Osteosarcoma of the jaw (JOS), is a relatively rare type of osteosarcoma, with a unique pathogenesis and pathological manifestations. The clinical manifestation of JOS is not characteristic, and it often needs to be diagnosed by combining radiological and pathological examination. At present, the conventional treatment of JOS is a comprehensive treatment based on surgery and supplemented by radiotherapy and chemotherapy. Recently, the emergence of new therapies such as immunotherapy, gene therapy, phototherapy and traditional Chinese medicine has provided more choices for treatment and brought new hope to patients with JOS. Therefore, this article summarized the current understanding of diagnosis and the latest treatment development of JOS.

Objective To explore the risk factors of incision complications after cerebral revasculariza-tion.Methods The patients who underwent vascular reconstruction for craniocerebral vascular diseases in the Affiliated Hospital of Xuzhou Medical University who underwent revascularization for cerebrovascular disea-ses from January 2018 to December 2022 were retrospectively included,and the patients were divided into the incision complications group and the no incision complications group.Among them,this study documented the delayed complications following incision healing after cerebral revascularization.The baseline clinical data of patients'demographics and incisional complications after cerebral revascularization were recorded,and possi-ble influencing factors were included in a binary logistic regression analysis to analyze the influencing factors that may contribute to the occurrence of incisional complications after cerebral revascularization.Results A total of 117 patients who underwent cerebral revascularization were included,including 25 cases(21.4％)in the group with incision complications,including 7 cases(28.0％)of fat liquefaction,4 cases(16.0％)of inci-sion dehiscence,7 cases(28.0％)of incision infection,and 7 cases(28.0％)of necrosis,while 92 cases(78.6％)in the group without incisional complications.Univariate analysis showed that there was no statisti-cally significant difference in gender,age,hypertension,hyperlipidemia,smoking,drinking,disease type,and vascular reconstruction type between the patients with incision complications after cerebral revascularization and those without incision complications(P＞0.05).The proportion of patients with diabetes mellitus and the frontal branches of superficial temporal artery not preserved in the incision complications group was higher than in the no incision complications group.BMI,scalp thickness,and operation time in the group with incision complications were higher than those in the no incision complications group,and the difference was statistical-ly significant(P＜0.05).Multifactorial analysis showed that scalp thickness(OR=1.484,95％CI:1.024-2.149,P=0.037),BMI(OR=1.323,95％CI:1.042-1.680,P=0.021),and the absence of the frontal branch of the superficial temporal artery(OR=3.582,95％CI:1.146-11.190,P=0.028),were the main risk factors for incisional complications(P＜0.05).Conclusion BMI,scalp thickness,and failure to preserve the frontal branch of the superficial temporal artery are independent risk factors for scalp incision complica-tions after cerebral revascularization.

Objectives: . The annual prevalence of chronic rhinosinusitis (CRS) is increasing, and the lack of effective treatments imposes a substantial burden on both patients and society. The formation of nasal polyps in patients with CRS is closely related to tissue remodeling, which is largely driven by the epithelial-mesenchymal transition (EMT). MicroRNA (miRNA) plays a pivotal role in the pathogenesis of numerous diseases through the miRNA-mRNA regulatory network; however, the specific mechanism of the miRNAs involved in the formation of nasal polyps remains unclear. Methods: . The expression of EMT markers and Smad3 were detected using western blots, quantitative real-time polymerase chain reaction, and immunohistochemical and immunofluorescence staining. Differentially expressed genes in nasal polyps and normal tissues were screened through the Gene Expression Omnibus database. To predict the target genes of miR-145-5p, three different miRNA target prediction databases were used. The migratory ability of cells was evaluated using cell migration assay and wound healing assays. Results: . miR-145-5p was associated with the EMT process and was significantly downregulated in nasal polyp tissues. In vitro experiments revealed that the downregulation of miR-145-5p promoted EMT. Conversely, increasing miR-145-5p levels reversed the EMT induced by transforming growth factor-β1. Bioinformatics analysis suggested that miR-145-5p targets Smad3. Subsequent experiments confirmed that miR-145-5p inhibits Smad3 expression. Conclusion . Overall, miR-145-5p is a promising target to inhibit nasal polyp formation, and the findings of this study provide a theoretical basis for nanoparticle-mediated miR-145-5p delivery for the treatment of nasal polyps.

Objective:To evaluate the clinical efficacy of modified all-arthroscopic reconstruction of medial patella femoral ligament (MPFL) for the treatment of recurrent patellar dislocation.Methods:A retrospective case series study was conducted to analyze the clinical data of 38 patients (46 knees) with recurrent patellar dislocation, who were treated at First Affiliated Hospital of Shenzhen University from January 2017 to January 2020. The patients included 12 males (12 knees) and 26 females (34 knees), aged 14-40 years [(24.6±5.4)years]. All patients underwent the modified all-arthroscopic MPFL reconstruction procedure. The femoral tunnel locations were assessed by 3D-CT immediately after surgery. The MRI was performed at 6 and 12 months after operation to assess the healing morphology of the reconstructed MPFL. The Lysholm score and Kujala score were used to assess the knee function before operation, at 6 months after operation, at 12 months after operation and at the last follow-up. The time to return to sports as well as complications were observed.Results:All patients were followed up for 26-48 months [(32.4±8.6)months]. Postoperative 3D-CT examination showed that the femoral tunnels were located in the groove area of the medial epicondyle of the femur and the adductor tubercle. At 6 and 12 months after operation, MRI T2 images showed that the reconstructed MPFL had a low signal and well tensioned ligament tissue, indicating that the MPFL was healed well. The Lysholm scores at 6 and 12 months postoperatively and at the last follow-up were (81.1±12.0)points, (91.2±3.8)points, and (92.2±9.8)points, respectively, being significantly higher than the preoperative (52.4±10.6)points (all P<0.01). The Kujala scores at 6 and 12 months postoperatively and at the last follow-up were (85.4±3.9)points, (91.4±3.6)points, and (93.1±8.5)points, respectively, being significantly higher than the preoperative (55.2±6.8)points (all P<0.01). Compared with 6 months postoperatively, the Lysholm score and Kujala score were significantly improved at 12 months postoperatively and at the last follow-up (all P<0.05). All patients returned to sports, with the time to return to sports for 3-12 months [(8.7±2.3)months] after operation. One patient had poor wound healing but was healed after dressing changes. No wound infection, nerve injury, joint stiffness, patella re-dislocation or other complications occurred. Conclusion:For recurrent patellar dislocation, the modified all-arthroscopic MPFL reconstruction has advantages of accurate bone tunnel positioning, good ligament healing, good function recovery, early return to sports, and less postoperative complications.

To investigate the therapeutic effect and mechanism of Qingwen Baiduyin on acute lung injury （ALI） in mice induced by lipopolysaccharide （LPS）. MethodA total of 144 C57BL/6 mice were randomly divided into the following groups： a normal group， a model group （LPS， 5 mg·kg^-1）， a dexamethasone group （5 mg·kg^-1）， and low-， medium-， and high-dose Qingwen Baiduyin groups （14.105， 28.21， 56.42 g·kg^-1）. The mice were treated once daily for 5 days. One hour after the final administration， the ALI model was established by intratracheal instillation of LPS， and samples were collected at 6 h and 24 h after modeling. The arterial blood gas index of mice was analyzed. The total protein content， total cell count， Evans blue dye （EBD） content， and lung tissue wet-to-dry weight ratio （W/D） of bronchoalveolar lavage fluid （BALF） were measured. Hematoxylin-eosin （HE） staining was performed to assess the pathological changes in mouse lung tissue. Western blot was used to detect the expression levels of key proteins in the Janus kinase 1/signal transducer and activator of transcription 1/interferon regulatory factor 1 （JAK1/STAT1/IRF1） signaling pathway in lung tissue. ResultCompared with the normal group， the model group showed reduced arterial oxygen pressure （pO₂）， oxygen saturation （SO₂）， and lung tissue W/D （P<0.05， P<0.01）， increased carbon dioxide pressure （pCO₂）， total protein content， total cell count， EBD content， interferon-γ （IFN-γ）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， chemokine CXC ligand 1 （CXCL1）， chemokine CXC ligand 2 （CXCL2）， chemokine CXC ligand 9 （CXCL9）， and chemokine CXC ligand 10 （CXCL10） content （P<0.05， P<0.01）， thickening of the alveolar walls， fusion of alveolar cavities， and infiltration of inflammatory cells in lung tissue， increased proportion of M1 macrophage polarization and lung cell apoptosis （P<0.05）， and increased protein expression levels of JAK1， phosphorylated JAK1 （p-JAK1）， inducible nitric oxide synthase （iNOS）， STAT1， phosphorylated STAT1 （p-STAT1）， IRF1， gasdermin D （GSDMD）， and mixed lineage kinase domain-like protein （MLKL） （P<0.05， P<0.01）. Compared with the model group， Qingwen Baiduyin significantly increased pO₂， SO₂， and lung tissue W/D （P<0.05， P<0.01）， improved the pathological changes in lung tissue， and reduced pCO₂， total protein content， total cell count， EBD content， IFN-γ， TNF-α， IL-1β， CXCL1， CXCL2， CXCL9， and CXCL10 content， proportion of M1 macrophage polarization， and protein expression levels of JAK1， p-JAK1， iNOS， STAT1， p-STAT1， IRF1， GSDMD， and MLKL （P<0.05， P<0.01）. ConclusionQingwen Baiduyin can improve the lung inflammatory response and reduce lung cell apoptosis in mice with ALI by inhibiting the JAK1/STAT1/IRF1 signaling pathway， thereby exerting a lung-protective effect.

ObjectiveTo explore the effect and mechanism of Zuojinwan （ZJW） in the treatment of ulcerative colitis （UC） through network pharmacology and experimental validation. MethodUsing network pharmacology and molecular docking， the active components and potential mechanism of ZJW in treating UC were preliminarily identified. Forty-eight male C57BL/6J mice were randomly divided into a normal group， a model group， a sulfasalazine group （300 mg·kg^-1）， and low-， medium-， and high-dose ZJW groups （1.82， 3.64， 7.28 g·kg^-1）. The UC model was induced by dextran sulfate sodium （DSS）， and oral administration of drugs began on the third day of modeling， lasting for 7 days. The general condition of mice was observed daily， and the disease activity index （DAI） was evaluated. Hematoxylin-eosin （HE） staining was performed to observe histopathological changes in colon tissue. Enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of tumor necrosis factor （TNF）-α， interleukin （IL）-6， and IL-10 in mouse serum. The molecular mechanism was validated using Western blot. ResultNetwork pharmacology predicted that the phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway might be a key pathway in the regulation of UC by ZJW. Molecular docking results showed good binding ability between the key components of ZJW and core targets. Animal experiment results showed that compared with the normal group， the model group had shortened colon length （P<0.01）， increased DAI scores， spleen index， colon tissue pathology scores， and levels of TNF-α and IL-6 in serum （P<0.05， P<0.01）， increased PI3K， phosphorylated Akt （p-Akt）， and B-cell lymphoma-2 （Bcl-2）-associated X protein （Bax） expression in colon tissue （P<0.05， P<0.01）， and decreased serum IL-10 levels and colon tissue Bcl-2 protein expression （P<0.01）. Compared with the model group， the ZJW groups showed significant improvement in UC symptoms， relieved colon tissue pathological damage， downregulated levels of inflammatory cytokines TNF-α and IL-6 in serum （P<0.01）， inhibited expression of PI3K， p-Akt， and Bax proteins in colon tissue （P<0.05， P<0.01）， and increased serum IL-10 levels and colon tissue Bcl-2 protein expression （P<0.01）， with the high-dose group showing the best effect. ConclusionZJW effectively alleviates DSS-induced UC， and its mechanism may be related to the inhibition of the PI3K/Akt signaling pathway and regulation of apoptosis-related protein expression.

OBJECTIVE To identify and evaluate the risk factors in the operation process of the vaccine supply chain ，clarify the importance of each process risk in the overall risk of the vaccine supply chain ，and provide reference for stakeholders in the vaccine supply chain to formulate risk management and control strategies. METHODS In the supply chain operation reference model，the risk factors existing in the operation of vaccine supply chain were identified ，and the vaccine supply chain risk evaluation index system was constructed. The best-worst method and entropy weight method were used to determine the subjective and objective weight of the index ，and the Lagrange multiplier method was used to solve the optimal combination weight value of the index. RESULTS & CONCLUSIONS A vaccine supply chain risk evaluation index system with 18 indexes was established. Only 67％ of the indexes reflected 85％ of the vaccine supply chain risk information. The construction of the system was reasonable. The results showed that the risk weight of production process was 0.607，which accounts for the highest weight in the overall risk of vaccine supply chain ，followed by procurement （0.234），distribution（0.102），planning（0.053）and return （0.004） process risk . When managing and controlling risks ，enterprises should attach great importance to the risk factors in vaccine production；at the same time ，enterprises should also focus on other risks such as unqualified materials for products ，mixed use of materials and so on.

Objective To investigate the therapeutic effect of multidisciplinary orthogeriatric management for geriatric hip fractures. Methods The 492 consecutive patients aged 65~99 years (mean ,79.6 years)with woman 69.9% (344/492)were recruited between May 2015 and April 2016 in the retrospective study. Clinical data ,time from admission to initiation of surgery ,in-hospital mortality and mobility status of patients receiving orthogeriatric co-management were analyzed. Results The operation was performed in 434 patients(88.2% ). The 49.8% (216/434)of patients underwent surgery within 48 hours after admission. The average time between admission and operation was 66.5 hours(6~246 hours).In-hospital mortality was 0.7% (3/434).The 382 patients(88.0% )were followed up , with mean follow-up of 21.2 months(range ,16~27 months). The total mortality was 9.9% (38/382) and one-year mortality was 6.5% (25/382). The average Parker mobility score of 344 survived patients was significantly reduced from 8.4 before injury to 6.6 at final follow up(P＜0.01).The 42.4% (162/382)of patients returned to their pre-injury mobility status. Re-operation was performed in 8 patients(2.1% )during follow up. Conclusions Multidisciplinary orthogeriatric management for geriatric hip fractures is effective with a low in hospital and one-year mortality ,while the mobility status is deteriorated significantly and more than half of the patients cannot return to their pre-injury mobility status.

Objective To investigate the current perioperative management of geriatric hip fractures in China.Methods The survey was performed between 15th to 21st of November,2017.An electric questionnaire was delivered to the orthopedic surgeons attending the 12th International Congress of Chinese Orthopedic Association (COA) and the orthopedic fellows attending grand round at Department of Orthopaedic Trauma,Beijing Jishuitan Hospital.The questionnaire addressed the current perioperative management of geriatric hip fractures (≥ 65 years) at the departments where the participants worked,covering preoperative examination and preparation,postoperative rehabilitation and multidisciplinary collaboration.Results 171 valid questionnaires were collected for this study.Of the 171 orthopedic surgeons from 28 provinces in China,106 (62.0％) came from a tertiary hospital and 65 (38.0％) from a secondary hospital.In 74.3％ (127/171) of the hospitals,more than 100 geriatric hip fractures were treated annually.63.2％ (108/171) of the hospitals treated 100 to 500 cases annually,5.9％ (10/171) 500 to 1,000 cases and 5.3％ (9/171) more than 1,000 cases.Multidisciplinary collaboration was not established in most hospitals (71.9％,123/171) for geriatric hip fractures.Pulmonary function test (61.4％,105/171),Holter (38.0％,65/171) and ambulatory blood pressure monitoring (53.8％,92/171) were indicated as routine preoperative investigations.In 56.3 ％ (96 / 171) of the hospitals,traction was performed before operation.In 80.1％ (137 / 171) of the hospitals,the interval between admission to surgery was more than 48h for the patients.In 36.3％ (62/171)of the hospitals,patients were allowed to ambulate within one week after surgery.In 4.1％ (7/171) of the hospitals,patients were allowed full weight-bearing within one week after surgery.Conclusion Significant gaps exist in perioperative management of geriatric hip fractures between current practice in China and worldwide guidelines and consensus.

Hip fractures,with an increasing morbidity in the elderly patients,pose a serious threat to the health of the aged.At the moment,surgery is the preferred treatment for the vast majority of these patients.Early surgical intervention is strongly recommended by most guidelines and articles.It is still controversial,however,whether surgery should be postponed or performed and whether medication therapy should be withdrawn or continued in some of the elderly patients with hip fracture who are taking anticoagulant or antithrombotic drugs before they are injured.Clopidogrel is one of the anti-platelet drugs commonly used clinically.This article reviews the literature regarding the impact of clopidogrel on surgical timing for hip fractures in the aged,hoping to provide useful clues to the clinical study and practice.