Ischemia-reperfusion (I/R) injury following skin flap transplantation is a critical factor leading to flap necrosis and transplant failure. Antagonizing inflammatory responses and oxidative stress are regarded as crucial targets for mitigating reperfusion injury and enhancing flap survival. In this study, caffeic acid-vanadium metal polyphenol nanoparticles (CA-V NPs) were prepared for the treatment of skin flap ischemia and reperfusion. This study was conducted using a one-step method to prepare new types of CA-V NPs with uniform sizes and stable structures. In vitro, the CA-V NPs exhibited CAT-like and SOD-like activities and could effectively scavenge ROS, generate oxygen, and alleviate oxidative stress. In the H₂O₂-induced cellular oxidative stress model, CA-V NPs effectively reduced ROS levels and inhibited apoptosis through the XIAP/Caspase-3 pathway. In the cellular inflammation model induced by LPS combined with IFN-γ, CA-V NPs reprogrammed macrophage polarization toward the M2 phenotype and reduced inflammatory responses by reducing the expression of the chemokines CCL4 and CXCL2. In addition, animal experiments have shown that CA-V NPs can alleviate oxidative stress in skin flap tissues, inhibit apoptosis, promote angiogenesis, and ultimately improve the survival rate of skin flaps. CA-V NPs provide a new target and strategy for the treatment of flap I/R injury.

ObjectiveThis study aimed to explore the correlation between the quality of life （QOL） and different traditional Chinese medicine （TCM） syndromes in patients with myasthenia gravis （MG）， identifying potential influencing factors to provide new insights for clinical interventions and improving the QOL of patients with MG. MethodsA questionnaire survey was conducted on 93 adults with MG who visited the Department of Neurology at the Affiliated Hospital of Changchun University of Chinese Medicine from March 2023 to January 2024. Statistical analysis was performed on the clinical data collected using SPSS 24.0 software. ResultsAmong the 93 patients with MG， the average score for myasthenia gravis quality of life-15 （MGQOL-15） was 17.65±6.27， and that for the 36-item short form health survey （SF-36） was （106.13±11.83） scores. The QOL was rated as good for 16 patients and moderate for 77 patients. There were no statistically significant differences in the scores of MGQOL-15， SF-36， and their individual scales by gender or education level. Age showed statistically significant differences in MGQOL-15 and the role physical （RP） scale （P<0.05）， and occupational type showed significant differences in the vitality （VT） scale （P<0.01）. The Myasthenia Gravis Foundation of America （MGFA） classification had statistical significance on the total SF-36 score （P<0.01）， VT scale （P<0.01）， role emotional （RE） scale （P<0.05）， social functioning （SF） scale （P<0.05）， and physical functioning （PF） scale （P<0.01）. Among patients with different TCM syndromes， there were significant differences in MGQOL-15 scores （F=4.919， P<0.01）. Moreover， significant differences were observed in SF-36 scores （P<0.01）， VT scale （P<0.01）， RE scale （P<0.05）， mental health （MH） scale （P<0.01）， and SF scale （P<0.05）. ConclusionFactors affecting the QOL of patients with MG include age， occupational type， and clinical classification of MG. Specifically， a greater impact on the QOL of older patients is observed， while physical laborers have a poorer QOL compared to non-physical laborers. Patients classified as MGFA type Ⅱ and higher have a poorer QOL. Additionally， there is a potential correlation between the QOL and TCM syndromes， with patients presenting with spleen and kidney Qi deficiency having a lower QOL than those with spleen and stomach Qi deficiency or Qi and Yin deficiency， which is particularly evident in the VT， RE， MH， and SF scales.

Objective:To investigate the value of the water pressure method (WPM) for endoscopic submucosal dissection (ESD) of difficult early gastrointestinal cancer.Methods:Clinical data of 7 patients with difficult early gastrointestinal cancer who underwent WPM-ESD at Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from April 2023 to April 2024 were retrospectively collected. Operation time, complete resection rate and complications were recorded.Results:WPM-ESD was successfully completed in all 7 cases. According to the lesion location and factors for difficulty, there were 2 cases of early esophageal cancer (1 case with remarkable external compression, and the other with remarkable hyperkeratosis), 1 case of early gastric cancer (a large lesion located at the greater curvature), 1 case of early descending duodenal cancer (severe submucosal fibrosis due to a history of two sessions of biopsies), 2 cases of early colon cancer (1 case with severe submucosal adipose deposition, and the other with deep submucosal invasion ), and 1 case of early rectal cancer (close to the dentate line). Operation time ranged from 15-85 min. Only 1 case required supplemental rubber-band traction. Complete resection was achieved in all 7 cases. Two patients developed fever postoperatively; no perforation, bleeding or other complications were observed.Conclusion:WPM demonstrates feasibility and efficacy for ESD in difficult early gastrointestinal cancer.

Objective:To analyze the clinical characteristics and identify predictive factors for spontaneous passage of common bile duct (CBD) stones.Methods:A retrospective analysis was conducted on patients diagnosed as having choledocholithiasis via abdominal imaging at outpatient and emergency departments of Jiangsu Province Hospital of Chinese Medicine and other medical institutions from January 2021 to November 2023. Participants were stratified into spontaneous passage versus non-passage groups. Multivariate logistic regression analysis was used to identify predictors for the spontaneous passage of common bile duct stones.Results:Spontaneous stone passage were confirmed in 70 cases (15.5%). Multivariate logistic regression analysis identified that an admission diagnosis of acute biliary pancreatitis ( OR=3.317, 95% CI: 1.427-7.713, P=0.005), larger common bile duct diameter ( OR=1.117, 95% CI: 1.000-1.248, P=0.049), and solitary stones ( OR=11.135, 95% CI: 3.602-34.418, P<0.001) significantly increased the probability of spontaneous stones. In contrast, larger stone long diameter ( OR=0.539, 95% CI: 0.441-0.659, P<0.001) markedly decreased passage likelihood. Receiver operator characteristic (ROC) curve analysis demonstrated that the common bile duct diameter predicted spontaneous stone passage with an area under the curve (AUC) of 0.662, yielding sensitivity of 52.9% (37/70) and specificity of 73.6% (51/70) at a cutoff value of 9.5 mm. The common bile duct stone diameter achieved an AUC of 0.852 for predicting spontaneous stone passage, with sensitivity of 75.7% (53/70) and specificity of 89.0% (62/70) at a cutoff value of 4.5 mm. Conclusion:Solitary small stones, ductal dilation, and an admission diagnosis of acute biliary pancreatitis are key predictive factors for spontaneous common bile duct stone passage. A common bile duct diameter ≥9.5 mm and stone long diameter ≤4.5 mm are more likely to result in spontaneous stone passage.

Extracorporeal membrane oxygenation(ECMO)provides blood circulation with assisted breathing for patients with severe cardiopulmonary failure,and buys valuable time for the rescue of critical patients.However,extracorporeal membrane oxygenation is often associated with serious complications.Small animal models have the advantages of low price,wide source,high flexibility and good reproducibility,and are an effective platform for evaluating strategies for prevention and treatment of ECMO complications.In recent years,more and more experimental studies have been conducted using small animal ECMO models.In this paper,the current status of the construction and application of small animal ECMO models at home and abroad is summarized,in order to optimize the related strategies of small animal ECMO model construction and promote the application and development of small animal ECMO models.

OBJECTIVES: This study aims to evaluate the changes in the mandibular canal following the treatment of large odontogenic keratocysts through decompression and curettage, providing a theoretical basis for sequential treatment. METHODS: Twenty patients were selected for each decompression and curettage treatment of large odontogenic keratocysts in the mandible. Postoperative follow-up with was conducted every three months, during which cone beam computed tomography (CBCT) scans were performed. Then, the data were imported into MIMICS software to observe 3D changes in the position and structure of the mandibular nerve canal, followed by a comparative analysis. RESULTS: The total displacement of the mandibular canal was (1.89±0.21) mm on the decompression side and (0.80±0.19) mm on the curettage side. Vertically, the displacement range of the mandibular canal on the decompression side (M=1.03, SD=0.17) was larger than on the curettage side (M=0.52, SD=0.010) within nine months post-operation. In the buccal-lingual direction, the ratio of the thickness of the buccal plate to the lingual plate gradually increased with time. The amount of bone reconstruction at the part of the mandibular nerve canal closest to the cyst was (1.75±0.15) mm on the decompression side and (1.45±0.09) mm on the curettage side after nine months. CONCLUSIONS The mandibular nerve canal showed varying degrees of recovery and "relocation" after two surgical procedures. Osteogenesis around the mandibular nerve canal was more remarkable after decompression than after curettage. Therefore, for large odontogenic keratocyst, decompression is recommended as the initial treatment, followed by secondary curettage nine months later.
Humans ; Odontogenic Cysts/diagnostic imaging* ; Retrospective Studies ; Cone-Beam Computed Tomography ; Decompression, Surgical/methods* ; Mandibular Nerve/surgery* ; Mandible/innervation* ; Curettage ; Male ; Female ; Adult ; Middle Aged

Digital biopsy for liver diseases is characterized by the deep integration of artificial intelligence （AI） technologies and large-scale liver disease data， through which intelligent analytics are applied to support clinical decision-making and full-cycle management. This article reviews the AI technical framework based on standardized data governance and centered on multimodal large medical models， covering the application of natural language processing， knowledge map， generative AI， and large language models in the establishment of databases for specialty diseases， diagnosis， prognosis prediction， treatment， and automated medical documentation. This article also discusses the application prospects of this framework in medical education， scientific research， and healthcare management. Although this technique shows broad application potential， it still faces challenges in areas such as multi-center data integration， model interpretability， ethics， and data security. In the future， a smart ecosystem with closed-loop optimization and human-AI collaboration should be established to promote the comprehensive implementation of digital biopsy in the whole process of medicine， education， research， and management， thereby providing help for the precise prevention and control and holistic health management of liver diseases.

With the increasing difficulty of traditional chemical drug research and development,peptide drugs have gradually become a hot spot in drug research and development due to their advantages of high specificity,significant efficacy,easy metabolism and low toxicity.This review systematically expounds the physicochemical properties,main advantages and limitations of peptide drugs,and summarizes the currently common strategies for structural modification and delivery.It focuses on the application and target of approved peptide drugs in various diseases such as diabetes,cancer,bacterial and viral infections,multiple sclerosis,and osteoporosis.Furthermore,the research analyzes the challenges in the research and development of peptide drugs,including poor in vivo stability,low bioavailability,and limited routes of administration.It also discusses the prospects of new technologies based on molecular modification,nanodelivery systems,and computer-aided design.In summary,peptide drugs have shown unique advantages in multi-field therapy,but they still need to break through bottlenecks in preparation,delivery and drug resistance to provide new ideas and directions for future precision therapy.

Extracorporeal membrane oxygenation(ECMO)provides blood circulation with assisted breathing for patients with severe cardiopulmonary failure,and buys valuable time for the rescue of critical patients.However,extracorporeal membrane oxygenation is often associated with serious complications.Small animal models have the advantages of low price,wide source,high flexibility and good reproducibility,and are an effective platform for evaluating strategies for prevention and treatment of ECMO complications.In recent years,more and more experimental studies have been conducted using small animal ECMO models.In this paper,the current status of the construction and application of small animal ECMO models at home and abroad is summarized,in order to optimize the related strategies of small animal ECMO model construction and promote the application and development of small animal ECMO models.

Objective:To investigate the value of the water pressure method (WPM) for endoscopic submucosal dissection (ESD) of difficult early gastrointestinal cancer.Methods:Clinical data of 7 patients with difficult early gastrointestinal cancer who underwent WPM-ESD at Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from April 2023 to April 2024 were retrospectively collected. Operation time, complete resection rate and complications were recorded.Results:WPM-ESD was successfully completed in all 7 cases. According to the lesion location and factors for difficulty, there were 2 cases of early esophageal cancer (1 case with remarkable external compression, and the other with remarkable hyperkeratosis), 1 case of early gastric cancer (a large lesion located at the greater curvature), 1 case of early descending duodenal cancer (severe submucosal fibrosis due to a history of two sessions of biopsies), 2 cases of early colon cancer (1 case with severe submucosal adipose deposition, and the other with deep submucosal invasion ), and 1 case of early rectal cancer (close to the dentate line). Operation time ranged from 15-85 min. Only 1 case required supplemental rubber-band traction. Complete resection was achieved in all 7 cases. Two patients developed fever postoperatively; no perforation, bleeding or other complications were observed.Conclusion:WPM demonstrates feasibility and efficacy for ESD in difficult early gastrointestinal cancer.