BACKGROUND:Zinc-based alloy medical implant materials have excellent mechanical properties,complete degradability and good biocompatibility,and are mainly used in orthopedic implants,cardiovascular stents,bile duct stents,tracheal stents,nerve catheters,etc. OBJECTIVE:To review the research progress of biodegradable zinc-based alloys in bone defect repair and prospect the promising research direction and achievements of zinc-based materials. METHODS:After searching PubMed,Web of Science,WanFang Data,and CNKI databases from the establishment of the database to June 2023,various relevant articles on biodegradable zinc-based alloys for bone implant material research were collected.The basic characteristics of biodegradable zinc based alloys were summarized,and the role of zinc-based alloys in promoting bone tissue repair was sorted and summarized.The current research hotspots and shortcomings were discussed. RESULTS AND CONCLUSION:(1)Zinc-based alloys have good biocompatibility.Using zinc-based alloys as the matrix material,with the help of scaffold structure construction technology and coating optimization process,the bone conductivity of zinc-based alloys will be effectively improved,and their degradation products will have efficient bone induction to regulate the gene expression of osteoblasts and osteoclasts,thereby promoting the repair and reconstruction of bone defects.(2)However,in the research on optimizing zinc-based alloys,the coating process is relatively insufficient,and additive loading technology is still lacking.(3)Zinc-based alloys have excellent mechanical and biological properties.Through special processes,their bone conductivity and osteoinductivity can be increased to effectively improve their ability to promote bone repair and reconstruction,and it is expected to further achieve the development of personalized transplant materials.Further research and development are needed to optimize the integration of coating and additive loading technologies into zinc-based alloys.

Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

Objective To construct a decision support education program for the family members of patients with advanced cancer and to investigate its application effects,so as to improve understanding and acceptance of hospice care for family members of advanced cancer patients.Methods Using the Ottawa Decision Support Framework as a theoretical guide,the program was initially drafted based on a literature review,qualitative interview and expert consultation.From September 2023 to January 2024,a convenience sampling method was used to select patients' families in a tertiary-level hospital in Tianjin as the research subjects,and they were randomly divided into an experimental group and a control group.The experimental group received the decision support education program in addition to routine care,while the control group received routine care.Family members' knowledge about hospice,the scores on the Death Attitude Profile Scale,and their willingness to choose hospice care were compared before and after the interventions.Results The program finally included 4 first-level items,15 second-level items,and 59 third-level items.During the program implementation phase,4 cases withdrew from the study,resulting in 46 cases in the experimental group and 47 cases in the control group.After intervention,the experimental group had higher scores on hospice knowledge and positive attitude towards death than the control group,while scores on negative attitude towards death were lower(P＜0.05);their willingness to choose hospice care for themselves and for the patients was higher than that of the control group(P＜0.05).Conclusion The hospice care decision support education program is scientific,feasible and practical,which can improve the knowledge of hospice care of the family members,improve their attitude towards death,and ultimately improve their willingness to choose hospice care.

Diabetic kidney disease(DKD)with increasing global prevalence lacks effective therapeutic targets to halt or reverse its progression.Therapeutic targets supported by causal genetic evidence are more likely to succeed in randomized clinical trials.In this study,we integrated large-scale plasma proteomics,genetic-driven causal inference,and experimental validation to identify prioritized targets for DKD using the UK Biobank(UKB)and FinnGen cohorts.Among 2844 diabetic patients(528 with DKD),we identified 37 targets significantly associated with incident DKD,supported by both observational and causal evi-dence.Of these,22％(8/37)of the potential targets are currently under investigation for DKD or other diseases.Our prospective study confirmed that higher levels of three prioritized targets-insulin-like growth factor binding protein 4(IGFBP4),family with sequence similarity 3 member C(FAM3C),and prostaglandin D2 synthase(PTGDS)—were associated with a 4.35,3.51,and 3.57-fold increased likeli-hood of developing DKD,respectively.In addition,population-level protein-altering variants(PAVs)analysis and in vitro experiments cross-validated FAM3C and IGFBP4 as potential new target candidates for DKD,through the classic NLR family pyrin domain containing 3(NLRP3)-caspase-1-gasdermin D(GSDMD)apoptotic axis.Our results demonstrate that integrating omics data mining with causal inference may be a promising strategy for prioritizing therapeutic targets.

Objective To construct a decision support education program for the family members of patients with advanced cancer and to investigate its application effects,so as to improve understanding and acceptance of hospice care for family members of advanced cancer patients.Methods Using the Ottawa Decision Support Framework as a theoretical guide,the program was initially drafted based on a literature review,qualitative interview and expert consultation.From September 2023 to January 2024,a convenience sampling method was used to select patients' families in a tertiary-level hospital in Tianjin as the research subjects,and they were randomly divided into an experimental group and a control group.The experimental group received the decision support education program in addition to routine care,while the control group received routine care.Family members' knowledge about hospice,the scores on the Death Attitude Profile Scale,and their willingness to choose hospice care were compared before and after the interventions.Results The program finally included 4 first-level items,15 second-level items,and 59 third-level items.During the program implementation phase,4 cases withdrew from the study,resulting in 46 cases in the experimental group and 47 cases in the control group.After intervention,the experimental group had higher scores on hospice knowledge and positive attitude towards death than the control group,while scores on negative attitude towards death were lower(P＜0.05);their willingness to choose hospice care for themselves and for the patients was higher than that of the control group(P＜0.05).Conclusion The hospice care decision support education program is scientific,feasible and practical,which can improve the knowledge of hospice care of the family members,improve their attitude towards death,and ultimately improve their willingness to choose hospice care.

This paper summarized the current status of infection and quality control of medical flexible endoscope (abbreviation:endoscope),which can identify that defect of the quality control of endoscopic forceps channels was a major cause of nosocomial infections of endoscopy. Based on this,a multifunctional quality control workstation with forceps channel of detecting flexible endoscope,and precision components included top ends for medical endoscopes has been developed,which can clearly display residual contaminants and damages in the forceps channels and precision components after the endoscope was reprocessed. It is contribute to enhance the quality control of reprocessing endoscope,and reduce cross-infection of endoscope.

Objective To explore the bi-directional dynamic associations of bullying perpetration and victimisation with psychopathological symptoms in children and adolescents.Methods The Adolescent Brain Cognitive Development(ABCD)public dataset was used.Three dimensions of bullying perpetration and victimisation and child-adolescent psychopathological symptoms:attention,externalisation and internalisation were collected from 8413 child-adolescents using the peer experiences questionnaire(EPQ)and the brief problem monitoring(BPM)questionnaire,respectively.Bidirectional dynamic associations between bullying and child-adolescent psychopathological symptoms were analysed using cross-lagged networks.Results Bullying implementation to externalising problems was a significant cross-lagged edge(OR=2.36);impulsivity was both the strongest node of out-expected influence(OEI=5.21)and bridge-expected influence(BEI=4.35),and the strongest node of in-expected influence(IEI)was threat of violence(IEI=5.61).Conclusion There is an interaction between bullying and child-adolescent pathology symptoms.Bullying perpetration exacerbates subsequent externalising problems,and impulsivity is the most likely psychopathological symptom to influence both bullying perpetration and externalising internalising problems and it is also the bridging symptom connecting the two.

Systemic lupus erythematosus(SLE)complicated refractory immune thrombocytopenia(ITP)is mainly characterized by persistent severe thrombocytopenia and bleeding.Currently,there are no guidelines for treating such ITP.Hereby we reported a patient diagnosed with SLE with more than 10 years history of anemia and thrombocytopenia.This patient had been treated by various immunity inhibitors,such as corticosteroids,cyclosporine,mycophenolate mofetil,azathioprine,tofacitinib and telitacicept,but there was no obvious effect.The platelet count continued to be below 50×109/L.However,when serum cyclosporine trough level between 100 and 150 ng/mL,the clinical efficacy was improved and the platelet count was above 100×109/L.The patient was followed up for more than 6 months,and no recurrence of disease was found.Cyclosporine combined with low-dose glucocorticoid is safe and effective for SLE associated ITP.Therapeutic drug monitoring is a powerful tool for improving clinical efficacy and ensuring drug safety.

Objective:To investigate the effects of 3 D laparoscopic radical resection prostatectomy(LRP)on urinary control and sexual function of patients with prostatic cancer.Methods:A total of 268 patients who were treated with LRP in the Fifth People's Hospital of Huai an City from January 2019 to May 2022 were selected and divided into 2 groups according to surgical methods,with 134 cases in each group.The patients in the control group were treated with traditional LRP,and the 3D LRP was used in the observa-tion group.The clinical effects of the two groups were compared.Results:The patients in observation group had less blood loss([135.62±13.58]mL vs[143.18±14.89]mL)and shorter indwelling catheter time([8.26±1.47]d vs[9.78±1.73]d)compared with control group,but the operation time([160.52±10.78]min vs[154.47±10.41]min)was longer than that in the control group(P＜0.05).The recovery of sexual function and urinary control in the observation group was better than that in the con-trol group after 3,6 and 12 months of the surgery(P＜0.05).After one month of surgery,the scores of ICIQ-SF and 1 h urine pad test were lower than those of the control group.The EPIC-UIN score([72.63±6.85]points vs[67.15±5.09]points)of the observation group was higher than that of the control group(P＜0.05).The patients in the observation group had lower level of residual urine volume([60.26±6.63]mL vs[76.89±7.89]mL),higher maximum urine flow rate([7.52±0.46]mL/s vs[6.17±0.43]mL/s)and detrusor pressure([85.19±7.18]mL vs[76.29±6.85]mL)at maximum urine flow rate compared with the control group(P＜0.05).There was no difference in the incidence of complications between the observation group and the control group(5.97％vs 8.27％,P＞0.05).The recurrence rate of tumor 3 years after operation in the observation group was lower than that in the control group(11.94％vs 29.10％,x2=12.102,P＜0.05).Conclusion:3D LRP has obvious advantages in surgical clarity and preci-sion,which reduces the risk of postoperative complications and improves urinary control ability and sexual function of patients.

Objective To explore the clinical efficacy of the new transumbilical laparoscopy and the conventional three-port method in the treatment of unilateral huge(≥15 mm)indirect inguinal hernia.Methods A retrospective analysis was conducted on the clinical data of 213 children with unilateral huge(≥15 mm)indirect inguinal hernia admitted to the hospital from July 2020 to August 2023.According to different surgical methods,the children were divided into the three-port group(107 cases,undergoing three-port laparoscopic high ligation of hernia sacs)and the new group(106 cases,undergoing new transumbilical laparoscopic surgery).The surgical indicators of the two groups of children,the face,legs,activity,cry,consolability(FLACC)score,parents'satisfaction with the appearance of the incision,testicular volume,postoperative complications and recurrence rate(within 1 year after surgery)were compared.Results The intraoperative blood loss and the number of incisions in the new group were less than those in the three-port group,while the incision length,operation time,postoperative incision healing time and hospital stay were shorter than those in the three-port group.The differences were statistically significant(P<0.05).At 6,12,24 and 48 hours after the operation,the FLACC score of the new group was lower than that of the three-port group,and the difference was statistically significant(P<0.05).The satisfaction rate of parents of children in the new group with the appearance of the incision was 100.00%,which was higher than 88.79%in the three-port group,and the difference was statistically significant(P<0.05).The volume of the affected testicle in both groups before the operation was smaller than that of the healthy side,and the volume of the affected testicle one year after the operation was larger than that before the operation.The differences were statistically significant(P<0.05).One year after the operation in the new group,there was no statistically significant difference in the testicular volume between the healthy side and the affected side(P>0.05).There was no statistically significant difference in the total incidence of complications and overall recurrence rate between the two groups(P>0.05).Conclusion Compared with the conventional three-port method,the new transumbilical laparoscopic surgery has the characteristics of convenient operation,less trauma,less pain,faster postoperative recovery and a beautiful incision.It has more advantages when applied in the treatment of unilateral huge indirect inguinal hernia≥15 mm.