Objective:To investigate the efficacy of a decellularized extracellular matrix (dECM)-quaternized chitosan (QCS)-gelatin (Gel) composite scaffold loaded with growth factors in repairing diabetic foot wounds in a rat model.Methods:A dECM-QCS-Gel composite scaffold (referred to as GDQ scaffold) was fabricated using a 3D bioprinter. Forty 8-week-old male Sprague-Dawley (SD) rats were selected to establish a diabetic foot wound model with a diameter of approximately 1 cm. Based on the treatment methods for diabetic foot wounds, the rats were divided into five groups: Control group (no treatment), Exosome group (wound covered with exosome suspension), Exosome+GDQ group (wound covered with GDQ scaffold loaded with exosome suspension), GDQ group (wound covered with GDQ scaffold alone), and Growth factor+GDQ group (wound covered with GDQ scaffold loaded with recombinant human basic fibroblast growth factor suspension). The wound healing rate was measured. Histological analysis was performed by HE staining and Masson staining. ELISA kits were used to determine the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, and IL-10 in wound tissues from each group. Protein expression levels of MIP-1 and MIP-2 genes were also assessed.Results:The wound healing rate of the growth factor+GDQ group on the 21st d was 94.89%±1.21%, which was higher than that of the exosome+GDQ group ( P<0.05). With increasing repair time, the expression levels of TNF-α, IL-1β and IL-6 in each group all decreased, while IL-10 increased in all groups ( P<0.05). Among them, the exosome+GDQ group (TNF-α: 46.54±1.26 pg/ml, IL-1β: 225.79±7.29 pg/ml, IL-6: 142.81±4.02 pg/ml and IL-10: 117.36±0.95 pg/ml, P<0.001) and the growth factor+GDQ group (TNF-α : 40.01±1.64 pg/ml, IL-1β: 209.15±2.98 pg/ml, IL-6: 138.50±2.61 pg/ml and IL-10: 127.66±1.23 pg/ml, P<0.05); The levels of TNF-α and IL-1β in the exosome+GDQ group were both lower than those in the exosome+GDQ group ( P<0.05), and IL-10 was higher than that in the exosome+GDQ group ( P<0.05). On the 7th d the control group showed the highest expression levels of MIP-1α and MIP-2. All other groups had lower levels, with the growth factor+GDQ group showing the lowest among them. On the 21st d, the inflammatory protein expression in the growth factor+GDQ group had further decreased and remained lower than in all other experimental groups. Conclusions:The GDQ composite scaffold, when combined with bioactive factors, can synergistically reduce inflammation in diabetic foot wounds and promote wound healing. The scaffold loaded with basic fibroblast growth factor demonstrated superior therapeutic efficacy compared to the scaffold loaded with exosomes.

Objective To investigate the structural changes and influencing factors of the average inpatient cost per admis-sion in public hospitals in Guangdong Province.Methods Grey relational analysis and structural variation degree analysis were used to analyze the correlation and changes between the average inpatient cost per admission and various cost components in public hospitals of Guangdong Province from 2017 to 2023.Results The average inpatient cost per admission in public hospitals of Guangdong Province showed an overall upward trend from 2017 to 2023,with an average annual growth rate of 3.84％.Among the components,laboratory test fees and examination fees grew at average annual rates of 6.17％and 6.68％,respectively.The top four cost components with the highest grey relational degree with the average inpatient cost were laboratory test fees(0.867),exam-ination fees(0.835),nursing fees(0.784),and treatment fees(0.728).The top four components with the largest structural vari-ation values were surgery fees(2.57％),medical material fees(1.77％),laboratory test fees(1.56％),and examination fees(1.45％).Conclusion The growth of the average inpatient cost per admission has slowed,and the cost structure has been opti-mized to some extent.However,the relatively rapid increase in laboratory test and examination fees has a significant impact on the cost structure.It is necessary to deepen the coordinated governance of healthcare,medical insurance,and medicine,strengthen the leveraging role of medical insurance payment,improve the external governance system and scientific compensation mechanism,and combine these with refined hospital management to promote reasonable cost control and high-quality development in public hospitals.

Objective:To investigate the efficacy of a decellularized extracellular matrix (dECM)-quaternized chitosan (QCS)-gelatin (Gel) composite scaffold loaded with growth factors in repairing diabetic foot wounds in a rat model.Methods:A dECM-QCS-Gel composite scaffold (referred to as GDQ scaffold) was fabricated using a 3D bioprinter. Forty 8-week-old male Sprague-Dawley (SD) rats were selected to establish a diabetic foot wound model with a diameter of approximately 1 cm. Based on the treatment methods for diabetic foot wounds, the rats were divided into five groups: Control group (no treatment), Exosome group (wound covered with exosome suspension), Exosome+GDQ group (wound covered with GDQ scaffold loaded with exosome suspension), GDQ group (wound covered with GDQ scaffold alone), and Growth factor+GDQ group (wound covered with GDQ scaffold loaded with recombinant human basic fibroblast growth factor suspension). The wound healing rate was measured. Histological analysis was performed by HE staining and Masson staining. ELISA kits were used to determine the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, and IL-10 in wound tissues from each group. Protein expression levels of MIP-1 and MIP-2 genes were also assessed.Results:The wound healing rate of the growth factor+GDQ group on the 21st d was 94.89%±1.21%, which was higher than that of the exosome+GDQ group ( P<0.05). With increasing repair time, the expression levels of TNF-α, IL-1β and IL-6 in each group all decreased, while IL-10 increased in all groups ( P<0.05). Among them, the exosome+GDQ group (TNF-α: 46.54±1.26 pg/ml, IL-1β: 225.79±7.29 pg/ml, IL-6: 142.81±4.02 pg/ml and IL-10: 117.36±0.95 pg/ml, P<0.001) and the growth factor+GDQ group (TNF-α : 40.01±1.64 pg/ml, IL-1β: 209.15±2.98 pg/ml, IL-6: 138.50±2.61 pg/ml and IL-10: 127.66±1.23 pg/ml, P<0.05); The levels of TNF-α and IL-1β in the exosome+GDQ group were both lower than those in the exosome+GDQ group ( P<0.05), and IL-10 was higher than that in the exosome+GDQ group ( P<0.05). On the 7th d the control group showed the highest expression levels of MIP-1α and MIP-2. All other groups had lower levels, with the growth factor+GDQ group showing the lowest among them. On the 21st d, the inflammatory protein expression in the growth factor+GDQ group had further decreased and remained lower than in all other experimental groups. Conclusions:The GDQ composite scaffold, when combined with bioactive factors, can synergistically reduce inflammation in diabetic foot wounds and promote wound healing. The scaffold loaded with basic fibroblast growth factor demonstrated superior therapeutic efficacy compared to the scaffold loaded with exosomes.

Objective To investigate the structural changes and influencing factors of the average inpatient cost per admis-sion in public hospitals in Guangdong Province.Methods Grey relational analysis and structural variation degree analysis were used to analyze the correlation and changes between the average inpatient cost per admission and various cost components in public hospitals of Guangdong Province from 2017 to 2023.Results The average inpatient cost per admission in public hospitals of Guangdong Province showed an overall upward trend from 2017 to 2023,with an average annual growth rate of 3.84％.Among the components,laboratory test fees and examination fees grew at average annual rates of 6.17％and 6.68％,respectively.The top four cost components with the highest grey relational degree with the average inpatient cost were laboratory test fees(0.867),exam-ination fees(0.835),nursing fees(0.784),and treatment fees(0.728).The top four components with the largest structural vari-ation values were surgery fees(2.57％),medical material fees(1.77％),laboratory test fees(1.56％),and examination fees(1.45％).Conclusion The growth of the average inpatient cost per admission has slowed,and the cost structure has been opti-mized to some extent.However,the relatively rapid increase in laboratory test and examination fees has a significant impact on the cost structure.It is necessary to deepen the coordinated governance of healthcare,medical insurance,and medicine,strengthen the leveraging role of medical insurance payment,improve the external governance system and scientific compensation mechanism,and combine these with refined hospital management to promote reasonable cost control and high-quality development in public hospitals.

Objective To investigate the relationships of preoperative serum V-set and immunoglobulin domain 4 (VSIG4) and long chain non-coding ribonucleic acid (LncRNA) SBF2 antisense RNA1 (SBF2-AS1) with acute kidneyinjury (AKI) after percutaneous nephrolithotomy in patients with renal calculus. Methods A total of 109 patients with renal calculus in the hospital from January 2020 to December 2022 were selected as research objects. Serum VSIG4 level and LncRNA SBF2-AS1 expression were detected in all the patients before operation, and incidence of AKI was recorded after operation. Multiple Logistic regression model was used to analyze the factors affecting AKI after percutaneous nephrolithotomy in patients with renal calculus; the receiver operating characteristic (ROC) curve was used to analyze the values of VSIG4 and LncRNA SBF2-AS1 in predicting AKI after percutaneous nephrolithotomy in patients with renal calculus. Results In this study, 16 cases had AKI after operation. The serum VSIG4 level in the AKI group was significantly lower than that in the non-AKI group, while the LncRNA SBF2-AS1 expression was significantly higher than that in the non-AKI group (P < 0.05). Multivariate Logistic regression analysis showed that preoperative high level of uric acid, preoperative high expression of LncRNA SBF2-AS1, the longer operation time and intraoperative hypotension were the risk factors for AKI after percutaneous nephrolithotomy in patients with renal calculus (P < 0.05), while preoperative high level of VSIG4 was the protective factor (P < 0.05). The values of area under the curve of preoperative serum VSIG4 and LncRNA SBF2-AS1 in predicting AKI after percutaneous nephrolithotomy in patients with renal calculus were 0.854 and 0.705 respectively, and the area under the curve of combined prediction of the two indexes was 0.948, which was significantly higher than that of single index prediction (Z=1.995, 2.958, P < 0.05). Conclusion Decreased preoperative serum VSIG4 level and increased expression of LncRNA SBF2-AS1 in patients with renal calculus are associated with the occurrence of AKI after percutaneous nephrolithotomy, and the combined detection of preoperative VSIG4 and LncRNA SBF2-AS1 can predict the risk of AKI after operation.

Objective:To investigate the effect of extracellular vesicles derived from mitotic cell death PC3 cells(MEV) on prostate cancer cells.Methods:After the phenotype of mitotic death was continuously induced by 1 μmol/L cisplatin for 5 days, nuclear damage was detected by immunofluorescence, cell stiffness was measured by Atomic Force Microscope, cell senescence marker(SA-β-Gal), proliferation, cycling, mitochondrial membrane potential, mitochondrial number by flow cytometry, and expression of senescence-secreting phenotype-associated factors including CDKNIA, CDKN2A, IL-6, IL-8, TNF-α, IFN-α/β/γ by qRT-PCR. Mitotic-death PC3 cells derived extracellular vesicles (MEV) were extracted, and the morphology and size of MEV were detected by electron microscopy and nanoparticle tracking analysis, and their stiffness and substance (β-actin and mtDNA) were separately detected by atomic force microscope and qRT-PCR. The effects of MEV on PC3 cells were further detected by immunofluorescence to detect phagocytosis, flow cytometry to detect proliferation and apoptosis, and qRT-PCR to detect the level of IFNα/β/γ. Finally, 50μg MEV were treated to PC3 cells combined with 15μmol/L adriamycin (Dox), and apoptosis was detected by flow assay.Results:Mitotic cell death PC3 cells and MEV were both obtained successfully.In comparison with normal PC3's, the number of MEV group was significantly increased[(4 530.9±353.6)×10 6(particle)/1×10 6 cell and (33.7±5.4)×10 6 particle/1×10 6 cell, P<0.01]. Additionally, the particle size of the extracellular vesicles were significantly smaller[(122.0±2.6)nm and (163.6±2.6)nm, P<0.01], along with significantly increased content of nuclear DNA[(111.0±20.7)/1×10 6 cell, P<0.01] and mtDNA[(26.2±3.8)/1×10 6 cell, P<0.01]. MEV were also easier to absorb by PC3 for their softness[(0.11±0.01)MPa and(0.18±0.01)MPa, P<0.01]. MEV could significantly induce PC3 cell apoptosis[(641.0±42.5)MFI and(351.7±37.0)MFI, P<0.01] and inhibit their proliferation[(1 523.0±64.9)MFI and(1 336.3±94.1)MFI, P<0.05].Besides, they did not affect the level of IFNβ but down-regulated IFNα/γmRNA level[(0.6±0.1)and(0.8±0.1), P<0.01].The combination of MEV and 15 μmol/L Dox can significantly promote PC3 cell apoptosis[(14 290.3±1315.9)MFI and(2 669.3±241.5)MFI, P<0.01]. Conclusions:Mitotic cell death PC3 cells can efficiently secrete DNA-rich flexible extracellular vesicles.The MEV were more easily taken up by PC3 and significantly inhibit its cellular activity and promote the anticancer effect of Dox.

Objective To investigate the serum tumor necrosis factor like weak inducer of apoptosis(TWE AK),sterol regulatory element-binding protein 1(SREBP-1)levels in patients with prostate cancer(PC)and their relationship with clinical pathological characteristics and progression free survival prognosis.Method A total of 94 PC patients who underwent PC radical surgery in Wuhan Dongxihu District People's Hospital from January 2018 to January 2020 were selected as the PC group.Meanwhile,50 patients with benign prostatic hyperplasia(BPH)during the same period were selected as the BPH group,and 50 healthy individuals who underwent physical examination during the same period were selected as the control group.Enzyme linked immunosorbent assay(ELISA)was used to detect the expression levels of serum TWEAK and SREBP-1.Kaplan-Meier survival analysis was used to analyze the effects of serum TWEAK and SREBP-1 on the progression free survival in prostate cancer patients.Multivariate COX regression analysis was used to analyze factors affecting the prognosis of progression free survival in prostate cancer patients.Results The serum TWEAK(77.14±15.46 ng/L)and SREBP-1(334.14±33.81 ng/L)levels in the PC group were higher than those in the BPH group(38.69±10.58 ng/L,201.69±28.74 ng/L)and control group(36.26±10.27 ng/L,189.51±27.65 ng/L),with significant differences(t=23.752,25.249;34.636,37.821,all P＜0.05).There was a positive correlation between serum TWEAK and SREBP-1 expression in PC patients(r=0.668,P=0.001).The serum TWEAK and SREBP-1 levels in PC patients with Gleason score＞7,TNM stage Ⅲ,and preoperative prostate specific antigen(PSA)level ≥ 20 ng/ml were higher than those with Gleason score≤7,TNM stage Ⅰ～Ⅱ,and preoperative PSA level＜20ng/ml,with significance differences(t=8.465～16.597,all P＜0.05).The 3-year overall progression free survival rates of the TWEAK high expression and low expression groups were 60.42％(29/48)and 86.96％(40/46),respectively.The 3-year overall progression free survival rates of the SREBP-1 high expression and low expression groups were 57.78％(26/45)and 87.76％(43/49),respectively.The 3-year cumulative progression free survival rates of the TWEAK high expression group and the SREBP-1 high expression group were lower than those of the TWEAK low expression group and the SREBP-1 low expression group,and the differences were significant(Log rankx2=8.125,9.547,P=0.004,0.002).TNM stage Ⅲ(OR=1.448,P＜0.001),Gleason score＞7(OR=1.401,P＜0.001),preoperative PSA ≥ 20 ng/ml(OR=1.353,P＜0.001),serum TWEAK(OR=1.338,P＜0.001),and SREBP-1(OR=1.293,P＜0.001)were independent risk factors affecting the progression free survival prognosis of PC patients.Conclusion Serum TWEAK and SREBP-1 in prostate cancer patients were increased,and they were correlated with the clinical pathological characteristics of PC.They could be serum biomarkers for evaluating the prognosis of progression free survival.

This article summarizes and organizes relevant publications in journals, along with a review of medical history, systematically summarizing the development process of dental alveolar surgery in China. The initial establishment phase (1935—1952) marked the starting point of Chinese Alveolar Surgery. Despite the impact of wars, it laid the foundation for subsequent research and practice. During the early development phase (1953—1966), the "Chinese Journal of Stomatology" was founded, which promoted the development of Alveolar Surgery. Research focused on tooth extraction methods and complications. Tooth Transplantation and Preprosthetic Surgery gradually began to take off. The stagnant phase (1967—1977) occurred due to the interruption of international exchanges, leading to an almost complete halt in the development of Alveolar Surgery. Entering the rapid catch-up phase (1978—1985), Alveolar Surgery scholars in China began striving to overcome the stagnation of the previous decade. While some progress was made, no significant innovative achievements emerged. In the scientific development phase (1986—2010), clinical research, basic experiments, and paper writing in modern Chinese Alveolar Surgery began to adhere to scientific standards with the rise of experimental medicine. The exploration and innovation stage (2011—2023) is the current development phase, during which Chinese Aveolar Surgery has reached its peak, making substantial progress in technology, clinical practices, and basic research, gradually reaching or even surpassing international advanced levels. Looking back at the development history in China, we can find the wisdom and hard work of the older generation of Alveolar Surgery scholars. However, contemporary challenges and issues, such as standardizing technology, promoting clinical practices, and talent cultivation, need to be addressed by present-day Alveolar Surgery professionals as they forge ahead.

Objective:To investigate the correlation between peripheral blood lymphocyte immunophenotyping,cytokine levels before and after immune and anti-angiogenesis combined therapy,and treatment efficacy as well as prognosis in patients with advanced mucosal melanoma.Methods:A total of 28 patients with advanced mucosal melanoma admitted to the Drum Tower Hospital of Nanjing University School of Medicine from April 2019 to June 2022 were included in this analysis.All patients received combined treatment of camrelizumab(PD-1 inhibitor)and apatinib(anti-angiogenic drug).Peripheral blood samples were collected before treatment and after two cycles of treatment for lymphocyte immunophenotyping and cytokine level testing.The correlation between these immune markers and treatment efficacy as well as patient prognosis was evaluated.Results:After two cycles of treatment with camrelizumab and apatinib in patients with mucosal melanoma,the proportion of PD-1 positive cytotoxic T lymphocytes(CD3+CD8+CD279+cells)in peripheral blood was significantly reduced(P<0.001),while the proportion of NK cells(CD3-CD16+CD56+cells)was significantly increased(P=0.0054).Pre-treatment peripheral blood IFN-γ levels were found to be associated with overall survival(OS)(P=0.013).Patients with low IFN-γ levels had a median OS of 329 days,while the median OS for patients with high IFN-γ levels was not reached.Higher baseline IFN-γ levels were associated with a greater benefit in progression-free survival(PFS).Conclusion:The proportion of PD-1-positive T lymphocytes,NK cells and IFN-γ levels in peripheral blood may have predictive value for the efficacy and prognosis of advanced mucosal melanoma patients undergoing immunotherapy and anti-angiogenesis combined therapy.Future large-sample studies are needed to better characterize the clinical potential of these markers.

Objective:To investigate the effect of extracellular vesicles derived from mitotic cell death PC3 cells(MEV) on prostate cancer cells.Methods:After the phenotype of mitotic death was continuously induced by 1 μmol/L cisplatin for 5 days, nuclear damage was detected by immunofluorescence, cell stiffness was measured by Atomic Force Microscope, cell senescence marker(SA-β-Gal), proliferation, cycling, mitochondrial membrane potential, mitochondrial number by flow cytometry, and expression of senescence-secreting phenotype-associated factors including CDKNIA, CDKN2A, IL-6, IL-8, TNF-α, IFN-α/β/γ by qRT-PCR. Mitotic-death PC3 cells derived extracellular vesicles (MEV) were extracted, and the morphology and size of MEV were detected by electron microscopy and nanoparticle tracking analysis, and their stiffness and substance (β-actin and mtDNA) were separately detected by atomic force microscope and qRT-PCR. The effects of MEV on PC3 cells were further detected by immunofluorescence to detect phagocytosis, flow cytometry to detect proliferation and apoptosis, and qRT-PCR to detect the level of IFNα/β/γ. Finally, 50μg MEV were treated to PC3 cells combined with 15μmol/L adriamycin (Dox), and apoptosis was detected by flow assay.Results:Mitotic cell death PC3 cells and MEV were both obtained successfully.In comparison with normal PC3's, the number of MEV group was significantly increased[(4 530.9±353.6)×10 6(particle)/1×10 6 cell and (33.7±5.4)×10 6 particle/1×10 6 cell, P<0.01]. Additionally, the particle size of the extracellular vesicles were significantly smaller[(122.0±2.6)nm and (163.6±2.6)nm, P<0.01], along with significantly increased content of nuclear DNA[(111.0±20.7)/1×10 6 cell, P<0.01] and mtDNA[(26.2±3.8)/1×10 6 cell, P<0.01]. MEV were also easier to absorb by PC3 for their softness[(0.11±0.01)MPa and(0.18±0.01)MPa, P<0.01]. MEV could significantly induce PC3 cell apoptosis[(641.0±42.5)MFI and(351.7±37.0)MFI, P<0.01] and inhibit their proliferation[(1 523.0±64.9)MFI and(1 336.3±94.1)MFI, P<0.05].Besides, they did not affect the level of IFNβ but down-regulated IFNα/γmRNA level[(0.6±0.1)and(0.8±0.1), P<0.01].The combination of MEV and 15 μmol/L Dox can significantly promote PC3 cell apoptosis[(14 290.3±1315.9)MFI and(2 669.3±241.5)MFI, P<0.01]. Conclusions:Mitotic cell death PC3 cells can efficiently secrete DNA-rich flexible extracellular vesicles.The MEV were more easily taken up by PC3 and significantly inhibit its cellular activity and promote the anticancer effect of Dox.