Objective:To prepare histatin 1 (Hst 1) and D-histatin 1 (D-Hst 1) coatings on pure titanium surfaces and to evaluate their impact on the initial adhesion and spreading of mouse bone marrow mesenchymal stem cells (mBMSC).Methods:The test pieces were divided into four groups: pure titanium, piranha solution-treated, 3-aminopropyltriethoxysilane-treated, Hst 1 modified groups or D-Hst 1 modified groups, with five pieces in each group. The surface hydrophilicity of the test pieces was detected by contact angle measurement. The surface microtopography was observed using atomic force microscopy (AFM), and the surface elemental composition was analyzed by X-ray photoelectron spectroscopy (XPS). The modification of Hst 1 on the titanium surface and the early adhesion and spreading of the third-generation normal mBMSC on Hst 1/D-Hst 1 modified group were observed using confocal laser scanning microscopy (CLSM).Results:The Hst 1 modified group had better surface hydrophilicity (contact angle 51.63°±3.80°) compared to the pure titanium group (contact angle 60.36°±4.38°). AFM observations revealed shallow mechanical scratches on the surfaces of all test pieces. CLSM and XPS elemental analysis confirmed the successful modification of Hst 1 on the titanium surface. Compared with the pure titanium group, both Hst 1 and D-Hst 1 could promoted the early adhesion of mBMSC. The Hst 1 modified group promoted the spreading of mBMSC after early adhesion, while the D-Hst 1 modified group showed no statistically significant difference in promoting mBMSC spreading compared to the pure titanium group ( P>0.05). Conclusions:The modification of Hst 1/D-Hst 1 on pure titanium surfaces using Schiff base reaction is effective. It is conducive to the early adhesion and spreading of mBMSC.

Cerebral venous sinus thrombosis(CVST)is one of the significant causes of pediatric stroke.Its clinical manifestations are non-specific,including seizures,altered state of consciousness,and neurological deficits.It is usually associated with a high risk of mortality and disability.Although anticoagulation remains the first-line therapy of CVST in children,some children still experience poor prognosis.In recent years,endovascular treatment(EVT),such as mechanical thrombectomy and intrasinus thrombolysis,has emerged as a crucial therapeutic approach for CVST.This review summarized the advances in EVT for pediatric CVST,aiming to provide insights for optimizing clinical management strategies.

Objective:To prepare histatin 1 (Hst 1) and D-histatin 1 (D-Hst 1) coatings on pure titanium surfaces and to evaluate their impact on the initial adhesion and spreading of mouse bone marrow mesenchymal stem cells (mBMSC).Methods:The test pieces were divided into four groups: pure titanium, piranha solution-treated, 3-aminopropyltriethoxysilane-treated, Hst 1 modified groups or D-Hst 1 modified groups, with five pieces in each group. The surface hydrophilicity of the test pieces was detected by contact angle measurement. The surface microtopography was observed using atomic force microscopy (AFM), and the surface elemental composition was analyzed by X-ray photoelectron spectroscopy (XPS). The modification of Hst 1 on the titanium surface and the early adhesion and spreading of the third-generation normal mBMSC on Hst 1/D-Hst 1 modified group were observed using confocal laser scanning microscopy (CLSM).Results:The Hst 1 modified group had better surface hydrophilicity (contact angle 51.63°±3.80°) compared to the pure titanium group (contact angle 60.36°±4.38°). AFM observations revealed shallow mechanical scratches on the surfaces of all test pieces. CLSM and XPS elemental analysis confirmed the successful modification of Hst 1 on the titanium surface. Compared with the pure titanium group, both Hst 1 and D-Hst 1 could promoted the early adhesion of mBMSC. The Hst 1 modified group promoted the spreading of mBMSC after early adhesion, while the D-Hst 1 modified group showed no statistically significant difference in promoting mBMSC spreading compared to the pure titanium group ( P>0.05). Conclusions:The modification of Hst 1/D-Hst 1 on pure titanium surfaces using Schiff base reaction is effective. It is conducive to the early adhesion and spreading of mBMSC.

Global public health faces substantial challenges from malignant tumors and infectious diseases. Vaccination provides an approach for treating and preventing these diseases. Oral vaccinations are particularly advantageous in disease treatment and prevention due to their non-invasive nature, high patient compliance, convenience, cost-effectiveness, and capacity to stimulate comprehensive and adaptive immune responses. However, the overwhelming majority of oral vaccines remain in experimental development, struggling with clinical and commercial translation due to their suboptimal efficacy. Thus, enhancing scientists' understanding of the interaction between vaccines and gastrointestinal immune system, creating antigen delivery systems suitable for the gut mucosal environment, developing more potent antigenic epitopes, and using personalized combination therapies are critical for advancing the next generation of oral vaccines. This article explores the fundamental principles and applications of current oral anti-tumor and anti-infective vaccines and discusses considerations necessary for designing future oral vaccines.

Cerebral venous sinus thrombosis(CVST)is one of the significant causes of pediatric stroke.Its clinical manifestations are non-specific,including seizures,altered state of consciousness,and neurological deficits.It is usually associated with a high risk of mortality and disability.Although anticoagulation remains the first-line therapy of CVST in children,some children still experience poor prognosis.In recent years,endovascular treatment(EVT),such as mechanical thrombectomy and intrasinus thrombolysis,has emerged as a crucial therapeutic approach for CVST.This review summarized the advances in EVT for pediatric CVST,aiming to provide insights for optimizing clinical management strategies.

Objective To analyze in depth the job satisfaction and influencing factors of medical staff in tertiary public hospitals in Gansu Province,especially to explore the important factors affecting the survival and development of hospitals as core talents,in order to provide reference for promoting the stable development of medical staff in medical institutions in Gansu Prov-ince.Methods From July to October 2024,a random sampling method was used to select relevant personnel from tertiary public hospitals in Gansu Province for a questionnaire survey.Descriptive analysis were conducted on the collected data.Multivariate lo-gistic regression analysis was used to identify the main influencing factors of job satisfaction among medical staff.The difference is statistically significant with P＜0.05,and the test level is α=0.05.Results 1 890 questionnaires were distributed and 1 885 valid questionnaires were collected,with an effective rate of 99.74％.The overall job satisfaction score of medical staff in tertiary hospitals in Gansu Province is 3.06±0.86,which is at a moderate level.Hospitals can consider improving management models,establishing scientific,reasonable,and humane management systems,enhancing doctors'sense of belonging,and improving sat-isfaction;The satisfaction brought by salary to medical staff is higher than promotion opportunities and career development,indi-cating that a reasonable salary incentive system in hospitals,with excellent performance and compensation,can increase doctors'subjective well-being and improve satisfaction.Optimising the allocation of health human resources and appropriately in creasing personnel allocation based can help improve doctors'job satisfaction.Conclusion The overall job satisfaction of medical staff in tertiary hospitals in Gansu Province is generally satisfactory,and there are statistically significant differences in job satisfaction a-mong medical staff with different work experience,education level and monthly income(P＜0.05).When formulating policies and measures,the government pays attention to factors that affect the job satisfaction of medical personnel,optimizes the alloca-tion of health human resources,continuously improves incentive mechanisms,and improves hospital management models,enhan-cing the job satisfaction of medical staff and laying the foundation for promoting the developmrnt of provincial health talent team.

Objective To analyze in depth the job satisfaction and influencing factors of medical staff in tertiary public hospitals in Gansu Province,especially to explore the important factors affecting the survival and development of hospitals as core talents,in order to provide reference for promoting the stable development of medical staff in medical institutions in Gansu Prov-ince.Methods From July to October 2024,a random sampling method was used to select relevant personnel from tertiary public hospitals in Gansu Province for a questionnaire survey.Descriptive analysis were conducted on the collected data.Multivariate lo-gistic regression analysis was used to identify the main influencing factors of job satisfaction among medical staff.The difference is statistically significant with P＜0.05,and the test level is α=0.05.Results 1 890 questionnaires were distributed and 1 885 valid questionnaires were collected,with an effective rate of 99.74％.The overall job satisfaction score of medical staff in tertiary hospitals in Gansu Province is 3.06±0.86,which is at a moderate level.Hospitals can consider improving management models,establishing scientific,reasonable,and humane management systems,enhancing doctors'sense of belonging,and improving sat-isfaction;The satisfaction brought by salary to medical staff is higher than promotion opportunities and career development,indi-cating that a reasonable salary incentive system in hospitals,with excellent performance and compensation,can increase doctors'subjective well-being and improve satisfaction.Optimising the allocation of health human resources and appropriately in creasing personnel allocation based can help improve doctors'job satisfaction.Conclusion The overall job satisfaction of medical staff in tertiary hospitals in Gansu Province is generally satisfactory,and there are statistically significant differences in job satisfaction a-mong medical staff with different work experience,education level and monthly income(P＜0.05).When formulating policies and measures,the government pays attention to factors that affect the job satisfaction of medical personnel,optimizes the alloca-tion of health human resources,continuously improves incentive mechanisms,and improves hospital management models,enhan-cing the job satisfaction of medical staff and laying the foundation for promoting the developmrnt of provincial health talent team.

Immune escape is one of the ten hallmarks of tumors， which plays an important role in the occurrence and development of tumors. Immune escape refers to a process where tumor cells remodel and edit the immune system through the model of immune clearance， immune balance， and immune escape to "transform" the immune cells into immunosuppressive cells in the tumor microenvironment， so as to support immune escape. The five-stage evolution is the summary of tumor pathogenesis by professor LI Jie. He believes that the gradual development of tumors follows the core pathogenesis of "deficiency-cold-toxin-obstruction-collapse"， in which "depression" runs through the whole process， and cancer toxin is the key. Based on immune editing， this paper combined phenotypic characteristics of tumor cells with the core pathogenesis of the five-stage evolution of professor LI to reveal the biological basis of malignant tumor five-stage evolution. The results indicate that the prominent change from deficiency to cold is the reduction of immune surveillance and the prominent change from toxin to obstruction is immune escape. The final stage of collapse is the outcome of immune failure. Depression is the booster of tumor immune editing. Therefore， the method of reinforcing the healthy Qi and removing toxins was proposed to regulate the immune editing and cut off the five-stage evolution of tumors. Supplementing Qi and warming Yang can reinforce the healthy Qi and restore immune surveillance. Removing toxins and dredging can reverse toxins and immune escape. The harmonizing method can maintain the dynamic balance of immune cells/immunosuppressive cells. Resolving depression can truncate tumor immune editing. Those methods can provide a certain reference for the treatment based on microscopic syndrome differentiation in traditional Chinese medicine （TCM）. In future studies， it is necessary to further explore the specific mechanism of the regulation of immune editing with the methods of supplementing Qi and warming Yang， removing toxins and dredging， their combination， and resolving depression， so as to find out specific Chinese medicines and targets and provide more sufficient evidence for the regulation of tumor immune editing by TCM.

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.

Objective To explore the application value of laparoscopic pedicled omentum acquisition technique in laparoscopic breast-conserving surgery of breast carcinoma.Methods From November 2016 to November 2017,there were 11 patients with breast carcinoma underwent laparoscopic breast-conserving surgery and breast plastic surgery with laparoscopic pedicled omentum acquisition technique in Beijing Friendship Hospital,Capital Medical University,and retrospectivly analyzed the clinical data of these patients.The operation time,intraoperative blood loss,drainage tube time,length of incision,surgical complications,postoperative cosmetic effect and tumor recurrence were recorded and analyzed.Results In 11 patients,the average of the total operation time was 186 min,the average intraoperative blood loss was 22 ml,the average drainage tube time was 3.1 d,and the average total length of the incision was 5.2 cm.There was no severe complication after surgery but only one patient had an increase of belching.The postoperative cosmetic results were excellent with the mean score was 14.7 (the total score was 15) along with getting full score in "shape of breast" and "scar of the incision".There was no locoregional recurrence or distant metastases.Conclusion The combination of laparoscopic breast-conserving surgery of breast carcinoma and the laparoscopic pedicled omentum acquisition technique assure the recovery of the breast shape safely and effectively,also provide better postoperative cosmetic results.