Intestinal fibrosis is a significant clinical challenge in inflammatory bowel diseases, but no effective anti-fibrotic therapy is currently available. Glucagon receptor (GCGR) and glucagon-like peptide 1 receptor (GLP1R) are both peptide hormone receptors involved in energy metabolism of epithelial cells. However, their role in intestinal fibrosis and the underlying mechanisms remain largely unexplored. Herein GCGR and GLP1R were found to be reduced in the stenotic ileum of patients with Crohn's disease as well as in the fibrotic colon of mice with chronic colitis. The downregulation of GCGR and GLP1R led to the accumulation of the metabolic byproduct lactate, resulting in histone H3K9 lactylation and exacerbated intestinal fibrosis through epithelial-to-mesenchymal transition (EMT). Dual activating GCGR and GLP1R by peptide 1907B reduced the H3K9 lactylation in epithelial cells and ameliorated intestinal fibrosis in vivo. We uncovered the role of GCGR/GLP1R in regulating EMT involved in intestinal fibrosis via histone lactylation. Simultaneously activating GCGR/GLP1R with the novel dual agonist peptide 1907B holds promise as a treatment strategy for alleviating intestinal fibrosis.

Objective:To compare the efficacy and safety among traditional open suture, modified Kessler method, and minimally invasive suture with threaded rivets in acute closed Achilles tendon rupture.Methods:A total of 60 patients with acute closed Achilles tendon rupture diagnosed and treated in the Affiliated Hospital of Jining Medical College from January 2018 to August 2022 were selected retrospectively as the study subjects and divided into group A (20 patients with traditional open suture), group B (20 patients with modified Kessler method) and group C (20 patients with minimally invasive suture with threaded rivets) according to operative method. The clinical efficacy, perioperative indexes, Achilles tendon activity, postoperative recovery work and exercise time, visual analog scale (VAS) score and complications were compared among the three groups.Results:The total effective rate in the group C was higher than that in the group A : 18/20 vs. 12/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total effective rate in the group B and group C had no statistical difference ( P>0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, time to return to work, exercise and VAS scores in the group B and group C were lower than those in the group A: (49.32 ± 4.74), (48.12 ± 4.68) min vs. (66.71 ± 5.84) min; (15.32 ± 1.01), (15.62 ± 0.79) ml vs.(19.86 ± 1.20) ml; (7.69 ± 0.57), (3.76 ± 0.50) cm vs. (8.98 ± 0.62) cm; (7.01 ± 0.91), (6.82 ± 0.83) d vs.(8.74 ± 1.12) d; (56.32 ± 8.01), (55.17 ± 7.84) d vs. (63.17 ± 6.68) d; (6.13 ± 1.20), (5.94 ± 1.04) months vs. (8.21 ± 1.20) months; (2.76 ± 0.50), (2.55 ± 0.76) scores vs. (3.98 ± 0.62) scores, there were statistical differences ( P<0.05). At 1, 6 and 12 months after surgery, the American Society for Foot and Ankle Surgery (AOFAS) scores in the three groups were significantly increased, and the AOFAS scores in the group B and group C were higher than those in the group A, there were statistical differences ( P<0.05). The total incidence of complications in the group C was lower than that in the group A: 2/20 vs. 8/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total incidence of complications in the group B and group C had no statistical difference ( P>0.05). Conclusions:Modified Kessler method and minimally invasive suture with threaded rivets have the advantages of high efficiency and safety in the treatment of acute closed Achilles tendon rupture, and their efficacy is higher than that of traditional open suture.

We report a case of a 14-year-old male with first metatarsocuneiform coalition. With a 1-month history of left foot pain the patient presented to some hospital 8 months ago, where conservative management, including rest, physiotherapy, and medication, was administered. However, symptoms gradually worsened. On admission to our hospital, radiograph revealed a bony bridge at the left first metatarsocuneiform joint, which had enlarged compared with the radiograph 8 months earlier. The patient was diagnosed as first metatarsocuneiform coalition in the left foot and underwent resection of the bony bridge, followed by plaster immobilization for 3 weeks. At 3 months postoperatively, he had resumed normal activity without pain or discomfort. First metatarsocuneiform coalition is a rare type of tarsal coalition. Currently, there are no standardized surgical indications or established treatment protocols. Given the uncertainty of surgical outcomes, conservative treatment should be the primary choice. Surgical intervention may be considered when conservative measures fail or symptoms continue to worsen.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To investigate the clinical efficacy of minimally invasive percutaneous internal fixation with double screws for delayed union or nonunion of scaphoid fracture.Methods:A retrospective study was conducted to analyze the 12 patients with delayed union or nonunion of scaphoid fracture who had been treated at Department of Hand and Foot Surgery, The Affiliated Hospital of Jining Medical University from March 2021 to December 2023. They were 11 males and 1 female, with an age of (29.9±13.8) years and an interval from injury to surgery of (5.1±2.6) months. They were all treated by minimally invasive percutaneous internal fixation with 2 hollow compression screws. The visual analogue scale (VAS), grip strength (percentage of the affected side to the healthy side), wrist range of motion, modified Mayo wrist score and other data were recorded and compared between pre-surgery and the last follow-up. The incidence of complications was recorded.Results:Follow-up for all patients lasted for (20.8±8.9) months. All patients achieved bony union after (10.1±3.2) weeks with no complications like infection. No post-surgery imaging revealed screw misplacement or penetration. At the last follow-up, the VAS pain score was 0 (0, 1) point, the wrist grip strength 100.6%±7.2%, the wrist flexion 88.3°±2.5°, the wrist dorsiflexion 88.5°±2.2°, and the modified Mayo wrist score (98.3±2.5) points, all significantly better than the pre-surgery values [4 (4, 5) points, 69.1%±16.0%, 61.3°±13.5°, 64.7°±9.1°, and (61.7±10.1) points] (all P < 0.05). Conclusion:In the treatment of delayed union or nonunion of scaphoid fracture, minimally invasive percutaneous internal fixation with double screws shows advantages of minimal invasion, quick fracture healing, fine functional recovery, and no need of bone grafting.

We report a case of a 14-year-old male with first metatarsocuneiform coalition. With a 1-month history of left foot pain the patient presented to some hospital 8 months ago, where conservative management, including rest, physiotherapy, and medication, was administered. However, symptoms gradually worsened. On admission to our hospital, radiograph revealed a bony bridge at the left first metatarsocuneiform joint, which had enlarged compared with the radiograph 8 months earlier. The patient was diagnosed as first metatarsocuneiform coalition in the left foot and underwent resection of the bony bridge, followed by plaster immobilization for 3 weeks. At 3 months postoperatively, he had resumed normal activity without pain or discomfort. First metatarsocuneiform coalition is a rare type of tarsal coalition. Currently, there are no standardized surgical indications or established treatment protocols. Given the uncertainty of surgical outcomes, conservative treatment should be the primary choice. Surgical intervention may be considered when conservative measures fail or symptoms continue to worsen.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To compare the efficacy and safety among traditional open suture, modified Kessler method, and minimally invasive suture with threaded rivets in acute closed Achilles tendon rupture.Methods:A total of 60 patients with acute closed Achilles tendon rupture diagnosed and treated in the Affiliated Hospital of Jining Medical College from January 2018 to August 2022 were selected retrospectively as the study subjects and divided into group A (20 patients with traditional open suture), group B (20 patients with modified Kessler method) and group C (20 patients with minimally invasive suture with threaded rivets) according to operative method. The clinical efficacy, perioperative indexes, Achilles tendon activity, postoperative recovery work and exercise time, visual analog scale (VAS) score and complications were compared among the three groups.Results:The total effective rate in the group C was higher than that in the group A : 18/20 vs. 12/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total effective rate in the group B and group C had no statistical difference ( P>0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, time to return to work, exercise and VAS scores in the group B and group C were lower than those in the group A: (49.32 ± 4.74), (48.12 ± 4.68) min vs. (66.71 ± 5.84) min; (15.32 ± 1.01), (15.62 ± 0.79) ml vs.(19.86 ± 1.20) ml; (7.69 ± 0.57), (3.76 ± 0.50) cm vs. (8.98 ± 0.62) cm; (7.01 ± 0.91), (6.82 ± 0.83) d vs.(8.74 ± 1.12) d; (56.32 ± 8.01), (55.17 ± 7.84) d vs. (63.17 ± 6.68) d; (6.13 ± 1.20), (5.94 ± 1.04) months vs. (8.21 ± 1.20) months; (2.76 ± 0.50), (2.55 ± 0.76) scores vs. (3.98 ± 0.62) scores, there were statistical differences ( P<0.05). At 1, 6 and 12 months after surgery, the American Society for Foot and Ankle Surgery (AOFAS) scores in the three groups were significantly increased, and the AOFAS scores in the group B and group C were higher than those in the group A, there were statistical differences ( P<0.05). The total incidence of complications in the group C was lower than that in the group A: 2/20 vs. 8/20, there was statistical difference ( χ2 = 4.80, P<0.05). The total incidence of complications in the group B and group C had no statistical difference ( P>0.05). Conclusions:Modified Kessler method and minimally invasive suture with threaded rivets have the advantages of high efficiency and safety in the treatment of acute closed Achilles tendon rupture, and their efficacy is higher than that of traditional open suture.

Objective:To investigate the clinical efficacy of minimally invasive percutaneous internal fixation with double screws for delayed union or nonunion of scaphoid fracture.Methods:A retrospective study was conducted to analyze the 12 patients with delayed union or nonunion of scaphoid fracture who had been treated at Department of Hand and Foot Surgery, The Affiliated Hospital of Jining Medical University from March 2021 to December 2023. They were 11 males and 1 female, with an age of (29.9±13.8) years and an interval from injury to surgery of (5.1±2.6) months. They were all treated by minimally invasive percutaneous internal fixation with 2 hollow compression screws. The visual analogue scale (VAS), grip strength (percentage of the affected side to the healthy side), wrist range of motion, modified Mayo wrist score and other data were recorded and compared between pre-surgery and the last follow-up. The incidence of complications was recorded.Results:Follow-up for all patients lasted for (20.8±8.9) months. All patients achieved bony union after (10.1±3.2) weeks with no complications like infection. No post-surgery imaging revealed screw misplacement or penetration. At the last follow-up, the VAS pain score was 0 (0, 1) point, the wrist grip strength 100.6%±7.2%, the wrist flexion 88.3°±2.5°, the wrist dorsiflexion 88.5°±2.2°, and the modified Mayo wrist score (98.3±2.5) points, all significantly better than the pre-surgery values [4 (4, 5) points, 69.1%±16.0%, 61.3°±13.5°, 64.7°±9.1°, and (61.7±10.1) points] (all P < 0.05). Conclusion:In the treatment of delayed union or nonunion of scaphoid fracture, minimally invasive percutaneous internal fixation with double screws shows advantages of minimal invasion, quick fracture healing, fine functional recovery, and no need of bone grafting.

BACKGROUND:Steroid-induced osteonecrosis of the femoral head is a refractory disease in the field of orthopedics.There is no definitive idea to fully explain its pathogenesis.With the increased research on the active ingredients of Panax notoginseng interfering with the signaling pathways related to various diseases,the active ingredients of Panax notoginseng that treat steroid-induced necrosis of the femoral head via the regulation of relevant signaling pathways have gradually become a hot research topic. OBJECTIVE:To systematically summarize the literature on the pathological mechanism of steroid-induced osteonecrosis of the femoral head and the regulation of signaling pathways by the active ingredients of Panax notoginseng in recent years,thereby providing a reference for the follow-up study on the active ingredients of Panax notoginseng in the treatment of this disease. METHODS:CNKI,WanFang,and PubMed were searched for relevant literature with the key words of"glucocorticoid,steroid-induced osteonecrosis of the femoral head,pathological mechanism,signaling pathway,Panax notoginseng,active ingredient"in Chinese and English.Documents related to the pathological mechanism of steroid-induced osteonecrosis of the femoral head as well as related to the intervention of active ingredients of Panax notoginseng on the signaling pathway of steroid-induced osteonecrosis of the femoral head were retrieved.A total of 63 documents were finally included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:The main ingredients of Panax notoginseng include Panax notoginseng saponins,ginsenoside,Panax notoginseng saponins,quercetin,kaempferol,etc.Panax notoginseng saponins,ginsenoside Rb1 and quercetin can promote bone repair and angiogenesis by acting on the transforming growth factor-β/bone morphogenetic protein pathway.Panax notoginseng saponins,ginsenoside CK and kaempferol can promote osteogenic differentiation and lipid metabolism by acting on the Wnt/β-catenin pathway.Panax notoginseng saponins and Panax notoginseng saponins R1/R2 act on the MAPK pathway to inhibit osteoclastogenesis and promote bone repair.Panax notoginseng saponins,ginsenoside Rb2 and quercetin can inhibit osteoclast proliferation and promote osteoblastic differentiation by acting on the RANKL/RANK/OPG pathway.Panax notoginseng saponins,quercetin and kaempferol can repair vascular injury and promote osteogenesis by acting on the hypoxia-inducible factor-1α pathway.Panax notoginseng saponins R1,quercetin combined with hydroxyapatite nanoparticles,Panax notoginseng saponins combined with polyethylene-L-lactic acid and other biomaterials have good research prospects in the treatment of steroid-induced osteonecrosis of the femoral head.The active ingredients of Panax notoginseng can regulate the signaling pathways related to steroid-induced osteonecrosis of the femoral head through various mechanisms,and play an active intervention role in the disease.However,the depth and breadth of relevant research are insufficient at present,and the future research should be based on the existing mechanism to explore the specific mechanism of Panax notoginseng regulating different pathways and the interaction between pathways,which will be beneficial to the multi-development of the active ingredients of Panax notoginseng in the treatment of steroid-induced osteonecrosis of the femoral head.