Bone regeneration is pivotal for restoring bone homeostasis,involving the coordinated collaboration of diverse cell types in a complex and heterogeneous process.Elucidating the molecular mechanisms at each stage to develop novel bone regeneration strategies represents a key direction in this field.Traditional high-throughput sequencing examines bulk transcriptomes,losing cellular-level resolution.Single-cell RNA sequencing(scRNA-seq)technology enables the analysis of subpopulation heterogeneity by revealing RNA expression profiles at the single-cell level.Based on single-cell atlases,researchers can further employ specific algorithms to simulate cellular differentiation trajectories,facilitating more profound mechanistic investigations.Utilizing this technology,critical cell subpopulations involved in long bone and craniofacial bone regeneration have been identified,characteristic cellular markers and potential diagnostic indicators have been defined,regenerative differences under inflammatory or aging conditions have been compared,the osteogenic mechanisms involved in guided bone regeneration procedures have been explored,and the differential bone-promoting effects of various biomaterials have been revealed.This review summarizes the applications of scRNA-seq in long bone and craniofacial bone regeneration,as well as in bone tissue engineering.It highlights its contributions in deciphering cellular heterogeneity,gene regulation,and microenvironmental interactions,consolidates key cell subpopulations and their functions identified through sequencing,and discusses current research limitations.Furthermore,it outlines future prospects for this technology in bone regeneration research,offering new perspectives for subsequent studies.

Bone regeneration is pivotal for restoring bone homeostasis,involving the coordinated collaboration of diverse cell types in a complex and heterogeneous process.Elucidating the molecular mechanisms at each stage to develop novel bone regeneration strategies represents a key direction in this field.Traditional high-throughput sequencing examines bulk transcriptomes,losing cellular-level resolution.Single-cell RNA sequencing(scRNA-seq)technology enables the analysis of subpopulation heterogeneity by revealing RNA expression profiles at the single-cell level.Based on single-cell atlases,researchers can further employ specific algorithms to simulate cellular differentiation trajectories,facilitating more profound mechanistic investigations.Utilizing this technology,critical cell subpopulations involved in long bone and craniofacial bone regeneration have been identified,characteristic cellular markers and potential diagnostic indicators have been defined,regenerative differences under inflammatory or aging conditions have been compared,the osteogenic mechanisms involved in guided bone regeneration procedures have been explored,and the differential bone-promoting effects of various biomaterials have been revealed.This review summarizes the applications of scRNA-seq in long bone and craniofacial bone regeneration,as well as in bone tissue engineering.It highlights its contributions in deciphering cellular heterogeneity,gene regulation,and microenvironmental interactions,consolidates key cell subpopulations and their functions identified through sequencing,and discusses current research limitations.Furthermore,it outlines future prospects for this technology in bone regeneration research,offering new perspectives for subsequent studies.

OBJECTIVE: To testify the spatial relationship between the subscapularis muscle splitting window and the axillary nerve in modified arthroscopic Latarjet procedure, which could provide anatomical basis for the modification of the subscapularis muscle splitting. METHODS: A total of 29 adult cadaveric shoulder specimens were dissected layer by layer, and the axillary nerve was finally confirmed to walk on the front surface of the subscapularis muscle. Keeping the shoulder joint in a neutral position, the Kirschner wire was passed through the subscapularis muscle from back to front at the 4 : 00 position of the right glenoid circle (7 : 00 position of the left glenoid circle), and the anterior exit point (point A, the point of splitting subscapularis muscle during Latarjet procedure) was recorded. The vertical and horizontal distances between point A and the axillary nerve were measured respectively. RESULTS: In the neutral position of the shoulder joint, the distance between the point A and the axillary nerve was 27.37 (19.80, 34.55) mm in the horizontal plane and 16.67 (12.85, 20.35) mm in the vertical plane. CONCLUSION In the neutral position of the shoulder joint, the possibility of axillary nerve injury will be relatively reduced when radiofrequency is taken from the 4 : 00 position of the right glenoid (7 : 00 position of the left glenoid circle), passing through the subscapularis muscle posteriorly and anteriorly and splitting outward.
Adult ; Humans ; Shoulder ; Rotator Cuff/surgery* ; Arthroscopy/methods* ; Scapula/surgery* ; Shoulder Joint/surgery* ; Cadaver ; Joint Instability/surgery*

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

A 68-year-old male patient with severe active ulcerative colitis developed sleep disorder after using hormone pulse therapy. He received dexzopiclone 3 mg orally once a night to improve sleep. On the next day of medication, the patient developed ataxia symptoms such as dizziness, head drooping, and body skewing when walking, etc. The patient had a history of Parkinson′s syndrome and treatment effect of levodopa and benserazide hydrochloride was good. Dyskinesia caused by levodopa and benserazide hydrochloride were suspected. Then the drug was stopped and symptomatic treatments were given for 3 days, but his symptoms were not improved. After consultation with the neurologist, the patient was diagnosed as having ataxia, which was suspected to be related to dextrzopiclone. Four days after dextrzopiclone withdrawal, the patient′s symptoms were improved obviously. The patient resumed to use levodopa and benserazide hydrochloride before discharge and the ataxia symptoms above mentioned did not recur.

A 68-year-old male patient with severe active ulcerative colitis developed sleep disorder after using hormone pulse therapy. He received dexzopiclone 3 mg orally once a night to improve sleep. On the next day of medication, the patient developed ataxia symptoms such as dizziness, head drooping, and body skewing when walking, etc. The patient had a history of Parkinson′s syndrome and treatment effect of levodopa and benserazide hydrochloride was good. Dyskinesia caused by levodopa and benserazide hydrochloride were suspected. Then the drug was stopped and symptomatic treatments were given for 3 days, but his symptoms were not improved. After consultation with the neurologist, the patient was diagnosed as having ataxia, which was suspected to be related to dextrzopiclone. Four days after dextrzopiclone withdrawal, the patient′s symptoms were improved obviously. The patient resumed to use levodopa and benserazide hydrochloride before discharge and the ataxia symptoms above mentioned did not recur.

Objective:To study the application of students as standardized patients in orthopedical practice teaching of foreign medical students.Methods:A total of 116 students who received Surgical practice teaching in Affiliated Renhe Hospital of China Three Gorges University from January 2014 to December 2017 were randomly divided into two groups. Bedside teaching model was adopted in the control group ( n=58) to help the interns manage the in-patients under the guidance of the teacher. Additional teaching using standardized patients was applied 1 to 2 times per week in the experimental group ( n=58) on the basis of control group. After the teaching, practical test and assessment survey were adopted to evaluate the effectiveness of teaching. SPSS 13.0 was used to analyze the data by t-test. Results:The scores of the practical test of the experimental group were significantly higher than those of control group, such as history taking [(15.23±3.15) vs. (13.56±3.54), P=0.008], physical examination [(17.24±4.23) vs. (10.32±3.75), P=0.000], and basic skill [(17.32±2.58) vs. (13.22±3.65), P=0.000]. The assessment survey showed that learning motivation [(8.25±1.04) vs. (4.82±0.93), P=0.000], and communication ability [(6.22±1.12) vs. (5.59±0.89), P=0.001] of the experimental group were effectively improved than those of the control group. Conclusion:The teaching mode using standardized patients can effectively improve the learning motivation and clinical practical skills of foreign medical students, as well as the teaching quality.

Objective:To construct a scientific and practical ovarian tumor nursing quality sensitive indicator system so as to provide a reference for evaluating the quality of nursing care for patients with ovarian tumors.Methods:Based on Donabedian's three-dimensional theoretical model of structure-process-outcome quality management, we used literature review and Delphi expert correspondence consultation to construct a nursing quality sensitive indicator system for ovarian tumor patients. From February to April 2019, we selected 20 experts from 16 ClassⅢ Grade A general hospitals and 2 higher nursing institutions from 7 provinces/municipalities in Shandong Province, Jiangsu Province, Beijing, Jilin Province, Shanghai, Guangdong Province and Sichuan Province for consultation.Results:Among two rounds of consultation, valid recovery rates were 90.00% and 94.44% respectively; authority coefficients were all 0.92; familiarity coefficients were 0.89 and 0.91 respectively; judgment coefficients were 0.94 and 0.92 respectively; Kendall harmony coefficients were 0.204 and 0.426 respectively; the differences were all statistically significant ( P<0.05) . The final nursing quality sensitive indicator system for ovarian tumor patients included 3 first-level indicators, 12 second-level indicators and 23 third-level indicators. Conclusions:The nursing quality sensitive indicator system for ovarian tumor patients is highly scientific and practical which can be used to standardize clinical nursing care for patients with ovarian tumors by gynecological nurses and improve the nursing quality.

Objective To develop a scale of catheter-associated urinary tract infection (CAUTI) knowledge-attitude-practice (KAP) and to test its psychometric properties, and to provide effective assessment tools for clinical evaluation of knowledge, attitude and practice of CAUTI prevention. Methods Based on KAP theory and CAUTI preventive current guideline,the scale was developed by using literature review,Delphi expert inquiry.A questionnaire survey was conducted among 300 medical workers in a third grade A hospital in Qingdao.Exploratory factor analysis and confirmatory factor analysis were both conducted to screen the items further.The psychometric properties of scale was tested. Results The finalized scale included 4 subscales and 45 items,amount to 63.21% of the variance contribution rate. The total Cronbach's alpha was 0.914,and the split half reliability was 0.812.The content validity of the scale was 0.895,while it ranged from 0.846-1.000 for each subscale.The correlation of item-to total was 0.711-0.862,and the correlation coefficient of item-to-item ranged from 0.425-0.564. Conclusions The scale of CAUTI KAP has good reliability and validity. It can be used to evaluate CAUTI related knowledge,attitude and practice level of medical workers.

BACKGROUND:During fracture healing, in addition to the need for appropriate biomechanical environment, the role of cytokines is also increasingly attracted attention.
OBJECTIVE:To study the effect of nerve growth factor and alpha-lipoic acid on fracture healing in rat models of femoral fracture.
METHODS:Sprague-Dawley rat models of femoral fracture were established. Seventy-two rats were randomly divided into three groups. In the control group, rats were intramuscularly injected with physiological saline. In the nerve growth factor group, rats were intramuscularly injected with nerve growth factor 200 ng/kg, once a day. In the combined therapy group, rats were intramuscularly injected with nerve growth factor 200 ng/kg and oral y taken alpha-lipoic acid 25 mg/kg, once a day. At 1, 2 and 3 weeks after administration, bony cal us volume was measured. Enzyme linked immunosorbent assay was used to measure serum bone morphogenetic protein-2 levels. Western blot assay was utilized to detect bone morphogenetic protein-2 protein expression at the broken end of fracture. Semi-quantitative RT-PCR was applied to examine vascular endothelial growth factor mRNA expression.
RESULTS AND CONCLUSION:(1) At 1 week after administration, no significant difference in bony cal us volume was detected among the three groups. Serum bone morphogenetic protein-2 level, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA expression were significantly higher in the nerve growth factor group and combined therapy group compared with the control group (P<0.05), but no significant difference was found between the two groups. (2) At 2 weeks after administration, the amount of cal us, serum bone morphogenetic protein-2 levels, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA levels were significantly higher in the nerve growth factor group and combined therapy group compared with the control group (P<0.05). Above expression levels were higher in the combined therapy group than in the nerve growth factor group (P<0.05). (3) At 3 weeks after administration, serum bone morphogenetic protein-2 levels, bone morphogenetic protein-2 protein expression, and vascular endothelial growth factor mRNA levels were significantly decreased in the nerve growth factor group. However, above expression levels were stil high in the combined therapy group, and significantly higher than in the nerve growth factor group (P<0.05). (4) These results indicate that nerve growth factor combined with alpha-lipoic acid had better effects on the fracture healing compared with the nerve growth factor alone.