BACKGROUND:Promoting skin wound healing is a huge challenge facing global public health.To promote faster and higher-quality wound healing,it is necessary to explore more advantageous dressings to address this problem.OBJECTIVE:To investigate the hemostatic properties of acellular dermal matrix hydrogel and its effect on skin wound healing.METHODS:(1)Acellular dermal matrix hydrogel was prepared,and the differences in microscopic morphology and main components between it and acellular dermal matrix were analyzed.(2)Acellular dermal matrix hydrogel and chitosan hydrogel were used to cover the femoral artery puncture site of rats,and the bleeding quality and coagulation time were recorded.Acellular dermal matrix hydrogel and chitosan hydrogel were mixed with rat anticoagulated blood,and the coagulation index within 30 minutes was detected.(3)A full-thickness skin defect model with a diameter of 12 mm was made on the back of 18 SD rats,and they were randomly divided into 3 groups,with 6 rats in each group:the model group used PBS to clean the wound,and the control group and the experimental group used chitosan hydrogel and acellular dermal matrix hydrogel to cover the wound,respectively.The hydrogel dressing was changed every day,and the treatment was continued for 14 days,and the wound healing was observed.On day 3 after modeling,immunofluorescence staining of inducible nitric oxide synthase(M1 macrophages)and CD206(M2 macrophages)was performed on the wound surface.On day 14 after modeling,hematoxylin-eosin staining,Masson staining,and CD31 immunohistochemical staining were performed on the wound surface.RESULTS AND CONCLUSION:(1)Scanning electron microscopy revealed that the acellular dermal matrix hydrogel had a porous structure,and the Fourier transform infrared spectrum showed that it had the same main components as the acellular dermal matrix.(2)Both acellular dermal matrix hydrogel and chitosan hydrogel had obvious hemostatic ability in vivo.In the in vitro coagulation experiments,the coagulation index of acellular dermal matrix hydrogel was significantly higher than that of chitosan hydrogel.(3)In the rat skin full-thickness defect model,both acellular dermal matrix hydrogel and chitosan hydrogel could improve the wound healing rate.Hematoxylin-eosin and Masson staining results showed that acellular dermal matrix hydrogel could reduce the infiltration of inflammatory cells in the center of the wound.Both acellular dermal matrix hydrogel and chitosan hydrogel could decrease scar width and increase collagen deposition rate.CD31 immunohistochemical staining results showed that both hydrogels could promote angiogenesis in the wound site.Immunofluorescence staining results showed that both hydrogels could reduce the proportion of M1 macrophages and increase the proportion of M2 macrophages,and the effect of acellular dermal matrix hydrogel was stronger than that of chitosan hydrogel.(4)The results show that the acellular dermal matrix hydrogel has good hemostatic properties and the ability to promote wound healing.

Neurocritical care involves complex pathophysiological mechanisms, and its incidence is higher, injuries are more severe, and treatment is more challenging in high-altitude environments. This consensus, based on the latest domestic and international evidence-based medical data, establishes a standardized, goal-oriented framework for neurocritical care management applicable in high-altitude regions and nationwide. The consensus was developed following international standards for evidence quality assessment and underwent two rounds of Delphi expert consultation, resulting in 32 recommendation statements covering three parts: management systems, monitoring and assessment, and core strategies. Key updates include: advocating for the establishment of independent neurocritical care units and implementing precise tiered diagnosis and treatment based on the "Five Differences in Critical Care" concept; constructing a "trinity" multimodal brain monitoring system centered on cerebral blood flow, cerebral oxygenation, and brain function, emphasizing routine bedside transcranial Doppler ultrasound, cerebral oximetry, and continuous electroencephalography monitoring; shifting management strategies from mild hypothermia therapy to targeted temperature management, and defining the "446" target management pathway for the supercritical stage; emphasizing the assessment of static and dynamic cerebrovascular autoregulation functions through multimodal methods to achieve individualized optimal mean arterial pressure management; elevating cerebrospinal fluid management goals to the level of "glymphatic system" function maintenance; implementing a multidisciplinary collaborative, whole-process management model focusing on patients' long-term neurological functional outcomes; de-escalation criteria include multidimensional indicators such as recovery of brain structure, restoration of cerebrovascular autoregulation, improvement in cerebrospinal fluid dynamics, and reduction in biomarker levels; and integrating cutting-edge technologies like artificial intelligence into post-critical care management and rehabilitation planning. This consensus systematically integrates the entire process of neurocritical care management, reflecting the modern connotation of goal-oriented, dynamic, and multimodal integration in neurocritical care medicine. It aims to adapt to new trends such as deepening understanding of pathophysiological mechanisms, the integration of medicine and engineering, and the empowerment of artificial intelligence, thereby further advancing the discipline of critical care medicine.

AIM:To investigate the predictive value of aqueous humor stromal cell-derived factor-1(SDF-1)and epithelial neutrophil-activating peptide-78(ENA78)for visual impairment following vitrectomy in patients with diabetic retinopathy(DR).METHODS: Patients with DR who underwent vitrectomy in the ophthalmology department of our hospital from March 2022 to March 2024 were enrolled as study group. According to the results of uncorrected visual acuity examination during the 1-year follow-up after surgery, they were further divided into visual impairment group and good visual acuity group. In addition, patients with cataracts who were treated in our hospital during the same period were recruited as control group. The levels of SDF-1 and ENA78 in aqueous humor were detected by enzyme-linked immunosorbent assay(ELISA). Pearson correlation analysis was used to evaluate the correlation of indicators. Multivariate Logistic regression analysis was performed to identify the influencing factors of postoperative visual impairment in DR patients. Relative risk analysis was conducted to assess the impact of different aqueous humor SDF-1 and ENA78 levels on postoperative visual impairment in DR patients. Receiver operating characteristic(ROC)curve analysis was applied to determine the predictive value of aqueous humor SDF-1 and ENA78 levels for postoperative visual impairment in DR patients.RESULTS: Totally 156 cases(156 eyes)were enrolled in the study group, including 87 males and 69 females, with a mean age of 60.65±8.91 years old; and 91 cases(91 eyes)were enrolled in the control group, including 53 males and 38 females, with a mean age of 58.72±8.43 years old. The levels of SDF-1 and ENA78 in aqueous humor of the study group were significantly higher than those of the control group(P<0.001). According to the results of uncorrected visual acuity during the 1-year follow-up after surgery, the study group was further divided into the visual impairment group(n=49)and the good visual acuity group(n=107), including 28 males and 21 females in the visual impairment group, with a mean age of 63.73±7.41 years, and 59 males and 48 females in the good visual acuity group, with a mean age of 59.24±8.47 years. The age and glycated hemoglobin(HbA1c)levels of the visual impairment group were higher than those of the good visual acuity group(all P<0.05). Compared with the good visual acuity group, the levels of SDF-1 and ENA78 in aqueous humor of the visual impairment group were significantly elevated(all P<0.05). A positive correlation was found in the study group between the levels of SDF-1, ENA78 in aqueous humor and HbA1c(r=0.314, 0.362, all P<0.05). Elevated levels of aqueous humor SDF-1(OR=2.936, 95% CI: 1.628-5.296)and ENA78(OR=3.092, 95% CI: 1.738-5.502)were identified as risk factors for postoperative visual impairment in DR patients(all P<0.05). High levels of SDF-1 and ENA78 increased the risk of postoperative visual impairment by 1.958-fold and 2.030-fold compared with the low-level groups, respectively; the area under the curve(AUC)of combined detection of aqueous humor SDF-1 and ENA78 for predicting postoperative visual impairment in DR patients was 0.936, which was superior to the predictive value of SDF-1 or ENA78 alone(Zcombination-SDF-1=2.850, Zcombination-ENA78=2.445, all P<0.05).CONCLUSION: Elevated levels of aqueous humor SDF-1 and ENA78 are risk factors for postoperative visual impairment in DR patients, and the combined detection of SDF-1 and ENA78 has high clinical application value for predicting postoperative visual impairment in DR patients.

BACKGROUND:Promoting skin wound healing is a huge challenge facing global public health.To promote faster and higher-quality wound healing,it is necessary to explore more advantageous dressings to address this problem.OBJECTIVE:To investigate the hemostatic properties of acellular dermal matrix hydrogel and its effect on skin wound healing.METHODS:(1)Acellular dermal matrix hydrogel was prepared,and the differences in microscopic morphology and main components between it and acellular dermal matrix were analyzed.(2)Acellular dermal matrix hydrogel and chitosan hydrogel were used to cover the femoral artery puncture site of rats,and the bleeding quality and coagulation time were recorded.Acellular dermal matrix hydrogel and chitosan hydrogel were mixed with rat anticoagulated blood,and the coagulation index within 30 minutes was detected.(3)A full-thickness skin defect model with a diameter of 12 mm was made on the back of 18 SD rats,and they were randomly divided into 3 groups,with 6 rats in each group:the model group used PBS to clean the wound,and the control group and the experimental group used chitosan hydrogel and acellular dermal matrix hydrogel to cover the wound,respectively.The hydrogel dressing was changed every day,and the treatment was continued for 14 days,and the wound healing was observed.On day 3 after modeling,immunofluorescence staining of inducible nitric oxide synthase(M1 macrophages)and CD206(M2 macrophages)was performed on the wound surface.On day 14 after modeling,hematoxylin-eosin staining,Masson staining,and CD31 immunohistochemical staining were performed on the wound surface.RESULTS AND CONCLUSION:(1)Scanning electron microscopy revealed that the acellular dermal matrix hydrogel had a porous structure,and the Fourier transform infrared spectrum showed that it had the same main components as the acellular dermal matrix.(2)Both acellular dermal matrix hydrogel and chitosan hydrogel had obvious hemostatic ability in vivo.In the in vitro coagulation experiments,the coagulation index of acellular dermal matrix hydrogel was significantly higher than that of chitosan hydrogel.(3)In the rat skin full-thickness defect model,both acellular dermal matrix hydrogel and chitosan hydrogel could improve the wound healing rate.Hematoxylin-eosin and Masson staining results showed that acellular dermal matrix hydrogel could reduce the infiltration of inflammatory cells in the center of the wound.Both acellular dermal matrix hydrogel and chitosan hydrogel could decrease scar width and increase collagen deposition rate.CD31 immunohistochemical staining results showed that both hydrogels could promote angiogenesis in the wound site.Immunofluorescence staining results showed that both hydrogels could reduce the proportion of M1 macrophages and increase the proportion of M2 macrophages,and the effect of acellular dermal matrix hydrogel was stronger than that of chitosan hydrogel.(4)The results show that the acellular dermal matrix hydrogel has good hemostatic properties and the ability to promote wound healing.

Yinqiao San （YQS） is a classic prescription in Systematic Differentiation of Warm Diseases， which has the effects of pungent dispersing， bitter descending， clearing heat， and removing toxin. It is a classic prescription for the treatment of the onset of warm disease. The prescription contains ten kinds of traditional Chinese medicines， which are in proper compatibility. The ancient and modern physicians often modify the prescription for the treatment of various diseases in children， which has a significant effect. At present， with the rapid development of modern technology， the research on the mechanism of YQS at the molecular level is constantly deepening and improving， which provides new ideas and scientific basis for the treatment of pediatric diseases by YQS. Therefore， this paper summarized and collated the relevant research literature on YQS published by scholars from China and other countries in recent years from six aspects： the textual research on the source of YQS prescription， the theory of formulation， clinical application， active ingredients of traditional Chinese medicine， pharmacological effects， and decocting and administration methods. It expounded on the diseases treated by YQS which were recorded in modern literature， involving the respiratory system， nervous system， rheumatic， immune， and renal disease systems， skin system， infectious system， and its application in diseases such as mucocutaneous lymph node syndrome， viral myocarditis， mesenteric lymphadenitis， and post-nasal drip syndrome. At the same time， it elucidated the mechanism of YQS in the treatment of diseases and its correlation with antiviral， antibacterial， antipyretic， and analgesic effects， improvement of microbiota， regulation of immune function， anti-inflammatory effect， and improvement of pulmonary damage. The decoction time of YQS had a significant effect on its clinical effect， and the best decoction time for its efficacy was 3 to 6 minutes after boiling.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) has a relatively low incidence in the general population, but it is the most common monogenic hereditary cerebral small vessel disease in adults. White matter hyperintensities (WMH) are the earliest and most common magnetic resonance imaging (MRI) manifestations of CADASIL. However, the total WMH burden on imaging often shows a weak correlation with cognitive impairment, the degree of disability, and stroke risk, suggesting that WMH may not be single homogeneous lesions but rather have significant heterogeneity. To thoroughly elucidate the heterogeneous characteristics of WMH, this article systematically analyzes representative recent studies on postmortem human brain histopathology and in vivo advanced quantitative MRI, summarizes the histopathological features, imaging manifestations, and clinical correlations of WMH heterogeneity related to CADASIL, and explores the sources and formation mechanisms of WMH heterogeneity. Given that WMH are the earliest and most characteristic imaging manifestations of CADASIL, a comprehensive understanding of their heterogeneity at the pathological and imaging levels as well as their clinical associations will not only help deepen the understanding of the occurrence and development of WMH and the pathogenesis of CADASIL, but also enable refined risk stratification and prognostic assessment in the early stage of the disease based on their heterogeneous characteristics, thereby providing a basis for the individualized management and intervention of the disease.

ObjectiveTo assess the risk of vector-born infectious diseases by monitoring the major vectors in the relevant venues of the 19th Hangzhou Asian Games in Fuyang competition area, so as to provide references for the prevention and control of vector in similar large-scale events or activities in the future. MethodsFrom April to October 2023, monitoring and evaluation of rodent, mosquito, fly and cockroach density levels were carried out in various venues and reception hotels in Fuyang competition area (venues and hotels were the 1st circle area, and various environments and places in the surrounding 500 meters were the 2nd circle area). SPSS 25.0 software was used to analyze the data, and chi-square test or Fisher’s precision probability test were used to calculate the qualified rate and positive rate. Moreover, the path index, landing index and Bretrau index were analyzed by Kruskal-Wallis H test. ResultsThe control effect of vector density in the 1st circle was significantly better than that in the 2nd circle. Since September, the monitoring indices of the venues in the two circles had reached the national A-level and B-level standard, respectively. The positive rate of rodent traces generally showed a trend of first increasing and then decreasing, and the peak was shown to occur in July and August, with the highest rate of 5.38%. The qualified rate of rodent prevention facilities continued to rise, and facilities in the 1st and 2nd circles had reached national A-level and B-level standard respectively in late August. The landing index and path index of mosquitoes basically showed a changing trend from high to low, with the highest landing index of 4.56 individuals·person-time^-1 and the highest path index of 2.44 places·km^-1.The adult fly infestation rate remained at a low level, with the highest rate of 4.17%, and the minimum qualified rate of fly prevention facilities was 28.57%, which reached the national standard after July. The positive detection rates of adult flies and cockroach traces showed no significant pattern, with the highest rate of 7.00% and 8.33%, respectively. The detection rate of live ootheca was always at a low level. ConclusionThe relevant venues in the Fuyang competition area of the 19th Asian Games in Hangzhou meet national standards in terms of vector control indicators such as rodents, mosquitoes, flies, cockroaches and other vectors. By means of environmental improvement, facilities for preventing rodents and flies, and deepening biological and chemical prevention and control methods, it can be ensured that there will be no vector-borne diseases and infestation incidents during the event.

BACKGROUND:At present,the incidence of scoliosis is increasing year by year,especially in adolescent idiopathic scoliosis.Therefore,it is more and more important to strengthen the research on the treatment of adolescent scoliosis. OBJECTIVE:To summarize the current status,hotspots,emerging trends,and frontiers of global research on the treatment of adolescent idiopathic scoliosis to provide reference and guidance for future related research. METHODS:The literature related to the treatment of adolescent idiopathic scoliosis was retrieved on the Web of Science Core Collection(WOSCC)database from 2013 to 2023.CiteSpace 6.2.R1 software was used for visual analysis of countries,institutions,authors,and keywords. RESULTS AND CONCLUSION:(1)A total of 561 English articles were included in this study.Among countries,institutions,and authors,the United States has contributed the most.Nanjing University and Qiu,Yong(Affiliated Drum Tower Hospital,Nanjing University School of Medicine)are the most published institution and author.The academic journal with the largest number of articles is the European Spine Journal.(2)In the analysis of cited literature,the top 10 most cited articles mainly describe the effects of surgical treatment and conservative treatment on improving adolescent idiopathic scoliosis,especially improving the curvature of patients.(3)Through the summary of highly cited articles and the keyword clustering,keyword prominence in-depth mining,the research hotspots are currently the relationship between Cobb angle and treatment choice,the therapeutic effect of exercise therapy and the therapeutic effect of posterior vertebral fusion.(4)The prognosis of patients with different curvatures has not been studied in depth,and the etiology of adolescent idiopathic scoliosis has not been clarified,so the relationship between curvature and prognosis and the etiology of adolescent idiopathic scoliosis may be a new research trend in the future.

Objective To quantitatively assess the correlation between the skeletal muscle index(SMI)of patients and the occur-rence of anastomotic leakage(AL)in rectal cancer patients after surgery,and to analyze the risk factors for AL in rectal cancer patients and the influencing factors of sarcopenia.Methods The clinical,pathological,and related imaging data of 362 patients who under-went radical surgery for rectal cancer were retrospectively analyzed.All patients underwent pelvic MRI and abdominal CT scans(plain/enhanced)within one month before surgery,and the third lumbar vertebra skeletal muscle area(L3-SMA)was measured from the images.All patients were divided into AL group(56 cases)and control group(306 cases)based on the presence or absence of postoperative complications.The differences in clinical characteristics and imaging parameters between the two groups were analyzed.A logistic risk prediction model was established.Results Significant differences were observed between the two groups in sarcopenia,type of surgery,surgical approach,serum albumin level,operation duration,stoma type,and extramural vascular invasion(EMVI)(P＜0.05).These factors were incorporated in a multivariate logistic regression analysis model,the area under the curve(AUC)of receiver operating characteristic(ROC)curve of the model was 0.810[95％confidence interval(CI)0.743-0.876,P＜0.001],with a sensitivity of 0.865 and specificity of 0.669.Conclusion Sar-copenia is a significant risk factor for AL after rectal cancer surgery.It enhances the predictive efficacy for postoperative AL and serves as a basis for identifying high-risk populations for AL in clinical practice.

Objective To investigate the effect of Yiqi Wenfei Tongqiao decoction on the inflammatory response in rats with allergic rhi-nitis(AR)of lung qi deficiency and cold type based on the Janus kinase 1(JAK1)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods A AR model of lung qi deficiency and cold type was established in rats using ovalbumin(OVA)combined with smoking and cold stimulation.After modeling,the rats were randomly divided into model,loratadine,low-dose Chinese medicine,high-dose Chinese medicine,and high-dose Chinese medicine+RO8191(JAK1/STAT3 signaling pathway activator)groups,with 12 rats per group.Twelve healthy rats were used as controls.After 14 days of drug intervention,the changes in the symptoms of lung qi deficiency and cold syndrome and AR were observed in the rats.Enzyme-linked immunosorbent assay was used to detect the serum levels of tumor necrosis factor α(TNF-α),interleukin(IL)-4,interferon-γ(IFN--γ),and ovalbumin-specific immunoglobulin E(OVA-sIgE).The number of inflammatory cells in the nasal lavage fluid was determined and the eosinophil(EOS)percentage was calculated.Pathological changes in the nasal mucosal tissue were observed after hematoxylin and eosin(HE)staining.Western blotting was used to detect the expression of JAK1/STAT3 signaling pathway-related proteins in nasal mucosal tissue.Results Compared with those in the model group,the AR symptom score,serum IL-4,TNF-α,and OVA-sIgE levels,EOS percentage in nasal lavage fluid,and levels of p-JAK1/JAK1 and p-STAT3/STAT3 in the nasal mucosal tissue of rats in the loratadine,low-dose Chinese medicine,and high-dose Chinese medicine groups were lower,whereas the serum IFN-γ level was higher(P＜0.05).RO8191 weakened the inhibitory effect of Yiqi Wenfei Tongqiao decoction on the inflammatory response in rats with AR of lung qi deficiency and cold type.Conclusion Overall,Yiqi Wenfei Tongqiao decoction can alleviate the inflammatory response in rats with AR of lung qi deficiency and cold type by inhibiting JAK1/STAT3 signaling pathway acti-vation and regulating the balance of Th1/Th2 cytokines.