Thyroid cancer is the most common malignant tumor in head and neck surgery.In recent years,the incidence rate of thyroid cancer has increased rapidly.The traditional treatment is mainly surgical resection,supplemented by 131I treatment,but for advanced or metastatic thyroid cancer,these methods have limited effect.With the deepening of research on the molecular pathogenesis of thyroid cancer,targeted therapy has become a new research hot spot and important treatment method.In recent years,targeted therapy drugs have emerged one after another,such as sorafenib,anlotinib,serpatinib,pratinib,etc.,all of which have shown good efficacy and significantly improved the progression free survival and objective remission rate of patients.However,targeted therapy still faces many problems such as drug resistance,and further research and development of more effective new drugs are needed.This article summarized the research progress of targeted therapy,and aimed to provide reference for the treatment of advanced or iodine refractory thyroid cancer.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Through literature research,this study expounds the emergence of wholly foreign-owned hospitals(WFOHs)from both policy formulation and intrinsic demand perspectives.By accessing the current services landscape of WFOHs,the study systematically analyzes their developmental opportunities and challenges.Strategic recommendations are subsequently proposed across four key aspects:strengthening regulatory supervision,improving the medical insurance system,enhancing professional workforce development,and promoting Sino-foreign cooperation.These measures aim to facilitate WFOHs'high-quality develop-ment,thereby elevating institutional competitiveness,driving continuous healthcare service innovation,and ultimately delivering enhanced medical care that is efficient,accessible,and patient-centered.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Through literature research,this study expounds the emergence of wholly foreign-owned hospitals(WFOHs)from both policy formulation and intrinsic demand perspectives.By accessing the current services landscape of WFOHs,the study systematically analyzes their developmental opportunities and challenges.Strategic recommendations are subsequently proposed across four key aspects:strengthening regulatory supervision,improving the medical insurance system,enhancing professional workforce development,and promoting Sino-foreign cooperation.These measures aim to facilitate WFOHs'high-quality develop-ment,thereby elevating institutional competitiveness,driving continuous healthcare service innovation,and ultimately delivering enhanced medical care that is efficient,accessible,and patient-centered.

Thyroid cancer is the most common malignant tumor in head and neck surgery.In recent years,the incidence rate of thyroid cancer has increased rapidly.The traditional treatment is mainly surgical resection,supplemented by 131I treatment,but for advanced or metastatic thyroid cancer,these methods have limited effect.With the deepening of research on the molecular pathogenesis of thyroid cancer,targeted therapy has become a new research hot spot and important treatment method.In recent years,targeted therapy drugs have emerged one after another,such as sorafenib,anlotinib,serpatinib,pratinib,etc.,all of which have shown good efficacy and significantly improved the progression free survival and objective remission rate of patients.However,targeted therapy still faces many problems such as drug resistance,and further research and development of more effective new drugs are needed.This article summarized the research progress of targeted therapy,and aimed to provide reference for the treatment of advanced or iodine refractory thyroid cancer.

OBJECTIVE To investigate the effect and underlying mechanism of hydroxytyrosol(HT)on mouse chondrocyte injury induced by oxidative stress.METHODS Mouse chondrocytes were incubated with varying concentrations of HT 0-400 μmol L-1 for 24 h,and the viability of the mouse chondrocytes was assessed using CCK-8 kit.An oxidative stress model of chondrocytes was estab-lished by the addition of H2O2 200 μmol L-1.The experimental groups included the cell control group,H2O2 group,and H2O2+HT 10,50 and 250 μmol·L-1 groups.After 24 h,the mRNA expression levels of interleukin-6(IL-6),cyclooxygenase-2(COX-2),prostaglandin E2(PGE2),inducible nitric oxide synthase(iNOS),matrix metalloproteinase-3(MMP-3),MMP-13,a disintegrin and metalloproteinase with throm-bospondin motifs-4(ADAMTS-4),ADAMTS-5,SRY-box transcription factor-9(SOX-9)and aggrecan(ACAN)in mouse chondrocytes were detected by real-time quantitative PCR,the intracellular reactive oxygen species(ROS)level in chondrocytes was measured with 2,7-dichlorodihydrofluorescein diace-tate(DCFH-DA)staining,while the mitochondrial membrane potential was evaluated using JC-1 staining.After 48 h,the protein expression levels of iNOS,COX-2,MMP-13,and type Ⅱ collagen(Col-2)in mouse chondrocytes were detected using Western blotting.RESULTS HT at concentrations≤350 μmol·L-1 had no significant effect on the survival of mouse chondrocytes.Compared with the cell control group,after 24 h,the mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MMP-3,MMP-13,ADAMTS-4 and ADAMTS-5 in the chondrocytes of mice in the H2O2 group were increased,while the mRNA expression levels of SOX-9 and ACAN were decreased.Additionally,there was an elevation in the ROS level and a significant loss of mitochondrial membrane potential in the chondrocytes of mice.Compared with the H2O2 group,after treatment with HT 10,50 and 250 μmol·L-1,there were significant decreases in mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MM P-3,MMP-13,ADAMTS-4 and ADAMTS-5,the mRNA expressions of SOX-9 and ACAN were increased,the ROS level was lowered.After treatment with HT 50 and 250 μmol L-1,the loss of mitochondrial membrane potential was ameliorated.Compared to the cell control group,the protein expressions of iNOS,COX-2 and MMP-13 were upregulated in the H2O2 group,while the protein expression of Col-2 was downregulated after 48 h.Compared to the H2O2 group,treatment with HT at concentrations of 10,50 and 250 μmol·L-1 resulted in decreased protein expressions of iNOS,COX-2 and MMP-13 in mouse chondrocytes,but the protein expression of Col-2 increased following treatment with HT 50 and 250 μmol L-1.CONCLUSION HT can ameliorate H2O2-induced chondrocyte injury by reducing intracellular ROS levels and alleviating the loss of mitochondrial membrane potential,suppressing the release of inflammatory cytokines,inhibiting catabolic processes,and promoting anabolic activities.

OBJECTIVE To investigate the effect and underlying mechanism of hydroxytyrosol(HT)on mouse chondrocyte injury induced by oxidative stress.METHODS Mouse chondrocytes were incubated with varying concentrations of HT 0-400 μmol L-1 for 24 h,and the viability of the mouse chondrocytes was assessed using CCK-8 kit.An oxidative stress model of chondrocytes was estab-lished by the addition of H2O2 200 μmol L-1.The experimental groups included the cell control group,H2O2 group,and H2O2+HT 10,50 and 250 μmol·L-1 groups.After 24 h,the mRNA expression levels of interleukin-6(IL-6),cyclooxygenase-2(COX-2),prostaglandin E2(PGE2),inducible nitric oxide synthase(iNOS),matrix metalloproteinase-3(MMP-3),MMP-13,a disintegrin and metalloproteinase with throm-bospondin motifs-4(ADAMTS-4),ADAMTS-5,SRY-box transcription factor-9(SOX-9)and aggrecan(ACAN)in mouse chondrocytes were detected by real-time quantitative PCR,the intracellular reactive oxygen species(ROS)level in chondrocytes was measured with 2,7-dichlorodihydrofluorescein diace-tate(DCFH-DA)staining,while the mitochondrial membrane potential was evaluated using JC-1 staining.After 48 h,the protein expression levels of iNOS,COX-2,MMP-13,and type Ⅱ collagen(Col-2)in mouse chondrocytes were detected using Western blotting.RESULTS HT at concentrations≤350 μmol·L-1 had no significant effect on the survival of mouse chondrocytes.Compared with the cell control group,after 24 h,the mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MMP-3,MMP-13,ADAMTS-4 and ADAMTS-5 in the chondrocytes of mice in the H2O2 group were increased,while the mRNA expression levels of SOX-9 and ACAN were decreased.Additionally,there was an elevation in the ROS level and a significant loss of mitochondrial membrane potential in the chondrocytes of mice.Compared with the H2O2 group,after treatment with HT 10,50 and 250 μmol·L-1,there were significant decreases in mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MM P-3,MMP-13,ADAMTS-4 and ADAMTS-5,the mRNA expressions of SOX-9 and ACAN were increased,the ROS level was lowered.After treatment with HT 50 and 250 μmol L-1,the loss of mitochondrial membrane potential was ameliorated.Compared to the cell control group,the protein expressions of iNOS,COX-2 and MMP-13 were upregulated in the H2O2 group,while the protein expression of Col-2 was downregulated after 48 h.Compared to the H2O2 group,treatment with HT at concentrations of 10,50 and 250 μmol·L-1 resulted in decreased protein expressions of iNOS,COX-2 and MMP-13 in mouse chondrocytes,but the protein expression of Col-2 increased following treatment with HT 50 and 250 μmol L-1.CONCLUSION HT can ameliorate H2O2-induced chondrocyte injury by reducing intracellular ROS levels and alleviating the loss of mitochondrial membrane potential,suppressing the release of inflammatory cytokines,inhibiting catabolic processes,and promoting anabolic activities.

Objective:To explore the related risk factors and clinical application value of lymph node metastasis in the pre laryngeal, pre tracheal, and para tracheal regions of multifocal papillary thyroid microcarcinoma.Method:The clincal data and of 629 patients with papillary thyroid microcarcinoma admitted to Peking University Cancer Hospital-Inner Mongolia Hospital from Feb 2023 to Apr 2024 were collected, for the incidence of lymph node metastasis in the central region of the neck, and the relationship between relevant factors and the central lymph node subregions.Result:Univariate analysis showed that gender, age, tumor diameter, and whether or not combining Hashimoto's thyroiditis were associated with paratracheal lymph node metastasis; Capsular invasion was associated with pre-tracheal and paratracheal lymph node metastasis, and gender, number was correlated with pre-laryngeal lymph node metastasis (all P<0.05). The results of multivariate analysis showed that male, age <55 years, and capsular invasion were independent risk factors for paratracheal lymph node metastasis ( χ2=8.331, P=0.004; χ2=9.139, P=0.003;χ 2=4.798, P=0.028); Male and multiple lesions (≥2 lesions) are independent risk factors for lymph node metastasis in the larynx ( χ2=7.182, P=0.007; χ2=5.541, P=0.019). Conclusions:Central lymph node metastasis in patients with papillary thyroid microcarcinoma is closely related to factors such as gender, age, tumor diameter, and capsular invasion, with the highest metastasis rate observed in the paratracheal lymph nodes.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.