OBJECTIVE: To review the latest research advancements in surgical techniques for the treatment of limb lymphedema. METHODS: The relevant literature at home and abroad in recent years was extensively reviewed, and the research on the treatment of limb lymphedema by surgical techniques were summarized and analyzed. RESULTS: Lymphovenous anastomosis has demonstrated good effectiveness for early to mid-stage limb lymphedema, however its long-term effectiveness and applicability for late-stage limb lymphedema still require further validation. Autologous lymphatic/venous grafting has shown clinical feasibility in the treatment of secondary limb lymphedema. Research on tissue-engineered lymphatic scaffolds remains insufficient, primarily due to the complexity of lymphatic anatomical structures and the technical challenges involved. Nevertheless, its potential application is promising. Vascularized lymph node flap transplantation has shown significant effectiveness in treating limb lymphedema, particularly yielding good outcomes in upper limb cases. However, it can not guarantee a complete cure for the condition. Charles' operation is the most effective treatment option for patients with late-stage limb lymphedema, but its extensive incision and severe postoperative complications limit its application. Liposuction has the advantages such as minimal invasiveness, high safety, and repeatability. It is suitable for patients with late-stage limb lymphedema who have failed conservative treatment or developed adiposity. However, its effectiveness is limited in patients with significant limb fibrosis. CONCLUSION Current treatments for limb lymphedema require further improvement, and there is considerable debate regarding treatment strategies for different stages of the condition. Future high-quality, multi-system combined treatment approaches are anticipated to guide clinical practice.
Humans ; Lymphedema/surgery* ; Surgical Flaps/blood supply* ; Lymphatic Vessels/surgery* ; Anastomosis, Surgical/methods* ; Lymph Nodes/transplantation* ; Lipectomy/methods* ; Extremities/surgery* ; Treatment Outcome ; Tissue Engineering ; Tissue Scaffolds ; Veins/transplantation*

Objective:To explore the research status and hotspots of Shenling Baizhu Powder by using bibliometrics methods.Methods:The journal literature related to Shenling Baizhu Powder was retrieved by computer from CNKI, VIP, Wanfang Data and CBM from January 1, 2010 to December 31, 2022. NoteExpress 3.2 was used to merge and deduplicate, and the authors, institutions and keywords were analyzed visually by using VOSviewer 1.6.18 and CiteSpace 6.1.R6.Results:A total of 2 695 journal articles were included, and the annual number of articles showed an upward trend. The source journal with the most relevant articles was Chinese Clinical Research (72 articles). The main treatment diseases were digestive system diseases and respiratory system diseases. The author with most publications was Yang Qinhe (15 articles) from Jinan University. Jiangxi University of Chinese Medicine published the most articles (51 articles). In addition to search terms, the top three high-frequency keywords were clinical efficacy, TCM therapy and diarrhea. Keyword cluster analysis showed that the main research contents were applicable diseases, treatment methods, treatment principles, experimental models and literature types.Conclusion:Shenling Baizhu Powder mainly focuses on the treatment of digestive system diseases and respiratory system diseases in clinical application research, and the mechanism research focuses on immune function and intestinal flora.

Objective To establish method for simultaneous determination of hesperidin, cinnamaldehyde and eugenol in Chunyang Zhengqi capsules by high performance liquid chromatography. Methods The column was Agilent PorosheⅡ 120 EC-C₁₈ (4.6 mm×150 mm, 4 μm). The mobile phase was acetonitrile-water with gradient elution. The column temperature was 35℃. The flow rate was 1.0 ml/min, and the detection wavelength was 284 nm. Results The methodological verification showed that hesperidin, cinnamaldehyde and eugenol had a good linearity (r≥0.999 9). The precisions were less than 2.0%. The average recovery was between 98.0% and 101.9%. The stability and repeatability of RSD were also less than 3.0%, which met the requirements of method validation. Conclusion The method is simple, stable, reproducible and accurate, which could be used to the quality control of Chunyang Zhengqi capsules.

BACKGROUND:Scaffold materials serve as platforms that provide space and structure,playing a crucial role in the regeneration of cartilage tissue.Scholars from around the world are exploring different approaches to fabricate more ideal scaffold materials. OBJECTIVE:To review the design principles and preparation methods of cartilage scaffolds,and to further explore the advantages and limitations of various preparation methods. METHODS:Literature searches were conducted on the databases of CNKI,WanFang Data,PubMed,and FMRS from 1998 to 2023.The search terms were"cartilage repair,cartilage tissue engineering,cartilage scaffold materials,preparation"in Chinese and English.A total of 57 articles were ultimately reviewed. RESULTS AND CONCLUSION:(1)The articular cartilage has a unique structure and limited self-repair capacity after injury.Even if self-repair occurs,the newly formed cartilage is typically fibrocartilage,which is far inferior to normal articular cartilage in terms of structure and mechanical properties.It is difficult to maintain normal function and often leads to degenerative changes.Currently,the design and fabrication of scaffold materials for cartilage repair need to consider the following aspects:biocompatibility and biodegradability,suitable pore structure and porosity,appropriate mechanical properties,and bioactivity.(2)Research on the preparation of cartilage scaffolds has made significant progress,continuously introducing new preparation methods and optimization strategies.These methods have their advantages and disadvantages,providing more possibilities for customized preparation and functional design of cartilage scaffolds according to specific requirements.

Objective:To investigate the efficacy of Compound Musk combined with nimodipine combined with minimally invasive surgery in the treatment of hypertensive cerebral hemorrhage and the effects on serum inflammation, stress and apoptosis.Methods:Prospective research methods was used. A total of 118 patients with hypertensive intracerebral hemorrhage who received treatment in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from March 2017 to January 2021 were randomly divided into control group and Compound Musk group (59 cases in each group). After minimally invasive surgery, patients in the control group were treated with nimodipine on the basis of conventional treatment, while patients in the Compound Musk group were treated with compound musk on the basis of the control group. After 2 weeks, the efficacy was evaluated and the levels of serum inflammatory indexes, oxidative stress indexes and apoptosis indexes were measured.Results:The total effective rate in Compound Musk group was higher than that in control group: 98.3% (58/59) vs. 88.1% (52/59), and the difference was statistically significant ( P<0.05). After 2 weeks of treatment, serum inflammatory indexes including nuclear factor-κB (NF-κB), interleukin-1β (IL-1β), matrix metalloproteinase-3 (MMP-3), matrix metalloproteinase-9 (MMP-9); apoptosis indexes including soluble Fas receptor (sFas), soluble Fas ligand (sFAS-L); oxidative stress indexes including advanced oxidation protein products (AOPP), malondialdehyde (MDA) decreased, and some oxidative stress indexes including glutathione peroxidase (GSH-Px), catalase (CAT) increased. The levels of the above inflammatory indexes, apoptosis indexes and oxidative stress indexes in Compound Musk group were lower than those in control group, NF-κB: (18.96 ± 2.17) ng/L vs. (24.10 ± 3.23) ng/L, IL-1β: (12.88 ± 1.74) ng/L vs. (15.19 ± 1.63) ng/L, MMP-3: (5.62 ± 0.95) ng/L vs. (7.97 ± 0.86) ng/L, MMP-9: (7.07 ± 0.86) ng/L vs. (9.26 ± 1.13) ng/L, sFas: (3.24 ± 0.38) μg/L vs. (4.19 ± 0.53) μg/L, sFas-L: (209.17 ± 24.39) ng/L vs. (288.54 ± 37.61) ng/L, AOPP: (10.76 ± 1.84) μg/L vs. (13.51 ± 2.09) μg/L, MDA: (2.87 ± 0.32) μmol/L vs. (3.45 ± 0.34) μmol/L, and the differences were statistically significant ( P<0.05). Some of the above oxidative stress indexes were higher than those in control group, GSH-Px: (3 274.91 ± 376.09) U/L vs. (2 854.19 ± 325.22) U/L, CAT: (60.82 ± 7.43) U/L vs. (52.17 ± 6.48) U/L, the differences were statistically significant ( P<0.05). During treatment, there was no significant difference in the incidence of rash, diarrhea, drug-induced liver and myocardial injury between two groups ( P>0.05). Conclusions:Compound Musk has a positive effect on improving the curative effect and internal environment of patients with hypertensive intracerebral hemorrhage after minimally invasive surgery, and will not increase the occurrence of serious adverse reactions.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Pancreatic cancer is the fourth leading cause of cancer-related death in the world.Most patients are diagnosed as locally advanced or metastatic disease at initial visit,losing the opportunity of surgery.Conversion therapy aims to give unresectable tumors the opportunity to receive radical surgery through comprehensive treatment.For unresectable pancreatic cancer,chemotherapy based on AG(abraxane+gemcitabine)or FOLFIRINOX(5-fluorouracil+leucovorin+irinotecan+oxaliplatin),radiotherapy combined with chemotherapy as well as other regimens have shown conversion potential.Targeted therapy and immunotherapy have also become new frontiers of conversion therapy for pancreatic cancer.Focusing on new drugs and new regimens,this review has summarized the latest research progress of conversion therapy for pancreatic cancer.

Objective:To investigate the effect of flap combined with 3D printed microporous titanium(tantalum)prosthesis in the treatment of lower extremity soft tissue defect with large bone defect.Methods:From January 2019 to December 2020, 2 patients with large soft tissue defects on dorsal foot together with large metatarsal bone defect and 4 patients with soft tissue defects of calf with large tibial bone defect were treated. The areas of soft tissue defect were 5.0 cm×8.0 cm-15.0 cm×10.0 cm. The length of the bone defect were 3.8 cm to 7.0 cm, 5.75 cm in average. In the first stage, metatarsal bone defect or tibial bone defect was filled with vancomycin blended bone cement, meanwhile, soft tissue defect was repaired with anterolateral femoral flap(ALTF) with vascular anastomosis in 2 cases of feet, and local fascia flap was trans-positioned in 4 cases of lower extremity defects. The sizes of repairing flap were 6.0 cm×8.5 cm-16.0 cm×11.0 cm. Two to 7 months after the initial surgery, the customer designed microporous titanium prostheses were used(5 cases with microporous titanium and 1 with microporous tantalum) to repair the bone defects. The wound healing, the integration of metatarsal and tibial fractures with 3D printed microporous titanium(tantalum) prostheses, and the walking condition were observed after surgery. The follow-up lasted from 6 to 25 months, with an average of 12.7 months.Results:The wound healing in 5 patients was good. The patients stood on the foot in 2 months after surgery, started to walk with the assistance of crutch in 3 months after surgery, and took walk without assistance in 5-6 months after surgery. Good osseous integration were achieved. One diabetic patient had infection of foot wound 3 months after surgery. After removal of microporous titanium prosthesis and replacement of vancomycin blended interstitial substance of bone cement, the wound healed and the patient resumed walking.Conclusion:It is an effective method to encourage the patients to take early ambulation after the surgery for lower extremity soft tissue defect with large bone defect that was repaired by a flap and 3D printed microporous titanium(tantalum)prosthesis. Further observations are required to investigate the long-term efficacy, and the reduction of prosthesis infection rate requires further exploration.

Cardiometabolic disease (CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually, a new concept of metaflammation has been proposed to define the state of metabolism connected with immunological adaptations. Amongst the continuously increased list of systemic metabolites in regulation of immune system, bile acids (BAs) represent a distinct class of metabolites implicated in the whole process of CMD development because of its multifaceted roles in shaping systemic immunometabolism. BAs can directly modulate the immune system by either boosting or inhibiting inflammatory responses via diverse mechanisms. Moreover, BAs are key determinants in maintaining the dynamic communication between the host and microbiota. Importantly, BAs via targeting Farnesoid X receptor (FXR) and diverse other nuclear receptors play key roles in regulating metabolic homeostasis of lipids, glucose, and amino acids. Moreover, BAs axis per se is susceptible to inflammatory and metabolic intervention, and thereby BAs axis may constitute a reciprocal regulatory loop in metaflammation. We thus propose that BAs axis represents a core coordinator in integrating systemic immunometabolism implicated in the process of CMD. We provide an updated summary and an intensive discussion about how BAs shape both the innate and adaptive immune system, and how BAs axis function as a core coordinator in integrating metabolic disorder to chronic inflammation in conditions of CMD.

Background and Objectives: Human umbilical cord mesenchymal stem cells (HUC-MSCs) are promising candidates for cell-based therapy in regenerative medicine or other diseases due to their superior characteristics, including higher proliferation, faster self-renewal ability, lower immunogenicity, a noninvasive harvest procedure, easy expansion in vitro, and ethical access, compared with stem cells from other sources. Methods: and Results: In the present study, we knocked down the expression of SOX9 in HUC-MSCs by lentivirus interference and found that knockdown of SOX9 inhibited the proliferation and migration of HUC-MSCs and influenced the expression of cytokines (IL-6 and IL-8), growth factors (GM-CSF and VEGF) and stemness-related genes (OCT4 and SALL4). In addition, the repair effect of skin with burn injury in rats treated with HUC-MSCs transfected with sh-control was better than that rats treated with HUC-MSCs transfected with shSOX9 or PBS, and the accessory structures of the skin, including hair follicles and glands, were greater than those in the other groups. We found that knockdown of the expression of SOX9 obviously inhibited the expression of Ki67, CK14 and CK18. Conclusions In conclusion, this study will provide a guide for modifying HUC-MSCs by bioengineering technology in the future.