Scarring is a key issue in plastic surgery research and there are limitations in the clinical outcomes of existing scar treatments.Autologous fat grafting is a new method that has been clinically proven to be effective in the treatment of pathological scarring.Autologous fat grafts contain adipose-derived mesenchymal stem cells and a variety of active factors that can effectively improve the appearance,texture and local symptoms of keloid scars through the mechanisms of immunomodulation of the inflammatory response,pro-angiogenesis,pro-cellular differentiation,extracellular matrix remodelling and resistance to oxidative stress damage,etc.It has the advantages of fewer complications and better therapeutic effect,and is a brand new field of keloid scar,which provides a new therapeutic direction for the keloid scar.The new field of scar treatment provides a new direction for scar treatment.The application and mechanism of autologous fat grafting in keloid scar is now reviewed,with the aim of providing a theoretical basis for the treatment of keloid scar and summarising the progress of its application in keloid scar treatment.

Objective To investigate the therapeutic effect of folic acid combined with decitabine in diabetic retinop-athy(DR)mice with different methylenetetrahydrofolate reductase(MTHFR)genotypes.Methods The DR model mice were created by mating 20 MTHFR-/-mice with 20 wild-type C57 mice.A random number table method was employed to allocate 20 successfully modelled mice into the model group,DAC group,FA group,and FA+DAC group,with five mice assigned to each group.Five untreated MTHFR-/-and wild-type mice served as normal control.After constructing the DR model,the DAC group was injected intraperitoneally with 0.25 mg·kg-1 decitabine once every 5 days;the FA group was given 70 μg·kg-1 folic acid by tube feed once a day;the FA+DAC group was given 0.25 mg·kg-1 decitabine and 70μg·kg-1 folic acid at the same time;and the normal group was given an equal amount of physiological saline.All of the above groups were intervened for 30 days.OCT was employed for the measurement of retinal thickness,OCTA for retinal vascular density,histopathology(HE staining)for pathological changes in the mouse retina,real-time fluorescence quanti-tative PCR for mRNA expression,and Western blot analysis for protein expression levels.Results Compared with the wild-type model group,the degree of increase in retinal thickness and vascular density in the retinal layer was more pro-nounced in the MTHFR-/-mice model group(all P＜0.05).In wild-type mice,retinal thickness and retinal layer vessel den-sity were reduced in the DAC,FA and FA+DAC groups compared to the model group,with the FA+DAC group show-ing the greatest degree of reduction.The differences were all statistically significant(all P＜0.05);In MTHFR-/-mice,reti-nal thickness and vascular density in the retinal layer were reduced in the DAC group and the FA+DAC group compared to the model group(allP＜0.05).HE staining results showed an increased extent of retinal damage in the MTHFR-/-mice model group compared with the wild-type mice model group.Compared with the model group,the DAC group and the FA+DAC group had thinner retinas and more aligned ganglion cell layers in all types of mice,with the FA group having a worse effect and the FA+DAC group having a better treatment effect.The results of the polymerase chain reaction(PCR)revealed that the relative expression of the SAHH,MAT2A and DNMT1 proteins in the retinal tissues of the wildtype and MTHFR-/-mice model groups was elevated in comparison to the control group(all P＜0.05).Furthermore,the relative mR-NA expression of the DAC,FA and FA+DAC groups was reduced in comparison to the model group(all P＜0.05).In wild-type mice,the relative expression of MTHFR protein mRNA was decreased in the model group compared with the con-trol group,and increased in the DAC group,FA group,and FA+DAC group compared with the model group(all P＜0.05).Western blot results showed that the relative expression of DNMT1,MAT2A and SAHH proteins in the retinal tissues of the wild-type and MTHFR-/-mice model groups was higher than that of the control group(all P＜0.05),and the relative expression was lower in the DAC,FA,and FA+DAC groups compared with that in the model group(all P＜0.05).In wild-type mice,the relative expression of MTHFR protein in the retinal tissue of the model group was lower than that of the control group,and the relative expression of MTHFR protein in the FA group and the FA+DAC group was elevated com-pared with that of the model group(all P＜0.05).Conclusion The protective effect of folic acid combined with decit-abine on DR was superior to that of decitabine alone;treatment with folic acid in combination with decitabine may have yielded better efficacy in wild-type DR mice.

Objective:Interpret the key differences between the China Health-care Security Diagnosis Related Groups(CHS-DRG)2.0 and CHS-DRG 1.1,and provide reference for optimizing management strategies in medical institutions.Methods:Text analysis was used to import the CHS-DRG 2.0 and 1.1 grouping scheme dictionary data into the SQL database in a structured table format using SQL Server 2014.The key differences between the two schemes in grouping structure,grouping rules,grouping results,and other aspects were identified.Results:CHS-DRG 2.0 version added 26 groups,deleted 3 groups,and refined 10 groups into 20 groups for 14 clinical specialties at the ADRG level compared to CHS-DRG 1.1.Some group codes,names,and grouping rules were adjusted;Adjusted some grouping conditions and grouping results at the DRG level.Conclusion:CHS-DRG 2.0 version has improved grouping efficiency compared to CHS-DRG 1.1,solved some clinical bottleneck problems,and standardized the role of clinical diagnosis in grouping from the perspective of resource consumption.However,it has not completely solved the grouping problems of multi disease co treatment,multi disease treatment,and combined surgery.The adjustment of DRG weights and rates,the follow-up of related supporting policy reforms,and the negative effects of DRG will still pose challenges for medical institutions.

Objective To investigate the impact of immunohistochemical detection of omentin-1(omentin-1),secreted phosphoprotein 1(SPP1),and mismatch repair(MMR)protein expression status on the clinicopathological characteristics and prognosis of endometrial cancer(EC),in order to provide references for disease assessment,prognosis evaluation,and the development of molecular targeted therapies.Methods A total of 159 patients diagnosed with EC who were admitted to our hospital between December 2019 and December 2021 were enrolled as the study group.Additionally,152 samples of normal endometrial tissue were collected from patients undergoing hysterectomy due to benign uterine diseases and served as the control group.The expression levels of omentin-1,SPP1,and MMR proteins in endometrial tissues were compared among the study group,the control group,and EC patients with different clinicopathological characteristics and prognostic outcomes.Spearman correlation analysis was performed to evaluate the correlations among these biomarkers in EC tissues.The influencing factors of EC prognosis were analyzed through multivariate logistic regression.Kaplan-Meier survival curves were constructed to assess the association between the expression of these proteins and patient prognosis.Results The positive expression rate of SPP1 and the MMR deletion rate in endometrial tissues of the study group were significantly higher than those in the control group(P<0.05),while the positive expression rate of omentin-1 in endometrial tissues was significantly lower than that in the control group(P<0.05).In patients with EC exhibiting myometrial invasion≥1/2,the proportion of omentin-1 negativity was lower compared to omentin-1 positivity(P<0.05).Among EC patients with poorly differentiated tumors,the rates of SPP1 positivity and MMR deficiency were significantly increased(P<0.05).Spearman correlation analysis revealed that omentin-1 expression was negatively correlated with both MMR protein deletion and SPP1 overexpres-sion(P<0.05),whereas MMR deficiency was positively correlated with SPP1 overexpression(P<0.05).In the poor prognosis group,the positive expression rate of SPP1 and the deletion rate of MMR were elevated,while omentin-1 expression was reduced in endometrial tissues(P<0.05).The results of multivariate logistic analysis showed that omentin-1 negative,SPP1 positive,and MMR deletion were risk factors for the prognosis of EC patients(P<0.05).Kaplan-Meier survival curves were constructed based on follow-up data(Figures 1-3),indicating that patients with omentin-1 negativity,SPP1 positivity,and MMR deficiency had significantly worse prognoses(P<0.05).Conclusions With the development and progression of the clinicopathological features of EC,abnormalities were observed in the immunohistochemical expression of omentin-1,SPP1,and MMR proteins.Specifically,omentin-1 negativity,SPP1 positivity,and MMR protein deletion were associated with a poorer prognosis in EC patients.

A total of 1 557 cases were included in the Febrile Respiratory Syndrome (FRS) surveillance conducted in Daxing District between 2018 and 2023. Twelve respiratory pathogens were investigated: human influenza virus (HIFV), human respiratory syncytial virus (HRSV), human parainfluenza virus (HPIV), human rhinovirus (HRV), human enterovirus (HEV), human adenovirus (HadV), human metapneumovirus (HMPV), human bocavirus (HBoV), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), human coronavirus (HCoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results demonstrated an overall pathogen detection rate of 25.31% (394/1 557), with descending prevalence as follows: HIFV, SARS-CoV-2, HRV, HPIV, MP, HCoV, HRSV, HEV, HMPV, HadV, HBoV, and CP. Temporal analysis revealed detection rates of 26.98% (150/556) for 2018-2019, 15.81% (95/601) for 2020-2022, and 37.25% (149/400) for 2023, showing statistically significant interannual variation (χ2=59.703, P<0.001). Compared with 2018-2019, 2023 exhibited significantly elevated detection rates for HIFV and HMPV ( P<0.05), while HRV, MP, HEV, and HBoV demonstrated significantly reduced rates ( P<0.05). Age-stratified analysis identified HIFV, HRSV, and HadV as the predominant pathogens in individuals aged <15 years, whereas SARS-CoV-2, HIFV, and HRV predominated in those aged ≥60 years.

This experiment was conducted to study the effects of replacing feed protein by Herme-tia illucens larvae meal on immune function,intestinal morphology and microflora of Sichuan white geese.A total of 64 healthy 1-day-old Sichuan white geese were randomly allocated into 4 groups with 4 replicates in each group and 4 geese in each replicate,namely the control group,the 2％HILM,4％HILM and 8％HILM groups fed diets contained 0％,2％,4％and 8％of HILM,re-spectively.The experimental period was 40 days.The results showed that compared with the con-trol group,8％HILM increased the levels of serum IgG1,IgG2a and complement C3,and the difference was statistically significant(P＜0.01).4％HILM significantly increased the expression level of CD4(P＜0.05),and 8％HILM significantly increased the expression level of IL-10(P＜0.05).The ratio of villus length to crypt depth(VH/CD)in the jejunum and ileum in 4％HILM group was significantly increased(P＜0.05).The SIgA level of jejunum was significantly increased in all HILM replacement groups(P＞0.05).The abundance of Bacteroides in 4％HILM group were extremely significantly increased(P＜0.01),and the abundance of Bilophila and Bilophila wadsworthia were significantly decreased in all HILM replacement groups(P＜0.05).In conclu-sion,HILM can enhance the immune function of Sichuan white geese,improve the intestinal mor-phology of jejunum and ileum,enhance the local mucosal immunity of jejunum,increase the abun-dance of beneficial bacteria in cecum and decrease the abundance of harmful bacteria in cecum,and protect intestinal health.

Danggui Buxue decoction(DBD)is a classic prescription with immunomodulatory and hematopoietic effects.Previous studies have shown the DBD has potential to be used as an oral im-mune booster.However,its immunomodulatory effects and mechanism of action have not been thoroughly studied,especially the protective mechanism of immunomodulatory regulation in the state of immunosuppressive is still unclear.The aim of this study was to explore the protective mechanism of DBD in the immunosuppressive state using network pharmacology combined with animal experiments verification.The active components,core targets and signaling pathways of DBD in treating immunosuppression were obtained using network pharmacology tools.On this ba-sis,the active components of DBD were identified using HPLC-MS,and in vivo studies were con-ducted at the same time.The key active components of DBD obtained using network pharmacology included quercetin,kaempferol and formononetin.The core targets included TP53,RELA,TNF,AKT1,and IL-6.KEGG pathway enrichment analysis showed that phosphoinositide 3-kinase(PI3K)-protein kinase B(AKT)may play an important role in the treatment of immunosuppres-sive diseases using DBD.Molecular docking confirmed that each core target had good binding activ-ity with its corresponding compounds.Animal experiments showed that after DBD intervention,the mRNA gene and protein expression of RELA,TNF,and IL-6 in the serum was significantly down-regulated.The mRNA expression of PI3K and AKT in the ileum and PI3K protein expression were also downregulated.In conclusion,DBD exerts its role in treating immunosuppressive diseases by regulating the PI3K-AKT signaling pathway.

To explore the effect of Macleaya cordata extract(MCE)on growth performance and serum biochemistry of Sichuan White Geese,and to analyze its mechanism of action by network pharmacology and molecular docking technology combined with animal experiments verification.A total of 90 1-day-old healthy goslings were randomly divided into 5 groups with 18 goslings per group after 5 d of adaptive feeding.The control group(CON)was fed with basal diet,the antibiotic group(CTC)was supplemented with 450 mg/kg chlortetracycline premix,and the low MCE group(MCEL),medium MCE group(MCEM)and high MCE group(MCEH)were supple-mented with 200,300 and 400 mg/kg MCE,respectively.The experimental period was 21 d.On the basis of the above experiments,Network pharmacology and molecular docking technology were used to predict the core targets and signaling pathways of MCE to promote geese growth from the levels of antioxidant,immune and apoptosis,and the expression levels of the core target genes were detected by Real-time fluorescence quantitative PCR.The results showed that compared with the CON group,MCE supplementation could increase the average daily weight gain,decrease the ratio of feed to gain,significantly increase the contents of serum GH,T3,T4,TP and ALB(P＜0.05),and significantly decrease the contents of serum AST and TG(P＜0.05).Network pharmacology analysis predicted 2 active ingredient and 237 active ingredient targets,and concluded that the mechanism of MCE promoting the growth of Sichuan White Geese may be related to the role of 5 key targets such as SRC,HSP90AA1,CASP3,ESR1 and MAPK14,and the action of MAPK,apop-tosis and other signaling pathways.Molecular docking results showed that the active ingredients of sanguinarine and chelerythrine in MCE could act through MAPK14.The validation results of core targets showed that MCE could significantly reduce the mRNA expression levels of CytC,CASP2,CASP3 and CASP9 in spleen(P＜0.05)and significantly increase the mRNA expression levels of Mcl-1(P＜0.05).These results indicated that MCE could promote the growth performance of Si-chuan White Geese by regulating apoptosis,promoting the secretion of serum growth-related hor-mones and improving biochemical indicators.

Objective:To investigate the efficacy and safety of off-label use of flow diverters (FDs) in aneurysms beyond the circle of Willis.Methods:Seventy-one patients with aneurysms beyond the circle of Willis treated with FDs from January 2016 to September 2023 at Department of Cerebrovascular Surgery, Neurosurgery Center (Zhujiang Hospital of Southern Medical University), Department of Neurosurgery (Guangdong Provincial People's Hospital), Department of Neurosurgery (First Affiliated Hospital of Chongqing Medical University), and Department of Neurosurgery (Beijing Tiantan Hospital, Capital Medical University) were selected. The clinical and imaging data of these patients were analyzed retrospectively, and the clinical characteristics, aneurysm characteristics, endovascular treatments, perioperative complications, and clinical and imaging follow-up results were summarized and analyzed.Results:Among the 71 patients, 22 (31.0%) had ischemic stroke history and 43 (60.6%) had hypertension history. A total of 76 aneurysms were found, including 5 aneurysms (6.6%) at the anterior communicating artery, 10 (13.2%) at the anterior cerebral artery, 53 (69.7%) at the middle cerebral artery, and 8 (10.5%) at the posterior cerebral artery. The median aneurysm size (Inter Quartile Range) was 5.65 (3.63, 10.12) mm, and mean diameter of the parent artery was (2.70±0.57) mm. A total of 80 FDs were used, including 38 (47.5%) Pipeline embolization devices and 42 (52.5%) Tubridge embolization devices; the implantation success rate was 98.8% (79/80). Seven patients (9.9%) had perioperative complications, of which 2 (2.8%) were permanent (1 patient with visual field defect and 1 patient with intracranial hemorrhage). Seventy-one patients had clinical follow-up for (19.73±11.90) months, of which 68 patients (95.8%) had good outcome (modified Rankin scale score of 0-2), 10 patients (14.1%) had ischemic complications, and one patient (1.4%) had hemorrhage complications. Sixty-seven aneurysms (88.2%) underwent angiographic follow-up for 7 (6-12) months, of which 44 aneurysms (65.7%) were completely occluded and 10 (14.9%) had in-stent stenosis.Conclusion:The results of this study preliminarily confirm that off-label use of FDs is relatively safe and effective in aneurysms beyond the circle of Willis.

Objective:To evaluate the efficacy and safety of intrasaccular flow disruptor in wide-necked intracranial aneurysms.Methods:One hundred and seventeen patients with wide-necked intracranial aneurysms treated with intrasaccular flow disruptor were collected from Department of Neurointervention (First Affiliated Hospital of Zhengzhou University), Department of Neurosurgery (Beijing Tiantan Hospital, Capital Medical University), Department of Cerebrovascular Surgery, Neurosurgery Center (Zhujiang Hospital, Southern Medical University), and Department of Neurosurgery (First Affiliated Hospital of Harbin Medical University) from August 2022 to March 2024. Raymond-Roy Occlusion Classification (RROC) was employed to evaluate aneurysm embolization immediately after procedure; cranial CT or MRI within 48 hours of embolization were performed to identify any new intracranial hemorrhage, subarachnoid hemorrhage, or new symptomatic cerebral infarction related to the intracranial aneurysms. Modified Rankin Scale (mRS) was used to assess the neurological function at discharge. Imaging follow-up and outpatient follow-up were performed at 6 months after embolization to evaluate the aneurysm occlusion degree and complications.Results:A total of 117 intrasaccular flow disruptors were implanted in 117 patients, with a technical success rate of 100%; 115 patients (98.3%) enjoyed successful one-time release of their disruptors, and 2 patients (1.7%) required retrieval and redirection of the disruptors before second successful attempt. Flow disruptor plus stent was performed in 13 patients (11.1%). Immediately after procedure, RROC grading I was noted in 3 patients, grading II in 51 patients and grading III in 63 patients. Cranial CT or MRI within 48 hours of embolization indicated no new intracranial hemorrhage, subarachnoid hemorrhage, or symptomatic cerebral infarction related to the intracranial aneurysms. All patients had mRS score of 0 at discharge. Eighty-three patients completed a 6-month follow-up (RROC grading I in 41 patients, grading II in 33 patients and grading III in 9 patients), without ischemic or hemorrhagic adverse events.Conclusion:The results of this study preliminarily suggest that intrasaccular flow disruptor is effective and safe in wide-necked intracranial aneurysms.