To explore the hub genes related to inflammation injury that changed significantly during the development of non-alcoholic fatty liver disease （NAFLD）.
Methods
A total of 98 patients with NAFLD were selected from the GSE167523 dataset in the Gene Expression Omnibus （GEO）database to calculate the inflammatory indices by performing the gene set variation analysis （GSVA）.Two separate groups of high-inflammatory indices and low-inflammatory indices were set up for comparison purposes.Using the limma software package in R language to identify differentially expressed genes （DEGs）between the groups.ClusterProfile software package in R language was used for gene ontology （GO）enrichment analysis and Kyoto encyclopedia of genes and genomes （KEGG） enrichment analysis on DEGs.Hub genes were screened by protein-protein interaction （PPI） network analysis using STRING database.Additionally， gene expression levels were validated in the GSE89632 and GSE130970 datasets.Used the ROC curves to evaluate the diagnostic ability of them and performed the miRNA and transcription factor regulatory network analysis.
Results
A total of 308 DEGs were identified， including 243 upregulated genes and 65 downregulated genes.The enrichment analysis results showed that these DEGs were mainly enriched in chemokine signaling pathways， interactions between viral proteins and cytokines， as well as cytokine receptor interactions.PPI network analysis showed that the key modules containing 16 genes， including TOP2A， MKI67，CDC20，DLGAP5，and MCM10.ROC curves analysis implied that these 16 hub genes were potential biomarkers of NAFLD.Among them， the expression of 11 hub genes showed statistically significant differences between control group and NAFLD group in the GSE89632 dataset， and between high inflammation indices group and low inflammation indices group in the GSE130970 dataset （P ＜0.05）.
Conclusion
Inflammation-related hub genes， such as TOP2A， CDC20， and HJURP， show promise as potential diagnostic and therapeutic targets for NAFLD.
To explore the therapeutic effect of repairing fingertip defects with a tibial flap of the second toe of the foot using an improved vein harvesting method.
Methods
From June 2020 to June 2023， 18 cases （18 fingers） of small-area finger defects in Department of Hand Surgery， Suzhou Ruihua Orthopedics Hospital were repaired using a lateral tibial flap of the second toe of the foot with an improved vein harvesting method.Among them， there were 12 males and 6 females， aged from 22 to 56 years， with an average age of 33 years.During the surgery， a free second toe tibial flap was used to repair the wound.The flap was harvested using a modified vein harvesting method， with the flap designed to be located on the lateral tibial side of the second toe of the foot.Compared to traditional surgical methods， there was no dorsal foot incision.The lateral or bottom vein of the toe was harvested as the return vein of the flap， and the recipient area was anastomosed end-to-end with the digital artery and subcutaneous vein.The harvested area of the skin flap was from 1.5 cm×1.0 cm to 2.5 cm×1.9 cm.5 cases of skin flap donor site were directly sutured， while the rest underwent free skin grafting from the lower leg.The postoperative follow-up was evaluated using the Michigan hand function questionnaire to assess the recovery of hand function， and total active motion （TAM） was used to evaluate the recovery of finger joint range of motion.
Results
All 18 skin flaps in this group survived without any vascular crisis.Postoperative follow-up ranged from 6 months to 2 years， with an average of 13 months.3 cases had slightly bloated skin flaps and underwent flap repair surgery three months after surgery， while the remaining skin flaps did not undergo plastic surgery.The two-point discrimination of the skin flap was from 12 to 14 mm.The incisions in the foot donor area and calf healed primarily， and the skin grafts in the donor area survived smoothly without contracture or ulceration.The scars in the foot donor area were small， and there were no significant functional impairments in the foot and calf donor areas.According to the Michigan hand function questionnaire evaluation criteria， 11 patients were very satisfied with the overall appearance of their hands， and 7 patients expressed satisfaction.According to the TAM evaluation criteria for finger mobility， 18 cases were rated as excellent.
Conclusion
The clinical efficacy of repairing finger tip defects with a lateral tibial skin flap of the second toe using an improved vein harvesting method is good， with advantages such as convenient harvesting， minimal foot injury， and small scar formation in the donor area.
To investigate the preparation process and clinical effect of gel platelet-rich plasma （PRP）in the treatment of skin ulcer in patients with systemic lupus erythematosus（SLE）.
Methods
A total of 35 female patients with systemic lupus erythematosus （SLE） accompanied by superficial ulcers，admitted to Department of Wound Repair，Xuzhou Renci Hospital from September 2017 to September 2024，were enrolled.The average age was 32 years （range 25-53 years）， and the duration of ulcers before admission ranged from 1 week to 7 months.The causes of ulcer formation were as follows.In 32 cases， the ulcers developed due to skin abrasions causedby trauma，which subsequently expanded into larger wounds.In 1 case， the ulcer resulted from necrosis and non-healing of the flap at the donor site of a hallux toenail flap used for middle finger reconstruction.And in 2 cases， the ulcers on the buttocks were caused by spontaneous rupture.On admission， the wound area ranged from 2.0 cm×3.5 cm to 7 cm×7 cm， with no exposed bones or tendons observed on the wound surface.After admission， a systemic condition assessment was performed，and rheumatology specialists were consulted to adjust the SLE treatment regimen.Following surgical debridement of the skin ulcers， the wound surface was covered with PRP gel to promote granulation tissue growth and epidermal epithelialization.Simultaneously， the wounds were treated with advanced wound dressings according to the moist wound healing theory.
Results
All 35 patients were treated according to the study plan， without skin grafting or flap repair or other operations covering the wound surface， and the wounds healed smoothly.
Conclusion
In the treatment of ulcers in patients with SLE after surgical debridement， platelet-rich plasma gel is applied to cover the wound surface， and the growth rate of granulation tissue at the wound base is rapid.Subsequently， new dressings are used for wound care，demonstrating significant therapeutic efficacy.This treatment has relatively low surgical difficulty and cost，making it easy to popularize in clinical practice.
To observe the clinical efficacy of traditional Chinese medicine fumigation in treating refractory wounds.
Methods
Fifty patients with refractory wounds treated in the Department of Burns and Plastic Surgery and Wound Repair Surgery， the Eighth Affiliated Hospital of Xinjiang Medical University from March to August 2022 were selected and divided into the control group and the observation group randomly according to the random number table method， with 25 cases in each group.The control group was given conventional treatment such as debridement and dressing changes， and the observation group was given traditional Chinese medicine fumigation on the basis of the conventional treatment.The clinical efficacy， granulation histopathologic changes， visual analogue scale （VAS） score， growth factor and total complication rate were compared between the two groups.
Results
The total effective rate of the observation group （96.00%） was higher than that of the control group（72.00%），χ2=5.357，P=0.021.After treatment，the number of new capillaries，fibroblasts and macrophages in the observation group were higher than those in the control group （t=20.485，16.071，8.992；P＜0.001）.The VAS score of the observation group was lower than that of the control group （t= 10.645，P ＜0.001）.The levels of epidermal growth factor （EGF）， basic fibroblast growth factor （bFGF）， platelet-derived growth factor （PDGF） and vascular endothelial growth factor （VEGF） in the observation group were higher than those in the control group （t=7.925，11.344，4.892，10.365； P＜0.001）.The total complication rate of the observation group （4.00%） was lower than that of the control group （32.00%），χ2=6.640，P=0.010.
Conclusion
Traditional Chinese medicine fumigation can effectively improve the clinical efficacy of refractory wounds， promote the growth of new granulation tissue， reduce the wound pain， increase the expression of growth factor， and reduce the incidence of complications.
To summarize the clinical characteristics of 66 patients with necrotizing fasciitis （NF） and analyze the factors influencing prognosis.
Methods
A retrospective analysis was performed on the clinical data of 66 NF patients admitted to the Department of Trauma Repair， Burns and Plastic Surgery， Liuzhou Workers' Hospital from January 2017 to December 2023 to summarize the disease characteristics.Clinical factors between the patients with good and poor prognosis were compared， identifed independent risk factors for poor prognosis in NF patients.ROC curves were plotted to evaluate the predictive value of potential independent risk factors for poor prognosis in NF.
Results
Among the 66 patients with NF， there were 52 males and 14 females， with a male-to-female ratio of 3.71 ∶1， the average age was（55.98±13.71） years， patients aged 50 to 70 years accounted for 59.09%， ethnic minority patients account for 53.03%， the average hospital stay was 40.50 （27.75，55.00） days， and the medical costs was 79 976.00（60 676.75， 122 300.25） yuan.The majority of wounds were located in the lower limbs （84.85%）.Diabetes was the main pathogenic factor （59.09%）， the amputation rate was 15.15% and the mortality rate was 3.03%.A total of 77 bacterial strains were cultured from the wounds， with Klebsiella pneumoniae being the most common （16.88%）， and drug-resistant strains accounting for 22.08%.The laboratory risk indicator for necrotizing fasciitis （LRINEC） score was 8.00 （5.75，9.00）， and the inflammation spread range （ISR）score was 1 （1，2）.The LRINEC score in the poor prognosis patients was significantly higher than that in the good prognosis patients （Z=-2.341， P=0.019）， and LRINEC score was an independent risk factor for poor prognosis in NF patients （OR=1.373， 95%CI：1.022-1.844， P=0.035）.The ROC curve showed that the area under the curve for LRINEC score predicting poor prognosis in NF was 0.723 （95%CI：0.546-0.900，P=0.020）.The optimal cutoff value was 7.5， with a sensitivity of 81.8% and a specificity of 54.5%.
Conclusion
Middle-aged and elderly men with diabetes are more susceptible to NF， which commonly affects the lower limbs， with Klebsiella pneumoniae being the most common strain.The LRINEC score is an independent risk factor for poor prognosis in NF patients and has certain predictive value for poor prognosis.LRINEC score greater than or equal to 7.5 indicates poor prognosis in NF patients.
To analyse the clinical characteristics of inpatients with extensive burns， and provide the relevant evidence for the prevention and treatment of extensive burns.
Methods
A retrospective analysis was conducted on the clinical data of 259 inpatients with extensive burns who met the inclusion and exclusion criteria and were admitted to the Institute for Burn，Frostbite and Tissue Function Reconstruction at the Characteristic Medical Center of Chinese People's Armed Police Force from January 1，2014 to December 31，2023，including gender，age，cause of injury，month and season of injury，area of full-thickness burn，treatment method，clinical outcome， days of special care，medical payment method，etc.Analyzed the clinical characteristics and factors influencing mortality in inpatients with extensive burns.
Results
There were 220 males and 39 females，with a ratio of 5.64 ∶1，and males were significantly more than females.The injured population was mainly concentrated among middle-aged and young people.The main cause of injury was thermal burns （236 cases， 91.12%）， with flame burns constituting the majority （151 cases， 58.30%）.The month with the highest number of hospitalized patients was August， with a total of 53 cases （20.46%）， and the season with the highest number was summer （June to August）， with a total of 119 cases （45.95%）.The main burn sites were 253 cases （97.68%） in the upper limbs，233 cases （89.96%） in the lower limbs，229 cases （88.42%） in the trunk， and 225 cases （86.87%） in the head， face， and neck.Totally 208 cases（80.31%） were treated with surgery， and 51 cases （19.69%） were treated conservatively.A total of 193 cases （74.52%） were cured and improved， 53 cases （20.46%） were automatically discharged， and 13 cases （5.02%） died.Out of 231 cases （89.19%）， self payment was the main medical payment method.Age， shock， area of full-thickness burn， and special care duration were the influencing factors for the death of patients with extensive burns（P＜0.05）.
Conclusion
Extensive burns are more common in summer， the injured population is mainly concentrated amony middle-aged and young people， there are more males than females，thermal burns are the main cause of injury，the medical payment method is mainly self funded.
To construct the rehabilitation care intervention plans for severe and extremely severe burn patients based on multiple perspectives， provide nursing basis for improving patients'quality of life during the rehabilitation period.
Methods
Based on the nursing program theory， welfare diversity theory， and ABC-X model， a preliminary rehabilitation care intervention plan for severe and extremely severe burn patients was developed through literature review and semi-structured interviews.The Delphi method was used for two rounds of expert consultations and formed the final intervention plans after summary.
Results
The response rates for the first and second rounds of questionnaires was 93.75% and 100%， respectively.The kendall's coefficient of concordance of expert consultations in the second round were 0.163-0.195 （P＜0.05）.The coefficients of variation of the indexes in the second round was＜0.25.The rehabilitation care intervention plans for severe and extremely severe burn patients were constructed，consisting of 61 items in four dimensions：burn rehabilitation assessment， rehabilitation care plan，rehabilitation care implementation， and rehabilitation care evaluation.
Conclusion
Multidimensional construction of rehabilitation care intervention plans for severe and extremely severe burn patients can provide more scientific， clear， and precise guidance for clinical nursing staff and patients， thereby improving the rehabilitation efficacy and quality of life of patients.
To investigate the current status of frailty of elderly patients with chronic wounds and analyze the influencing factors， in order to provide reference for the assessment and prevention of frailty in elderly patients with chronic wounds.
Methods
From May 2022 to September 2023， 154 elderly patients with chronic wounds treated at the Wound Care Center of West China Hospital， Sichuan University were selected by convenience sampling method.General information questionnaire， FRAIL scale， and the pressure ulcer scale for healing were used to investigate.Analyzed the incidence of frailty in elderly patients with chronic wounds， and Logistic regression was used to analyze the influencing factors of frailty in elderly patients with chronic wounds.
Results
Among the 154 elderly patients with chronic wounds， there were 23 cases of non-frailty， 66 cases of pre-frailty， and 65 cases of frailty.The incidence of non-frailty， pre-frailty and frailty were 14.9%， 42.9% and 42.2%， respectively.Multivariable Logistic regression analysis showed that the self-care ability， mobility， wound type and polypharmacy were independent influencing factors of frailty in elderly patients with chronic wounds（P＜0.05）.
Conclusion
The incidence of frailty and prefrailty is higher among elderly patients with chronic wounds， those who are unable to self-care， have diabetic foot ulcers， limited mobility， and polypharmacy being at a higher risk of frailty.Early screening and evaluation of frailty in elderly patients with chronic wounds should be emphasized， along with timely intervention and guidance for high-risk groups to effectively prevent or delay the occurrence of frailty.
To compare the effect of silicone rubber vacuum sealing drainage system and traditional polyurethane vacuum sealing drainage system in treating acute skin defect in pigs.
Methods
Five Bama miniature pigs were selected to establish an acute skin injury model in pigs.Four wounds were constructed on the backs of the experimental Bama miniature pigs.The No.1 and No.3 wounds were sutured injury with a length of 7 cm and the deep from epidermis to the muscle layer （sutured wounds）， while the NO.2 and NO.4 wounds were cutting injury with 4 cm×4 cm full-thickness skin defect （incised wounds）.The NO.1 and NO.2 wounds were treated with silicone rubber vacuum sealing drainage system （experimental group）， while the NO.3 and NO.4 wounds were treated with polyurethane vacuum sealing drainage system（control group）.The dressings were changed every 5 days.On day 10 of the treatment， wound healing was assessed by measuring wound area and volume， the wounds were measured to compare the wound healing rate， adhesion and bleeding between the wound and dressing， and the angiogenesis and collagen formation were observed by hematoxylin-eosin staining， Masson staining， and CD31 immunohistochemical staining.
Results
The epidermis of suture injury wounds had healed on day 5 of the treatment both in experimental group and control group， but the results of hematoxylin-eosin staining and Masson staining showed that more collagen fiber connections between the two sides of the wounds was observed in experimental group.On day 10 of the treatment， the wound areas of cutting injury in both groups decreased， there was no significant difference between the two groups （41.13%±12.15% vs 34.14%±8.24%， t=-1.225， P=0.288）， while the wound volume reduction rate in experimental group was significantly higher than that in control group（72.47%±8.25% vs 51.12%±9.39%， t=5.061， P=0.007）.Capillary hyperplasia and collagen formation were both observed by CD31 immunohistochemical staining and Masson staining in the two groups， while the average optical density value of CD31 （1.00±0.05 vs 0.57±0.04， t=-19.806， P＜0.001） and collagen volume fraction of Masson staining （40.53%±10.71% vs 24.94%±7.68%， t=-3.154， P= 0.034） in experimental group were higher than that in control group.For suture injury，when changing the dressings on day 5， there was no adhesions in either group.When changing the dressings on day 10， there was no adhesion and bleeding in experimental group， while there were obvious adhesion and bleeding in control group（P＜0.05）.
Conclusion
The silicone rubber vacuum sealing drainage system used in acute fullthickness skin defect in pigs can accelerate the vascularization and collagen formation，promote wound healing， and reduce dressing adhesion during dressing changes.
Recent advancements in anatomical research on the knee joint have expanded the understanding of the medial patellofemoral complex （MPFC）， a structure comprising ligamentous tissues connecting the femur to both the patella and the quadriceps tendon.The MPFC primarily functions to prevent lateral patellar dislocation， involving key components such as the medial patellofemoral ligament （MPFL）and the medial quadriceps-tendon femoral ligament （MQTFL）.With continuous progress in anatomical，biomechanical， and clinical research， surgical techniques for MPFC reconstruction have been refined.Nonetheless， there remains debate over whether simultaneous reconstruction of both MPFL and MQTFL is warranted for patellar dislocation cases， and no consensus has been reached regarding the optimal surgical strategy for MPFC reconstruction.This review aims to provide a comprehensive overview of current research advancements in MPFC.
Wounds refer to the loss or disruption of the integrity of the skin or mucous membranes caused by various factors such as accidents，surgery，pressure，or disease.Wound dressings act as temporary skin substitutes following tissue damage and are essential therapeutic materials in wound management.Compared to traditional dressings， new dressings not only effectively cover wounds， absorb exudate， and maintain moisture but also possess various functions such as antimicrobial action， infection prevention，autolytic debridement， pain relief， and promotion of wounds healing， making them widely applicable in various clinical settings.Currently， there are many types of wound dressings available for clinical selection and under development， each with distinct advantages， disadvantages， and clinical indications.The application of wound dressings should be based on clinical needs， considering factors such as the nature of the wounds， patient symptoms， and cost-effectiveness.This article reviews and analyzes the characteristics，clinical applications， and research progress of the main used and newly developed types of new dressings，aiming to provide guidance and direction for the selection and functional optimization of clinical wound dressings.
Decellularized extracellular matrix （dECM） is a type of biological material obtained after the cellular components have been removed from tissues or organs， which is achieved through a decellularization process.Due to its unique physical properties and biochemical cues，it has shown significant potential in the repair of tissue and organ injuries.This article reviews the characteristics of dECM from different sources and its application in skin injury repair，analyzes the role of the physical properties of dECM such as stiffness， porosity， pore size， and surface topography in skin injury repair， summarizes the research progress of allogeneic sources of dECM and their application effects in wound healing， and discusses the future development and challenges of dECM in tissue engineering and clinical therapy.
Rete ridges （RRs） are structural units located at the dermal-epidermal junction of the skin， consisting of a base， slope， and tip.By increasing the contact area between the epidermis and dermis，RRs facilitate mechanical interlocking between the two layers， thereby enhancing the mechanical properties and stability of the skin.Additionally， RRs contribute to optimizing nutrient supply， promoting stem cell proliferation and differentiation， and maintaining skin homeostasis.The formation of RRs is regulated by physical stress， cellular tension， and molecular signaling pathways.In skin tissue engineering， the reconstruction of RRs microstructures plays a critical role in promoting wound healing and improving graft performance.Recent advancements have enabled the fabrication of biomaterials and grafts incorporating RRs microstructures through techniques such as photolithography and 3D printing， offering new approaches for wound repair.Despite these advancements， challenges remain in the standardized fabrication of RRs，material selection， cell types， and culture conditions.This review summarizes the structural characteristics，formation mechanisms， and applications of RRs in skin tissue engineering， highlights their significance in wound healing to provide effective technological solutions for complex wound repair.
Depleted uranium （DU） is a byproduct of the processing and enrichment of natural uranium， primarily remaining after the extraction of highly concentrated uranium.It is widely used in both military and civilian applications.Once DU enters the human body，it exerts adverse effects on multiple organ systems， including the kidneys， lungs， bones， nervous system， and immune system.Mitochondria are sensitive targets of DU toxicity.The accumulation of DU can lead to damage in the mitochondrial electron transport chain， alterations in membrane permeability and potential， oxidative stress， and calcium ion dysregulation.This review comprehensively summarizes the mitochondrial toxicity of DU and its potential mechanisms， aiming to provide a reference for further research into the mechanisms of DU poisoning and the development of intervention strategies.This article elucidates the mitochondrial toxicity of depleted uranium and its potential mechanisms，aiming to provide a reference for further research into the mechanisms to depleted uranium poisoning and the development of interventianal treatments.
