OBJECTIVE: To investigate the efficacy of minimally invasive osteotomy with preservation of blood supply to the transversely transported bone segment in the treatment of chronic ischemic lower limb diseases using tibial transverse bone transport. METHODS: A retrospective analysis was conducted on the clinical data of 12 patients with chronic ischemic lower limb diseases who met the selection criteria and were treated between June 2016 and December 2023. The cohort included 7 males and 5 females, aged 26-87 years (mean, 61.2 years). Among them, 7 patients had diabetic foot (DF), including 2 cases complicated by arteriosclerosis obliterans (ASO), with a DF duration ranging from 1.7 to 23.0 months (mean, 9.6 months) and ulcer sizes ranging from 3.2 cm×2.4 cm to 10.0 cm×6.6 cm. Three patients had ASO with a disease duration of 1.7-23.0 months (mean, 10.4 months) and ulcer or post-amputation wound sizes ranging from 2.2 cm×2.1 cm to 12.0 cm×7.7 cm. Additionally, 2 patients with thromboangiitis obliterans (TAO) had a disease duration of 7 and 12 months, respectively. Preoperatively, the mean foot skin temperature was (27.63±0.34)℃, and the visual analogue scale (VAS) score was 8.5±0.7. All patients underwent tibial transverse bone transport using minimally invasive osteotomy while preserving the blood supply to the transported bone segment. Postoperative complications and foot ulcer healing were observed. The effectiveness of tibial transverse bone transport was evaluated by comparing preoperative and postoperative foot skin temperature, VAS scores, as well as through CT angiography (CTA). RESULTS: One DF patient with ASO was lost to follow-up, while the remaining 11 patients were followed up 10-29 months (mean, 20.5 months). One DF patient had a displaced fracture at the site of tibial transport due to trauma, which healed after plaster immobilization; 1 DF patient had a small amount of pigmentation in the skin of the donor site, but the blood circulation was good; no complication such as pin tract infection, skin necrosis, or osteomyelitis occurred in the donor site of all patients. At 2-3 weeks postoperatively, the foot skin temperature was (34.21±0.65)℃, and the VAS score was 0.3±0.1, both significantly improved compared to preoperative ones ( t=-31.578, P<0.001; t=49.000, P<0.001). Two TAO patients experienced recurrent, persistent, intolerable pain at 7-10 days postoperatively, with no reduction in ulcer size or necrotic areas; 1 underwent toe amputation, and the other required a mid-leg amputation. The remaining patients achieved complete ulcer healing, with healing time ranging from 5.1 to 9.2 weeks (mean, 6.8 weeks). CTA showed no new vascular occlusions or embolisms. X-ray films at 4 months postoperatively demonstrated proper repositioning and good healing of the transported tibial bone segment. CONCLUSION The application of minimally invasive osteotomy with preserved blood supply to the transversely transported bone segment in tibial transverse bone transport for the treatment of chronic ischemic lower limb diseases effectively minimizes extensive soft tissue dissection, reduces surgical soft tissue damage, and better maintains local blood supply. This approach lowers the risk of postoperative infection and skin necrosis while accelerating postoperative recovery.
Humans ; Osteotomy/methods* ; Middle Aged ; Male ; Female ; Aged ; Tibia/surgery* ; Minimally Invasive Surgical Procedures/methods* ; Retrospective Studies ; Adult ; Bone Transplantation/methods* ; Aged, 80 and over ; Diabetic Foot/surgery* ; Treatment Outcome ; Arteriosclerosis Obliterans/surgery* ; Ischemia/surgery* ; Lower Extremity/blood supply*

OBJECTIVE: To evaluate the feasibility and short-term effectiveness of three-dimensional (3D)-printed customized porous acetabular components for reconstruction of extensive acetabular bone defects during primary total hip arthroplasty (THA). METHODS: The clinical data of 8 patients with extensive acetabular bone defects, who were treated with 3D-printed individualized porous acetabular components between July 2018 and January 2022, were retrospectively analyzed. The cohort comprised 4 males and 4 females with an average age of 48 years ranging from 34 to 56 years. Acetabular bone defects were classified as Paprosky type ⅢA in 3 cases and type ⅢB in 5 cases. The causes of acetabular destruction were hip tuberculosis (5 cases), pigmented villonodular synovitis (2 cases), and syphilitic arthritis (1 case). Visual analogue scale (VAS) score and Harris hip score (HHS) were used to evaluate the pain relief and hip function before and after operation. Reconstruction outcomes were further assessed by imaging results [X-ray film and Tomosynthesis Shimadzumetal artefact reduction technology (T-SMART)], and the mechanical properties were evaluated by finite element analysis. RESULTS: The operation time ranged from 174 to 195 minutes (mean, 187 minutes), and intraoperative blood loss ranged from 390 to 530 mL (mean, 465 mL). All 8 patients were follow-up 26-74 months (mean, 44 months). Among the 5 patients with tuberculosis, none experienced postoperative recurrence. At last follow-up, the VAS score was 0.3±0.5 and the HHS score was 87.9±3.7, both significantly improved compared to preoperative values ( t=25.170, P<0.001; t=-28.322, P<0.001). X-ray films at 2 years after operation demonstrated satisfactory matching between the 3D-printed customized acetabular component and the acetabulum. The postoperative center of rotation of the operated hip was shifted by (2.1±0.5) mm horizontally and (2.0±0.7) mm vertically relative to the contralateral side, with both offsets showing significant differences compared to preoperative values ( t=24.700, P<0.001; t=55.230, P<0.001). T-SMART imaging showed satisfactory osseointegration at the implant-host bone interface. No complications such as aseptic loosening or screw breakage was observed during follow-up. Finite element analysis showed that the acetabular component had good mechanical properties. CONCLUSION The application of 3D-printed individualized porous acetabular components in the reconstruction of extensive acetabular bone defects demonstrated precise anatomical reconstruction, stable mechanical support, and good functional performance in short-term follow-up, offering a potential alternative for acetabular defect reconstruction in primary THA.
Humans ; Middle Aged ; Male ; Female ; Printing, Three-Dimensional ; Arthroplasty, Replacement, Hip/instrumentation* ; Acetabulum/diagnostic imaging* ; Adult ; Follow-Up Studies ; Retrospective Studies ; Hip Prosthesis ; Prosthesis Design ; Porosity ; Treatment Outcome ; Plastic Surgery Procedures/methods*

Bacterial biofilms can make traditional antibiotics impenetrable and even promote the development of antibiotic-resistant strains. Therefore, non-antibiotic strategies to effectively penetrate and eradicate the formed biofilms are urgently needed. Here, we demonstrate the development of self-propelled biohybrid microrobots that can enhance the degradation and penetration effects for Pseudomonas aeruginosa biofilms in minimally invasive strategy. The biohybrid microrobots (CR@Alg) are constructed by surface modification of Chlamydomonas reinhardtii (CR) microalgae with alginate lyase (Alg) via biological orthogonal reaction. By degrading the biofilm components, the number of CR@Alg microrobots with fast-moving capability penetrating the biofilm increases by around 2.4-fold compared to that of microalgae. Massive reactive oxygen species are subsequently generated under laser irradiation due to the presence of chlorophyll, inherent photosensitizers of microalgae, thus triggering photodynamic therapy (PDT) to combat bacteria. Our algae-based microrobots with superior biocompatibility eliminate biofilm-infections efficiently and tend to suppress the inflammatory response in vivo, showing huge promise for the active treatment of biofilm-associated infections.

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Objective: To explore the association between waist circumference and beverage consumption behaviors among junior high school students, so as to provide a theoretical basis for improving their nutritional status. Methods: Using a multi stage cluster random sampling method, 1 611 junior high school students aged 13-15 years from Yushan, Yanshan, Yiyang, and Wannian counties in Shangrao City, Jiangxi Province, were selected for a survey in September 2021 through questionnaires and waist circumference measurements. Stratified analyses were conducted by sex, t-test and analysis of variance (ANOVA) were used to compare waist circumference across groups, and analysis of covariance (ANCOVA) was applied to examine the associations between different types of beverage consumption and waist circumference. Results: Boarding students had significantly greater average waist circumference than day students[boys:(71.86±9.24, 69.69±12.19)cm；girls:(66.53±13.30, 64.63±11.90)cm； t =2.69, 2.08, both P < 0.05 ]. Among boys, waist circumference differed significantly by vigorous physical[vigorous physical:(69.71±9.53)cm; non vigorous exercise:(71.53±12.99)cm]( t=-2.31, P <0.05). Boys waist circumference also differed significantly by consumption frequency (high and medium,low,none) of milk containing beverages[(71.83±7.40, 69.92±9.98, 72.29±13.90)cm], functional beverages[( 73.36± 11.87, 65.97±10.46, 70.71±10.55)cm] and purified water beverages[(69.36±10.87, 71.93±12.15, 71.50±10.09)cm]( F =4.06, 5.93, 4.85, all P <0.05). Girls waist circumference also differed significantly by consumption frequency (high and medium,low,none) of milk containing beverages[(68.81±5.55, 66.59±13.02, 65.36±11.69)cm, F=9.67, P <0.01]. After controlling for the confounding variables, ANCOVA results indicated that the consumption of milk containing beverages, functional beverages and Purified water beverages were significantly associated with waist circumference of boys ( F =3.79, 5.26, 5.08, all P < 0.05 ). Milk containing beverages were significantly associated with waist circumference of girls ( F=4.17, P <0.05). Conclusion The consumption frequency of milk containing beverages and functional beverages by junior high school students is positively correlated with their waist circumference.

Objective To analyze the current status and hotspots of surgical transmural ablation of atrial fibrillation using CiteSpace and VOSviewer. Methods The Web of Science Core Collection database was used as the data source. The CiteSpace 5.8.R3 and VOSviewer software were used to analyze the related studies on surgical transmural ablation of atrial fibrillation about the authors, countries/institutions, literature co-citation and keywords. Results A total of 109 articles were enrolled. Damiano RJ was the most prolific researcher, while Cox JL was the author with the highest number of citations. The United States was the leading country in this research field. The University of Washington was an important institution in the study of atrial fibrillation transmural ablation. The main hotpots were the effectiveness of surgical ablation, especially Cox-maze procedure, selection of the energy source of surgical ablation, combination of surgical and catheter ablations, and pulmonary vein isolation. Conclusion This study visualizes the current research status of surgical ablation of atrial fibrillation. How to improve the effectiveness and transmurality of surgical ablation is a hot research topic in the surgical treatment of atrial fibrillation. The combination of electrophysiology mapping and surgical ablation may be the development direction in the surgical treatment of atrial fibrillation.

【Objective】 To investigate the efficacy and safety of 450 nm blue laser with 6 o’clock positioning in the treatment of middle lobe hyperplasia of prostate, in order to promote the clinical application of this surgery. 【Methods】 Clinical data of 20 patients with middle lobe hyperplasia of prostate treated with 450 nm blue laser with 6 o’clock positioning during Mar.and Aug.2023 were retrospectively analyzed.The operation time, postoperative bladder irrigation time, catheter indwelling time, hospital stay, and complications were recorded.The maximum urinary flow rate (Qmax), post-void residual volume (PVR), quality of life scale (QoL), international prostate symptom score (IPSS) before surgery and 1 month after surgery were compared. 【Results】 The operation time was (26.80±7.22) min, and bladder irrigation time was (20.50±1.79) h.The catheter was removed on the next day after surgery and all patients were discharged 2 days after operation.Compared to preoperative, one month after surgery, the Qmax [(7.40±1.05) mL/s vs.(19.60±1.76) mL/s] was significantly higher, PVR [(73.50±12.26) mL vs.(9.25±4.94) mL], QoL [(4.55±1.19) vs.(1.95±0.95)], and IPSS [(26.55±1.88) vs.(10.05±1.36)] were significantly lower, the differences being statistically significant (P<0.05).No complications occurred during operation and 1-month follow-up. 【Conclusion】 The 450 nm blue laser with 6 o’clock positioning is a new, safe and effective surgical treatment of middle lobe hyperplasia of prostate, which is worthy of clinical promotion and application.

Parkinson's disease (PD) is a chronic neurodegenerative disease. At present, levodopa and other drugs are mainly used for dopamine supplementation therapy. However, the absorption of levodopa in the gastrointestinal tract is unstable and its half-life is short, and long-term use of levodopa will lead to the end-of-dose deterioration, dyskinesia, the "ON-OFF" phenomenon and other symptoms. Therefore, new preparations need to be developed to improve drug efficacy, reduce side effects or improve compliance of patients. Based on the above clinical needs, this review briefly introduced the preparation modification strategies for the treatment of PD through case analysis, in order to provide references for the research and development of related preparations.

Objective To investigate the impact of cardiomyocyte ferroptosis on acute myocardial infarction(AMI)and its relationship with the expression of long non-coding RNA(lncRNA)GAS5.Methods An AMI model was established in eighteen male SD rats(6-8 weeks old),and then the subjected rats were randomly divided into blank control group,sham operation group,and model group,6 animals in each group.In 2 weeks after surgery,echocardiography was used to evaluate heart function,and TTC staining,HE staining and TUNEL staining were employed re-spectively to observe myocardial infarct area,histopathological changes of myocardial tissues and apoptosis in cardiomyocytes.Serum Fe2+concentration was measured with an iron ion detection kit.The expression levels of lncRNA GAS5,nuclear factor erythroid-derived 2-like 2(Nrf2),and glutathione peroxidase 4(GPX4)in myocardial tissues were detected with QT-PCR.Linear corre-lation analysis was performed to investigate the relationship between the expression of lncRNA GAS5,Nrf2 and GPX4 with Fe2+concentration.Western blotting was conducted for the protein levels of ferroptosis-related proteins,glutathione peroxidase 4(GPX4),nuclear factor erythroid-derived 2-like 2(Nrf2),glucose-regulated protein 78(GRP78),and cysteinyl aspartate specific proteinase 12(Caspase-12)in myocardial tissues.Results Western blotting revealed obvious in-creases in the protein levels of ferroptosis related proteins GRP78(1.11±0.13 vs 0.51±0.08,P＜0.01)and Caspase-12(1.23±0.05 vs 0.92±0.07,P＜0.05)and a decrease in those of ferroptosis inhibitor GPX4(0.27±0.11 vs 0.68±0.10,P＜0.01)and Nrf2(0.30±0.12 vs 0.58±0.04,P＜0.05)in the model group than the sham operation group.Additionally,QT-PCR showed that the mRNA levels of GPX4 and Nrf2 were notably lower,indicating cardiomyocyte ferroptosis,while that of lncRNA GAS5 was remarkably higher in the myocardial tissues of the model group than the sham operation group(P＜0.01).What's more,the expression of lncRNA GAS5 had a positive correlation with serum Fe2+concentration(P＜0.05).Conclusion AMI is closely associated with cardiomyocyte ferroptosis.lncRNA GAS5 is involved in the regulation of ferroptosis by Nrf2/GPX4 signaling pathway,which thus mediating the occurrence of heart failure after AMI.