BACKGROUND:Pediatric flexible flatfoot is a common foot deformity that often leads to foot pain and reduced quality of life.OBJECTIVE:To explore the relationship between radiographic parameters and clinical efficacy of subtalar arthroereisis in the treatment of pediatric flexible flatfoot.METHODS:A retrospective study was conducted on 56 pediatric patients(mean age of 11.8 years)who underwent subtalar arthroereisis at Guangzhou Orthopedic Hospital between January 2022 and May 2023.All patients underwent detailed radiographic examinations and clinical evaluations before and after surgery,including the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score and Visual Analog Scale score.Paired t-tests and independent t-tests were used to compare changes in radiographic parameters and clinical scores before and after surgery.Correlation analyses were conducted to evaluate the relationship between radiographic parameters and clinical outcomes.RESULTS AND CONCLUSION:(1)All radiographic parameters significantly improved during the 8 to 12-month follow-up after surgery(P＜0.001).(2)Clinical evaluation results indicated that the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score significantly improved from 66.2±6.0 preoperatively to 91.3±5.8 postoperatively,and the Visual Analog Scale score significantly decreased from 3.1±0.8 preoperatively to 1.3±0.8 postoperatively(P＜0.001).(3)Independent t-tests showed a significant difference in postoperative the first metatarsal angle and Visual Analog Scale score grades(P=0.043),with a smaller the first metatarsal angle associated with less postoperative pain;preoperative lateral arch angle showed a significant difference between the"excellent"and"good"groups in postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scores(P=0.033),suggesting that a smaller preoperative posterior arch angle might predict better postoperative foot function recovery.(4)Correlation analysis showed that preoperative posterior arch angle(r=-0.486,P＜0.01)and heel pitch angle(r=-0.344,P＜0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,while preoperative medial longitudinal arch angle(r=0.293,P＜0.05)was significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.Postoperative medial longitudinal arch angle(r=0.331,P＜0.05)and lateral arch angle(r=0.387,P＜0.01)were significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,whereas postoperative Bohler's angle(r=-0.272,P＜0.05),posterior arch angle(r=-0.461,P＜0.01),and heel pitch angle(r=-0.318,P＜0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.(5)It is concluded that subtalar arthroereisis is significantly effective in correcting pediatric flexible flatfoot,and improvements in radiographic parameters are closely related to clinical efficacy.Preoperative and postoperative radiographic evaluations can serve as important reference indicators for predicting postoperative clinical outcomes,guiding clinicians to optimize treatment plansand rehabilitation programs.

BACKGROUND:Pediatric flexible flatfoot is a common foot deformity that often leads to foot pain and reduced quality of life.OBJECTIVE:To explore the relationship between radiographic parameters and clinical efficacy of subtalar arthroereisis in the treatment of pediatric flexible flatfoot.METHODS:A retrospective study was conducted on 56 pediatric patients(mean age of 11.8 years)who underwent subtalar arthroereisis at Guangzhou Orthopedic Hospital between January 2022 and May 2023.All patients underwent detailed radiographic examinations and clinical evaluations before and after surgery,including the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score and Visual Analog Scale score.Paired t-tests and independent t-tests were used to compare changes in radiographic parameters and clinical scores before and after surgery.Correlation analyses were conducted to evaluate the relationship between radiographic parameters and clinical outcomes.RESULTS AND CONCLUSION:(1)All radiographic parameters significantly improved during the 8 to 12-month follow-up after surgery(P＜0.001).(2)Clinical evaluation results indicated that the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot score significantly improved from 66.2±6.0 preoperatively to 91.3±5.8 postoperatively,and the Visual Analog Scale score significantly decreased from 3.1±0.8 preoperatively to 1.3±0.8 postoperatively(P＜0.001).(3)Independent t-tests showed a significant difference in postoperative the first metatarsal angle and Visual Analog Scale score grades(P=0.043),with a smaller the first metatarsal angle associated with less postoperative pain;preoperative lateral arch angle showed a significant difference between the"excellent"and"good"groups in postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scores(P=0.033),suggesting that a smaller preoperative posterior arch angle might predict better postoperative foot function recovery.(4)Correlation analysis showed that preoperative posterior arch angle(r=-0.486,P＜0.01)and heel pitch angle(r=-0.344,P＜0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,while preoperative medial longitudinal arch angle(r=0.293,P＜0.05)was significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.Postoperative medial longitudinal arch angle(r=0.331,P＜0.05)and lateral arch angle(r=0.387,P＜0.01)were significantly positively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot,whereas postoperative Bohler's angle(r=-0.272,P＜0.05),posterior arch angle(r=-0.461,P＜0.01),and heel pitch angle(r=-0.318,P＜0.01)were significantly negatively correlated with postoperative American Orthopaedic Foot & Ankle Society Ankle-Hindfoot.(5)It is concluded that subtalar arthroereisis is significantly effective in correcting pediatric flexible flatfoot,and improvements in radiographic parameters are closely related to clinical efficacy.Preoperative and postoperative radiographic evaluations can serve as important reference indicators for predicting postoperative clinical outcomes,guiding clinicians to optimize treatment plansand rehabilitation programs.

[摘 要] 树突状细胞（DC）是连接固有免疫与适应性免疫的核心枢纽，其功能稳态是介导肿瘤免疫监视的关键。然而，肿瘤微环境（TME）通过营养竞争及免疫抑制代谢产物的累积，驱动DC发生代谢重编程，进而诱导免疫应答功能缺陷。本文系统综述了TME中DC各亚型在三大代谢层面的重塑机制：糖代谢层面，高乳酸微环境通过GPR81信号抑制MHC-Ⅱ类分子表达，削弱传统树突状细胞（cDC）的抗原提呈能力；脂代谢层面，Wnt5a-β-catenin-PPARγ-CPT1A轴介导的脂肪酸氧化促进cDC向免疫抑制表型极化；氨基酸代谢层面，Arg1-IDO1通路的级联激活诱导DC获得耐受表型。针对上述代谢异常，当前干预策略已由单一靶点调控拓展至多模式联合，包括基于脂质纳米颗粒的原位疫苗与mRNA递送系统、代谢-免疫协同阻断，以及代谢状态优化的DC疫苗等。因此，深化对DC代谢检查点的认知，并靶向干预关键代谢检查点，不仅有望逆转免疫抑制微环境、克服治疗耐药，更为开发新一代代谢-免疫联合疗法提供了重要的科学依据与转化策略。

Animal experimentation constitutes a critical link between basic research and clinical application, making its research quality and translational efficiency paramount. Although considerable progress has been made in standardizing operational procedures and ethical guidelines, the standardization of outcome evaluation systems has significantly lagged, creating a key bottleneck that constrains the quality of biomedical research and evidence synthesis. This deficiency is manifested by pronounced heterogeneity in outcome selection across similar studies, incomplete methodological reporting, and disparate criteria for result interpretation, which severely impairs the comparability of findings and the evidence integration. To cope with this challenge, this paper systematically introduces a mature methodological tool from clinical research–the core outcome set (COS)–and explores its construction strategies and application potential in the field of animal experimentation. Given the extensive diversity of animal experiments, a pragmatic strategy of "focusing on key areas, implementing phased pilots, and promoting gradual expansion" should be adopted. This approach prioritizes the development of domain-specific COS for disease areas characterized by high research volume, urgent translational needs, and well-established animal models. A multi-source integration pathway for COS development is detailed, comprising systematic literature searches, methodological appraisals, and expert consensus, with the feasibility of leveraging artificial intelligence (AI) to enhance efficiency also being examined. The development and promotion of such COS are not intended to restrict scientific exploration; rather, they aim to establish a new, tiered evaluation paradigm consisting of "core outcomes" (mandatory), "recommended outcomes" (encouraged), and "exploratory outcomes" (optional). This framework is expected not only to enhance research quality through standardization and to adhere to the "3R" principles but also to accelerate the accumulation of high-quality evidence. This, in turn, provides a solid foundation for higher-level evidence synthesis, ultimately facilitating the effective translation of basic research findings into clinical practice and providing an essential methodological framework for scientific advancement in relevant disciplines.

The incidence of papillary thyroid microcarcinoma (PTMC) is steadily rising. Although conventional thyroid surgery techniques are well-established, they present challenges such as functional impairment and overtreatment. Cellular-level fluorescence-guided imaging technology (EndoSCell^®) enables precise intraoperative tumor localization and real-time identification of neurovascular structures via high-resolution imaging and targeted labeling. This technology significantly improves surgical precision, reduces the incidence of postoperative complications including recurrent laryngeal nerve injury and hypoparathyroidism, and strengthens standards for functional preservation. This article aimed to systematically explore recent advances in the application of EndoSCell^® for PTMC management, analyze its influence on the innovation of surgical approaches and the enhancement of functional preservation criteria, and discuss future directions, thereby providing a theoretical basis for clinical practice.

BackgroundIn recent years， the incidence of depression among adolescents has been increasing steadily， posing a serious threat to their physical and mental health and even leading to severe consequences such as self-harm and suicide. At the same time， the detection rate of subclinical depression symptoms among adolescents is even higher. Although these symptoms do not meet the clinical diagnostic criteria， they have significantly affected their quality of life， and their persistence over time may further develop into depression. Therefore， in-depth exploration of adolescent depression symptoms and the predictive factors holds significant practical significance and research value. However， up to now， no large-scale investigation and research on depression symptoms among children and adolescents has been conducted in Inner Mongolia Autonomous Region. ObjectiveTo understand the prevalence of depressive symptoms among children and adolescents in Inner Mongolia Autonomous Region， in order to provide references for formulating scientific and effective prevention strategies and intervention measures. MethodsBy using the cluster stratified random sampling method， 6 281 students from the third grade of primary school to the second grade of high school in 12 leagues and cities of Inner Mongolia Autonomous Region were selected in March 2024. A self-designed questionnaire and the Self-rating Depression Scale （SDS） were used for on-site investigation. ResultsA total of 6 058 （96.45%） children and adolescents completed the valid questionnaire survey， and 2 728 cases （45.03%） were found to have depressive symptoms. There were statistically significant differences in the detection rates of depressive symptoms among children and adolescents of different genders， ages， whether they were only children， different family types， family monthly income， parents' educational levels， and whether the mother was employed （χ²=33.769， 40.618， 48.593， 29.972， 142.648， 195.999， 168.190， 5.445， P<0.05 or 0.01）.The results of the Logistic regression analysis showed that for children and adolescents， being female， aged between 12 and 16， over 16 years old， not being an only child， living in a reconstituted family， having a monthly family income of less than 5 000 yuan， and having parents with an education level of primary school or below were predictors of depressive symptoms （OR=1.241， 1.427， 1.273， 1.177， 1.549， 1.278， 1.462， 1.417， 1.514， 1.929， 1.660， 1.528， P<0.05 or 0.01）. ConclusionThe detection rate of depressive symptoms among children and adolescents in Inner Mongolia Autonomous Region is relatively high. Factors that may predict depressive symptoms in children and adolescents include female gender， ages between 12 and 16， ages over 16 years old， non-only children， families with a restructured structure， monthly family income of less than 5 000 yuan， and parents with an education level of primary school or below. ［Funded by Science and Technology Planning Project of the Inner Mongolia Autonomous Region （number， 2022YFSH0119）］

Extracellular vesicles(EVs)are small vesicles secreted by cells,widely present in various body fluids,and they play important biological roles.In recent years,EVs have garnered significant attention as novel diagnostic and thera-peutic tools in multiple ocular diseases.Glaucoma,as a common cause of irreversible blindness,is primarily caused by optic nerve damage associated with pathologically elevated intraocular pressure.Emerging evidence indicates that EVs hold considerable therapeutic potential in glaucoma management,particularly in modulating aqueous humor circulation and pro-viding retinal neuroprotection.This review summarizes the latest research progress on EVs in the treatment of glaucoma.

Extracellular vesicles(EVs)are small vesicles secreted by cells,widely present in various body fluids,and they play important biological roles.In recent years,EVs have garnered significant attention as novel diagnostic and thera-peutic tools in multiple ocular diseases.Glaucoma,as a common cause of irreversible blindness,is primarily caused by optic nerve damage associated with pathologically elevated intraocular pressure.Emerging evidence indicates that EVs hold considerable therapeutic potential in glaucoma management,particularly in modulating aqueous humor circulation and pro-viding retinal neuroprotection.This review summarizes the latest research progress on EVs in the treatment of glaucoma.

BACKGROUND:In recent years,artificial intelligence has been increasingly integrated into the diagnosis and treatment of lumbar disc herniation,enhancing the accuracy and efficiency of diagnostic procedures and diversifying therapeutic approaches.This integration has positioned artificial intelligence as a burgeoning focal point within the field.OBJECTIVE:To provide a comprehensive overview of the current applications of artificial intelligence in the diagnosis and treatment of lumbar disc herniation,to analyze the limitations of the relevant technologies.METHODS:A systematic computer-assisted literature search was performed in PubMed,CNKI,WanFang Database,and VIP Database for relevant publications regarding the application of artificial intelligence in the diagnosis and treatment of lumbar disc herniation from database inception up to August 2024.The search keywords included"lumbar disc herniation,artificial intelligence,machine learning,deep learning,big data,robot,neural network,model,algorithm."A total of 101 articles were selected based on predefined inclusion criteria and were reviewed.RESULTS AND CONCLUSION:Different artificial intelligence technologies have propelled the intelligent treatment of lumbar disc herniation,showing great potential for future development.Deep learning technology,based on advanced algorithms,constructs corresponding learning models to optimize the processing of X-ray,CT,and MRI images,achieving precise localization,identification,and analysis of degenerated intervertebral discs,and improving the accuracy of automated diagnosis.Big data technology utilizes data platforms to analyze vast medical data,simulate disease development trends,and provide a new perspective for disease assessment and prediction.Surgical robots,combined with robotic arms,3D high-definition vision systems,and 5G communication technology,support remote precise surgical operations,demonstrating significant technological advantages.In the future,the diagnosis and treatment of lumbar disc herniation by artificial intelligence will evolve towards standardization,efficiency,and precision through continuous optimization of algorithms and the professional development of data platforms.

Glaucoma,characterized by optic nerve damage and progressive damage to retinal ganglion cells(RGCs),is the leading cause of irreversible blindness.However,the specific mechanism of RGC damage has not been fully elucida-ted.In recent years,there is increasing evidence that microglia,especially disease-associated microglia(DAM),may play an important role in glaucomatous ganglion cell injury.In this paper,we reviewed the role and mechanism of DAM in RGC damage in glaucoma,aiming to provide new insights for further research on the mechanism of RGC damage and subsequent protection of RGCs.