OBJECTIVE: To explore the effectiveness of primary interventional revascularization combined with secondary perforator composite flap in the treatment of peripheral arterial disease (PAD) accompanied by soft tissue defects around the ankle. METHODS: Between January 2022 and January 2025, 12 patients with PAD and soft tissue defects around the ankle were admitted. Among them, there were 9 males and 3 females; their ages ranged from 52 to 82 years, with an average of 68.9 years. The causes of injury included 4 cases of traffic accident, 5 cases of falls, 1 case of falling from height, 1 case of foreign body puncture injury, and 1 case of electric shock injury. The infection duration ranged from 1 month to 35 years, with a median duration of 3.5 months. The wound size ranged from 5.5 cm×3.0 cm to 15.0 cm×9.0 cm. The ankle-brachial index (ABI) was 0.32±0.12. The visual analogue scale (VAS) score for pain was 3.3±0.5. Preoperative vascular stenosis assessment was performed in all patients, with primary intervention to dredge large and medium-sized arteries, followed by secondary repair of the wound using a perforator composite flap. The flap size ranged from 6.5 cm×4.0 cm to 16.0 cm×10.0 cm. The donor sites were sutured directly or repaired with skin grafts. After two stages of treatment, the effectiveness was evaluated by measuring ABI, observing flap survival and wound healing, assessing VAS scores, and American Orthopedic Foot and Ankle Society (AOFAS) scores. RESULTS: All 12 cases completed two stages of treatment; all patients were followed up after the second-stage treatment, with a follow-up period ranging from 7 to 28 months, with an average of 16.8 months. After the first-stage treatment, the skin temperature around the ankle was significantly higher than that before treatment, and the ABI increased to 0.71±0.07, with a significant difference ( t=9.918, P<0.001). After the second-stage treatment, the blisters on the distal end of the skin flap occurred in 3 cases. The flaps survived and the wounds healed, with a healing time ranging from 10 to 14 days (mean, 11.8 days). The incisions at the donor site healed by first intention, and the skin grafts survived. The VAS score was 0.5±0.5 at 3 weeks, which was significantly lower than that before treatment ( t=13.675, P<0.001). No infection recurrence occurred during follow-up. At 6 months after the second-stage treatment, the AOFAS score of the ankle joint ranged from 92 to 97, with an average of 94.7, all reaching excellent. CONCLUSION Interventional revascularization combined with perforator composite flap for staged treatment of PAD with ankle soft tissue defects can obtain good effectiveness, by unclogging the main blood vessels, improving lower limb blood supply, and improving the survival rate of the skin flap.
Humans ; Male ; Female ; Middle Aged ; Aged ; Peripheral Arterial Disease/surgery* ; Soft Tissue Injuries/surgery* ; Perforator Flap/blood supply* ; Plastic Surgery Procedures/methods* ; Aged, 80 and over ; Ankle/blood supply* ; Treatment Outcome ; Ankle Brachial Index ; Skin Transplantation/methods*

Smoking is a well-established risk factor for periodontitis, yet the precise mechanisms by which smoking contributes to periodontal disease remain poorly understood. Recent advances in spatial transcriptomics have enabled a deeper exploration of the periodontal tissue microenvironment at single-cell resolution, offering new opportunities to investigate these mechanisms. In this study, we utilized Visium HD single-cell spatial transcriptomics to profile gingival tissues from 12 individuals, including those with periodontitis, those with smoking-associated periodontitis, and healthy controls. Our analysis revealed that smoking disrupts the epithelial barrier integrity, induces fibroblast alterations, and dysregulates fibroblast-epithelial cell communication, thereby exacerbating periodontitis. The spatial analysis showed that endothelial cells and macrophages are in close proximity and interact, which further promotes the progression of smoking-induced periodontal disease. Importantly, we found that targeting the endothelial CXCL12 signalling pathway in smoking-associated periodontitis reduced the proinflammatory macrophage phenotype, alleviated epithelial inflammation, and reduced alveolar bone resorption. These findings provide novel insights into the pathogenesis of smoking-associated periodontitis and highlight the potential of targeting the endothelial-macrophage interaction as a therapeutic strategy. Furthermore, this study establishes an essential information resource for investigating the effects of smoking on periodontitis, providing a foundation for future research and therapeutic development for this prevalent and debilitating disease.
Humans ; Gingiva/cytology* ; Smoking/adverse effects* ; Male ; Periodontitis/pathology* ; Single-Cell Analysis ; Female ; Adult ; Middle Aged ; Macrophages ; Fibroblasts ; Endothelial Cells ; Case-Control Studies ; Chemokine CXCL12/metabolism*

  Objective  To promote the development of high-quality health standards in China and summarize the characteristics of global health standards management systems and development processes.  Methods  We conducted a systematic search of relevant databases and the websites of standardization institutions. A descriptive method was used to analyze the basic characteristics of the standard management systems and development processes.  Results  The majority of the investigated countries and organizations primarily implement voluntary standards, with the exception of Chinese and the European Committee for Standardization that enforce compulsory standards. All countries and organizations have health standards at the national, group, and enterprise levels. In China and Japan, standards authorities are subordinate to the government, while in other countries or organizations, they operate as independent civil societies. The development process for health standards generally involves five stages: "Project/Proposal → Draft → Enquiry → Review → Publication". However, the specific steps in the development of health standards vary across different countries and organizations. Furthermore, China ranks high in the number of both standards and health standards issued, but the proportion of health standards is only 2.06%.  Conclusions  There are significant differences between China and other countries in terms of the management system and development process of health standards. To promote the management and development of high-quality health standards in China, we recommend promoting the coordination mechanism for standard development, increasing efforts to publicize standards and evaluate the implementation effect, strengthening the construction of personnel for the development of health standards, optimizing the efficiency of standard development and improving the internationalization level of health standards.

National health standards involve all kinds of technical requirements formulated and numbered in accordance with the procedures and formats stipulated in the standardisation system for the implementation of national health and hygiene laws, regulations and policies, and the protection of human health. The establishment of health standards in China should align with our legal framework, including laws, regulations, departmental rules, and health and hygiene policies. During the development of these standards, a comprehensive approach is advocated, encompassing in-depth investigations, rigorous demonstrations, and extensive stakeholder engagement. However, the process of standard formulation may suffer from insufficient research evidence. The evidence-based concept emphasizes the significance of evidence. Therefore, integrating evidence-based concept into the process of developing health standards can enhance the quality and scientific basis of these standards. This article systematically elucidates the current status and development process of health standards in China, explores the necessity and feasibility of incorporating evidence-based concept into the development of these standards, analyzes the challenges and opportunities, and presents reflections and suggestions.

Objectives: . The necessity to develop a method for prognostication and to identify novel biomarkers for personalized medicine in patients with head and neck squamous cell carcinoma (HNSCC) cannot be overstated. Recently, pathomics, which relies on quantitative analysis of medical imaging, has come to the forefront. CXCL8, an essential inflammatory cytokine, has been shown to correlate with overall survival (OS). This study examined the relationship between CXCL8 mRNA expression and pathomics features and aimed to explore the biological underpinnings of CXCL8. Methods: . Clinical information and transcripts per million mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA)-HNSCC dataset. We identified correlations between CXCL8 mRNA expression and patient survival rates using a Kaplan-Meier survival curve. A retrospective analysis of 313 samples diagnosed with HNSCC in the TCGA database was conducted. Pathomics features were extracted from hematoxylin and eosin–stained images, and then the minimum redundancy maximum relevance, with recursive feature elimination (mRMR-RFE) method was applied, followed by screening with the logistic regression algorithm. Results: . Kaplan-Meier curves indicated that high expression of CXCL8 was significantly associated with decreased OS. The logistic regression pathomics model incorporated 16 radiomics features identified by the mRMR-RFE method in the training set and demonstrated strong performance in the testing set. Calibration plots showed that the probability of high gene expression predicted by the pathomics model was in good agreement with actual observations, suggesting the model’s high clinical applicability. Conclusion . The pathomics model of CXCL8 mRNA expression serves as an effective tool for predicting prognosis in patients with HNSCC and can aid in clinical decision-making. Elevated levels of CXCL8 expression may lead to reduced DNA damage and are associated with a pro-inflammatory tumor microenvironment, offering a potential therapeutic target.

Objective:To investigate the predictive value of atherogenic index of plasma (AIP) in the assessment of acute pancreatitis (AP).Methods:598 patients diagnosed with AP admitted to the Affiliated Hospital of Yangzhou University between January 2016 and December 2020 were recruited and divided into severe acute pancreatitis group (SAP group, n=57) and non-severe acute pancreatitis group (non SAP group, n=541) according to the Atlanta Classification (2012 revision). General clinical data and related biochemical indicators of all enrolled patients were collected, and Bedside Index of Acute Pancreatitis Severity (BISAP) score, Ranson score and CT Severity Index (CTSI) score were performed. The risk factors of SAP were analyzed by logistic regression. Receiver operating characteristic (ROC) curve was used to analyze the evaluation value of AIP and various scoring systems on the severity of pancreatitis. Results:The AIP, white blood cell (WBC), neutrophil count (NEUT), fasting blood glucose (FBG), serum total cholesterol (TC) level, proportion of hyperlipidemia, proportion of diabetes, Ranson score, BISAP score, CTSI score of patients in SAP group were higher than those in non SAP group, and the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that AIP was an independent risk factor for SAP ( P<0.05). ROC curve showed that the are under the curve (AUC) of SAP predicted by AIP was 0.706(95% CI: 0.631-0.782, P<0.001). Conclusions:AIP is an independent risk factor for SAP, which helps to assess the severity of AP.

Objective:To investigate the changes and clinical significance of serum S100β and neuron-specific enolase (NSE) levels of children with acute brain injury(ABI).Methods:100 children with ABI treated in the pediatric intensive care unit (PICU) of the Affiliated Hospital of Inner Mongolia Medical University from June 2019 to June 2020 were prospectively selected as the ABI group, and 30 normal children in the children′s health clinic of the hospital were selected as the control group. The serum S100β and NSE levels of all subjects was detected. According to the Glasgow Coma Scale (GCS), children with ABI were divided into severe brain injury group ( n=26), moderate brain injury group ( n=35) and mild brain injury group ( n=39). The prognosis of children with ABI after 3 months of treatment was evaluated according to the Glasgow prognosis scale (GOS) and they were divided into poor prognosis group ( n=26) and good prognosis group ( n=74). The relationship between serum S100β and NSE levels and the severity and prognosis of children with ABI was analyzed. Results:The serum S100β and NSE levels in the ABI group were significantly higher than those in the control group, and the serum S100β and NSE levels in children with ABI increased with the severity of injury and poor prognosis ( P<0.05). Pearson correlation analysis showed that serum S100β and NSE levels in children with ABI were positively correlated with GCS scores ( r=0.521, 0.643, P<0.05). Multiple logistic regression analysis showed that glucose(GLU) ( OR=1.631, 95% CI: 1.278-2.082), S100β ( OR=1.907, 95% CI: 1.558-5.877), NSE ( OR=2.896, 95% CI: 1.193-7.029) were independent prognostic factor in children with ABI ( P<0.05). Receiver operating characteristic (ROC) curve showed that the sensitivity, specificity and accuracy of serum S100β+ NSE [area under curve (AUC)=0.932, 95% CI: 0.875-0.969] in predicting the poor prognosis of children with ABI were higher than those of serum S100β(AUC=0.728, 95% CI: 0.643-0.803), NSE (AUC=0.808, 95% CI: 0.729-0.871) alone. Conclusions:The levels of serum S100β and NSE in children with ABI aresignificantly increased, which are closely related to the severity of the disease and prognosis. They can be used as predictors of poor prognosis in children with ABI. Combined detection can enhance the diagnostic value.

Objective:To explore the application of clinical nursing pathway (CNP) standardized management in children with primary vesicoureteral reflux (VUR) undergoning Politano-Leadbetter operation for.Methods:From January 2016 to December 2018, we selected 69 children with VUR from the First Affiliated Hospital of Zhengzhou University. Children all underwent modified Politano-Leadbetter operation and were divided into CNP group ( n=39) and control group ( n=30) with the method of random number table. Control group carried out routine clinical nursing management, while CNP group implemented CNP standardized management. We compared the general operation situation, hospitalization, improvement of reflux level and incidence of postoperative complications among children between two groups. Results:There were no intestinal and important vascular injury events during operation in both groups, and there was no significant difference in the operation time, intraoperative blood loss and postoperative hematuria duration between the two groups ( P>0.05) . However, the length of hospitalization, hospitalization costs and incidence of postoperative complications in CNP group were lower than those in control group; the improvement rate of reflux of CNP group was higher than that of control group; the differences were statistically significant ( P<0.05) . Conclusions:For VUR children with Politano-Leadbetter operation, CNP standardized management is more conducive to postoperative recovery of children than routine nursing management, and it can obtain better therapeutic benefits and reduce the risk of postoperative complications to a certain extent.

A whole-cell catalyst using Escherichia coli BL21(DE3) as a host, expressing L- threonine dehydratase from Escherichia coli, and co-expressing leucine dehydrogenase from Bacillus cereus and glucose dehydrogenase from Bacillus subtilis for cofactor regeneration, was constructed and used for one-pot production of L-2-aminobutyric acid (L-ABA) and D- gluconic acid from L-threonine and D-glucose. We used shake-flask culture to study the whole-cell catalytic condition including temperature, pH, proper permeabilization of cells and optimal wet cells amount. Moreover, the whole-cell catalyst was cultured in 5-L fermentor by fed-batch fermentation, and 164 g/L L-threonine and 248 g/L D-glucose were converted to 141.6 g/L L-ABA and 269.4 g/L D-gluconic acid. The whole-cell catalyst is promising to fulfill industrial requirements for L-ABA and D-gluconic acid.

Background:Functional gastrointestinal disorders(FGIDs)is a common disease of digestive system which severely affects the quality of life. Recently,more and more attentions have been paid to the relationship between FGIDs and psychological factors. Aims:To investigate the relationship between FGIDs and psychological factors and related treatment. Methods:A total of 270 patients with FGIDs admitted from Sept. 2013 to Sept. 2014 at Anhui No. 2 Province People’s Hospital were enrolled. Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the mental state of patients,and symptom severity of digestive system was scored. Patients with psychological abnormalities received conventional therapy to relieve digestive symptoms,and those who failed from conventional therapy were assigned into refractory group and others were assigned into response group. Patients in refractory group were further divided into conventional therapy group and combined therapy group for receiving paroxetine in addition to conventional therapy. Results:The rates of anxiety and depression were 61. 5%(166 / 270)and 57. 0%(154 / 270),respectively. The scores of HAMA and HAMD were positively correlated with the score of digestive symptoms(r = 0. 585,P < 0. 01;r = 0. 584,P <0. 01)in patients with anxiety and depression in response group. The scores of HAMA,HAMD and digestive symptoms in response group after conventional therapy were significantly decreased(P < 0. 05),while the scores of HAMA and HAMD in refractory group after therapy were significantly higher than those in response group before therapy(P < 0. 05). The scores of HAMA,HAMD and digestive symptoms in combined therapy group were significantly lower than those in conventional therapy group(P < 0. 05). Conclusions:Relationship is found between FGIDs and psychological factors,and antidepressants might contribute to the amelioration of symptoms of FGIDs.