Steroid-induced avascular necrosis of femoral head（SANFH） is a bone and joint disease caused by prolonged and excessive steroid use. Its typical pathological features involve progressive circulatory disorders in the blood supply system of femoral head， leading to osteocyte apoptosis and bone tissue necrosis. As the disease progresses， it ultimately results in structural collapse and necrotic lesions of the femoral head， severely affecting patients' limb function and quality of life. Glucocorticoids mediate pathological damage through dual mechanisms， on the one hand， they disrupt the dynamic equilibrium between bone formation and resorption by suppressing osteoblast differentiation activity and activating osteoclastogenesis， on the other hand， they induce lipid metabolism disorders， inhibit angiogenesis， and impair endothelial cell function， thereby triggering microcirculatory disorders. Epimedii Folium and its active components exhibit multidimensional regulatory effects in SANFH prevention and treatment. Literature review reveals that it is rich in multiple active ingredients， primarily including total flavonoids of Epimedii Folium， icaritin， icariin， kaempferol， icariside Ⅱ， etc. These compounds exert multiple pharmacological effects（regulating bone metabolic homeostasis， modulating angiogenesis， correcting lipid metabolism disorders， and controlling cellular autophagy processes） through multiple signaling pathways， including Wnt/β-catenin， transforming growth factor（TGF）-β/bone morphogenetic protein（BMP）/Smad， mitogen-activated protein kinase（MAPK）， phosphoinositide 3-kinase/protein kinase B（PI3K/Akt）， osteoprotegerin/receptor activator of nuclear transcription factor-κB ligand/receptor activator of nuclear transcription factor-κB（OPG/RANKL/RANK）， etc. Based on existing research findings， this paper systematically elucidates the intervention mechanisms of active components in Epimedii Folium on key pathological processes of SANFH through the above pathways. It also deeply analyzes their regulatory roles in key nodes of different signaling pathways， aiming to provide valuable references for future clinical treatment and experimental research.

Objective To evaluate the diagnosis and emergency surgical treatment of ruptured intracerebral aneurysms (RIAs) accompanied with intracerebral hematomas (ICH).Methods A retrospective study was performed on the clinical data of 23 patients ofICH following RIAs,admitted to our hospital from May 2009 to September 2013.CTA was performed in 17 patients and cranial CT in 6 before the operation.The emergent operations were performed in all the patients within 24 hours of aneurysm rupture; pterion approach was adopted to clip the arterial aneurysm and clear intracerebral hematoma.Results According to Glasgow outcome scale (GOS) scores,4 recovered well,6 were mildly disabled,8 were severely disabled and 5 died.After follow-up for 3.3 years in 15 patients,no further bleeding occurred.Eight aneurysms were re-checked by CTA,7 aneurysms were completely clipped and 1 aneurysm had residual neck.Conclusions Preoperative CTA is essential for the correct diagnosis of ICHs due to RIA.The curative effect of the emergent operation can improve the survival rate and prognosis of patients with RIA accompanied with ICH.

Objective To explore the significance of palpation-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction.Methods 46 cases of small breast tumors with the diameter from 0.5 cm to 1.0 cm were double labeled with methylene blue under the guide of ultrasound l hour preoperatively.The tumors were fixed,drew outward with percutaneous suture and resected accurately.All the 46 cases were rechecked by ultrasound to verify whether residual or false resection occurred 1 month later.Results All the 58 tumors of the 46 patients were accurately resected.No residue or false resection occurred.The average operation duration was 10 min to 20 min.Conclusion Palpable-negative breast tumor resection with ultrasound-guided methylene blue labeling and percutaneous suture traction has the advantages of small invasion,accurate positioning and short operation duration.