The arterial supply of the lower end of the human femur in 100 specimens, ranging in age from the newborn to 87 years, was studied by the perfusion method. Its blood supply is derived from the medial and lateral superior genicular arteries, the descending genicular artery and the middle genicular artery. A complete extracapsular anastomotic ring, surrounding the supracondylar portion of the lower end of the femur, is formed by the medial and lateral superior genicular arteries and the descending genicular artery in 55?4.97%. Its incomplete anterior part is linked by the periosteal arterial network in 45?4.97%. The vessels at the metaphyseal side of the growth plate end in a brush-like pattern, intimately connected to the hypertrophic layer of cells of the growth plate, each vessel turning back in a sharp loop. The anterior and posterior metaphyseal arteries which arise from the extracapsular anastomotic ring and network supply the supracondylar area. The medial and lateral epiphyseal arteries, arising respectively from the descending genicular artery and both superior genicular arteries, supply the medial part of the medial condyle and the lateral part of the lateral condyle. The anterior and intercondylar epiphyseal arteries, arising respectively from the periosteal network and the mildle genicular artery, supply the intercondylar area. The epiphyseal arteries which anastomose with each other in the ossific area of the epiphysis form the precapillaries and capillary network. The anastomotic branches between the epiphyseal arteries, ranging from 25 to 100 microns in diameter, form the arterial plexus in the epiphysis. With the closure of the epiphyseal plate, a free anastomosis is established between the metaphyseal and the epiphyseal vessels. The clinical significance of the topographical characteristics, the course and the distribution of the arterial supply to the lower end of the femur were discussed.

The arterial supply of the human tibia in 50 specimens, ranging in age from 4 to 87 years, has been studied by the arterial perfusion method. The tibia is supplied principally by branches of the anterior and posterior tibial arteries and the peroneal artery, with additional contributions from the inferior genicular arteries, the middle genicular artery and from the infrapatellar branch of the descending genicular artery. There is a continuous arterial anastomosis in the periosteal network on the non-articular surface of the tibia. The segmental periosteal ring arteries dividing into ascending and descending branches, connect with the branches from above and below to form the longitudinal anastomoses along the anterior, medial and the lower one-third of lateral tibial borders. The epiphyseal-metaphyseal regions are copiously supplied by vessels entering from the periphery and by the nutrient artery. With the fusion of the epiphyseal plate, a free anastomosis is established between the epiphyseal and metaphyseal nutrient vessels. The whole of the marrow and the inner two-thirds or three-quarters of its cortex are supplied by the nutrient artery. The outer third or fourth of the cortex is supplied by the periosteal vessels. Because the cortical longitudinal and transverse capillary systems are profusely anastomosed with each other and with the periosteal and endosteal circulatory networks, the blood can flow in either direction, depending on physiological conditions.The clinical significance of the arterial distribution to the tibia is briefly discussed.

Since the late twentieth century,the progress of ge-nomics,proteomics and other areas has promoted modern medi-cine from the era of evidence-based medicine to the era of preci-sion medicine.With the studies of the relationships between ge-nomic information and clinical phenotypes,precise medicine,to improve clinical outcomes and minimize unnecessary side effects,develops and implements individualized medicine ac-cording to patients’personalized specificities through pharma-cogenomics.Basic research and clinical translation of precision medicine do help to improve the health system of our country.

As research delves deeper into the mechanisms of tumor immune responses,studies reveal the importance of microbial com-munities within the tumor microenvironment in tumor progression and their interactions with the host immune system.Intratumoral micro-biota could influence the tumor microenvironment,thereby promoting or inhibiting tumor growth and development.Despite this import-ance,the specific role of intratumoral microbiota impacting cancer immunotherapeutic efficacy remains largely unexplored.A deeper under-standing of the characteristics and biological functions of tumor-specific microbiota heralds a potential revolutionary innovation in cancer treatment.In this review,we introduce the discovery and sources of intratumoral microbiota,also addressing its composition,and discuss tumor tissue characteristics.Moreover,we briefly review the history of cancer immunotherapy development with a particular focus on the research progress concerning the impact of intratumoral microbiota on cancer immunotherapy.Furthermore,we explore emerging strategies that combine targeting intratumoral microbiota with immunotherapy to enhance immune efficacy,inhibit tumor progression,and improve cure rates,anticipating that this approach could represent a new direction for enhancing treatment outcomes and prospects.