BACKGROUND:Gradient artificial bone repair scaffolds can mimic unique anatomical features in musculoskeletal tissues,showing great potential for repairing injured musculoskeletal tissues. OBJECTIVE:To review the latest research advances in gradient artificial bone repair scaffolds for tissue engineering in the musculoskeletal system and describe their advantages and fabrication strategies. METHODS:The first author of the article searched the Web of Science and PubMed databases for articles published from 2000 to 2023 with search terms"gradient,bone regeneration,scaffold".Finally,76 papers were analyzed and summarized after the screening. RESULTS AND CONCLUSION:(1)As an important means of efficient and high-quality repair of skeletal system tissues,gradient artificial bone repair scaffolds are currently designed bionically for the natural gradient characteristics of bone tissue,bone-cartilage,and tendon-bone tissue.These scaffolds can mimic the extracellular matrix of native tissues to a certain extent in terms of structure and composition,thus promoting cell adhesion,migration,proliferation,differentiation,and regenerative recovery of damaged tissues to their native state.(2)Advanced manufacturing technology provides more possibilities for gradient artificial bone repair scaffold preparation:Gradient electrospun fiber scaffolds constructed by spatially differentiated fiber arrangement and loading of biologically active substances have been developed;gradient 3D printed scaffolds fabricated by layered stacking,graded porosity,and bio-3D printing technology;gradient hydrogel scaffolds fabricated by in-situ layered injections,simple layer-by-layer stacking,and freeze-drying method;and in addition,there are also scaffolds made by other modalities or multi-method coupling.These scaffolds have demonstrated good biocompatibility in vitro experiments,were able to accelerate tissue regeneration in small animal tests,and were observed to have significantly improved histological structure.(3)The currently developed gradient artificial bone repair scaffolds have problems such as mismatch of gradient scales,unclear material-tissue interactions,and side effects caused by degradation products,which need to be further optimized by combining the strengths of related disciplines and clinical needs in the future.

Objective To investigate the safety and validity of laparoscopic autologous lingual mucosal graft ureteroplasty for the treatment of complex ureteral stricture.Methods A total of 10 patients who underwent laparoscopic autologous lingual mucosal graft ureteroplasty in our hospital from May 2021 to October 2023 were retrospectively analyzed.During the operation,the narrow segment was longitudinally dissected,and according to the length of stricture,the lingual mucosal graft of 2.0-7.0 cm in length and 1.0-1.5 cm in width was harvested and precisely anastomosed with the stenosed ureter,followed by double J stent placement.Results All the operations were successfully completed with no conversion to open surgery or intraoperative complications.The operative duration was(237.0±67.1)min,the estimated blood loss was 25.0(20.0,30.0)ml,the duration of drainage tube indwelling was 4.0(4.0,4.8)d,the duration of urinary catheter indwelling was 6.5(6.0,9.5)d,and the duration of postoperative hospitalization was 6.0(6.0,6.8)d.All the patients'oral function recovered well within 1 week,and the double J stent was removed 1-2 months after the surgery.The mean follow-up time was(12.3±7.1)months.One case of aggravated hydronephrosis on the affected side underwent a second laparoscopic ureteral stricture resection and end-to-end anastomosis.The remaining 9 cases showed significant improvement in hydronephrosis on the affected side,with improved renal pelvis separation[(2.9±1.2)cm,t=8.022,P=0.000]and renal function compared to before surgery.Their blood creatinine was(74.3±25.5)μmol/L,with no significant difference compared to preoperation[(80.1±26.6)μmol/L,t=1.825,P=0.105].Conclusion Laparoscopic autologous lingual mucosal graft ureteroplasty for the treatment of complex ureteral stricture is a safe and feasible ureteral reconstruction technique with advantages of quick recovery and reliable outcomes.

Objective:To analyze the current status and related factors of occupational burnout among immunization program staff in Dezhou City in 2025.Methods:From February to March 2025, 1 209 healthcare workers engaged in immunization programs in all disease prevention and control centers (CDCs), vaccination clinics and obstetrics vaccination rooms within the jurisdiction of Dezhou City were enrolled in this study. Basic information was collected via questionnaires. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to assess occupational burnout status across three dimensions: emotional exhaustion, depersonalization and low personal achievement, with severity graded by scores. Multivariate logistic regression models were adopted to analyze the related factors of occupational burnout.Results:Among 1 209 participants, 986 (81.56%) were female and 513 (42.43%) were aged ≥40 years old. About 91 (7.53%) worked in CDCs, 970 (80.23%) in vaccination clinics and 148 (12.24%) in obstetric units. The detection rate of occupational burnout was 83.87% (1 014/1 209), with mild-to-moderate and severe occupational burnout rates of 16.38% (198/1 209) and 67.49% (816/1 209), respectively. Multivariate logistic regression model showed that compared with those who had no intention of resigning, those who frequently had turnover intention ( OR=10.225, 95% CI: 4.093-25.543) had a higher risk of experiencing occupational burnout. Compared with those who slept for more than seven hours a day, those who slept for less than six hours a day ( OR=4.266, 95% CI: 1.773-10.266) and those who slept for 6-7 hours ( OR=1.543, 95% CI: 1.100-2.164) had a higher risk of developing occupational burnout. Conclusion:The detection rate of occupational burnout among immunization program staff in Dezhou City is relatively high, significantly related to frequent turnover intention and insufficient sleep.

To analyze the relationship between serum non-HDL-C levels and cardiovascular disease (CVD) mortality in community populations. A retrospective cohort study was conducted using the Yuecheng District Health Information Platform in Shaoxing City, Zhejiang Province. The study cohort included individuals aged 40 years or older with no prior history of CVD who underwent physical examinations at Yuecheng District healthcare institutions between January and December 2019. A total of 39 038 participants were included, including 19 085 males (48.9%) and 19 953 females (51.1%), with a mean age of (73.64±9.10) years. The mean follow-up duration was 52.3 months. During follow-up, 1 227 CVD death events occurred. The results indicated a significant overall association between non-HDL-C levels and the risk of CVD mortality, including coronary heart disease (CHD) and stroke. Cox models indicated that, using the ideal level of non-HDL-C as the reference, the hazard ratios (HRs) for risk of CVD death in the suitable level, borderline elevated level and elevated level groups were 1.24 (95% CI: 1.08-1.42), 1.57 (95% CI: 1.34-1.85) and 2.31 (95% CI: 1.87-2.86), respectively. The corresponding HRs for CHD death were 1.39 (95% CI: 1.10-1.76), 1.69 (95% CI: 1.28-2.12) and 2.53 (95% CI: 1.76-3.64), respectively. Subgroup analysis revealed significant interaction effects between non-HDL-C and sex, smoking, alcohol consumption, and diabetes (all P interaction<0.05). Sensitivity analyses confirmed that results were consistent with the primary findings regarding the association between non-HDL-C and CVD mortality risk. In conclusion, increasing non-HDL-C levels are associated with higher risks of death from cardiovascular diseases, including stroke and CHD. The risk of CVD death associated with elevated non-HDL-C is greater among males, individuals with a history of diabetes, smokers or drinkers. In the future, attention should be paid to the monitoring of non-HDL-C in community health management, and the intensive and personalized management of blood lipids in high-risk population should be strengthened.

Tumors exhibit abnormal glucose metabolism, consuming excessive glucose and excreting lactate, which constructs a tumor microenvironment that facilitates cancer progression and disrupts immunotherapeutic efficacy. Currently, tumor glucose metabolic dysregulation to reshape the immunosuppressive microenvironment and enhance immunotherapy efficacy is emerging as an innovative therapeutic strategy. However, glucose metabolism modulators lack specificity and still face significant challenges in overcoming tumor delivery barriers, microenvironmental complexity, and metabolic heterogeneity, resulting in poor clinical benefit. Nanomedicines, with their ability to selectively target tumors or immune cells, respond to the tumor microenvironment, co-deliver multiple drugs, and facilitate combinatorial therapies, hold significant promise for enhancing immunotherapy through tumor glucose metabolic reprogramming. This review explores the complex interactions between tumor glucose metabolism-specifically metabolite transport, glycolysis processes, and lactate-and the immune microenvironment. We summarize how nanomedicine-mediated reprogramming of tumor glucose metabolism can enhance immunotherapy efficacy and outline the prospects and challenges in this field.

Objective To explore the influences of transcranial direct current stimulation(tDCS)in combination with cognitive-motor dual task training(CMDT)on memory and executive function in patients suffering from post-stroke cognitive impairment.Methods A total of 75 stroke patients were randomly divided into the tDCS group,the CMDT group and the combined group,each consisting of 25 cases.All patients in the three groups received routine rehabilitation treatment.The tDCS group underwent tDCS stimulation of dorsolateral prefrontal lobe(DLPFC)of the region,the CMDT group received CMDT and the combined group received CMDT on the basis of tDCS treatment.The fourth edition of the Wechsler Memory Scale(WMS-IV),Wisconsin Card Test(WCST),Montreal Cognitive Assessment(MoCA)and Modified Barthel Index(MBI)were used to evaluate the overall cognitive function,memory,executive function,and daily living ability of the patients before and 4 weeks after treatment,respectively.Results Before treatment,there were no significant differences in the evaluation indices between the three groups(P＞0.05).After 4 weeks of treatment,the scores of WCST,WMS-IV,MoCA and MBI in the three groups were improved compared with those before the treatment(P＜0.05),and the combined group was significantly superior to the tDCS group and the CMDT group(P＜0.05).Conclusion The combination of tDCS and CMDT can improve the cognitive function after stroke,and at the same time exert a synergistic effect on memory and executive function.

Colorectal cancer is the third leading cause of cancer-related mortality worldwide.Hepatic resection is the standard treatment for colorectal cancer liver metastasis.Microwave ablation(MWA),as a minimally invasive therapeutic approach,offers an alternative treatment option for these patients.But the clinical efficacy of hepatic resection and MWA in treating colorectal cancer liver metastasis patients is still inconclusive.Literatures were retrieved on comparative studies about the treatment of colorectal cancer liver metastasis with hepatic resection and MWA from multiple databases,including sinoMed,PubMed,Web of Science,EMBASE,CNKI,Wanfang,etc.The cutoffdate of retrieval was September 2024.Finally,a total of 13 studies comprising 2 057 patients,were included in this study.The papers were assessed using the Newcastle-Ottawa Scale and Jadad Scale.All included studies were of high quality.Data extraction focused on postoperative complications,length of hospital stay,surgical duration,hospitalization costs,and patient survival outcomes,including overall survival(OS)and disease-free survival(DFS).A meta-analysis was performed using Review Manager 5.4 software.There were no significant differences in OS(HR=1.03,95%CI:0.85-1.25,P=0.77)and DFS(HR=1.27,95%CI:0.94-1.71,P=0.13)between the MWA group and the hepatic resection group.In the subgroup analysis of patients with≤5 liver metastases and size of metastases≤3 cm,there were no statistically significant differences in OS and DFS between the MWA group and the hepatic resection group.The MWA group exhibited shorter hospital stay,reduced hospitalization costs,decreased surgical duration,less intraoperative blood loss,and lower incidence of complications compared to the hepatic resection group(P＜0.05).Therefore,for patients with colorectal liver metastases characterized by a number of liver metastases≤5 and size of metastases≤3 cm,MWA serves as an effective alternative to hepatic resection,with a lower morbidity associated with treatment.Further validation of these findings is warranted through additional randomized controlled trials and cohort studies.The registration number of this Meta-analysis on the PROSPERO platform is CRD42024610278.

Objective:To establish a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products,screen critical quality markers,and provide methodological support for their intelligent quality control.Methods:Ultra-performance liquid chromatography coupled with quadrupole-orbitrap mass spectrometry(UPLC-Q-Orbitrap-MS)was employed to quantitatively analyze 34 bioactive components(e.g.,tanshinone Ⅱ A and alvianol-ic acid B)in 20 batches of fermentation products.The key markers were screened through hierarchical cluster anal-ysis and partial least squares discriminant analysis,and an intelligent discriminant model was constructed with sup-port vector machine machine learning algorithm to digitally analyze the characteristics of quality differences between batches.Results:Thirty-four common peaks were calibrated across all batches.Combined with partial least squares analysis,six key difference markers were further screened,including terpenoids such as isotanshinone Ⅱ A and tan-shinone Ⅱ A and phenolic acids such as salvianolic acid G.The support vector machine model can achieve 100％accuracy of origin discrimination by optimizing parameters jointly with genetic algorithm and grid search.Conclusion:This study developed a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products through a three-step analytical strategy("chemical feature exploration-marker screening-model valida-tion"),providing a transferable technical pathway for the intelligent transformation of traditional Chinese medicine quality control.

Objective:To evaluate the short-term efficacy of our modified anterior pelvic ring internal fixator(INFIX) in the treatment of anterior pelvic ring injuries.Methods:A retrospective study was conducted to analyze the clinical data from the 16 patients with pelvic anterior ring injury who had been treated with our modified INFIX at Department of Orthopaedics, The First Hospital Affiliated to Bengbu Medical University from June 2020 to June 2023. There were 9 males and 7 females with an age of (49.1±14.3) years. According to the AO/OTA classification, 10 cases were of type B2 and 6 cases of type C1. Their time from injury to surgery was (7.6±2.9) days. Fixation with our modified INFIX was as follows: Three pedicle screws were inserted into the anterior inferior iliac spine on one side and into the pubic symphysis on both sides. Next, a subcutaneous tunnel was created from the anterior inferior iliac spine incision toward the pubic symphysis, and connecting rods were inserted for fixation. The surgical incision length, intraoperative blood loss, surgical time, postoperative fracture reduction quality, fracture healing time, incidence of complications during follow-up, and pelvic functional recovery at the last follow-up were recorded in this cohort.Results:In this cohort, surgical incision length was (5.8±0.4) cm, intraoperative blood loss (75.4±11.9) mL, and surgical time (66.1±8.9) min. By the end of one week after surgery, the quality of fracture reduction was evaluated according to the Matta scoring criteria as excellent in 11 cases and as good in 5 cases. All patients were followed up for (17.4±3.1) months after surgery. The fractures got united in all the 16 patients after (11.2±1.2) weeks. At the last follow-up, the pelvic function recovery was evaluated according to the Majeed scoring system as excellent in 13 cases and as good in 3 cases, yielding a Majeed score of (90.1±4.2) points. During the follow-up period, no patient developed complications such as nerve injury, wound infection, or loosening, breakage or withdrawal of internal fixation devices.Conclusion:In the treatment of anterior pelvic ring injuries, our modified INFIX has the advantages of few complications, simple operation and minimal invasion, leading to good short-term efficacy.

The specific mechanisms of interferon regulatory factor 8(IRF8)in porcine intestinal in-nate immunity and resistance to enteric virus infection remain to be elucidated.To investigate the immunoregulatory role of IRF8,establishing an IRF8 gene knockout porcine intestinal epithelial cell(IPEC-J2)monoclonal cell line is of significant importance.This study initially aimed to obtain recombinant adeno-associated virus rAAV-sgIRF8-eGFP capable of knocking out the IRF8 gene through co-transfection of HEK-293T cells with three plasmids.Subsequently,IPEC-J2 cells were infected with the virus,and those expressing eGFP were selected by flow cytometry and cultured to form monoclonal cell lines.These cell lines were then identified by Sanger sequencing and West-ern blot techniques.Lastly,qPCR analysis was used to measure the expression levels of interferon factors IFN-α,IFN-β,IFN-γ and IFN-λ,providing preliminary insights into the impact of IRF8 gene knockout on IPEC-J2 cell immunity.The results demonstrated successful generation of rAAV-sgIRF8-eGFP,which successfully infected IPEC-J2 cells leading to eGFP fluorescence.Flow cytometry followed by cell culture led to the establishment of two monoclonal cell lines,IRF8-KO1 and IRF8-KO3.Sanger sequencing revealed a five-base deletion in IRF8-KO1 and a seven-base dele-tion in IRF8-KO3.Western blot confirmed the absence of IRF8 protein expression in IRF8-KO1,making it an ideal candidate monoclonal cell line.qPCR analysis of interferon factors indicated sig-nificant decrease in IFN-γ(P＜0.05)and IFN-λ(P＜0.01)transcription level in IRF8-knockout cells,while the transcription levels of IFN-α and IFN-β remained relatively unchanged.This study successfully established an IRF8 gene knockout IPEC-J2 monoclonal cell line,providing a founda-tion for further research on IRF8-related porcine intestinal immune regulation and mechanisms of intestinal virus infection.