Traumatic injuries represent the fifth leading cause of death in China and the primary cause of death among young adults. While facial fractures can lead to significant aesthetic and psychological consequences, fractures in the limbs and joints impair functional mobility. In traumatic incidents requiring forensic evaluation, such as traffic accidents or violent conflicts, the type and severity of fractures directly determine injury grading and disability assessment. Consequently, the accurate diagnosis of traumatic fractures is not only a critical medical issue impacting patient management and rehabilitation but also a significant social issue influencing judicial fairness. This article systematically reviews advancements in multi-modal imaging techniques. While conventional X-ray radiography remains a fundamental screening tool, it faces challenges in detecting occult fractures. Multi-slice spiral computed tomography (MSCT), utilizing 3D reconstruction, enables spatial analysis of complex fractures. Magnetic resonance imaging (MRI), with its multi-sequence capabilities, plays an indispensable role in detecting bone marrow edema and assessing concomitant soft tissue injuries. Regarding innovative technologies, dual-energy computed tomography (DECT) employs virtual non-calcium (VNC) techniques for quantitative bone marrow edema analysis; ultra-high-resolution computed tomography (U-HRCT) breaks through imaging limitations of trabecular microarchitecture with a resolution of approximately 10 μm; and 7.0 T ultra-high-field MRI, alongside MRI-based CT-like imaging techniques, advances radiation-free bone structure evaluation. Artificial intelligence (AI) models significantly enhance diagnostic efficiency in fracture detection. Future developments will focus on multi-modal image fusion, the construction of intelligent decision-support systems, and the quantitative functional assessment of bone microstructure, facilitating a paradigm shift from anatomical description to prognostic prediction and realizing the principles of personalized medicine.

Objective:To explore the clinical efficacy of the splenic vessel-oriented anatomical plane priority strategy in Da Vinci robotic Kimura distal pancreatectomy.Methods:A retrospective analysis was conducted on 26 patients who underwent robotic-assisted distal pancreatectomy at Zhejiang Provincial People’s Hospital from January 2019 to September 2024. The cohort included 7 male and 19 female patients, aged (49.3±16.7) years. Surgical outcomes, including operative time, intraoperative blood loss, postoperative complications, and hospital stay, were analyzed, and surgical techniques were summarized.Results:All 26 patients successfully completed the surgery. Pathological diagnoses included 5 cases of intraductal papillary mucinous neoplasm, 5 serous cystadenomas, 1 pancreatic neuroendocrine tumor, 6 solid pseudopapillary neoplasms, 4 mucinous cystic neoplasms, and 5 neuroendocrine tumors. The maximum tumor diameter was (2.3±1.1) cm, and the operative time was (183.2±77.4) min. The spleen preservation rate was 100% (26/26). Intraoperative blood loss was 50.0 (17.5, 125) ml, and postoperative hospital stay was (10.1±3.7) d. No Clavien-Dindo grade III or higher complications occurred. The post-operative pancreatic fistula (POPF) rate was 53.8% (14/26), including 38.5% (10/26) biochemical leak and 15.3% (4/26) grade B POPF, with no grade C POPF.Conclusion:The splenic vessel-oriented anatomical plane priority strategy in robotic-assisted spleen-preserving distal pancreatectomy (Kimura technique) is safe and feasible, significantly improving the spleen preservation rate.

ObjectiveTo investigate the whole genomic characteristics and phylogenetic relationships of clinical isolates of enteroaggregative Escherichia coli (EAEC) in diarrhea outpatients in Pudong New Area, Shanghai. MethodsBased on the diarrheal disease surveillance network in Pudong New Area, Shanghai, whole-genome sequencing was performed on a total of 55 EAEC strains isolated from fecal samples of the diarrhea outpatients from January 2015 to December 2019. The genome analyses based on raw sequencing data encompassed genome size, coding genes, dispersed repeat sequences, genomic islands, and protein coding regions, and pan-genome analyses were conducted simultaneously. Contigs sequences assays were performed to analyze molecular characteristics including serotypes, antibiotic resistance genes, and virulence factors. The phylogenetic clusters and multilocus sequence typing (MLST) were identified, and a phylogenetic tree was constructed. ResultsEAEC exhibited an open pan-genome. The predominant serotype of EAEC in diarrhea outpatients in Pudong New Area was O130:H27, and the carriage rate of β-lactam resistance genes was the highest (67.27%, 37/55). A total of 29 virulence factors and 106 virulence genes were identified, phylogenic group B1 was the predominant group, and clonal group CC31 was the dominant clonal group. The strain distribution was highly heterogeneous. ConclusionThe genomic characteristics of EAEC displayed significant strain polymorphism. It is necessary to develop effective strategies for differential diagnosis and improve detection capabilities for infection with EAEC of different serotypes and genotypes.

The application of mechanics in clinical wound healing has a long history;however,the systematic underlying mechanisms remain unclear.With recent advancements in biomechanics and mechanobiology,the principles regarding how mechanical factors influence the formation,progression,and healing of wounds have gradually been elucidated.Herein,based on progress in theories,technologies,and clinical practices concerning the interplay between mechanics and wound healing,this study introduces the concept of wound-repairing mechanomedicine.Relevant research is systematically reviewed from the perspectives of biomechanics,mechanobiology,and mechanotherapy.Additionally,potential future development directions are prospectively analyzed to provide novel insights into wound care and strategies for preventing scar formation.

Hepatolenticular degeneration is an autosomal recessive hereditary disease characterized by copper metabolism disorder,which affects the liver,kidneys,and brain.In traditional Chinese medicine,this disease is closely associated with dysfunction of the"liver-kidney-brain"axis.The liver,kidney,and brain form a physiological whole through the mutual transformation and distribution of essence and blood,the coordination of qi transformation,and the connection of meridians and collaterals.This article explores the pathogenesis of hepatolenticular degeneration based on the"liver-kidney-brain"axis.The deficiency of liver and kidney essence leads to the malnutrition of brain marrow,which is the fundamental cause of the disease.The internal accumulation of copper toxins generates dampness-heat and phlegm-stasis,which are the key factors causing the disease.In view of the characteristics of this disease with deficiency in nature and excess in superficiality,the principle of dynamic treating both manifestation and root cause of disease is established:treating the manifestation starts with eliminating copper and detoxifying,combined with clearing heat and dampness,and removing phlegm and stasis;treating the root cause follows the concept of the same origin of yi and gui,emphasizing the simultaneous treatment of liver and kidney to nourish the brain marrow.Throughout the treatment process,copper elimination(treating the symptoms)should be taken into account,and stratified measures should be applied based on the primary focus of the lesion:either treating the liver as the main focus and supplemented by tonifying the kidney and filling the marrow;or treating the kidney as the main focus and assisted by regulating the liver and nourishing the brain;or co-regulating the three zang-organs of liver,kidney,and brain,to achieve the therapeutic goal of eliminating pathogenic factors and restoring normal functions,and combining tonification and purgation.

Hepatolenticular degeneration is an autosomal recessive hereditary disease characterized by copper metabolism disorder,which affects the liver,kidneys,and brain.In traditional Chinese medicine,this disease is closely associated with dysfunction of the"liver-kidney-brain"axis.The liver,kidney,and brain form a physiological whole through the mutual transformation and distribution of essence and blood,the coordination of qi transformation,and the connection of meridians and collaterals.This article explores the pathogenesis of hepatolenticular degeneration based on the"liver-kidney-brain"axis.The deficiency of liver and kidney essence leads to the malnutrition of brain marrow,which is the fundamental cause of the disease.The internal accumulation of copper toxins generates dampness-heat and phlegm-stasis,which are the key factors causing the disease.In view of the characteristics of this disease with deficiency in nature and excess in superficiality,the principle of dynamic treating both manifestation and root cause of disease is established:treating the manifestation starts with eliminating copper and detoxifying,combined with clearing heat and dampness,and removing phlegm and stasis;treating the root cause follows the concept of the same origin of yi and gui,emphasizing the simultaneous treatment of liver and kidney to nourish the brain marrow.Throughout the treatment process,copper elimination(treating the symptoms)should be taken into account,and stratified measures should be applied based on the primary focus of the lesion:either treating the liver as the main focus and supplemented by tonifying the kidney and filling the marrow;or treating the kidney as the main focus and assisted by regulating the liver and nourishing the brain;or co-regulating the three zang-organs of liver,kidney,and brain,to achieve the therapeutic goal of eliminating pathogenic factors and restoring normal functions,and combining tonification and purgation.

The application of mechanics in clinical wound healing has a long history;however,the systematic underlying mechanisms remain unclear.With recent advancements in biomechanics and mechanobiology,the principles regarding how mechanical factors influence the formation,progression,and healing of wounds have gradually been elucidated.Herein,based on progress in theories,technologies,and clinical practices concerning the interplay between mechanics and wound healing,this study introduces the concept of wound-repairing mechanomedicine.Relevant research is systematically reviewed from the perspectives of biomechanics,mechanobiology,and mechanotherapy.Additionally,potential future development directions are prospectively analyzed to provide novel insights into wound care and strategies for preventing scar formation.

Traumatic injuries represent the fifth leading cause of death in China and the primary cause of death among young adults. While facial fractures can lead to significant aesthetic and psychological consequences, fractures in the limbs and joints impair functional mobility. In traumatic incidents requiring forensic evaluation, such as traffic accidents or violent conflicts, the type and severity of fractures directly determine injury grading and disability assessment. Consequently, the accurate diagnosis of traumatic fractures is not only a critical medical issue impacting patient management and rehabilitation but also a significant social issue influencing judicial fairness. This article systematically reviews advancements in multi-modal imaging techniques. While conventional X-ray radiography remains a fundamental screening tool, it faces challenges in detecting occult fractures. Multi-slice spiral computed tomography (MSCT), utilizing 3D reconstruction, enables spatial analysis of complex fractures. Magnetic resonance imaging (MRI), with its multi-sequence capabilities, plays an indispensable role in detecting bone marrow edema and assessing concomitant soft tissue injuries. Regarding innovative technologies, dual-energy computed tomography (DECT) employs virtual non-calcium (VNC) techniques for quantitative bone marrow edema analysis; ultra-high-resolution computed tomography (U-HRCT) breaks through imaging limitations of trabecular microarchitecture with a resolution of approximately 10 μm; and 7.0 T ultra-high-field MRI, alongside MRI-based CT-like imaging techniques, advances radiation-free bone structure evaluation. Artificial intelligence (AI) models significantly enhance diagnostic efficiency in fracture detection. Future developments will focus on multi-modal image fusion, the construction of intelligent decision-support systems, and the quantitative functional assessment of bone microstructure, facilitating a paradigm shift from anatomical description to prognostic prediction and realizing the principles of personalized medicine.

Objective:To explore the clinical efficacy of the splenic vessel-oriented anatomical plane priority strategy in Da Vinci robotic Kimura distal pancreatectomy.Methods:A retrospective analysis was conducted on 26 patients who underwent robotic-assisted distal pancreatectomy at Zhejiang Provincial People’s Hospital from January 2019 to September 2024. The cohort included 7 male and 19 female patients, aged (49.3±16.7) years. Surgical outcomes, including operative time, intraoperative blood loss, postoperative complications, and hospital stay, were analyzed, and surgical techniques were summarized.Results:All 26 patients successfully completed the surgery. Pathological diagnoses included 5 cases of intraductal papillary mucinous neoplasm, 5 serous cystadenomas, 1 pancreatic neuroendocrine tumor, 6 solid pseudopapillary neoplasms, 4 mucinous cystic neoplasms, and 5 neuroendocrine tumors. The maximum tumor diameter was (2.3±1.1) cm, and the operative time was (183.2±77.4) min. The spleen preservation rate was 100% (26/26). Intraoperative blood loss was 50.0 (17.5, 125) ml, and postoperative hospital stay was (10.1±3.7) d. No Clavien-Dindo grade III or higher complications occurred. The post-operative pancreatic fistula (POPF) rate was 53.8% (14/26), including 38.5% (10/26) biochemical leak and 15.3% (4/26) grade B POPF, with no grade C POPF.Conclusion:The splenic vessel-oriented anatomical plane priority strategy in robotic-assisted spleen-preserving distal pancreatectomy (Kimura technique) is safe and feasible, significantly improving the spleen preservation rate.

OBJECTIVE To explore the effect and mechanism of Prunus mume against hepatic fibrosis(HF).METHODS Male SD rats were randomly divided into normal control group(n=10)and modeling group(n=50).The modeling group established HF model using carbon tetrachloride.The modeled rats were randomly divided into model group(normal saline),positive control group[colchicine,0.09 mg/(kg·d)],and P.mume low-dose,medium-dose and high-dose groups[1.35,2.70,5.40 g/(kg·d)],with 9 rats in each group.They were given the corresponding drug/normal saline intragastrically,once a day,for 8 consecutive weeks.After the last medication,the liver index was calculated,while liver function indexes,liver fiber indexes,oxidative stress indicators and inflammatory factors of rats were measured.HE staining was used to observe the pathological changes in liver tissue of rats;Masson staining was used to observe the degree of HF in liver tissue of rats;transmission electron microscopy was used to observe the ultrastructure of liver tissue in rats;TUNEL staining was used to detect liver cell apoptosis in each group of rats.Western blot method was used to detect the protein expressions of transforming growth factor-[31(TGF-[3i)and platelet-derived growth factor(PDGF)in liver tissue of rats.RESULTS Compared with normal control group,the levels of alanine transaminase,alkaline phosphatase,aspartate transaminase,total bilirubin,malondialdehyde,procollagen type Ⅲ protein,IV-type pre collagenase,laminin,hyaluronic acid,interleukin-6,tumor necrosis factor-α,as well as the protein expressions of TGF-β1and PDGF in model group were increased significantly,while the levels of superoxide dismutase and glutathione peroxidase were significantly reduced(P＜0.01);the HE,Masson staining and transmission electron microscopy observation results showed obvious HF characteristics in rats of model group.Compared with model group,varying degrees of improvement in above indexes were observed in P.mume groups,and the above indicators of rats in P.mume medium-dose and high-dose groups were reversed significantly(P＜0.05 or P＜0.01).CONCLUSIONS P.mume has an anti-HF effect,which may be achieved through mechanisms such as antioxidation,anti-inflammation,reduction of collagen production,inhibition of PDGF protein expression,and regulation of TGF-β1 signaling pathway.