Objective: This study aimed to elucidate the mechanisms underlying the impaired bone healing capacity in type 1 diabetes (T1DM) by investigating the role of the Hedgehog (Hh) signaling pathway in the impaired healing of cranial defects caused by T1DM. Methods: This study was approved by the experimental animal ethics committee of our hospital. A cranial defect model was established using Akita transgenic mice with spontaneous type I diabetes. The impact of T1DM on osteogenic differentiation and the Hh signaling pathway during cranial defect healing was explored by MicroCT scanning and immunohistochemical (IHC) analysis of osteocalcin (Ocn), Indian Hedgehog (Ihh), Patched1 (Ptch1), and zinc finger protein GLI1 (Gli1). Subsequently, the Hh signaling pathway was activated using smoothened agonist (SAG) (10 mg/kg, gavage), and its potential to improve cranial defect healing in T1DM was assessed by MicroCT and IHC staining. Finally, the ability of SAG (1 000 nmol/L) to counteract the inhibitory effects of a high-glucose environment (25 mol/L) on osteogenic differentiation of mouse bone marrow mesenchymal stem cells (BMSCs) was investigated through in vitro experiments. Detection methods included Alkaline Phosphatase and Alizarin Red staining, as well as quantitative real-time PCR (qPCR) analysis of the osteogenesis-related genes Alp, Spp1, Bglap, and Sp7. Results: Akita mice exhibited early, stable, and significant spontaneous T1DM characteristics. On postoperative day 21, the newly formed bone in the cranial defect area of Akita mice showed significant decreases in the bone volume-to-tissue volume ratio, volumetric bone mineral density, and Ocn expression (P < 0.05), with significant downregulation of Ihh, Ptch1, and Gli1 (P < 0.05). Activation of the Hh signaling pathway by SAG significantly mitigated the negative impact of T1DM on cranial defect healing in Akita mice (P < 0.05). Moreover, after SAG treatment, the inhibitory effects of the high-glucose environment on the alkaline phosphatase activity and in vitro mineralization capacity of BMSCs were significantly alleviated (P < 0.05), and the expression levels of osteogenic differentiation-related genes were significantly upregulated (P < 0.05). Conclusion T1DM inhibits cranial defect healing in Akita mice by suppressing the expression of the Hh signaling pathway, whereas activation of the Hh signaling pathway promotes osteogenesis and ameliorates the inhibitory effects of T1DM on bone healing.

The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery, underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines. This review aims to elucidate the available approaches for TMJ reconstruction, with a particular emphasis on recent groundbreaking advancements. The current spectrum of TMJ reconstruction integrates diverse surgical techniques, such as costochondral grafting, coronoid process grafting, revascularized fibula transfer, transport distraction osteogenesis, and alloplastic TMJ replacement. Despite the available options, a singular, universally accepted 'gold standard' for reconstructive techniques or materials remains elusive in this field. Our review comprehensively summarizes the current available methods of TMJ reconstruction, focusing on both autologous and alloplastic prostheses. It delves into the differences of each surgical technique and outlines the implications of recent technological advances, such as 3D printing, which hold the promise of enhancing surgical precision and patient outcomes. This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ, thereby improving the quality of life for patients with end-stage TMJ disorders.
Humans ; Temporomandibular Joint/surgery* ; Temporomandibular Joint Disorders/surgery* ; Transplantation, Autologous ; Arthroplasty, Replacement/methods* ; Joint Prosthesis ; Plastic Surgery Procedures/methods*

Background and Aims:Approximately 20％-25％of individuals experience insufficient weight loss(IWL)or weight regain(WR)after bariatric surgery.However,there is limited research on using semaglutide in this patient population,and its efficacy and safety remain to be confirmed.Therefore,this study was conducted to evaluate the effectiveness and safety of semaglutide in patients with IWL or WR after bariatric surgery through a systematic review to provide evidence to support clinical decision-making.Methods:A comprehensive search was conducted across multiple domestic and international databases for studies using semaglutide in patients with IWL or WR after bariatric surgery.The search period was from the database's inception to July 1,2024.Relevant studies were screened according to inclusion and exclusion criteria,and data were analyzed using Stata 14.0 software.Results:A total of 5 retrospective studies were included,encompassing 289 patients who received semaglutide treatment after bariatric surgery.The analysis showed that,compared to baseline,semaglutide use resulted in an average total weight reduction of 10.66％(MD=10.66％,95％CI=6.47％-14.89％);body mass index decreased by 3.57 kg/m2(MD=3.57 kg/m2,95％CI=2.46-4.67 kg/m2);the type of surgery did not significantly affect the degree of weight loss(P＞0.05).The proportion of patients who experienced＞5％weight loss was 80％(OR=0.80,95％CI=0.76-0.85);＞10％weight loss was observed in 45％of patients(OR=0.45,95％CI=0.41-0.50);and＞15％weight loss occurred in 18％of patients(OR=0.18,95％CI=0.08-0.27).Most patients had undergone sleeve gastrectomy(69.8％).There was no significant difference in HbA1c levels before and after treatment(P＞0.05).The incidence of adverse events was 14％(OR=0.14,95％CI=0.01-0.28),primarily gastrointestinal side effects.Conclusion:Semaglutide can significantly reduce body weight in patients with IWL or WR after bariatric surgery,with a relatively low incidence of adverse effects.It may be considered for patients who experience suboptimal weight loss following bariatric surgery.However,further prospective and large-scale clinical studies are needed to confirm these findings.

Viruses,with high adaptability and immune evasion capabilities,are responsible for a wide spectrum of diseases from lo-calized infections to global pandemics,continuously posing threats to global public health.In recent years,traditional Chinese medi-cine(TCM)has demonstrated significant potential in antiviral therapy.With its multi-component,multi-target synergistic mechanism,TCM offers unique advantages in the intervention of viral diseases.However,progress in elucidating the active antiviral constituents of TCM and identifying their precise molecular targets remains limited,primarily due to the lack of humanized models that can faithfully recapitulate the natural course of viral infection.The emergence of organoid technology has introduced new opportunities for antiviral research in TCM.Human organoids,which recapitulate the three-dimensional architecture and physiological functions of human tis-sues,provide an advanced platform for modeling host-virus interactions in a human-relevant context.This article highlights the latest advances in applications of human tissue organoids,including lung,liver,and brain organoids,in the study of respiratory viruses(SARS-CoV-2,influenza virus,respiratory syncytial virus),hepatitis viruses(HBV,HCV,HEV),and neurotropic viruses(ZIKV,pri-ons,HCMV);illustrates how organoid models have been leveraged to evaluate both the efficacy and safety of TCM-based antiviral inter-ventions.Although human tissue organoids still face technical challenges in insufficient vascularization and incomplete immune micro-environment,they represent a powerful tool for dissecting the mechanism of TCM antiviral action and for guiding the development of personalized antiviral strategies.Looking ahead,human tissue organoid technology is expected to become key enabling platform for pro-moting the clinical transformation of TCM in the field of antiviral medicine.

Focal therapy has emerged as an alternative to surgical treatment for selected renal tumors.The core principle of this approach lies in the local destruction of tumor tissue through physical or chemical means to achieve tumor control.Focal therapy is particularly applicable to patients with tumors ≤4 cm in diameter who are unfit for surgery or anesthesia due to advanced age,comorbidities,solitary kidney,or renal insufficiency,as well as those with recurrent tumors after prior partial nephrectomy.This review summarizes the mechanisms,advantages,limitations,and clinical efficacy of six focal therapy modalities for renal tumors,including radiofrequency ablation,cryoablation,microwave ablation,irreversible electroporation,high-intensity focused ultrasound,and stereotactic ablative radiotherapy.The aim is to provide reference for achieving individualized and precise clinical management.