Objective:To analyze the predictive value of combined detection of serum tumor abnormal protein (TAP), cytokeratin 19 fragment antigen (CYFRA21-1), and endothelial cell specific molecule 1 (ESM1) for postoperative recurrence and metastasis of colorectal cancer patients.Methods:Seventy-five patients with colorectal cancer(colorectal cancer group) admitted to Jinhua Guangfu Cancer Hospital from June 2021 to May 2023 and 60 healthy subjects (control group) during the same period were retrospectively selected as the study objects. The levels of serum TAP, CYFRA21-1 and ESM1 were compared between the two groups. The levels of serum TAP, CYFRA21-1 and ESM1 in colorectal cancer patients with different clinicopathological features were compared. All patients with colorectal cancer were followed up for 1 year, and 5 cases were lost to follow-up, including 40 cases in the non-recurrence and metastasis group and 35 cases in the recurrence and metastasis group. The levels of serum TAP, CYFRA21-1, and ESM1 were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of three indexes for postoperative recurrence and metastasis of colorectal cancer.Results:The levels of serum TAP, CYFRA21-1 and ESM1 in the colorectal cancer group were higher than those in the control group: (134.52 ± 26.18) μm 2 vs. (95.52 ± 10.03) μm 2, (6.96 ± 0.73) μg/L vs. (3.15 ± 0.42) μg/L, (36.78 ± 4.97) μg/L vs. (421 ± 0.35) μg/L, there were statistical differences ( P<0.01). There were significant differences in serum TAP, CYFRA21-1, and ESM1 levels among patients with different clinical stages, tissue differentiation, and lymph node metastasis ( P<0.01). The levels of serum TAP, CYFRA21-1 and ESM1 in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group: (155.25 ± 28.02) μm 2 vs. (121.05 ± 21.03) μm 2, (8.58 ± 0.93) μg/L vs. (5.25 ± 0.62) μg/L, (42.05 ± 5.23) μg/L vs. (34.62 ± 5.01) μg/L, there were statistical differences ( P<0.01). ROC curve analysis results showed that the combined detection of serum TAP, CYFRA21-1 and ESM1 levels predicted postoperative recurrence and metastasis of colorectal cancer patients with the largest of the area under the curve (AUC), which was 0.811, and was higher than any single index. Conclusions:The levels of TAP, CYFRA21-1 and ESM1 are increased in colorectal cancer patients, and combined detection of serum TAP, CYFRA21-1 and ESM1 levels has high predictive value for postoperative recurrence and metastasis.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To analyze the predictive value of combined detection of serum tumor abnormal protein (TAP), cytokeratin 19 fragment antigen (CYFRA21-1), and endothelial cell specific molecule 1 (ESM1) for postoperative recurrence and metastasis of colorectal cancer patients.Methods:Seventy-five patients with colorectal cancer(colorectal cancer group) admitted to Jinhua Guangfu Cancer Hospital from June 2021 to May 2023 and 60 healthy subjects (control group) during the same period were retrospectively selected as the study objects. The levels of serum TAP, CYFRA21-1 and ESM1 were compared between the two groups. The levels of serum TAP, CYFRA21-1 and ESM1 in colorectal cancer patients with different clinicopathological features were compared. All patients with colorectal cancer were followed up for 1 year, and 5 cases were lost to follow-up, including 40 cases in the non-recurrence and metastasis group and 35 cases in the recurrence and metastasis group. The levels of serum TAP, CYFRA21-1, and ESM1 were compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of three indexes for postoperative recurrence and metastasis of colorectal cancer.Results:The levels of serum TAP, CYFRA21-1 and ESM1 in the colorectal cancer group were higher than those in the control group: (134.52 ± 26.18) μm 2 vs. (95.52 ± 10.03) μm 2, (6.96 ± 0.73) μg/L vs. (3.15 ± 0.42) μg/L, (36.78 ± 4.97) μg/L vs. (421 ± 0.35) μg/L, there were statistical differences ( P<0.01). There were significant differences in serum TAP, CYFRA21-1, and ESM1 levels among patients with different clinical stages, tissue differentiation, and lymph node metastasis ( P<0.01). The levels of serum TAP, CYFRA21-1 and ESM1 in the recurrence and metastasis group were higher than those in the non-recurrence and metastasis group: (155.25 ± 28.02) μm 2 vs. (121.05 ± 21.03) μm 2, (8.58 ± 0.93) μg/L vs. (5.25 ± 0.62) μg/L, (42.05 ± 5.23) μg/L vs. (34.62 ± 5.01) μg/L, there were statistical differences ( P<0.01). ROC curve analysis results showed that the combined detection of serum TAP, CYFRA21-1 and ESM1 levels predicted postoperative recurrence and metastasis of colorectal cancer patients with the largest of the area under the curve (AUC), which was 0.811, and was higher than any single index. Conclusions:The levels of TAP, CYFRA21-1 and ESM1 are increased in colorectal cancer patients, and combined detection of serum TAP, CYFRA21-1 and ESM1 levels has high predictive value for postoperative recurrence and metastasis.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

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.

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.

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 explore the possible correlation between allostatic load (AL) and clinical symptoms in patients with first-episode schizophrenia (FES) and AL influence upon the onset.Methods:Patients with FES (schizophrenia group, n=93) who received treatment at Beijing Huilongguan Hospital from October 2017 to July 2019 and the healthy controls (control group, n=111) recruited during the same period were enrolled in the research. Systolic blood pressure, diastolic blood pressure, resting heart rate, body mass index, waist-hip ratio, high-density lipoprotein cholesterol, total cholesterol, glycosylated hemoglobin, high-sensitivity C-reactive protein, 12-hour urine adrenaline, 12-hour urine norepinephrine, 12-hour urine cortisol, and serum dehydroepiandrosterone of all subjects were collected to calculate the AL index. The positive and negative symptom scale (PANSS) was used to assess the psychopathological symptoms of patients. Covariance analysis was used to compare the differences of AL index and the thirteen biological components between FES patients and controls. Pearson correlation analysis was used to explore the correlation between AL index and clinical symptoms, and the Logistic regression analysis was used to explore the risk factors of schizophrenia. Results:AL index among schizophrenic patients was higher than the controls (5.87±1.90 vs. 3.50±2.21, F=65.97, P<0.001). AL index was possitively correlated with PANSS positive symptoms ( r=0.25, P=0.019) and was a risk factor of schizophrenia ( OR=1.76, 95% CI: 1.47-2.11, P<0.01). Conclusions:The AL is possitively correlated with positive symptoms in the FES, and the higher AL may be one of important inducements to the schizophrenia onset.