Microsurgery is a surgical technique that applies fine instruments to perform precise operations on tiny tissues and organs under optical magnification devices. Digital and intelligent technologies, such as digital imaging, virtual reality (VR), augmented reality (AR), mixed reality (MR), 3D design and reconstruction, 3D printing, digital navigation, mixed perception of multi-source heterogeneous information, automatic control, digital twins, Internet of Things, cloud computing, machine learning, deep learning, large-scale AI models, generative artificial intelligence and so on, have been enabling the innovative development in microsurgery. It will make significant changes in disease diagnosis and monitoring, treatment decision-making and surgical planning, precise and individualised surgery, doctor-patient interaction and healthcare, team collaboration and professional education, and will drive the innovative development in microsurgery.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Objective:Based on the adverse drug event active surveillance and assessment system-Ⅱ (ADE-ASAS-Ⅱ) and the information of inpatients in the hospital information system (HIS), the automatic monitoring module of movement disorders was constructed and its application effect in the real-world study of drug-induced movement disorders (DIMDs) was explored.Methods:Literature reviews, case reports, spontaneous reports and medical records were collected, the keyword set was screened based on ADE-ASAS-Ⅱ system and text classification technology, and an automatic monitoring module was constructed. The information of hospitalized patients in Chinese PLA General Hospital (our hospital) was selected from October 10 to 16, 2022. The results of manual evaluation and the system alarm by the automatic monitoring module were compared, and the performance of the automatic monitoring module was evaluated and optimized through repeated machine learning. The medical record information of hospitalized patients who used sodium valproate throughout the year in our hospital in 2022 were collected, and the occurrence of movement disorders related to sodium valproate was analyzed using the automatic monitoring module.Results:A total of 4 918 hospitalized patients (146 with movement disorders) were collected, and the final setting conditions of the automatic monitoring module were determined, including inclusion criteria (43 text keywords, 3 diagnosis) and exclusion criteria (11 text and 20 document titles were omitted). Among the 1 138 hospitalized patients using sodium valproate in 2022, the incidence of DIMDs with tic and tremor as main clinical manifestations detected by automatic monitoring module was 1.67% (19/1 138).Conclusion:The automatic monitoring module of drug-induced movement disorders based on machine learning and manual evaluation can be applied to explore the occurrence characteristics of DIMDs in the real world, and provide information for pharmacovigilance in clinic.

Objective To evaluate the clinical outcome of posterior cruciate ligament(PCL)recon-struction using ligament augmentation and reconstruction system(LARS)artificial ligament,and ana-lyze factors affecting the prognosis.Methods A total of 45 patients(31 males and 14 females,with an average age of 38.0±12.8 years)underwent PCL reconstruction using LARS artificial ligament in China-Japan Friendship Hospital in years from 2018 to 2021 were analyzed retrospectively.Their aver-age time from injury to surgery of 2.8±4.2 months.They were followed up for no less than 1 year about the stability of knee,Lysholm score and Tegner score,as well as the patient's satisfaction.Moreover,the effect of patient's age,time from injury to surgery,and complications of other ligament injuries of the knee on the final outcomes were analyzed.Results For all the 45 patients,the mean follow-up time was 35.0±14.1 months,with their satisfaction rate of 91.1%.There were 31 cases of 3° instability and 14 cases of 2° instability before surgery,which improved significantly as only 4 cas-es were of 2° instability,22 cases of 1° instability at the final follow-up(χ2=77.56,P<0.000).More-over,the average Lysholm and Tegner scores increased significantly from 37.2±15.2 and 0.9±0.9,to 85.3±12.7 and 4.4±1.3,respectively(t=16.34,P<0.000;t=15.72,P<0.000).What's more,the age of over 40 years had effect on the prognosis,while the time from injury to surgery and the com-plicated ligament injuries of the knee did not.Conclusion Using LARS artificial ligament as graft for PCL reconstruction can achieve satisfactory clinical results on the short-term.

Objective:Based on the adverse drug event active surveillance and assessment system-Ⅱ (ADE-ASAS-Ⅱ) and the information of inpatients in the hospital information system (HIS), the automatic monitoring module of movement disorders was constructed and its application effect in the real-world study of drug-induced movement disorders (DIMDs) was explored.Methods:Literature reviews, case reports, spontaneous reports and medical records were collected, the keyword set was screened based on ADE-ASAS-Ⅱ system and text classification technology, and an automatic monitoring module was constructed. The information of hospitalized patients in Chinese PLA General Hospital (our hospital) was selected from October 10 to 16, 2022. The results of manual evaluation and the system alarm by the automatic monitoring module were compared, and the performance of the automatic monitoring module was evaluated and optimized through repeated machine learning. The medical record information of hospitalized patients who used sodium valproate throughout the year in our hospital in 2022 were collected, and the occurrence of movement disorders related to sodium valproate was analyzed using the automatic monitoring module.Results:A total of 4 918 hospitalized patients (146 with movement disorders) were collected, and the final setting conditions of the automatic monitoring module were determined, including inclusion criteria (43 text keywords, 3 diagnosis) and exclusion criteria (11 text and 20 document titles were omitted). Among the 1 138 hospitalized patients using sodium valproate in 2022, the incidence of DIMDs with tic and tremor as main clinical manifestations detected by automatic monitoring module was 1.67% (19/1 138).Conclusion:The automatic monitoring module of drug-induced movement disorders based on machine learning and manual evaluation can be applied to explore the occurrence characteristics of DIMDs in the real world, and provide information for pharmacovigilance in clinic.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Microsurgery is a surgical technique that applies fine instruments to perform precise operations on tiny tissues and organs under optical magnification devices. Digital and intelligent technologies, such as digital imaging, virtual reality (VR), augmented reality (AR), mixed reality (MR), 3D design and reconstruction, 3D printing, digital navigation, mixed perception of multi-source heterogeneous information, automatic control, digital twins, Internet of Things, cloud computing, machine learning, deep learning, large-scale AI models, generative artificial intelligence and so on, have been enabling the innovative development in microsurgery. It will make significant changes in disease diagnosis and monitoring, treatment decision-making and surgical planning, precise and individualised surgery, doctor-patient interaction and healthcare, team collaboration and professional education, and will drive the innovative development in microsurgery.

Objective:To observe the effects of acupuncture on intestinal flora and inflammatory factor interleukin(IL)-6 in ulcerative colitis(UC)model rats and to explore the related mechanism of acupuncture in treating UC.Methods:Thirty-two Sprague-Dawley rats were randomly divided into a normal control(NC)group,a model(MO)group,a mesalazine(ME)group,and an acupuncture(AC)group,with 8 rats in each group.Rats,except those in the NC group,were given a 2.5%sodium dextran sulfate solution to establish UC models.After successful modeling,rats in the ME group were treated with mesalazine by gavage twice a day for 7 continuous days;rats in the AC group received acupuncture at bilateral Tianshu(ST25)and Zusanli(ST36)with needles retained for 20 min each time,once a day for 7 consecutive days.After intervention,changes in the intestinal flora diversity,colon tissue damage degree,and inflammatory factor expression in each group of rats were evaluated.Results:The body mass increased slowly in the MO group compared to the NC group.After intervention,the body mass increased more significantly,colon injuries recovered,and intestinal flora diversity improved in the ME and AC groups compared to the MO group(P<0.05).The IL-6 expression level was higher in the MO group compared to the NC group(P<0.05).The IL-6 expression level decreased in the AC group compared to the MO group(P<0.05).Conclusion:Acupuncture at Tianshu(ST25)and Zusanli(ST36)improves body mass loss and colon injuries,regulates intestinal flora diversity,and reduces the expression of inflammatory factor IL-6 in the colon tissue of UC rats,therefore alleviating the disease severity of UC.

Objective To evaluate the clinical outcome of posterior cruciate ligament(PCL)recon-struction using ligament augmentation and reconstruction system(LARS)artificial ligament,and ana-lyze factors affecting the prognosis.Methods A total of 45 patients(31 males and 14 females,with an average age of 38.0±12.8 years)underwent PCL reconstruction using LARS artificial ligament in China-Japan Friendship Hospital in years from 2018 to 2021 were analyzed retrospectively.Their aver-age time from injury to surgery of 2.8±4.2 months.They were followed up for no less than 1 year about the stability of knee,Lysholm score and Tegner score,as well as the patient's satisfaction.Moreover,the effect of patient's age,time from injury to surgery,and complications of other ligament injuries of the knee on the final outcomes were analyzed.Results For all the 45 patients,the mean follow-up time was 35.0±14.1 months,with their satisfaction rate of 91.1%.There were 31 cases of 3° instability and 14 cases of 2° instability before surgery,which improved significantly as only 4 cas-es were of 2° instability,22 cases of 1° instability at the final follow-up(χ2=77.56,P<0.000).More-over,the average Lysholm and Tegner scores increased significantly from 37.2±15.2 and 0.9±0.9,to 85.3±12.7 and 4.4±1.3,respectively(t=16.34,P<0.000;t=15.72,P<0.000).What's more,the age of over 40 years had effect on the prognosis,while the time from injury to surgery and the com-plicated ligament injuries of the knee did not.Conclusion Using LARS artificial ligament as graft for PCL reconstruction can achieve satisfactory clinical results on the short-term.

Objective:To explore the application value of integrated Chinese and western medicine in the treatment of sepsis-induced coagulopathy (SIC) induced by bacterial pneumonia sepsis.Methods:A total of 60 inpatients with bacterial pneumonia and sepsis admitted to the Dongzhimen Hospital of Beijing University of Chinese Medicine from October 2023 to June 2024 were collected in a cross-sectional study. Serum samples were collected, and immune indexes, coagulation function and some laboratory test results of the patients were detected or recorded. Sepsis Associated Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were evaluated.Results:Among the 60 patients, 71.7%( n=43) were associated with coagulation disorder, 65%( n=39) showed hemorrhagic SIC; A total of 37 patients (61.7%) were treated with integrated traditional Chinese and western medicine, and 23 patients (38.3%) were treated with Western medicine. The main types of syndrome differentiation were toxic-heat syndrome ( n=48, 80.0%) and blood-stasis syndrome ( n=11, 18.3%). Serum human monocyte chemoattractant protein-1 (MCP-1) and platelet count (PLT) in patients with blood stasis syndrome were significantly lower than those in toxic-heat syndrome (all P<0.05). In patients with bacterial pneumonia sepsis, the total score of syndrome of excess of fu-viscera (Fu-shi-zheng) was positively correlated with programmed death ligand-1 (PD-L1) ( r=0.293, P=0.023) and tumor necrosis factor-α (TNF-α) ( r=0.436, P=0.001). The total score of toxin-heat syndrome ( r=0.323, P=0.016) and excess of fu-viscera syndrome ( r=0.354, P=0.008) were positively correlated with prothrombin time (PT). PD-1 was positively correlated with SOFA score ( r=0.343, P=0.007) and APACHE Ⅱ score ( r=0.354, P=0.006). The PD-1 level and SOFA and APACHE Ⅱ scores of the patients treated with integrated Chinese and western medicine were significantly lower than those treated with Western medicine alone (all P<0.05). Conclusions:The combined intervention of traditional Chinese medicine and Western medicine based on " Fuzheng Touxie Jiedu (The method of strengthening the body and removing the toxin)" has strong clinical guiding significance, and can effectively improve the immune function and prognosis of bacterial pneumonia SIC.