This study evaluates the safety and early clinical outcomes of a novel 3D-printed titanium alloy "sleeve" component for revising fractured femoral stem prostheses in distal femoral megaprostheses without removing the fractured stem. The six patients included 2 males and 4 females, with an age range of 8-57 years. They were treated at Peking University People's Hospital between August 2020 and December 2023 and underwent revision surgery using the customized sleeve. A self-designed 3D-printed titanium alloy "sleeve" component was used for revision without removing the fractured stem, in the form of an external sleeve around the stem. Postoperative imaging was performed every three months to assess implant stability and bone integration. Functional outcomes were evaluated using the Musculoskeletal Tumor Society (MSTS)-93 score. All six patients successfully completed the surgery and follow-up, with surgical durations ranging from 120 to 230 minutes and intraoperative blood loss ranging from 150 to 800 ml. The follow-up period ranged from 6 to 46 months. At three months postoperatively, X-ray and CT imaging showed cortical bridging between the host bone and the "sleeve" component. By six months, full integration of the host cortical bone with the metal trabecular interface of the "sleeve" was observed. At the final follow-up, MSTS-93 scores ranged from 26 to 29 points, with no complications such as wound healing issues, implant loosening, fracture, infection, or degenerative arthritis. These findings suggest that 3D-printed titanium "sleeve" provide an effective, bone-preserving solution for femoral stem revision in oncologic megaprostheses, leading to favorable early stability and functional recovery.

Viruses,as important biological agents influencing human health and social development,have played a key role in the spread of epidemics and the evolution of diseases since ancient times.Upon infecting hosts,viruses often trigger a series of com-plex responses,including innate and adaptive immunity,inflammatory responses and pathological damage.Despite advances in mod-ern antiviral drugs development,chemical drugs typically rely on a single molecular target within the viral life cycle,making them highly susceptible to the emergence of drug resistance and the induction of systemic toxic side effects.In contrast,traditional Chi-nese medicines(TCMs),posing the distinctive advantage of multi-component,multi-target,and multi-pathway,have exerted a pivotal role in viral prevention and viral treatment.In recent years,fresh herbs have gained increasing attention for their ability to preserve intact bioactive components.Fresh herb-derived nanovesicles possess excellent biocompatibility,targeting and cross-species regula-tory capabilities.These fresh herb-derived nanovesicles can effectively encapsulate and deliver a variety of antiviral components,demonstrating significant potential in antiviral immunomodulation,inflammation control and viral-induced pathologies.This review systematically sorts out the mechanisms of viral infection,and summarizes the advantages of fresh herbs,and the application pros-pects of fresh herb-derived nanovesicles in antiviral therapy.Furthermore,it focuses on summarizing the research progress of fresh herb-derived nanovesicles in the field of antiviral therapy,with the aim of providing insights and references for the development of fresh herb-derived nanovesicles-based antiviral strategies,as well as offering novel approaches and perspectives for the clinical treat-ment of viral diseases.

This study evaluates the safety and early clinical outcomes of a novel 3D-printed titanium alloy "sleeve" component for revising fractured femoral stem prostheses in distal femoral megaprostheses without removing the fractured stem. The six patients included 2 males and 4 females, with an age range of 8-57 years. They were treated at Peking University People's Hospital between August 2020 and December 2023 and underwent revision surgery using the customized sleeve. A self-designed 3D-printed titanium alloy "sleeve" component was used for revision without removing the fractured stem, in the form of an external sleeve around the stem. Postoperative imaging was performed every three months to assess implant stability and bone integration. Functional outcomes were evaluated using the Musculoskeletal Tumor Society (MSTS)-93 score. All six patients successfully completed the surgery and follow-up, with surgical durations ranging from 120 to 230 minutes and intraoperative blood loss ranging from 150 to 800 ml. The follow-up period ranged from 6 to 46 months. At three months postoperatively, X-ray and CT imaging showed cortical bridging between the host bone and the "sleeve" component. By six months, full integration of the host cortical bone with the metal trabecular interface of the "sleeve" was observed. At the final follow-up, MSTS-93 scores ranged from 26 to 29 points, with no complications such as wound healing issues, implant loosening, fracture, infection, or degenerative arthritis. These findings suggest that 3D-printed titanium "sleeve" provide an effective, bone-preserving solution for femoral stem revision in oncologic megaprostheses, leading to favorable early stability and functional recovery.

Viruses,as important biological agents influencing human health and social development,have played a key role in the spread of epidemics and the evolution of diseases since ancient times.Upon infecting hosts,viruses often trigger a series of com-plex responses,including innate and adaptive immunity,inflammatory responses and pathological damage.Despite advances in mod-ern antiviral drugs development,chemical drugs typically rely on a single molecular target within the viral life cycle,making them highly susceptible to the emergence of drug resistance and the induction of systemic toxic side effects.In contrast,traditional Chi-nese medicines(TCMs),posing the distinctive advantage of multi-component,multi-target,and multi-pathway,have exerted a pivotal role in viral prevention and viral treatment.In recent years,fresh herbs have gained increasing attention for their ability to preserve intact bioactive components.Fresh herb-derived nanovesicles possess excellent biocompatibility,targeting and cross-species regula-tory capabilities.These fresh herb-derived nanovesicles can effectively encapsulate and deliver a variety of antiviral components,demonstrating significant potential in antiviral immunomodulation,inflammation control and viral-induced pathologies.This review systematically sorts out the mechanisms of viral infection,and summarizes the advantages of fresh herbs,and the application pros-pects of fresh herb-derived nanovesicles in antiviral therapy.Furthermore,it focuses on summarizing the research progress of fresh herb-derived nanovesicles in the field of antiviral therapy,with the aim of providing insights and references for the development of fresh herb-derived nanovesicles-based antiviral strategies,as well as offering novel approaches and perspectives for the clinical treat-ment of viral diseases.

Objective To compare H_p(3) calibration with a homemade (A) thermoluminescent dosimeter (TLD) and an imported (B) TLD in a standard X-ray RQR radiation field, to explore the different responses of A and B, and to provide foundation for the calibration of H_p(3). Methods A column mode was selected. H_p(3) calibration was performed using A and B in a standard X-ray RQR radiation field in the Secondary Standard Dosimetry Laboratory, National Institute for Radiological Protection, China Center for Disease Control and Prevention. Angle response, energy response, and linear response were calibrated with RQR4 (60 kV), RQR7 (90 kV), and RQR9 (120 kV), respectively. Results In terms of angle response, the calibration results of A were relatively high, while the calibration results of B were relatively low. In terms of energy response, the calibration results showed a similar pattern to angle response. In terms of linear response, the calibration results of both A and B were satisfactory. Conclusion Both A and B can be used for normal calibration of H_p(3) in a standard X-ray RQR radiation field. However, in actual monitoring, attention should be paid to the energy and angle response values of TLDs.

Objective:To investigate the influencing factors of refractory anastomotic stenosis after laparoscopic intersphincteric resection (Ls-ISR) for rectal cancer and construction of nomogram prediction model.Methods:The retrospective case-control study was conducted. The clinicopatho-logical data of 495 patients who underwent Ls-ISR for rectal cancer in two medical centers, including 448 patients in Peking University First Hospital and 47 patients in Cancer Hospital Chinese Academy of Medical Sciences, from June 2012 to December 2021 were collected. There were 311 males and 184 females, aged 61 (range, 20-84)years. Observation indicators: (1) incidence of anastomotic stenosis; (2) influencing factors of refractory anastomotic stenosis after Ls-ISR; (3) construction and evaluation of nomogram prediction model for refractory anastomotic stenosis after Ls-ISR. Follow-up was conducted using outpatient examination and telephone interview to detect the incidence of postoperative anastomotic leakage and anastomotic stenosis up to August 2022. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Univariate and multivariate analyses were conducted using the Logistic regression model. Factors with P<0.10 in univariate analysis were included in multivariate analysis. The R software (3.6.3 version) was used to construct nomogram prediction model. The receiver operating characteristic (ROC) curve was drawn and the area under curve (AUC) was used to evaluate the efficacy of nomogram prediction model. Results:(1) Incidence of anastomotic stenosis. All 495 patients underwent Ls-ISR successfully, without conversion to laparotomy, and all patients were followed up for 47(range, 8-116)months. During the follow-up period, there were 458 patients without anas-tomotic stenosis, and 37 patients with anastomotic stenosis. Of the 37 patients, there were 15 cases with grade A anastomotic stenosis, 3 cases with grade B anastomotic stenosis and 19 cases with grade C anastomotic stenosis, including 22 cases being identified as the refractory anastomotic stenosis. Fifteen patients with grade A anastomotic stenosis were relieved after anal dilation treat-ment. Three patients with grade B anastomotic stenosis were improved after balloon dilation and endoscopic treatment. Nineteen patients with grade C anastomotic stenosis underwent permanent stoma. During the follow-up period, there were 42 cases with anastomotic leakage including 17 cases combined with refractory anastomotic stenosis, and 453 cases without anastomotic leakage including 5 cases with refractory anastomotic stenosis. There was a significant difference in the refractory anastomotic stenosis between patients with and without anastomotic leakage ( χ2=131.181, P<0.05). (2) Influencing factors of refractory anastomotic stenosis after Ls-ISR. Results of multivariate analysis showed that neoadjuvant therapy, distance from tumor to anal margin ≤4 cm, clinic N+ stage were independent risk factors of refractory anastomotic stenosis after Ls-ISR ( hazard ratio=7.297, 3.898, 2.672, 95% confidence interval as 2.870-18.550, 1.050-14.465, 1.064-6.712, P<0.05). (3) Construction and evaluation of nomogram prediction model for refractory anastomotic stenosis after Ls-ISR. Based on the results of multivariate analysis, neoadjuvant therapy, distance from tumor to anal margin and clinic N staging were included to constructed the nomogram prediction model for refractory anastomotic stenosis after Ls-ISR. Results of ROC curve showed the AUC of nomogram prediction model for refractory anastomotic stenosis after Ls-ISR was 0.739 (95% confidence interval as 0.646-0.833). Conclusions:Neoadjuvant therapy, distance from tumor to anal margin ≤4 cm, clinic N+ stage are independent risk factors of refractory anastomotic stenosis after Ls-ISR. Nomogram prediction model based on these factors can predict the incidence of refractory anastomotic stenosis after Ls-ISR.

Objective:To evaluate the clinical outcome of a special physeal sparing knee prosthesis for pediatric distal femoral osteosarcoma regarding the functional outcome, retention of the growth potential of the proximal tibia, and postoperative complications.Methods:A retrospective study was conducted to review 37 pediatric patients with osteosarcoma of distal femur who were treated in a single musculuskeletal tumor center between August 2015 and January 2019. Among them, 21 were boys and 16 were girls, aged from 5 to 12 years at the time of operation, with an average age of 9.1±2.1 years and the height of 115 to 160 cm, with an average of 140±10 cm. Tumor resection of distal femur was performed and the bone defect was reconstructed by a special hinged knee prosthesis which can preserve the proximal tibial epiphyseal plate. Demographic data was recorded. Overall leg length and tibial length was assessed by full-length standing anteroposterior radiographs of bilateral lower extremity with the patella pointing anteriorly preoperativelly and postoperativelly at each follow up. And the growth potential of the affected proximal tibia was calculated by comparing with the preoperative length of tibia. Meanwhile, the functional outcome was assessed by using the Musculoskeletal Tumor Society (MSTS) system, and the postoperative complications were analysed.Results:All patients underwent the tumor resection and reconstruction operation successfully. The average operation duration was 143±41 minutes, ranging 90 to 250 minutes. The average intraoperative blood loss was 314±397 ml, ranging 30 to 2 200 ml. The patients were followed up for 24 to 64 months, averaging 42.3±12.1 months. The postoperative knee range of motion was 100-130 degrees, with an average of 115.6±7.2 degrees. The postoperative MSTS score was 23-30, with an average of 26.7±1.6. To the last follow-up, the limb length discrepancy of the lower limb was 1.3 to 10 cm, and the length of the tibia was shortened from 0 to 3.8 cm compared with the opposite side, with an average of 1.3±1.0 cm. The growth percentage of the proximal tibial epiphysis on the affected side was 30% to 100%, with an average of 70%±17%. Totally, 13 patients suffered postoperative complication, the overall incidence of complications was 35% (13/37), and prosthesis-related complications were 16% (6/37). Three patients with wound dehiscence were managed by debridement and antibiotics. Radiographs revealed femoral stem loosening in a single patient 3 years after the initial operation and then the prosthesis was converted to an adult tumor knee endoprosthesis. Two cases experienced breakage of the femoral stem at 30 and 33 months, respectively, due to an accidental injury. They received revision surgery, and a new femoral prosthesis component was replaced. One patient developed femoral stem breakage at 10 months after surgery due to fatigue fracture, which treated with revision surgery. Tumor recurrence occurred in 6 patients. Among them, tumor recurrence in soft tissue occurred in 4 patients, and treated with regional resection without further recurrence. The other 2 patients experienced tumor recurrence at the distal femoral site, and treated with resection and prosthetic revision.Conclusion:The physeal sparing pediatric knee prosthesis can preserve the growth potential of the proximal tibial epiphyseal plate with good postoperative function and low incidence of prosthesis complications. Therefore, it can be an alternativeespecially for skeletally immature patients with distal femur osteosarcoma.

Objective:To investigate the efficacy of 3D-printed segmental tumor prosthesis for reconstruction of bone defects after resection of weight-bearing long bone tumors in the lower extremity.Methods:A total of 71 patients who received 3D-printed segmental metal tumor prosthesis for reconstruction of bone defects from August 2015 to August 2021 at the Musculoskeletal Tumor Center of Peking University People's Hospital were retrospectively analyzed. There were 40 males and 31 females, aged 23.08±18.52 years (range, 10-63 years). Tumor types: 49 cases of osteosarcoma, 9 cases of Ewing sarcoma, 3 cases of chondrosarcoma, 3 cases of synovial sarcoma, 2 cases of pleomorphic undifferentiated sarcoma, 2 cases of rhabdomyosarcoma, 2 cases of bone metastasis, and 1 case of low-grade malignant tumor of mesenchymal origin. Ennecking stage of bone tumor: 19 cases of stage III, 52 cases of stage IIb. Tumor location: femur 43 cases, tibia 28 cases. Operative time, intraoperative bleeding, patient survival and postoperative complications were recorded. Kaplan-Meier curves for prosthetic survival were plotted. The osseointegration at the prothesis-bone interface was determined by combination of clinical presentation and imaging. Limb function scores were evaluated using the Musculoskeletal Tumor Society (MSTS) 93 function score.Results:All 71 patients successfully completed the operation and were followed up for 24.4±13.2 months (range, 6.6-65.4 months). At the last follow-up, 50 patients survived without disease, 12 survived with the disease, and the remaining 9 cases died with disease. A total of 11 cases showed prosthesis failure, including 1 case of aseptic loosening, 3 cases of screw breakage or periprosthetic fracture, 1 case of periprosthetic infection, and 6 cases of tumor progression involving the prosthesis. The Kaplan-Meier curve showed that the 1-year, 3-year and 5-year survival rates of prosthesis were 94.2%±2.8%, 86.1%±4.7% and 79.5%±9.2%, respectively. 62 patients received functional follow-up, and the MSTS93 functional score at the last follow-up was 23.95±5.03 points (range, 10-30 points), with an excellent rate of 90% (56/62). The score of femoral prosthesis was 24.63±4.97 points (range, 13-30 points) and the score of tibial prosthesis was 23.29±5.09 points (range, 10-29).Conclusion:3D-printed segmental tumor prosthesis for reconstruction of bone defect after resection of weight-bearing long bone tumors in the lower extremity has a relative high survival rate, a low incidence of prosthetic complications, and a good recovery of function, and it can be used as an option for the postoperative reconstruction of bone tumors in weight-bearing bones of the lower extremity.

OBJECTIVE： To establish a method for simultaneous determination of contents of β-pinene， linalool， L-camphor， L-borneol， β-caryophyllene and xanthoxylin in the oil of Blumea balsamifera. METHODS： GC method was adopted. The determination was performed on RTX-1701 capillary column （programmed temperature）. The FID detector was controlled at 240 ℃. The inlet temperature was set at 240 ℃. The carrier gas was high-purity nitrogen 3 mL/min. The the sample size was 0.5 μL， and split ratio was 50 ∶ 1. RESULTS： The linear range of β-pinene， linalool， L-camphor， L-borneol， β-caryophyllene and xanthoxylin were 0.029 7-0.267 1 mg/mL （r＝0.999 9）， 0.024 3-0.218 9 mg/mL （r＝0.999 9）， 0.126 0-1.134 0 mg/mL （r＝0.999 9）， 0.217 2-1.954 8 mg/mL （r＝0.999 9）， 0.136 3-1.226 9 mg/mL （r＝0.999 9）， 0.044 5-0.400 3 mg/mL（r＝0.999 5）， respectively. The limits of quantitation were 0.028 5， 0.008 7， 0.018 6， 0.016 8， 0.014 5， 0.042 1 mg/mL； the limits of detection were 0.009 4， 0.002 9， 0.006 1， 0.005 5， 0.004 8， 0.013 9 mg/mL， respectively. RSDs of precision， stability， reproducibility and durability tests were all lower than 3％. The average recoveries were 98.13％-101.30％（RSD＝1.20％，n＝9），98.44％-101.81％（RSD＝1.28％，n＝9），98.26％-101.05％（RSD＝1.19％，n＝9），99.08％-101.58％（RSD＝0.89％，n＝9），98.66％-101.66％（RSD＝1.17％，n＝9），98.84％-103.60％（RSD＝0.96％，n＝9）， respectively. The contents of 6 components in the sample were 14.552-46.766， 16.951-22.096， 80.597-113.115， 205.224-242.537， 47.761-135.697， 26.493-45.771 mg/g， respectively. CONCLUSIONS： The established method is simple， accurate， precise and reproducible， which can be used for simultaneous determination of contents of 6 components in the oil of B. balsamifera. It can provide reference for comprehensive evaluation and extraction technology study of the oil of B. balsamifera.

Objective:To investigate the effect of thermal conductivity on the apical sealing ability of different dental gutta-percha cones during the warm vertical condensation obturation.Methods:Four kinds of dental gutta-percha cones were used in this study:Bio-GP points (BP,B&L,Korea),large-tapered gutta-percha (DP,DENTSPLY,America),PROTAPER Universal gutta-percha points (DPP,DENTSPLY,America) and mtwo gutta-percha points (VP,VDW,Germany).Volume differences method was used to determine the main components and the thermal conductivity determinator was used to measure the thermal conductivity of these dental gutta-percha cones.Furthermore,20 cones randomly selected from each kind of dental gutta-percha cones.And 10 cones of each dental gutta-percha cones,which were cut out the part of 4 mm in length from the apical end,were heated (200 ℃) from the upper end without compression,and the temperature of the gutta perchacones surface was monitored in time by the infrared thermal imager during the whole heating process.In addition,the rest of the 10 cones of each dental gutta-percha cones were used to obturate the root canal in the transparent root canal resin model using warm vertical condensation technique.The cross-sectional surface was observed by stereomicroscope (× 40) at 1 mm and 3 mm from the working length and the gutta-percha obturation area proportion was measured and analyzed.The data were analyzed by one-way ANOVA.Results:The proportion of inorganic fillers (80.90％ ± 1.14 ％) (P ＜ 0.05) and the thermal conductivity (2.247 ± 0.002)of DP was siguificantly higher than BP (79.28％ ± 3.88％,1.179 ± 0.003),DPP (68.46％ 5.09％,0.604 ±0.001),VP (78.86％ ± 1.87％,1.150 ±0.001) (P ＜0.05).During the thermal obturation without compression at the setting temperature (200 ℃),DP could achieve 65 ℃ beyond 1 mm from the heating point,and BP,DPP and VP only reached 65 ℃ within 1 mm.After warm vertical condensation obturation,all the groups showed increased gutta-percha obturation area proportion.At the position of WL-3,DP (96.89％ ±0.03％) showed significantly higher proportion of gutta-percha obturation area than BP (95.47％ ±0.06％),DPP (95.21％ ±0.03％) and VP (95.15％ ±0.03％) (P ＜ 0.05).Conclusion:DP contains more inorganic fillers,possesses higher thermal conductivity,and leads a better apical sealing ability than BP,DPP and VP at the position of WL-3 during warm vertical condensation obturation.