Objective To understand the current situation and influencing factors of the quality of life(QOL)of elderly people in Xinjiang,explore the relationship between the quality of life of elderly people,chronic disease comorbidities,and daily living activities,and provide new ideas and reference research for improving the quality of life of elderly people.Methods Stratified cluster random sampling was used,and 2610 permanent elderly population in Urumqi,Aksu,Karamay and Changji of Xinjiang Uygur Autonomous Region were selected in 2023 for questionnaire survey.Results The quality of life score of the elderly was(68.38±20.76),and the comorbidity rate of chronic diseases was 53.1%.Multiple chronic conditions(MCC)had a significant predictive effect on QOL score(β=-4.3497,P<0.001),and activities of daily living(ADL)grading had a significant predictive effect on QOL score(β=0.5534,P<0.001).MCC can affect QOL score through the mediating effect of ADL directly or indirectly.The direct effect(-6.2894)and indirect effect(-1.7820)account for 70.18%and 29.82%of the total effect,respectively.There is a certain mediating effect of ADL between QOL and MCC status in elderly people.Conclusion Chronic comorbidities are significantly negatively correlated with QOL and ADL scores for the elderly.The more chronic diseases,the lower the QOL score and ADL score in the elderly,and the more severe the impairment of daily living ability.

Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

Objective To explore the surgical techniques and therapeutic effects of hematoma evacuation for hypertensive cerebral hemorrhage(HCH)with different bleeding sites under neuroendoscopy.Methods This study enrolled 101 patients with HCH treated in our hospital from May 2022 to January 2024.Based on CT imaging results,patients were divided into lobar cerebral hemorrhage group(n=43)and basal ganglia hemorrhage group(n=58).The Pearson was used to analyze the correlations between cerebral microcirculation indicators and the scores of national institutes of health stroke scale(NIHSS),mini mental state examination(MMSE),and the Barthel index(BI)of activities of daily living.The generalized estimating equation was employed to analyze the improvement effects of neuroendoscopic hematoma evacuation on cerebral microcirculation indicators in patients with different hemorrhage locations.A difference-in-differences equation model with full specifications was applied to analyze the improvement effects of neuroendoscopic hematoma evacuation on NIHSS score,MMSE score,and BI score in patients with different hemorrhage locations,incorporating baseline indicators as control variables.Results The operative time of basal ganglia hemorrhage group was significantly longer than those of lobar cerebral hemorrhage group,and the differences of NIHSS,MMSE,BI,mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV)and mean arterial pressure(MAP)before and after treatment were significantly smaller than those of lobar cerebral hemorrhage group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The correlation analysis results showed that MTT was positively correlated with NIHSS,and negatively correlated with BI and MMSE;CBF,CBV and MAP were negatively correlated with NIHSS,but positively correlated with BI and MMSE,the differences were statistically significant(P<0.05).The result of generalized estimating equation analysis showed that the improvement of MTT,CBF,CBV and MAP in patients with lobar cerebral hemorrhage group was better than those in patients with basal ganglia hemorrhage group,the differences were statistically significant(P<0.05).The result of difference-in-differences equation model analysis showed that increase of age,prolongation of MTT and prolongation of the time from onset to operation had positive effects on NIHSS score(B=0.884,1.291,0.758,P<0.05),and had negative effects on MMSE score(B=-1.014,-1.569,-0.821,P<0.05).The prolongation of MTT had a negative effect on BI score(B=-0.973,P<0.05).The increase of CBV,CBF and MAP had a negative effect on NIHSS score(B=-0.841,-0.767,-1.213,P<0.05),and had a positive effect on MMSE and BI score(MMSE:B=0.932,0.738,0.874;BI:B=0.897,0.751,0.842,P<0.05).Conclusion Neuroendoscopic hematoma evacuation can improve the NIHSS score,MMSE score,BI score of patients with HCH by adjusting MTT,CBF,CBV and MAP,and the improvement effect of patients with lobar cerebral hemorrhage is significantly better than that of patients with basal ganglia hemorrhage.

Objective To understand the current situation and influencing factors of the quality of life(QOL)of elderly people in Xinjiang,explore the relationship between the quality of life of elderly people,chronic disease comorbidities,and daily living activities,and provide new ideas and reference research for improving the quality of life of elderly people.Methods Stratified cluster random sampling was used,and 2610 permanent elderly population in Urumqi,Aksu,Karamay and Changji of Xinjiang Uygur Autonomous Region were selected in 2023 for questionnaire survey.Results The quality of life score of the elderly was(68.38±20.76),and the comorbidity rate of chronic diseases was 53.1%.Multiple chronic conditions(MCC)had a significant predictive effect on QOL score(β=-4.3497,P<0.001),and activities of daily living(ADL)grading had a significant predictive effect on QOL score(β=0.5534,P<0.001).MCC can affect QOL score through the mediating effect of ADL directly or indirectly.The direct effect(-6.2894)and indirect effect(-1.7820)account for 70.18%and 29.82%of the total effect,respectively.There is a certain mediating effect of ADL between QOL and MCC status in elderly people.Conclusion Chronic comorbidities are significantly negatively correlated with QOL and ADL scores for the elderly.The more chronic diseases,the lower the QOL score and ADL score in the elderly,and the more severe the impairment of daily living ability.

Objective To explore the surgical techniques and therapeutic effects of hematoma evacuation for hypertensive cerebral hemorrhage(HCH)with different bleeding sites under neuroendoscopy.Methods This study enrolled 101 patients with HCH treated in our hospital from May 2022 to January 2024.Based on CT imaging results,patients were divided into lobar cerebral hemorrhage group(n=43)and basal ganglia hemorrhage group(n=58).The Pearson was used to analyze the correlations between cerebral microcirculation indicators and the scores of national institutes of health stroke scale(NIHSS),mini mental state examination(MMSE),and the Barthel index(BI)of activities of daily living.The generalized estimating equation was employed to analyze the improvement effects of neuroendoscopic hematoma evacuation on cerebral microcirculation indicators in patients with different hemorrhage locations.A difference-in-differences equation model with full specifications was applied to analyze the improvement effects of neuroendoscopic hematoma evacuation on NIHSS score,MMSE score,and BI score in patients with different hemorrhage locations,incorporating baseline indicators as control variables.Results The operative time of basal ganglia hemorrhage group was significantly longer than those of lobar cerebral hemorrhage group,and the differences of NIHSS,MMSE,BI,mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV)and mean arterial pressure(MAP)before and after treatment were significantly smaller than those of lobar cerebral hemorrhage group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The correlation analysis results showed that MTT was positively correlated with NIHSS,and negatively correlated with BI and MMSE;CBF,CBV and MAP were negatively correlated with NIHSS,but positively correlated with BI and MMSE,the differences were statistically significant(P<0.05).The result of generalized estimating equation analysis showed that the improvement of MTT,CBF,CBV and MAP in patients with lobar cerebral hemorrhage group was better than those in patients with basal ganglia hemorrhage group,the differences were statistically significant(P<0.05).The result of difference-in-differences equation model analysis showed that increase of age,prolongation of MTT and prolongation of the time from onset to operation had positive effects on NIHSS score(B=0.884,1.291,0.758,P<0.05),and had negative effects on MMSE score(B=-1.014,-1.569,-0.821,P<0.05).The prolongation of MTT had a negative effect on BI score(B=-0.973,P<0.05).The increase of CBV,CBF and MAP had a negative effect on NIHSS score(B=-0.841,-0.767,-1.213,P<0.05),and had a positive effect on MMSE and BI score(MMSE:B=0.932,0.738,0.874;BI:B=0.897,0.751,0.842,P<0.05).Conclusion Neuroendoscopic hematoma evacuation can improve the NIHSS score,MMSE score,BI score of patients with HCH by adjusting MTT,CBF,CBV and MAP,and the improvement effect of patients with lobar cerebral hemorrhage is significantly better than that of patients with basal ganglia hemorrhage.

Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

Bone Transplantation/adverse effects* ; Transplantation, Autologous/adverse effects*

BACKGROUND:In recent years,the development of liver organoids has made it a hot spot in the field of international liver disease research,but there is still no article on the bibliometric analysis of liver organoids. OBJECTIVE:To explore the hot trends in liver organoids in the last 20 years based on bibliometrics and visualization analysis. METHODS:We searched the articles about liver organoids in the Web of Science Core Collection from January 1,2002 to November 12,2022.Origin,Office,and CiteSpace software were used for bibliometrics and visualization analysis.We statistically analyzed the number of annually published articles,countries,institutions,authors,journals,and keywords of the articles by generating charts. RESULTS AND CONCLUSION:The number of articles,citation frequency,institutions and personnel involved in the research about liver organoids showed an overall upward trend in the last 20 years,indicating that the field was growing rapidly and attention was increasing.The USA had published the most papers and had the strongest influence in this field.Although it had invested a lot of time and energy,the number of papers published by a single research institution in the USA was not the highest among many research institutions.China was second only to the USA in the number of publications,with the Chinese Academy of Sciences and Fudan University leading the list.Utrecht University in the Netherlands was the institution with the most publications.Clevers H was the author with the highest number of articles.The article with the highest co-citation frequency was"Long-term culture of genome-stable bipotent stem cells from adult human liver".The main fields of study for liver organoids were Molecular Science,Biology,and Immunology.The most frequently occurring keywords were stem cell,in vitro,and culture.The research hotspots in the liver organoids field were mainly focused on in vitro stem cell three-dimensional culture,differentiation and gene expression.

OBJECTIVE To extract the-SH active fractions(SHF)from Bubali Cornu(water buffalo horn)and evaluate its an-tipyretic activity.METHODS SHF was extracted from Bubali Cornu by SDS-DTT,and the content of native thiols(-SH)was deter-mined by Ellman reagent method.SHF was identified based on nano LC-MS/MS technology.Evaluation of antipyretic activity of SHF was based on LPS-induced fever rat model.The levels of PGE2,IL-1β,and TNF-α in plasma as well as the levels of cAMP,PGE2,and TNF-α in the hypothalamus were measured by ELISA kits.An untargeted metabolomics approach was used to further investigate the intervention of SHF on plasma metabolites in febrile rats.RESULTS SDS-DTT could effectively extract SHF from Bubali Cornu,in which the main components were type Ⅰ,type Ⅱ keratins and keratin-associated proteins,which were rich in Cys,and the ratio of-SH to protein in SHF was increased about 20 times more than that of traditional decoction.SHF could significantly decrease(P＜0.01)the body temperature which lasted for 4.5 hours.SHF could also significantly decrease the levels of PGE2,IL-1β,TNF-α and cAMP in plasma and hypothalamic.A total of 137 potentially differential metabolites were identified from plasma samples of the control and model groups,of which 31 metabolites could be dialed back after SHF administration,including lysophosphatidic acid,phosphatidyli-nositol,phosphatidic acid,triglycerides,phosphatidylcholine and so on,which were mainly involved in the glycerophospholipid meta-bolic pathway.CONCLUSION SHF has precise antipyretic effect,and the dosage of 1/10 of the aqueous extract can show its com-parable antipyretic effect,which provides the direction and basis for the basic research on the antipyretic efficacy of Bubali Cornu.

Objective To understand the quality of life of elderly people elderly and its influence factors under the community-based care model in Xinjiang.Methods A stratified cluster random sampling method was used to select 1910 elderly people who enjoy community home-based elderly care services from four prefectures in Xinjiang,the SF-36 scale was used for investigation,and single factor and multiple linear regression analysis were used to study the main influence factors and related relationships of the quality of life of the elderly.Results The QOL score of quality of life is 67.93±21.04,the PCS score is 66.26±22.67,and the MCS score is 69.60±21.15 for elderly people living in Xinjiang communities.Education level,living in elderly care institutions,pension insurance,and stable economic sources are positive factors for the quality of life score(P<0.05).Age,comorbidity of chronic diseases,and other factors are risk factors for quality of life scores(P<0.05).Conclusion It is relatively good for the quality of life of elderly people living in Xinjiang communities,that is influenced by multiple factors and linearly correlated.The higher the education level,the higher the score,and the higher the score living in elderly care institutions.The older the age,the lower the score,and the lower the score for two or more chronic disease comorbidities.It is necessary for the government,community and family to work together,and they should focus on the elderly population with lower age and multiple chronic diseases,further popularizing and optimizing community home-based elderly care services,and providing better protection for the health of the elderly.