Temporomandibular joint osteoarthritis is a common chronic degenerative disease,in which joint pain is the most signif-icant symptom,but its pathogenesis is still unclear.Significant subchondral bone lesions can occur in the early stage of osteoarthritis progression,and more and more experimental evidence shows that subchondral bone lesions play an important role in the pain caused by osteoarthritis.Osteoclasts,osteocytes,osteoblasts,endothelial cells,new generating nerves and blood vessels in the sub-chondral bone matrix microenvironment interact with each other and participate in the process of osteoarthritis pain.Therefore,regu-lating the subchondral bone matrix microenvironment is expected to become a new strategy to control joint pain.

Objective:To develop the Amputation Scale for Severe Open Pelvic Fractures and explore its application value in patients with severe open pelvic fractures.Methods:A total of 27 patients with severe open pelvic fractures who underwent surgical treatment in Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2010 to January 2023 were retrospectively analyzed. There were 15 males and 12 females, aged 38.6±11.6 years (range, 13-65 years). There were 13 cases of traffic injuries, 10 cases of fall from height injuries, and 4 cases of mechanical crushing injuries; 20 cases were admitted to the hospital in emergency, and 7 cases were transferred from other hospitals. All fracture types were Tile C, including 14 cases of Tile C1, 8 cases of Tile C2, and 5 cases of Tile C3. There were 16 cases of genitourinary system injury, 8 cases of anal or rectal injury, 12 cases of abdominal injury, 9 cases of chest injury, and 6 cases of craniocerebral trauma. The mangled extremity severity score (MESS) and the Amputation Scale for Severe Open Pelvic Fractures were used to evaluate whether amputation was performed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two evaluation methods were calculated.Results:Among the 27 patients, 21 cases were treated with pelvic external fixator to control the volume, 16 cases were treated with gauze packing to stop bleeding, 8 cases were treated with temporary abdominal aorta occlusion, and 12 cases were treated with laparotomy because of abdominal injury. Seven of the 27 patients died, with a mortality rate of 26%. In 12 cases of one-stage amputation, 3 cases died, including 1 case died of multiple organ failure syndrome, 1 case died of gastrointestinal bleeding on the 7th day after amputation, and 1 case died of severe infection on the 4th day after amputation. Among the 15 cases of one-stage limb salvage, 4 cases died, of which 2 cases of second-stage amputation died of infection on the 5th day after one-stage limb salvage, and 1 case of one-stage limb salvage died of limb necrosis on the 3rd day after one-stage limb salvage. Two patients died of multiple organ failure syndrome. The MESS score of 27 patients was 6(6, 8) points (range, 6-13 points), and the Amputation Scale for Severe Open Pelvic Fractures score was 9.6±1.8 points (range, 6-14 points). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MESS were 66.7%, 50%, 40%, 75% and 56%, respectively, while those of Amputation Scale for Severe Open Pelvic Fractures were 80%, 89%, 73%, 88% and 82%, respectively. The specificity and accuracy of MESS were significantly lower than those of Amputation Scale for Severe Open Pelvic Fractures ( P<0.05). All 20 patients who survived were followed up for 23.6±7.5 months (range, 11-37 months). Five cases had soft tissue infection at the stump of amputation, which were treated with debridement, and 3 cases underwent skin grafting, and the stump healed well at the last follow-up. Conclusion:The Amputation Scale for Severe Open Pelvic Fractures is better than MESS in the assessment of early amputation in patients with severe pelvic fractures.

Objective To investigate the occurrence risk for common complications of internal jugular vein(IJV)and subclavian vein(SCV)catheterization,and provide reference for the prevention and treatment of common com-plications during clinical intravenous infusion therapy.Methods Data from China National Knowledge Infrastruc-ture(CNKI),Wanfang Database,VIP Database,Embase(via OVID),PubMed,Cochrane Library,CINAHL,Web of Science,and ScienceDirect were retrieved,with the search period from database establishment to August 3,2023.Prospective cohort and experimental studies on common complications in patients with IJV and SCV cathete-rization were collected.Meta-analysis on the extracted data was performed with RevMan 5.3 software.Results A total of 29 studies involving 14 096 patients were included in the analysis,including 6 355 patients with SCV cathe-terization(SCV group)and 7 741 patients with IJV catheterization(IJV group).Meta-analysis results showed that the occurrence risk for hemopneumothorax(OR=0.23,95％CI[0.14-0.37])and catheter tip ectopic(OR=0.16,95％CI[0.03-0.85])in SCV group was higher than that in IJV group,and the occurrence risk for central venous catheter-related deep venous thrombosis in IJV group was higher than that in SCV group(OR=2.35,95％CI[1.31-4.21]),with statistically significant differences(all P＜0.01).There were no statistical differences in the occurrence risk of vascular catheter-related bloodstream infection(CRBSI),catheter blockage,and catheter local he-matoma between the two groups(all P＞0.05),there was difference in the combined result of subgroup analysis re-garding catheter bacterial colonization.Conclusion Compared with IJV,patients in SCV group have a higher risk of developing hemopneumothorax and catheter tip ectopic,while patients with catheterization in IJV group have a high-er risk of deep veinous thrombosis.There are no significant differences in the occurrence risk for CRBSI,catheter blockage,and catheter local hematoma between two groups of patients.It is suggested that patient's own conditions and the accessibility of deep vein catheterization should be considered more when selecting the site of deep venous catheterization.

Objective:To develop the Amputation Scale for Severe Open Pelvic Fractures and explore its application value in patients with severe open pelvic fractures.Methods:A total of 27 patients with severe open pelvic fractures who underwent surgical treatment in Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2010 to January 2023 were retrospectively analyzed. There were 15 males and 12 females, aged 38.6±11.6 years (range, 13-65 years). There were 13 cases of traffic injuries, 10 cases of fall from height injuries, and 4 cases of mechanical crushing injuries; 20 cases were admitted to the hospital in emergency, and 7 cases were transferred from other hospitals. All fracture types were Tile C, including 14 cases of Tile C1, 8 cases of Tile C2, and 5 cases of Tile C3. There were 16 cases of genitourinary system injury, 8 cases of anal or rectal injury, 12 cases of abdominal injury, 9 cases of chest injury, and 6 cases of craniocerebral trauma. The mangled extremity severity score (MESS) and the Amputation Scale for Severe Open Pelvic Fractures were used to evaluate whether amputation was performed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two evaluation methods were calculated.Results:Among the 27 patients, 21 cases were treated with pelvic external fixator to control the volume, 16 cases were treated with gauze packing to stop bleeding, 8 cases were treated with temporary abdominal aorta occlusion, and 12 cases were treated with laparotomy because of abdominal injury. Seven of the 27 patients died, with a mortality rate of 26%. In 12 cases of one-stage amputation, 3 cases died, including 1 case died of multiple organ failure syndrome, 1 case died of gastrointestinal bleeding on the 7th day after amputation, and 1 case died of severe infection on the 4th day after amputation. Among the 15 cases of one-stage limb salvage, 4 cases died, of which 2 cases of second-stage amputation died of infection on the 5th day after one-stage limb salvage, and 1 case of one-stage limb salvage died of limb necrosis on the 3rd day after one-stage limb salvage. Two patients died of multiple organ failure syndrome. The MESS score of 27 patients was 6(6, 8) points (range, 6-13 points), and the Amputation Scale for Severe Open Pelvic Fractures score was 9.6±1.8 points (range, 6-14 points). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MESS were 66.7%, 50%, 40%, 75% and 56%, respectively, while those of Amputation Scale for Severe Open Pelvic Fractures were 80%, 89%, 73%, 88% and 82%, respectively. The specificity and accuracy of MESS were significantly lower than those of Amputation Scale for Severe Open Pelvic Fractures ( P<0.05). All 20 patients who survived were followed up for 23.6±7.5 months (range, 11-37 months). Five cases had soft tissue infection at the stump of amputation, which were treated with debridement, and 3 cases underwent skin grafting, and the stump healed well at the last follow-up. Conclusion:The Amputation Scale for Severe Open Pelvic Fractures is better than MESS in the assessment of early amputation in patients with severe pelvic fractures.

Temporomandibular joint osteoarthritis is a common chronic degenerative disease,in which joint pain is the most signif-icant symptom,but its pathogenesis is still unclear.Significant subchondral bone lesions can occur in the early stage of osteoarthritis progression,and more and more experimental evidence shows that subchondral bone lesions play an important role in the pain caused by osteoarthritis.Osteoclasts,osteocytes,osteoblasts,endothelial cells,new generating nerves and blood vessels in the sub-chondral bone matrix microenvironment interact with each other and participate in the process of osteoarthritis pain.Therefore,regu-lating the subchondral bone matrix microenvironment is expected to become a new strategy to control joint pain.

Objective To investigate the occurrence risk for common complications of internal jugular vein(IJV)and subclavian vein(SCV)catheterization,and provide reference for the prevention and treatment of common com-plications during clinical intravenous infusion therapy.Methods Data from China National Knowledge Infrastruc-ture(CNKI),Wanfang Database,VIP Database,Embase(via OVID),PubMed,Cochrane Library,CINAHL,Web of Science,and ScienceDirect were retrieved,with the search period from database establishment to August 3,2023.Prospective cohort and experimental studies on common complications in patients with IJV and SCV cathete-rization were collected.Meta-analysis on the extracted data was performed with RevMan 5.3 software.Results A total of 29 studies involving 14 096 patients were included in the analysis,including 6 355 patients with SCV cathe-terization(SCV group)and 7 741 patients with IJV catheterization(IJV group).Meta-analysis results showed that the occurrence risk for hemopneumothorax(OR=0.23,95％CI[0.14-0.37])and catheter tip ectopic(OR=0.16,95％CI[0.03-0.85])in SCV group was higher than that in IJV group,and the occurrence risk for central venous catheter-related deep venous thrombosis in IJV group was higher than that in SCV group(OR=2.35,95％CI[1.31-4.21]),with statistically significant differences(all P＜0.01).There were no statistical differences in the occurrence risk of vascular catheter-related bloodstream infection(CRBSI),catheter blockage,and catheter local he-matoma between the two groups(all P＞0.05),there was difference in the combined result of subgroup analysis re-garding catheter bacterial colonization.Conclusion Compared with IJV,patients in SCV group have a higher risk of developing hemopneumothorax and catheter tip ectopic,while patients with catheterization in IJV group have a high-er risk of deep veinous thrombosis.There are no significant differences in the occurrence risk for CRBSI,catheter blockage,and catheter local hematoma between two groups of patients.It is suggested that patient's own conditions and the accessibility of deep vein catheterization should be considered more when selecting the site of deep venous catheterization.

Objective To investigate the therapeutic effect and mechanism of non-mitogenic acid fibroblast growth factor 1( NMFGF1) on diabetic cardiomyopathy ( DCM) by using PEG-modified nano-liposomes combined with ultrasound-targeted microbubble destruction technique ( UTMD ) . Methods The NMFGF1 loaded PEG-modified nano-liposomes were prepared by a water-in-water emulsion method and their quality inspections were also investigated. Type 1 diabetes animal model was induced by intraperitoneal injection of streptozotocin ( 70 mg/kg) in male SD rats. The diabetic rats were raised twelve weeks after the diabetes model was established and DCM rats were selected by ultrasonic heart function examination. After two weeks of intervention, all rats were kept for another two weeks and then underwent transthoracic echocardiography examination. The rats were sacrificed and myocardial tissue was obtained to quantify myocardial collagen fraction ( CVF ) and cardiac myocyte apoptotic index by Sirius red staining and TUNEL staining. Results NMFGF1-loaded PEG-nano-liposomes showed a good morphology and 90.3％± 1.4％ NMFGF1 encapsulation efficiency. Compared with DCM group, NMFGF1group, and NMFGF1-PEG-nano-liposomes group, NMFGF1-loaded PEG-nano-liposome plus UTMD group showed increased left ventricular end diastolic diameter (LVIDd) [(7.36±0.42) vs (5.75±0.24), (6.64±0.27), (6.72±0.24)mm, all P<0.05]and leftventricularfractionshortening(LVFS) [(50±3) vs (33±2), (44±5), (43±3)mm, all P<0.05], and decreased left ventricular posterior wall thickness (LVPW) [(1.65±0.07) vs (1.89±0.08), (1.73±0.11), (1.73 ±0.07) mm, all P<0.05], with decreased CVF and apoptotic index(all P<0.05). Conclusion PEG-nano-liposomes combining with UTMD technique has a greater translational potential in the delivery of NMFGF1 for the treatment of DCM by attenuating oxidative stress-induced injury and may provide a promising strategy for treating diabetes cardiomyopathy.

[Abstract] Objective: To evaluate the expression level of FOXD1 in glioma tissues of different grades, and to investigate the correlation between the expression of FOXD1 and the prognosis of glioma patients. Methods: The tumor tissues were collected from 40 glioma patients, who received surgical treatment in the neurosurgery department of the First Hospital of China Medical University from September 2014 to February 2015; Seven non-tumor tissues obtained from patients underwent internal decompression for traumatic brain injury were used as controls. The FOXD1 expression in glioma and non-tumor brain tissues was analyzed by qRT-PCR and IHC, and the correlations between clinical pathological features of glioma patients and FOXD1 expression level were analyzed. Furthermore, the Kaplan-Meier method was used to analyze the relationship between FOXD1 expression and survival time of patients. In addition, the expression of FOXD1 in glioma tissues and its relationship with patients’prognosis were confirmed by the data from GEO (GSE4290, GSE2223) and Rembrandt database. Results: qRT-PCR showed that the FOXD1 mRNA expression in glioma tissues of WHO grade IV was significantly higher than that of non-tumor brain tissues and glioma tissues of WHO grade II (P<0.01). German immunohistochemical score (GIS) was used to evaluate the immunohistochemical staining intensity, and the relationship between FOXD1 expression and clinical pathological features was analyzed. The results showed that FOXD1 in glioma tissues was related to WHO phathological grade level (χ2=11.73， P<0.01). There was statistically significant difference between the survival time of FOXD1 high expression group and FOXD1 low expression group (P=0.043). The data from GEO data base (GSE4290, GSE2223) and Rembrandt datasets showed that glioma tissues have a higher FOXD1 mRNA expression level than normal brain tissues, and the elevated expression of FOXD1 mRNA was negatively associated with the survival time of glioma patients. Conclusion: FOXD1 was highly expressed in glioma tissues, and the expression level of FOXD1 was increased as the pathological grade increases. The elevated expression of FOXD1 was related with the poor survival of glioma patients.

Objective To investigate the advanced preventive effect of acid fibroblast growth factor (aFGF) on diabetic cardiomyopathy(DCM) by using heparin-modified nano-liposomes combined with ultrasoundtargeted microbubble destruction technique (UTMD).Methods aFGF-loaded nano-liposomes (aFGF-lips) were prepared by lyophilization technique.Type Ⅰ diabetes model was induced by intraperitoneal injection of streptozotocin (STZ,70 mg/kg) in male SD rats.Before and twelve weeks after intervention,all rats underwent the transthoracic echocardiography.The segmental mean peak systolic radial velocity (Vs),systolic circumferential strain (Sc),and systolic circumferential strain rate (SRc) were measured.The expression of aFGF in DCM rats was detected by western blot.The rats were sacrificed and myocardial tissue were stained with masson staining and Tunel staining to quantify myocardial collagen fraction(CVF) and cardiac myocyte apoptosis index(AI).Results aFGF-lips showed good morphology and aFGF encapsulation efficiency (89.4±1.2)％ with high stability.From the animal experiments,the echocardiographic indexes including Vs,Sc and SRc had significantly improvements over DM group (P＜0.05) and all other treatment group (P＜0.05).The Masson's trichrome staining demonstrated that CVF was significantly higher in DM group than in the control group and was significantly lower in the aFGF-loaded nano-liposome+UTMD group than other groups(all P＜0.05).The TUNEL results showed that AI was significantly higher in DM group than in the control group and was significantly lower in aFGF-loaded nano-liposome +UTMD group than other groups (all P＜0.05).Conclusion aFGF nano-liposome combining with UTMD technique can improve the functions and pathologies of the hearts in type 1 diabetes mellitus model,which might provide a novel technique for aFGF in DCM prevention.

Objective Evaluation of efficacy and safety of combination of Yinxin Damo injection and low molecular heparin for deep venous thrombosis (DVT) in orthopedics operation.Methods Randomized controlled trials of combination of Yinxin Damo injection and low molecular heparin intervention study of DVT in orthopedics operation were searched from the Cochrane Library,clinicaltrials,gov,PubMed,EMBASE,CNKI,Wanfang database,VIP database,and Chinese biomedical database (CBM).According to the Cochrane Handbook 5.1,Meta analysis was performed by Revman 5.3 software.Results A total of 4 studies included 358 patients.The results of Meta-analysis showed that,compared with control group,incidence of DVT was significantly reduced (P =0.01),value of D-D significantly decreased (P ＜0.000 01) and value of PT increased (P =0.04),and increased value of APTT (P =0.07) in combined group.Heterogeneous sources of PT and APTT were analyzed,and the results after excluding literature 7,as compared with the control group,APTT and PT were significantly increased in combined group (P ＜ 0.000 1).Conclusion Based on the current clinical evidence,combination of Yinxin Damo injection and low molecular heparin treatment for DVT of orthopedics operation patients is effective and safe,but there is certain heterogeneity between the studies,therefore it is necessary to design a randomized controlled trial of high quality,large scale and multicenter to research.