The deficiency of fingers due to various reasons leads to a certain degree of loss of full or part hand functions. Physical and mental health of patients are seriously affected, and patients have varying degrees of reduced quality of life. Prosthesis fingers play an important role in completing the body shape and enhancing patients’ self-confidence and self-esteem. However, how to make prosthesis fingers perform coordinated movements and restore complete functions is a crucial problem that urgently needs to be solved. This paper reviews the methods of brain-computer interface controlled fine finger movements and elaborates on the origin, current situation, and advancements of the development of this technology, laying a foundation for subsequent research, with the expectation of helping patients solve the problems arising from the insufficiency or absence of finger functions.

Objective:To explore the short-term clinical effects of deep cervical lymph node-venous anastomosis in the treatment of Alzheimer’s disease (AD).Methods:A prospective exploratory study was conducted on the treatment of AD patients using the cervical deep lymph node-venous anastomosis technique in Scar and Wound Treatment Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from September to October 2024. The patients underwent high-frequency ultrasound to locate deep cervical lymph nodes and the external jugular vein. Under general anesthesia, bilateral deep cervical lymph node-venous anastomoses were performed. Indocyanine green (ICG) lymphography was conducted via subcutaneous injection behind the ear to visualize lymph nodes in levels Ⅱ and Ⅲ. After making a skin incision along the posterior margin of the sternocleidomastoid muscle, the external jugular vein, internal jugular veins, and associated lymph nodes were exposed. Adjacent veins were selected for anastomosis of lymph node. Using microsurgical techniques, end-to-side or end-to-end anastomosis was completed for lymph nodes in levels Ⅱ and Ⅲ. Preoperative assessments included the mini-mental state examination (MMSE, a higher score indicates better cognitive function), Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog, a higher score indicates greater impairment of cognitive function), Alzheimer’s disease cooperative study scale for activities of daily living (ADCS-ADL, a higher score indicates better ability to perform daily activity), and neuropsychiatric inventory (NPI, a higher score indicates more severe behavioral and emotional symptom). Postoperative follow-up included the same scales to observe changes in cognitive function, activities of daily living, and emotional communication.Results:Four patients (1 male, 3 females, aged 58-79 years) with AD were included. All were diagnosed based on cerebrospinal fluid biomarkers. All patients successfully underwent bilateral deep cervical lymph node-venous anastomoses. On average, 4.3 (2-7 per person) anastomoses were performed per patient. Surgical procedures lasted an average of 6.5 h (5.5-8.5 h) with minimal blood loss (less than 50 ml). Patients resumed normal activity within 6 hours postoperatively and were discharged after an average of 4.1 d (3.5-5.0 d). Postoperative complications included one case each of aspiration pneumonia, lower limb venous thrombosis, and transient delirium, all of whom resolved without long-term effects. Clinical symptoms, including memory decline, mood swings, and anxiety, showed varying degrees of improvement. Patients reported enhanced quality of life, emotional stability, and social engagement, confirming the procedure’s safety and potential cognitive benefits. At one month postoperatively, the MMSE scores of the four patients increased by an average of 0.8 points compared to preoperative levels. Additionally, the two patients who completed the ADAS-Cog assessments showed a decrease in their scores (reduced by 1.0 points and 11.3 points, respectively, compared to preoperative scores), indicating a certain degree of improvement in cognitive function during this period. The ADCS-ADL and NPI scores of four patients varied significantly, without showing any clear pattern.Conclusion:Lymphovenous anastomosis of the deep cervical lymph node-venous anastomosis may provide a new surgical intervention approach for AD, but further large-scale studies and long-term follow-up are needed to validate its safety and effectiveness.

Various researches have reported on the relationship between homocysteine levels and adverse pregnancy outcomes. Researchers are increasingly focusing on the impact of homocysteine on female reproductive health and figuring out the potential positive effects of lowering homocysteine levels on women fertility. Our review aims to systematically summarize the possible roles of homocysteine in female reproductive disorders based on relevant studies from the past 15 years and therapeutic prospects targeting homocysteine to improve the reproductive health of women.

Objective:To evaluate corrective intra-articular osteotomy in the treatment of malreduced tibial pilon fractures in young patients.Methods:A retrospective study was conducted to analyze the 23 patients who had been treated for malreduced tibial pilon fractures by corrective intra-articular osteotomy from January 2013 to December 2022 at Department of Orthopedics, Orthopedic Research Institute, West China Hospital. They were 21 males and 2 females with a median age of 42.9(28.6, 48.1) years. The median interval between intra-articular osteotomy and initial injury or previous surgery was 97 (51, 166) d. The clinical efficacy was assessed by the ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS), MOS item short form health survey (SF-36), visual analog scale (VAS) pain score, ankle range of motion (ROM), modified Kellgren-Lawrence arthritis grading, and complications.Results:The median follow-up period was 35.4 (26.2, 72.2) months. At the last follow-up, the AOFAS ankle-hindfoot score, SF-36, VAS pain score, and ankle ROM for all patients were, respectively, (80.7±12.1) points, (72.2±13.9) points, 2.0(0, 3.0) points and 23.0°(18.0°, 30.0°), and the modified Kellgren-Lawrence arthritis grading revealed stage Ⅱ in 17 cases, stage Ⅲ in 5 cases, and stage Ⅳ in 1 case. For the 12 patients with sufficient preoperative data, the AOFAS ankle-hindfoot score [(80.9±10.1) points], SF-36 [(72.9±12.0) points], VAS pain score [2.5 (0.5, 3.0) points], and ankle ROM (26.5°±7.9°) at the last follow-up were significantly better than the preoperative values [(42.2±16.0) points, (36.0±8.8) points, 6.0 (5.5, 6.5) points, and 21.3°±7.0°] (all P<0.05). One patient who experienced significant pain postoperatively planned to receive ankle fusion surgery. No patients experienced deep infection, fracture non-union, or failure of internal fixation. Conclusion:Corrective intra-articular osteotomy may be a viable alternative treatment of malreduced tibial pilon fractures in young patients, because it can effectively improve short-term clinical and radiographic outcomes.

Various researches have reported on the relationship between homocysteine levels and adverse pregnancy outcomes. Researchers are increasingly focusing on the impact of homocysteine on female reproductive health and figuring out the potential positive effects of lowering homocysteine levels on women fertility. Our review aims to systematically summarize the possible roles of homocysteine in female reproductive disorders based on relevant studies from the past 15 years and therapeutic prospects targeting homocysteine to improve the reproductive health of women.

Objective:To explore the establishment, implementation, and application effect of the annual progressive assessment mode for standardized training of resident physicians in a medical laboratory base.Methods:Since 2020, the base has improved the annual progressive assessment system through assessment system establishment, question bank construction, routine assessment, rotation examination, and annual examination. This new assessment mode was adopted for the residency trainees enrolled in the base after 2020. The control group consisted of seven residency trainees enrolled before 2020, while the experimental group comprised 13 trainees enrolled in 2020 and later. The two groups were compared based on the rotation and annual examination scores of second- and third-year trainees, as well as their academic achievements. Additionally, teaching outcomes of the base before and after 2020 were analyzed. The t test, rank-sum test, and Fisher's exact test were performed using SPSS 27.00. Results:There were no significant differences in age, sex, and education level between the two groups. The experimental group showed significantly higher scores than the control group in theory assessment ( P<0.001 for second-year trainees and P=0.008 for third-year trainees) and skill assessment ( P<0.001 for second-year trainees and P=0.038 for third-year trainees) in rotation examination, as well as in theory assessment (both P<0.001) and skill assessment (both P<0.001) in annual examination. The improvement was particularly pronounced among second-year trainees. The trainees of the experimental group submitted 17 case reports in three years, and won awards at national conferences, provincial conferences, and institutional case speech competitions. In a national academic conference, the trainees won the second prize of "Excellent Case". Since 2020, we have been granted with our first teaching reform project and published our first teaching article. To date, we have obtained five teaching reform projects, published six teaching articles, and won multiple awards in provincial and institutional teaching competitions. Conclusions:The establishment of the annual progressive assessment mode is critical for training high-quality laboratory physicians, and puts forward higher requirements for residency training teachers.

Objective:To evaluate corrective intra-articular osteotomy in the treatment of malreduced tibial pilon fractures in young patients.Methods:A retrospective study was conducted to analyze the 23 patients who had been treated for malreduced tibial pilon fractures by corrective intra-articular osteotomy from January 2013 to December 2022 at Department of Orthopedics, Orthopedic Research Institute, West China Hospital. They were 21 males and 2 females with a median age of 42.9(28.6, 48.1) years. The median interval between intra-articular osteotomy and initial injury or previous surgery was 97 (51, 166) d. The clinical efficacy was assessed by the ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS), MOS item short form health survey (SF-36), visual analog scale (VAS) pain score, ankle range of motion (ROM), modified Kellgren-Lawrence arthritis grading, and complications.Results:The median follow-up period was 35.4 (26.2, 72.2) months. At the last follow-up, the AOFAS ankle-hindfoot score, SF-36, VAS pain score, and ankle ROM for all patients were, respectively, (80.7±12.1) points, (72.2±13.9) points, 2.0(0, 3.0) points and 23.0°(18.0°, 30.0°), and the modified Kellgren-Lawrence arthritis grading revealed stage Ⅱ in 17 cases, stage Ⅲ in 5 cases, and stage Ⅳ in 1 case. For the 12 patients with sufficient preoperative data, the AOFAS ankle-hindfoot score [(80.9±10.1) points], SF-36 [(72.9±12.0) points], VAS pain score [2.5 (0.5, 3.0) points], and ankle ROM (26.5°±7.9°) at the last follow-up were significantly better than the preoperative values [(42.2±16.0) points, (36.0±8.8) points, 6.0 (5.5, 6.5) points, and 21.3°±7.0°] (all P<0.05). One patient who experienced significant pain postoperatively planned to receive ankle fusion surgery. No patients experienced deep infection, fracture non-union, or failure of internal fixation. Conclusion:Corrective intra-articular osteotomy may be a viable alternative treatment of malreduced tibial pilon fractures in young patients, because it can effectively improve short-term clinical and radiographic outcomes.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To explore the effect and mechanism of keratin 17(KRT17)on proliferation of human esophageal squamous cell line KYSE-150.Methods The correlation of KRT17 expression with the disease stage and survival of patients with esophageal squamous cell carcinoma was analyzed by GEPIA2 website.Human esophageal squamous cell line KYSE-150 was divided into control group,si-NC group,si-KRT17 group and activator group.Small interfering RNA of si-NC and si-KRT17 were transfected into cells of si-NC group and si-KRT17 group,re-spectively.Cells in the activator group were transfected with si-KRT17 and treated with 740 Y-P(PI3K/AKT/mTOR pathway activator)with a final concentration of 30 μmol/L in the medium.The cell proliferation was detec-ted by CCK-8 assay.The clonal formation was detected by clonal formation experiment.The apoptosis was detected by TUNEL staining.The cell cycle was detected by flow cytometry.The cell migration and invasion were detected by Transwell assay.The contents of glucose,lactic acid and pyruvate in cell supernatant were detected by commercially available kits.The expression of KRT17 mRNA was detected by qRT-PCR.And the expression of KRT17,GLUT1,PDK1 and LDHA,p-PI3K,PI3K,p-AKT,AKT,p-mTOR and mTOR protein were detected by Western blot.Results The expression level of KRT17 in esophageal squamous cell carcinoma tissues was significantly higher than that in normal tissues(P＜0.05).There was a statistically significant correlation between the expression level of KRT17 and the stage of esophageal squamous cell carcinoma(P＜0.05).The survival prognosis of patients with low KRT17 expression was better than that of patients with high KRT17 expression(P＜0.05).Compared with control group or si-NC group,the mRNA and protein expression of KRT17 in si-KRT17 group were decreased(P＜0.05),and the cell proliferation activity,number of clone formation,migration and invasion cells were de-creased(P＜0.05).And the lactic acid content,protein expression levels of GLUT1,PDK1 and LDHA were de-creased(P＜0.05),values of p-PI3K/PI3K,p-Akt/AKT and p-mTOR/mTOR were decreased(P＜0.05).The proportion of cells in G0/G1 phase,TUNEL positive rate,and contents of glucose and pyruvate were increased(P＜0.05).Compared with si-KRT17 group,the mRNA and protein expression levels of KRT17 in activator group were increased(P＜0.05),and the cell proliferation activity,number of clone formation,migration and in-vasion cells were increased(P＜0.05).And the lactic acid content,protein expression levels of GLUT1,PDK1 and LDHA were increased(P＜0.05),the values of p-PI3K/PI3K,p-Akt/AKT and p-mTOR/mTOR were in-creased(P＜0.05).The proportion of cells in G0/G1 phase,TUNEL positive rate,and contents of glucose and pyruvate were decreased(P＜0.05).Conclusions KRT17 is highly expressed in esophageal squamous cell car-cinoma tissues and cells.Silencing KRT17 inhibits proliferation,migration and invasion of human esophageal squamous cell line KYSE-150,and promotes apoptosis and cell cycle arrest.