BACKGROUND:Gradient artificial bone repair scaffolds can mimic unique anatomical features in musculoskeletal tissues,showing great potential for repairing injured musculoskeletal tissues. OBJECTIVE:To review the latest research advances in gradient artificial bone repair scaffolds for tissue engineering in the musculoskeletal system and describe their advantages and fabrication strategies. METHODS:The first author of the article searched the Web of Science and PubMed databases for articles published from 2000 to 2023 with search terms"gradient,bone regeneration,scaffold".Finally,76 papers were analyzed and summarized after the screening. RESULTS AND CONCLUSION:(1)As an important means of efficient and high-quality repair of skeletal system tissues,gradient artificial bone repair scaffolds are currently designed bionically for the natural gradient characteristics of bone tissue,bone-cartilage,and tendon-bone tissue.These scaffolds can mimic the extracellular matrix of native tissues to a certain extent in terms of structure and composition,thus promoting cell adhesion,migration,proliferation,differentiation,and regenerative recovery of damaged tissues to their native state.(2)Advanced manufacturing technology provides more possibilities for gradient artificial bone repair scaffold preparation:Gradient electrospun fiber scaffolds constructed by spatially differentiated fiber arrangement and loading of biologically active substances have been developed;gradient 3D printed scaffolds fabricated by layered stacking,graded porosity,and bio-3D printing technology;gradient hydrogel scaffolds fabricated by in-situ layered injections,simple layer-by-layer stacking,and freeze-drying method;and in addition,there are also scaffolds made by other modalities or multi-method coupling.These scaffolds have demonstrated good biocompatibility in vitro experiments,were able to accelerate tissue regeneration in small animal tests,and were observed to have significantly improved histological structure.(3)The currently developed gradient artificial bone repair scaffolds have problems such as mismatch of gradient scales,unclear material-tissue interactions,and side effects caused by degradation products,which need to be further optimized by combining the strengths of related disciplines and clinical needs in the future.

Tumors exhibit abnormal glucose metabolism, consuming excessive glucose and excreting lactate, which constructs a tumor microenvironment that facilitates cancer progression and disrupts immunotherapeutic efficacy. Currently, tumor glucose metabolic dysregulation to reshape the immunosuppressive microenvironment and enhance immunotherapy efficacy is emerging as an innovative therapeutic strategy. However, glucose metabolism modulators lack specificity and still face significant challenges in overcoming tumor delivery barriers, microenvironmental complexity, and metabolic heterogeneity, resulting in poor clinical benefit. Nanomedicines, with their ability to selectively target tumors or immune cells, respond to the tumor microenvironment, co-deliver multiple drugs, and facilitate combinatorial therapies, hold significant promise for enhancing immunotherapy through tumor glucose metabolic reprogramming. This review explores the complex interactions between tumor glucose metabolism-specifically metabolite transport, glycolysis processes, and lactate-and the immune microenvironment. We summarize how nanomedicine-mediated reprogramming of tumor glucose metabolism can enhance immunotherapy efficacy and outline the prospects and challenges in this field.

Objective To investigate the effects of long non-coding RNA FEZ family zinc finger 1 antisense RNA 1(lncRNA FEZF1-AS1)on enhancer of zeste homolog 2(EZH2)in regulation of proliferation,migration,invasion and epithelial-mesenchymal transition(EMT)of pulmonary interstitial cells and its mechanism.Methods The A549 cells human lung adenocarcinoma cell line were divided into control group and model group[model cells were induced into lung interstitial cells after being treated with transforming growth factor β1(TGF-β1)20 ng/mL for 48 h].The protein expression of E-cadherin,N-cadherin and vimentin in each group was detected by Western blot.The expression of lncRNA FEZF1-AS1 and EZH2 in the two groups was detected by RT-qPCR.Cells in the trans-fection group were divided into si NC group,lncRNA FEZF1-AS1+OE vector group and si lncRNA FEZF1-AS1+OE EZH2 group.Cell proliferation was examined by CCK-8 method,cell migration was detected by cell scratch,and cell invasion was detected by Transwell assays.The protein expression of E-cadherin,N-cadherin,vimentin and EZH2 in each group was detected by Western blot.The direct binding effect of FEZF1-AS1 and EZH2 was deter-mined by RNA immuno-precipitation(RIP).Results Compared with the control group,the protein expression level of E-cadherin in the model group was significantly decreased(P＜0.05),and the protein expression of N-cadherin and vimentin was significantly increased(P＜0.05).Compared with the control group,the expression level of lncRNA FEZF1-AS1 and EZH2 genes was significantly increased in the model group(P＜0.05).Compared with si NC group,the proliferation,migration and invasion ability of si lncRNA FEZF1-AS1+OE vector group were decreased,the ex-pression of E-cadherin protein was increased while the expression of N-cadherin,vimentin and EZH2 was decreased(P＜0.05).Compared with si lncRNA FEZF1-AS1+OE vector group,the proliferation,invasion and migration of si lncRNA FEZF1-AS1+OE EZH2 group were increased(P＜0.05).E-cadherin expression was decreased,while N-cad-herin,vimentin and EZH2 expressions were increased(P＜0.05).RIP experiment further confirmed that lncRNA FEZF1-AS1 had direct binding effect with EZH2.Conclusions LncRNA FEZF1-AS1 can promote the proliferation,invasion,metastasis and EMT process of pulmonary fibrosis cells by regulating EZH2.

Delirium is an acute brain dysfunction syndrome characterized by confusion and difficulty concentrating,which mainly affects intensive care unit patients and elderly inpatients.Treatment is expensive and may also lead to increased risks of serious complications and death.The complex etiology and unknown pathological mechanisms of delirium mean that clinical drug treatment is largely ineffective.Animal models therefore provide a powerful tool to help understand the mechanism of delirium,screen new drugs,and study potential intervention measures.We review experimental research related to delirium animal models worldwide,and summarize the latest progress in the construction and evaluation of these models from the aspects of animal selection,model construction method,and model evaluation,to provide a reference for further experimental research based on delirium animal models.

Objective:To comprehensively search the relevant literature on prone position-cardiopulmonary resuscitation (PP-CPR) in adults at home and abroad, analyze the content, summarize the evidence, and provide reference for clinical health care professionals.Methods:Systematic search of CNKI, China Biomedical Literature Service System (SinoMed), Wanfang Data, VIP database, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochran Library, Web of Science, Scopus literature database and other Chinese and English databases was conducted. The search period was from inception to June 15 in 2024. The contents of PP-CPR from randomized controlled trial (RCT), non-RCT (prospective or retrospective), cohort studies and case reports were extracted and systematically analyzed. The search results were standardized by the method of scoping review.Results:A total of 523 articles were obtained through preliminary search, and 14 references and gray literature were retrieved, totaling 537 articles. After strict screening by two researchers, a total of 26 literatures were included, 3 were non-RCT and 23 were case reports, involving 12 countries, including 3 in Chinese, 19 in English, 2 in French, 1 in German, and 1 in Korean. Three non-RCT demonstrated that compared with standard cardiopulmonary resuscitation (CPR), PP-CPR could produce higher pressure, and provide good respiratory and circulatory support. A total of 25 adult patients were included in the 23 case reports, of which 17 reported total recovery time and 13 reported PP-CPR time ≤ 5 minutes, all of which recovered spontaneous circulation, indicating the effectiveness of PP-CPR technology. In terms of final outcome, 4 patients (16.0%) died and 21 patients (84.0%) survived, indicating that PP-CPR technology could provide timely blood circulation and improve clinical outcomes for prone cardiac arrest patients. Among the 11 patients who reported complications after resuscitation, no neurological damage was found in the short-term outcomes, indicating that PP-CPR technology had a certain level of safety.Conclusions:PP-CPR can provide timely blood circulation for patients with cardiac arrest who are unable to lie supine quickly, and win "golden time" for defibrillation and further treatment. In clinical practice, medical staff need to evaluate the emergency environment, the number of rescuers and the specific condition of the patient, and implement first aid as soon as possible, so as to reduce the time of no blood flow in the vital organs of patients with cardiac arrest in prone position, and improve the clinical prognosis.

OBJECTIVE: To analyze the accuracy of prosthesis size selection in Naton robot-assisted medial unicondyle knee arthroplasty by comparing the actual prosthesis size used during operation and the preoperative planning. METHODS: The clinical data of 100 patients (110 knees) who underwent Naton robot-assisted medial unicondylar knee arthroplasty between June 2023 and July 2024 was retrospectively analyzed, including 47 knees on left side and 63 knees on right side. There were 37 males (40 knees) and 63 females (70 knees) with a mean age of 65.4 years (range, 59-71 years). Body mass index was 22.2-28.6 kg/m ² (mean, 25.4 kg/m ²). The disease duration ranged from 1 to 8 years (mean, 3.4 years). Preoperative planning was performed by Naton robotic surgical system based on lower limb CT data. The final prosthesis size after osteotomy was recorded and compared with the preoperative plan to analyse whether it was consistent with the preoperative plan, as well as the situation of knee flexion and extension gaps (<0.5 mm, >2.0 mm) corresponding to the different models of prostheses. RESULTS: During operation, 5 patients (5 knees) were treated with traditional UKA due to mechanical arm failure, software obstacles, significant bone amputation bias, or loose reference frame, and were excluded from the final analysis. The remaining 95 patients (105 knees) successfully received Naton robot-assisted surgery, and no related complications occurred. The prosthesis size was consistent with the preoperative plan in 101 knees (96.2%) on the femur side, 100 knees (95.2%) on the tibia side, and 97 knees (92.4%) on both femur and tibia sides. The prosthesis size was inconsistent in 3 cases (2.86%) on the femur side alone, 4 cases (3.81%) on the tibial side alone, and 1 case (0.95%) on both femur and tibial sides. Among the prostheses with different models, the flexion and extension gaps were less than 0.5 mm in 3 knees, the flexion gap was less than 0.5 mm and the extension gap was more than 2.0 mm in 3 knees, and the flexion gap was more than 2.0 mm and the extension gap was less than 0.5 mm in 2 knees. CONCLUSION The accuracy of prosthesis size selection for Naton robot-assisted medial unicondylar knee arthroplasty is relatively high.
Humans ; Arthroplasty, Replacement, Knee/instrumentation* ; Female ; Male ; Middle Aged ; Aged ; Knee Prosthesis ; Retrospective Studies ; Robotic Surgical Procedures/methods* ; Prosthesis Design ; Knee Joint/surgery* ; Osteoarthritis, Knee/surgery* ; Range of Motion, Articular

Objective:To explore the short-term and long-term prognostic outcomes of anatomical liver resection(AR)for patients with perihilar cholangio-carcinoma. Methods:This is a retrospective study.All data were obtained from 4 centers,including The First Affiliated Hospital of Army Medical University,Eastern Hepatobiliary Hospital of Naval Medical University,Sichuan Provincial People's Hospital and Affiliated Hospital of Qinghai University,of a multi-center database.A total of 305 consecutive perihilar cholangiocarcinoma patients receiving radical resection between January 2013 and June 2021 were included in this study.According to the method of liver resection,all patients were divided into the AR group(n=205)and the non-anatomical liver resection(NAR)group(n=100).The baseline characteristics,short-term prognosis and long-term prognosis of the 2 groups were compared. Results:The perioperative transfusion rate and the 30-day complication rate were significantly lower in the AR group than those in the NAR group(P＜0.05).There was no statistically significant difference in the survival rates between the AR and the NAR groups(P＞0.05). Conclusion:The 2 hepatic resection modalities had no obvious effect on the long-term prognosis of perihilar cholangiocarcinoma patients after radical resection,but choosing AR tends to achieve a better short-term prognosis and is worth promoting in clinical practice.

Objective:To explore the short-term efficacy and safety for the new adjuvant therapy of programmed cell protein-1(PD-1)inhibitor combined with Oxaliplatin+Tegafur(SOX)in locally advanced gastric adenocarcinoma. Methods:Retrospective collection of clinical data from 72 locally advanced(stage Ⅲ)gastric adenocarcinoma patients admitted to our gastrointestinal surgery department from January 2020 to July 2020,according to different treatment plans,patients were divided into a control group(n=36)and an observation group(n=36).The control group received SOX chemotherapy regimen,while the observation group received PD-1 inhibitor combined with SOX regimen.Both groups of patients underwent chemotherapy for 3 cycles,and were re-evaluated after resting for 3-4 weeks.Patients with no disease progression and tolerable surgery underwent D2 gastric cancer radical surgery.The overall survival(OS),pathological complete response(pCR)rate,progression free survival period(PFS),RO resection rate,objective response rate(ORR),disease control rate(DCR)and adverse drug reaction were compared between the two groups. Results:The pCR rate,ORR and DCR of the observation group were significantly higher than those of the control group[pCR rate:25％(9/36)vs 5.6％(2/36),x2=5.258,P=0.022;ORR:58.33％(21/36)vs 25.00％(9/36),x2=8.229,P=0.004;DCR:88.89％(32/36)vs 69.44％(25/36),x2=4.1 26,P=0.042].The incidence of adverse reactions such as elevated ALT,elevated AST,and hand foot syndrome during neoadjuvant chemotherapy in the observation group was significantly higher than those in the control group(P＜0.05).The incidence of other adverse reactions was not significantly difference between the two groups of patients(P＞0.05),and there were no neoadjuvant chemotherapy related death events in both groups.The R0 resection rates of the two groups were 97.22％and 91.67％,respectively(x2=1.059,P=0.303).The median OS and median PFS of 72 patients were 36 and 1 3 months,respectively.The 2-year OS rate of the two groups were 82.2％and 71.5％,respectively.Kaplan Meier survival curve analysis showed that the OS rate of the observation group was significantly higher than that of the control group(x2=4.240,P=0.039);the median PFS of the observation group was higher than that of the control group at 14 and 1 1 months,respectively(x2=4.173,P=0.041);COX univariate regression analysis did not identify any factors affecting survival of locally advanced gastric adenocarcinoma. Conclusion:The neoadjuvant treatment of locally advanced gastric adenocarcinoma with PD-1 inhibitor combined with SOX regimen is safe and effective,and the adverse reactions are controllable.

Objective:To investigate the clinical efficacy differences of stereotactic electroencephalogram (SEEG) electrode implantation in medically-refractory temporal lobe epilepsy (TLE) patients with different neuroimaging manifestations before surgery.Methods:A total of 59 patients with medically-refractory TLE who accepted SEEG electrode implantation in Department of Neurosurgery, First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from January 2018 to December 2021 were enrolled. These were divided into groups according to neuroimaging manifestations before surgery, including MRI-positive group and MRI-negative group, PET-positive group and PET-negative group, or PET&MRI concordant group (concordant group) and PET&MRI discordant group (discordant group). Modified Engel classification was used to evaluate the clinical efficacy of these patients at 12-month follow-up after surgery, and efficacy differences among different patient groups were compared.Results:Significant differences were noted in distributions of modified Engel classification between the MRI positive and negative groups, as well as the concordant and discordant groups at 12-month follow-up after surgery ( P<0.05); patients in the MRI positive group had better outcomes than those in the MRI negative group (mean rank judgment: 27.00 and 34.08), while patients in concordant group had better outcomes than those in discordant group (mean rank judgment: 23.32 and 31.19). Significant differences were noted in distributions of modified Engel classification at 12-month follow-up after surgery between different signal abnormal regions in the MRI positive group ( P<0.05); patients with hippocampal sclerosis or amygdala abnormalities had better outcomes than those with simultaneous abnormalities in the temporal lobe internal and external regions (mean rank judgment: 14.50 and 16.50). Conclusion:When the preoperative MRI of patients with medically-refractory TLE is negative, especially when results of structural imaging and functional imaging are inconsistent, SEEG electrode implantation and path planning as well as later surgical plan should be considered more carefully.

OBJECTIVE To accurately analyze the components of glandular hairs in Lonicera japonica Thunb. buds, and provide reference for quality evaluation and control of Lonicera japonica Thunb.. METHODS Laser microdissection technology was used to obtain glandular hairs of Lonicera japonica Thunb. buds, low-temperature freezing vortex method was used to removal flower buds surface hairs(glandular hairs and non glandular hairs), and the components of flower buds, flower buds removed surface hairs and glandular hairs were detected by HPLC-TOF/MS. Through comparison with standards, database retrieval and mass spectrometry fragmentation, the components were analyzed and identified. RESULTS Thirty-seven components were identified in the flower buds, 31 components were identified in the flower buds removed surface hairs, and 35 components were identified in the glandular hairs. Compared with flower buds, glandular hairs lack 2 phenolic acids, and flower buds removed surface hairs lack 6 flavonoids. CONCLUSION The glandular hair, which contains many secondary substances, is an important place for the synthesis and accumulation of secondary substances in Lonicera japonica Thunb. buds, and is closely related to the quality of Lonicera japonica Thunb..