BACKGROUND:In recent years,with the development of biological scaffold materials and bioprinting technology,tissue-engineered bone has become a research hotspot in bone defect repair. OBJECTIVE:To summarize the current treatment methods for bone defects,summarize the biomaterials and bioprinting technology for preparing tissue-engineered bone scaffolds,and explore the application of biomaterials and printing technology in tissue engineering and the current challenges. METHODS:Search terms were"bone defect,tissue engineering,biomaterials,3D printing technology,4D printing technology,bioprinting,biological scaffold,bone repair"in Chinese and English.Relevant documents published from January 1,2009 to December 1,2022 were retrieved on CNKI,PubMed and Web of Science databases.After being screened by the first author,high-quality references were added.A total of 93 articles were included for review. RESULTS AND CONCLUSION:The main treatment methods for bone defects include bone transplantation,membrane-guided regeneration,gene therapy,bone tissue engineering,etc.The best treatment method is still uncertain.Bone tissue engineering technology is a new technology for the treatment of bone defects.It has become the focus of current research by constructing three-dimensional structures that can promote the proliferation and differentiation of osteoblasts and enhance the ability of bone formation.Biological scaffold materials are diverse,with their characteristics,advantages and disadvantages.A single biological material cannot meet the demand for tissue-engineered bone for the scaffold.Usually,multiple materials are combined to complement each other,which is to meet the demand for mechanical properties while taking into account the biological properties of the scaffold.Bioprinting technology can adjust the pore of the scaffold,build a complex spatial structure,and is more conducive to cell adhesion,proliferation and differentiation.The emerging 4D printing technology introduces"time"as the fourth dimension to make the prepared scaffold dynamic.With the synchronous development of smart materials,4D printing technology provides the possibility of efficient repair of bone defects in the future.

Objective:To investigate the expression of IL-18, IL-18-binding protein a(IL-18BPa) and IL-18 receptor α(IL-18Rα) by peripheral blood CD4 + Th17 cells of patients with allergic rhinitis (AR) and the effects of allergens on their expression. Methods:This study enrolled 45 outpatients with AR and 23 healthy control subjects receiving physical examination in the First Affiliated Hospital of Jinzhou Medical University from October 2019 to September 2020. According to the results of skin prick test, the 45 patients were divided into two groups: AR group with positive results (24 cases) and nAR group with negative results (21 cases). Blood samples of them were collected. Flow cytometry was used to analyze the effects of allergens on the expression of IL-18, IL-18BPa and IL-18Rα at protein level by peripheral blood CD4 + Th17 cells. The level of IL-17A in plasma was measured by Bioplex system, and its correlation with the percentage of IL-18 + Th17 cells was analyzed. Results:Compared with the healthy control group, the AR group showed increased ratios of CD4 + Th17 and IL-18 + Th17 cells ( P<0.01), decreased ratio of IL-18BPa + Th17 cells ( P<0.01), enhanced mean fluorescence intensity (MFI) of IL-18BPa ( P<0.01) and reduced MFI of IL-18Rα ( P<0.01); the nAR group showed enhanced MFI of IL-18BPa ( P<0.000 1) and reduced MFI of IL-18Rα ( P<0.000 1). The ratio of IL-18 + Th17 cells and the MFI of IL-18Rα in the AR group were higher than those in the nAR group ( P<0.05, P<0.01). House dust mite extract and Platanus pollen extract induced the expression of IL-18 and IL-18BPa by CD4 + Th17 cells of AR patients ( P<0.05). Moreover, house dust mite extract directly induced the CD4 + Th17 cells isolated from the healthy control subjects to express IL-18 and IL-18R ( P<0.05). Compared with healthy control subjects, AR patients had higher level of IL-17A in plasma and it was moderately correlated with the ratio of IL-18 + Th17 cells ( P<0.05). Conclusions:Allergens may be involved in the pathogenesis of AR by inducing blood CD4 + Th17 cells to express IL-18 and IL-18Rα.

A major challenge facing photodynamic therapy (PDT) is that the activity of the immune-induced infiltrating CD8⁺ T cells is subject to the regulatory T lymphocytes (Tregs), leaving the tumor at risk of recurrence and metastasis after the initial ablation. To augment the antitumor response and reprogram the immunosuppressive tumor microenvironment (TME), a supramolecular photodynamic nanoparticle (DACss) is constructed by the host-guest interaction between demethylcantharidin-conjugated β-cyclodextrin (DMC-CD) and amantadine-terminated disulfide-conjugated FFVLGGGC peptide with chlorin e6 decoration (Ad-ss-pep-Ce6) to achieve intelligent delivery of photosensitizer and immunomodulator for breast cancer treatment. The acid-labile β-carboxamide bond of DMC-CD is hydrolyzed in response to the acidic TME, resulting in the localized release of DMC and subsequent inhibition of Tregs. The guest molecule Ad-ss-pep-Ce6 can be cleaved by a high level of intracellular GSH, reducing photosensitizer toxicity and increasing photosensitizer retention in the tumor. With a significant increase in the CTL/Treg ratio, the combination of Ce6-based PDT and DMC-mediated immunomodulation adequately achieved spatiotemporal regulation and remodeling of the TME, as well as improved primary tumor and in situ lung metastasis suppression with the aid of PD-1 antibody.

Chronic heart failure （CHF） is a clinical syndrome resulting from damage to the myocardium， leading to changes in the function or structure of the heart and causing reduced pumping and/or filling capacity. Its pathogenesis is complex， potentially involving myocardial fibrosis， apoptosis and autophagy of cardiomyocytes， inflammatory responses， oxidative stress， and myocardial remodeling. Our team believes that the fundamental pathogenesis of CHF is heart-Qi deficiency， with the disease location in the heart， which is closely related to other organs. Due to heart-Qi deficiency， blood circulation weakens， leading to blood stasis， which in turn generates water-dampness and phlegm turbidity that accumulate over time and become toxic. The interaction between water stasis， Qi stagnation， blood stasis， and phlegm toxicity further weakens the body， creating a vicious cycle （deficiency， stasis， water retention， and toxicity） that is difficult to resolve. Under physiological conditions， the nuclear factor-κB （NF-κB） signaling pathway functions normally， maintaining vital activities and immune responses. However， in pathological states， the NF-κB signaling pathway becomes imbalanced， triggering inflammatory responses and other issues. Research has shown that traditional Chinese medicine （TCM） can regulate the NF-κB signaling pathway through multiple pathways， targets， and effects， effectively improving the progression of CHF. As a result， this has become a research hotspot for the prevention and treatment of the disease. Guided by TCM theory， this research group reviewed the literature to summarize the activation pathways of the NF-κB pathway and its interactions with other pathways. Additionally， the group summarized the research progress on the regulation of the NF-κB pathway in the treatment of CHF using Chinese medicines， their active ingredients， Chinese medicine compounds， and Chinese patent medicines. This study is expected to clarify the mechanisms and targets by which TCM treats CHF by regulating the NF-κB pathway， thereby guiding clinical treatment and drug development for CHF.

Objective To establish the categories and structure of physical activity in children with autism spectrum disorder(ASD),and systematically evaluate the long-term effect of physical activity on the executive function of children with ASD,based on the theoretical and methodological framework of the International Classification of Functioning,Disability,and Health-Children and Youth version(ICF-CY). Methods A search was conducted in databases such as Wanfang data,CNKI,PubMed,Web of Science and ProQuest,to collect literatures about long-term physical activity for executive function of children with ASD published from 2014 to 2023.The literatures were reviewed based on inclusion and exclusion criteria,following PRISMA guide-lines for systematic review,and the quality of the included literatures were assessed with the Physiotherapy Evi-dence Database(PEDro)scale. Results Totally,ten articles were included,consisting of nine randomized controlled trials(RCTs)and one non-random-ized controlled trial,with a total of 351 children diagnosed as ASD,aged three to 18 years,came from Italy,Cana-da,South Korea,China and the United States,published mainly after 2016.Physical activity primarily included sports activities(such as baseball,basketball,table tennis and equine-assisted activities),skill-based activities(such as cycling,cognitive-motor training and active gaming),physical fitness activities(SPARK),as well as combat-related activities(martial arts and karate);30 to 70 minutes a time(mainly 45 minutes),one to five times a week(mainly twice a week),for two to 24 weeks(mainly twelve weeks).Long-term physical activities had been found to improve inhibitory control and cognitive flexibility in children with ASD,although the effect on working memory was inconsistent. Conclusion Long-term physical activity may positively impact on executive function in children with ASD,especially inhibitory control and cognitive flexibility.However,the effect on working memory need more researches.

Non-tuberculosis mycobacterium (NTM) refers to a general term for a large group of mycobacteria, excluding the mycobacterium tuberculosis and mycobacterium leprae, which is an opportunistic pathogen. NTM pulmonary disease and pulmonary tuberculosis have very similar clinical and imaging manifestations. Ordinary sputum tests can not distinguish between mycobacterium tuberculosis and NTM accurately, and it needs to be differentiated through detection methods such as mycobacterium culture medium, high-performance liquid chromatography, and molecular biology. During the diagnosis of occupational pneumoconiosis, a sandblasting and polishing worker's lung CT showed dynamic changes in infiltrating shadows and cavities in the right lung. A sputum drug sensitivity test showed NTM infection, but the patient refused treatment. After 20 months, the CT examination of the lung showed further enlargement of infiltrating shadows and cavities, and NTM bacterial identification showed intracellular mycobacterial infection. Amikacin, moxifloxacin, azithromycin, and ethambutol combined antibacterial treatment were given. Currently, the patient is still under treatment.

Non-tuberculosis mycobacterium (NTM) refers to a general term for a large group of mycobacteria, excluding the mycobacterium tuberculosis and mycobacterium leprae, which is an opportunistic pathogen. NTM pulmonary disease and pulmonary tuberculosis have very similar clinical and imaging manifestations. Ordinary sputum tests can not distinguish between mycobacterium tuberculosis and NTM accurately, and it needs to be differentiated through detection methods such as mycobacterium culture medium, high-performance liquid chromatography, and molecular biology. During the diagnosis of occupational pneumoconiosis, a sandblasting and polishing worker's lung CT showed dynamic changes in infiltrating shadows and cavities in the right lung. A sputum drug sensitivity test showed NTM infection, but the patient refused treatment. After 20 months, the CT examination of the lung showed further enlargement of infiltrating shadows and cavities, and NTM bacterial identification showed intracellular mycobacterial infection. Amikacin, moxifloxacin, azithromycin, and ethambutol combined antibacterial treatment were given. Currently, the patient is still under treatment.

Objective:To integrate the best evidence of sexual health management for colorectal cancer patients both domestically and internationally, so as to provide guidance for clinical practice.Methods:Evidence on sexual health management of colorectal cancer patients in domestic and foreign databases and websites was systematically searched, and evidence from literature that met quality evaluation standards was extracted and summarized. The search period was from July 2003 to July 2023.Results:A total of 16 articles were included, including five clinical decisions, six clinical practice guidelines, three expert consensus/group standards, and two systematic reviews. Thirty-four recommended opinions were formed, including eight aspects of evaluation and screening, assessment tools, manifestations of sexual dysfunction, coping strategies for sexual problems, psychological intervention, measures for fertility protection, health education, and follow-up management.Conclusions:This study summarizes the best evidence for sexual health management in colorectal cancer patients. It is necessary to selectively apply evidence based on the evaluation of patient conditions by medical and nursing staff and clinical situations to ensure effective and scientific sexual health management strategies for patients, and promote the translation of best evidence into clinical practice.

Objective:To investigate the relationship between lifestyle factors and stroke in the elderly.Methods:Data were obtained from a natural cohort of the Multimodal Intervention to Delay Dementia and Disability in Rural China(MIND-China)study.A total of 5 009 participants aged 60 years and above were enrolled, of whom 954(19.05%)had experienced a stroke.Logistic regression analyses were conducted to assess the association between five lifestyle factors(smoking, drinking, physical exercise, social activity and sleep quality)and the incidence of stroke.Results:In model 1, after adjusting for age, sex and education, only social activity( OR=0.783, 95% CI: 0.668-0.917)and good sleep quality( OR=0.731, 95% CI: 0.621-0.860)emerged as protective factors against stroke(both P<0.05).No statistically significant associations were found between other lifestyle factors and stroke.Analysis of a variety of healthy lifestyle practice combinations showed that having 3( OR=0.639, 95% CI: 0.433-0.944), 4( OR=0.620, 95% CI: 0.409-0.941)and 5( OR=0.397, 95% CI: 0.197-0.799)healthy lifestyle practices were protective factors against stroke(all P<0.05).In model 2, after adjusting for age, sex, education, body mass index, diabetes, hyperlipidemia, hypertension, and the APOE genotype, the results were consistent with those of Model 1. Conclusions:Lifestyle factors are significantly associated with the risk of stroke in the elderly population.The healthier lifestyle practices are adopted, the lower the risk of stroke will be.

Objective:To observe the effect of lung distension stabilization formula combined with Liu Zi Jue exercise on the rehabilitation of patients with lung and kidney deficiency syndrome in stable phase of chronic obstructive pulmonary disease (COPD).Methods:Randomized controlled trial. A total of 179 patients with lung and kidney deficiency syndrome in stable COPD (admitted from April 2019 to April 2022) were enrolled in this study. The patients were randomly divided into western medicine conventional treatment group, combined treatment group and Liu Zi Jue group by random number table method. All the patients in the group received conventional western medicine treatment, and 59 patients in the Liu Zi Jue group received Liu Zi Jue treatment. Combined treatment group to take Liu Zi Jue + Lung distension stabilization formula. Data observation: clinical curative effect and TCM syndrome and total integral change before and after the treatment level of interleukin 8 (IL-8), pulmonary function index changes, COPD patients self-assessment scale (CAT) score, st George's hospital respiratory questionnaire (SGRQ) scores change were observed.Results:The total response rate was 66.67% (40/60) in the conventional treatment group, 83.05% (49/59) in the Liu Zi Jue group and 96.67% (58/60) in the combined treatment group. The total response rate in the combined treatment group was significantly higher than that in the conventional treatment group and the Liu Zi Jue group ( Z=3.76, P<0.01). The Liu Zi Jue group was significantly higher than the conventional western medicine group ( χ2=4.24, P=0.040). After treatment, the symptom score of combined treatment group was significantly lower than that of Liu Zi Jue group and conventional treatment group ( F=14.87, P<0.01), and that of Liu Zi Jue group was significantly lower than that of conventional treatment group ( t=5.87, P<0.01). The scores of CAT and SGRQ were significantly lower than those in the Liu Zi Jue group and conventional treatment group ( F values were 76.72 and 312.36, P<0.01), and those in Liu Zi Jue group were significantly lower than that of the conventional treatment group ( t=4.97, P<0.01). After treatment, the serum IL-8 level of the combined treatment group was significantly lower than that of the Liu Zi Jue group and the conventional treatment group ( F=154.64, P<0.01), and the Liu Zi Jue group was significantly lower than that of the conventional treatment group ( t=11.35, P<0.01). FVC [(2.93±0.60) L vs. (2.49±0.65) L, (2.25±0.63) L, F=20.62], FEV1 [(2.20±0.42) L vs. (1.88±0.41) L, (1.72±0.40) L, F=21.30] and FEV1% [(42.34±4.86) % vs. (38.85±5.00) %, (36.95±4.91) %, F=18.49] were significantly higher than those in the Liu Zi Jue group and conventional treatment group ( P<0.01). The Liu Zi Jue group was higher than that of the conventional treatment group ( t values were 3.76, 2.87, 5.15, P<0.01). Conclusion:Lung distension stabilization formula combined with Liu Zi Jue exercisecan promote the rehabilitation of COPD patients with lung and kidney deficiency syndrome in stable phase, improve the curative effect of patients, improve lung function, relieve symptoms, and improve the quality of life.