To explore the clinical efficacy of endoscopic injection of autologous platelet-rich plasma （PRP） in the treatment of chronic sinus tract，analyze the factors affecting sinus tract healing.

A retrospective analysis was performed on the clinical data of 93 patients with chronic sinus tract admitted to the Department of Burns，Plastic Surgery and Wound Repair，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine，from June 2023 to June 2025，including 42 males and 51 females，with a mean age of （42.2±16.1） years. All patients were divided into the PRP group （43 cases） and the control group （50 cases） according to treatment regimens. Patients in both groups underwent endoscopic sinus tract exploration and debridement. In the PRP group，1-10 mL of PRP was injected into the sinus tract base and wall after debridement based on the size and depth of the sinus tract. The sinus tract healing rate，length of stay and treatment duration were compared between the two groups，and subgroup stratified analysis was conducted according to sinus tract types. Univariate and multivariate Logistic regression analyses were used to identify the influencing factors on sinus tract healing，and the interaction effect between PRP treatment and sinus tract type was tested. Modified Poisson regression was applied for sensitivity analysis. The Enter method was adopted to construct the regression model. The calibration degree and discrimination degree of the model were evaluated by the Hosmer-Lemeshow test and the area under the receiver operating characteristic curve （AUC），respectively.

The sinus tract healing rate of the PRP group was higher than that of the control group （90.7% vs. 58.0%，χ²=12.58，P<0.001）. Subgroup analysis showed that patients with refractory sinus tract derived a relatively greater benifit from PRP treatment （78.6% vs. 5.3%，χ²=18.72，P<0.001）. Univariate analysis indicated that PRP treatment，maximum sinus tract depth，disease course，bacterial detection，sinus tract type and anatomical site were correlated with sinus tract healing （P values all<0.05）. Multivariate Logistic regression analysis revealed that PRP treatment was an independent protective factor for sinus tract healing （OR=15.32，95%CI： 2.91-80.68，P=0.001）. Increased maximum sinus tract depth （OR=0.65，95%CI： 0.49-0.86，P=0.002） and prolonged disease course （OR=0.90，95%CI： 0.82-0.98，P=0.012） were independent risk factors for sinus tract healing. No significant interaction was observed between PRP treatment and sinus tract type （P=0.838）. The AUC of the model was 0.882 （95%CI： 0.795-0.969），and the Hosmer-Lemeshow test verified good calibration of the model （P=0.098）. Modified Poisson regression confirmed the robustness of the conclusions.

Endoscopic PRP treatment can improve the healing rate of chronic sinus tract and serves as an independent protective factor for sinus tract healing. Increased sinus tract depth and prolonged disease course are independent risk factors for sinus tract healing. PRP exhibits a relatively greater efficacy in the treatment of refractory sinus tract，which is recommended as a priority therapy for this subtype.

To investigate the differences between a deep learning model and manual measurement in assessing postoperative parameters of intertrochanteric femoral fractures after intramedullary nail fixation.

A retrospective study was conducted, including 150 patients with intertrochanteric femoral fractures who met the inclusion criteria and underwent unilateral intramedullary nail fixation at the Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University, from January to December 2024. Among them, 50 patients each in the proximal femoral nail antirotation (PFNA), Gamma-type intramedullary nail, and InterTan intramedullary nails groups. There were 81 males and 69 females, aged (64.1±17.3) years; 79 cases were on the left side and 71 on the right. The deep learning model and manual method were used to measure the postoperative neck-shaft angle, tip-apex distance (TAD), and medial femoral cortex support, and the results were compared. Bland-Altman analysis was used to evaluate the agreement between the two measurement methods.

For TAD, there was no statistically significant difference between the deep learning model and manual measurement in all cases and each subgroup (P>0.05). The overall mean difference was (-0.21±5.29) mm, and Bland-Altman analysis showed good agreement. The overall Kappa value for the measurement of medial femoral cortical support was 0.716, with the best agreement in the PFNA group (Kappa=0.803), followed by the Gamma-type intramedullary nail group and InterTan intramedullary nail group (0.675 and 0.651, respectively). The overall neck-shaft angle measured by the deep learning model was higher than that measured by the manual method, especially in the InterTan intramedullary nail group, where the difference was statistically significant (P<0.001), while no statistically significant difference was found in the PFNA group or the Gamma-type intramedullary nail group (P>0.05).

The deep learning model showed good agreement with the manual method in measuring TAD and medial femoral cortical support, as well as postoperative neck-shaft angle in the PFNA and Gamma-type intramedullary nail fixation. However, there was a systematic bias in the measurement of postoperative neck-shaft angle in the InterTan intramedullary nail fixation, suggesting that the model still needs further optimization for complex dual-screw configurations.

To systematically evaluate the efficacy and safety of nebulized heparin in patients with inhalation injury.

A systematic search was conducted in PubMed，Embase，the Cochrane Library，the China National Knowledge Infrastructure （CNKI），and the Wanfang Data Knowledge Service Platform for literatures about the use of nebulized heparin in patients with inhalation injury published from database inception to September 1，2025. Two reviewers independently conducted literature screening，data extraction，and risk of bias assessment. Meta-analysis was performed using RevMan 5.4 software.

A total of 11 studies involving 710 patients with inhalation injury were included. Meta-analysis results showed that，compared with conventional treatment，nebulized heparin reduced 28-day mortality （RR=0.74，95%CI：0.59 to 0.92，P=0.008），shortened the duration of mechanical ventilation （MD=-3.86，95%CI： -5.71 to -2.01，P<0.001）. The pooled result of only 2 studies （238 patients） showed that nebulized heparin could improve the oxygenation index （MD=18.07，95%CI： 12.51 to 23.64，P<0.001）. In terms of safety，there was no statistically significant difference in the incidence of pneumonia between patients receiving nebulized heparin therapy and those receiving conventional treatment （RR=0.95，95%CI： 0.68 to 1.32，P=0.76）. The pooled result of only 3 studies （223 patients） showed no statistically significant difference in the incidence of bleeding events between patients treated with the two methods （RR=1.02，95%CI： 0.82 to 1.27，P=0.87）.

Early initiation of a combination regimen centered on nebulized heparin in patients with inhalation injury may help reduce 28-day mortality and shorten the duration of mechanical ventilation, without increasing the risk of pneumonia，indicating a favorable safety profile.

To investigate the predictive value of baseline blood lactate, lactate clearance, and lactate-to-albumin ratio for 28-day all-cause mortality in patients with necrotizing fasciitis (NF) admitted to the intensive care unit (ICU), and to inform early clinical risk stratification and dynamic monitoring.

Data of 156 patients with NF were extracted from the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ) database and retrospectively analyzed. The associations of baseline blood lactate, lactate clearance, and lactate-to-albumin ratio with 28-day all-cause mortality were evaluated. Univariate and multivariate logistic regression, receiver operating characteristic (ROC) curves, likelihood ratio tests, and sensitivity analyses were used to compare the predictive performance of each indicator.

The initial lactate level measured within 24 hours of ICU admission was associated with 28-day all-cause mortality in patients with NF (OR=1.67, 95%CI: 1.39-2.10, P<0.001). After adjusting for lactate, lactate clearance ≥10% was an independent protective factor for 28-day all-cause mortality (OR=0.23, 95%CI: 0.05-0.77, P=0.028). Models constructed using cutoff values of 10%, 15%, and 20% for lactate clearance showed similar assessment efficacy, the area under the curve (AUC) values were 0.826 (95%CI: 0.714-0.937), 0.824 (95%CI: 0.711-0.938), 0.817 (95%CI: 0.701-0.932), respectively, with no statistically significant differences (all P values were >0.05). Likelihood ratio tests indicated that combining lactate and lactate clearance significantly improved model goodness-of-fit (χ²=5.753, P=0.016). The lactate-to-albumin ratio was an independent predictor in the multiple imputation model (OR=2.92, 95%CI: 1.03-9.14, P=0.049), and a consistent trend was observed in the complete case analysis, although it did not reach statistical significance (OR=2.31, 95%CI: 0.81-7.52, P=0.128). After 1∶1 propensity-score matching, 36 well-balanced patients were obtained. Upon further adjusting for the Charlson comorbidity index, both baseline lactate (OR=1.39, 95%CI: 1.10-1.91, P=0.017) and lactate-to-albumin ratio (OR=2.05, 95%CI: 1.23-4.21, P=0.020) remained independent risk factors for 28-day all-cause mortality in patients with NF, and the lactate-to-albumin ratio showed a stronger association.

The initial lactate level measured within 24 hours of ICU admission serves as a core prognostic indicator for 28-day all-cause mortality in patients with NF. The lactate clearance dynamically reflects treatment response, while the lactate-to-albumin ratio offers additional predictive value.

To investigate the effect of carrier-free self-assembled berberine-curcumin nanoparticles （Ber-Cur NPs） on chronic wound healing in rats.

Ber-Cur NPs were prepared using the antisolvent precipitation method. The physicochemical characteristics of Ber-Cur NPs were evaluated by scanning electron microscopy，transmission electron microscopy，energy-dispersive spectroscopy，dynamic light scattering，Fourier transform infrared spectroscopy，and confocal laser scanning microscopy. The in vitro antioxidant activity of Ber-Cur NPs were assessed using 2，2'-azino-bis （3-ethylbenzothiazoline-6-sulfonic acid） （ABTS），1，1-diphenyl-2-picrylhydrazyl （DPPH），and 2-phenyl-4，4，5，5-tetramethylimidazoline-1-oxyl 3-oxide （PTIO） free radical scavenging assays. Intracellular reactive oxygen species （ROS） scavenging ability was detected using the 2'，7'-dichlorodihydrofluorescein diacetate （DCFH-DA） fluorescent probe. Cell compatibility and the protective effect of Ber-Cur NPs against hydrogen peroxide （H₂O₂） -induced oxidative stress injury were evaluated using the methyl thiazolyl tetrazolium （MTT） assay. Twenty-five Sprague-Dawley rats were established chronic wound models on the back and were randomly divided into the control group，model group，and low，medium，and high dose Ber-Cur NPs groups. Wounds in each group were treated with daily dressing changes. The control and model groups received normal saline，while the low，medium，and high dose Ber-Cur NPs groups received 0.1，0.5，and 2.0 mg/mL Ber-Cur NPs，respectively. Wound images were obtained on days 7 and 15 after treatment，and the wound healing rate was calculated. On day 15 after treatment，wound tissues were collected to determine superoxide dismutase （SOD） activity and malondialdehyde （MDA） levels. Interleukin-6 （IL-6） expression was detected by immunohistochemistry，and CD31 expression was detected by immunofluorescence staining. The biosafety of Ber-Cur NPs were evaluated using the MTT assay，hematoxylin and eosin （HE） staining of major organs，and hematological analysis.

Ber-Cur NPs exhibited a quasi-spherical morphology，with a particle size of （44.25±11.73） nm，a hydration particle size of 108.10 nm，and a zeta potential of +7.6 mV. Fourier-transform infrared spectroscopy indicated that hydrogen bonding，π-π stacking，and electrostatic interactions between Ber and Cur may jointly drive the self-assembly process. Dual-channel fluorescence localization showed a high degree of overlap between the fluorescence signals of Ber and Cur in the nanoparticles，suggesting that both components participated in the formation of the self-assembled nanoparticles. In vitro experiments showed that Ber-Cur NPs had favorable scavenging effects on ABTS，DPPH，and PTIO free radicals，as well as intracellular ROS，and improved the survival rate of cells subjected to oxidative stress injury. MTT results showed that the cell survival rates of Ber-Cur NPs treatment were above 80% within the concentration range of 0–200 μg/mL. After high dose Ber-Cur NPs treatment，no significant abnormalities were observed on the liver and kidney function indicators or the HE staining of major organs in the rats. Compared with the model group，Ber-Cur NPs treatment increased the wound healing rate，enhanced SOD activity and CD31 expression，and reduced MDA level and IL-6 expression in wound tissues.

Ber-Cur NPs can improve chronic wound healing in rats by reducing oxidative stress，inhibiting inflammatory responses，and promoting angiogenesis.

To investigate the ameliorative effects of selenium nanoparticles (Se NPs) on induced myoblast injury and inhibition of myogenic differentiation.

Using hyaluronic acid (HA) as a stabilizing component，Se NPs were synthesized by reducing sodium selenite with ascorbic acid. The physicochemical properties of Se NPs were characterized by transmission electron microscopy，nanoparticle tracking analysis，Zeta potential measurement，and ultraviolet-visible absorption spectroscopy. The in vitro antioxidant capacity was assessed using the 3，3'，5，5'-tetramethylbenzidine chromogenic system and the 2，2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) radical cation (ABTS^•+) scavenging assay. C2C12 myoblasts were treated with lipopolysaccharide （LPS） to simulate the effects of the inflammatory microenvironment formed by skeletal muscle aging or injury on myoblasts, and a hydrogen peroxide-induced oxidative damage model was also used. The effects of Se NPs on cell viability，apoptosis，reactive oxygen species (ROS)/reduced glutathione (GSH) levels，mitochondrial membrane potential，and the expression of inflammation- and myogenic differentiation-related genes were examined. Myosin heavy chain （MHC） expression，myotube formation，and fusion index were also evaluated.

Se NPs were spherical and well-dispersed，with an average core diameter of （117.96±14.27） nm，an average hydrodynamic diameter of （136.71±18.48） nm，and an average Zeta potential of （-25.99±7.60） mV，showing a characteristic absorption peak at approximately 290 nm. In vitro antioxidant experiments demonstrated that the antioxidant capacity of Se NPs increased with increasing manner. Se NPs exhibited good colloidal stability and cytocompatibility. Treatment with 100-500 ng/mL Se NPs attenuated LPS-induced decreases in cell viability and increases in apoptosis. After Se NPs intervention，LPS-induced ROS accumulation was reduced，GSH levels were increased，the expression of tumor necrosis factor-α, inducible nitric oxide synthase, and interleukin-1β was downregulated，and glutathione peroxidase 1 expression was restored. Concurrently，MHC-positive myotube formation was enhanced，and myotube length，diameter，and fusion index were increased，the expression of muscle atrophy-related genes Atrogin-1 and muscle RING finger protein 1 was downregulated，and the expression of myogenic regulatory factor myogenic differentiation 1 and myogenin was upregulated.

HA-stabilized Se NPs possess favorable antioxidant capacity and can alleviate C2C12 cell injury and improve suppressed myogenic differentiation by mitigating LPS-induced oxidative stress and inflammatory responses.

With population aging and the widespread use of abdominal CT，opportunistic assessment of skeletal muscle using existing imaging data has received increasing attention. The paraspinal muscles are an important component of the active stabilizing system of the lumbar spine and contribute to segmental stability，postural control，and load transmission. With advancing age，these muscles may exhibit atrophy，reduced CT attenuation，and increased fatty infiltration； changes in their structure and tissue composition have been associated with low back pain，lumbar degenerative changes，and functional impairment. The third lumbar vertebral （L3） level is generally included in abdominal CT scans and can be readily identified. At this level，the cross-sectional area，mean CT attenuation，and fatty infiltration of the posterior paraspinal muscles （hereafter referred to as the L3-level paraspinal muscles） may reflect local muscle degeneration in terms of muscle quantity and tissue composition in middle-aged and older adults. This review summarizes the anatomical definition of the L3-level paraspinal muscles，CT-based quantitative parameters，scanning and segmentation methods，and requirements for methodological standardization； describes age-，sex-，and body size-related differences in these parameters； reviews evidence regarding their associations with low back pain，lumbar degenerative changes，and bone mass parameters； and discusses their potential value in risk identification and opportunistic assessment. It aims to provide a reference for standardizing CT-based quantitative assessment of the L3 paraspinal muscles，facilitating comparisons across multicenter studies，and promoting clinical translation.

Burns are life-threatening severe traumas that not only cause physical impairment but also severely affect patient's appearance，thereby significantly increasing the risk of psychological problems. The incidence of post-traumatic stress disorder （PTSD） in this population is relatively high，and the influencing factors are complex. In recent years，research on PTSD in burn patients has been growing, but the applicability of existing assessment tools and interventions in patients with different characteristics still needs further exploration. This article reviews the characteristics of burn patients with PTSD，influencing factors，commonly used screening scales，and non-pharmacological therapies in recent years，aiming to provide a reference for clinical assessment and intervention of PTSD in this population.

Chronic refractory wounds are a common clinical condition characterized by a prolonged course and frequent pain, which severely affect patients' quality of life and mental health. Conventional treatments such as surgical dressing changes have limited efficacy and often result in extended healing times, posing considerable challenges in clinical management and rehabilitation. Curcumin, with its multiple pharmacological properties including anti-inflammatory, antioxidant, pro-angiogenic, and antibacterial effects, has increasingly become a research focus in the treatment of chronic refractory wounds. This article reviews the mechanisms by which curcumin promotes the healing of chronic refractory wounds, the current status of its clinical application, and the research progress on novel delivery systems. In addition, current challenges and future directions are discussed, aiming to provide a reference for the clinical application of curcumin.

Dipeptidyl peptidase-4 （DPP4） is a multifunctional transmembrane glycoprotein that plays a key role in metabolic regulation，immune costimulation，and extracellular matrix remodeling. In recent years，with the development of single-cell sequencing and lineage tracing technologies，DPP4⁺ fibroblast subpopulations have been identified as a key cell population driving fibrosis in multiple organs. This article systematically elaborates the bidirectional regulatory roles of DPP4 in the skin，visceral organs，skeletal muscle，and vascular system，focusing on the balance mechanism between its pro-scarring/pro-fibrotic and pro-healing/pro-regeneration effects. It reviews research progress on tendon stem progenitor cell fate determination，gut microbiota-derived DPP4，and fibroblast-to-adipocyte transdifferentiation，and evaluates the clinical application prospects of DPP4 inhibitors and related therapeutic strategies，providing novel target candidates and combination treatment strategies for the precise intervention of organ fibrosis and tissue regeneration.