In current clinical practice, various dermal templates and skin substitutes are used to enhance wound healing. However, the role of wound commensal microbiome in regulating scaffold performance and the healing process remains unclear. In this study, we investigated the influence of both natural and synthetic scaffolds on the wound commensal microbiome and wound repair in three distinct models including diabetic wounds, burn injuries, and germ-free (GF) wounds. Remarkably, synthetic electrospun polycaprolactone (PCL) scaffolds were observed to positively promote microbiome diversity, leading to enhanced diabetic wound healing compared to the natural scaffolds Integra® (INT) and MatriDerm® (MAD). In contrast, both natural and synthetic scaffolds exhibited comparable effects on the diversity of the microbiome and the healing of burn injuries. In GF wounds with no detectable microorganisms, a reversed healing rate was noted showing natural scaffold (MAD) accelerated wound repair compared to the open or the synthetic scaffold (PCL) treatment. Furthermore, the response of the wound commensal microbiome to PCL scaffolds appears pivotal in promoting anti-inflammatory factors during diabetic wound healing. Our results emphasize that the wound commensal microbiome, mediated by different scaffolds plays an important role in the wound healing process.

Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

In the past 30 years, gastrointestinal surgery in China has made significant progress, which is reflected in the gradual standardization of clinical diagnosis and treatment, significant improvement in surgical quality, improvement in short-term and long-term postoperative outcomes, and continuous development of high-quality clinical research. At present, the spectrum of disease in gastrointestinal surgery has changed from traditional benign diseases to malignant diseases represented by gastric cancer and colorectal cancer, metabolic diseases represented by obesity and diabetes, and immune diseases represented by inflammatory bowel disease. It is necessary to carry out full-cycle management for patients. In the new era full of opportunities and challenges, surgeons must be driven by innovation in surgical technology, guided by high-quality clinical research and guaranteed by standardized diagnosis and treatment of diseases, to continue to promote the high-quality development of gastrointestinal surgery in China.

Objective To analyze the pharmacodynamic interaction of esketamine and propofol in hysteroscopic surgery by response surface method.Methods Forty-five patients underwent elective hystero-scopic surgery,aged 18.5-64.0 years,BMI 18.5-28.0 kg/m2,ASA physical status Ⅰ or Ⅱ.Compound propofol target control infusion of esketamine(0,0.1,0.2,0.3,0.4,0.5,0.6,0.7,and 0.8 μg/ml)with different plasma drug concentrations were selected to keep the plasma drug concentration of esketamine unchanged,and the plasma drug concentration of propofol was increased step by step.To evaluate body re-sponse caused by dilation of the cervix.A response surface model was used to analyze the pharmacodynamic interaction of esketamine and propofol.Results The three-dimensional response surface of esketamine(0.0-0.8 μg/ml)and propofol(1.0-7.0 μg/ml)showed that the two have an additive effect in sedation and inhibition of body activity reaction caused by dilated cervix.The median effective concentration(EC50)of esketamine was 0.61 μg/ml(95％CI 0.41-0.81 μg/ml),and the EC50 of propofol was 4.69 μg/ml(95％CI 3.17-6.21 μg/ml)when inhibits the body activity reaction caused by dilated cervix.Conclusion Response surface method can qualitatively and quantitatively analyze the pharmacodynamic interaction of es-ketamine and propofol.Esketamine and propofol have additive effects in inhibiting the body activity reaction caused by dilated cervix.

Objective:To explore the effect of "Internet plus" exercise prescription intervention on upper limb dysfunction and quality of life of breast cancer patients at home after surgery, so as to provide reference for health management of breast cancer patients after surgery.Methods:Adopting a prospective randomized controlled trial research method. From November 2021 to January 2023, 124 breast cancer patients in the breast and thyroid surgery department of Xiang′an Hospital Affiliated to Xiamen University were selected for the study. According to the random number table method, they were randomly divided into an intervention group (62 cases) and a control group (62 cases). The control group patients were given routine training, and the intervention group patients received routine training in the first four weeks after operation, and "Internet plus" exercise prescription intervention in the fifth week after operation. The upper limb dysfunction, quality of life before and after the intervention and motor compliance after the intervention between the two groups were compared.Results:A total of 117 patients were ultimately included, and they were all female, with 58 patients in the intervention group aged (51.01 ± 9.77) years old and 59 patients in the control group aged (51.47 ± 9.85) years old. There was no statistically significant difference in upper limb dysfunction and quality of life between the two groups of patients before intervention ( P>0.05). After the intervention, the degree of upper limb dysfunction in the intervention group was (63.55 ± 7.02) points, which were lower than that in the control group (67.13 ± 7.25) points, and the difference was statistically significant ( t = 2.71, P<0.01). After the intervention, the total score of quality of life and the scores of physiological status, social/family status, emotional status, functional status and additional attention of breast cancer patients in the intervention group were (115.27 ± 17.35), (22.65 ± 4.53), (22.79 ± 4.36), (20.96 ± 3.95), (19.56 ± 4.22), (29.31 ± 5.24) points, which were higher than those in the control group (104.28 ± 17.04), (20.57 ± 4.48), (20.85 ± 4.23), (18.75 ± 4.04), (17.18 ± 4.06), (26.93 ± 5.21) points, the differences were statistically significant ( t values were 2.44-3.46, all P<0.05). In terms of exercise compliance of breast cancer patients in the intervention group, the aerobic exercise completion rate was 91.38% (53/58), muscle strength training completion rate was 77.59% (45/58), stretching exercise completion rate was 86.21% (50/58), exercise frequency was (3.96 ± 1.13) times/week, exercise duration was (29.51 ± 7.64) min/time, which was superior to 77.97% (46/59), 57.63% (34/59), 69.49% (41/59), (3.38 ± 0.94) times/week, (23.96 ± 7.33) min/time in the control group, the differences were statistically significant ( χ2 = 4.04, 5.31, 4.73, t = 3.02, 4.01, all P<0.05). Conclusions:"Internet plus" exercise prescription intervention has the characteristics of convenience, intuition and strong operability, which is conducive to improving the upper limb dysfunction, quality of life and exercise compliance of breast cancer patients at home after surgery. It is recommended to be popularized and applied clinically.

To develop a new type of moxibustion treatment equipment based on moxibustion heat,light and smoke factors.It was composed of three parts:upper cylinder,middle cylinder and lower cylinder,which integrated multiple functions such as temperature control,ash collection,adsorption,and anti-scalding,and all parts could be disassembled.It is convenient to use,convenient for clinical treatment and health care,can overcome the problem of not being able to adjust the temperature of moxibustion therapy and easy to burn in the process of moxibustion,reduce the irritation and pollution of moxa smoke smell and smoke dust on doctors,patients and the diagnosis and treatment environment,and make moxibustion therapy more convenient,efficient and safe.

Respiratory syncytial virus(RSV)infection is a potential susceptibility factor for recurrent wheezing,which can affect the occurrence and development of asthma through immune damage,airway epithelial barrier damage,airway inflammatory infiltration,airway hyperresponsiveness,and high expression of induced susceptibility genes.Traditional Chinese medicine believes that asthma caused by RSV infection is mostly caused by the imbalance of the body's qi after infection and the retention of evil qi.By combing the mechanism of RSV infection in the occurrence and development of asthma and the research on traditional Chinese medicine intervention in recent years,it is hoped to provide ideas for the future application of combined Chinese and Western medicine to prevent and treat asthma.

Standardized reporting is a crucial factor affecting the use of patient guidelines （PGs）， particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting， including the research on PG content and presentation formats， and provided comprehensive recommendations for PG reporting from aspects such as overall framework， recommendations， presentation format， and readability. First， the presentation of PG recommendations should include clearly defined clinical questions， recommendations and their rationale， and guidance on how patients should implement the interventions； for specific content in the PG， such as level of evidence， level of recommendation， it is recommended to explain in text the reasons for giving different levels of recommendation， i.e.， to present the logic behind giving the level of recommendation to the patient； additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently， the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines （RIGHT-PVG） reporting framework. Finally， to enhance readability and comprehension， it is recommended to refer to the Patient Education Materials Assessment Tool （PEMAT） for translating PG content. To enhance the readability of PGs， it is suggested to present the PG content in a persona-lized and layered manner.

Objective:To establish a two-stage surgical procedure of impacted mandibular third molars (IMTM) extractions assisted by coronectomy and microimplant anchorage traction and to investigate the influencing factors of root movement and the effects of different traction angles on the clinical outcomes.Methods:Fifty-three IMTM in contact with inferior alveolar nerve (IAN) that underwent tooth extraction in the Department of Oral and Maxillofacial Surgery Peking University School of Stomatology from January 2022 to June 2023 were included, with coronectomy and microimplant anchorage implantation in the first stage of the surgery, root traction was achieved with orthodontic elastic and microimplant anchorages by about 5.886 N of force, when the IMTM root was detached from IAN, a second surgery was performed to extract the residual root. The basic information of patients and M3M, data on the microimplant anchorage implantation and traction, imaging measurements, and complications were recorded and analyzed.Results:The movement distance of the residual roots was (1.80±0.92) mm, and the duration of traction was (32.9±7.9) d. Multiple linear regression analysis showed that the residual root movement distance was significantly correlated with age, gender, number of roots, traction angle, and depth of the distal bone defect of the second molar ( P<0.05). The smaller the traction angle, the more significant the movement of the residual roots ( P=0.044). In one case, the patient experienced abnormal sensation in the lower lip 16 days after one IMTM (1.9%, 1/53) traction. Conclusions:The two-stage surgical method of combined coronectomy with rapid traction technique to extract the IMTM allows for rapid movement of the residual root and reduces the risk of IAN injury. The efficiency of root movement can be accelerated by appropriately reducing the traction angle during surgery. The traction effect can be predicted based on indicators such as age, gender, number of roots and depth of distal bone defects of second molar.

Diabetic lower extremity vascular disease is one of the common chronic complications of diabetes,which has a strong disabling effect,clinically,it is of great significance to actively and effectively control the progression of the disease and improve the quality of life of patients.In Sanxiao Lun,LIU Wansu put forward the theory of"dryness-heat and stagnation"according to the pathogenesis of consumptive thirst,and thought that the dryness-heat and stagnation in the stomach and intestines of sanjiao were too severe,the xuanfu was blocked,and the qi and liquid failed to diffuse,which caused diabetes.Vascular endothelial injury and inflammatory reaction are important factors in the development of vascular disease,the pathogenesis evolution of"dryness-heat and stagnation"conforms to the pathological characteristics of inflammatory reaction in western medicine,and the dryness-heat runs through the diabetic lower extremity vascular disease throughout.In this paper,it is believed that diabetic lower extremity vascular disease belongs to the category of"flaccidity and paralysis"in traditional Chinese medicine,and lung scorched by heat is the cause of flaccidity."Dryness-heat and stagnation"is the source of invading heat(dryness-heat),lung scorched by heat,pulse failure and vein stasis occurred,which causes diabetic lower extremity vascular disease.Treatment should be based on flaccidity,combined with the viewpoint of LIU Wansu's Sanxiao Lun,taking yangming as the top priority,regulating the triple diabetes,solving the problem of dryness-heat and stagnation,combined with the method of purging the south and supplementing the north,so that the invading heat is cleared,lung heat is diminished,and flaccidity disease cannot occur,in order to provide new ideas for the clinical prevention and treatment of diabetic lower extremity vascular disease.