Exploring flatfeet morphology in children aged 6-12 years: relationships with body mass and body height through footprints and three-dimensional measurements.

The aim of the study was to determine the relationship between flatfoot morphology and body mass and height in children aged 6-12 years. A total of 6471 Chinese children (mean age 9.0 ± 1.9 years, 41% female) were assessed for foot morphometry, body height, and body mass index. Foot morphology, including foot length, width, girth, arch height, hallux valgus angle, and rearfoot valgus angle, was measured using a 3D laser scanner. Flatfoot evaluations were conducted using the Sztriter-Godunov index (KY) from footprints. All measurements were analyzed by age and sex using the mean values of the left and right sides. Comparisons were performed between flatfoot groups, between body mass index (BMI) groups, and between body height groups. The study revealed a significant decrease in the incidence of bipedal flatfoot with age (p < 0.001), whereas the prevalence of obesity remained consistent (p > 0.05). Bipedal flatfoot was associated with distinct morphological changes, including lower arches, reduced instep height, diminished ankle heights and a greater rearfoot valgus angle (p < 0.05). When comparing the BMI groups, overweight children had larger and thicker feet (p < 0.05), but no differences were found in arch height and ankle height (p > 0.05). When comparing the body height groups, short-statured children had a shorter feet girth, shorter arches, and shorter ankle height (p < 0.05), but no differences were found in the rearfoot valgus angle (p > 0.05). CONCLUSION: The main characteristics of flat feet include lower arches and instep heights and ankle heights but higher rearfoot valgus angles. In general, overweight children's feet do not have the common features of flat feet. In contrast, short children had similar features of flatfoot except for rearfoot valgus. Assessment of posture, such as rearfoot valgus, can be critical in identifying children with flat feet. WHAT IS KNOWN: • The morphology of children's feet is associated with body growth, but the relationship between flatfeet and body mass and height remains controversial. WHAT IS NEW: • Three-dimensional foot measurement shows that body mass is generally not associated with flatfeet, while short children have lower arches but no rearfoot valgus.

Dl-3n-butylphthalide improves traumatic brain injury recovery via inhibiting autophagy-induced blood-brain barrier disruption and cell apoptosis.

Blood-brain barrier (BBB) disruption and neuronal apoptosis are important pathophysiological processes after traumatic brain injury (TBI). In clinical stroke, Dl-3n-butylphthalide (Dl-NBP) has a neuroprotective effect with anti-inflammatory, anti-oxidative, anti-apoptotic and mitochondrion-protective functions. However, the effect and molecular mechanism of Dl-NBP for TBI need to be further investigated. Here, we had used an animal model of TBI and SH-SY5Y/human brain microvascular endothelial cells to explore it. We found that Dl-NBP administration exerts a neuroprotective effect in TBI/OGD and BBB disorder, which up-regulates the expression of tight junction proteins and promotes neuronal survival via inhibiting mitochondrial apoptosis. The expressions of autophagy-related proteins, including ATG7, Beclin1 and LC3II, were significantly increased after TBI/OGD, and which were reversed by Dl-NBP treatment both in vivo and in vitro. Moreover, rapamycin treatment had abolished the effect of Dl-NBP for TBI recovery. Collectively, our current studies indicate that Dl-NBP treatment improved locomotor functional recovery after TBI by inhibiting the activation of autophagy and consequently blocking the junction protein loss and neuronal apoptosis. Dl-NBP, as an anti-inflammatory and anti-oxidative drug, may act as an effective strategy for TBI recovery.

Calcium ion assisted fluorescence determination of microRNA-167 using carbon dots-labeled probe DNA and polydopamine-coated Fe3O4 nanoparticles.

A selective and sensitive fluorescence biosensor is described for determination of microRNA-167 using fluorescent resonant energy transfer (FRET) strategy. The FRET system comprises carbon dots (CDs, donor) labeled with probe DNA (pDNA) and polydopamine (PDA)-coated Fe3O4 nanoparticles (Fe3O4@PDA NPs, acceptor). The CDs-pDNA can be absorbed onto the surface of Fe3O4@PDA NPs because of the strong π interaction between pDNA and PDA. With the enhanced adsorption ability of Fe3O4@PDA NPs by Ca2+, the fluorescence intensity of CDs at 445 nm (excitation at 360 nm) is quenched. In presence of microRNA-167, the hybridized complex of CDs-pDNA-microRNA-167 will be released from the surface of Fe3O4@PDA NPs due to the weak π interaction of the complex and PDA. This results in the fluorescence recovery of CDs. By application of twice-magnetic separation, the biosensor shows a wide linear range of 0.5-100 nM to microRNA-167 with a 76 pM detection limit. The method was applied to the determination of microRNA-167 in samples of total microRNA extractions from A. thaliana seedlings, and the recoveries ranged from 96.4 to 98.3%.

High cholesterol inhibits tendon-related gene expressions in tendon-derived stem cells through reactive oxygen species-activated nuclear factor-κB signaling.

Clinical studies have indicated that increased serum cholesterol levels raised the risk of tendinopathy in hypercholesterolemia, but the effect of cholesterol on tendon-derived stem cells (TDSCs) and its underlying mechanism have not been studied. The purpose of this study is to investigate the association between cholesterol and tendinopathy in vitro and in vivo, and its underlying molecular mechanism as well. In TDSCs, the effect of cholesterol was assessed by quantitative polymerase chain reaction, western blot analysis, and immunofluorescence staining. Intracellular levels of reactive oxygen species (ROS) was detected, using flow cytometry. The link between nuclear factor (NF)-κB signaling and the effect of cholesterol was evaluated using a representative IκB kinase (IKK) inhibitor, BAY 11-7082. In addition, Achilles tendons from apolipoprotein E mice fed with a high-fat diet were histologically assessed using hematoxylin and eosin staining and immunohistochemistry. We found that high cholesterol apparently lowered the expression of tendon cell markers (collagen 1, scleraxis, tenomodulin), and elevated ROS levels via the NF-κB pathway both in vitro and in vivo. The ROS scavenger N-acetylcysteine (NAC) and BAY 11-7082 reversed the inhibiting effect of cholesterol on the tendon-related gene expressions of TDSCs. Moreover, NAC blocked cholesterol-induced phosphorylation of IκBα and p65. Significant histological alternation in vivo was shown in Achilles tendon in the hypercholesterolemic group. These results indicated that high cholesterol may inhibit the tendon-related gene expressions in TDSCs via ROS-activated NF-кB signaling, implying pathogenesis of tendinopathy in hypercholesterolemia and suggesting a new mechanism underlying hypercholesterolemia-induced tendinopathy.

Interleukin-6 Promotes Proliferation but Inhibits Tenogenic Differentiation via the Janus Kinase/Signal Transducers and Activators of Transcription 3 (JAK/STAT3) Pathway in Tendon-Derived Stem Cells.

BACKGROUND Previous studies demonstrated that tendon-derived stem cells (TDSCs) were vital healing cells and that mRNA expression of anti-inflammatory cytokine IL-6 was significantly upregulated in injured tendons. The aim of the present study was to investigate the effects of IL-6 on the TDSCs in vitro. MATERIAL AND METHODS TDSCs isolated from the Achilles tendons in SD rats were co-cultured with various concentrations of IL-6. Cell proliferation, cell cycle analysis, quantitative real-time PCR, western blotting analysis, and statistical analysis were used in the study. RESULTS The result showed that IL-6 strongly increased proliferation capability, and induced cell cycle activation and transition into G2/M phase from G1 phase in TDSCs. However, IL-6 treatment strongly inhibited gene expression of Scleraxis, Collagen 1, Tenomodulin, Collagen 3, Early Growth Response Protein 1, Decorin, Lumican, Biglycan and Fibromodulin in TDSCs. It also strongly inhibited protein expression of tendon cell markers like scleraxis, collagen 1, collagen 3, and tenomodulin. IL-6 treatment strongly activated the JAK/Stat3 signaling pathway in TDSCs. Furthermore, WP1066, a JAK/Stat3 signaling pathway inhibitor, abrogated the effects of IL-6 on TDSCs. CONCLUSIONS These findings indicated that IL-6 might exert dual effects on TDSCs in vitro: strongly enhancing their proliferation but inhibiting their tenogenic differentiation via the JAK/Stat3 pathway.

IL-1ß irreversibly inhibits tenogenic differentiation and alters metabolism in injured tendon-derived progenitor cells in vitro.

Tendon injuries are common, and the damaged tendon often turns into scar tissue and never completely regains the original biomechanical properties. Previous studies have reported that the mRNA levels of inflammatory cytokines such as IL-1ß are remarkably up-regulated in injured tendons. To examine how IL-1ß impacts tendon repair process, we isolated the injured tendon-derived progenitor cells (inTPCs) from mouse injured Achilles tendons and studied the effects of IL-1ß on the inTPCs in vitro. IL-1ß treatment strongly reduced expression of tendon cell markers such as scleraxis and tenomodulin, and also down-regulated gene expression of collagen 1, collagen 3, biglycan and fibromodulin in inTPCs. Interestingly, IL-1ß stimulated lactate production with increases in hexokinase II and lactate dehydrogenase expression and a decrease in pyruvate dehydrogenase. Inhibition of lactate production restored IL-1ß-induced down-regulation of collagen1 and scleraxis expression. Furthermore, IL-1ß significantly inhibited adipogenic, chondrogenic and osteogenic differentiation of inTPCs. Interestingly, inhibition of tenogenic and adipogenic differentiation was not recovered after removal of IL-1ß while chondrogenic and osteogenic differentiation abilities were not affected. These findings indicate that IL-1ß strongly and irreversibly impairs tenogenic potential and alters glucose metabolism in tendon progenitors appearing in injured tendons. Inhibition of IL-1ß may be beneficial for maintaining function of tendon progenitor cells during the tendon repair process.

Tendon progenitor cells in injured tendons have strong chondrogenic potential: the CD105-negative subpopulation induces chondrogenic degeneration.

To study the cellular mechanism of the tendon repair process, we used a mouse Achilles tendon injury model to focus on the cells recruited to the injured site. The cells isolated from injured tendon 1 week after the surgery and uninjured tendons contained the connective tissue progenitor populations as determined by colony-forming capacity, cell surface markers, and multipotency. When the injured tendon-derived progenitor cells (inTPCs) were transplanted into injured Achilles tendons, they were not only integrated in the regenerating area expressing tenogenic phenotype but also trans-differentiated into chondrogenic cells in the degenerative lesion that underwent ectopic endochondral ossification. Surprisingly, the micromass culture of the inTPCs rapidly underwent chondrogenic differentiation even in the absence of exogenous bone morphogenetic proteins or TGFßs. The cells isolated from human ruptured tendon tissues also showed connective tissue progenitor properties and exhibited stronger chondrogenic ability than bone marrow stromal cells. The mouse inTPCs contained two subpopulations one positive and one negative for CD105, a coreceptor of the TGFß superfamily. The CD105-negative cells showed superior chondrogenic potential in vitro and induced larger chondroid degenerative lesions in mice as compared to the CD105-positive cells. These findings indicate that tendon progenitor cells are recruited to the injured site of tendons and have a strong chondrogenic potential and that the CD105-negative population of these cells would be the cause for chondroid degeneration in injured tendons. The newly identified cells recruited to the injured tendon may provide novel targets to develop therapeutic strategies to facilitate tendon repair.

Preparation of calcium phosphate cement and polymethyl methacrylate for biological composite bone cements.

BACKGROUND: We studied the biological safety, biomechanics, and tissue compatibility of calcium phosphate cement and Polymethyl Methacrylate composite bone cement mixed in different ratios. MATERIAL/METHODS: CPC and PMMA were mixed in different ratios (3:1, 2:1, 1:1, 1:2, 1:5, 1:10, 1:15, and 1:20). PMMA solvent is a general solvent containing a dissolved preparation of the composite bone cement specific to a given specimen to determine biological safety, biomechanics, and tissue compatibility. RESULTS: The CPC/PMMA (33%) group, CPC/PMMA (50%) group, CPC/PMMA (67%) group, and CPC/PMMA (75%) group were more in line with the composite bone cement without cytotoxicity requirements. The compressive strength of the CPC/PMMA (67%) group and CPC/PMMA (75%) group was 20 Mpa-30 Mpa, while that of the CPC/PMMA (4.8%) group, CPC/PMMA (6.25%) group, CPC/PMMA (9.1%) group, CPC/PMMA (16.7%) group, CPC/PMMA (33%) group, and CPC/PMMA (50%) group was 40 Mpa-70 Mpa. Curing time was longer in the CPC group (more than 11 min) and shorter in the PMMA group (less than 2 min). The results of weight loss rate showed that there were no significant differences between the CPC/PMMA group (4.8%, 6.25%, 9.1%, 16.7%, 33%) and PMMA control group (p>0.05). With the decrease of CPC content, the rate of weight loss gradually decreased. CONCLUSIONS: The CPC/PMMA (50%) group, CPC/PMMA (67%) group, and CPC/PMMA (75%) group provide greater variability and selectivity for the composite bone cement in obtaining better application.

Effects of celecoxib on proliferation and tenocytic differentiation of tendon-derived stem cells.

NSAIDs are often ingested to reduce the pain and improve regeneration of tendon after tendon injury. Although the effects of NSAIDs in tendon healing have been reported, the data and conclusions are not consistent. Recently, tendon-derived stem cells (TDSCs) have been isolated from tendon tissues and has been suggested involved in tendon repair. Our study aims to determine the effects of COX-2 inhibitor (celecoxib) on the proliferation and tenocytic differentiation of TDSCs. TDSCs were isolated from mice Achilles tendon and exposed to celecoxib. Cell proliferation rate was investigated at various concentrations (0.1, 1, 10 and 100 µg/ml) of celecoxib by using hemocytometer. The mRNA expression of tendon associated transcription factors, tendon associated collagens and tendon associated molecules were determined by reverse transcription-polymerase chain reaction. The protein expression of Collagen I, Collagen III, Scleraxis and Tenomodulin were determined by Western blotting. The results showed that celecoxib has no effects on TDSCs cell proliferation in various concentrations (p>0.05). The levels of most tendon associated transcription factors, tendon associated collagens and tendon associated molecules genes expression were significantly decreased in celecoxib (10 µg/ml) treated group (p<0.05). Collagen I, Collagen III, Scleraxis and Tenomodulin protein expression were also significantly decreased in celecoxib (10 µg/ml) treated group (p<0.05). In conclusion, celecoxib inhibits tenocytic differentiation of tendon-derived stem cells but has no effects on cell proliferation.

Proximal femoral nail vs. dynamic hip screw in treatment of intertrochanteric fractures: a meta-analysis.

BACKGROUND: The aim of this meta-analysis was to compare the outcomes of proximal femoral nail (PFN) and dynamic hip screw (DHS) in treatment of intertrochanteric fractures. MATERIAL AND METHODS: Relevant randomized or quasi-randomized controlled studies comparing the effects of PFN and DHS were searched for following the requirements of the Cochrane Library Handbook. Six eligible studies involving 669 fractures were included. Their methodological quality was assessed and data were extracted independently for meta-analysis. RESULTS: The results showed that the PFN group had significantly less operative time (WMD: -21.15, 95% CI: -34.91 - -7.39, P=0.003), intraoperative blood loss (WMD: -139.81, 95% CI: -210.39 - -69.22, P=0.0001), and length of incision (WMD: -6.97, 95% CI: -9.19 - -4.74, P<0.00001) than the DHS group. No significant differences were found between the 2 groups regarding postoperative infection rate, lag screw cut-out rate, or reoperation rate. CONCLUSIONS: The current evidence indicates that PFN may be a better choice than DHS in the treatment of intertrochanteric fractures.

Response of dissolved carbon dioxide and methane concentration to warming in shallow lakes.

Shallow lake ecosystems are highly sensitive to temperature fluctuation because of their high water surface-to-volume ratios. Shallow lakes have been increasingly identified as a hotspot of CO2 and CH4 emissions, but their response to temperature variation remains unclear. Here, we report from a 5-month outdoor mesocosm experiment where we investigated the impacts of a projected 3.5 °C future warming and monthly temperature changes on lake CO2 and CH4, as well as the key drivers affecting the lake carbon cycling. Our results show that CO2 and CH4 concentrations had a significantly positive correlation with monthly temperatures. CH4 concentration was primarily regulated by monthly temperature, while nutrients effects on CO2 concentration overrode climate warming and temporal temperature changes. These findings imply the varied roles that temperature and nutrient levels can play on CO2 and CH4 dynamics in shallow lake systems. The relationship between temperature and CO2 concentration was nonlinear, showing a threshold of approximately 9 °C, at which CO2 concentration could be strongly modified by nutrient level in the lake systems. Understanding this complex relationship between temperature with CO2 and CH4 concentrations in shallow lakes is crucial for effective lake management and efficient control of greenhouse gases (GHGs) emissions.

Evaluation of appropriateness of antibiotic prescribing in primary healthcare institutions in China using proxy indicator.

Background: Our objectives were to develop a set of proxy indicators (PIs) suited for assessing antibiotic use appropriateness in China's primary healthcare institutions (PHIs), and assess performance scores of these PIs while exploring factors that influence the antibiotic appropriateness. Methods: We selected potential PIs for the PHIs through a RAND-modified Delphi procedure, and assessed clinimetric properties, focusing on measurability, applicability, and potential for improvement. PIs with favorable clinimetric properties were used to evaluate antibiotic prescription appropriateness by calculating performance scores of each PI. Institutions were categorized into three clusters representing different levels of appropriateness. We used the chi-square test and an ordinal logistic regression model at PHI level to explore factors influencing antibiotic appropriateness. Findings: Eighteen PIs were developed through two rounds of online surveys and one face-to-face meeting involving 20 stakeholders. All PIs met the clinimetric properties criteria and were used to analyze 209,662 antibiotic prescriptions across 269 PHIs. The percentage of PHIs meeting the target ranged from 3.1% to 69.3%, with 6 PIs below 10%. The appropriateness of antibiotic prescriptions was significantly associated with percentages of patients' gender of the PHIs. Interpretation: The varied and suboptimal performance of the PIs indicated the need for diverse efforts to enhance the rational antibiotic use at PHI level. It was necessary to devise distinct sets of PIs for diverse settings in future endeavors. Funding: This work was supported by the National Natural Science Foundation of China (grant numbers 72374009, 81973294).

Using three-dimensional computational modeling to compare the geometrical fitness of two kinds of proximal femoral intramedullary nail for Chinese femur.

OBJECTIVE: The aim of this study was to use three-dimensional (3D) computational modeling to compare the geometric fitness of these two kinds of proximal femoral intramedullary nails in the Chinese femurs. Computed tomography (CT) scans of a total of 120 normal adult Chinese cadaveric femurs were collected for analysis. With the three-dimensional (3D) computational technology, the anatomical fitness between the nail and bone was quantified according to the impingement incidence, maximum thicknesses and lengths by which the nail was protruding into the cortex in the virtual bone model, respectively, at the proximal, middle, and distal portions of the implant in the femur. The results showed that PFNA-II may fit better for the Chinese proximal femurs than InterTan, and the distal portion of InterTan may perform better than that of PFNA-II; the anatomic fitness of both nails for Chinese patients may not be very satisfactory. As a result, both implants need further modifications to meet the needs of the Chinese population.

Celecoxib inhibits the heterotopic ossification in the rat model with Achilles tenotomy.

Celecoxib, a selective cox-2 inhibitor, has been shown to prevent the heterotopic ossification following total hip arthroplasty. However, the effects of celecoxib on heterotopic ossification at other locations remain unclear. This study aimed to investigate the effect of celecoxib on heterotopic ossification in the rat model with Achilles tenotomy. Forty male Sprague-Dawley rats, which were randomly divided into 2 groups (n = 20), underwent midpoint Achilles tenotomy on left legs through a posterior approach under aseptic condition. Experimental group was treated with the saline solution of celecoxib (10 mg/kg) per day, while control group was treated by normal saline (0.9%). At 3, 5 and 10 postoperative weeks, all animals were examined by X-ray to assess new bone formation in the Achilles tendon. At 10 weeks after surgery, all animals were killed and Achilles tendons were taken for hematoxylin-eosin (HE) and immunohistochemical staining. Heterotopic ossification developed in 3 rats (15%) in experimental group and 20 rats (100%) in control group by postoperative 10 weeks. The incidence of heterotopic ossification was significantly lower in experimental group than in control group (P < 0.05). Our findings suggest that celecoxib inhibits HO development in rat model with Achilles tenotomy.

Nitrogen addition effect overrides warming effect on dissolved CO2 and phytoplankton structure in shallow lakes.

Shallow lakes are numerous in all climate zones, but our knowledge about their dissolved carbon dioxide (CO2) response to future climate change and nutrient enrichment is rather limited. Here we performed a mesocosm experiment with four treatments to investigate how warming and nitrogen addition will impact the partial pressure of CO2 (pCO2) and phytoplankton community individually and combined. We found that warming alone had no significant effect on pCO2, while nitrogen addition increased pCO2 significantly. The combined effects of nitrogen addition and warming on pCO2 level were prevalent, indicating that eutrophic shallow lakes would be double-jeopardized in the future climate. Warming and nitrogen addition together also showed to have changed the phytoplankton community structure, suggesting a potential shifting of biological system in shallow lakes under changing climate. These findings highlight the importance of reducing nitrogen pollution to shallow lake systems for sustainable development goal.

Artificial nerve graft constructed by coculture of activated Schwann cells and human hair keratin for repair of peripheral nerve defects.

Studies have shown that human hair keratin (HHK) has no antigenicity and excellent mechanical properties. Schwann cells, as unique glial cells in the peripheral nervous system, can be induced by interleukin-1ß to secrete nerve growth factor, which promotes neural regeneration. Therefore, HHK with Schwann cells may be a more effective approach to repair nerve defects than HHK without Schwann cells. In this study, we established an artificial nerve graft by loading an HHK skeleton with activated Schwann cells. We found that the longitudinal HHK microfilament structure provided adhesion medium, space and direction for Schwann cells, and promoted Schwann cell growth and nerve fiber regeneration. In addition, interleukin-1ß not only activates Schwann cells, but also strengthens their activity and increases the expression of nerve growth factors. Activated Schwann cells activate macrophages, and activated macrophages secrete interleukin-1ß, which maintains the activity of Schwann cells. Thus, a beneficial cycle forms and promotes nerve repair. Furthermore, our studies have found that the newly constructed artificial nerve graft promotes the improvements in nerve conduction function and motor function in rats with sciatic nerve injury, and increases the expression of nerve injury repair factors fibroblast growth factor 2 and human transforming growth factor B receptor 2. These findings suggest that this artificial nerve graft effectively repairs peripheral nerve injury.

The Effects of Partial Substitution of Fertilizer Using Different Organic Materials on Soil Nutrient Condition, Aggregate Stability and Enzyme Activity in a Tea Plantation.

Fertilization plays a crucial role in enhancing tea production. However, it has been demonstrated that the long-term single application of chemical fertilizer will reduce soil nutrient content and the formation of soil aggregates, which is not conducive to the sustainable development of soil and agriculture. Many studies have shown that partial substitution of chemical fertilizer with organic fertilizer can improve soil physicochemical properties and soil nutrient content. This study compared the effects of different organic materials as substitutes for chemical fertilizer. We partially replaced chemical fertilizer with rabbit manure, wine lees and rapeseed cake, amounting to 30% of the total annual nitrogen application in the field experiment, and we set nine different fertilization methods to assess and analyze the soil nutrient condition, aggregate stability and enzyme activity. The results showed that the experimental soil aggregate mean weight diameter (MWD) and geometric mean diameter (GMD) were significantly increased compared with control (p < 0.05); the aforementioned fertilization methods also decreased the soil aggregate fractal dimension (D), disruption rate (PAD), average weight-specific surface area (MWSSA) and soil erodibility factor (K). The application of the fertilizer containing organic materials and microbial agent increased soil organic carbon (SOC) by 20.7% to 22.6% and total nitrogen (TN) by 34.6% to 38.1%; it also significantly promoted sucrase, urease and protease activities in all aggregate sizes (p < 0.05) and increased the 2-5 mm aggregate content. The correlation coefficients between the SOC and the enzyme activities were 0.18-0.95, and most of them showed an extremely significant positive correlation (p < 0.01). In conclusion, the application of fertilizers containing organic materials and microbial agents can improve soil aggregate stability, aggregate enzyme activity and soil structural stability.

Exploring Facilitators and Barriers to Delayed Antibiotic Prescribing in Rural Northwest China: A Qualitative Study Using the Theoretical Domains Framework and Behavior Change Wheel.

BACKGROUND: Antimicrobial resistance, exacerbated by antibiotic misuse, poses a global threat. Though delayed antibiotic prescribing (DAP) can mitigate antibiotic overuse, its adoption in developing nations, such as China, is limited. This study probed barriers and facilitators to DAP in Xinjiang, characterized by extensive rural landscapes and primary care institutions (PCIs). METHODS: Adopting a qualitative methodology, we conducted key informant interviews with thirty participants across six county hospitals in Xinjiang using VooV Meeting. Employing a two-stage sampling method targeting economically diverse areas, our interviews spanned physicians, pharmacists, patients, and caregivers. We organized the data according to the Theoretical Domains Framework (TDF) and the Behavior Change Wheel (BCW), spotlighting behavioral and policy elements impacting DAP. RESULTS: Our research included thirty interviewees. Twelve physicians contemplated delayed prescriptions, while five adult patients and six caregivers encountered recommendations for delayed antibiotic prescriptions. Six patients sought pharmacists' advice on antibiotic necessity. Prominent TDF domains were memory, attention, and beliefs about consequences. Critical intervention functions included education and environmental restructuring, while vital policy categories encompassed communication/marketing and guidelines. CONCLUSIONS: Countering antibiotic misuse and resistance in China necessitates overcoming barriers through strategic resource distribution, comprehensive education, rigorous training, and consistent monitoring, thereby promoting DAP adoption. The adoption of DAP in rural healthcare settings in China has the potential to significantly reduce antibiotic misuse, thereby mitigating the global threat of antimicrobial resistance.

Chondroblastoma of the talus: a case report and literature review.

Chondroblastoma is a rare, benign cartilaginous neoplasm that accounts for approximately 1% of all bone tumors, and approximately 4% of all chondroblastomas arise in the talus. Here we report a case of chondroblastoma in the left talus. The 22-year-old male patient presented with a 16-month history of ankle pain. Based on radiological and pathological examination, we diagnosed the patient with chondroblastoma. A posterolateral approach was used to allow access to the lesion. After curettage, the allogenic bone chips were packed into the talar body defect. After 2 years' follow-up, we found no recurrence or metastasis of chondroblastoma, suggesting our surgery procedure was effective.

The Application and Efficacy Evaluation of Autologous Fat Transplantation in Antiaging of the Face: Systematic Review and Meta-Analysis.

Objective: To evaluate the therapy of autologous fat fine-grain transplantation in the application of antiaging facial by metaelaboration method. Methods: In Chinese and English databases, such as Wanfang, Weipu, CNKI, PubMed, Cochrane Library, and EMBASE, the literature on the use of autologous fat fines graft in antiaging facial was collected, covering randomized comparative trials, nonrandomized comparative studies, comparative case studies, cohort studies, case reports, and so forth. Meta-analyses were also conducted on complication rates, beauty seeker satisfaction, and one-shot success rates. Results: This study included 23 studies that held metaelaborations, including a total of 2852 beauty seekers. According to metaelaboration, the complication rate was 0.02 (95% CI: 0.01, 0.04), the satisfaction rate of beauty seekers was 0.95 (95% CI: 0.91, 0.97), and the success rate of one injection is 0.79 (95% CI: 0.73, 0.84). Conclusion: Autologous fat fine-grain transplantation is obvious and stable in the use of antiaging facial, and it is necessary to popularize the use in clinical practice.