The global aging intensification has made geriatric wound repair a medical challenge. Diabetic foot and venous ulcers are highly prevalent and difficult to heal in the elderly population, seriously affecting patients′ quality of life and increasing medical burdens. The repair of geriatric wounds is constrained by multiple factors, including weakened regenerative capacity and immune dysfunction. Current research has gradually focused on mechanism analysis and precise intervention. Fibroblast growth factor (FGF) has been confirmed as a key factor in wound repair, and exogenous FGF can activate signaling pathways to promote wound healing. Exosomes have shown an important role in wound regeneration by promoting cell migration and proliferation, thereby accelerating the wound healing process. Geriatric wounds also face the challenge of drug-resistant bacterial infections, so future treatment strategies should combine microecological reconstruction and immune function recovery. Overall, research on geriatric wounds has formed a multidimensional repair framework aimed at activating the regenerative capacity of aging organisms.

Objective:To reveal the global evolution, cooperation models and research hotspots of wounds with drug-resistant bacterial infections in the elderly, and provide information support for future research directions.Methods:All literatures on wounds with drug-resistant bacterial infections in the elderly were retrieved from the Web of Science Core Collection. Bibliometric analysis was performed using CiteSpace and VOSviewer to visualize contributions from countries/regions, institutions, authors and journals, and to analyze keyword co-occurrence and temporal evolution.Results:After strict screening, a total of 130 literatures were included. Global research achievements on wounds with drug-resistant bacterial infections in the elderly showed a continuous growth. The United States was the main contributor in terms of the number of literatures, followed by Spain, Germany and the United Kingdom. However, international cooperation was still limited, and the institutional network was sparse. The most significant burst keywords at present included " risk factors", " methicillin-resistant", " inpatients", " molecular epidemiology", " Staphylococcus aureus", " long-term care facilities", " nosocomial infections", " mortality", " pressure ulcers", " complex wounds" and " emerging drug-resistant bacteria" .Conclusions:In the future, priority must be given to in-depth research on the pathogenesis of wounds with drug-resistant bacterial infections in the elderly (epidemiological investigation of drug-resistant bacterial infections in elderly patients, interaction between single cells of aging wounds and drug-resistant microbiome); verification of the mode and effect of stratified precise treatment through multi-country trials; and establishment of a professional database through data collection and multi-modal information integration.

The global aging intensification has made geriatric wound repair a medical challenge. Diabetic foot and venous ulcers are highly prevalent and difficult to heal in the elderly population, seriously affecting patients′ quality of life and increasing medical burdens. The repair of geriatric wounds is constrained by multiple factors, including weakened regenerative capacity and immune dysfunction. Current research has gradually focused on mechanism analysis and precise intervention. Fibroblast growth factor (FGF) has been confirmed as a key factor in wound repair, and exogenous FGF can activate signaling pathways to promote wound healing. Exosomes have shown an important role in wound regeneration by promoting cell migration and proliferation, thereby accelerating the wound healing process. Geriatric wounds also face the challenge of drug-resistant bacterial infections, so future treatment strategies should combine microecological reconstruction and immune function recovery. Overall, research on geriatric wounds has formed a multidimensional repair framework aimed at activating the regenerative capacity of aging organisms.

Objective:To reveal the global evolution, cooperation models and research hotspots of wounds with drug-resistant bacterial infections in the elderly, and provide information support for future research directions.Methods:All literatures on wounds with drug-resistant bacterial infections in the elderly were retrieved from the Web of Science Core Collection. Bibliometric analysis was performed using CiteSpace and VOSviewer to visualize contributions from countries/regions, institutions, authors and journals, and to analyze keyword co-occurrence and temporal evolution.Results:After strict screening, a total of 130 literatures were included. Global research achievements on wounds with drug-resistant bacterial infections in the elderly showed a continuous growth. The United States was the main contributor in terms of the number of literatures, followed by Spain, Germany and the United Kingdom. However, international cooperation was still limited, and the institutional network was sparse. The most significant burst keywords at present included " risk factors", " methicillin-resistant", " inpatients", " molecular epidemiology", " Staphylococcus aureus", " long-term care facilities", " nosocomial infections", " mortality", " pressure ulcers", " complex wounds" and " emerging drug-resistant bacteria" .Conclusions:In the future, priority must be given to in-depth research on the pathogenesis of wounds with drug-resistant bacterial infections in the elderly (epidemiological investigation of drug-resistant bacterial infections in elderly patients, interaction between single cells of aging wounds and drug-resistant microbiome); verification of the mode and effect of stratified precise treatment through multi-country trials; and establishment of a professional database through data collection and multi-modal information integration.

Objective:To study the antibacterial properties and in vivo and vitro biocompatibility of Cu-Fe-Zn alloy microfilament dressings, and to evaluate their wound healing promoting effect through clinical application.Methods:We evaluated the comprehensive antibacterial performance of dressings in vitro using plate counting method; After co culturing the extract of Cu-Fe-Zn alloy microfilament dressings with epidermal cells (HaCaT) and fibroblasts (NIH-3T3), their in-vitro biocompatibility was determined through the cell counting kit-8 (CCK-8) test; Further, Cu-Fe-Zn alloy microfilament dressing was applied to the wound surface of diabetes mice to test the biocompatibility of the material in vivo; Through a prospective randomized controlled trial, 50 burn and trauma patients admitted to the Burn and Plastic Surgery Department of the Third Xiangya Hospital of Central South University were selected and divided into an observation group of 25 patients and a control group of 25 patients. The observation group was treated with Cu-Fe-Zn alloy microfilament dressing, and the control group was treated with silver nanoparticle antibacterial dressing. The wound healing time and wound treatment effect of the two groups were compared.Results:The Cu 2+ release concentration of Cu-Fe-Zn alloy microfilament dressings detected by inductively coupled plasma-mass spectrometry (ICP-MS) was 1.3 μ g/ml, which had the effect of promoting the proliferation of HaCaT and NIH-3T3 cells (all P<0.05). The antibacterial rate of Cu-Fe-Zn alloy microfilament dressing against pseudomonas aeruginosa, escherichia coli and staphylococcus aureus reached 100%. The wound healing rate [(87.39±1.83)%] of diabetes mice treated with Cu-Fe-Zn alloy microfilament dressing was significantly higher than that of the control group [(58.66±3.54)%, P<0.05]. The inflammatory response of the wound tissue was relatively mild and the wound margin matrix was intact. The wound healing time of 25 patients treated with Cu-Fe-Zn alloy microfilament dressing [(23.52±10.02)d] was shorter than that of the control group [(40.84±21.22)d] ( t=17.159, P<0.001), and the overall treatment response rate of patients (96%) was significantly higher than that of the control group patients (64%) (χ 2=8.472, P=0.015). Conclusions:Cu-Fe-Zn alloy microfilament dressings have good antibacterial properties and biocompatibility, and have significant therapeutic effects on promoting wound healing. They not only effectively promote wound healing but also exert anti infection effects, and are expected to be a new type of wound repair dressing.

Ulcerative colitis (UC) is a chronic nonspecific inflammatory bowel disease that is considered to be multifactorial with environmental factors, genetic basis, intestinal immune regulation and intestinal flora. The appendix may effect intestinal immune system regulation and microecological stability. Previous studies indicated appendectomy may reduce the risk of UC incidence and alleviate the severity of the disease. And appendectomy for relapsed and refractory UC may have a certain therapeutic effect. However, appendectomy as a treatment for UC is still controversial. This article discusses the impact of appendectomy on UC in the view of disease incidence, disease course, and basic research.

Ulcerative colitis (UC) is a chronic nonspecific inflammatory bowel disease that is considered to be multifactorial with environmental factors, genetic basis, intestinal immune regulation and intestinal flora. The appendix may effect intestinal immune system regulation and microecological stability. Previous studies indicated appendectomy may reduce the risk of UC incidence and alleviate the severity of the disease. And appendectomy for relapsed and refractory UC may have a certain therapeutic effect. However, appendectomy as a treatment for UC is still controversial. This article discusses the impact of appendectomy on UC in the view of disease incidence, disease course, and basic research.

Objective To investigate the clinical treatment strategy of large and giant pituitary adenomas invading the cavernous sinus.Methods One hundred and nine patients with large and giant pituitary adenomas invading the cavernous sinus,admitted to our hospital from January 2010 to December 2018,were chosen in our study.Four patients with prolactin-type pituitary adenomas received oral treatment with bromocriptine;the remaining 105 patients received surgical treatment,and choices of surgical approach were based on classification of pituitary adenomas.The clinical data and efficacies of these patients accepted different treatment approach were retrospectively analyzed.Results Of the 105 patients with pituitary adenomas,63 (60％) were of type Ⅰ,15 (14.3％) were of type Ⅱ,18 (17.1％)were of type Ⅲ,and 9 (8.6％) were of type Ⅳ.Single extended transsphenoidal approach was used in 75 patients,transcranial approach was used in 26 patients,and combined extended transsphenoidal and transcranial approach was used in 4 patients.Gross total tumor resection was achieved in 86 patients,subtotal resection in 17 patients,and partial resection in two patients.Ten patients had new cranial nerve palsy after surgery,including 7 with oculomotor nerve palsy and three with abductor nerve palsy;two patients with preoperative neurological paralysis were aggravated,and both of them were oculomotor nerves;transient insipidus was noted in 19 patients and electrolyte disorder was noted in 23 patients;no permanent insipidus,cerebrospinal fluid leakage or intracranial infection,and no new or aggravated visual field vision disorder were noted.Conclusion Reasonable clinical treatment strategies and appropriate microsurgical approaches can achieve good therapeutic effect in patients with large and giant pituitary adenomas invading the cavernous sinus.

Objective: To explore the association between methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C gene polymorphisms and toxicity of Methotrexate(MTX) chemotherapy in pediatric acute lymphoblastic leukemia (ALL). Methods: From January 2015 to June 2018, 128 pediatric patients with ALL in southern Fujian who were admitted at the First Affiliated Hospital of Xiamen University were selected.Their peripheral blood 2 mL was collected and genomic DNA was extracted.The MTHFR genotype was detected by polymerase chain reaction(PCR) direct sequencing method, and the clinical significance of HD-MTX on ALL children with toxic and side effects was evaluated according to the National Cancer Institute-Common Toxicity Criteria. Results: Among 128 children, 54 cases(42.2%) presented rash, 48 cases (37.5%)with mucosal lesions, 51 cases (39.8%) with liver function damage, 23 cases (18.0%) with renal function damage, 52 cases (40.6%) with gastrointestinal reactions, 38 cases (29.7%)with leukopenia, 34 cases (26.6%) with thrombocytopenia and 63 cases (49.2%) with hemoglobin reduction.There was no significant difference in the incidence of MTX adverse reactions (rash, mucosa lesions, liver and renal function damage, gastrointestinal reaction, leukopenia, hemoglobin decrease and thrombocytopenia) between the MTHFR C677T and A1298C polymorphisms (all P>0.05). The different clinical risk (MTX dose) of the children was not statistically signi-ficant in the MTHFR C677T and A1298C genotypes and allele frequencies (χ²=2.573, 2.264, 1.615, 0.267; all P>0.05). There was no significant difference among the abnormal incidence of MTX at 24 h, 48 h and 72 h (all P>0.05). Conclusions MTHFR C677T and A1298C polymorphisms do not seem to be good markers of MTX-related toxicity and/or outcome in pediatric ALL in southern Fujian, and its clinical application still needs further discussion.

Objective To evaluate the association between methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and susceptibility to methotrexate (MTX) adverse reaction in children with acute lymphoblastic leukemia (ALL) chemotherapy. Method The data bases of The Cochrane Library, PubMed, EMbase, EMCC, OVID, CNKI, VIP and WanFang Data were searched for relevant articles published in English and Chinese up to March 2016. Two researchers independently screened literature, extracted data, and assessed bias risk in the included studies. The RevMan 5.3 and Stata 12 software were used to analyze the association between gene polymorphism and the adverse reaction of MTX chemotherapy with the recessive, dominance, co-dominance, addition and allele gene model respectively. Results A total of 12 studies were included and all of them were case-control study, with 1419 cases in case group and 2188 cases in control group. The results of meta-analysis showed that the MTHFR gene polymorphism was unrelated to the untoward effect of neutropenia, thrombocytopenia, hemoglobin reduction, mucosal damage and liver function damage during MTX chemotherapy in children with ALL under the 5 analytical models. Under the co-dominance gene model, the association between MTHFR polymorphism C677T and overall adverse reaction of MTX was statistically significant (OR=1.39, 95％CI: 1.02～1.91, P=0.04). In the recessive gene model, the C677T polymorphism of MTHFR was associated with a reduced risk of gastrointestinal adverse reactions during MTX chemotherapy (OR=3.31, 95％CI: 1.03～10.59, P=0.04). In the dominance gene model, the C677T polymorphism of MTHFR was associated with a reduced risk of skin damage induced by MTX chemotherapy (OR=3.05, 95％CI: 1.25～7.41, P=0.01). Conclusion There is no significant association between the C677T polymorphism of MTHFR and the adverse effects of MTX chemotherapy, butfurther studies with larger sample size are needed.