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10 August 2026, Volume 22 Issue 4 Previous Issue   

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Strategy and surgical protocol for unilateral breast reconstruction using a combined bilateral lower abdominal flap and a unilateral free perforator flap from the deep femoral artery Yizhitigu Ergen, SONG Dajiang 2026, 22 (4):  337.  Abstract ( 0 )   PDF (10668KB) ( 14 )   Objective To summarize the strategy and surgical procedure for unilateral breast reconstruction using a combined bilateral lower abdominal flap and a unilateral free perforator flap from the deep femoral artery. Methods From December 2019 to October 2022， four patients with breast cancer underwent unilateral breast reconstruction using a combined bilateral lower abdominal flap and a unilateral free perforator flap from the deep femoral artery. The patients were aged 27 to 40 years， with a mean age of （32.4±2.3） years. All cases involved immediate breast reconstruction for early-stage breast cancer， and all patients underwent modified radical mastectomy. Lower abdominal flap designs included： transverse unilateral vascular pedicle （1 case）， transverse bilateral vascular pedicle （1 case）， transverse pedicled rectus abdominis muscle flap combined with a free lower abdominal flap （1 case）， and longitudinal bilateral vascular pedicle （1 case）. Directions of the deep femoral artery perforator flaps included： transverse thin thigh muscle flap （1 case）， transverse adductor magnus perforator flap （1 case）， vertical thin thigh muscle flap combined with adductor magnus perforator flap （1 case）， and oblique adductor magnus perforator flap （1 case）. All femoral flap vascular pedicles were anastomosed to the anterior serratus branch of the thoracodorsal vessels， with the second set of vascular pedicles anastomosed to the lateral thoracic artery and vein. All lower abdominal flap vascular pedicles were anastomosed to the proximal end of the intrathoracic  vessels， with the second set of vascular pedicles anastomosed to the distal end of the intrathoracic vessels. Results All flaps survived. The reconstructed breasts had acceptable contours and good elasticity， with no flap contracture or deformation. The donor site for the lower abdominal flap harvested longitudinally showed poor healing and was repaired using a Z-plasty； All other donor sites healed smoothly， leaving only linear scars， with no significant impact on lower abdominal or lower limb function. Follow-up ranged from 6 to 40 months （mean 19.4 months）. Breast contour was satisfactory， and no cases of breastcancer recurrence were observed. Conclusion The combination of bilateral lower abdominal flaps with a unilateral free perforator flap from the deep femoral artery is suitable for reconstructing a relatively large unilateral breast. Adequate preoperative preparation and the formulation of a clear surgical strategy are key to ensuring a safe and satisfactory outcome. Related Articles | Metrics

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Clinical study on immediate free autologous flap breast reconstruction/chest wall repair following neoadjuvant chemotherapy for breast cancer XIA Ying, ZHU Jingjun, YANG Jinzhe, et al 2026, 22 (4):  343.  Abstract ( 0 )   PDF (1112KB) ( 9 )   Objective To explore the clinical feasibility and safety of immediate free autologous flap breast reconstruction and chest wall repair after neoadjuvant chemotherapy in patients with breast cancer. Methods Clinical data of 42 patients who underwent immediate autologous flap breast reconstruction or chest wall repair from June 2023 to December 2025 were retrospectively collected. All patients were divided into two groups according to treatment regimens： the neoadjuvant chemotherapy group （26 cases， including 1 male breast cancer patient and 1 patient with bilateral breast cancer） and the control group （16 cases， including 5 patients with carcinoma in situ）. The clinicopathological characteristics， perioperative indicators， and incidence of complications such as flap necrosis were compared between the two groups. The BREAST-Q scale was adopted to evaluate patients’ satisfaction with postoperative breast appearance and function. Results There were no statistically significant intergroup differences in age， body mass index （BMI）， smoking history， underlying diseases （diabetes， hypertension）， tumor molecular subtypes and distribution of flap types （P>0.05）. No significant differences were  found in perioperative indicators including intraoperative blood loss， operative duration， postoperative drainage duration，total drainage volume and length of hospital stay between the two groups （P>0.05）. The overall postoperative complication rates were comparable between groups. Complications occurred in 3 patients （11.5%） in the neoadjuvant chemotherapy group and 1 patient （6.3%） in the control group； All complications presented as partial marginal flap necrosis and healed after  secondary surgical intervention. All patients were followed up for at least 6 months after surgery， and both groups reported high postoperative satisfaction without significant intergroup difference （P>0.05）. Conclusion Immediate free autologous flap breast reconstruction or chest wall repair performed after neoadjuvant chemotherapy for breast cancer is as safe and feasible as primary immediate reconstruction without prior chemotherapy. This approach yields high flap survival rate， low complication rates and satisfactory patient outcomes， without increasing perioperative risks or hospital stay. It is a safe and effective reconstructive strategy worthy of wide clinical promotion and application. Related Articles | Metrics

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Anatomical basis and technical points of free lower abdominal flap transplantation using the distal end of the inferior abdominal wall vascular pedicle as the pedicle ZHU Zhijun, SONG Dajiang, CHEN Kaixuan 2026, 22 (4):  348.  Abstract ( 0 )   PDF (13969KB) ( 13 )   Objective To explore the anatomical basis and technical points of a free lower abdominal skin flap graft using the distal end of the inferior abdominal wall vascular pedicle as the pedicle. Methods Retrospective analysis was conducted on the clinical data of 43 patients （43 sides） with breast cancer who underwent free lower abdominal flap transplantation using the distal end of the inferior epigastric artery as the pedicle between April 2019 and April 2025. All patients were female， ranging in age from 24 to 54 years， with a mean age of 28.7 years. Among them，36 cases underwent immediate breast reconstruction， and 7 cases underwent delayed breast reconstruction. The proximal end of the intrathoracic vessels was selected as the recipient vessel in all cases. In the flap preparation group， the dissection of the free lower abdominal flap was completed first； After exposing the perforating vessels， these were dissected to the plane where they anastomose with the main trunk of the inferior epigastric artery. The distal end of the infraportal vascular pedicle was dissected antegradely to a sufficient length. The proximal end of the contralateral infraportal vascular pedicle was then ligated and transected at the segment following the confluence of the perforating vessels. ICG fluorescence  angiography was used to assess flap perfusion； After confirming that the flap received a reliable blood supply via the distal end of the infraportal vascular pedicle， the distal end was ligated. The pedicle length was （5.4±0.5） cm， and the arterial diameter was （0.9±0.2） mm. 25 cases had two accompanying veins， and 18 cases had one accompanying vein. The selected larger vein for anastomosis had a diameter of （1.2±0.3） mm. The flap was then transferred to the recipient site， and the distal end of the subcutaneous pedicle was anastomosed to the proximal end of an intra-thoracic vessel on the affected side. In all cases， only one artery and one vein were anastomosed. Results All flaps took well with no significant complications， and all patients successfully completed comprehensive treatment， including postoperative radiation therapy. During a follow-up period of 18 to 47 months （mean 31.4 months）， no local tumor recurrence or distant metastasis was observed. The affected limbs remained flexible， with no significant limitations or signs of lymphedema， and abdominal wall function was not significantly impaired. Patient satisfaction was high. Conclusion Breast reconstruction using a free lower abdominal flap with a pedicle originating from the distal end of the infraportal vascular pedicle increases the technical difficulty of the procedure， but does not compromise the flap’s blood supply and significantly reduces damage to the donor site. Related Articles | Metrics

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Design a pedicled local rotating skin flap on the lower abdominal skin flap used for chest wall reconstruction to repair axillary defects DING Yanni, SONG Dajiang 2026, 22 (4):  354.  Abstract ( 0 )   PDF (8893KB) ( 12 )    Objective To explore the surgical indications and specific strategies for designing a transfer and rotation flap based on a lower abdominal flap in complex axillary reconstruction surgery. Methods A retrospective analysis was conducted on the medical records of 42 patients who underwent complex axillary reconstruction from August 2015 to October 2025， including 6 cases of secondary axillary contracture after burns or trauma，28 cases of radical mastectomy for advanced breast cancer， and 8 cases of chest wall and axillary reconstruction due to radiation-induced osteonecrosis. The lower abdominal flap preparations included： A unilateral pedicled rectus abdominis flap combined with a contralateral free lower abdominal flap in 22 cases， bilateral free rectus abdominis flaps in 12 cases， and unilateral free rectus abdominis flaps in 8 cases. In 30 cases， the transferred lower abdominal flap simultaneously achieved chest wall reconstruction and axillary soft tissue defect repair， with partial necrosis observed in 5 cases postoperatively. After debridement， a rotation flap was rationally designed on the transplanted lower abdominal flap to further repair the axillary defect. In 12 cases， the transferred lower abdominal flap first completed chest wall reconstruction， and after 28 to 180 days （average 112.5 days） of stable flap survival， a rotation flap was further designed on the lower abdominal flap to repair the axillary defect. Postoperative routine rehabilitation involved fixing the shoulder joint in external rotation of 30° to 60° ， with enhanced shoulder joint function exercises initiated at 3 weeks postoperatively. Results All the flaps survived. The shoulder joint abduction was 0° to 90° before  the operation. The postoperative follow-up was （16±4.5） months， and the range of motion of the shoulder joint improved to 90° to 145°. In 8 cases， an additional thinning procedure was performed on the flap repairing the axilla. The patient satisfaction rate was 100%. Long-term follow-up showed no occurrence of ulcers， tumor recurrence， or aggravation of scar contracture. Conclusion Transplanting a lower abdominal flap for chest wall reconstruction and designing a rotation flap to repair the axillary defect on this basis is a relatively safe strategy and surgical method for complex axillary reconstruction Related Articles | Metrics

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AAnatomical Observation of the Intercostobrachial Nerve in Minimally Invasive Axillary Lymph Node Dissection：A Retrospective Video-Based Study of 72 Breast Cancer Patients TENG Yueyue, LIU Qiwen, LI Zongyan, et al 2026, 22 (4):  360.  Abstract ( 0 )   PDF (3544KB) ( 19 )   Objective To observe the origin， branching patterns， and trajectory distribution of the intercostobrachial nerve （ICBN） during minimally invasive （robot-assisted and endoscopic） axillary lymph node dissection （ALND）， and to provide anatomical evidence for intraoperative nerve preservation. Methods A retrospective analysis was conducted on surgical videos of 72 breast cancer patients who underwent minimally invasive axillary lymph node dissection （ALND） from September 2023 to April 2025. Under the magnified view of minimally invasive surgery， the ICBN was identified and recorded intraoperatively. Observation indicators included the origin of ICBN （T1/T2/T3/common trunk）， branching patterns （single trunk without branches/single trunk with two branches/single trunk with multiple branches/double trunks）， and the trajectory of each branch （medial arm/axilla， mammary tail， lateral chest wall）. Results The ICBN was identified in all 72 patients （identification rate 100%）， and a total of 170 ICBN nerve trunks were recorded. The most common origin was T2（67 cases， 93.1%）， followed by T1（58 cases，80.6%） and T3（36 cases，50.0%）， with common trunk observed in 5 cases （6.9%）. Regarding branching patterns， single trunk without branches （53.4%） and single trunk with two branches （40.9%） were the most prevalent types. Stratified analysis revealed that T2 was predominantly of the single trunk with two branches type  （73.1%）， while T1 and T3 were mainly of the single trunk without branches type （70.6% and 88.9%， respectively）. Regarding trajectory distribution， T1 mainly traveled to the medial arm/axilla （79.7%）， while T2 and T3 predominantly traveled to the lateral chest wall （83.3% and 90.5%， respectively）. Branches traveling to the mammary tail （anterior chest wall） were mainly derived from T2（69.6%）. Conclusion The origin， branching patterns， and trajectory variations of the ICBN can be clearly visualized under the magnified view of minimally invasive surgery. The observed branching types and trajectories may provide an anatomical reference for ICBN identification and preservation during ALND. Related Articles | Metrics

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Study on the treatment of mouse hindlimb ischemia using HGF modRNA-engineered human mesenchymal stromal cells LIN Xinjun, ZHANG Lei, WU Cong, et al 2026, 22 (4):  365.  Abstract ( 0 )   PDF (8951KB) ( 8 )   Objective To Explore the therapeutic effects of HGF modRNA-engineered human mesenchymal stromal cells in treating lower limb ischemia in mice. Methods First， HGF modRNA was prepared and electroporated into human mesenchymal stromal cells. After 24 hours， the cell supernatant was collected for ELISA detection. Subsequently， the cell  supernatant was used to culture human umbilical vein endothelial cells. Cell migration ability was assessed using a scratch assay， tube formation ability was evaluated through a tube formation assay， and cell proliferation ability was measured using an EdU assay with smooth muscle cells. Further， the pro-angiogenic effects in vivo were analyzed via a subcutaneous Matrigel plug assay. After establishing a mouse hindlimb ischemia model， PBS （PBS group）， the cells’ suspension of hMSCs after Luciferase modRNA electroporation （hMSCs Luc group）， or hMSCs after HGF modRNA electroporation （hMSCs HGF group） were respectively injected intramuscularly. Laser Doppler flowmetry was employed to assess hindlimb blood perfusion. On day 14， the ischemic gastrocnemius muscle was harvested for tissue sectioning. HE and Masson staining were performed to evaluate tissue damage and fibrosis， while immunofluorescence staining was used to assess tissue angiogenesis and apoptosis. Results After electroporation of HGF modRNA into human mesenchymal stromal cells for 24 hours， ELISA detection showed sustained expression of HGF protein for more than 3 days， peaking at 24 hours. Human umbilical vein endothelial cells cultured with cell supernatant exhibited higher migration rates and tube formation effects， as well as stronger abilities to promote smooth muscle cell proliferation， with more significant subcutaneous angiogenesis effects. The lower limb blood flow detection results showed that the hMSCs HGF group had significantly better blood flow reperfusion compared to the control group. Histological staining results indicated that the hMSCs HGF group effectively protected against tissue damage caused by lower limb ischemia， demonstrating superior angiogenesis effects and anti-apoptotic capabilities. Conclusion HGF modRNA engineered human mesenchymal stromal cells significantly protect against ischemic limb injury in mice and promote the recovery of limb blood flow Related Articles | Metrics

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Jellyfish collagen dynamic hydrogel for three-dimensional cell culture WANG Wentao, BAI Shengqi, ZHA Lixia, et al 2026, 22 (4):  376.  Abstract ( 0 )   PDF (13414KB) ( 29 )   Objective To investigate the physicochemical properties of a multifunctional jellyfish collagen （JC） dynamic hydrogel and its effectiveness for three-dimensional （3D） cell culture. Methods The JC-HEC/OHEC-GNP dynamic hydrogels with multiple physical and reversible covalent cross-linking were constructed using JC， hydroxyethyl cellulose （HEC） and its oxidized product （OHEC）， and genipin （GNP）. The physicochemical structures were characterized by ATRFTIR， SEM， XPS， and water contact angle tests. The biological effects on human umbilical vein endothelial cells （HUVECs） and fibroblasts （FBs） were evaluated via CCK-8 assay， Calcein/PI dual staining， EdU assay， tube formation assay， and Transwell migration assay. Through the 3D cell-embedding co-culture experiment， the growth status of HUVECs， FBs and human adipose-derived mesenchymal stem cells （AD-MSCs） in the three-dimensional hydrogel was observed. Results The JC-HEC/OHEC-GNP hydrogels formed a continuous and stable porous 3D network structure. The oxidized JC-OHEC-GNP showed more uniform pores and stronger hydrophilicity. The hydrogels exhibited excellent biocompatibility， significantly promoted the proliferation and migration of HUVECs and FBs， and enhanced the tube formation of HUVECs. Antioxidant assays indicated a significant reduction in reactive oxygen species （ROS） and protection against H2O2-induced oxidative damage. The 3D co-culture showed that HUVECs， FBs， and AD-MSCs grew stably and formed complex dendritic 3D branching networks in the hydrogels， and the number of branching nodes and the volume of the network are significantly better than those of the traditional Matrigel （P<0.05）. Conclusion The JC-HEC/OHEC-GNP dynamic biomimetic hydrogel possesses good physicochemical properties， biocompatibility， antioxidant properties， and pro-angiogenic capabilities， making it a promising biomaterial platform for 3D cell culture and cell therapy in diabetic foot ulcers. Related Articles | Metrics

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Study on the distribution of epicardial lymphatic vessels in goats and model construction LI Yao, ZENG Fanqiang, MA Chuanxiang, et al 2026, 22 (4):  392.  Abstract ( 0 )   PDF (6636KB) ( 13 )   Objective To reveal and analyze the distribution of epicardial lymphatic vessels in the goat heart， as well as their spatial relationships with adjacent arteries. Methods After thoroughly rinsing the goat heart with normal saline， a micro-lymphatic injection technique was utilized to visualize the epicardial lymphatic vessels and arteries. The distribution， trajectory， and spatial relationships of the lymphatic vessels in relation to the arteries were systematically observed. Results The epicardial lymphatic vessels in the goat demonstrated a distinct regional distribution， with six major lymphatic branches identified： the right atrial branch， posterior interventricular branch， right ventricular branch， anterior interventricular branch， left atrial branch， and left ventricular branch. All these branches were closely associated with the corresponding coronary artery branches. The lymphatic vessels formed a comprehensive reflux network through collateral anastomoses， transsulcal anastomoses， and apical transmyocardial anastomoses. Conclusion A technique of the low-toxicity visualization specimen developed in this study systematically elucidates the anatomical principles and spatial relationships of goat epicardial lymphatic vessels. This advancement enhances the theoretical framework of cardiac lymphatic anatomy and offers high-quality physical teaching aids for medical education. The precise anatomical data obtained can serve as a crucial reference for cardiac 3D printing， the design of tissue engineering scaffolds， and clinical interventions for lymph-related cardiac diseases Related Articles | Metrics

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A stable and efficient method for establishing a UV-induced skin hyperpigmentation mouse model HUANG Xinyi, YAO Min 2026, 22 (4):  396.  Abstract ( 0 )   PDF (5197KB) ( 14 )   Objective To establish and evaluate a stable and efficient animal model of cutaneous hyperpigmentation induced by ultraviolet （UV） radiation. Methods Male C57BL/6J mice， aged 6-8 weeks， were used in this study. Following dorsal hair removal， the mice were randomly assigned to either the control （sham） group （n=5） or the ultraviolet-irradiation （UV） group （n=5）. To establish the skin hyperpigmentation model， mice in the UV group were subjected to periodic UV exposure （200 s per treatment， three times per week） for a total of nine times over three weeks. The sham group was exposed only to ambient indoor light and received no experimental UV radiation. Dorsal skin tissues were obtained 24 h after the final irradiation. Histological alterations in the skin were assessed via HE staining. Melanin deposition was evaluated through gross observation and Masson-Fontana （MF） staining. Furthermore， the expression of tyrosinase （TYR） in skin tissues was detected by immunofluorescence （IF）， while the protein levels of microphthalmia-associated transcription factor （MITF） were analyzed using western blot. Results UV exposure for three weeks did not induce significant pathological changes in the structure of the mouse skin. Gross observation and MF staining demonstrated a significant increase in melanin deposition in the UV group compared to the sham group （P<0.01）. Molecular analysis revealed that the protein expression levels of TYR （P<0.001）， and MITF （P<0.05） were significantly up-regulated in the UV group. Conclusion Regular UV exposure induces robust melanin accumulation in C57BL/6J mice without destroying skin structure. This modeling approach offers a short induction period， high stability， and distinct phenotypic presentation， serving as an ideal animal model for investigating the mechanisms underlying hyperpigmentation. Related Articles | Metrics

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Comparison of the effects of pedicled perforator flap and fascial pedicled flap in repairing soft tissue defects of limb CHEN Zhifeng, WANG Xianzao 2026, 22 (4):  401.  Abstract ( 0 )   PDF (1106KB) ( 11 )   Objective To compare the repair effect of pedicled perforator flap and traditional fascial pedicled flap in soft tissue defects of limb wounds. Methods A total of 145 patients with soft tissue defects of limb wounds who underwent flap repair in the hospital were retrospectively analyzed between February 2022 and October 2024. According to different treatment methods， they were divided into group A （73 cases， repair with pedicled perforator flaps） and group B （72 cases， repair with traditional fascial pedicled flaps）. The flaps survival， wound healing， levels of growth factors in wound tissues， degree of wound pain， postoperative scars， recovery of limb function and the incidence of complications were compared between the two groups. Results At 7 days after surgery， difference in flaps survival between the two groups was not statistically significant （P>0.05）. At 1 week and 2 weeks after surgery， wound healing rates in group A were higher than those in group B （P<0.05）， but difference in wound healing rate between the two groups was not statistically significant at 3 weeks after surgery （P>0.05）. The wound healing time in group A was shorter than that in group B （P<0.05）. At 1 week after surgery， levels of PDGF， VEGF and EGF in group A were higher than those in group B （P<0.05）. At 1 week and 2 weeks after surgery， VAS scores in group A were lower than those in group B （P<0.05）， but difference in VAS score between the two groups was not statistically significant at 3 weeks after surgery （P>0.05）. At 6 months after surgery， scores of VSS （scar color， thickness， softness， vascular distribution） in group A were lower than those in group B （P<0.05）. At 3 months after  surgery， score of upper limb DASH in group A was lower than that in group B， while score of lower limb DASH was higher than that in group B （P<0.05）. At 6 months after surgery， difference in scores of upper and lower limbs between the two groups was not statistically significant （P>0.05）. The incidence of postoperative complications in group A was lower than that in group B （16.67% vs 5.48%，P<0.05）. Conclusion For the repair of soft tissue defects in limb wounds， compared with traditional fascial pedicled flap， pedicled perforator flap has more advantages in promoting early wound healing， increasing levels of growth factors， alleviating early pain， improving postoperative scars and early limb function， and reducing the incidence of complications Related Articles | Metrics

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Neurofibromatosis with cranial bone defects in children：A report of 5 cases with literature review KONG Chenxu, WEI Jia, WANG Jiajia, et al 2026, 22 (4):  407.  Abstract ( 0 )   PDF (6333KB) ( 16 )   Objective To investigate the clinical characteristics， surgical treatment strategies， and prognosis of cranial bone defects in children with neurofibromatosis type 1（NF1）. Methods A retrospective analysis was conducted on the clinical data of 5 pediatric patients with NF1 and cranial bone defects treated at our hospital， including 2 males and 3 females， with an average age of 9 years. One case involved a frontal defect， while 4 involved occipital defects. All patients presented with adjacent plexiform neurofibromas and underwent simultaneous resection of the neurofibromas and cranioplasty using 3D-printed polyetheretherketone （PEEK） implants. The pathogenesis and key points in the diagnosis and treatment of this condition are discussed in conjunction with relevant literature. Results All 5 patients underwent successful surgeries with no postoperative complications such as infection or hemorrhage. Short-term follow-up revealed well-positioned implants with no signs of displacement or recurrence， and satisfactory restoration of cranial contour was achieved. Conclusion Cranial bone defects associated with NF1 are relatively rare， predominantly occurring in the occipital region and often related to plexiform neurofibromas. For pediatric patients with clear surgical indications， personalized cranioplasty using 3D-printed PEEK materials， combined with simultaneous management of associated lesions， represents a safe and effective treatment strategy. Long-term follow-up is crucial for evaluating long-term efficacy. Related Articles | Metrics

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Effects of physician-nurse-social work group psychological counseling service model in outpatient families with cleft lip and palate HU Xiangying, YUAN Weijun, MAO Lixia, et al 2026, 22 (4):  411.  Abstract ( 0 )   PDF (1114KB) ( 14 )   families with cleft lip and palate. Methods A total of 75 pediatric patients who participated in multidisciplinary outpatient discussions on cleft lip and palate treatment from October 2023 to August 2024 were selected. They were randomly divided into control group （40 cases） and experimental group （35 cases） by random number method. The control group received conventional multidisciplinary outpatient reception management model， while the experimental group implemented physician-nurse-social work group psychological counseling service model. The differences in social anxiety of children （SASC）， Mishel uncertainty in illness scales for family members （MUIS-FM）， and satisfaction with outpatient services between the two groups were compared. Results After the intervention， the social anxiety score of the experimental group  was （6.66±1.57） points， which was lower than that of the control group （10.25±2.78） points （P<0.05）； The MUIS-FM score of the experimental group was （52.66±9.953） points， which was lower than that of the control group （64.98±10.766） points （P<0.05）. The satisfaction score of the experimental group was （97.17±7.74） points， which was significantly higher than that of the control group （90.18±13.46） points （P<0.05）. Conclusion Physician-nurse-social work group psychological counseling service model is beneficial for alleviating social anxiety in children with cleft lip and palate， reducing the uncertainty in illness among family caregivers， and improving dental outpatient service satisfaction. Related Articles | Metrics

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Mechanism and feasibility study of curcumin-loaded hydrogel combined with PCL scaffold in promoting cartilage repair ZENG Mao, WU Shengzhong 2026, 22 (4):  416.  Abstract ( 0 )   PDF (1121KB) ( 13 )   Osteoarthritis （OA） is a chronic degenerative disease characterized by articular cartilage degeneration， synovitis and subchondral bone sclerosis. Traditional clinical interventions are difficult to achieve substantial regeneration of damaged cartilage. In recent years， tissue engineering technology has provided a new strategy for cartilage defect repair by combining seed cells， bionic scaffolds and bioactive molecules. As a natural polyphenolic compound， curcumin has excellent pharmacological activities such as anti-inflammatory， anti-oxidation and anti-chondrocyte apoptosis. However， its poor water solubility and low bioavailability limit its clinical application. Loading curcumin into hydrogels with good biocompatibility and combining with polycaprolactone （PCL） scaffolds with excellent mechanical properties can construct a ‘soft-hard’ composite system with both mechanical support and biological activity. In this paper， the construction basis of curcumin-loaded hydrogel/PCL composite scaffold was systematically discussed， and its molecular mechanisms such as regulating local immune microenvironment， promoting chondrogenic differentiation of stem cells， maintaining mitochondrial homeostasis and inhibiting ferroptosis of chondrocytes were deeply analyzed. The application efficiency and future clinical transformation prospects of curcumin-loaded hydrogel/PCL composite scaffold in cartilage defect model were comprehensively prospected， in order to provide theoretical basis for targeted therapy and cartilage tissue engineering of OA. Related Articles | Metrics

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Research and translational applications of microphysiological systems in plastic and reconstructive surgery WEI Tianxiao, YAO Yu, YIN Ningbe 2026, 22 (4):  423.  Abstract ( 0 )   PDF (1108KB) ( 14 )   Many challenges in plastic and reconstructive surgery are multi-tissue， multi-scale， and strongly timedependent. Traditional cell and animal models are hampered by limited human relevance， insufficient control of mechanical loading， limited fidelity in physicochemical emulation， and the lack of noninvasive functional assessments. Microphysiological systems integrate controlled microfluidic perfusion， programmable stretch， chemical gradients， and human-derived multicellular co-culture to reconstruct key processes on a single platform： In wound-healing studies， transepithelial electrical resistance and permeability assessments quantitatively relate wound-closure rate to barrier restoration； In keloid disease modeling， programmable tensile loading and stable TGF- β gradients enable dissection of extracellular-matrix remodeling and macrophage polarization during fibrosis； For fat grafting， an “endothelium high-shear—membrane-separated exchange—adipose low-shear” architecture quantifies oxygenation， nutrient delivery， and the immunometabolic state； For neural and musculoskeletal regeneration， topographic cues， chemical concentration gradient， and electrical/mechanical stimulation drive directed maturation and support functional evaluation. This review synthesizes these model elements and representative applications， outlines engineering implementations （air-liquid interface， cyclic stretch， membrane-separated dual-chamber designs， and multimodal stimulation）， and discusses key challenges （crossplatform comparability， donor-to-donor variability， and long-term operational stability）—to provide a practical roadmap for deploying advanced in vitro models in preclinical validation and individualized preoperative assessment. Related Articles | Metrics

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Analysis of the application prospects of carbon-fiber artificial bone in oncologic orthopedic surgery CAI Zhixia, LIU Xiaoyan, WU Chengfen, et al 2026, 22 (4):  430.  Abstract ( 0 )   Bone defect repair is one of the key issues to be addressed in oncoplastic surgery. Traditional repair methods have obvious limitations in terms of mechanical matching， biological activity and individualization. The new carbon-fiber artificial bone （CFAB）， which takes carbon fiber and its composites as the core， is used as a medical bone substitute implant for bone defect repair. It has become a research hotspot in bone defect repair due to its advantages such as light weight and high strength， adjustable elastic modulus， radiolucency， excellent biocompatibility and strong designability. Based on recent literature， this article systematically elucidates the material properties， key technological breakthroughs， current applications in surgical oncology， existing challenges， and future directions of CFAB， aiming to provide a reference for subsequent research and translational applications. Related Articles | Metrics

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Mechanisms and clinical research progress of mesenchymal stem cell therapy for hypertrophic scars WANG Bofei, SUN Yutong, XIANG Guangjun, et al 2026, 22 (4):  435.  Abstract ( 0 )   PDF (1127KB) ( 13 )   Hypertrophic scar is a pathological condition resulting from aberrant activation of fibroblasts and excessive deposition of extracellular matrix during cutaneous wound healing. Various therapeutic approaches， including both surgical and non-surgical modalities， have been employed； However， the treatment outcomes are often unsatisfactory. Mesenchymal stem cells （MSCs）， through their potent paracrine effects， exert multi-target regulatory actions on fibroblasts， signaling pathways， and the immune microenvironment， demonstrating considerable potential for the prevention and treatment of scars. In this paper， the recent advances in the application of MSCs for treating hypertrophic scars were reviewed. Related Articles | Metrics

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Research on the application of“reverse outline AI（ROAI）”in undergraduate scientific writing instruction YANG Zijiang, GU Xiang, CHEN Yuxiao, et al 2026, 22 (4):  443.  Abstract ( 0 )   PDF (1097KB) ( 8 )   Objective To explore the application effect of the “reverse outline AI （ROAI）” in the teaching of scientific research writing for undergraduate students in clinical medicine. Methods A single-center retrospective study design was employed. Teaching records from two academic years of the general education elective course “case decoding—exploring clinical research”（course code： EC08201） were retrieved， including a total of 81 undergraduate students. Based on the actual teaching model， students were divided into a traditional lecture group （n=39， implementing traditional lectures and after-class grading） and a ROAI teaching group （n=42， incorporating the ROAI method）. The logical scores， writing time， and teaching satisfaction of the two groups of students in their final papers were compared and analyzed. Results The logicality score of the ROAI teaching group’s papers was （89.30±4.27） points， significantly higher than that of the traditional lecture group’s （74.96±6.11） points （P<0.001）. The average total writing time of the ROAI teaching group was （215.07± 22.23） minutes， significantly shorter than that of the traditional lecture group’s （286.79±25.03） minutes （P<0.001）. The complete satisfaction rate of the teaching mode of the ROAI teaching group reached 92.86%， which was better than that of the traditional lecture group’s 74.36% （P=0.033）. Conclusion The ROAI model has re-engineered the research writing process， significantly improving writing efficiency and logical thinking， and providing an empirical paradigm for the digital transformation of new medical higher education. Related Articles | Metrics