The connection between tendons and bones is called the tendon bone connection. With the continuous improvement of national sports awareness, excessive exercises and the related intensity are prone to damage the tendon bone connection. Tendon bone healing is a complex repair and healing process involving multiple factors, and good tendon bone healing is a prerequisite for its physiological function. The complexity of tendon bone structure also poses great challenges to the repair of tendon bone injuries. In recent years, researches have found that stem cells, growth factors, macrophages, and other factors are closely related to the healing process of tendon bone injuries, among which macrophages play an important role in the healing process. The authors reviewed relevant research literature in recent years and summarized the role of macrophages in tendon bone healing, in order to provide new ideas and directions for treatment strategies to promote tendon bone healing.
Humans ; Macrophages/metabolism* ; Wound Healing ; Animals ; Tendons/physiology* ; Bone and Bones/injuries* ; Tendon Injuries

Although symptomatic treatment is widely applied in clinical practice， it is often regarded as a relatively low-level therapeutic method. Based on Traditional Chinese Medicine （TCM） state theory， the macroscopic， mesoscopic， and microscopic characterization parameters of TCM symptomatology are horizontally integrated， the full life cycle of states （pre-disease， incipient disease， manifest disease， post-disease） is vertically covered， and the cognitive system of "symptoms" is reconstructed from multiple dimensions. Accordingly， the application approach of symptomatic treatment at different state stages is proposed： implementing preventive intervention in the pre-disease state， strengthening the interception of disease progression in the incipient disease state， regulating dynamic development and treatment in the manifest disease state， and formulating a staged diagnosis and treatment strategy which focuses on functional rehabilitation in the post-disease state.

Osteoarthritis(OA)is a common joint disease in clinical practice,and cartilage damage is a typical pathological change.The pathogenesis of OA is complex,and various adverse factors can lead to the occurrence of OA.Mitochondria are im-portant organelles within cells and play important roles in cellular physiological and pathological activ-ities.Mitochondrial quality control is an important regulatory mechanism in the body to maintain nor-mal mitochondrial structure and function,mainly including mitochondrial biogenesis,mitochondrial dynamics,mitochondrial autophagy,mitochondrial oxidative stress,and other forms.The imbalance of mitochondrial quality control in chondrocytes is closely related to the occurrence and development of osteoarthritis,and regulating the balance of mi-tochondrial quality control is a potential therapeu-tic point for osteoarthritis.The author reviewed rel-evant research literature in recent years to provide a review of the relationship between mitochondrial quality control and the occurrence and develop-ment of osteoarthritis,in order to provide new ideas and directions for the research and diagnosis and treatment strategies of osteoarthritis.

BACKGROUND:Currently,the pathogenesis of Parkinson's disease is not clear.Relevant studies have shown that α-synuclein and mitochondria are closely related to the pathogenesis of Parkinson's disease.It mainly involves oxidative stress,mitochondrial complex damage,calcium homeostasis,mitochondrial dynamics and mitochondrial quality control.OBJECTIVE:To review the association between α-synuclein and mitochondrial damage in Parkinson's disease.METHODS:The first author searched more than 50 documents from CNKI and WanFang databases from 2010 to 2024 using the keywords of"Parkinson's disease,mitochondrial damage and mechanism,α-synuclein"in Chinese as well as more than 750 documents from PubMed between 2010 and 2024 using the keywords of"Parkinson's disease,alpha-synuclein,mitochondria,oxidative stress,calcium homeostasis,mitophagy,mitochondrial dynamics,mitochondrial protein introduction"in English.Finally,70 documents were included for review.RESULTS AND CONCLUSION:Recent studies have confirmed the important role of mitochondrial dysfunction in the pathophysiology of Parkinson's disease,and the interaction between α-synuclein and mitochondria is a particularly significant factor in the pathogenesis of Parkinson's disease.The cascade of events that begin with naturally unfolded α-synuclein and eventually form mature fibril is collectively known as α-synuclein aggregation.The toxicity of aggregation accumulates in dopaminergic neurons and then disrupts mitochondrial function,thereby triggering Parkinson's disease.Therefore,the underlying mechanism of this bidirectional relationship between α-synuclein and mitochondrial dysfunction may provide new insights into the pathophysiology of Parkinson's disease.

Objective To investigate the expression and mechanistic role of the M2-type pyruvate kinase(PKM2)/signal transducer and activator of transcription 3(STAT3)signaling pathway in the development of experimental autoim-mune uveitis(EAU).Methods Eighteen 4-to 5-week-old C57BL/6J mice were selected and randomly divided into a control group(normal breeding,set as the 0-day state post-modeling),Experimental Group A,and Experimental Group B(both established as stable EAU mouse models using the interphotoreceptor retinoid-binding protein peptide 651-670,com-plete Freund's adjuvant,and pertussis toxin,designated as the 14-day and 21-day states post-modeling,respectively),with 6 mice in each group.The anterior segment of the mice was observed using a slit-lamp microscope,fundus findings were collected using a fundus camera,and clinical and histopathological scores were evaluated after hematoxylin-eosin stai-ning.The protein expression level of serum interleukin(IL)-17A was detected by ELISA.The expression level of PKM2 protein in retinal tissue was detected by immunohistochemistry.The protein expression levels of PKM2,phosphorylated STAT3(p-STAT3),and STAT3 in mouse retinal tissue were detected by Western blot.Results The clinical scores of the anterior segment and fundus,as well as the retinal histopathological scores in Experimental Group A and Experimental Group B,were all significantly higher than those in the control group(all P＜0.05).The serum IL-17A protein expression levels in the control group,Experimental Group A,and Experimental Group B were(69.05±0.45)ng·L-1,(75.06±0.46)ng·L-1,and(72.04±0.82)ng·L-1,respectively.The optical density values of PKM2 protein expression in retinal tissue were(18.51±2.59)％,(37.35±4.67)％,and(29.75±2.17)％,respectively.The expression levels of serum IL-17A protein,retinal PKM2 protein,and retinal STAT3 and p-STAT3 proteins in Experimental Group A and Experimental Group B were all significantly higher than those in the control group(all P＜0.05).Conclusion The expression levels of key factors in the PKM2/STAT3 signaling pathway are positively correlated with the severity of EAU,indicating that this sig-naling pathway,as a positive regulator of the immune response,is involved in the pathological process of EAU.

Objective:To identify the serotype and genotype characteristics of the first cluster infection of Brucella in Nujiang Lisu Autonomous Prefecture of Yunnan Province. Methods:The information of seven suspected cluster brucellosis cases reported in Lanping County, Nujiang Lisu Autonomous Prefecture in April 2023 were collected, blood samples were collected, and the strains were isolated and cultured. Serological methods were employed for brucellosis diagnosis, bacterial species identification was performed using BCSP31-PCR and AMOS-PCR. Multilocus locus variable-number tandem repeat analysis (MLVA) was conducted for strain genotyping, followed by phylogenetic analysis comparing the strains with those from other regions of China.Results:All seven cases were diagnosed with brucellosis, they were all villagers from the same village and had daily contact with sheeps. Four suspected Brucella strains were isolated, identified as Brucella melitensis biotype by BCSP31-PCR and AMOS-PCR. The four isolated strains exhibited identical MLVA-16 genotype, with MLVA-8 genotype 42 and MLVA-11 genotype 180, belonging to the Eastern Mediterranean lineage. Compared with the MLVA-16 of the isolated strains from other regions of China, the four isolated strains formed an independent cluster. Conclusion:The first cluster infection of Brucella in Nujiang Lisu Autonomous Prefecture of Yunnan Province is caused by Brucella melitensis biotype, and the four isolated strains have showed unique MLVA genotype.

Objective:To investigate the prevalence of skeletal fluorosis and the management and treatment of patients in endemic fluorosis areas of Shaanxi Province.Methods:From March to November 2023, in accordance with the requirements of the "2023 Monitoring Plan for Endemic Fluorosis in Shaanxi Province", the implementation of prevention and control measures of endemic fluorosis in Shaanxi Province was investigated. The data of patients with skeletal fluorosis from January to December 2023 were downloaded from Shaanxi Province Endemic Disease Control Information Management Platform, and the epidemiological characteristics were analyzed. At the same time, the management and treatment of patients with skeletal fluorosis in endemic fluorosis areas of Shaanxi Province were carried out in accordance with the requirements of the "Shaanxi Province Endemic Disease Patient Management Service Specification".Results:In 2023, there were 10 drinking water-borne endemic fluorosis cities in Shaanxi Province, involving 3 715 endemic villages, including 3 650 water improvement villages with a water-improving rate of 98.25%. There were 2 coal-burning-borne endemic fluorosis cities in Shaanxi Province, involving 641 746 households in 1 414 endemic villages. Among them, 641 617 households had changed their furnaces and stoves, with a furnace and stove change rate of 99.98%. There were 37 462 patients with skeletal fluorosis in the province, with 35 792 from drinking water-borne endemic fluorosis areas and 1 670 from coal-burning-borne endemic fluorosis areas. The condition was mainly mild and moderate (94.12%, 35 258/37 462), with females accounting for 55.13% (20 654/37 462). The education level was mainly primary school and illiteracy (83.64%, 31 333/37 462), and the occupation was mainly farmers (99.29%, 37 196/37 462). A total of 37 116 patients with skeletal fluorosis were followed up and managed, with a management rate of 99.08% (37 116/37 462). A total of 35 756 patients were managed in a standardized manner, and the standardized management rate was 96.34% (35 756/37 116). A total of 30 649 patients with skeletal fluorosis were actually treated, with a treatment rate of 84.27% (30 649/36 370) and a total effective rate of 98.08% (30 062/30 649).Conclusion:In 2023, the prevalence of skeletal fluorosis in endemic fluorosis areas of Shaanxi Province is mainly mild and moderate, with a wide coverage of community management and a high level of treatment efficiency.

Objective:To learn about the geographical distribution and bio-tying diversity characteristics of Brucella strains isolated in Yunnan Province. Methods:From March 2017 to December 2023, 516 suspected Brucella strains were collected from brucellosis surveillance sites and hospitals in Yunnan Province, and Yunnan Institute of Endemic Disease Control and Prevention. The Brucella isolates were confirmed to genus level by BCSP31-PCR, and subsequently identified to species and biovar level using conventional biotyping methods and AMOS-PCR. The geographical distribution of the strains was visualized using ArcGIS 10.8 software, simultaneously analyze the general characteristics of brucellosis patients. Results:Among the 516 suspected Brucella strains, 514 strains were isolated from patient blood samples and 2 strains were isolated from sheep blood samples. BCSP31-PCR identification showed that all strains were Brucella spp. The results of conventional biotyping and AMOS-PCR identification revealed that the isolates comprised 514 Brucella melitensis strains (16 strains of Brucella melitensis biovar 1 and 498 strains of Brucella melitensis biovar 3), one Brucella abortus (biovar 1) strain, and one Brucella canis strain. The strain was distributed in 69 counties/cities of 13 prefectures/cities in Yunnan Province, involving 390 administrative villages in 186 townships. Brucella melitensis was the dominant epidemic strain, and the largest number of Brucella melitensis was distributed in Kunming City( n = 205), followed by Honghe Hani and Yi Autonomous Prefecture ( n = 98) and Qujing City ( n = 72). Brucella abortus was only distributed in Lincang City ( n = 1), and Brucella canis was distributed Wenshan Zhuang and Miao Autonomous Prefecture ( n = 1). The age range of 514 brucellosis patients ranged from 10 months to 88 years, with the majority being between 40 and 60 years old (52.72%, 271/514). The predominant occupational group was farmers (89.11%, 458/514), followed by students (5.06%, 26/514). Conclusion:Brucella exhibits a wide distribution and species/biovar diversity in Yunnan Province, with infection among the farming population emerging as a serious public health problem in the area.

The composition of the Gut Microbiome(GM)is regulated by numerous factors,including geography,ethnicity,diet,and genetics.This review systematically synthesizes studies on the GM across different geographic regions and ethnic minority groups in China.It focuses on elucidating the impact of geographical factors and ethnic backgrounds on GM composition and structure and provides an in-depth discussion on the association between ethnicity-specific microbial taxa,their metabolic functions,and susceptibility to diseases.By systematically comparing microbial compositional differences in microbiota-related diseases among different populations,this review aims to uncover the underlying patterns.The findings are expected to provide a theoretical foundation for ethnicity-specific GM research,the elucidation of disease mechanisms,and the development of targeted prevention and control strategies.

To address the challenges associated with traditional medical treatment modalities that hinder the efficiency of healthcare delivery,and to facilitate the sharing of medical service information across multiple campuses via mobile platforms,the First Affiliated Hospital to Zhejiang University School of Medicine has proactively leveraged digital intelligence to innovate its medical service model.This program involved the development of a comprehensive process guidance service applet on the Alipay platform specifically for outpatient services.The applet offers intelligent support services,standardizes electronic authentication processes,coordinates medical resources across various hospital locations,and establishes an integrated service delivery system that seamlessly combines online and offline interactions.This approach has optimized the outpatient treatment process,enhanced the patient experience,and fostered standardized management of medical services across multiple campuses.