To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

Non-specific Low Back Pain (NSLBP) is a common musculoskeletal disorder. Currently, diagnosis relies on subjective evaluations and traditional imaging, which lack objectivity and quantitative precision. Multiple biomechanical assessment technologies, such as surface electromyography, ultrasound, and gait analysis, dynamically monitor and quantitatively analyze NSLBP patients from perspectives of neuromuscular control, movement patterns, and biomechanics. This paper summarizes the research progress of multiple biomechanical assessment in clinical decision-making for NSLBP. It focuses on discussing the application value of each assessment technology and the advantages of multimodal data fusion. It also prospects the future development path driven by artificial intelligence.

To observe the tongue characteristics of burn patients during the reabsorption phase and preliminarily analyze their relationship with disease severity and hematological indicators.

From February 2024 to April 2025， 115 hospitalized burn patients meeting inclusion and exclusion criteria in the Department of Burn and Wound Repair Surgery of the First Affiliated Hospital of Anhui Medical University were enrolled. Basic data of patients were collected. Traditional Chinese medicine tongue diagnosis was performed 3–5 days post-injury， documenting tongue color， shape， coating color， and coating texture. The tongue characteristics were compared among patients with different burn severities， and their relationships with routine blood parameters ［white blood cell （WBC）， neutrophil （NEU）］， liver and kidney function ［alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， blood urea nitrogen （BUN）， creatinine （Cr）］， and coagulation function ［prothrombin time （PT）， fibrinogen （FIB）］ were analyzed.

There were statistically significant differences in tongue color (P<0.001) and tongue body thickness （swollen/thin） (χ²=9.971, P=0.019) among burn patients of different severities during the reabsorption phase. There was a statistically significant difference in BUN levels among patients with different coating textures （Z=-2.754， P=0.006）. The differences of PT among patients with different tongue colors were statistically significant （H=16.041， P=0.001）. Statistically significant differences in FIB levels were observed among patients with different tongue colors， tongue body thicknesses， coating colors， and coating textures （H value was 17.225，Z values were -2.032， -2.924， and -2.351； P values were <0.001， 0.042， 0.003， and 0.019， respectively）.

The tongue characteristics of burn patients during the reabsorption phase correlate with disease severity and hematological indicators such as BUN， PT and FIB levels. These features may serve as supplementary indicators for assessing burn severity and hematological abnormalities， thereby providing reference for integrated Traditional Chinese and Western medicine diagnosis and treatment.

To explore the clinical application value of high-frequency ultrasound （HFUS） combined with shear wave elastography （SWE） in the quantitative evaluation of the thickness and hardness of hypertrophic scars （HS）， and provide a new method for the objective diagnosis and efficacy monitoring of scars.

Forty patients with HS （77 scars） after burn and scald injury，admitted to the Department of Burns and Plastic Surgery of Guangzhou Red Cross Hospital of Ji′nan University， from July 2024 to February 2025 were selected for this study. The Vancouver scar scale （VSS） scoring， HFUS for thickness measurement， and SWE for hardness measurement were performed respectively， and the results were compared with pathological findings. Multiple linear regression was used to analyze the influencing factors of the thickness and hardness of scars.

Both the thickness and hardness values of HS were significantly higher than those of normal skin （Z=6.567， P<0.001；Z=-6.535，P<0.001）. With pathology as the gold standard， ultrasound demonstrated superior accuracy to VSS in evaluating scar thickness （R²=0.930 vs. R²=0.723） and hardness （R²=0.909 vs. R²=0.738）. Multiple linear regression analysis showed that the location of the scar was an independent influencing factor for hardness differences， and facial and cervical scars showed significantly reduced hardness differences compared to limb （P=0.004）.

The combination of HFUS and SWE can objectively and quantitatively evaluate the thickness and hardness of HS， demonstrating results highly consistent with pathology and superior to the subjective evaluation of VSS. It has important clinical value in the objective diagnosis， treatment decision-making， and efficacy monitoring of scars.

To explore the clinical efficacy of ultrasound-assisted percutaneous channel release in the treatment of chronic carpal tunnel syndrome.

Retrospective analysis was conducted on patients with carpal tunnel syndrome treated in the Department of Hand and Foot Surgery, the People's Hospital of Danyang from November 2020 to December 2023， who met the inclusion and exclusion criteria. Among them， 26 cases underwent ultrasound-assisted percutaneous channel release （ultrasound group） and 40 cases underwent a small longitudinal incision （small incision group） at the palm base for carpal tunnel release. Surgical time， incision length， and postoperative recovery were recorded and compared.

There was no statistically significant difference in surgical time between the two groups （P>0.05）； the surgical incision length in the ultrasound group was shorter than that in the small incision group， showing a statistically significant difference （P<0.001）； follow-up at 3 months postoperatively using Gu Yudong's postoperative functional evaluation criteria for carpal tunnel syndrome indicated satisfactory surgical outcomes， with marked improvement in numbness， pain symptoms， sensory tests and grip strength in both groups， with no statistically significant difference between the ultrasound group and the small incision group （P>0.05）； early postoperative columnar pain did not occur in the ultrasound group， while 2 cases occurred in the small incision group. There was no statistically significant difference in the postoperative Boston carpal Tunnel Questionnaire (BCTQ) scores between the two groups （P>0.05）.

Ultrasound-assisted percutaneous channel release for chronic carpal tunnel syndrome allows precise cutting of the thickened transverse carpal ligament while reducing tissue damage， effectively relieving median nerve compression. It has advantages such as accurate incision placement， short scarring， and minimal early columnar pain， making it a surgical option for the treatment of carpal tunnel syndrome.

To investigate the clinical effect of medical suspension bed for stage Ⅲ-Ⅳ gluteal-sacral pressure injuries after flap transplantation.

A retrospective analysis was conducted on the clinical data of 55 patients with stage Ⅲ-Ⅳ gluteal-sacral pressure injuries admitted to the Department of Traumatology， Burns and Plastic Surgery of Liuzhou Workers' Hospital from June 2021 to May 2025. All the patients received flap transplantation to repair the wound. Patients treated with conventional hospital bed after flap transplantation were assigned to the conventional bed group (29 cases), while those treated with medical suspension bed were assigned to the suspension bed group (26 cases). The wound healing time in the recipient area， the postoperative length of hospital stay， the total length of hospital stay， hospitalization costs， incidence of complications in the donor and recipient areas （such as hematoma， infection， incision dehiscence， flap necrosis， etc.）， and reoperation rate were observed.

Compared with the conventional bed group， the suspension bed group showed significantly shorter wound healing time in the recipient area ［（12.8±3.4） days vs. （16.0±5.6） days， t=-2.47， P=0.008］， postoperative length of hospital stay ［（13.8±3.9） days vs. （16.8±6.0） days， t=-2.14， P=0.019］， and total length of hospital stay ［（27.9±4.6） days vs. （30.7±6.6） days， t=-1.78，P=0.040］. There was no statistically significant difference in hospitalization costs between the two groups ［（3.9±0.9） ten thousand yuan vs. （3.6±1.1） ten thousand yuan， t=1.17， P=0.124］.The total complication rate （7.7%） and reoperation rate （3.8%） in the suspension bed group were significantly lower than those in the conventional bed group （34.5% and 24.1%， respectively），with statistically significant differences （P values were 0.016 and 0.033， respectively）.

The application of medical suspension bed in the treatment of stage Ⅲ-Ⅳ gluteal-sacral pressure injuries after flaps transplantation can accelerate wound healing， shorten length of hospital stay， and reduce the risk of complications and reoperation.

To investigate the clinical effect of dorsal metatarsal relay flap in repairing the donor site of the second toe free flap.

From June 2020 to October 2025， 7 patients who met the inclusion criteria and underwent second toe free flap reconstruction for hand wounds were admitted to the Department of Hand Surgery of Suzhou Ruihua Orthopedic Hospital. There were 5 males and 2 females， aged 22 to 56 years， with an average age of 32.6 years. The donor sites of the second toe free flaps in all patients were repaired using dorsal metatarsal relay flaps， the area of the relay flaps ranged from 2.0 cm×1.5 cm~3.0 cm×2.5 cm， and the donor sites of the relay flaps were sutured directly. Postoperative follow-up was performed to evaluate the dorsal metatarsal relay flap in terms of appearance， color， texture， two-point discrimination， and scar hyperplasia.

The dorsal metatarsal relay flaps and second toe free flaps of 7 patients survived after surgery. Postoperative follow-up ranged from 2-14 months， with an average of 7 months. The appearance of the dorsal metatarsal relay flaps were satisfactory， with color close to the contralateral side and soft texture. The two-point discrimination distance was 7-12 mm， with an average of 8.5 mm. The walking function of the foot was good， and there was no contracture between the toe webs.

Repairing the donor site of the second toe free flap using dorsal metatarsal relay flap offers the advantages of simple surgical technique， fewer complications， and high flap survival rate， making it suitable for clinical application.

To evaluate the clinical efficacy of moldable splint containing silicone gel in the prevention and management of scars.

A total of 34 patients with post-burn or post-traumatic hypertrophic scars （HS） admitted to the Department of Burns and Wound Repair Surgery of the First Affiliated Hospital of Anhui Medical University from June 2022 to March 2025 were selected for retrospective analysis of their clinical data. Based on different treatment methods， the patients were divided into an observation group （19 cases） and a control group （15 cases）. Patients in the observation group received treatment with moldable splint containing silicone gel， while patients in the control group received treatment with conventional splint. After 6 months of treatment, scar thickness， color， flexibility， and vascularity were evaluated， and scar outcomes were compared using the Vancouver scar scale （VSS） score and the patient and observer scar assessment scale （POSAS） score. The incidence of adverse reactions during treatment was recorded for both groups.

After 6 months of treatment， the observation group showed better outcomes than the control group in terms of scar color （1.11±0.57 vs. 2.00±0.76， t=-3.946， P<0.001）， thickness （0.89±0.66 vs. 2.33±0.62， t=-6.504， P<0.001）， vascularity （0.79±0.25 vs. 1.60±0.74， t=-4.486，P<0.001）， pliability （1.05±0.52 vs. 1.73±0.59， t=-3.547，P=0.001）， VSS score （3.47±1.54 vs. 7.67±1.29， t=-8.448， P<0.001）， and POSAS score （23.58±4.76 vs. 37.33±7.17， t=-6.399， P<0.001）. There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group （15.8% vs. 20.0%， P>0.05）.

Silicone gel-containing moldable splint is effective in the treatment of post-burn or post-traumatic hypertrophic scars and significantly inhibits scar hypertrophy.

To investigate the effects and underlying mechanism of CXC chemokine ligand-12 （CXCL12） pretreated bone marrow mesenchymal stem cells （BMSCs） on the wound healing of full-thickness skin defects in mice.

The 3^rd to 5^th passages of BMSCs were divided into control group， CXCL12 group， CXCL12 + CXCL12 receptor antagonist group and treated accordingly. After 48 h of culture， the cell survival rate was detected by cell counting kit 8 （CCK-8） method， and the cell proliferation activity was observed by staining with 5-ethynyl-2'-deoxyuridine （EdU） cell proliferation test kit. After 24 h of culture， the protein expressions of exchange protein directly activated by cAMP 1 （Epac1）， extracellular regulated protein kinase （Erk）， phosphorylated Erk （p-Erk） were detected by Western blotting， and the ratio of p-Erk to Erk was calculated. The number of samples in above experiments was six. Eighteen adult male BALB/c mice were divided into PBS group， BMSCs group and CXCL12 pretreated BMSCs group （6 mice in each group） according to the random number table method. Full-thickness skin defect wound model was created on the back of all mice. On day 3 post-wounding， the mice in PBS group， BMSCs group and CXCL12 pretreated BMSCs group were topically， intra-dermally administered 100 μl of PBS， 100 μl of cell suspension containing 1×10⁶ BMSCs and 100 μl of cell suspension containing 1×10⁶ CXCL12 pretreated BMSCs， respectively. On day 4， 7 and 10 post-wounding， the wound healing was observed and the wound healing rate was calculated. On day 11 post-wounding， the samples of wound tissue from 3 groups of mice were collected. Hematoxylin-eosin staining and Masson staining were used to detect the length of wound tissue defect and the collagen volume fraction （CVF）， respectively.

After 48 h of culture， compared with control group， the cell survival rate of CXCL12 group was significantly increased （P<0.05）. Compared with CXCL12 group， the cell survival rate of CXCL12 + CXCL12 receptor antagonist group was significantly decreased （P<0.05）. After 48 h of culture， the number of EdU-positive cells was increased， and the cell proliferation activity was enhanced in CXCL12 group compared to those in control group. In CXCL12 + CXCL12 receptor antagonist group， the number of EdU-positive cells was decreased and the cell proliferation activity was attenuated compared to those in CXCL12 group. After 24 h of culture， compared with control group， the protein level of Epac1 and the ratio of p-Erk to Erk in CXCL12 group were significantly increased （P<0.05）. Compared with CXCL12 group， the protein level of Epac1 and the ratio of p-Erk to Erk in CXCL12 + CXCL12 receptor antagonist group were significantly decreased （P<0.05）. On day 4， 7 and 10 post-wounding， the wound healing rate of mice in CXCL12 pretreated BMSCs group （56.7%±2.6%，70.4%±1.6%，84.5%±0.5%，respectively） was significantly higher than that in BMSCs group （37.4%±5.2%，49.2%±3.7%，67.9%±1.1%，respectively），P<0.05. On day 11 post-wounding， the length of wound tissue defect in CXCL12 pretreated BMSCs group was significantly shorter than that in BMSCs group ［（1.79±0.05） mm vs. （2.20±0.15） mm，P<0.05）］. On day 11 post-wounding， the CVF of BMSCs group was significantly increased compared with PBS group （P<0.05）. Compared with BMSCs group， the CVF of CXCL12 pretreated BMSCs group was significantly decreased （P<0.05）.

Pretreatment of BMSCs with CXCL12 could significantly promote the wound healing of full-thickness skin defects in mice， and the mechanism may be ascribed to the activation of Epac1/Erk signaling pathway by CXCL12 in the improvement of BMSCs' biological function， which finally enhance the therapeutic effects of BMSCs on skin defect wounds.

Pain is one of the most common and distressing symptoms in burn patients，seriously affecting their treatment experience and rehabilitation process. Currently， the conventional pain relief method is pharmacological intervention. However， achieving effective analgesia while minimizing the use of painkillers is a key clinical issue that deserves significant attention. Meanwhile， with the in-depth development of research on pain management， the unique advantages of non-pharmacological interventions in burn pain management have gained recognition. These interventions can serve as a supplementary approach to pharmacological analgesia， and in some cases， even replace it. Therefore， it is necessary to systematically elaborate on common non-pharmacological interventions and their mechanisms of action in burn pain management， aiming to provide a more comprehensive theoretical basis and practical guidance for clinical burn pain management.

Microcirculation serves as the central link connecting systemic circulatory failure to multiple organ dysfunction syndrome. Following extensive burns， the body enters a complex pathophysiological state characterized by the interplay of hypovolemic shock， burn wounds， sepsis， and intense inflammatory responses， with severe microcirculatory dysfunction at its core. Currently， the importance of research and monitoring methods on post-burn microcirculation monitoring has gradually attracted attention. This review summarizes recent advances in systemic microcirculation monitoring and local wound perfusion assessment in patients with extensive burns. Various microcirculation monitoring techniques， including handheld vital microscopy imaging， near-infrared spectroscopy imaging， laser Doppler imaging， and glycocalyx assessment， have demonstrated significant diagnostic and prognostic potential， which may offer new perspectives for precision treatment in critically ill burn patients.

First dorsal interosseous muscle atrophy is a common clinical manifestation of intrinsic hand muscle dysfunction. Its etiology is complex， involving damage to multiple components such as motor neurons， cervical nerve roots， brachial plexus nerves， and the deep branch of the ulnar nerve. Neurophysiological techniques， as core technologies for assessing neuromuscular function， are particularly crucial for localizing the diagnosis and differentiating the causes of this condition.This paper reviews current diagnostic strategies for first dorsal interosseous muscle atrophy using neuroelectrophysiological techniques， enhancing diagnostic accuracy and efficiency through systematic testing protocols. The strategy emphasizes starting with medical history and physical examination， followed by targeted needle electromyography （EMG） and nerve conduction velocity （NCV） testing. Key focus is placed on muscles innervated by the deep branch of the ulnar nerve， the recurrent branch of the median nerve， and the C8/T1 nerve roots. This approach enables precise localization from peripheral to central， and from distal to proximal， providing reliable objective evidence for formulating clinical treatment plans.

　Wound healing depends on the dynamic regulation of the immune microenvironment， in which the sequential phenotypic transition of macrophages plays a pivotal role. Platelet-rich plasma （PRP） is a blood-derived biological product enriched with multiple bioactive molecules and has been shown to improve wound healing outcomes by modulating macrophage polarization. This review summarizes the mechanisms by which PRP regulates macrophage recruitment， metabolic reprogramming， and phenotypic transition through multiple platelet-derived secretory systems， including platelet α-granules， dense granules， and extracellular vesicles. The roles of growth factors， metabolic signaling pathways， and exosomes in these processes are also discussed. Furthermore， potential strategies for optimizing PRP based on precise macrophage regulation and their prospective applications in the repair of complex wounds are highlighted.