Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

No case of moyamoya syndrome with bilateral posterior cerebral artery (PCA) occlusion has been reported in China so far as this disease is extremely rare. The case shown in this article is a middle-aged women who has a history of atrial fibrillation, hypertension and type 2 diabetes acutely attacked by this syndrome. The main clinical manifestations included binocular blindness, right limb weakness. Imaging findings showed bilateral acute cerebral infarction in the parietal occipital lobe, bilateral anterior cerebral artery and middle cerebral artery smoke angiogenesis, bilateral PCA occlusion with distal smoke angiogenesis. Considering the medical history of the patient, the cause of the disease was diagnosed as embolic stroke of undetermined source. The patient′s consciousness has been recovered and the limb weakness has been improved after active symptomatic treatment. However, the blindness did not see any improvements. This case report aims to improve clinicians′ understanding of bilateral PCA embolization in patients with moyamoya syndrome so the occurrence of cerebral infarction can be effectively prevented.

Bionic untethered micro-nano robots, due to their advantages of small size, low weight, large thrust-to-weight ratio, strong wireless mobility, high flexibility and high sensitivity, have very important application values in the fields of biomedicine, such as disease diagnosis, minimally invasive surgery, targeted therapy, etc. This review article systematically introduced the manufacturing methods and motion control, and discussed the biomedical applications of bionic untethered micro-nano robots. Finally, the article discussed the possible challenges for bionic untethered micro-nano robots in the future. In summary, this review described bionic untethered micro-nano robots and their potential applications in biomedical fields.
Bionics ; Equipment Design ; Minimally Invasive Surgical Procedures ; Motion ; Robotics

Animals ; Antigens, Surface/genetics* ; Cell Communication/genetics* ; Copulation/physiology* ; Fallopian Tubes/metabolism* ; Female ; Fertilization/genetics* ; GPI-Linked Proteins/genetics* ; Gene Expression Regulation ; Genes, Reporter ; Green Fluorescent Proteins/metabolism* ; Litter Size ; Luminescent Proteins/metabolism* ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Mitochondria/metabolism* ; Reproduction/genetics* ; Signal Transduction ; Sperm Count ; Sperm Motility/genetics* ; Spermatozoa/metabolism* ; Uterus/metabolism*

Objective:To develop nursing quality evaluation indicator system for perioperative patients with Da Vinci robotic under enhanced recovery after surgery(ERAS), in order to provide references for clinical evaluation of nursing quality for lobectomy patients.Methods:Based on the theory of structure-process-outcome quality model and ERAS, literature review, semi-structured interviews were adopted to determine nursing quality indicator system for perioperative patients. Delphi method was used in two rounds of consultation among 21 experts.Results:The positive coefficient was 100%, authority coefficient was 0.839,0.901, and the coefficients of concordance were 0.317,0.335. The final indicator system consisted of 3 first-level indicators, 14 second-level indicators, and 52 third-level indicators.Conclusion:The nursing quality evaluation indicator system for lobectomy patients with Da Vinci robotic was scientific and reliable, which can provide scientific references for evaluating nursing quality for perioperative patients with Da Vinci robotic under ERAS.

Precise biomarker development is a key step in disease management. However, most of the published biomarkers were derived from a relatively small number of samples with supervised approaches. Recent advances in unsupervised machine learning promise to leverage very large data-sets for making better predictions of disease biomarkers. Denoising autoencoder (DA) is one of the unsupervised deep learning algorithms, which is a stochastic version of autoencoder techniques. The principle of DA is to force the hidden layer of autoencoder to capture more robust features by reconstructing a clean input from a corrupted one. Here, a DA model was applied to analyze inte-grated transcriptomic data from 13 published lung cancer studies, which consisted of 1916 human lung tissue samples. Using DA, we discovered a molecular signature composed of multiple genes for lung adenocarcinoma (ADC). In independent validation cohorts, the proposed molecular signature is proved to be an effective classifier for lung cancer histological subtypes. Also, this signature suc-cessfully predicts clinical outcome in lung ADC, which is independent of traditional prognostic fac-tors. More importantly, this signature exhibits a superior prognostic power compared with the other published prognostic genes. Our study suggests that unsupervised learning is helpful for bio-marker development in the era of precision medicine.

Objective To investigate the expression of miRNA (miR-21) in mucosa-associated lymphoid tissue(MALT) lymphomas and its relationship with the effects in CHOP regimen. Methods Lymph gland tissues and preoperative peripheral blood of 52 patients pathologically diagnosed with MALT lymphoma in Department of Hematology of Affiliated Hospital of Hebei University of Engineering from January 2015 to December 2017 were collected; meanwhile, 10 tissues from patients with lymphadenitis and 20 peripheral serum from healthy examination patients were also collected. Quantitative real-time polymerase chain reaction (qPCR) was used to compare the lymph gland tissues in MALT lymphoma patients and lymphadenitis patients, and the expression of miR-21 in peripheral serum of MALT lymphoma and healthy people. The selected 20 cases of MALT lymphoma were given CHOP regimen treatment for 6 cycles, and then the efficiency and inefficiency were compared; at the same time, the expression of miR-21 in peripheral serum of the patients in the effective group was detected. Results The relative expression of miR-21 of lymph node tissues in lymphadenitis patients and MALT lymphoma patients was 1.03±0.12 and 4.53±0.73 respectively, and the relative expression of miR-21 in preoperative peripheral serum of healthy people and MALT lymphoma patients was 0.83±0.04 and 3 . 87 ± 0 . 21 respectively , and the differences were statistically significant (P ＝ 0.047, P ＝ 0.044). After 6 cycles of CHOP regimen, the total effect rate of MALT lymphoma was 70 % (14/20), and the relative expression of miR-21 in preoperative and postoperative peripheral serum for the patients who obtained the effective results after CHOP regimen was 3.95 ±0.08 and 1.62 ±0.41, and the differences were statistically significant (P＝ 0.035). Conclusions The expression of miR-21 has a certain correlation with the occurrence and development of MALT lymphoma. Furthermore, the serum miR-21 expression may be related to the effect of CHOP regimen chemotherapy in MALT lymphoma.

Objective To study the value of parameters of Transit-Time Flow Measurement(TTFM) as predictor and judge for one-year after coronary artery bypass transplantation in patency rate of vessel grafts .Methods Parameters of quantity of blood flow and the value of PI( pulsation index) were measured and recorded by intraoperative TTFM in CABG .One-year of follow-ing up, coronary artery CT or coronary angiography examination were accomplished.Results Our study include artery grafts 46(including LIMA grafts 44, RIMA graft 1 and radial artery graft 1) with the patency rate of grafts 91.3％ for one-year after CABG, and vein grafts 48 with the patency rate of grafts 66.7％ .There exists statistically significant difference between above two groups(P<0.001).High PI is independent risk factor(P =0.037) in patency rate of vessel grafts for one-year after CABG by binary logistics regression analysis but no other parameters have the statistical significance (P>0.05) .The results from logistic regression were summarized using the area under the ROC curve(AUC) .The pulsation index has been found hav-ing moderate judgment ability(P=0.016) for the dysfunction of grafts after CABG for one-year with optimal cut-off value of 2. 45.Conclusion Intraoperative high value of PI is the independent risk factor in patency rate of vessel grafts for one-year after CABG.

Objective: To investigate the effect of thalidomide on the expressions of Th17 cells, interleukin 17 (IL-17), macrophage inflammatory protein 3α (MIP3α) in peripheral blood of patients with diffuse large B-cell (DLBCL) and 3-year survival rate. Methods: Sixty patients with DLBCL from January 2009 to January 2013 in the Affiliated Hospital of Hebei University of Engineering were enrolled. According to envelope method, the patients were randomly divided into the combined group (n = 30, thalidomide combined with CHOP regimen) and chemotherapy group (n = 30, CHOP regimen alone). Clinical adverse reactions, efficacy, the expressions of Th17 cells, IL-17, MIP3α in peripheral blood before and after treatment, and 3-year survival rate between two groups were compared. Results: The total effective rate and 3-year survival rate were 73.3% (22/30) vs. 46.7% (14/30), 87.4% vs. 40.7% respectively in the combined group and the chemotherapy group (both P < 0.05). The levels of Th17 cells percentage and the expression level of IL-17 before and after treatment in combined group were (0.52±0.14)% vs. (1.61±0.53)%, (5.61±0.75) pg/ml vs. (8.87±1.84) pg/ml, and the difference was statistically significant (both P < 0.05). However, the expression levels of Th17 cells and IL-17 before and after treatment in the chemotherapy group were (0.75±0.05)% vs. (0.74±0.07)%, (5.69±0.29) pg/ml vs. (5.26±0.24) pg/ml, and there was no statistical difference (both P > 0.05). The levels of IL-17 and MIP3α mRNA in peripheral serum before and after treatment in the combined group were 8.51±0.23 vs.13.96±0.89, 27.4±1.5 vs. 83.0±8.5 (both P < 0.05). While in the treatment group before and after treatment the above mentioned were 8.85±0.32 vs. 9.45±0.55, 23.7±1.8 vs. 38.7±5.5, and the difference was no statistically significant (both P > 0.05). There was no statistical difference in the adverse reactions between the combined group and the chemotherapy group (P > 0.05). Conclusion Thalidomide may prolong survival time of DLBCL patients by intervening Th17 cells and associated cytokines.