0 cm × 1.0 cm. Here, we describe a relatively convenient approach for the management of a patient with a large TCF. In our treatment strategy, a coverd tracheal stent was used to cover the defect by bronchoscopy, the bronchial defect was closed with a local turnover flap, the structure was reinforced with biodegradable material (RapidSorb Plate 2.0), and then transplantation of a deltopectoral flap was performed. It is worth noting that the patency of the trachea was maintained during the whole surgery course. No recurrence or complications occurred after the 12-month follow-up. The large TCF was successfully treated with bronchoscopic intervention, biodegradable material and flap grafting, and without cartilage grafting.

Concurrent injuries to multiple extremities present unique challenges to the reconstructive surgeon. The primary goal in such scenarios is to optimize functional outcomes. The goal of this article is to present an overview of various techniques necessary to provide sufficient soft tissue and preserve amputation limb lengths and function. The concept of innovative techniques for maximizing limb savage and function is presented using an index patient with multiple extremity third- and fourth-degree burn injuries resulting in nonsalvageable lower extremities and severe left-hand wounds. A review of other potential innovative techniques is discussed. The burn injury resulted in a need for bilateral guillotine below-knee amputations. Above-knee amputation was avoided in the left leg using a parascapular free fasciocutaneous flap, while through-knee amputation was preferred to above-knee amputation in the right leg. The preservation of areas with questionable viability resulted in salvaging the left hand of the patient using digital palmar flaps to resurface the dorsum with creation of a first web-space. Maintenance of maximal viable length of limbs and any residual function in the limbs can be of significant functional benefit to multiple limb amputation patients. Maximizing the limb length in such patients is critical, and typical "rules" that have traditionally been utilized to minimize numbers of operations and optimize prosthetic fit may not apply.

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Rabbits are comparatively small, easily available, easy to handle, and cost-effective experimental models. Use of the innervated gracilis muscle free flap in rabbits can provide an excellent and economic model for free tissue transfer and reinnervation studies.