BACKGROUND:Spondylolisthesis is a common disease,and there is a lack of effective drugs to treat it.There is still a need to further define the pathogenesis and screen out more suitable therapeutic targets for spondylolisthesis.Mendelian randomization analysis can be used to explore the drugable genes associated with spondylolisthesis and provide valuable guidance for the development of more effective and targeted therapeutic drugs.OBJECTIVE:To explore potential therapeutic targets and effective drugs for spondylolisthesis by means of pharmaceutically available genome-wide Mendelian randomization analysis.METHODS:Using the Finnish database,eQTLGen consortium,drug signature database,drug-gene interaction database,protein-protein interaction database,organic small molecule biological activity database and protein structure database,which contains genome and health information of half a million Finns,data on druggable genes were subjected to two-sample Mendelian randomization analysis and co-localization analysis with data from genome-wide association studies of spondylolisthesis to identify genes highly associated with spondylolisthesis.In addition,GO and KEGG enrichment analysis,protein network construction,drug prediction and molecular docking were performed to provide valuable guidance for the development of more effective and targeted therapeutic agents.RESULTS AND CONCLUSION:In this study,we identified 34 potential drug target genes that were significantly associated with spondylolisthesis,particularly the gene APOBEC3G.This gene showed a significant association with spondylolisthesis outcomes through Mendelian analysis and co-localization analysis,suggesting that APOBEC3G may be a priority therapeutic target.As for other potential mechanisms and drugs,we still need to conduct more in-depth research to determine their roles.This study used a database from a European population,which can be used as a reference for the study of population genetics in China.

BACKGROUND:Spondylolisthesis is a common disease,and there is a lack of effective drugs to treat it.There is still a need to further define the pathogenesis and screen out more suitable therapeutic targets for spondylolisthesis.Mendelian randomization analysis can be used to explore the drugable genes associated with spondylolisthesis and provide valuable guidance for the development of more effective and targeted therapeutic drugs.OBJECTIVE:To explore potential therapeutic targets and effective drugs for spondylolisthesis by means of pharmaceutically available genome-wide Mendelian randomization analysis.METHODS:Using the Finnish database,eQTLGen consortium,drug signature database,drug-gene interaction database,protein-protein interaction database,organic small molecule biological activity database and protein structure database,which contains genome and health information of half a million Finns,data on druggable genes were subjected to two-sample Mendelian randomization analysis and co-localization analysis with data from genome-wide association studies of spondylolisthesis to identify genes highly associated with spondylolisthesis.In addition,GO and KEGG enrichment analysis,protein network construction,drug prediction and molecular docking were performed to provide valuable guidance for the development of more effective and targeted therapeutic agents.RESULTS AND CONCLUSION:In this study,we identified 34 potential drug target genes that were significantly associated with spondylolisthesis,particularly the gene APOBEC3G.This gene showed a significant association with spondylolisthesis outcomes through Mendelian analysis and co-localization analysis,suggesting that APOBEC3G may be a priority therapeutic target.As for other potential mechanisms and drugs,we still need to conduct more in-depth research to determine their roles.This study used a database from a European population,which can be used as a reference for the study of population genetics in China.

OBJECTIVE To screen and quantitatively analyze the quality marker （Q-Marker） associated with anti-renal fibrosis in Shenqi shenshuai mixture （SQSS）， so as to provide references for the analysis of pharmacodynamic substances and new drug transformation of SQSS. METHODS The chemical components of SQSS were characterized by untargeted metabolomics. Combined with network pharmacology， gene expression omnibus （GEO） and connectivity map （CMAP） databases， the anti-renal fibrosis Q-Markers of SQSS were screened. HPLC-MS/MS was applied to determine the contents of Q-Markers in 10 batches of SQSS. RESULTS A total of 1 319 compounds were identified from SQSS via untargeted metabolomics，and 84 active ingredients with anti-renal fibrosis activity were further screened out， such as formononetin. Nine anti-renal fibrosis Q-Markers were obtained by network pharmacology and GEO database， including berberine， quercetin， honokiol， nicotinamide， daidzein， coumarin， kaempferol， formononetin and amygdalin. The quantitative results showed that the average contents of the above components （excluding amygdalin） in 10 batches of SQSS were 2.523， 1.942， 26.848， 1.415， 0.692， 0.171， 0.374， 7.401 μg/mL， respectively. CONCLUSIONS Nine anti-renal fibrosis Q-Markers of SQSS were screened in this study， and the contents of eight among them were determined. The results can provide a basis for elucidating the pharmacodynamic material basis and promoting the new drug transformation of SQSS.

OBJECTIVE To screen and quantitatively analyze the quality marker （Q-Marker） associated with anti-renal fibrosis in Shenqi shenshuai mixture （SQSS）， so as to provide references for the analysis of pharmacodynamic substances and new drug transformation of SQSS. METHODS The chemical components of SQSS were characterized by untargeted metabolomics. Combined with network pharmacology， gene expression omnibus （GEO） and connectivity map （CMAP） databases， the anti-renal fibrosis Q-Markers of SQSS were screened. HPLC-MS/MS was applied to determine the contents of Q-Markers in 10 batches of SQSS. RESULTS A total of 1 319 compounds were identified from SQSS via untargeted metabolomics，and 84 active ingredients with anti-renal fibrosis activity were further screened out， such as formononetin. Nine anti-renal fibrosis Q-Markers were obtained by network pharmacology and GEO database， including berberine， quercetin， honokiol， nicotinamide， daidzein， coumarin， kaempferol， formononetin and amygdalin. The quantitative results showed that the average contents of the above components （excluding amygdalin） in 10 batches of SQSS were 2.523， 1.942， 26.848， 1.415， 0.692， 0.171， 0.374， 7.401 μg/mL， respectively. CONCLUSIONS Nine anti-renal fibrosis Q-Markers of SQSS were screened in this study， and the contents of eight among them were determined. The results can provide a basis for elucidating the pharmacodynamic material basis and promoting the new drug transformation of SQSS.

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'Injury but not disability, disability but not useless’ is the guiding principle behind the establishment of plastic and reconstructive surgery, making it a unique specialty in modern medicine. Its development relies not only on the optimized use of donor resources but also on technological advancements and innovations in concepts. However, in the face of severe tissue damage caused by burns, trauma, and congenital deformities, traditional repair method often fall short, necessitating more effective solutions. Against this backdrop, progress in donor sourcing and interdisciplinary innovation will inject new vitality into reconstructive surgery. In this context, we take facial transplantation reconstruction as a starting point, reviewing and organizing the technological development, issues, and challenges of autologous and allogeneic facial transplantation reconstruction from the perspective of donors. This exploration aims to shed light on the future direction of this field and gain a deeper understanding of the present and future of donor-driven reconstructive surgery.

The Department of Plastic and Reconstructive Surgery of the Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medical, has witnessed and propelled the remarkable evolution of China’s plastic and reconstructive surgery over the past sixty years. Established in 1961 under the leadership of its founding father, Professor Ti-sheng Chang, the department was built on the mission of "Preventing the injured from disabled, the disabled from incapable". It pioneered groundbreaking advancements in flap microsurgery, craniofacial surgery, and lymphatic medicine. Entering the 21st century, guided by its motto of "Openness, Innovation, Excellence, and Dedication", the department has developed a comprehensive, full-cycle diagnostic and treatment system covering all disease spectrums. With seven major specialties and 24 subspecialty divisions, it has achieved continuous breakthroughs in surface organ reconstruction, hemangioma and neurofibroma treatment, fat transplantation, and craniomaxillofacial surgery. These innovations have yielded landmark achievements, with multiple technologies receiving National Science and Technology Progress Awards, significantly advancing the field of reconstructive surgery in China. Committed to talent development, the department, as one of China’s first doctoral training centers and a national standardized training base for resident and specialist physicians, has trained over 750 postgraduate students, more than 240 resident and specialist trainees, and over 2 000 clinic fellow. It has also led the compilation of multiple national standardized textbooks in plastic surgery, making substantial contributions to professional education and training standardization. Through administration innovation, the department has established a "bed-bench-bed" closed-loop model, driving technological advancements and facilitating major translational achievements, including Class 1.1 new drugs and stem cell therapies. It pioneered a structured multi-site practice platform for surgeons, optimizing the allocation of medical resources. Now, the department is focusing on high-quality patient cohort and biobank development while exploring cutting-edge fields such as AI-assisted diagnostics, gene therapy, and brain-computer interfaces, striving to build a world-class discipline at the forefront of global reconstructive surgery.

Operation management is an important tool to promote the high-quality development of public hospitals in China.Since the founding of New China,based on China's economic and social development and medical and health system reform,the evolution of operation management of public hospitals in China can be divided into four stages,the system building stage(1949-1978),the liberalization and revitalization stage(1979-1996),the operation mechanism reform stage(1997-2020),and the new stage of high-quality development(2021 present).The development trend of public hospital operation management in future should deepen the public welfare-oriented public hospital operation management,explore the value-oriented medical operation management model based on high-quality development and the refined operation and management model of public hospitals,so as to promote the high-quality development of public hospitals in China.

To explore the correlation between the level of serum interleukin-6 (IL-6) and the severity of infection in patients with diabetic foot (DF) and the auxiliary value of IL-6 in DF diagnosis, and aim to provide reference for clinical treatment. Based on the hospital medical record system and the laboratory system, a retrospective analysis with case-control study was conducted on the data of patients in Liyuan Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2020 to September 2024. A total of 377 patients′ information was collected, including 31 cases in control group with 17 males and 14 females from 31 to 91 years old and a median age of 71, 63 cases in NDF group with 43 males and 20 females from 37 to 96 years old, with a median age of 71, and 283 patients in DF group with 197 males and 86 females from 36 to 96 years, with a median age of 67. According to classification of infection severity, paints in the group of diabetes with DF were divided into mild infection subgroup (72 cases), moderate infection subgroup (143 cases) and severe infection subgroup (68 cases). The results showed that there were no statistically significant differences in age and gender among the three groups in the study ( F=1.795/ χ 2=2.81, P>0.05). The non parametric test results showed that there were statistically significant differences in IL-6, C-reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC) and glucose (GLU) among the three groups of patients ( H=12.480, 36.277, 12.432, 12.838, 18.334, P<0.05). The pairwise comparison results showed that compared with the control group, the NDF group had higher levels of CRP, PCT and GLU ( H=20.259, 20.118, 20.056, P<0.05), and the levels of IL-6, CRP, PCT and WBC( H=14.934,14.933,14.829,14.934, P<0.05) were higher in the DF group. Both of the differences were statistically significant. But the difference of IL-6, CRP, PCT, WBC and GLU between the NDF and DF group was not statistically significant( H=1.202,0.622,0.737,1.036,1.899, P>0.05). In DF group, there were statistically significant differences in IL-6, CRP, PCT, WBC, and GLU levels among patients in the three infection subgroups ( H=11.174, 15.136, 8.657, 8.348, 3.698, P<0.05).Compared to the mild subgroup, the levels of IL-6, CRP, PCT, WBC and GLU were higher in the severe subgroup were higher( H=111.789,237.066,74.683,83.203,15.328, P<0.05) and the levels of IL-6, CRP, PCT in the moderate subgroup were higher ( H=6.877, 8.846, 5.183, P<0.05). And both of the differences were statistically significant. But there was no statistically significant difference in WBC and GLU level between the mild and the moderate subgroup( H=1.684, 1.039, P>0.05). The severity of infection in diabetic foot patients was positively correlated with the IL-6 level ( OR=1.033, 95% CI: 0.024-0.043, P<0.05). ROC curve showed that AUC of IL-6 for diagnosis in diabetic foots were 0.635. And joint testing showed that the AUC of IL-6+CRP, IL-6+PCT and IL-6+WBC were 0.718, 0.621, and 0.638 respectively. In conclusion,the level of serum IL-6 may be positively correlated with the severity of infection in diabetic foot patients, which may have auxiliary diagnostic value in predicting diabetic foot infection. And it may provide a reference for the grading of infection severity in diabetic foot patients to gauging serum IL-6 level.

ObjectiveTo analyze the characteristics and influencing factors of elderly hospitalized patients with carbapenem-resistant gram-negative bacillus (CRO) infection in the intensive care unit (ICU) of a gradeⅡ level A general hospital in Yangpu District of Shanghai, and to provide scientific basis for the prevention and control of hospital-acquired CRO infection in such hospitals. MethodsThe clinical data of elderly ICU patients (age ≥60 years) from January 2019 to December 2023 were retrospectively collected. A total of 122 cases with hospital-acquired CRO infection were used as the case group, and a total of 68 cases with carbapenem-sensitive gram-negative (CSO) infection were used as the control group. The clinical characteristics of the two groups were analyzed, and univariate analysis and logistic regression analysis were performed for screening for possible influencing factors on hospital-acquired CRO infection. ResultsThe main pathogens of CRO infection were carbapenem-resistant Acinetobacter baumannii (CRAB) (53 cases, 43.44%) and carbapenem-resistant Klebsiella pneumoniae (CRKP) (46 cases, 37.70%), and 17 patients (13.93%) had more than two types of CRO infection. Among the CRO infection, the main sites were lower respiratory tract infection (58 cases, 47.54%), ventilator-associated pneumonia (21 cases, 17.21%), and catheter-associated urinary tract infections (16 cases, 13.11%). The incidence rate of poor prognosis was higher in the CRO infection group (54.10%) than that in the CSO infection group (36.76%) (P=0.021). The results of univariate analysis showed that male, history of hospitalization within three months, chronic respiratory disease, hypoproteinemia, anemia, and history of invasive procedures prior to infection, including indwelling central venous catheter, invasive mechanical ventilation, urinary catheter, gastric tube placement and parenteral nutrition, in addition, heparin anticoagulation, the use of broad-spectrum penicillin, third-generation cephalosporins, fluoroquinolones, carbapenems, carbapenems combined with fluoroquinolones, carbapenems combined with glycopeptides, use of ≥3 antibiotics and long time of antibiotic use prior to infection were all associated with the CRO infection (P<0.05). The results of logistic regression analysis showed that use of carbapenems (OR=7.739, 95%CI: 2.226‒26.911), ≥3 types of antibiotics (OR=6.307, 95%CI: 1.674‒23.754), invasive mechanical ventilation (OR=4.082, 95%CI: 1.795‒9.281), urinary catheter (OR=3.554, 95%CI: 1.074‒11.758), and comorbid hypoproteinemia (OR=4.741, 95%CI: 2.039‒11.022) and diabetes (OR=3.245, 95%CI: 1.344‒7.839) were positively correlated with the risk of CRO infection. ConclusionConcurrent use of carbapenems with multiple other antibiotics, as well as the use of invasive mechanical ventilation, urinary catheter, and comorbid hypoproteinemia and diabetes, may be associated with an increased influencing of CRO infection. More attention should be paid to the prevention and control of infection in elderly patients with the above-mentioned risk factors, and active screening of drug-resistant bacteria should be strengthened. Besides, the rational use of broad-spectrum antibiotics such as carbapenems, avoiding unnecessary invasive operations, and paying attention to patient nutrition and blood glucose control all can reduce the incidence of CRO infection and help to improve clinical outcomes.