Objective:To observe the efficacy of arthroscopic LUtarjet procedure in the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect.Methods:A retrospective study was conducted to analyze the data of 15 patients with recurrent anterior shoulder dislocation combined with a glenoid bone defect who had been treated by the arthroscopic LUtarjet procedure at Department of Orthopedics, The 928th Hospital of PLA Joint Logistics Support Force from September 2022 to November 2023. All patients were male, aged (25.0±1.9) years, involving 10 left and 5 right sides. The anterior fear test for the affected shoulder was positive in all cases before surgery, and the dislocations averaged (13.8±5.4) times. By comparing the three-dimensional CT scans of both shoulders before surgery, the severity of the glenoid bone defect was calculated as over 20% wider than the width of the healthy glenoid. The shoulder function was evaluated at 6 and 18 months after operation using the American Shoulder and Elbow Surgeons score (ASES), Rowe score, Walch-Duplay score and shoulder active range of motion. Comparisons were made between preoperation and postoperation. CT plain scan and three-dimensional reconstruction were used to evaluate the location and resorption of the transferred bone block of the coracoid process.Results:All patients were followed up for (19.8±1.1) months. The operation time for the 15 patients was (117.6±13.8) min. Re-dislocation occurred in none of the patients during postoperative follow-up. There was no significant difference in the flexion elevation, lateral external rotation, internal rotation or abduction 90° external rotation between preoperation, 6 months or 18 months after operation ( P>0.05). Respectively, the ASES, Rowe and Walch-Duplay scores were (93.3±2.3) points, (90.8±2.6) points, and (95.9±1.0) points at 18 months after operation, and (89.6±3.8) points, (84.5±2.7) points, and (87.2±3.9) points at 6 months after operation, showing significant improvements compared with the preoperative values [(70.9±6.1) points, (42.9±6.0) points, and (66.2±11.0) points] ( P<0.05). In the 3 patients whose immediately postoperative CT scan showed that their bone blocks were slightly lower in position, the bone blocks grew and shaped well at the last follow-up. The last follow-up observed partial bone resorption in one patient. Conclusion:In the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect, the arthroscopic LUtarjet procedure can restore satisfactory stability of the shoulder joint, leading to good short- and mid-term efficacy.

Objective:To observe the efficacy of arthroscopic LUtarjet procedure in the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect.Methods:A retrospective study was conducted to analyze the data of 15 patients with recurrent anterior shoulder dislocation combined with a glenoid bone defect who had been treated by the arthroscopic LUtarjet procedure at Department of Orthopedics, The 928th Hospital of PLA Joint Logistics Support Force from September 2022 to November 2023. All patients were male, aged (25.0±1.9) years, involving 10 left and 5 right sides. The anterior fear test for the affected shoulder was positive in all cases before surgery, and the dislocations averaged (13.8±5.4) times. By comparing the three-dimensional CT scans of both shoulders before surgery, the severity of the glenoid bone defect was calculated as over 20% wider than the width of the healthy glenoid. The shoulder function was evaluated at 6 and 18 months after operation using the American Shoulder and Elbow Surgeons score (ASES), Rowe score, Walch-Duplay score and shoulder active range of motion. Comparisons were made between preoperation and postoperation. CT plain scan and three-dimensional reconstruction were used to evaluate the location and resorption of the transferred bone block of the coracoid process.Results:All patients were followed up for (19.8±1.1) months. The operation time for the 15 patients was (117.6±13.8) min. Re-dislocation occurred in none of the patients during postoperative follow-up. There was no significant difference in the flexion elevation, lateral external rotation, internal rotation or abduction 90° external rotation between preoperation, 6 months or 18 months after operation ( P>0.05). Respectively, the ASES, Rowe and Walch-Duplay scores were (93.3±2.3) points, (90.8±2.6) points, and (95.9±1.0) points at 18 months after operation, and (89.6±3.8) points, (84.5±2.7) points, and (87.2±3.9) points at 6 months after operation, showing significant improvements compared with the preoperative values [(70.9±6.1) points, (42.9±6.0) points, and (66.2±11.0) points] ( P<0.05). In the 3 patients whose immediately postoperative CT scan showed that their bone blocks were slightly lower in position, the bone blocks grew and shaped well at the last follow-up. The last follow-up observed partial bone resorption in one patient. Conclusion:In the treatment of recurrent anterior shoulder dislocation combined with a glenoid bone defect, the arthroscopic LUtarjet procedure can restore satisfactory stability of the shoulder joint, leading to good short- and mid-term efficacy.

Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

AIM:To investigate the potential of atractylenolide Ⅲ(AⅢ)in mitigating dextran sulfate sodium(DSS)-induced injury in a mouse model of chronic inflammatory bowel disease(IBD),and to explore the mechanisms in-volved,particularly the modulation of signal transducer and activator of transcription 3(STAT3)signaling,which plays a crucial role in the homeostasis of T helper 17(Th17)and regulatory T(Treg)cells.METHODS:A mouse model of DSS-induced chronic IBD was established,and the mice were divided into 4 groups:control,model(DSS),high-dose(50 mg/kg)AⅢ,and low-dose(30 mg/kg)AⅢ.The disease activity index(DAI)was utilized to assess disease severity.Histo-pathological damage in the colons of IBD mice was evaluated by hematoxylin-eosin(HE)staining.The protein levels of phosphorylated STAT3,occludin and zonula occludens-1(ZO-1)were analyzed using immunohistochemical staining and Western blot.Flow cytometry was employed to examine the differentiation of splenic lymphocytes into Th17/Treg cells.RESULTS:Both DAI assessments and HE staining indicated that AⅢ significantly alleviated inflammatory injury in mice with DSS-induced chronic IBD.Immunohistochemical analysis demonstrated that AⅢ enhanced the expression of ZO-1 and occludin in colonic tissues.Flow cytometry results revealed that AⅢ helped maintain the balance between splenic Th17 and Treg cells.Furthermore,immunohistochemical staining and Western blot showed that AⅢ inhibited the phos-phorylation of STAT3.CONCLUSION:Treatment with AⅢ effectively reduced inflammatory injury in a mouse model of chronic IBD by preserving Th17/Treg homeostasis through the inhibition of STAT3 phosphorylation.As a natural com-pound,AⅢ exhibits significant therapeutic potential for the treatment of chronic IBD.

To effectively play the guiding role of pathogenic diagnosis in the rational use of antibiotics, hospitals at all levels urgently need to establish an effective control system for clinical microbial specimen submission. In response to the common problems in medical institutions in China, such as the low rate of microbiological specimen submission before antibiotic treatment, unreasonable structure of microbiological specimens, and the majority of morning sputum and urine specimens collected for pathogen testing, the Second Affiliated Hospital of Zhejiang University School of Medicine has constructed a management system for clinical microbiological specimen submission using artificial intelligence technology. It used a built-in intelligent rule engine to implement full process control over the sampling and submission of microbiological specimens by doctors when prescribing antibiotics, urge doctors to implement the requirement of collecting samples before using antibiotics for treatment, and recommend priority the collection of sterile specimens. In addition, the hospital transformed the laboratory and testing process with the goal of receiving microbial samples 24 hours without interruption and inoculating in real-time. The informatization management system began to be applied throughout the hospital in December 2015. The average rate of microbial sample submission before the first therapeutic use of antibiotics from June 2016 to 2023 was 79.2%, an increase of 90.2 percentage points from 41.7% in June 2014 ( χ2=467.781, P<0.01). The structure of microbial specimens continued to be optimized, and the proportion of sterile specimens in all submitted specimens increased from 47.2% in 2014 to 49.9% in 2023 ( χ2=139.119, P<0.01). The proportion of morning sputum and morning urine specimens decreased from 65.2% and 60.6% in 2014 to 11.1% and 16.9% in 2023, respectively ( χ2 values were 19 787.434 and 4 346.664, respectively, P<0.01), providing a more reliable basis for pathogenic diagnosis in clinical practice and providing reference for improving the management of pathogenic specimen submission in medical institutions.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

AIM:To investigate the potential of atractylenolide Ⅲ(AⅢ)in mitigating dextran sulfate sodium(DSS)-induced injury in a mouse model of chronic inflammatory bowel disease(IBD),and to explore the mechanisms in-volved,particularly the modulation of signal transducer and activator of transcription 3(STAT3)signaling,which plays a crucial role in the homeostasis of T helper 17(Th17)and regulatory T(Treg)cells.METHODS:A mouse model of DSS-induced chronic IBD was established,and the mice were divided into 4 groups:control,model(DSS),high-dose(50 mg/kg)AⅢ,and low-dose(30 mg/kg)AⅢ.The disease activity index(DAI)was utilized to assess disease severity.Histo-pathological damage in the colons of IBD mice was evaluated by hematoxylin-eosin(HE)staining.The protein levels of phosphorylated STAT3,occludin and zonula occludens-1(ZO-1)were analyzed using immunohistochemical staining and Western blot.Flow cytometry was employed to examine the differentiation of splenic lymphocytes into Th17/Treg cells.RESULTS:Both DAI assessments and HE staining indicated that AⅢ significantly alleviated inflammatory injury in mice with DSS-induced chronic IBD.Immunohistochemical analysis demonstrated that AⅢ enhanced the expression of ZO-1 and occludin in colonic tissues.Flow cytometry results revealed that AⅢ helped maintain the balance between splenic Th17 and Treg cells.Furthermore,immunohistochemical staining and Western blot showed that AⅢ inhibited the phos-phorylation of STAT3.CONCLUSION:Treatment with AⅢ effectively reduced inflammatory injury in a mouse model of chronic IBD by preserving Th17/Treg homeostasis through the inhibition of STAT3 phosphorylation.As a natural com-pound,AⅢ exhibits significant therapeutic potential for the treatment of chronic IBD.

Objective:This study aims to analyze of the quality of diagnosis and treatment data of community medical institutions on the national health information platform in a district of Beijing from the perspective of scientific research informatization, to provide experience and reference for promoting the informatization construction of primary medical units and tapping the scientific research potential of the regional data platform.Methods:Based on the data backup database of the national health information platform in the region, the data quality was analyzed and evaluated mainly in three dimensions: integrity, integration, and consistency.Results:Through the construction of the national health information platform, the district successfully achieved the effective collection of diagnosis and treatment data from community medical institutions, covering the main data such as patients′ basic information, visit information, test information, prescription information, etc. However, the data collected so far were still insufficient in terms of data integration and consistency.Conclusions:A regional medical data center is suggested to construct to break down the barriers between data systems, conduct pre-structuring of diagnosis and treatment data, improve data integration and consistency, and at the same time, carry out effective scientific research prospective design to promote the effective transformation of clinical data to scientific research data.

Deepening the teaching reform of medical education is the strategic initiatives to improve the quality of medical talents in the new period. At present, curriculum teaching reform and the certification work in medical colleges and universities is still in the initial exploration stage. Although some achievements have been made, there are still some prominent problems, such as insufficient teacher drive, inaccurate orientation for the curriculum, improper ways of teaching, lack of organizational and appraising system. Xuzhou Medical University takes the declaration and accreditation of educational reform courses as the forerunner, and takes many measures to stimulate teachers' endogenous motivation of educational reform, innovate the organizational system of educational reform courses evaluation, establish progressive evaluation and accreditation management, formulate evaluation standards of educational reform courses, and form a closed loop of multiple evaluation and feedback. It not only effectively improves the quality of teaching and further promote the curriculum reform process, but also provides reference for the development and promotion of curriculum teaching reform in other colleges and universities.

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China