Objective To introduce a modified technique of right ventricular outflow tract (RVOT) reconstruction using a handmade bicuspid pulmonary valve crafted from expanded polytetrafluoroethylene (ePTFE) and to summarize the early single-center experience. Methods Patients with complex congenital heart diseases (CHD) who underwent RVOT reconstruction with a handmade ePTFE bicuspid pulmonary valve due to pulmonary regurgitation at Guangdong Provincial People’s Hospital from April 2021 to February 2022 were selected. Postoperative artificial valve function and right heart function indicators were evaluated. Results A total of 17 patients were included, comprising 10 males and 7 females, with a mean age of (18.18±12.14) years and a mean body weight of (40.94±19.45) kg. Sixteen patients underwent reconstruction with a handmade valved conduit, with conduit sizes ranging from 18 to 24 mm. No patients required mechanical circulatory support, and no in-hospital deaths occurred. During a mean follow-up period of 12.89 months, only one patient developed valve dysfunction, and no related complications or adverse events were observed. The degree of pulmonary regurgitation was significantly improved post-RVOT reconstruction and during follow-up compared to preoperative levels (P<0.001). Postoperative right atrial diameter, right ventricular diameter, and tricuspid regurgitation area were all significantly reduced compared to preoperative values (P<0.05). Conclusion The use of a 0.1 mm ePTFE handmade bicuspid pulmonary valve for RVOT reconstruction in complex CHD is a feasible, effective, and safe technique.

With the continuous advancement of modern medical technology,wearable patch ultrasound technology is emerging as a crucial tool for real-time and dynamic monitoring of visual information within the human body.This technology seamlessly integrates the precision of ultrasound with the convenience of wearable devices,enabling continuous and dynamic monitoring of internal physiological parameters,and providing a more accurate and efficient method for medical diagnosis and health monitoring.Wearable patch ultrasound can obtain the image information of human body in real time,including the structure and functional status of the heart,blood vessels,muscles,and bones,facilitating early disease detection and diagnosis.This review summarizes the major clinical application scenarios and frontier research advances of wearable patch ultrasound and discusses the opportunities and challenges in the future.

Fatty liver is common disease of nutritional metabolism in the perinatal period,character-ized by elevated levels of NEFA in the blood and disorders of lipid metabolism.High concentra-tions of NEFA damage mitochondria and promote the release of reactive oxygen species(ROS).At the same time,lipid peroxidation occurs in lipid accumulation in hepatocytes,producing free radi-cals such as ROS,which leads to oxidative stress in the liver.When the level of intracellular ROS increases,thioredoxin-interacting protein(TXNIP)activates nucleotide-binding oligomerization structure-like protein 3(NLRP3)inflammasomes,and oxidative stress can regulate pyroptosis,but it is unclear whether reactive oxygen species(ROS)produced by oxidative stress in hepatocytes can mediate pyroptosis and induce liver injury in dairy cows through the TXNIP/NLRP3 pathway.In this study,liver tissue samples from healthy dairy cows and fatty liver cows were collected,and NEFA was used to construct a fatty liver cell model,and triglyceride(TG)content and oxidative stress related indicators were detected by kit.Western blot was used to detect the activation of NL-RP3 inflammasomes,the inflammatory pathway of NF-κB and the expression levels of pyroptosis-related proteins.Fluorescence quantitative PCR was used to detect the relative expression level of inflammatory factor mRNA.The results showed that compared with the healthy(control)group,the TG content of fatty liver tissue and fatty liver cells was significantly increased(P＜0.05),the activities of SOD and GSH-Px were significantly decreased(P＜0.05),and the protein expression levels of TXNIP,NLRP3,GSDMD-N and Caspase-1 were significantly up-regulated(P＜0.05).The results of the antioxidant model of fatty hepatocytes using NEFA and antioxidants(NAC)showed that compared with the fatty hepatocyte model,the content of ROS in hepatocytes was sig-nificantly reduced,and oxidative stress,NLRP3 inflammasome activation and pyroptosis were alle-viated.In summary,this study found that when fatty liver disease occurs in dairy cows,ROS pro-duced by oxidative stress in the liver can mediate pyroptosis through the TXNIP/NLRP3 path-way,which can lead to liver injury in fatty liver cows.

Fatty liver is common disease of nutritional metabolism in the perinatal period,character-ized by elevated levels of NEFA in the blood and disorders of lipid metabolism.High concentra-tions of NEFA damage mitochondria and promote the release of reactive oxygen species(ROS).At the same time,lipid peroxidation occurs in lipid accumulation in hepatocytes,producing free radi-cals such as ROS,which leads to oxidative stress in the liver.When the level of intracellular ROS increases,thioredoxin-interacting protein(TXNIP)activates nucleotide-binding oligomerization structure-like protein 3(NLRP3)inflammasomes,and oxidative stress can regulate pyroptosis,but it is unclear whether reactive oxygen species(ROS)produced by oxidative stress in hepatocytes can mediate pyroptosis and induce liver injury in dairy cows through the TXNIP/NLRP3 pathway.In this study,liver tissue samples from healthy dairy cows and fatty liver cows were collected,and NEFA was used to construct a fatty liver cell model,and triglyceride(TG)content and oxidative stress related indicators were detected by kit.Western blot was used to detect the activation of NL-RP3 inflammasomes,the inflammatory pathway of NF-κB and the expression levels of pyroptosis-related proteins.Fluorescence quantitative PCR was used to detect the relative expression level of inflammatory factor mRNA.The results showed that compared with the healthy(control)group,the TG content of fatty liver tissue and fatty liver cells was significantly increased(P＜0.05),the activities of SOD and GSH-Px were significantly decreased(P＜0.05),and the protein expression levels of TXNIP,NLRP3,GSDMD-N and Caspase-1 were significantly up-regulated(P＜0.05).The results of the antioxidant model of fatty hepatocytes using NEFA and antioxidants(NAC)showed that compared with the fatty hepatocyte model,the content of ROS in hepatocytes was sig-nificantly reduced,and oxidative stress,NLRP3 inflammasome activation and pyroptosis were alle-viated.In summary,this study found that when fatty liver disease occurs in dairy cows,ROS pro-duced by oxidative stress in the liver can mediate pyroptosis through the TXNIP/NLRP3 path-way,which can lead to liver injury in fatty liver cows.

Objectives:To analyze the effects of preoperative traction and surgical osteotomy correction in patients with severe scoliosis(SS)accompanied by syringomyelia(SM),and explore the safety and efficacy of one-stage posterior osteotomy surgery following preoperative traction in treating patients with SS accompanied with SM(SS-SM).Methods:A retrospective study was conducted on 40 cases of SS-SM patients who under-went one-stage posterior osteotomy surgery following preoperative traction in our department from January 2007 to October 2023.There were 19 males and 21 females,aged 11 to 41 years(18.28±6.66 years).All the patients had no history of neurosurgical operational treatment and underwent full-spine X-rays,CT,and MRI examinations before surgery to measure the major curve angle on coronal plane,kyphosis angle on sagittal plane,length of SM,to evaluate whether combined with Chiari malformation,and to calculate the size of SM(maximal syrinx/cord ratio,S/C)and deformity angular ratio(DAR).During traction and after operation,full-spine X-rays were re-examined in a timely manner to assess the correction conditions of deformity.According to whether SM was accompanied with Chiari Ⅰ malformation(CM Ⅰ),the patients were divided into the CM Ⅰ-related SM group(CS group)and the idiopathic SM group(IS group);According to the size of SM,the pa-tients were also divided into the big syrinx group(BS group,S/C＞0.6)and the little syrinx group(LS group,S/C ≤0.6).The contribution rates of preoperative traction and surgery to correction were statistically analyzed and compared between different groups(CS group vs IS group,BS group vs LS group).Results:The S/C ratio of SM in 40 patients was 0.59±0.18,with a length of 9.43±5.50 segments.Preoperative skull-femoral traction(SFT)was performed in 36 cases,and halo-gravity traction(HGT)in 4 cases.During traction,5 cases experi-enced temporary local numbness,2 cases had temporary local muscle weakness,and 5 cases developed trac-tion nail tract infections.Low-grade osteotomy was performed in 29 cases(72.5％),and high-grade osteotomy with spinal shortening and fusion was performed in 11 cases(27.5％),with an average of 13.48±1.34 fusion segments.Postoperative complications included local trunk numbness in 2 cases,pulmonary infection in 4 cases,and superficial wound infection in 3 cases,with no motor dysfunction observed.The coronal main curve angle,sagittal kyphosis angle,and total DAR(T-DAR)before operation were 104.80°±18.58°,66.57°±31.21° and 25.73°±8.30°/segment,respectively,which were 65.55°±19.00°,44.95°±23.32° and 16.73°±7.24°/segment,respectively after traction.After correction operation,the scoliosis and kyphosis angles were 37.78°±14.91° and 29.95°±14.14°,respectively,with a main curve flexibility of(20.79±11.02)％.The total correction rates for coronal scoliosis and sagittal kyphosis were(64.44±9.44)％and(51.74±18.40)％,respectively.The av-erage contribution rates of traction and surgery to the correction of coronal scoliosis and sagittal kyphosis were(59.90±17.67)％and(40.10±17.67)％,and(59.21±27.51)％and(40.79±27.51)％,respectively.There were no significant differences in the total correction rates of scoliosis and kyphosis,or the contribution rates of traction and surgery to the correction of scoliosis and kyphosis between the CS and IS groups,and between the BS and LS groups.Preoperative traction improved the DAR by more than 34％and achieved a correction contribution rate of over 50％.The proportion of males was higher in the CS group,while the proportion of females was higher in the IS group(P=0.027).There were no statistical differences between the CS and IS groups in terms of age,preoperative main curve Cobb angle and flexibility,spinal kyphosis angle,DAR value,S/C ratio and SM length,traction improvement effect,total postoperative correction rate,number of fusion seg-ments,osteotomy grade,blood loss,operational duration,or the contribution rates of traction and surgery to spinal correction(P＞0.05).The average S/C ratio in the BS group was significantly higher than that in the LS group(0.74 vs 0.45,P＜0.001),the number of fusion segments was lower in the BS group than in the LS group(13.00 vs 13.90,P=0.031),and the proportion of high-grade osteotomy was higher in the BS group than in the LS group(8/19 vs 3/21,P=0.049).There were no statistical differences between the BS and LS groups in terms of age,preoperative main curve Cobb angle and flexibility,spinal kyphosis angle,DAR value,SM length,traction improvement effect,total postoperative correction rate,blood loss,operational duration,or the contribution rates of traction and surgery to spinal correction(P＞0.05).Conclusions:Preoperative traction can improve spinal deformity to a certain extent,reducing the difficulty of intraoperative correction and risks of neurological injury.For SS-SM patients,regardless of whether they are accompanied with CM Ⅰ or the size of SM,preoperative traction can contribute more than half of the deformity correction rate for coronal scoliosis and sagittal kyphosis.One-stage posterior osteotomy correction surgery following preoperative traction is a safe and effective treatment strategy for SS-SM patients who have not undergone preventive neurosurgical interven-tion.

Objective To observe the promoting effect of pulsed shortwave therapy on wound healing in pediatric patients with upper limb burns and explore its underlying mechanisms.Methods A total of 40 children with deep Ⅱ ° upper limb burns treated in our hospital from June 2021 to June 2023 were enrolled,and randomly divided into a control group and an observation group,with 20 cases in each group.The control group received conventional dressings,and the observation group received conventional dressings combined with pulsed shortwave therapy.The wound healing time,first appearance of skin islands on the wound,and initial number of skin islands were observed and recorded using a camera.The proportion of granulation tissue area in the wound was observed using eKare inSight 3D.The positive rate of wound bacteria was detected by collecting wound secretions for bacterial culture examination.Blood flow perfusion on the wound was measured using a blood flow meter.Results The observation group showed significantly faster wound healing and initial appearance of epithelialization(P＜0.05),and obviously higher rate of granulation tissue growth than the control group(P＜0.05).Moreover,the observation group demonstrated better control of bacterial infection in the wounds than the control group(P＜0.05).Blood flow measurement results revealed no significant increase in blood flow perfusion after pulsed shortwave therapy in the observation group(P＞0.05).However,with the elapse of time,both groups exhibited an increasing trend in blood flow perfusion(P＜0.05).Conclusion Pulsed shortwave therapy effectively promotes wound healing in pediatric patients with burns,by facilitating necrotic tissue clearance and granulation tissue regeneration,which may be associated with its non-thermal effects.

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of～260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Recently, sponsored by the Science Popularization Department of the China Anti Cancer Association, jointly organized by the Rehabilitation Branch of the China Anti Cancer Association and the Mijian Digital Cancer Patient Course Management Platform, and co-organized by the Science Popularization Special Committee of the China Anti Cancer Association, The "2022 White Paper on the Quality of Life of Chinese Lung Cancer Patients" has been officially released (herein after referred to as the "White Paper"), which mainly elaborates on the basic situation of Chinese lung cancer patients and the medical, social, and economic impacts caused by the disease. This article interprets the White Paper in order to help the public understand the real situation of lung cancer patients and provide important empirical evidence and valuable insights for the diagnosis, treatment, and rehabilitation of lung cancer in China.

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.