Objective To compare the smile incision combined with indirect reduction technique with traditional ORIF technique and systematically evaluate the advantages of this innovative surgical method in terms of functional recovery and postoperative cosmetic effects.Methods A total of 60 patients with midshaft clavicle fractures were enrolled between October 2022 and August 2024.The patients were randomly assigned to either ORIF group(open reduction and internal fixation,n=30)or MIPPO group(MIPPO combined with smile incision,n=30).Outcomes assessed included surgical trauma,functional recovery,and cosmetic outcomes.Results The MIPPO group exhibited significantly reduced intraoperative blood loss[(32.9±7.6)mL vs.(90.2±14.0)mL,P＜0.05],shorter incision length[(3.0±0.5)cm vs.(8.5±1.2)cm,P＜0.05],and reduced operative time compared to the ORIF group.Functional recovery indicators such as bone healing time[(10.1±1.7)weeks vs.(12.8±2.0)weeks,P＜0.05],initial and complete self-care time,and weight-bearing recovery were all significantly improved in the MIPPO group.The Constant-Murley score was higher in the MIPPO group(91.5±5.1 vs.82.4±6.0,P＜0.05).Cosmetic outcomes also favored the MIPPO group,with a superior SBSES score(9.2±0.4 vs.3.0±0.7,P＜0.05)and better results in scar visibility,pigmentation,thickness,and elasticity.Conclusion The smile incision combined with indirect reduction technique significantly reduces surgical trauma,accelerates postoperative recovery,and provides substantially better cosmetic outcomes compared to conventional methods,making it particularly suitable for patients with high aesthetic expectations.

Hypercholesterolemia is a significant risk factor for the development of atherosclerosis. 2',3',5'-Tri-O-acetyl-N ⁶-(3-hydroxyphenyl) adenosine (IMM-H007), a novel AMPK agonist, has shown protective effects in metabolic diseases. However, its impact on cholesterol and triglyceride metabolism in hypercholesterolemia remains unclear. In this study, we aimed to elucidate the effects and specific mechanisms by which IMM-H007 regulates cholesterol and triglyceride metabolism. To achieve this goal, we used Apoe ^-/- and Ldlr ^-/- mice to establish a hypercholesterolemia/atherosclerosis model. Additionally, hepatocyte-specific Ampka1/2 knockout mice were subjected to a 5-week high-cholesterol diet to establish hypercholesterolemia, while atherosclerosis was induced via AAV-PCSK9 injection combined with a 16-week high-cholesterol diet. Our results demonstrated that IMM-H007 improved cholesterol and triglyceride metabolism in mice with hypercholesterolemia. Mechanistically, IMM-H007 modulated the AMPKα1/2-LDLR signaling pathway, increasing cholesterol uptake in the liver. Furthermore, IMM-H007 activated the AMPKα1-FXR pathway, promoting the conversion of hepatic cholesterol to bile acids. Additionally, IMM-H007 prevented hepatic steatosis by activating the AMPKα1/2-ATGL pathway. In conclusion, our study suggests that IMM-H007 is a promising therapeutic agent for improving hypercholesterolemia and atherosclerosis through the activation of AMPKα.

The Maillard reaction is a complex process in which amine compounds such as amino acids， peptides， and proteins undergo condensation， polymerization， and other reactions with carbonyl compounds such as reducing sugars， ketones， and aldehydes at room temperature or under heating conditions， ultimately producing substances such as melanoidins and aromatic compounds. The processing of traditional Chinese medicine（TCM） often involves heating and the addition of auxiliary materials， providing complete conditions for the occurrence of the Maillard reaction. The Maillard reaction is affected by various factors such as temperature， pH， moisture， substrate， reaction time and pressure， the progress of the reaction also affected by different processing technologies of TCM and the addition of different excipients. The Maillard reaction involves multiple substances， most of which have significant physiological activity or toxicity， affecting the efficacy and pharmacological effects of TCM. It can also produce various flavor substances and browning products that change the flavor and color of TCM. The Maillard reaction mechanism， influencing factors， related components， and the impact of Maillard reaction on various aspects of TCM processing are reviewed from multiple perspectives in this article， providing reference for the further improvement of processing mechanism and quality control of TCM.

OBJECTIVE To explore the effects of limonin on renal lesions， glucose metabolism， inflammation， and oxidative stress in gestational diabetic rats and its possible mechanisms. METHODS The model of gestational diabetic rats was established by intraperitoneal injection of streptozotocin. The diabetic rats were divided into the model group （intragastrical administration and tail vein injection of equal volume of normal saline）， limonin low-， medium-， and high-dose groups （intragastrical administration of limonin， at doses of 12.5， 25.0 and 50.0 mg/kg， and equal volume of normal saline into the tail vein）， and combination group [intragastrical administration of limonin 50.0 mg/kg + tail vein injection of c-Jun N-terminal kinase （JNK） activator Anisomycin 2 mg/kg ]， with 12 rats in each group. In addition， 12 pregnant rats were selected as the control group （intragastrical administration and tail vein injection of equal volume of normal saline）. They were given relevant medicine， once a day， for 14 consecutive days. After the last administration， fasting blood glucose （FBG）， the levels of fasting insulin （FINS）， interleukin-1β （IL-1β）， IL-6， and tumor necrosis factor-α （TNF-α） in the serum were detected； the levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， blood urea nitrogen （BUN）， and creatinine （Cr） in the renal tissue were detected； the pathological changes of renal tissue were observed； the expressions of proteins related to the JNK/nuclear factor-κB （NF-κB） signaling pathway in the renal tissue were detected. RESULTS Compared with control group， in model group， the rats showed pathological injuries in the kidney tissue， such as glomerular atrophy， edema of renal tubular epithelial cells； the levels of FBG， FINS， IL-1β， IL-6， TNF-α， MDA， BUN and Cr， HOMA-IR， as well as the phosphorylation levels of JNK and NF-κB 0453-6602005。E-mail：mcvi45@163.com p65 proteins were increased significantly （P＜0.05）， while the levels of SOD and GSH-Px were decreased significantly （P＜0.05）. Compared with model group， in each dose group of limonin， the degree of renal tissue lesions in rats was alleviated， and the above-mentioned indicators were significantly improved （P＜0.05）， showing an obvious dose-effect relationship （P＜0.05）. Compared with high-dose limonin group， in the combination group， the degree of renal tissue lesions in rats was relatively aggravated， and the changes in the above-mentioned indicators were significantly reversed （P＜0.05）. CONCLUSIONS Limonin has a certain improvement effect on renal lesions， glucose metabolism， inflammation， and oxidative stress in pregnant rats with gestational diabetes. Its mechanism may be related to the inhibition of the JNK/NF-κB signaling pathway.

Objective:To construct an index system for the systematic evalaution of response capabiity for public health risk in mass gathgering and improvemet of preparedness and level of public health risk response.Methods:Based on the theory of health emergency management and the public health practice to support domestic and international mass events, the theoretical framework was constructed. Authoritative experts in relevant fields were invited to conduct multiple rounds of expert consultation for the construction of an evaluation index system, with Delphi method.Results:In this study, 12 authoritative experts in relevant professional fields were selected to participate in the survey, with an expert response rate of 100.0% and an average authority coefficient of 0.89. The final Kendall's W coefficient was 0.408 for the second-level indicators, and 0.416 for the third-level indicators (all P<0.001). Finally, an evaluation index system consisting of 4 first-level indicators (surveillance, risk assessment, laboratory support and response), 15 second-level indicators, and 75 third-level indicators was constructed. Conclusion:The evaluation index system constructed in this study can provide a reference for evaluation of the response capability for the public health risk in mass gathering.

Objective To establish a prediction model for the occurrence of non-occupational carbon monoxide poisoning events in Beijing, and to provide scientific basis and theoretical support for the prevention and warning of poisoning events. Methods Based on the monitoring data of non-occupational carbon monoxide poisoning events in Beijing from 2016 to 2024, the seasonal ARIMA model and seasonal index model were established to analyze the data and predict the occurrence of events. Results Between 2016 and 2024, a total of 436 cases of non-occupational carbon monoxide poisoning were reported in Beijing, showing a downward trend. The established SARIMA model and seasonal index model were SARIMA (1,0,0) (1,1,0) 12, Yt = (-0.0339t+5.8863) × St, and the average relative errors were 65.42% and 29.19%, respectively. In terms of months, the SARIMA model had better predictive performance during April and summer (June to August), while the seasonal index model was superior in other months. By combining the two models, the predicted number of events in 2025 was as follows: 3, 2, 2, 3, 1, 5, 2, 7, 1, 1, 1, and 2. Conclusion The seasonal index model has the best prediction effect on the non-occupational carbon monoxide poisoning events in Beijing throughout the year, and the number of summer events predicted by SARIMA model is closer to the actual values. The two models can be combined to predict the trend of non-occupational carbon monoxide poisoning, which provides a scientific basis for the prevention and control of carbon monoxide poisoning in the future.

Objective:To explore the impact mechanism of strategic human resource management (SHRM) capabilities in hospital clinical departments on departmental organizational performance, providing references for improving the overall performance of hospitals.Methods:The research subjects were 46 clinical departments of a tertiary public hospital in Beijing. Using a stratified sampling method, at least one middle-level manager was selected from each department, and 30% of the medical staff were randomly sampled from each professional title level within the department. A self-made questionnaire was used to investigate the SHRM capabilities of each department from September to December 2023. The organizational performance of clinical departments was assessed using the departmental performance evaluation system established by the hospital. First, the performance target values for each department in 2023 were set based on the historical data from 2020 to 2022. Then, the actual performance evaluation data of 2023 were compared with the target values to calculate the achievement rate or deviation. Finally, the comprehensive performance scores of each department were calculated by weighting. The performance scores of the departments in 2023 were used as the outcome variable, while SHRM capabilities, department size, number of beds, and whether the department was a key department were used as antecedent condition variables. Fuzzy-set qualitative comparative analysis (fsQCA) was employed to explore the combinations of antecedent conditions that lead to high and low organizational performance in clinical departments.Results:A total of 1 391 valid questionnaires were collected. The weighted average score of SHRM capabilities in clinical departments was (4.23±0.27) points, and the total score of organizational performance evaluation in 2023 was 70.75 (52.50, 79.47) points. The consistency of each antecedent condition variable did not reach the critical value of 0.90, indicating that none of them were sufficient to be a necessary condition for high or low organizational performance in the departments. Two pathways to high organizational performance and two pathways to low organizational performance were identified. The solution consistency for the high organizational performance pathway was 0.83, with a coverage of 0.35, and both core conditions, acquisition capability and maintenance capability, were present. The solution consistency for the low organizational performance pathway was 0.85, with a coverage of 0.08, and the core conditions, development capability, was absent.Conclusions:Different combinations of antecedent condition variables, including the strategic human resource management capability of clinical departments, had varying impacts on the organizational performance of clinical departments. The possession of human resource acquisition, maintenance, and development capabilities by clinical departments was an essential condition for achieving high organizational performance. It is recommended to strengthen the construction of these three capabilities and emphasize the coordinated development of human resource management capabilities to enhance the organizational performance of clinical departments.

Objective:To explore the impact mechanism of strategic human resource management (SHRM) capabilities in hospital clinical departments on departmental organizational performance, providing references for improving the overall performance of hospitals.Methods:The research subjects were 46 clinical departments of a tertiary public hospital in Beijing. Using a stratified sampling method, at least one middle-level manager was selected from each department, and 30% of the medical staff were randomly sampled from each professional title level within the department. A self-made questionnaire was used to investigate the SHRM capabilities of each department from September to December 2023. The organizational performance of clinical departments was assessed using the departmental performance evaluation system established by the hospital. First, the performance target values for each department in 2023 were set based on the historical data from 2020 to 2022. Then, the actual performance evaluation data of 2023 were compared with the target values to calculate the achievement rate or deviation. Finally, the comprehensive performance scores of each department were calculated by weighting. The performance scores of the departments in 2023 were used as the outcome variable, while SHRM capabilities, department size, number of beds, and whether the department was a key department were used as antecedent condition variables. Fuzzy-set qualitative comparative analysis (fsQCA) was employed to explore the combinations of antecedent conditions that lead to high and low organizational performance in clinical departments.Results:A total of 1 391 valid questionnaires were collected. The weighted average score of SHRM capabilities in clinical departments was (4.23±0.27) points, and the total score of organizational performance evaluation in 2023 was 70.75 (52.50, 79.47) points. The consistency of each antecedent condition variable did not reach the critical value of 0.90, indicating that none of them were sufficient to be a necessary condition for high or low organizational performance in the departments. Two pathways to high organizational performance and two pathways to low organizational performance were identified. The solution consistency for the high organizational performance pathway was 0.83, with a coverage of 0.35, and both core conditions, acquisition capability and maintenance capability, were present. The solution consistency for the low organizational performance pathway was 0.85, with a coverage of 0.08, and the core conditions, development capability, was absent.Conclusions:Different combinations of antecedent condition variables, including the strategic human resource management capability of clinical departments, had varying impacts on the organizational performance of clinical departments. The possession of human resource acquisition, maintenance, and development capabilities by clinical departments was an essential condition for achieving high organizational performance. It is recommended to strengthen the construction of these three capabilities and emphasize the coordinated development of human resource management capabilities to enhance the organizational performance of clinical departments.

Liver diseases, particularly cirrhosis and cancer, significantly threat human health for a long time, and their diagnosis and treatment are important topics in medical research. Tradi-tional diagnostic and therapeutic approaches have focused on biochemical properties of liver diseases, yet often neglecting the mechanical microenvironment of liver at molecular, cellular, and tissue levels. This oversight makes it difficult to meet clinical needs. Recent advancements in biomechanics and mechanobiology have underscored the importance of mechanical properties of liver in understanding disease mechanisms, presenting profound implications for both basic research and clinical practice. However, there is still a lack of in-depth exploration of the mechanical properties of liver in both basic research and clinical treatment, making it unclear of the specific mechanisms and application scenarios. The authors propose and introduce the emerging field of liver mechanomedicine, examine the biomechanical properties of liver and their alterations during disease progression, elucidate mechanobiological mechanisms of cellular mechanical responses and signal transduction, explore the application of mechanical characteristics in the diagnosis and treatment of liver diseases, aiming to provide a new perspective for basic research and clinical practice.

Objective To explore the effects of transverse cervical artery related skin flaps in repairing skin soft tissue defects in the neck and shoulder.Methods A total of 13 patients with soft tissue defects in neck and shoulder admitted to Linyi People's Hospital from January 2018 to January 2022 were selected.The wounds of patients were repaired with transverse cervical artery related skin flaps,and the donor area was repaired with direct suturing and/or full-thick skin graft from the inguinal area.The survival,appearance and texture of the flap after surgery were recorded.The wound healing in the donor area and the survival of the grafted skin were observed.The follow-up was conducted for 5 to 12 months,and the appearance of the grafted flap and the recovery of function in the surgical area were observed.Results The flaps had good survival in the first stage after surgery,the color and texture of the flap matched well with the surrounding tissue,and the wound healing in the donor area was good.During the follow-up,the function and appearance of neck and shoulder for patients recovered well.Conclusion The advantages of transverse cervical artery related skin flaps in repairing skin soft tissue defects in the neck and shoulder is that the color and texture of the flap matched well with the surrounding tissue,with reliable blood circulation,and the appearance and postoperative function recover well,which is worthy of promotion and application in clinic.