The occurrence and development of solid tumors rely on the autonomous drive of tumor cells and the crosstalk of the tumor microenvironment (TME). As a crucial component of the TME, cancer-associated fibroblasts (CAFs) are the center of the cross-communication among various cells in the tumor stroma and participate in tumorigenesis, progression, invasion, and migration. Hence, targeting CAF subpopulations or their functional pathways might offer a new breakthrough for tumor prevention and treatment. However, the concurrent tumor-promoting and tumor-suppressive functions of CAFs pose an impediment to this breakthrough. By summarizing CAFs role in tumor occurrence and progression, this review proposes the application of CAFs in tumor prevention and treatment and discusses their potential and value as a therapeutic target.

The new era imposes heightened demands on medical professionals,who must not only possess a solid theoretical foundation but also exhibit strong practical skills and innovative capabilities.The quality of medical func-tional laboratory construction is crucial for cultivating high-caliber medical talents.In light of the current developmental status and trends regarding functional experiment teaching within Chinese higher education institutions,particularly the disparities in development across various regions and institutions,the Functional Experiment Teaching Committee of the Chinese Pathophysiology Society has developed an expert consensus on laboratory construction standards.This consensus was established through comprehensive investigations,research,and extensive discussions to provide a reference for di-verse institutions to continuously enhance their levels of laboratory construction.

Osteoarthritis is a chronic degenerative joint disorder that adversely affects the quality of life of patients.Its pathological characteristics mainly involve the degeneration,destruction,and functional loss of articular cartilage.As one of the most crucial structures in the joint,articular cartilage is an avascular tissue composed of extracellular matrix synthesized by sparsely distributed chondrocytes.Chondrocyte apoptosis is one of the programmed cell death modalities of chondrocytes.During the normal physiological process,the proliferation and apoptosis of chondrocytes maintain a dynamic equilibrium,jointly safeguarding the homeostasis of articular cartilage.However,in the osteoarthritis process,the stimulation of related cytokines after tissue damage induces an imbalance between chondrocyte proliferation and apoptosis,resulting in excessive chondrocyte apoptosis,and subsequently leading to the degradation and degeneration of cartilage.Clinically,traditional Chinese medicine and its related therapeutic approaches remain one of the principal means for treating osteoarthritis in China.The traditional Chinese medicine,which are bioactive compounds extracted from traditional herbal medicines,has gradually gained recognition thanks to their convenient to take and remarkable therapeutic effect.Therefore,this review takes the signaling pathways involved in the inhibition of chondrocyte apoptosis by traditional Chinese medicine as the entry point,systematically retrieves and screens and summarizes relevant studies at home and abroad in the past five years,and analyzes the mechanism of action of related signaling pathways in the treatment of chondrocyte apoptosis in osteoarthritis by traditional Chinese Medicine,providing new options for the pharmacological treatment of osteoarthritis.

The new era imposes heightened demands on medical professionals,who must not only possess a solid theoretical foundation but also exhibit strong practical skills and innovative capabilities.The quality of medical func-tional laboratory construction is crucial for cultivating high-caliber medical talents.In light of the current developmental status and trends regarding functional experiment teaching within Chinese higher education institutions,particularly the disparities in development across various regions and institutions,the Functional Experiment Teaching Committee of the Chinese Pathophysiology Society has developed an expert consensus on laboratory construction standards.This consensus was established through comprehensive investigations,research,and extensive discussions to provide a reference for di-verse institutions to continuously enhance their levels of laboratory construction.

Osteoarthritis is a chronic degenerative joint disorder that adversely affects the quality of life of patients.Its pathological characteristics mainly involve the degeneration,destruction,and functional loss of articular cartilage.As one of the most crucial structures in the joint,articular cartilage is an avascular tissue composed of extracellular matrix synthesized by sparsely distributed chondrocytes.Chondrocyte apoptosis is one of the programmed cell death modalities of chondrocytes.During the normal physiological process,the proliferation and apoptosis of chondrocytes maintain a dynamic equilibrium,jointly safeguarding the homeostasis of articular cartilage.However,in the osteoarthritis process,the stimulation of related cytokines after tissue damage induces an imbalance between chondrocyte proliferation and apoptosis,resulting in excessive chondrocyte apoptosis,and subsequently leading to the degradation and degeneration of cartilage.Clinically,traditional Chinese medicine and its related therapeutic approaches remain one of the principal means for treating osteoarthritis in China.The traditional Chinese medicine,which are bioactive compounds extracted from traditional herbal medicines,has gradually gained recognition thanks to their convenient to take and remarkable therapeutic effect.Therefore,this review takes the signaling pathways involved in the inhibition of chondrocyte apoptosis by traditional Chinese medicine as the entry point,systematically retrieves and screens and summarizes relevant studies at home and abroad in the past five years,and analyzes the mechanism of action of related signaling pathways in the treatment of chondrocyte apoptosis in osteoarthritis by traditional Chinese Medicine,providing new options for the pharmacological treatment of osteoarthritis.

Active herbal ingredients are gaining recognition for their potent anti-tumor efficacy, attributable to various mechanisms including tumor cell inhibition, immune system activation, and tumor angiogenesis inhibition. Recent studies have revealed that numerous anti-tumor herbal ingredients, such as ginsenosides, ursolic acid, oleanolic acid, and Angelica sinensis polysaccharides, can be utilized to develop smart drug carriers like liposomes, micelles, and nanoparticles. These carriers can deliver active herbal ingredients and co-deliver anti-tumor drugs to enhance drug accumulation at tumor sites, thereby improving anti-tumor efficacy. This study provides a comprehensive analysis of the mechanisms by which these active herbal ingredients-derived carriers enhance therapeutic outcomes. Additionally, it highlights the structural properties of these active herbal ingredients, demonstrating how their unique features can be strategically employed to design smart drug carriers with improved anti-tumor efficacy. The insights presented aim to serve as a reference and guide future innovations in the design and application of smart drug carriers for cancer therapy that leverage active herbal ingredients.
Humans ; Neoplasms/drug therapy* ; Drug Delivery Systems ; Drug Carriers/chemistry* ; Animals ; Drugs, Chinese Herbal/therapeutic use* ; Antineoplastic Agents, Phytogenic/administration & dosage* ; Nanoparticles/chemistry* ; Antineoplastic Agents/administration & dosage*

Objective:To summarize the treatment experience of diabetes mellitus combined with necrotizing fasciitis.Methods:A retrospective analysis was conducted on the clinical data of patients diagnosed with diabetes mellitus and necrotizing fasciitis who were admitted to the Department of Burns and Plastic Surgery, Affiliated Hospital of Guizhou Medical University between September 2018 and December 2020. Upon admission, initial treatment involved blood glucose management, the administration of empirical antibiotics to combat infection, and concurrent nutritional support therapy. Surgical interventions, including either dilatation or incision and drainage, were promptly performed within 24 to 72 hours. During these procedures, necrotic tissues and purulent exudates were collected for pathogen culture and antibiotic sensitivity testing to guide appropriate treatment. Post-operatively, a negative pressure closed drainage system was installed to facilitate wound drainage, combined with 1.5% hydrogen peroxide solution to flush the wound or subcutaneous placement of multiple drainage tubes to drain the wound. If post-surgical infection persisted, additional dilatations were deemed necessary. Under the condition of clean wound and fresh granulation tissue, the wound was repaired by medium-thickness skin grafting on the lateral thigh. The laboratory risk indicator for necrotizing fasciitis (LRINEC) was checked and scored, including C-reactive protein, white blood cell count, hemoglobin, blood sodium, blood creatinine, and blood glucose levels. The total score was 0-13 points. When the score was ≥ 6 points, necrotizing fasciitis should be actively suspected. Observation of trauma infection control, statistics on the number of dilatations, trauma repair modalities, hospitalization time, and amputations, and follow-up of trauma healing and recurrence of necrotizing fasciitis were recorded.Results:A total of nine patients were enrolled, consisting of seven males and two females, with an age range of 39 to 81 years. The study population comprised patients with diabetes mellitus, with durations ranging from 0.5 to 10 years. The affected body parts included one upper extremity, six lower extremities, one perineum, and one case involving both a perineum and a lower extremity. LRINEC score ≥ 8 points in 5 cases and 6-7 points in 4 cases. The wound infection was controlled after 1 time dilatations in 4 cases, 2 times in 3 cases and 3 times in 2 cases, the infection of the trauma was controlled and reached a clean and fresh state of granulation tissue.In 7 cases, the trauma was healed after repairing with thick-medium-thick dermal grafting; in 1 case, the trauma was repaired by thin-medium-thick dermal grafting with scattered punctate recurring oozing, which was healed after changing the medication; and in 1 case, the right middle calf leg was amputated. Microbiological culture result: 2 cases of Staphylococcus aureus treated with intravenous drip of ceftazidime 2 000 mg once a day; 1 case of Pseudomonas pseudomallei was treated with intravenous drip of fluconazole 400 mg once a day; 2 cases of Enterococcus faecalis and 2 cases of Enterococcus faecium treated with intravenous drip of piperacillin and tazobactam sodium 4 500 mg 3 times a day, 2 cases of Escherichia coli treated with intravenous drip of levofloxacin 500 mg once a day. The duration of hospitalization of 9 patients ranged from 24 to 56 days. At discharge, LRINEC was significantly improved compared with admission, and LRINEC score was 0-2 points. Follow-up ranged from 3 months to 2 years, relapsed infection happended in the affected limb wound in one case, which healed after anti-infection and dressing change. The other cases healed well without recurrence. Conclusion:In the management of diabetic necrotizing fasciitis, concurrent comprehensive glycemic control and surgical intervention are crucial. The integration of vacuum sealing drainage and the employment of 1.5% hydrogen peroxide for wound cleansing, along with a consistent and prolonged antibiotics reatment course significantly contributes to improved disease control, promote wound healing, leading to reduced mortality and lower rates of amputation.

Objective:To explore the clinical effects of anterolateral femoral or anteromedial femoral perforator flaps in repairing skin and soft tissue defects after resection of cutaneous squamous cell carcinoma (CSCC).Methods:This study was a retrospective observational study. From July 2015 to July 2022, 21 patients with CSCC were treated in the Department of Burns and Plastic Surgery of Guizhou Provincial People's Hospital, including 15 males and 6 females, aged from 27 to 74 years. The area of skin and soft tissue defects after extended resection of CSCC was 7.5 cm×4.0 cm to 23.0 cm×8.5 cm. The wounds in 18 patients were repaired with anterolateral femoral perforator flaps; variations of perforating branch of the descending branch of lateral circumflex femoral artery were observed in 3 patients during the operation, and the wounds were repaired with anteromedial femoral perforator flaps. The flap areas were 8.0 cm×5.0 cm to 25.0 cm×10.0 cm. The wounds in the donor areas were sutured directly in 19 patients, and the wounds in the donor areas were repaired with thin and medium-thickness skin grafts in the contralateral thigh in 2 patients. The postoperative survival of flaps and the occurrence of vascular crisis were observed. The length of operation and the hospitalization day were recorded. The recurrence of tumor, the appearances of the donor and recipient areas of flaps, the function of the flap donor area were followed up. At the last follow-up, the satisfaction degree of patients for the curative effects was evaluated.Results:The flaps survived in 20 patients, while the vascular crisis occurred in 1 patient within 48 hours after operation, and the flap survived after immediate emergency operation. The length of operation was 4 to 5 hours, and the hospitalization day was 15 to 38 days. The patients were followed up for 1 to 6 years after operation, there was no local tumor recurrence, the color and texture of the flaps were with no obvious differences to those of the surrounding tissue, and the elasticity and appearance were good. The skin grafts in the flap donor areas of 2 patients survived well with local pigmentation. There was only linear scar in the flap donor areas of all patients, and there were no significant effects on sensory and motor functions. At the last follow-up, fifteen patients were satisfied with the curative effect, and 6 patients were generally satisfied with the curative effect.Conclusions:For skin and soft tissue defects after CSCC resection, the anterolateral femoral perforator flaps can be used preferentially. In the case of variation of the perforating branch of descending branch of the lateral circumflex femoral artery, the anteromedial femoral perforator flap is selected. The areas of the two flaps are large and can be adjusted according to the amount of defect tissue, thus accurately and effectively repairing skin and soft tissue defects after CSCC resection. The postoperative appearance and function are good.

Objective:To summarize the treatment experience of diabetes mellitus combined with necrotizing fasciitis.Methods:A retrospective analysis was conducted on the clinical data of patients diagnosed with diabetes mellitus and necrotizing fasciitis who were admitted to the Department of Burns and Plastic Surgery, Affiliated Hospital of Guizhou Medical University between September 2018 and December 2020. Upon admission, initial treatment involved blood glucose management, the administration of empirical antibiotics to combat infection, and concurrent nutritional support therapy. Surgical interventions, including either dilatation or incision and drainage, were promptly performed within 24 to 72 hours. During these procedures, necrotic tissues and purulent exudates were collected for pathogen culture and antibiotic sensitivity testing to guide appropriate treatment. Post-operatively, a negative pressure closed drainage system was installed to facilitate wound drainage, combined with 1.5% hydrogen peroxide solution to flush the wound or subcutaneous placement of multiple drainage tubes to drain the wound. If post-surgical infection persisted, additional dilatations were deemed necessary. Under the condition of clean wound and fresh granulation tissue, the wound was repaired by medium-thickness skin grafting on the lateral thigh. The laboratory risk indicator for necrotizing fasciitis (LRINEC) was checked and scored, including C-reactive protein, white blood cell count, hemoglobin, blood sodium, blood creatinine, and blood glucose levels. The total score was 0-13 points. When the score was ≥ 6 points, necrotizing fasciitis should be actively suspected. Observation of trauma infection control, statistics on the number of dilatations, trauma repair modalities, hospitalization time, and amputations, and follow-up of trauma healing and recurrence of necrotizing fasciitis were recorded.Results:A total of nine patients were enrolled, consisting of seven males and two females, with an age range of 39 to 81 years. The study population comprised patients with diabetes mellitus, with durations ranging from 0.5 to 10 years. The affected body parts included one upper extremity, six lower extremities, one perineum, and one case involving both a perineum and a lower extremity. LRINEC score ≥ 8 points in 5 cases and 6-7 points in 4 cases. The wound infection was controlled after 1 time dilatations in 4 cases, 2 times in 3 cases and 3 times in 2 cases, the infection of the trauma was controlled and reached a clean and fresh state of granulation tissue.In 7 cases, the trauma was healed after repairing with thick-medium-thick dermal grafting; in 1 case, the trauma was repaired by thin-medium-thick dermal grafting with scattered punctate recurring oozing, which was healed after changing the medication; and in 1 case, the right middle calf leg was amputated. Microbiological culture result: 2 cases of Staphylococcus aureus treated with intravenous drip of ceftazidime 2 000 mg once a day; 1 case of Pseudomonas pseudomallei was treated with intravenous drip of fluconazole 400 mg once a day; 2 cases of Enterococcus faecalis and 2 cases of Enterococcus faecium treated with intravenous drip of piperacillin and tazobactam sodium 4 500 mg 3 times a day, 2 cases of Escherichia coli treated with intravenous drip of levofloxacin 500 mg once a day. The duration of hospitalization of 9 patients ranged from 24 to 56 days. At discharge, LRINEC was significantly improved compared with admission, and LRINEC score was 0-2 points. Follow-up ranged from 3 months to 2 years, relapsed infection happended in the affected limb wound in one case, which healed after anti-infection and dressing change. The other cases healed well without recurrence. Conclusion:In the management of diabetic necrotizing fasciitis, concurrent comprehensive glycemic control and surgical intervention are crucial. The integration of vacuum sealing drainage and the employment of 1.5% hydrogen peroxide for wound cleansing, along with a consistent and prolonged antibiotics reatment course significantly contributes to improved disease control, promote wound healing, leading to reduced mortality and lower rates of amputation.

Objective:To observe the effect of vacuum sealing drainage(VSD)combined with hydrogen peroxide irrigation in the treatment of venous leg ulcer (VLU).Methods:The clinical data was focused on the cases with venous leg ulcer, who were treated by the Department of Plastic and Burn Surgery, Affiliated Hospital of Guizhou Medical University from January 2014 to March 2021. According to the treatment method, patients were divided into two groups. After debridement, the intervention group was irrigated with VSD combined with hydrogen peroxide, while the control group was irrigated with VSD combined with normal saline . The duration of VSD treatment was recorded, and the effective rate of wound treatment was calculated. According to the treatment situation, the medium thickness skin graft was performed, and the good survival rate of skin graft was calculated.Results:A total of 55 patients were enrolled in this study. Aged 35 to 86 years old, including 32 males and 23 females. Before the procedure, all the above patients underwent pathological examination to exclude the ulcers caused by malignant tumors. There were 34 cases in the intervention group and 21 cases in the control group. The duration of VSD treatment in the intervention group was (8.53±1.52) d, and that in the control group was (10.33±3.25) d, and the difference was statistically significant ( t=2.39, P=0.025). The effective rate of wound assessment was 82.35% (28/34) in the intervention group and 57.14% (12/21) in the control group; the difference was statistically significant ( χ2=4.16, P=0.041). The good survival rate of skin graft was 91.18% (31/34) in the intervention group and 61.90% (13/21) in the control group; the difference was statistically significant ( χ2=5.24, P=0.022). Conclusions:VSD combined with hydrogen peroxide irrigation is an effective method to treat VLU, which can shorten the preparation time of wounds and improve the survival rate of skin grafts.