Drug administration via hollow microneedles (HMN) have the advantages of painlessness, avoidance of first-pass effect, capability of sustained infusion, and no need for professional personnel operation. In addition, HMN can also be applied in the fields of body fluid extraction and biosensors, showing broad application prospects. However, traditional manufacturing technologies cannot meet the demand for low-cost mass production of HMN, limiting its widespread application. This paper reviews the main manufacturing technologies used for HMN in recent years, which include photolithography and etching, laser etching, sputtering and electroplating, micro-molding, three-dimensional (3D) printing and drawing lithography. It further analyzes the characteristics and limitations of existing manufacturing technologies and points out that the combination of various manufacturing technologies can improve production efficiency to a certain extent. In addition, this paper looks forward to the future trends of HMN manufacturing technology and proposes possible directions for its development. In conclusion, it is expected that this review can provide new ideas and references for follow-up research.
Printing, Three-Dimensional ; Needles ; Humans ; Drug Delivery Systems/methods* ; Equipment Design ; Microinjections/methods*

OBJECTIVE: To investigate the effects of combined platelet-rich plasma (PRP) and arterial supercharging technique on the survival rate and functional restoration of cross-body region skin flaps in rabbits. METHODS: Twelve healthy 6-month-old New Zealand White rabbits were randomly assigned to 4 groups ( n=3): sham group, PRP group, anastomosis group, and combined treatment group. An axial skin flap with an area of 12 cm×6 cm on the inner side of the hind limbs of all animals were prepared, with the saphenous artery as the main blood supply. Following the ligation of both the proximal and distal ends of the saphenous artery across all groups, the sham group received no further intervention, the PRP group was subjected to PRP injection, the anastomosis group underwent in situ end-to-end anastomosis of the distal saphenous artery, and the combined treatment group received both in situ distal saphenous artery anastomosis and PRP administration. Flap survival was evaluated and recorded on postoperative days 1, 3, and 7, with survival rates calculated accordingly. On day 7, flap tissue samples were harvested for HE staining to assess basal tissue morphology. Additionally, immunohistochemical staining was conducted to detect the expression of α-smooth muscle actin (α-SMA), vascular endothelial growth factor (VEGF), and CD31 in the flap tissues. RESULTS: At postoperative day 1, no significant difference in flap survival rates were observed among the 4 groups ( P>0.05). At day 3, the PRP group showed no significant difference compared to the sham group ( P>0.05); however, both the anastomosis and combined treatment groups exhibited significantly higher survival rates than the sham group ( P<0.05), the combined treatment group further demonstrated superior survival rates compared to both the PRP and anastomosis groups ( P<0.05). At day 7, the combined treatment group maintained significantly higher survival rates than all other groups ( P<0.05), while both the PRP and anastomosis groups exceeded the sham group ( P<0.05). HE staining at day 7 revealed persistent inflammatory cell infiltration, sheet-like erythrocyte deposition, and disordered collagen fibers in the sham group. The PRP group showed nascent microvessel formation and early collagen reorganization, whereas the anastomosis group displayed mature microvasculature with resolved interstitial edema. The combined treatment group exhibited differentiated microvessels with densely packed collagen bundles. Immunohistochemical analysis at day 7 demonstrated significantly larger relative area percentages of α-SMA, VEGF, and CD31 positive cells in the combined treatment group compared to all other groups ( P<0.05). Both the PRP and anastomosis groups also showed significantly higher values than the sham group ( P<0.05). CONCLUSION The combination of PRP and arterial supercharging techniques significantly enhances flap healing, potentially through mechanisms involving augmented angiogenesis and improved blood supply.
Animals ; Rabbits ; Platelet-Rich Plasma ; Surgical Flaps/blood supply* ; Graft Survival ; Anastomosis, Surgical/methods* ; Ischemia/surgery* ; Arteries/surgery* ; Skin/blood supply* ; Vascular Endothelial Growth Factor A/metabolism* ; Male ; Skin Transplantation/methods*

OBJECTIVE: To investigate the antioxidant and osteogenic induction capabilities of calcium phosphate nanoflowers (hereinafter referred to as nanoflowers) in vitro at different concentrations. METHODS: Nanoflowers were prepared using gelatin, tripolyphosphate, and calcium chloride. Their morphology, microstructure, elemental composition and distribution, diameter, and molecular constitution were characterized using scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, and energy-dispersive spectroscopy. Femurs and tibias were harvested from twelve 4-week-old Sprague Dawley rats, and bone marrow mesenchymal stem cells (BMSCs) were isolated and cultured using the whole bone marrow adherent method, followed by passaging. The third passage cells were identified as stem cells by flow cytometry and then co-cultured with nanoflowers at concentrations of 0, 0.4, 0.8, 1.2, 1.6, 2.0, 2.4, 2.8, 3.2, and 3.6 mg/mL. Cell counting kit 8 (CCK-8) assay was performed to screen for the optimal concentration that demonstrated the best cell viability, which was subsequently used as the experimental concentration for further studies. After co-culturing BMSCs with the screened concentration of nanoflowers, the biocompatibility of the nanoflowers was verified through live/dead cell staining, scratch assay, and cytoskeleton staining. The antioxidant capacity was assessed by using reactive oxygen species (ROS) fluorescence staining. The in vitro osteoinductive ability was evaluated via alkaline phosphatase (ALP) staining, alizarin red staining, and immunofluorescence staining of osteocalcin (OCN) and Runt-related transcription factor 2 (RUNX2). All the above indicators were compared with the control group of normally cultured BMSCs without the addition of nanoflowers. RESULTS: Scanning electron microscopy revealed that the prepared nanoflowers exhibited a flower-like structure; transmission electron microscopy scans discovered that the nanoflowers possessed a multi-layered structure, and high-magnification images displayed continuous atomic arrangements, with the nanoflower diameter measuring (2.00±0.25) μm; energy-dispersive spectroscopy indicated that the nanoflowers contained elements such as C, N, O, P, and Ca, which were uniformly distributed across the flower region; Fourier transform infrared spectroscopy analyzed the absorption peaks of each component, demonstrating the successful preparation of the nanoflowers. Through CCK-8 screening, the concentrations of 0.8, 1.2, and 1.6 mg/mL were selected for subsequent experiments. The live/dead cell staining showed that nanoflowers at different concentrations exhibited good cell compatibility, with the 1.2 mg/mL concentration being the best (P<0.05). The scratch assay results indicated that the cell migration ability in the 1.2 mg/mL group was superior to the other groups (P<0.05). The cytoskeleton staining revealed that the cell morphology was well-extended in all concentration groups, with no significant difference compared to the control group. The ROS fluorescence staining demonstrated that the ROS fluorescence in all concentration groups decreased compared to the control group after lipopolysaccharide induction (P<0.05), with the 1.2 mg/mL group showing the weakest fluorescence. The ALP staining showed blue-purple nodular deposits around the cells in all groups, with the 1.2 mg/mL group being significantly more prominent. The alizarin red staining displayed orange-red mineralized nodules around the cells in all groups, with the 1.2 mg/mL group having more and denser nodules. The immunofluorescence staining revealed that the expressions of RUNX2 and OCN proteins in all concentration groups increased compared to the control group, with the 1.2 mg/mL group showing the strongest protein expression (P<0.05). CONCLUSION The study successfully prepares nanoflowers, among which the 1.2 mg/mL nanoflowers exhibits excellent cell compatibility, antioxidant properties, and osteogenic induction capability, demonstrating their potential as an artificial bone substitute material.
Animals ; Osteogenesis/drug effects* ; Mesenchymal Stem Cells/drug effects* ; Calcium Phosphates/pharmacology* ; Rats, Sprague-Dawley ; Rats ; Antioxidants/chemistry* ; Cells, Cultured ; Cell Differentiation/drug effects* ; Nanostructures/chemistry* ; Tissue Engineering/methods* ; Bone Marrow Cells/cytology* ; Coculture Techniques ; Tissue Scaffolds/chemistry* ; Male ; Biocompatible Materials/chemistry* ; Cell Survival ; Core Binding Factor Alpha 1 Subunit/metabolism* ; Cell Proliferation

Objective:To translate the Moyamoya Health Behavior Scale for Adolescent Patients into Chinese and to test its reliability and validity.Methods:Based on the Brislin translation model, the scale was forward-translated, back-translated, cross-culturally adapted, and pretested to develop the Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients. A convenience sampling method was used to recruit 220 adolescent inpatients with moyamoya disease from the Department of Neurosurgery, Zhongnan Hospital of Wuhan University, between January 2023 and December 2024. Reliability and validity analyses were conducted on the scale.Results:A total of 220 questionnaires were distributed, and 206 valid questionnaires were returned, yielding a valid response rate of 93.64%. The Chinese version of the scale comprised 12 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index was 0.917. Exploratory factor analysis extracted three common factors: treatment implementation for moyamoya disease, health-promoting behaviors for moyamoya disease, and health coping behaviors for moyamoya disease, with a cumulative variance contribution of 69.741%. Confirmatory factor analysis showed that the overall model fit was acceptable. The Cronbach's α coefficient for the total scale was 0.872, with subscale Cronbach's α coefficients ranging from 0.810 to 0.871. The test-retest reliability coefficient for the total scale was 0.983, and the split-half reliability coefficient was 0.766.Conclusions:The Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients demonstrated good reliability and validity and can be used as an assessment tool for health behaviors in this patient population.

Objective:To evaluate the diagnostic performance of 64Cu-prostate specific membrane antigen (PSMA)-Q compared with 18F-FDG in patients with advanced prostate cancer and to analyze the radiation dosimetry of 64Cu-PSMA-Q. Methods:This study was an open-label, single-arm, self-controlled diagnostic evaluation trial. A total of 29 patients (age 58-87 years) with pathologically confirmed advanced prostate cancer in the Affiliated Hospital of North Sichuan Medical College from September 2023 to December 2023 were included. All patients underwent both 64Cu-PSMA-Q PET/CT and 18F-FDG PET/CT examinations. McNemar test was used to compare the detection rates of 64Cu-PSMA-Q PET/CT and 18F-FDG PET/CT for primary lesions, lymph node metastases, and bone metastases. Mann-Whitney U test was applied to compare differences in SUV max and tumor-to-background ratio (TBR) between 64Cu-PSMA-Q PET/CT and 18F-FDG PET/CT. Radiation dosimetry of 64Cu-PSMA-Q PET/CT imaging was performed using OLINDA/EXM 2.1 (adult male model) in 9 patients. Results:Primary lesions were detected in 21 patients. 64Cu-PSMA-Q PET/CT demonstrated a detection rate of 95.2%(20/21) for primary lesions, which was significantly higher than that of 18F-FDG PET/CT (66.7%(14/21); χ2=6.00, P=0.031). Detection rates of lymph node metastases were 65.5%(19/29) for 64Cu-PSMA-Q and 55.2%(16/29) for 18F-FDG, with no significant difference ( χ2=3.00, P=0.250). Similarly, detection rates of bone metastases were 72.4%(21/29) for 64Cu-PSMA-Q and 65.5%(19/29) for 18F-FDG respectively ( χ2=2.00, P=0.500). TBRs on 64Cu-PSMA-Q PET/CT were significantly higher than those on 18F-FDG PET/CT across primary lesions (8.3(2.2, 13.3) vs 2.3(1.0, 5.5); Z=7.16, P=0.002), regional lymph node metastases (4.9(1.4, 8.3) vs 1.7(0.9, 4.0), Z=189.34, P=0.001), and bone metastases (18.7(4.5, 26.9) vs 5.1(2.1, 9.7); Z=24.83, P=0.003). No significant difference in TBR was observed for distant lymph node metastases ( Z=1.49, P=0.135) or benign lesions ( Z=0.91, P=0.558). The whole-body effective dose of 64Cu-PSMA-Q was (28.200±1.590)μSv/MBq among the 9 patients analyzed, with no adverse events related to the tracer observed. Conclusion:64Cu-PSMA-Q is a promising novel PET imaging agent with potential clinical utility for diagnosing prostate cancer and supporting clinical decision-making.

Objective:To explore the effect of staged pressure therapy, in addition to rehabilitation training, on scar hyperplasia and motor function after a deep hand burn.Methods:Sixty patients with deep hand burns were randomly divided into a control group ( n=30) and an observation group ( n=30). In addition to specialized burn treatment and early rehabilitation training, the control group was given routine pressure treatment, while the observation group was provided with staged pressure therapy for 6 months. Before the treatment and after 3 and 6 months of treatment, scar hyperplasia and hand function in both groups was evaluated using the Vancouver scar scale (VSS), grip strength and pinch strength tests, and the Jebsen hand function test (JHFT). Total active motion (TAM) and total passive motion (TPM) of the finger joints was quantified, and any complications during the treatment were recorded. Results:After 3 and 6 months of the treatment, all of the observations in both groups had improved significantly, but the improvements were significantly better among the treatment group, on average.Conclusions:Staged pressure therapy can more effectively inhibit scar hyperplasia after a deep hand burn. In conjunction with rehabilitation training, it better improves the mobility of the finger joints, hand muscle strength and the recovery of hand function. It is worthy of clinical promotion and application.

Objective:Surgical site infection (SSI) is a common health care-related infection after gastrointestinal surgery. Once SSI occurs after surgery, it can significantly prolong the postoperative hospital stay, increase the cost burden of patients and society, and even endanger the life safety of patients. The purpose of this study was to investigate the clinical phenotypes of gastrointestinal surgery, identify the clinical characteristics of SSI, and provide reference for the prevention of SSI after gastrointestinal surgery.Methods:This is a multicenter prospective cohort study that collected clinical data from all adult patients undergoing gastrointestinal surgery from March 2021 to February 2022 at 42 hospitals in China, including baseline and perioperative characteristics. Based on the variables associated with SSI, latent class analysis (LCA) was used to explore the population characteristics of SSI.Results:In total, 16 087 patients were included in the study, of whom 345 (2.1%) developed SSI. LCA analysis revealed that patients undergoing gastrointestinal surgery were classified into four clinical phenotypes, including α (3851), β (1538), γ (6387), and δ (4311). Type α had minimal abnormality on related system functions (ASA score > 2: 4.5% [173/3851]), and mainly underwent appendix surgery (98.9% [3808/3851]). The postoperative SSI incidence of type α was 0.4% (16/3,851), which belonged to the group of SSI low risk. The abnormality of system functions of type β (ASA score > 2: 17.4% [268/1538]) was worse than that of type α. Type β mainly underwent stomach surgery (72.4% [1113/1538]), and its incidence of postoperative SSI was 1.2% (18/1538), belonging to the group of SSI medium risk. The ASA score of type γ (ASA score > 2: 18.0% [1148/6387]) was comparable to that of type β. Type γ mainly received colorectal surgery (colon surgery: 40.1% [2562/6387]; rectal surgery: 33.6%[2143/6387]), and its incidence of postoperative SSI was 1.7% (106/6387), belonging to the group of SSI medium risk. Type δ (ASA score > 2: 23.5%[1015/4311]) was the most serious type with the highest proportion of open surgery. Type δ mainly underwent small intestine (54.0%[2327/4311]) and stomach surgery (32.3% [1392/4311]) and had the highest incidence of SSI (4.8% [205/4311]) and the highest mortality rate (0.6% [24/4311]), belonging to the group of SSI high risk. Compared with type α and β, the median length of hospital stay (α, β, γ, and δ: 5.0 days, 9.6 days, 13.0 days, and 16.0 days, P<0.001) and postoperative hospital stay (α, β, γ, and δ: 4.0days, 6.0days, 8.3 days, and 10.0 days, P<0.001) of type γ and δ were significantly increased, and the median medical costs (α, β, γ, and δ: 14 178.7 yuan, 39 514.2 yuan, 62 893.0 yuan and 57 266.6 yuan, P<0.001) were also significantly increased. Conclusion:LCA analysis elucidated four clinical phenotypes of patients undergoing gastrointestinal surgery. Type α had a low risk of SSI. Type β and γ had a medium risk of SSI, and type δ had a high risk of SSI.

Objective:To translate the Moyamoya Health Behavior Scale for Adolescent Patients into Chinese and to test its reliability and validity.Methods:Based on the Brislin translation model, the scale was forward-translated, back-translated, cross-culturally adapted, and pretested to develop the Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients. A convenience sampling method was used to recruit 220 adolescent inpatients with moyamoya disease from the Department of Neurosurgery, Zhongnan Hospital of Wuhan University, between January 2023 and December 2024. Reliability and validity analyses were conducted on the scale.Results:A total of 220 questionnaires were distributed, and 206 valid questionnaires were returned, yielding a valid response rate of 93.64%. The Chinese version of the scale comprised 12 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index was 0.917. Exploratory factor analysis extracted three common factors: treatment implementation for moyamoya disease, health-promoting behaviors for moyamoya disease, and health coping behaviors for moyamoya disease, with a cumulative variance contribution of 69.741%. Confirmatory factor analysis showed that the overall model fit was acceptable. The Cronbach's α coefficient for the total scale was 0.872, with subscale Cronbach's α coefficients ranging from 0.810 to 0.871. The test-retest reliability coefficient for the total scale was 0.983, and the split-half reliability coefficient was 0.766.Conclusions:The Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients demonstrated good reliability and validity and can be used as an assessment tool for health behaviors in this patient population.

Objective:Surgical site infection (SSI) is a common health care-related infection after gastrointestinal surgery. Once SSI occurs after surgery, it can significantly prolong the postoperative hospital stay, increase the cost burden of patients and society, and even endanger the life safety of patients. The purpose of this study was to investigate the clinical phenotypes of gastrointestinal surgery, identify the clinical characteristics of SSI, and provide reference for the prevention of SSI after gastrointestinal surgery.Methods:This is a multicenter prospective cohort study that collected clinical data from all adult patients undergoing gastrointestinal surgery from March 2021 to February 2022 at 42 hospitals in China, including baseline and perioperative characteristics. Based on the variables associated with SSI, latent class analysis (LCA) was used to explore the population characteristics of SSI.Results:In total, 16 087 patients were included in the study, of whom 345 (2.1%) developed SSI. LCA analysis revealed that patients undergoing gastrointestinal surgery were classified into four clinical phenotypes, including α (3851), β (1538), γ (6387), and δ (4311). Type α had minimal abnormality on related system functions (ASA score > 2: 4.5% [173/3851]), and mainly underwent appendix surgery (98.9% [3808/3851]). The postoperative SSI incidence of type α was 0.4% (16/3,851), which belonged to the group of SSI low risk. The abnormality of system functions of type β (ASA score > 2: 17.4% [268/1538]) was worse than that of type α. Type β mainly underwent stomach surgery (72.4% [1113/1538]), and its incidence of postoperative SSI was 1.2% (18/1538), belonging to the group of SSI medium risk. The ASA score of type γ (ASA score > 2: 18.0% [1148/6387]) was comparable to that of type β. Type γ mainly received colorectal surgery (colon surgery: 40.1% [2562/6387]; rectal surgery: 33.6%[2143/6387]), and its incidence of postoperative SSI was 1.7% (106/6387), belonging to the group of SSI medium risk. Type δ (ASA score > 2: 23.5%[1015/4311]) was the most serious type with the highest proportion of open surgery. Type δ mainly underwent small intestine (54.0%[2327/4311]) and stomach surgery (32.3% [1392/4311]) and had the highest incidence of SSI (4.8% [205/4311]) and the highest mortality rate (0.6% [24/4311]), belonging to the group of SSI high risk. Compared with type α and β, the median length of hospital stay (α, β, γ, and δ: 5.0 days, 9.6 days, 13.0 days, and 16.0 days, P<0.001) and postoperative hospital stay (α, β, γ, and δ: 4.0days, 6.0days, 8.3 days, and 10.0 days, P<0.001) of type γ and δ were significantly increased, and the median medical costs (α, β, γ, and δ: 14 178.7 yuan, 39 514.2 yuan, 62 893.0 yuan and 57 266.6 yuan, P<0.001) were also significantly increased. Conclusion:LCA analysis elucidated four clinical phenotypes of patients undergoing gastrointestinal surgery. Type α had a low risk of SSI. Type β and γ had a medium risk of SSI, and type δ had a high risk of SSI.