The analysis presented here is based on the blood components of Guanxin Qiwei tablets, the key anti-atherosclerosis pathway of Guanxin Qiwei tablets was screened by network pharmacology, and the anti-atherosclerosis mechanism of Guanxin Qiwei tablets was clarified and verified by cell experiments. HPLC-Q-Exactive-MS/MS technique was used to analyze the components of Guanxin Qiwei tablets into blood, to determine the precise mass charge ratio of the compounds, and to conduct a comprehensive analysis of the components by using secondary mass spectrometry fragments and literature comparison. Finally, a total of 42 components of Guanxin Qiwei tablets into blood were identified. To better understand the interactions, we employed the Swiss Target Prediction database to predict the associated targets. Atherosclerosis (AS) disease targets were searched in disease databases Genecard, OMIM and Disgent, and 181 intersection targets of disease targets and component targets were obtained by Venny 2.1.0 software. Protein interactions were analyzed by String database. The 32 core targets were selected by Cytscape software. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed in DAVID database. It was found that the anti-atherosclerosis pathways of Guanxin Qiwei tablets mainly include lipid metabolism and atherosclerosis and AGE-RAGE signaling pathway in diabetic complications and other signal pathways. The core targets and the core compounds were interlinked, and it was found that cryptotanshinone and tanshinone ⅡA in Guanxin Qiwei tablets were well bound to TNF, PPARγ, AKT1, PTG2 and other targets. The lipid metabolism and atherosclerotic pathway was verified using human hl-7702 hepatocytes. This study preliminarily identified the potential pharmacodynamic components of Guanxin Qiwei tablets in the treatment of AS diseases and predicted their pathways of action, and verified the relationship between regulating lipid metabolism and atherosclerosis of Guanxin Qiwei tablets in vitro, providing a reference for the further study of the pharmacodynamic material basis and mechanism of action of this prescription. This experiment was approved by the Medical Ethics Committee of Inner Mongolia Medical University (No. YKD202401262).

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.

Purpose: We report the diagnosis and conservative treatment of a patient with dacryocystitis accompanied by a congenital lacrimal sac diverticulum.Case summary: An 11-year-old boy presented with itching and redness in his right eye. His best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left. Physical examination revealed redness, swelling, and tenderness around the right lacrimal sac area. Probing of the nasolacrimal duct showed no obstruction. Additional tests were performed under the diagnosis of acute dacryocystitis. Computed tomography and magnetic resonance imaging suggested inflammation of the soft tissue with abscess formation around the right orbit, with inflammation extending to the lower eyelid. After 7 days of inpatient treatment, the symptoms improved. Dacryocystography performed after the symptoms improved showed a small amount of residual contrast in a space near the lacrimal sac, leading to the diagnosis of a right lacrimal sac diverticulum. Conclusions In patients with dacryocystitis without nasolacrimal duct obstruction, congenital lacrimal diverticulum should be suspected.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.

Objective:To introduce the clinical application of three-dimensional(3D) printed titanium alloy prosthesis in the reconstruction of mandibular defects.Methods:Three patients with extensive mandibular defects, who were either ineligible for or refused autologous bone transplantation were selected from the Oral and Maxillofacial-Head and Neck Oncology Department at School & Hospital of Stomatology, Wuhan University between April 2019 and December 2021. Preoperative oral and maxillofacial CT scanning was performed, followed by a virtual surgical plan and the design and manufacture of titanium mandibular prosthesis as well as the surgery guide-plate. Repair of mandibular defects using 3D printed titanium mandibular prosthesis. Follow-up after surgery to evaluate the patient’s functional and cosmetic recovery.Results:The study included three male patients aged 27, 10 years and 8 months, and 74 years, respectively. Two cases involved recurrent mandibular tumors postoperatively, and one case involved mandibular defects following gingival tumor surgery that affected the patient’s facial appearance and eating. All surgeries were successfully completed, with postoperative outpatient follow-ups at 36, 32, and 6 months, respectively. Follow-up indicated that the facial contours were basically symmetrical, the degree of mouth opening was normal, and the occlusion on the healthy side was essentially normal. No exposure, loosening, or fracturing of the prostheses was observed.Conclusion:3D printed titanium mandibular prosthesis can effectively restore the facial contour and mandibular function of patients.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective:To introduce the clinical application of three-dimensional(3D) printed titanium alloy prosthesis in the reconstruction of mandibular defects.Methods:Three patients with extensive mandibular defects, who were either ineligible for or refused autologous bone transplantation were selected from the Oral and Maxillofacial-Head and Neck Oncology Department at School & Hospital of Stomatology, Wuhan University between April 2019 and December 2021. Preoperative oral and maxillofacial CT scanning was performed, followed by a virtual surgical plan and the design and manufacture of titanium mandibular prosthesis as well as the surgery guide-plate. Repair of mandibular defects using 3D printed titanium mandibular prosthesis. Follow-up after surgery to evaluate the patient’s functional and cosmetic recovery.Results:The study included three male patients aged 27, 10 years and 8 months, and 74 years, respectively. Two cases involved recurrent mandibular tumors postoperatively, and one case involved mandibular defects following gingival tumor surgery that affected the patient’s facial appearance and eating. All surgeries were successfully completed, with postoperative outpatient follow-ups at 36, 32, and 6 months, respectively. Follow-up indicated that the facial contours were basically symmetrical, the degree of mouth opening was normal, and the occlusion on the healthy side was essentially normal. No exposure, loosening, or fracturing of the prostheses was observed.Conclusion:3D printed titanium mandibular prosthesis can effectively restore the facial contour and mandibular function of patients.

Hyaluronan and proteoglycan link protein 1(Hapln1)supports active cardiomyogenesis in zebrafish hearts,but its regulation in mammal cardiomyocytes is unclear.This study aimed to explore the potential regulation of Hapln1 in the dedifferentiation and proliferation of cardiomyocytes and its therapeutic value in myocardial infarction with human induced pluripotent stem cell(hiPSC)-derived car-diomyocytes(CMs)and an adult mouse model of myocardial infarction.HiPSC-CMs and adult mice with myocardial infarction were used as in vitro and in vivo models,respectively.Previous single-cell RNA sequencing data were retrieved for bioinformatic exploration.The results showed that recombinant human Hapln1(rhHapln1)promotes the proliferation of hiPSC-CMs in a dose-dependent manner.As a physical binding protein of Hapln1,versican interacted with Nodal growth differentiation factor(NODAL)and growth differentiation factor 11(GDF11).GDF11,but not NODAL,was expressed by hiPSC-CMs.GDF11 expression was unaffected by rhHapln1 treatment.However,this molecule was required for rhHapln1-mediated activation of the transforming growth factor(TGF)-β/Drosophila mothers against decapentaplegic protein(SMAD)2/3 signaling in hiPSC-CMs,which stimulates cell dedifferentiation and proliferation.Recombinant mouse Hapln1(rmHapln1)could induce cardiac regeneration in the adult mouse model of myocardial infarction.In addition,rmHapln1 induced hiPSC-CM proliferation.In conclusion,Hapln1 can stimulate the dedifferentiation and proliferation of iPSC-derived cardiomyocytes by promoting versican-based GDF11 trapping and subsequent activation of the TGF-β/SMAD2/3 signaling pathway.Hapln1 might be an effective hiPSC-CM dedifferentiation and proliferation agent and a po-tential reagent for repairing damaged hearts.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.