Driven by the widespread adoption of minimally invasive thoracic surgical techniques and the deepening integration of enhanced recovery after surgery (ERAS) protocols, evidence-based perioperative airway management has emerged as a pivotal determinant of surgical safety, pulmonary functional recovery, and long-term prognosis. Currently, substantial regional disparities in thoracic surgical expertise persist across China, manifesting as heterogeneity in preoperative assessment standardization, inconsistent airway preparation strategies, divergent approaches to complication prevention, and limited penetration of advanced anesthetic technologies. To promote the standardization of clinical practices in this domain among hospitals at all levels, a multidisciplinary expert consortium has initiated the development of the Chinese Guidelines for Perioperative Airway Management in Thoracic Surgery (2026 edition). This protocol systematically delineates the methodological framework and structural blueprint underpinning the guideline’s formulation. Compared to the 2020 edition, the updated guideline places specific emphasis on refining stratified criteria for preoperative cardiopulmonary reserve assessment, establishing standardized management pathways for non-intubated spontaneous-ventilation techniques, formulating individualized multimodal perioperative pulmonary rehabilitation regimens, and defining precise intervention workflows for persistent postoperative cough. Collectively, these measures aim to further reduce the baseline incidence of perioperative pulmonary complications and to provide robust support for the clinical translation of enhanced recovery principles within the field of thoracic surgery.

BACKGROUND:Currently,treatment method for knee osteoarthritis includes oral medicine,joint cavity drug injection,and physiotherapy,but the curative effect is limited.Existing studies have confirmed that silicon-based bioceramics can promote cartilage and subchondral bone repair and vascular regeneration.OBJECTIVE:To explore the effect of different concentrations of silicon-based bioceramics injected into the knee joint cavity in the treatment of knee osteoarthritis in rats.METHODS:Silicon-based bioceramics-calcium silicate was prepared.Twenty-five SD rats were randomly divided into five groups,with five rats in each group.The healthy group did not receive any intervention,and the modeling group,low-dose calcium silicate group,high-dose calcium silicate group,and saline group used anterior cruciate ligament transection to establish bilateral knee osteoarthritis models.Four weeks after modeling,0.05 mL of 50 and 100 mg/mL calcium silicate solution were injected into the knee joint cavity in the low-dose calcium silicate group and high-dose calcium silicate group,respectively,and 0.05 mL of saline was injected into the knee joint cavity in the saline group,once a week for 4 consecutive weeks.In the fifth week of administration,bilateral knee joint Micro-CT detection,knee joint cartilage hematoxylin-eosin staining,and modified Mankin score were performed.RESULTS AND CONCLUSION:(1)Micro-CT quantitative analysis showed that compared with the healthy group,the volume fraction and number of trabeculae of the medial tibial plateau in the modeling group decreased(P＜0.05),and the separation of trabeculae increased(P＜0.05).Compared with the modeling group,the volume fraction and number of trabeculae of the medial tibial plateau in the low-dose calcium silicate group and the saline group increased(P＜0.05),and the separation of trabeculae decreased(P＜0.05).(2)Hematoxylin-eosin staining showed that the cartilage surface of the healthy group and the low-dose calcium silicate group was relatively smooth and flat,the chondrocytes were evenly distributed,without clustered chondrocytes,the tide line was complete,and the staining was uniform;the cartilage surface of the high-dose calcium silicate group was slightly uneven,the middle and deep cells were disordered,with a small number of clustered chondrocytes,the tide line was discontinuous,and the staining was uneven;the cartilage surface of the saline group and the modeling group was obviously rough,the cells were disordered,with a large number of clustered chondrocytes,the tide line disappeared,and the staining was uneven.The modified Mankin score of the healthy group was lower than that of the high-dose calcium silicate group,the saline group,and the modeling group(P＜0.05).The modified Mankin score of the high-dose calcium silicate group and the low-dose calcium silicate group was lower than that of the saline group and the modeling group(P＜0.05).(3)The results show that calcium silicate knee joint injection has a certain effect in the treatment of knee osteoarthritis.Compared with 100 mg/mL calcium silicate solution,50 mg/mL calcium silicate solution can promote the recovery of subchondral bone and cartilage.

Osteoarthritis (OA), a highly prevalent degenerative joint disease worldwide, is defined by articular cartilage degradation, abnormal bone remodeling, and persistent chronic inflammation. It severely compromises patients’ quality of life, and currently, there is no radical cure. Abnormal mechanical stress is widely regarded as a core driver of OA pathogenesis, and the exploration of mechanical signal perception and transduction mechanisms has become crucial for deciphering OA’s pathophysiological processes. Piezo1, a key mechanosensitive cation channel belonging to the Piezo protein family, has recently gained significant attention due to its pivotal role in mediating cellular responses to mechanical stimuli in joint tissues. This review systematically examines Piezo1’s expression patterns, regulatory mechanisms, and pathological functions in OA, with a particular focus on its dual roles in modulating chondrocyte homeostasis and bone metabolism disorders, while also delving into the underlying molecular signaling pathways and potential therapeutic implications. Piezo1, consisting of approximately 2 500 amino acids and forming a unique trimeric propeller-like structure, is widely expressed in chondrocytes, osteocytes, mesenchymal stem cells, and synovial cells. It exhibits permeability to cations such as Ca²⁺, K⁺, and Na⁺, and directly responds to membrane tension changes induced by mechanical stimuli like fluid shear stress and mechanical overload. In OA patients and animal models, Piezo1 expression is significantly upregulated, especially in cartilage regions subjected to abnormal mechanical stress (e.g., human temporomandibular joint cartilage). This overexpression is closely associated with aggravated cartilage degeneration, increased chondrocyte apoptosis, accelerated cellular senescence, and intensified inflammatory responses. Mechanical overload and pro-inflammatory cytokines (e.g., IL-1β) are key inducers of Piezo1 upregulation: IL-1β activates the PI3K/AKT/mTOR signaling pathway to enhance Piezo1 expression, forming a pathogenic positive feedback loop that inhibits chondrocyte autophagy, promotes apoptosis, and further accelerates joint degeneration. Mechanistically, Piezo1 mediates OA progression through multiple interconnected pathways. When activated by mechanical stress, Piezo1 triggers excessive Ca²⁺ influx, leading to endoplasmic reticulum stress (ERS) and mitochondrial dysfunction, which directly induce chondrocyte apoptosis. This process involves the activation of downstream signaling cascades such as cGAS-STING and YAP-MMP13/ADAMTS5. YAP, a transcriptional regulator, upregulates the expression of matrix metalloproteinase 13 (MMP13) and aggrecanase (ADAMTS5), thereby accelerating cartilage matrix degradation. Additionally, Piezo1-driven Ca²⁺ overload promotes the accumulation of reactive oxygen species (ROS) and upregulates senescence markers (p16 and p21), accelerating chondrocyte senescence via the p38MAPK and NF-κB pathways. Senescent chondrocytes secrete senescence-associated secretory phenotype (SASP) factors (e.g., IL-6, IL-1β), further amplifying joint inflammation. In terms of bone metabolism, Piezo1 maintains joint homeostasis by promoting the differentiation of fibrocartilage stem cells into chondrocytes and balancing bone formation and resorption through regulating the FoxC1/YAP axis and RANKL/OPG ratio. Therapeutically, targeting Piezo1 shows promising potential. Preclinical studies have demonstrated that Piezo1 inhibitors (e.g., GsMTx4) can reduce joint damage and alleviate pain in OA mice. Simultaneously, siRNA-mediated co-silencing of Piezo1 and TRPV4 (another mechanosensitive channel) decreases intracellular Ca²⁺ concentration, inhibits chondrocyte apoptosis, and promotes cartilage repair. Conditional knockout of Piezo1 using Gdf5-Cre transgenic mice alleviates cartilage degeneration in post-traumatic OA models by downregulating MMP13 and ADAMTS5 expression. Despite existing challenges, such as off-target effects of inhibitors, inefficient local drug delivery, and interindividual genetic variability, strategies like developing selective Piezo1 antagonists, optimizing targeted nanocarriers, and combining Piezo1-targeted therapy with physical therapy provide viable avenues for clinical translation. The authors propose that Piezo1 serves as a critical therapeutic target for OA, and future research should focus on deciphering its context-dependent regulatory networks, developing tissue-specific intervention strategies, and validating their efficacy and safety in clinical trials to address the unmet medical needs of OA patients.

BACKGROUND:Currently,treatment method for knee osteoarthritis includes oral medicine,joint cavity drug injection,and physiotherapy,but the curative effect is limited.Existing studies have confirmed that silicon-based bioceramics can promote cartilage and subchondral bone repair and vascular regeneration.OBJECTIVE:To explore the effect of different concentrations of silicon-based bioceramics injected into the knee joint cavity in the treatment of knee osteoarthritis in rats.METHODS:Silicon-based bioceramics-calcium silicate was prepared.Twenty-five SD rats were randomly divided into five groups,with five rats in each group.The healthy group did not receive any intervention,and the modeling group,low-dose calcium silicate group,high-dose calcium silicate group,and saline group used anterior cruciate ligament transection to establish bilateral knee osteoarthritis models.Four weeks after modeling,0.05 mL of 50 and 100 mg/mL calcium silicate solution were injected into the knee joint cavity in the low-dose calcium silicate group and high-dose calcium silicate group,respectively,and 0.05 mL of saline was injected into the knee joint cavity in the saline group,once a week for 4 consecutive weeks.In the fifth week of administration,bilateral knee joint Micro-CT detection,knee joint cartilage hematoxylin-eosin staining,and modified Mankin score were performed.RESULTS AND CONCLUSION:(1)Micro-CT quantitative analysis showed that compared with the healthy group,the volume fraction and number of trabeculae of the medial tibial plateau in the modeling group decreased(P＜0.05),and the separation of trabeculae increased(P＜0.05).Compared with the modeling group,the volume fraction and number of trabeculae of the medial tibial plateau in the low-dose calcium silicate group and the saline group increased(P＜0.05),and the separation of trabeculae decreased(P＜0.05).(2)Hematoxylin-eosin staining showed that the cartilage surface of the healthy group and the low-dose calcium silicate group was relatively smooth and flat,the chondrocytes were evenly distributed,without clustered chondrocytes,the tide line was complete,and the staining was uniform;the cartilage surface of the high-dose calcium silicate group was slightly uneven,the middle and deep cells were disordered,with a small number of clustered chondrocytes,the tide line was discontinuous,and the staining was uneven;the cartilage surface of the saline group and the modeling group was obviously rough,the cells were disordered,with a large number of clustered chondrocytes,the tide line disappeared,and the staining was uneven.The modified Mankin score of the healthy group was lower than that of the high-dose calcium silicate group,the saline group,and the modeling group(P＜0.05).The modified Mankin score of the high-dose calcium silicate group and the low-dose calcium silicate group was lower than that of the saline group and the modeling group(P＜0.05).(3)The results show that calcium silicate knee joint injection has a certain effect in the treatment of knee osteoarthritis.Compared with 100 mg/mL calcium silicate solution,50 mg/mL calcium silicate solution can promote the recovery of subchondral bone and cartilage.

Objective:To understand the information needs and experiences of primary caregivers of patients in the emergency resuscitation room of the emergency department, and to provide a reference for clinical staff to meet caregivers′ information needs as well as to develop targeted and effective health information support for doctors and patients.Methods:A descriptive phenomenological research method was used to conduct semi-structured interviews with primary caregivers of 14 patients in the emergency resuscitation room of the First Affiliated Hospital of Nanjing Medical University from November 2023 to February 2024 through purposive sampling, and the Colaizzi 7-step analysis method was applied to summarize and analyze the interview data and refine the themes.Results:Totally 14 respondents aged 28-66, including 6 males and 8 females. Four themes were refined including diverse information needs, information access dilemma, integration of doctor-patient information for joint decision-making and communication, and desire for information and emotional support.Conclusions:The information needs of primary caregivers of patients in the emergency department were diverse, and caregivers were eager to seek patient-related information and crave emotional support and communication when faced with the onset of a patient's illness. Healthcare professionals should strengthen the assistance of caregivers′ information needs to improve the experience of patients and caregivers in medical consultation services and realize the sustainable development of the doctor-patient relationship.

Objective:To develop a vasectomy intention scale (VIS) and evaluate its reliability and validity for assessing men's intentions toward vasectomy.Methods:Based on the Theory of Planned Behavior, the VIS was developed through a process that included literature review, panel discussions, expert consultations, and a pilot survey. A total of 264 men seeking vasectomy consultation at the Andrology Center, Department of Urology, the Third Xiangya Hospital of Central South University between December 2023 and December 2024 were recruited to assess reliability and validity of the VIS.Results:The VIS comprises 11 items across three dimensions: "background" factors, "stance and behavior" factors and "information" factors. The scale demonstrated satisfactory internal consistency (Cronbach's α=0.739). Correlations between each dimension and the total scale ("background" factors r=0.849, "stance and behavior" factors r=0.744, "information" factors r=0.440) exceeded inter-dimension correlations (ranging from 0.145 to 0.312), confirming robust construct validity. The vasectomy rates among men with different intention levels were 65.7% (92/140) in the high-intention group, 28.9% (33/114) in the moderate-intention group, and 0% (0/11) in the low-intention group, with a statistically significant difference (χ2=43.42, P<0.001). Conclusion:The VIS exhibits strong reliability and validity, serving as a validated instrument for measuring the strength of men's vasectomy intentions.

Objective:To investigate the predictive value of interventricular septal thickness(IVST),the ratio of mitral ear-ly diastolic peak flow velocity to late diastolic peak flow velocity(E/A)combined with aortic valve flow velocity(AV)for hypertensive heart disease(HHD)and its association with blood pressure grade.Methods:A total of 202 patients with hy-pertension suspected of HHD admitted to Qinhuangdao Hospital of Dongfang Hospital,Beijing University of Chinese Medi-cine between May 2020 and May 2023 were enrolled and divided into HHD group(n=102)and non-HHD group(n=100)according to color Doppler energy imaging and blood pressure diagnosis.Blood pressure,IVST,E/A and AV were measured in two groups.The predictive value of IVST,E/A and AV for HHD were evaluated by receiver operating charac-teristic(ROC)curve.According to hypertension grading,patients in HHD group was divided into grade 1～2 group(n=59)and grade 3 group(n=41).The association of IVST,E/A,AV with blood pressure grade in HHD patients were ana-lyzed by Spearman correlation analysis.Results:Compared with patients in non-HHD group,those in HHD group had significant higher IVST,and significant lower E/A and AV(P＜0.001 all);Compared with patients in grade 1～2 group,those in grade 3 group had significant higher IVST,and significant lower E/A and AV(P＜0.001 all).ROC curve showed that the AUC of IVST,E/A and AV alone and their combination in HHD diagnosis was 0.798(95％CI 0.736～0.851),0.682(95％CI 0.613～0.746),0.810(95％CI 0.748～0.862)and 0.927(95％CI 0.881～0.959)respectively,and the diagnostic value of combined detection was significantly higher than those of single detections(Z=4.431,5.669,3.948,P=0.001 all).Spearman correlation analysis showed that E/A and AV were significant negatively correlated with blood pressure grade(r=-0.725,-0.781),while I VST was significant positively correlated with blood pressure grade(r=0.714),and combined detection possessed a stronger correlation with it in HHD patients(r=0.875,P＜0.001 all).Con-clusion:The combined detection of I VST,E/A and AV demonstrates a good predictive value for HHD and exhibits a sig-nificant correlation with blood pressure grade in HHD patients.

On the basis of that the fluorescence wavelength of copper nanoclusters(CuNCs)could cover the entire visible region,multicolor fluorescent CuNCs/starch composites were prepared and applied in fingermark development.With L-glutathione as the reducing agent and protective ligand,blue emissive and orange emissive CuNCs solutions were obtained in alkaline solutions at 90℃and 25℃,respectively.With the aggregation-induced emission effect induced by ethanol as a poor solvent,the fluorescence of orange emissive CuNCs with a higher intensity was achieved in an ethanol-water solution.With ascorbic acid as the reducing agent and 3-mercaptopropionic acid as the protective agent,green emissive CuNCs solution was prepared in an acid solution.Particle morphologies,chemical compositions and optical properties of these three CuNCs above were investigated using physical characterization and spectroscopic analysis,indicating that well-dispersed CuNCs had excellent photoluminescent properties.These CuNCs solutions were combined with starch to form composite powders by simply drying.The influences of the type of CuNCs and the ratio of CuNCs to starch on the emission wavelength and fluorescence intensity of the products were studied.The obtained CuNCs/starch composites could emit blue,green and orange fluorescence under 365 nm ultraviolet light,respectively,which were suitable for fingermark development.Minutiae and partial level-3 features of latent fingermarks could be effectively developed.High-quality fluorescence fingermark images would be captured using appropriate optical filters to eliminate background interference of various substrates.

Objective:To investigate the predictive value of serum β 2-microglobulin (β 2M) and pro-inflammatory cytokines for post-stroke depression (PSD) in patients with acute ischemic stroke (AIS). Methods:Patients with AIS admitted to the Department of Neurology, the Affiliated Municipal Hospital of Xuzhou Medical University from January 2020 to May 2023 were included retrospectively. At the 6-month outpatient follow-up, the Self-rating Depression Scale (SDS) was used to assess depression. Multivariate logistic regression analysis was used to determine the independent influencing factors of PSD. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of individual and combined independent influencing factors on PSD. Results:A total of 161 patients were enrolled, including 82 males (50.93%), aged 61.78±11.95 years; 47 patients (29.20%) developed PSD. Univariate analysis showed that the proportion of males, serum β 2M, interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein level, and baseline National Institutes of Health Stroke Scale (NIHSS) score in the PSD group were significantly different from those in the non-PSD group (all P<0.05). Multivariate logistic regression analysis showed that serum β 2M (odds ratio [ OR] 4.257, 95% confidence interval [ CI]1.441-12.574; P=0.009), IL-1β ( OR 1.415, 95% CI 1.116-1.793; P=0.004), IL-6 ( OR 1.262, 95% CI 1.020-1.561; P=0.032), and TNF-α ( OR 1.246, 95% CI 1.021-1.521; P=0.030) were the independent influencing factors of PSD. ROC curve analysis showed that the area under the curve of serum β 2M for predicting PSD was 0.753 (95% CI 0.668-0.838), with an optimal cutoff value of 2.255 mg/L. The sensitivity and specificity were 59.6% and 80.7%, respectively. When serum β 2M was combined with IL-1β, IL-6 and TNF-α for prediction, the area under the curve increased to 0.893 (95% CI 0.837-0.948). Conclusion:The serum β 2M in combination with pro-inflammatory cytokines has good predictive value for PSD.

In recent years, a variety of innovative fast algorithm techniques have emerged in the field of transcranial magnetic stimulation (TMS) electric field solving, which show great potential to meet the requirements of real-time clinical applications. In this review, the crucial processes of TMS electric field modeling were summarized, focusing on two prominent fast algorithm techniques, namely the basis function method and the deep neural network (DNN)-based method. The advantages and limitations of these two techniques were analyzed in detail. Commonly used software tools for electric field modeling were discussed, and a prospective discussion of future developments was offered, aiming to provide a reference for the further development of TMS electric field modeling technology.