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.

Against the backdrop of China's escalating population aging, the incidence of prostate cancer is rising significantly, leading to an increasing disease burden. Prostate-specific antigen (PSA) screening is currently an effective method for improving early diagnosis rates and patient prognosis. However, there is a lack of large-scale, prospective studies in China to guide the development of screening strategies. This article analyzes the impact of population aging on healthcare economics, describes the current status and trends of the prostate cancer disease burden, and combines the latest evidence on PSA screening from both domestic and international sources to conduct an in-depth discussion on the necessity, and existing models of PSA screening in China. It also emphasizes that when developing screening strategies, the disease burden brought about by aging and health economic benefits must be fully considered. This article aims to provide a reference for the development of an individualized prostate cancer screening program that aligns with China's national conditions and considers cost-effectiveness, thereby helping to improve the overall diagnosis and treatment level of prostate cancer in China and improve patient survival and quality of life.

Calyceal diverticulum is a relatively rare congenital renal malformation with an incidence of 0.21%-0.45%, frequently accompanied by stone formation, which may cause pain, hematuria, or recurrent urinary tract infections. Treatment options include extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy (PCNL), flexible ureteroscopic lithotripsy (FURL), laparoscopic surgery, and traditional open surgery. With advances in minimally invasive techniques, PCNL and FURL have become the primary treatment modalities, though optimal surgical selection remains controversial. The advantages of PCNL including high stone clearance rates (87.5%-100%) and diverticular closure rates (76%-100%) through diverticular wall fulguration or neck incision, but carries risks of bleeding, renal parenchymal injury, and prolonged recovery. FURL demonstrates minimal trauma, rapid recovery, and reduced postoperative inflammatory response with high stone clearance rates, particularly suitable for stones <2 cm in the upper-middle calyces, though challenging for lower calyceal or narrow-necked diverticula. This article aims to review the progress in minimally invasive treatment of calyceal diverticulum stones.

To observe the clinical effect of medical tissue adhesive in fixing large sheet autologous split-thickness skin grafts.

A retrospective study was conducted on the clinical data of 196 patients who underwent large sheet autologous split-thickness skin grafting，including acellular allodermal matrix composite split-thickness skin grafting for wound repair，and were hospitalized in the Department of Burns and Dermatologic Surgery， Xijing Hospital of Air Force Medical University， from February 2021 to June 2024. According to the different skin graft fixation methods， patients were divided into the observation group （n=104） and the control group （n=92）. In the observation group， skin grafts were fixed with medical tissue adhesive， the first dressing change was performed at 4-5 days postoperatively for simple split-thickness skin grafting， and 8-10 days postoperatively for acellular allodermal matrix composite split-thickness skin grafting. In the control group，skin grafts were fixed with skin suture needles for patients undergoing simple split-thickness skin grafting，and the skin grafts were fixed with interrupted silk sutures for patients undergoing acellular allodermal matrix composite split-thickness skin grafts， the first dressing change time after surgery was the same as that in the observation group. The occurrence of skin graft displacement， hematoma formation， infection， and the survival of skin graft were observed during the first dressing change.

The incidence of skin graft displacement in the observation group （4.8%） was lower than that in the control group （13.0%）， and the proportion of displaced skin graft area （3.63%±1.38%） was also lower than that in the control group （6.60%±2.08%）, the differences were statistically significant （P<0.05）. There was no statistically significant difference in skin graft survival rate between the observation group （99.24%±3.55%） and the control group （97.77%±6.08%） （t=2.046， P=0.151）. In the observation group， 5 cases of hematoma and 2 cases of skin graft infection with necrosis occurred， while in the control group， 4 cases of hematoma and 3 cases of skin graft infection with necrosis occurred. There was no statistically significant difference between the two groups （P>0.05）. Among the patients who developed complications，4 in the observation group and 5 in the control group healed after undergoing additional skin grafting； the remainder healed with dressing changes.

Compared with traditional fixation methods， medical tissue adhesive for securing large sheet autologous split-thickness skin grafts demonstrates more stable and effective fixation， reduces skin graft displacement， and avoids operational injuries and pain caused by removing fixatives. It is worthy of clinical promotion and application.

To explore the therapeutic effect of the surgical approach combining staged debridement， vacuum sealing drainage and acellular dermal matrix and other appropriate techniques on gluteal muscle and skin necrosis after transcatheter arterial embolization （TAE）.

From August 2020 to September 2023， 6 patients with gluteal muscle and skin necrosis after TAE for massive hemorrhage caused by pelvic fracture who met the inclusion criteria were admitted to the Department of Plastic and Burn Surgery， Northern Jiangsu People's Hospital， including 4 males and 2 females， aged 42 to 65 years. All patients were treated with a surgical method combining staged debridement， vacuum sealing drainage and acellular dermal matrix and other appropriate techniques. The changes of creatine kinase levels after TAE and the CT or MRI imaging characteristics of gluteal muscle and skin necrosis were observed. The number of wound treatment operations， wound healing time and wound healing status were recorded.

The creatine kinase levels showed an overall upward trend from 1 to 3 days after TAE， peaked at 3 to 7 days after surgery， and maintained a high level （>10 000 U/L） for 2 to 7 days. CT or MRI showed edema of gluteal soft tissues and gluteal muscles （gluteus maximus， gluteus medius and gluteus minimus）， with uneven density of some muscles. The number of wound treatment operations was （4.7±0.8） times， and the wound healing time was （42.5±5.4） days. All 6 patients achieved good wound healing after surgery， and no wound rupture or exudation was found during the 2-month follow-up.

The combination of staged debridement， vacuum sealing drainage， acellular dermal matrix and other appropriate techniques can effectively treat gluteal muscle and skin necrosis after TAE.

To explore the clinical efficacy of autologous vascularized fibula flap transplantation for the treatment of infectious femoral bone defects.

A retrospective analysis was conducted on the clinical data of 11 patients with infectious femoral bone defects treated in the Department of Orthopedic Trauma， Norinco General Hospital from January 2018 to January 2022. There were 8 males and 3 females， with an average age of （34.0±4.5） years and an average bone defect length of （9.5±1.7） cm. During surgery， after thorough debridement of the bone defect ends， the femur was fixed. An autologous vascularized fibula composite tissue flap was harvested for one-stage reconstruction. The vascular pedicle of the vascularized fibula was anastomosed to the recipient vessels via end-to-side technique after isolating and trimming the vascularized fibula. Among them， 5 cases were repaired with a single fibula graft， and 6 cases were repaired with a two-segment fibula graft， with an average transplanted fibula length of （14.5±3.2） cm. The vascularized fibula was fixed with plates or an external fixator. Postoperatively， routine anti-infection， anticoagulation， and antivasospasm treatments were administered （anti-infection treatment course lasted 4-6 weeks， and anticoagulation and antivasospasm treatments lasted for 2 weeks）. Infection control and vascularized fibula survival were closely observed. The healing status at the junction of the vascularized fibula and the recipient site was evaluated by follow-up radiological examinations during reconsultations. Patients were instructed to perform lower limb functional exercises， and the healing conditions of the affected limb and donor site， as well as limb function， were evaluated using the Enneking score， Baird-Jackson ankle function score， association for the study and application of the method of Ilizarov （ASAMI） criteria， and lower extremity functional scale （LEFS） score.

All 11 patients were followed up， with an average follow-up time of （24.5±12.8） months. All wounds healed primarily without infection recurrence， all vascularized fibula survived with no vascular crisis observed， and there was no significant functional impairment at the donor sites. All transplanted vascularized fibula achieved stable bony union， without bone resorption， osteosclerosis， or refracture. The average time to bony union was （5.5±1.2） months. At 12 months postoperatively， the average Enneking score of the affected limb was （24.0±3.3） points， the average Enneking score of the donor site was （27.2±1.1） points， and the average Baird-Jackson ankle function score of the donor site was （95.5±1.6） points. At the final follow-up， ASAMI criteria assessment of the affected limb showed excellent bone results in all 11 patients， with 7 cases of excellent functional results and 4 cases of good functional results. The average LEFS score of the affected limb was （75.5±2.2） points.

The application of vascularized fibula transplantation and vascular reconstruction helps improve local blood supply and control infection， can effectively repair large-scale infectious femoral bone defects， and improve the bone healing rate. It is an effective clinical treatment for this type of disease.

To investigate the clinical efficacy of free flap repair for distal tibial bone exposure and analyze the factors affecting flap survival and postoperative complications.

A retrospective analysis was conducted on 78 patients with distal tibial bone exposure treated at the Department of Burns and Plastic Surgery， Beijing Jishuitan Hospital， Capital Medical University， from May 2019 to May 2024. The flap survival rate， complication rate， and functional recovery were statistically analyzed. Risk factors were analyzed using chi-square test and multivariate logistic regression analysis.

The flap survival rate was 94.9% (74/78). Complications included vascular crisis in 6 cases （7.7%） （comprising 4 arterial and 3 venous crises， with 1 case involving both）， infection in 2 （2.6%）， hematoma in 3 （3.8%）， wound dehiscence in 1 （1.3%）， and donor site complications in 4 （5.1%）. The good-to-excellent rate according to the Enneking score was 85.9% (67/78). Chronic infected wounds were identified as an independent risk factor for vascular crisis （OR=3.45， 95%CI： 1.12-10.67， P=0.031） and for wound infection or sinus tract formation at follow-up （OR=5.20， 95%CI： 1.80-15.10， P=0.002）. Smoking and diabetes were not significantly associated with complications.

Chronic infected wounds are the main risk factor for postoperative complications. Preoperative strengthening of infection control can improve the surgical success rate.

To retrospectively investigate factors influencing wound healing in patients with deep partial-thickness burns on neck undergoing non-surgical treatment, and provide references for optimizing non-surgical treatment strategies.

A total of 122 patients with deep partial-thickness burns on neck who received non-surgical treatment at the Department of Burns and Plastic Surgery， the First Hospital of Hebei Medical University between December 2018 and June 2024 were included. General demographic and clinical data of the patients were collected， including gender， age， body mass index （BMI）， injury causes， neck burn area， total burn area， wound management approach （exposure， semi-exposure， or occlusive dressing） ， and presence of inhalation injury. Univariate analysis and multiple linear regression were performed to identify factors associated with wound healing time.

The wound healing time ranged from 11 to 36 days， with an average of （19.3±5.6） days. Univariate analysis showed that wound healing time differed significantly among patients with different causes of injury， wound management approach， total burn area， and presence or absence of inhalation injury（P<0.05）. Multiple linear regression analysis showed that patients with flame burns or hydrothermal scald had a longer wound healing time compared with those with electrical flash burns （β=0.368， P=0.006； β=0.276， P=0.047， respectively）. Patients treated with occlusive dressings had significantly shorter wound healing time than those managed without occlusive dressings （β=-0.208， P=0.030）. Additionally， patients complicated with inhalation injury exhibited a longer wound healing time than those without inhalation injury（β=0.278， P=0.014）.

Occlusive dressing therapy may offer advantages in reducing wound healing time compared to exposure or semi-exposure approaches for non-surgical management of deep partial-thickness burn on neck. Flame burns and hydrothermal scald and concomitant inhalation injury are associated with prolonged healing， underscoring the need for early targeted interventions in such patients to enhance recovery.

To optimize the management mode of the plantar donor sites in severe burn patients and evaluate its application effect.

A retrospective study was conducted on 42 severe burn patients treated with bilateral plantar skin grafts at the Department of Burns and Plastic Surgery，the 910th Hospital of Joint Service Support Unit of PLA from April 2021 to September 2024. The patients were divided into a control group （20 cases） and an observation group （22 cases）， with the control group receiving conventional management and the observation group undergoing optimized management. The protocol included： reoperative skin keratin layer softening and partial removal，intraoperative graft area definition，surgical instrument selection and techniques，postoperative use of suspended beds and wound dressings，and discharge rehabilitation guidance. Comparative analysis was conducted on the number of harvestable procedures from the plantar sites，final graft area，initial dressing pain scores，dressing frequency，healing time，6-month scar scores，and complication rates.

The observation group underwent a greater number of harvestable procedures and had a larger final graft area （P<0.05） compared to the control group. In addition，the observation group showed significantly lower initial dressing pain scores，dressing frequency，healing time，6-month scar scores，and complication rates （P<0.05）.

Optimizing the management of plantar donor sites can increase the number of harvestable procedures and the amount of skin graft obtained， reduce wound dressing pain and frequency， promote healing， mitigate scar hyperplasia， without affecting postoperative ambulation.

Based on the framework of timing theory， this study explores the caregiving experiences of caregivers for children with severe burns at different disease stages， providing a basis for constructing staged intervention plans and establishing a diversified support system.

A qualitative research method was employed， using purposive sampling combined with maximum differentiation sampling strategy to select 18 caregivers of children with severe burns who were treated at Department of Burns and Cutaneous Surgery， Burn Center of PLA， Xijing Hospital, Air Force Medical Univercity from January 2024 to December 2024 as study subjects. Guided by the timing theory， face-to-face semi-structured interviews were conducted at different stages， and data were collected and analyzed using content analysis to extract themes.

Three themes were identified based on burn staging， comprising 9 sub-themes. (1) Shock stage： self-blame/guilt and urgent treatment needs； (2) Treatment stage： shift in life priorities， anxiety due to lack of knowledge， heavy financial burden， demanding caregiving tasks， and desire for social assistance； (3) Rehabilitation stage： increased concerns about the child's future and the need for rehabilitation care.

Healthcare providers， family members， and social organizations should pay attention to the dynamic caregiving experiences and changing needs of caregivers for children with severe burns at different disease stages， providing comprehensive， meticulous physical and psychological care and professional guidance. While improving the treatment success rate of pediatric burn patients， it is essential to address the needs of their caregivers by establishing a comprehensive support system to alleviate psychological burdens. This approach will better facilitate the treatment and rehabilitation process for severe burn patients， ultimately enhancing their quality of life.

To evaluate the therapeutic effect and potential mechanism of action of embryonic stem cell-derived immunity and matrix regulatory cells （IMRC） on traumatic heterotopic ossification （THO）.

A THO model was established via Achilles tendon injury in SD rats， which were then randomly divided into a sham operation group， a control group， and an IMRC treatment group. The IMRC group received local injections of a suspension containing 1×10⁶ IMRCs twice weekly for 4 weeks post-operation. At 4， 8， and 12 weeks post-surgery， heterotopic bone volume and bone mineral density （BMD） were quantitatively analyzed using micro-computed tomography (Micro-CT). Tissue inflammation， fibrosis， and heterotopic bone formation were assessed via haematoxylin-eosin stain and Masson staining. The protein expression levels of α-smooth muscle actin （α-SMA） and osteocalcin （OCN） were detected by immunohistochemistry. Safety was evaluated by monitoring body weight and examining the pathology of major organs.

Compared to the control group， IMRC treatment significantly inhibited heterotopic bone formation. Micro-CT revealed that at 12 weeks post-operation， the heterotopic bone volume in the IMRC group [（16.67±0.90） mm³] was reduced by 79.5% compared to the control group [（81.42±2.72） mm³] （P<0.001）， and the BMD was also significantly lower [（223.78±16.65） mg/cm³ vs （595.14±30.31） mg/cm³， P<0.001]. Histological analysis showed significant reductions in inflammatory cell infiltration， collagen deposition， and fibrosis scores in the IMRC group （all P<0.01）， alongside markedly suppressed expression of α-SMA and OCN （all P<0.01）. All rats exhibited steady body weight gain， and no pathological changes were observed in the major organs， indicating a favorable safety profile for IMRC treatment.

Local injection of IMRC can safely and effectively inhibit the development and progression of THO through a multi-mechanism approach involving anti-inflammation， anti-fibrosis， and inhibition of osteogenesis， representing a novel cell therapy strategy with broad translational potential.

Malnutrition is a common comorbidity in patients with diabetic foot ulcers (DUF) that significantly impairs wound healing and adversely affects patient prognosis， thereby garnering increasing clinical attention. This review aims to summarize nutritional management strategies by analyzing the epidemiological characteristics of malnutrition and its impact on wound healing. It further delves into a systematic approach to nutritional assessment， the specific roles of various macro- and micronutrients， and current nutritional intervention methods. The synthesis of these elements is intended to provide an evidence-based reference for optimizing clinical care.

The issue of wound healing is a significant clinical concern that warrants immediate attention. For example， delayed re-epithelialization and hypopigmented scars are manifestations of impaired skin regeneration resulting from suboptimal healing processes. Furthermore， existing prognostic techniques for plastic surgery repair continue to be insufficient in fully addressing these challenges. Epidermal stem cells are situated in the basal layer and have the capacity for self-renewal and multipotent differentiation. Epidermal stem cells derived exosomes regulate and promote the multi-stage wound healing process by carrying abundant bioactive factors. Therefore， it is necessary to conduct a systematic review on the research progress of exosomes derived from epidermal stem cells in wound repair， with the aim of providing references for the development of new therapeutic strategies for acute and chronic wound repair.