Objective:To compare the efficacy of arthroscopic figure-of-eight transtibial tension-reducing technique combined with interference screw fixation versus interface screw fixation alone in the treatment of anterior cruciate ligament (ACL) rupture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 43 patients with ACL rupture admitted to Taihe Hospital between January 2022 and October 2023, including 24 males and 19 females, aged 17-61 years [(38.0±12.6)years]. Based on the tibial fixation method, 20 patients were treated with interference screw fixation alone (interference screw group) and 23 patients with figure-of-eight transtibial tension-reduction technique combined with interference screw fixation (figure-of-eight tension-reduction combined with interference screw group). An Endobutton suspension plate was used in femoral fixation in both groups. The following parameters were compared between the two groups: operative duration and graft diameter; coronal and sagittal tibial tunnel measurements by MRI within 72 hours postoperatively and at the last follow-up; knee range of motion, visual analogue scale (VAS) scores, International Knee Documentation Committee (IKDC) scores, and Lysholm scores preoperatively, at 1 month postoperatively, and at the last follow-up; perioperative complication rates.Results:All the patients were followed up for 11-28 months [(14.1±3.4)months]. There were no significant differences in operative duration or graft diameter between the two groups ( P>0.05). No significant differences were observed in coronal or sagittal tibial tunnel measurements between the two groups within 72 hours postoperatively ( P>0.05). Whereas at the last follow-up, the coronal and sagittal tibial tunnel measurements in the figure-of-eight tension-reduction combined with interference screw group were (11.6±0.7)mm and (11.7±1.1)mm, significantly lower than (13.5±0.6)mm and (13.4±1.9)mm in the interference screw group ( P<0.01). Preoperative knee range of motion, IKDC scores, Lysholm scores, and VAS scores showed no significant differences between the two groups ( P>0.05). At 1 month postoperatively and at the last follow-up, the figure-of-eight tension-reduction combined with interference screw group demonstrated significantly greater knee range of motion [100.0(95.0, 100.0)° and 130.0(120.0, 135.0)°], compared with 72.5(60.0, 95.0)° and 120.0(105.0, 133.3)° in the interference screw group ( P<0.05). VAS scores at 1 month postoperatively and at the last follow-up were 2.0(2.0, 2.0)]points and 1.0(1.0, 1.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly lower than 3.0(2.3, 4.0)points and 2.0(1.0, 2.0)points in the interference screw group ( P<0.05). IKDC scores at 1 month postoperatively and at the last follow-up were (58.8±5.7)points and (72.4±6.7)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (51.1±5.2)points and (67.4±7.9)points in the interference screw group ( P<0.05). Lysholm scores at 1 month postoperatively and at the last follow-up were (58.9±12.7)points and (89.1±6.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (41.2±15.0)points and (78.3±12.3)points in the interference screw group ( P<0.05). No perioperative complications were observed in either group. Conclusion:Compared with interface screw fixation alone, arthroscopic figure-of-eight transtibial tension-reduction technique combined with interference screw fixation for ACL rupture can enhance graft stability, restore knee joint range of motion, alleviate pain, and improve knee function recovery.

Objective To observe the value of multi-detector CT(MDCT)for evaluating changes of aortic root parameters caused by aortic stenosis(AS).Methods MDCT data of 20 cases with severe AS were retrospectively analyzed.The changes of the long diameter,short diameter,mean diameter,area,circumference,as well as diameter derived from area(DA)and diameter derived from circumference(DC)of aortic annulus(AA),left ventricular outflow tract(LVOT)and sinotubular junction(STJ)during early systole,late systole,early diastole and late diastole were measured and calculated,respectively.Results In early systole,the short diameter,mean diameter,area,circumference,DA and DC of A A were all significantly larger than that those in late systole,early diastole and late diastole(all P＜0.05).No significant difference of the long diameter of AA was found among different phases(all P＞0.05).Meanwhile,the short diameter,mean diameter,area,circumference,DA and DC of LVOT in early systole were all significantly larger than those in late systole,early diastole and late diastole(all P＜0.05).The long diameter of LVOT in early systole was larger than in late systole(P＜0.05),but not significantly different compared with that in early and late diastole(both P＞0.05).No significant difference of the above parameters of STJ was found among different phases(all P＞0.05).At early systole,DA and the mean diameter of AA were both significantly smaller than those of DC(both P＜0.05).Conclusion AA parameters obtained with MDCT in patients with severe AS were valuable for selecting prosthetic valves during transcatheter aortic valve replacement.

Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

Objective:To explore the coordinated development status of the medical service supply-economy-society trinity systems in Zhejiang Common Prosperity Demonstration Zone,and to offer references for formulating policies conducive to the efficient and coordinated development of these three systems.Methods:Based on the panel data from 2013 to 2022,this research was conducted on the 11 prefectural-level cities in Zhejiang Province.Firstly,an evaluation index system for the three systems was established,and the entropy method was employed to determine the weights of each index and calculate the comprehensive evaluation index.Secondly,a triangular model was introduced to delineate the relative relationships among the three systems,and the coupling coordination degree model was utilized to disclose the coordination degree of the three systems.Finally,the spatial autocorrelation analysis method was applied to investigate the spatial autocorrelation of the coupling coordination degree of the three systems.Results:(1)On the whole,the development status of the three systems has improved over time,yet the comprehensive development level remains to be improved.(2)Overall,each prefectural-level city has transited from a medical service supply-society-dominated development to a balanced and coordinated development of the medical service supply-economy-society trinity systems.The coupling coordination degree of the three systems has risen from 0.468(on the verge of imbalance)in 2013 to 0.609(primary coordination)in 2022,presenting an upward trend in general.However,the coordination level remains to be improved and there exist imbalances among regions.(3)The coupling coordination degree of the three systems in Zhejiang Province exhibits a significant positive spatial correlation,and the spatial distribution characteristics are relatively stable. Conclusion:The coupling coordination degree of the medical service supply-economy-society trinity systems in Zhejiang Province awaits further enhancement. At the level of Zhejiang Province,favorable policy support should be provided,the layout of medical resources should be rationally planned,and high-quality economic and social development should be promoted. Each prefectural-level city should formulate strategies for medical service supply,economic,and social development in accordance with its own development level and local conditions,strengthen inter-city linkage and cooperation,and thereby elevate the coordinated development level of the three systems.

Aim To establish the pyroptosis model of rat chondrocytes induced by tumor necrosis factor α(TNF-α)in order to study the effect of lysine acetyl-transferase 7(KAT7)on pyroptosis of chondrocytes.Methods Chondrocytes of rat knee joint were isolated by type Ⅱ collagenase digestion,and were identified by toluidine blue staining and Col Ⅱ immunofluorescence.CCK-8 was used to evaluate cell viability.Western blot was used to detect the expression of pyroptosis-related proteins NLRP3,GSDMD,caspase-8 and KAT7 in cells intervened with TNF-α,adenovirus overexpression of KAT7(KAT7-oe)and KAT7 inhibitor WM-3835.The microstructure of the cells was observed by scanning e-lectron microscopy.Pyroptosis was detected by TUNEL staining,and the expression of pyroptosis-related pro-tein and KAT7 was detected by immunofluorescence.Results Compared with the empty virus group,KAT7-oe inhibited cell viability,promoted the expression of pyroptosis-related proteins,and TNF-α enhanced this effect.At the same time,the expression of KAT7 and pyroptosis-related proteins in the TNF-α stimulation group increased,and WM-3835 reduced the related proteins expression.Electron microscopy showed that KAT7-oe caused cell swelling,deformation,membrane perforation and rupture,while WM-3835 could restore cell morphology.TUNEL staining and immunofluores-cence results also confirmed that KAT7-oe induced chondrocyte pyroptosis,and WM-3835 could down-reg-ulate the fluorescence of pyroptosis-related proteins.Conclusions The expression of KAT7 increases in rat chondrocyte pyroptosis model,and the intervention of KAT7 expression affects signal molecules related to py-roptosis pathway,suggesting that KAT7 may be related to chondrocyte pyroptosis.

Oropharyngeal squamous cell carcinoma(OPSCC)is a malignant tumor originating from the squamous epithelium of the oro-pharyngeal mucosa,accounting for more than 90％of oropharyngeal malignancies.In recent years,human papillomavirus(HPV)infec-tion has become one of the primary etiological factors of oropharyngeal squamous carcinoma.The incidence of HPV-associated oropharyn-geal squamous carcinoma has been rising annually,with a noticeable trend toward younger populations,posing a significant threat to hu-man health.Due to the distinct biological behavior and clinical characteristics of HPV-associated oropharyngeal squamous carcinoma com-pared to its non-HPV-related counterpart,the diagnostic and treatment strategies for oropharyngeal squamous carcinoma have undergone substantial changes.Prevention and screening for oropharyngeal squamous carcinoma are of critical importance.The diagnostic and treat-ment process involves multi-disciplinary collaboration,including oral and maxillofacial surgery,otolaryngology,head and neck surgery,oncology,radiology and pathology.Based on evidence from clinical practice,a comprehensive,integrated diagnostic and therapeutic ap-proach has been established,centered around the concept of"prevention,screening,diagnosis,treatment,and rehabilitation",covering the entire patient lifecycle and providing a valuable reference for clinical practice.

[Purpose]To analyze the compliance of liver cancer clinical screening and related in-fluencing factors in Inner Mongolia from 2016 to 2018.[Methods]The liver cancer screening pro-gram was conducted among permanent residents aged 40～74 years old in Inner Mongolia from 2016 to 2018.The risk factor assessment questionnaire was used for primary screening,and the identified high-risk subjects of liver cancer were subject to undergo clinical screening including ul-trasound examination and serum AFP test.The clinical screening rate of high-risk subjects and de-tection rate were calculated and compared among different groups.Multivariate Logistic regression model was used to analyze influencing factors related to the clinical screening rate of liver cancer.[Results]A total of 70 109 residents completed questionnaires risk assessments from 2016 to 2018,and 11 211 subjects were identified as high-risk of liver cancer with the high-risk rate of 15.99％.Among 11 211 high-risk subjects,4 998 underwent clinical screening with a screening rate of 44.58％.There were 125 cases of AFP positive(2.50％),11 cases of occupying lesions in the liver(0.22％),6 cases of cirrhosis(0.12％),and 2 303 cases of fatty liver(46.08％).Multivariate Logistic regression analysis showed that female,age of 45～54 years old,Mongolians and other ethnic minorities,individuals with vegetables intake＜2.5 kg/week and ≥2.5 kg/week,high-fat diet,history of smoking,smoking,alcohol drinking,history of tea-drinking,history of psychologi-cal trauma and stress in recent years,diseases of hepatobiliary system,and chronic hepatitis B were more likely to participate in clinical screening(all P＜0.05).[Conclusion]The screening com-pliance of high-risk population for liver cancer is low but the detection rate is high in Inner Mongo-lia from 2016 to 2018.The program mechanism should be improved to increase the liver cancer screening compliance.

AIM To investigate the effects of Changpu Yujin Decoction(CPYJD)on striatal mitophagy and PINK1/Parkin signaling pathway in a rat model of Tourette syndrome(TS).METHODS Thirty-six SPF male SD rats were randomly assigned to the control group(n=9)and the TS modeling group(n=27).Rats in the modeling group received daily intraperitoneal injections of 3,3'-iminodipropionitrile(IDPN)(300 mg/kg)for 7 consecutive days to establish the TS model.Post-modeling,successfully induced TS rats were re-randomized into model group(no treatment),tiapride group(47.91 mg/kg)and CPYJD group(77.28 g/kg).All groups received their respective interventions via intragastric administration daily for 28 days.Following drug administration,behavioral scores were assessed in each group.Pathological alterations in the striatum were examined using HE staining,while ultrastructural changes were evaluated by transmission electron microscopy(TEM).Neuronal apoptosis was quantified via TUNEL staining,and ROS levels in striatum were measured by ELISA.Co-localization of PINK1 and LC3B was assessed using immunofluorescence(IF).Finally,mRNA and protein expressions of PINK1,Parkin,Beclin-1,P62 and LC3B(LC3B-Ⅱ/Ⅰ ratio)were analyzed by RT-qPCR and Western blot.RESULTS Compared to the control group,the model group demonstrated significantly increased behavioral scores(P＜0.01),elevated neuronal apoptosis rate and higher ROS levels in the striatum(P＜0.01);severe neuronal and mitochondrial damage in the striatum;significantly reduced mRNA and protein expressions of PINK1,Parkin,Beclin-1 and LC3B(LC3B-Ⅱ/Ⅰ ratio)in the striatum(P＜0.01);markedly upregulated P62 mRNA and protein expressions(P＜0.01).Compared to the model group,both the tiapride and CPYJD intervention groups exhibited significantly reduced behavioral scores(P＜0.01);decreased neuronal apoptosis rate and lower ROS levels(P＜0.01);improved pathological alterations in the striatal neurons and mitochondria;increased mRNA and protein expressions of PINK1,Parkin and Beclin-1 in the striatum(P＜0.05,P＜0.01);and decreased P62 mRNA and protein expressions(P＜0.01).Furthermore,the rats in the CPYJD group specifically showed elevated LC3B mRNA level and LC3B-Ⅱ/Ⅰ protein ratio in striatum(P＜0.05,P＜0.01).CONCLUSION The effect of CPYJD intervention in TS rats may involve activation of mitophagy through regulation of the PINK1/Parkin signaling pathway,improving mitochondrial function,reducing ROS levels,and thereby protecting neurons.

Objective To investigate the effect of exogenous luteinizing hormone (LH) on vitrification granulosa cells and its mecha-nisms. Methods The granulosa cells of 4-week-old preadolescent mice were selected and divided into the fresh group (without vitrification procedure),the vitrification group (treated according to vitrification procedure) and the LH group (treated with 0.3 IU/L of LH intervention on the basis of the vitrification group). Granulocyte count was performed,and Realtime PCR and Western blot were used to detect the expression changes of Foxl2,PI3K,AKT and mTOR mRNAs and proteins in each group. Results Compared with the vitrification group,the total number of granulosa cells in the LH group was significantly increased (P<0.05),and the expression of Foxl2,PI3K,AKT and mTOR mRNAs and proteins were elevated (P<0.05). Conclusion The intevention of exogenous LH is beneficial for the survival of vitrifi-cation granulosa cells,and the mechanism may be related to the activation of PI3K/AKT/mTOR pathway.