Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Objective:To develop a comprehensive training curriculum to enhance the effective implementation of the national initiative promoting dementia care and prevention.Methods:The Delphi method was utilized in an expert consultation that included 44 participants.The initial draft of the training curriculum was developed based on the current state of dementia care and prevention.This draft was subsequently evaluated for its importance, feasibility, and ease of dissemination.Experts offered targeted modifications and additional recommendations.Results:The recovery rate of the expert consultation questionnaire was 95.5%, with a recovery validity rate of 90.9%.The expert authority coefficient was 0.91, and the Kendall's coordination coefficient( W)for expert scoring was 0.316, with a significance level of P<0.001.Four course modules were ultimately identified: the foundation of memory clinic work, the complete management practice skills, group counseling techniques for caregivers, and practical skills for caregivers.The importance of these modules was rated with a mean of 4.92 to 4.95, and the coefficient of variation ranged from 0.044 to 0.063.Each module had a mean value of 4.92 to 4.95, with a coefficient of variation of 0.044 to 0.063; the mean value for practicality was between 4.78 and 4.92, with a coefficient of variation of 0.055 to 0.098; and the mean value for ease of generalization ranged from 4.28 to 4.65, with a coefficient of variation from 0.140 to 0.203.The four modules comprised a total of 55 specific course content items, with the mean value for each item ranging from 4.76 to 5.00 and a coefficient of variation from 0.000 to 0.121.The mean value of usefulness assigned to each entry ranged from 4.55 to 4.98, with a coefficient of variation from 0.031 to 0.150.Additionally, the mean value for ease of propagation assigned to each entry ranged from 4.00 to 4.83, with a coefficient of variation from 0.091 to 0.245. Conclusions:The developed training curriculum, which comprises four course modules and 55 items, demonstrated consistently high levels of importance, practicality, and ease of dissemination.These findings indicate that the curriculum is well-aligned with national initiatives aimed at enhancing dementia care and prevention.

OBJECTIVE To investigate the induction of apoptosis in hepatocellular carcinoma cells by polyphyllin 9 （PP9） through the regulation of the Fas/Fas ligand （FasL） signaling pathway， and its inhibitory effect on the growth of transplanted tumor in nude mice. METHODS Based on the screening of cell lines and intervention conditions， HepG2 cells were selected as the experimental subject to investigate the effects of 2 μmol/L and 4 μmol/L PP9 treatment on cell colony formation activity， apoptosis rate， as well as the protein expressions of Fas， FasL， cleaved caspase-8 and cleaved caspase-3. Additionally， Fas inhibitor KR- 33493 was introduced to investigate the underlying mechanism of PP9’s anti-hepatocellular carcinoma activity. Using HepG2 cell tumor-bearing nude mice model as the object， and 5-fluorouracil （20 mg/kg） as the positive control， the effects of 10 mg/kg PP9 on tumor volume， tumor mass， and the protein expressions of the nuclear proliferation-associated antigen Ki-67 and cleaved caspase-3 in tumor-bearing nude mice were investigated. RESULTS Compared with the control group， 2， 4 μmol/L PP9 significantly decreased the number of clones and the clone formation rate of cells， but significantly increased the apoptosis rate， the protein expressions of Fas， FasL， cleaved caspase-8 and cleaved caspase-3 （P＜0.05 or P＜0.01）. However， the combination of Fas inhibitor KR-33493 could significantly reverse the effect of PP9 on the up-regulation of proteins related to the Fas/FasL signaling pathway （P＜0.01）. Compared with the control group， the tumor volume （on day 27）， mass and protein expression of Ki- 67 in nude mice of the PP9 group were significantly decreased， while the protein expression of cleaved caspase-3 was significantly increased （P＜0.01）. CONCLUSIONS PP9 can induce apoptosis of HepG2 cells by activating the Fas/FasL signaling pathway. Meanwhile， PP9 can also effectively inhibit the growth of transplanted tumors in nude mice.

Cognitive dysfunction often occurs in Alzheimer's disease, Parkinson's disease, cerebrovascular disease, or other neurodegenerative diseases, and can significantly impact the life quality of patients and create serious social, psychological, and economic burdens for individuals and their families. Numerous studies have confirmed that exercise can slow the decline in cognitive function through multiple pathways, in which fibronectin type III domain-containing protein 5 (FNDC5) plays an important role. However, the current research on the modulation of FNDC5 by exercise and its ability to improve hippocampal cognitive function lacks a systematic and comprehensive understanding. Therefore, this review focuses on the latest research progress regarding the role of exercise-induced FNDC5 in cognitive function, systematically reviews the positive effects of FNDC5 on cognitive function impairment caused by various factors, and clarifies the specific mechanisms by which exercise-induced FNDC5 improves cognitive function by inhibiting neuroinflammation and improving hippocampal neurogenesis and hippocampal synaptic plasticity. Based on the existing literature, we also identify the areas that require further research in this field. Overall, this review provides a theoretical basis for exercise-based prevention and improvement of cognitive function impairment.
Humans ; Cognition/physiology* ; Fibronectins/physiology* ; Exercise/physiology* ; Hippocampus/physiology* ; Cognitive Dysfunction/prevention & control* ; Neuronal Plasticity ; Animals ; Neurogenesis

OBJECTIVE: Paridis Rhizoma (Chonglou in Chinese), a traditional Chinese herbal medicine, has been shown have strong anti-tumor effects. Paris saponin VII (PSVII), an active constituent isolated from Paridis Rhizoma, was demonstrated to significantly suppress the proliferation of BxPC-3 cells in our previous study. Here, we aimed to elucidate the anti-pancreatic ductal adenocarcinoma (PDAC) effect of PSVII and the underlying mechanism. METHODS: Cell viability was determined by CCK-8, colony formation, and cell migration assays. Cell apoptosis and reactive oxygen species (ROS) production were measured by flow cytometry with annexin V/propidine iodide (Annexin V/PI) and 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA), respectively. Pyroptosis was evaluated by morphological features, Hoechst 33342/PI staining assay, and release of lactate dehydrogenase (LDH). JC-1 fluorescent dye was employed to measure mitochondrial membrane potential. Western blotting and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were used to determine the levels of proteins or mRNAs. The effect in vivo was assessed by a xenograft tumor model. RESULTS: PSVII inhibited the viability of PDAC cells (BxPC-3, PANC-1, and Capan-2 cells) and induced gasdermin E (GSDME) cleavage, as well as the simultaneous cleavage of Caspase-3 and poly (ADP-ribose) polymerase 1 (PARP). Knockdown of GSDME shifted PSVII-induced pyroptosis to apoptosis. Additionally, the effect of PSVII was significantly attenuated by Z-Asp(OMe)-Glu(OMe)-Val-Asp(OMe)-fluoromethylketone (Z-DEVD-FMK), on the induction of GSDME-dependent pyroptosis. PSVII also elevated intracellular ROS accumulation and stimulated Bax and Caspase-3/GSDME to conduct pyroptosis in PDAC cells. The ROS scavenger N-acetyl cysteine (NAC) suppressed the release of LDH and inhibited Caspase-9, Caspase-3, and GSDME cleavage in PDAC cells, ultimately reversing PSVII-induced pyroptosis. Furthermore, in a xenograft tumor model, PSVII markedly suppressed the growth of PDAC tumors and induced pyroptosis. CONCLUSION These results demonstrated that PSVII exerts therapeutic effects through Caspase-3/GSDME-dependent pyroptosis and may constitute a novel strategy for preventing chemotherapeutic resistance in patients with PDAC in the future.

Objective To observe the effect of ultrasound-guided sacral canal injection of Neurotropin combined with comprehen-sive rehabilitation on severe sacral plexus injury after sacral fracture.Methods A case with severe sacral plexus injury ten months after sacral fracture was reviewed.He accepted ultrasound-guided sacral canal injection of Neurotropin along with comprehensive rehabilitation,and was assessed with American Spinal Injury Association Impairment Scale(AIS)impairment scale,manual muscle testing,Visual An-alog Scale(VAS),modified Barthel Index(MBI),Short-form of Health Survey(SF-36)and Functional Gait As-sessment(FGA),and measured the nerve conduction velocity and the structural organization of the sacrococcy-geal ligament using nerve conduction velocity tests,electromyography(EMG)and ultrasound examination be-fore and after treatment.Results After four weeks and ten weeks of treatment,the muscle strength,and scores of MBI,FGA and SF-36 increased,while the ASIA score improved from grade D to grade E,and VAS score decreased.During follow-up,the VAS score and physical pain and general health status scores of the SF-36 increased.After ten weeks of treatment,nerve conduction velocity increased,latency shortened,and the amplitude of evoked action potentials increased.The presence of spontaneous sharp waves decreased,and the peak of active potentials increased.The peak of ac-tive potentials in the right gluteus maximus,vastus lateralis and gastrocnemius muscles increased.The structural organization of the sacrococcygeal ligament appeared clearer and more orderly.No adverse reaction was ob-served.Conclusion Ultrasound-guided sacral canal injection of Neurotropin combined with comprehensive rehabilitation is ef-fective on pain,activities of daily living and quality of life for patients with severe sacral plexus injury during the sequelae period.

Objective:To investigate the clinical effects and advantages of laparoscopic total mesorectal excision in the treatment of colorectal cancer.Methods:A total of 82 patients with colorectal cancer who received treatment at the Second Affiliated Hospital of Guizhou Medical University from January 2020 to January 2023 were selected for a prospective study. They were randomly assigned to two groups using a random number table, with 41 cases in each group. The control group underwent conventional laparotomy, while the observation group received laparoscopic total mesorectal excision. Clinical efficacy, clinical indicators, and immune function indicators were compared between the two groups.Results:The operation time for patients in the observation group was (1.98 ± 0.31) hours, the length of hospital stay was (8.32 ± 2.38) days, the recovery time for bowel function was (2.15 ± 0.34) days, and the intraoperative blood loss was (112.35 ± 12.66) mL, all of which were shorter and lower than those in the control group [(2.46 ± 0.32) hours, (14.52 ± 2.42) days, (3.25 ± 0.15) days, and (167.78 ± 12.35) mL, t = 6.90, 11.70, 18.95, 20.07, all P < 0.001). The short-term response rate in the observation group was higher than that in the control group ( χ2 = 4.10, P < 0.05). The immune function indicators in the observation group, including the CD4 +/CD8 + ratio (1.78 ± 0.54), immunoglobulin A [(3.87 ± 0.73) g/L], and immunoglobulin G [(11.83 ± 2.88) g/L], were all better than those in the control group [(1.36 ± 0.53), (1.78 ± 0.63) g/L, (6.37 ± 2.45) g/L, t = 3.55, 13.88, 9.25, all P < 0.001]. The incidence of complications in the observation group was 2.44% (1/41), which was significantly lower than that in the control group [19.51% (8/41), χ2 = 4.49, P < 0.05]. Conclusions:Laparoscopic total mesorectal excision for patients with colorectal cancer has significant advantages, including faster recovery, less bleeding, and fewer complications, making it more superior to conventional laparotomy.

Objective:To investigate the clinical effects and advantages of laparoscopic total mesorectal excision in the treatment of colorectal cancer.Methods:A total of 82 patients with colorectal cancer who received treatment at the Second Affiliated Hospital of Guizhou Medical University from January 2020 to January 2023 were selected for a prospective study. They were randomly assigned to two groups using a random number table, with 41 cases in each group. The control group underwent conventional laparotomy, while the observation group received laparoscopic total mesorectal excision. Clinical efficacy, clinical indicators, and immune function indicators were compared between the two groups.Results:The operation time for patients in the observation group was (1.98 ± 0.31) hours, the length of hospital stay was (8.32 ± 2.38) days, the recovery time for bowel function was (2.15 ± 0.34) days, and the intraoperative blood loss was (112.35 ± 12.66) mL, all of which were shorter and lower than those in the control group [(2.46 ± 0.32) hours, (14.52 ± 2.42) days, (3.25 ± 0.15) days, and (167.78 ± 12.35) mL, t = 6.90, 11.70, 18.95, 20.07, all P < 0.001). The short-term response rate in the observation group was higher than that in the control group ( χ2 = 4.10, P < 0.05). The immune function indicators in the observation group, including the CD4 +/CD8 + ratio (1.78 ± 0.54), immunoglobulin A [(3.87 ± 0.73) g/L], and immunoglobulin G [(11.83 ± 2.88) g/L], were all better than those in the control group [(1.36 ± 0.53), (1.78 ± 0.63) g/L, (6.37 ± 2.45) g/L, t = 3.55, 13.88, 9.25, all P < 0.001]. The incidence of complications in the observation group was 2.44% (1/41), which was significantly lower than that in the control group [19.51% (8/41), χ2 = 4.49, P < 0.05]. Conclusions:Laparoscopic total mesorectal excision for patients with colorectal cancer has significant advantages, including faster recovery, less bleeding, and fewer complications, making it more superior to conventional laparotomy.

Objective To observe the effect of ultrasound-guided sacral canal injection of Neurotropin combined with comprehen-sive rehabilitation on severe sacral plexus injury after sacral fracture.Methods A case with severe sacral plexus injury ten months after sacral fracture was reviewed.He accepted ultrasound-guided sacral canal injection of Neurotropin along with comprehensive rehabilitation,and was assessed with American Spinal Injury Association Impairment Scale(AIS)impairment scale,manual muscle testing,Visual An-alog Scale(VAS),modified Barthel Index(MBI),Short-form of Health Survey(SF-36)and Functional Gait As-sessment(FGA),and measured the nerve conduction velocity and the structural organization of the sacrococcy-geal ligament using nerve conduction velocity tests,electromyography(EMG)and ultrasound examination be-fore and after treatment.Results After four weeks and ten weeks of treatment,the muscle strength,and scores of MBI,FGA and SF-36 increased,while the ASIA score improved from grade D to grade E,and VAS score decreased.During follow-up,the VAS score and physical pain and general health status scores of the SF-36 increased.After ten weeks of treatment,nerve conduction velocity increased,latency shortened,and the amplitude of evoked action potentials increased.The presence of spontaneous sharp waves decreased,and the peak of active potentials increased.The peak of ac-tive potentials in the right gluteus maximus,vastus lateralis and gastrocnemius muscles increased.The structural organization of the sacrococcygeal ligament appeared clearer and more orderly.No adverse reaction was ob-served.Conclusion Ultrasound-guided sacral canal injection of Neurotropin combined with comprehensive rehabilitation is ef-fective on pain,activities of daily living and quality of life for patients with severe sacral plexus injury during the sequelae period.

Objective:To develop a comprehensive training curriculum to enhance the effective implementation of the national initiative promoting dementia care and prevention.Methods:The Delphi method was utilized in an expert consultation that included 44 participants.The initial draft of the training curriculum was developed based on the current state of dementia care and prevention.This draft was subsequently evaluated for its importance, feasibility, and ease of dissemination.Experts offered targeted modifications and additional recommendations.Results:The recovery rate of the expert consultation questionnaire was 95.5%, with a recovery validity rate of 90.9%.The expert authority coefficient was 0.91, and the Kendall's coordination coefficient( W)for expert scoring was 0.316, with a significance level of P<0.001.Four course modules were ultimately identified: the foundation of memory clinic work, the complete management practice skills, group counseling techniques for caregivers, and practical skills for caregivers.The importance of these modules was rated with a mean of 4.92 to 4.95, and the coefficient of variation ranged from 0.044 to 0.063.Each module had a mean value of 4.92 to 4.95, with a coefficient of variation of 0.044 to 0.063; the mean value for practicality was between 4.78 and 4.92, with a coefficient of variation of 0.055 to 0.098; and the mean value for ease of generalization ranged from 4.28 to 4.65, with a coefficient of variation from 0.140 to 0.203.The four modules comprised a total of 55 specific course content items, with the mean value for each item ranging from 4.76 to 5.00 and a coefficient of variation from 0.000 to 0.121.The mean value of usefulness assigned to each entry ranged from 4.55 to 4.98, with a coefficient of variation from 0.031 to 0.150.Additionally, the mean value for ease of propagation assigned to each entry ranged from 4.00 to 4.83, with a coefficient of variation from 0.091 to 0.245. Conclusions:The developed training curriculum, which comprises four course modules and 55 items, demonstrated consistently high levels of importance, practicality, and ease of dissemination.These findings indicate that the curriculum is well-aligned with national initiatives aimed at enhancing dementia care and prevention.