The microstructures of pharmaceutical preparations play a pivotal role in determining their critical quality attributes(CQAs),such as drug release,content uniformity,and stability,which greatly impact the safety and efficacy of drugs.Unlike the inherent molecular structures of active pharmaceutical in-gredients(APIs)and excipients,the microstructures of pharmaceutical preparations are developed during the formulation process,presenting unique analytical challenges.In this review,we primarily focus on presenting the research methods used to elucidate the microstructures of pharmaceutical preparations,including X-ray imaging(XRI),scanning electron microscopy(SEM),atomic force microscopy(AFM),Raman spectroscopy,infrared(IR)spectroscopy,and rheometer technology.Subse-quently,we highlight the applications,advantages,and limitations of these methods.Finally,we discuss the current challenges and future perspectives in this field.This review aims to provide a comprehensive reference for understanding the microstructures of pharmaceutical preparations,offering new insights and potential advancements in their development.

Objective:To evaluate the short-term clinical outcomes of minimally invasive surgery for severe hallux valgus deformity using absorbable screw fixation.Methods:This retrospective study included 35 patients with severe hallux valgus deformities treated with third-generation minimally invasive Chevron and Akin osteotomies (MICA) using absorbable screws at the Foot and Ankle Surgery Department of Guangzhou Orthopedic Hospital from January 2022 to January 2023. The cohort consisted of 2 males and 33 females, with an average age of 56.75±13.27 years (ranging from 20 to 72 years).There were 18 cases of left foot and 17 of right. Preoperative and 12-month postoperative radiographic and clinical data were collected and analyzed. Radiographic evaluations included measurements of the hallux valgus angle (HVA) and intermetatarsal angle (IMA) on weight-bearing foot X-ray films. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and the visual analogue scale (VAS) for pain. All complications during follow-up were recorded to comprehensively assess surgical outcomes and safety.Results:All the 35 cases successfully underwent the surgery, with a surgery time of 61.5±3.2 minutes and intraoperative blood loss of 5.4±1.2 ml. No patients lost follow-up, with a mean follow-up of 15.65±2.48 months (ranging from12 to 19 months). At the final follow-up, the AOFAS score significantly improved from 39.8±4.7 preoperatively to 92.3±4.1 postoperatively ( P<0.05), and the VAS significantly decreased from 8.7±1.2 to 1.8±0.8 ( P<0.05). The HVA decreased from 42.5°±4.1° to 12.5°±3.7° ( P<0.05), and the IMA decreased from 18.5°±2.8° to 7.3°±2.1° ( P<0.05). Radiographic follow-up demonstrated complete osseous union at the osteotomy sites in all cases, with no complications of nonunion or displacement. 7 patients with concurrent gastrocnemius tightness underwent gastrocnemius release, and 11 patients with associated transfer metatarsalgia were treated with Weil osteotomy ( n=8) or metatarsal head recontouring ( n=3), achieving satisfactory outcomes for all cases. Complications were minimal, with 2 cases of localized numbness around the surgical incision observed on postoperative day 3; the symptoms were gone spontaneously 3 months postoperatively. No other major complications, such as infection, hematoma, or neurovascular injury, were observed. Conclusion:Minimally invasive surgery using absorbable screw fixation effectively improves clinical function and symptoms in patients with severe hallux valgus deformities without any major complications, suggesting that it is a safe and effective treatment option.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To evaluate the short-term clinical outcomes of minimally invasive surgery for severe hallux valgus deformity using absorbable screw fixation.Methods:This retrospective study included 35 patients with severe hallux valgus deformities treated with third-generation minimally invasive Chevron and Akin osteotomies (MICA) using absorbable screws at the Foot and Ankle Surgery Department of Guangzhou Orthopedic Hospital from January 2022 to January 2023. The cohort consisted of 2 males and 33 females, with an average age of 56.75±13.27 years (ranging from 20 to 72 years).There were 18 cases of left foot and 17 of right. Preoperative and 12-month postoperative radiographic and clinical data were collected and analyzed. Radiographic evaluations included measurements of the hallux valgus angle (HVA) and intermetatarsal angle (IMA) on weight-bearing foot X-ray films. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and the visual analogue scale (VAS) for pain. All complications during follow-up were recorded to comprehensively assess surgical outcomes and safety.Results:All the 35 cases successfully underwent the surgery, with a surgery time of 61.5±3.2 minutes and intraoperative blood loss of 5.4±1.2 ml. No patients lost follow-up, with a mean follow-up of 15.65±2.48 months (ranging from12 to 19 months). At the final follow-up, the AOFAS score significantly improved from 39.8±4.7 preoperatively to 92.3±4.1 postoperatively ( P<0.05), and the VAS significantly decreased from 8.7±1.2 to 1.8±0.8 ( P<0.05). The HVA decreased from 42.5°±4.1° to 12.5°±3.7° ( P<0.05), and the IMA decreased from 18.5°±2.8° to 7.3°±2.1° ( P<0.05). Radiographic follow-up demonstrated complete osseous union at the osteotomy sites in all cases, with no complications of nonunion or displacement. 7 patients with concurrent gastrocnemius tightness underwent gastrocnemius release, and 11 patients with associated transfer metatarsalgia were treated with Weil osteotomy ( n=8) or metatarsal head recontouring ( n=3), achieving satisfactory outcomes for all cases. Complications were minimal, with 2 cases of localized numbness around the surgical incision observed on postoperative day 3; the symptoms were gone spontaneously 3 months postoperatively. No other major complications, such as infection, hematoma, or neurovascular injury, were observed. Conclusion:Minimally invasive surgery using absorbable screw fixation effectively improves clinical function and symptoms in patients with severe hallux valgus deformities without any major complications, suggesting that it is a safe and effective treatment option.

Objective:To compare suture-button, absorbable screws (AS), and metal screws (MS) in the fixation of ankle fracture complicated with distal tibiofibular syndesmosis injury.Methods:A retrospective study was conducted to analyze the 71 patients with ankle fracture and distal tibiofibular syndesmosis injury who had been treated at Department of Foot and Ankle Surgery, Guangzhou Orthopedics Hospital from February 2020 to February 2023. There were 27 males and 44 females with an age of (49.6±10.3) years. The patients were assigned into 3 groups according to different treatment methods: a suture-button group in which 32 cases were treated with suture-button, an AS group in which 24 cases were treated with AS, and a MS group in which 15 cases were treated with MS to be removed at 8 to 12 weeks after operation. The 3 groups were compared in terms of intraoperative blood loss, operation time, and ankle range of motion, tibiofibular clear space (TFCS), and tibio-fibular overlap (TFOL) at the last follow-up, as well as American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and visual analogue scale (VAS) pain scores at 3 months after operation and at the last follow-up.Results:There was no significant difference in the preoperative general data between the 3 groups, indicating comparability ( P>0.05). There were no significant differences in intraoperative blood loss, operation time, ankle range of motion, TFCS or TFOL between the 3 groups ( P>0.05). TFCS and TFOL at the last follow-up in all patients were significantly improved compared with those before operation ( P<0.05). The AOFAS ankle-hindfoot scores and VAS pain scores in the suture-button group and the AS group at 3 months after operation were significantly better than those in the MS group ( P<0.05). There was no significant difference in AOFAS ankle-hindfoot score or VAS pain score between the 3 groups at the last follow-up ( P>0.05). In all patients, the AOFAS ankle-hindfoot score and VAS pain score at the last follow-up were significantly better than those at 3 months after operation which were significantly better than those before operation ( P<0.05). Conclusions:In the fixation of ankle fracture complicated with distal tibiofibular syndesmosis injury, suture-button, AS and MS can all achieve definite clinical efficacy. As fixation with MS requires secondary surgical removal, its early functional score and pain score may be relatively poorer.

The microstructures of pharmaceutical preparations play a pivotal role in determining their critical quality attributes (CQAs), such as drug release, content uniformity, and stability, which greatly impact the safety and efficacy of drugs. Unlike the inherent molecular structures of active pharmaceutical ingredients (APIs) and excipients, the microstructures of pharmaceutical preparations are developed during the formulation process, presenting unique analytical challenges. In this review, we primarily focus on presenting the research methods used to elucidate the microstructures of pharmaceutical preparations, including X-ray imaging (XRI), scanning electron microscopy (SEM), atomic force microscopy (AFM), Raman spectroscopy, infrared (IR) spectroscopy, and rheometer technology. Subsequently, we highlight the applications, advantages, and limitations of these methods. Finally, we discuss the current challenges and future perspectives in this field. This review aims to provide a comprehensive reference for understanding the microstructures of pharmaceutical preparations, offering new insights and potential advancements in their development.

Venous malformation is a common congenital, non-tumor vascular malformation, accounting for about 60% of all vascular malformations, of which 40% occur in the head and neck. Due to the complex anatomical structure of the oral and maxillofacial region and the diverse classification of venous malformations, their clinical treatment poses certain difficulties and challenges. This article systematically elaborates on the etiology, clinical manifestations, imaging features, and clinical treatment strategies of venous malformations in the oral and maxillofacial region. Molecular genetic studies have shown that the occurrence and development of venous malformations are closely related to abnormal activation of the ANGPT/TIE2/PI3K/AKT/mTOR signaling pathway; its clinical manifestations are gradually growing blue purple masses and its histological features are tortuous venous ducts; and clinical imaging examinations have high specificity, among which digital subtraction angiography classification has important clinical guidance value for the treatment of venous malformation sclerosis. According to different classifications, strategies, such as sclerosis treatment, surgical treatment, and laser treatment, can be applied separately or in combination. This article also explores the advantages and disadvantages of targeted therapy in the treatment of venous malformations, with a focus on improving clinical outcomes while reducing complications. At the same time, through the analysis of typical clinical cases, it summarizes the key points of diagnosis and treatment and treatment plans, in order to provide a reference for improving the clinical efficacy of venous malformation treatment and reducing treatment complications.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To compare suture-button, absorbable screws (AS), and metal screws (MS) in the fixation of ankle fracture complicated with distal tibiofibular syndesmosis injury.Methods:A retrospective study was conducted to analyze the 71 patients with ankle fracture and distal tibiofibular syndesmosis injury who had been treated at Department of Foot and Ankle Surgery, Guangzhou Orthopedics Hospital from February 2020 to February 2023. There were 27 males and 44 females with an age of (49.6±10.3) years. The patients were assigned into 3 groups according to different treatment methods: a suture-button group in which 32 cases were treated with suture-button, an AS group in which 24 cases were treated with AS, and a MS group in which 15 cases were treated with MS to be removed at 8 to 12 weeks after operation. The 3 groups were compared in terms of intraoperative blood loss, operation time, and ankle range of motion, tibiofibular clear space (TFCS), and tibio-fibular overlap (TFOL) at the last follow-up, as well as American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and visual analogue scale (VAS) pain scores at 3 months after operation and at the last follow-up.Results:There was no significant difference in the preoperative general data between the 3 groups, indicating comparability ( P>0.05). There were no significant differences in intraoperative blood loss, operation time, ankle range of motion, TFCS or TFOL between the 3 groups ( P>0.05). TFCS and TFOL at the last follow-up in all patients were significantly improved compared with those before operation ( P<0.05). The AOFAS ankle-hindfoot scores and VAS pain scores in the suture-button group and the AS group at 3 months after operation were significantly better than those in the MS group ( P<0.05). There was no significant difference in AOFAS ankle-hindfoot score or VAS pain score between the 3 groups at the last follow-up ( P>0.05). In all patients, the AOFAS ankle-hindfoot score and VAS pain score at the last follow-up were significantly better than those at 3 months after operation which were significantly better than those before operation ( P<0.05). Conclusions:In the fixation of ankle fracture complicated with distal tibiofibular syndesmosis injury, suture-button, AS and MS can all achieve definite clinical efficacy. As fixation with MS requires secondary surgical removal, its early functional score and pain score may be relatively poorer.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.